How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer

Ensemble programme for early intervention in informal caregivers of psychiatric adult patients: a protocol for a randomised controlled trial

INTRODUCTION

Informal caregivers play a major role in the support and maintenance of community patients with severe psychiatric disorders. A pilot study showed that an individualised brief intervention such as the Ensemble programme leads to significant improvements in psychological health state and optimism.

METHODS AND ANALYSIS

This randomised controlled trial aims to compare the efficacy of using Ensemble in improving informal caregivers' psychological health states and the ability to play an active role in their situations with that of support as usual. Improvements on the psychological health global index will be measured three times (T0-pre, T1-post and T3 2 months follow) with standardised questionnaires (the Global Severity Index of Brief Inventory Symptoms, the Life Orientation Test-Revised, the 36-item Medical Outcome Study Short-Form Health Survey and the French Zarit Burden Interview). Differences between groups in post-test and pretest values will be examined using an analysis of covariance for each outcome variable. The severity of illness measured by the Social and Occupational Functioning Assessment Scale will also be collected at T0 and T2 to compare eventual patient improvements. At the end of the programme, the experiences of the 20 patients participating in the Ensemble programme will be evaluated qualitatively.

ETHICS AND DISSEMINATION

The research protocol received full authorisation from the Human Research Ethics Committee of the Vaud state, Switzerland. The principal paper will concern the results of the experimental design used to test the Ensemble programme. The research team will prioritise open access publications.

TRIAL REGISTRATION NUMBER

NCT04020497.

[Optimism and COVID-19: A resource to support people in confinement?]

This text envisages looking at the psychological consequences of the health situation related to COVID-19 from the concept of optimism. Positive psychology has for several years been dealing with this concept, which is well known to the general public, but which has been the subject of major conceptual development in the field of science. It seems to us that the concept of optimism can be particularly useful in understanding and influencing the behaviour of our fellow citizens during the period of confinement that is currently imposed on everyone, in the same way that we must consider the consequences in the short, medium and long term, both economically and in terms of the moral and physical health of our fellow citizens, that is, after the period of confinement. Traditionally, being optimistic means being confident in the positive outcome of an event, whereas pessimism means expecting the worst. The uncertainty that this virus imposes on us and the new situations that it brings about, forces us to think the world in uncertain terms, which can be destabilizing. Understanding the contribution of the concept of optimism in the potential of the adaptive processes that each of us may or may not be able to mobilize to face and adapt to this unprecedented and unprecedented health crisis is essential. This will undoubtedly be a major challenge for the social sciences and psychology. This is why we believe that the concept of optimism can help to provide additional insights that will enable us to better grasp the rational (or non-rational) behaviours that we may face in the future, and in which we are already involved.

The developmental precursors of blunted cardiovascular responses to stress

Blunted cardiovascular responses to stress have been associated with both mental and physical health concerns. This multi-method, longitudinal study examined the role of chronic social-developmental stress from adolescence onward as a precursor to these blunted stress responses. Using a diverse community sample of 184 adolescents followed from age 13 to 29 along with friends and romantic partners, this study found that high levels of parental psychological control at age 13 directly predicted a blunted heart rate response and indirectly predicted blunted respiratory sinus arrhythmia (RSA) reactivity under stress. Heart rate effects were mediated via indicators of a developing passive response style, including observational measures of withdrawal during conflict with friends and romantic partners, social disengagement, and coping with stressors by using denial. RSA effects were mediated via withdrawal during conflict with romantic partners and coping by using denial. The current findings are interpreted as suggesting a mechanism by which a key social/developmental stressor in adolescence may alter relational and ultimately physiological patterns of stress responding into adulthood.

Negative affect and stress-related brain metabolism in patients with metastatic breast cancer

BACKGROUND

Cancer and its treatment represent major stressors requiring that patients make multiple adaptations. Despite evidence that poor adaptation to stressors is associated with more distress and negative affect (NA), neuroimmune dysregulation and poorer health outcomes, current understanding is very limited of how NA covaries with central nervous system changes to account for these associations.

METHODS

NA was correlated with brain metabolic activity using ¹⁸ F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸ F-FDG PET/CT) in several regions of interest in 61 women with metastatic breast cancer. Patients underwent ¹⁸ F-FDG PET/CT and completed an assessment of NA using the Brief Symptom Inventory.

RESULTS

Regression analyses revealed that NA was significantly negatively correlated with the standardized uptake value ratio of the insula, thalamus, hypothalamus, ventromedial prefrontal cortex, and lateral prefrontal cortex. Voxel-wise correlation analyses within these 5 regions of interest demonstrated high left-right symmetry and the highest NA correlations with the anterior insula, thalamus (medial and ventral portion), lateral prefrontal cortex (right Brodmann area 9 [BA9], left BA45, and right and left BA10 and BA8), and ventromedial prefrontal cortex (bilateral BA11).

CONCLUSIONS

The regions of interest most strongly negatively associated with NA represent key areas for successful adaptation to stressors and may be particularly relevant in patients with metastatic breast cancer who are dealing with multiple challenges of cancer and its treatment.

Psychological functioning, coping styles and their relationship to appraisal of physical limitations following invasive surgical procedures for soft-tissue sarcoma: A qualitative study

BACKGROUND AND OBJECTIVES

This study explored psychological functioning and coping styles in adult patients with soft-tissue sarcoma who underwent surgical procedures in a single expert sarcoma medical center in Canada.

METHODS

This is a qualitative study with three formats of data collection. The interview guide was based on theoretical health-related quality of life model. We began the investigation with 2 online and 2 in-person focus groups. Four individual semistructured interviews were added to further explore emerging themes. Data were analyzed using inductive thematic networks approach.

RESULTS

Twenty-eight adults (13 female, 24-75 years of age) participated. In the domain of psychological functioning we identified three main themes; changes in mood, worry, and body image concerns. In the domain of coping styles, we identified four adaptive coping styles; positive reframing and optimism, finding a purpose, being proactive, and using humor. Among the maladaptive coping styles, we found passive acceptance, and avoidance and denial.

CONCLUSIONS

Psychological well-being can be contingent on physical functioning and coping styles in adults with soft-tissue sarcoma. Both psychological and physical function impact quality of life. Patients with more physical limitations, psychological distress and maladaptive coping styles should be monitored for their well-being.

The effects of psychoeducational interventions on caregivers of children with cancer: A meta-analysis of randomized controlled trials

This meta-analysis aims to evaluate the best available evidence concerning the effects of psychoeducational interventions (PEIs) on the psychosocial and coping outcomes for caregivers of pediatric oncology patients. A literature search was performed using 11 databases, from inception to June 2017. Keywords such as pediatric, caregiver, parents, cancer, and intervention were used. Only randomized controlled trials (RCTs) were included. Studies with full text available online in English and those conducted of caregivers of children diagnosed with any form of cancer were included. Eleven RCTs were included in the analysis. Our meta-analysis revealed that PEIs have small to large effects on three outcomes, including post-traumatic stress symptoms (PTSSs), mood, and problem-solving skills. However, the outcomes from PEI were not superior to the usual standard of care for anxiety, depression, and social support. Our meta-analysis provided moderate evidence that PEI enhances psychological and coping outcomes. Because coping affects both physical and psychological health, health care professionals could consider including coping as a core component in PEI delivered to caregivers of children with cancer.

Study protocol for a multisite randomised controlled trial of a rehabilitation intervention to reduce participation restrictions among female breast cancer survivors

INTRODUCTION

Many breast cancer survivors report an inability to fully participate in activities of daily living after completing cancer treatment. Reduced activity participation is linked to negative consequences for individuals (eg, depression, reduced quality of life) and society (reduced workforce participation). There is currently a lack of evidence-based interventions that directly foster cancer survivors' optimal participation in life roles and activities. Pilot study data suggest rehabilitation interventions based on behavioural activation (BA) and problem-solving treatment (PST) can facilitate post-treatment role resumption among breast cancer survivors.

METHODS AND ANALYSIS

This protocol describes a multisite randomised controlled trial comparing a 4-month long, nine-session BA and PST-informed rehabilitation intervention (BA/PS) against a time-matched, attention control condition. The overall objective is to assess the efficacy of BA/PS for enhancing breast cancer survivors' activity participation and quality of life over time. A total of 300 breast cancer survivors reporting participation restrictions after completing curative treatment for stage 1-3 breast cancer within the past year will be recruited across two sites (Dartmouth-Hitchcock Medical Center and University of Alabama at Birmingham). Assessments are collected on enrolment (T1) and 8 (T2), 20 (T3) and 44 (T4) weeks later.

ETHICS AND DISSEMINATION

Study procedures are approved by the Committee for the Protection of Human Subjects at Dartmouth College, acting as the single Institutional Review Board of record for both study sites (STUDY 00031380). Results of the study will be presented at national meetings and submitted for publication in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT03915548; Pre-results.

Preferences for notification of imaging results in patients with metastatic cancer

OBJECTIVE

This study examines the preferences of patients with metastatic cancer regarding notification of imaging results, as well as distress surrounding the process.

METHODS

On imaging day, preferences for notification, expectations of results, health literacy, and social support were measured. After receiving results, patients reported on actual delivery methods. At both times, patients were screened for overall distress, anxiety, and depression.

RESULTS

The majority of patients preferred notification within 2 days and during a face-to-face visit with their oncologist. Although levels of distress, anxiety, and depression were low, patients with higher anxiety, depression, and social isolation had higher distress. There was no correlation between absolute distress levels and agreement between notification preferences and actual delivery methods. Receiving results from a preferred provider was associated with a decrease in distress from imaging day to follow-up. Face-to-face delivery of results was more important to people with lower health literacy.

CONCLUSIONS

While distress regarding the receipt of results was low, it was higher for some groups of patients. Attending to the preferences of these subgroups may help to minimize distress.

PRACTICE IMPLICATIONS

Receiving results from preferred personnel and diminishing patients' sense of social isolation might provide psychological benefit during the period surrounding imaging.

Coping and psychopathology in children with malignancy and bronchiectasis

AIM

We aimed to evaluate the coping styles and social support perceived by the children with two different chronic diseases (cancer and bronchiectasis), their mothers' coping styles and compare them with a control group without any chronic physical or psychiatric disorder.

METHODS

Our sample consisted of 114 children and adolescents, with an age range from 9 to 15 years. The data were collected by using schedule for affective disorders and schizophrenia for school-age children-present and lifetime version, kid-coping orientation to problems experienced (Kid-COPE), social support appraisals scale (SSAS), and COPE.

RESULTS

All three groups were similar with respect to age and sex distribution. Around 50% to 60% of the children in both patient groups had a psychiatric diagnosis. Remarkably, 30% of the children had an internalizing disorder. The most commonly used coping style by the mothers was religious coping in all groups. Kid-COPE scores did not significantly differ between groups. The scores on Family and Friend subscales of SSAS in the bronchiectasis group were significantly lower when compared with those of participants in hematology-oncology and control groups.

CONCLUSION

Chronic medical illnesses may have a similar psychological impact on children regardless of disease-specific clinical presentations and outcomes. Future studies need to focus on identifying protective and risk factors that potentially mediate psychosocial well-being.

Otimismo Disposicional, Afetos e Personalidade em Pacientes com Doença Renal Crônica

Resumo Este estudo investiga relações entre otimismo disposicional, afetos e traços de personalidade em pacientes com doença renal crônica que aguardam por um transplante renal (grupo pré-transplante) e em pacientes que já fizeram o procedimento (grupo pós-transplante). Teve como objetivos específicos: verificar se houve diferença nos escores desses três constructos nas duas amostras; se houve diferenças de desempenho no teste de otimismo e na escala de afetos em função do tempo de transplante; e se houve diferenças de desempenho no teste de otimismo e na escala de afetos em função do tempo de espera em lista. A pesquisa contou com quinze participantes em cada grupo sendo usados quatro instrumentos para coleta de dados: questionário sociodemográfico, Teste para avaliar o Otimismo (LOT-R), Inventário dos Cinco Grandes Fatores (NEO-FFI-R) e Escala de Afetos Positivos e Afetos Negativos (Panas). Os resultados indicaram maior otimismo nos participantes do grupo Pré-transplante (Md = 29; IIQ = 2) comparado com os do grupo Pós-transplante (Md = 26; IIQ = 1). Conclui-se que no grupo pré-transplante, o otimismo disposicional não se associou de maneira significativa com nenhum fator de personalidade, o que pode indicar que o otimismo esteja voltado para um objetivo-alvo, mais do que para expectativas gerais de que coisas boas aconteçam e se evidencia como fator de proteção da personalidade, ou como mecanismo de ajustamento à condição crítica de hemodiálise. O tempo passado em lista de espera e de realização do transplante não tiveram associação significativa às demais variáveis.

The use of generic avoidant coping scales for psychosocial adaptation to chronic illness and disability: A systematic review

This systematic review examined the validity of generic coping-with-stress measures in the relationships between avoidance-type coping and psychosocial adaptation to chronic illness and disability. Major data bases were searched for studies on the association between avoidance-type coping and psychosocial adaptation to chronic illness and disability. Findings indicated that reliance upon avoidance-type coping is linked to reports of poorer psychosocial adaptation. The veracity of these findings must be treated cautiously owing to conceptual, structural, psychometric, and other issues. Users of generic coping measures should consider these concerns prior to empirically investigating the link between generic avoidance-type coping measures and psychosocial adaptation among people with chronic illness and disability.

Influence of the Sense of Coherence, the Doctor-Patient Relationship, Optimism and Non-Haematological Adverse Reactions on Health-Related Quality of Life in Patients with Breast Cancer

Breast cancer is the most common malignant tumour in women around the world. The objective of this study was to quantify the number of non-haematological adverse reactions associated with chemotherapy, as well as to assess the effect of the sense of coherence, optimism-pessimism and the quality of the doctor-patient relationship on the quality of life of breast cancer patients. To this end, a cross-sectional descriptive study was conducted involving 110 breast cancer patients who were treated with docetaxel, epirubicin, and cyclophosphamide during the period 2012-2014. The difference in the quality of life in patients who have five or fewer toxicities compared to those with more than six is highlighted. This difference is not as important when comparing patients with 6 to 10 toxicities and those with more than 10. The multivariate model used in this study corroborates the direct implication of the sense of coherence on the quality of life and adds the number of adverse reactions as a new construct. This has virtually the same impact on the quality of life of these patients, but in reverse. In conclusion, to improve the quality of life of breast cancer patients it would be necessary to have an impact on the number of adverse reactions involved in chemotherapeutic treatment, as well as on psychological interventions, with the sense of coherence as a possible starting point.

Coping strategies of patients with advanced lung or colorectal cancer in six European countries: Insights from the ACTION Study

Objective

Even when medical treatments are limited, supporting patients’ coping strategies could improve their quality of life. Greater understanding of patients’ coping strategies, and influencing factors, can aid developing such support. We examined the prevalence of coping strategies and associated variables.

Methods

We used sociodemographic and baseline data from the ACTION trial, including measures of Denial, Acceptance, and Problem‐focused coping (COPE; Brief COPE inventory), of patients with advanced cancer from six European countries. Clinicians provided clinical information. Linear mixed models with clustering at hospital level were used.

Results

Data from 675 patients with stage III/IV lung (342, 51%) or stage IV colorectal (333, 49%) cancer were used; mean age 66 (10 SD) years. Overall, patients scored low on Denial and high on Acceptance and Problem‐focused coping. Older age was associated with higher scores on Denial than younger age (β = 0.05; CI[0.023; 0.074]), and patients from Italy (β = 1.57 CI[0.760; 2.388]) and Denmark (β = 1.82 CI[0.881; 2.750]) scored higher on Denial than patients in other countries.

Conclusions

Patients with advanced cancer predominantly used Acceptance and Problem‐focused coping, and Denial to a lesser extent. Since the studied coping strategies of patients with advanced cancer vary between subpopulations, we recommend taking these factors into account when developing tailored interventions to support patients’ coping strategies.

Attachment to God and coping with the diagnosis and treatment of breast cancer: a longitudinal study

BACKGROUND

Religious/spiritual factors are important for some individuals in the context of life stress. To the authors' knowledge, the present study is the first to explore the role of women's attachment to God (anxious vs secure) in their adjustment to breast cancer.

OBJECTIVE

To explore the (1) pattern of change in women's attachment to God across time and (2) relationship between attachment to God and coping behaviors and depression.

METHODS

All English-speaking women who were scheduled to receive a core breast biopsy at a women's breast health center were eligible to participate in the study. Women were assessed on attachment to God, positive and negative coping, and depression at pre-diagnosis and 3, 6, and 12 months post-diagnosis. Women who received a benign diagnosis and those with a diagnosis of breast cancer participated in the study.

RESULTS

Attachment to God remained stable across time for both diagnostic groups (cancer, benign). Women from both groups who had a more anxious attachment to God utilized more avoidance coping and reported more depression at different points across time. Breast cancer patients with a more anxious attachment to God reported engaging in less acceptance coping post-diagnosis. Finally, the association between attachment to God and depression was partially mediated by avoidance coping at pre-diagnosis.

CONCLUSIONS

Findings indicate that a more anxious attachment to God may contribute to negative patterns of adjustment while a secure attachment may help women remain more directly engaged in their coping with the threat of breast cancer and related diagnostic procedures.

IMPLICATIONS FOR PRACTICE

It is suggested that clinicians remain sensitive to and assess the role of spiritual beliefs in women's adjustment to the threat of breast cancer from pre-diagnosis up to 1 year post-diagnosis. In particular, women's belief in and experience of a secure or an anxious attachment with God or higher power may function as a potential resource or as an exacerbating factor, respectively, in their adjustment to breast cancer.

Dispositional optimism and physical health: A long look back, a quick look forward

Dispositional optimism is the generalized, relatively stable tendency to expect good outcomes across important life domains. This article provides a representative review of 30 years of research on dispositional optimism and physical well-being. Assessment of optimism is described, along with data regarding its stability. A review of the research linking optimism and physical health is then presented. Included in the review are initial studies suggesting that optimism and physical well-being might be linked as well as more recent, larger scale epidemiological studies that make the point more emphatically. Also considered are potential pathways-behavioral, biological, and social-that might explain these associations. The article concludes with a brief look to the future, describing several issues and questions that still need to be answered. These questions include the relationship of optimism and pessimism to each other (and the implications of that relationship for physical well-being), the origins of optimism and pessimism, and interventions that might be implemented to reduce the negative impact of a pessimistic outlook. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Relational and Spiritual Coping Among Emerging and Young Adult Cancer Survivors

Cancer presents uncertainties for individuals of any age; however, emerging and young adults (EYA) are challenged to cope with developmental tasks in addition to cancer-related stressors. Guided by the double ABC-X model and biopsychosocial-spiritual framework, the current study investigates coping strategies used by this population and the role of psychological resources (perception of parental care/control and spirituality) on their coping ability. Recruited from online social media, 210 EYA cancer survivors self-reported demographic, medical information, and completed the Brief Cope scale. In addition, spirituality reliance, perceived parental care, and parental control were measured and examined in relation to coping ability. While nearly half of participants experienced positive adaptation in relation to multiple stressors, hierarchical multiple regression revealed the developmental nature of coping and indicated that higher spirituality reliance and higher degree of parental care were predictive of adaptive coping among EYA cancer survivors. Content analyses of the open-ended questions confirmed these results. In order to facilitate adaptive coping, attention must be paid to the unique biopsychosocial-spiritual and developmental needs of young cancer survivors while encouraging family support and spirituality reliance as significant tools in coping. Practical recommendations for nursing support and healthcare teams are discussed.

Gauging the Effects of Self-efficacy, Social Support, and Coping Style on Self-management Behaviors in Chinese Cancer Survivors

BACKGROUND

Better self-management control in cancer survivors would benefit their functional status, quality of life, and health service utilization. Factors such as self-efficacy, social support, and coping style are important predictors of self-management behaviors of cancer survivors; however, the impact of these factors on self-management behaviors has not yet been empirically tested in Chinese cancer survivors.

OBJECTIVES

The aim of this study was to examine how self-efficacy, social support, and coping style affect specific self-management behaviors.

METHODS

A secondary data analysis was completed from a cross-sectional study. A total of 764 cancer survivors were recruited in the study. Validated instruments were used to assess patients' self-efficacy, social support, and coping style. Structural equation modeling (SEM) was used to test the hypothesis.

RESULTS

The SEM model fits the data very well, with root mean square error of approximation (RMSEA) of 0.034; close-fit test cannot reject the hypothesis of root mean square error of approximation of 0.05 or less, comparative fit index of 0.91, Tucker-Lewis index of 0.90, and weighted root mean square residual of 0.82. For the measurement models in the SEM, all items loaded highly on their underlying first-order factors, and the first-order factors loaded highly on their underlying second-order factors (self-efficacy and social support, respectively). The model demonstrated that self-efficacy and social support directly and indirectly, via coping style, affect 3 self-management behaviors (ie, communication, exercise, and information seeking).

CONCLUSION

Our results provide evidence that self-efficacy and social support impose significant direct effects, as well as indirect effects via copying style, on the self-management of cancer survivors.

IMPLICATIONS FOR PRACTICE

Our findings may help nurses to further improve their care of cancer survivors in terms of their self-management behaviors, specifically communication, exercise, and information seeking.

Uncertainty and Quality of Life in Women With Breast Cancer: Moderating Role of Coping Styles

BACKGROUND

The negative relationship between uncertainty and quality of life is well reported in the literature. Also, there is abundant research linking coping strategies to cancer patients' quality of life. However, there exists a paucity of information on the moderating effect of coping styles on the relationship between uncertainty and quality of life in cancer patients.

OBJECTIVE

The aim of this study was to examine whether uncertainty in illness is negatively correlated with quality of life and whether this relationship is moderated by coping strategies, namely, problem-focused, avoidant, and active emotional coping.

METHODS

A convenience sample of 135 Malaysian women with breast cancer participated in the study. Participants completed measures of uncertainty in illness, quality of life, and coping styles.

RESULTS

Uncertainty in breast cancer was negatively related to quality of life (β = -0.379, P < .001), and active emotional coping was found to moderate this negative relationship (β = 0.155, P < .05). The model explained 22.20% of the variance of quality of life.

CONCLUSION

Lack of information about breast cancer, treatment, hospitalization, and disease recurrence is related to poorer quality of life. However, this negative relationship becomes weaker when active emotional coping strategies are used.

IMPLICATIONS FOR PRACTICE

Nurses and health providers should help patients reduce their uncertainty in illness by providing them information on breast cancer or referring them to relevant sources. Moreover, they could reduce the deleterious effect of uncertainty on quality of life by encouraging patients to use more active emotional coping strategies.

Coping Among Breast Cancer Survivors: A Confirmatory Factor Analysis of the Brief COPE

BACKGROUND AND PURPOSE

Cancer survivors continue to cope with significant stressors after completing treatment. The Brief COPE (Carver, 1997) is frequently used to measure coping; however, its factor structure remains unclear. The purpose of this study was to determine the best factor conceptualization of the Brief COPE for use among breast cancer survivors.

METHODS

Breast cancer survivors (N = 1,127) completed the Brief COPE. We conducted confirmatory factor analyses comparing several a priori models based on research in cancer-relevant populations.

RESULTS

Of the eight models examined, the 14-factor model of the Brief COPE showed the best fit.

CONCLUSIONS

Despite efforts to simplify the structure of the Brief COPE, our results suggest coping among breast cancer survivors is best assessed using Carver's (1997) original 14-factor conceptualization.

The Role of Optimism, Social Constraints, Coping, and Cognitive Processing in Psychosocial Adjustment Among Breast Cancer Survivors

The social-cognitive processing model suggests that a socially constrained environment may impede adjustment to a chronic illness. The present study primarily investigated the mediating psychological pathways through which social constraints on cancer-related disclosure, low optimism, disengagement-oriented coping, and brooding could be associated with low levels of psychosocial adjustment. One hundred twenty-five female breast cancer survivors participated in a cross-sectional study. Path analysis was used to examine the proposed model. Low optimism, increased social constraints, and higher levels of brooding appeared to be risk factors for poor psychosocial adjustment to breast cancer. Disengagement-oriented coping and brooding partially mediated the relationship between social constraints and adjustment. Brooding totally mediated the relationship between disengagement-oriented coping and adjustment. The current findings provide support for the value of the social-cognitive processing model among breast cancer survivors. The mapping of psychological pathways of adjustment to breast cancer may have useful clinical implications for better adjustment outcomes.

A Randomized Clinical Trial Comparing the Impact of a Web-Based Multimedia Intervention Versus an Educational Pamphlet on Patient Outcomes in Breast Cancer Survivors with Chronic Secondary Lymphedema

Objective: The purpose of this study was to evaluate the effects of a Web-based Multimedia Intervention (WBMI) for breast cancer-related lymphedema (BCRL) patients on symptom burden, function, psychological well-being, costs, and arm volume. Methods: Women with BCRL were randomized to intervention (n = 80) or control (n = 80) groups. The WBMI offered 12 modules, each of which took about 30 minutes to complete. The Pamphlet took about 2 hours to read. Data on symptom burden, psychological well-being, function, and costs were collected preintervention; and 1, 3, 6, and 12 months postintervention. A subgroup of 45 regional patients had arm extracellular fluid measured by bioimpedance at baseline and at 3, 6, and 12 months postintervention. Intervention perceived value was also captured. Results: A statistically significant difference (p = 0.011) was observed for rates of intervention completion, WBMI (58%), and Pamphlet (77%). With the exception of the number of biobehavioral symptoms (mood), no statistically significant differences between groups in symptom reduction were apparent between baseline and 1 or 12 months (effect sizes = 0.05-0.28, p > 0.05) based on the Lymphedema Symptom Intensity and Distress Scale-Arm (LSIDS-A). No statistically significant differences between the groups were observed for changes in other variables. The WBMI was perceived as providing better self-care information than the Pamphlet (p = 0.001). Conclusions: WBMI participants experienced improved biobehavioral symptoms and higher perceived quality of information. The lack of significant differences on other variables may be due to the high percentage of participants who did not complete the WBMI.

Psychosocial interventions for informal caregivers of people living with cancer

BACKGROUND

Increasingly, cancer is recognised as a chronic condition with a growing population of informal caregivers providing care for cancer patients. Informal caregiving can negatively affect the health and well-being of caregivers. We need a synthesised account of best evidence to aid decision-making about effective ways to support caregivers for individuals 'living with cancer'.

OBJECTIVES

To assess the effectiveness of psychosocial interventions designed to improve the quality of life (QoL), physical health and well-being of informal caregivers of people living with cancer compared with usual care.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, PsycINFO, ProQuest, Open SIGLE, Web of Science from inception up to January 2018, trial registries and citation lists of included studies.

SELECTION CRITERIA

We included randomised and quasi-randomised controlled trials comparing psychosocial interventions delivered to adult informal caregivers of adults affected by cancer on a group or individual basis with usual care. Psychosocial interventions included non-pharmacological interventions that involved an interpersonal relationship between caregivers and healthcare professionals. We included interventions delivered also to caregiver-patient dyads. Interventions delivered to caregivers of individuals receiving palliative or inpatient care were excluded. Our primary outcome was caregiver QoL. Secondary outcomes included patient QoL, caregiver and patient depression, anxiety, psychological distress, physical health status and intervention satisfaction and adverse effects.

DATA COLLECTION AND ANALYSIS

Pairs of review authors independently screened studies for eligibility, extracted data and conducted 'Risk of bias' assessments. We synthesised findings using meta-analysis, where possible, and reported remaining results in a narrative synthesis.

MAIN RESULTS

Nineteen trials (n = 3, 725) were included in the review. All trials were reported in English and were undertaken in high-income countries. Trials targeted caregivers of patients affected by a number of cancers spanning newly diagnosed patients, patients awaiting treatment, patients who were being treated currently and individuals post-treatment. Most trials delivered interventions to caregiver-patient dyads (predominantly spousal dyads) and there was variation in intervention delivery to groups or individual participants. There was much heterogeneity across interventions though the majority were defined as psycho-educational. All trials were rated as being at 'high risk of bias'.Compared to usual care, psychosocial interventions may improve slightly caregiver QoL immediately post intervention (standardised mean difference (SMD) 0.29, 95% confidence interval (CI) 0.04 to 0.53; studies = 2, 265 participants) and may have little to no effect on caregiver QoL at 12 months (SMD 0.14, 95% CI - 0.11 to 0.40; studies = 2, 239 participants) post-intervention (both low-quality evidence).Psychosocial interventions probably have little to no effect on caregiver depression immediately to one-month post-intervention (SMD 0.01, 95% CI -0.14 to 0.15; studies = 9, 702 participants) (moderate-quality evidence). Psychosocial interventions may have little to no effect on caregiver anxiety immediately post-intervention (SMD -0.12, 95 % CI -0.33 to 0.10; studies = 5, 329 participants), depression three-to-six months (SMD 0.03, 95% CI -0.33 to 0.38; studies = 5. 379 participants) post-intervention and patient QoL six to 12 months (SMD -0.05, 95% CI -0.37 to 0.26; studies = 3, 294 participants) post-intervention (all low-quality evidence). There was uncertainty whether psychosocial interventions improve patient QoL immediately (SMD -0.03, 95 %CI -0.50 to 0.44; studies = 2, 292 participants) or caregiver anxiety three-to-six months (SMD-0.25, 95% CI -0.64 to 0.13; studies = 4, 272 participants) post-intervention (both very low-quality evidence). Two studies which could not be pooled in a meta-analysis for caregiver physical health status found little to no effect immediately post-intervention and a small intervention effect 12 months post-intervention. Caregiver or patient satisfaction or cost-effectiveness of interventions were not assessed in any studies. Interventions demonstrated good feasibility and acceptability.Psychosocial interventions probably have little to no effect on patient physical health status immediately post-intervention (SMD 0.17, 95 % CI -0.07 to 0.41; studies = 4, 461 participants) and patient depression three to six months post-intervention (SMD-0.11, 95% CI -0.33 to 0.12; studies = 6, 534 participants) (both moderate-quality evidence).Psychosocial interventions may have little to no effect on caregiver psychological distress immediately to one-month (SMD -0.08, 95% CI -0.42 to 0.26; studies = 3, 134 participants), and seven to 12 months (SMD 0.08, 95% CI -0.42 to 0.58; studies = 2, 62 participants) post-intervention; patient depression immediately (SMD -0.12, 95% CI -0.31 to 0.07; studies = 9, 852 participants); anxiety immediately (SMD -0.13, 95% CI -0.41 to 0.15;studies = 4, 422 participants), and three to six months (SMD -0.22, 95% CI -0.45 to 0.02; studies = 4, 370 participants); psychological distress immediately (SMD -0.02, 95% CI -0.47 to 0.44; studies = 2, 74 participants) and seven to 12 months (SMD -0.27, 95% CI -0.78 to 0.24; studies = 2, 61 participants); and physical health status six to 12 months (SMD 0.06, 95% CI -0.18 to 0.30; studies = 2, 275 participants) post-intervention (all low-quality evidence).Three trials reported adverse effects associated with the interventions, compared with usual care, including higher distress, sexual function-related distress and lower relationship satisfaction levels for caregivers, higher distress levels for patients, and that some content was perceived as insensitive to some participants.Trials not able to be pooled in a meta-analysis did not tend to report effect size and it was difficult to discern intervention effectiveness. Variable intervention effects were reported for patient and caregiver outcomes.

AUTHORS' CONCLUSIONS

Heterogeneity across studies makes it difficult to draw firm conclusions regarding the effectiveness of psychosocial interventions for this population. There is an immediate need for rigorous trials with process evaluations and clearer, detailed intervention descriptions. Cost-effectiveness studies should be conducted alongside future trials.

Dispositional optimism and cognitive functioning following traumatic brain injury

Objective: The association of dispositional optimism with health-related factors has been well established in several clinical populations, but little is known about the role of optimism in recovery after traumatic brain injury (TBI). Given the high prevalence of cognitive complaints after TBI, the present study examined the association between optimism and cognitive functioning after TBI. Methods: 171 individuals with complicated mild, moderate or severe TBI completed a series of questionnaires via structured interview and self-report, including a self-report assessment of dispositional optimism, the revised Life Orientation Test (LOT-R), and an objective assessment of cognition, the Brief Test of Adult Cognition by Telephone (BTACT). Multiple hierarchical regression analysis was conducted to examine the relationships between optimism and cognitive functioning. Results: Dispositional optimism was significantly and positively associated with post-TBI cognitive functioning after controlling for the effects of age, race, injury severity, health status, and positive and negative affect. Conclusion: Dispositional optimism may promote higher levels of cognitive functioning in people who sustained a TBI. Research is warranted to examine whether interventions that promote optimism in clinical and social encounters can enhance cognitive recovery in individuals with TBI.

Pessimism predicts anxiety and depression in breast cancer survivors: A 5-year follow-up study

OBJECTIVE

We investigated the prevalence of anxiety and depression at diagnosis and at 1, 3, and 5 years after breast cancer diagnosis. We hypothesized that a low level of optimism (pessimism) at diagnosis could predict change in anxiety and depression 5 years later.

METHODS

Three hundred sixty-seven women with operable breast cancer were included, and data were collected at all five-time points for 293 of these. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Dispositional optimism/pessimism was measured using the Life Orientation Test-Revised (LOT-R). Frequency analysis was used to determine the prevalence of anxiety and depression. Logistic regression was used to examine dispositional optimism/pessimism as a predictor of change in anxiety and depression 5 years after diagnosis.

RESULTS

The prevalence rates of anxiety and depression 5 years after diagnosis were 26.3% and 9.6%, respectively. Predictors of change in anxiety 5 years after diagnosis were pessimism (odds ratio [OR] = 0.82; 95% confidence interval [CI]: 0.76-0.89, P < .001); younger age (OR = 0.96; 95% CI: 0.93-0.99, P = .005); and anxiety at diagnosis (OR = 2.41; 95% CI: 1.33-4.37, P = .004). Predictors of change in depression 5 years after diagnosis were pessimism (OR = 0.84; 95% CI: 0.77-0.94, P < .001) and comorbidity (OR = 1.51, 95% CI: 1.10-2.06, P = 0.01).

CONCLUSION

Anxiety and depression did not decrease after the first postoperative year. Pessimism was a predictor of change in both anxiety and depression 5 years after breast cancer diagnosis.

The Coping Circumplex Model: An Integrative Model of the Structure of Coping With Stress

It seems obvious that the identification of coping structure is necessary to understand how stress affects human health and functioning. Despite numerous coping conceptualization proposals, there is no agreement as to the core coping categories. This article presents the Coping Circumplex Model (CCM), which is designed to integrate various coping distinctions, drawing inspiration from the tradition of circumplex models in psychology. The model is based on the assumption that individuals in stressful situations face two tasks: they need to solve the problem and regulate their emotions, which are reflected in two corresponding dimensions, that is, the problem coping dimension and emotion coping dimension. Problem coping and emotion coping are interpreted as bipolar dimensions. Importantly, these dimensions define a space for other coping categories. The model contains a total of eight coping styles forming a circumplex: positive emotional coping, efficiency, problem solving, preoccupation with the problem, negative emotional coping, helplessness, problem avoidance, and hedonic disengagement. The paper discusses the potential of the CCM to overcome some of the problems of stress psychology by: (a) supplementing the set of coping categories (i.e., process, strategy, style) with coping mode; (b) providing a foundation for the integration of numerous coping constructs; (c) enabling the interpretation of results obtained by means of different coping measures, thus facilitating knowledge consolidation; (d) explaining relationships between coping and adjustment after trauma, as well as explaining the mechanisms of psychological interventions (e.g., cognitive therapy, exposure therapy); (e) clarifying linkages between the effectiveness of coping strategies and situation controllability. Moreover, the CCM may elucidate the relationship between coping and emotion regulation (e.g., cognitive reappraisal and expressive suppression).

Does other-affirmation increase self-directed exposure to and persuasiveness of a threatening anti-alcohol message?

OBJECTIVE

Self-affirmation of personal values can reduce defensive responses to threatening health promotion messages, probably because it induces a positive and expansive view of the self. However, coping with threat is also an interpersonal process. We developed other-affirmation inductions that focus on values held by others. Two studies examined the effects of common affirmation inductions modified for other-affirmation: affirmation of a specific value (kindness) and affirmation of a personally chosen value.

DESIGN

Randomized and controlled three-group (self-, other-, or no-affirmation conditions) single-factor design. Outcomes were time spent in self-directed viewing the message and self-reported outcomes that included intentions to reduce drinking, evaluations of the message, and risk perceptions.

METHODS

Students were randomized to self-, other, or no-affirmation conditions and asked to read a threatening anti-alcohol message.

RESULTS

Self- and other-affirmation increased message viewing time in Study 1. In both studies, other-affirmation increased self-reported outcomes, and study 1 showed this effect to be more prominent in females. In Study 1, the effects of self- and other-affirmation on message exposure were greater in participants with defensive coping styles, and other-affirmation effects were mediated by more positive views of others and their values. This mediation was independent of self-affirmation.

CONCLUSION

Other-affirmation increased self-reported outcomes and, in Study 1, reduced defensiveness to and improved viewing times to an anti-alcohol message. Other-affirmation could be useful, because it may be suited to particular subpopulations, such as females, and can be easily incorporated into mass-reach health communications. Statement of contribution What is already known on this subject? Self-affirmation of personally important values can reduce defensive responding to threatening health communications. Self-affirmation effects have been shown to be mediated by feelings of connectedness. What does this study add? Affirmation of personally important values in others can improve effects of a health communication. Other-affirmation effects may be greater in those with defensive coping styles. Other-affirmation was mediated by enhanced perceptions of others and their values.

Interpersonal positive reframing in the daily lives of couples coping with breast cancer

OBJECTIVES

This study examined word use as an indicator of interpersonal positive reframing in daily conversations of couples coping with breast cancer and as a predictor of stress.

DESIGN

The Electronically Activated Recorder (EAR) and Linguistic Inquiry and Word Count (LIWC) were used to examine naturally occurring word use conceptually linked to positive reframing (positive emotion, negative emotion, and cognitive processing words).

SAMPLE

Fifty-two couples coping with breast cancer.

METHODS

Couples wore the EAR, a device participants wear, that audio-recorded over one weekend (>16,000 sound files), and completed self-reports of positive reframing (COPE) and stress (Perceived Stress Scale). LIWC, a software program, measured word use.

FINDINGS

Both partners' word use (i.e., positive emotion and cognitive processing words) was associated with their own reported positive reframing, and spouses' word use was also indicative of patients' positive reframing. Results also revealed that, in general, words indicating positive reframing predicted lower levels of stress.

CONCLUSIONS

Findings supported the hypothesis that partners-and particularly spouses of breast cancer patients-may assist each other's coping by positively reframing the cancer experience and other negative experiences in conversation.

Resilience and Coping in Cancer Survivors: The Unique Effects of Optimism and Mastery

Optimism and mastery are two cognitive traits that involve positive expectations for the future and that have been demonstrated to be important predictors of reduced anxiety as well as superior coping and physical health in many populations, including cancer survivors. There is limited research, however, examining the unique effects of these traits when examined simultaneously. The present cross-sectional study used structural equation modeling to examine the unique effects of optimism and mastery on emotion, coping, and health in 603 adult cancer survivors, and whether results were consistent in men and women. Results indicated that both optimism and mastery were associated with improved emotion, coping, and health and together accounted for a small to moderate amount of variance. Although the effects of optimism were generally greater, mastery also uniquely predicted most dependent variables and there was some evidence that gender influenced these effects, with optimism predicting health control more so in women and mastery predicting health control more so in men. These results demonstrate that it is important to examine both generalized positive expectancies such as optimism and positive expectancies regarding mastery when investigating resilience and emotional well-being in cancer survivors.

Social comparisons predict health-related quality of life and depressive symptoms across the first year of breast cancer treatment

BACKGROUND

Social comparisons (SCs) are common among cancer patients, but their prospective associations are not well understood. This study examined concurrent and prospective relationships of SCs with health-related quality of life (HRQOL) and depressive symptoms during the first year of breast cancer treatment.

METHODS

Nonmetastatic breast cancer patients (N = 240) enrolled in a larger intervention trial reported on the frequencies of SCs postsurgery (T1) and 6 months later (T2). HRQOL and depressive symptoms were assessed at T1, T2, and 12 months after T1 (T3). Path analysis via structural equation modeling was used to assess three models relating SCs to HRQOL and depressive symptoms from T1-T2, T1-T3, and T2-T3, controlling for stage of disease, intervention condition, and dispositional optimism.

RESULTS

Upward contrast SCs were associated with poorer concurrent HRQOL at T1 and T2, and with more concurrent depressive symptoms at T2. However, upward contrast SC at T1 predicted better T2 and T3 HRQOL. Upward identification SC at T1 predicted more T2 depressive symptoms, and at T2 was associated with poorer concurrent HRQOL and more concurrent depressive symptoms. Downward identification SCs at T1 were associated with poorer concurrent HRQOL. Downward identification SCs at T2 predicted poorer T3 HRQOL.

CONCLUSIONS

Upward SCs were related to compromised concurrent psychosocial well-being, but prospective effects varied by the interpretation of the comparison (ie, contrast vs identification). Findings have implications for the development and deployment of group-based psychosocial interventions during the early phases of survivorship, during which opportunities for SC are prevalent.

Resilience in Cancer Patients

Background: Being diagnosed with cancer and undergoing its treatment are associated with substantial distress that can cause long-lasting negative psychological outcomes. Resilience is an individual's ability to maintain or restore relatively stable psychological and physical functioning when confronted with stressful life events and adversities. Posttraumatic growth (PTG) can be defined as positive life changes that result from major life crises or stressful events. Objectives: The aims of this study were to 1) investigate which factors can strengthen or weaken resilience and PTG in cancer patients and survivors; 2) explore the relationship between resilience and PTG, and mental health outcomes; and 3) discuss the impact and clinical implications of resilience and PTG on the process of recovery from cancer. Methods: A literature search was conducted, restricted to PubMed from inception until May 2018, utilizing the following key words: cancer, cancer patients, cancer survivors, resilience, posttraumatic growth, coping, social support, and distress. Results: Biological, personal, and most importantly social factors contribute to cancer patients' resilience and, consequently, to favorable psychological and treatment-related outcomes. PTG is an important phenomenon in the adjustment to cancer. From the literature included in this review, a model of resilience and PTG in cancer patients and survivors was developed. Conclusions: The cancer experience is associated with positive and negative life changes. Resilience and PTG are quantifiable and can be modified through psychological and pharmacological interventions. Promoting resilience and PTG should be a critical component of cancer care.

A Comparative Study on Perceived Stress, Coping, Quality of Life, and Hopelessness between Cancer Patients and Survivors

Background and Aim:

Cancer patients and survivors need to cope with many physical and emotional stressors. This cross-sectional study compared the perceived stress, coping, quality of life (QOL), and hopelessness between cancer patients and cancer survivors and examined the relationship of perceived stress with coping, QOL, and hopelessness in cancer patients and cancer survivors.

Materials and Methods:

Using a purposive sampling technique, this study was conducted in the Medical Oncology Department of a multi-specialty tertiary care teaching hospital between February and May 2018. Thirty participants (15 cancer patients and 15 cancer survivors) in the age range of 30–60 years took part in the study. Both groups were assessed by the following instruments: Perceived Stress Scale, Coping Checklist, Quality of Life-Cancer, and Beck Hopelessness Scale.

Results:

Cancer patients are using maladaptive coping strategies and experiencing psychological distress with reduced QOL than cancer survivors. Furthermore, hopelessness was positively correlated with QOL among cancer survivors.

Conclusions:

Cancer patients are found to be distressed and hopeless with significant reductions in their QOL.

Fear of cancer recurrence, anxiety and depressive symptoms in adolescent and young adult cancer patients

Background: Previous studies have indicated that younger age is consistently associated with high levels of fear of cancer recurrence (FCR), anxiety and depression. However, the associations among these variables in adolescent and young adult (AYA) cancer patients are not clear. This study explores the prevalence and correlates of FCR, anxiety and depressive symptoms in Chinese AYA cancer population. Methods: This is a cross-sectional study that includes 249 patients aged between 15 and 39 yrs at the time of cancer diagnosis. Patient's sociodemographic, clinical as well as psychological characteristics were collected by an information sheet, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), General Anxiety Disorder Questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9). Descriptive statistics and multivariate analyses were conducted. Results: Eighty-nine (35.74%) patients experienced dysfunctional level of FCR, eighty-two (32.93%) patients experienced anxiety symptoms and ninety-six (38.55%) reported depressive symptoms. In multivariate analyses, being single, pessimistic, having more concurrent stressful life events and physical comorbidity were independently associated with higher FCR, anxiety and depressive symptoms. Patients who were not engaging in radiotherapy were more likely to report higher anxiety level. Conclusion: FCR, anxiety and depressive symptoms are frequently reported problems among AYA cancer patients. Age-appropriate and flexible psychological interventions are needed for this high-risk population.

When life gives you lemons make lemonade: cross-sectional age and gender differences in optimism

Purpose

The purpose of this paper is to test the cognitive construct of optimism (positive future outcome expectancies) and the age-gender differences in Indian sample.

Design/methodology/approach

The sample consists of 363 older, middle-aged and younger male and female employees. The study adopted a cross-sectional survey based research design.

Findings

Results revealed that middle-aged employees have high levels of optimism as compared to the old age and younger employees. Further, the males reflected high optimism levels in comparison to female employees in middle and old aged adult employees, whereas females have higher optimism level in younger age in Indian select organisations.

Research limitations/implications

The study suggests that the continuous changes in the lifespan lead to changes in one’s attitude and hence results in behavioural changes. The research indicates that optimism should be cultivated in the individuals by providing training and development to promote the competence and skill-building events which would help in enhancing the productivity resulting in better understanding of the scenario at workplace.

Originality/value

The work supplements the existing literature on positive attitude or outcome expectancies by adding to the lifespan development theory.

Factors associated with fear of progression in chinese cancer patients: sociodemographic, clinical and psychological variables

OBJECTIVE

Fear of progression (FoP) is a widespread problem among cancer patients and is considered to be one of the most distressing psychological consequences of cancer. The aim of this study was to investigate the association of sociodemographic, clinical, and psychological variables to FoP in Chinese cancer patients.

METHODS

In this cross-sectional study, six hundred and thirty-six cancer patients were recruited. All participants were asked to complete a personal information sheet, the Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder Questionnaire (GAD-7). Descriptive statistics and hierarchical multiple regression was conducted to analyze the data.

RESULTS

Hierarchical multiple regression revealed that childhood severe illness experience (P = .011), stress (P < .001), anxiety (P < .001), depressive symptom (P < .001) and personality (P = .042) were independently predictive of higher FoP. The final regression model explained up to 40.0% (adjusted R square: 38.8%) of the observed variance.

CONCLUSION

There are a number of factors that increase the likelihood of the development of FoP. The findings underline the necessity to provide effective psychological intervention for patients with high FoP in the future.

Examining variation across treatment clinics in cancer patients' psychological outcomes: results of a cross sectional survey

PURPOSE

The majority of research on psychological outcomes for cancer patients has focussed on the role of individual characteristics, and disease and treatment factors. There has been very little exploration of the potential contribution of the treatment clinic to these outcomes. This study explored whether there is variation among clinics in cancer patients' psychological outcomes.

METHODS

Cancer outpatients were recruited from 22 medical oncology and haematology clinics in Australia. Participants completed a pen and paper survey including the Hospital Anxiety and Depression Scale (HADS), as well as sociodemographic, disease and treatment characteristics.

RESULTS

Of those eligible to participate, 4233 (82%) consented and 2811 (81% of consenters) returned the completed survey. There was no statistically significant variation in HADS depression scores across clinics. Some difference in anxiety scores derived from the HADS questionnaire between clinics (p = 0.03) was found with the percentage of between-clinic variation estimated to be 1.11%. However, once all demographic, disease and treatment predictors were adjusted for there was no statistical differences between clinics (percent of between-clinic variation = 0.53%; p = 0.1415).

CONCLUSIONS

Psychological outcomes were not found to vary between clinics. Other sources of variation including patient characteristics may over-ride between-clinic variability, if it exists.

Coping strategies, trajectories, and their associations with patient-reported outcomes among women with ovarian cancer

OBJECTIVE

Most women with ovarian cancer present with advanced stage disease and face aggressive treatments, recurrence, and possible death, yet little is known about how they cope. Our objective was to identify coping strategies used by women with ovarian cancer and their trajectories of use after diagnosis and to assess if coping trajectories are associated with subsequent anxiety, depression, or quality of life.

METHODS

Women with ovarian cancer completed questionnaires including the Brief-COPE, HADS, and FACT at 3, 6, and 9 months after diagnosis and the HADS and FACT at 12 months. Using data from 634 women who completed the 3-month questionnaire, factor analysis was conducted to identify coping strategy clusters. Trajectory modeling was used to assess patterns of coping over time. Associations between coping trajectory from 3 to 9 months and patient-reported outcomes at 12 months were investigated using general linear models.

RESULTS

Three coping strategy clusters were identified. Use of "taking action/positive framing" followed four distinct trajectories over time: low-stable (44%), medium-stable (32%), medium-decreasing (11%), high-stable (12%). Use of "social/emotional support" had four trajectories: low-increasing (7%), low-decreasing (44%), medium-decreasing (40%), and high-stable (8%). Women either "accepted their reality" (26%) or "used some denial" (74%). Women who accepted reality reported significantly less anxiety and depression and better quality of life at 12 months. Women with high-stable use of taking action/positive framing reported less depression. Women with high-stable use of social/emotional support reported better quality of life.

CONCLUSIONS

Strategies to assist women with acceptance, action-planning, positive-framing, and maintaining psychosocial support should be considered.

Hope and self-efficacy are associated with better satisfaction with life in people with ALS

The psychological phenotype in amyotrophic lateral sclerosis (ALS) is less negative than in other neurodegenerative diseases, manifested by a lower prevalence of psychopathology, such as anxiety and major depression, and a higher perceived quality of life by patients, irrespective of physical impairment. We hypothesized that positive psychological factors such as hope, optimism, and self-efficacy in people with ALS (PALS) were key determinants of satisfaction with life (SWL), despite physical impairment, and were protective against psychopathology. Forty PALS, at different functional levels, completed objective questionnaires to evaluate psychological factors of hope, optimism, self-efficacy, and SWL. Approximately 41% of the variance in SWL was accounted for by the Agency factor of hope. The results indicated that SWL was significantly correlated to specific positive psychological factors of hope and self-efficacy. Physical impairment was not correlated with positive psychological factors or SWL. These results support the role of hope and self-efficacy in maintaining satisfaction with life in PALS and consideration of these potentially modifiable factors could improve palliative therapy.

Optimism, Symptom Distress, Illness Appraisal, and Coping in Patients With Advanced-Stage Cancer Diagnoses Undergoing Chemotherapy Treatment

PURPOSE/OBJECTIVES

To explore the relationships between optimism, self-efficacy, symptom distress, treatment complexity, illness appraisal, coping, and mood disturbance in patients with advanced-stage cancer.
.

DESIGN

Cross-sectional study.
.

SETTING

Smilow Cancer Hospital at Yale New Haven in Connecticut, an outpatient comprehensive cancer center.
.

SAMPLE

A convenience sample of 121 adult patients with stages III-IV cancer undergoing active chemotherapy.
.

METHODS

Participants completed common self-report questionnaires to measure variables. Treatment hours and visits were calculated from data retrieved from medical record review. Mediation and path analysis were conducted to identify direct and indirect pathways from the significant antecedent variables to mood disturbance.
.

MAIN RESEARCH VARIABLES

Dispositional optimism, self-efficacy, social support, treatment complexity, symptom distress, illness appraisal, coping, and mood disturbance.
.

FINDINGS

Greater optimism and self-efficacy were associated with less negative illness appraisal, less avoidant coping, and decreased mood disturbance. Conversely, greater symptom distress was associated with greater negative illness appraisal, greater avoidant coping, and greater mood disturbance. In the final model, optimism and symptom distress had direct and indirect effects on mood disturbance. Indirect effects were partially mediated by illness appraisal.
.

CONCLUSIONS

Mood disturbance resulted from an interaction of disease stressors, personal resources, and cognitive appraisal of illness. Avoidant coping was associated with greater disturbed mood, but neither avoidant nor active coping had a significant effect on mood in the multivariate model. 
.

IMPLICATIONS FOR NURSING

Illness appraisal, coping style, and symptom distress are important targets for intervention. Optimism is a beneficial trait and should be included, along with coping style, in comprehensive nursing assessments of patients with cancer.

Does the Factor Structure of the Brief COPE Fit Different Types of Traumatic Events?

Abstract. The current study aims to explore the likelihood of there being a higher-order factorial model of the Brief COPE ( Carver, 1997 ) that is equally appropriate and valid for different traumatic groups (i.e., breast cancer patients and female flood survivors) at 3–4 months after the traumatic event. Both groups of participants include 180 survivors. Five factorial models for the Brief COPE were identified when reviewing the literature, and model comparisons were made by conducting confirmatory factor analyses (CFAs). The three dimensions of the Brief COPE posited by Litman (2006) and Gutiérrez, Peri, Torres, Caseras, and Valdés (2007) , namely self-sufficient coping, socially-supported coping, and avoidant coping, were supported in both traumatic populations. Tests of measurement invariance generally supported invariance (factor form, factor loadings, item intercepts, error variances, factor variances, and covariances) across groups, implying that groups perceive the latent factors in the same way and the higher-order coping across different traumatic groups is meaningful. Moreover, the relationship between the three higher-order coping factors and variables of psychological adjustment was examined. Generally, different relationships between the subtypes of coping and the outcomes of adaptation existed between female flood survivors and breast cancer patients. Further theoretical and practical implications for these relationships are discussed.

Optimism, Pessimism, Coping, and Depression: A Study on Individuals With Parkinson's Disease

Few published studies exist on how individuals with Parkinson's disease (PD) deal with their disease. We conducted this study to examine the relationship between optimism, pessimism, coping strategies, and depressive symptoms in individuals with PD. Specifically, we assessed the possible mediator role of optimism and pessimism on the relation between coping strategies and depressive symptoms in those with PD. Seventy individuals with PD (35 females and 35 males) were assessed with the Brief COPE scale, Life Orientation Test-Revised, and Center for Epidemiological Studies Depression Scale. Findings showed that individuals with PD used similar amounts of problem-focused coping strategies and emotion-focused coping strategies, and they reported more optimism than pessimism. There was only one gender difference: Females reported more problem-focused coping than males. Optimism was positively related to both emotion-focused and problem-focused coping, and pessimism was negatively related to emotion-focused and problem-focused coping. Optimism and pessimism fully mediated the relation between coping strategies and depressive symptoms.

"Straight from the heavens into your bucket": domestic rainwater harvesting as a measure to improve water security in a subarctic indigenous community

Background: Black Tickle-Domino is an extremely water-insecure remote Inuit community in the Canadian subarctic that lacks piped-water. Drinking water consumption in the community is less than a third of the Canadian national average. Water insecurity in the community contributes to adverse health, economic, and social effects and requires urgent action.

Objectives: To test the ability of domestic rainwater harvesting (DRWH) for the first time in the subarctic with the goal of improving water access and use in the community.

Design: This project utilised quantitative weekly reporting of water collection and use, as well as focus group discussions. DRWH units were installed at seven water-insecure households chosen by the local government. Results were measured over a 6-week period in 2016.

Results: Participants harvested 19.07 gallons of rainwater per week. General purpose water consumption increased by 17% and water retrieval efforts declined by 40.92%. Households saved $12.70 CDN per week. Participants reported perceived improvements to psychological health. Because no potable water was collected, drinking water consumption did not increase. The study identified additional water-insecurity impacts.

Conclusion: DRWH cannot supply drinking water without proper treatment and filtration; however, it can be a partial remedy to water insecurity in the subarctic. DRWH is appropriately scaled, inexpensive, and participants identified several significant benefits.