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Ismael N, Jaber A, Malkawi S, Al Awady S, Ismael T. Exploring coping strategies among caregivers of children who have survived paediatric cancer in Jordan. BMJ Paediatr Open 2024; 8:e002453. [PMID: 38604770 PMCID: PMC11015291 DOI: 10.1136/bmjpo-2023-002453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/03/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE To explore the coping strategies of caregivers of children who have survived paediatric cancer in Jordan. MATERIALS AND METHODS This study used a cross-sectional survey design and convenient sampling. The sample included 102 caregivers of children who have survived cancer, and outcome measures included the Arabic-translated Brief COPE, and caregiver and child demographic and condition questionnaire. Data analyses included descriptive statistics, analysis of frequencies, Spearman-rank order correlations and linear regression. RESULTS Caregivers most frequently used religion coping (mean=6.42, SD=1.85), followed by acceptance (mean=5.95, SD=1.96) and planning (mean=5.05, SD=1.94). The least used coping strategies were humour (mean=2.98, SD=1.24) and behavioural disengagement as coping strategies (mean=3.01, SD=1.42). Having a female child predicted more self-distraction utilisation (β=0.265, p=0.007). CONCLUSION Caregivers of children who have survived cancer in Jordan frequently use passive coping strategies like religion and acceptance coping to overcome daily life stressors. Caregivers might benefit from psychosocial occupational therapy interventions to support their engagement in more active or problem-focused coping strategies.
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Affiliation(s)
- Noor Ismael
- Jordan University of Science and Technology, Irbid, Jordan
| | - Ala'a Jaber
- Jordan University of Science and Technology, Irbid, Jordan
| | | | | | - Taleb Ismael
- Pediatrics, King Hussein Cancer Center, Amman, Jordan
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2
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Stavish CM, Lengua LJ. Parent Behaviors as Predictors of Preadolescent Appraisal and Coping. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023; 89:101599. [PMID: 37981997 PMCID: PMC10655564 DOI: 10.1016/j.appdev.2023.101599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Preadolescent appraisal and coping are significant predictors of youth psychopathology. However, little research examines how parenting behaviors relate to the development of these skills by forming a key context in which children learn to manage stressors. This study examined how observed maternal and paternal behaviors derived from a parent-child interaction task relate to levels of and growth in child appraisal (threat, positive) and coping (active, avoidant) across three years in preadolescence (n = 214, ages 8-12 years old at Time 1). Greater maternal warmth predicted lower threat appraisal and avoidant coping, and greater maternal negativity predicted greater increases in avoidance. Increased paternal warmth predicted lower initial levels of threat appraisal. Boys showed less growth in active coping than girls. These findings suggest parenting behaviors relate to preadolescents' utilization of maladaptive coping strategies such as avoidance and may be important intervention targets for supporting youth managing stressors.
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Davis S, Serfaty M, Low J, Armstrong M, Kupeli N, Lanceley A. Experiential Avoidance in Advanced Cancer: a Mixed-Methods Systematic Review. Int J Behav Med 2023; 30:585-604. [PMID: 36284042 PMCID: PMC10522753 DOI: 10.1007/s12529-022-10131-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND People with advanced cancer experience psychological distress due to physical symptoms, functional decline, and a limited prognosis. Difficult thoughts, feelings, and emotions may exacerbate distress and lead to avoidance of these experiences which is sometimes referred to as experiential avoidance (EA). Advanced cancer patients may be more likely to engage in EA especially when no obvious solutions to their problems exist. This study aims to examine the terms used to describe EA, the processes that might indicate EA, associations between EA and psychological distress, and to understand why individuals might engage in EA. METHODS A mixed-methods review. Literature search of Medline, Embase, Psych INFO, and CINAHL 1980-October 2019. INCLUSION adults ≥ 18 years; advanced cancer not amenable to cure. EXCLUSION no measures of EA or psychological distress. Risk of bias and study quality assessed. Evidence of statistical techniques collected. Themes coded, grouped, and developed based on meaning. RESULTS Nineteen studies identified, 13 quantitative studies and 6 qualitative. The quantitative of which 6 compared early-stage cancers with advanced cancers and examined subscales of EA alongside mood, quality of life, and psychological distress. EA covers a range or terms of which 'avoidant coping' is the commonest. EA is manifest as cognitive, behavioural, and emotional avoidance. A thematic synthesis suggests the function of EA is to protect people from distress, and from confronting or expressing difficult emotions by avoiding communication about cancer, controlling negative information, and maintaining normality and hope and optimism. CONCLUSIONS EA may be beneficial in the short term to alleviate distress, but in the longer term, it can impair function and limit engagement in life. Greater clinical awareness of the complexity of EA behaviours is needed. Clinicians and researchers should define EA precisely and be aware of the function it may serve in the short and longer term. Future research studies may consider using specific measures of EA as a primary outcome, to assess the impact of psychological interventions such as ACT.
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Affiliation(s)
- Sarah Davis
- Division of Psychiatry, Marie Curie Palliative Care Research Dept, University College London, Maple House, Tottenham Court Road, London, W1T 7NF, UK.
| | - Marc Serfaty
- Division of Psychiatry, University College London, London, UK
| | - Joe Low
- Division of Psychiatry, Marie Curie Palliative Care Research Dept, University College London, Maple House, Tottenham Court Road, London, W1T 7NF, UK
| | - Megan Armstrong
- Primary Care and Population Health, University College London, London, UK
| | - Nuriye Kupeli
- Division of Psychiatry, Marie Curie Palliative Care Research Dept, University College London, Maple House, Tottenham Court Road, London, W1T 7NF, UK
| | - Anne Lanceley
- EGA Institute for Women's Health, Department of Women's Cancer, University College London, London, UK
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van der Velden NC, van Laarhoven HW, Nieuwkerk PT, Kuijper SC, Sommeijer DW, Ottevanger PB, Fiebrich HB, Dohmen SE, Creemers GJ, de Vos FY, Smets EM, Henselmans I. Attitudes Toward Striving for Quality and Length of Life Among Patients With Advanced Cancer and a Poor Prognosis. JCO Oncol Pract 2022; 18:e1818-e1830. [DOI: 10.1200/op.22.00185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE: When deliberating palliative cancer treatment, insight into patients' attitudes toward striving for quality of life (QL) and length of life (LL) may facilitate goal-concordant care. We investigated the (1) attitudes of patients with advanced cancer toward striving for QL and/or LL and whether these change over time, and (2) characteristics associated with these attitudes (over time). METHODS: We performed a secondary analysis of a randomized controlled trial on improving shared decision making (SDM), without differentiation between intervention arms. Patients (n = 173) with advanced cancer, a median life expectancy of < 12 months without anticancer treatment, and a median survival benefit of < 6 months from systemic therapy were included in seven Dutch hospitals. We used audio-recorded consultations and surveys at baseline (T0), shortly after the consultation (T2), at 3 and 6 months (T3 and T4). Primary outcomes were patients' attitudes toward striving for QL and LL (Quality Quantity Questionnaire; T2, T3, and T4). RESULTS: Overall, patients' attitudes toward striving for QL became less positive over 6 months ( P < .01); attitudes toward striving for LL did not change on group level. Studying individual patients, 76% showed changes in their attitudes toward striving for QL and/or LL at some point during the study, which occurred in various directions. More helplessness/hopelessness ( P < .001), less fighting spirit ( P < .05), less state anxiety ( P < .001), and more observed SDM ( P < .05) related to more positive attitudes toward striving for QL. Lower education, less helplessness/hopelessness, more fighting spirit, and more state anxiety ( P < .001) related to more positive attitudes toward striving for LL. CONCLUSION: Oncologists may explore patients' attitudes toward striving for QL and LL repeatedly and address patients' coping style and emotions during SDM to facilitate goal-concordant care throughout the last phase of life.
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Affiliation(s)
- Naomi C.A. van der Velden
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Hanneke W.M. van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Pythia T. Nieuwkerk
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Steven C. Kuijper
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Dirkje W. Sommeijer
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
- Department of Medical Oncology, Flevoziekenhuis, Almere, the Netherlands
| | - Petronella B. Ottevanger
- Department of Medical Oncology, Radboud University Medical Center, Radboud University, Nijmegen, the Netherlands
| | | | - Serge E. Dohmen
- Department of Medical Oncology, BovenIJ Ziekenhuis, Amsterdam, the Netherlands
| | - Geert-Jan Creemers
- Department of Medical Oncology, Catharina Ziekenhuis, Eindhoven, the Netherlands
| | - Filip Y.F.L. de Vos
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Ellen M.A. Smets
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Inge Henselmans
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
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Trompetter HR, Bonhof CS, van de Poll-Franse LV, Vreugdenhil G, Mols F. Exploring the relationship among dispositional optimism, health-related quality of life, and CIPN severity among colorectal cancer patients with chronic peripheral neuropathy. Support Care Cancer 2021; 30:95-104. [PMID: 34232392 PMCID: PMC8636445 DOI: 10.1007/s00520-021-06352-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/08/2021] [Indexed: 02/07/2023]
Abstract
Purpose Chemotherapy-induced peripheral neuropathy ((CI)PN) becomes chronic in 30% of cancer patients. Knowledge of predictors of chronic (CI)PN and related impairments in health-related quality of life (HRQoL) is lacking. We examined the role of optimism in chronic (CI)PN severity and associated HRQoL in colorectal cancer (CRC) patients up to two years after diagnosis. Methods CRC patients from a prospective cohort study participated, with sensory peripheral neuropathy (SPN) 1 year after diagnosis (n = 142). Multivariable regression analyses examined the cross-sectional association between optimism (measured by the LOT-R) and SPN severity/HRQoL (measured by the EORTC QLQ-CIPN20 and QLQ-C30), as well as the prospective association in a subsample that completed measures 2 years after diagnosis and still experienced SPN (n = 86). Results At 1-year follow-up, higher optimism was associated with better global HRQoL, and better physical, role, emotional, cognitive, and social functioning (all p < .01). Optimism at year one was also prospectively associated with better global HRQoL (p < .05), and emotional and cognitive functioning at 2-year follow-up (both p < .01). Optimism was not related to self-reported SPN severity. Significant associations were retained when controlling for demographic/clinical variables, and became non-significant after controlling for depressive and anxiety symptoms. Conclusions Optimism and depressive and anxiety symptoms are associated with HRQoL in CRC patients with chronic (CI)PN. Future research may illuminate the mechanisms that these factors share, like the use of (non)adaptive coping styles such as avoidance and acceptance that may inform the design of targeted interventions to help patients to adapt to chronic (CI)PN.
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Affiliation(s)
- Hester R Trompetter
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.
| | - Cynthia S Bonhof
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Lonneke V van de Poll-Franse
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gerard Vreugdenhil
- Department of Internal Medicine, Máxima Medical Centre, Eindhoven and Veldhoven, The Netherlands
| | - Floortje Mols
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Plasticity in Colorectal Cancer: Why Cancer Cells Differentiate. Cancers (Basel) 2021; 13:cancers13040918. [PMID: 33671641 PMCID: PMC7926445 DOI: 10.3390/cancers13040918] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/09/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary The cancer stem cell hypothesis postulates that tumors arise from a few cells with self-renewal capabilities. The identification of stem cell markers, the development of mouse and human tumor organoids and their application in mouse models, allowing lineage tracing, helped to better understand the cancer stem cell model as well as the role of differentiation. This review aims at providing insights on the interplay between cancer stem cells and differentiated cells, as well as the importance of plasticity between the two states. Abstract The cancer stem cell hypothesis poses that the bulk of differentiated cells are non-tumorigenic and only a subset of cells with self-renewal capabilities drive tumor initiation and progression. This means that differentiation could have a tumor-suppressive effect. Accumulating evidence shows, however, that in some solid tumors, like colorectal cancer, such a hierarchical organization is necessary. The identification of Lgr5 as a reliable marker of normal intestinal epithelial stem cells, together with strategies to trace cell lineages within tumors and the possibility to selectively ablate these cells, have proven the relevance of Lgr5+ cells for cancer progression. On the contrary, the role of Lgr5− cells during this process remains largely unknown. In this review, we explore available evidence pointing towards possible selective advantages of cancer cells organized hierarchically and its resulting cell heterogeneity. Clear evidence of plasticity between cell states, in which loss of Lgr5+ cells can be replenished by dedifferentiation of Lgr5− cells, shows that cell hierarchies could grant adaptive traits to tumors upon changing selective pressures, including those derived from anticancer therapy, as well as during tumor progression to metastasis.
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Affiliation(s)
- Phyllis Butow
- Psycho‐Oncology Co‐Operative Research Group,
- Centre for Medical Psychology and Evidence‐based Decision‐Making, University of Sydney,
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Samoil D, Abdelmutti N, Gallagher LO, Jivraj N, Quartey NK, Tinker L, Giuliani M, Trang A, Ferguson SE, Papadakos J. Evaluating the effect of a group pre-treatment chemotherapy psycho-education session for chemotherapy-naive gynecologic cancer patients and their caregivers. Gynecol Oncol 2020; 160:234-243. [PMID: 33077261 DOI: 10.1016/j.ygyno.2020.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The objective was to evaluate the effects of a pre-chemotherapy education class on chemotherapy-naïve patients diagnosed with gynecologic cancer and their informal caregivers. METHODS A prospective cohort study was conducted at a cancer centre in Toronto, Canada. All women diagnosed with gynecologic cancer, who were scheduled to receive chemotherapy treatment, and their caregivers were invited to attend the GyneChemo class, newly introduced as the centre's standard of care. Consenting attendees were asked to complete pre-and post-class survey measures assessing anxiety, self-efficacy, information needs, preparedness to begin chemotherapy treatment, and satisfaction with the class. RESULTS Between September 2014 to September 2016, 642 individuals attended the GyneChemo class. 75 patients and 64 caregivers completed both pre- and post-class measures. Over 80% of participants agreed that the class was beneficial, specific to their needs, and administered in an appropriate setting. Significant increases in patient and caregiver self-efficacy (p < 0.001) and preparedness to begin chemotherapy treatment (p < 0.001) were found following class completion. Significant differences in patient's anxiety scores were found, with patients who reported an annual household income of <$25,000 experiencing increased anxiety (MD = +5.33) and patients reporting an income of $25,000-$75,000 reporting decreased anxiety (MD = -4.75) following class completion (p = 0.034). No significant difference in the average pre-post caregiver anxiety score (p = 0.207) was found. CONCLUSION This educational model provides patients and informal caregivers with information specific to their chemotherapy regimen and disease site. Integrating pre-treatment education into cancer care has the potential to improve the survivorship experience by increasing self-efficacy, treatment preparedness, and psychological well-being.
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Affiliation(s)
- Diana Samoil
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Nazek Abdelmutti
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Lisa Ould Gallagher
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Nazlin Jivraj
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Naa Kwarley Quartey
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Lisa Tinker
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Meredith Giuliani
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Aileen Trang
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Sarah E Ferguson
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Janet Papadakos
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada; Ontario Health, Cancer Care Ontario, 620 University Ave, Toronto, Ontario M5G 2L7, Canada; University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada.
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Abstract
INTRODUCTION Adolescence is a critical period of human development, where adaptive or maladaptive experiences can happen. These experiences are associated with psychological, social, biological and health factors. Previous empirical evidence suggests that mental health is associated with individual assets and positive states, whose presence may become a factor of protection and resistance to mental disorders. Among these, optimism could play a fundamental role in sustaining physical and mental well-being and in dealing with threats potentially harmful to health. Given the rise of research on optimism and its importance in the various health outcomes, it is necessary to initiate processes of compilation and synthesis of this evidence to facilitate the understanding of the importance of this variable on the mental health of adolescents. METHODS AND ANALYSIS The included studies will be experimental, observational, cross-sectional and longitudinal focussed on the role of optimism on mental health in adolescents, regardless of whether they belong to clinical or non-clinical populations. This systematic review protocol will be carried out following the Cochrane Manual for systematic reviews and will follow the statement on systematic reviews and meta-analysis of PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols). Searches will run from October 2019 to March 2020, and will be carried out from the following electronic databases: APA PsycNet, BVS (Biblioteca Virtual em Saúde), Web of Science, PubMed Central and Scopus. Two reviewers will obtain the eligible articles, published from January 2009 onward, to assess the quality of each study and extract the data. For the presentation of the results, a narrative and quantitative synthesis will be carried out that groups the data found. ETHICS AND DISSEMINATION The approval of an ethics committee is not required for a systematic review protocol. The results will be presented at congresses in social sciences and psychology and will be published in a peer-reviewed social or health science journal. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019142616.
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Affiliation(s)
| | - Cristian Ariel Neira Espejo
- Programa de Pós-Graduação em Teoria e Pesquisa do Comportamento, Universidade Federal do Pará, Belém, Para, Brazil
| | - Janari da Silva Pedroso
- Programa de Pós-Graduação em Teoria e Pesquisa do Comportamento, Universidade Federal do Pará, Belém, Para, Brazil
- Bolsista produtividade CNPq - Nível 2. Programa de Pós-graduação em Psicologia, Universidade Federal do Pará, Belém, Pará, Brazil
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Use of non-conventional medicine and lifestyle change among cancer survivors: evidence from the national VICAN survey. J Cancer Surviv 2020; 14:779-789. [DOI: 10.1007/s11764-020-00892-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/04/2020] [Indexed: 12/16/2022]
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Dordoni P, Badenchini F, Alvisi MF, Menichetti J, De Luca L, Di Florio T, Magnani T, Marenghi C, Rancati T, Valdagni R, Bellardita L. How do prostate cancer patients navigate the active surveillance journey? A 3-year longitudinal study. Support Care Cancer 2020; 29:645-651. [PMID: 32424643 DOI: 10.1007/s00520-020-05524-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 05/09/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate whether prostate cancer (PCa) patients' coping strategies (i.e., fighting spirit, anxious preoccupation, fatalism, helplessness/hopelessness, and avoidance) significantly change during the first 3-year follow-up period of active surveillance (AS). MATERIALS AND METHODS Altogether, 104 patients on AS completed the Mini-Mental Adjustment to Cancer (Mini-MAC) at baseline (T0), at 10 and 12 months after diagnostic biopsy (T1 and T2, respectively) and then at 24- (T3) and 36-month (T4) follow-up. Paired samples T test was used to detect statistically significant changes over time. Changes ≥ 1 point (or ≤ - 1) were hypothesized to be clinically relevant. RESULTS During the first 3 years on AS, men experienced decreased anxiety, avoidance thoughts/behaviors, and fight-against-cancer attitudes, and these changes were found to be statistically significant. When considering clinically significant changes between inclusion in AS (T0) and 3-year follow-up (T4), avoidance decreased in 19% of patients. CONCLUSIONS Most patients were observed to have adopted functional coping strategies at baseline, which were maintained through the first 3 years on AS. Overall, men on AS may perceive increasing control over their cancer and comfort with the AS protocol over time and experience slight decreases in anxious preoccupation, cancer-related avoidance thoughts and behaviors, and fight-against-cancer reactions. For those men who find it difficult to cope with AS, psychological monitoring and interventions could be helpful throughout the monitoring journey.
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Affiliation(s)
- Paola Dordoni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy.
| | - Fabio Badenchini
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy
| | | | - Julia Menichetti
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Letizia De Luca
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy
| | - Teresa Di Florio
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy
| | - Tiziana Magnani
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy
| | - Cristina Marenghi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy
| | - Tiziana Rancati
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy
| | - Riccardo Valdagni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy
- Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milan, Italy
- Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lara Bellardita
- Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy
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Coping Strategies Used by Breast, Prostate, and Colorectal Cancer Survivors: A Literature Review. Cancer Nurs 2019; 41:E23-E39. [PMID: 28723724 DOI: 10.1097/ncc.0000000000000528] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individual coping strategies are a fundamental element underpinning psychosocial distress. OBJECTIVE The aim of this study was to describe coping strategies and their measurement used by survivors of breast, prostate, and/or colorectal cancer after treatment. METHODS A search of electronic databases (PubMed, CINAHL, and PsycINFO) was conducted from January 1980 to March 2015. Data were extracted using standardized forms and included studies that explored the coping mechanisms of survivorship of breast, prostate, or colorectal cancer. RESULTS Two thousand one hundred forty-seven studies were retrieved for potential inclusion; 19 publications met the inclusion criteria and were included in the review. CONCLUSIONS Breast, prostate, and colorectal cancer survivors seem to use different coping strategies that varied throughout the survivorship trajectory. Breast cancer survivors highlighted the importance of accepting their diagnosis and engaging in physical activities that provided social and emotional support. Personality seemed to have a significant effect on coping for prostate cancer survivors. Colorectal cancer survivors emphasized the importance of seeking information to master self-management and return to social activities. IMPLICATIONS FOR PRACTICE Understanding coping strategies, during the survivorship trajectories, is essential to planning contemporary care after cancer treatment. Nurses and other healthcare professionals may use this knowledge to improve quality of life and decrease distress after diagnosis.
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Belief in a Just World and Emotional Intelligence in Subjective Well-Being of Cancer Patients. THE SPANISH JOURNAL OF PSYCHOLOGY 2019; 22:E28. [PMID: 31148537 DOI: 10.1017/sjp.2019.28] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The study of coping strategies has provided valuable insights about the process of helping cancer patients adapt to their disease. However, new approaches must be explored to increase the knowledge of this adjustment. In this study, we will analyze the relationship between patients' psychological well-being and quality of life and less well-studied constructs such as the belief in a just world (BJW) and emotional intelligence (EI). Sixty-eight cancer patients (35 men, 33 women; mean age 53.5 years; range: 20-86) were asked about their personal and general BJW, EI, Perception of Quality of Life, Anxiety, and Depression. Different multiple regression analyses showed that patients' personal BJW negatively predicted their anxiety (p < .05) and a trend to a better quality of life. In addition, patients with high scores in the Mood Repair subfactor of EI showed better quality of life (p < .05), and those with higher Attention to Feelings exhibited more Anxiety (p < .01) and a trend to more Depression. These results underline the need to take into consideration new factors, such as BJW and EI, in clinical interventions for cancer patients.
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Cognitive and emotional factors in health behaviour: Dual-process reasoning, cognitive styles and optimism as predictors of healthy lifestyle, healthy behaviours and medical adherence. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00268-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Wang AWT, Cheng CP, Chang CS, Chen DR, Chen ST, Shieh V, Lo A, Hsu WY. Does the Factor Structure of the Brief COPE Fit Different Types of Traumatic Events? EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2018. [DOI: 10.1027/1015-5759/a000321] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
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.
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Affiliation(s)
| | - Chung-Ping Cheng
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Shyong Chang
- Division of Hematology-Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Dar-Ren Chen
- Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Shou-Tung Chen
- Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Vincent Shieh
- Graduate Institute of Gender Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Angela Lo
- Department of Psychiatry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Yau Hsu
- Department of Psychology, National Chengchi University, Taipei, Taiwan
- Research Center for Mind, Brain, and Learning, National Chengchi University, Taiwan
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Jang M, Kim J. A structural model for stress, coping, and psychosocial adjustment: A multi-group analysis by stages of survivorship in Korean women with breast cancer. Eur J Oncol Nurs 2018; 33:41-48. [DOI: 10.1016/j.ejon.2018.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 01/04/2018] [Accepted: 01/07/2018] [Indexed: 11/15/2022]
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17
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Roberts D, Calman L, Large P, Appleton L, Grande G, Lloyd-Williams M, Walshe C. A revised model for coping with advanced cancer. Mapping concepts from a longitudinal qualitative study of patients and carers coping with advanced cancer onto Folkman and Greer's theoretical model of appraisal and coping. Psychooncology 2017; 27:229-235. [DOI: 10.1002/pon.4497] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 06/07/2017] [Accepted: 07/06/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Diane Roberts
- The Division of Nursing, Midwifery and Social Work; The University of Manchester; Manchester UK
| | - Lynn Calman
- Faculty of Health Sciences; University of Southampton; Southampton UK
| | | | - Lynda Appleton
- Clatterbridge Cancer Centre NHS Foundation Trust; Wirral UK
| | - Gunn Grande
- The Division of Nursing, Midwifery and Social Work; The University of Manchester; Manchester UK
| | - Mari Lloyd-Williams
- Institute of Psychology, Health, and Society; University of Liverpool; Liverpool UK
| | - Catherine Walshe
- International Observatory on End of Life Care; Lancaster University; Lancaster UK
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Richardson EM, Schüz N, Sanderson K, Scott JL, Schüz B. Illness representations, coping, and illness outcomes in people with cancer: a systematic review and meta-analysis. Psychooncology 2016; 26:724-737. [PMID: 27412423 DOI: 10.1002/pon.4213] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 06/27/2016] [Accepted: 07/07/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Cancer is associated with negative health and emotional outcomes in those affected by it, suggesting the need to better understand the psychosocial determinants of illness outcomes and coping. The common sense model is the leading psychological model of self-regulation in the face of illness and assumes that subjective illness representations explain how people attempt to cope with illness. This systematic review and meta-analysis examines the associations of the common sense model's illness representation dimensions with health and coping outcomes in people with cancer. METHODS A systematic literature search located 54 studies fulfilling the inclusion criteria, with 38 providing sufficient data for meta-analysis. A narrative review of the remaining studies was also conducted. RESULTS Random-effects models revealed small to moderate effect sizes (Fisher Z) for the relations between illness representations and coping behaviors (in particular between control perceptions, problem-focused coping, and cognitive reappraisal) and moderate to large effect sizes between illness representations and illness outcomes (in particular between identity, consequences, emotional representations, and psychological distress). The narrative review of studies with insufficient data provided similar results. CONCLUSIONS The results indicate how illness representations relate to illness outcomes in people with cancer. However, more high-quality studies are needed to examine causal effects of illness representations on coping and outcomes. High heterogeneity indicates potential moderators of the relationships between illness representations and health and coping outcomes, including diagnostic, prognostic, and treatment-related variables. This review can inform the design of interventions to improve coping strategies and mental health outcomes in people with cancer.
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Affiliation(s)
- Emma M Richardson
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Natalie Schüz
- School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Kristy Sanderson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jennifer L Scott
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Benjamin Schüz
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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'Life is still worth living': a pilot exploration of self-reported resources of palliative care patients. BMC FAMILY PRACTICE 2016; 17:52. [PMID: 27164989 PMCID: PMC4862164 DOI: 10.1186/s12875-016-0450-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/02/2016] [Indexed: 01/10/2023]
Abstract
Background Facing a terminal illness can be highly stressful and palliative care patients frequently suffer from mood symptoms. The focus of health care is often on treating symptoms whereas health-promoting factors receive less attention. The aim of this study was to explore the views of palliative care patients on resources and ways of coping that help them prevent or manage mood symptoms. Methods A pilot qualitative study was performed through face-to-face semi-structured interviews with fifteen ambulant patients with advanced cancer. The interviews were transcribed verbatim and qualitative analysis was performed independently by two researchers, according to the principle of constant comparative analysis. Results Patients reported on attitudes and specific coping strategies that they found helpful, as well as aspects of their life narrative and spirituality. Resources were found in meaningful contacts with family and friends and in personal attention of professional medical caregivers for their wellbeing. Conclusions We conclude that palliative care patients could identify resources to cope with mood symptoms in the context of their unique life. In helping patients to identify the personal resources that are accessible and available in their specific context, patient autonomy in enhancing resilience could be increased.
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Avvenuti G, Baiardini I, Giardini A. Optimism's Explicative Role for Chronic Diseases. Front Psychol 2016; 7:295. [PMID: 26973582 PMCID: PMC4773598 DOI: 10.3389/fpsyg.2016.00295] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/16/2016] [Indexed: 11/13/2022] Open
Abstract
The increasing interest about dispositional optimism's role in health status and its positive modulating effect on health outcomes has led to a remarkable scientific production in the last decade. To date lot is known for which diseases optimism is relevant, instead much less is known about how optimism interacts with other factors, both biological and psychological, in determining health status. The aim of this mini review is to explore the literature derived from clinical and experimental research assessing the associations between dispositional optimism and health status. Dispositional optimism can be considered as facet of personality that is cognitive in nature which holds the global expectation that the future will be plenty of good events. Optimists view desired goals as obtainable, so they often confront adversities in active manners resulting in perseverance and increased goal attainment. Only studies that explicitly included optimism and health outcomes, as measurable variables, and that reported a clear association between them have been reviewed. Cancer, cardiovascular disease, respiratory failure, and aging with multimorbidity were considered. Among the possible explicative hypotheses, two seem to best describe results: optimism may have a direct effect on the neuroendocrine system and on immune responses, and it may have an indirect effect on health outcomes by promoting protective health behaviors, adaptive coping strategies and enhancing positive mood. The research on optimism and health status has already shed light on important mechanisms regarding chronic diseases' management, however, further studies are needed to deepen the knowledge.
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Affiliation(s)
- Giulia Avvenuti
- Psychology Unit, Scientific Institute of Montescano, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico Montescano, Italy
| | - Ilaria Baiardini
- Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa - IRCCS AOU San Martino-IST Genova, Italy
| | - Anna Giardini
- Psychology Unit, Scientific Institute of Montescano, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico Montescano, Italy
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Holton MK, Barry AE, Chaney JD. Employee stress management: An examination of adaptive and maladaptive coping strategies on employee health. Work 2016; 53:299-305. [DOI: 10.3233/wor-152145] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- M. Kim Holton
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Adam E. Barry
- Department of Health and Kinesiology, College of Education and Human Development, Texas A & M University, College Station, TX, USA
| | - J. Don Chaney
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
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Dempster M, Howell D, McCorry NK. Illness perceptions and coping in physical health conditions: A meta-analysis. J Psychosom Res 2015; 79:506-13. [PMID: 26541550 DOI: 10.1016/j.jpsychores.2015.10.006] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/28/2015] [Accepted: 10/19/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE There is a considerable body of research linking elements of Leventhal's Common Sense Model (CSM) to emotional well-being/distress outcomes among people with physical illness. The present study aims to consolidate this literature and examine the evidence for the role of coping strategies within this literature. METHODS A systematic review was conducted where the outcomes of interest were: depression, anxiety and quality of life. A total of 1050 articles were identified and 31 articles were considered eligible to be included in the review. RESULTS Across a range of illnesses, perceptions of consequences of the illness and emotional representations were consistently the illness perceptions with the strongest relationship with the outcomes. Coping variables tend to be stronger predictors of outcomes than the illness perception variables. The evidence for the mediating effect of coping was inconsistent. CONCLUSIONS Illness perceptions and coping have an important role to play in the explanation of distress outcomes across a range of physical health conditions. However, some clarity about the theoretical position of coping in relation to illness perceptions, and further longitudinal work is needed if we are to apply this information to the design of interventions for the improvement of psychological health among people with physical health conditions.
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Affiliation(s)
- Martin Dempster
- School of Psychology, Queen's University Belfast, Northern Ireland, UK.
| | - Doris Howell
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Noleen K McCorry
- Marie Curie Cancer Care, Marie Curie Hospice Belfast, Northern Ireland, UK
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Kim HS, Oh EG, Lee H, Kim SH, Kim HK. Predictors of symptom experience in Korean patients with cancer undergoing chemotherapy. Eur J Oncol Nurs 2015; 19:644-53. [DOI: 10.1016/j.ejon.2015.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 04/01/2015] [Accepted: 04/10/2015] [Indexed: 12/20/2022]
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Govender M, Bowen RC, German ML, Bulaj G, Bruggers CS. Clinical and Neurobiological Perspectives of Empowering Pediatric Cancer Patients Using Videogames. Games Health J 2015; 4:362-74. [PMID: 26287927 PMCID: PMC4545566 DOI: 10.1089/g4h.2015.0014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Pediatric oncology patients often experience fatigue and physical and mental deconditioning during and following chemotherapy treatments, contributing to diminished quality of life. Patient empowerment is a core principle of patient-centered care and reflects one's ability to positively affect his or her own health behavior and health status. Empowerment interventions may enhance patients' internal locus of control, resilience, coping skills, and self-management of symptoms related to disease and therapy. Clinical and technological advancements in therapeutic videogames and mobile medical applications (mobile health) can facilitate delivery of the empowerment interventions for medical purposes. This review summarizes clinical strategies for empowering pediatric cancer patients, as well as their relationship with developing a “fighting spirit” in physical and mental health. To better understand physiological aspects of empowerment and to elucidate videogame-based intervention strategies, brain neuronal circuits and neurotransmitters during stress, fear, and resilience are also discussed. Neuroimaging studies point to the role of the reward system pathways in resilience and empowerment in patients. Taken together, videogames and mobile health applications open translational research opportunities to develop and deliver empowerment interventions to pediatric cancer patients and also to those with other chronic diseases.
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Affiliation(s)
- Meveshni Govender
- 1 Division of Hematology-Oncology, University of Utah School of Medicine , Salt Lake City, Utah
| | - Randy C Bowen
- 2 Department of Pediatrics, University of Utah School of Medicine , Salt Lake City, Utah
| | - Massiell L German
- 2 Department of Pediatrics, University of Utah School of Medicine , Salt Lake City, Utah
| | - Grzegorz Bulaj
- 3 Department of Medicinal Chemistry, College of Pharmacy, University of Utah , Salt Lake City, Utah
| | - Carol S Bruggers
- 1 Division of Hematology-Oncology, University of Utah School of Medicine , Salt Lake City, Utah.,2 Department of Pediatrics, University of Utah School of Medicine , Salt Lake City, Utah.,4 Huntsman Cancer Institute, University of Utah School of Medicine , Salt Lake City, Utah.,5 Primary Children's Hospital , Salt Lake City, Utah
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A singing choir: Understanding the dynamics of hope, hopelessness, and despair in palliative care patients. A longitudinal qualitative study. Palliat Support Care 2015; 13:1643-50. [PMID: 25912395 DOI: 10.1017/s147895151500019x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Hope, despair, and hopelessness are dynamic in nature; however, they have not been explored over time. The objective of the present study was to describe hope, hopelessness, and despair over time, as experienced by palliative care patients. METHOD We employed a qualitative longitudinal method based on narrative theories. Semistructured interviews with palliative care patients were prospectively conducted, recorded, and transcribed. Data on hope, hopelessness and despair were thematically analyzed, which led to similarities and differences between these concepts. The concepts were then analyzed over time in each case. During all stages, the researchers took a reflexive stance, wrote memos, and did member checking with participants. RESULTS A total of 29 palliative care patients (mean age, 65.9 years; standard deviation, 14.7; 14 females) were included, 11 of whom suffered from incurable cancer, 10 from severe chronic obstructive pulmonary disease, and 8 from severe heart failure. They were interviewed a maximum of three times. Participants associated hope with gains in the past or future, such as physical improvement or spending time with significant others. They associated hopelessness with past losses, like loss of health, income, or significant others, and despair with future losses, which included the possibility of losing the future itself. Over time, the nature of their hope, hopelessness, and despair changed when their condition changed. These dynamics could be understood as voices in a singing choir that can sing together, alternate with each other, or sing their own melody. SIGNIFICANCE OF RESULTS Our findings offer insight into hope, hopelessness, and despair over time, and the metaphor of a choir helps to understand the coexistence of these concepts. The findings also help healthcare professionals to address hope, hopelessness, and despair during encounters with patients, which is particularly important when the patients' physical condition has changed.
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Olsman E, Leget C, Willems D. Palliative care professionals’ evaluations of the feasibility of a hope communication tool: A pilot study. PROGRESS IN PALLIATIVE CARE 2015. [DOI: 10.1179/1743291x15y.0000000003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Jensen CG, Elsass P, Neustrup L, Bihal T, Flyger H, Kay SM, Khan S, Jensen SS, Pedersen A, Würtzen H. What to listen for in the consultation. Breast cancer patients' own focus on talking about acceptance-based psychological coping predicts decreased psychological distress and depression. PATIENT EDUCATION AND COUNSELING 2014; 97:165-172. [PMID: 25086446 DOI: 10.1016/j.pec.2014.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 07/11/2014] [Accepted: 07/13/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To analyze whether qualitative themes in breast cancer patients' self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process. METHODS Ninety-seven breast cancer patients gave unstructured, 10-min self-presentations at their first consultation in a clinical registered trial (CRT identifier: NCT00990977). Self-presentations were categorized thematically and the most prevalent themes investigated as predictors for scores on the symptom check-list 90-revised (SCL-90-R) and the center for epidemiological studies depression scale (CES-D). RESULTS Among the qualitative themes, only the percentage of words spent on talking about 'Acceptance-based psychological coping' was related to symptoms. In regression models controlling for age, education and time since diagnosis, a stronger focus on acceptance-based coping predicted less psychological distress and depression, respectively. A cross-validation including only the first few minutes of speech per patient confirmed these results and supported their practical utility in health consultations. CONCLUSION Patients' focus on acceptance-based coping significantly predicted decreased psychological distress and depression, respectively. No other qualitative themes predicted symptoms. Doctor-patient studies may benefit from combined qualitative-quantitative methods. PRACTICE IMPLICATIONS While quantitative symptom assessment is important for a consultation, health care providers may improve their understanding of patients by attending to patients' presentations of acceptance-based psychological coping.
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Affiliation(s)
- Christian Gaden Jensen
- Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Dep. 6931, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Peter Elsass
- Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Line Neustrup
- Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Tina Bihal
- Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Signe Maria Kay
- Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Sadia Khan
- Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Sivi Svenning Jensen
- Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Hanne Würtzen
- Department of Psychosocial Cancer Research at the Institute of Cancer Epidemiology, The Danish Cancer Society (EPI), Copenhagen, Denmark
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Jiang BS, Speicher PJ, Thomas S, Mosca PJ, Abernethy AP, Tyler DS. Quality of life after isolated limb infusion for in-transit melanoma of the extremity. Ann Surg Oncol 2014; 22:1694-700. [PMID: 25120251 DOI: 10.1245/s10434-014-3979-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Isolated limb infusion (ILI) has been associated with persistent edema, numbness, pain, and functional impairment of the treated limb. However, health-related quality of life (HRQOL) has not yet been assessed using a validated questionnaire. METHODS Functional Assessment of Cancer Therapy-Melanoma (FACT-M) questionnaires were collected from subjects enrolled a phase I ILI trial with temozolomide at baseline and 2, 6 weeks, and 3 months post-ILI. Of 28 enrolled patients, 19 patients received maximum tolerated dose of temozolomide and are included in the HRQOL analysis. Clinical and operative variables and treatment response data also were collected. RESULTS HRQOL scores showed a trend of improvement from baseline through 3-months post-ILI as measured by FACT-M and the melanoma surgery scores. There were no differences in HRQOL when patients were stratified by disease burden, clinical toxicity level, and 3-month disease response. Additionally, fewer patients complained of pain, numbness, and swelling of the affected limb at 3 months post-ILI compared to baseline, and also these symptoms were improved at the immediate postoperative visit compared with baseline. CONCLUSIONS Despite the known morbidity of ILI, we have demonstrated with a validated HRQOL questionnaire that HRQOL is not adversely impacted at therapeutic doses of temozolomide delivered intra-arterially from baseline through 3 months posttreatment. Patient centered-outcomes should be evaluated as a standard part of all future regional therapy trials using standardized melanoma-specific HRQOL questionnaires to more completely evaluate the utility of this type of treatment strategy.
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Affiliation(s)
- Betty S Jiang
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
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Goodwin L, Price A, Lee W, Rayner L, Moorey S, Monroe B, Sykes N, Hansford P, Higginson IJ, Hotopf M. I've had a good life, what's left is a bonus: factor analysis of the Mental Adjustment to Cancer Scale in a palliative care population. Palliat Med 2014; 28:243-55. [PMID: 23935014 DOI: 10.1177/0269216313498435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Mental Adjustment to Cancer Scale is an assessment tool commonly used to measure coping in cancer patients, which characterises adaptive coping under the label of 'fighting spirit'. AIM This study explores adaptation in patients with advanced cancer, by examining the factor structure of the Mental Adjustment to Cancer Scale. Further aims were to examine associations between types of coping and psychological outcomes measured at the same time (time 1) and 4 weeks after referral to palliative care services (time 2). DESIGN A cross-sectional study with a follow-up assessment 4 weeks later. Factor analysis examined the structure of the Mental Adjustment to Cancer Scale at time 1. SETTING/PARTICIPANTS A total of 275 patients with advanced cancer receiving palliative care, of whom 193 took part at follow-up. RESULTS This study provided evidence for the internal consistency and validity of a new scale of 'acceptance and positivity' for use in advanced cancer patients. Patients with a desire for hastened death had lower acceptance and positivity, and patients with higher global quality of life reported a higher level. Social support was positively associated with acceptance and positivity. Higher scores on the acceptance and positivity scale were associated with reduced odds of a desire for hastened death at time 2. CONCLUSION Adaptation to advanced cancer differs from adaptation to early stage cancer, comprising a general acceptance of the illness and trying to make the most of the time that is left. Individuals with low social support were less likely to evidence appropriate adaptation to their illness.
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Affiliation(s)
- Laura Goodwin
- 1Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
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Trevino KM, Balboni M, Zollfrank A, Balboni T, Prigerson HG. Negative religious coping as a correlate of suicidal ideation in patients with advanced cancer. Psychooncology 2014; 23:936-45. [PMID: 24577802 DOI: 10.1002/pon.3505] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 01/08/2014] [Accepted: 01/27/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study is to examine the relationship between negative religious coping (NRC) and suicidal ideation in patients with advanced cancer, controlling for demographic and disease characteristics and risk and protective factors for suicidal ideation. METHODS Adult patients with advanced cancer (life expectancy ≤6 months) were recruited from seven medical centers in the northeastern and southwestern USA (n = 603). Trained raters verbally administered the examined measures to patients upon study entry. Multivariable logistic regression analyses regressed suicidal ideation on NRC controlling for significant demographic, disease, risk, and protective factors. RESULTS Negative religious coping was associated with an increased risk for suicidal ideation (OR, 2.65 [95% CI, 1.22, 5.74], p = 0.01) after controlling for demographic and disease characteristics, mental and physical health, self-efficacy, secular coping, social support, spiritual care received, global religiousness and spirituality, and positive religious coping. CONCLUSIONS Negative religious coping is a robust correlate of suicidal ideation. Assessment of NRC in patients with advanced cancer may identify patients experiencing spiritual distress and those at risk for suicidal ideation. Confirmation of these results in future studies would suggest the need for interventions targeting the reduction of NRC to reduce suicidal ideation among advanced cancer patients.
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Affiliation(s)
- K M Trevino
- Rowan University, 201 Mullica Hill Rd, Glassboro, NJ, USA
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Abstract
Advanced cancer is likely to be perceived as a non-controllable source of stress for the individual. The patient distress at this stage of the illness and the strategies he uses to cope with it need to be explored so as physical symptoms, since they are correlated with quality of life at the end-of-life. But very few recent studies have considered patient coping and quality of life in the palliative stage of cancer. For patient at advanced stage of cancer, quality of life includes the quality of death, including being prepared to death, being informed about prognosis and receiving global care. For relatives, get medical information is a key point since uncertainty is often perceived as frightening. Patient coping strategies interact with those of the physician, who has to cope with different sources of stress. Taking into account these strategies among patients with advanced cancer could facilitate a medical communication respectful of the patient's mental state, under the complex context of palliative care in oncology.
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Krikorian A, Limonero JT, Román JP, Vargas JJ, Palacio C. Predictors of Suffering in Advanced Cancer. Am J Hosp Palliat Care 2013; 31:534-42. [DOI: 10.1177/1049909113494092] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Context: Suffering is a complex experience. Identifying its predictors is useful to signal at-risk patients. Objective: To identify suffering predictors in patients with advanced cancer in palliative care. Methods: A total of 98 patients participated in the study. A semistructured interview examining suffering levels and physical, psychological, social, and spiritual aspects was used. Instruments included Pictorial Representation of Illness and Self Measure (PRISM), Edmonton Symptom Assessment System (ESAS), Detection of emotional distress (DED), and Structured Interview of Symptoms and Concern (SISC). Variance-based structural equation model was used for the data analysis. Results: All measures were valid and reliable. The structural model explained 64% of the variance. Suffering levels were directly determined by psychological and adjustment problems and indirectly determined by physical, psychological, and spiritual aspects and coping strategies. Conclusion: Our study supports the proposed theoretical model and signals the important mediating effect of psychological and spiritual variables between physical symptoms and suffering.
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Affiliation(s)
- Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Joaquín T. Limonero
- Research Group on Stress and Health (GIES), Faculty of Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - John Jairo Vargas
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia
- Instituto de Cancerología, Clínica Las Américas, Medellín, Colombia
| | - Carolina Palacio
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia
- Instituto de Cancerología, Clínica Las Américas, Medellín, Colombia
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33
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Step MM, Kypriotakis GM, Rose JH. An Exploration of the relative influence of patient's age and cancer recurrence status on symptom distress, anxiety, and depression over time. J Psychosoc Oncol 2013; 31:168-90. [PMID: 23514253 PMCID: PMC10161869 DOI: 10.1080/07347332.2012.761318] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Past research suggests that psychosocial responses to advanced or recurrent cancer vary by age. This study compares the relative influences of patients' age and recurrence status on indicators of symptom distress, anxiety, and depression following a diagnosis of advanced cancer. A prospective study of advanced cancer support provided patient outcome data reported at baseline, 3-, and 6-month intervals. Cohorts were defined by age group and recurrence status and latent growth curves fit to anxiety, depression, and symptom distress outcomes. Middle-age recurrent patients reported the highest symptom distress, depression, and anxiety across time points. Older recurrent patients fared worse at baseline than older nonrecurrent patients, but outcome scores converged across time points. Recurrent cancer presents a distinct challenge that, for middle-age patients, persists across time. It may be beneficial to develop targeted educational and support resources for middle-age patients with recurrent disease.
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Affiliation(s)
- Mary M Step
- Case Western Reserve University School of Medicine and Case Comprehensive Cancer Center Program on Aging and Cancer, Cleveland, OH, USA.
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Romppel M, Herrmann-Lingen C, Wachter R, Edelmann F, Düngen HD, Pieske B, Grande G. A short form of the General Self-Efficacy Scale (GSE-6): Development, psychometric properties and validity in an intercultural non-clinical sample and a sample of patients at risk for heart failure. PSYCHO-SOCIAL MEDICINE 2013; 10:Doc01. [PMID: 23429426 PMCID: PMC3578200 DOI: 10.3205/psm000091] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE General self-efficacy has been found to be an influential variable related to the adaptation to stress and chronic illness, with the General Self-Efficacy (GSE) Scale by Jerusalem and Schwarzer being a reliable and valid instrument to assess this disposition. The aim of this study was to construct and test a short form of this scale to allow for a more economical assessment of the construct. METHODS The item characteristics of the original scale were assessed using an intercultural non-clinical sample (n=19,719). Six items with the highest coefficient of variation and good discrimination along the range of the trait were selected to build a short form of the instrument (GSE-6). Subsequently, the psychometric properties and the concurrent and predictive validity of the GSE-6 were tested in a longitudinal design with three measurements using a sample of patients with risk factors for heart failure (n=1,460). RESULTS Cronbach's alpha for the GSE-6 was between .79 and .88. We found negative associations with symptoms of depression (-.35 and -.45), anxiety (-.35), and vital exhaustion (-.38) and positive associations with social support (.30), and mental health (.36). In addition, the GSE-6 score was positively associated with active problem-focused coping (.26) and distraction/self-encouragement (.25) and negatively associated with depressive coping (-.34). The baseline GSE-6 score predicted mental health and physical health after 28 months, even after controlling for the respective baseline score. The relative stability over twelve and 28 months was r=.50 and r=.60, respectively, while the mean self-efficacy score did not change over time. CONCLUSIONS The six item short form of the GSE scale is a reliable and valid instrument that is useful for the economical assessment of general self-efficacy in large multivariate studies and for screening purposes.
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Affiliation(s)
- Matthias Romppel
- Faculty of Applied Social Sciences, University of Applied Sciences Leipzig, Germany
- *To whom correspondence should be addressed: Matthias Romppel, Faculty of Applied Social Sciences, Leipzig University of Applied Sciences, POB 301166, 04251 Leipzig, Germany, Phone: +49-341-3076-3217, Fax: +49-341-3076-4402, E-mail:
| | | | - Rolf Wachter
- Department of Cardiology, University of Göttingen, Germany
| | - Frank Edelmann
- Department of Cardiology, University of Göttingen, Germany
| | - Hans-Dirk Düngen
- Department of Internal Medicine – Cardiology, Charité – Universitätsmedizin, Campus Virchow-Klinkum, Berlin, Germany
| | - Burkert Pieske
- Department of Cardiology, Medical University Graz, Austria
| | - Gesine Grande
- Faculty of Applied Social Sciences, University of Applied Sciences Leipzig, Germany
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35
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Abstract
Prognosis is poor and quantity of life is compromised for individuals with advanced cancer. Quality of life is impacted, for some, by psychological distress. According to Acceptance and Commitment Therapy (ACT), psychological distress is associated with emotional avoidance and lack of valued living. ACT aims to increase psychological health via acceptance of one’s “minding,” a focus on present-moment living, and a commitment to value-driven life. In this article, we introduce the advanced cancer patient, the theory behind ACT, and how ACT may be delivered. We present the hypothetical case of J.B., a 56-year-old woman with recurrent Stage III ovarian cancer who reports thoughts of hopelessness and worthlessness, and how ACT might be applied to help J.B. experience a rich and meaningful life irrespective of her time remaining.
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36
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Fan SY, Eiser C, Ho MC, Lin CY. Health-related quality of life in patients with hepatocellular carcinoma: the mediation effects of illness perceptions and coping. Psychooncology 2012; 22:1353-60. [DOI: 10.1002/pon.3146] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Revised: 07/03/2012] [Accepted: 07/09/2012] [Indexed: 01/12/2023]
Affiliation(s)
- Sheng-Yu Fan
- Department of Human Development; Tzu Chi University; Hualien Taiwan
| | - Christine Eiser
- Department of Psychology; University of Sheffield; Sheffield UK
| | - Ming-Chih Ho
- Department of Surgery; National Taiwan University Hospital; Taipei Taiwan
| | - Cheng-Yao Lin
- Department of Hematology and Oncology; Chi-Mei Medical Center; Liou Ying Taiwan
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Wills TA, Bantum EO. Social Support, Self-Regulation, and Resilience in Two Populations: General-Population Adolescents and Adult Cancer Survivors. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2012. [DOI: 10.1521/jscp.2012.31.6.568] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Price A, Goodwin L, Rayner L, Shaw E, Hansford P, Sykes N, Monroe B, Higginson I, Hotopf M, Lee W. Illness perceptions, adjustment to illness, and depression in a palliative care population. J Pain Symptom Manage 2012; 43:819-32. [PMID: 22285286 DOI: 10.1016/j.jpainsymman.2011.05.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 05/09/2011] [Accepted: 05/18/2011] [Indexed: 11/24/2022]
Abstract
CONTEXT Representations of illness have been studied in several populations, but research is limited in palliative care. OBJECTIVES To describe illness representations in a population with advanced disease receiving palliative care and to examine the relationship between illness perceptions, adaptive coping, and depression. METHODS A cross-sectional survey of 301 consecutive eligible patients recruited from a palliative care service in south London, U.K. Measures used included the Brief Illness Perception Questionnaire (Brief IPQ), the Mental Adjustment to Cancer (MAC) Scale, and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire-9. RESULTS Scores were not normally distributed for most questions on the Brief IPQ. The correlations found between items on the Brief IPQ were understandable in the context of advanced disease. MAC helplessness-hopelessness and fighting spirit were highly correlated with items on the Brief IPQ in opposite directions. The Brief IPQ domains of consequences, identity, concern, personal control, and emotion were associated with depression, a relationship that was not explained by adaptive coping. Seven causal attribution themes were identified: don't know, personal responsibility, exposure, pathological process, intrinsic personal factors, chance, fate or luck, and other. Both lung cancer diagnosis and gender were found to be independently associated with personal responsibility attribution. None of the attribution themes were associated with the presence of depression. CONCLUSION Assessment of illness perceptions in palliative care is likely to yield important information about risk of depression and will help clinicians to personalize management of advanced disease.
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Affiliation(s)
- Annabel Price
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.
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39
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Krikorian A, Limonero JT, Maté J. Suffering and distress at the end-of-life. Psychooncology 2011; 21:799-808. [DOI: 10.1002/pon.2087] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 09/09/2011] [Accepted: 09/20/2011] [Indexed: 11/07/2022]
Affiliation(s)
| | - Joaquín T. Limonero
- Research Group on Stress and Health, Faculty of Psychology; Universidad Autónoma de Barcelona; Barcelona; Spain
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