The role of goal adjustment in symptoms of depression, anxiety and fatigue in cancer patients receiving psychosocial care: a longitudinal study.

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The role of goal adjustment in symptoms of depression, anxiety and fatigue in cancer patients receiving psychosocial care: a longitudinal study.

Psychol Health. 2015;30(3):268-83

Authors: Zhu L, Ranchor AV, van der Lee M, Garssen B, Sanderman R, Schroevers MJ

Abstract

OBJECTIVE: This study examined whether cancer patients reported increases in their goal adjustment capacities while receiving psychosocial care and whether these increases were related to changes in symptoms of depression, anxiety and fatigue. Goal adjustment was conceptualised as two independent capacities: goal disengagement (i.e. disengage from unattainable goals) and goal reengagement (i.e. reengage into new goals).

DESIGN: This naturalistic, longitudinal study focused on 241 cancer patients receiving psychosocial care at one of the seven psycho-oncology institutions in the Netherlands. Data was collected before the start of psychosocial care (T1) and nine months thereafter (T2). Hierarchical regression analysis was used to examine the research questions.

MAIN OUTCOME MEASURES: Goal adjustment, symptoms of depression, anxiety and fatigue.

RESULTS: At group level, patients reported small increases in goal disengagement (d = .22) but no significant change in goal reengagement (d = .09). At an individual level, 34% of cancer patients reported an increase in goal disengagement and 30% reported an increase in goal reengagement. Increases in goal reengagement were significantly associated with decreases in both depressive and anxiety symptoms, but not to changes in fatigue.

CONCLUSION: Findings indicate that particularly improvements in goal reengagement are beneficial for cancer patients’ psychological functioning.

PMID: 25264270 [PubMed - indexed for MEDLINE]

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A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial.

A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial.

BMC Public Health. 2015;15(1):303

Authors: Köhle N, Drossaert CH, Schreurs KM, Hagedoorn M, Verdonck-de Leeuw IM, Bohlmeijer ET

Abstract

BACKGROUND: There is a growing recognition that cancer not only affects the lives of the patients, but also the lives of their partners. Partners of cancer patients are highly involved in the illness trajectory by providing informal care and they often experience distress. However, supporting interventions for this group are scarce and existing interventions bear several limitations. On the basis of the need for theory- and evidence-based supportive interventions for partners of cancer patients, the web-based self-help intervention Hold on, for each other has been developed. This intervention is based on Acceptance and Commitment Therapy. The primary objective of the RCT is to investigate the (cost-) effectiveness of the intervention. Additional goals are (1) to examine if psychological flexibility, self-compassion, mastery, supportive behavior, posttraumatic growth and resilience are mediators of the intervention’s effects on the partners’ mental health; (2) to examine the moderating effects of the socio demographics (age, gender, education, working situation, family situation) and disease-related characteristics of the patients (sort of cancer, stage of disease, duration and treatment of cancer); and (3) to investigate to what extend participants are satisfied with the intervention, which parts of the intervention are mostly used, and how adherent the users are.

METHODS/DESIGN: A three-armed randomized controlled trial (RCT) will be conducted to compare two versions of the intervention Hold on, for each other with a waiting list control condition. Both intervention conditions contain the same content and differ only with regard to the form of professional support (personal support versus automatic support). Adult partners of cancer patients with mild to moderate depressive and anxiety symptoms, will be recruited through a multi-component strategy. Online measurements by self-assessment will be made on four measurement points (prior to randomization (baseline-measurement) and 3, 6 and 12 months after baseline).

DISCUSSION: When proven effective, Hold on, for each other can be an invaluable contribution to the healthcare system and it could be offered to all partners of cancer patients who are in need for additional support.

TRIAL REGISTRATION: Dutch Trial Register, trial registration number NTR4035 , date of registration: 17 March 2013.

PMID: 25884187 [PubMed - as supplied by publisher]

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Sweet and sour after renal transplantation: a qualitative study about the positive and negative consequences of renal transplantation.

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Sweet and sour after renal transplantation: a qualitative study about the positive and negative consequences of renal transplantation.

Br J Health Psychol. 2014 Sep;19(3):580-91

Authors: Schipper K, Abma TA, Koops C, Bakker I, Sanderman R, Schroevers MJ

Abstract

OBJECTIVES: This qualitative study investigated the renal patients’ experience of positive and negative consequences of transplantation, as well as the strategies they use to adapt to the transplantation.

DESIGN AND METHODS: A qualitative design (30 participants in total), using individual interviews (18 participants) and two focus groups (12 participants in total), was used.

RESULTS: The results showed that patients experienced a wide range of positive and negative emotions, in particular, guilt, gratefulness, and fear, partly as a result of their normative persuasions. Normative persuasions may transform inherent positive emotions into negative emotions and subsequent maladaptive behaviour. Not only physical limitations but also physical improvements were found to be related to the experience of negative emotions. Finally, the results indicated that patients mainly used adaptive coping strategies to adjust to life after transplantation, such as looking for opportunities, setting different priorities, making own choices, trying to maintain control, taking good care of oneself, and appreciating other things in life.

CONCLUSIONS: This study offers several new insights regarding the range of experiences of renal patients after transplantation. Health professionals are invited to pay more attention to the full range of positive and negative experiences following transplantation, including the existence of normative persuasions. Health professionals may assist renal patients by helping them to recognize and acknowledge both positive and negative emotions and to encourage the use of more beneficial coping strategies.

STATEMENT OF CONTRIBUTION: What is already known on this subject? The quality of life (QoL) of renal patients significantly improves after transplantation but the post-transplant QoL is lower compared with the QoL in healthy populations. Patients on dialysis and those who have received a donor kidney tend to use mainly emotion-focused coping strategies. What does this study add? This study offers several new insights regarding experiences of renal patients after transplantation: Patients experience a range of positive and negative emotions like guilt, gratefulness, and fear. Emotions are partly a result of normative persuasions. Persuasions may transform positive emotions into negative emotions and maladaptive behaviour. Physical limitations and improvements can due to the persuasions lead to negative emotions. Patients mainly use adaptive coping strategies.

PMID: 23826640 [PubMed - indexed for MEDLINE]

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Long-term effects of individual mindfulness-based cognitive therapy and cognitive behavior therapy for depressive symptoms in patients with diabetes: a randomized trial.

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Long-term effects of individual mindfulness-based cognitive therapy and cognitive behavior therapy for depressive symptoms in patients with diabetes: a randomized trial.

Psychother Psychosom. 2015;84(3):186-7

Authors: Tovote KA, Schroevers MJ, Snippe E, Sanderman R, Links TP, Emmelkamp PM, Fleer J

PMID: 25832365 [PubMed - in process]

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Predictors of all-cause mortality in patients with stable COPD: medical co-morbid conditions or high depressive symptoms.

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Predictors of all-cause mortality in patients with stable COPD: medical co-morbid conditions or high depressive symptoms.

COPD. 2014 Aug;11(4):468-74

Authors: Maters GA, de Voogd JN, Sanderman R, Wempe JB

Abstract

Co-morbid conditions are frequently found in patients with COPD. We evaluate the association of co-morbidities with mortality, in stable COPD. 224 patients, mean age 61.2 (± 10.00), 48.2% female, mean FEV1 1.1 (± 0.5) liters, median follow-up time 4.2 years, participated. Medical co-morbidities were scored according to the Charlson Co-morbidity Index (CCI). Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS) and Symptom Checklist-90 (SCL-90). The Cox proportional hazard model was used for survival analyses. In our sample, 70% of all patients have a co-morbid medical condition or high depressive symptoms. During follow-up 51% of all patients died, and those with heart failure have the highest mortality rate (75%). Age, fat-free mass and exercise capacity were predictive factors, contrary to CCI-scores and high depressive symptoms. An unadjusted association between heart failure and survival was found. Although the presence of co-morbidities, using the CCI-score, is not related to survival, heart failure seems to have a detrimental effect on survival. Higher age and lower exercise capacity or fat-free mass predict mortality.

PMID: 24831411 [PubMed - indexed for MEDLINE]

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Malnutrition is associated with worse health-related quality of life in children with cancer.

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

Abstract

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]

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A Longitudinal Case-Control Study on Goals in Adolescents with Cancer.

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

Abstract

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]

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Personal Networks and Mortality Risk in Older Adults: A Twenty-Year Longitudinal Study.

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

Abstract

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]

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Dyadic Coping Within Couples Dealing With Breast Cancer: A Longitudinal, Population-Based Study.

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

Abstract

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]

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Lower levels of trust in one’s physician is associated with more distress over time in more anxiously attached individuals with cancer.

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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

Abstract

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]

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