Malnutrition is associated with worse health-related quality of life in children with cancer.
Support Care Cancer. 2015 Mar 10;
Authors: Brinksma A, Sanderman R, Roodbol PF, Sulkers E, Burgerhof JG, de Bont ES, Tissing WJ
PURPOSE: Malnutrition in childhood cancer patients has been associated with lower health-related quality of life (HRQOL). However, this association has never actually been tested. Therefore, we aimed to determine the association between nutritional status and HRQOL in children with cancer.
METHODS: In 104 children, aged 2-18 years and diagnosed with hematological, solid, or brain malignancies, nutritional status and HRQOL were assessed at diagnosis and at 3, 6, and 12 months using the child- and parent-report versions of the PedsQL 4.0 Generic scale and the PedsQL 3.0 Cancer Module. Scores on both scales range from 0 to 100.
RESULTS: Undernourished children (body mass index (BMI) or fat-free mass < -2 standard deviation score (SDS)) reported significantly lower PedsQL scores compared with well-nourished children on the domains physical functioning (-13.3), social functioning (-7.0), cancer summary scale (-5.9), and nausea (-14.7). Overnourished children (BMI or fat mass >2 SDS) reported lower scores on emotional (-8.0) and cognitive functioning (-9.2) and on the cancer summary scale (-6.6), whereas parent-report scores were lower on social functioning (-7.5). Weight loss (>0.5 SDS) was associated with lower scores on physical functioning (-13.9 child-report and -10.7 parent-report), emotional (-7.4) and social functioning (-6.0) (child-report), pain (-11.6), and nausea (-7.8) (parent-report). Parents reported worse social functioning and more pain in children with weight gain (>0.5 SDS) compared with children with stable weight status.
CONCLUSIONS: Undernutrition and weight loss were associated with worse physical and social functioning, whereas overnutrition and weight gain affected the emotional and social domains of HRQL. Interventions that improve nutritional status may contribute to enhanced health outcomes in children with cancer.
PMID: 25752883 [PubMed - as supplied by publisher]
A Longitudinal Case-Control Study on Goals in Adolescents with Cancer.
Psychol Health. 2015 Mar 2;:1-36
Authors: Sulkers E, Janse M, Brinksma A, Roodbol PF, Kamps WA, Tissing WJ, Sanderman R, Fleer J
Objective: This study examined whether: (1) the goals of adolescents with cancer at 3 months post-diagnosis (T1) and healthy peers differed in terms of content, valuation, and abstraction level, (2) the content, valuation and abstraction level of the goals of the adolescents with cancer differed between 3 and 12 months post-diagnosis (T2). Methods: Thirty-three adolescents with cancer and 66 matched controls completed the Personal Project Analysis Inventory. After nine months the adolescents with cancer completed the measure again. Results: Compared to controls, adolescents with cancer at 3 months post-diagnosis (T1) reported more intrinsic than extrinsic goals, appraised intrinsic goals as more important than extrinsic goals, and reported more concrete goals. Within the adolescents with cancer, the content, valuation and abstraction level of the goals did not differ between T1 and T2. Conclusions: Adolescents recently diagnosed with cancer set different types of goals than healthy peers, and continue to set these types of goals until one year post-diagnosis. Future research can help determine how the personal goals of adolescents with cancer develop in the long term and to what extent personal goal setting during cancer influences the attainment of age-graded developmental tasks and well-being.
PMID: 25728044 [PubMed - as supplied by publisher]
Personal Networks and Mortality Risk in Older Adults: A Twenty-Year Longitudinal Study.
PLoS One. 2015;10(3):e0116731
Authors: Ellwardt L, van Tilburg T, Aartsen M, Wittek R, Steverink N
BACKGROUND: Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investigate whether effects on and pathways to mortality risk differ between functional and structural characteristics of the personal network. The objective is to inquire which personal network characteristics are the best predictors of mortality risk after adjustment for mental, cognitive and physical health.
METHODS AND FINDINGS: Empirical tests were carried out by combining official register information on mortality with data from the Longitudinal Aging Study Amsterdam (LASA). The sample included 2,911 Dutch respondents aged 54 to 85 at baseline in 1992 and six follow-ups covering a time span of twenty years. Four functional characteristics (emotional and social loneliness, emotional and instrumental support) and four structural characteristics (living arrangement, contact frequency, number of contacts, number of social roles) of the personal network as well as mental, cognitive and physical health were assessed at all LASA follow-ups. Statistical analyses comprised of Cox proportional hazard regression models. Findings suggest differential effects of personal network characteristics on survival, with only small gender differences. Mortality risk was initially reduced by functional characteristics, but disappeared after full adjustment for the various health variables. Mortality risk was lowest for older adults embedded in large (HR = 0.986, 95% CI 0.979-0.994) and diverse networks (HR = 0.948, 95% CI 0.917-0.981), and this effect continued to show in the fully adjusted models.
CONCLUSIONS: Functional characteristics (i.e. emotional and social loneliness) are indirectly associated with a reduction in mortality risk, while structural characteristics (i.e. number of contacts and number of social roles) have direct protective effects. More research is needed to understand the causal mechanisms underlying these relations.
PMID: 25734570 [PubMed - as supplied by publisher]
Dyadic Coping Within Couples Dealing With Breast Cancer: A Longitudinal, Population-Based Study.
Health Psychol. 2015 Mar 2;
Authors: Rottmann N, Hansen DG, Larsen PV, Nicolaisen A, Flyger H, Johansen C, Hagedoorn M
Objective: The way couples deal with stressors is likely to influence their adjustment after breast cancer diagnosis. Based on the systemic-transactional model, this study examined whether the supportive, delegated and negative dyadic coping provided by patients and partners and their common dyadic coping as a couple were associated with change in relationship quality and depressive symptoms over time. Method: Women with breast cancer and their male partners (N = 538 couples) participated in a longitudinal study (Time 1, ≤4 months after surgery; Time 2, 5 months later). Dyadic coping was assessed using the Dyadic Coping Inventory (Bodenmann, 2008). The Center for Epidemiologic Studies-Depression Scale (Radloff, 1977) and the Relationship Ladder (Kuijer, Buunk, De Jong, Ybema, & Sanderman, 2004) measured depressive symptoms and relationship quality, respectively. Results: Negative dyadic coping was adversely associated with both patients’ and partners’ outcomes. The more patients rated the couple as engaging in common dyadic coping, the higher relationship quality and the fewer depressive symptoms both patients and partners experienced. Patients experienced more depressive symptoms the more delegated coping (i.e., taking over tasks) they provided to the partner. Partners experienced fewer depressive symptoms the more delegated coping they provided to the patient, but more depressive symptoms the more supportive coping the patient provided to them. Conclusion: This study has contributed to disentangling how dyadic coping behaviors influence couples’ adjustment. Interventions may focus on reducing negative dyadic coping and strengthening common dyadic coping, and be attentive to the different effects of dyadic coping on patients and partners. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
PMID: 25730611 [PubMed - as supplied by publisher]
Lower levels of trust in one’s physician is associated with more distress over time in more anxiously attached individuals with cancer.
Gen Hosp Psychiatry. 2014 Jul-Aug;36(4):382-7
Authors: Hinnen C, Pool G, Holwerda N, Sprangers M, Sanderman R, Hagedoorn M
OBJECTIVE: In the present study, we investigated individual differences in the outcome of patient-physician trust when confronted with cancer from an attachment theoretical perspective. We expected that lower levels of trust are associated with more emotional distress and more physical limitations within the first 15 months after diagnosis, especially in those who score relatively high on attachment anxiety. No such association was expected for more avoidantly attached individuals.
METHOD: A group of 119 patients with different types of cancer (breast, cervical, intestinal and prostate) completed questionnaires concerning trust (short version of the Wake Forest Physician Trust Scale) and attachment (Experiences in Close Relationship scale Revised) at 3 months after diagnosis. Emotional distress (Hospital Anxiety and Depression Scale) and physical limitations (physical functioning subscales of the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire-C30) were assessed at 3, 9 and 15 months after diagnosis. To test the hypotheses, multiple hierarchical regression analyses were performed.
RESULTS: Lower levels of trust were associated with more emotional distress and more physical limitations at 3, 9 and 15 months after diagnosis in more anxiously attached patients, but not in less anxiously attached patients.
DISCUSSION: These results indicate an attachment-dependent effect of trust in one’s physician. Explanations and clinical implications are discussed.
PMID: 24725971 [PubMed - indexed for MEDLINE]
Geographic Proximity of Adult Children and the Well-Being of Older Persons.
Res Aging. 2014 Aug 19;
Authors: van der Pers M, Mulder CH, Steverink N
This article aims to contribute to the discussion of how adult children affect the well-being of their older parents by investigating the importance of living in close geographic proximity. We investigate whether having children at all, and/or having them geographically proximate, contributes differently to the well-being of older persons living with and without a partner. We enriched survey data for the Netherlands (N = 8,379) with municipal register data and regressed life satisfaction of persons aged 65+ on having children and three different measures of geographic proximity. Having children contributes to the well-being of older men with a partner. There is evidence for a positive association between proximity of children and parental well-being, in particular for widowed and separated mothers and for separated fathers. Our findings suggest that close proximity may be a condition under which adult children can significantly add to the well-being of widowed and separated mothers and separated fathers.
PMID: 25651582 [PubMed - as supplied by publisher]
A group approach to genetic counselling of cardiomyopathy patients: satisfaction and psychological outcomes sufficient for further implementation.
Eur J Hum Genet. 2015 Feb 4;
Authors: Otten E, Birnie E, Ranchor AV, van Tintelen JP, van Langen IM
The introduction of next-generation sequencing in everyday clinical genetics practise is increasing the number of genetic disorders that can be confirmed at DNA-level, and consequently increases the possibilities for cascade screening. This leads to a greater need for genetic counselling, whereas the number of professionals available to provide this is limited. We therefore piloted group genetic counselling for symptomatic cardiomyopathy patients at regional hospitals, to assess whether this could be an acceptable alternative to individual counselling. We performed a cohort study with pre- and post-counselling patient measurements using questionnaires, supplemented with evaluations of the group counselling format by the professionals involved. Patients from eight regional hospitals in the northern part of the Netherlands were included. Questionnaires comprised patient characteristics, psychological measures (personal perceived control (PPC), state and trait anxiety inventory (STAI)), and satisfaction with counsellors, counselling content and design. In total, 82 patients (mean age 57.5 year) attended one of 13 group sessions. Median PPC and STAI scores showed significantly higher control and lower anxiety after the counselling. Patients reported they were satisfied with the counsellors, and almost 75% of patients were satisfied with the group counselling. Regional professionals were also, overall, satisfied with the group sessions. The genetics professionals were less satisfied, mainly because of their perceived large time investment and less-than-expected group interaction. Hence, a group approach to cardiogenetic counselling is feasible, accessible, and psychologically effective, and could be one possible approach to counselling the increasing patient numbers in cardiogenetics.European Journal of Human Genetics advance online publication, 4 February 2015; doi:10.1038/ejhg.2015.10.
PMID: 25649380 [PubMed - as supplied by publisher]
The Temporal Order of Change in Daily Mindfulness and Affect During Mindfulness-Based Stress Reduction.
J Couns Psychol. 2015 Jan 26;
Authors: Snippe E, Nyklíček I, Schroevers MJ, Bos EH
Increases in mindfulness are assumed to lead to improvements in psychological well-being during mindfulness-based treatments. However, the temporal order of this association has received little attention. This intensive longitudinal study examines whether within-person changes in mindfulness precede or follow changes in negative affect (NA) and positive affect (PA) during a mindfulness based stress reduction (MBSR) program. This study also examines interindividual differences in the association between mindfulness and affect and possible predictors of these differences. Mindfulness, NA, and PA were assessed on a daily basis in 83 individuals from the general population who participated in an MBSR program. Multilevel autoregressive models were used to investigate the temporal order of changes in mindfulness and affect. Day-to-day changes in mindfulness predicted subsequent day-to-day changes in both NA and PA, but reverse associations did not emerge. Thus, changes in mindfulness seem to precede rather than to follow changes in affect during MBSR. The magnitude of the effects differed substantially between individuals, showing that the strength of the relationship between mindfulness and affect is not the same for all participants. These between-subjects differences could not be explained by gender, age, level of education, average level of mindfulness home practice, or baseline levels of mindfulness and affect. Mindfulness home practice during the day did predict subsequent increases in mindfulness. The findings suggest that increasing mindfulness on a daily basis can be a beneficial means to improve daily psychological well-being. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
PMID: 25621590 [PubMed - as supplied by publisher]
The impact of age on changes in quality of life among breast cancer survivors treated with breast-conserving surgery and radiotherapy.
Br J Cancer. 2015 Jan 20;
Authors: Bantema-Joppe EJ, de Bock GH, Woltman-van Iersel M, Busz DM, Ranchor AV, Langendijk JA, Maduro JH, van den Heuvel ER
Background:The purpose of the study was to determine the impact of young age on health-related quality of life (HRQoL) by comparing HRQoL of younger and older breast cancer patients, corrected for confounding, and of young patients and a general Dutch population.Methods:The population consisted of breast cancer survivors (stage 0-III) after breast-conserving surgery and radiotherapy. Health-related quality of life was prospectively assessed using the EORTC QLQ-C30 and QLQ-BR23 questionnaires. The association between age (⩽50; 51-70; ⩾70 years) and HRQoL over time was analysed with mixed modelling. The clinical relevance of differences between/within age groups was estimated with Cohen’s D and consensus-based guidelines. The HRQoL data from the young patient cohort were compared with Dutch reference data at 3 years after radiotherapy.Results:A total of 1420 patients completed 3200 questionnaires. Median follow-up was 34 (range 6-70) months. Median age was 59 (range 28-85) years. Compared with older subjects, young women reported worse HRQoL in the first year after radiotherapy, but clinical relevance was limited. Three years after radiotherapy, HRQoL values in the younger group were equal to those in the reference population. Pain and fatigue after radiotherapy improved, with medium clinical relevance.Conclusions:Three years after radiotherapy for breast cancer, young age was not a risk factor for decreased HRQoL.British Journal of Cancer advance online publication, 20 January 2015; doi:10.1038/bjc.2014.632 www.bjcancer.com.
PMID: 25602967 [PubMed - as supplied by publisher]
Caregivers’ attentional bias to pain: does it affect caregiver accuracy in detecting patient pain behaviors?
Pain. 2015 Jan;156(1):123-130
Authors: Mohammadi S, Dehghani M, Khatibi A, Sanderman R, Hagedoorn M
Attentional bias to pain among family caregivers of patients with pain may enhance the detection of pain behaviors in patients. However, both relatively high and low levels of attentional bias may increase disagreement between patients and caregivers in reporting pain behaviors. This study aims to provide further evidence for the presence of attentional bias to pain among family caregivers, to examine the association between caregivers’ attentional bias to pain and detecting pain behaviors, and test whether caregivers’ attentional bias to pain is curvilinearly related to patient and caregiver disagreement in reporting pain behaviors. The sample consisted of 96 caregivers, 94 patients with chronic pain, and 42 control participants. Caregivers and controls completed a dot-probe task assessing attention to painful and happy stimuli. Both patients and caregivers completed a checklist assessing patients’ pain behavior. Although caregivers did not respond faster to pain congruent than pain incongruent trials, caregiver responses were slower in pain incongruent trials compared with happy incongruent trials. Caregivers showed more bias toward pain faces than happy faces, whereas control participants showed more bias toward happy faces than pain faces. Importantly, caregivers’ attentional bias to pain was significantly positively associated with reporting pain behaviors in patients above and beyond pain severity. It is reassuring that attentional bias to pain was not related to disagreement between patients and caregivers in reporting pain behaviors. In other words, attentional bias does not seem to cause overestimation of pain signals.
PMID: 25599308 [PubMed - as supplied by publisher]
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Tagged R. Sanderman