Delay in diagnosis of testicular cancer.
J Clin Oncol. 2004 Jul 15;22(14_suppl):4602
Authors: Fleer J, Sleijfer DT, Hoekstra-Weebers JE, Hoekstra HJ
4602 Background: Delay in presentation of a testis tumor may result in an advanced stage of disease at diagnosis, which may affect disease free and overall survival. The aim of this study was to determine variables related to delay in diagnosis of testicular cancer (TC).
METHODS: A questionnaire was developed to assess patient delay (time from first symptom till first consultation with general practitioner (GP)) and doctor delay (time from first consultation with GP till final diagnosis). In addition, patient and disease characteristics possibly related to patient and/or doctor delay, were collected: age, marital status, educational level, extensiveness of the disease (stage I vs disseminated disease), number of symptoms, change in testicle as a symptom, pain as a symptom, patients’ knowledge of TC, appraisal of symptoms as threatening, embarrassment, and whether the doctor referred the patient immediately for further examination.
RESULTS: 48 men (median age 25, range 16-44 years) who were consecutively referred to the Groningen University Hospital completed the questionnaire. Median patient delay was 30 (range 1-365) days. Only educational level correlated with patient delay (r=-.30, p=.03). Median doctor delay was 14 (0-240) days. After first consultation, only 20 patients (42%) were immediately referred for further examination. The remaining 28 patients were not immediately referred, which led to a significantly longer doctor delay (median = 23 days, t=-4.47, p90 days. Age was significantly related to total delay (r=-.33, p=.03). Six patients (12.5%) did not have a change in testicle as presenting symptom, but this was not related to delay. Extensiveness of disease was not related to delay.
CONCLUSIONS: Surprisingly, having disseminated disease and having a change in a testicle as presenting symptom were not related to delay, but younger and lower educated men appeared to be more likely to report delay in diagnosis. Over half of the men were not immediately referred for further examination, resulting in a significantly longer GP delay. This finding stresses the responsibility of GPs in the diagnostic process of TC. No significant financial relationships to disclose.
PMID: 28015713 [PubMed – in process]
Chronic multimorbidity impairs role functioning in middle-aged and older individuals mostly when non-partnered or living alone.
PLoS One. 2017;12(2):e0170525
Authors: Müller F, Hagedoorn M, Tuinman MA
BACKGROUND: Due to the aging of the population, society includes a growing proportion of older individuals prone to chronic morbidity. This study aimed to investigate the adverse effects of single and multiple chronic morbidity on psychosocial health and whether these effects are more pronounced in individuals who are non-partnered or living alone.
MATERIALS AND METHODS: Baseline data from the ‘Lifelines Cohort Study’ collected between 2006 and 2013 in the Netherlands were used. Individuals aged 50+ (n = 25,214) were categorized according to their health status (healthy, single chronic morbidity, multiple chronic morbidity), relationship status (partnered, non-partnered), and living arrangement (living with someone, living alone). Analyses of covariance (ANCOVA) were performed to study the main- and the interaction-effects on mental health and role functioning as assessed with the RAND-36.
RESULTS: Irrespective of having chronic morbidity, having a partner was associated with better mental health when partners shared a home. Individuals with single and especially multiple chronic morbidity had impaired role functioning. Having a partner mitigated the adverse effects of multimorbidity on role functioning, but only in individuals who shared a home with their partner. Non-partnered individuals with multimorbidity and those not sharing a home with their partner demonstrated impaired role functioning.
CONCLUSIONS: The results demonstrate that multimorbidity negatively affects role functioning, but not the mental health, of middle-aged and older individuals. Sharing a home with a partner can mitigate these adverse effects, while other combinations of relationship status and living arrangement do not. Offering intervention to those individuals most vulnerable to impaired functioning may relieve some of the increasing pressure on the health care system. An individual’s relationship status along with one’s living arrangement could foster the identification of a target group for such interventions attempting to sustain physical functioning or to adapt daily goals.
PMID: 28151967 [PubMed – in process]
Changes of Perceived Control after Kidney Transplantation: a prospective Study.
J Adv Nurs. 2017 Jan 25;:
Authors: Schulz T, Niesing J, Homan Van Der Heide JJ, Westerhuis R, Ploeg RJ, Ranchor AV
AIMS: To determine if kidney transplantation is associated with increases of perceived control and how changes of perceived control affect the course of psychological distress until one year after transplantation.
BACKGROUND: Low levels of perceived control are associated with reduced well-being among dialysis patients.
DESIGN: Prospective longitudinal cohort study.
METHODS: Perceived control (Mastery Scale) and psychological distress (GHQ-12) were prospectively assessed before (T0; n = 470) and three (T1; n = 197), six (T2; n = 210) and twelve (T3; n = 183) months after transplantation. Differences between T1 and T0 perceived control were used to stratify the sample into three groups (control gain, stable control and control loss). Socio-demographic and clinical variables, including complications, were examined as potential correlates and the course of psychological was distress compared across groups. Data were collected between July 2008 – July 2013.
RESULTS: Perceived control showed a small increase overall, with 35.1%, 50.0% and 14.9% reporting gain, stable level and loss respectively. Patients with secondary schooling were overrepresented in the control loss group. The course of psychological distress varied across perceived control change groups, with patients in the control gain group experiencing a significant reduction of psychological distress.
CONCLUSION: A considerable number of patients report increased levels of perceived control after transplantation that are associated with a subsequent decrease of psychological distress. Results emphasize the importance of perceived control and could inform interventions to facilitate well-being after kidney transplantation. This article is protected by copyright. All rights reserved.
PMID: 28122152 [PubMed – as supplied by publisher]
Group and Individual Mindfulness-Based Cognitive Therapy (MBCT) Are Both Effective: a Pilot Randomized Controlled Trial in Depressed People with a Somatic Disease.
Mindfulness (N Y). 2016;7(6):1339-1346
Authors: Schroevers MJ, Tovote KA, Snippe E, Fleer J
Depressive symptoms are commonly reported by individuals suffering from a chronic medical condition. Mindfulness-based cognitive therapy (MBCT) has been shown to be an effective psychological intervention for reducing depressive symptoms in a range of populations. MBCT is traditionally given in a group format. The aim of the current pilot RCT was to examine the effects of group-based MBCT and individually based MBCT for reducing depressive symptoms in adults suffering from one or more somatic diseases. In this study, 56 people with a somatic condition and comorbid depressive symptoms (i.e., Beck Depression Inventory-II [BDI-II] ≥14) were randomized to group MBCT (n = 28) or individual MBCT (n = 28). Patients filled out questionnaires at three points in time (i.e., pre-intervention, post-intervention, 3 months follow-up). Primary outcome measure was severity of depressive symptoms. Anxiety and positive well-being as well as mindfulness and self-compassion were also assessed. We found significant improvements in all outcomes in those receiving group or individual MBCT, with no significant differences between the two conditions regarding these improvements. Although preliminary (given the pilot nature and lack of control group), results suggest that both group MBCT and individual MBCT are associated with improvements in psychological well-being and enhanced skills of mindfulness and self-compassion in individuals with a chronic somatic condition and comorbid depressive symptoms. Our findings merit future non-inferiority trials in larger samples to be able to draw more firm conclusions about the effectiveness of both formats of MBCT.
PMID: 27909465 [PubMed – in process]
Mindfulness and Self-compassion as Unique and Common Predictors of Affect in the General Population.
Mindfulness (N Y). 2016;7(6):1289-1296
Authors: López A, Sanderman R, Schroevers MJ
In contrast to the increased research interest in the benefits of mindfulness and self-compassion, relatively few studies have examined their unique and combined effects in predicting affect. This cross-sectional study examined the predictive value of mindfulness and self-compassion for depressive symptoms, negative affect, and positive affect in a large representative sample of community adults (N = 1736). The Five Facets of Mindfulness Questionnaire (FFMQ) was used as a measure of mindfulness and the Self-Compassion Scale (SCS) as a measure of self-compassion. Five FFMQ facets were explored: observe, describe, act with awareness, non-judgment, and non-reactivity. Two SCS facets were explored: its positive items (SCS Pos) and its negative items (SCS Neg). When simultaneously examining all seven facets of mindfulness and self-compassion, three of the five FFMQ facets and SCS Neg significantly predicted both depressive symptoms and negative affect, with SCS Neg and act with awareness being the strongest predictors. These findings suggest that a harsh attitude towards oneself and a lack of attention when acting have the greatest value in predicting the presence of psychological symptoms. With respect to positive affect, four of the five FFMQ facets (except non-judgment) were significant predictors, with no unique predictive value of the two SCS’s facets, suggesting that mindfulness is a more important predictor of positive affect than self-compassion, as measured by the FFMQ and SCS.
PMID: 27909464 [PubMed – in process]
Marijuana Use and Dependence in Chilean Adolescents and Its Association with Family and Peer Marijuana Use.
Int J Behav Med. 2016 Oct 3;:
Authors: Lobato M, Sanderman R, Pizarro E, Hagedoorn M
PURPOSE: The purpose of the study is to examine (1) whether family and peer marijuana use are independently related to adolescent marijuana use in Chile, (2) whether family and peer marijuana use are associated with adolescent marijuana dependence in adolescents using marijuana, and (3) whether the adolescent’s age moderates the association between family or peer use and adolescent marijuana use and/or dependence.
METHOD: This study used data from the National Survey on Drug Use in the General Population in Chile (a cross-sectional observational study), which was conducted in 2008 and 2010 in 4413 adolescents aged 12-19. Adolescents answered questions about their past-year marijuana use and dependence (ICD-10 criteria) and the marijuana use of their family and peers. Logistic regressions were performed while controlling for confounders.
RESULTS: Adolescents who had a family member who used marijuana were five times more likely to use the drug. Adolescents with a close friend who used marijuana were eight times more likely to use marijuana. When adolescents were using marijuana, they were three times more likely to be dependent if they had a family member who used the drug. However, no significant relationship was found between peer use and dependence. No statistically significant interactions were found between family or peer use and age.
CONCLUSION: Family and peer marijuana use was independently associated with adolescent’s past-year marijuana use; however, only family marijuana use was statistically associated with adolescent’s marijuana dependence.
PMID: 27699626 [PubMed – as supplied by publisher]
More Questions than Answers: Continued Critical Reanalysis of Fredrickson et al.’s Studies of Genomics and Well-Being.
PLoS One. 2016;11(6):e0156415
Authors: Brown NJ, MacDonald DA, Samanta MP, Friedman HL, Coyne JC
We critically re-examine Fredrickson et al.’s renewed claims concerning the differential relationship between hedonic and eudaimonic forms of well-being and gene expression, namely that people who experience a preponderance of eudaimonic well-being have gene expression profiles that are associated with more favorable health outcomes. By means of an extensive reanalysis of their data, we identify several discrepancies between what these authors claimed and what their data support; we further show that their different analysis models produce mutually contradictory results. We then show how Fredrickson et al.’s most recent article on this topic not only fails to adequately address our previously published concerns about their earlier related work, but also introduces significant further problems, including inconsistency in their hypotheses. Additionally, we demonstrate that regardless of which statistical model is used to analyze their data, Fredrickson et al.’s method can be highly sensitive to the inclusion (or exclusion) of data from a single subject. We reiterate our previous conclusions, namely that there is no evidence that Fredrickson et al. have established a reliable empirical distinction between their two delineated forms of well-being, nor that eudaimonic well-being provides any overall health benefits over hedonic well-being.
PMID: 27270924 [PubMed – as supplied by publisher]
Posted in PLoS One
Tagged J.C. Coyne
Survey nonresponse among informal caregivers: effects on the presence and magnitude of associations with caregiver burden and satisfaction.
BMC Public Health. 2016;16(1):480
Authors: Oldenkamp M, Wittek RP, Hagedoorn M, Stolk RP, Smidt N
BACKGROUND: Informal caregiving is becoming more relevant with current trends such as population ageing. However, little is known about nonconsent and nonresponse bias in caregiving research. We investigated nonconsent and nonresponse bias in a sample of informal caregivers who participated in the LifeLines Cohort Study, and were invited for participation in an additional caregiving study.
METHODS: We compared socio-demographic characteristics, caregiver health, caregiving situation, and caregiver outcomes of nonconsent and consent caregivers, and nonresponse and response caregivers, on LifeLines data, by using Chi-square tests, Independent Sample T-tests, and Mann-Whitney tests. Furthermore, we examined the influence of nonconsent and nonresponse on the presence and magnitude of the associations between caregiver characteristics and two commonly used caregiving outcomes (caregiver burden and satisfaction). We conducted multinomial logistic regression analyses, including interaction terms with nonconsent and nonresponse.
RESULTS: Within a subcohort of 8443 caregivers, aged >18 years, 5095 caregivers (60 %) gave consent for participation in the caregiving study. Within the subgroup of 2002 caregivers who received the questionnaire, 965 (48 %) responded. Caregivers who were highly involved in caregiving (i.e. high time investment, high caregiver burden), gave more commonly consent to participate, and responded more often to the questionnaire. Nonconsent and nonresponse influenced the associations between caregiver characteristics and caregiver burden for only a few characteristics, mainly indicating the level of caregiving involvement (e.g. time investment, caregiving duration). Especially for caregiver burden, these indicators were stronger for consent and response caregivers than for nonconsent and nonresponse caregivers.
CONCLUSIONS: Our findings are important for caregiving research, as they emphasized that participation might not be evenly distributed among caregivers, and that the possibility of nonconsent and nonresponse bias should be considered.
PMID: 27278386 [PubMed – in process]
Replication initiatives will not salvage the trustworthiness of psychology.
BMC Psychol. 2016;4(1):28
Authors: Coyne JC
Replication initiatives in psychology continue to gather considerable attention from far outside the field, as well as controversy from within. Some accomplishments of these initiatives are noted, but this article focuses on why they do not provide a general solution for what ails psychology. There are inherent limitations to mass replications ever being conducted in many areas of psychology, both in terms of their practicality and their prospects for improving the science. Unnecessary compromises were built into the ground rules for design and publication of the Open Science Collaboration: Psychology that undermine its effectiveness. Some ground rules could actually be flipped into guidance for how not to conduct replications. Greater adherence to best publication practices, transparency in the design and publishing of research, strengthening of independent post-publication peer review and firmer enforcement of rules about data sharing and declarations of conflict of interest would make many replications unnecessary. Yet, it has been difficult to move beyond simple endorsement of these measures to consistent implementation. Given the strong institutional support for questionable publication practices, progress will depend on effective individual and collective use of social media to expose lapses and demand reform. Some recent incidents highlight the necessity of this.
PMID: 27245324 [PubMed – in process]
Impaired Mood in Headache Clinic Patients: Associations With the Perceived Hindrance and Attainability of Personal Goals.
Headache. 2016 May 20;
Authors: Ciere Y, Visser A, Lebbink J, Sanderman R, Fleer J
BACKGROUND: Headache disorders are often accompanied by impaired mood, especially in the headache clinic population. There is a large body of literature demonstrating that an illness or disability may affect the way in which patients perceive their personal goals and that the perception that the attainability of goals is hindered by the illness is a risk factor for impaired mood. However, empirical evidence regarding the extent to which goals are hindered or less attainable as a result of a headache disorder, and how that is related to mood, is currently lacking.
OBJECTIVE: The aim of this cross-sectional study was to examine associations between headache severity, goal hindrance and attainability, and mood in a headache clinic population.
METHODS: The sample consisted of 65 adult patients seeking treatment at a tertiary headache clinic. Prior to their first appointment in the clinic, patients completed self-report measures of headache severity, goals and mood (PANAS).
RESULTS: Higher self-reported headache intensity was associated with higher goal hindrance (r = .38, P = .004), whereas greater headache frequency was associated with lower goal attainability (r = .30, P = .022). Higher perceived goal hindrance was associated with lower positive mood (r = -.27, P = .032) and higher negative mood (r = .28, P = .027). Furthermore, lower perceived goal attainability was associated with higher negative mood (r = -.34, P = .007). Goal perceptions explained an additional 11.4% of the variance in positive mood (F = 3.250, P = .047 <.05) and 10.5% of the variance in negative mood (F = 3.459, P = .039) beyond the effect of age and headache severity.
CONCLUSION: The results of this preliminary study suggest that perceptions of increased goal hindrance and decreased goal attainability may indeed be a risk factor for impaired mood in the headache clinic population and highlight the need for further, longitudinal research. Obtaining more insight into goal processes (eg, what types of goals are specifically disturbed, which goal adjustment strategies are (mal)adaptive) may help to identify ways to improve outcomes in the headache clinic population.
PMID: 27197699 [PubMed – as supplied by publisher]