Age differences in negative and positive expectancy bias in comorbid depression and anxiety.

Anxious individuals report disproportionately negative expectations concerning the future, termed the negative expectancy bias. In contrast, ageing is associated with an inflated expectancy for positive future events. A recent study [Steinman, S. A., Smyth, F. L., Bucks, R. S., MacLeod, C., & Teachman, B. A. (2013). Anxiety-linked expectancy bias across the adult lifespan. Cognition and Emotion, 27, 345-355. doi: 10.1080/02699931.2012.711743 ] found using an interpretation bias task, a negative expectancy bias in young adults and positive expectancy bias in older adults with high trait anxiety. Extending this, the current study examined expectancy bias for positive, negative and ambiguously emotionally toned information in younger and older adults with clinical levels of depression and anxiety to community control groups, thus allowing examination of both disorder status and age on biases. Clinical participants reported a pervasive tendency to expect negative events relative to positive regardless of whether the current scenarios were positive, negative or ambiguous. Older adults showed greater expectancy for future positive scenarios when the initial scenario was negative or ambiguous. Age moderated the negative expectancy bias shown by clinical participants for ambiguous scenarios. Clinical disorders in older adults attenuated the positive expectancy bias that was otherwise strong in community participants. These findings provide further evidence for age differences in processing of emotionally toned information, with older adults showing a greater expectancy for positive future events.

Psychometric properties of the Geriatric Anxiety Inventory (GAI) and its short-form (GAI-SF) in a clinical and non-clinical sample of older adults.

BACKGROUND: The Geriatric Anxiety Inventory is a 20-item geriatric-specific measure of anxiety severity. While studies suggest good internal consistency and convergent validity, divergent validity from measures of depression are weak. Clinical cutoffs have been developed that vary across studies due to the small clinical samples used. A six-item short form (GAI-SF) has been developed, and while this scale is promising, the research assessing the psychometrics of this scale is limited. METHODS: This study examined the psychometric properties of GAI and GAI-SF in a large sample of 197 clinical geriatric participants with a comorbid anxiety and unipolar mood disorder, and a non-clinical control sample (N = 59). RESULTS: The internal consistency and convergent validity with other measures of anxiety was adequate for GAI and GAI-SF. Divergent validity from depressive symptoms was good in the clinical sample but weak in the total and non-clinical samples. Divergent validity from cognitive functioning was good in all samples. The one-factor structure was replicated for both measures. Receiver Operating Characteristic analyses indicated that the GAI is more accurate at identifying clinical status than the GAI-SF, although the sensitivity and specificity for the recommended cutoffs was adequate for both measures. CONCLUSIONS: Both GAI and GAI-SF show good psychometric properties for identifying geriatric anxiety. The GAI-SF may be a useful alternative screening measure for identifying anxiety in older adults.

Oral administration of antineoplastic agents: the challenges for healthcare professionals.

Recent progress in cancer treatment has increased the use of oral antineoplastic agents. It is now estimated that at least 25% of the existing antineoplastic agents are planned to be used as oral agents and this mode of administration is likely to increase in the coming years. The use of oral anti- neoplastic agents affects many aspects of cancer treatment, and despite advantages, it also poses challenges to health care professionals and patients, many of which refer to the adherence and safety. Low patient adherence demonstrates the need for better management and monitoring of patients on oral antineoplastic agents. Patient education is essential to maintain adherence to oral antineoplastic therapy, promoting a better understanding of the patient treatment regimen, treatment goals and potential side-effects, patient safety and implementation of self-care measurement. This article discusses the above-mentioned challenges, as well as the possibilities of patient and family education to improve adherence, outcomes of treatment and quality of life, and offers recommendations for practice and further research.

The impact of structured education of breast cancer patients receiving capecitabine on mental disorders.

PURPOSE: This study was conducted to assess the impact of structured education of breast cancer patients receiving capecitabine treatment on depression, anxiety and stress. METHODS: The study included 142 breast cancer patients who were receiving capecitabine at the Institute of Oncology and Radiology of Serbia in 2016 and 2017. Patients were randomized into two study groups: the experimental group had additional individual, structured, specific education, before chemotherapy by using a Serbian version of the Multinational Association of Supportive Care in Cancer (MASCC) Oral Agent Teaching Tool (MOATT V1.0), while the control group had usual standard education. Patients were followed up for 3 weeks, during their first chemotherapy cycle. Two instruments were used: specifically designed, for the purpose of this study, sociodemographic questionnaire and the Serbian version of the Depression Anxiety Stress Scales-21 (DASS 21) self-report questionnaire. RESULTS: Before starting capecitabine and education, breast cancer patients with metastatic disease had symptoms of depression (29.58%), anxiety (35.92%) and stress (21.13%), mostly mild and moderate. These symptoms were decreased in the whole group of patients after the first and the third week from education, with significant difference in depression and anxiety. Depression, anxiety and stress were decreased significantly in experimental group of patients from the initial measurement to the one-week and three-week follow-up, comparing to the control group of patients. CONCLUSIONS: Structured education has a significant positive impact on depression, anxiety and stress symptoms of breast cancer patients receiving capecitabine. Therefore, it may be recommended for use in everyday clinical practice.

Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment: an international survey.

PURPOSE: The aim of this study was to explore the nursing role in education and follow-up of patients who were taking oral chemotherapy (CT) and to identify the worldwide gap in patient education about oral CT. MATERIALS AND METHODS: Multinational Association of Supportive Care in Cancer members were invited to participate in a survey on oral CT. Nurse coordinators collected data via a 16-item questionnaire. Respondents totaled 1115 oncology nurses from 15 countries. RESULTS: Findings showed that about half of subjects work in outpatient/ambulatory clinics and had given at least two or more oral CT drugs. Although 52% had some type of guidelines/protocols, 47% reported not having received any education about oral CT drugs. While 64% report being involved in patient education, 58% of subjects indicated lack of patient education materials that are specific for oral CT agents. Only 27% stated that they gave all necessary information such as when and how to take the drugs, drug safety and storage, side effects, and symptom management. Reasons for not being involved in oral CT education and follow-up included beliefs that the physician plans the oral CT and gives patients necessary instructions (34%), that nurses only see patients who receive intravenous chemotherapy (16%), that nurses have lack of knowledge about oral agents (15%), and belief that physicians are responsible for patient follow-up. The nurses suggested better education and follow-up of patients to include the written patient education materials (33%) and professional education for nurses (30%). CONCLUSIONS: Findings revealed the need for professional education for nurses to ensure comprehensive, consistent patient education and development of written materials for patients receiving oral CT treatment.