A prospective study on educational level and adaptation to cancer, within one year after the diagnosis, in an older population

Socio-economic status (SES) has often been associated with health disparities and mortality in cancer patients, yet systematic research into the role of SES in the course of the disease is lacking. This prospective study intends to examine the role of SES (i.e. educational level in this study) in psychological and physical adaptation to cancer. Ninety-nine cancer patients were followed from a community-based survey. Pre- and post-morbid data on patients' quality of life (QoL) were available. Adaptation was defined by looking at the level and pattern of scores on QoL scales from pre- to post-disease assessments. Results show some non-significant trends that more high-educated patients managed to adapt completely to cancer in relation to role and physical functioning when compared with low-educated participants. Furthermore, the greater part of high-educated patients who completely adapted in physical functioning achieved this result more rapidly without an initial deterioration. Unexpectedly, these differences were not significant when tested in a regression model. Hence, although there are some indications for differences in adaptation to role and physical functioning between educational groups, we did not find any evidence that proved such a relation. For the group as a whole, it is very interesting to see that based on our operationalization of adaptation, only a small percentage of patients deteriorated from pre- to post-disease assessments. Copyright (c) 2007 John Wiley & Sons, Ltd

Socioeconomic Status and the Course of Quality of Life in Older Patients with Coronary Heart Disease

BACKGROUND: Previous research suggests that socioeconomic status (SES) might be related to the course of quality of life (QoL) in coronary heart disease (CHD) patients. The authors sought to determine whether there are differences in the course of QoL before and after the incidence of CHD among older persons of differing SES. METHOD: Two hundred two CHD patients were followed up longitudinally using a community-based survey. Data on patients' QoL were collected before the diagnosis and at three follow-up assessments. RESULTS: High SES patients reported better outcomes at the premorbid assessment with fewer depressive feelings and better physical functioning. In physical functioning, similar results were repeated 6 and 12 months after the diagnosis. Additionally, high SES patients showed better role and social functioning 1 year after CHD. A multivariate analysis of variance revealed differential longitudinal pathways in relation to SES in role, social, and physical functioning. CONCLUSION: CHD modulates premorbid differences in depressive feelings. Conversely, high SES leads to better outcomes in all functional domains in the long-term after diagnosis. Postmorbid differences in physical functioning are not directly related to CHD, but rather the reestablishment of a premorbid situation. In contrast, socioeconomic inequalities in social and role functioning are a direct response to the impact of the disease

A European multi-language initiative to make the general population aware of independent clinical research: the European Communication on Research Awareness Need project

BACKGROUND: The ECRAN (European Communication on Research Awareness Needs) project was initiated in 2012, with support from the European Commission, to improve public knowledge about the importance of independent, multinational, clinical trials in Europe. METHODS: Participants in the ECRAN consortium included clinicians and methodologists directly involved in clinical trials; researchers working in partnership with the public and patients; representatives of patients; and experts in science communication. We searched for, and evaluated, relevant existing materials and developed additional materials and tools, making them freely available under a Creative Commons licence. RESULTS: The principal communication materials developed were: 1. A website ( http://ecranproject.eu ) in six languages, including a Media centre section to help journalists to disseminate information about the ECRAN project 2. An animated film about clinical trials, dubbed in the 23 official languages of the European Community, and an interactive tutorial 3. An inventory of resources, available in 23 languages, searchable by topic, author, and media type 4. Two educational games for young people, developed in six languages 5. Testing Treatments interactive in a dozen languages, including five official European Community languages 6. An interactive tutorial slide presentation testing viewers' knowledge about clinical trials CONCLUSIONS: Over a 2-year project, our multidisciplinary and multinational consortium was able to produce, and make freely available in many languages, new materials to promote public knowledge about the importance of independent and international clinical trials. Sustained funding for the ECRAN information platform could help to promote successful recruitment to independent clinical trials supported through the European Clinical Research Infrastructure Network

Socioeconomic status and the course of quality of life in coronary heart disease and cancer: from description toward an explanation

The present thesis provides insights into the impact of socio-economic status (SES) on cancer and coronary heart disease (CHD) by exploring cross-sectional and longitudinal differences in patients’ quality of life (QoL) and by suggesting possible mechanisms which might regulate such disparities. Additionally this research considers potential explanations for the relation between SES and disparities in QoL by addressing the mediating role of psychological resources. The methodological strengths of all four studies presented in the thesis are the longitudinal and prospective designs and the multiple assessments of the patients. This research points to the conclusion that the influence of SES on the course of QoL is disease-specific and, in the long term, is relevant to CHD but not to cancer. Regarding CHD, most socioeconomic inequalities in the course of the disease are related to functional status, particularly physical functioning. However, due to the unique prospective design of the study it is possible to attribute disparities in physical functioning after diagnosis to pre-morbid conditions, rather than to the direct consequences of the disease. Regarding the role of psychological factors in the relation between SES and the course of QoL, two main findings emerged. 1) Heart failure patients with different SES respond differently to the same level of psychological distress: high SES patients experience less impairment in role functioning, possibly due to an uneven distribution of resources between socioeconomic groups. 2) Self-efficacy is the only aspect of perceived control which mediates the relationship between SES and changes in physical functioning in CHD patients.

Lutter contre le "gradient de santé" qui affecte les enfants et les parents

status: publishe