Relationship of psychological characteristics and self-efficacy in gastrointestinal cancer survivors

Self-efficacy of PLHIV for self-management at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a cross-sectional study

BACKGROUND

Self-efficacy is the ability to execute, and it is a critical predictor of health-related outcomes among people living with human immunodeficiency virus (PLHIV). Self-efficacy directly determines treatment outcome. However, there is no evidence on the self-efficacy of PLHIV for self-management in Ethiopia. Currently, HIV is considered a manageable chronic disease. However, the burden remains high despite all the taken measures.

OBJECTIVES

This study aimed to assess the self-efficacy of PLHIV for self-management at the University of Gondar Comprehensive Specialized Hospital (UOGCSH), northwest Ethiopia, 2022.

METHODS

A cross-sectional study was conducted on PLHIV selected by a systematic random sampling technique using an interviewer-administered questionnaire at the UOGCSH from August 10 to September 30, 2022. The data was entered and analyzed using the Statically Package for Social Science version 25.0. Categorical variables were summarized as frequency (percentage) of the total. Both descriptive and inferential statistics, such as the Kruskal-Wallis H test and Mann-Whitney U test were performed to detect difference. P-value < 0.05 was considered to indicate statistically significance.

RESULTS

Overall, 405 PLHIV participated in the study, giving a 96% response rate. The overall median (Interquartile range) self-efficacy score of PLHIV for self-management was 22 (4) and 67.4% of the PLHIV self-efficacy score was above the median. A statistically significant difference was detected between the social support groups (χ2 (2) = 37.17, p < 0.0001), education background (U = 10,347, Z = 2.279, P = 0.023, r = 0.113), living conditions (U = 12,338, Z = 2.457, P = 0.014, r = 0.122) and medication adherence (U = 9516.5, Z = 3.699, P < 0.0001, r = 0.184).

CONCLUSION

Most participants' self-efficacy score was above the median. Statistically significant differences in self-efficacy were observed based on individual, environmental, and clinical factors. We suggest training and workshops for healthcare workers and the hospital and adherence support groups should work to improve the self-efficacy of PLHIV.

Evaluation of the Effect of Self-Efficacy on Symptoms in Gastrointestinal Cancer Patients

Objective: The incidence of gastrointestinal cancer is increasing day by day and is among the highest 10 cancer types in the world. This study was conducted to evaluate the effects of self-efficacy of patients with gastrointestinal system cancer on symptom clusters. Methods: This cross-sectional study was conducted with 105 patients treated for gastrointestinal system cancer in a hospital located in the south of Turkey. In the study, patients over 18 years of age without hearing or speech impairment were included. To determine symptom clusters, Latent Profile Analysis and comparison of self-efficacy scale items by symptom clusters were performed with Chi-square, ANOVA, and Kruskal Wallis test. Results: The mean age of the patients was 58.83 ± 13.1 years; of the patients, 37.1% had colon ca, 21.9% had rectum ca. The patients had higher mean scores of fatigue, pain, feeling distressed, feeling sad, dry mouth, sleep disturbance, loss of appetite and nausea in the last week. The patients had higher mean scores of fatigue, pain, feeling distressed, feeling sad, dry mouth, sleep disturbance, loss of appetite and nausea in the last week. Three symptom clusters were determined by latent profile analysis; high, moderate, mild. It was determined that the level of self-efficacy was high in the symptom cluster which is low symptom severity and number of symptoms (p < .05). Conclusion: The number and the severity of symptoms are lower in patients with high self-efficacy perceptions.

Self-efficacy in managing post-treatment care among oral and oropharyngeal cancer survivors

OBJECTIVE

Physical and psychosocial effects of oral cancer result in long-term self-management needs. Little attention has been paid to survivors' self-efficacy in managing their care. Study goals were to characterise self-care self-efficacy and evaluate socio-demographics, disease, attitudinal factors and psychological correlates of self-efficacy and engagement in head and neck self-exams.

METHODS

Two hundred thirty-two oral cancer survivors completed measures of socio-demographics, self-care self-efficacy, head and neck self-exams and attitudinal and psychological measures. Descriptive statistics characterised self-efficacy. Hierarchical regressions evaluated predictors of self-efficacy.

RESULTS

Survivors felt moderately confident in the ability to manage self-care (M = 4.04, SD = 0.75). Survivors with more comorbidities (β = -0.125), less preparedness (β = 0.241), greater information (β = -0.191), greater support needs (β = -0.224) and higher depression (β = -0.291) reported significantly lower self-efficacy. Head and neck self-exam engagement (44% past month) was relatively low. Higher preparedness (OR = 2.075) and self-exam self-efficacy (OR = 2.606) were associated with more engagement in self-exams.

CONCLUSION

Many survivors report low confidence in their ability to engage in important self-care practices. Addressing unmet information and support needs, reducing depressive symptoms and providing skill training and support may boost confidence in managing self-care and optimise regular self-exams.

The Dyadic Effects of Self-Efficacy on Quality of Life in Advanced Cancer Patient and Family Caregiver Dyads: The Mediating Role of Benefit Finding, Anxiety, and Depression

Objectives. To explore the dyadic interdependence of self-efficacy, benefit finding, anxiety, depression, and QOL in cancer patient (CP) and family caregiver (FC) dyads, and to ascertain the dyadic effects of self-efficacy on quality of life (QOL) in CP-FC dyads. Methods. Conducted from November 2014 to December 2015, participants comprised 772 CP-FC dyads. The study surveyed participant characteristics, self-efficacy, benefit finding, anxiety, depression, and QOL. Data were analyzed using Pearson’s correlation, T-test, and actor-partner interdependence mediation model (APIMeM). Results. CPs’ self-efficacy was positively correlated with both their own and FCs’ benefit finding and mental component summary (MCS), and negatively associated with anxiety and depression (all Ps < 0.01, |r| = 0.144∼0.432). However, CPs’ self-efficacy was only positively correlated with their own physical component summary (PCS) (r = 0.193), but not FCs’ PCS. The same profile was identified in FCs’ self-efficacy (all Ps < 0.01, |r| = 0.100∼0.468). FCs reported higher levels of self-efficacy and PCS compared to CPs (both Ps < 0.001). Significant positive correlations (r = 0.168–0.437) were identified among all paired variables in CP-FC dyads (all Ps < 0.001). To some extent, dyads’ self-efficacy influences dyads’ MCS and PCS through improving positive emotions (benefit finding) and relieving negative emotions (anxiety and depression). Conclusions. Study findings not only support the dyadic interdependence of self-efficacy, benefit finding, anxiety, depression, and QOL in CP-FC dyads but confirm the hypothesis that dyads’ self-efficacy may impact their MCS/PCS via an indirect approach to improve benefit finding and relieve anxiety and/or depression in CP-FC dyads.

Evaluation of quality of life and self-efficacy in adolescents with amblyopia

Amblyopia is an acquired defect due to a lack of visual stimulation. Self-efficacy is one of the factors affecting the quality of life (QoL) of individuals. Low self-efficacy can decrease cognitive and behavioral functioning, whereas increased self-efficacy leads to a change in treatment acceptance behavior and, subsequently, physical and mental health. This study aimed to determine the QoL and self-efficacy in adolescents with amblyopia. This descriptive cross-sectional study was performed on 300 patients referred to hospitals affiliated with Mashhad University of Medical Sciences, Iran, between 2015 and 2016. Data collection tools included: 1) demographic questionnaire, 2) general self-efficacy scale, and 3) WHO QoL questionnaire. Data were analyzed using SPSS software 24 using descriptive statistics. The results showed that the mean percentage in QoL was 45.43% (weak), and the mean score in self-efficacy was 21.66%, with a standard deviation of 8.10. There was also a positive and significant relationship between patients' self-efficacy and QoL on each dimension. This study showed that demographic characteristics had no significant relationship with any of the variables of QoL and self-efficacy. However, data analysis showed a significant and positive relationship between self-efficacy and QoL.

Development and Validation of the Oral Health-Related Self-Efficacy Scale for Cancer Patients

This study aimed to validate the Oral Health-related Self-Efficacy Scale for Patients with Cancer (OSEC), comprised of 17 questions (five factors). To this end, a sample of 203 cancer patients was recruited (August 2018-April 2019) followed by a random subsampling for test-retest reliability. Concurrent validity was tested by correlating scores with the Self-efficacy Scale for Advanced Cancer (SEAC), discriminant validity was tested by comparing high OSEC to low OSEC groups, and predictive validity was tested using a plaque control record. Five OSEC factors had Cronbach's alpha coefficients ranging from 0.75 to 0.88. The intraclass correlation coefficient of the total score was 0.92 upon test-retest reliability. The factor-level scores significantly related to all the SEAC factor-level scores. The differences between the high OSEC and low OSEC groups were statistically significant in the total score and on all factor-level scores (p < 0.01). The plaque control record of the high OSEC group was significantly lower than that of the low OSEC group (p < 0.01). In conclusion, the OSEC can be used for understanding cancer patients' motives for oral care behaviors and applied to program planning to increase self-efficacy and health behaviors.

Self-efficacy, post-traumatic growth, and quality of life of pediatric cancer survivors: A cross-sectional study

PURPOSE

This study explored the relationships among self-efficacy, post-traumatic growth, and quality of life in a sample of pediatric cancer survivors and analyzed the factors associated with quality of life in pediatric cancer survivors.

METHOD

A questionnaire assessed self-efficacy, post-traumatic growth, and health-related quality of life. Data were collected from December 2017 to December 2018 at a hospital in Seoul, South Korea from 115 pediatric cancer survivors.

RESULTS

Health-related quality of life showed significant positive correlations with general self-efficacy and social self-efficacy, but did not significantly correlate with post-traumatic growth. Factors that significantly influenced health-related quality of life were current age (β = 0.24, p = .007), currently not attending school (β = -0.19, p = .029), having many uncomfortable symptoms (β = -0.26, p = .006), some daily life difficulties (β = -0.23, p = .015), general self-efficacy (β = 0.17, p = .043), and social self-efficacy (β = 0.32, p = .001). This model explained 50% of the variance in self-reported health-related quality of life.

CONCLUSION

Health-related quality of life in pediatric cancer survivors was not associated with post-traumatic growth. However, high health-related quality of life was related to being older, attending school, lacking uncomfortable symptoms and difficulties in daily life, and having high self-efficacy. Interventions may improve health-related quality of life in pediatric cancer survivors if they increase self-efficacy, reduce uncomfortable symptoms and difficulties in daily life and for children who are survivors of cancer, and encourage maintaining school life.

Psychological effects of the COVID-19 outbreak on nurses working in tertiary women's and children's hospitals from Sichuan, China: A cross-sectional study

The evolving COVID-19 pandemic is placing unprecedented pressures on health systems. Accumulative studies suggest that nurses were more likely to develop negative psychiatric outcomes following a public health disaster than other medical staffs, due to their more frequent and closer contact with patients. We examined the psychological status of nurses working in the tertiary women's and children's hospitals in Sichuan, China, in order to explore the possible effect of the COVID-19. The cross-sectional survey was conducted at the peak period of COVID-19 among 1971 nurses. Their anxiety, depression and self-efficacy were assessed by the seven-item anxiety scale (GAD-7), the nine-item Patient Health Questionnaire (PHQ-9), and the General Self-efficacy Scale (GSES), respectively. 1934 valid questionnaires were returned with a response rate of 98.1%. We found that 29.3% and 22.7% of the nurses were identified with anxiety and depressive symptoms, respectively. The median score of GSES was 30, which was at the upper middle level among all populations. Nurses having longer working years and cold-like symptoms, those who were at work during breakout period and working in pediatric ward were significantly associated with the presence of anxiety and depression. Findings suggest that the epidemic of COVID-19 does not necessarily affect the psychological health of nurses working in women's and children's hospitals in Sichuan. The results of this study could serve as valuable suggestions to direct the promotion of psychological well-being among targeted nurses.

Prevalence and predictors of anxiety and depressive symptoms among patients diagnosed with oral cancer in China: a cross-sectional study

BACKGROUND

Anxiety and depression are common mental health problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. The present study aims to explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms.

METHOD

A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. Two hundred thirty patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms.

RESULTS

The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Social isolation dimension of stigma (β = 0.436, OR = 1.547, CI:1.211 ~ 1.975), optimism (β = - 0.276, OR = 0.759, CI:0.624 ~ 0.922), and perceived stress (β = 0.217, OR = 1.243, CI:1.092 ~ 1.414) were predictors of anxiety symptoms. Marriage (β = 1.648, OR = 5.198, CI:1.427 ~ 18.924), positive readiness and expectancy dimension of hope (β = - 0.505, OR = 0.604, CI:0.395 ~ 0.923), social isolation dimension of stigma (β = 0.314, OR = 1.368, CI:1.054 ~ 1.776) and perceived stress (β = 0.273, OR = 1.314, CI:1.134 ~ 1.524) were predictors of depressive symptoms among oral cancer patients.

CONCLUSION

The prevalence of anxiety symptoms and depressive symptoms was high among oral cancer patients in China. The communal predictors of anxiety and depressive symptoms in patients with oral cancer were levels of perceived stress and social isolation of stigma. In addition, optimism was a predictor of anxiety symptoms and hope was a predictor of depressive symptoms.

TRIAL REGISTRATION

2015-16, registered 20 Dec 2015.

Exploring Barriers and Potential Solutions in Home Dialysis: An NKF-KDOQI Conference Outcomes Report

Home dialysis therapy, including home hemodialysis and peritoneal dialysis, is underused as a modality for the treatment of chronic kidney failure. The National Kidney Foundation-Kidney Disease Outcomes Quality Initiative sponsored a home dialysis conference in late 2017 that was designed to identify the barriers to starting and maintaining patients on home dialysis therapy. Clinical, operational, policy, and societal barriers were identified that need to be overcome to ensure that dialysis patients have the freedom to choose their treatment modality. Education of patients and patient partners, as well as health care providers, about home dialysis therapy, if offered at all, is often provided in a cursory manner. Lack of exposure to home dialysis therapies perpetuates a lack of familiarity and thus a hesitancy to refer patients to home dialysis therapies. Patient and care partner support, both psychosocial and financial, is also critical to minimize the risk for burnout leading to dropout from a home dialysis modality. Thus, the facilitation of home dialysis therapy will require a systematic change in chronic kidney disease education and the approach to dialysis therapy initiation, the creation of additional incentives for performing home dialysis, and breakthroughs to simplify the performance of home dialysis modalities. The home dialysis work group plans to develop strategies to overcome these barriers to home dialysis therapy, which will be presented at a follow-up home dialysis conference.

The function of fatigue and illness perceptions as mediators between self-efficacy and health-related quality of life during the first year after surgery in persons treated for colorectal cancer

AIMS AND OBJECTIVES

To measure changes in health-related quality of life, two dimensions of illness perceptions (i.e., consequences and emotional representations), fatigue and self-efficacy in persons treated for colorectal cancer during the first year after surgical treatment, and to study how fatigue, illness perceptions and self-efficacy measured at 3 months affect health-related quality of life at 12 months postsurgery.

BACKGROUND

There are fluctuations in health-related quality of life during the first year after treatment for colorectal cancer, and fatigue may negatively influence health-related quality of life. Illness perceptions (consequences and emotional representations) and self-efficacy have been shown to be associated with health-related quality of life in other cancer diagnoses. Concerning colorectal cancer, there is a lack of knowledge concerning how illness perceptions and self-efficacy change during recovery, and how these variables and fatigue at 3 months relate to health-related quality of life at 12 months.

DESIGN

A prospective longitudinal design.

METHODS

Thirty-nine persons surgically treated for colorectal cancer, of whom 17 had a colostomy, participated. Health-related quality of life, fatigue, illness perceptions and self-efficacy were assessed using QLQ-C30, the Revised Illness Perception Questionnaire and the Maintain Function Scale. Descriptive and analytical statistics were used.

RESULTS

No changes were reported in levels of health-related quality of life, fatigue or illness perceptions. Self-efficacy was lower at 12 months compared to 3 months. Fatigue and one dimension of illness perceptions mediated the effect of self-efficacy at 3 months on health-related quality of life at 12 months.

CONCLUSION

Persons treated for colorectal cancer who have lower self-efficacy 3 months postsurgery are inclined to have more negative illness perceptions concerning emotions and to experience more fatigue.

RELEVANCE TO CLINICAL PRACTICE

Nurses need to support persons with fatigue and negative illness perceptions concerning emotions and to bolster their self-efficacy, that is carry out follow-up consultations focusing on illness management, symptoms, emotions and information on ways to increase self-efficacy.

Psychophysical well-being profiles in patients before hematopoietic stem cell transplantation

OBJECTIVES

The literature offers very few in-depth reports on the time directly before hematopoietic stem cell transplantation (HSCT). Also, researchers have focused on selected aspects of psychophysical well-being and treated the sample as homogeneous. Thus, we chose to investigate distinct multidimensional well-being profiles (including anxiety, depressive symptoms, and health-related quality of life [HRQOL] domains) among patients just before HSCT, as well as profile predictors (generalized self-efficacy) and outcomes (transplant appraisal) on the basis of the transactional stress model.

METHODS

Depression (CES-D), anxiety (HADS-A), HRQOL (EORTC QOL-C30), generalized self-efficacy (GSES), and transplant appraisal (single-item scale referred to threat and challenge) were measured in 290 patients (56.9% male; mean age = 47.28, SD = 13.79) after admission for HSCT (67.2% autologous). Unconditional and conditional latent profile analyses were applied.

RESULTS

Four latent well-being profiles were identified: well-functioning (51%, highest well-being in all aspects), dysfunctional (10%, weakest functioning in all aspects), and 2 profiles with moderate HRQOL and high (5.6%) or low (33.4%) anxiety and depressive symptoms. Generalized self-efficacy predicted profile membership, controlling for demographic and clinical variables. The highest levels were observed in the well-functioning group (P < .01). Appraisal was predicted by latent profile analyses classes: low threat in the well-functioning group (P < .001) and the highest threat and challenge in the dysfunctional group (P < .01).

CONCLUSIONS

The findings highlight the diverse nature of well-being in pre-HSCT patients and the manner in which transplant appraisal and generalized self-efficacy are related to different profiles of pre-HSCT multidimensional well-being, thus indicating the practical implications of the study.

Meaning in life in cancer patients: relationships with illness perception and global meaning changes

Background

Meaning in life seems to play an important role at various stages of coping in cancer patients. It can influence the ways in which cancer patients perceive their illness and potential changes in beliefs and goals. The main aim of the current study is to examine how two dimensions – presence of and search for meaning – are related to illness perception and global meaning changes.

Participants and procedure

The research was conducted among 231 cancer patients (136 women and 95 men), between 27 and 86 years of age (M = 56.73, SD = 12.64). They were diagnosed with gastrointestinal cancer (stomach, colon, pancreas, liver, large intestine). The following research methods were used: the Meaning in Life Questionnaire, the Appraisal of the Disease Scale, and the Scale of Changes in Beliefs and Goals.

Results

Presence of meaning was associated with illness perceptions, changes of beliefs, and changes of goals. In contrast, there were no statistically significant relations between search for meaning and illness perception. The cluster analysis showed that the patients who were in presence style less negatively perceived their illness than those in presence and search style. The former also experienced fewer disruptions in important beliefs and goals than the latter. In addition, the patients in presence style were characterized by less negative illness perceptions and fewer disruptions in beliefs and goals than their compeers in indifferent style.

Conclusions

Having meaning in life is related to a more satisfactory image of the illness and fewer violations in the belief and goal system. Searching for meaning, even though accompanied by presence of meaning, is rather detrimental to illness perception and changes in beliefs and goals. The awareness of having a purpose and overarching aim in life helps cancer patients to interpret and organize their stressful experiences, and perceive the illness from a less negative perspective.

Evaluation of coping as a mediator of the relationship between stressful life events and cancer-related distress

OBJECTIVE

Lifetime stressful life events (SLEs) may predispose oncology patients to cancer-related distress (i.e., intrusive thoughts, hyperarousal, avoidance). Coping may influence cancer-related distress by mediating this relationship. This study sought to (a) determine the prevalence and impact of lifetime SLEs among oncology outpatients receiving chemotherapy and (b) examine the relationship between SLEs and cancer-related distress and the mediating role of coping on this relationship.

METHOD

Patients (n = 957), with breast, gastrointestinal, gynecologic or lung cancer, who were undergoing chemotherapy, completed the Life Stressor Checklist-Revised (LSC-R), a measure of lifetime SLEs. Cancer-related distress was assessed with the Impact of Event Scale-Revised. Coping strategies since beginning chemotherapy were assessed with the Brief COPE; 2 latent variables (engagement and disengagement coping) were identified based on these scores. LSC-R scores (number of SLEs and perceived impact during the prior year) were evaluated in relation to demographic and clinical characteristics. Structural equation modeling was used to evaluate the relationship between LSC-R and Impact of Event Scale-Revised scores and the mediating role of engagement and disengagement coping on this relationship.

RESULTS

On average, patients reported 6.1 (SD = 4.0; range = 0-23 out of 30) SLEs. Patients who were not married/partnered, had incomes <$30,000/year, or who had lower functional status or greater comorbidity had higher LSC-R scores. The relationship between more SLEs and more severe cancer-related distress was completely mediated by disengagement coping. Engagement coping did not mediate this relationship.

CONCLUSIONS

Disengagement coping, including behavioral disengagement, avoidance, and denial, should be targeted to mitigate cancer-related distress. (PsycINFO Database Record

Factors related to self-efficacy among men and women undergoing outpatient chemotherapy in Japan

OBJECTIVE

This study aims to examine factors that influence self-efficacy in Japanese patients with cancer receiving outpatient chemotherapy and to identify whether there are gender-specific similarities or differences that determine self-efficacy in this setting.

METHODS

A cross-sectional survey was conducted among 156 patients with cancer (86 men and 70 women) undergoing chemotherapy as outpatients across five hospitals in Japan. The patients completed the European Organization for Research and Cancer Core Quality of Life questionnaire (EORTC QLQ-C30), the Self-Efficacy for Advanced Cancer questionnaire (SEAC) which consists of three subscales (affect regulation efficacy, symptom-coping efficacy and activities of daily living efficacy), and a patient information form. Multiple regression analysis was conducted to identify factors associated with self-efficacy in men and women.

RESULTS

In both men and women, insomnia was related to affect regulation efficacy, while fatigue and nausea/vomiting correlated with activities of daily living efficacy. For male patients, fatigue and nausea/vomiting also correlated with affect regulation efficacy and symptom-coping efficacy. Emotional functioning influenced self-efficacy for both genders, while physical functioning affected self-efficacy in female patients only.

CONCLUSIONS

These results suggest that to enhance self-efficacy in Japanese patients with cancer undergoing outpatient chemotherapy, effective intervention is required with regard to the management of both emotional and physical functioning, specifically symptoms such as fatigue, nausea/vomiting and insomnia in both genders. Furthermore, women with a reduced level of physical function may require particular attention, as they may be at risk of lower levels of self-efficacy.

General health, symptom occurrence, and self-efficacy in adult survivors after allogeneic hematopoietic stem cell transplantation: a cross-sectional comparison between hospital care and home care

PURPOSE

Earlier studies have shown that home care during the neutropenic phase after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is medically safe, with positive outcomes. However, there have been few results on long-term outcomes after home care. The aims of this study were to compare general health, symptom occurrence, and self-efficacy in adult survivors who received either home care or hospital care during the early neutropenic phase after allo-HSCT and to investigate whether demographic or medical variables were associated with general health or symptom occurrence in this patient population.

METHODS

In a cross-sectional survey, 117 patients (hospital care: n = 78; home care: n = 39) rated their general health (SF-36), symptom occurrence (SFID-SCT, HADS), and self-efficacy (GSE) at a median of 5 (1-11) years post-HSCT.

RESULTS

No differences were found regarding general health, symptom occurrence, or self-efficacy between groups. The majority of patients in both hospital care (77 %) and home care (78 %) rated their general health as "good" with a median of 14 (0-36) current symptoms. Symptoms of fatigue and sexual problems were among the most common. Poor general health was associated with acute graft-versus-host disease (GVHD), low self-efficacy, and cord blood stem cells. A high symptom occurrence was associated with female gender, acute GVHD, and low self-efficacy.

CONCLUSIONS

No long-term differences in general health and symptom occurrence were observed between home care and hospital care. Thus, home care is an alternative treatment method for patients who for various reasons prefer this treatment option. We therefore encourage other centers to offer home care to patients.

The influence of demographics, psychological factors and self-efficacy on symptom distress in colorectal cancer patients undergoing post-surgical adjuvant chemotherapy

PURPOSE

To explore the influence of self-efficacy and demographic, disease-related, and psychological factors on symptom distress among Chinese colorectal cancer patients receiving postoperative adjuvant chemotherapy.

METHODS

Two-hundred and fifty-two colorectal cancer patients who had undergone postoperative adjuvant chemotherapy completed Chinese versions of M. D. Anderson Symptom Inventory (MDASI-GI), Stanford Inventory of Cancer Patient Adjustment (SICPA), and Hospital Anxiety and Depression Scale (HADS). Associations between patients' self-efficacy and demographic, disease-related, psychological factors and symptom distress were examined.

RESULTS

Patients' overall symptom distress level was mild; MDASI median subscale scores showed mild symptom severity and symptom interference. Anxiety and depression were positively associated with symptom distress. Multivariable analysis showed that more severe symptoms were associated with age ≥60 years, female gender, suburban residence, body mass index <18.5, and stage III cancer. Age ≥60 years, female gender, marital status of single or divorced, and suburban residence were associated with greater symptom interference with daily activities. Greater self-efficacy was associated with milder symptoms severity and less symptom interference with daily life. After adjusting for confounders, patients with higher SICPA scores had less symptom distress.

CONCLUSIONS

Self-efficacy is strongly associated with reduced symptom severity and symptom interference with daily life in CRC patients. Symptom severity is associated with age >60 years, female gender, body mass index <18.5, suburban residence and stage III disease. Nurse-administered self-efficacy interventions may help to improve self-efficacy and reduce symptom distress.

Affect as a mediator between self-efficacy and quality of life among Chinese cancer survivors in China

Previous studies have shown that self-efficacy influences cancer survivors' quality of life. As most of the relevant findings are based on Caucasian cancer survivors, whether the same relationship holds among Asian cancer patients and through what mechanism self-efficacy influences quality of life are unclear. This study examined the association between self-efficacy and quality of life among Chinese cancer survivors, and proposed affect (positive and negative) as a mediator between self-efficacy and quality of life. A sample of 238 Chinese cancer survivors (75% female, mean age = 55.7) were recruited from Beijing, China. Self-efficacy, affect (positive and negative) and quality of life were measured in a questionnaire package. Self-efficacy was positively associated with quality of life and positive affect, and negatively associated with negative affect. Path analyses revealed the direct effect from self-efficacy to quality of life and the indirect effects from self-efficacy to quality of life through positive affect and negative affect. The beneficial role of self-efficacy in Chinese cancer survivors' quality of life and the mediating role of affect in explaining the relationship between self-efficacy and quality of life are supported. Future interventions should include self-care and affect regulation skills training to enhance cancer survivors' self-efficacy and positive affect, as this could help to improve Chinese cancer survivors' quality of life.

Low self-efficacy is a risk factor for depression among male Japanese workers: a cohort study

The identification of risk factors for depression is necessary for the primary prevention of depression. The aim of this study is to determine whether self-efficacy (SE) is associated with onset of depression among workers. Medical expenditure records of 1,803 workers, who were clerks, system engineers, researchers, and service and sales workers in a software development company, were analyzed. Gender, age, job post, marital status, working hours, and SE were measured at baseline. Participants were divided according to quartiles of SE points. Risk ratios for undergoing a medical consultation due to depression were calculated using a multivariable Cox proportional hazards model. Of the 1,803 participants, 58 underwent medical consultation due to depression during a mean of 1.8 years of follow-up. Compared with the lowest quartile (Q1) of SE, adjusted hazard ratios (HR) were 0.65 (95%CI 0.34-1.25) for Q2, 0.49 (0.24-1.00) for Q3, and 0.40 (0.18-0.88) for Q4. In men, adjusted HRs were 0.87 (0.41-1.86) for Q2, 0.61 (0.26-1.41) for Q3, and 0.37 (0.14-0.98) for Q4. In women, no significant association was found. The present study suggests that low SE is a risk factor for onset of depression among male Japanese workers.

Stress, coping and cognitive deficits in women after surgery for breast cancer

Research on neuropsychological difficulties among cancer patients has focused on chemotherapy as a primary cause, yet several studies have now shown that some patients evidence cognitive weaknesses prior to chemotherapy. As an alternative to the 'chemo-brain' theory, this study examined the hypothesis that stress and coping style may be associated with observed neuropsychological difficulties among female cancer patients. Thirty-six women completed neuropsychological testing and psychological questionnaires following surgery for breast cancer and prior to any subsequent treatments. Twenty-seven percent of participants evidenced deficits on at least one measure of verbal fluency, and 14% of participants were impaired on at least one memory measure. Self-reported stress was correlated with deficits in memory, verbal fluency, and attention. Subsequent mediational analyses indicated that use of passive coping styles may underlie this relationship between stress and neuropsychological deficits. These findings highlight the potential relevance of psychological mechanisms, such as coping style, in cancer patients' experience of neuropsychological deficits.

Factors associated with self-care self-efficacy among gastric and colorectal cancer patients

BACKGROUND

Many studies have demonstrated that self-efficacy plays a crucial role in self-care. However, findings from previous studies indicate that the relationships between self-efficacy and several variables are inconsistent.

OBJECTIVE

The purpose of this study was to assess the level of self-care self-efficacy among Chinese gastric and colorectal cancer patients and to identify the demographic and disease-related, physical, psychological, and social factors associated with their self-care self-efficacy.

METHODS

One hundred forty-eight cancer patients were recruited from hospitals in Shanghai and Shandong Province. Their self-efficacy, health status, social support, and mental health were assessed during face-to-face interview, using the Strategies Used by People to Promote Health (Chinese version), Medical Outcome Study Short Form 36, Social Support Questionnaire, and the Hospital Anxiety and Depression Scale.

RESULTS

The overall level of self-care self-efficacy was moderate (mean, 80.34). The multiple regression analyses indicated that depression, physical functioning, use of available social support, vitality, and profession were indicators of the level of self-care self-efficacy and accounted for 60.9% of the variances.

CONCLUSION

Participants who had less depression, better physical function, more social support, and higher vitality tended to have higher levels of self-care self-efficacy. Depression levels had the largest influence on self-care self-efficacy.

IMPLICATIONS FOR PRACTICE

Findings indicate that nurses may be able to influence certain cancer patients' self-care self-efficacy by attending to depression and other variables related to physical and social functioning.

Health-promotion behaviors and psychological distress in cancer survivors

PURPOSE/OBJECTIVES

To determine whether cancer survivors engage in health-promotion behaviors, to evaluate the extent of their experience of psychological distress, and to investigate the relationship between the practice of health-promotion behaviors and psychological distress.

DESIGN

Cross-sectional secondary data analysis.

SETTING

A national, face-to-face interview conducted by personnel of the U.S. Census Bureau using a random sampling of American adults.

SAMPLE

1,784 survey respondents who reported a previous cancer diagnosis.

METHODS

Data from the 2009 National Health Interview Survey were used to examine the prevalence of smoking, physical inactivity, alcohol use, and reports of psychosocial distress. Interviews pertained to the amount and distribution of illness, its effects in terms of disability and chronic impairments, and the kinds of health services people receive.

MAIN RESEARCH VARIABLES

Age, current smoking prevalence, alcohol consumption, physical activity, and the experience of feeling hopelessness, sadness, and anxiety.

FINDINGS

Cancer survivors continue to smoke at a rate similar to the national average. Overall, most respondents reported no symptoms of psychological distress. However, age appears to play a major role, showing significant differences in the prevalence of current smoking, participation in physical activity, alcohol use, and reported level of distress.

CONCLUSIONS

This study provides estimates of the prevalence of health-promotion behaviors and experience of psychological distress among American cancer survivors. The results reveal opportunities for interventions among cancer survivors.

IMPLICATIONS FOR NURSING

Nurses should be proactive in providing guidance to survivors regarding the adoption of healthy lifestyle behaviors. Those who encounter younger cancer survivors need to be alert to the higher potential for distress in that population, perform appropriate screenings, and be prepared to offer guidance, supportive care, and referrals for psychological care if needed.

Depression and cancer survivorship: importance of coping self-efficacy in post-treatment survivors

BACKGROUND

An estimated 30% of cancer patients are expected to experience clinically significant psychological distress during the treatment phase of their disease. Despite significant attention being directed to the mental health needs of individuals undergoing and completing treatment, there is less known about the mental health needs of survivors and the role of potential protective factors in survivorship, such as coping self-efficacy and social support.

METHOD

One hundred and twenty-four post-treatment cancer survivors (mean age = 62.23 years, women = 70%, average 9.3 years post-treatment) were asked to complete measures of physical symptoms, coping self-efficacy, social support, and depression as part of a national convenience sample of cancer patients and survivors.

RESULTS

About 20% of participants possessed scores on the Center for Epidemiologic Studies-Depressed Mood Scale indicative of clinically relevant depression. Coping self-efficacy was not only a significant predictor of depression (43% Variance Accounted For); it also partially mediated the relationship between symptoms and depression. Social support accounted for limited variance and was not a significant predictor of depression in a model containing both social support and coping self-efficacy as predictors.

CONCLUSION

A substantial minority of post-treatment survivors reported depression symptomatology. Coping self-efficacy may be an important component of patients' adjustment and possible target for intervention. These results highlight the ongoing mental health and support needs of cancer survivors.

The overlooked relationship between motivational abilities and posttraumatic stress: a review

How does traumatic stress change the ability to motivate oneself to achieve certain goals? How do motivational abilities influence the development and course of trauma sequelae? Few studies have focused on motivational constructs within posttraumatic stress research. From a trauma research perspective, it can be hypothesized that traumatic stress may contribute to motivational dysfunction. The main goal of the present article is to fill this gap in research by reviewing and discussing the existing trauma literature in terms of motivation-related concepts, such as self-efficacy, locus of control, self-esteem, and self-control/impulsivity. Fifty-four studies were reviewed, 10 of which were longitudinal studies. Approximately 20% of the reviews assessed whether motivational concepts predict posttraumatic stress, whereas only 8% examined the reverse relationship. With the exception of a few studies, motivational constructs seem to predict posttraumatic stress over the life span. The strongest relationships were reported for self-efficacy, followed by locus of control and self-esteem and, lastly, impulsivity/self-control. Overall, the findings of this review indicate that there is a lack of research investigating motivational factors as outcome variables following traumatic experiences. Furthermore, the need for longitudinal studies and studies with older adults is noted.

Self-efficacy and fear of cancer progression during the year following diagnosis of breast cancer

OBJECTIVE

The aim of this study was to investigate fear of disease progression (FoP) during the year following diagnosis of breast cancer and its association with general self-efficacy (SE).

METHODS

In a prospective study, 118 breast cancer patients were recruited shortly after diagnosis disclosure (response rate: 54%) and at 1-year follow-up (follow-up rate: 90%). Participants completed self-report measures of general self-efficacy (General Self-Efficacy Scale) and fear of progression (short form of the Fear of Progression Questionnaire).

RESULTS

Cross-sectional regression analysis revealed that high FoP is significantly associated with low SE, even when controlling for demographic and medical characteristics (total R² = 0.17). Having children and a relatively short time since diagnosis also significantly predicted higher FoP. Longitudinal analyses showed that FoP decreased significantly over time (p = 0.001; d = 0.25), but a significant decrease was only observed for patients with high initial FoP (p < 0.001; d = 0.74) and not for those with low initial FoP (p = 0.688; d = 0.08). SE was not a significant predictor of FoP at follow-up when controlling for initial FoP and other patient characteristics (incremental R² = 0.001; p = 0.674; total R² = 0.47). Overall, only initial FoP significantly predicted FoP at follow-up (p < 0.001; β = 0.671).

CONCLUSION

Findings that low SE is associated with high FoP can help to improve the treatment of dysfunctional fears in breast cancer patients. As FoP changes only slightly over time, treatment to enhance SE and reduce FoP should be initiated soon after disease disclosure.

Self-efficacy, perceived preparedness, and psychological distress in women completing primary treatment for breast cancer

The present analyses were conducted to examine demographic and clinical variables associated with mood and health-related distress in a sample of 440 women completing primary treatment for early-stage breast cancer. The authors' aim was to test the hypothesis that higher levels of self-efficacy and perceived preparedness for the end of treatment--the reentry phase--are associated with better mood and lower health-related distress in this sample. Women who had received chemotherapy and who were younger (<50 years) had significantly higher mood disturbance and health-related distress scores. Younger age, preparedness, and self-efficacy predicted 36% of the variance in mood disturbance scores. Self-efficacy and age predicted 26% of the variance in health-related distress. Although further research is needed, our findings suggest that self-efficacy and perceived preparedness represent important constructs to target in the development of interventions for women at the reentry transition.