Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: an unexpected outcome

The population in the western world has been aging while the cancer survival rates have been systematically increasing. Knowledge is lacking about psychological processes and effects of gender difference among middle-aged cancer patients and their healthy spouses. This study assesses psychological distress, coping and social support among middle-aged couples, where one of the partners was diagnosed with colon cancer. A repeated-measure MANOVA and Pearson's correlation coefficient were used to assess the relationships between the variables. Levels of social support were found to be negatively correlated to levels of psychological distress among all of the participants. Surprisingly, men (healthy or sick) were found to be more distressed than their wives (p<0.0001). Men also reported receiving more support from their wives than did the female spouses (p<0.0005). The gender differences found in our study imply that men (healthy or sick) tend to receive more support than they give to their wives. It also implies that men do not use the support they receive as effectively as their wives. Thus, although men report higher levels of support from their spouses, they also report higher levels of psychological distress. Practical implications are discussed.     

Is age a risk factor for depression among the oldest old with cancer?

Introduction

Age is negatively related to depression among young and middle age patients with cancer. Nevertheless the relationship between age and depression among older patients with cancer is unclear. The goal of the current study is to assess the association of depression with increasing age among older patients with cancer.

Changes in psychological distress of women with breast cancer in long-term remission and their husbands

The purpose of this randomized, prospective study was to identify factors influencing the psychological distress of breast cancer patients and their husbands during remission. Background variables and distress levels of 172 couples in two locations (Graz, Austria, and Jerusalem, Israel) were assessed by using three standardized instruments in two interviews conducted 6-8 months apart. In both geographic-cultural groups, women whose partners refused to participate in the interview reported significantly less perceived family support. The global severity index (measuring total psychological distress) reflected minor changes in psychological distress of both patients and their husbands over time.     

Psychoonkologie aus der Sicht des am Krankenbett arbeitenden Psychologen/Psychotherapeuten

Psychoonkologie ist ein weitgefasster Begriff in der Behandlung von Krebspatienten und erfordert daher eine qualifizierte Vermittlung vom Wissen jener Konzepte und M?glichkeiten, die einerseits auf Wissenschaftlichkeit und andererseits auf den Erfahrungen von Experten in diesem Bereich beruhen.     

Effects of age on coping and psychological distress in women diagnosed with breast cancer: review of literature and analysis of two different geographical settings

Age-related differences in emotional distress were examined by studying two random samples (N=424) of women diagnosed with early stages of breast cancer in Graz, Austria and Jerusalem, Israel. We found that psychological distress, coping abilities, and different perceptions of illness are attributable to socialization differences of age experience according to young (49 or younger), intermediate (50-64) and old (65 and older) age groups. Patients were interviewed at home to obtain sociodemographic and medical background data. They also completed five standardized instruments (Brief Symptom Inventory, Psychological Adjustment to Illness Scale, Impact of Events Scale, Mental Adjustment to Cancer, and Perceived Family Support). A two-way MANOVA for all the demographic variables yielded significant main group (Graz vs. Jerusalem) effect (P<0.0001), significant main age effect (P<0.0001) and significant interaction (group by age) effect (P<0.001). Examination of the contribution of the age category to the level of the coping variables showed a different pattern in each group. The psychological distress variables revealed that, in the Jerusalem sample, there is a tendency toward decreasing distress levels with age and, in the Graz sample, elevated scores for the intermediate-age group. Age was found to be related to the level of Global Severity Index (GSI) and to the variables correlated to the GSI level. Psychological intervention should be guided to the different age groups.     

Global quality of life and its potential predictors in breast cancer patients: an exploratory study

Goals of work This study reflects variables being depicted as predictors of global quality of life in current research. The evaluation was conducted at the Division of Clinical Oncology at the Medical University in Graz, Austria. Patients and methods A sample of 210 breast cancer patients between ages 30 and 80 years was assessed 1−5 years after initial diagnosis in a tumor-free stage. Besides the socio-demographic and medical variables, the Brief Symptom Inventory (BSI), Impact of Event Scale (IES), Mental Adjustment to Cancer (MAC), and the Perceived Family Support (PFS) were used. To identify variables related to quality of life, stepwise multiple regression analyses were calculated. Main results In a regression analysis, the general severity index (BSI) was identified as the most important and helplessness/hopelessness (MAC) as the second important variable related to QoL. Including the BSI-subscales as predictors, the depression-subscale (BSI) explained 25% of the variance; in addition, somatization (BSI), helplessness/hopelessness (MAC), and having financial problems (semi-structured interview) were significantly related to global quality of life, but the medical variables showed no associations to the measured quality of life. Depression itself is associated with negative the impact of cancer, the number of stressful life events, being uncomfortable with the body, having financial problems and anxious preoccupation (MAC). Conclusions The awareness of the role of multi-factorial and associated variables could provide patients, family, and medical staff with appropriate and adequate tools to treat specific symptoms.     

Changes in psychological distress of women in long-term remission from breast cancer in two different geographical settings: a randomized study

Goals of work Psychological distress and coping styles in women diagnosed with stages I and II breast cancer have attracted substantial clinical and research attention over the last several decades. The contradictory and, at times, controversial findings stimulated the present randomized research whose purpose was to explore the possibility and probability of predicting which variables affect the psychological distress level of women with breast cancer 1 to 5 years after diagnosis (time period 1) and 6 to 8 months after period 1 (time period 2).Patients and methods The study was conducted in two large oncology centers in Graz, Austria, and Jerusalem, Israel, with a sample population comprising 424 patients.Main results The only variables that significantly predicted change in the psychological distress levels (Grand Severity Index, GSI; except for the GSI level during period 1) were Fighting Spirit (Mental Adjustment to Cancer, MAC) in the Graz sample and Perceived Family Support (PFS) in the Jerusalem sample. These results are discussed in relation to other findings.Conclusions In light of these findings, it is highly important to preliminarily identify women with less adaptive psychological coping mechanisms and to provide them with efficacy tools for behavioral and cognitive changes within their own network of social and health resources.     

Do different cultural settings affect the psychological distress of women with breast cancer? A randomized study

Breast cancer is the most common malignant disease among women in developed countries. In Austria and Israel, it accounts for 15% and 18%, respectively, of all cancers and 30% of all cancers in women. The purpose of this study, conducted in Graz, Austria, and Jerusalem, Israel, was to determine whether different geographical and cultural settings differentially affect the psychological distress of women who have survived breast cancer and why. The dependence of psychological distress on psychosocial variables such as quality of life, body image, impact of cancer and coping styles was examined at time 1 in a randomized sample of 424 breast cancer women who were disease-free at the time of the study and were surveyed 1–5 years after diagnosis. The most contributing variables to the level of psychological distress in both populations were: the number of stressful life events during last year, financial problems and feeling uncomfortable with the body. Regarding coping styles, mental adjustment to cancer was the principal contributor to psychological distress level [determined by the Grand Severity Index (GSI) scores] in the Graz group, while intrusion was the principal contributor to the GSI level in the Jerusalem group.     

Psychoonkologie aus der Sicht einer Betroffenen

Am 28. Oktober 1996 teilt mir ein Radiologe mit, dass meine Knoten in der rechten Brust, die ich auch selbst spürte, entfernt werden müssen. Es war ein Schlag auf den Kopf. Für mich bedeutete dies sofort “Ich habe Krebs”, und ich dachte, jetzt ist alles aus und vorbei – ich muss sterben. Ich konnte nicht darüber reden. Ich habe mich eingeigelt!