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Honda N, Shiroshita Y, Miyazaki A, Sobue I. Factors associated with cancer disclosure in adolescent and young adult cancer survivors: An integrative review from the social-ecological model perspective. Eur J Oncol Nurs 2024; 69:102542. [PMID: 38460390 DOI: 10.1016/j.ejon.2024.102542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE Young cancer survivors ("young survivors") may need to disclose their cancer experiences to reintegrate into society. In such cases, the recognition of social support through the disclosure of cancer experiences may prevent potential social disadvantages. This review aimed to describe the motivations, strategies and outcomes, and benefits and disadvantages of disclosure in young survivors based on the social-ecological model (SEM) to identify the support survivors need when disclosing their cancer experiences. METHODS Using the integrated review methodology, we systematically searched six databases in English and Japanese as well as searched the reference lists of the selected studies. The themes identified via thematic analysis were categorized within the SEM levels. RESULTS This review analyzed 14 studies and identified four themes, including "Motivation for Cancer Disclosure," "Barriers to Cancer Disclosure," "Consequences of Cancer Disclosure: Benefits," and "Consequences of Cancer Disclosure: Disadvantages." Motivations for young survivors to disclose their cancer involved post-cancer differences, perceptions, relationships, and social context. In navigating barriers, including self-stigma, peer exclusion, and discrimination, they employed strategies such as reassurance and information limitation. Tailored disclosure strategies at each SEM level offered social and psychological benefits, however, disadvantages, including stress, vulnerability, employment issues, and limited insurance coverage, were experienced by young survivors due to cancer disclosure. CONCLUSIONS To optimize the benefits of cancer disclosure for young survivors, addressing psychological burdens, enhancing disclosure skills, offering familial psychological support, and fostering public awareness of cancer are essential.
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Affiliation(s)
- Naoko Honda
- Department of Reproductive Health, Institute of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan.
| | - Yui Shiroshita
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Asuka Miyazaki
- Department of Reproductive Health, Institute of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan.
| | - Ikuko Sobue
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
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Lee H, Jeong Y. Self-disclosure in Adult Patients With Cancer: Structural Equation Modeling. Cancer Nurs 2023:00002820-990000000-00194. [PMID: 37991473 DOI: 10.1097/ncc.0000000000001302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
BACKGROUND Health-related self-disclosure has been studied in various aspects, as has self-disclosure of cancer patients. However, any theoretical models that comprehensively include self-disclosure events, factors associated with self-disclosure, and the outcomes of self-disclosure of cancer patients have not yet been presented. OBJECTIVE The purpose of this study was to explore the relationships between self-disclosure, perception toward cancer, intention for self-disclosure, level and range of self-disclosure, social support, and well-being in adult patients with cancer. METHODS Data were collected from adult cancer patients via an online survey using self-report questionnaires and analyzed using structural equation modeling. The data from 359 participants were included in the final analysis. RESULTS Positive intention for self-disclosure was a significant predictor of both self-disclosure level and range, whereas negative perception toward cancer significantly decreased self-disclosure level. The self-disclosure level significantly improved both social support and well-being, whereas the self-disclosure range did not present a significant impact on social support and well-being. CONCLUSION Self-disclosure is closely associated with social support and well-being, and self-disclosure can be promoted by improving negative perceptions and positive intentions about self-disclosure. In addition, to improve the social support and well-being of cancer patients, it suggests increasing the self-disclosure depth level rather than widening the range of self-disclosure. IMPLICATIONS FOR PRACTICE The results of this study can be used as evidence for the development of nursing intervention programs to reduce negative perceptions toward cancer and improve positive intentions and levels of self-disclosure among cancer patients.
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Affiliation(s)
- Hyungran Lee
- Authors' Affiliations: College of Nursing Science, Kyung Hee University, Seoul, Korea
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Wells I, Zemedikun DT, Simons G, Stack RJ, Mallen CD, Raza K, Falahee M. Predictors of the likelihood that patients with rheumatoid arthritis will communicate information about rheumatoid arthritis risk to relatives: A quantitative assessment. PATIENT EDUCATION AND COUNSELING 2023; 112:107713. [PMID: 37003160 DOI: 10.1016/j.pec.2023.107713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/10/2023] [Accepted: 03/17/2023] [Indexed: 05/09/2023]
Abstract
First-degree relatives (FDRs) of people with rheumatoid arthritis (RA) are increasingly recruited to prediction and prevention studies. Access to FDRs is usually via their proband with RA. Quantitative data on predictors of family risk communication are lacking. RA patients completed a questionnaire assessing likelihood of communicating RA risk information to their FDRs, demographic variables, disease impact, illness perceptions, autonomy preferences, interest in FDRs taking a predictive test for RA, dispositional openness, family functioning, and attitudes towards predictive testing. Ordinal regression examined associations between patients' characteristics and their median likelihood of communicating RA risk to FDRs. Questionnaires were completed by 482 patients. The majority (75.1%) were likely/extremely likely to communicate RA risk information to FDRs, especially their children. Decision-making preferences, interest in FDRs taking a predictive test, and beliefs that risk knowledge would increase people's empowerment over their health increased patients' odds of being likely to communicate RA risk information to FDRs. Beliefs that risk information would cause stress to their relatives decreased odds that patients would be likely to communicate RA risk. These findings will inform the development of resources to support family communication about RA risk.
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Affiliation(s)
- Imogen Wells
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Dawit T Zemedikun
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Gwenda Simons
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Rebecca J Stack
- Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Christian D Mallen
- Primary Care Centre Versus Arthritis, School of Medicine, David Weatherall Building, Keele University, Keele, United Kingdom
| | - Karim Raza
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, United Kingdom; Sandwell and West Birmingham NHS Trust, Birmingham, United Kingdom; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and the Research into Inflammatory Arthritis Centre Versus Arthritis, University of Birmingham, Birmingham, United Kingdom
| | - Marie Falahee
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
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Stigma, Discrimination and Disclosure of the Diagnosis of Multiple Sclerosis in the Workplace: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159452. [PMID: 35954811 PMCID: PMC9367867 DOI: 10.3390/ijerph19159452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/18/2022] [Accepted: 07/23/2022] [Indexed: 11/16/2022]
Abstract
The objective of the study was to describe and analyze the stigma, discrimination and the disclosure of the diagnosis of Multiple Sclerosis (MS) in the workplace. The protocol was registered in PROSPERO (CRD42022320437). We systematically searched four scientific databases with key search terms. We included any original peer-reviewed articles reporting the stigma or discrimination experienced at work due to MS or the disclosure of the diagnosis of MS in the workplace. No time limits were set for the search. An appraisal of the individual study quality was performed with the JBI critical appraisal checklist. Overall, 26 studies were deemed to fulfil all the eligibility criteria. The total number of participants in this review was 9571. The prevalence of people with MS who experience some degree of stigma in the workplace can be as high as 79.2%. Those who report greater feelings of discrimination are more likely to be unemployed. The prevalence of employers’ and co-workers’ awareness of the diagnosis varies from 31.7 to 90.2%. The main reason for non-disclosure is the fear of being discriminated against. The psychosocial work environment needs to be taken into consideration as part of public and individual policies to promote the health of patients with MS.
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Building Awareness of Diagnosis Together: Ambiguity During Progression-Free Survival Experienced by Patients With Lung Cancer and Caregivers in China. Cancer Nurs 2022; 46:198-206. [PMID: 35353739 DOI: 10.1097/ncc.0000000000001084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lung cancer, as a multistep and multifactorial disease, is among the most fatal cancers worldwide. As new therapies are developed and early screening increases, patients tend to experience progression-free survival (PFS) as a coexistence of living and dying simultaneously. OBJECTIVE The aim of this study was to explore the awareness context experienced by Chinese elderly patients and family members. METHODS Interviews were conducted with 20 interviewees, including 13 elderly patients with lung cancer and 7 caregivers that were recruited using purposive sampling. Semistructured, face-to-face, in-depth interviews were conducted using a qualitative descriptive approach. RESULTS Ambiguity was commonly experienced by patients with lung cancer with PFS. Three themes emerged from the data analysis: "ambiguity in cancer diagnosis," "ambiguity in prognostic awareness," and "ambiguity in identity." In this case, ambiguity refers to a situation or context in which patients are uncertain about whether there will be a recurrence of their cancer and when it might occur. CONCLUSIONS The findings highlighted that patients experienced ambiguity in response to unclear diagnoses, uncertain prognoses, and identity crises during PFS. IMPLICATIONS FOR PRACTICE Healthcare teams should be equipped with psychosocial knowledge and communication skills to manage ambiguity in diagnosis and prognosis for patients with PFS.
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Wu Y, Shao J, Zhang D, Wang Y, Wang S, Wang Z, Qu Y, Gu J. Pathways from self-disclosure to medical coping strategy among adolescents with moderate and major depression during the COVID-19 pandemic: A mediation of self-efficacy. Front Psychiatry 2022; 13:976386. [PMID: 36117657 PMCID: PMC9478381 DOI: 10.3389/fpsyt.2022.976386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The prevalence of adolescent depression in China during the COVID-19 pandemic is increasing. Self-disclosing depressive emotions could help release stress. Self-disclosure, which is a prerequisite for self-efficacy, can directly contribute to people's psychological health, and depression and the choice of coping strategy are determined by the level of self-efficacy perceived. PURPOSE We aimed to discuss the relationship between self-efficacy, self-disclosure, and medical coping strategy. Further, we explore the mediation effect of self-efficacy on the influence of self-disclosure on medical coping strategies in adolescents with depression. METHODS A total of 585 patients aged 11-24 years with moderate and major depression were recruited. All the assessments were completed on the second day after admission, including the General Self-Efficacy Scale (GSE), Distress Disclosure Index (DDI), and Medical Coping Modes Questionnaire (MCMQ). Pearson correlation was performed to explore the relationships of these variables. The bootstrap analysis was used to conduct to assess the mediation effects. RESULTS Both direct and indirect effects of self-disclosure on medical coping strategy were found. As predicted, self-efficacy partially mediated the relationship between self-disclosure and medical coping strategy (b = 0.0385, 95% CI: 0.0244-0.0538 for Confrontation; b = -0.0466, 95%CI: -0.0651 to -0.0296 for Resignation), respectively. The effect size for Confrontation and Resignation was 0.2659 and 0.2485, respectively. CONCLUSION Self-efficacy played a partial mediating role in the effect of self-disclosure on medical coping strategies for adolescent depression during the COVID-19 pandemic, and the use of a positive self-disclosure mechanism may be anticipated to promote improved self-efficacy and the use of active coping strategies.
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Affiliation(s)
- Yan Wu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jing Shao
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dawei Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yongna Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shufen Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zhiren Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yanhua Qu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jianing Gu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
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Tan FSI, Shorey S. Experiences of women with breast cancer while working or returning to work: a qualitative systematic review and meta-synthesis. Support Care Cancer 2021; 30:2971-2982. [PMID: 34647131 DOI: 10.1007/s00520-021-06615-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/03/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review aims to consolidate the available qualitative evidence regarding the experiences of women with breast cancer while working or returning to work. METHODS Six electronic databases were searched until December 2020 for qualitative English-language articles examining the experiences of adult females with reproductive cancers while working or returning to work. The Critical Appraisal Skills Program checklist was used to assess the quality of included studies while the Sandelowski and Barroso's two step approach was used to meta-summarize and meta-synthesize the extracted data. RESULTS Four themes were derived from the 28 included studies: (i) being lost to finding meaning after the cancer diagnosis; (ii) concerns and considerations before returning to work; (iii) reasons for returning to work; and (iv) life at work after cancer diagnosis and treatment. CONCLUSIONS Current findings allowed a deeper understanding into the way the women with breast cancer coped during their cancer journey. Challenges and motivating factors faced by these women while working or returning to work were discussed. Improvements to current support systems and working policies are needed to better support this group of women.
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Affiliation(s)
- Faustine Sze Ing Tan
- KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.
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Sebri V, Mazzoni D, Triberti S, Pravettoni G. The Impact of Unsupportive Social Support on the Injured Self in Breast Cancer Patients. Front Psychol 2021; 12:722211. [PMID: 34616337 PMCID: PMC8488137 DOI: 10.3389/fpsyg.2021.722211] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/24/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Valeria Sebri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Davide Mazzoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Triberti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
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Gutiérrez-Hermoso L, Velasco-Furlong L, Sánchez-Román S, Berzal-Pérez E, Alcocer-Castillejos N, Quiroz-Friedman P. The effect of treatment and coping on the quality of life in breast cancer patients: a moderated mediation model. Qual Life Res 2021; 31:147-158. [PMID: 34024017 DOI: 10.1007/s11136-021-02885-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Breast cancer involves complicated emotional processes. One of the factors that impacts the psychological symptoms and decreases QoL is the side effects of treatment. The purpose of this study is to explore the effect of the main medical treatment (chemotherapy or hormone therapy) on the three domains of quality of life. For this, coping strategies were considered as psychological variables that mediate the relationship based on high or low alexithymia as a moderating variable. METHODS This study had a cross-sectional design. The participant sample comprised 129 women with breast cancer in early stage (I to III) (63 receiving chemotherapy and 66 hormone therapy) and were evaluated from September 2015 to September 2019. Physical, emotional and social functioning were measured by the Quality of Life Questionnaire for cancer patients (EORTC-QLQ-C30), coping strategies were measured by Mental Adjustment to Cancer Questionnaire (MAC) and alexithymia was evaluated by the Alexithymia Toronto Scale (TAS-20). RESULTS Treatment had a significant negative effect on physical domain in both patients receiving chemotherapy and hormone therapy. Moderated mediation analysis show that this relationship was significant when it was mediated by helplessness. Furthermore, this model is only significant when there are high levels of alexithymia. No significant effect direct was found on emotional and social functioning of quality of life. CONCLUSIONS Results confirmed that coping based on helplessness and stable emotional variables such as alexithymia can have an effect, mediator or moderator, respectively, in the decrease of the physical functionality of women with breast cancer. Our findings highlight the need to include psychological therapy to help patients alleviate their psychological state because it can affect their physical condition.
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Affiliation(s)
| | | | - Sofía Sánchez-Román
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | | | - Natasha Alcocer-Castillejos
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Paulina Quiroz-Friedman
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
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Zhou LH, Hong JF, Qin RM, Henricson M, Stenmarker M, Browall M, Enskär K. Post-traumatic growth and its influencing factors among Chinese women diagnosed with gynecological cancer: A cross-sectional study. Eur J Oncol Nurs 2021; 51:101903. [PMID: 33618228 DOI: 10.1016/j.ejon.2021.101903] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE The experience of cancer could lead to positive psychological changes following the struggle with diagnosis and treatment. Understanding post-traumatic growth and its influencing factors in women affected by gynecological cancer is essential to enhance their possibility of achieving positive changes. The purpose of this study was to describe the post-traumatic growth level and explore the influencing factors of post-traumatic growth in Chinese women diagnosed with gynecological cancer. METHOD A cross-sectional survey with a convenience sampling method was employed to collect data using the Post-traumatic Growth Inventory (PTGI), Distress Disclosure Index (DDI), Medical Coping Modes Questionnaire (MCMQ), and Multidimensional Scale of Perceived Social Support (MSPSS). The questionnaires were administered to 344 participants recruited from two hospitals in Hefei City, the capital of Anhui Province in China, between March 2018 and March 2019. All statistical analyses were performed using nonparametric tests. The Mann-Whitney U Test was used to distinguish the intergroup differences. Correlations were evaluated with Spearman rank correlation coefficients. RESULTS Total score for PTGI was 56.5 (range 48.0-68.0). The subscale with the highest centesimal score in the PTGI was appreciation of life and the lowest was spiritual change. The top five items with the highest scores of PTGI belonged to appreciating life, personal strength, and relating to others. Self-disclosure, confrontation, avoidance, acceptance-resignation, perceived social support, education level, cancer type and the place they lived had significant influence on post-traumatic growth. CONCLUSIONS The findings indicate that women who have high levels of perceived social support, confrontation, avoidance, self-disclosure and education level tend to experience more post-traumatic growth, while, conversely, high levels of acceptance-resignation have a negative influence on promoting post-traumatic growth. These meaningful findings propose new perspectives for promoting post-traumatic growth in Chinese women diagnosed with gynecological cancer.
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Affiliation(s)
- Li-Hua Zhou
- School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, He Fei City, 230032, Anhui Province, PR China.
| | - Jing-Fang Hong
- School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, He Fei City, 230032, Anhui Province, PR China.
| | - Ru-Meng Qin
- The First Affiliated Hospital of Anhui Medical University, No. 218 Ji Xi Road, Shu Shan District, He Fei City, 230022, Anhui Province, PR China.
| | - Maria Henricson
- IMPROVE, Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Margaretha Stenmarker
- Department of Paediatrics, Jönköping, Region Jönköping County, And Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Paediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Maria Browall
- IMPROVE, Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Affiliated to Dep of Oncology, Inst of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Karin Enskär
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
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Zhang MM, Chen JJ, Zhang T, Wang QL, Li HP. Feasibility and effect of a guided self-disclosure intervention designed to facilitate benefit finding in breast cancer patients: A pilot study. Eur J Oncol Nurs 2020; 50:101879. [PMID: 33338740 DOI: 10.1016/j.ejon.2020.101879] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE This pilot study aimed to evaluate the feasibility and effect of a guided self-disclosure intervention (GSDI) promoting benefit finding (BF) for breast cancer patients. METHODS A total of 40 women with breast cancer were randomized either to a GSDI group, which included a 6-session face-to-face self-disclosure intervention, or to a control group. The Benefit Finding Scale (BFS) was used to measure BF, the Distress Disclosure Index (DDI) was used to measure self-disclosure, and the Impact of Event Scale-Revised (IES-R) was used to measure cognitive reappraisal. The outcomes were evaluated at baseline and the 3rd and 6th months. RESULTS The GSDI group had more satisfaction (t = 2.35, P = .02) than the control group and had significant group effects of higher BF (t = 2.214, P = .03) and a lower avoidance of the IES-R (t = -2.353, P = .024) at the 3rd month. There was a significant difference of BF (t = 2.036, P = .049) between the two groups at the 6th month, and other outcomes were not significant (P > .05). Intention-to treat (ITT) analysis showed significant time effects for all outcomes (P < .05); there were slightly significant time × group effects for BF (F = 4.15, P = .052) and disclosure (F = 2.719, P = .090). There were no time × group effects for the other outcomes (all P > .05). CONCLUSION This study suggests that the GSDI intervention may be feasible in the clinic and might improve BF for breast cancer patients. However, future research needs to further refine the intervention and expand the sample to carry out a full-scale randomized controlled trial.
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Affiliation(s)
- Mao-Mao Zhang
- Oncology Nursing Care Research, School of Nursing, Anhui Medical University, Hefei, China; Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Juan-Juan Chen
- Oncology Nursing Care Research, School of Nursing, Anhui Medical University, Hefei, China
| | - Ting Zhang
- Oncology Nursing Care Research, School of Nursing, Anhui Medical University, Hefei, China
| | - Quan-Lan Wang
- Oncology Nursing Care Research, School of Nursing, Anhui Medical University, Hefei, China
| | - Hui-Ping Li
- Research of Oncology Nursing Care & Nursing Education, School of Nursing, Anhui Medical University, Hefei, China.
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Van Humbeeck L, Dillen L, Piers R, Grypdonck M, Verhaeghe S, Van Den Noortgate N. Cancer patients' experiences of communicating and dealing with their older parents: A qualitative study. Eur J Oncol Nurs 2019; 38:98-103. [DOI: 10.1016/j.ejon.2018.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 12/13/2018] [Accepted: 12/16/2018] [Indexed: 02/04/2023]
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Al Qadire M. Disclosure of Cancer Diagnosis: an Individualized and Non-paternalistic Approach Is Preferred. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:996-1001. [PMID: 28238031 DOI: 10.1007/s13187-017-1192-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
There is no consensus among healthcare providers on a unified disclosure practice with regard to cancer diagnosis, whether to tell or not. This issue is complicated by the absence of a clear policy for healthcare practitioners, who face this dilemma every day in their clinical practice. This study uniquely aims to explore Jordanian public preference on cancer diagnosis disclosure and the type of information they need. A descriptive cross-sectional survey design was used in this study. The sample consisted of 485 participants who were conveniently selected from the Jordanian public, and data was collected using the Arabic-Cancer Patients Information Needs Questionnaire. The majority of participants were females (56.1%) and most of them (62.1%) were aged between 18 and 29 years. It was found that 421 (86.8%) participants wanted to be informed of the diagnosis if they developed cancer. Participants show high needs of information with mean of total score of 4.2 SD 0.7 out of 5. They mainly demanded to know the things that participants could do to help their cure (mean = 4.47, SD 0.77). Also, they wanted to know whether their cancer was under control or not (item no. 4, mean = 4.42, SD 0.81). This study marks a point of change in public thinking about health issues. Jordanian public preferred to be fully informed of their cancer diagnosis. They wanted information about their prognosis, treatment and the available supportive services, which are of great interest to the Jordanian public.
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Affiliation(s)
- Mohammad Al Qadire
- Adult Healthcare Nursing Department, Princess Salma Faculty of Nursing, Al Al-Bayt University, P.O.Box 130040, Mafraq, 25113, Jordan.
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Kim MA, Yi J, Prince KC, Nagelhout E, Wu YP. The effects of individual- and network-level factors on discussion of cancer experiences: Survivors of childhood cancer in Korea. J Psychosoc Oncol 2017; 36:31-48. [PMID: 28922073 DOI: 10.1080/07347332.2017.1379582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to identify young adult Korean cancer survivors' individual- (psychological distress, stigma, sociodemographic variables, and cancer-related variables) and network-level factors (relationship type, social support type) that influence discussion of their cancer experiences. Sixty-eight survivors of childhood cancer who were recruited using snowball sampling nominated 245 individuals from their networks, including family and intimate partners (40%) and friends and acquaintances (60%), as people with whom they most frequently interacted. Results of multilevel modeling analysis indicated that higher levels of internalized shame were a prominent individual-level factor associated with a lack of discussion of cancer experiences. Relationship type and support type at the network-level were also significant correlates of discussion of cancer experiences. Programs for reducing the survivors' shame, improving illness identity, and providing professional training for building social relationships that are intimate and in which they could exchange reciprocal support may help Korean childhood cancer survivors to openly share their cancer experiences with others in their social network and to be successful in the journey of cancer survivorship.
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Affiliation(s)
- Min Ah Kim
- a Department of Social Welfare , Myongji University , Seoul , Republic of Korea
| | - Jaehee Yi
- b College of Social Work , University of Utah , Salt Lake City , Utah , USA
| | - Kort C Prince
- b College of Social Work , University of Utah , Salt Lake City , Utah , USA
| | - Elizabeth Nagelhout
- c Department of Family and Preventive Medicine , University of Utah , Salt Lake City , Utah , USA
| | - Yelena P Wu
- d Department of Dermatology , University of Utah , Salt Lake City , Utah , USA.,e Huntsman Cancer Institute , Salt Lake City , Utah , USA
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15
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Lee M, Song Y, Zhu L, Ma GX. Coping Strategies and Benefit-finding in the Relationship between Non-disclosure and Depressive Symptoms among Breast Cancer Survivors in China. Am J Health Behav 2017; 41:368-377. [PMID: 28601096 DOI: 10.5993/ajhb.41.4.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Open communication about cancer diagnosis and relevant stress is frequently avoided among breast cancer survivors in China. Non-disclosure behavior may lead to negative psychological consequences. We aimed to examine the relationship between non-disclosure and depressive symptoms, and the role of coping strategies and benefit-finding in that relationship among Chinese breast cancer survivors. METHODS Using convenience sampling, we recruited 148 women in an early survivorship phase (up to 6 years post-treatment) in Nanjing, China. Participants were asked to complete a set of questionnaires in Chinese language, regarding sociodemographic characteristics, depressive symptoms, disclosure views, coping strategies, and benefit-finding. RESULTS A higher level of non-disclosure was associated with more depressive symptoms. This relationship was mediated by self-blame and moderated by benefit-finding. Specifically, non-disclosure was associated with depressive symptoms through self-blame. The impact of non-disclosure was minimized among the women with a higher level of benefit-finding. CONCLUSION Unexpressed cancer-related concern may increase self-blame, which leads to emotional distress among Chinese breast cancer survivors. Practicing benefit-finding may reduce the negative impact of non-disclosure. As a culturally appropriate way of disclosure, written expression may be beneficial to Chinese breast cancer patients.
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Affiliation(s)
- Minsun Lee
- Center for Asian Health, Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Yuan Song
- Nanjing Cancer Survivor Association, Nanjing, China
| | - Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.,
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16
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Badr H. New frontiers in couple-based interventions in cancer care: refining the prescription for spousal communication. Acta Oncol 2017; 56:139-145. [PMID: 27937437 DOI: 10.1080/0284186x.2016.1266079] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The diagnosis and treatment of cancer is a life-altering experience that signals profound changes in a person's life. However, most people do not experience cancer in isolation or cope alone. Despite the fact that partners (i.e. spouses, significant others) provide emotional support and play a critical role in caregiving, cancer exacts a heavy toll on them and challenges their relationship with the patient by altering established communication patterns and roles. In recognition of this, a burgeoning literature involving couple-based interventions to improve patient and partner quality of life and adaptation has emerged. However, questions remain regarding how we can improve these interventions to exact greater impact on patient and partner outcomes. MATERIAL AND METHODS A narrative review of the literature on couples' communication processes in cancer was conducted in order to describe knowledge gaps and directions for future research. RESULTS Most couple-based interventions have included a communication skills training component because communication is an important process through which couples make sense of cancer, engage in social support, negotiate role changes and coordinate coping responses. However, scholars still know very little about what they should instruct couples to talk about, how often they should talk and when talking (or not talking) is beneficial (and for whom - the patient, partner, or both). CONCLUSION In order push this field forward, we need to develop a more nuanced view of couples' communication that acknowledges that there are multiple ways to talk, different aspects of the cancer experience to talk about, and preexisting communication patterns and preferences for different couples that may influence the utility of talk. Interventions that replace the unilateral and generic prescription to talk openly about cancer with targeted questions that prompt reflection on couples' unique strengths, preexisting communication patterns and support resources may thus help bolster the impact of couple-based interventions on patient and partner quality of life.
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Affiliation(s)
- Hoda Badr
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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17
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Moseholm E, Lindhardt BO, Rydahl-Hansen S. The experiences of health-related quality of life in patients with nonspecific symptoms who undergo a diagnostic evaluation for cancer: a qualitative interview study. Scand J Caring Sci 2016; 31:463-473. [PMID: 27327438 DOI: 10.1111/scs.12359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/31/2016] [Indexed: 11/28/2022]
Abstract
The diagnostic phase of cancer can affect health-related quality of life (HRQoL). The aim of this study was to investigate how patients with nonspecific symptoms experience HRQoL while undergoing diagnostic evaluations for cancer. Twenty-one participants who had completed a fast-track evaluation for possible cancer at one of three hospitals in the Capital Region, Denmark were interviewed 2-4 weeks after completing diagnostic evaluations. The interviews were semi-structured and were supported by an interview guide based on the same themes as in The European Organisation for Research and Treatment of Cancer Quality of Life questionnaire (EORCT-QLQ-C30). Data analysis was based on qualitative content analysis by Krippendorff. The analysis generated six categories: symptoms, physical-, role-, emotional-, cognitive- and social functioning, and the diagnostic fast-track experience. From these categories, a main theme was identified: Health-related quality of life is not solely affected by the diagnostic process. The results provide a comprehensive understanding of HRQoL in the diagnostic phase of possible cancer, which can be used not only to enhance evidence-based care, but also in the interpretation of the EORTC-QLQ-C30 scores. Psycho-social support with a focus on individual informational needs during the diagnostic phase may be warranted.
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Affiliation(s)
- Ellen Moseholm
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Nordsjaelland, Hillerød, Denmark
| | | | - Susan Rydahl-Hansen
- Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark.,Department of Public Health, Section for Nursing, Aarhus University, Aarhus, Denmark
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