Symptom burden in advanced breast cancer patients and its association between death anxiety and psychological distress

Objective:Recent research has documented psychological distress in advanced breast cancer(ABC)patients,but few studies have examined how death anxiety is affected by the symptom burden.Therefore,this study aims to explore the association among symptom burden,death anxiety and psychological distress(depression and anxiety)in ABC patients.Methods:This cross-sectional study used the Death and Dying Anxiety Scale(DADDS),9-item Patient Health Questionnaire(PHQ-9),General Anxiety Disorder-7(GAD-7)and MD Anderson Symptom Inventory(MDASI)to assess death anxiety,depression,anxiety,and symptom burden,respectively.Bias-corrected bootstrapping methods were used to estimate indirect effects and 95%confidence intervals.Results:Two hundred ABC patients completed the questionnaires.All of the respondents were females,with a mean age of 50±10 years.Initial correlation analyses revealed significant associations of death anxiety with depression(r=0.57,P<0.001),anxiety(r=0.60,P<0.001)and symptom burden(r=0.43,P<0.001).Moreover,depression(r=0.53,P<0.001)and anxiety(r=0.45,P<0.001)were significantly correlated with symptom burden.An analysis using Hayes’PROCESS macro revealed the partial effecting role of death anxiety in the relationship between depression and symptom burden,and between anxiety and symptom burden(contributions to the total effect of 0.247 and 0.469,respectively).Conclusions:This study provides insight into the relationship between death anxiety and symptom burden.The results suggest that interventions addressing death anxiety may be more effective for alleviating the depression and anxiety experienced by ABC patients with a symptom burden.

A Chinese version of a Likert-type death anxiety scale for colorectal cancer patients

Objective:This study aimed to evaluate and validate the performance of a Chinese version of a Likerttype death anxiety scale for colorectal cancer patients.Methods:This study assessed the death anxiety of 50 colorectal cancer patients,which were selected by convenience sampling method,by using the Chinese version of a Likert-type Templer death anxiety scale(CL-TDAS)on the first day of admission.Results:Most of the respondents finished the entire scale in 3e5 min,and the recovery rate was 94.0%.Cronbach's a indicated that the internal consistency was 0.821 for the complete 15 items,and the correlation between the CL-TDAS and the C-TDAS(non-Likert-type)was 0.79(P<0.05).The structural validity of the CL-TDAS revealed that the scale items accounted for>63.78%of the total variability,and that the four-component structure of the data well fitted the model.The mean score of the CL-TDAS was 36.16±9.99(first day of admission).Conclusion:The CL-TDAS showed reliable performance and can thus be a promising instrument for evaluating the death anxiety of cancer patients.Death anxiety varied for different periods and different genders.

Cognitive and Emotional Factors Related to Obstructive Sleep Apnea Diagnoses: A Brief Review

Sleep apnea is a clinical condition characterized by cessation of breathing in the sleeper due to pharyngeal airway closure. The reduction in air exchange results in decreased cerebral blood circulation with consequential behavioral deficits cognitively and emotionally. Untreated sleep apnea is associated with chronic illnesses of depression, cardiovascular disorder, obesity and diabetes mellitus. Measured cognitive behavior before and following CPAP treatment demonstrates the cognitive deficit as the effectiveness of CPAP treatment. Emotional factors related to sleep apnea diagnosis and adherence to treatment are facilitated in patients with cognitive behavior therapy (CBT) interventions by sleep specialists. This is a brief review paper that presents findings about cognition and emotional factors related to sleep apnea. This is a brief review paper.