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Zerbinati L, Folesani F, Caruso R, Belvederi Murri M, Nanni M, Righetti S, Chiefari L, Muscettola A, Toffanin T, Costantini A, Zaccagnino B, Ruffilli F, Grassi L. Maladaptive coping styles moderate the relationship between information on cancer treatment and psychosocial symptoms: an Italian multicenter study. Front Psychol 2024; 15:1338193. [PMID: 38966736 PMCID: PMC11223643 DOI: 10.3389/fpsyg.2024.1338193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/30/2024] [Indexed: 07/06/2024] Open
Abstract
Objectives Disclosing information on diagnosis, prognosis and treatment is a delicate process in oncology, although awareness levels have over time increased in people with cancer. However, individual characteristics should be considered when communicating difficult information. We conducted a multicentric study to explore the moderating role of coping styles on the relationship between information about cancer, quality of life and psychological distress. Methods In the period between October 2015 and February 2016, 288 patients with a diagnosis of a solid tumor were recruited from seven Italian oncology units. All participants were administered the Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC), the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30), and the EORTC QLQ 25-item information module (INFO25). We explored the moderating effect of coping style with quality of life (QoL) and distress (DT) as dependent variables and information on cancer treatment as independent variable. Results Low levels of anxious preoccupation significantly moderated the relationship between information on treatment and QoL (R2 6%, p < 0.001), while low and medium levels of hopelessness significantly moderated the relationship between information on treatment and DT (R2 = 14%, p = 0.033). Adaptive coping strategies, such as fighting spirit and fatalism, and borderline strategies such as avoidance, did not play a role in this relationship. Conclusion Taking into account and evaluating coping mechanisms in cancer care is a priority when disclosing information on treatments, in order to tailor communication style to individual features.
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Affiliation(s)
- L. Zerbinati
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - F. Folesani
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - R. Caruso
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - M. Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - M.G. Nanni
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - S. Righetti
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - L. Chiefari
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - A. Muscettola
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - T. Toffanin
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - A. Costantini
- Psycho-oncology Service, Villa Margherita Clinic, Rome, Italy
| | - B. Zaccagnino
- Psycho-Oncology Service, Palliative Care, Pain Therapy and Integrative Medicine Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - F. Ruffilli
- Psycho-Oncology Service, Palliative Care, Pain Therapy and Integrative Medicine Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - L. Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Artioli G, Deiana L, Bertuol M, Casella G, Guasconi M, Foà C, De Simone R, Sarli L, Bonacaro A. Evaluating a nurse-led narrative interview intervention with cancer patients with a first diagnosis: A feasibility study. Heliyon 2024; 10:e31802. [PMID: 38868003 PMCID: PMC11167297 DOI: 10.1016/j.heliyon.2024.e31802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/14/2024] Open
Abstract
Narrative Medicine and Nursing are clinical-supporting intervention methodologies that aim to enhance professionals' communication skills and place patients at the heart of their therapeutic path. A narrative interview (NI) is a communication tool between practitioner and patient. The role of NI is debated extensively in the literature, but no studies focus on its use by nurses responsible for first-diagnosed cancer patients. This study aimed to evaluate the feasibility and utility of NI, carried out by Nurses, in managing people recently diagnosed with cancer. A pilot mixed-methods study with before-and-after-intervention evaluation, qualitative longitudinal data analysis, and concurrent data triangulation was conducted. The Mini-Mental Adjustment to Cancer assessed disease adaptation, while the Psychological Distress Inventory investigated psychological distress. The qualitative analysis of the narrative interviews assessed the usefulness of this intervention. 13 out of 14 eligible patients took voluntary part in the study. Of those, 9 (69 %) completed T1 and T2 questionnaires and NI. The following five themes emerged from thematic analysis: reaction to the disease, feelings related to the new condition of life, changes, importance of relationships and perception of care. Patients reported being highly stressed and recognized the importance of a supporting social network for better coping with the condition. The adoption of an NI approach at the time of cancer diagnosis is feasible. Due to the limited sample size, it is unclear if NI may positively impact psychological distress in this patient population. Further studies would benefit from the integration of an additional investigation tool aiming to clarify whether NI promotes disease awareness in cancer patients. Furthermore, the recruitment of a larger sample is equally recommended.
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Affiliation(s)
- Giovanna Artioli
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Laura Deiana
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Maria Bertuol
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Giovanna Casella
- University of Parma, Department of Medicine and Surgery, Parma, Italy
- “Azienda Unità Sanitaria Locale” of Piacenza, Piacenza, Italy
| | - Massimo Guasconi
- University of Parma, Department of Medicine and Surgery, Parma, Italy
- “Azienda Unità Sanitaria Locale” of Piacenza, Piacenza, Italy
| | - Chiara Foà
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | | | - Leopoldo Sarli
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Antonio Bonacaro
- University of Parma, Department of Medicine and Surgery, Parma, Italy
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3
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Vagnini D, Grassi MM, Valenti F, Bombardieri E, Saita E. Beauty Therapy to Support Psychosocial Recovery from Oncological Care: A Qualitative Research on the Lived Experience of Women with Breast Cancer Treated with Chemotherapy. Curr Oncol 2024; 31:2527-2541. [PMID: 38785470 PMCID: PMC11119433 DOI: 10.3390/curroncol31050189] [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: 03/12/2024] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
During the oncological care path, breast cancer patients treated with chemotherapy suffer from a number of psycho-physical changes, and appearance-related side effects are among the primary determinants of psychosocial impairment. Appropriate interventions are needed due to the fact that treatment-induced transformations have been associated with a decline in overall quality of life, interpersonal and sexual difficulties, and adverse effects on therapeutic adherence. In the framework of integrative oncology, beauty therapy is an affordable and straightforward intervention that could be used in the clinical management of breast cancer side effects. This study aims to comprehend the emotional and lived experiences of women undergoing chemotherapy after a brief beauty therapy intervention with licensed beauticians. The Interpretative Phenomenological Analysis was used as a methodological guideline. Sixteen women were purposefully recruited in a day hospital of a cancer unit, where the beauty therapy was implemented. At the end of the intervention, data were gathered using a semi-structured interview with open-ended questions. A thematic analysis was performed on verbatim transcriptions. Findings support the proposal of beauty therapy for patients undergoing chemotherapy. Assuming a relational viewpoint, beauty therapy could improve patients' feelings about themselves and the way they feel about others, even if they do not declare a specific interest in their outward appearance.
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Affiliation(s)
- Denise Vagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| | | | | | | | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
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Vagnini D, Grassi MM, Saita E. Evaluating Somatic Experiencing ® to Heal Cancer Trauma: First Evidence with Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6412. [PMID: 37510644 PMCID: PMC10380079 DOI: 10.3390/ijerph20146412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
Somatic Experiencing® is a bio-psychological method for the treatment and prevention of trauma and chronic stress, which has never been investigated with breast cancer (BC) survivors. Eight weeks of web-based synchronous group sessions were structured between April and June 2022. Potential participants were recruited using a convenience sampling approach and through the collaboration of a public hospital in northern Italy and a non-profit association of BC women. Thirty-five eligible participants were enrolled and divided into an intervention group (n = 21) and a control group (n = 14). Anxiety, depression, distress (HADS), coping strategies (Mini-MAC), trauma reworking skills (PACT), and body image (BIS) were assessed at T0 and after 8 weeks (T1). Qualitative items concerning the most significant moments and learnings were completed at T1 by the intervention group. An independent t-test confirmed no between-group psychological differences at T0. As hypothesized, paired-sample t-tests showed decreases in anxiety, depression, distress (p < 0.05), and anxious preoccupation coping strategy (p < 0.001), but also improvements in forward focus (p < 0.05) and body image (p < 0.001) in the intervention group. The controls worsened over time with increases in hopeless/helplessness (p < 0.001) and avoidance (p < 0.05) coping strategies. Textual analyses extracted five dominant themes that summarized the meaning of the experience for participants. The preliminary results suggest the effectiveness of the intervention.
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Affiliation(s)
- Denise Vagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| | | | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
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Macciò A, Sanna E, Piras R, Lavra F, Vallerino V, Maricosu G, Giglio E, Mura A, Tidore M, Madeddu C. Survival as a clinical outcome and its spiritual significance in a cohort of patients with advanced central pelvic neoplastic disease undergoing total pelvic evisceration: a poorly debated issue. Front Med (Lausanne) 2023; 10:1173687. [PMID: 37359011 PMCID: PMC10288149 DOI: 10.3389/fmed.2023.1173687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Background Patients with either treatment-resistant or relapsing advanced central pelvic neoplastic disease present with a condition responsible for debilitating symptoms and consequently poor quality of life (QoL). For these patients, therapeutic strategies are very limited and total pelvic evisceration is the only option for relieving the symptoms and increasing survival. Of note, taking charge of these patients cannot be limited to increasing their lifespan but must also be aimed at improving the clinical, psychological, and spiritual conditions. This study aimed to prospectively evaluate the improvement in survival and QoL, focusing on spiritual wellbeing (SWB), in patients with poor life expectancy who underwent total pelvic evisceration for advanced gynecological cancers at our center. Patients and methods The QoL and SWB were assessed using the European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30), EORTC QLQ-SWB32, and SWB scale, which were repeatedly administered: 30 days before surgery, 7 days after the procedure, 1 and 3 months after surgery, and then every 3 months until death or the last follow-up assessment. Operative outcomes (blood loss, operative time, hospitalization, and incidence of complications) were evaluated as secondary endpoints. The patients and their families were included in a dedicated psycho-oncological and spiritual support protocol, which was managed by specifically trained and specialized personnel who accompanied them during all phases of the study. Results A total of 20 consecutive patients from 2017 to 2022 were included in this study. Of these patients, 7 underwent total pelvic evisceration by laparotomy and 13 underwent laparoscopy. The median survival was 24 months (range: 1-61 months). After a median follow-up of 24 months, 16 (80%) and 10 patients (50%) were alive at 1 year and 2 years after surgery, respectively. The EORTC-QLQ-C30 scores significantly improved yet at 7 days and at 1, 3, 6, and 12 months, as compared with the preoperative values. In particular, an early improvement in pain, overall QoL, and physical and emotional functions was observed. With respect to the SWB, the global SWB item score of the EORTC QLQ-SWB32 questionnaire significantly increased after 1 month and 3 months, as compared with preoperative values (p = 0.0153 and p = 0.0018, respectively), and remained stable thereafter. The mean SWB scale score was 53.3, with a sense of low overall SWB in 10 patients, a sense of moderate SWB in eight patients, and a sense of high SWB in two patients. The SWB scale score significantly increased after 7 days, 1 month, and 3 months, as compared with the preoperative value (p = 0202, p = 0.0171, and p = 0.0255, respectively), and remained stable thereafter. Conclusion Total pelvic evisceration is a valid approach for improving both survival and QoL in selected patients with advanced pelvic neoplasms and poor life expectancy. Our results particularly underline the importance of accompanying the patients and their families during the journey with dedicated psychological and spiritual support protocols.
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Affiliation(s)
- Antonio Macciò
- Unit of Obstetrics and Gynecology, Department of Gynecologic Oncology, ARNAS G. Brotzu, Cagliari, Italy
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Elisabetta Sanna
- Unit of Obstetrics and Gynecology, Department of Gynecologic Oncology, ARNAS G. Brotzu, Cagliari, Italy
| | - Roberta Piras
- Unit of Obstetrics and Gynecology, Department of Gynecologic Oncology, ARNAS G. Brotzu, Cagliari, Italy
| | - Fabrizio Lavra
- Unit of Obstetrics and Gynecology, Department of Gynecologic Oncology, ARNAS G. Brotzu, Cagliari, Italy
| | - Valerio Vallerino
- Unit of Obstetrics and Gynecology, Department of Gynecologic Oncology, ARNAS G. Brotzu, Cagliari, Italy
| | - Giovanni Maricosu
- Unit of Obstetrics and Gynecology, Department of Gynecologic Oncology, ARNAS G. Brotzu, Cagliari, Italy
| | - Emanuela Giglio
- Unit of Obstetrics and Gynecology, Department of Gynecologic Oncology, ARNAS G. Brotzu, Cagliari, Italy
| | | | | | - Clelia Madeddu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Park H, Kim KE, Moon E, Kang T. Psychometric Properties of Assessment Tools for Depression, Anxiety, Distress, and Psychological Problems in Breast Cancer Patients: A Systematic Review. Psychiatry Investig 2023; 20:395-407. [PMID: 37253465 DOI: 10.30773/pi.2022.0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/19/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE Various and accurate psychiatric assessments in patients with breast cancer who frequently suffer from psychological problems due to long-term survivors are warranted. This systematic review aimed to investigate the current evidence on psychometric properties of psychiatric assessment for evaluating psychological problems in breast cancer patients. METHODS This systematic review progressed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Four electronic databases such as Web of Science, PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched. This study protocol was registered on Open Science Framework. RESULTS Of the 2,040 articles, 21 papers were finally included. Among them, only five studies showed the performance of psychiatric assessment tools. Among 13 assessment tools used in the selected articles, the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), or Mini-Mental Adjustment to Cancer Scale was frequently used for the evaluation of psychological problems. The DT and Psychosocial Distress Questionnaire-Breast Cancer showed acceptable performances for the prediction of depression and anxiety assessed by the HADS. CONCLUSION This systematic review found psychiatric assessment tools with acceptable reliability and validity for breast cancer patients. However, comparative studies on reliability and validity of various scales are required to provide useful information for the selection of appropriate assessment tools based on the clinical settings and treatment stages of breast cancer. Joint research among the fields of psychiatry and breast surgery is needed for research to establish the convergent, concurrent, and predictive validity of psychiatric assessment tools in breast cancer patients.
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Affiliation(s)
- Heeseung Park
- Breast Cancer Clinic, Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Kyoung-Eun Kim
- Breast Cancer Clinic, Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Eunsoo Moon
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Taewoo Kang
- Breast Cancer Clinic, Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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7
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Saita E, Acquati C, Molgora S, Vagnini D, Piccolo EM, Valenti F, Stratta G, Grassi MM. Locally advanced breast cancer (LABC) and delayed care: a qualitative analysis of psychosocial factors. PSYCHOL HEALTH MED 2023; 28:408-418. [PMID: 35521977 DOI: 10.1080/13548506.2022.2073379] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The literature has extensively documented how delayed access to health care services in the context of cancer can result from subjective characteristics, dysfunctional coping styles, barriers to care, or procrastination. However, limited research has investigated the psychosocial experience of women diagnosed with Locally Advanced Breast Cancer (LABC). This qualitative study aimed at understanding cognitive, emotional and relational factors associated with delayed access to care and treatment decision-making. In-depth interviews with 14 Italian women were conducted. A thematic analysis of elementary contexts using T-LAB was used to identify the association between emerging clusters and participants' coping styles as measured by the Mini-MAC. Five clusters were identified: 'relationships', 'ineluctability', 'disease', 'surgery', and 'diagnosis'. The 'relationships' cluster was characterized by elevated rates of Fighting Spirit (p < 0.01) while Anxious Preoccupation was associated with 'surgery' (p < 0.01). Findings contribute to explain individual and relational variables related to delay seeking care of LABC patients by illustrating the interplay of personal motivations and social networks' characteristics. Evidence from this work expands current understanding of the interplay of factors contributing to delays in seeking medical attention and may be utilized to inform strategies to timely identify women at greater risk.
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Affiliation(s)
- Emanuela Saita
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, USA.,Department of Clinical Sciences, College of Medicine, University of Houston, Houston, TX, USA.,Department of Health Disparities Research, The UT MD Anderson Cancer Center, Houston, TX, USA
| | - Sara Molgora
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
| | - Denise Vagnini
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
| | | | | | - Gregorio Stratta
- Breast Unit, Humanitas Gavazzeni Clinical Institute, Bergamo, Italy
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8
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Coping with cancer: the role of different sources of psychosocial support and the personality of patients with cancer in (mal)adaptive coping strategies. Support Care Cancer 2022; 31:27. [PMID: 36513853 DOI: 10.1007/s00520-022-07454-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/02/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Cancer is a serious event in a person's life. However, certain coping strategies in relation to selected social, emotional, and personality factors appear to manage the disease. METHODS Sources of social support were tested in cancer survivors (N = 696) using hierarchical linear regression. Selected personality variables in terms of sociodemographic, clinical, and emotional factors were used as predictors of adaptive and maladaptive coping strategies. RESULTS It was found that adaptive coping strategies were more frequent in younger patients, in patients who attended cancer support groups and those with a greater level of optimism. Maladaptive coping was related to the higher level of experience of pain and sadness, neuroticism, and pessimism. The absence of a relapse and the time since the disease had been diagnosed were also important factors in coping with cancer. CONCLUSIONS The results point to the importance of considering various individual factors in the process of intervention to facilitate adaptive coping and to reduce maladaptive coping.
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Serpentini S, Silvestri G, Catarinella A, Cristaldi G, Borgese C, Deledda G, Sommacal S, Iannopollo L, Calvo V, Ronconi L, Merluzzi TV. Assessment of socio-relational self-efficacy in breast cancer patients: Italian validation of the social relationship coping efficacy scale (SRCE-I). BMC Psychol 2022; 10:248. [PMID: 36329538 PMCID: PMC9632030 DOI: 10.1186/s40359-022-00966-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Social relationship coping efficacy (SRCE) represents the ability to maintain or enhance social relationships in the context of serious illness. The purpose of the current study was to confirm the factor structure, psychometric properties, and utility of the Italian version of the SRCE scale. METHODS 181 breast cancer patients completed the SRCE-Italian (SRCE-I), the Cancer Behavior Inventory-Brief/Italian (CBI-B/I), quality of life (QOL) measures (EORTC QLQ-C30; EORTC QLQ-BR23), and the Hospital Anxiety and Depression Scale (HADS). RESULTS The SRCE-I was internally consistent (Cronbach alpha = .95) and factor analysis confirmed that the SRCE-I was a unidimensional construct. In terms of validity, the SRCE-I was correlated with QOL (EORTC QLQ-30, Social Functioning, r = .33, Emotional Functioning, r = .57, and Global Health/Quality of Life; r = .54) and scales of the EORTC QLQ-BR23 (e.g., Future Perspective, r = .38; Breast Symptoms, -.31). SRCE-I was also correlated negatively with the HADS (r = -.72) and positively with the CBI-B/I (r = .79), a measure of coping efficacy (all ps < .001). Mediation analyses confirmed the utility of the SRCE-I scale as a mediating mechanism in enhancing social functioning and QOL. CONCLUSIONS The SRCE-I is a structurally sound, reliable, and valid measure that assesses the ability to maintain or enhance social support and mitigate the loss of social support. The SRCE-I can be used as a screening measure to assess low efficacy for maintaining social support or as a measure to detect the change in efficacy for enhancing social support in interventions to improve the QOL of patients.
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Affiliation(s)
- Samantha Serpentini
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Giulia Silvestri
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Antonio Catarinella
- grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy
| | - Grazia Cristaldi
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Caterina Borgese
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Giuseppe Deledda
- grid.416422.70000 0004 1760 2489Sacro Cuore Hospital- Don Calabria-IRCCS of Negrar (VR), Negrar, Italy
| | | | - Letizia Iannopollo
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Vincenzo Calvo
- grid.5608.b0000 0004 1757 3470Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padua, Padua, Italy
| | - Lucia Ronconi
- grid.5608.b0000 0004 1757 3470Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padua, Padua, Italy
| | - Thomas V. Merluzzi
- grid.131063.60000 0001 2168 0066Department of Psychology, University of Notre Dame, Notre Dame, IN USA
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Adamkovič M, Fedáková D, Kentoš M, Bozogáňová M, Havrillová D, Baník G, Dědová M, Piterová I. Relationships between satisfaction with life, posttraumatic growth, coping strategies, and resilience in cancer survivors: A network analysis approach. Psychooncology 2022; 31:1913-1921. [PMID: 35524705 PMCID: PMC9790334 DOI: 10.1002/pon.5948] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/24/2022] [Accepted: 04/30/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Cancer survivors' satisfaction with life should be seen through the psychological factors related to a person's capabilities to face and handle the situation. This study aimed to (1) examine the relationships of satisfaction with life, posttraumatic growth, resilience and coping strategies in a global network model, (2) find the bridge indicators between satisfaction with life and the other constructs, and (3) test for the invariance of the network structures across several moderating variables. METHODS In a heterogeneous sample of 696 cancer survivors (69% female; mean age = 53.1 ± 15.44 years; median time from being diagnosed = 4 years; breast cancer was the most frequent type of cancer) their satisfaction with life, resilience, coping strategies and posttraumatic growth was measured. In order to account for their complexity, the relationships between the constructs were explored using a network analysis approach. RESULTS The network analysis shows that satisfaction with life is strongly connected to resilience, moderately connected to coping strategies, and has a weak connection with posttraumatic growth. In the separate networks, the relationships between the psychological constructs were examined in greater detail. Besides some exceptions observed in the degree of disability, the networks were invariant across gender, age, years since being diagnosed, cancer type and treatment type. CONCLUSION The findings suggest that interventions focused on cancer survivors' coping strategies and resilience could help increase their satisfaction with life. However, further replication of the proposed and/or modified model is needed.
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Affiliation(s)
- Matúš Adamkovič
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
- Institute of PsychologyFaculty of ArtsUniversity of PrešovPrešovSlovakia
- Faculty of Humanities and Social SciencesUniversity of JyväskyläJyväskyläFinland
| | - Denisa Fedáková
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
| | - Michal Kentoš
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
| | - Miroslava Bozogáňová
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
| | - Dominika Havrillová
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
- Department of PsychologyFaculty of ArtsPavol Jozef Šafárik UniversityKošiceSlovakia
| | - Gabriel Baník
- Institute of PsychologyFaculty of ArtsUniversity of PrešovPrešovSlovakia
| | - Mária Dědová
- Department of PsychologyFaculty of ArtsUniversity of TrnavaTrnavaSlovakia
| | - Ivana Piterová
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
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11
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Costanzo G, Marchetti D, Manna G, Verrocchio MC, Falgares G. The role of eating disorders features, psychopathology, and defense mechanisms in the comprehension of orthorexic tendencies. Eat Weight Disord 2022; 27:2713-2724. [PMID: 35648315 PMCID: PMC9556392 DOI: 10.1007/s40519-022-01417-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/07/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Recent studies pointed out the importance to distinguish orthorexia nervosa (ON) from non-problematic forms of interest with healthy eating. This distinction needs to be further explored since it may favor a better comprehension of the relationship between orthorexic behaviors and psychopathology and lead to an improved understanding of the psychological processes implicated in ON. Therefore, the aim of the current study was to investigate the associations between ON and the core features of eating disorders (EDs), psychopathological symptoms and defense mechanisms, by differentiating three groups of individuals: an ON symptoms group, a healthy-eating control group, and a normal-eating control group. METHODS College students (n = 270, Mage = 21.57, SD = 2.16) were recruited from Palermo's University, in the south of Italy, and were assigned to three groups: 52 in the ON symptoms group, 157 in the healthy-eating control group and 61 in the normal-eating control group. Participants completed four questionnaires assessing ON (EHQ-21), eating psychopathology (EDI-3), psychopathological symptoms (BSI) and defense mechanisms (DSQ-40). RESULTS Compared to the control groups, the ON symptoms group reported greater EDs' features, higher psychopathological symptoms and greater employment of different neurotic and immature defense mechanisms. No differences were found between groups with regard to obsessive-compulsive symptoms. CONCLUSION Our findings support the notion that ON behaviors should be carefully distinguished from non-problematic forms of interest with healthy eating. Indeed, results suggest that ON individuals are characterized by similar clinical features and defensive functioning as those observed in traditional EDs, indicating the importance of deepening our understanding of the relationship between these conditions. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Giulia Costanzo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, G. d'Annunzio University of Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Giovanna Manna
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Maria Cristina Verrocchio
- Department of Psychological, Health and Territorial Sciences, G. d'Annunzio University of Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy.
| | - Giorgio Falgares
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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12
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Cancer-related posttraumatic growth and posttraumatic stress: how are they connected and what are their correlates? Support Care Cancer 2022; 30:8183-8192. [PMID: 35796888 DOI: 10.1007/s00520-022-07252-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Cancer is a stressful life event that can lead to specific posttraumatic reactions. Posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) are two main posttraumatic reactions that are related to each other, and both have different correlates. METHODS The linearity of the relationship between PTG and PTSS and the different socio-demographic, cancer-related, emotional, and psychological correlates were analyzed in patients with cancer (N = 126). RESULTS The relationship between PTG and PTSS was found to be more curvilinear than linear. PTSS was more strongly related to psychological factors (e.g., anxious preoccupation, hope-helplessness, and resilience) while PTG was strongly related to existential factors (e.g., self-transcendence and religiosity). CONCLUSION The results show that cancer-related PTSS and PTG are specifically related constructs which are related differently to particular correlates. Specifically, the greatest differences were observed in the psychological variables. In the early phases, therapeutic interventions focused on variables related to PTSS can lead to the reduction of PTSS. In follow-up phases, the therapeutic intervention focused on the increase of the level of variables related to PTG can help the development of PTG.
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13
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Saita E, Ferraris G, Acquati C, Molgora S, Sorge A, Valenti F, Grassi MM, Vagnini D. Dyadic Profiles of Couples Coping With Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis. Front Psychol 2022; 13:869905. [PMID: 35401315 PMCID: PMC8983958 DOI: 10.3389/fpsyg.2022.869905] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer treatments have multiple adverse effects, including concerns about body appearance and function that are experienced by most patients. Altered body image negatively affects mental health, social, and relationship functioning. While the relationship with a partner is critical for patients’ psychological wellbeing and partners can promote positive body image, limited research has investigated individual and relational factors affecting the experience of both. This cross-sectional study aimed at (1) exploring rates of body image concerns among breast cancer patients, and (2) identifying dyadic profiles among participating dyads. Couples composed by patients who had undergone surgery and their romantic partners (n = 32) were recruited from the Breast Unit of a hospital in northern Italy. Both partners completed measures of personality characteristics (BFQ-2), psychological distress (HADS), coping flexibility (PACT), dyadic coping (DCQ), and closeness (IOS). Body image (BIS) and adjustment to cancer (Mini-MAC) measures were completed by patients only. K-mean cluster analyses identified 2-cluster solution among patients and partners, respectively. “Active patients” (cluster-1) reported low rates of body image concerns (p < 0.001), anxious preoccupation, negative dyadic coping, and self-oriented stress communication (p < 0.05), compared to “worried patients” (cluster-2). “Comfortable partners” (cluster-1) reported lower anxiety and depression (p < 0.001), self-oriented negative dyadic coping and closeness (p < 0.05) than “uncomfortable partners” (cluster-2). Three different dyadic profiles emerged: functional, dysfunctional, and ambivalent. Significant variations (p < 0.05) by anxiety, depression, and delegating dyadic coping existed. Results indicate there are groups of couples at greater risk for impaired psychological distress and body image concerns, which should be addressed in the context of dyadic psychosocial interventions.
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Affiliation(s)
- Emanuela Saita
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States.,Department of Clinical Sciences, College of Medicine, University of Houston, Houston, TX, United States.,Department of Health Disparities Research, The UT MD Anderson Cancer Center, Houston, TX, United States
| | - Sara Molgora
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Antonia Sorge
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | | | | | - Denise Vagnini
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
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14
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Mirandola M, Andreis F, Abdel Kader S, Bianchetti M, Runcan M, Malighetti C, Meriggi F, Zaniboni A. Cancer and Covid-19: a preliminary study on the trauma aspects of Coronavirus in cancer patients. Psychooncology 2022; 31:1340-1346. [PMID: 35394096 PMCID: PMC9088541 DOI: 10.1002/pon.5936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 11/07/2022]
Abstract
Objective Because of Covid 19, it has become necessary to revise the treatment of cancer patients (“how” and “when”). That has had important psychological repercussions. The purpose of this study is the evaluation of the impact of Covid19 in terms of Post‐Traumatic Stress Disorder and Depression and the potential association with coping strategies. Methods We conducted an exploratory study with 106 patients undergoing treatment, using following questionnaires: Screening Questionnaire for Disaster Mental Health and Mini‐Mental Adjustment to Cancer. Results Only 25.5% of our sample showed symptoms of posttraumatic stress disorder (PTSD) and 6.6% revealed a probable presence of depression. In addition, it came up a significant correlation between SQD_P and the coping styles “Hopelessness” (r = 0.41 p < 0.001) and “Anxious Preoccupation” (r = 0.45, p < 0.001). A strong correlation also emerged between non‐Covid 19 patients and PTSD (r = 0.29, p = 0.002). Conclusions Our preliminary data did not reveal a prevalence of PTSD, but the persistence of the health emergency requires to focus future research on protective and risk factors related to PTSD and psychological distress in cancer patients, in order to reduce the mental health burden of Covid19.
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Affiliation(s)
- Mara Mirandola
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Federica Andreis
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Sonia Abdel Kader
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Margherita Bianchetti
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Mariana Runcan
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Clelia Malighetti
- Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milano, Italy
| | - Fausto Meriggi
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Alberto Zaniboni
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
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15
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Longares Segarra M, Beleña Mateo MÁ. Sentido de la enfermedad y afrontamiento en pacientes con cáncer de cabeza y cuello. PSICOONCOLOGIA 2022. [DOI: 10.5209/psic.80795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
El cáncer entraña la necesidad de llevar a cabo una movilización de los recursos físicos, instrumentales y psicológicos para lograr una adaptación óptima de la persona enferma a su nueva situación. Asimismo, el sufrimiento derivado de la enfermedad lleva a los pacientes a plantearse el sentido de la misma y genera cambios en distintas áreas de la vida. Objetivo: explorar el sentido que la enfermedad posee para los pacientes con cáncer de cabeza y cuello (en adelante CCC) y los cambios derivados de ésta, en relación con las relaciones interpersonales y prioridades vitales de éstos. En segundo lugar, explorar la relación del afrontamiento del cáncer en función del sentido dado a la enfermedad. Método: la muestra está constituida por 114 pacientes diagnosticados de CCC. Se utilizaron los siguientes instrumentos de evaluación: cuestionario de datos sociodemográficos elaborado ad hoc y Mini-Mental Adjustment to Cancer Scale (Mini-MAC). Resultados: los pacientes que han dado un sentido negativo a la enfermedad se caracterizan por una mayor evitación cognitiva. Aquellos que han experimentado cambios positivos en sus relaciones personales se caracterizan por afrontar la enfermedad con mayor espíritu de lucha, y los que han vivenciado cambios en sentido negativo afrontan su enfermedad con mayor desamparo/desesperanza. Los pacientes que se dan prioridad a sí mismos obtienen una puntuación más elevada en fatalismo (U = 124,0), con respecto a los que tienen como prioridad su familia y los demás. Conclusión: se ha hallado una relación entre el sentido positivo y los cambios positivos en las relaciones personales con un afrontamiento más adaptativo de la enfermedad. Y un afrontamiento menos adaptativo para quienes tienen como meta sus propias personas, en lugar de la familia o los demás.
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16
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Czerw A, Religioni U, Szymański F, Nieradko-Heluszko A, Mękal D, Hering D, Kowalczuk A, Merks P, Borowska M, Bogdan M, Pajewska M. Normalization of the Mini-MAC (Mental Adjustment to Cancer) Questionnaire among Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312603. [PMID: 34886329 PMCID: PMC8656664 DOI: 10.3390/ijerph182312603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022]
Abstract
Cancer is associated with discomfort and many changes in patients’ lives to which they must adapt. The main objective of the study was to assess the use of the mini-MAC questionnaire scale among persons diagnosed with malignant cancer and to develop standards allowing differentiation of patients with diagnosed cancer in terms of their style of adjustment to the disease. The mini-MAC questionnaire is a widely used tool in assessing coping strategies among cancer patients. Sten standards have been developed to determine the level of results on the questionnaire scales in the low–average–high categories. The study included 1187 patients diagnosed with malignant cancer who are covered by outpatient care at the Maria Sklodowska-Curie Institute—Oncology Center in Warsaw. The questionnaire concerning mental adjustment to cancer was used (mini-MAC). Patients with cancer most often adopt strategies of fighting spirit and positive reevaluation. The variables that differentiate the results most significantly include gender, presence of metastasis, and the state of undergoing chemotherapy. The mini-MAC questionnaire should be a tool for psycho-oncological diagnosis of patients’ attitudes towards cancer. The obtained results indicate that cancer patients are characterized by their constructive style of adjustment to the disease.
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Affiliation(s)
- Aleksandra Czerw
- Department of Health Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Department of Economic and System Analyses, National Institute of Public Health—NIH—National Research Institute, 00-791 Warsaw, Poland;
- Correspondence:
| | - Urszula Religioni
- Collegium of Business Administration, Warsaw School of Economics, 02-513 Warsaw, Poland;
| | - Filip Szymański
- Departament of Civilization Diseases, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Kazimierza Woycickiego 1 Street, 01-938 Warsaw, Poland;
| | - Agnieszka Nieradko-Heluszko
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, 70-103 Szczecin, Poland;
| | - Dominika Mękal
- Department of Oncological Prevention, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Dagmara Hering
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | | | - Piotr Merks
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, 01-938 Warszawa, Poland;
| | - Mariola Borowska
- Department of Health Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Magdalena Bogdan
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland;
| | - Monika Pajewska
- Department of Economic and System Analyses, National Institute of Public Health—NIH—National Research Institute, 00-791 Warsaw, Poland;
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17
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Guariglia L, Ieraci S, Villani V, Tanzilli A, Benincasa D, Sperati F, Terrenato I, Pace A. Coping Style in Glioma Patients and Their Caregiver: Evaluation During Disease Trajectory. Front Neurol 2021; 12:709132. [PMID: 34539556 PMCID: PMC8440902 DOI: 10.3389/fneur.2021.709132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Patients with glioma have a poor prognosis and, in a short period of time, have to deal with severe forms of disability, which compromise their psychological distress and quality of life. The caregivers of these patients consequently carry a heavy burden in terms of emotional and patient care. The study aims to evaluate the coping strategies of patients and their caregivers during the course of the disease in order to frame the adaptation process in a rapidly progressing pathology. Methods: A prospective study on 24 dyads of patients affected by malignant glioma and their caregivers was conducted between May 2016 and July 2018. Questionnaires designed to identify the coping style (MINI-MaC Scale) and psychological distress (HADS scores) and assess QOL (EQ-5D) were administered at two time points: at first lines of treatment and at disease recurrence. Results: Patients and their caregiver structure adaptive coping strategies during the disease: a coping style oriented toward a fighting spirit prevails at baseline (Mini-Mac Mean 3.23); fatalism prevails at recurrence (Mini-Mac Mean 3.03). Psychological distress affects the coping style expressed: high levels of anxiety symptoms were found to be significantly associated with a coping style oriented toward anxious preoccupation, helpless–hopeless, and fatalism; low depressive symptoms were inversely correlated with fighting spirit coping style. Patients' and caregivers' perceptions of quality of life were correlated between them and with performance status assessed by clinicians. In a dyadic perspective, the adaptation of a member of the couple varies as a function of the other partner's coping style. Conclusions: Our data are in line with previous literature on cancer patients, demonstrating that coping style is not a persistent dimension of personality, but can change depending on the situation. Despite the disease rapid course, patients and their caregivers can structure adaptive and functional defenses to manage the disease.
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Affiliation(s)
- Lara Guariglia
- Psychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena Cancer Institute, Rome, Italy
| | - Sonia Ieraci
- Psychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena Cancer Institute, Rome, Italy
| | - Veronica Villani
- Neuro-Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena Cancer Institute, Rome, Italy
| | - Antonio Tanzilli
- Neuro-Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena Cancer Institute, Rome, Italy
| | - Dario Benincasa
- Neuro-Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena Cancer Institute, Rome, Italy
| | - Francesca Sperati
- Biostatistics and Bioinformatic Unit-Scientific Direction, Istituto di Ricovero e Cura a Carattere Scientifico San Gallicano Dermatological Insititute, Rome, Italy
| | - Irene Terrenato
- Biostatistics and Bioinformatic Unit-Scientific Direction, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Pace
- Neuro-Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena Cancer Institute, Rome, Italy
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18
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Ragala MEA, El Hilaly J, Amaadour L, Omari M, AsriI AEL, Atassi M, Benbrahim Z, Mellas N, Rhazi KEL, Halim K, Zarrouq B. Validation of Mini-Mental Adjustment to Cancer scale in a Moroccan sample of breast cancer women. BMC Cancer 2021; 21:1042. [PMID: 34544362 PMCID: PMC8454091 DOI: 10.1186/s12885-021-08755-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 09/06/2021] [Indexed: 12/24/2022] Open
Abstract
Background The Mini-Mental Adjustment to Cancer Scale (Mini-MAC) instrument is commonly used worldwide by professionals of oncology, but the scale has not, up to date, been validated in Arabic and Moroccan context, and there is an absence of data in the Moroccan population. This study aims to validate the Mini-MAC, translated and adapted to the Arabic language and Moroccan culture, in women with breast cancer. Methods Data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 158). Then, this structure was confirmed in the validation sample (N = 203) using confirmatory factor analysis (CFA). Results Confirmatory factor analysis confirmed Watson’s original structure underlying the Mini-MAC items: Helpless/Hopeless, Anxious Preoccupation, Fighting Spirit, Cognitive Avoidance, and Fatalism. Absolute, incremental, and parsimonious fit indices showed a highly significant level of acceptance confirming a good performance of the measurement model. The instrument showed sufficient reliability and convergent validity demonstrated by acceptable values of composite reliability (CR =0.93–0.97), and average variance extracted (AVE = 0.66–0.93), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio of correlations values were lesser than 0.85, indicating acceptable discriminant validity. Conclusions reliability; and both convergent and discriminant validity tests indicated that the Arabic version of the Mini-MAC had a good performance and may serve as a valid tool measuring psychological responses to cancer diagnosis and treatment.
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Affiliation(s)
- Mohammed El Amine Ragala
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, P. B 1796 Atlas, 30003, Fez, Morocco.,Teachers Training College (Ecole Normale Superieure), Department of Biology and Geology, Sidi Mohamed Ben Abdellah University, P. B 5206 Bensouda, 30030, Fez, Morocco
| | - Jaouad El Hilaly
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRMEF) of Fez. Rue Koweit, P.B 49 Agdal, 30050, Fes, Morocco.,R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, P. B 1223, Route Oujda, 35000, Fez, Morocco
| | - Lamiae Amaadour
- Medical Oncology Department, Hassan II University Hospital, Route Sidi Harazem, 30070, Fez, Morocco
| | - Majid Omari
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, P. B 1796 Atlas, 30003, Fez, Morocco.,Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, 2.200 Route Sidi Harazem, 30070, Fez, KM, Morocco
| | - Achraf E L AsriI
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, 2.200 Route Sidi Harazem, 30070, Fez, KM, Morocco
| | - Mariam Atassi
- Laboratory of Epidemiology, Clinical Research, and Public Health, Faculty of Medicine and Pharmacy, Mohamed I University, BP724 Hay Al Quods, 60000, Oujda, Morocco.,Mohamed VI University Hospital, Oujda, Morocco
| | - Zineb Benbrahim
- Medical Oncology Department, Hassan II University Hospital, Route Sidi Harazem, 30070, Fez, Morocco
| | - Nawfel Mellas
- Medical Oncology Department, Hassan II University Hospital, Route Sidi Harazem, 30070, Fez, Morocco
| | - Karima E L Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, 2.200 Route Sidi Harazem, 30070, Fez, KM, Morocco
| | - Karima Halim
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, P. B 1796 Atlas, 30003, Fez, Morocco.,Teachers Training College (Ecole Normale Superieure), Department of Human and Social Sciences - Education Sciences, Sidi Mohamed Ben Abdellah University, P. B 5206 Bensouda, 30030, Fez, Morocco
| | - Btissame Zarrouq
- Teachers Training College (Ecole Normale Superieure), Department of Biology and Geology, Sidi Mohamed Ben Abdellah University, P. B 5206 Bensouda, 30030, Fez, Morocco. .,Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, 2.200 Route Sidi Harazem, 30070, Fez, KM, Morocco.
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19
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De Padova S, Grassi L, Vagheggini A, Belvederi Murri M, Folesani F, Rossi L, Farolfi A, Bertelli T, Passardi A, Berardi A, De Giorgi U. Post-traumatic stress symptoms in long-term disease-free cancer survivors and their family caregivers. Cancer Med 2021; 10:3974-3985. [PMID: 34061453 PMCID: PMC8209622 DOI: 10.1002/cam4.3961] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/25/2022] Open
Abstract
Background The experience of cancer is highly stressful and potentially traumatic. We assessed the presence of Post‐Traumatic Stress Symptoms (PTSS) in long‐term cancer survivors and their caregivers, while examining the association between PTSS and clinical, demographic and psychological variables in the long term. Methods In this cross‐sectional study 212 survivor‐family caregiver dyads completed measures of post‐traumatic stress symptoms (PTSS) (Impact of Event Scale), depression and anxiety (Hospital Anxiety Depression Scale). Coping strategies, fatigue, cognitive decline, stressful life events and psychopathological history were also assessed among survivors. Data were analyzed using mixed models, accounting both for individual and dyadic effects. Results Cancer survivors and their caregivers were assessed after a mean of 6 years after treatment. Twenty per cent of survivors and 35.5% of caregivers had possible posttraumatic stress disorder (PTSD), while 23 patients (11.0%) and 33 caregivers (15.6%) had probable PTSD. Among cancer patients, the severity of post‐traumatic symptoms was associated with an anxious coping style, previous psychopathology and depression (p < 0.001), whereas among caregivers it was associated with depression and having a closer relationship with patients (p < 0.001). Patients’ depression was associated with caregivers’ intrusion symptoms. Conclusions High levels of cancer‐related PTSS were still present several years after treatment in both survivors and caregivers. Psychopathology may derive from complex interactions among coping, previous disorders and between‐person dynamics.
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Affiliation(s)
- Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Luigi Grassi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara and University Hospital Psychiatry Unit, Integrated Department of Mental Health S. Anna University Hospital and Health Authorities, Anna University Hospital, Ferrara, Italy
| | - Alessandro Vagheggini
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Martino Belvederi Murri
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara and University Hospital Psychiatry Unit, Integrated Department of Mental Health S. Anna University Hospital and Health Authorities, Anna University Hospital, Ferrara, Italy
| | - Federica Folesani
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara and University Hospital Psychiatry Unit, Integrated Department of Mental Health S. Anna University Hospital and Health Authorities, Anna University Hospital, Ferrara, Italy
| | - Lorena Rossi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alberto Farolfi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Tatiana Bertelli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alessandro Passardi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alejandra Berardi
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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20
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Bongelli R, Bertolazzi A, Piccioni L, Burro R. Italian onco-haematological patients' preferences in bad news communication: a preliminary investigation. BMC Cancer 2021; 21:555. [PMID: 34001021 PMCID: PMC8127256 DOI: 10.1186/s12885-021-08181-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The manner in which bad news is communicated in oncological contexts can affect patients' engagement, their coping strategies and therapeutic compliance. Although this topic has been broadly investigated since the nineties, to the best of our knowledge, little has been written about Italian patients' experiences and preferences concerning what the oncologists should disclose and how they should intimate patients about their health conditions in different stages of oncological disease. METHODS In an attempt to fill this gap, an online self-report questionnaire was administered to a sample of Italian onco-haematological patients. Data were analysed both qualitatively (by a content analysis) and quantitatively (by descriptive analysis and Generalized Linear Mixed Model). RESULTS While the majority of patients elected to know the truth during their clinical course, a polarisation between those arguing that the truth be fully disclosed and those claiming that the truth be communicated in a personalised way was observed at the attitude level. Among demographic variables accounted for, age seems to most affect patients' preferences. Indeed, younger Italian patients decidedly reject concealment of the truth, even when justified by the beneficence principle. This result could be a reaction to some protective and paternalistic behaviours, but it could even reflect a relation according to which the more the age increases the more the fear of knowing rises, or an intergenerational change due to different ways of accessing the information. The qualitative analysis of the final open-ended question revealed three main sources of problems in doctor-patient encounters: scarcity of time, absence of empathy and use of not-understandable language that makes it difficult for patients to assume a more active role. CONCLUSIONS The results of the present study, which represents a preliminary step in the subject investigation, will be deployed for the construction and validation of a more sophisticated questionnaire. Better awareness of the Italian onco-haematological patients' preferences concerning bad news communication and truth-telling could be useful in adopting more suitable medical practices and improving doctor-patient relationships.
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Affiliation(s)
- Ramona Bongelli
- Department of Political Science, Communication and International Relations, University of Macerata, Via Don Minzoni 22/A, 62100, Macerata, Italy.
| | - Alessia Bertolazzi
- Department of Political Science, Communication and International Relations, University of Macerata, Via Don Minzoni 22/A, 62100, Macerata, Italy
| | - Ludovica Piccioni
- Department of Political Science, Communication and International Relations, University of Macerata, Via Don Minzoni 22/A, 62100, Macerata, Italy
| | - Roberto Burro
- Department of Human Sciences, University of Verona, Verona, Italy
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21
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Gutiérrez Hermoso L, Velasco Furlong L, Sánchez-Román S, Salas Costumero L. The Importance of Alexithymia in Post-surgery. Differences on Body Image and Psychological Adjustment in Breast Cancer Patients. Front Psychol 2020; 11:604004. [PMID: 33391123 PMCID: PMC7775299 DOI: 10.3389/fpsyg.2020.604004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/30/2020] [Indexed: 12/22/2022] Open
Abstract
Breast cancer is a disease that is difficult to face and that often hinders body acceptance. Body changes due to surgery can be very emotionally challenging for those who experience them. The aim of this study is to explore the differences on body image and psychological adjustment on women with breast cancer with high and low alexithymia according to the type of surgery. In this cross-sectional study, 119 women diagnosed with breast cancer (stages I, II, and III) were evaluated with different self-report questionnaires. Afterward, patients were divided into two groups (high and low levels of alexithymia) to analyze dependent variables (body image and psychological adjustment) according to the type of surgery (radical mastectomy or breast conserving therapy). The results of the General Linear Model suggest that when patients show high alexithymia combined with having undergone a radical mastectomy, they show higher levels of Hopelessness. Furthermore, in patients with high alexithymia, higher scores of maladaptive coping styles and greater distortion of body image were found. Alexithymia seems to play an important role in the way in which women cope with their disease, especially in those with radical mastectomy.
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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
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22
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Grassi L, Belvederi Murri M, Riba M, de Padova S, Bertelli T, Sabato S, Nanni MG, Caruso R, Ounalli H, Zerbinati L. Hostility in cancer patients as an underexplored facet of distress. Psychooncology 2020; 30:493-503. [PMID: 33205480 DOI: 10.1002/pon.5594] [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: 08/26/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE In the present study, we aimed to assess hostility and to examine its association with formal psychiatric diagnosis, coping, cancer worries, and quality of life in cancer patients. METHODS The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) to make an ICD-10 (International Classification of Disease) psychiatric diagnosis was applied to 516 cancer outpatients. The patients also completed the Brief Symptom Inventory-53 to assess hostility (BSI-HOS), and the Mini-Mental Adjustment to cancer scale (Mini-MAC). A subset of patients completed the Cancer Worries Inventory (CWI), the Openness Scale, and the Quality of Life Index. RESULTS By analyzing the distribution of the responses 25% of the patients had moderate and 11% high levels of hostility, with about 20% being BSI-HOS "cases." Hostility was higher in patients with a formal ICD-10 psychiatric diagnosis (mainly major depression, other depressive disorders, anxiety disorders) than patients without ICD-10 diagnosis. However, about 25% of ICD-10-non cases also had moderate-to-high hostility levels. Hostility was associated with Mini-MAC hopelessness and anxious preoccupation, poorer quality of life, worries (mainly problems sin interpersonal relationships), and inability to openly discuss these problems within the family. CONCLUSIONS Hostility and its components should be considered as dimensions to be more carefully explored in screening for distress in cancer clinical settings for its implications in negatively impacting on quality of life, coping and relationships with the family, and possibly the health care system.
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Affiliation(s)
- Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
| | - Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
| | - Michelle Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Depression Center, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Psycho-oncology Program, Ann Arbor, Michigan, USA
| | - Silvia de Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Tatiana Bertelli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Silvana Sabato
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
| | - Rosangela Caruso
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
| | - Heifa Ounalli
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
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23
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Ghiggia A, Bianco A, Castelli L, Baratta F, Birocco N, Scaldaferri M, Milla P, Tesio V, Rosso S, Torta R, Brusa P, Cattel F. Adherence to oral chemotherapy: Evidence from a randomised clinical trial. Eur J Cancer Care (Engl) 2020; 30:e13336. [PMID: 33006220 DOI: 10.1111/ecc.13336] [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: 01/29/2020] [Revised: 06/23/2020] [Accepted: 08/19/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate the efficacy of a reinforcement message (RM) administered by a hospital pharmacist on adherence, through a randomised study involving patients undergoing oral chemotherapy from which an objective outcome measure and patients' subjective opinions were collected. A secondary aim was to detect which psychological or clinical factors influence adherence. METHODS Forty patients were enrolled and randomised to an experimental group (EG) or a control group (CG). The EG received a 10-minute RM provided by a hospital pharmacist with a doctor and a nurse. The CG received the standard of care. To measure adherence, plasma drug concentration and subjective evaluation were taken during the visits, in addition to a psychological assessment (coping strategies, psychological distress and personality traits). RESULTS The EG reported higher drug levels and a statistically significant higher mean score on the subjective evaluation. A linear regression model highlighted statistically significant differences in the plasma drug concentration, after considering toxicity and dose reduction and controlling for the Reward Dependence Scale of the Temperament and Character Inventory between the EG and the CG. CONCLUSION Adequate information and education on the therapy, using an RM strategy provided by a hospital pharmacist, seems to positively influence adherence to the treatment.
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Affiliation(s)
- Ada Ghiggia
- Clinical Psychology Unit, Città della Salute e della Scienza, Turin, Italy.,Department of Psychology, University of Turin, Turin, Italy
| | | | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
| | - Francesca Baratta
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Nadia Birocco
- Department of Oncology, Città della Salute e della Scienza, Turin, Italy
| | | | - Paola Milla
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | | | - Stefano Rosso
- Piedmont Cancer Registry, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology Unit, Città della Salute e della Scienza, Turin, Italy
| | - Paola Brusa
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Francesco Cattel
- Hospital Pharmacy, Città della Salute e della Scienza, Turin, Italy
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24
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Calderon C, Lorenzo-Seva U, Ferrando PJ, Gómez-Sánchez D, Ferreira E, Ciria-Suarez L, Oporto-Alonso M, Fernández-Andujar M, Jiménez-Fonseca P. Psychometric properties of Spanish version of the Mini-Mental Adjustment to Cancer Scale. Int J Clin Health Psychol 2020; 21:100185. [PMID: 33363578 PMCID: PMC7753027 DOI: 10.1016/j.ijchp.2020.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/16/2020] [Indexed: 12/19/2022] Open
Abstract
Background/Objective The aim of the study was to examine the factor structure and psychometric properties of the Spanish version of the Mini-Mental Adjustment to Cancer Scale (Mini-MAC) in a large sample of patients with non-metastatic, resected cancer. Methods Prospective, observational, multicenter study for which 914 patients were recruited from 15 Spanish hospitals. Exploratory and confirmatory factor analyses, validity and reliability analyses were conducted. Results Factor-analytic results indicated a 4-factor structure of the Spanish version of the Mini-MAC. Three subscales have psychometric properties similar to those of Helplessness, Anxious preoccupation, and Cognitive avoidance of the original the Mini-MAC. The Fighting spirit and the Fatalism subscales were combined on the Positive attitude scale. The four factor-derived scale scores exhibited acceptable accuracy for individual measurement purposes, as well as stability over time in test-retest assessments at 6 months. Validity assessments found meaningful relations between the derived scale scores, and Brief Symptom Inventory depression and anxiety scores and Functional Assessment of Chronic Illness Therapy spiritual well-being scores. Conclusions The Spanish version of the Mini-MAC provides reliable and valid measures for patients with non-metastatic, resected cancer, and results corroborate the instrument’s cross-cultural validity.
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Affiliation(s)
- Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain.,University of Basque Country, Spain
| | - Urbano Lorenzo-Seva
- Department of Psychology, Faculty of Psychology, Rovira and Virgili University, Spain
| | - Pere Joan Ferrando
- Department of Psychology, Faculty of Psychology, Rovira and Virgili University, Spain
| | - David Gómez-Sánchez
- Department of Medical Oncology, Hospital Universitario Central of Asturias, Spain.,University of Basque Country, Spain
| | - Estrella Ferreira
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain
| | - Laura Ciria-Suarez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain
| | | | | | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central of Asturias, Spain.,University of Basque Country, Spain
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25
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Artioli G, Foà C, Bertuol M, Benzi L, Deiana L, Meneghetti C, Neri C, Pigoni L, Zanotti M, Sarli L. The impact of a "narrative interview" intervention in oncology. A study protocol for a feasibility study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:38-47. [PMID: 32573505 PMCID: PMC7975842 DOI: 10.23750/abm.v91i6-s.10016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Oncological diagnosis determines a biographical breakdown and requires the person to adapt to the disease. If patients, after diagnosis, ask professionals for 'compassionate care', research on these issues is still underdeveloped. There are currently no studies that use the narrative interview as an intervention tool. The objectives of the study are to evaluate: (1) the feasibility of the narrative interview intervention on cancer patients in the first diagnosis; (2) the impact of the narrative medicine intervention on the patient's self-perception, his psychological distress and adaptation to the disease. METHODS It is a mixed-method study, with an intervention (narrative interview) and quantitative evaluation before/after intervention and qualitative evaluation post-intervention (reflective writing). The analysis will use the Psychological Distress Inventory scale for the assessment of psychological distress and the Mini-Mental Adjustment to Cancer Scale for the assessment of disease adaptation. Adult patients, with oncological pathology will be recruited one month after the communication of the diagnosis, regardless of the type of tumor. The Wilcoxon test for paired data will be used to verify pre-post-intervention differences. The 'reflective writings' will be subjected to thematic analysis. DISCUSSION AND CONCLUSION The study evaluates the feasibility of the narrative interview intervention as a primary outcome. Secondly, the impact of the intervention is assessed in relation to: a) identification of risk or protective factors on psychological distress and adaptation to the disease; b) re-elaboration of the patient's experiences and experiences related to his/her own illness.
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Affiliation(s)
| | - Chiara Foà
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Maria Bertuol
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Linda Benzi
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Laura Deiana
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Chiara Meneghetti
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Cecilia Neri
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Laura Pigoni
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Martina Zanotti
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Leopoldo Sarli
- Department of Medicine and Surgery, University of Parma, Italy.
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26
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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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27
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Kondylakis H, Bucur A, Crico C, Dong F, Graf N, Hoffman S, Koumakis L, Manenti A, Marias K, Mazzocco K, Pravettoni G, Renzi C, Schera F, Triberti S, Tsiknakis M, Kiefer S. Patient empowerment for cancer patients through a novel ICT infrastructure. J Biomed Inform 2019; 101:103342. [PMID: 31816400 DOI: 10.1016/j.jbi.2019.103342] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 11/15/2019] [Accepted: 11/21/2019] [Indexed: 12/17/2022]
Abstract
As a result of recent advances in cancer research and "precision medicine" approaches, i.e. the idea of treating each patient with the right drug at the right time, more and more cancer patients are being cured, or might have to cope with a life with cancer. For many people, cancer survival today means living with a complex and chronic condition. Surviving and living with or beyond cancer requires the long-term management of the disease, leading to a significant need for active rehabilitation of the patients. In this paper, we present a novel methodology employed in the iManageCancer project for cancer patient empowerment in which personal health systems, serious games, psychoemotional monitoring and other novel decision-support tools are combined into an integrated patient empowerment platform. We present in detail the ICT infrastructure developed and our evaluation with the involvement of cancer patients on two sites, a large-scale pilot for adults and a small-scale test for children. The evaluation showed mixed evidences on the improvement of patient empowerment, while ability to cope with cancer, including improvement in mood and resilience to cancer, increased for the participants of the adults' pilot.
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Affiliation(s)
| | - Anca Bucur
- PHILIPS Research Europe, Eindhoven, The Netherlands
| | | | - Feng Dong
- Department of Computer Science and Technology, University of Bedfordshire, Luton, UK
| | - Norbert Graf
- Saarland University, Pediatric Oncology and Hematology, Homburg, Germany
| | | | | | | | - Kostas Marias
- Computational BioMedicine Laboratory, FORTH-ICS, Heraklion, Greece
| | | | | | | | - Fatima Schera
- Fraunhofer Institute for Biomedical Engineering, Germany
| | | | | | - Stephan Kiefer
- Fraunhofer Institute for Biomedical Engineering, Germany
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28
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Romeo A, Di Tella M, Ghiggia A, Tesio V, Gasparetto E, Stanizzo MR, Torta R, Castelli L. The Traumatic Experience of Breast Cancer: Which Factors Can Relate to the Post-traumatic Outcomes? Front Psychol 2019; 10:891. [PMID: 31105621 PMCID: PMC6491882 DOI: 10.3389/fpsyg.2019.00891] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/03/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Post-traumatic growth (PTG) is considered a positive outcome of struggling with a traumatic event, distinct, and opposite from negative outcomes, i.e., psychological distress. The present study aimed to shed light on the relationship between potentially relating factors (i.e., coping strategies, perceived social support, and attachment style) and both positive and negative psychological outcomes. Methods: A total of 123 breast cancer survivors were recruited, who completed a battery of self-report questionnaires, assessing PTG, psychological distress, coping strategies, perceived social support, and attachment style. Three regression analyses were run to evaluate whether relating factors were significant predictors of the positive and negative psychological outcomes. Results: The regression analyses showed that the "Fatalism" coping strategy and perceived social support were two significant predictors of PTG. Instead, the "Helpless-Hopeless" and "Anxious Preoccupation" coping strategies, as well as an insecure attachment style, were significant predictors of depression, while the "Anxious Preoccupation" coping strategy and an insecure attachment style were significant predictors of anxiety. Conclusions: The present findings showed that the factors underlying a positive or negative outcome are different and specific. While perceived social support and a fatalistic attitude seem to play a key role in the positive outcome, dysfunctional coping strategies, together with an insecure attachment style, appear to be related with negative psychological outcome. Considering these factors in clinical practice would help patients to give meaning to their traumatic experience, enhancing psychological growth.
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Affiliation(s)
| | | | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Eleonora Gasparetto
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Maria Rosa Stanizzo
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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29
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Serpentini S, Del Bianco P, Chirico A, Merluzzi TV, Martino R, Lucidi F, De Salvo GL, Trentin L, Capovilla E. Self-efficacy for coping: utility of the Cancer behavior inventory (Italian) for use in palliative care. BMC Palliat Care 2019; 18:34. [PMID: 30953485 PMCID: PMC6449975 DOI: 10.1186/s12904-019-0420-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 03/27/2019] [Indexed: 11/25/2022] Open
Abstract
Background Newer models of palliative and supportive cancer care view the person as an active agent in managing physical and psychosocial challenges. Therefore, personal efficacy is an integral part of this model. Due to the lack of instruments in Italian to assess coping self-efficacy, the present study included the translation and validation of the Italian version of the Cancer Behavior Inventory–Brief (CBI-B/I) and an initial analysis of the utility of self-efficacy for coping in an Italian sample of palliative care patients. Methods 216 advanced cancer patients who attended palliative care clinics were enrolled. The CBI-B/I was administered along with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), the Mini Mental Adjustment to Cancer Scale (Mini-MAC), the Cancer Concerns Checklist (CCL), and the Hospital Anxiety and Depression Scale (HADS). The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ratings of functional capacity were completed by physicians. Results Factor analysis confirmed that the structure of the CBI-B/I was consistent with the English version. Internal consistency reliability and significant correlations with the EORTC QLQ-C30, Mini-MAC, and HADS supported the concurrent validity of the CBI-B/I. Differences in CBI-B/I scores for high versus low levels of the CCL and ECOG-PS supported the clinical utility of the CBI-B/I. Conclusions The CBI-B/I has strong psychometric properties and represents an important addition to newer model of palliative and supportive care. In order to improve clinical practice, the CBI-B/I could be useful in identifying specific self-efficacy goals for coping in structured psychosocial interventions.
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Affiliation(s)
- Samantha Serpentini
- Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy.
| | - Paola Del Bianco
- Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy
| | | | | | - Rosalba Martino
- Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy
| | | | - Gian Luca De Salvo
- Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy
| | - Leonardo Trentin
- Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy
| | - Eleonora Capovilla
- Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy
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Biopsychosocial Correlates of Adjustment to Cancer during Chemotherapy: The Key Role of Health-Related Quality of Life. ScientificWorldJournal 2019; 2019:9750940. [PMID: 30983914 PMCID: PMC6431483 DOI: 10.1155/2019/9750940] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 02/21/2019] [Indexed: 12/18/2022] Open
Abstract
Background Patients adjust to cancer in a continuous process that follows the course of the disease. Previous research has considered several illness-related variables and demographics, quality of life, personality, and social factors as predictors of adjustment to cancer, which can be maladaptive (e.g., helplessness-hopelessness and anxious preoccupation) or adaptive (e.g., fighting spirit). Aims Assuming a biopsychosocial view, we test an empirical model in which disease stage, patient's age, and gender are viewed as the distal antecedents of positive and negative adjustment to cancer for chemotherapy patients. Health-related quality of life (HRQoL) has a key role, interposing between the distal antecedents and adaptational outcomes. Social support and positive thinking are also included in the model as related to adjustment. Methods One-hundred-sixty-two consecutive cancer patients receiving adjuvant or standard chemotherapy participated in the study. Patients completed the Mini-Mental Adjustment to Cancer, the Brief-COPE, the Social Provision Scale, and the SF-12 Health Survey. Partial least squares structural equation modeling (PLS-SEM) was applied for model building and hypotheses testing. Results We found a negative association between advanced stage and physical functioning, a strong positive link between physical functioning and mental health, and significant relations between mental health and helpless-hopelessness, anxious preoccupation, and cognitive avoidance. Social support and positive thinking were related to fighting spirit and fatalism. Cancer stage and female gender were indirectly associated with adaptational outcomes through HRQoL. The patient's age had no significant relationships in the model. Discussion HRQoL (both physical and mental) is a key factor for preventing maladjustment in chemotherapy patients. Social support and positive thinking coping style fosters fighting spirit and fatalism on health outcomes. Two potential lines of action seem promising: preventing maladaptive and promoting adaptive adjustments working on patient's mental health individually and involving significant others in supportive care, respectively.
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Calderon C, Carmona-Bayonas A, Hernandez R, Castelo B, Varma S, Donnay O, Gomez D, Jimenez-Fonseca P. Incidence of sleep problems and their mediating role on depression and anxious preoccupation in patients with resected, non-advanced cancer: data from NEOcoping study. Clin Transl Oncol 2019; 21:1104-1107. [PMID: 30712235 DOI: 10.1007/s12094-018-02018-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 12/13/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Our study analyzes the incidence of sleep problems and their mediating role on depression and anxious preoccupation in patients with resected, non-advanced cancer. METHODS A multi-institutional, prospective, observational study was conducted with 750 participants of 14 hospitals in Spain. Participants' socio-demographic and clinical characteristics were collected using a standardized self-report form and using EORTC QoL-QLQ-C30, BSI, Mini-MAC questionnaires. RESULTS In women, sleep problems, depression and anxious preoccupation were observed in 65, 41 and 21%, respectively. In men, sleep problems, depression and anxious preoccupation were reported in 51, 29 and 61%, respectively. More sleep problems, depression and anxious preoccupation were found among women than males. Depression was a significant predictor of anxious preoccupation. In males, sleep problems partially mediated this association. This was not confirmed in women. CONCLUSION Our findings point toward the importance of developing interventions that decrease depression and sleep problems in cancer.
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Affiliation(s)
- C Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - A Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - R Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - B Castelo
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - S Varma
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - O Donnay
- Department of Medical Oncology, Hospital Universitario La Princesa, Madrid, Spain
| | - D Gomez
- Department of Medical Oncology, Hospital Universitario Central of Asturias, Avenida Roma, sn, 33011, Oviedo, Spain
| | - P Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central of Asturias, Avenida Roma, sn, 33011, Oviedo, Spain.
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Gelkopf MJ, Chang TE, Zhang Y, Zhang C, Yi K, Fang V, Mendlowitz S, Zhao J, Dimaras H. Parental coping with retinoblastoma diagnosis. J Psychosoc Oncol 2019; 37:319-334. [PMID: 30633662 DOI: 10.1080/07347332.2018.1509165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To characterize coping and distress among parents of children with retinoblastoma, and to uncover their association with perceived health literacy, self-efficacy, and social support. METHODS This was a cross-sectional study performed in the retinoblastoma clinics of Beijing Children's Hospital, Jilin Eye Hospital and Changchun Hospital in China. Parents of children with retinoblastoma (n = 104) completed a print Mandarin language questionnaire consisting of four sections: (i) demographic information, (ii) mini-mental adjustment to cancer scale, (iii) hospital anxiety and depression scale, and (iv) perceived health literacy, self-efficacy, and social support scales. Scores were tabulated for each measure and analyzed by bivariate correlation. RESULTS Moderate anxiety affected 59.2% of parents, and 77.7% experienced low, moderate, or high levels of depression. Combined anxiety and depression was positively correlated with helplessness/hopelessness (R = 0.42, p < .01) and anxious preoccupation (R = 0.247, p < .05), and negatively correlated with perceived self-efficacy (R = -0.228, p < .05). Perceived social support from a partner was negatively correlated with depression (R = -0.207, p < .05) and helplessness/hopelessness (R = -0.271, p < .01). CONCLUSIONS Knowledge of how parents cope with their child's cancer diagnosis can help healthcare teams understand how best to support their psychosocial needs.
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Affiliation(s)
- Maxwell J Gelkopf
- a Department of Ophthalmology & Vision Sciences , The Hospital for Sick Children , Toronto , Canada.,b Child Health Evaluative Sciences Program , SickKids Research Institute , Toronto , Canada
| | - Trillium E Chang
- a Department of Ophthalmology & Vision Sciences , The Hospital for Sick Children , Toronto , Canada.,c Department of Molecular Genetics, Faculty of Arts & Science , University of Toronto , Toronto , Canada.,d Department of Human Biology Program, Faculty of Arts & Science , University of Toronto , Toronto , Canada
| | - Yan Zhang
- e Department of Ophthalmology , Beijing Children's Hospital , Beijing , China.,f Department of Ophthalmology , Capital Medical University , Beijing , China
| | - Chengyue Zhang
- e Department of Ophthalmology , Beijing Children's Hospital , Beijing , China.,f Department of Ophthalmology , Capital Medical University , Beijing , China
| | - Khairi Yi
- g Department of Statistics, Faculty of Arts & Science , University of Toronto , Toronto , Canada
| | - Vixey Fang
- a Department of Ophthalmology & Vision Sciences , The Hospital for Sick Children , Toronto , Canada.,g Department of Statistics, Faculty of Arts & Science , University of Toronto , Toronto , Canada
| | - Sandra Mendlowitz
- h Department of Psychiatry , The Hospital for Sick Children , Toronto , Canada
| | - Junyang Zhao
- e Department of Ophthalmology , Beijing Children's Hospital , Beijing , China.,f Department of Ophthalmology , Capital Medical University , Beijing , China
| | - Helen Dimaras
- a Department of Ophthalmology & Vision Sciences , The Hospital for Sick Children , Toronto , Canada.,b Child Health Evaluative Sciences Program , SickKids Research Institute , Toronto , Canada.,i Division of Clinical Public Health, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.,j Department of Ophthalmology & Vision Sciences, Faculty of Medicine , University of Toronto , Toronto , Canada.,k Department of Human Pathology, College of Health Sciences , University of Nairobi , Nairobi , Kenya
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Andreu Vaillo Y, Murgui Pérez S, Martínez López P, Romero Retes R. Mini-Mental Adjustment to Cancer Scale: Construct validation in Spanish breast cancer patients. J Psychosom Res 2018; 114:38-44. [PMID: 30314577 DOI: 10.1016/j.jpsychores.2018.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/07/2018] [Accepted: 09/07/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The Mini-Mental Adjustment to Cancer Scale (MiniMAC) is widely used to evaluate cancer patients' psychological responses to diagnosis and treatment. Validation studies of the scale have shown inconsistency in the obtained factor structures. The aim of this study was to explore the factor structure, using Confirmatory Factor Analysis (CFA), and other psychometric properties of the MiniMAC in Spanish breast cancer patients. METHODS A sample of 368 women with breast cancer completed the MiniMAC and the 18 items version of the Brief Symptom Inventory (BSI-18). RESULTS The original pentafactorial model and three additional models derived from the empirical research -two first-order structures with four and three factors, and a second-order bifactorial structure- were tested. The five-factor model showed the best model fit and largely replicated the original MiniMAC's subscales. Five factors had acceptable reliability and showed modest correlations with emotional distress in the expected direction. CONCLUSIONS The Spanish version of the MiniMAC has a satisfactory overall performance and serves as a brief, reliable and valid tool measuring cognitive appraisals and ensuing reactions to cancer.
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Affiliation(s)
- Yolanda Andreu Vaillo
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, Spain.
| | | | - Paula Martínez López
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, Spain
| | - Rocío Romero Retes
- Psychology Unit, Fundación Instituto Valenciano de Oncologia - FIVO, Valencia, Spain
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Italian cultural adaptation of the Memorial Anxiety for Prostate Cancer scale for the population of men on active surveillance. TUMORI JOURNAL 2018. [DOI: 10.5301/tj.5000646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) is a self-report questionnaire that was developed in English to assess prostate cancer (PCa)-related anxiety. The aim of this study was to perform a cultural adaptation for the tool to be used in a population of Italian men on active surveillance (AS). Methods: A total of 222 patients with localized PCa who were recruited for the Prostate Cancer Research International: Active Surveillance (PRIAS) protocol completed the MAX-PC. Psychometric analysis was performed to assess reliability indexes. A Spearman rank correlation was used to test the association between MAX-PC scales and other questionnaires and was used for longitudinal analysis. Results: Cronbach coefficients and item to total correlation demonstrated good internal consistency. Some items related to the repetition of the PSA test showed a large floor effect and thus were poorly effective in measuring anxiety for PSA testing in patients on AS. Confirmatory factor analysis partly failed to reproduce the structure of the original version. A modified version of MAX-PC, excluding the items with a large floor effect, was thus considered for AS patients. Factor analysis on this version demonstrated considerable consistency with the presence of 3 subscales: anxiety related to PCa, anxiety related to PSA testing, and anxiety related to the fear of tumor progression. Longitudinal analysis showed an acceptable validity over time. The MAX-PC was correlated with the anxious preoccupation subscale of the Mini-Mental Adjustment to Cancer scale. Conclusions: A slightly modified version of the MAX-PC was developed for use in Italian men on AS. This instrument appears to be a valid and reliable tool that measures anxiety in men with PCa who are enrolled in AS programs.
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Grassi L, Caruso R, Mitchell AJ, Sabato S, Nanni MG. Screening for emotional disorders in patients with cancer using the Brief Symptom Inventory (BSI) and the BSI-18 versus a standardized psychiatric interview (the World Health Organization Composite International Diagnostic Interview). Cancer 2018; 124:2415-2426. [PMID: 29660109 DOI: 10.1002/cncr.31340] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Given the adverse consequences of psychiatric and psychosocial morbidity on the quality of life for patients with cancer, prompt detection of psychological symptoms is mandatory. The authors examined the properties and accuracy of the Brief Symptom Inventory (the 53-item version [BSI] and the 18-item version [BSI-18]) for the detection of psychiatric morbidity compared with the World Health Organization Composite International Diagnostic Interview (CIDI) for International Classification of Diseases-10th Revision psychiatric diagnoses. METHODS A convenience sample of 498 patients with newly diagnosed cancer who were recruited in cancer outpatient services participated in the CIDI interview and in BSI and BSI-18 assessments. RESULTS The prevalence of psychiatric morbidity was 39.75%. When participants were classified as cases using the BSI standard case rule, agreement with the CIDI was potentially acceptable (sensitivity, 72.7%; specificity, 88.7%). In contrast, the accuracy of the BSI-18 in identifying cases was poor according to the standard case rule, with very low sensitivity (29.3%) (misclassification rate, 28.7%). By using a first alternative case-rule system (a BSI-18 global severity index [GSI] T-score ≥57), sensitivity marginally improved (45%), whereas a second alternative case-rule system (a GSI T-score ≥50) significantly increased sensitivity (77.3%). In receiver operating characteristic curve analysis, a further cutoff GSI T-score ≥48 exhibited good discrimination levels (sensitivity, 82.3%; specificity, 72.4%). There were some differences in GSI cutoff T-scores according to the International Classification of Diseases-10th Revision diagnosis and sex. CONCLUSIONS The BSI appeared to have acceptable diagnostic accuracy compared with a standardized psychiatric interview. For the BSI-18, it is mandatory to use alternative case-rule systems, to identify patients with psychiatric morbidity. Cancer 2018;124:2415-26. © 2018 American Cancer Society.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Unit of Hospital Psychiatry, S. Anna Hospital and Health Authorities, Ferrara, Italy
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Unit of Hospital Psychiatry, S. Anna Hospital and Health Authorities, Ferrara, Italy
| | - Alex J Mitchell
- Department of Psycho-Oncology, Cancer, and Molecular Medicine, University of Leicester, Leicester, United Kingdom
| | - Silvana Sabato
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Unit of Hospital Psychiatry, S. Anna Hospital and Health Authorities, Ferrara, Italy
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Capozzo MA, Schillani G, Aguglia E, De Vanna M, Grassi L, Conte MA, Giraldi T. Serotonin Transporter 5-HTTLPR Polymorphism and Response to Citalopram in Terminally ill Cancer Patients: Report of Twenty-One Cases. TUMORI JOURNAL 2018; 95:479-83. [DOI: 10.1177/030089160909500412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to examine the effects of the SSRI antidepressant drug citalopram on anxiety, depression and mental adjustment to cancer in terminally ill cancer patients, considering also the 5-HTTLPR genetic polymorphism. A group of twenty-one consecutive patients admitted to the hospice of the Casa di Cura Pineta del Carso (Trieste, Italy) with different types of advanced cancer, who were clinically judged to require treatment with an antidepressive drug, was treated with citalopram for two weeks. The response was determined and related to 5-HTTLPR. Citalopram significantly reduced the scores on the depression and anxiety subscales of the Hospital Anxiety and Depression Scale (HADS). When the effects of citalopram were analyzed in relation to the 5-HTTLPR polymorphism, the HADS depression score was significantly decreased only in patients with the “l/l” allelic variant of the serotonin transporter conferring high functional activity, while the score of the Mini-MAC fatalism scale was significantly increased in patients carrying at least one “s” allele. These preliminary findings seem to indicate that two weeks of treatment with citalopram are effective in reducing depressive symptoms in terminally ill cancer patients. Moreover, the effects of citalopram on fatalism as a strategy of mental adaptation to cancer, and on depressive symptoms depend on the allelic variants of the 5-HTTLPR genotype of the patients. These results seem to encourage the examination of a larger patient sample and of different treatment schedules, as well as a more thorough characterization of fatalism as a coping strategy in cancer patients.
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Affiliation(s)
- Maria Anna Capozzo
- Section of Pharmacology, Department of Biomedical Sciences, Faculty of Medicine, University of Trieste, Trieste, Italy
| | - Giulia Schillani
- Section of Pharmacology, Department of Biomedical Sciences, Faculty of Medicine, University of Trieste, Trieste, Italy
| | - Eugenio Aguglia
- Psychiatric Clinic, Faculty of Medicine, University of Trieste, Trieste, Italy
| | - Maurizio De Vanna
- Psychiatric Clinic, Faculty of Medicine, University of Trieste, Trieste, Italy
| | - Luigi Grassi
- Section of Psychiatry, Department of Medical Sciences of Communication and Behavior, University of Ferrara, Ferrara, Italy
| | | | - Tullio Giraldi
- Section of Pharmacology, Department of Biomedical Sciences, Faculty of Medicine, University of Trieste, Trieste, Italy
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Renzi C, Perinel G, Arnaboldi P, Gandini S, Vadilonga V, Rotmensz N, Tagini A, Didier F, Pravettoni G. Memories of paternal relations are associated with coping and defense mechanisms in breast cancer patients: an observational study. BMC Psychol 2017; 5:37. [PMID: 29122005 PMCID: PMC5679357 DOI: 10.1186/s40359-017-0206-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 10/30/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Breast cancer diagnosis and treatment represent stressful events that demand emotional adjustment, thus recruiting coping strategies and defense mechanisms. As parental relations were shown to influence emotion regulation patterns and adaptive processes in adulthood, the present study investigated whether they are specifically associated to coping and defense mechanisms in patients with breast cancer. METHODS One hundred and ten women hospitalized for breast cancer surgery were administered questionnaires assessing coping with cancer, defense mechanisms, and memories of parental bonding in childhood. RESULTS High levels of paternal overprotection were associated with less mature defenses, withdrawal and fantasy and less adaptive coping mechanisms, such as hopelessness/helplessness. Low levels of paternal care were associated with a greater use of repression. No association was found between maternal care, overprotection, coping and defense mechanisms. Immature defenses correlated positively with less adaptive coping styles, while mature defenses were positively associated to a fighting spirit and to fatalism, and inversely related to less adaptive coping styles. CONCLUSIONS These data suggest that paternal relations in childhood are associated with emotional, cognitive, and behavioral regulation in adjusting to cancer immediately after surgery. Early experiences of bonding may constitute a relevant index for adaptation to cancer, indicating which patients are at risk and should be considered for psychological interventions.
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Affiliation(s)
- Chiara Renzi
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
| | - Giada Perinel
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - Paola Arnaboldi
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - Valeria Vadilonga
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - Nicole Rotmensz
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - Angela Tagini
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy
| | - Florence Didier
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Onco-Hematology, University of Milano, Via Festa del Perdono 7, Milan, Italy
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Kestenbaum A, Shields M, James J, Hocker W, Morgan S, Karve S, Rabow MW, Dunn LB. What Impact Do Chaplains Have? A Pilot Study of Spiritual AIM for Advanced Cancer Patients in Outpatient Palliative Care. J Pain Symptom Manage 2017; 54:707-714. [PMID: 28736103 PMCID: PMC5650916 DOI: 10.1016/j.jpainsymman.2017.07.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 12/13/2022]
Abstract
CONTEXT Spiritual care is integral to quality palliative care. Although chaplains are uniquely trained to provide spiritual care, studies evaluating chaplains' work in palliative care are scarce. OBJECTIVES The goals of this pre-post study, conducted among patients with advanced cancer receiving outpatient palliative care, were to evaluate the feasibility and acceptability of chaplain-delivered spiritual care, utilizing the Spiritual Assessment and Intervention Model ("Spiritual AIM"), and to gather pilot data on Spiritual AIM's effects on spiritual well-being, religious and cancer-specific coping, and physical and psychological symptoms. METHODS Patients with advanced cancer (N = 31) who were receiving outpatient palliative care were assigned based on chaplains' and patients' outpatient schedules, to one of three professional chaplains for three individual Spiritual AIM sessions, conducted over the course of approximately six to eight weeks. Patients completed the following measures at baseline and post-intervention: Edmonton Symptom Assessment Scale, Steinhauser Spirituality, Brief RCOPE, Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp-12), Mini-Mental Adjustment to Cancer (Mini-MAC), Patient Dignity Inventory, Center for Epidemiological Studies-Depression (10 items), and Spielberger State Anxiety Inventory. RESULTS From baseline to post-Spiritual AIM, significant increases were found on the FACIT-Sp-12 Faith subscale, the Mini-MAC Fighting Spirit subscale, and Mini-MAC Adaptive Coping factor. Two trends were observed, i.e., an increase in Positive religious coping on the Brief RCOPE and an increase in Fatalism (a subscale of the Mini-MAC). CONCLUSION Spiritual AIM, a brief chaplain-led intervention, holds potential to address spiritual needs and religious and general coping in patients with serious illnesses.
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Affiliation(s)
- Allison Kestenbaum
- Doris A. Howell Palliative Care Service, University of California, San Diego Health, San Diego, California, USA
| | - Michele Shields
- Spiritual Care Services, University of California San Francisco Medical Center and UCSF Benioff Children's Hospital, San Francisco, California, USA
| | - Jennifer James
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Will Hocker
- Spiritual Care Services, University of California San Francisco Medical Center and UCSF Benioff Children's Hospital, San Francisco, California, USA
| | - Stefana Morgan
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA
| | - Shweta Karve
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Michael W Rabow
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Laura B Dunn
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA.
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Grassi L, Costantini A, Kissane D, Brunetti S, Caruso R, Piazza G, Marchetti P, Sabato S, Nanni MG. The factor structure and use of the Demoralization Scale (DS-IT) in Italian cancer patients. Psychooncology 2017; 26:1965-1971. [DOI: 10.1002/pon.4413] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences; University of Ferrara; Ferrara Italy
- University Hospital Psychiatry Unit; Integrated Department of Mental Health and Addictive Behaviors, Health Authorities and University S. Anna Hospital; Ferrara Italy
| | - Anna Costantini
- Psychoncology Unit, Sant'Andrea Hospital Sapienza; University of Rome; Rome Italy
| | - David Kissane
- Department of Psychiatry; Monash University and Szalmuk Family Research Unit at Cabrini Health; Clayton Victoria Australia
| | - Serena Brunetti
- Psychoncology Unit, Sant'Andrea Hospital Sapienza; University of Rome; Rome Italy
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences; University of Ferrara; Ferrara Italy
- University Hospital Psychiatry Unit; Integrated Department of Mental Health and Addictive Behaviors, Health Authorities and University S. Anna Hospital; Ferrara Italy
| | - Giulia Piazza
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences; University of Ferrara; Ferrara Italy
| | - Paolo Marchetti
- Medical Oncology; La Sapienza University of Rome and IDI-IRCCS; Rome Italy
| | - Silvana Sabato
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences; University of Ferrara; Ferrara Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences; University of Ferrara; Ferrara Italy
- University Hospital Psychiatry Unit; Integrated Department of Mental Health and Addictive Behaviors, Health Authorities and University S. Anna Hospital; Ferrara Italy
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Saita E, Acquati C, Molgora S. Promoting Patient and Caregiver Engagement to Care in Cancer. Front Psychol 2016; 7:1660. [PMID: 27826279 PMCID: PMC5079095 DOI: 10.3389/fpsyg.2016.01660] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/11/2016] [Indexed: 11/13/2022] Open
Abstract
The positive outcomes associated with Patient Engagement (PE) have been strongly supported by the recent literature. However, this concept has been marginally addressed in the context of cancer. Limited attention has also received the role of informal caregivers in promoting physical and psychological well-being of patients, as well as the interdependence of dyads. The Cancer Dyads Group Intervention (CDGI) is a couple-based psychosocial intervention developed to promote engagement in management behaviors, positive health outcomes, and the quality of the relationship between cancer patients and their informal caregivers. The article examines the ability of the CDGI to promote adaptive coping behaviors and the perceived level of closeness by comparing cancer patients participating in the intervention and patients receiving psychosocial care at usual. Results indicate that individuals diagnosed with cancer attending the CDGI present significant increases in Fighting Spirit and Avoidance, while reporting also reduced levels of Fatalism and Anxious Preoccupation. Initial indications suggest that the intervention may contribute to strengthening the relationship with the primary support person.
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Affiliation(s)
- Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston Houston, TX, USA
| | - Sara Molgora
- Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
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"What if…": decisional regret in patients who discontinued active surveillance. TUMORI JOURNAL 2016; 102:562-568. [PMID: 27716881 DOI: 10.5301/tj.5000564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the presence of regret in patients about having followed an active surveillance (AS) protocol. The secondary aim was to identify variables that influence regret. METHODS From February 2006 to May 2014, 204 patients discontinued the AS protocols and were invited to enter the study. Sociodemographic variables were collected at AS enrollment, together with health-related quality of life (Functional Assessment of Cancer Therapy-Prostate version [FACT-P]) and coping (Mini-Mental Adjustment to Cancer). Patients were asked to complete a Treatment Regret Scale as well as the FACT-P questionnaire. Clinical data were gathered, as well as time of stay within the AS protocol, reason for discontinuing AS, kind of post-AS treatment, and time elapsed since AS discontinuation. Questionnaires were completed by 105 patients (51.5% of those who had been invited to enter the study). RESULTS Most of the patients had a low or null degree of regret on the Treatment Regret Scale from 0 to 100 (82/105 patients [78.1%] obtained a score <30, and about 30% of the sample had a score equal to zero). Only 5 patients (4.7%) scored 60 or more, indicating some degree of regret. None of the statistical tests between regret scores and a number of analyzed variables reached significance. CONCLUSIONS These results show that the degree of regret about following an AS protocol and after its discontinuation because of entering active treatment was very low. The regret after AS was not related to sociodemographic or clinical factors.
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Foley NM, O'Connell EP, Lehane EA, Livingstone V, Maher B, Kaimkhani S, Cil T, Relihan N, Bennett MW, Redmond HP, Corrigan MA. PATI: Patient accessed tailored information: A pilot study to evaluate the effect on preoperative breast cancer patients of information delivered via a mobile application. Breast 2016; 30:54-58. [PMID: 27611236 DOI: 10.1016/j.breast.2016.08.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/01/2016] [Accepted: 08/18/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The information needs of cancer patients are highly variable. Literature suggests an improved ability to modulate personalised stress, increased patient involvement with decision making, greater satisfaction with treatment choices and reduced anxiety levels in cancer patients who have access to information. The aim of this project was to evaluate the effects of a mobile information application on anxiety levels of patients undergoing surgery for breast cancer. MATERIALS AND METHODS An application was developed for use with Apple iPad containing information on basic breast cancer biology, different treatments used and surgical techniques. Content and face validity studies were performed. A randomized control trial was designed, with a 1:2 allocation. Data collected include basic demographics and type of surgery. Questionnaires used included: the HADS, Mini-MAC, information technology familiarity and information satisfaction. RESULTS A total of 39 women participated. 13 women had access to an iPad containing additional information and 26 women acted as controls. The mean age was 54 and technology familiarity was similar among both groups. Anxiety and depression scores at seven days were significantly lower in control patients without access to the additional information provided by the mobile application (p = 0.022 and 0.029 respectively). CONCLUSION Anxiety and depression in breast cancer patients is both multifactorial and significant, with anxiety levels directly correlating with reduced quality of life. Intuitively, information should improve anxiety levels, however, we have demonstrated that surgical patients with less information reported significantly lower anxiety. We advise the thorough testing and auditing of information initiatives before deployment.
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Affiliation(s)
- N M Foley
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland.
| | - E P O'Connell
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - E A Lehane
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - V Livingstone
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - B Maher
- School of Medicine, University College Cork, Cork, Ireland
| | - S Kaimkhani
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - T Cil
- Division of General Surgery, University of Toronto, Toronto, Ontario, Canada
| | - N Relihan
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - M W Bennett
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - H P Redmond
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - M A Corrigan
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland; Royal College of Surgeons, Dublin, Ireland
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Ghiggia A, Castelli L, Riva G, Tesio V, Provenzano E, Ravera M, Garzaro M, Pecorari G, Franco P, Potenza I, Rampino M, Torta R. Psychological distress and coping in nasopharyngeal cancer: an explorative study in Western Europe. PSYCHOL HEALTH MED 2016; 22:449-461. [PMID: 27687515 DOI: 10.1080/13548506.2016.1220600] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Nasopharyngeal carcinoma (NPC) is the head and neck cancer with the greatest impact on patients' quality of life. The aim of this explorative study is to investigate the psychological distress, coping strategies and quality of life of NPC patients in the post-treatment observation period. Twenty-one patients disease-free for at least two years were assessed with a medical and a psycho-oncological evaluation. Clinically relevant depressive symptoms (CRD) were present in 23.8% of patients and 33.3% reported clinically relevant anxiety symptoms (CRA). Patients with CRD and CRA showed a significantly higher score in the use of hopelessness/helplessness and anxious preoccupation coping strategies and a worse quality of life. Even in the post-treatment period, about a quarter of patients showed CRD and CRA. Results showed that patients with high anxiety or depressive symptoms seem to use dysfunctional coping strategies, such as hopelessness and anxious preoccupation, more than patients with lower levels of anxiety and depression. The use of these styles of coping thus seems to be associated to a higher presence of CRA or CRD symptomatology and to a worse quality of life.
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Affiliation(s)
- Ada Ghiggia
- a Department of Psychology , University of Turin , Turin , Italy
| | - Lorys Castelli
- a Department of Psychology , University of Turin , Turin , Italy
| | - Giuseppe Riva
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Valentina Tesio
- a Department of Psychology , University of Turin , Turin , Italy
| | - Erica Provenzano
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Mattia Ravera
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Massimiliano Garzaro
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Giancarlo Pecorari
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Pierfrancesco Franco
- c Radiation Oncology Unit, Department of Oncology , University of Turin , Turin , Italy
| | - Ilenia Potenza
- c Radiation Oncology Unit, Department of Oncology , University of Turin , Turin , Italy
| | - Monica Rampino
- c Radiation Oncology Unit, Department of Oncology , University of Turin , Turin , Italy
| | - Riccardo Torta
- d Clinical and Oncological Psychology, Department of Neuroscience , 'Città della Salute e della Scienza', Hospital of Turin , Turin , Italy
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The Paradox of Pelvic Exenteration: The Interaction of Clinical and Psychological Variables. Int J Gynecol Cancer 2016; 25:1534-40. [PMID: 26244759 DOI: 10.1097/igc.0000000000000523] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To text the feasibility of a psychological intervention package administered to 49 pelvic exenteration candidates, aimed at evaluating the preoperative prevalence of psychological distress and assessing the presence of any correlation between preoperative psychological distress and clinical variables such as pain and hospitalization length. METHODS Patients were referred to the psychology unit from the very beginning of their clinical pathway and were administered the Psychological Distress Inventory (PDI) and the Mini-Mental Adjustment to Cancer (Mini-MAC) questionnaire at prehospital admission. Patients presenting with a significant level of distress received nonstandardized psychological support. Statistical analyses were performed to detect the presence of any correlation between psychological variables at prehospital admission and clinical outcomes. RESULTS The 40% of patients had significant levels of distress at prehospital admission (PDI ≥ 30). As regards Mini-MAC, the mean value of fighting spirit attitude and fatalism was higher in our sample than in the normative sample of the Mini-MAC validation study in the Italian cancer population. Their anxious preoccupation attitude was lower. There were no correlations between clinical and psychological variables: level of postsurgery pain was higher (3.7) in the subgroup of patients with presurgery PDI < 30 compared with those with PDI ≥ 30 (3.5). However, this difference was not statistically significant (P = 1.00). Considering hospitalization length, the above described trend was similar. CONCLUSIONS Although highly distressed, pelvic exenteration candidates show an adaptive range of coping mechanisms. This calls for a greater effort in studying the complexity of their psychoemotional status to provide them with the best multidisciplinary care. Extensive study of the real effectiveness of psychological intervention is warranted: randomized clinical trials could help in detecting the presence of any correlation between clinical and psychological variables in a multidisciplinary approach.
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Parents with cancer: Searching for the right balance between telling the truth and protecting children. Palliat Support Care 2016; 15:88-97. [PMID: 27324110 DOI: 10.1017/s1478951516000444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Recent scientific approaches to cancer patients draw attention to the psychological aspects of the disease and the involvement of their families, who are forced to reorganize themselves in order to manage the patient's illness. Functional responses to a stressful event facilitate open communication between family members and empathy for the patient's children, who need to be involved and informed about the illness in a clear and open fashion. The primary goal of this observational study was to explore the communication styles used by cancer-stricken parents with their children and to identify a correlation with the patient's levels of anxiety and depression and their ability to cope. We also sought to understand whether location, severity, and time from diagnosis influenced communication, coping, anxiety, or depression. METHOD From September of 2011 to July of 2015, 151 questionnaires were given to patients who had received at least one course of chemotherapy. The instruments that we employed were the Openness to Discuss Cancer in the Nuclear Family Scale, the Hospital Anxiety and Depression Scale, and the Mini-Mental Adjustment to Cancer Scale. Our sample included patients with children aged from 3 to 18 years. The patients had different types of cancer, mainly gastrointestinal and breast cancer. Their disease was at the metastatic stage in approximately 20% of patients. RESULTS Our results showed statistically significant correlations between higher levels of anxiety and depression and more closed communication styles. The coping styles "hopelessness/helplessness," "cognitive avoidance," and "anxious preoccupation" were associated with a closed communication style that is correlated with higher levels of anxiety and depression. Tumor location, time from diagnosis, and stage of disease did not show statistically significant correlations with anxiety, depression, coping mechanisms, or communication styles. SIGNIFICANCE OF RESULTS Our study confirmed what has been reported in the literature: high levels of anxiety and depression affect communication among family members. Not surprisingly, the "fighting spirit" coping style engenders open communication.
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Patoo M, Allahyari AA, Moradi AR, Payandeh M. Iranian Version of the Mini-Mental Adjustment to Cancer Scale: Factor Structure and Psychometric Properties. J Psychosoc Oncol 2015; 33:675-85. [DOI: 10.1080/07347332.2015.1082169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Costantini A, Grassi L, Picardi A, Brunetti S, Caruso R, Nanni MG, Bonetti L, de Feudis R, Barni S, Marchetti P. Awareness of cancer, satisfaction with care, emotional distress, and adjustment to illness: an Italian multicenter study. Psychooncology 2015; 24:1088-96. [DOI: 10.1002/pon.3768] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 01/13/2015] [Accepted: 01/13/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Anna Costantini
- Psycho-Oncology Departmental Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology; La Sapienza University of Rome; Rome Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences; University of Ferrara; Ferrara Italy
- University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program; Department of Mental Health; Ferrara Italy
| | - Angelo Picardi
- Mental Health Unit, Centre of Epidemiology, Surveillance, and Health Promotion; Italian National Institute of Health; Rome Italy
| | - Serena Brunetti
- Psycho-Oncology Departmental Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology; La Sapienza University of Rome; Rome Italy
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences; University of Ferrara; Ferrara Italy
- University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program; Department of Mental Health; Ferrara Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences; University of Ferrara; Ferrara Italy
- University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program; Department of Mental Health; Ferrara Italy
| | - Luisa Bonetti
- Psycho-Oncology Service; Azienda Ospedaliera Treviglio; Treviglio Italy
| | - Rossana de Feudis
- Clinical Psychology Unit, Medical Oncology Unit; San Paolo Hospital; Bari Italy
| | - Sandro Barni
- Division of Medical Oncology; Azienda Ospedaliera Treviglio; Treviglio Italy
| | - Paolo Marchetti
- Unit of Medical Oncology, Sant'Andrea Hospital, Faculty of Medicine and Psychology; La Sapienza University of Rome; Rome Italy
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Saita E, Acquati C, Kayser K. Coping with early stage breast cancer: examining the influence of personality traits and interpersonal closeness. Front Psychol 2015; 6:88. [PMID: 25699003 PMCID: PMC4318273 DOI: 10.3389/fpsyg.2015.00088] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/15/2015] [Indexed: 11/16/2022] Open
Abstract
The study examines the influence of personality traits and close relationships on the coping style of women with breast cancer. A sample of 72 Italian patients receiving treatment for early stage breast cancer was recruited. Participants completed questionnaires measuring personality traits (Interpersonal Adaptation Questionnaire), interpersonal closeness (Inclusion of the Other in the Self Scale), and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale). We hypothesized that diverse personality traits and degrees of closeness contribute to determine the coping styles shown by participants. Multiple regression analyses were conducted for each of the five coping styles (Helplessness/Hopelessness, Anxious Preoccupation, Avoidance, Fatalism, and Fighting Spirit) using personality traits and interpersonal closeness variables (Strength of Support Relations, and Number of Support Relations) as predictors. Women who rated high on assertiveness and social anxiety were more likely to utilize active coping strategies (Fighting Spirit). Perceived strength of relationships was predictive of using an active coping style while the number of supportive relationships did not correlate with any of the coping styles. Implications for assessment of breast cancer patients at risk for negative adaptation to the illness and the development of psychosocial interventions are discussed.
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Affiliation(s)
- Emanuela Saita
- Department of Psychology, Catholic University of Milan Milan, Italy
| | - Chiara Acquati
- Raymond A. Kent School of Social Work, University of Louisville Louisville, KY, USA
| | - Karen Kayser
- Raymond A. Kent School of Social Work, University of Louisville Louisville, KY, USA
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Pereira FMP, Santos CSVDB. Initial validation of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale: Study of Portuguese end-of-life cancer patients. Eur J Oncol Nurs 2014; 18:534-9. [DOI: 10.1016/j.ejon.2014.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 04/03/2014] [Accepted: 04/19/2014] [Indexed: 11/16/2022]
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Re-examining the factor structure and psychometric properties of the Mini-Mental Adjustment to Cancer Scale in a sample of 364 Chinese cancer patients. Support Care Cancer 2014; 23:353-8. [DOI: 10.1007/s00520-014-2367-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 07/22/2014] [Indexed: 10/24/2022]
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