Emotional Thermometer Research Articles

Patient efficacy in telehealth is moderated by distress among patients with cancer: A cross-sectional survey study.

1590 Background: The COVID-19 pandemic increased the use of telehealth to reduce exposure, which was critical for patients with cancer. The extent to which patients with cancer view telehealth visits as meeting their medical needs was investigated using a cross-sectional survey. Methods: Patients currently receiving cancer treatment at a single cancer institute who had had at least one telehealth visit were emailed an online survey. Response rate was 5% (94/1944). The survey measured patients’: 1) Emotional Thermometer (i.e. distress, anger, depression, anxiety, and need for help on a 0-10 scale); 2) Telehealth usability questionnaire (TUQ; 21-items with various subscales, like interaction quality; α=0.98).); and 3) Perceived Efficacy in Patient-Physician Interactions (PEPPI-5) scale (five items, e.g., “How confident are you in your ability to make the most of your visits with your doctors?”). Respondents completed the PEPPI-5 for in-person visits and for telehealth visits. Descriptive statistics were calculated for all measures. A generalized linear model was estimated predicting PEPPI-5 for telehealth visits from emotional thermometer and TUQ scores. The interaction between emotional thermometer and TUQ scores was estimated to test the hypothesis that emotional distress moderated the relationship between TUQ and efficacy in patient-provider interactions during telehealth visits. Results: Across all five thermometers, 30.8% (28/91) reported a high score on at least one metric. The most frequently reported high score was for anxiety, 23.3% (21/90) and least frequently reported high score was for anger, 12.2% (11/90). The mean TUQ score was 5.5 (SD=1.5) and mean PEPPI-5 score for telehealth visits was 8.1 (SD=2.4). As shown in Table, emotional thermometer scores did moderate the relation between TUQ and patient self-efficacy during telehealth visits. For high emotional thermometer scores, self-efficacy decreased as TUQ scores decreased. Conclusions: For patients experiencing high emotional distress, low comfort and ability with telehealth usability resulted in low patient self-efficacy in communicating with providers and getting medical needs met. Telehealth is a convenient and effective modality; however, in times of emotional distress for patients who are not familiar with telehealth, in-person clinic visits may result in greater patient self-efficacy.[Table: see text]

Relationship between muscular fitness and quality of life as well as psychological distress in radiotherapy patients with cervical cancer.

Patients with cervical cancer who have received radiotherapy often suffer from systemic muscle volume reduction and quality of life decline due to systemic effects of tumor and side effects of radiotherapy. The purpose of this study was to investigate the status of muscle fitness, quality of life, and psychological pain in patients with cervical cancer who received radiotherapy, and to explore the correlation between muscle fitness, quality of life, and psychological pain. A total of 202 cervical cancer patients aged 19-71, who received radiotherapy in Hunan Cancer Hospital from July 2020 to February 2021, were selected by convenience sampling method. Functional Assessment of Cancer Therapy Cervix (FACT-CX) and Distress Thermometer (DT) were used for the survey. The patient's grip strength was assessed by a handgrip meter and compared with that of healthy Chinese women of the same age. The correlation between muscle fitness and quality of life and psychological pain was analyzed. The grip strength of cervical cancer patients receiving radiotherapy was significantly lower than that of healthy Chinese women at the same age (P<0.05). Multiple linear regression analysis showed that there were 4 factors affecting grip strength, including emotional thermometer score, social and family status score, cervical cancer related function score and tumor metastasis (all P<0.05). The grip strength of patients with cervical cancer undergoing radiotherapy is generally decreased, which is affected by many factors, and is closely related to the quality of life and psychological pain of patients. In the future, dynamic attention should be paid to the changes of grip strength and related functions in patients receiving radiotherapy for cervical cancer, the potential risks in the treatment should be identified early, and targeted intervention should be taken.

Rapid screening of depression and anxiety in cancer patients: Interview validation of emotion thermometers

This study aimed to determine the degree of depression and anxiety in cancer patients using the Emotion Thermometers (ET) and confirming their clinical usefulness compared to the gold standard interview, as well as determining optimal cut-off values for the appropriate identification of cancer patients' distress. We included 238 cancer patients and we used ET (Emotion Thermometers) to screen depression and anxiety and the Beck depression inventory for adults (BDI-II), the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Mini-International Neuropsychiatric Interview (M.I.N.I) was used as the criterial validity standard. The prevalence of anxiety on the M.I.N.I. was 24% and depression was 11%. The optimal value for diagnosis of depression from ET (Dep ET) appears to be >4.5 (AUC 0.928) against M.I.N.I. Optimal score for anxiety from ET (AnxT ET) compared to GAD according to M.I.N.I. we determined the value of 3.5 (AUC 0.899). To determine the cut off score for distress using from ET (DT), we compared against GAD-7 and BDI-II RS (raw total score) and the most optimal was 4.5 (AUC 0.953). For analysis of the cut off score for quality of life (QoL) against the total sums of all parts of the ET, the value of 14.5 (AUC 0.892) forms the cut off between the negative and the positive clinical finding. The results of the study support the use of ET as a rapid screening tool for the detection of depression, anxiety and distress in cancer patients.

Coronavirus Disease 2019 Emergency and Remote Eye Movement Desensitization and Reprocessing Group Therapy With Adolescents and Young Adults: Overcoming Lockdown With the Butterfly Hug.

The coronavirus disease 2019 (COVID-19) pandemic has represented an individual and collective trauma with an impact on mental health. Restrictive measures such as lockdowns have increased risk factors for the development or triggering of various psychopathologies. Timely psychological intervention has constituted a protective factor that has been indicated as a form of prevention. The main objective of this study was to measure changes in the levels of traumatic stress and anxiety in a clinical population of adolescents and young adults aged 13 to 24 years – already assisted by the local primary and specialty care services before the pandemic – following a trauma-focused psychotherapeutic group intervention according to the eye movement desensitization and reprocessing protocol, conducted remotely before the end of the first lockdown. The Impact of Event Scale-Revised (IES-R), State-Trait Anxiety Inventory (STAI) scales, and the Emotion Thermometer were administered pre- and post-treatment. At the end of the treatment, the Post-Traumatic Growth Inventory (PTGI) questionnaire was administered. The results show that there was a significant improvement pre- and post-intervention in the scores of the scales STAI, IES-R, and Emotion Thermometer with a reduction in post-traumatic symptoms related in particular to the domains of intrusiveness and hyperarousal. The domain of avoidance was less significantly modified by therapy. This overall clinical improvement did not correlate with any of the demographic variables of the sample. In addition, the results show a significant positive global perceived change (PTGI) that did not correlate with the reduction of anxiety or post-traumatic symptoms measured by the other self-report scales. The explored use of telemedicine has revealed a valuable clinical opportunity.

Siblings of young people with chronic illness: Caring responsibilities and psychosocial functioning.

Siblings of young people with chronic illness commonly undertake caring responsibilities for their affected brother/sister, which may encourage maturation, yet may also be perceived as a burden. Our study determined (1) siblings' caring responsibilities, (2) siblings' current emotional distress and psychosocial functioning, and (3) how siblings' caring responsibilities and psychosocial functioning related to familial relationships and coping strategies. Siblings completed questionnaires which contained Sibling Inventory of Behavior, Sibling Inventory of Differential Experiences, PedsQL, emotion thermometers, Brief COPE, and a checklist of caregiving responsibilities. We analyzed the data with t-tests and multi-level models. Forty-five siblings (mean age = 15.40 years, SD = 3.31years; 60.0% female) participated. Siblings who had caring responsibilities (n = 26, 57.8%) reported lower anxiety symptoms, lower need for help, greater use of problem-focused coping, and more companionship and teaching/directiveness with their affected brother/sister than siblings without caring responsibilities. Siblings reported lower psychosocial and physical functioning when they perceived their parents provided them with less affection than their affected brother/sister. Family-based psychosocial interventions may aim to improve the sibling-parent relationship (including expressing affection) and the sibling-sibling relationship. Future interventions may also focus on increasing siblings' use of problem-focused coping strategies.

Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population.

Purpose: The Demoralization scale (DS-I) is a validated and frequently used instrument to assess existential distress in patients with cancer and other severe medical illness. The purpose of this study was to provide normative values derived from a representative German general population sample and to analyze the correlational structure of the DS-I.Methods: A representative sample of the adult German general population completed the DS-I (24 Items), the Emotion Thermometers (ET) measuring distress, anxiety, depression, anger, need for help, and the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-fatigue).Results: The sample consists of N = 2,407 adults (mean age = 49.8; range = 18–94 years), 55.7% women). The percentages of participants above the DS-I cutoff (≥30) was 13.5%. The mean scores of the DS-I dimensions were as follows: (1) loss of meaning and purpose: M = 2.78 SD = 4.49; (2) disheartenment: M = 3.19 SD = 4.03; (3) dysphoria M = 4.51 SD = 3.20; (4) sense of failure: M = 6.24 SD = 3.40; and for the DS-I total score: M = 16.72 SD = 12.74. Women reported significantly higher levels of demoralization than men, with effect sizes between d = 0.09 (Loss of Meaning) and d = 0.21 (Dysphoria). Age was not associated with demoralization in our sample. DS-I reliability was excellent (α = 0.94) and DS-I subscales were interrelated (r between 0.31 and 0.87) and significantly correlated with ET, especially depression, anxiety, and need for help and fatigue (r between 0.14 and 0.69).Conclusions: In order to use the DS-I as a screening tool in clinical practice and research the normative values are essential for comparing the symptom burden of groups of patients within the health care system to the general population. Age and sex differences between groups of patients can be accounted for using the presented normative scores of the DS-I.

Using Mindfulness to Reduce Anxiety and Depression of Patients With Fever Undergoing Screening in an Isolation Ward During the COVID-19 Outbreak.

The coronavirus disease 2019 (COVID-19) continues to spread globally. This infectious disease affects people not only physically but also psychologically. Therefore, an effective psychological intervention program needs to be developed to improve the psychological condition of patients screened for fever during this period. This study aimed to investigate the effect of a brief mindfulness intervention on patients with suspected fever in a screening isolation ward awaiting results of the COVID-19 test. The Faces Scale and the Emotional Thermometer Tool were used to investigate 51 patients who were randomly divided into an intervention group and a control group. All patients completed self-rating questionnaires online at the time they entered the isolation ward and before they were informed of the results. The intervention group listened to the mindfulness audios through hospital broadcasts in the isolation ward before their lunch break and while they slept. Compared with the control group, the intervention group’s life satisfaction score increased (F = 4.02, p = 0.051) and the emotional thermometer score decreased (F = 8.89, p = 0.005). The anxiety scores (F = 9.63, p = 0.003) and the needing help scores decreased significantly (F = 4.95, p = 0.031). Distress (F = 1.41, p = 0.241), depression (F = 1.93, p = 0.171), and anger (F = 3.14, p = 0.083) also decreased, but did not reach significance. Brief mindfulness interventions can alleviate negative emotions and improve the life satisfaction of patients in the isolation ward who were screened for COVID-19 during the waiting period.

Joven y Fuerte (J&amp;F): Multidisciplinary distance care program in Mexico for young women with breast cancer (YWBC) during the COVID-19 pandemic.

e13536 Background: The COVID-19 Pandemic represents unprecedented new challenges for healthcare systems, care programs and especially for vulnerable populations like oncologic patients. The J&amp;F Program, developed at the National Cancer Institute (INCan) in Mexico City, provides multidisciplinary care and navigation support for YWBC patients. During the first months of 2020, the whole mexican healthcare system, including the INCan and programs like J&amp;F had to undergo structural adjustments to offer distance care attention (DCA) and face the Pandemic challenges. Methods: From March to September 2020, 196 patients received DCA (phone and video calls, text messages and virtual workshops), which addressed navigation, unmet psychological needs, psychoeducation, oncology and sexual support provided by different healthcare professionals (oncologists, psychologists, sexual specialists). Seventy agreed to participate in this study (intervention group, IG). Forty-three recently diagnosed breast cancer patients could not be contacted by the Program (control group, CG). The patients from the IG completed the emotional distress thermometer and were interviewed about stressors, coping strategies during the Pandemic, and satisfaction with the multidisciplinary support given by the J&amp;F Program. We compared thestandard care given within the institutional facilities and the multidisciplinary support provided virtually by J&amp;F Program for YWBC during the COVID-19 Pandemic regarding their perceived stressors and emotional distress. Results: The CG had more concerns about oncology treatments and their side effects (nausea p = 0.031, fever p = 0.007, anorexia p = 0.006) than the IG. Emotional distress was present in 77% and 86% in the IG and the CG respectively. The IG received significant navigation guidance and multidisciplinary support with the J&amp;F Program’s DCA strategy during the Pandemic than the CG (p &lt; 0.01 and p = 0.019). The J&amp;F Program's psychological care significantly helped YWBC manage their distress (p = 0.001); 70% of the IG patients considered that the support given by the J&amp;F Program dealt with the COVID-19 Pandemic challenges successfully (p &lt; 0.01). Conclusions: DCA by theJ&amp;F Program showed feasibility and benefit in the COVID-19 Pandemic context for YWBC. These findings suggest that multidisciplinary care could be preserved by combining care provision physically and virtually depending on patients' resources or unmet needs.

Oncology expressive arts: providing a window to reflect on a stressful experience

Purpose Evaluate changes in mood, perceived need for help, and task enjoyment after participation in a one-time Oncology on Canvas expressive arts workshop intervention. Methods Mixed methods design. Sample: military-veteran oncology survivors and their adult `ohana (family members, caregivers, friends, healthcare providers, volunteers). Measurement tools: Emotion Thermometers, Multiple Affect Adjective Checklist-Revised, Task Enjoyment Question, semi-structured interviews, and self-reflective narratives. Colaizzi’s Phenomenological Method was used to conduct a thematic analysis. Findings Significant improvements in mood, increased task enjoyment, and decreased perceived need for help, with continued effects for up to 30-60 days post-intervention. Conclusions A one-time expressive arts workshop intervention can provide a window for oncology survivors and their adult `ohana to reflect on a stressful experience. Implications for Psychosocial Providers Psychosocial healthcare providers (APRNs, nurse educators, LCSWs, psychologists) who are not professional art therapists can effectively implement expressive arts workshops as a cost-effective intervention for oncology survivors and their `ohana.

Opening Minds through Art: A preliminary study evaluating the effects of a creative-expression program on persons living with dementia and their primary care partners.

For people living with dementia and their care partners, a decline in the ability to effectively communicate can cause significant distress. However, in recent decades, the arts have emerged as an effective care modality in fostering communication and expression for those with declining verbal skills and memory loss. Opening Minds through Art (OMA) is a national initiative that empowers people living with dementia by facilitating creative expression and social engagement through art-making in partnership with trained college student volunteers. Research has demonstrated that participation in the program benefits quality of life for those living with dementia and also improves student attitudes toward dementia. To date, however, no research has involved primary care partners. We implemented an OMA program at three residential care homes in State College, Pennsylvania, with residents cocreating artwork alongside primary care partners (i.e., a family member or primary medical personnel) over the course of four art-making sessions. We evaluated the effects of participation on quality of life and care partner burnout through pre-post use of "emotional thermometers" (measuring levels of distress, anxiety, depression, anger, and perceived quality of life), the National Institute of Health NIH emotional support scale, and the NIH caregiver assessment (care partner burnout). For people living with dementia, participation significantly increased perceived quality of life while decreasing distress, anxiety, depression, and anger (p < .01; n = 12) after each class; however, the intervention did not significantly impact perceived emotional support. For care partners, participation significantly lowered post-intervention measures of burnout and self-rated stress (p < .01; n = 9). This preliminary study suggests that a structured art-based activity appears to positively impact acute mood for patients and, importantly, decrease care partner burnout. Future research can bring more robust methods to bear in determining how to use OMA and other arts interventions to optimize social support for people living with dementia and their care partners.

Group-led creative writing and behavioural health in cancer: a randomised clinical trial

BackgroundCancer diagnosis can adversely affect mental well-being and overall clinical outcome. We evaluated the efficacy of a group-led creative writing workshop (CWW) on mood in patients with cancer prospectively.MethodsWe conducted...

Quality of life and psycho-emotional wellbeing in bladder cancer patients and their caregivers: a comparative analysis between urostomy versus ileal orthotopic neobladder.

BackgroundThe impact of neobladder and urostomy on bladder cancer patient’s health-related quality of life (HR-QoL) is controversial and many issues currently remain under-investigated. Initial studies pointed out that the emotional responses of caregivers might be ‘contagious’, influencing emotional reactions in bladder cancer patients undergoing radical cystectomy.MethodsThree hundred and eighty-two bladder cancer patients (aged M = 67.29 years; SD = 9.23) (16.9% (65) were female and 82.9% (319) were male) and their caregivers were enrolled. Data were collected prospectively: at T0 (1 month before the surgery), at T1 (2 weeks after the surgery, at patient discharge from the hospital) and at T2 (6-month follow-up). At each time point (T0, T1 and T2), a set of questionnaires (EORT QLQ-C30 and emotion thermometer) were given to patients and their caregivers.ResultsAll patients reported a general improvement in the HR-QoL and global health status/QoL from T0 to T2 (p < 0.001). No significant differences were observed between neobladder and urostomy. At T0, the emotional thermometer total scoring in caregivers was positive in relation to HR-QoL (p < 0.001) and negative in relation to the patient’s perception of QoL (p < 0.001) and global health (p < 0.001). Similar trends were observed at T1 and T2.ConclusionsThese results suggest that patients and their caregiver’s emotional reactions to cancer are deep-rooted and strongly interconnected, and they provide innovative insights for the clinical management of bladder cancer patients.

Effectiveness of Expressive Writing protocol in Palliative Care Healthworkers: a quantitative study.

Background and aim of the work:Palliative Care professionals are exposed to intense emotional environment. This puts them at risk for Compassion Fatigue and Burnout. The protective factors that can counter their onset are Compassion Satisfaction, Organizational Commitment and Resilience. Expressive Writing is a valid tool for adapting to traumatic events and enhancing psychological well-being. Aim of this study is to evaluate the effect of the Expressive Writing in Palliative Care professionals on Compassion Satisfaction, Organizational Commitment, Resilience, Compassion Fatigue and perceived distress.Methods:Prospective experimental study with experimental/control groups and pre/post measurements. 50 Palliative Care professionals were recruited in Northern and Central Italy. Participants filled: Organizational Commitment Questionnaire; ProQol - revision III; Resilience Scale for Adults; Impact of Event-Scale Revised; Emotion Thermometer; ad hoc questionnaire for the evaluation of protocol usefulness.Results:Wilcoxon test demonstrated change in Continuative Commitment (Z = -3.357, p = .001), anger (Z = -2.214, p = .027), sleep (Z = -2.268, p = .023), help (Z = -2.184, p = .029), intrusiveness (Z = -2.469, p = .014), hyperarousal (Z = -2.717, p = .007), and total IES (Z = -2.456 , p =, 014). Mann Whitney test showed a significantly lower score on post-test Intrusiveness in the experimental group (U = 202, p = .038).Conclusions:The Expressive Writing intervention was effective in improving organizational and emotional variables. Expressive Writing supports healthcare professionals in relieving the burden of traumatic episodes, ordering associated thoughts and emotions, and implementing a process of deep comprehension.

The prevalence of depression and anxiety among neuroendocrine tumour and general gastroenterology outpatients and the psychometric validity of emotional thermometers

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Feasibility and Acceptability of Digital Legacy-Making: An Innovative Story-Telling Intervention for Adults With Cancer.

This study examined the feasibility, burden and acceptability of a legacy-making intervention in adults with cancer and preliminary effects on patient quality-of-life (QOL) measures. We conducted a Stage IB pilot, intervention study. The intervention was a digital video legacy-making interview of adults with advanced cancer to create a digital video of their memories and experiences. Baseline and post-video QOL assessments included: Functional Assessment of Cancer Therapy-General (FACT-G), Patient Dignity Inventory (PDI), Hospital Anxiety and Depression Scale (HADS), and Emotional Thermometers for distress, anxiety, anger, help and depression. Participants received a final copy of the digital video for distribution to their families. Adults (n = 16) ages 38-83 years old with an advanced or life-limiting cancer diagnosis completed an intervention. Feasibility and acceptability was strong with 0% attrition. While the pilot study was not powered for quantitative significance, there were changes from baseline to post-intervention in the participants' total or subscale FACT-G scores, PDI, HADS anxiety or depression scores, and Emotional Thermometer scores. A digital video legacy-making intervention is feasible for adults with cancer without significant negative outcomes for individuals completing the study. It remains unclear whether this intervention contributes to positive quality of life outcomes.

320P Psychometric interplay of the perception of the real-life impact of COVID-19 pandemic: A cross-sectional survey of patients with newly diagnosed malignancies

Patients newly diagnosed with malignancies amidst the COVID19 pandemic outbreak face the psychological double whammy of a gruesome diagnosis and a public health crisis. We conducted a cross-sectional survey to examine the association between common psychological disorders and cancer patients’ perception of COVID19’s real-life impact. Newly diagnosed cancer patients were surveyed with a two-part questionnaire constructed by oncologists and clinical psychologists. It first explored patients’ perceptions of pandemic’s impact on cancer care resources, treatment quality, health-seeking behaviour and other concerns. The second part involved the measurement of post-traumatic stress disorder (PTSD) (abbreviated PCL-5), anxiety and depression (emotion thermometer) and intolerance to uncertainty (IUS12), where patients were assigned into high and low-risk groups accordingly. Their associations were observed and analysed using chi-square test. 103 new cancer patients in Hong Kong were surveyed in May 2020. Results revealed there were more worries about the impact of COVID19 on cancer care manpower, and secondly about risk of infection during OPD waiting time, in patients of high risk group for PTSD (p= 0.011; p=0.015 respectively), anxiety (p=0.013; p=0.034), depression (p=0.017; p=0.043) and uncertainty tolerance (p=0.004; p=0.044). High IUS12 score was associated with more worry on pandemic’s impact on progress of cancer research and drug development (p=0.03). Patients of the high anxiety risk group were less likely to accept hospital’s “no visitor” policy during admission (p=0.013). High-risk group for anxiety (p=0.024) and depression (p=0.044) tend to consider the availability of media information on COVID19’s impact on cancer as inadequate. Patients of high PTSD risk group showed greater fear of being infected by family/carers (p=0.005). This original survey revealed the potential value of psychometrics in understanding cancer patient’s perception of COVID19’s impact and predicting particular concerns in patients with different psychological phenotypes, allowing better-tailored pandemic time cancer care.

Healthcare professionals' opinions on psychological screening in follow-up care for childhood cancer survivors.

Implementation of screening for psychological distress in populations at risk, as recommended in existing guidelines, can be challenging on different levels: structural, organisational and personal (provider and patient). A specific group at risk for psychological distress, including anxiety and depression, is the growing population of childhood cancer survivors (CCS). In many countries, including Switzerland, the standardised assessment of psychological late effects during follow-up care is not yet established. The emotion thermometer, a short and validated assessment tool to screen for psychological distress, might facilitate implementation of psychological screening in Swiss CCS follow-up care. To inform implementation strategy and assess readiness of centres to integrate standardised psychological screening, we conducted a cross-sectional survey. We describe healthcare professionals&rsquo; opinions on (i) the current standard of psychological screening in follow-up care, (ii) their experience using the emotion thermometer, and (iii) perceived barriers and facilitators of possible implementation of psychological screening, including the emotion thermometer. We contacted 49 healthcare professionals involved in CCS follow-up care in all nine paediatric oncology clinics in Switzerland. The electronic survey included closed and open questions. A majority of the healthcare professionals (17/24, 71%) stated that assessment of psychological distress is currently not standard in follow-up care. On the contrary, about half of them (11/24, 46%) think that psychological distress is adequately assessed in follow-up care. None of the participants had any previous experience with the emotion thermometer. After being informed about the emotion thermometer, nearly 80% (19/24) agree that it appears to be a good screening instrument and support the idea of regular application during follow-up care. Facilitators of implementation included the instrument&rsquo;s brevity, its ability to visualise psychological topics and raising awareness of the need to think about the psychological side of follow-up care. Barriers included lack of time, the additional effort and the perception that instead an informal assessment would be sufficient. Concerns about using an artificial assessment, rather than a natural conversation, were also expressed. There is overall agreement that screening for psychological late effects is not yet standard in follow-up care in Switzerland. It is important to mitigate perceived barriers and concerns of healthcare professionals to enable a successful implementation of psychological distress screening according to the established standards of care.

Transgender patients’ satisfaction with their mental health providers prior to gender affirming surgery

Purpose Given the World Professional Association for Transgender Health guidelines requiring patients to present letters from mental health professionals prior to gender affirming surgery (GAS), this study was designed to evaluate patient satisfaction with their mental health provider prior to GAS. Methods Transgender patients seeking GAS completed three validated questionnaires to evaluate satisfaction with mental health provider (MHP), severity of depression (PHQ-9), and emotional distress (Emotional Thermometer). Statistical analysis was performed to evaluate patient satisfaction with MHP and its association with the length of relationship with MHP, PHQ-9 score, and Emotional Thermometer score. Statistical significance was established for p-values <0.05. Results Ninety-seven patients (TGW 52; TGM 45) completed the survey. Patients were highly satisfied with their MHP (mean PatSat score 70.68), and this did not differ based upon the length of relationship (p = 0.72). Lower emotional distress was associated with higher patient satisfaction with provider increased (r = −0.255, p = 0.017). Conclusion In our study, patients demonstrated satisfaction with their MHP prior to GAS, regardless of the length of this relationship. This finding supports current WPATH SOC recommendations and may provide reassurance to those who perceive these guidelines to be barriers to GAS for transgender patients.

Screening for depression in movement disorders clinic.

Depression is the most common, though often under-recognised, neuropsychiatric disturbance in movement disorders (MD). This study aimed to establish whether a briefer screening measure such as a visual analogue screening measure (Emotions Thermometer) or Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) could be a potentially suitable screening tool for depression in MD patients. Patients attending a regional MD outpatient clinic completed the Emotional Thermometer 7-item tool (ET7), the Hospital Anxiety and Depression Scale (HADS) and the Neurological Disorders Depression Inventory for Epilepsy (NDDIE). We used the Major Depression Inventory which provided the diagnosis of depression based on ICD-10 and DSM-IV as our diagnostic gold standard to compare the performance of ET7 and its individual sub-scales, its briefer version ET4, HADS, and NDDIE. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operating characteristic curves were calculated to compare the performance of the screening tools. In total, 188 patients were included in the analysis. The most accurate tools as determined by Receiver Operating Characteristics curve were HADS-D for ICD-10 depressive episode and DepT for DSM-IV major depression. ET4 performed well as a 'rule-out' screening tool for both DSM-IV and ICD-10 depression. ET4 performance was comparable to HADS without the need for clinician scoring. The briefer ET4 performed almost as well as ET7. Emotions Thermometer and NDDI-E are quick and reliable screening tools for depression in the MD population and are comparable to HADS. We suggest routine use of visual analogue ET4 as it is briefer, requires less time to complete and does not require scoring from the clinicians. It has the potential to be widely implemented across busy neurology clinics to assist in depression screening.

Gender and time estimation as novel potent indicators of emotional concerns in cancer patients.

e24195 Background: Psychological stress is frequent after a cancer diagnosis. Thus screening is crucial for detecting it. The emotion thermometers (ETs) are validated screening tools and have five dimensions (distress, anxiety, depression, anger, and need‐for‐help). Methods: Time estimation was assessed in 374 chemonaïve patients with solid tumors by evaluating each subject’s prospective estimation of how quickly one minute passed compared to the actual time. ETs were used at the beginning of treatment to evaluate level of psychological stress of each patient. A multivariate analyses of covariance was run for the ETs as dependent variables with the addition of the following covariates: age and time estimation and gender as a fixed factor. Results: There were significant negative correlations between values of ETs and time estimation except anger. Women exhibited significantly faster time estimation than men. Using Pillai’s Trace, we found that there was a significant effect of gender and fast time estimation on reported values of ETs (V = 0.06, F (5,366) = 4.96, p &lt; .001; V = 0.05, F (5,366) = 3.84, p = .002, respectively). The covariate, time estimation, was significantly related to reported values of all ETs. There was also a significant effect of relationship on the gender and reported values of all ETs, except for depression and need-for-help after controlling for the effect of age and time estimation. Planned contrasts revealed that female are significantly more distressed, anxious and less angry when compared to males. Conclusions: Gender and time estimation are novel potent indicators of emotional concerns in cancer patients prior to starting chemotherapy.