Cancer: Recent submissions

Now showing items 21-23 of 23

    • Breast reconstruction following cancer: Its impact on patients' and partners' sexual functioning
      Marshall, Catherine (2005)
      Previous literature lacks a theoretical conceptualisation of breast reconstruction and its impact on patients' and partners' sexual functioning. The aims of the present study were to identify factors that impact on the sexual relationship, to explore coping strategies used by patients and partners, and to highlight service needs. In total, 12 women who had undergone breast reconstructive surgery within the last three years and their partners (10 men) took part in the study. Grounded theory methodology was used to analyse the data and identify key categories for both patients and partners. Patients' key categories included anxiety and worry, influencing factors, self-image and sexual changes. All women experienced some degree of sexual change and sexual anxiety, and a minority reported a loss of sexual self. Partners' key categories included anxiety and stress, influencing factors and negotiating sexual changes. The majority of partners reported that initially, their priority was their partner's survival rather than sexual concerns; however the majority of men acknowledged some degree of sexual anxiety. The study highlighted the lack of information and discussion about sexual issues for both patients and partners, and the timing of such information if it were to be provided. It also stresses the need for services to include partners throughout the process.

    • Can the Distress Thermometer be improved by additional mood domains? Part II. What is the optimal combination of Emotion Thermometers?
      Baker-Glenn, Elena A.; Park, Bert G. (2010)
      Purpose: To examine the added value of an algorithmic combination of visual-analogue thermometers compared with the Distress Thermometer (DT) when attempting to detect depression, anxiety or distress in early cancer. Methods: We report Classification and Regression Tree and logistic regression analyses of the new five-domain Emotion Thermometers tool. This is a combination of five visual-analogue scales in the form of four mood domains (distress, anxiety, depression, anger) as well as need for help. 130 patients attending for their first chemotherapy treatment were assessed. We calculated optimal accuracy for each domain alone and in combination against several criterion standards. Results: When attempting to diagnose depression the Depression Thermometer (DepT) used alone was the optimal approach, but when attempting to detect broadly defined distress or anxiety then a combination of thermometers was most accurate. The DepT was significantly more accurate in detecting depression than the DT. For broadly defined distress a combination of depression, anger and help thermometers was more accurate than the DT alone. For anxiety, while the anxiety thermometer (AnxT) improves upon the DT alone, a combination of the DepT and AnxT are optimal. In each case the optimal strategy allowed the detection of at least an additional 9%, of individuals. However, combinations are more laborious to score. In settings where the simplest possible option is preferred the most accurate single thermometer might be preferable as a first stage assessment. Conclusion: The DT can be improved by specific combinations of simple thermometers that incorporate depression, anxiety, anger and help. Copyright (C) 2009 John Wiley & Sons, Ltd.

    • A large scale validation of the emotion thermometers as a screening tool for distress in an ethnically diverse cancer population
      Baker-Glenn, Elena A. (2010)
      OBJECTIVES: We previously reported initial validation of the Emotion Thermometers, a simple 5-domain visual analogue scale inspired by the Distress Thermometer (Psychooncology. 2009 Mar 18; Epub), against depression. Here we aimed to report a definitive validation in a large ethnically diverse sample against Hospital Anxiety and Depression Scale (HADS) defined distress. METHOD: We analysed data collected from Leicester Cancer Centre from 2007-2009 involving approximately 1000 people approached by a research nurse, research physician and two therapeutic radiographers. The researcher applied the HADS and used a HADS-T \gt 14 to signify distress. We collated full data on 660 patient assessments of whom 12.9% had MDD and 14.8 were from ethnic minorities (largely British South Asian of India descent). RESULTS: In the parent sample of 660, sensitivity, specificity and AUC were as follows: DT - 71.9%; 78.4%; 0.814; cut point = 4 AnxT -75.7%; 73.4%; 0.821; cut point = 5 DepT - 77.6%; 82.2%; 0.855; cut point = 3 AngT - 77.5%; 77.6%; 0.823; cut point = 2 HelpT -69.1%; 80.8%; 0.809; cut point = 3. Thus DepT was optimal and has superior sensitivity and specificity to the DT. There was no significant difference by ethnicity. CONCLUSIONS: In this large scale validation of the ET against cancer related distress (on the HADS-T) the DepT may be the optimal thermometer. The optimal cut-point appears to be= >3. The DepT also performs well in those in an ethnic minority namely British South Asian patients.