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Conference Paper: Understanding Mediation Effect of Cancer-Related Rumination Between Physical Symptom Distress and Psychological Distress in Chinese Colorectal Cancer Patients

TitleUnderstanding Mediation Effect of Cancer-Related Rumination Between Physical Symptom Distress and Psychological Distress in Chinese Colorectal Cancer Patients
Authors
Issue Date2013
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/5807
Citation
The IPOS 15th World Congress of Psycho-Oncology and Psychosocial Academy, Rotterdam, The Netherlands, 4-8 November 2013. In Psycho-Oncology, 2013, v. 22 suppl. 3, p. 313-314, abstract no. P3-58 How to Cite?
AbstractBACKGROUND: The age-adjusted incidence of colorectal cancer has increased over the past decade both globally and locally. Physical symptoms distress is known to be an important contributor to psychological distress among cancer patients. In addition, intrusive thoughts are associated with the onset of depression and anxiety. This study aims to examine the possible mediation role of cancerrelated rumination between physical symptom distress and depression and anxiety among Chinese Colorectal cancer patients across the cancer journey. METHOD: Newly diagnosed colorectal cancer (CRC) patients recruited from a Hong Kong teaching hospital were interviewed three times: 1 day before surgery (T1), 1 month (T2) and 4 months post-surgery (T3) respectively. Patient’s anxiety and depression (psychological distress), physical symptom distress, cancer-related rumina-tion and demographic information were recorded at each of three interviews. Linear Mixed Modelling was adopted to investigate if there was any mediation effect from rumination. RESULTS: Overall, 205/219 (93.6%) patients participated in this study. Anxiety (b = 0.41, SE = 0.12, p = 0.001), but not depression (b = 0.11, SE = 0.13, p = 0.395) levels declined significantly from pre-surgery to 4 months post-surgery. Physical symptom distress was positively related to both anxiety level (b = 2.35, SE = 0.37, p < 0.001) and depression level (b = 2.80, SE = 0.47, p < 0.001) respectively. In addition, higher physical symptom distress was associated with stronger rumination (b = 0.408, SE = 0.46, p < 0.001). Sobel test suggested a significant mediation effect from rumination between physical symptom distress and anxiety (z = 7.19, p < 0.001) and depression (z = 5.84, p < 0.001). CONCLUSIONS: CRC patients had decreasing anxiety level but maintained fairly stable levels of depression over the time from pre-surgery to 4 months post-surgery. Cancer-related rumination seems to carry some of the impact associated with physical symptom distress on cancer patients’ anxiety and depression level. There was a partially mediation effect of cancer-related rumination on the relationship between physical symptom distress and psychological morbidity. This points to the meanings and/or disruption attributed to physical symptoms as potential therapeutic targets. RESEARCH IMPLICATIONS: This study revealed the pattern change on psychological distress (depression and anxiety) across the period from pre-surgery to 4 months post-surgery among CRC patients as well as rumination partially affected the relationship between physical symptom distress and depression and anxiety. Further investigation may be needed to reveal if the relationship between physical symptom distress and prolonged psychological distress (e.g. 1 year post-surgery) would also be mediated by rumination. CLINICAL IMPLICATIONS: Health care providers need to pay more attention to patients’ physical symptoms. Distress arising from physical symptoms appears to be in response to either the potential meanings attributed to those symptoms, or to the disruptive effect of these symptoms on daily life, preventing ‘forgetting about’ cancer that is necessary for return to near normal life. Interventions should address either physical symptoms themselves or ruminative thinking about cancer prompted by these to minimize psychological morbidities. ACKNOWLEDGEMENT OF FUNDING: This project was funded by The Health and Health Service Research Fund of the Hong Kong Government, grant number 0708651.
DescriptionConference theme: Innovation in Psycho-Oncology: Clinical Care, Research and Advocacy
Poster Presentation: no. P3-58
Persistent Identifierhttp://hdl.handle.net/10722/199823
ISSN
2015 Impact Factor: 3.256
2015 SCImago Journal Rankings: 1.904
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, WYen_US
dc.contributor.authorLam, WWTen_US
dc.contributor.authorLaw, WLen_US
dc.contributor.authorPoon, TCJen_US
dc.contributor.authorFielding, Ren_US
dc.date.accessioned2014-07-22T01:39:57Z-
dc.date.available2014-07-22T01:39:57Z-
dc.date.issued2013en_US
dc.identifier.citationThe IPOS 15th World Congress of Psycho-Oncology and Psychosocial Academy, Rotterdam, The Netherlands, 4-8 November 2013. In Psycho-Oncology, 2013, v. 22 suppl. 3, p. 313-314, abstract no. P3-58en_US
dc.identifier.issn1057-9249-
dc.identifier.urihttp://hdl.handle.net/10722/199823-
dc.descriptionConference theme: Innovation in Psycho-Oncology: Clinical Care, Research and Advocacy-
dc.descriptionPoster Presentation: no. P3-58-
dc.description.abstractBACKGROUND: The age-adjusted incidence of colorectal cancer has increased over the past decade both globally and locally. Physical symptoms distress is known to be an important contributor to psychological distress among cancer patients. In addition, intrusive thoughts are associated with the onset of depression and anxiety. This study aims to examine the possible mediation role of cancerrelated rumination between physical symptom distress and depression and anxiety among Chinese Colorectal cancer patients across the cancer journey. METHOD: Newly diagnosed colorectal cancer (CRC) patients recruited from a Hong Kong teaching hospital were interviewed three times: 1 day before surgery (T1), 1 month (T2) and 4 months post-surgery (T3) respectively. Patient’s anxiety and depression (psychological distress), physical symptom distress, cancer-related rumina-tion and demographic information were recorded at each of three interviews. Linear Mixed Modelling was adopted to investigate if there was any mediation effect from rumination. RESULTS: Overall, 205/219 (93.6%) patients participated in this study. Anxiety (b = 0.41, SE = 0.12, p = 0.001), but not depression (b = 0.11, SE = 0.13, p = 0.395) levels declined significantly from pre-surgery to 4 months post-surgery. Physical symptom distress was positively related to both anxiety level (b = 2.35, SE = 0.37, p < 0.001) and depression level (b = 2.80, SE = 0.47, p < 0.001) respectively. In addition, higher physical symptom distress was associated with stronger rumination (b = 0.408, SE = 0.46, p < 0.001). Sobel test suggested a significant mediation effect from rumination between physical symptom distress and anxiety (z = 7.19, p < 0.001) and depression (z = 5.84, p < 0.001). CONCLUSIONS: CRC patients had decreasing anxiety level but maintained fairly stable levels of depression over the time from pre-surgery to 4 months post-surgery. Cancer-related rumination seems to carry some of the impact associated with physical symptom distress on cancer patients’ anxiety and depression level. There was a partially mediation effect of cancer-related rumination on the relationship between physical symptom distress and psychological morbidity. This points to the meanings and/or disruption attributed to physical symptoms as potential therapeutic targets. RESEARCH IMPLICATIONS: This study revealed the pattern change on psychological distress (depression and anxiety) across the period from pre-surgery to 4 months post-surgery among CRC patients as well as rumination partially affected the relationship between physical symptom distress and depression and anxiety. Further investigation may be needed to reveal if the relationship between physical symptom distress and prolonged psychological distress (e.g. 1 year post-surgery) would also be mediated by rumination. CLINICAL IMPLICATIONS: Health care providers need to pay more attention to patients’ physical symptoms. Distress arising from physical symptoms appears to be in response to either the potential meanings attributed to those symptoms, or to the disruptive effect of these symptoms on daily life, preventing ‘forgetting about’ cancer that is necessary for return to near normal life. Interventions should address either physical symptoms themselves or ruminative thinking about cancer prompted by these to minimize psychological morbidities. ACKNOWLEDGEMENT OF FUNDING: This project was funded by The Health and Health Service Research Fund of the Hong Kong Government, grant number 0708651.-
dc.languageengen_US
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/5807-
dc.relation.ispartofPsycho-Oncologyen_US
dc.rightsPsycho-Oncology. Copyright © John Wiley & Sons Ltd.-
dc.titleUnderstanding Mediation Effect of Cancer-Related Rumination Between Physical Symptom Distress and Psychological Distress in Chinese Colorectal Cancer Patientsen_US
dc.typeConference_Paperen_US
dc.identifier.emailLam, WWT: wwtlam@hku.hken_US
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_US
dc.identifier.emailPoon, TCJ: tcjensen@hku.hken_US
dc.identifier.emailFielding, R: fielding@hku.hken_US
dc.identifier.authorityLam, WWT=rp00443en_US
dc.identifier.authorityLaw, WL=rp00436en_US
dc.identifier.authorityPoon, TCJ=rp01603en_US
dc.identifier.authorityFielding, R=rp00339en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1111/j.1099-1611.2013.3394-
dc.identifier.hkuros231850en_US
dc.identifier.volume22-
dc.identifier.issuesuppl. 3-
dc.identifier.spage313, abstract no. P3-58-
dc.identifier.epage314, abstract no. P3-58-
dc.identifier.isiWOS:000325687200002-
dc.publisher.placeUnited Kingdom-

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