Audiotaped social comparison information for cancer patients undergoing radiotherapy: differential effects of procedural, emotional and coping information

Selection of social comparison standards in cardiac patients with and without experienced defibrillator shock

Patients with an implantable cardioverter-defibrillator (ICD) often report psychological distress. Literature suggests that patients with physical disease often compare their well-being and coping to fellow patients. However, we lack knowledge on social comparison among patients with ICD. In this study, we examined psychological distress and social comparison selection in patients with (ICD+) and without experienced ICD shocks (ICD-). We theorized that relative to ICD- patients, those with ICD+ display higher levels of psychological distress and thereby compare more frequently with fellow patients with more severe disease, but better disease coping and try to identify more strongly with these standards to improve their own coping. We recruited 92 patients with (ICD+, n = 38) and without an experienced ICD shock (ICD-, n = 54), who selected one of four comparison standards varying in disease severity and coping capacity. Relative to ICD-, ICD+ patients reported higher levels of device-related distress, but there were no significant differences in anxiety, depression, or quality of life. ICD+ patients selected more often comparison standards with poor coping and, irrespective of standard choice, displayed more negative mood following comparison. Our results show that ICD+ patients tend to perform unfavorable comparisons to fellow patients, which might explain higher psychological distress and worse coping. These findings warrant further research into social comparison as a relevant coping mechanism in ICD patients.

Women with gynaecological cancer awaiting radiotherapy: Self-reported wellbeing, general psychological distress, symptom distress, sexual function, and supportive care needs

OBJECTIVE

To better serve women with gynaecological cancers, we need a sound understanding of their health, wellbeing and needs. This study sought to explore these issues in a sample of Australian women before commencing curative radiotherapy.

METHODS

We undertook a secondary analysis of baseline data from a supportive care trial (n = 311). Descriptive statistics were used to summarise responses to measures of wellbeing, general psychological distress, symptom distress, sexual function and vaginal changes, and supportive care needs. Pre-specified regression models were used to examine sources of variation in wellbeing and sexual function.

RESULTS

Women reported lower emotional, functional and physical wellbeing than population norms (all p < 0.001). The prevalence of general psychological distress was 31% (95% CI 26-36%). Distress caused by physical symptoms was typically low. Health system and information needs comprised eight of the top ten moderate-to-high supportive care needs. Most women reported no change in interest for physical contact or sex compared to pre-diagnosis, but some sexually active women (16-24%) reported smaller vaginal size, increased dryness, and more pain on intercourse. General psychological distress was a robust marker of poorer wellbeing and sexual function.

CONCLUSIONS

Before radiotherapy, a substantial minority of women with gynaecological cancers experience general psychological distress, reduced wellbeing and moderate-to-high health system and information needs. A model of comprehensive care incorporating assessment of unmet needs, general psychological distress, and sexual issues is recommended. Healthcare providers may require training to elicit and respond to a constellation of interrelated issues and access relevant services for women requiring additional support.

Neuroticism and responses to social comparison among cancer patients

The present study examined how the effects of three audiotapes containing different types of social comparison information on the mood of cancer patients depended on the level of neuroticism. On the procedural tape, a man and woman discussed the process of radiation therapy, on the emotion tape, they focussed on emotional reactions to their illness and treatment, while on the coping tape they focussed on the way they had been coping. A validation study among 115 students showed that the tapes were perceived as they were intended. The main study was conducted among 226 patients who were about to undergo radiation therapy. Compared to patients in the control group, as patients were higher in neuroticism, they reported less negative mood after listening to the procedural and the coping tape. Furthermore, as patients were higher in neuroticism, they reported less negative mood after listening to the coping tape than to the emotion tape. Copyright © 2009 John Wiley & Sons, Ltd.

The impact of an educational video about radiotherapy and its toxicities in head and neck cancer patients. Evaluation of patients' understanding, anxiety, depression, and quality of life

OBJECTIVES

Head and neck radiotherapy can cause several toxicities, and its management has important treatment implications. Proper information about treatment is crucial to assist patients by preparing them and enhancing their ability to manage their illness. Thus, this study aimed to verify the impact of an educational video on the improvement of the patient's understanding, satisfaction, quality of life, and influence on their emotional state in different moments of treatment.

METHODS

A 10 min video about head and neck radiotherapy and its toxicities was produced. A prospective randomized clinical trial was performed in two groups: a control group (n = 65), which received standard verbal and written information, and an experimental group (n = 65), which received standard information and the video. Appropriated questionnaires (HADS, UW-QOLv4, IRTU, and Post-RTU) were applied in four different moments in order to evaluate patients' understanding, anxiety, depression, and quality of life.

RESULTS

The video improved the understanding of treatment and its side effects. Also, the video group reported better awareness about oral health care during the treatment. Osteoradionecrosis and radiation-related caries were the most unknown side effects. On the other hand, the educational video did not modify the patients' anxiety, depression, and quality of life. All patients reported high satisfaction with the video.

CONCLUSIONS

Audiovisual tools may improve patients' understanding of radiotherapy and were shown to be a useful tool when used in association with verbal and written information in cancer centers. In addition, information about osteoradionecrosis and radiation-related caries must be reinforced to patients.

Information in radiotherapy for men with localised prostate cancer: An integrative review

INTRODUCTION

Men with prostate cancer may receive radiotherapy as part of their management. They encounter a range of information related to radiotherapy, and a crucial role for therapeutic radiographers and other healthcare practitioners is ensuring patients receive appropriate information related to their treatment. This integrative review aims to identify, synthesise and analyse literature reporting experiences of men with localised prostate cancer related to information in radiotherapy.

METHODS

A systematic literature search encompassing database and hand searches was carried out between February and March 2017 with date limits of 2000-2017 applied. Initially, 4,954 articles were identified. Systematic screening and detailed examination identified that 33 met the inclusion criteria. Data were synthesised and analysed thematically.

RESULTS

Few studies explicitly addressed the issue of information in radiotherapy for men with localised prostate cancer. Themes that emerged and were explored are information needs, information regarding adverse effects, information and time, information preferences, satisfaction with information related to radiotherapy and patient experience related to radiotherapy information.

CONCLUSION

This review suggests that although several aspects related to information for men with localised prostate cancer have been documented, few were explored in detail with respect to radiotherapy indicating that further research in this area is warranted.

Am I a 6 or a 10? Mate Value Among Young Adult Survivors of Childhood Cancer and Healthy Peers

PURPOSE

This study focused on self-perceived mate value of young adult survivors of childhood cancer relative to healthy peers. Qualitative studies indicate potential problems surrounding romantic relationships among survivors, but systematic studies are missing.

METHODS

One-hundred forty-nine childhood cancer survivors and 149 matched controls completed online questionnaires about their mate value, social comparison strategies (i.e., upward/downward identifying/contrasting strategies), and marital status. Survivors and controls were aged 20-40 (M = 27.8), 55% were female, and survivors had been treated for brain tumors (n = 52; 35%), leukemia (n = 42; 28%), lymphoma (n = 31; 21%), or other solid tumors (n = 24; 16%) at 5-33 years before study participation.

RESULTS

Survivors and controls did not differ on overall mate value, but on individual characteristics: Survivors thought they had a better sense of humor (d = 0.36), were more loyal (d = 0.32), had higher social status (d = 0.26), and were more ambitious (d = 0.19), while also considering themselves less sexually adventurous (d = 0.31), less healthy (d = 0.26), having less desire to have children (d = 0.21), and a less attractive face (d = 0.20). Higher mate value was related to being partnered, more upward-identifying, less upward-contrasting, and less downward-identifying strategies. Moreover, less downward-identifying was associated with higher mate value in survivors, but not controls; whereas greater downward-contrasting was associated with higher mate value among controls only (R² = 30.8%).

CONCLUSIONS

Survivors do not generally view themselves as less valuable (potential) romantic partners, but they evaluate different characteristics either more positively or more negatively. Social comparison strategies offer targetable points of interventions to intervene on negative self-evaluations, potentially enhancing well-being.

A nurse- and peer-led support program to assist women in gynaecological oncology receiving curative radiotherapy, the PeNTAGOn study (peer and nurse support trial to assist women in gynaecological oncology): study protocol for a randomised controlled trial

Background

Women who undergo radiotherapy for gynaecological cancer (GC) can experience distressing side effects which impact on psychosocial functioning and intimate relationships. Cancer-related distress may be ameliorated by comprehensive preparation for treatment and addressing women’s informational, physical, psychological and psychosexual needs. This paper describes the protocol for a multisite randomised controlled trial (RCT) testing a novel intervention package which combines tailored specialist nursing consultations and telephone peer support with the primary aim to reduce psychological distress. Secondary aims assess patient quality of life, symptom distress, unmet supportive care needs, preparation for treatment, psychosexual functioning and vaginal stenosis.

Methods/design

This multifaceted intervention comprises four nurse-led consultations coupled with four phone calls from a peer support volunteer (GC survivor). The evidence-based intervention will be delivered at critical points in the illness trajectory: pre-treatment, mid-treatment, treatment completion and post-treatment. Nurses and peers undergo 2-day intensive training workshops, are guided by comprehensive study intervention manuals and receive ongoing supervision and support. Eligible patients will have a diagnosis of GC, be scheduled to receive curative radiotherapy, be aged 18 years or over and speak English. Three-hundred and six participants will be randomized to receive usual care or usual care with the intervention package. Study outcome measures will be collected at baseline, day 1 of radiotherapy and 1, 6 and 12 months post radiotherapy. Clinical assessments of vaginal toxicity will occur at baseline, and 3, 6, and 12 months post radiotherapy.

Discussion

This timely research has the potential to substantially reduce the physical, psychosexual and supportive care needs of women with GC. Using a telephone peer support model, the intervention package ensures equitable access to support services for geographically isolated patients. The novel intervention engages peer volunteers who liaise with nurses to encourage adherence to professionally-delivered information and provide emotional support. It has been designed to be potentially transferable to a range of treatment settings and diseases. Based on pilot data, the proposed intervention was found to be useful and acceptable to patients and clinicians. If effective and feasible in the multisite RCT, the program could be widely disseminated.

Trial registration

Australian New Zealand Clinical Trial Registry ACTRN12611000744954

Effects of the source of social comparison information on former cancer patients' quality of life

OBJECTIVE

Life, following curative treatment, can be a struggle for former cancer patients. In this phase of their illness, social comparison information may help to improve a patient's quality of life (QOL). The objective of this study was to determine whether the effects of this information depend on the following two variables: (1) the individual's physical health and (2) the individual's sensitivity to social comparison.

DESIGN

In the current study, the effects on a patient's QOL were tested that occur when they are listening to a psychological oncological expert talking about cancer patients' experiences. Three different recorded interviews with experts were compared (on negative emotions, effective coping, or both), and individual differences were tested as moderators. In addition, the expert source conditions were compared with a condition in which the source was not an expert but a former patient.

METHODS

In a randomized field experiment, 154 Dutch former cancer patients (M(age) = 55 years; 68% women) were assigned to one of the four conditions (three expert source and one former patient source condition). QOL was assessed after 2 months.

RESULTS

The effects of the expert source conditions on QOL depended on the participants' physical health (good vs. poor) and on the participants' sensitivity to social comparison (whether the recipient reacts with contrast or identification), as indicated by significant three-way interactions (p < .001). Depending on these two variables, one of the three expert source conditions was at least as effective as the former patient source condition.

CONCLUSIONS

The results show that desired and undesired effects are found when individual differences relevant to the processing of intervention information are examined.

Social comparisons and chronic illness: research synthesis and clinical implications

The chronically ill patient must adjust to new life circumstances and manage ongoing threats to personal health. Patients often make comparisons with each other, which can have effects on their psychological and physical well-being. One question is whether health psychologists can develop interventions to strategically facilitate the use of such comparisons to optimise adjustment. This paper critically reviews evidence on patients' comparisons in studies using selection, narration and reaction methods. Discussion focuses on gaps in the empirical literature and describes some new basic concepts in social comparison, which may advance knowledge about the process in medical patients. Recommendations also are provided about the kinds of studies needed to inform the future design of effective social comparison interventions.

Follow-up effects of social comparison information on the quality of life of cancer patients: the moderating role of social comparison orientation

OBJECTIVE

To examine how social comparison orientation (SCO) moderates the effects of three types of social comparison information on the global quality of life of cancer patients 2 weeks and 3 months later.

DESIGN

Cancer patients (n=226) were provided with social comparison information just prior to undergoing radiation therapy, using audiotapes. Each participant was confronted with one of three tapes: (1) focusing on procedural aspects, (2) focusing on emotional reactions and (3) focusing on coping strategies.

MAIN OUTCOME MEASURES

Quality of life as measured with the Cantril self-anchoring scale [Cantril, H. (1965). The pattern of human concerns. New Brunswick, NJ: Rutgers University Press].

RESULTS

With increasing SCO, a lower quality of life was reported after listening to the emotion tape, while a higher quality of life was reported after listening to the coping tape. These effects were found 2 weeks as well as 3 months after the radiation therapy had ended.

CONCLUSION

Social comparison information may have longitudinal effects on quality of life, but these effects are to an important extent dependent on the nature of the information and individual differences in SCO.

Patient's perception of care quality during radiotherapy sessions using respiratory gating techniques: validation of a specific questionnaire

This prospective study was designed to validate a questionnaire on patients' perception of care quality during respiratory-gated radiotherapy for breast or lung cancer. Psychometric tests were performed on selected patients. Confirmatory factorial analyses and capacity to discriminate the responses were achieved to validate the best model on 297 patients. Factorial analyses identified the following three scales: (a) perception of quality, (b) global satisfaction, and (c) physical or emotional experience. The scales were able to differentiate patients' responses according to radiotherapy modalities. The questionnaire presented adequate psychometric properties. This tool could be used for the assessment from the patient's point of view.

An exploration of the internet as a self-management resource

Abstract

In this paper, we explore the role of the internet as a resource for self-managing problems experienced by people affected by cancer. To do this, we draw on our observations of a UK online discussion forum used by people affected by cancer. We explored online contributions to the online discussion forum to identify examples of how people used the internet to seek and share information and support in the context of cancer to support their self-management of problems. Our findings show that of those registering on an online discussion forum only a minority (18%) contributed posts. Few people contributed to the online discussion forum more than five times although a minority of contributors participated numerous times. Examples of emotional and informational support exchanged in the online discussions are described. Benefits of contributing to the online discussions were noted. In conclusion, the online discussion forum can provide a useful resource for people to seek and share experiences, information and support with others in similar situations.

Not all emotions are created equal: the negativity bias in social-emotional development

There is ample empirical evidence for an asymmetry in the way that adults use positive versus negative information to make sense of their world; specifically, across an array of psychological situations and tasks, adults display a negativity bias, or the propensity to attend to, learn from, and use negative information far more than positive information. This bias is argued to serve critical evolutionarily adaptive functions, but its developmental presence and ontogenetic emergence have never been seriously considered. The authors argue for the existence of the negativity bias in early development and that it is evident especially in research on infant social referencing but also in other developmental domains. They discuss ontogenetic mechanisms underlying the emergence of this bias and explore not only its evolutionary but also its developmental functions and consequences. Throughout, the authors suggest ways to further examine the negativity bias in infants and older children, and they make testable predictions that would help clarify the nature of the negativity bias during early development.

Cancer treatments

Cancer is of particular importance to gerontology due to the changing nature of the disease. Survival rates are at all time highs as a result of technological advances in early detection and treatment of cancer. Some less aggressive or invasive forms of cancer are now seen as chronic illnesses rather than acute, terminal diseases. As a result, demand is increasing for evidence-based psychosocial interventions designed to improve the health and well-being of people living with cancer. This article reviews evidence-based psychosocial interventions designed to address the needs of persons with cancer and their family members. Traditional and technology enhance interventions are discussed as are complementary and alternative therapies designed to augment traditional interventions.

A review of the literature surrounding the provision of interpreters in health care, focusing on their role in translating information for non-English-speaking cancer patients and issues relating to informed consent

Informed consent is a fundamental principle of health care ethics. All patients should have equal opportunities in accessing information to help them make informed decisions about their treatments.

Literature on informed consent, translators in health care, non-English-speaking patients and the importance of communication and information, most specifically in radiotherapy, were reviewed. Western studies published between 1995 and 2005 were accessed and filtered though two eligibility screens and a critique framework to assess quality.

The evidence suggested that many non-English-speaking patients are not in a position to give true informed consent due to lack of interpreters. This may lead to health care professionals giving treatment without full consent. Written information for radiotherapy patients was often only available in English, apart from inner city areas.

There appears to be a scarcity of professional interpreters used in the health care setting; the most common practice is to use family members and friends to interpret. This practice results in breach of patient confidentiality, extra pressure on family members and filtration of information.

This patient group is often excluded from certain treatment opportunities such as clinical trials. Ideally, a fully accessible professional interpreting service should be available to allow non-English patients equal rights in accessing appropriate health care options and treatments.

Targets and dimensions of social comparison among people with spinal cord injury and other health problems

The present research examined comparison targets and comparison dimensions among two Spanish samples of individuals facing serious illnesses and diseases. In Study 1, 90 older patients (mean age 66.36) with various age-related diseases, particularly cardiovascular diseases and diabetes, indicated that they compared themselves most often with others with the same disease, next with others with another disease and least with people without health problems. They compared themselves more often on their mental state, symptoms and physical activities than on their social activities. Social comparison orientation (SCO) as an individual difference characteristic was associated with more frequent comparisons with particularly similar targets, and with more frequent comparisons of one's symptoms and physical activities. Neuroticism was correlated only with more comparisons of one's symptoms. Study 2 was conducted in a sample of 70 relatively young patients (mean age 43.97) with spinal cord injury (SCI). Overall, they compared themselves more often with others than the participants in Study 1, and they compared themselves to a similar extent with people with SCI as with people with another disease and with people without health problems. While they felt on average better off than people with other diseases and other people with SCI, people with SCI felt on average worse off than people without health problems. They compared themselves more often on physical activities than on any other dimension. Higher levels of stress and uncertainty were associated with more frequent comparisons with people without SCI, and with more frequent comparisons of one's mental state, one's symptoms and one's future perspectives. The discussion focuses on the theoretical relevance of the results for social comparison theory, and on the practical relevance of the findings for interventions.

Prospective trial of a video educational tool for radiation oncology patients

OBJECTIVES

Prospective assessment of the informational needs of radiation oncology patients and efficacy of an educational video in meeting them.

METHODS

Subjects completed baseline self-administered questionnaires and subsequently viewed the patient education video. Post-testing was performed after initiation of therapy and subjects rated their satisfaction with the video, its relevance, and their emotional response. Analyses were performed with respect to patient and disease characteristics.

RESULTS

Fifty-three subjects were enrolled and completed both before and after video measures. The mean age of participants was 58 years (range, 33 to 83). Pretreatment, >90% of patients reported specific information needs. One hundred percent of patients watched the video and 77% rated it as highly relevant. High levels of satisfaction (>90%) were reported with video information describing radiation and simulation. Older subjects (58 years and older) found video information significantly more relevant than those younger (55% versus 27%, P = 0.04) and rated greater satisfaction with side effect information (78% versus 41%, P = 0.006). Subjects with breast cancer exhibited a trend towards feeling better informed by the video.

CONCLUSIONS

Radiation oncology patients reported informational needs unmet by standard educational measures. High levels of satisfaction were reported with video education. It promoted better understanding of radiotherapy. Older patients found the video to be significantly more relevant and informative.