Abstract Objectives Diagnosis of cancer is emotionally threatening not only for patients but also for their family caregivers (FC) who witness and share much of the illness experience. This study compares distress experienced by lung cancer patients and their FC during the year following the diagnosis. Methods A prospective cohort study of 206 patients recently diagnosed with inoperable lung cancer (participation rate 79.5%) and 131 FC (participation rate 63.6%) was conducted in an ambulatory oncology clinic in Quebec City (Canada). They completed validated questionnaires regarding their personal and psychological characteristics (Hospital and Anxiety Depression Scale—HADS), in the first months after the diagnosis of lung cancer and after 6 and 12 months. Univariate, bivariate, and linear mixed models were conducted to compare patient and FC distress. Results At baseline, 7.8% of patients reported distress (HADS total score >15) and their mean distress score was 7.0 ± 4.9 (range 0–42). In contrast, 33.6% of FC presented significant distress and their mean distress score was 12.0 ± 7.2 ( P < 0.0001). Proportions of patients and FC with distress remained relatively stable at 6 and 12 months, and at every time point, FC reported higher levels of distress compared to their relative with cancer ( P < 0.0001). Comparable trends were found when looking at the mean scores of distress, anxiety, and depression throughout the study. Significance of results Being diagnosed with lung cancer and going through its different phases seems to affect more FC than patients. The psychological impact of such diagnosis appears early after the diagnosis and does not significantly change over time. These findings reinforce the importance for oncology teams, to include FC in their systematic distress screening program, in order to help them cope with their own feelings and be able to play their role in patient support and care throughout the cancer journey.
Insomnia is a problem frequently reported by patients in various clinical settings, a problem that may have important clinical implications. Insomnia is particularly prevalent in patients with medical illnesses such as cancer. In this chapter a clinical case of a woman with insomnia secondary to breast cancer will be described using a case formulation approach. This will be preceded by a brief literature review on the nature, assessment, and treatment of insomnia.
e19675 Background: Cancer survivors are faced with physical and psychological problems. In follow-up care we have to give greater attention to the quality of life. The fear of cancer recurrence (FCR) is one the most disturbing aspects, resulting in pointless examinations and one of the most prevalent areas of unmeet needs. Yet few efforts have been made to better understand this phenomenon and to work out a validated measures. The goal of this study was to develop the Italian version of the Fear of Cancer Recurrence Inventory (FCRI). Methods: The FCRI is a multidimensional 42-items questionnaire evaluating seven fear components: Triggers, Severity, Psychological distress, Functioning impairments, Insight, Reassurance and Coping strategies. It was initially worked out and validated with French-speaking Canadian cancer survivors (Simard & Savard Supp Care Cancer 2009 17:241-251). A forward-backwards procedure was used to translate the original FCRI into Italian, then it was pilot tested in fifty Italian cancer survivors to assess face and content validity. Results: The partecipants were able to identify correctly the general content being measured (i.e. good face validity). Italian FCRI was considered to be clear, useful, simple to use and no time consuming; it could help to investigate the fears of patients facilitating the communication with physicians. It was found to be distressful only by one partecipant, but this was associated with a recent death of a relative. Partecipants were happy to collaborate in a project that could help other patients. 16% of interviewed suggested questions about God in coping strategies; in their mind God represents an important support to fight their fears. Conclusions: These findings provide preliminary evidence about the usefulness and the utility of FCRI in people with different culture. Further studies are needed to assess its validity and its transcultural availability. If cancer treatments move from cytotoxic agents to molecular ones, Physicians need to take care of survivors exploring more global perspectives. FCRI will be released at sebastien.simard@criucpq.ulaval.ca No significant financial relationships to disclose.
Abstract The objective of this exploratory study was to evaluate the impact of advanced parental cancer on adolescents' psychological status. A sample of 28 adolescents, having a parent with advanced cancer, was recruited and compared with a sample from the general population (N = 2,346). Late adolescents (age 15 to 18) experienced significantly more psychological distress than early adolescents (age 12 to 14). Moreover, late adolescents experienced significantly higher psychological distress than the general population for the same age group, which was not the case for early adolescents. Implications for adolescents living in families touched by advanced cancer are discussed. KEYWORDS: oncologycancerparental canceradvanced cancerpsychological distressadolescents Acknowledgments This study was part of a master's degree in social work obtained at Laval University. The student responsible for this study received funds from the Canadian Institute of Health Research Strategic Training Program in Palliative Care Research, Fonds Québécois de recherche sur la société et la culture, Centre de recherche de l'Hôtel-Dieu de Québec and Laval University Chair of Palliative Care.
