title: DISTRESS AND PTSD IN PATIENTS WITH CANCER: COHORT STUDY CASE.
abstract: BACKGROUND
  embarrassed emotional experience may affect the ability to oncology patient effectively cope with cancer, symptoms and treatment. Distress extends a long period, from common, normal feelings of vulnerability, sadness and fears to problems of PTSD, depression, anxiety, panic, social isolation and the perception of spiritual crisis. The aim of the research is to determine the level of distress and PTSD in cancer patients.
  
  
  METHODS
  In a prospective, cohort study cases from 2011- 2014 were included patients with cancer who are treated under the supervision of his chosen family medicine doctor. Including a factor for the participation of patients in the study is that from the moment of diagnosis of malignant disease passed <12 months. The total sample was 174 of the planned 200 (response rate=87%). The subjects were divided into three groups. A key factor in the creation of the group was the time elapsed from the moment of acknowledgment and confirmation of the diagnosis: T1 <14 days, n=56 patients; T2>14 days-<6 months, n=79 patients; T3>6 months n=39 patients. To achieve the set goals of the research was used instruments of 3 questionnaires: Questionnaire on the clinical characteristics of patients with malignant disease, demographic and individual characteristics; questionnaire distress oncology patient-hospital scales of depression and anxiety, HADS scale (Hospital Anxiety and Depression Scale - HADS) and a rapid test for self-assessment of the symptoms of PTSD.
  
  
  RESULTS
  Age of patients was 54.63 ± 11:46 years, and the age of the respondents when they were diagnosed with cancer 54.34 ± 11.26 years. The prevalence of distress was a high 76% 82x higher than expected), and PTSD 55%. Predictors of burnout syndrome in cancer patients are all important determinants of malignant disease: the time elapsed since the diagnosis of the disease which determines the clinical status of malignant disease (β=0.280; P=0.001; 95% CI, 0742-2259), discovered metastases (β=0.304; P=0.001; 95% CI -2621 to 0978) and treatments (β=0.160; P=0.031, 95% CI 0050 to 1.060).
  
  
  CONCLUSIONS
  The problem of distress in cancer patients is widespread and has a high prevalence of 76% in our environment, while still absent intervention and treatment.
authors.affiliation: Department of Occupational Health, Faculty of Medicine, University of Tuzla, Bosnia and Herzegovina; Teaching Department for Professional Pathology and Toxicology, Health Center in Tuzla, Bosnia and Herzegovina.
authors.forename: Nurka
authors.initials: N
authors.lastname: Pranjic
authors.affiliation: Family Medicine, Health Centre Tuzla, Bosnia and Herzegovina.
authors.forename: Amila
authors.initials: A
authors.lastname: Bajraktarevic
authors.affiliation: Family Medicine, Health Centre Tuzla, Bosnia and Herzegovina.
authors.forename: Enisa
authors.initials: E
authors.lastname: Ramic
keywords: cancer patients; distress; post-traumatic stress disorder; psycho-oncology