Objective: To assess psychosocial distress in patients with early (localised) and advanced (metastatic) prostate cancer (PCA) at diagnosis (Time 1) and 12 months later (Time 2), and identify psychosocial factors predictive of later distress. Design, participants and setting: Observational, prospective study of 367 men with early (211) or advanced (156) PCA recruited as consecutive attendees at clinics at seven public hospitals and practices in metropolitan Melbourne between 1 April 2001 and 30 December 2005. Both groups completed questionnaires at Time 1 and Time 2. Main outcome measures: Health-related quality of life as assessed by the Short Form 36-item Health Survey; psychological distress, including depression and anxiety as assessed by the Brief Symptom Inventory; and coping patterns as assessed by the Mini-Mental Adjustment to Cancer scale. Results: Over the 12 months, both the early and advanced RCA group showed reduced vitality and increased depression and anxiety; this effect was greater in the advanced PCA group. Mental health, social functioning and role-emotional functioning also deteriorated in the advanced group. Predictors of depression at Time 2 for the early PCA group were depression, vitality and a fatalistic coping pattern at Time 1; anxiety at Time 2 was predicted by anxiety and vitality at Time 1. In the advanced PCA group, depression at Time 2 was predicted by depression and mental health at Time 1; anxiety at Time 2 was predicted by anxiety, mental health, cognitive avoidance and lower anxious preoccupation at Time 1. Conclusions: Men with early PCA experience decreasing vitality and increasing psychological distress over the 12 months following diagnosis; this trend is accelerated after diagnosis with advanced RCA. A fatalistic coping pattern at diagnosis of early PCA predicts later depression while cognitive avoidance and lower anxious preoccupation at diagnosis of advanced PCA predict later anxiety.
Background: Enjoyment and play during school lunchtime are correlated with children's physical activity. Despite this, there is an absence of studies reporting children's enjoyment of play during school lunchtime breaks. The purpose of this study was to examine the intraday and interday reliability of children's enjoyment of school lunchtime play. Methods: Surveys used to assess children's enjoyment of lunchtime play were distributed to and completed by 197 children (112 males, 85 females), aged 8-12 years attending an elementary school in Victoria, Australia. Children completed the surveys during class before lunch (expected enjoyment) and after lunch (actual enjoyment) for 5 days. The intra- and interday enjoyment of school lunchtime play reliability were determined using a weighted kappa. Results: Intraday kappa values ranged from fair (0.31) to substantial (0.75) within each of the 5 days (median kappa = 0.41). In comparison, "expected" (0.09-0.40; median 0.30) and "actual" (0.05-0.46; median 0.28) interday enjoyment of lunchtime play displayed low reliability. Conclusions: Children's enjoyment of lunchtime play appears to be more consistent within days than across days. The findings suggest that assessment of children's enjoyment of lunchtime play once on a single day would be representative of a particular day but not necessarily that particular school week.