Disclosure of cancer diagnosis and quality of life in cancer patients: should it be the same everywhere?

<p>Abstract</p> <p>Background</p> <p>Evidence suggests that truth telling and honest disclosure of cancer diagnosis could lead to improved outcomes in cancer patients. To examine such findings in Iran, this trial aimed to study the various dimensions of quality of life in patients with gastrointestinal cancer and to compare these variables among those who knew their diagnosis and those who did not.</p> <p>Methods</p> <p>A consecutive sample of patients with gastrointestinal cancer being treated in Cancer Institute in Tehran, Iran was prospectively evaluated. A psychologist interviewed patients using the Iranian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Patients were categorized into two groups: those who knew their diagnosis and those who did not. Independent sample t-test was used for group comparisons.</p> <p>Results</p> <p>In all 142 patients were interviewed. A significant proportion (52%) of patients did not know their cancer diagnosis and 48% of patients were aware that they had cancer. They were quite similar in most characteristics. The comparison of quality of life between two groups indicated that those knew their diagnosis showed a significant lower degree of physical (P = 0.001), emotional (P = 0.01) and social functioning (P < 0.001), whereas the global quality of life and other functional scales including role functioning and cognitive functioning did not show significant result. There were no statistically significant differences between symptoms scores between two groups, except for fatigue suggesting a higher score in patients who knew their diagnosis (P = 0.01). The financial difficulties were also significantly higher in patients who knew their cancer diagnosis (P = 0.005). Performing analysis of variance while controlling for age, educational status, cancer site, and knowledge of cancer diagnosis, the results showed that the knowledge of cancer diagnosis independently still contributed to the significant differences observed between two groups.</p> <p>Conclusion</p> <p>Contrary to expectation the findings indicated that patients who did not know their cancer diagnosis had a better physical, social and emotional quality of life. It seems that due to cultural differences between countries cancer disclosure guidelines perhaps should be differing.</p

Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter?

<p>Abstract</p> <p>Background</p> <p>Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. An investigation was carried out to examine anxiety and depression in this group of patients and to investigate whether the knowledge of cancer diagnosis affect their psychological distress.</p> <p>Methods</p> <p>This was a cross sectional study of anxiety and depression in patients with gastrointestinal cancer attending to the Tehran Cancer Institute. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS). This is a widely used valid questionnaire to measure psychological distress in cancer patients. Demographic and clinical data also were collected to examine anxiety and depression in sub-group of patients especially in those who knew their cancer diagnosis and those who did not.</p> <p>Results</p> <p>In all 142 patients were studied. The mean age of patients was 54.1 (SD = 14.8), 56% were male, 52% did not know their cancer diagnosis, and their diagnosis was related to esophagus (29%), stomach (30%), small intestine (3%), colon (22%) and rectum (16%). The mean anxiety score was 7.6 (SD = 4.5) and for the depression this was 8.4 (SD = 3.8). Overall 47.2% and 57% of patients scored high on both anxiety and depression. There were no significant differences between gender, educational level, marital status, cancer site and anxiety and depression scores whereas those who knew their diagnosis showed a significant higher degree of psychological distress [mean (SD) anxiety score: knew diagnosis 9.1 (4.2) vs. 6.3 (4.4) did not know diagnosis, P < 0.001; mean (SD) depression score: knew diagnosis 9.1 (4.1) vs. 7.9 (3.6) did not know diagnosis, P = 0.05]. Performing logistic regression analysis while controlling for demographic and clinical variables studied the results indicated that those who knew their cancer diagnosis showed a significant higher risk of anxiety [OR: 2.7, 95% CI: 1.1–6.8] and depression [OR: 2.8, 95% CI: 1.1–7.2].</p> <p>Conclusion</p> <p>Psychological distress was higher in those who knew their cancer diagnosis. It seems that the cultural issues and the way we provide information for cancer patients play important role in their improved or decreased psychological well-being.</p

The role of rumination and the sadness emotion management skills in predicting emotional eating behavior of 9-12 year-old children with obesity and overweight

Introduction: Emotional eating behavior is considered one of the pathological eating behaviors, and the components related to it have special importance, especially in children and adolescents. Aim: The aim of the research was to investigate the role of rumination and sadness emotion management skills in predicting emotional eating behavior in overweight and obese children aged 9 to 12 years. Method: The descriptive research design was of the correlational type and the statistical population included obese and overweight children aged 9 to 12 in Hamedan City in 2019-2020. A total of 268 of these children were selected by convenient sampling method and responded to questionnaires of children’s responses to imaginal situations that Elicit Sadness (Lopez, 2006), Children’s Sadness Management Scale (Shipman and Penza-Clive, 2001), Emotional Eating Scale-Children (Tanfoski, 2007). To analyze the data, Pearson correlation and multiple regression analysis were used with the help of SPSS-22. Results: The results of correlation analysis showed that there is a significant relationship between rumination variable and emotion regulation management skills with children's emotional eating behavior (P<0.05). Also, based on the regression results, 45.4% and 53% of the variance of the variable of emotional eating behavior could be predicted with the help of the predictor variables dimensions of rumination and emotion regulation management skills (P<0.05). Conclusion: The results indicated that there is a significant relationship between emotional eating behavior with rumination and ineffective strategies for managing the emotion of sadness in obese and overweight children. In order to prevent and treat obesity and overweight in children, it is important to pay attention to their psychological issues. It is suggested that more research be done, in the field of psychological causes of problems related to obesity and overweight

The Mediating Role of Self-Compassion in the Relationship between Body Image and Severity of Anxiety and Depression in Pregnant Women

Pregnancy and being a mother have been taken into account as enjoyable and evolutionary events in the women's life, however, due to Physiological and Psychological changes; it can be associated with Anxiety and Depression. This study aimed to investigate the Mediating Role of Self-Compassion in the Relationship between Body Image and the Severity of Anxiety and Depression in Pregnant Women. The research method was Non-Experimental and Correlational. The research population consisted of all pregnant women who were in their third trimester of pregnancy and referred to the health centres of Tehran hospital for pregnancy care. A sample of 140 pregnant women was selected using convenience sampling from three Hospitals of Quds, Hedayat, and Alghadir. To collect data, the Neff Self-Compassion scale (2003), Pregnancy Related Anxiety Questionnaire (1990), Edinburgh Postnatal Depression Scale (1987), and Body Image in Pregnancy Scale (2017) were used. Pearson's correlation coefficient and Hayes PROCESS procedure extension in the Regression analysis were used to analysing the data. The results of Pearson's correlation showed that Body image had a significant positive correlation with the severity of Anxiety and Depression and self-compassion had a significant negative correlation with body image, anxiety, and depression (P<0.01). The results of Multiple Linear Regression confirmed the mediating role of self-compassion in the relationship between body image and the severity of anxiety and depression in pregnant women (R2=0/33, P<0.01). According to the finding, it's recommended to pay serious attention to increasing self-compassion and reducing body image dissatisfaction in health care planning to improve the mental health of pregnant women..‌Anxiety, Body Image, Depression, Pregnancy, Self-Compassion.‌‌IntroductionPregnancy due to physiological and psychological changes may put women at risk of psychological distress. research has shown, anxiety and depression are the most important and common disorders during pregnancy. 1 in 10 mothers experiences anxiety and depression during pregnancy and postpartum, and if they are not identified and treated during pregnancy, they can have adverse consequences for the mother and her child. Therefore, it is important to investigate the risk and protective factors of these disorders. researchers have reported a significant positive relationship between body image dissatisfaction and anxiety and depression, but a review of the research suggests that the relationship between them may not be linear and that self-compassion plays a mediating role between them. According to Research evidence, self-compassion has a significant negative relation with anxiety and depression and can help reduce emotional distress such as anxiety and depression and also act as a protective factor against negative body image. According to the mentioned research findings and the fact that a study in Iran has not investigated the mediating role of self-compassion in the relationship between body image and the severity of anxiety and depression in pregnant women; The question of the present study is whether self-compassion plays a mediating role in the relationship between body image dissatisfaction and the severity of anxiety and depression in pregnant women?. MethodologyThe research method was non-experimental and correlational. The research population consisted of all pregnant women who were in their third trimester of pregnancy and referred to the health centre of Tehran hospital for pregnancy care. A sample of 140 pregnant women was selected using convenience sampling from three hospitals of Quds, Hedayat, and AL-Ghadir. To collect data, the Neff self-compassion scale (SCS), Edinburgh postnatal depression scale (EPDS), Pregnancy related anxiety questionnaire (PRAQ-17), and Body image in pregnancy scale (BIPS) were used. Data were analyzed by Pearson’s Correlation coefficient and Hayes Regression. FindingsThe finding of the research showed there was a significant positive relationship between body image dissatisfaction and severity of anxiety (r=0/43) and depression (r=0/44), further it was indicated that self-compassion had a significant negative correlation with the severity of anxiety (r=-0/55) and depression (r=-0/56). Additionally, Hayes regression showed that self-compassion played a mediating role in the relationship between body image dissatisfaction and the severity of anxiety and depression symptoms in pregnant women (R2= 0/33). ResultAccording to the cognitive view, if a person has a negative attitude towards her body, she experiences dissatisfaction with her body image. This body image dissatisfaction leads to the activation of negative automatic thoughts and basic assumptions that cause anxiety and depression. as these disorders progress, negative automatic thoughts about body image increase and this process leads to increased anxiety and depression. However, not all pregnant women with body image dissatisfaction experience anxiety and depression, so factors may affect the consequences of body image, one of which is self-compassion. Self-compassion entails being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical; perceiving one’s experiences as part of the larger human experience rather than seeing them as isolating, and holding painful thoughts as feeling in mindful awareness rather than over-identifying with them. Therefore, it can be said that pregnant women with body image dissatisfaction who have high self-compassion have a higher resilience when faced with stressful situations caused by body image dissatisfaction, experience fewer negative emotions, and can manage their negative emotions. As a result, the ground for creating psychological well-being and preventing the symptoms of anxiety and depression is provided in them, and the cycle of negative automatic thoughts and the experience of anxiety and depression do not occur. Hence self-compassion can be considered as a strategy for regulating emotion during pregnancy, which creates the background of mental health in the person.‌

Effect of Urinary Incontinence on Quality of Life among Iranian Women.

Objective: Present study aimed to evaluate the effects of stress, urge and mixed urinary incontinence on the quality of life and mental health of Iranian women with urinary incontinence (UI). Materials and methods:This was a cross sectional study of quality of life and mental health among women without and with different types of urinary incontinence (n = 140). Quality of life (QOL) and mental health were compared and measured using the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the 12-items General Health Questionnaire (GHQ-12). Results: Women with any types of urinary incontinence showed a significant lower degree of mental health. Women with mixed incontinence reported significantly lower QOL and mental health (P < 0.0001) compared to those with stress and urge incontinence, while there was no significant difference between women with stress and urge incontinence (P= 0.95). Conclusion: Patients with UI showed inferior mental health and QOL while these symptoms were more severe among patients with mixed urinary incontinence

Sexual Therapy for Women with Multiple Sclerosis and Its Impact on Quality of Life

Objective: Multiple Sclerosis (MS) is a disease with a detrimental effect on functional status. The present study investigated the effect of a sexual therapy program on the quality of life (QOL) of women with multiple sclerosis. Method: Women with multiple sclerosis and sexual dysfunction (n = 30) were selected, and were randomly assigned into the treatment (n = 15), or the control groups (n = 15). Participants of the treatment group (n = 15) received 12 weekly sessions of sexual therapy. Participants in both groups completed the Female Sexual Function Inventory (FSFI) and the MS Quality of Life- 54 (MSQOL-54) in the onset of the program and at the end of the program. Results: ANCOVA(s) using pre-test scores as covariate(s) revealed that in comparison to the control condition, MS patients within the treatment group showed a significant improvement in their sexual desire (0.0001), arousal (0.022), lubrication (0.001), orgasm (0.001), satisfaction (0.0001), overall quality of life (0.001), energy (0.023), cognitive function (0.005), and social function (0.001) at the end of the program. In addition, they were less limited in their roles due to the emotional and health problems. Conclusion: The present study revealed that addressing sexual dysfunction in MS patients could improve their quality of life. In the future, this research can extend its results, and apply the same method to men with MS to find whether sexual therapy enhances their quality of life

Miulness based Cognitive therapy versus Cognitive Behavioral therapy on predictors of relapse in recurent Depression

Introduction: The present study was carried out to examine the effectiveness of Mindfulness based Cognitive therapy versus Cognitive Behavioral therapy on predictors of relapse in recurrent Depression. Method: The study design pre-test - post-test in which 40 patients with recurrent depression who were selected and randomly assigned to either group MBCT and CBT. They were assessed with Beck Depression Inventory – II, Ruminative Responses Scale, Dysfunctional Attitude Scale, Self-Compassion scale at pre - post assessment. Results: The results of MANCOVA and ANCOVA Test supported the effectiveness of Cognitive behavioral therapy on residual depression, dysfunctional attitudes. On the other hand. Mindfulness based cognitive therapy has been proved to be more effective in rumination, cognitive reactivity and self compassion. Conclusion: In sum, it is proposed that combination of CBT and MBCT could be more effective on predictors of relapse in recurrent Depression