Health-related quality of life and leisure physical activity during pregnancy

The practice of physical activity during pregnancy plays an important role related to improvement how women perceive their health status. The aim of this study was to investigate the relationship between perceived quality of life during pregnancy and the practice of physical activity during leisure time. It is a cross-sectional study of 187 postpartum women. A retrospective questionnaire was administered to obtain information regarding pregnancy, being evaluated the pattern of physical activity and health status. To evaluate the aspects related to quality of life we used the SF-12 questionnaire. The statistical analysis were t-test, chi-square and multiple linear regression analysis. From the results it was observed that mothers who were active during pregnancy considered their good or excellent health compared do non active (p=0.005, 35.9% and 15.5% respectively). Active women had higher mental component when compared to those who did not practice (p=0.035). There was a relationship between mental component with the private health service, income, education level, disease and presence of a partner. The physical component was related to maternal age, low birth weight, obesity, and smoking during pregnancy. Despite univariate analysis showed a positive association between physical activity during leisure time and the mental component of quality of life related to health, this association lost significance when included age and care health sectors. Longitudinal studies should be developed to measure effects of physical activity in quality of life

Déterminants des trajectoires de détresse pendant la première année qui suit l'annonce d'un cancer primitif ou récidivant

Introduction. La détresse émotionnelle est inhérente au parcours du patient à qui l on annonce un cancer primitif ou récidivant. Cette étude a deux objectifs fondamentaux : (1) identifier différentes trajectoires de détresse de patients présentant un cancer et (2) identifier et étudier les déterminants de ces trajectoires de détresse émotionnelle de ces patients de l annonce d un cancer primitif ou d une récidive et durant les neuf mois de traitement qui suiventMéthode. 286 patients ont été évalués un mois, 3, 6 et 9 mois après le diagnostic de cancer. Les variables de personnalité (névrosisme et l'optimisme) et les variables transactionnelles (contrôle perçu, coping, le soutien social et qualité de la relation) ont été mesurées. La détresse psychologique a été évaluée avec l HAD.Résultats. Quatre trajectoires de détresse émotionnelle ont été identifiées : une trajectoire résiliente (40.1%) qui présente un niveau de détresse émotionnelle bas qui se maintient durant les neuf mois qui suivent l annonce, une trajectoire différée (37.63%) qui présente un niveau de détresse émotionnelle bas, qui tend à augmenter légèrement et de façon linéaire durant les trois premiers mois et restent stable et inférieur aux seuils au-delà, une trajectoire récupérante (19.58%) qui présente un niveau de détresse émotionnelle significatif qui tend à augmenter légèrement et de façon linéaire durant les trois premiers mois et restent stables au-delà et une trajectoire chronique (2.77%) qui présente une détresse élevée et constante. S il apparaît que ce soit davantage les variables de personnalité qui distinguent les trajectoires résiliente et chronique , ce serait la profondeur du soutien social qui différencierait particulièrement les trajectoires détresse différée et récupérante , engendrant le recours à des stratégies de coping différentes. Cependant, cette étude n a pas pu mettre en évidence de résultats significatifs concernant la variable sentiment de contrôle .Conclusion. Nos résultats semblent soutenir l idée que des personnes, confrontées à des événements de vie stressants, isolés et potentiellement très perturbateurs comme le diagnostic de cancer primitif ou récidivant, parviendraient à maintenir des niveaux de fonctionnements psychologique et physique relativement stables et sains. Cependant, nous n avons pas observé de diminution du niveau de détresse des patients pendant la première année après le diagnostic du cancer primitif ou de récidive.Introduction. Emotional distress is a significant problem for patients with cancer experience and particularly recurrence. We aim to (a) identify distinct trajectories of psychological distress in the first year after primitive cancer diagnosis or recurrence treated with chimiotherapy and (b) explore possible determinants of these trajectories, that is personal (neuroticism, optimism) and transactional (control, coping, social support, quality of relation) characteristics.Method. 286 patients were assessed after diagnosis in the reentry phase of treatment and in the survivorship phase: 3, 6 and 9 months after the diagnosis announce. Personality (neuroticism and optimism) and transactional variables (coping, social support and quality of relation) have been measured. Psychological distress was assessed with HAD scale.Results. There were four trajectories of distress: a group resilient (40.1%) that experienced no or low distress, a group delayed (37.63%) that experienced no signifcative distress but levels of depression and emotional distress, which tend to increase slightly and linearly during the first three months and remain stable and below the thresholds beyond, a group recovery (19.58%) that experienced signifcative distress, which tend to increase slightly and linearly during the first three months and remain stable and below the thresholds beyond, and a group chronic (2.77%) that experienced chronic distress. Variables of Personality and transactional variables could distinguish the distress trajectories. No significant results have been found with perceived control Conclusion. Most patients were not distressed or only temporarily so, in response to primitive cancer or recurrence. However, emotional distress of patients has not decreased during the first year after primitive cancer diagnosis or recurrence.BORDEAUX2-Bib. électronique (335229905) / SudocSudocFranceF

Effets acteurs-partenaires du soutien social et des stratégies de coping sur la qualité de vie et les troubles anxio-dépressifs de patients atteints d'un cancer de la prostate et de leur conjointe

Le traitement d un premier cancer de la prostate et les mois qui suivent, sont une période stressante pour les patients et leur conjointe. Les objectifs de cette étude sont, d une part, de déterminer l évolution de variables psychosociales (soutien social, qualité de la relation conjugale, ajustement dyadique et stratégies de coping) et du bien-être émotionnel et physique, et d autre part, d identifier les effets acteurs-partenaires, c'est-à-dire les effets des variables psychosociales d un membre du couple sur son bien-être et sur celui de l autre membre. Nous avons mené une étude longitudinale auprès de 132 patients atteints d un cancer de la prostate et de 100 de leurs conjointes. Une évaluation psychologique leur a été proposée au début, au milieu, à la fin du traitement et quatre mois après. Les résultats montrent que les patients ont un état émotionnel et une qualité de vie satisfaisants et que les conjointes présentent une symptomatologie dépressive. Chez les patients, on observe des effets acteurs positifs du soutien social, de la relation conjugale et des stratégies de coping, centrées sur le problème ou sur la recherche de soutien social, sur leur bien-être, et des effets partenaires positifs de ces mêmes variables sur le bien-être de leur conjointe. Chez les conjointes, la relation conjugale a un effet acteur positif sur leur bien-être, mais le soutien social et les stratégies de coping centrées sur l émotion ont des effets acteurs négatifs. De plus, l effet partenaire soutien social des conjointes est positif sur le bien-être des patients, alors que celui des stratégies de coping centrées sur l émotion est négatif. Celui de la relation conjugale est positif quand il s agit de la disponibilité et de l intensité du soutien, et négatif quand il s agit de l ajustement dyadique. De façon générale, le soutien social, la relation conjugale et les stratégies de coping sont de bons prédicteurs de la qualité de vie, directement ou par le biais du partenaire.The treatment of a first prostate cancer and the following months are a stressful period for the patients and their spouse. The first aim of this study was to determine the evolution of psychosocial variables (social support, quality of conjugal relationships, dyadic adjustment and coping strategies) and of emotional and physical well-being. The second aim was to identify actors-partners effects - that is the effect of one of partner s psychosocial variables on his/her well-being and on that of the other. A longitudinal study was carried on 132 patients with prostate cancer and 100 of their spouses. A psychological evaluation was conducted at the beginning, half way through, at the end of the treatment and four months afterwards. Results showed that patients had a good emotional state and a good quality of life and, that the spouses developed a depressive symptomatology. For patients, positive actor effects of social support, conjugal relationships and coping strategies (problem-focused or seeking social support focused) on their well-being and, positive partner effects of the same variables on the spouses well-being were observed. For the spouses, conjugal relationships had a positive actor effect on their well-being, but social support and emotion-focused coping strategies had negative actor effects. Also, spouses social support had a positive partner effect on the patients well-being while emotion-focused coping strategies had a negative effect. Conjugal relationship effect was positive when referring to availability and intensity of support and, negative when referring to dyadic adjustment. Overall, social support, conjugal relationship and coping strategies were found to be good predictors of quality of life, directly or indirectly through the partner.BORDEAUX2-Bib. électronique (335229905) / SudocSudocFranceF

Fonctionnement et dysfonctionnement du système visuel (une dissociation entre systèmes parvocellulaire et magnocellulaire chez l'adulte jeune et âgé et rôle de la dopamine)

L'objectif de cette thèse était l'investigation du fonctionnement et des dysfonctionnements des deux systèmes visuels principaux (magnocellulaire et parvocellulaire). Une synthèse théorique sur la dissociation de ces deux systèmes et une revue sur les procédures expérimentales permettant de les dissocier constituaient la première partie de cette thèse. Ensuite, des arguments neuropsychologiques concernant le vieillissement normal et pathologique du système visuel ont été synthétisés et différents résultats de la littérature ont été analysés pour étayer cette dissociation. La quinzaine d expériences réalisées a mis en évidence deux résultats principaux. Il y a un déficit massif du système parvocellulaire dans le vieillissement normal dès les étapes précoces du traitement et qui perdure aux étapes plus tardives, ainsi qu un déficit magnocellulaire sous certaines conditions seulement. L'étude des dysfonctionnements visuels dans les pathologies à syndromes extrapyramidaux a montré que ces patients présentaient un déficit spécifiquement magnocellulaire en lien avec la dénervation dopaminergique dans le système central, objectivée à l aide d une technique de scintigraphie cérébrale.The objective was to investigate the normal functioning and the impairment of the two main visual systems, the parvocellular and the magnocellular systems. A theoretical review on the two systems and on the experimental procedures that have been used to dissociate them is proposed in the first chapter. In a second part, a synthesis of the neuropsychological studies focusing on the normal aging of the visual system and on the visual deficits found in various pathologies, that support the parvocellular / magnocellular dissociation is presented. The experimental chapter comprised about fifteen experiments and showed two main results: 1/ a major low-level parvocellular impairment with normal aging that was not compensated at the later stages, and a slighter magnocellular impairment under certain conditions: 2/ a specific deterioration of the magnocellular system in extrapyramidal patients, correlated with dopamine denervation in two structures of the central system.BORDEAUX2-Bib. électronique (335229905) / SudocSudocFranceF

Faire face au cancer. Images de soi. Images du corps.

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Subjective Lexical Characteristics: Comparing Ratings of Members of the Target Population and Doctors for Words Stemming from a Medical Context

The present study investigated the subjective lexical characteristics of words stemming from a medical context by comparing estimations of the target population (age range = 46–89) and of doctors. A total of 58 members of the target population and 22 oncologists completed measures of subjective frequency and emotional valence for words previously collected in interviews of announcement of cancer diagnosis. The members of the target population also completed tests of word definitions, without and within context. As expected, most of the words were rated less familiar, more negative and as generating more intense emotions to the target population than to the doctors. Moreover, only a few words were correctly defined by the target population. Adding a context helped the participants to define most of the words correctly. Importantly, we identified words that were rated familiar by the patients although they did not know their exact meaning. Overall, these results highlight the importance of taking into account the subjective lexical characteristics of words used in specific contexts

The importance of using ordinal scores for patient classification based on health-related quality of life trajectories

Changes in health-related quality of life (HRQoL) over time are not necessarily homogeneous within a population of interest. Our study aim was twofold: to determine homogeneous patient subpopulations distinguished by HRQoL trajectories, and to identify the particular patient profile associated with each subpopulation. To classify patients according to HRQoL dimension scores, we compared mixtures of linear mixed models (LMMs) classically applied to scores defined by the EORTC procedure, and mixtures of random effect cumulative models (CMs) applied to scores treated as ordinal variables. A simulation study showed that the mixture of LMMs overestimated the number of subpopulations and was less able to correctly classify patients than the mixture of CMs. Considering HRQoL scores as ordinal rather than continuous variables is relevant when classifying patients. The mixture of CMs for ordinal scores is able to identify homogeneous subpopulations and their associated trajectories. The application focused on changes over time in HRQoL data (collected using the EORTC QLQ-C30 questionnaire) from 132 breast cancer patients from the Moral study. Once the classification is obtained only from HRQoL scores, class membership was then explained through a logistic regression model, given a large panel of variables collected at baseline. Analysis of data revealed that deterioration over time of role functioning and insomnia was closely related to patient anxiety: anxiety at baseline is a prognostic factor for a poor level and/or a deterioration over time of HRQoL. For functional dimensions, large tumor size and high education level were associated with worse HRQoL scores

Magnetic resonance and near infrared spectroscopy for investigation of perinatal hypoxic-ischaemic brain injury

To deal with stress, parents of children with ASD use coping strategies that help to tackle the challenging situations of raising their child. This systematic review examines parental coping strategy's questionnaires, factors which influence these coping strategies, interactions between these strategies and perceived stress and their impact on parental quality of life. According to PRISMA guidelines, an electronic search was conducted on Medline, PsycInfo and Eric: 156 articles were identified and 11 studies were selected. Many types of self-reported questionnaires were used to assess parental coping strategies. Studies highlighted that parents of a child with ASD used more avoidance strategies and less social support-seeking strategies than those of typical children. Furthermore, problem-focused coping protects parental stress and quality of life, that on the contrary, emotion-focused coping is a risk factor for alteration. Our systematic review illustrates the need to adapt psychoeducational interventions for parents of children with ASD

Determinants of distinct trajectories of fatigue in patients undergoing chemotherapy for a metastatic colorectal cancer: 6-month follow-up using Growth Mixture Modeling

OBJECTIVE: This longitudinal prospective and observational study was designed to identify fatigue trajectories during a 6-month period of chemotherapy in patients with metastatic colorectal cancer, and examine the psychosocial factors predicting these trajectories. Associations between fatigue and survival were also investigated. METHODS: A total of 169 patients (M(age)=64.36 years, SD=10.5) reported their fatigue levels every 2 weeks for 6 months. Psychological variables (anxiety, depression, internal control, and coping) were assessed at baseline. A Growth Mixture Model was used to identify latent trajectories of fatigue, and a multinomial logistic regression tested covariate predictors of patients' trajectories. RESULTS: Four clinically distinct fatigue trajectories were identified: intense fatigue (6.51%), moderate fatigue (48.52%), no fatigue (33%), and increasing fatigue (11.83%). Fatigue severity was directly associated with overall survival. High depression levels were associated with fatigue severity over time for intense (OR=1.80 [1.32-2.47]) and for moderate (OR=1.58 [1.25-2.00]) fatigue, compared to patients reporting no fatigue. Patients who did not report fatigue were better adjusted, and had more resources, such as better internal control over the disease and less emotion-focused coping (guilt and avoidance), than those who reported intense (OR(control)=0.77 [0.65-0.92]) or moderate (OR(control)=0.89 [0.79-0.99] and OR(coping)=1.13 [1.02-1.24]) fatigue. CONCLUSIONS: Fatigue trajectories differed considerably across patients with metastatic colorectal cancer. This first longitudinal study on colorectal cancer patients involving transactional variables suggests that psychosocial interventions should target these specific outcomes, in order to help patients manage their fatigue

Major depressive disorder and associated factors in elderly patients with non-Hodgkin’s lymphoma

Background: Data regarding elderly patients with cancer, more particularly with non-Hodgkin’s lymphomas (NHL), are scarce, as is our knowledge concerning to comorbid depression in this population. The purpose of this work was to explore the frequency of major depressive disorder (MDD) and related factors in a group of elderly patients with these forms of cancer. Method: 42 elderly NHL patients aged 70 years and older were interviewed using the Mini International Neuropsychiatric Interview screening tool. Psychological variables such as coping strategies, cognitive status and quality of relationships, as well as clinical and socio-demographic data were collected. Results: Fourteen patients (33.3%) met criteria for current MDD of which five had melancholy features (35.7%). Elderly patients with comorbid NHL-MDD had a significantly poorer self-perceived global health and performance status than those without MDD, as well as more fatigue and history of depression. No other clinical, psychological or socio-demographic variable appeared associated with MDD in this sample. Conclusion: Further studies are needed in order to confirm these early results concerning a potential high frequency of MDD among elderly NHL patients. Depressive mood should be early recognized in order to provide appropriate treatments and avoid a detrimental effect of depression on cancer prognosis