BACKGROUND: Recent studies conducting changes in depressive symptoms among the elderly reported mixed results. The present study sought to determine if subgroups of elderly Koreans follow distinctive depressive symptom trajectories and the characteristics associated with the depressive symptom trajectories. METHODS: Subjects were those who had participated in a longitudinal study of quality of life in older adults. A latent class mixture model was examined to identify the trajectories of depressive symptom changes with time. RESULTS: We found four depressive symptom trajectories. Poorer health status, poor economic status, and less social support were risk factors in the high depression group. CONCLUSIONS: Early intervention to help elderly individuals manage their health, economic concerns, and social relationships may decrease the risk of high level depression.
Adult ; Aged* ; Demography ; Depression* ; Early Intervention (Education) ; Humans ; Longitudinal Studies ; Quality of Life ; Risk Factors

BACKGROUND/OBJECTIVES: The association between nutritional status and health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus (T2DM) is not fully understood. This study was conducted to understand the role of nutritional status on HRQoL among people with and without T2DM. SUBJECTS/METHODS: Structured survey and direct measurement of anthropometric data were conducted among people with and without T2DM. Nutritional status was measured with Mini Nutritional Assessment tool and HRQoL was measured with a 36-item Short Form Healthy Survey. Data collection was conducted in Chuncheon, South Korea with 756 participants who are older than 40 yrs of age. RESULTS: This study found that overall HRQoL were significantly lower in people with T2DM than people without T2DM after controlling for key covariates. When stratified by nutritional status, a greater degree of negative impact of T2DM on overall physical HRQoL was observed among well-nourished or at risk of malnutrition, whereas significant and more evident negative impact of diabetes on overall psychological HRQoL was observed only among malnourished. CONCLUSIONS The study results suggest the role of nutritional status among people with T2DM on overall, especially psychological aspects of HRQoL. Future longitudinal or intervention studies are warranted to test the impact of nutritional status on HRQoL among people with T2DM.

Background: To systematically review studies on inhaled corticosteroids (ICS) and lung cancer incidence in chronic airway disease patients. Methods: We conducted electronic bibliographic searches on OVID-MEDLINE, EM- BASE, and the Cochrane Database before May 2020 to identify relevant studies. Detailed data on the study population, exposure, and outcome domains were reviewed. Results: Of 4,058 screened publications, 13 eligible studies in adults with chronic obstructive pulmonary disease (COPD) or asthma evaluated lung cancer incidence after ICS exposure. Pooled hazard ratio and odds ratio for developing lung cancer in ICS exposure were 0.81 (95% confidence interval, 0.64 to 1.02; I2=95.7%) from 10 studies and 1.02 (95% confidence interval 0.50 to 2.07; I2=94.7%) from three studies. Meta-regression failed to explain the substantial heterogeneity of pooled estimates. COPD and asthma were variously defined without spirometry in 11 studies. Regarding exposure assessment, three and 10 studies regarded ICS exposure as a time-dependent and fixed variable, respectively. Some studies assessed ICS use for the entire study period, whereas others assessed ICS use for 6 months to 2 years within or before study entry. Smoking was adjusted in four studies, and only four studies introduced 1 to 2 latency years in their main or subgroup analysis. Conclusion Studies published to date on ICS and lung cancer incidence had heterogeneous study populations, exposures, and outcome assessments, limiting the generation of a pooled conclusion. The beneficial effect of ICS on lung cancer incidence has not yet been established, and understanding the heterogeneities will help future researchers to establish robust evidence on ICS and lung cancer incidence.

BACKGROUND: The study examined the correlations among the results of the European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire, Core 30 (QLQ-C30) completed by elderly cancer patients and their family caregivers and the Eastern Cooperative Oncology Group (ECOG)-performance status (PS) evaluated by medical doctors. METHODS: The study sample included 269 persons with cancer aged 55 years or older and their family caregivers recruited from hospitals located in Seoul and Gyeonggi-do. The results of the ECOG-PS evaluated by medical doctors were obtained from medical records. Intra-class correlation analysis was used to assess rater reliability between the elderly cancer patients and their family caregivers. Correlations among the EORTC QLQ-C30 and the ECOG-PS were tested using the Kruskal-Wallis test and Spearmen's correlation. RESULTS: The results showed that four subscales of quality of life (physical functioning, emotional functioning, social functioning, and global health status) and three items under symptoms (fatigue, pain, and financial difficulties) in the EORTC QLQ-C30 were highly consistent between patients and their family caregivers. From the EORTC QLQ-C30 results, social functioning, role functioning, health status, fatigue, pain, and appetite loss (patients results) and physical functioning (family caregivers results) were highly consistent with the results of the ECOG-PS by the physicians. CONCLUSIONS: The findings suggest that when the older persons with cancer have difficulty expressing their own thoughts or feelings, the EORTC QLQ-C30 completed by their family caregivers and the results of the ECOG-PS completed by the physicians could be used as substitutes.
Aged ; Appetite ; Caregivers* ; Fatigue ; Gyeonggi-do ; Humans ; Medical Records ; Medical Staff* ; Quality of Life* ; Seoul

BACKGROUND: Numerous studies have demonstrated that spirituality has protective effects on depression. However, there are only few studies on the theoretical mechanism showing how spirituality effects on depression. Thus, to find mediating variables explaining the relationship between the spirituality and depression may help to develop appropriate program for reducing depression in elderly cancer patients. In this study, we examined the effect of optimism and pessimism as their mediating effects on depression. METHODS: This study is to verify the relationships between spirituality and depression along with the mediating effects of optimism and pessimism among 600 South Korean elderly cancer patients who participated in a community-based study about their mental health. RESULTS: Optimism and pessimism are linked with spirituality and depression. Higher spirituality levels were associated with increased optimistic thinking, and then optimistic thinking is associated with low possibility of depression, whereas lower spirituality levels were associated with more pessimistic thinking, and in turn pessimistic thinking is associated with high depression scores. CONCLUSIONS: Understanding optimism and pessimism affecting depression level is critical for developing spirituality-based programs to reduce depression in elderly cancer patients.
Aged* ; Depression* ; Humans ; Mental Health ; Negotiating* ; Optimism* ; Pessimism* ; Spirituality* ; Thinking

BACKGROUND: Appropriate intervention has not been developed and implemented because depression has been overlooked for older cancer patients. However, because depression is prevalent among this population, the need for the intervention is high. The objective of this study was to verify the effectiveness of the problem-solving therapy program in reducing depression level for older cancer patients. METHODS: The experimental participants were recruited by social workers in five university hospitals in Seoul, Gyeonggi, and Gangwon. Using Patient Health Questionnaire-9 (PHQ-9), older cancer patients who scored between 10–19 points are selected. The subjects were assigned to the experimental group (30 patients) and the control group (30 patients) according to their will, and the experimental group participated in the problem solving therapy program for 6 weeks. The Center for Epidemiological Studies Depression 10 Scale and the Social Problem Solving Ability Scale were used to verify the effectiveness of the problem-solving program. RESULTS: The group homogeneity test indicated that the experimental group and the control group are homogeneous. The results of this study showed that the depression of older cancer patients had a significant positive correlation with the negative attitude toward the problem. The effectiveness of the problem solving program was significantly reduced in the experimental group (Z=−3.534, P < 0.001). And the social problem solving ability of experimental group was significantly improved (Z=−2.908, P=0.003). CONCLUSIONS: The problem-solving therapy program is effective for depression in geriatric cancer patients and this result suggests that it can be implemented as an alternative medical treatment.
Depression ; Epidemiologic Studies ; Gangwon-do ; Gyeonggi-do ; Hospitals, University ; Humans ; Problem Solving ; Seoul ; Social Problems ; Social Work ; Social Workers

Objective: We conducted a systematic review and meta-analysis of the tissue adequacy and complication rates of percutaneous transthoracic needle biopsy (PTNB) for molecular analysis in patients with non-small cell lung cancer (NSCLC). Materials and Methods: We performed a literature search of the OVID-MEDLINE and Embase databases to identify original studies on the tissue adequacy and complication rates of PTNB for molecular analysis in patients with NSCLC published between January 2005 and January 2020. Inverse variance and random-effects models were used to evaluate and acquire meta-analytic estimates of the outcomes. To explore heterogeneity across the studies, univariable and multivariable metaregression analyses were performed. Results: A total of 21 studies with 2232 biopsies (initial biopsy, 8 studies; rebiopsy after therapy, 13 studies) were included.The pooled rates of tissue adequacy and complications were 89.3% (95% confidence interval [CI]: 85.6%–92.6%; I2 = 0.81) and 17.3% (95% CI: 12.1%–23.1%; I2 = 0.89), respectively. These rates were 93.5% and 22.2% for the initial biopsies and 86.2% and 16.8% for the rebiopsies, respectively. Severe complications, including pneumothorax requiring chest tube placement and massive hemoptysis, occurred in 0.7% of the cases (95% CI: 0%–2.2%; I2 = 0.67). Multivariable meta-regression analysis showed that the tissue adequacy rate was not significantly lower in studies on rebiopsies (p = 0.058). The complication rate was significantly higher in studies that preferentially included older adults (p = 0.001). Conclusion PTNB demonstrated an average tissue adequacy rate of 89.3% for molecular analysis in patients with NSCLC, with a complication rate of 17.3%. PTNB is a generally safe and effective diagnostic procedure for obtaining tissue samples for molecular analysis in NSCLC. Rebiopsy may be performed actively with an acceptable risk of complications if clinically required.

BACKGROUND: Appropriate intervention has not been developed and implemented because depression has been overlooked for older cancer patients. However, because depression is prevalent among this population, the need for the intervention is high. The objective of this study was to verify the effectiveness of the problem-solving therapy program in reducing depression level for older cancer patients. METHODS: The experimental participants were recruited by social workers in five university hospitals in Seoul, Gyeonggi, and Gangwon. Using Patient Health Questionnaire-9 (PHQ-9), older cancer patients who scored between 10–19 points are selected. The subjects were assigned to the experimental group (30 patients) and the control group (30 patients) according to their will, and the experimental group participated in the problem solving therapy program for 6 weeks. The Center for Epidemiological Studies Depression 10 Scale and the Social Problem Solving Ability Scale were used to verify the effectiveness of the problem-solving program. RESULTS: The group homogeneity test indicated that the experimental group and the control group are homogeneous. The results of this study showed that the depression of older cancer patients had a significant positive correlation with the negative attitude toward the problem. The effectiveness of the problem solving program was significantly reduced in the experimental group (Z=−3.534, P < 0.001). And the social problem solving ability of experimental group was significantly improved (Z=−2.908, P=0.003). CONCLUSIONS The problem-solving therapy program is effective for depression in geriatric cancer patients and this result suggests that it can be implemented as an alternative medical treatment.

Objective: To compare the incidence of aspiration pneumonia, nausea, and vomiting after intravascular administration of nonionic iodinated contrast media (ICM) between patients who fasted before contrast injection and those who did not. Materials and Methods: Ovid-MEDLINE and Embase databases were searched from their inception dates until September 2022 to identify original articles that met the following criteria: 1) randomized controlled trials or observational studies, 2) separate reports of the incidence of aspiration pneumonia, nausea, and vomiting after intravascular injection of non-ionic ICM, and 3) inclusion of patients undergoing radiological examinations without fasting. A bivariate beta-binomial model was used to compare the risk difference in adverse events between fasting and non-fasting groups. The I2 statistic was used to assess heterogeneity across the studies. Results: Ten studies, encompassing 308013 patients (non-fasting, 158442), were included in this meta-analysis. No cases of aspiration pneumonia were reported. The pooled incidence of nausea was 4.6% (95% confidence interval [CI]: 1.4%, 7.8%) in the fasting group and 4.6% (95% CI: 1.1%, 8.1%) in the non-fasting group. The pooled incidence of vomiting was 2.1% (95% CI: 0.0%, 4.2%) in the fasting group and 2.5% (95% CI: 0.7%, 4.2%) in the non-fasting group. The risk difference (incidence in the non-fasting group–incidence in the fasting group) in the incidence of nausea and vomiting was 0.0% (95% CI: -4.7%, 4.7%) and 0.4% (95% CI: -2.3%, 3.1%), respectively. Heterogeneity between the studies was low (I2 = 0%–13.5%). Conclusion Lack of fasting before intravascular administration of non-ionic ICM for radiological examinations did not increase the risk of emetic complications significantly. This finding suggests that hospitals can relax fasting policies without compromising patient safety.

BACKGROUND: This study examined moderating effects of optimism and family support on the depression of family caregivers of cancer patients aged 55 and over by adopting stress process model. METHODS: 359 family caregivers who accompanied with cancer patients to out-patient clinics were recruited and completed questionnaire at three university hospitals located in Seoul and Gyeonggi province. Exploratory factor analysis was applied to test validity of the construction of the scale. Hierarchical multiple regression analysis was used to determine moderating effects of optimism and family support on depression after making mean centering of each variable. RESULTS: Results showed that spouse caregivers have more depression than do adult children as the nursing period gets longer. Education and income status were significant variables affecting depression of family caregivers. Optimism and family support for family caregivers have moderating effects on the association between stressors (emotional functioning of cancer patients and role overload of family caregivers) and depression of family caregivers. CONCLUSIONS: The findings suggest that more attentions are needed to the depression of spouse caregivers. Interventions are strongly recommended for health professionals to provide cancer patients and their family caregivers with "holding environments" caring for emotions and facilitating adjustment.
Adult Children ; Attention ; Caregivers* ; Depression* ; Education ; Gyeonggi-do ; Health Occupations ; Hospitals, University ; Humans ; Nursing ; Optimism* ; Outpatients ; Seoul