Fatigue screening in breast cancer patients: identifying likely cases of cancer-related fatigue.

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Fatigue screening in breast cancer patients: identifying likely cases of cancer-related fatigue.

Psychooncology. 2015 Jul 22;

Authors: Goedendorp MM, Jacobsen PB, Andrykowski MA

Abstract

OBJECTIVE: For clinical and research purposes, efficient identification of cases of cancer-related fatigue (CRF) is important, as CRF can be persistent and interfere with usual functioning. While various fatigue-screening instruments are available, no brief screening indices have been developed using formally diagnosed CRF cases as the criterion.

METHODS: Breast cancer patients (n = 385) completed a fatigue diagnostic interview and self-report fatigue measures (Profile of Mood States-fatigue subscale, Fatigue Symptom Inventory, and SF-36 vitality subscale), after initial adjuvant therapy (post-treatment (post-Tx) 1 assessment), after completion of radiotherapy for women receiving chemotherapy + radiotherapy (post-Tx 2 assessment), and 6 months after completion of all adjuvant therapy (6-month post-Tx assessment). CRF cases were identified using specific diagnostic criteria. ROC analyses identified screening indices, which could accurately identify CRF cases after initial adjuvant therapy. Screening indices were cross-validated using post-Tx 2 and 6-month follow-up assessment data.

RESULTS: A total of 104 women (27%) met CRF criteria after initial adjuvant therapy. Six two-item screening indices were identified. For all indices, area under the curve exceeded 0.80, sensitivity exceeded 0.80, and specificity exceeded 0.57. Cross-validation suggested that, except for the index based on SF-36, all the indices continued to accurately identify CRF cases at the post-Tx 2 and 6-month post-Tx assessments. Overall, a two-item composite index based on Fatigue Symptom Inventory ‘most severity’ and ‘work interference’ items performed best.

CONCLUSIONS: Breast cancer patients and survivors meeting CRF diagnostic criteria can be accurately identified using brief screening indices derived from common self-report fatigue measures. Copyright © 2015 John Wiley & Sons, Ltd.

PMID: 26202003 [PubMed - as supplied by publisher]

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A Reconsideration of the Self-Compassion Scale’s Total Score: Self-Compassion versus Self-Criticism.

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A Reconsideration of the Self-Compassion Scale’s Total Score: Self-Compassion versus Self-Criticism.

PLoS One. 2015;10(7):e0132940

Authors: López A, Sanderman R, Smink A, Zhang Y, van Sonderen E, Ranchor A, Schroevers MJ

Abstract

The Self-Compassion Scale (SCS) is currently the only self-report instrument to measure self-compassion. The SCS is widely used despite the limited evidence for the scale’s psychometric properties, with validation studies commonly performed in college students. The current study examined the factor structure, reliability, and construct validity of the SCS in a large representative sample from the community. The study was conducted in 1,736 persons, of whom 1,643 were included in the analyses. Besides the SCS, data was collected on positive and negative indicators of psychological functioning, as well as on rumination and neuroticism. Analyses included confirmatory factor analyses (CFA), exploratory factor analyses (EFA), and correlations. CFA showed that the SCS’s proposed six-factor structure could not be replicated. EFA suggested a two-factor solution, formed by the positively and negatively formulated items respectively. Internal consistency was good for the two identified factors. The negative factor (i.e., sum score of the negatively formulated items) correlated moderately to strongly to negative affect, depressive symptoms, perceived stress, as well as to rumination and neuroticism. Compared to this negative factor, the positive factor (i.e., sum score of the positively formulated items) correlated weaker to these indicators, and relatively more strongly to positive affect. Results from this study do not justify the common use of the SCS total score as an overall indicator of self-compassion, and provide support for the idea, as also assumed by others, that it is important to make a distinction between self-compassion and self-criticism.

PMID: 26193654 [PubMed - as supplied by publisher]

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Identifying the determinants of use of the G&G interventions for older adults in health and social care: protocol of a multilevel approach.

Identifying the determinants of use of the G&G interventions for older adults in health and social care: protocol of a multilevel approach.

BMC Res Notes. 2015;8(1):296

Authors: Kuiper D, Goedendorp MM, Sanderman R, Reijneveld SA, Steverink N

Abstract

BACKGROUND: Despite aging-related losses, many older adults are able to maintain high levels of subjective well-being. However, not all older adults are able to self-manage and adapt. The GRIP&GLEAM [Dutch: GRIP&GLANS] (G&G) interventions have shown to significantly improve self-management ability, well-being and loneliness in older adults. Actual use of the evidence-based G&G interventions, however, remains limited as long as the interplay between implementation factors at different hierarchical stakeholder levels is poorly understood. The aim of the study is to identify the determinants of successful implementation of the G&G interventions.

METHODS/DESIGN: The study is performed in health and social care organizations in the northern part of the Netherlands. The degree of implementation success is operationalized by four parameters: use (yes/no), pace (time to initial use), performance (extent of use) and prolongation (intention to continue use). Based on the Fleuren model, factors at four hierarchical stakeholder levels (i.e. target group, professionals, organizations and financial-political context) are assessed at three measurement points in 2 years. The nested data are analyzed applying multilevel modeling techniques.

DISCUSSION: In this study, health and social care organizations are considered to be part of multilevel functional systems, in which factors at different hierarchical stakeholder levels impede or facilitate use of the G&G interventions. Strengths of the study are the multifaceted measurement of use, and the multilevel approach in identifying the determinants. The study will contribute to the development of ecologically valid implementation strategies of the G&G interventions and comparable evidence-based practices.

PMID: 26148775 [PubMed - as supplied by publisher]

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Studying learning in the healthcare setting: the potential of quantitative diary methods.

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Studying learning in the healthcare setting: the potential of quantitative diary methods.

Perspect Med Educ. 2015 Jul 17;

Authors: Ciere Y, Jaarsma D, Visser A, Sanderman R, Snippe E, Fleer J

Abstract

Quantitative diary methods are longitudinal approaches that involve the repeated measurement of aspects of peoples’ experience of daily life. In this article, we outline the main characteristics and applications of quantitative diary methods and discuss how their use may further research in the field of medical education. Quantitative diary methods offer several methodological advantages, such as measuring aspects of learning with great detail, accuracy and authenticity. Moreover, they enable researchers to study how and under which conditions learning in the health care setting occurs and in which way learning can be promoted. Hence, quantitative diary methods may contribute to theory development and the optimization of teaching methods in medical education.

PMID: 26183248 [PubMed - as supplied by publisher]

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Great expectations? Pre-transplant quality of life expectations and distress after kidney transplantation: a prospective study.

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Great expectations? Pre-transplant quality of life expectations and distress after kidney transplantation: a prospective study.

Br J Health Psychol. 2014 Nov;19(4):823-38

Authors: Schulz T, Niesing J, Homan van der Heide JJ, Westerhuis R, Ploeg RJ, Ranchor AV

Abstract

OBJECTIVES: Previous research suggests that prior to kidney transplantation, patients overestimate their post-transplant quality of life (QoL). The current study aimed to corroborate these findings, identify determinants of QoL overestimation, examine its association with subsequent distress, and clarify the role of optimism.

DESIGN: Prospective observational study.

METHODS: Physical, psychological, and social QoL expectations, actual QoL, and distress (GHQ-12) of participants (56% male) were prospectively assessed before (T0; n = 228) and 3 (T1; n = 149), 6 (T2; n = 146), and 12 (T3; n = 114) months after successful transplantation.

RESULTS: Patients who were treated with haemodialysis before transplantation reported greater physical QoL overestimation than those who received treatment with peritoneal dialysis. Neither physical nor social QoL overestimation at T1 was prospectively associated with increased distress at T2 or T3. The interaction between optimism and social QoL overestimation at T1 (β = -.56, p < .001) for distress at T2 was significant, with patients low in optimism experiencing more distress after QoL overestimation.

CONCLUSIONS: QoL overestimation is not associated with subsequent distress. Findings suggest that patients low in optimism are more vulnerable to distress following QoL overestimation.

STATEMENT OF CONTRIBUTION: What is already known on this subject? Kidney transplantation improves patients’ quality of life. Prior to kidney transplantation, patients overestimate the scale of this improvement. What does this study add? Quality of life overestimation is not associated with subsequent distress. When optimism is low, kidney transplant recipients experience higher distress following quality of life overestimation.

PMID: 24330416 [PubMed - indexed for MEDLINE]

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Keeping up appearances: the role of identity concealment in the workplace among adults with degenerative eye conditions and its relationship with wellbeing and career outcomes.

Keeping up appearances: the role of identity concealment in the workplace among adults with degenerative eye conditions and its relationship with wellbeing and career outcomes.

Disabil Rehabil. 2015 Jun 16;:1-10

Authors: Spiegel T, De Bel V, Steverink N

Abstract

PURPOSE: This study aims to describe the interplay between the work trajectories and the passing patterns of individuals with degenerative eye conditions in different phases of their career, as well as the disease progression and the career and well-being outcomes associated with different works and passing trajectories.

METHODS: Qualitative interviews on the topic of work trajectories were conducted with 36 working or retired individuals with degenerative eye conditions. The “bigger picture” method was used to explore passing and concealment behavioral patterns, and their associations with various work trajectories.

RESULTS: Five patterns of passing and concealment behavior in the workplace were identified and were linked with various work trajectories among visually impaired study participants: (1) no career adjustments, concealed condition throughout career; (2) revealed condition after adjusting career plans; (3) increasingly open about their condition over the course of their career; (4) engaged in career planning, always open about their condition; and (5) engaged in limited career planning, always open about their condition.

CONCLUSIONS: Patterns characterized by less planning and more identity concealment were associated with more stress and lower levels of self-acceptance, while patterns characterized by more planning for vision deterioration and less passing behavior were associated with higher levels self-acceptance and fewer obstacles over the course of an individual’s career. The study’s findings can serve as a guide for health professionals. Implications for Rehabilitation Many individuals with degenerative eye conditions try to conceal their identity as visually impaired in the professional setting. Different aspects of career outcomes (e.g. age of retirement) and wellbeing outcomes (e.g. self-acceptance and stress) associate with identity concealment patterns of individuals throughout their careers. Identifying concealment patterns will allow health professionals to tackle particular adverse outcomes and challenges associated with these patterns.

PMID: 26079635 [PubMed - as supplied by publisher]

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A randomized controlled trial of an Internet-based cognitive-behavioural intervention for non-specific chronic pain: an effectiveness and cost-effectiveness study.

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A randomized controlled trial of an Internet-based cognitive-behavioural intervention for non-specific chronic pain: an effectiveness and cost-effectiveness study.

Eur J Pain. 2014 Nov;18(10):1440-51

Authors: de Boer MJ, Versteegen GJ, Vermeulen KM, Sanderman R, Struys MM

Abstract

BACKGROUND: Cognitive-behavioural treatment can nowadays be delivered through the Internet. This form of treatment can have various advantages with regard to availability and accessibility. Previous studies showed that Internet-based treatment for chronic pain is effective compared to waiting-list control groups.

METHODS: We conducted a randomized controlled trial comparing an Internet-based cognitive-behavioural intervention with e-mail therapist contact to a face-to-face cognitive-behavioural group intervention. Of the 72 participants who were randomly assigned to an Internet or a group course, 50 participants completed the intervention. Participants were assessed at baseline (T0), immediately after the 7-week course (T1) and at the booster session 2 months later (T2). Pain-related catastrophizing was the primary outcome measure. Pain intensity, fatigue, pain-related interference, locus of control, pain coping, global health-related quality of life and medical expenses were secondary outcome variables.

RESULTS: Significant improvement was found on catastrophizing, pain coping, locus of control and aspects of global health-related quality of life in both the Internet and the group courses directly after the course and at the booster session. Pain intensity was improved in both courses at the booster session. At T2, improvement in catastrophizing, pain intensity, pain coping and some quality of life dimensions was significantly greater in completers of the Internet course than in the group course. Furthermore, the Internet course was cost-effective compared to the group course.

CONCLUSIONS: We conclude that the Internet-based cognitive-behavioural intervention was at least as effective as the face-to-face group intervention and, on some outcome measures appeared to be even more effective.

PMID: 24777973 [PubMed - indexed for MEDLINE]

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A web-based cognitive behaviour therapy for chronic fatigue in type 1 diabetes (Dia-Fit): study protocol for a randomised controlled trial.

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A web-based cognitive behaviour therapy for chronic fatigue in type 1 diabetes (Dia-Fit): study protocol for a randomised controlled trial.

Trials. 2015 Jun 6;16(1):262

Authors: Menting J, Nikolaus S, Wiborg JF, Bazelmans E, Goedendorp MM, van Bon AC, van den Bergh JP, Mol MJ, Tack CJ, Knoop H

Abstract

BACKGROUND: Fatigue is frequently reported by patients with type 1 diabetes mellitus. A recent study showed that 40 % of patients experienced severe fatigue that lasted for more than six months and was accompanied by substantial impairments in daily functioning. Currently, there is no effective treatment available for chronic fatigue in patients with type 1 diabetes. Cognitive behaviour therapy aimed at cognitions and behaviours that perpetuate fatigue is effective in reducing fatigue in other chronic diseases. Recent research showed that these cognitions and behaviours are also potential determinants of fatigue in type 1 diabetes. We designed Dia-Fit, a web-based cognitive behaviour therapy for severe and chronic fatigue in patients with type 1 diabetes. This patient-tailored intervention is aimed at reducing fatigue by changing cognitions and behaviours assumed to maintain fatigue. The efficacy of Dia-Fit will be investigated in this study.

METHODS/DESIGN: A randomised controlled trial will be conducted in 120 patients with type 1 diabetes who are chronically and severely fatigued. Patients will be randomised to a treatment or waiting list group. The treatment group will receive Dia-Fit, a blended care therapy consisting of up to eight internet modules and face-to-face sessions with a therapist during a five-month period. The treatment will be tailored to the fatigue-maintaining cognitions and behaviours that are relevant for the patient and are determined at baseline. The waiting list group will receive Dia-Fit after a waiting period of five months. The primary outcome measure is fatigue severity. Secondary outcome measures are functional impairment and glucose control determined by haemoglobin A1c and blood glucose variability.

DISCUSSION: To our knowledge, this is the first study investigating the efficacy of a cognitive behavioural intervention for chronic fatigue in patients with type 1 diabetes.

TRIAL REGISTRATION: Dutch trial register NTR4312 (10 December 2013).

PMID: 26044447 [PubMed - as supplied by publisher]

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A web-based cognitive behaviour therapy for chronic fatigue in type 1 diabetes (Dia-Fit): study protocol for a randomised controlled trial.

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A web-based cognitive behaviour therapy for chronic fatigue in type 1 diabetes (Dia-Fit): study protocol for a randomised controlled trial.

Trials. 2015 Jun 6;16(1):262

Authors: Menting J, Nikolaus S, Wiborg JF, Bazelmans E, Goedendorp MM, van Bon AC, van den Bergh JP, Mol MJ, Tack CJ, Knoop H

Abstract

BACKGROUND: Fatigue is frequently reported by patients with type 1 diabetes mellitus. A recent study showed that 40 % of patients experienced severe fatigue that lasted for more than six months and was accompanied by substantial impairments in daily functioning. Currently, there is no effective treatment available for chronic fatigue in patients with type 1 diabetes. Cognitive behaviour therapy aimed at cognitions and behaviours that perpetuate fatigue is effective in reducing fatigue in other chronic diseases. Recent research showed that these cognitions and behaviours are also potential determinants of fatigue in type 1 diabetes. We designed Dia-Fit, a web-based cognitive behaviour therapy for severe and chronic fatigue in patients with type 1 diabetes. This patient-tailored intervention is aimed at reducing fatigue by changing cognitions and behaviours assumed to maintain fatigue. The efficacy of Dia-Fit will be investigated in this study.

METHODS/DESIGN: A randomised controlled trial will be conducted in 120 patients with type 1 diabetes who are chronically and severely fatigued. Patients will be randomised to a treatment or waiting list group. The treatment group will receive Dia-Fit, a blended care therapy consisting of up to eight internet modules and face-to-face sessions with a therapist during a five-month period. The treatment will be tailored to the fatigue-maintaining cognitions and behaviours that are relevant for the patient and are determined at baseline. The waiting list group will receive Dia-Fit after a waiting period of five months. The primary outcome measure is fatigue severity. Secondary outcome measures are functional impairment and glucose control determined by haemoglobin A1c and blood glucose variability.

DISCUSSION: To our knowledge, this is the first study investigating the efficacy of a cognitive behavioural intervention for chronic fatigue in patients with type 1 diabetes.

TRIAL REGISTRATION: Dutch trial register NTR4312 (10 December 2013).

PMID: 26044447 [PubMed - as supplied by publisher]

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Do individuals with and without depression value depression differently? And if so, why?

Do individuals with and without depression value depression differently? And if so, why?

Qual Life Res. 2015 Jun 3;

Authors: Papageorgiou K, Vermeulen KM, Schroevers MJ, Stiggelbout AM, Buskens E, Krabbe PF, van den Heuvel E, Ranchor AV

Abstract

PURPOSE: Health state valuations, used to evaluate the effectiveness of healthcare interventions, can be obtained either by the patients or by the general population. The general population seems to value somatic conditions more negatively than patients, but little is known about valuations of psychological conditions. This study examined whether individuals with and without depression differ in their valuations of depression and whether perceptions regarding depression (empathy, perceived susceptibility, stigma, illness perceptions) and individual characteristics (mastery, self-compassion, dysfunctional attitudes) bias valuations of either individuals with or without depression.

METHODS: In an online study, a general population sample used a time-trade-off task to value 30 vignettes describing depression states (four per participant) and completed questionnaires on perceptions regarding depression and individual characteristics. Participants were assigned to depression groups (with or without depression), based on the PHQ-9. A generalized linear mixed model was used to assess discrepancies in valuations and identify their determinants.

RESULTS: The sample (N = 1268) was representative of the Dutch population on age, gender, education and residence. We found that for mild depression states, individuals with depression (N = 200) valued depression more negatively than individuals without depression (N = 1068) (p = .007). Variables related to perceptions of depression and individual characteristics were not found to affect valuations of either individuals with or individuals without depression.

CONCLUSION: Since the general population values depression less negatively, using their perspective might result in less effectiveness for interventions for mild depression. Perceptions of depression or to individual characteristics did not seem to differentially affect valuations made by either individuals with or without depression.

PMID: 26038219 [PubMed - as supplied by publisher]

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