The Effect of Metacognitive Therapy on Depression and Resilience of Cancer Patients in Selected Hospitals of Shahid Beheshti University of Medical Sciences
while cancer causing physical problems for patients, also causes many social and psychological problems. Crisis resulting from cancer causes disturbance in balance and psychological coordination, including sense of despair and depression. The aim of this study was to investigate the effectiveness of meta-cognitive therapy on depression and resilience of cancer patients in selected hospitals of Shahid Beheshti University of Medical Sciences.
Group positive psychotherapy was found to be effective in reducing depression and increasing happiness in breast cancer patients based on a randomized controlled trial. 42 breast cancer patients were randomly assigned to a positive psychotherapy group or control group. The positive psychotherapy group received 10 weekly 1.5 hour group sessions, while the control group only received usual care. Depression was measured using the Beck Depression Inventory and happiness was measured using the Oxford Happiness Inventory before and after the intervention. The results showed that the positive psychotherapy group had a significant reduction in depression and a significant increase in happiness compared to the control group. Positive psychotherapy is a promising low-cost intervention that can improve psychological health in breast cancer patients.
This study examined characteristics of cancer patients interested in bibliotherapy and their motivation and adherence to a self-help program. The majority of participants were female, over 50 years old, and had education beyond high school. Participants had various cancer types and stages. They reported high autonomous motivation to engage in the program and over half had clinically significant psychological distress. Participants completed on average 80% of the workbook and spent 57 minutes weekly engaging with it. Those with more depressive symptoms spent less time reading. Motivation was unrelated to adherence measures but wanting responsibility for well-being related to seeking social support. The findings support bibliotherapy as an intervention option for a broad range of cancer patients.
Explore the Relationship between Post Traumatic Growth, Ways of Coping and An...iosrjce
A cancer diagnosis is hard to take and having cancer is not easy. Like all chronic illnesses, cancer
involves a series of negative threat to life of individual that may be due to the diagnosis and treatment of cancer
as it has the ability to shake one’s worldview and significantly impact one’s assumption about life. In addition to
commonly recognized negative effects such as posttraumatic stress symptoms (PTSS), there may also be positive
personal developmental change, including posttraumatic growth (PTG)which is affected by the anxiety level of
the patient. The purpose of the study was to determine the relationship between post traumatic growth, ways of
coping and anxiety among cancer patients. The study involved 100 cancer patients. There was a highly positive
correlation between PTG and WAYS. State-trait anxiety was found to be highly negatively co-related to post
traumatic growth and ways of coping.Thus it can be concluded that post traumatic growth and ways of coping
goes in same manner which suggest that the better the coping behavior used by cancer patients more will be the
post traumatic growth and there was negative relationship between post traumatic growth, ways of coping and
state-trait anxiety
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
Imperatives for psychiatric education and leadershipNarirat Pinkul
1) The number of cancer survivors in the US is currently over 15 million and expected to exceed 20 million by 2026. Many cancer survivors experience psychiatric issues like adjustment disorder, cognitive changes, pain, sexual dysfunction, depression, and anxiety.
2) There is currently a shortage of psychiatrists trained to care for the growing population of cancer survivors. While some specialties receive some training in behavioral health, it is not mandatory and overall training capacity is limited.
3) Most psychiatric residents are not well prepared to treat cancer survivors upon graduation, as training requirements do not guarantee experience with cancer patients. The article proposes ways to better prepare trainees through expanded curricula and clinical experiences focused on psychiatric issues in cancer care.
Evidence-Based Practices & Nursing
Introduction
Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Summary of Case Study
The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Research Question
In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?
PICOT Format
1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.
2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.
3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.
4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded i ...
Evaluating the Quality of Life and Social Support in Patients with Cervical C...CrimsonpublishersTTEH
Aims: Purposes of this descriptive correlational research were to 1) describe quality of life and social support and 2) look at the correlation of certain factors and quality of life in women with cervical cancer after treatment. Methods: Fifty-three women diagnosed with cervical cancer who were followed up after finished the treatments at the Gynecological outpatient department of a university hospital in 2016.They were asked to fill 3 questionnaires; 1) the general information; 2) Social support; and 3) Functional Assessment of Chronic Illness Therapy (FACT-Cervix). Alpha Cronbach’s coefficients for the social support was .73 and for the FACT-Cervix was .91. Data were analyzed by descriptive statistic and Spearman Rank Test.Result: Results showed that participants’ age was ranged from 30 to 86, mean=55.15 (SD=10.05). Social support was about 29 to 59, mean=48.23 (SD=6.76). Symptom distress was from 0 to 9, mean=3.36 (SD=2.83). For quality of life was diverted from 75 to159, mean=126.02 (SD=21.09). The results discovered that there was no correlation between age and social support with the quality of life, however, there was negative correlation between symptom distress and quality of life with r=-.40 at p=0.003.Conclusion: This study disclosed that social support for this women’s group could not help to improve their quality of life. Their symptom distress seems to have a direct effect on their QOL. Thus, the healthcare team needs to alleviate patients’ distress in order to improve the quality of life in cervical cancer survivors.
Effect of Behavioral Intervention on Reducing Symptom Severity during First C...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Group positive psychotherapy was found to be effective in reducing depression and increasing happiness in breast cancer patients based on a randomized controlled trial. 42 breast cancer patients were randomly assigned to a positive psychotherapy group or control group. The positive psychotherapy group received 10 weekly 1.5 hour group sessions, while the control group only received usual care. Depression was measured using the Beck Depression Inventory and happiness was measured using the Oxford Happiness Inventory before and after the intervention. The results showed that the positive psychotherapy group had a significant reduction in depression and a significant increase in happiness compared to the control group. Positive psychotherapy is a promising low-cost intervention that can improve psychological health in breast cancer patients.
This study examined characteristics of cancer patients interested in bibliotherapy and their motivation and adherence to a self-help program. The majority of participants were female, over 50 years old, and had education beyond high school. Participants had various cancer types and stages. They reported high autonomous motivation to engage in the program and over half had clinically significant psychological distress. Participants completed on average 80% of the workbook and spent 57 minutes weekly engaging with it. Those with more depressive symptoms spent less time reading. Motivation was unrelated to adherence measures but wanting responsibility for well-being related to seeking social support. The findings support bibliotherapy as an intervention option for a broad range of cancer patients.
Explore the Relationship between Post Traumatic Growth, Ways of Coping and An...iosrjce
A cancer diagnosis is hard to take and having cancer is not easy. Like all chronic illnesses, cancer
involves a series of negative threat to life of individual that may be due to the diagnosis and treatment of cancer
as it has the ability to shake one’s worldview and significantly impact one’s assumption about life. In addition to
commonly recognized negative effects such as posttraumatic stress symptoms (PTSS), there may also be positive
personal developmental change, including posttraumatic growth (PTG)which is affected by the anxiety level of
the patient. The purpose of the study was to determine the relationship between post traumatic growth, ways of
coping and anxiety among cancer patients. The study involved 100 cancer patients. There was a highly positive
correlation between PTG and WAYS. State-trait anxiety was found to be highly negatively co-related to post
traumatic growth and ways of coping.Thus it can be concluded that post traumatic growth and ways of coping
goes in same manner which suggest that the better the coping behavior used by cancer patients more will be the
post traumatic growth and there was negative relationship between post traumatic growth, ways of coping and
state-trait anxiety
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
Imperatives for psychiatric education and leadershipNarirat Pinkul
1) The number of cancer survivors in the US is currently over 15 million and expected to exceed 20 million by 2026. Many cancer survivors experience psychiatric issues like adjustment disorder, cognitive changes, pain, sexual dysfunction, depression, and anxiety.
2) There is currently a shortage of psychiatrists trained to care for the growing population of cancer survivors. While some specialties receive some training in behavioral health, it is not mandatory and overall training capacity is limited.
3) Most psychiatric residents are not well prepared to treat cancer survivors upon graduation, as training requirements do not guarantee experience with cancer patients. The article proposes ways to better prepare trainees through expanded curricula and clinical experiences focused on psychiatric issues in cancer care.
Evidence-Based Practices & Nursing
Introduction
Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Summary of Case Study
The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Research Question
In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?
PICOT Format
1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.
2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.
3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.
4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded i ...
Evaluating the Quality of Life and Social Support in Patients with Cervical C...CrimsonpublishersTTEH
Aims: Purposes of this descriptive correlational research were to 1) describe quality of life and social support and 2) look at the correlation of certain factors and quality of life in women with cervical cancer after treatment. Methods: Fifty-three women diagnosed with cervical cancer who were followed up after finished the treatments at the Gynecological outpatient department of a university hospital in 2016.They were asked to fill 3 questionnaires; 1) the general information; 2) Social support; and 3) Functional Assessment of Chronic Illness Therapy (FACT-Cervix). Alpha Cronbach’s coefficients for the social support was .73 and for the FACT-Cervix was .91. Data were analyzed by descriptive statistic and Spearman Rank Test.Result: Results showed that participants’ age was ranged from 30 to 86, mean=55.15 (SD=10.05). Social support was about 29 to 59, mean=48.23 (SD=6.76). Symptom distress was from 0 to 9, mean=3.36 (SD=2.83). For quality of life was diverted from 75 to159, mean=126.02 (SD=21.09). The results discovered that there was no correlation between age and social support with the quality of life, however, there was negative correlation between symptom distress and quality of life with r=-.40 at p=0.003.Conclusion: This study disclosed that social support for this women’s group could not help to improve their quality of life. Their symptom distress seems to have a direct effect on their QOL. Thus, the healthcare team needs to alleviate patients’ distress in order to improve the quality of life in cervical cancer survivors.
Effect of Behavioral Intervention on Reducing Symptom Severity during First C...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Background: The COVID-19 pandemic and control measures taken by countries around the worldcause stress and anxiety. The outbreak of corona virus not onlyhas a major impact on the physical health of the community, but also has a foremosteffect on thementalhealth of the public.Investigating the coping strategies to deal with this unique crisis is essential. Objective: The aim of this study was to assess the impact of covid-19 on stress and coping responses among general population. Methods: A descriptive cross-sectional study is adapted among 100 general populations. A convenient sampling technique was applied. The demographic data were collected using a structured questionnaire via interview method. The level of stress was measured by the perceived stress scale (PSS) and coping responses was evaluated by the brief cope scale. Result: The study outcomesdisplaysthat 53 (53%) had moderate stress, 28 (28%) had mild stress and 19 (19%) had severe stress during Covid-19. In respect to level of coping strategies among general population, 96% of the participants used planning coping strategy, 93% of them used religion coping strategy followed by 92% used self-distraction coping strategy. Conclusion: In our study, general population presented a moderate level of stress, in addition avoidance coping strategies was mostly used.Aiding the mental health care needs of public during these difficult times (pandemic) should be the top priority soadequate measures must be taken to promote the mental health of general public.
The Meaningful Assessment of Therapy OutcomesIncorporating .docxcherry686017
The Meaningful Assessment of Therapy Outcomes:
Incorporating a Qualitative Study Into a Randomized Controlled Trial
Evaluating the Treatment of Adolescent Depression
Nick Midgley
University College London and Anna Freud Centre, London,
United Kingdom
Flavia Ansaldo
Southwark Targeted Services—CAMHS, London,
United Kingdom
Mary Target
University College London
For many years, there have been heated debates about the best way to evaluate the efficacy and
effectiveness of psychological therapies. On the one hand, there are those who argue that the randomized
controlled trial (RCT) is the only reliable and scientifically credible way to assess psychological
interventions. On the other hand, there are those who have argued that psychological therapies cannot be
meaningfully assessed using a methodology developed to evaluate the impact of drug treatments, and that
the findings of RCTs lack “external validity” and are difficult to translate into routine clinical practice.
In this article, we advocate the use of mixed-method research designs for RCTs, combining the rigor of
quantitative data about patterns of change with the phenomenological contextualized insights that can be
derived from qualitative data. We argue that such an approach is especially important if we wish to
understand more fully the impact of therapeutic interventions within complex clinical settings. To
illustrate the value of a mixed-method approach, we describe a study currently underway in the United
Kingdom, in which a qualitative study (IMPACT-My Experience [IMPACT-ME]) has been “nested”
within an RCT (the Improving Mood With Psychoanalytic and Cognitive Behavioral Therapy [IMPACT]
study) designed to evaluate the effectiveness of psychological therapies in the treatment of adolescent
depression. We argue that such a mixed-methods approach can help us to evaluate the effectiveness of
psychological therapies and support the real-world implementation of our findings within increasingly
complex and multidisciplinary clinical contexts.
Keywords: adolescent depression, randomized controlled trials (RCTs), qualitative research, mixed-
methods design, outcome research
For many years, there have been heated debates about the best
way to evaluate the efficacy and effectiveness of psychological
therapies. On the one hand, there are those who argue that the
randomized controlled trial (RCT) (and meta-analyses of such
trials) is the only reliable and scientifically credible way to assess
psychological interventions. The RCT has long been considered
the “gold standard” approach, placed at the top of the “hierarchy of
evidence” and given almost exclusive credence by bodies such as
the Cochrane Collaboration and guideline developers such as the
National Institute for Health and Clinical Excellence (NICE). On
the other hand, there are those who have argued that psychological
therapies cannot be meaningfully assessed using a methodology
developed to evaluate the impact of drug treatme ...
A cross sectional and comparative study of attitudes in undergraduate medical...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document summarizes a systematic review of studies examining mind-body practices for the treatment of psoriasis. The review identified 9 relevant randomized controlled trials involving a total of 379 participants comparing mind-body interventions like meditation, mindfulness, hypnosis and relaxation techniques to conventional medical treatments or other complementary interventions. While the studies showed some improvements in disease symptoms and psychosocial outcomes, the review found high risks of bias and noted limitations in the available evidence.
Self-Regulatory Model of Illness Perception .pptxanmolayaz
The document summarizes Leventhal's Self-Regulatory Model of Illness Perception. The model proposes that individuals form cognitive and emotional representations of their illness based on symptoms, which influence their perception and guide coping behaviors. Research has applied this model to cancers like breast and lung cancer, finding that illness perceptions impact quality of life, distress, and treatment adherence. Therapies like psychoeducation, CBT, and mindfulness have been shown to improve illness perceptions and psychological outcomes for patients. While insightful, the model has limitations like overlooking socio-cultural factors and environmental influences on health.
Summary of SAMHSA's review of and listing of feedback Informed Treatment as an evidence-based practice. The International Center for Clinical Excellence received perfect scores for readiness for dissemination materials
1PAGE 21. What is the question the authors are asking .docxfelicidaddinwoodie
1
PAGE
2
1. What is the question the authors are asking?
They asked about a reduction in judgmental biases regarding the cost and probability associated with adverse social events as they are presumed as being mechanisms for the treatment of Social Anxiety Disorder (SAD). Also, the authors poised on the changes in judgmental biases as mechanisms to explain cognitive-behavioral therapy for social anxiety disorder. On top of that, they stated that methodological limitations extant studies highlight the possibility that rather than causing symptom relief, a significant reduction in judgmental biases tends to be consequences of it or correlate. Considerably, they expected cost bias at mid-treatment to be a predictor of the treatment outcome.
2. Why do the authors believe this question is important?
According to the authors, this question was relevant as methodological limitations of present studies reflect on the possibility that instead of causing symptom belief, a significant reduction in judgmental biases can be consequences or correlated to it. Additionally, they ought to ascertain the judgment bias between treated and non-treated participants. Significantly, this was important as they had to determine the impact of pre and post changes in cost and probability of the treatment outcomes. But, probability bias at mid-treatment was a predictor of the treatment outcome contrary to the cost bias at mid-treatment that could not be identified as a significant predictor of the treatment outcome.
3. How do they try to answer this question?
They conducted a study to evaluate the significant changes in judgmental bias as aspects of cognitive-behavioral therapy for social anxiety disorders. To do this, they conducted a study using information from two treatment studies; an uncontrolled trial observing amygdala activity as a response to VRE (Virtual Reality Exposure Therapy) with the use of functional magnetic resonance imaging and a randomized control trial that compared Virtual Reality Exposure Therapy with Exposure Group Therapy for SAD. A total of 86 individuals who met the DSM-IV-TR criteria for the diagnosis of non-generalized (n=46) and generalized (n=40) SAD participated. After completing eight weeks of the treatment protocol, the participants who identified public speaking as their most fearsome social situation were included. The SCID (Structured clinical interview for the DSM-IV) was used to ascertain diagnostic and eligibility status on Axis 1 conditions within substance abuse, mood and anxiety disorder modules. The social anxiety measures were measured with the use of BFNE (Brief Fear of Negative Evaluation), a self-reporting questioner that examined the degree to which persons fear to be assessed by other across different social settings. Additionally, the OPQ (Outcome Probability Questionnaire) self-reporting questionnaire was used to evaluate individual’s estimate on the probability that adverse, threatening events will occur at t ...
This is a presentation that I give to medical professionals educating them on the role and potential use of social work in the hospital setting. I presented this on May 22, 2009 to the Trauma Education & Research Committee.
Homeopathic treatment of elderly patients - a prospective observational study...home
The severity of disease showed marked and sustained improvements under homeopathic treatment,
but this did not lead to an improvement of quality of life. Our findings might indicate that homeopathic medical
therapy may play a beneficial role in the long-term care of older adults with chronic diseases and studies on
comparative effectiveness are needed to evaluate this hypothesis.
This study evaluated depression, anxiety, and stress in 111 patients with oral cancer using the DASS-21 questionnaire. Scores were highest for stress at diagnosis, depression one month after treatment and three months after discharge, but lowest for anxiety at all timepoints. Depression and stress scores significantly increased between diagnosis and three months after surgery, while anxiety scores were stable. The DASS-21 effectively evaluated stress. A positive correlation was found between DASS-21 and HADS questionnaire results. Psychological intervention is recommended to improve patient outcomes.
This qualitative systematic review synthesized 77 papers reporting on 60 studies to understand patients' experiences of chronic non-malignant musculoskeletal pain. The key finding was that patients experience chronic pain as an adversarial struggle on multiple levels, including affirming their identity, reconstructing their identity over time, explaining their suffering, navigating the healthcare system, and proving the legitimacy of their pain. However, some patients also expressed a sense of moving forward alongside their pain. The review provides insight for improving the patient experience by better understanding their pain and forming collaborative partnerships to help patients manage their condition.
This document summarizes the results of moderator analyses from a large randomized controlled trial testing the effectiveness of cognitive behavioral therapy (CBT) for chronic pain from osteoarthritis. The trial compared 10 sessions of Pain Coping Skills Training (PCST), a form of CBT, delivered by nurse practitioners to a usual care control group. Several demographic and clinical variables were examined as potential moderators of treatment response. The analyses found that patients' pain coping style, expectations for treatment, disease severity, age, and education level significantly moderated outcomes, with some subgroups showing stronger responses to PCST. Sex, race, BMI, and depression did not impact treatment response. Specifically, patients with interpersonal pain coping problems did not benefit much from
Circulating Tumor Cells and Cell-Free Nucleic Acids as Predictor Factors for ...AnonIshanvi
Pancreatic cancer remains as one of the most aggressive and deadliest of cancers largely due to formidable challenges in diagnosis and therapy. Consensus standard treatment for patients with nonmetastatic Pancreatic Cancer (PC) incorporates possible neoadjuvant chemotherapy with timely surgical resection and adjuvant chemotherapy. However, despite all the sophistication of modern radiological and endoscopic techniques, the decision regarding operability is often only made intra-operatively, therefore subjecting a patient to unnecessary surgical intervention, and postponing the possibility of starting early chemotherapy.
Research Progress in Chronic Lymphocytic LeukemiaAnonIshanvi
Cancer is an uncontrolled division of cell occurs due to genetic alterations and mutation. Chronic lymphocytic leukemia is the heterogeneous lymphocytic malignancy worldwide that leads to death.
Genetics of Breast and Ovary Cancers Associated with Hereditary Cancers and t...AnonIshanvi
Carriers of the BRCA-1/2 mutation have increased and variable risks of Breast Cancer (BC) and ovarian cancer and vary or are modified by common genetic variants and their incidence genetic testing and risk-reducing surgery has increased, they should receive advice and evaluation by the physician with experience in genetics.
Increased of Protein O-Fucosyl Transferase 1 and 2 Genes Expression in Gastri...AnonIshanvi
Gastric cancer is one of the most common cancers in the world. Gastric cancer usually occurs at an advanced age (average ≥ 65 years) and has symptoms similar to gastric ulcers and other gastric infections, its early diagnosis is one of the major problems of this type of cancer. Molecular mechanisms initiate cancer and the molecular changes of normal cells compared to cancer cells are very important. dysfunction of Fucosyl transferase enzymes is associated with gastric cancer.
The impact of the SARS-CoV-2 infection in all areas at the national and international level is undeniable, the aftermath of this “tornado” will be visible for a long time, even when the infection manages to be controlled. Two aspects of great interest to those of us who work in the area of oncology must be considered: on the one hand, the need to contain and control the devastating effects of the disease forced a reorganization in the operation of services, giving priority to COVID, conversion of medical units to hospitals COVID created a high-risk scenario for patients with other types of pathologies; This reorganization includes the allocation of large amounts of budget to COVID areas to the detriment of patients with other types of equally serious diseases - such as cancer, among others - who cannot wait for care in better times.
Meta-Analysis of Lateral Lymph Node Dissection for Mid Lower Rectal Cancer: I...AnonIshanvi
Presence of lateral lymph node metastasis in rectal cancer was originally reported in the 1950s.Lateral lymph node metastasis occurs in 15 to 20% of patients with locally advanced low rectal cancer which escalates likelihood of local recurrence and reduced survival following neoadjuvant chemoradiotherapy (nCRT) and Total Mesolectal Excision (TME).
Analyzing Speech Outcomes in Hemiglossectomy Patients Using Telecare PlatformAnonIshanvi
This study analyzed speech outcomes in 20 patients who underwent hemiglossectomy for tongue cancer and reconstruction using a radial forearm free flap. The study aimed to evaluate the feasibility of using telemedicine for clinical research during COVID-19 and to analyze factors influencing postoperative speech outcomes. Patients completed speech evaluations remotely with speech language pathologists, assessing range of motion, speech clarity, articulation rate, and a speech handicap questionnaire. Early tumor stage, no radiation therapy, and base of tongue cancer were associated with better speech outcomes, particularly range of motion and clarity. Telemedicine was found to be an effective platform for conducting this clinical research during the pandemic.
Uterine Myoma, Risk Factor and Pathophysiology: A Review ArticleAnonIshanvi
This document reviews uterine myomas (fibroids), including their risk factors and pathophysiology. Some key points:
- Uterine myomas are benign muscle tumors that are common in women of reproductive age. Risk factors include age, family history, ethnicity, obesity, diet, pregnancy history, and smoking.
- The tumors are thought to be sensitive to estrogen and progesterone levels, which may explain why they typically grow during reproductive years and shrink after menopause.
- Cells in uterine myomas have a higher density of estrogen receptors compared to normal uterine muscle cells, and they convert estrogen to weaker forms less efficiently. This creates a relatively hyperestrogenic environment conducive to tumor growth.
Functional Disparity of Carcinoma Associated Fibroblasts in Different Stages ...AnonIshanvi
This document reports on a study that found functional differences between carcinoma-associated fibroblasts (CAFs) isolated from two different stages of breast cancer in a mouse model. CAFs isolated from stage 2 tumors (CAF-II) exhibited higher expression of immune-suppressive enzymes IDO and TGF-β compared to CAFs from stage 4 tumors (CAF-IV), which exhibited higher expression of iNOS and IL-10. This suggests the tumor microenvironments influenced by CAFs differ between cancer stages, which may contribute to varying responses to cancer therapies depending on the stage. Further research is needed to fully understand how CAF functions change during cancer progression and their potential as therapeutic targets at different stages.
Linitis plastica is a diffuse form of gastric cancer and accounts for about 10% of all cases of gastric malignancy and its exact general population distribution is unknown. There are no characteristic or specific symptoms, the symptoms are similar to those of other forms of stomach cancer and can manifest as a feeling of fullness after eating, nausea and vomiting, epigastric pain, weight loss, and progressive dysphagia [1]. Plastic linitisis characterized by malignant glandular proliferation of cricoid cells in the fibrous stroma, which ultimately leads to thickening and rigidity of the stomach wall.
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Background: The COVID-19 pandemic and control measures taken by countries around the worldcause stress and anxiety. The outbreak of corona virus not onlyhas a major impact on the physical health of the community, but also has a foremosteffect on thementalhealth of the public.Investigating the coping strategies to deal with this unique crisis is essential. Objective: The aim of this study was to assess the impact of covid-19 on stress and coping responses among general population. Methods: A descriptive cross-sectional study is adapted among 100 general populations. A convenient sampling technique was applied. The demographic data were collected using a structured questionnaire via interview method. The level of stress was measured by the perceived stress scale (PSS) and coping responses was evaluated by the brief cope scale. Result: The study outcomesdisplaysthat 53 (53%) had moderate stress, 28 (28%) had mild stress and 19 (19%) had severe stress during Covid-19. In respect to level of coping strategies among general population, 96% of the participants used planning coping strategy, 93% of them used religion coping strategy followed by 92% used self-distraction coping strategy. Conclusion: In our study, general population presented a moderate level of stress, in addition avoidance coping strategies was mostly used.Aiding the mental health care needs of public during these difficult times (pandemic) should be the top priority soadequate measures must be taken to promote the mental health of general public.
The Meaningful Assessment of Therapy OutcomesIncorporating .docxcherry686017
The Meaningful Assessment of Therapy Outcomes:
Incorporating a Qualitative Study Into a Randomized Controlled Trial
Evaluating the Treatment of Adolescent Depression
Nick Midgley
University College London and Anna Freud Centre, London,
United Kingdom
Flavia Ansaldo
Southwark Targeted Services—CAMHS, London,
United Kingdom
Mary Target
University College London
For many years, there have been heated debates about the best way to evaluate the efficacy and
effectiveness of psychological therapies. On the one hand, there are those who argue that the randomized
controlled trial (RCT) is the only reliable and scientifically credible way to assess psychological
interventions. On the other hand, there are those who have argued that psychological therapies cannot be
meaningfully assessed using a methodology developed to evaluate the impact of drug treatments, and that
the findings of RCTs lack “external validity” and are difficult to translate into routine clinical practice.
In this article, we advocate the use of mixed-method research designs for RCTs, combining the rigor of
quantitative data about patterns of change with the phenomenological contextualized insights that can be
derived from qualitative data. We argue that such an approach is especially important if we wish to
understand more fully the impact of therapeutic interventions within complex clinical settings. To
illustrate the value of a mixed-method approach, we describe a study currently underway in the United
Kingdom, in which a qualitative study (IMPACT-My Experience [IMPACT-ME]) has been “nested”
within an RCT (the Improving Mood With Psychoanalytic and Cognitive Behavioral Therapy [IMPACT]
study) designed to evaluate the effectiveness of psychological therapies in the treatment of adolescent
depression. We argue that such a mixed-methods approach can help us to evaluate the effectiveness of
psychological therapies and support the real-world implementation of our findings within increasingly
complex and multidisciplinary clinical contexts.
Keywords: adolescent depression, randomized controlled trials (RCTs), qualitative research, mixed-
methods design, outcome research
For many years, there have been heated debates about the best
way to evaluate the efficacy and effectiveness of psychological
therapies. On the one hand, there are those who argue that the
randomized controlled trial (RCT) (and meta-analyses of such
trials) is the only reliable and scientifically credible way to assess
psychological interventions. The RCT has long been considered
the “gold standard” approach, placed at the top of the “hierarchy of
evidence” and given almost exclusive credence by bodies such as
the Cochrane Collaboration and guideline developers such as the
National Institute for Health and Clinical Excellence (NICE). On
the other hand, there are those who have argued that psychological
therapies cannot be meaningfully assessed using a methodology
developed to evaluate the impact of drug treatme ...
A cross sectional and comparative study of attitudes in undergraduate medical...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document summarizes a systematic review of studies examining mind-body practices for the treatment of psoriasis. The review identified 9 relevant randomized controlled trials involving a total of 379 participants comparing mind-body interventions like meditation, mindfulness, hypnosis and relaxation techniques to conventional medical treatments or other complementary interventions. While the studies showed some improvements in disease symptoms and psychosocial outcomes, the review found high risks of bias and noted limitations in the available evidence.
Self-Regulatory Model of Illness Perception .pptxanmolayaz
The document summarizes Leventhal's Self-Regulatory Model of Illness Perception. The model proposes that individuals form cognitive and emotional representations of their illness based on symptoms, which influence their perception and guide coping behaviors. Research has applied this model to cancers like breast and lung cancer, finding that illness perceptions impact quality of life, distress, and treatment adherence. Therapies like psychoeducation, CBT, and mindfulness have been shown to improve illness perceptions and psychological outcomes for patients. While insightful, the model has limitations like overlooking socio-cultural factors and environmental influences on health.
Summary of SAMHSA's review of and listing of feedback Informed Treatment as an evidence-based practice. The International Center for Clinical Excellence received perfect scores for readiness for dissemination materials
1PAGE 21. What is the question the authors are asking .docxfelicidaddinwoodie
1
PAGE
2
1. What is the question the authors are asking?
They asked about a reduction in judgmental biases regarding the cost and probability associated with adverse social events as they are presumed as being mechanisms for the treatment of Social Anxiety Disorder (SAD). Also, the authors poised on the changes in judgmental biases as mechanisms to explain cognitive-behavioral therapy for social anxiety disorder. On top of that, they stated that methodological limitations extant studies highlight the possibility that rather than causing symptom relief, a significant reduction in judgmental biases tends to be consequences of it or correlate. Considerably, they expected cost bias at mid-treatment to be a predictor of the treatment outcome.
2. Why do the authors believe this question is important?
According to the authors, this question was relevant as methodological limitations of present studies reflect on the possibility that instead of causing symptom belief, a significant reduction in judgmental biases can be consequences or correlated to it. Additionally, they ought to ascertain the judgment bias between treated and non-treated participants. Significantly, this was important as they had to determine the impact of pre and post changes in cost and probability of the treatment outcomes. But, probability bias at mid-treatment was a predictor of the treatment outcome contrary to the cost bias at mid-treatment that could not be identified as a significant predictor of the treatment outcome.
3. How do they try to answer this question?
They conducted a study to evaluate the significant changes in judgmental bias as aspects of cognitive-behavioral therapy for social anxiety disorders. To do this, they conducted a study using information from two treatment studies; an uncontrolled trial observing amygdala activity as a response to VRE (Virtual Reality Exposure Therapy) with the use of functional magnetic resonance imaging and a randomized control trial that compared Virtual Reality Exposure Therapy with Exposure Group Therapy for SAD. A total of 86 individuals who met the DSM-IV-TR criteria for the diagnosis of non-generalized (n=46) and generalized (n=40) SAD participated. After completing eight weeks of the treatment protocol, the participants who identified public speaking as their most fearsome social situation were included. The SCID (Structured clinical interview for the DSM-IV) was used to ascertain diagnostic and eligibility status on Axis 1 conditions within substance abuse, mood and anxiety disorder modules. The social anxiety measures were measured with the use of BFNE (Brief Fear of Negative Evaluation), a self-reporting questioner that examined the degree to which persons fear to be assessed by other across different social settings. Additionally, the OPQ (Outcome Probability Questionnaire) self-reporting questionnaire was used to evaluate individual’s estimate on the probability that adverse, threatening events will occur at t ...
This is a presentation that I give to medical professionals educating them on the role and potential use of social work in the hospital setting. I presented this on May 22, 2009 to the Trauma Education & Research Committee.
Homeopathic treatment of elderly patients - a prospective observational study...home
The severity of disease showed marked and sustained improvements under homeopathic treatment,
but this did not lead to an improvement of quality of life. Our findings might indicate that homeopathic medical
therapy may play a beneficial role in the long-term care of older adults with chronic diseases and studies on
comparative effectiveness are needed to evaluate this hypothesis.
This study evaluated depression, anxiety, and stress in 111 patients with oral cancer using the DASS-21 questionnaire. Scores were highest for stress at diagnosis, depression one month after treatment and three months after discharge, but lowest for anxiety at all timepoints. Depression and stress scores significantly increased between diagnosis and three months after surgery, while anxiety scores were stable. The DASS-21 effectively evaluated stress. A positive correlation was found between DASS-21 and HADS questionnaire results. Psychological intervention is recommended to improve patient outcomes.
This qualitative systematic review synthesized 77 papers reporting on 60 studies to understand patients' experiences of chronic non-malignant musculoskeletal pain. The key finding was that patients experience chronic pain as an adversarial struggle on multiple levels, including affirming their identity, reconstructing their identity over time, explaining their suffering, navigating the healthcare system, and proving the legitimacy of their pain. However, some patients also expressed a sense of moving forward alongside their pain. The review provides insight for improving the patient experience by better understanding their pain and forming collaborative partnerships to help patients manage their condition.
This document summarizes the results of moderator analyses from a large randomized controlled trial testing the effectiveness of cognitive behavioral therapy (CBT) for chronic pain from osteoarthritis. The trial compared 10 sessions of Pain Coping Skills Training (PCST), a form of CBT, delivered by nurse practitioners to a usual care control group. Several demographic and clinical variables were examined as potential moderators of treatment response. The analyses found that patients' pain coping style, expectations for treatment, disease severity, age, and education level significantly moderated outcomes, with some subgroups showing stronger responses to PCST. Sex, race, BMI, and depression did not impact treatment response. Specifically, patients with interpersonal pain coping problems did not benefit much from
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The impact of the SARS-CoV-2 infection in all areas at the national and international level is undeniable, the aftermath of this “tornado” will be visible for a long time, even when the infection manages to be controlled. Two aspects of great interest to those of us who work in the area of oncology must be considered: on the one hand, the need to contain and control the devastating effects of the disease forced a reorganization in the operation of services, giving priority to COVID, conversion of medical units to hospitals COVID created a high-risk scenario for patients with other types of pathologies; This reorganization includes the allocation of large amounts of budget to COVID areas to the detriment of patients with other types of equally serious diseases - such as cancer, among others - who cannot wait for care in better times.
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Analyzing Speech Outcomes in Hemiglossectomy Patients Using Telecare PlatformAnonIshanvi
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Linitis plastica is a diffuse form of gastric cancer and accounts for about 10% of all cases of gastric malignancy and its exact general population distribution is unknown. There are no characteristic or specific symptoms, the symptoms are similar to those of other forms of stomach cancer and can manifest as a feeling of fullness after eating, nausea and vomiting, epigastric pain, weight loss, and progressive dysphagia [1]. Plastic linitisis characterized by malignant glandular proliferation of cricoid cells in the fibrous stroma, which ultimately leads to thickening and rigidity of the stomach wall.
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On February 21, 2020, at Codogno Hospital (in the Lodi?s Province, Lombardy, Italy), Italy?s Coronavirus ?patient one? was discovered. In the following week the cases within the Province of Lodi increased exponentially and it was interpreted as a disease cluster originating from the hospital.
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Osvaldo Bernardo Muchanga
Gastrointestinal Infections
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These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
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PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
The Effect of Metacognitive Therapy on Depression and Resilience of Cancer Patients in Selected Hospitals of Shahid Beheshti University of Medical Sciences
2. diagnosis changes the mental image of the patient and changes the
role of the home or work environment [3]. Because of the chronic
nature of the cancer, the patient should accept long-term treatment
with chemotherapy drugs. The treatment lasts weeks or months
and its side effects can be nausea, hair loss, fatigue, muscle aches,
skin burns, weight changes, and psychological problems [6].
Moreover, it causes many social and psychological problems,
while causing physical problems for patients. Crisis caused by can-
cer causes disturbance in the balance and coordination of thought,
body and soul, but the most common in this period for the patient
is the sense of despair, despair and depression [7]. Depression is
very harmful to cancer patients because it needs submission to dis-
ease. Other depressed people do not try to survive, and they miss
better opportunities to live in the remainder of their lives [8]. The
components that affect the incidence and severity of depression
are Resilience. Resilience is one of the most significant positive
psychologists, which is defined as a dynamic process positive and
significant adaptation in dangerous conditions [9]. Resilience is
defined as an act of self-restoration and of the conformity of behav-
ior and actions in order to overcome the dangerous situations and
promote life [10]. Many treatments for depression have been used
in these patients. One of these treatments is metacognitive therapy
in group therapy. The use of metacognitive therapy is considered
as a group of several directions. First, in group therapy, patients
do not need to be put on long waiting lists and therapists can use
them better than their own time [11]. Second, the group environ-
ment offers other advantages to patients, such as the experience of
being the same, modeling peer and peer support [12]. Karami et al.
(2014) concluded that there was a negative significant relationship
between metacognitive beliefs and mental health, and there was a
positive significant relationship between metacognitive beliefs and
self-esteem [13]. Also, the results of Mohammad Pour et al (2016)
in the research on the effectiveness of the participating in the
metacognitive therapy group on meta-cognitive beliefs in women
with breast cancer revealed that metacognitive therapy with pre-
test control had a significant effect on the reduction of symptoms
associated with the meta-cognitive factors of positive beliefs in
concern, uncontrollability, risk and the need to control thoughts
in women with breast cancer [14]. But a review of the literature
suggests that rare studies have concentrated on the effectiveness of
meta-cognitive therapy on depression and the Resilience of cancer
patients. Thus, more investigation is required about the effect of
the treatment. The aim of this study was to examine the effective-
ness of meta-cognitive therapy on depression and the Resilience
of cancer patients.
3. Materials and Methods
A semi-experimental study with intervention and control group
was performed and research population was 40 persons with can-
cer who referred to Taleghani Hospital affiliated of Shahid Behesh-
ti University of Medical Sciences in 2018. Sampling was firstly
based on the objective and then simple random method. Inclusion
criteria were not having a known psychological disorder, insight
toward of their cancer, duration at least 6 months from the diagno-
sis of cancer, and obtaining a score of 11 up from Beck Depression
Inventory (BDI). The samples who did not participate more than
two sessions exited from study. The sample size in each group was
also confirmed based on the following assumptions: power = 0.80,
α= 0.05, and Ơ=0.65 (20 for each group). The patients were ran-
domly assigned into intervention and control groups. Data were
collected using a socio-demographic questionnaire (included age,
gender, education level, insurance type and promotion system, the
duration of cancer, and type of cancer), Beck Depression Invento-
ry (BDI), and Connor- Davidson resilience Scale (CD-RISC).
3.1. Beck Depression Inventory (BDI)
This scale is included 21 items. Items receive a rating of zero to
three to reflect their intensity and are summed linearly to create a
score which ranges from 0 to 63. The 21 items included reflect a
variety of symptoms and attitudes commonly found among clin-
ically depressed individuals. The BDI is interpreted through the
use of cut-off scores. Cut-off scores may be derived based on the
use of the instrument (i.e., if a clinician wishes to identify very se-
vere depression, then the cut-off score would be set high). Scores
from 0 through 9 indicate no or minimal depression; scores from
10 through 18 indicate mild to moderate depression; scores from
19 through 29 indicate moderate to severe depression; and scores
from 30 through 63 indicate severe depression [15].
3.2. Connor- Davidson resilience Scale (CD-RISC)
Conner -Davidson Resilience Scale is designed by Connor and
Davidson in 2003 in the United States, which has 25 items and 5
components; personal competence / solidity, trust in instincts / tol-
erance of negative emotions, positive acceptance of changes / re-
lationships, safety, inhibition, and spirituality. The CD-RISC con-
tains 25 items, all of which carry a 5-point range of responses, as
follows: not true at all (0), rarely true (1), sometimes true (2), often
true (3), and true nearly all of the time (4). The scale is rated based
on how the subject has felt over the past month. The total score
ranges from 0–100, with higher scores reflecting greater resilience.
In order to obtain the total score of the questionnaire, the total
score of all questions is calculated; the higher the score, the greater
the respondent's level of resilience will be, and vice versa, the cut-
off point of the questionnaire is 50 points. In other words, the score
above 50 will be for higher Resilience.
Partovi, 1974; Wahhabzadeh, 1972 and Chegini in 2002 reported
that the reliability of the questionnaire was high and the maximum
was 90% [16]. In the research of Basharat (2007), the validity and
reliability of the Conor and Davidson questionnaire was confirmed
[17]. In the research of Haghranjbar et al (2011) the reliability of
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Volume 4 Issue 3 -2021 Research Article
3. Conor and Davidson questionnaire was tested using Cronbach's
alpha coefficient test, which obtained 0.84 for this questionnaire
[16].
In this study, the internal consistency reliability was performed
using Cronbach's alpha coefficient that was calculated for Beck
Depression Inventory (0.90) and Conor Davidson Questionnaire
(0.88).
3.3. Intervention Method
At first, 40 patients with cancer were selected based on inclusion
criteria. Then, the objectives and benefits of participating in the
study were explained to patients and, if agreeing, written informed
consent was obtained. Patients were assured that the company was
volunteering and their information would be kept confidential.
All participants were completed questionnaires and after that they
were randomly divided into two groups, intervention(n==20) and
control (n=20) group. The metacognitive therapy group comprised
9 women and 11 men, control group including 10 women and 10
men. At the beginning intervention group, a meta cognitive group
therapy based on Adrian Wells [18] eight sessions (two sessions
per week) was being held in hospital by first researcher. Each ses-
sion took 90 minutes. Table 1 presents the content of each treat-
ment session separately.
Immediately after the completion of the intervention and one
month later, the participants in both groups simultaneously com-
pleted the study’s questionnaire again. Participants in the control
group received the educational package too, but one month after
the end of the intervention.
The ethical considerations for this research have been done to
get the approval of the Ethics Committee of Islamic Azad Uni-
versity of Medical Sciences with ethics Code of IR.IAU.TMU.
REC.1396.143 and obtain the essential permissions and coordina-
tion with the authorities of the research community.
Table 1: Intervention Sessions Features
Session Subjects
1ST
Make Case Formulation. Introduction of model and preparation, identification and naming of rumination courses (increased knowledge).
Attenuation Training Technique Practice (ATT). Complete the ATT Training Summary. Homemade homework: Practicing attentive in-
struction technique (twice a day), daily recording of the practice of teaching attentive techniques
2ND Review homework and MDD-S scale, especially rumination and unbeliever beliefs. Introducing and rumination as a test for uncontrol-
lability Homemade homework: ATT instruction exercises, deployment A mind-boggling consciousness and postponement of rumination
3RD
Review homework and MDD-S scale, especially rumination and unbeliever beliefs. Challenging meta-cognitive impairment (for example,
modulation testing), Technician's practice, and the use of mind-boggling consciousness (DM) (counteracting active rumination by perform-
ing postponement of rumination in the treatment session). Attitudinal Education (ATT). Surveying the level of activity and avoidance of
homework: ATT training, the use of flaccid consciousness (DM), and postponement of rumination (in the case of all inducers) Increases
activity level
4TH
Review of homework and MDD-S scale, especially rumination time, uncontrollable belief, level of activity, and maladaptive check-up,
postponement of rumination about at least 75% of instigators and more than 2 minutes of non-period Rhymes (Enhanced Application)
Challenge with Positive Beliefs about Ruminating Attitude Training Technique Practice (ATT) Homework: Attention Training Technique
(ATT), Extending the Application of Fuzzy Mindfulness and Delaying Rhyming, Activity Planning
5TH
Review homework and MDD-S scale, especially rumination time, positive beliefs, level of activity and maladaptive coping, review of
widespread and sustainable use of Diffused Mind (DM) Continue the challenge with positive beliefs about rumination Assessing the level
of activity and providing recommendations for its improvement (examination and prohibition of other maladaptive coping methods such
as excessive sleep, alcohol consumption), Attention Training Technique (ATT) Homemade homework: ATT instruction exercises, delayed
rumination, increased activity levels
6TH
homework and MDD-S scale review, especially rumination time, positive beliefs, activity level Investigating and Challenging with Neg-
ative Beliefs on Excitement / Depression Practicing Attention Training Technique (ATT) (Increasing Difficulty) Homework: Practicing
Attention Training Technique
7TH
Review homework and MDD-S scale, especially rumination, misconceptions and coping.Work on the development of new programs
(completion of the summary sheet of the program and presentation of a copy to the patient) Investigating and changing the fear of return-
ing symptoms, ATT training practice homework: ATT instruction exercises, new program execution, Start work on developing a general
treatment plan
8TH homework and MDD-S scale review, prevent recurrence (complete the treatment plan) Work on meta-cognitive beliefs, anticipating future
stimuli and discussing how to use the new program of reinforcement session planning
3.4. Statistical Analysis
In order to analyze the data, descriptive statistics (central indica-
tors and dispersion) and inferential statistics used. To define the
quantitative data, the mean, standard deviation, percentage and
frequency were used. To determine the differences before and af-
ter education, t-test was used. All statistical tests were performed
at a significance level of 0.05 and data were analyzed using SPSS
software version 19.
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4. 4. Findings
Of the 40 participants in the study, 20 participants were placed in
the intervention or meta-cognitive therapy group (9 men and 11
women) and 20 participants in the control group (10 men and 10
women). Table 2 shows the mean and standard deviation of age of
the participations in two groups. According to findings the distri-
bution of cancer patients in the two groups of control and interven-
tion in terms of age variables were no significant differences. Also,
other variables are presented at Table 3. The distribution of cancer
patients in terms of sex, education level and type of insurance,
were also no significant differences between control and interven-
tion groups. In addition, the two groups were homogeneous.
Also, results showed that the mean of depression in the control,
immediately after and one month after therapy in the intervention
group was 18.25, 14.40 and 2.30 respectively. Moreover, the level
of resilience in the control group, immediately after and one month
after the intervention was 69.45, 74 and 88.35 respectively (Table
4).
According to Table 5 the highest mean difference between the
cases before intervention one month after the intervention was
13.75. So, the rate of depression has decreased significantly and
metacognitive therapy has been effective. Table 5 showed that the
highest mean difference between the case before intervention and
one month after the intervention 18.95, that shows an increase in
the doping of the subjects in the intervention group who have un-
dergone metacognitive treatment.
Table 2: the average age of patients in both intervention and control group
Age Number Average Standard deviation F Lewin Test( P-value) t P-value
Control
Intervention
20
20
39.94
40.45
13.95
10.88
2.562
(0.115)
0.125 0.901
Table 3: Distribution of education level, insurance type and gender in both control and intervention group
Control
Number /frequency
Intervention
Number / frequency
K 2 P-value
Education level
Illiterate
Less than diploma
Diploma
Bachelor
Higher education
1 5
9 45
4 20
5 25
1 5
1 5
7 35
9 45
2 10
1 5
3.459 0.484
Insurance type
Health
Social supply
Medical services
non
9 45
9 45
2 10
0 0
5 25
11 55
3 15
1 5
2.543 0.468
Gender
Male
female
10 50
10 50
11 55
9 45
0.100 0.500
Table 4: Depression and Resilience rate in control and intervention groups, before, immediately and one month after therapy
Variable Group Average Standard deviation t P –value
Depression Control 17.95 8.86 -6.836 0.0001
Before intervention Intervention 16.05 7.75 -8.916 0.0001
Depression Control 18.25 8.66 -6.84 0.0001
Intervention (Immediately after) 14.4 6.86 -11.144 0.0001
After intervention Intervention (One month after intervention) 2.3 2.03 -64.368 0.0001
Resilience Control 69.5 11.46 8.387 0.0001
Before intervention Intervention 69.4 14.23 6.724 0.0001
Resilience Control 69.45 11.37 8.144 0.0001
Intervention (Immediately after) 74 13.62 12.476 0.0001
After intervention Intervention (One month after intervention) 88.35 4.7 40.446 0.0001
clinicsofoncology.com 4
Volume 4 Issue 3 -2021 Research Article
5. Table 5: Difference in average level of Depression and Resilience of intervention groups, before, immediately and one month after therapy
Variable Group Difference Average Standard deviation t P –value
Depression before intervention
immediately after intervention
1.65 5.60
-1.317 0.204
before intervention
one month after intervention
13.75 6.57 -9.362 0.0001
immediately after intervention
one month after intervention
12.10 5.65 -14.746 0.0001
Resilience before intervention
immediately after intervention
4.60 8.64 2.381 0.028
before intervention
one month after intervention
18.95 12.16 6.967 0.0001
immediately after intervention
one month after intervention
14.35 2.55 5.623 0.0001
5. Discussion
The aim of this study was to study the effectiveness of metacogni-
tive therapy on depression and resilience of cancer patients. In this
study, 40 cancer patients were studied in both experimental and
control groups, each of which was 20. The results of this study on
meta-cognitive therapy on the rate of depression in patients with
cancer indicated that there was a significant difference in depres-
sion in the control and control groups. Furthermore, meta-cogni-
tive therapy is effective in decreasing the incidence of depression
in cancer patients. Comparison of mean depression scores before
and after intervention in control group did not show statistically
significant difference.
But the mean comparison of this variable after meta-cognitive
therapy presented a significant difference in depression; telling in-
creased mental health and increasing the use of strategies to reduce
depression in the experimental group. In the follow up study, the
results after 1 month of metacognitive therapy, an improvement
in the rate of depression reduction were obtained. The finding
that metacognitive therapy reduces depression is similar to that of
study by Zhang et al [19] Kuyken et al [20], Bergersen [21], and
Parhoon et al [22]. Parhoon et al. in a similar explanation state that
metacognitive therapy leads to the control of the underlying mech-
anisms of cognitive, emotional and behavioral symptoms because
of the reduction of meta-cognitive beliefs involved in the continu-
ation of depression symptoms. Wells et al [23] presented that 75%
of depressed patients recovered after meta-cognitive therapy and
66% of them after a 6-month follow-up. In a study done by Gha-
hari et al [24], the effect of cognitive-behavioral intervention on
decreasing depression and anxiety in women with breast cancer
was not confirmed, which is not consistent with the results of this
study.
In a research by Sadeghi firoozabadi et al [25], supplementary psy-
chotherapy was effective in reducing the amount of anxiety and
depression in patients. Furthermore, in the follow up to a month,
the level of anxiety and depression remained constant. It can be
determined that the training techniques helped patients to manage
their thoughts and mental conditions when confronted with anxi-
ety events that were consistent with the present study. Only in one
study, supplementary psychotherapy did not affect anxiety and de-
pression in patients with prostate cancer [26], which did not match
the results of the present study.
The results of one-month follow-up also showed that there was a
significant difference between the persistency levels in the control
and control groups. Besides, meta-cognitive therapy is effective
on the Resilience of cancer patients. The study of Hosseini Ghomi
et al [27] indicated that survival education in mothers with a can-
cerous child who experienced a specified education has been re-
lated to increased survival and reduced stress compared to those
who did not have these training. They have made better progress
in controlling their mental conditions and their families and their
families, which is corresponding to the results of this study. Zami-
ri nejad and colleagues [28] indicated that the method of group
vibration training plus cognitive therapy causes girl students de-
pressed and is consistent with the results of this study.
Based on the findings of the study by Almasi et al [29], it has been
found that training coping skills with stress has a positive effect on
maternal relief and the degree of Resilience in them has increased
after training. So the maternal Resilience scores increased signifi-
cantly after 8 sessions of education (p <0.001), which is consistent
with the results of the present study. It appears that in clarifying the
significant relationship between vibration and emotional stresses
of depression and stress, it can be concluded that the focus of pro-
grams and psychological interventions on increasing the Resilience
of people with cancer can be a strategy infrastructure to decrease
the emotional distress of these patients. This research had several
limitations. Including time constraints, low sample sizes, tracking
results only in the four-week period can be mentioned. Because
of obstacles for further extensive research, it is recommended that
future research study the effect of this treatment on other variables,
such as adaptation to cancer. If there is a possibility to follow the
results of meta-cognitive therapy in the long term (3 months and 6
months), it is probable that the effectiveness of this type of treat-
clinicsofoncology.com 5
Volume 4 Issue 3 -2021 Research Article
6. ment for depressive disorder can be more persuasive.
6. Conclusion
The results indicate that metacognitive therapy has been effective
in depression and resilience of cancer patients after the interven-
tion and one month after the intervention. It is important to pre-
vent emotional disorders such as depression in people with cancer.
Therefore, according to the results, it can be said that the use of
metacognitive therapy is a useful intervention for r patients with
cancer. Because cancer has psychological dimensions and compli-
cations, metacognitive therapeutic behavior is not only effective in
curing many chronic diseases but also helps patients to minimize
the negative psychological effects of their disease. Therefore, re-
ducing psychological symptoms is not only effective in treatments
and future advances, but also in promoting supportive, coping, and
rehabilitation programs. Therefore, it is recommended that by es-
tablishing and upgrading counseling and psychotherapy centers in
hospitals and centers, effective assistance be provided in the im-
proving process of these patients.
This research has faced several limitations. For example, time
constraints, low sample size, follow-up of results only in the four-
week period can be mentioned. Due to the existence of barriers to
the wider implementation of research, it is suggested that in future
research, the effect of this treatment on other variables such as
adaptation to cancer will be investigated. If it is possible to follow
the results of metacognitive therapy in the long term (3 months
and 6 months), we can probably speak more effectively about the
effectiveness of this type of treatment for depressive disorder.
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