Structure factorielle de l'Inventaire d'agitation de Cohen-Mansfield

Près de la moitié des personnes âgées vivant dans un Centre d'hébergement et de soins de longue durée (CHSLD) souffrent d'agitation. Il est donc essentiel pour les chercheurs de disposer de mesures valides et fiables de ce phénomène. Le Cohen-Mansfield Agitation Inventory (CMAI) est l'un des instruments de mesure les plus utilisés dans le domaine. Il a récemment été traduit et partiellement validé. Cette étude vise donc à déterminer la structure factorielle de la version française de cet instrument, administré à 373 personnes âgées de plus de 60 ans. Les résultats de l'analyse factorielle en composantes principales avec rotation orthogonale (varimax) suggèrent l'existence de trois facteurs (agitation verbale, agitation physique sans agressivité et agitation avec agressivité). Ces résultats corroborent ceux obtenus avec la version originale anglaise et la version allemande du CMAI. De plus, ils confirment que l'agitation est un concept multidimensionnel

Utilization of hypnotic medication in the context of cancer : predictors and frequency of use

OBJECTIVE : The present study aims to document the frequency of use of hypnotic medication among a large sample of randomly selected patients having been treated for various types of cancer, as well as to identify the sociodemographic, psychosocial, and medical factors that characterize the users of this type of medication. METHODS: Five thousand patients who had received treatment for breast, prostate, lung, or colorectal cancer at the L'Hôtel-Dieu de Québec were solicited by mail to take part in this study. Among these patients, 1,984 (39.7%) agreed to complete a battery of questionnaires. RESULTS: Overall, 22.6% of the patients were currently consuming hypnotic medication. Factors associated with a greater utilization of hypnotic medication were older age, greater difficulties initiating sleep, more stressful life events experienced in the past 6 months, higher levels of anxiety, past or current psychological difficulties, poorer role functioning, less severe urinary symptoms, greater use of opioids, and past or current chemotherapy treatments. CONCLUSIONS: These results are consistent with those of previous studies conducted in cancer patients in showing high rates of hypnotic medication use. Moreover, this study identified several factors that might help identify persons at risk of using this type of medication and, therefore, to experience the potential negative effects of chronic hypnotics use

Development and feasibility of a group cognitive-behavioral therapy for fear of cancer recurrence

This paper describes the development, content, and preliminary results of a group cognitive-behavioral therapy (CBT) for fear of cancer recurrence (FCR). A manualized CBT intervention was developed and offered to 38 patients with various cancer types and stages in two hospitals. Four weekly group CBT sessions were administered by two licensed psychologists as part of routine care. Patients completed self-report scales before the first treatment session and, a second time, 1 month after the last session. Overall, 33 patients had clinical levels of FCR at baseline. The participants’ satisfaction toward the group CBT for FCR was high. Significant reductions on the total score and most subscales of the Fear of Cancer Recurrence Inventory (FCRI) were observed, as well as significant improvements on most of the other psychological variables measured (i.e., insomnia, anxiety, depression, dysfunctional beliefs about cancer, and intolerance of uncertainty). In addition, 52% of the patients with clinical levels of FCR (FCRI-severity subscale score ≥ 13) at baseline no longer reached this clinical threshold at posttreatment. These preliminary results suggest that our group CBT for FCR is well accepted and feasible, and shows promising efficacy for decreasing FCR and improving other psychological variables among cancer patients. The next step is to investigate the efficacy of this minimal intervention in larger and controlled clinical trials, as well as its usefulness as part of a stepped care approach. This low-cost intervention is easy to implement in various clinical settings and has a strong potential to help large numbers of patients with FCR