Hopelessness in Turkish cancer inpatients: The relation of hopelessness with psychological and disease-related outcomes

WOS: 000266230900002PubMed ID: 19246240The purpose of this Study was to investigate the hopelessness level and the relationship of depression, anxiety and disease-related factors to the presence of hopelessness among Turkish patients with cancer. Ninety-five patients hospitalized for cancer treatments were recruited for current study. Data were collected by using a demographic questionnaire, the Pain Numeric Rating Scale, the Beck Hopelessness Scale, and the Hospital Anxiety Depression Scale. The mean hopelessness score was 5.20 +/- 4.39. There were significant differences in terms of hopelessness between the patients who had metastasis and pain as compared with those without metastasis and pain (p < 0.05). There were also found that significant correlation between hopelessness and depression and between hopelessness and anxiety (r = 0.721; r = 0.645, respectively, p < 0.001). Foreword stepwise multiple regression analysis revealed that the independent predictors of hopelessness were depression score and thr presence of metastasis (F = 55.133: p < 0.001). The findings suggest that levels of hopelessness among cancer patients with pain and metastasis are higher than among those without pain and metastasis, and that the severity of pain, anxiety, and depression is positively correlated with hopelessness level. The assessment of hopelessness, pain, anxiety and depression levels of the patients with cancer should be an essential part of health care practice. Therefore, when arranging care assessment, to evaluate hopelessness could help professionals to appropriately refer patients to further psychological care resources. (C) 2009 Elsevier Ltd. All rights reserved

Variables affecting patient satisfaction in breast surgery: A cross-sectional sample of Turkish women with breast cancer

WOS: 000243290000004PubMed ID: 17236697Objective: In Turkey, despite the fact that breast cancer accounts for 24.1% of all cancer in women, a very small number of these patients receive breast reconstruction. This low percentage would seem to indicate that there are several factors affecting the decision of which surgical procedure should be selected. The aim of this study was to establish the demographical, medical, and psychological factors associated with the breast cancer patient's decision-making process, and assess their satisfaction with the type of surgery received. Method: We assessed long-term satisfaction with the type of surgery received; satisfaction with the information process by which the surgery decision is taken; feelings of ambivalence or regret regarding the type of surgery received in both mastectomy (n = 50) and breast reconstruction patients (n = 25). Additionally, breast cancer survivors were compared with age-matched healthy control volunteers (n = 50) in terms of demographics, body image and self-esteem, which could be expected to affect their preferences. We administered a demographical and medical information form, Structured Clinical Interview for DSM-IV, Clinical Version (SCID-I), the Body Cathexis Scale (BCS); and the Rosenberg Self-Esteem Scale (RSE). Results: In both groups, women with a low income and less education were more likely to experience decision regret or low satisfaction. Moreover, total mastectomy-alone patients had lower self-esteem compared to reconstructive surgery patients and healthy women. Conclusion: Early stage breast cancer is a chronic disease and patients have to live with the consequences of their decision for many years. At the same time, the type of surgery is decided on when patients are in an acute phase and under intense pressure. Therefore, the decision making process needs to be explored more, especially breast cancer patients with less education and low income need better assistance and more detailed explanation of their options

Impact of Direct Acting Antiviral Agents on Psychiatric and Sexual Health of Patients with Hepatitis C Virus

WOS: 000466134600005Objectives: Data about the psychosocial side effects of direct-acting antiviral agents (DAA) used for the treatment of hepatitis C virus (HCV) infection is scarce. In this study, it is aimed to assess the psychiatric and sexual effects of ledipasvir/sofosbuvir (L/S) combination and paritaprevir-ritonavir-ombitasvir-dasabuvir (PROD) combination in patients with HCV infection. Materials and Methods: The sample of this retrospective study consisted of patients who were diagnosed with HCV infection and received PROD or L/S treatment. The patients were assessed by the Hospital Anxiety and Depression (HAD) scale and Arizona Sexual Experiences (ASEX) scale at baseline and first-, third- and sixth-month visits. Besides these, demographic data and data about the liver disease were collected. Results: During the studied period, 42 patients were started DAA treatment. The average age of the sample was 56.64 +/- 12.04 years. Thirty-five (83.3%) patients achieved sustained viral response. Data of the patients who filled HAD or ASEX at baseline and at least in one of the following visits within six months were used. Anxiety, depression and sexual measures did not differ between baseline and following assessments. Conclusion: L/S and PROD do not seem to have a significant effect on anxiety and depression levels and sexual experiences of the patients while they made an improvement in viral load

The role of BDNF and HPA axis in the neurobiology of burnout syndrome

Chronic stress is known to affect the HPA axis. The few clinical studies which have been conducted on HPA-axis function in burnout have produced inconsistent results. The etiological relationship between sBDNF and burnout has not yet been studied. The aim of the current study was to investigate the role of BDNF and HPA axis in the neurobiology of burnout. In the current study 37 clinically diagnosed burnout participants were compared with 35 healthy controls in terms of BDNF, HPA axis, burnout symptoms, depression, anxiety and psychosomatic complaints. Basal serum cortisol, sBDNF and cortisol level after 1 mg DST was sampled. We found no significant differences in terms of HPA-axis function (for basal serum cortisol, p =0.592: for cortisol level after I mg DST, p=0.921), but we did find lowered sBDNF levels in burnout group (88.66 +/- 18.15 pg/ml) as compared to healthy controls (102.18 +/- 20.92 pg/ml) and the difference was statistically significant (p=0.005). Logistic Regression Analysis revealed that emotional exhaustion (p=0.05), depersonalization (p=0.005) and depression (p=0.025) were significantly associated with burnout. sBDNF levels correlated negatively with emotional exhaustion (r=-,268, p=0.026), depersonalization (r=-,333, p=0.005) and correlated positively with competence (r=0.293, p=0.015) sub-scales of burnout inventory. However, there were no significant relationships between cortisol levels and sBDNF levels (r=0.80, p=0.51), depression, anxiety, psychosomatic complaints and burnout inventory. Our results suggest that low BDNF might contribute to the neurobiology of burnout syndrome and it seems to be associated with burnout symptoms including altered mood and cognitive functions. (C) 2008 Elsevier Inc. All rights reserved

Comparison of quality of life in hepatitis B virus carriers versus chronic hepatitis B virus carriers versus the normal population

WOS: 000281832100010Aim: To compare health related quality of life (HRQOL) in hepatitis B virus (HBV) carriers versus chronic HBV disease carriers versus the normal population Materials and methods: The study sample consisted of 2 groups. HBV carriers were recruited from individuals who were regularly followed-up at the Infectious Diseases and Clinical Microbiology outpatient clinic of our setting due to inactivity in HBV infection The control group was recruited from the same outpatient clinic among patients who had a diagnosis of chronic HBV infection and who were not undergoing active treatment yet Both groups were requested to fill in the short form 36 questionnaire on HRQOL (HRQOL-SF-36) and a form to gather data about age, gender, and education. We also compared the mean values of the SF-36 domain scores of these 2 groups with published scores of healthy controls derived from the Turkish population Results: QOL in HBV carriers was greatly similar to that of patients with chronic HBV disease except for physical role limitation scores and both HBV carriers and patients with chronic disease had lower HRQOL. than the normal Turkish population Conclusion: When compared with the normal Turkish population, QOL is affected negatively both in chronic HBV infection patients and in HBV carriers