Kristine A. Donovan

Screening for psychologic distress in ambulatory cancer patients : A multicenter evaluation of the distress thermometer

Based on evidence that psychologic distress often goes unrecognized although it is common among cancer patients, clinical practice guidelines recommend routine screening for distress. For this study, the authors sought to determine whether the single‐item Distress Thermometer (DT) compared favorably with longer measures currently used to screen for distress.

Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue

CONTEXT Fatigue is among the most common and distressing symptoms experienced by cancer patients. OBJECTIVE This systematic review and meta-analysis evaluates the efficacy of psychological and activity-based interventions against cancer-related fatigue in cancer patients. DATA SOURCES MEDLINE, PsycINFO, and CINAHL. STUDY SELECTION Randomized controlled trials of psychological and activity-based interventions involving adult cancer patients in which fatigue was an outcome were reviewed. EXTRACTION Forty-one trials were reviewed and 30 were included in a meta-analysis. DATA SYNTHESIS Fifty percent of psychological trials and 44% of activity-based trials rated fair or better in quality yielded significant findings favoring the intervention condition. Meta-analysis yielded an overall effect size of 0.09 (95% CI = .02- .16) favoring nonpharmacological conditions. Further analysis indicated that effect sizes were significant for psychological interventions (d-sub(w) = .10, 95% CI = .02-.18) but not activity-based interventions (d-sub(w) = .05, 95% CI = -.08 - .19). CONCLUSIONS Findings provide limited support for use of nonpharmacological interventions to manage cancer-related fatigue. The lack of research with heightened fatigue as an eligibility criterion is a notable weakness of the existing evidence base.

Validation of the Distress Thermometer Worldwide: State of the Science

The Distress Thermometer (DT) has been used in psycho‐oncology research across the globe and has been recommended as a clinical tool to be used routinely in cancer settings to detect clinically significant distress. We sought to characterize the translation and validation of the DT in cancer patients in different countries and cultures and summarize how the translated versions function to detect clinically significant distress.

Prevalence, predictors, and characteristics of off‐treatment fatigue in breast cancer survivors

Lack of consensus regarding how to identify cancer patients with significant fatigue has hampered research regarding cancer‐related fatigue (CRF).

Relationships between youth sport participation and selected health risk behaviors from 1999 to 2007.

BACKGROUND How adolescents spend their out-of-school time represents one of the most important factors for predicting positive youth development. Sport participation relates to many beneficial outcomes. However, current economic conditions threaten high school sport programs around the United States. This investigation examined relationships by year between sport participation and numerous health risk behaviors among high school students. METHODS Data were derived from the Centers for Disease Control and Preventions Youth Risk Behavior Surveys administered every 2 years from 1999 through 2007. Items assessed were sport participation, vigorous physical activity, dietary habits, weight loss, sexual activity, interpersonal violence and suicidality, and substance use. Multiple logistic regression analyses were used to examine relationships between sport participation and each health behavior. Interaction effects tested whether relationships varied by year, sex, age, and/or race/ethnicity. RESULTS Analyses revealed some consistencies across years in relationships between sport participation and health risk behaviors for both sexes. However, most relationships varied by race/ethnicity. Among White students, sport participation related to multiple positive health behaviors. Conversely, African American, Hispanic, and Other athletes showed fewer positive health behaviors and some negative behaviors. CONCLUSIONS Findings suggest that participation in organized sports affords many health benefits to most adolescents, but relates to some negative health behaviors in certain subgroups. Information regarding sport participation and health risk behaviors among subgroups across years can inform school policy, practice, and future research.

Cognitive Functioning in Breast Cancer Survivors: A Controlled Comparison

The current study was performed to determine whether neuropsychologic functioning differs in breast cancer survivors 6 months after the completion of adjuvant treatment compared with women without cancer.

Utility of a Cognitive–Behavioral Model to Predict Fatigue Following Breast Cancer Treatment

The objective of the current study was twofold: (a) to determine whether subgroups of breast cancer patients could be identified on the basis of their distinct trajectory or pattern of fatigue following treatment for early stage cancer using growth mixture modeling and (b) to examine whether the subgroups could be distinguished on the basis of a cognitive-behavioral model. Growth mixture modeling and a prospective longitudinal design were used to examine the course of fatigue after treatment for early stage breast cancer. Women (n = 261; mean age = 55.2 years) provided fatigue ratings for 6 months following treatment. A low-fatigue group (n = 85) and a high-fatigue group (n = 176) were extracted. Women who were not married, had a lower income, had a higher body mass index, engaged in greater fatigue catastrophizing, and were lower in exercise participation were more likely to be in the high-fatigue group. Only body mass index and catastrophizing remained significant predictors in multivariate analysis. Findings suggest considerable heterogeneity in the experience of fatigue following treatment and support the utility of a cognitive-behavioral model in predicting the course of posttreatment fatigue.

Fatigue after treatment for early stage breast cancer: a controlled comparison.

Evidence suggests that fatigue may be a greater problem for cancer survivors than people without cancer. The present study sought to determine whether fatigue was greater in women who had completed treatment for early‐stage breast cancer relative to a demographically matched comparison group of women with no cancer history.

Identifying Clinically Meaningful Fatigue with the Fatigue Symptom Inventory

The Fatigue Symptom Inventory has been used extensively to assess and measure fatigue in a number of clinical populations. The purpose of the present study was to further establish its utility by examining its operating characteristics and determining the optimal cutoff score for identifying clinically meaningful fatigue. The MOS 36-Item Short Form Vitality scale, a measure widely used to identify individuals with significant fatigue-related disability, was used to determine the sensitivity and specificity of the Fatigue Symptom Inventory. Results indicate that a score of 3 or greater on those items assessing fatigue in the past week is the optimal cutoff score for identifying clinically meaningful fatigue. Individuals who scored at or above the cutoff also reported significantly greater fatigue interference, more days of fatigue on average, and fatigue a greater proportion of each day in the past week. Findings suggest that the Fatigue Symptom Inventory can be used to discriminate effectively between individuals with and without clinically meaningful fatigue.

Oxaliplatin-induced peripheral neuropathy’s effects on health-related quality of life of colorectal cancer survivors

Oxaliplatin is a highly neurotoxic chemotherapeutic agent routinely used for the treatment of colorectal cancer. Recent data suggest that oxaliplatin-induced peripheral neuropathy may be long-lasting; however, the effects of persistent neuropathy on colorectal cancer survivors’ physical and emotional well-being are not well understood. This cross sectional, descriptive study included persons who had received oxaliplatin-based chemotherapy for treatment of colorectal cancer at Moffitt Cancer Center between 2003 and 2010. Questionnaires including the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool, Center for Epidemiological Studies Depression Scale (CES-D), Insomnia Severity Index, Medical Outcomes Study Short Form 36, and a demographic survey were administered. Pearson’s correlations and linear regression analyses were used to examine relationships between neuropathy and depressive symptoms, sleep quality, and health-related quality of life (HRQOL). Eighty-nine percent of participants reported at least one symptom of peripheral neuropathy with a mean of 3.8 (±2.4) neuropathic symptoms. Depressive symptoms on the CES-D were significantly associated with more severe peripheral neuropathy(r = 0.38, p = 0.0001) and interference with activities (r = 0.59, p < 0.0001). Higher degrees of sleep disturbance on the Insomnia Severity Index (ISI) were significantly associated with more severe peripheral neuropathy (r = 0.35, p = 0.0004) and interference with activities(r = 0.52, p < 0.0001). HRQOL was significantly associated with peripheral neuropathy and interference with activities.