Cognitive Function in Older Women With Breast Cancer Treated With Standard Chemotherapy and Capecitabine on Cancer and Leukemia Group B 49907.

Cognitive function in older women with breast cancer treated with standard chemotherapy and capecitabine on Cancer and Leukemia Group B 49907.

Breast Cancer Res Treat. 2013 May 17;
Freedman RA, Pitcher B, Keating NL, Ballman KV, Mandelblatt J, Kornblith AB, Kimmick GG, Hurria A, Winer EP, Hudis CA, Cohen HJ, Muss HB,

Cognitive changes in older women receiving chemotherapy are poorly understood. We examined self-reported cognitive function for older women who received adjuvant chemotherapy on Cancer and Leukemia Group B (CALGB) 49907. CALGB 49907 randomized 633 women aged ?65 with stage I-III breast cancer to standard adjuvant chemotherapy (cyclophosphamide-methotrexate-5-fluorouracil or doxorubicin-cyclophosphamide) versus capecitabine. We examined self-reported cognitive function in 297 women (CALGB 361002) who enrolled on the quality of life substudy and had no gross impairment on cognitive screening. Women were evaluated using an 18-item instrument at six time points (baseline through 24 months). At each time point for each patient, we calculated a cognitive function score (CFS) defined as the mean response of items 1-18 and defined impairment as a score >1.5 standard deviations above the overall average baseline score. Differences in scores by patient characteristics were evaluated using a Kruskal-Wallis test. A linear mixed-effects model was used to assess CFSs by treatment over time. Among 297 women, the median age was 71.5 (range 65-85) and 73 % had performance status of 0. Baseline depression and fatigue were reported in 6 and 14 % of patients, respectively. The average CFS at baseline was 2.08 (corresponding to “normal ability”), and baseline cognitive function did not differ by treatment regimen (p = 0.350). Over 24 months, women reported minimal changes at each time point and insignificant differences by treatment arm were observed. In a healthy group of older women, chemotherapy was not associated with longitudinal changes in self-reported cognitive function. HubMed – depression


Correlations Among Social Support, Depression, and Anxiety in Patients With Type-2 Diabetes.

J Nurs Res. 2013 Jun; 21(2): 129-138
Wu SF, Young LS, Yeh FC, Jian YM, Cheng KC, Lee MC

BACKGROUND:: Social support is related to patient self-care and health status. Patients’ psychosocial issues play an important role in diabetes care. PURPOSE:: This study investigates correlations among social support, depression, and anxiety in patients with diabetes. METHODS:: A cross-sectional study design and purposive sampling were used. One hundred eleven patients with type-2 diabetes were recruited from three regional teaching hospitals in northern, central, and southern Taiwan, respectively. Questionnaires used included the social support and psychological referral inventory, Beck depression inventory, and Beck anxiety inventory. RESULTS:: Approximately 12.6% of the study population had depression, and 27.0% had anxiety. Depression and anxiety were positively correlated (r = .65, p < .01), whereas depression was negatively correlated with the sum of disease control types (r = -0.26, p < .01) and social support (r = -0.27, p <.01). The sum of disease control types and social support were the most important explanatory factors for depression in patients, explaining 45.5% of variance. Anxiety was correlated positively with age (r = .26, p < .01), total number of complications (r = .31, p < .01), and depression (r = .65, p < .01). Anxiety correlated negatively with weight (r = -0.20, p < .05) and sum of disease control types (r = -0.25, p < .05). The above variables were important explanatory factors for anxiety, accounting for 15.2% of variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE:: Psychological factors, such as depression and anxiety, are common symptoms in patients with diabetes. If social support can be strengthened in these patients, then psychological factors can be improved. Professional care providers should focus on reducing the patient depression and anxiety levels, strengthening social support, and providing referrals to psychology-related professionals. HubMed – depression


The Relationship Between Geriatric Depression and Health-Promoting Behaviors Among Community-Dwelling Seniors.

J Nurs Res. 2013 Jun; 21(2): 75-82
Chang CF, Lin MH, Wang J, Fan JY, Chou LN, Chen MY

BACKGROUND:: People older than 65 years old account for about 10.9% of Taiwan’s total population; it is also known that the older adults experience a higher incidence of depression. Public health nurses play an important role in promoting community health. Policymaking for community healthcare should reflect the relationship between health-promoting behavior and depression in community-dwelling seniors. Therefore, the encouragement of healthy aging requires strategic planning by those who provide health promotion services. OBJECTIVE:: This study was designed to elicit the health-promoting behaviors of community seniors and investigate the relationship between geriatric depression and health-promoting behaviors among seniors who live in rural communities. METHODS:: We used a cross-sectional, descriptive design and collected data using a demographic information datasheet, the Health Promotion for Seniors and Geriatric Depression Scale short forms. RESULTS:: The study included 427 participants. Most were women; mean age was 75.8 years. Most were illiterate; roughly half engaged in a limited number of health-promoting activities. The Geriatric Depression Scale score was negatively associated with health-promoting behavior. Social participation, health responsibility, self-protection, active lifestyle, and total Health Promotion for Seniors score all reached statistical significance. Multivariate analysis indicated that geriatric depression and physical discomfort were independent predictors of health-promoting behavior after controlling the confounding factors. CONCLUSIONS/IMPLICATIONS FOR PRACTICE:: Participants practiced less than the recommended level of health-promoting behaviors. We found a negative correlation between the geriatric depression score and health-promoting behavior. Results can be referenced to develop strategies to promote healthy aging in the community, especially with regard to promoting greater social participation and increased activity for community-dwelling older adults experiencing depression. HubMed – depression



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