1,721,004 research outputs found
Developing a psycho-oncology program in cancer settings. Experiences from Southern Europe: the models of Ferrara and Lisbon
No full textFollowing the indications and recommendations of associations, institutions and councils around the world, psycho-oncology should have a “mandatory” function in programs within the health system, with particular reference to oncology. The steps in the development of psycho-oncology services and/or units, their functions in terms of clinical, educational and research activities, the standards that should be respected and the organizational characteristics are discussed. With regards to this, the experience of Southern Europe and countries, specifically the models developed in Ferrara, Italy and Lisbon, Portugal, are presented. The objective of psycho-oncology, namely that no cancer health is possible without taking into consideration mental health, and, consequently, it is not possible to provide cancer care without a specific investment in the psychosocial area, represents the challenge for the health system
The role of psychosocial oncology in cancer care
No full textCancer is one of the most common diseases worldwide and the second leading cause of death. The IARC reports 3.2 million new cases and 1.7 million deaths from cancer in Europe in 2006. Within these figures, the EU25 accounted for nearly 2.3 million new cases and over 1 million cancer deaths. The incidence of cancer increased between 1950 and 2005, partly as a result of population growth and ageing. Survival from cancer is also improving –several million people are cured or live with cancer for many years in Europe. In this context, evaluation and understanding of the psychosocial aspects of cancer and its treatment have become a mandatory part of cancer care. The psychosocial dimensions of cancer have been explored in the literature since the 1950s. Only over the past 25 years has it developed into a specific discipline and subspecialty – psycho-oncology. Psycho-oncology addresses a range of psychosocial, behavioural, spiritual and existential dimensions along the entire journey travelled by cancer patients and their families. Its goal is to ensure that all of these receive optimal psychosocial care at all stages of disease and survivorship. This chapter sets out a discussion of the main psychosocial concomitants of cancer; their consequences for patients and their families; and the development and application of guidelines for screening and evaluating the psychosocial needs of cancer patients. This is followed by a description of the contributions that psychosocial interventions can offer to the process of educating and training cancer physicians, and the evidence-based psychosocial treatment of cancer patients that can be pursued by means of a multidisciplinary approach
What Concerns Them Most? Report from the Southern European Psycho-Oncology Study (SEPOS)
No full textPURPOSE: In a previous study by the SEPOS group, cancer patients concerns were correlated to psychosocial morbidity (HADS) and maladaptive coping styles (MiniMAC) and negatively to QoL variables. As part of the SEPOS general investigation the aim of the present study is: i) to identify the main concerns in southern European cancer patients and its relation to age, sex, cancer site, type of treatment received, and ii) identify specific concerns with regard to each country. METHODS: A convenience sample of 287 outpatients with a diagnosis of cancer between 6 to 18 months, a good performance status (KPS>80), no cognitive deficits were approached in university or affiliated cancer centres or hospitals in Italy, Portugal and Spain. Each patient was evaluated for concerns about illness (CWI), socio-demographic characteristics and clinical data. RESULTS: Concerns in general were not high in our population. However the most significant ones concern illness, emotional issues and the future. Significant differences were found for CWI-total score only in terms of age, but using descriptive analysis significant differences emerged for specific concerns relatively to all the variables studied and its categories (e.g., 36-45 yrs old are mostly worried with relationship with partner, economical and work-related issues) and for each country (e.g., Portuguese patients were most worried and Italians least). DISCUSSION: A good KPS used as recruitment criterion may have influenced a relatively low rate of concerns in our study. Addressing patients’ specific concerns is an important target in cancer care to meet their needs and develop tailored psychosocial programs. ACKNOWLEDGEMENTS: Project funded by the European Commission Health and Consumer Protection – Commission on Cancer agreement University of Ferrara, Italy SI2.307317.2000CVG2-026
Training southern European oncologists to recognize psychosocial morbidity in their cancer patients
No full textThe SEPO Study set up a model to be used in cancer care to train physicians, especially medical oncologists, in examining and recognizing depression and psychsocoail morbidity among cancer patients. The model consisting of a workshop of 12 hours has been appleid to 30 oncologists with good appreciation in terms of feasibility in clinical practice (muhe-very much related to their goals 86%; methods helful-very helpful 96.7%; role-play exercise helpfu-very helpful 93.3%)
Does spirituality make a difference? Report from the Southern European Psycho-Oncology Study (SEPOS)
No full textSpirituality and coping mechanism related to patints' religion affiliation were explore among 307 cancer patients participating in the cross-cultural Southern European Psycho-Oncology Study (SEPO-S). 79.3% patients reported to be supported by tehir spirituality/faith. spirituality was significantly related to fighting spirit, fatalsim and avoidacne as measured by the Mini-Menta Adjustment to Cancer Scale and negatively correlated with depression and totla emotional distress as measured by the Hospital Anxiety and Depression scale. Spirituality seems to play a protective role among cancer patients of the Mediterranean area
Does spirituality and faith make a difference? Report from the Southern European Psycho-Oncology Study (SEPOS)
No full textPURPOSE. In the last decade some attention has been given to spirituality and faith and its role in cancer patients’ coping. Few data is available about spirituality among cancer patients in Southern European countries, which have a big tradition in religious spirituality, namely catholic religion. As part of a more general investigation (Southern European Psycho-Oncology Study – SEPOS), the aim of this study was to examine the effect of spirituality in moulding psychosocial implications in Southern European cancer patients. METHODS. A convenience sample of 323 outpatients with a diagnosis of cancer between 6 to 18 months, a good performance status (KPS> 80), no cognitive deficits or CNS involvement by disease were approached in university and affiliated cancer centers in Italy, Spain, Portugal and Switzerland (Italian speaking area). Each patient was evaluated for spirituality (VAS 0-10), psychological morbidity (HADS), coping strategies (Mini-MAC) and concerns about illness (CWI). RESULTS. The majority of patients (79.3%) referred being supported by their spirituality/faith throughout their illness. Significant differences were found between the spirituality versus non-spirituality groups (p<.01) in terms of education, coping styles and psychological morbidity. Spirituality was significantly correlated with fighting spirit (r=.27), fatalism (r=.50) and avoidance (r=.23) coping styles and negatively correlated with education (r=-.25), depression (r=-.22) and HAD total (r=-.17). CONCLUSION. Spirituality is frequent among southern European cancer patients with lower education and seems to play some protective role towards psychological morbidity, specifically depression. Further studies should examine this trend in Southern European cancer patients
Use of distress and depression thermometers to measure psychosocial morbidity among southern European cancer patients
No full textGOALS OF WORK: Recent literature has indicated the need for rapid evaluation of psychosocial issues secondary to cancer. Because of the problems of routine use of psychometric instruments, short instruments such as visual analogue scales or one-item 0-10 scales have been developed as valid assessment alternatives. PATIENTS AND METHODS: A study was conducted to examine the role of two 0-10 scales in measuring emotional stress (distress thermometer, DT) and depressed mood (mood thermometer, MT), respectively, in a multicenter study carried out in southern European countries (Italy, Portugal, Spain, and Switzerland). A convenience sample of 312 cancer outpatients completed the DT and MT and the Hospital Anxiety Depression Scale (HADS). MAIN RESULTS: DT was more significantly associated HADS anxiety than HADS depression while MT was related both to HADS anxiety and depression. The correlation of MT with HADS was higher than DT. A cutoff point >4 on the DT maximized sensitivity (65%) and specificity (79%) for general psychosocial morbidity while a cutoff >5 identified more severe "caseness" (sensitivity=70%; specificity=73%). On the MT, sensitivity and specificity for general psychosocial morbidity were 85% and 72% by using the cutoff score >3. A score >4 on the MT was associated with a sensitivity of 78% and a specificity of 77% in detecting more severe caseness. CONCLUSIONS: Two simple instruments, the DT and the MT, were found to have acceptable levels of sensitivity and specificity in detecting psychosocial morbidity. Compared to the HADS, however, the mood MT performed better than the DT
A communication intervention for training Southern European oncologists to recognize psychosocial morbidity in cancer. I - Development of the model and preliminary results on physicians' satisfaction
No full textBACKGROUND: The detection of psychosocial distress is a significant communication problem in Southern Europe and other countries. Work in this area is hampered by a lack of data. Because not much is known about training aimed at improving the recognition of psychosocial disorders in cancer patients, we developed a basic course model for medical oncology professionals. METHODS: A specific educational and experiential model (12 hours divided into 2 modules) involving formal teaching (ie, journal articles, large-group presentations), practice in small groups (ie, small-group exercises and role playing), and discussion in large groups was developed with the aim of improving the ability of oncologists to detect emotional disturbances in cancer patients (ie, depression, anxiety, and adjustment disorders). RESULTS: A total of 30 oncologists from 3 Southern European countries (Italy, Portugal, and Spain) participated in the workshop. The training course was well accepted by most participants who expressed general satisfaction and a positive subjective perception of the utility of the course for clinical practice. Of the total participants, 28 physicians (93.3%) thought that had they been exposed to this material sooner, they would have incorporated the techniques received in the workshop into their practices; 2 participants stated they would likely have done so. Half of the doctors (n = 15) believed that their clinical communication techniques were improved by participating in the workshop, and the remaining half thought that their abilities to communicate with cancer patients had improved. CONCLUSIONS: This model is a feasible approach for oncologists and is easily applicable to various oncology settings. Further studies will demonstrate the effectiveness of this method for improving oncologists skills in recognizing emotional disorders in their patients with cancer
Physician-patient communication among Southern European cancer physicians: The influence of psychosocial orientation and burnout
No full textPhysician-patient communication is a critical factor for comprehensive care in oncology. Although a number of studies have been carried out in Northern Europe and the US on this subject, no data are available in Southern European countries. As a part of a multicenter Southern European Psycho-Oncology study (SEPOS), the present investigation was conducted to examine communication skills and related variables (i.e. psychosocial orientation, and burnout) among 125 physicians from Italy, Portugal, and Spain. The Self-Confidence in Communication Skills (SCCS) scale was given to assess physicians' perception of their communication skills and the Expected Outcome of Communication (EOC) scale was administered to examine the physicians' expectations about the effects of communicating with their patients. Doctors' psychosocial orientation was measured by using the Physician Belief Scale (PBS) and burnout was measured by using the Maslach Burnout Inventory (MBI). Although the physicians reported receiving minimal training in communication during their education, they tended to perceive themselves as skilled in patient communication, apart from some areas (e.g. dealing with denial, managing uncertainty, assessing anxiety and depression, and promoting patient-family openness). Low psychosocial orientation and burnout symptoms (i.e. emotional exhaustion, depersonalization, and poor personal accomplishment in their job) were associated with lower confidence in communication skills and higher expectations of a negative outcome, following physician-patient communication. The results suggest that there is a need for training cancer physicians in communication and for increasing a more definite psychosocially oriented approach in cancer care in Mediterranean countries
Psychosocial morbidity and its correlates in cancer patients of the Mediterranean area: findings from the Southern European Psycho-Oncology Study
No full textBACKGROUND: A few and partial data are available on psychosocial morbidity among cancer patients in Mediterranean countries. As a part of a more general investigation (Southern European Psycho-Oncology Study-SEPOS), the rate of psychosocial morbidity and its correlation with clinical and cultural variables were examined in cancer patients in Italy, Portugal and Spain. METHODS: A convenience sample of cancer outpatients with good performance status and no cognitive impairment were approached. The Hospital Anxiety-Depression scale (HAD-S), the Mini-Mental Adjustment to Cancer scale (Mini-MAC), and the Cancer Worries Inventory (CWI) were used to measure psychological morbidity, coping strategies and concerns about illness. RESULTS: Of 277 patients, 34% had pathological scores ("borderline cases" plus "true cases") on HAD-S Anxiety and 24.9% on HAD-S Depression. Total psychiatric "caseness" was 28.5% and 16.6%, according to different HAD cut-offs (14 and 19, respectively). Significant relationships of HAD-S Anxiety, HAD-S Depression, HAD-S Total score, with Mini-MAC Hopeless and Anxious Preoccupation, and CWI score were found. No differences emerged between countries on psychosocial morbidity, while some differences emerged between the countries on coping mechanisms. Furthermore, Fatalism, Avoidance and marginally Hopeless were higher compared to studies carried out in English-speaking countries. LIMITATIONS: The relatively small sample size and the good performance status prevent us to generalize data on patients with different cancer sites and advanced phase of illness. CONCLUSIONS: One-third of the patients presented anxiety and depressive morbidity, with significant differences in characteristics of coping in Mediterranean countries in comparison with English-speaking countries
- …
