Methods: A total of 123 patients and their attending physicians were asked to estimate a prognosis selleck inhibitor on a six-point scale. The patients were also asked to fill out questionnaires addressing their psychological state and coping.
Results: The mean prognostic estimations differed by 1.17 points (p<0.001), with the patients being more optimistic than the physicians. With respect to concordance: Pearson correlation r = 0.024 (ns); unweighted kappa and kappa with linear weighting are 0.115 and 0.068, respectively. The prognostic estimates of the patients correlated with their psychological state, but not with the objective
disease- or treatment-related variables, whereas the physicians’ selleck chemical estimates were partially based on such objective factors.
Conclusions: A clear significant association between actual survival and the physicians’ estimates, but not the patients’ estimates, was observed. If agreement regarding the prognosis exists, the relationship between physicians’ and patients’ estimates is probably non-linear. Assessing one’s chances
of being cured is a highly emotional task, and psychological processes such as denial or repression most likely play a decisive role. Moreover, collusion between the patient and physician may be inevitable in this situation. Whether it is desirable to gain concordance and who will benefit from such efforts must be discussed and empirically studied. Copyright (C) 2009 John Wiley & learn more Sons, Ltd.”
“Background: The distinct trajectories of psychological distress over the first year of the diagnosis with breast cancer (BC) and its determinants have not been explored.
Methods: 285 of 405 Chinese women receiving surgery for
BC were assessed at 5-day, 1-month, 4-month, and 8-month post-surgery on measures of psychological distress, optimism, treatment decision-making (TDM) difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, and physical symptom distress. Latent growth mixture modelling identified trajectories of psychological response to BC. Multinominal logistic regression compared TDM difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, optimism, and physical symptom distress, by distress pattern adjusted for age, education, employment status, and stage of disease.
Results: Four distinct trajectories of distress were identified, namely, resilience (66%), chronic distress (15%), recovered (12%), and delayed-recovery (7%). TDM difficulties, optimism, satisfaction with consultation, and physical symptom distress predicted distress trajectories. Psychologically resilient women had less physical symptom distress at early post-surgery compared with women with other distress patterns.