Psycho-oncology
-
Controlled Clinical Trial
Delirium prevention in terminal cancer: assessment of a multicomponent intervention.
Delirium is a highly prevalent and deleterious disorder in terminally ill cancer patients. We assessed whether a multicomponent preventive intervention was effective in decreasing delirium incidence and severity among cancer patients receiving end-of-life care. ⋯ A simple multicomponent preventive intervention was ineffective in reducing delirium incidence or severity among cancer patients receiving end-of-life care. Delirium prevention remains a difficult challenge in terminally ill cancer patients.
-
Few studies have used rapid screening instruments to document the prevalence of distress among metastatic breast cancer patients. This study used the one-item Distress Thermometer (DT) to assess distress in this population. Anxiety and depressive symptoms, sleep problems, fatigue, and mental health service use were assessed for patients who met the cutoff on the DT for probable distress (score ≥4). ⋯ Results point to a high prevalence of distress, sleep problems, and fatigue across demographic and medical subgroups of metastatic breast cancer patients. A rapid one-item screening tool may be used to identify patients with a potential need for psychosocial assessment and intervention.
-
To explore how initial trajectories of distress experienced during the first year following diagnosis with early-stage breast cancer (ESBC) relate to subsequent long-term(6 years) psychosocial outcomes. ⋯ Women with an illness trajectory characterized by chronic distress over the first 8 months post-operatively had poorest longer-term psychosocial outcomes. Clarification of determinants of chronic distress and means for early identification of at-risk women are needed.This will enable targeted optimization of interventions to prevent and manage chronic distress,improving ESBC rehabilitation efficiency.
-
Previous research has suggested that endocrine therapy is associated with cognitive limitations in breast cancer survivors (BCS); this study examined the relationship in employed BCS, an average of three years post-primary treatment. ⋯ Symptoms of depression, anxiety, and fatigue should be screened for and treated in BCS, as an approach to mitigating perceived cognitive limitations. However, healthcare providers should be aware that cognitive limitations exist in excess of what can be associated with symptom burden, and may be related to endocrine therapy and other cancer treatments.
-
When one person in a couple has cancer, both members may experience depressive symptoms and may react as an emotional system. However, the variables that influence this depressive system have not been identified. This study examined whether social problem solving, an important moderator of individual cancer-related depression, is related to depression in the couple system. ⋯ Partners with more positive beliefs about solving problems were less likely to experience depression together with the patients. Further investigation into the role of social problem solving in the interpersonal depression system is warranted.