Effects of optimism, social support, fighting spirit, cancer worry and internal health locus of control on positive affect in cancer survivors: a path analysis

Misalignment of social support in the social media posts of young adult cancer caregivers

BACKGROUND

Compared with older cancer caregivers, young adult cancer caregivers (YACC) experience greater stress and depression during the first 6 months of caregiving. Social support can buffer the negative psychological effects associated with cancer caregiving. However, the misalignment of social support is associated with increased distress and worse emotional well-being. As YACC are more likely to utilize social media (SM) to seek social support compared with older cancer caregivers, they may be at greater risk of experiencing the misalignment of social support and related negative outcomes.

OBJECTIVE

The purpose of this study was to identify ways that SM posts containing support for YACC's were potentially misaligned with the social support desired by YACC.

METHODS

In this secondary analysis, cancer-related SM posts (N = 760) from 34 YACC's SM accounts were extracted for 6 months following the day of cancer diagnosis and imported into NVivo qualitative analysis software. Open coding of posts from four YACC identified a pattern of SM posts containing responses that may misalign with social support requests, and could be perceived as dismissive of YACC's emotions. Similar posts were grouped together, forming categories which were used to create a codebook and applied in coding all posts from the remaining 30 YACC.

RESULTS

Content analysis identified three categories of social support misalignment originating from YACC's SM posts: supplications (n = 251, 33%), prevailing (n = 7, 10.1%), and consolations (n = 16, 2.1%). Supplications involved prayer or trust in god, prevailing posts compared dealing with cancer to a fight and suggested that the person would overcome cancer, and consolations used quotes, song lyrics, and or general reassurances in SM posts.

CONCLUSIONS

Findings suggest that when YACC use SM during cancer experiences, they may interpret SM posts as social support or as misalignment of social support requests, which in turn can lead to either improved quality of life or additional distress (respectively). This study adds to the body of knowledge regarding how YACC use social media for social support and may inform future interventions designed to match YACC's desired support with support offered.

Subjective Well-Being in Cancer Patients: The Roles of Social Support, Purpose in Life, Resilience, and Informativeness

The aim of this research was to determine the relationship between subjective well-being (life satisfaction, positive and negative experiences, and prosperity) and various psychosocial factors (social support received from family members and partners, purpose in life, resilience and information) in cancer patients and to examine the possibility of predicting components of subjective well-being based on these mentioned factors in cancer patients. A total of 338 adult cancer patients from Croatia participated in the study (41.1% male and 58.9% female). To measure the constructs, the Diener Subjective Well-Being Scale, the Social Support Scale at work and in the family, the Purpose in Life Scale, the Short Resilience Scale, and the EORTC-QLQ information questionnaire were used. Results showed a high level of life satisfaction and prosperity, as well as more frequent positive compared to negative experiences. A medium to high level of social support received from family members and from the partner was determined. High levels of purpose in life and medium levels of resilience and information were found. A high correlation was found among the components of the construct of subjective well-being, and a low to medium correlation among the predictors. Positive associations were found between the criteria of life satisfaction and prosperity with psychosocial factors. Negative associations were established between the positive/negative experience variables and the factors. Furthermore, the purpose in life was determined as an important predictor of all three components of subjective well-being, social support (both sources) as important for predicting life satisfaction, resilience for experiencing positive and negative experiences, and social family support for predicting the prosperity of cancer patients.

Patient Experiences After Aborted Cancer Surgery: A Qualitative Study

BACKGROUND

Surgical resection is a necessary component of curative-intent treatment for most solid-organ cancers but is occasionally aborted, most often due to occult metastatic disease or unanticipated unresectability. Despite its frequency, little research has been performed on the experiences, care needs, and treatment preferences of patients who experience an aborted cancer surgery.

METHODS

Semistructured interviews of patients who had previously experienced an aborted cancer surgery were conducted, focusing on their recalled experiences and stated preferences. All interviews were audio recorded, transcribed, and coded by two independent researchers by using NVivo 12. An integrative approach to qualitative analysis was used-both inductive and deductive methods-and iteratively identifying themes until saturation was reached.

RESULTS

Fifteen patients with an aborted cancer surgery participated in the interviews. Cancer types included pancreatic (n = 9), cholangiocarcinoma (n = 3), hepatocellular carcinoma (n = 1), gallbladder (n = 1), and neuroendocrine (n = 1). The most common reasons for aborting surgery included local tumor unresectability (n = 8) and occult metastatic disease (n = 7). Five subthemes that characterized the patient experience following an aborted cancer surgery emerged, including physical symptoms, emotional responses, impact on social and life factors, coping mechanisms, and support received.

CONCLUSIONS

This qualitative study characterizes the impact of aborted cancer surgery on multiple domains of quality of life: physical, emotional, social, and existential. These results highlight the importance of developing patient-centered interventions that focus on enhancing quality of life after aborted cancer surgery.

The Prospective Effects of Coping Strategies on Mental Health and Resilience at Five Months after HSCT

OBJECTIVES

Hematopoietic stem cell transplantation (HSCT) is a stressful event that engenders psychological distress. This study examines the prospective effects of coping strategies during hospitalization on resilience and on various mental-health dimensions at five months after transplantation.

METHODS

One hundred and seventy patients (M_age = 52.24, SD = 13.25) completed a questionnaire assessing adjustment strategies during hospitalization, and 91 filled out a questionnaire five months after HSCT (M_age = 51.61, SD = 12.93).

RESULTS

Multiple regression analyses showed that a fighting spirit strategy positively predicted resilience (p < 0.05), whereas anxious preoccupations predicted anxiety (p < 0.05), poorer mental QoL (p < 0.01), and were associated with an increased risk of developing PTSD (OR = 3.27, p < 0.01; 95% CI: 1.36, 7.84) at five months after transplantation. Hopelessness, avoidance, and denial coping strategies were not predictive of any of the mental health outcomes. Finally, the number of transplantations was negatively related to a fighting spirit (p < 0.01) and positively related to hopelessness-helplessness (p < 0.001): Conclusions: These results highlight the importance of developing psychological interventions focused on coping to alleviate the negative psychological consequences of HSCT.

The Impact of Bevacizumab and Chemotherapy on Quality of Life in Metastatic Colorectal Cancer Patients

Health-related quality is of life of great importance in cancer care. This prospective study aimed to evaluate the impact of chemotherapy and bevacizumab on the activities of daily living, cancer symptoms, and general well-being in 59 metastatic colorectal cancer patients. We gathered information using the EORTC QLQ-C30 and QLQ-CR29 questionnaires. The paired sample t-test, MANOVA test, and Pearson's correlation test were used to analyze the presence of significant differences in mean scores before and after 6 months of treatment. The results revealed significant differences in the functioning and symptoms that influence patients' quality of life after 6 months of treatment: increased pain (p = 0.003), nausea and vomiting (p = 0.003), diarrhea (p = 0.021) and decreased appetite (p = 0.003). At the same time, there were several aspects that improved the quality of life. Increases in emotional function (p = 0.009), cognitive function (p = 0.033), and perception of body image (p = 0.026) were observed after 6 months of treatment. Elderly patients reported a higher frequency of stools (p = 0.028), and young patients had increased concerns about body perception (p = 0.047). Assessing the quality of life of metastatic colorectal cancer patients is an important way to identify and treat symptoms related to both cancer and therapy by establishing a holistic care plan and implementing measures to increase the quality of life.

Core self-evaluations as resilience and risk factors of psychological distress during the COVID-19 pandemic

In view of the grave consequences of distress reactions to the COVID-19 pandemic, this study investigated CSE (Core Self-evaluations) - internal/external health locus of control, generalized self-efficacy and trait optimism - and intolerance of uncertainty as potential correlates of distress reactions. We conducted an online questionnaire-based cross-sectional study with 422 Israeli respondents. Pandemic-related distress was defined by perceived stress, negative and positive affect, and worries. Predictors were: health locus of control, generalized self-efficacy, trait optimism, and intolerance of uncertainty. The findings show that CSEs and intolerance of uncertainty added between 11% (to perceived stress) and 22% (to negative affect) of explained variance beyond the background variables. Specifically, higher trait optimism and generalized self-efficacy were associated with less distress, and greater intolerance of uncertainty was correlated with higher distress. In conclusion, the CSE framework is useful for explaining psychological distress during the COVID-19 pandemic. Beyond their theoretical contribution, the findings may have practical implications for increasing resilience and ameliorating distress during a pandemic.

Coping with cancer: the role of different sources of psychosocial support and the personality of patients with cancer in (mal)adaptive coping strategies

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.

Optimism and subjective well-being in nursing home older adults: The mediating roles of gratitude and social support

OBJECTIVES

To examine the level of subjective well-being (SWB) and the mediating roles of gratitude and social support in the relationship between optimism and SWB amongst older Chinese people in nursing homes.

METHODS

A total of 354 older adults in Chinese nursing homes completed the World Health Organization's well-being index, Life Orientation Test-Revised, Gratitude Questionnaire-Six-Item Form, and Multidimensional Scale of Perceived Social Support. Structural equation modeling was used to evaluate the relationships between optimism, gratitude, social support and SWB.

RESULTS

The mean SWB score of the older people was (63.14 ±15.31), with 21.0% of subjects reporting low SWB. Gratitude and social support in serial partially mediated the relationship of optimism with SWB (total indirect effect: Standardized β = 0.157, 95% CI [0.109,0.216], p<0.001).

CONCLUSION

These findings provide good evidence for the inter-relationship mechanism amongst the protective factors of SWB, suggesting the need to prioritize positive psychological nursing interventions to promote SWB in older people in residential care.

Expanding the purview of wellness indicators: validating a new measure that includes attitudes, behaviors, and perspectives

Objective

The present study validated the DeltaQuest Wellness Measure (DQ Wellness), a new 15-item measure of wellness that spans relevant attitudes, behaviors, and perspectives.

Design

This cross-sectional web-based study recruited chronically-ill patients and/or caregivers (n = 3,961) and a nationally representative comparison group (n = 855).

Main Outcome Measures

The DQ Wellness assesses: a way of being in the world that involves seeing and embracing the good and expressing kindness toward others; engagement in one's activities and self-care; downplaying negative thoughts that reduce one's energy; and an ability to feel joy. Six widely used measures of physical and mental health, cognition, and psychological well-being enabled construct-validity comparisons. Item-response theory (IRT) methods evaluated reliability, factor structure, and differential item functioning (DIF) by gender.

Results

The DQ Wellness showed strong cross-sectional reliability (marginal reliability = 0.89) and fit a bifactor model (RMSEA = 0.063, CFI = 0.982, TLI = 0.983). The DQ Wellness general score demonstrated construct validity, convergent and divergent validity, unique variance, and known-groups validity, and minimal gender DIF. The study is limited to addressing cross-sectional reliability and validity, and response rates are not known due to the recruitment source.

Conclusion

The DQ Wellness is a relatively brief measure, taps novel content, and could be useful for observational or interventional studies.

Relations among positivity, positive affect in school, and learning flow in elementary school students: A longitudinal mediation model

BACKGROUND

Learning flow is an optimal learning experience representing full engagement in one's studies. The belief-affect-engagement model and control-value theory suggest that positivity would be a motivator of learning flow, while positive affect in school would be a mediator of the relation between positivity and learning flow.

AIMS

The current research aimed to examine (1) the longitudinal relations among positivity, positive affect in school, and learning flow, and (2) the mediational role of positive affect in school between positivity and learning flow.

SAMPLE AND METHOD

A sample of 4681 Chinese elementary school students (44.9% girls; M_age  = 9.87 years, SD = 0.70 at Time 1) completed reliable measures for each construct on four occasions across 2 years, using 6-month intervals. Structural equation modelling was used for examining study hypotheses.

RESULTS

After controlling for gender, age, and family socioeconomic status, the results showed that (1) positivity, positive affect in school, and learning flow reciprocally facilitated each other directly; (2) positive affect in school mediated the relation between positivity and later learning flow, as well as the relation between learning flow and later positivity.

CONCLUSIONS

These findings revealed that positivity, positive affect in school, and learning flow form a complex, dynamic system, suggesting that school professionals should consider monitoring and developing interventions based upon these variables as early as elementary school.

"Lights and Shadows": An Interpretative Phenomenological Analysis of the Lived Experience of Being Diagnosed With Breast Cancer During Pregnancy

Cancer diagnosed during pregnancy is a rare event. The most common type of malignancy diagnosed in pregnant women is breast cancer, whose incidence is expected to raise in the next future due to delayed childbirth, as well as to the increased occurrence of the disease at young age. Pregnant women diagnosed with breast cancer are exposed to multiple sources of stress, which may lead to poorer obstetric outcomes, such as preterm birth and low birth weight. In addition, pregnancy involves physiological changes in the breasts that may blur the signs of cancer, with delayed diagnosis and poor prognosis. However, the lived experience of these women was investigated in very few studies. Given this scenario, we conducted this qualitative study to describe and understand women’s subjective experience of being diagnosed with breast cancer during pregnancy. The study was conducted following the principles of Interpretative Phenomenological Analysis. Participants were five women with breast cancer diagnosed during pregnancy, purposefully recruited at a public hospital during medical visits and interviewed at treatment initiation. The interview transcripts were analyzed using thematic analysis. The textual analysis led to the identification of three main themes related to: (1) the emotional storm experienced after cancer diagnosis, and the importance of receiving appropriate information and being focused on treatment decisions; (2) physical changes and comparisons with healthy women, associated with feelings of sadness and inadequacy; (3) being positive, feeling free to disclose all kinds of emotions, religion and spirituality as sources of strength. The paradoxical coexistence of pregnancy and cancer represents a stressful experience for women and their loved ones. Adopting a systemic perspective may be important to understand the effects of such a complex condition, also considering its impact on healthcare workers.

Living with mesothelioma: A qualitative study of the experiences of male military veterans in the UK

PURPOSE

The UK has the highest incidence of mesothelioma in the world. Evidence in the United States suggests that mesothelioma may disproportionately affect military veterans. However, there has been no investigation of the experience of UK veterans living with mesothelioma. The Military Mesothelioma Experience Study (MiMES) aimed to understand the experience and health/support needs of British Armed Forces personnel/veterans with mesothelioma.

METHODS

Semi-structured interviews were conducted with 13 veterans living with mesothelioma, and nine family members of veterans living with mesothelioma. Participants were recruited via charities and asbestos support groups. Data were analysed using thematic analysis.

RESULTS

Participants' experiences are presented using three themes, i) exposure to asbestos and awareness of asbestos related diseases, ii) using military strategies to cope with mesothelioma and iii) preferences for information and support. MiMES indicates that the nature and range of UK military veterans' asbestos exposure is varied and not limited to high risk occupations. Participants' knowledge of asbestos and experience of mesothelioma influenced their experiences of diagnosis. Participants had coping strategies influenced by their military experiences. Assistance in navigating health and military systems was considered beneficial, especially if support was provided by professionals with knowledge or experience of the military. Attributes which may inhibit veterans from seeking professional support are discussed.

CONCLUSION

MiMES provides insight into how UK military veterans experience and cope with mesothelioma. Key implications focus on the role that Mesothelioma Nurse Specialists, Asbestos Support Groups and veterans groups play in providing acceptable support for UK veterans.

Effects of stigma, hope and social support on quality of life among Chinese patients diagnosed with oral cancer: a cross-sectional study

BACKGROUND

Improving quality of life (QoL) has been one of the goals of health care for people living with oral cancer. This study aimed to assess QoL and investigate the effects of stigma, hope, and social support on QoL among Chinese oral cancer patients.

METHODS

A cross-sectional study was conducted at the Department of Stomatology, Shengjing Hospital of China Medical University and Stomatology Hospital of China Medical University in Liaoning Province, China, between May 2016 and October 2017. A total of 230 oral cancer patients were recruited to complete a questionnaire including the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N), the Social Impact Scale (SIS), the Herth Hope Index (HHI) and the Multidimensional Scale of Perceived Social Support (MSPSS). Univariate one-way ANOVA/t-test, Person's r and hierarchical linear regression analysis were conducted to explore the factors influencing QoL and the relationships between stigma, hope, perceived social support and QoL.

RESULTS

The mean QoL score was 90.85 ± 20.15 among the patients with oral cancer. Stigma was negatively related to QoL, explaining 39.3% of the variance. In addition, hope and perceived social support were positively associated with QoL, explaining 8.1% of the variance.

CONCLUSION

Overall, Chinese patients with oral cancer suffer from low QoL. Stigma was significantly and negatively associated with QoL, while hope and perceived social support were positively associated with QoL. Oral cancer patients' psychological states should be addressed, and adequate intervention based on positive psychological resources should be provided to improve the QoL of patients with oral cancer.

Relationships Between Smoking Status and Psychological Distress, Optimism, and Health Environment Perceptions at Time of Diagnosis of Actual or Suspected Lung Cancer

BACKGROUND

While much research and practice resources have addressed smoking cessation among cancer patients, less emphasis has been placed on personal psychological and environment factors associated with smoking at the time of diagnosis.

OBJECTIVE

The aim of this study was to examine differences in psychological distress, optimism, and perceptions of the health environment/illness experience based on smoking status in patients with current, former, and no smoking history with newly diagnosed suspected or actual lung cancer.

METHODS

Data were derived from a descriptive study of 52 patients (34 men and 18 women aged 37-83 years) undergoing diagnostic evaluation for actual or suspected lung cancer. Descriptive statistics were used to characterize data. Analysis of variance, χ, and Spearman correlation tests were used to determine relationships among main study variables (smoking status, anxiety, worry, perceived cognitive functioning, optimistic outlook, health environment/illness experience perceptions).

RESULTS

Current smoking status was associated with higher psychological distress (anxiety and worry) among patients facing a new suspected or actual cancer diagnosis.

CONCLUSIONS

The study was able to provide important information relative to smoking status and psychological distress at the time of diagnosis of suspected or actual lung cancer. Findings demonstrate needs for assessment and targeted interventions to reduce psychological distress and to promote long-term adaptation in patients smoking at time of diagnosis.

IMPLICATIONS FOR PRACTICE

Nurses are positioned to provide support and resources for cancer patients. It is critical that smoking cessation interventions also address nicotine craving, emotion regulation, and adaptive coping skills.

Different Effects of Motivation Orientation on Ideational Flexibility: Key Role of Optimism

The present study investigated the relationships between motivation orientation (approach and avoidance motivations) and ideational flexibility and the potential effects of optimism on these associations in a large behavioral sample of 320 healthy young adults. As predicted, the approach motivation-ideational flexibility relationship and the avoidance motivation-ideational flexibility relationship were differentially affected by individual difference measures of dispositional optimism. More specifically, optimism significantly moderated the relationship between avoidance motivation and ideational flexibility, whereas it did not moderate the relationship between approach motivation and ideational flexibility. Detailed analysis revealed that avoidance motivation related positively to ideational flexibility, especially for people with low optimism. Furthermore, in an external validation analysis using data obtained from an independent sample of participants (replication cohort; n = 249), we showed that dispositional optimism can reliably affect the approach motivation-ideational flexibility relationship and the avoidance motivation-ideational flexibility relationship differentially. These findings help resolve the ongoing controversy surrounding the nature of the motivation orientation-creativity nexus and have potential implications for current practice and interventions.

Coping Strategies Used by Breast, Prostate, and Colorectal Cancer Survivors: A Literature Review

BACKGROUND

Individual coping strategies are a fundamental element underpinning psychosocial distress.

OBJECTIVE

The aim of this study was to describe coping strategies and their measurement used by survivors of breast, prostate, and/or colorectal cancer after treatment.

METHODS

A search of electronic databases (PubMed, CINAHL, and PsycINFO) was conducted from January 1980 to March 2015. Data were extracted using standardized forms and included studies that explored the coping mechanisms of survivorship of breast, prostate, or colorectal cancer.

RESULTS

Two thousand one hundred forty-seven studies were retrieved for potential inclusion; 19 publications met the inclusion criteria and were included in the review.

CONCLUSIONS

Breast, prostate, and colorectal cancer survivors seem to use different coping strategies that varied throughout the survivorship trajectory. Breast cancer survivors highlighted the importance of accepting their diagnosis and engaging in physical activities that provided social and emotional support. Personality seemed to have a significant effect on coping for prostate cancer survivors. Colorectal cancer survivors emphasized the importance of seeking information to master self-management and return to social activities.

IMPLICATIONS FOR PRACTICE

Understanding coping strategies, during the survivorship trajectories, is essential to planning contemporary care after cancer treatment. Nurses and other healthcare professionals may use this knowledge to improve quality of life and decrease distress after diagnosis.

Influence of family income and medical insurance coverage on health-related quality of life and optimism in cancer patients at a Hong Kong private hospital: A cross-sectional study

OBJECTIVE

Health-related quality of life (HRQL) and optimism are important health domains that express the physical, emotional, and psychological well-being of cancer patients. Previous studies have explored income and medical insurance coverage as predictors of their well-being with the aim to better understand their financial needs. The primary objective of this study was to examine the associations in the private health sector in Hong Kong.

METHODS

The study was conducted cross-sectionally with a structured questionnaire in traditional Chinese. HRQL was assessed with the RAND 12-item Health Survey, and optimism was assessed with the Life Orientation Test. The two primary predictors were family income and medical insurance coverage. The associations were tested using logistic regression, controlling for other sociodemographic and clinical covariates.

RESULTS

A total of 428 questionnaires were used in the regression model. After adjusting for other covariates, no significant association was observed with family income as the predictor. Medical insurance coverage was a significant and positive predictor of optimism with odds ratio of 2.30 and 95% confidence interval of 1.30 to 4.05 for the group with the most coverage with little to no coverage as the reference group.

CONCLUSIONS

The significant association between medical insurance coverage and optimism might be an indication that the medical cost was a financial burden to many cancer patients in Hong Kong. In addition to their medical needs, cancer support organization and health care practitioners must be able to recognize and assist with the financial needs of the cancer patients.

Resilience and Coping in Cancer Survivors: The Unique Effects of Optimism and Mastery

Optimism and mastery are two cognitive traits that involve positive expectations for the future and that have been demonstrated to be important predictors of reduced anxiety as well as superior coping and physical health in many populations, including cancer survivors. There is limited research, however, examining the unique effects of these traits when examined simultaneously. The present cross-sectional study used structural equation modeling to examine the unique effects of optimism and mastery on emotion, coping, and health in 603 adult cancer survivors, and whether results were consistent in men and women. Results indicated that both optimism and mastery were associated with improved emotion, coping, and health and together accounted for a small to moderate amount of variance. Although the effects of optimism were generally greater, mastery also uniquely predicted most dependent variables and there was some evidence that gender influenced these effects, with optimism predicting health control more so in women and mastery predicting health control more so in men. These results demonstrate that it is important to examine both generalized positive expectancies such as optimism and positive expectancies regarding mastery when investigating resilience and emotional well-being in cancer survivors.

The Imperative for a Triumph-Over-Tragedy Story in Women's Accounts of Undergoing Chemotherapy for Ovarian Cancer

We aimed to examine how women construct their experiences of chemotherapy treatment for ovarian cancer. Through semistructured interviews, we explored the accounts of 18 Australian women about their experiences within a broader cultural imperative-or discourse-to "think positively." By applying a critical realist lens to the analysis, we identified two discursive themes that shaped women's accounts. The "feeling different and managing support" theme highlights the identity challenges women faced because of the lack of formal support for ovarian cancer. Conversely, the theme "women's reconstructions of difficult experiences" illustrates the imperative for women to present a positive story as a way of restoring their position of a lucky and stoic survivor. Such speaking served to mask some of the underlying difficulties that were part of these women's experiences. Health care professionals need to consider looking for the hidden stories of vulnerability that lie beneath the triumphant ones.

Quality of life of older adults with cancer in Korea

This study examines the quality of life (QoL) of older adults with cancer (N = 176), by comparing them with age- and gender-matched groups without cancer (N = 176), and investigates factors associated with their QoL. The results of Medical Outcome Study Short Form-36 (MOS SF-36) showed that the study group had significantly lower scores than the noncancer group on all eight scales and on the Physical Component Summary and the Mental Component Summary. Comparison with gender and age groups revealed some differences. Optimism and social support were positively related to QoL while comorbidity, cancer-related concerns, and financial worries were inversely related.

Family Intervention Based on the FOCUS Program Effects on Cancer Coping in Iranian Breast Cancer Patients: a Randomized Control Trial

Background:

Breast cancer affects patients’ lives. Many breast cancer patients have problems with coping and they need support from their families. Family involvement based on the FOCUS program is designed to support breast cancer survivors within their families. The aim of this study was to investigate the effect of family involvement based on the FOCUS program on coping in breast cancer patients undergoing chemotherapy in academic centers in Urmia in 2016.

Methods:

In this randomized controlled trial study, sixty breast cancer survivors were randomly assigned into intervention (N=30) and control (N=30) groups. The FOCUS program family-based intervention featured six sessions covering subject areas of family involvement, optimism, cancer coping, uncertainty reduction and symptom management. The instruments used were demographic and cancer coping questionnaires. Data were analyzed with SPSS 20 software.

Result:

The findings revealed a significant improvement in total cancer coping scores (t= -12/39, p<0.001), in all subscales including individual (t= -11/52, p<0.001), positive focus (t= -7/03, p<0.001), coping (t= -7/28, p<0.001), diversion (t= -11/76, p<0.001), planning (t=-4/91, p<0.001) and in interpersonal (t=-11/14, p<0.001). No significant changes were observed for the control group.

conclusion:

The results showed that family involvement based on the FOCUS program increases the ability to cope in breast cancer survivors.

Advice to patients undergoing stem cell transplant: Content analysis of survivor peer support narratives

Hematopoietic stem cell transplant survivors often share advice with patients undergoing this difficult treatment. We content analyzed narratives written by 59 transplant survivors given the opportunity to share advice with patients. Analyses described categories of advice they shared and evaluated their perceptions of the helpfulness of advice they had received. We found nine advice categories and evidence for variation in their perceived helpfulness, especially for advice to "be your own advocate," "have someone you can rely on," and "think positive." Findings suggest the need to investigate how seemingly innocuous advice can be unhelpful and potentially distressing to some patients.

Acquisition of Social Support and Linguistic Characteristics of Social Media Posts About Young Adult Cancer

PURPOSE

Social media (SM) is a burgeoning source of social support for young adults (YAs). We explored the language used to communicate about YA cancer on Instagram and for indicators of social support (i.e., number of likes and comments).

METHODS

Instagram posts using #youngadultcancer were randomly selected (N = 50). Text and hashtags were collected, and posts were coded for gender (female and male), treatment status (active treatment and survivorship), type of user (individual and organization), and caregiver status (yes and no). Indicators of social support, valence (e.g., positive vs. negative terms), and lexical content (e.g., emotional terms and pronouns) were measured using Yoshikoder and Linguistic Inquiry Word Count and compared by gender, treatment status, type of user, and caregiver status.

RESULTS

Survivors' posts had more likes compared to those in active treatment (mean: 54.5 vs. 32.3, p = 0.03). Individuals' posts had more comments than those of organizations (mean: 5.3 vs. 1.2, p = 0.01). More positive (30%) than negative (13%) terms were used by survivors (p < 0.01) and those in active treatment (20% vs. 9%, p = 0.04). Individuals' used more positive than negative language (p < 0.01), whereas organizations used equally positive and negative terms. Survivors used more emotional terms (79.6% vs. 34.9%, p < 0.01) and fewer pronouns (mean: 39.5 vs. 71.7, p = 0.01) than those in active treatment. Organizations (71.0%) used more emotional terms than individuals (55.9%, p = 0.03).

CONCLUSIONS

We describe how Instagram users communicate about YA cancer and whether the language they use garners social support. Studying online language use may help YA patients, caregivers, and organizations use SM to gain social support.

Predicting general and cancer-related distress in women with newly diagnosed breast cancer

BACKGROUND

Psychological distress can impact medical outcomes such as recovery from surgery and experience of side effects during treatment. Identifying the factors that explain variability in distress would guide future interventions aimed at decreasing distress. Two factors that have been implicated in distress are illness perceptions and coping, and are part of the Self-Regulatory Model of Illness Behaviour (SRM). The model suggests that coping mediates the relationship between illness perceptions and distress. Despite this; very little research has assessed this relationship with cancer-related distress, and none have examined women with screen-detected breast cancer. This study is the first to examine the relative contribution of illness perceptions and coping on general and cancer-related distress in women with screen-detected breast cancer.

METHODS

Women recently diagnosed with breast cancer (N = 94) who had yet to receive treatment completed measures of illness perceptions (Revised Illness Perception Questionnaire), cancer-specific coping (Mental Adjustment to Cancer Scale), general anxiety and depression (Hospital Anxiety and Depression scale), and cancer-related distress.

RESULTS

Hierarchical regression analyses revealed that medical variables, illness perceptions and coping predicted 50% of the variance in depression, 42% in general anxiety, and 40% in cancer-related distress. Believing in more emotional causes to breast cancer (β = .22, p = .021), more illness identity (β = .25, p = .004), greater anxious preoccupation (β = .23, p = .030), and less fighting spirit (β = -.31, p = .001) predicted greater depression. Greater illness coherence predicted less cancer-related distress (β = -.20, p = .043). Greater anxious preoccupation also led to greater general anxiety (β = .44, p < .001) and cancer-related distress (β = .37, p = .001). Mediation analyses revealed that holding greater beliefs in a chronic timeline, more severe consequences, greater illness identity and less illness coherence increases cancer-specific distress (ps < .001) only if women were also more anxiously preoccupied with their diagnosis.

CONCLUSIONS

Screening women for anxious preoccupation may help identify women with screen-detected breast cancer at risk of experiencing high levels of cancer-related distress; whilst illness perceptions and coping could be targeted for use in future interventions to reduce distress.

Effects of social support, hope and resilience on quality of life among Chinese bladder cancer patients: a cross-sectional study

Background

Improvement of quality of life has been one of goals in health care for people living with bladder cancer. Meanwhile, positive psycho-social variables in oncology field have increasingly received attention. However, the assessment of quality of life of bladder cancer patients and the integrative effects of positive psycho-social variables has limited reporting. The aim of this study was to assess quality of life as well as the integrative effects of social support, hope and resilience on quality of life among Chinese bladder cancer patients.

Methods

A cross-sectional study was conducted at the First Hospital of China Medical University in Liaoning Province, China. A total of 365 bladder cancer patients eligible for this study completed questionnaires on demographic variables, FACT-BL, Perceived Social Support Scale, Adult Hope Scale, and Resilience Scale-14 during July 2013 to July 2014.

Results

The average score of FACT-BL was 87.60 ± 16.27 (Mean ± SD). Hierarchical regression analyses indicated that social support, hope and resilience as a whole accounted for 30.3 % variance of quality of life. Under standardized estimate (β) sequence, social support, hope and resilience significantly and positively associated with quality of life, respectively.

Conclusions

Quality of life for bladder cancer patients was at a low level in China, which should receive more attention in Chinese medical institutions. More importantly, efforts to increase social support, hope and resilience might be useful to support the quality of life among Chinese bladder cancer patients.

Determinants of long-term quality of life in patients with differentiated thyroid carcinoma - a population-based cohort study in Sweden

BACKGROUND

Although differentiated thyroid cancer (DTC) has an excellent prognosis and a low incidence of recurrence, lifelong follow-up and medication might be needed. The aim of this study was to clarify how living with a cancer diagnosis for many years affects health-related quality of life (HRQoL) in DTC patients in Sweden.

MATERIAL AND METHODS

From the national all-encompassing population-based Swedish Cancer Registry, 353 patients diagnosed with DTC between 1995 and 1998 were identified and invited to answer the HRQoL questionnaire SF-36 and a study-specific questionnaire, 14-17 years after their diagnosis. Data were compared with a reference population as well between subgroups of patients.

RESULTS

Of the patients with DTC, 279 (79%) answered the questionnaires. In all, only 19 (7%) reported a recurrence, however, as many as 134 (48%) stated that they still had concerns about having a recurrence. The HRQoL in those with a recurrence was significantly lower than those without concerns of a recurrence in five of eight domains (p < 0.001-0.049). Similarly, patients with concerns of a recurrence reported poorer HRQoL than those without concerns, with significantly lower values in five domains (p < 0.001-0.008). Those few who stated that their disease had given them a negative view on life reported poor HRQoL in all eight domains (p < 0.001-0.030).

CONCLUSIONS

Even if DTC comes with an excellent prognosis, almost half of the patients, fully 15 years after diagnosis, worried about a recurrence which negatively impacted their HRQoL. Awareness among healthcare practitioners might improve information, supportive care and, in the end, the patient's HRQoL.

Understanding Group and Leader (UGL) trainers' personality characteristics and affective profiles

BACKGROUND

The Understanding Group and Leader (UGL), provided by the Swedish National Defense College and mentored by UGL-trainers, is one of the most popular management programs among civilians in Sweden. However, there is a lack of scientific evidence regarding the training. We used the affective profile model (i.e., the combination of positive, PA, and negative affect, NA) to mapp important markers of empowerment, self-awareness, adaptive coping skills, and maturity among the UGL-trainers. The aims were: (1) to compare profiles between UGL-trainers and managers/supervisors and (2) to investigate differences in personal characteristics.

METHOD

UGL-trainers (N = 153) and the comparison group (104 Swedish Chiefs of Police) completed an online survey on optimism, self-esteem, locus of control, and affect. The four profiles are: self-fulfilling (high PA, low NA), high affective (high PA, high NA), low affective (high PA, low NA), and self-destructive (low PA, high NA).

RESULTS

The self-fulfilling profile was more common among UGL-trainers (25.70%) than among Chiefs of Police (19.20%). UGL-trainers, compared to Chiefs of Police, were more likely to express a self-fulling than a low affective profile (OR = 2.22, p < 0.05) and a high affective than a low affective profile (OR = 1.43, p < 0.001). UGL-trainers with a self-fulfilling profile, compared to those with a self-destructive profile, scored higher in optimism, higher in self-esteem, and lower in external locus of control.

CONCLUSIONS

The probability of self-fulfillment rather than low affectivity was higher among UGL-trainers. Self-fulfillment was associated to markers of self-awareness and adaptive coping skills. However, the most common profile was the low affective, which is associated to low performance during stress, low degree of personal development, low degree of purpose in life, and low resilience. Hence, it might be important for UGL-trainers to have a continuous training in awareness after certification.

Effects of optimism on creativity under approach and avoidance motivation

Focusing on avoiding failure or negative outcomes (avoidance motivation) can undermine creativity, due to cognitive (e.g., threat appraisals), affective (e.g., anxiety), and volitional processes (e.g., low intrinsic motivation). This can be problematic for people who are avoidance motivated by nature and in situations in which threats or potential losses are salient. Here, we review the relation between avoidance motivation and creativity, and the processes underlying this relation. We highlight the role of optimism as a potential remedy for the creativity undermining effects of avoidance motivation, due to its impact on the underlying processes. Optimism, expecting to succeed in achieving success or avoiding failure, may reduce negative effects of avoidance motivation, as it eases threat appraisals, anxiety, and disengagement-barriers playing a key role in undermining creativity. People experience these barriers more under avoidance than under approach motivation, and beneficial effects of optimism should therefore be more pronounced under avoidance than approach motivation. Moreover, due to their eagerness, approach motivated people may even be more prone to unrealistic over-optimism and its negative consequences.

Web psychosocial surveys in cancer survivorship--a methodological note

The number of Internet surveys is increasing, and there is a need to examine critically their value in psychosocial cancer care research. This study explored the use of an online method of recruiting and surveying people affected by cancer. An online survey was designed to measure the health status and service needs of adult cancer survivors and caregivers. The online survey received 491 page visits; only 5% of visitors (13 survivors and 14 cancer caregivers) completed the online questionnaire. The average age of survivors and caregivers was 43 and 42 years, respectively. The majority of survivor and caregiver online respondents were female (23/27, 85%) and had been affected by cancer between 1 and 3 years previously (16/27, 59%). Our online research did not appear to be an effective method for recruiting and surveying the psychosocial health of cancer survivors. This study identified potential pitfalls and obstacles of online cancer care surveys particularly in relation to the age of cancer survivors, access to the Internet and the need to ensure surveys are easily and immediately accessible. Future Internet surveys should pay particular attention to the need to advertise and improve survey access via targeted and tailored techniques.

Affect mediates the association between mental adjustment styles and quality of life among Chinese cancer survivors

This study examined the association between mental adjustment styles and quality of life, and affect as a mediator among 238 Chinese cancer survivors. Regression analysis showed that quality of life was positively associated with fighting spirit and negatively associated with fatalism. Path analysis showed that greater fighting spirit was associated with more positive affect, which in turn was associated with higher quality of life. Greater fatalism was associated with less positive affect and more negative affect, which in turn was associated with lower quality of life. Findings suggest that positive affect and negative affect are important in understanding mental adjustment styles and its health implications.