We examined the course and the prevalence of a high fear of cancer recurrence (FCR) in patients undergoing allogeneic PBSC transplantation (hematopoietic SCT (HSCT)) before HSCT (N = 239), 100 days after (n = 150, and 12 months after allogeneic HSCT (n = 102). The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the EORTC Quality of Life Questionnaire, and the Hospital Anxiety and Depression Scale were used. Pre-HSCT 36% of patients, 100 days after HSCT 24% of patients, and 1 year after HSCT 23% of patients fulfilled the criteria for high FCR (FoP-Q-SF cutoff = 34). Being married (b = 2.76, P = 0.026), female gender (b = 4.45, Po 0.001) and depression (b = 4.44, P o 0.001) were significantly associated with FCR at baseline. One hundred days after HSCT, depression significantly predicted FCR (b = 6.46, Po 0.001). One year following HSCT, female gender (b = 6.61, P = 0.008) and higher depression were (b = 4.88, P = 0.004) significant predictors for FCR. Over the three assessment points, patients with high FCR had a significantly lower quality of life compared to patients with low FCR in physical functioning (P = 0.019), role functioning (P = 0.003), emotional functioning (P o 0.001), cognitive functioning (P = 0.003), social functioning (P o 0.001) and global quality of life (P o 0.001). Our data provide evidence that FCR is a prevalent problem in patients with hematological malignancies and has a significant adverse impact on health-related quality of life.
Below average cognitive performance is common in this patient group. In addition, a subgroup shows reliable cognitive decline after allogeneic HSCT. Healthcare professionals should be aware of these treatment-related cognitive side effects.
The Relationship Assessment Scale (RAS) is a short seven-item measure for the assessment of relationship satisfaction. It can be used with different types of relationships. We aimed to investigate the psychometric properties of the German version of the RAS in a community sample of N = 145 persons. The principal component analysis revealed one general factor, which accounted for more than 60 per cent of the variance. The internal consistency of the RAS was high (α = .89). While there were no significant associations between RAS scores and age or gender, several other sociodemographic parameters had an impact on the RAS, e. g. presence of children. The RAS correlated significantly with scales of the Dyadic Adjustment Scale (DAS), most impressively with the DAS satisfaction scale (r = .87). Persons living in a distressing relationship, as indicated by a DAS total score below 100, also had lower scores on the RAS. In conclusion, our results extend the evidence on the reliability and validity of the RAS.
Adequate knowledge regarding hereditary diseases and genetics, as well as personal attitudes toward gene tests, are major determinants of optimal utilization of genetic testing. In the present study, we aimed to explore the general attitudes toward genetic testing in a sample representative of the German general population (n = 2,076) and to compare the attitudes of persons at risk for hereditary non-polyposis colorectal cancer/familial adenomatous polyposis (HNPCC/FAP) (n = 36) who had attended a university genetic counseling service, with a matched general population sample. We administered a subset of a questionnaire previously used in a Finnish study (Jallinoja et al., 1998). The 12 statements pertain to approval, disapproval, and concern for genetic testing. Overall, the results reveal high approval of genetic testing in the German population and in at-risk persons. In accordance with other studies, we find that the attitudes of individuals for whom hereditary disease is a salient issue of personal relevance and the attitudes of the general public are very similar. Only a few significant differences between these two samples emerged, indicating that at-risk persons hold a more favourable view of the testing. One intriguing finding was the high rate of "don't know" responses, especially in the general population sample. Compared to results from Finland, approval of genetic testing is lower in the German population, and endorsement of "don't knows" is remarkably higher. We argue for increased attention to the issue of attitude change after genetic counseling and for the need of comparative cross-cultural research on attitudes toward gene technology.
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