Living with a brain tumor

Petruzzi, Alessandra; Finocchiaro, Claudia Yvonne; Lamperti, E.; Salmaggi, Andrea

doi:10.1007/s00520-012-1632-3

Cited by 63 publications

(34 citation statements)

References 24 publications

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“…The findings that higher scores for burden or negative impact on the caregiver’s life, were positively related to anxiety and depression supports previous research (Petruzzi et al, 2013), with caregivers reporting scores not only significantly greater than the matched non-caregiver controls, but well above the scores reported in the general population and are considered clinically meaningful (>2 or 2.5 points; respectively) (Kroenke et al, 2014). The positive relationship between burden and stress seen in this sample of HSCT caregivers supports previous work in cancer caregivers (Simoneau et al, 2013, Cohen, 1988, Li et al, 2007).…”

Section: Discussionsupporting

confidence: 88%

Documenting stress in caregivers of transplantation patients: initial evidence of HPA dysregulation

Bevans

Ross

Wehrlen

et al. 2016

Stress

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There is growing evidence linking caregiver stress with an increased risk for morbidity and mortality. While the emotional and practical burden experienced by caregivers is well established, the physiological changes that may affect the caregiver’s health are less understood. This study sought to compare self-reported stress, anxiety, and depression along with neuroendocrine and immune markers of stress among adult caregivers of allogeneic hematopoietic stem cell transplantation patients during the acute transplant recovery period to matched non-caregivers controls. Biomarkers and self-reported data were collected at three points during the patient’s HSCT: (1) before transplant, (2) after initial transplantation discharge (±7 days), and (3) six weeks after initial transplantation discharge. Mixed linear modeling was used to examine differences by group and time. Twenty-one caregivers and 20 controls completed all study procedures. The majority of caregivers were female (57.0%) and married (95.2%), with a mean age of 52±11.4 years. Caregiver perceived stress, anxiety, and depression scores were significantly higher than controls (p<0.001) with effect sizes (ES) ranging from 1.37 – 1.80 and they did not change over time (p>0.05) for either group. Caregivers had significantly lower serum cortisol levels than controls at both discharge (p=0.013; ES=0.81) and 6 weeks after discharge (p=0.028; ES=0.71) but exhibited no significant relationship between self-reported stress and serum cortisol. Additionally, caregivers showed a significant inverse relationship between stress and epinephrine levels (rs=− 0.654, p=0.021). These findings support the evidence of the caregiving experience being stressful. The counter-intuitive relationship between cortisol and epinephrine might suggest dysregulation of the HPA axis and central nervous system but additional research on the physiological impact of caregiving is warranted.

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Section: Discussionsupporting

confidence: 88%

Documenting stress in caregivers of transplantation patients: initial evidence of HPA dysregulation

Bevans

Ross

Wehrlen

et al. 2016

Stress

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“…The HADS scales were more strongly associated. Petruzzi et al [ 24 ] also found a high correlation between the two HADS scales in patients with brain cancer ( r = 0.57). The results reveal that there is an overlap between anxiety and depression.…”

Section: Discussionmentioning

confidence: 93%

Distress, anxiety and depression in patients with brain metastases before and after radiotherapy

et al. 2014

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BackgroundMany patients with cancer suffer from distress, anxiety and depression. However, studies on patients with brain metastases are lacking. In this exploratory study we prospectively assessed distress, anxiety and depression in patients with brain metastases from different solid primary tumour treated with radiotherapy to the brain.MethodsPatients were recruited between May 2008 and December 2010. Distress, anxiety and depression were subjectively evaluated before radiotherapy, 6 weeks, 3 months and 6 months after radiotherapy using the validated National Comprehensive Cancer Network Distress Thermometer (DT) and the Hospital Anxiety and Depression Scale (HADS). The treatment group consisted of adult patients (n = 67) with brain metastases who were treated with whole-brain radiotherapy (n = 40) or hypofractionated stereotactic radiotherapy (n = 27). The control group comprised of patients (n = 32) diagnosed with breast cancer without cranial involvement who received adjuvant whole breast radiotherapy. Forty-six patients (24 in the treatment group) completed the study after six months.ResultsBefore radiotherapy, the treatment group experienced higher distress than the control group (p = 0.029). Using a cut-off ≥5, 70% of the treatment group were suffering from significant distress (66% of the control group). No significant time-by-group interaction on distress, anxiety and depression was observed. At all time points, a high proportion of patients reported psychological stress which featured more prominently than most of the somatic problems. Global distress correlated strongly with the Hospital Anxiety score before radiotherapy, but only moderately or weakly with both HADS scores after radiotherapy with the weakest association 6 months after radiotherapy.ConclusionIn conclusion, the course of distress, anxiety and depression does not differ significantly between patients with brain metastases and breast cancer patients without cranial involvement. This finding suggests that both groups need similar psychological support during their treatment. Both screening instruments should be used as they cover different facets of distress.

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“…53 Cameron et al also reported fatigue in caregivers of survivors of acute respiratory distress syndrome from six to 53 months (average 23 months) post-ICU discharge. 54 Similar to the caregivers of persons living with other chronic conditions, such as dementia, 44–46 post-stroke, 47 psychiatric diagnoses (e.g., schizophrenia), 48 and cancer, 49,50 fatigue may be an important yet under-recognized problem experienced by caregivers of ICU survivors. More research is needed to better understand and manage fatigue in this caregiver population.…”

Section: Discussionmentioning

confidence: 99%

Fatigue in Family Caregivers of Adult Intensive Care Unit Survivors

Choi

Tate

Hoffman

et al. 2014

Journal of Pain and Symptom Management

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Context Family caregivers are a vital resource in the recovery of intensive care unit (ICU) survivors. Of concern, the stress associated with this role can negatively affect caregiver health. Fatigue, an important health indicator, has been identified as a predictor of various illnesses, greater use of health services, and early mortality. Examining the impact of fatigue on caregivers’ physical health can assist in identifying critical time points and potential targets for intervention. Objectives To describe self-reported fatigue in caregivers of ICU survivors from patients’ ICU admission to ≤ two weeks, two- and four-months post-ICU discharge. Methods Patient-caregiver pairs were enrolled from a medical ICU. Caregiver fatigue was measured using the Short-Form-36 Health Survey Vitality subscale (SF-36 Vitality). Caregiver psychobehavioral stress responses included depressive symptoms, burden, health risk behaviors, and sleep quality. Patient data included self-reported physical symptoms and disposition (home vs. institution). Results Forty seven patient-caregiver pairs were initially enrolled. Clinically significant fatigue (SF-36 Vitality ≤ 45) was reported by 43% to 53% of caregivers across the time points and these caregivers reported worse scores in measures of depressive symptoms, burden, health risk behaviors and sleep quality, and patients’ symptom burden. In 26 caregivers with data for all time points (55% of the total sample), SF-36 Vitality scores showed trends of improvement when the patient returned home and greater impairment when institutionalization continued. Conclusion In caregivers of ICU survivors, fatigue is common and potentially linked with poor psychobehavioral responses. Worsening fatigue was associated with greater symptom distress and long-term patient institutionalization.

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Living with a brain tumor

Cited by 63 publications

References 24 publications

Documenting stress in caregivers of transplantation patients: initial evidence of HPA dysregulation

Documenting stress in caregivers of transplantation patients: initial evidence of HPA dysregulation

Distress, anxiety and depression in patients with brain metastases before and after radiotherapy

Fatigue in Family Caregivers of Adult Intensive Care Unit Survivors

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