169,768 research outputs found
Lo stato psicologico di orienting: determinanti psicosociali nella valutazione del proprio stato di salute da parte del malato oncologico [The psychological state of orienting: psicosocial determinants in the subjective evaluation of own health conditions in cancer patients]
No full textQuando e perché l’univocità del parere medico può aiutare la percezione dello stato di salute e del tono emotivo nel paziente oncologico
No full textIn many occasions, we are usually inclined to think that a deci- sion based on multiple (sources of) information may - or even must
- be “better” than a decision based on a single piece of information, or source. However, in certain psychological conditions - such as tho- se of oncological patients - decisions made on the basis of a single, clear-cut medical opinion, rather than on a multiplicity of even con- trasting medical views, should be maximally useful in satisfying pa- tients’“need for univocal views” and, in turn, also in fostering their sense of a positive emotional and physical condition. The present re- search, conduced with 40 oncological patients, was thus interested in establishing 1) in which proportion patients acquired “one-single” vs. “multiple” medical opinions while choosing among different treatment alternatives, and 2) the quality of patients’perception of their emotional and physical state. As hypothesized and then discussed on the basis of the Theory of Multiple Perspectives (TMP), results sup- ported the hypotheses, revealing a comparatively better perception of their emotional and physical state among patients who asked for just “one single” (univocal) medical opinion - thereby satisfying their “need for univocal views” - but not among patients asking for more than one single medical opinion, that is among patients using a strategy ostensibly at odds with the possibility of satisfying their psy- chological need for univocal, unambiguous views.mente si è portati a ritenere che una decisione basata su una molteplicità di informazioni e/o fonti possa, o addirittura debba, ri- velarsi “migliore” di una decisione basata su una sola informazio- ne o una sola fonte. Tuttavia, in condizioni psicologiche particolari, come quelle che caratterizzano il malato oncologico, decidere il pro- prio percorso di cura sulla base di un solo parere medico anziché sul- la base di più e molteplici pareri dovrebbe rivelarsi utile ad assecon- dare il “bisogno di univocità” del paziente oncologico e, di conse- guenza, favorirne pure la percezione di un miglior tono emotivo e sta- to di salute fisica. La ricerca, condotta con 40 pazienti oncologici, ha stabilito, innanzitutto, in che misura i pazienti avessero raccolto “un solo” (= univocità) oppure “più” (= molteplicità) pareri medici re- lativi alle proprie scelte di cura e, successivamente, la qualità del tono emotivo di ciascun paziente, assieme all’auto-percezione dello pro- prio stato di salute fisica. I risultati, ipotizzati e discussi alla luce del- la Teoria delle Prospettive Multiple (TPM), confermano appieno le previsioni, dimostrando la percezione di un miglior tono emotivo e di un migliore stato di salute fisica fra quei pazienti che avevano chie- sto un solo parere medico assecondando, con ciò, il proprio “biso- gno di univocità”, ma non fra i pazienti che avevano richiesto, inve- ce, più di un parere medico e, con ciò, disatteso - e nei fatti impedi- to - la soddisfazione di tale importante bisogno psicologic
From fear to hopelessness: The buffering effect of patient-centered communication in a sample of oncological patients during covid-19
No full textBackground: COVID-19 represents a threat both for the physical and psychological health of oncological patients experiencing heightened distress levels to which the fear of the virus is also added. Moreover, fear of COVID-19 could lead oncological patients to experience feelings of hopelessness related to their medical care. Patient-centered communication may act as a buffer against the aforementioned variables. This study aimed to test the role of doctor–patient communication in the relationship between fear of COVID-19 and hopelessness. Methods: During the COVID-19 pandemic, a sample of 90 oncological outpatients was recruited (40 males (44.4%) and 50 females (55.6%), mean age = 66.08 (SD = 12.12)). A structured interview was developed and used during the pandemic to measure the patients’ perceived (A) fear of COVID-19, and (B) feelings of hopelessness, and (C) physicians’ use of empathetic and (D) clear language during the consultation. A multiple mediation model was tested, and the effects between males and females were also compared. Results: Empathetic and clear doctor–patient communication buffered the adverse effect of the fear of COVID-19 on hopelessness through a full-mediation model. The effects did not differ between males and females in the overall model but its indirect effects. Discussions: Patient-centered communication using empathy and clear language can buffer the adverse effect of the fear of COVID19 and protect oncological patients from hopelessness during the pandemic. These findings might help to improve clinical oncological practice
When the loss of spirituality leads to the loss of the path: The moderating role of spirituality in a multiple-step-mediation process from physical suffering to distress
No full textBackground: A diagnosis of Cancer often leads patients to experience a breakdown in spirituality that could undermine his/hers life. Spirituality troubles seem to be related with emotional problems – triggered by physical and practical difficulties – that lead to experience psychological distress. However, there aren’t definitive results on these relationships. This study aimed to test a multiple step mediation moderated analysis in which spirituality moderates
the process that leads to distress.
Methods: Patients (N = 200, 54.6% female, mean age = 64.3, SD = 12.3) were consecutively enrolled at “Presidio Ospedaliero” of Saronno, ASST Valle Olona, Italy – Department of Medical Oncology. Patients were tested with NCCN’s Distress Thermometer and Problem List (DT&PL; NCCN, 2003) assessing: (A) distress and (B) physical
(α = .77), (C) practical (α = .68), (D) social (α = .70), (E) emotional (α = .85) and (F) spirituality problems.
Results: First, a CFA was performed to test the factorial structure of the PL. The factor structure was confirmed: RMSEA = .064; CFI = .904. Then, a multiple step mediation moderated analysis (5000 bootstrap resampling) shows model’s significance [F = 59.9; p < .001; R2 = .49; Eff.Size = .364]. Surprisingly, in absence of spiritualty problems, the
relationship between physical problems and distress was partially mediated (path c’: β = .118, p = .016) by practical problems (path a1: β = .061, p = .001) by relationships problems (path d1: β = .281, p .05) – showing effects of interaction on each of these paths.
Conclusions: These surprising results highlight the role of spirituality. The process from physical difficulties to psychological distress follows a specific path only in absence of spirituality issues. These findings suggest new ways in which psycho-oncologists should structure interventions to improve quality of life and reduce psychological suffering paying attention to the spirituality sphere of the oncological patient
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The accuracy of the Psychological Distress Inventory - Revised (PDI-R) in identifying distress in oncological outpatients: A pilot study using a machine learning approach
No full textProfiling cancer-related needs and the role of physical, practical and psychological difficulties: A latent class analysis approach
No full textBackground: There was an increasing attention to the humanization of oncological cares that focused on patients’ needs – which have a strong impact on quality of life. Cancer-related needs seem to be related both to physical, practical and psychological difficulties as well as gender and age. Using a Latent Class Analysis (LCA) the aim of the study was to identify a latent structure accounting for the covariance between cancer-related needs. A one-factor model with two classes was hypothesized, which comprised needs as indicators and difficulties as external variables that moderate the latent structure.
Methods: Patients (N = 171, 50.3% female, mean age = 64.6, SD = 12.7) were enrolled at the Department of Medical Oncology, “Presidio Ospedaliero” of Saronno, ASST Valle Olona, Italy. Using a standardized checklist patients were tested for physical issues, practical problems and distress (Psychological Distress Inventory: PDI; α = .88). Then, patients were tested with the Need Evaluation Questionnaire (NEQ) measuring: (A) communicative (α = .78) and (B) relational needs (α = .74); needs of information related to (C) the diagnosis (α = .72) and (D) treatments (α = .70).
Results: A CFA was performed to confirm the original factorial structure of the NEQ (RMSEA = .059; CFI = .913) and the PDI (RMSEA = 0.72; CFI = .902). Then, the LCA (5000 bootstrap) shows the goodness-of-model fit [χ2 (6) = 9.06; p = .17; LRχ2 (6) = 10.64; p = .10] and the goodness-of-classification quality [Entropy = .84 ( > .7); Average-Latent-Class-Assignment-Probability: .950 and .964 for Class1 and Class2, respectively]. The LCA identified a latent variable with two classes (VLMR = 161.33; p < .001; Class1 = .54%; Class2 = .46%). In addition, interactions with the latent variable were found only for distress (β = .892; p = .019), practical (β = 1.26; p = .010) and physical (β = .983; p = .012) issues.
Conclusions: These results provide a better understand of cancer-related needs: each class represents a specific “profile” that are moderated by physical, practical and psychological difficulties. These findings suggest paying
more attention to the specific need expressed by the patient proposing new ways to improve quality of life
Profiling cancer-related distress and problems: A latent class analysis approach.
No full textBackground: Psychological distresses, emotional troubles, social difficulties as well as both physical and practical issues are all among oppressive problems that oncological patients have to face almost every day. On one hand, these problems seem to have a strong impact on quality of life; and to the other hand, these issues seem to be related to specific cancer-related variables (e.g.: type and localization of the tumor). Thus, the aim of the study was to use a Latent Class Analysis (LCA) approach to profile a latent structure accounting for the covariance between psychological distress and everyday problems due to cancer. A one-factor model with three classes was hypothesized, which comprised distress and cancer-related problems as indicators and age, type of medical treatment as well as type and localization of tumor as external variables that moderate the latent structure. Methods: Patients (N = 264, 62.3% female, mean age = 65.3, SD = 12.4) were enrolled at the Oncology Day Hospital, “Presidio Ospedaliero” of Saronno, ASST Valle Olona, Italy. Using the standardized Distress Thermometer and Problem List (TD&PL; NCCN, 2015) patients were tested for: (A) distress; (B) practical problems (Cronbach’s α = .63); (C) social difficulties (Cronbach’s α = .65); (D) emotional issues (Cronbach’s α = .86) and (E) physical problems (Cronbach’s α = .77). Results: First of all, a CFA was performed to test the original factorial structure of the DT&PL. The original five factor solution was supported by adequate fit indices: RMSEA = .063; CFI = .924. Then, the LCA (10000 bootstrap resampling) shows the goodness-of-model fit [χ2 = 10.01; p = .11; LRχ2 = 9.30; p = .09] and the goodness-of-classification quality [Entropy = .80 ( > .7); Average-Latent-Class-Assignment-Probability: .975, .900, and .902 for Class1, Class2, and Class3, respectively]. The LCA identified a latent variable with three classes (VLMR = 193.38; p < .001; Class1 = .49%; Class2 = .23%, and Class3 = .28%). In addition, interactions with the latent variable were found for age (β = .12; p = .039), type of medical treatment (β = .29; p = .009), as well as type and localization of tumor (β = .20; p = .025). Conclusions: These results provided a better understand of psychological distress and cancer-related issues: each class represents a specific “profile” – moderated by age, type of medical treatment, and type and localization of tumor. These results recommend paying more attention to the specific profile expressed by the patient suggesting new ways to improve their quality of life
Mitomycin C in highly myopic eyes - Author reply
No full textOphthalmology. 2005 Feb;112(2):208-18; discussion 219.
Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes.
Gambato C, Ghirlando A, Moretto E, Busato F, Midena E.
SourceRefractive Surgery Service and Antimetabolite Therapy Research Unit, Department of Ophthalmology, University of Padova, Padova, Italy.
Abstract
PURPOSE: To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes.
DESIGN: Prospective, double-masked, randomized clinical trial.
PARTICIPANTS: Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia.
METHODS: In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months).
MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH.
RESULTS: Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively).
CONCLUSION: Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK.
Comment in
Ophthalmology. 2006 Feb;113(2):357; author reply 357-8
Dispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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