Monthly Archives: September 2015

People with cancer use goal adjustment strategies in the first 6 months after diagnosis and tell us how.






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People with cancer use goal adjustment strategies in the first 6 months after diagnosis and tell us how.

Br J Health Psychol. 2015 Sep 28;

Authors: Janse M, Ranchor AV, Smink A, Sprangers MA, Fleer J

Abstract
OBJECTIVES: Theory has offered suggestions on how people may adjust their personal goals after goal disturbance or altered life situations. However, the actual use of these goal adjustment strategies has rarely been studied. This study aimed to investigate whether the goal adjustment strategies identified in the literature are used in the first 6 months following a diagnosis of cancer and whether alternative strategies can be identified.
DESIGN: Exploratory design with a qualitative method of data collection.
METHODS: Patients were asked to list their current personal goals within a month after being diagnosed with colorectal cancer. Six months later, they were asked what had happened to each of these goals. For each goal, raters scored whether (1) it was achieved or being pursued as planned, (2) a known strategy was used, or (3) an alternative strategy was used.
RESULTS: Patients with colorectal cancer (n = 130) reported that more than half of their goals had been achieved or were being pursued as planned. The remaining goals (n = 210) required goal adjustment strategies. Patients used five of six known strategies that involved mostly limited adjustment. Additionally, they used combinations of goal adjustment strategies, and two alternative strategies were identified.
CONCLUSIONS: This study found that patients with cancer use goal adjustment strategies, and it provides illustrations on how these strategies are used, thus deepening and extending existing knowledge of and theory on goal adjustment. Future studies should take the newly identified strategies into account as well as the possible use of combinations of strategies. Statement of contribution What is already known on this subject? The successful pursuit of personal goals is important for maintaining well-being. However, an unexpected and serious illness such as cancer can lead to the need to adjust goals, either because they have become difficult or impossible to attain due to physical hindrance of the illness and/or its treatment, or because other goals have become important due to the confrontation with the fragility of life. Theories have proposed options of how people may deal with their personal goals, but whether these so-called goal adjustment strategies are actually used by cancer patients, and whether there are alternative strategies we need to take into account, is still unclear. What does this study add? This study employs a qualitative method of data collection to study what actually happens to cancer patients’ goals during the first 6 months after diagnosis. This study found that almost all goal adjustment strategies from theory are indeed used by cancer patients and that they mostly use strategies which involve only limited adjustment and a continued focus on the original goal. We found that patients with cancer use combinations of strategies and two alternative strategies, thereby complementing and expanding theories on goal adjustment.

PMID: 26412011 [PubMed – as supplied by publisher]

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Mindfulness-based cognitive therapy for seasonal affective disorder: a pilot study.






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Mindfulness-based cognitive therapy for seasonal affective disorder: a pilot study.

J Affect Disord. 2014 Oct;168:205-9

Authors: Fleer J, Schroevers M, Panjer V, Geerts E, Meesters Y

Abstract
BACKGROUND: The best available treatment for seasonal affective disorder (SAD) is light therapy. Yet, this treatment does not prevent recurrence of depression in subsequent seasons. The aim of the study is to gain preliminary insight in the efficacy of Mindfulness Based Cognitive Therapy (MBCT) in the prevention of SAD recurrence.
METHODS: This is a randomized controlled pilot study, in which SAD patients in remission were randomly allocated to an individual format of MBCT or a control condition (i.e. treatment as usual). MBCT was given between May and June 2011, when there was no presence of depressive symptoms. The Inventory for Depressive Symptomatology Self-Report (IDS-SR), which patients received on a weekly basis from September 2011 to April 2012, was used to assess moment of recurrence (≥20) and severity at moment of recurrence.
RESULTS: 23 SAD patients were randomized to MBCT and 23 to the control condition. Kaplan-Meier survival curve showed that the groups did not differ in moment of recurrence (χ²(1).41, p=.52). T-tests showed no group difference in mean IDS-SR scores at moment of recurrence (t(31)=-.52, p=.61).
LIMITATIONS: The results are limited by small sample size (n=46) and missing data of weekly IDS-SR assessments.
CONCLUSION: The findings of this pilot RCT suggest that individual MBCT is not effective in preventing a SAD recurrence when offered in a symptom free period (i.e. spring).

PMID: 25063959 [PubMed – indexed for MEDLINE]

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The Elusory Upward Spiral: A Reanalysis of Kok et al. (2013).






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The Elusory Upward Spiral: A Reanalysis of Kok et al. (2013).
Psychol Sci. 2015 Jul;26(7):1140-3
Authors: Heathers JA, Brown NJ, Coyne JC, Friedman HL
PMID: 26025022 [PubMed – indexed for MEDL… Continue reading

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Subtypes of depression in cancer patients: an empirically driven approach.






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Subtypes of depression in cancer patients: an empirically driven approach.

Support Care Cancer. 2015 Sep 5;

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

Abstract
PURPOSE: This study aimed to (1) identify subgroups of cancer patients with distinct subtypes of depression before the start of psychological care, (2) examine whether socio-demographic and medical characteristics distinguished these subtypes, and (3) examine whether people with distinct subtypes reported differential courses of depression during psychological care.
METHOD: This naturalistic, longitudinal study included cancer patients who sought psychological care at specialized psycho-oncology institutions in the Netherlands. Data were collected before psychological care (T1) and three (T2) and nine (T3) months thereafter. Latent class analysis was performed to identify depression subtypes in 243 patients at T1.
RESULTS: Before starting psychological care, three depressive subtypes were identified, differing in severity and type of symptoms. Class 1 (47 %) with mild depression reported mostly concentration and sleep problems and fatigue. Class 2 (41 %), with slightly higher levels of depression, reported similar concentration and sleep problems and fatigue as class 1, and additionally depressed mood. Class 3 (12 %), with severe depression, reported mainly a depressed mood and, to a lesser extent but still elevated, fatigue and concentration problems. None of socio-demographic and medical characteristics significantly distinguished these subtypes. These subtypes significantly predicted the course of depression over time, with class 1 reporting moderate improvements, class 2 large improvements, and class 3 the largest improvements.
CONCLUSIONS: Results indicate the presence of three subtypes of depression in cancer patients before starting psychological care. Our findings suggest that psychological interventions could be tailored to respond to the specific subtype of depression experienced by each individual.

PMID: 26341521 [PubMed – as supplied by publisher]

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Fatigue and its associated psychosocial factors in cancer patients on active palliative treatment measured over time.






Fatigue and its associated psychosocial factors in cancer patients on active palliative treatment measured over time.

Support Care Cancer. 2015 Sep 3;

Authors: Peters ME, Goedendorp MM, Verhagen CA, Bleijenberg G, van der Graaf WT

Abstract
PURPOSE: Fatigue is a frequently reported symptom by patients with advanced cancer, but hardly any prospective information is available about fatigue while on treatment in the palliative setting. In a previous cross-sectional study, we found several factors contributing to fatigue in these patients. In this study, we investigated the course of fatigue over time and if psychosocial factors were associated with fatigue over time.
METHODS: Patients on cancer treatment for incurable solid tumors were observed over 6 months. Patients filled in the Checklist Individual Strength monthly to measure the course of fatigue. Baseline questionnaires were used to measure disease acceptance, anxiety, depressive mood, fatigue catastrophizing, sleeping problems, discrepancies in social support, and self-reported physical activity for their relation with fatigue over time.
RESULTS: At baseline 137 patients and after 6 months 89 patients participated. The mean duration of participation was 4.9 months. At most time points, fatigue scores were significantly higher in the group dropouts in comparison with the group participating 6 months (completers). Overall fatigue levels remained stable over time for the majority of participants. In the completers, 42 % never experienced severe fatigue, 29 % persisted being severely fatigued, and others had either an increasing or decreasing level. Of the investigated factors, low reported physical activity and non-acceptance of cancer were associated significantly to fatigue.
CONCLUSION: A substantial number of participants never experienced severe fatigue and fatigue levels remained stable over time. For those who do experience severe fatigue, non-acceptance of having incurable cancer and low self-reported physical activity may be fatigue-perpetuating factors.

PMID: 26335403 [PubMed – as supplied by publisher]

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Exploring Subjective Well-being in Older Age by Using Participant-generated Word Clouds.






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Exploring Subjective Well-being in Older Age by Using Participant-generated Word Clouds.
Gerontologist. 2015 Sep 1;
Authors: Douma L, Steverink N, Hutter I, Meijering L
Abstract
PURPOS… Continue reading

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A longitudinal case-control study on goals in adolescents with cancer.






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A longitudinal case-control study on goals in adolescents with cancer.
Psychol Health. 2015;30(9):1075-87
Authors: Sulkers E, Janse M, Brinksma A, Roodbol PF, Kamps WA, Tissing WJ, Sanderman R, Fleer … Continue reading

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