Longitudinal Study of Depressive Symptoms in Patients With Metastatic Gastrointestinal and Lung Cancer

Lo, Christopher; Zimmermann, Camilla; Rydall, Anne; Walsh, Andrew; Jones, Jennifer; Moore, Malcolm J.; Shepherd, Frances A.; Gagliese, Lucia; Rodin, Gary

doi:10.1200/jco.2009.26.9712

Cited by 204 publications

(183 citation statements)

References 41 publications

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“…In contrast to the flat pattern found with the ESAS, depression increased in a curvilinear fashion toward the end of life. 21 The limited psychometric evidence supports the need for further ESAS validation studies. 22 Surprisingly, hemodynamic values have never been included in previous prognostic models, despite the likelihood that these parameters are meaningfully associated with a short survival and are worthy of appropriate assessment.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Survival in Patients With Advanced Cancer Admitted to Home Care

Mercadante

Valle²,

Porzio

et al. 2013

Journal of Pain and Symptom Management

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Context. Data regarding prognostication of life expectancy in patients with advanced cancer are of paramount importance to patients, families, and clinicians. However, data regarding patients followed at home are lacking.Objectives. The aim of this study was to evaluate the correlation between various factors recorded at the beginning of home care assistance and survival.Methods. A sample of consecutive patients admitted to two home care programs was surveyed. A preliminary consensus was achieved as to the possible variables easy to be recorded at home. These included age at the time of home care admission, gender, residence, marital status, primary cancer diagnosis, Karnofsky Performance Status (KPS) score, measures of systolic blood pressure and heart rate, cyanosis, use of oxygen, and body temperature. The Edmonton Symptom Assessment System was used to record the intensity of each symptom. Patients were divided into two groups: patients with a survival of less than 10 days (short survival) and patients with a survival of 10 days or more (medium-long survival).Results. Three hundred seventy-four consecutive patients admitted to home care programs were surveyed, of which 187 were male. The mean AE SD age was 72.1 AE 12.7 years. The mean survival was 56.2 AE 65 days. Mean survival was 71.5 AE 67 days (287 patients) and 5.6 AE 2.7 days (87 patients) in the short and medium-long survival groups, respectively. No association between type of tumor and survival was observed (P ¼ 0.162). Univariate logistic regression analysis revealed that male gender (P ¼ 0.020), older age (P ¼ 0.012), lower KPS scores (P < 0.0005), systolic blood pressure less than 100 mm Hg (P ¼ 0.003), heart rate greater than 100 beats per minute (P ¼ 0.0006), delirium (P ¼ 0.004), the use of oxygen (P ¼ 0.002), intensity of fatigue (P ¼ 0.006), drowsiness (P < 0.0005), anorexia (P < 0.0005), dyspnea (P < 0.0005), poor sense of well-being (P < 0.0005), and distress score (P < 0.0005) were associated with a survival of less than 10 days. Marital status, residence, cognitive function, fever, pain, depression, and anxiety were not found to be significantly correlated with survival. In a multiple logistic regression model, low systolic blood pressure and high heart rate, gender, delirium, use of oxygen, KPS score, drowsiness, anorexia, and dyspnea were significantly correlated with a shorter survival. Conclusion. Low systolic blood pressure and high heart rate, male gender, poor KPS score, anorexia, and dyspnea were correlated with a shorter survival. Moreover, patients with low systolic blood pressure and high heart rate, male gender, poor KPS score, and greater intensity of anorexia and dyspnea are more likely to die within one week. The combination of physical symptoms from the Edmonton Symptom Assessment System and other parameters included in this study, which are simple to assess and are repeatable at home, should be further explored in future studies to provide a simple tool for use with patients with advanced cancer admitted to a home...

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Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Survival in Patients With Advanced Cancer Admitted to Home Care

Mercadante

Valle²,

Porzio

et al. 2013

Journal of Pain and Symptom Management

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“…Intense pain was associated with lack of appetite, fatigue, nausea and psychological distress, as in patients with solid tumors [3,24,29,36]. The additional association of pain with mouth sores and changes in taste may be due either to gum disease from the leukemia itself or to mucositis from its treatment.…”

Section: Discussionmentioning

confidence: 99%

“…However, while there has been extensive study of the symptom burden in patients with solid tumor cancers [1][2][3], there has been little systematic study of symptoms in patients with acute leukemia. Retrospective studies in patients with leukemia and other hematological malignancies have revealed that in the last month of life, pain is reported by 27-76% [4,5], shortness of breath by 44-50% [4][5][6], and fatigue by 88% [6].…”

Section: Introductionmentioning

confidence: 99%

Symptom burden and supportive care in patients with acute leukemia

Zimmermann¹,

Yuen²,

Mischitelle³

et al. 2013

Leukemia Research

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We examined the symptoms and referral rates to specialized palliative care and psychosocial oncology services of patients with acute leukemia. The Memorial Symptom Assessment Scale (MSAS) was completed by 249 adult patients with acute leukemia. Patients reported a median of 9 physical and 2 psychological symptoms, and those with intense lack of energy, difficulty sleeping and pain were more likely to report intense worrying/sadness (P < 0.001). No patients with moderate-severe pain were referred for specialized symptom control and only 13% of those with severe worrying/sadness were referred to psychiatry/psychology within one month of the *

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“…Individuals were excluded if they did not speak English sufficiently well to provide informed consent. The low recruitment rate is typical of psychological studies in this setting (44) and favored selection of individuals who were physically healthy enough to participate in the study. The sample may under-represent individuals struggling with death anxiety and other distress who were unable or unwilling to discuss their concerns with a therapist as part of a trial.…”

Section: Discussionmentioning

confidence: 99%

Initial Validation of the Death and Dying Distress Scale for the Assessment of Death Anxiety in Patients With Advanced Cancer

Krause

Rydall

Hales

et al. 2015

Journal of Pain and Symptom Management

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How to cite TSpace itemsAlways cite the published version, so the author(s) will receive recognition through services that track citation counts, e.g. Scopus. If you need to cite the page number of the author manuscript from TSpace because you cannot access the published version, then cite the TSpace version in addition to the published version using the permanent URI (handle) found on the record page.This article was made openly accessible by U of T Faculty. Please tell us how this access benefits you. Your story matters. 1 Full citation and link to published version:Krause S, Rydall A, Hales S, Rodin G, Lo C. Abstract ContextThe experience of death anxiety in patients with advanced cancer has been understudied partly due to the lack of a tailored measure for this population. The Death and Dying Distress Scale (DADDS) was constructed to address this gap. Although an initial version of this instrument has shown promising psychometric properties, validation of the finalized version is needed. ObjectivesThis study aims to validate the recent 15-item DADDS by examining its factor structure and construct validity. MethodsSixty participants with advanced or metastatic cancer were recruited from the Princess Margaret Cancer Centre, Toronto, Canada, into a pilot trial of a psychological intervention. This paper analyzes the baseline measures on death anxiety, depressive symptoms (PHQ-9, SCID), generalized anxiety (GAD-7), and preparation for end of life (QUAL-EC). Exploratory factor analysis was conducted. Construct validity was assessed by correlations between measures. ResultsFactor analysis revealed a dominant single factor explaining over 75% of the shared variation between items. Factor loadings were high, ranging from 0.57 to 0.86. Item communalities were evenly ranged from 0.33 to 0.75 and with the 15:1 variable to factor ratio, suggest the viability of parameter estimates despite the small sample size. Cronbach's alpha was 0.95. Death anxiety was associated with less preparation for end of life, r = -0.68, p < 0.0001, and more generalized anxiety, r = 0.63, p < 0.0001, and depressive symptom severity, r = 0.50, p < 0.0001. Individuals with major depression had greater death anxiety than the non-depressed, mean difference = 17, CI .95 = (1.5, 33), as did individuals with minor depression, mean difference = 25, CI .95 = (10, 41). ConclusionThe DADDS is a valid measure of death anxiety in patients with advanced cancer. It may provide useful information in the assessment and treatment of distress in patients near the end of life.4

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Longitudinal Study of Depressive Symptoms in Patients With Metastatic Gastrointestinal and Lung Cancer

Cited by 204 publications

References 41 publications

Prognostic Factors of Survival in Patients With Advanced Cancer Admitted to Home Care

Prognostic Factors of Survival in Patients With Advanced Cancer Admitted to Home Care

Symptom burden and supportive care in patients with acute leukemia

Initial Validation of the Death and Dying Distress Scale for the Assessment of Death Anxiety in Patients With Advanced Cancer

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