Thecla Brakel

Neuroticism and Responses to Social Comparison Among Cancer Patients

The present study examined how the effects of three audiotapes containing different types of social comparison information on the mood of cancer patients depended on the level of neuroticism. On the procedural tape, a man and woman discussed the process of radiation therapy, on the emotion tape, they focussed on emotional reactions to their illness and treatment, while on the coping tape they focussed on the way they had been coping. A validation study among 115 students showed that the tapes were perceived as they were intended. The main study was conducted among 226 patients who were about to undergo radiation therapy. Compared to patients in the control group, as patients were higher in neuroticism, they reported less negative mood after listening to the procedural and the coping tape. Furthermore, as patients were higher in neuroticism, they reported less negative mood after listening to the coping tape than to the emotion tape. Copyright

Development of an allergy management support system in primary care

Background Management of allergic patients in the population is becoming more difficult because of increases in both complexity and prevalence. Although general practitioners (GPs) are expected to play an important role in the care of allergic patients, they often feel ill-equipped for this task. Therefore, the aim of this study was to develop an allergy management support system (AMSS) for primary care. Methods Through literature review, interviewing and testing in secondary and primary care patients, an allergy history questionnaire was constructed by allergists, dermatologists, GPs and researchers based on primary care and specialists’ allergy guidelines and their clinical knowledge. Patterns of AMSS questionnaire responses and specific immunoglobulin E (sIgE)-test outcomes were used to identify diagnostic categories and develop corresponding management recommendations. Validity of the AMSS was investigated by comparing specialist (gold standard) and AMSS diagnostic categories. Results The two-page patient-completed AMSS questionnaire consists of 12 (mainly) multiple choice questions on symptoms, triggers, severity and medication. Based on the AMSS questionnaires and sIgE-test outcome of 118 patients, approximately 150 diagnostic categories of allergic rhinitis, asthma, atopic dermatitis, anaphylaxis, food allergy, hymenoptera allergy and other allergies were identified, and the corresponding management recommendations were formulated. The agreement between the allergy specialists’ assessments and the AMSS was 69.2% (CI 67.2–71.2). Conclusion Using a systematic approach, it was possible to develop an AMSS that allows for the formulation of diagnostic and management recommendations for GPs managing allergic patients. The AMSS thus holds promise for the improvement of the quality of primary care for this increasing group of patients.

Targeting cancer patients’ quality of life through social comparison: A randomised trial

Objective: Former cancer patients’ quality of life can be improved by offering social comparison information. Whether patients, however, benefit from the information may depend on how negative they perceive their present and their future. Design: We conducted a randomised experimental field study with a pre- and post-measurement. Dutch former cancer patients – recruited through different media – were assigned to a social comparison intervention condition or a no-intervention control condition (experimental condition n = 62; control condition n = 88; Mage = 52 years). In the intervention condition, patients received a 20 min computer-tailored interview in audio format. Patients’ present perceived life threat and future health expectations were measured at pretest. Main outcome measures: Quality of life and life satisfaction after 2 months were the outcome variables. Results: The intervention increased life satisfaction only in patients who experienced a high present life threat ( = .08) and in patients who had negative future health expectations, the intervention increased quality of life ( = .05). Conclusions: Not all patients did benefit from the intervention; for some patients, the social comparison intervention was even detrimental. Moderator analyses seem necessary to evaluate psycho-social interventions for cancer patients.

Influence of content of patients testimonials on the evaluation of patient characteristics.

Background:This correlational study examined the value of the HAPA theory at predicting weight-loss in a weight-loss trial. Methods:Participants (N¼22) undergoing an 8-week weight-loss programme were recruited from aprivate hospital. Baseline questionnaires measured demographics, height, weight, self-efficacy,risk-perception, outcome-expectancies and intentions. Findings:Questionnaires at 4 and 8 weeks measured weight-loss behaviours – physical activity,dietary variables, effort and weight. The HAPA was able to significantly predict weight-loss(RAˆ2¼0.57,p¼0.027). Self-efficacy and risk-perceptions were significantly related to intention(r¼0.80,p50.001 andr¼�0.48,p50.01 respectively). Intentions were significantly related to weight-loss behaviour was significantly related toweight-loss (r¼0.73,p50.01). The study provides evidence for the predictive value of the HAPAat predicting weight-loss. Discussion:Findings build on current knowledge of the cognitions and behaviours involved insuccessful weight-loss and may contribute to the development of interventions designed to increaseweight-loss in the overweight and clinically obese population.Background: Previous reports of this prospective study highlight the psychological benefits of a breast screening programme for younger women with a family history of breast cancer. The present paper identified risk factors for cancer worry in these women. Methods: 1286 women completed questionnaires one month prior to screening (T1), and one (T2)and six (T3) months after screening results. Breast cancer worry, perceived risk, cognitive appraisals, coping, and dispositional optimism were measured. Findings: T1 cancer worry explained 56/61% and 54/57% of the variance in worry at T2 and T3 respectively. Other salient predictors included high perceived risk of breast cancer, appraisals of high relevance and threat associated with the family history, and low perceived ability to cope emotionally. A false positive screening result, pessimistic personality, and religion/substance use coping predicted outcomes at T2 but not T3. Discussion: Interventions to ameliorate high levels of cancer worry and negative appraisals are needed.Background: Personal disclosures of patients may influence how they are evaluated by others. These evaluations may be influenced by the information the patient provides but also by the recipients needs. Methods: In an experimental study, healthy female participants (N = 61) listened to a female cancer patient’s testimonial (25 minutes) in which the patient told about either her negative emotions during radiation therapy or coping strategies she used. The dependent variable was participant’s evaluation of the patient. Findings: The results showed a main effect of condition, meaning that patients who told about their coping were perceived as more sympathetic, courageous and realistic. As indicated by a significant interaction, this effect was especially strong in participants with a strong inclination to compare themselves to others. Discussion: These data show that the personal information that patients provide to others influences how others perceive them. This may have consequences for the others’ motivation to provide social support.Background: Ovarian cancer is known as the “silent killer”. A prospective psychological evaluation study (PsyFOCS) is underway in partnership with the UK Familial Ovarian Cancer Screening Study, which aims to determine the clinical effectiveness of ovarian screening for high risk women. Methods: Prior to screening, 991 women completed the Illness Perception Questionnaire (adapted for ovarian cancer risk), Impact of Event Scale (IES), and Hospital Anxiety and Depression Scale. Findings: Over one third of women were moderately or highly distressed about their risk according to IES scores. Hierarchical multiple regression showed that negative emotional representations (p<.001), higher anxiety (p<.001), stronger ovarian cancer screening control beliefs (p<.01), and past ovarian cancer screening recall (p<.05) were associated with higher pre-screening distress. Discussion: The association between ovarian cancer screening control beliefs and distress suggests that more distressed women may place greater faith in screening as a means of controlling genetic risk.

Reported characteristics of children referred from primary care to pediatric allergy specialist care

Background: For the majority of patients suspected of allergy, management is mostly the responsibility of general practitioners (GPs), but may include specialist referral in selected cases. The purpose of this study is to obtain insight in characteristics of children that are referred from primary care to pediatric specialist care for diagnosis and treatment. Methods: Children referred September 2011 and October 2012 to a pediatric allergy clinic were sent a questionnaire which was completed at home. Parents of referred children reported about their childs allergy. Results: Of the questionnaires that were sent out 62% was returned. From the children (n = 81, Mage = 8 years; range 3 months to 17 years) 57% was male. For 17.3% of the children no diagnosis had been established, 1 allergy diagnose was reported in 25.9% of the referred children, and 56.7% reported to have a diagnose for multiple allergies. Of the children for whom one or more diagnoses were reported, 59.8% had eczema, 43.9% food allergy, 29.2% rhinitis, 23.2% asthma and 24.4% had another allergy, not specified. Reference to the specialist due to anaphylactic reactions was reported in 81.6% of the cases. The anaphylactic reactions were caused by food products (80.3%), drugs (9.1%), insect venoms (6.1%), and unknown cause (4.5%). Reported symptoms of anaphylaxis to foods, drugs, and insect venoms were: dizziness and/or palpitations 12.1%, loss of consciousness 6.1%, nausea and/or abdominal cramps 37.9%, vomiting and/or diarrhea 24.2%, itching in the mouth, ears and/or throat 36.4%, itching of the tongue and/or lips 19.7%, itchy and/or watery eyes 37.9%, tongue and/or lips swelling 28.8%, tightness of the throat 37.9%, and cough 28.8%. It was reported what quantity of food caused complaints, in 64.3% it were crumbs to a few bites/sips, in 12.5% it was a daily portion, and 23.2% did not know. The most common allergenic foods suspected to cause the allergy in food induced anaphylaxis were peanuts 62.3%, milk 34%8%, hazelnut 30.2%, walnut 26.4%, egg 24.5%, cashew 24.5%, pistachio 24.5%, and almond 20.8%. Conclusion: Anaphylaxis was the most frequently suspected diagnosis leading to specialist referral and foods were the most frequent cause of anaphylaxis. This suggests that GPs seek specialist support most often for this category of patients. Our next step will be to evaluate the management plan developed by specialists for these 81 children.

Assessing allergy management information needs in primary care based on requests for sIgE determinations

Background: Epidermal growth factor (EGF) is one of the perspective clinical, diagnostic, pathogenetic and prognostic markers in various forms of cancer, associated with its overexpression. Abnormalities in signaling system of EGF and its receptor cause more than 70% of all malignant tumors. The EGF concentration estimation (its overexpression) can be performed only with the use of modern highly sensitive methods, which includes immunochemical assays, and in particular, the immunochromatographic assay. Method: A new express immunochromatographic assay of epidermal growth factor in serum was elaborated. Results: The developed method based on the usage of two types of specific antibodies and multimembrane complex – test strips, on which monoclonal antibodies to EGF (analytical zone) and anti-specific antibodies controlling the validity of the test (control zone) were immobilised. The method has the following analytical characteristics: sensitivity (the detectable minimum of EGF concentration) – 1 ng/ml, analysis duration – 10–15 min. The approbation of the developed method was carried out on the clinical material from the patients with cancer of various localisation with obtained ELISA data comparison. A comparative analysis of two methods has shown the comparability of the obtained data that indicate the clinical and diagnostic value of new method and confirm the possibility of its usage in medical practice. Conclusion: The new method allows with high accuracy and specificity to detect an increased EGF concentration and to diagnose initial stages of cancer development, associated with its overexpression. It also provide researchers with express quantitative criterion of the pathological process manifestation control, therapy effectiveness and prognosis of the disease. 415 The cytotoxicity of aflatoxin B1 in human lymphocytes