Factors influencing quality of life, function, reintegration and participation after musculoskeletal tumour operations.

BACKGROUND: The number of people living with soft-tissue and bone sarcomas is increasing due to improved individual therapy and changes in demographics. At present, there are no recommendations for psychological co-treatment, occupational and social reintegration following the treatment of soft tissue and bone sarcomas. METHODS: Seventy-four patients, 42 males and 32 females, aged between 18 and 80 years (54.58 ± 16.99 yr.) with soft-tissue (62) and bone sarcomas (12) were included to answer five standardized and one personal questionnaire regarding quality of life, function, reintegration and participation after surgical treatment. RESULTS: A number of tumour-specific and patient-specific factors were identified that affected the therapeutic outcome. Patients with sarcoma of the lower extremity described poorer mobility. Patients who underwent amputation reported a higher anxious preoccupation. Patients with a higher range of education were less fatalistic and avoiding. The size of tumours or additive radiation therapy did not affect the post-therapeutic quality of life, coping and function. There was a good correlation between anxiety and depression with occupational reintegration, function, quality of life and coping. CONCLUSION: Patients with sarcomas of the lower limb have a higher demand for postoperative rehabilitation and need more help in the postoperative occupational reintegration. Furthermore patients that underwent limb-preserving operations reported better postoperative function and quality of life. Risk assessment using patient-specific factors and an intensive psychological co-treatment may have a large role in the co-treatment of patients from the beginning of their cancer therapy.

Replication of a two-factor model of the Beck Depression Inventory in alcohol dependents and suicide attempters.

The factor structure of the Beck Depression Inventory (BDI) is still controversial. The present study attempted to replicate a general two-factor model (cognitive-affective and somatic factors) of the BDI with a confirmatory Procrustes rotation procedure in two clinical samples of patients being treated for alcohol dependence (N(1) = 243, N(2) = 148) and one clinical sample of patients admitted to an acute psychiatric ward because of an act of deliberate self-harm (N(3) = 144). In addition, due to the neglect of gender-specific analysis in factor-analytic studies of the BDI, the two-factor model was tested for males and females separately. The results did not support the validity of the two-factor model in the total samples. Gender-specific findings indicated a better fit of the model in male samples. Possible implications of a gender-specific factor structure of the BDI are discussed.