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Wan X, Zhang Y, Peng Q, Zhang Y, Lu G, Liu S, Chen C. A study of the relationship and mediating effects of perceived stress and post-traumatic growth in patients undergoing postoperative chemotherapy for breast cancer. Eur J Oncol Nurs 2024; 71:102659. [PMID: 39003842 DOI: 10.1016/j.ejon.2024.102659] [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: 02/09/2024] [Revised: 06/08/2024] [Accepted: 06/30/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE The traumatic experience of cancer, in addition to its negative impact on breast cancer patients, can also bring about positive change, i.e., post-traumatic growth (PTG). PTG can help boost patients' confidence in their fight against the disease and improve their adherence to treatment, thereby facilitating their recovery. The study aimed to investigate the effect of perceived stress on the PTG of patients undergoing postoperative chemotherapy for breast cancer and to examine the roles of rumination and self-efficacy between two. METHODS The data was collected using a cross-sectional design. From December 2021 to October 2022, a total of 306 breast cancer patients who had undergone chemotherapy following surgery and met the inclusion and exclusion criteria were selected from three tertiary-level A hospitals in Henan Province, China. We conducted descriptive analysis, Pearson correlation analysis, and a regression analysis using PROCESS Macro Model 80 to explore the relationships among perceived stress, rumination, self-efficacy, and PTG. RESULTS Perceived stress of patients undergoing postoperative chemotherapy for breast cancer had a negative predictive effect on PTG (r = -0.340, P < 0.01); Rumination and self-efficacy played a partial mediating effect between perceived stress and PTG, accounting for 45.25% of the total effect. CONCLUSIONS Clinical nursing staff could promote PTG by strengthening psychological assessment and timely psychological intervention for patients with high perceived stress levels, encourage patients to adopt a positive way of thinking about illness and improve their self-efficacy level, so as to improve their PTG level.
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Affiliation(s)
- Xiao Wan
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China
| | - Yiqiu Zhang
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China
| | - Qianwen Peng
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China
| | - Yiming Zhang
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China
| | - Guangli Lu
- Institute of Business Administration, School of business, Henan University, Kaifeng, 475004, China
| | - Shejuan Liu
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China.
| | - Chaoran Chen
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China.
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Cooper DJ, Eckstein J, Sidiqi B, Rana ZH, Matarangas A, Shah A, Chacko N, Mancuso J, Minutoli T, Zinkin A, Sharma K, Mehta R, Potters L, Parashar B. Trait Mindfulness and Social Support Predict Lower Perceived Stress Burden in Patients Undergoing Radiation Therapy. Adv Radiat Oncol 2024; 9:101546. [PMID: 39035172 PMCID: PMC11259697 DOI: 10.1016/j.adro.2024.101546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 05/17/2024] [Indexed: 07/23/2024] Open
Abstract
Purpose Cancer diagnosis and treatment, including radiation therapy (RT), cause significant patient stress. Mindfulness and social support have been shown to help manage the psychological effects of cancer treatment. The objective of our study was to determine the sociodemographic and clinical factors associated with stress burden in patients receiving RT. Methods and Materials Patients receiving RT for cancer at a single institution were given a 3-section survey to complete during the first on-treatment visit. The survey included the Perceived Stress Scale, Medical Outcomes Study Social Support Survey, and Mindfulness Attention Awareness Scale, which were used to measure stress, social support, and trait mindfulness, respectively. Linear regression analysis was performed to determine associations between perceived stress and age, patient sex, race and ethnicity, treatment intent, disease site, trait mindfulness, and social support. Factors significant in univariable analysis were analyzed with a multivariable analysis. Results A total of 93 patients undergoing RT at a tertiary care academic institution were recruited from July to September 2019. Median scores for Perceived Stress Scale, Medical Outcomes Study Social Support Survey, and Mindfulness Attention Awareness Scale were 14.6 (range, 0-31; SD, 6.9), 4.2 (range, 1-5; SD, 1.0), and 5.1 (range, 3.1-6.0; SD, 0.8), respectively. On univariable analysis, mindfulness and social support were associated with decreased stress burden, and female sex and palliative intent were associated with increased stress burden. These factors all maintained significance in multivariable analysis. Conclusions These results suggest measures to improve mindfulness and perceived social support, such as mindfulness meditation and psychoeducational approaches, may lessen the stress burden and improve quality of life for patients undergoing RT. Future studies should analyze the longitudinal impact of individual patient characteristics, including patient sex and treatment intent, to better understand their effects on psychological maladjustment during cancer care.
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Affiliation(s)
- Dylan J. Cooper
- Northwell, New Hyde Park, New York
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, New York
| | - Jacob Eckstein
- Northwell, New Hyde Park, New York
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, New York
| | - Baho Sidiqi
- Northwell, New Hyde Park, New York
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, New York
| | - Zaker H. Rana
- Northwell, New Hyde Park, New York
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, New York
| | | | | | | | | | | | | | | | | | - Louis Potters
- Northwell, New Hyde Park, New York
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, New York
| | - Bhupesh Parashar
- Northwell, New Hyde Park, New York
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, New York
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Jiao XA, Bai RA, Li N, Liu K. Influencing factors on the psychosomatic health of medical staff since the normalized stage of COVID-19 in mainland China. Eur J Public Health 2024; 34:600-605. [PMID: 38423544 PMCID: PMC11161144 DOI: 10.1093/eurpub/ckae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, there were under-recognized and unaddressed psychosomatic health problems among medical staff. The purpose of this study was to investigate their psychosomatic status. METHODS An online questionnaire was performed to the medical staff of major hospitals in Jinan in January 2023. In total, 1244 valid questionnaires were collected, and their psychosomatic status was assessed by the Psychosomatic Symptom Scale (PSSS) and Perceived Stress Scale-10 (PSS-10). Finally, we analyzed the influencing factors for their psychosomatic status. RESULTS The psychological health of the medical staff was poor, and the level of stress perception was intense, accompanied by obvious psychosomatic symptoms. Regression analysis indicated that age, gender, frontline involvement, work experience, marriage, presence of disease history and COVID-19 infection history were risk factors for psychosomatic symptoms, while education, frontline involvement and presence of disease history were risk factors for stress feeling. CONCLUSION Medical staff often showed obvious psychosomatic symptoms and intense stress. Psychological health education and intervention should be given in order to improve their working quality.
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Affiliation(s)
- Xing-ai Jiao
- Venous Configuration Center, Qilu Hospital of Shandong University, Jinan, China
| | - Run-ai Bai
- Department of Nursing, Qingjian County People’s Hospital, Yulin, China
| | - Na Li
- Department of Organ Transplantation, Qilu Hospital of Shandong University, Jinan, China
| | - Kao Liu
- Department of Organ Transplantation, Qilu Hospital of Shandong University, Jinan, China
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Ng WH, Zaid ZA, Yusof BNM, Nordin SA, Lim PY. Predictors of elevated C-reactive protein among pre-treatment, newly diagnosed breast cancer patients: A cross-sectional study. Cancer Treat Res Commun 2024; 39:100813. [PMID: 38582031 DOI: 10.1016/j.ctarc.2024.100813] [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: 11/30/2023] [Revised: 03/03/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND & AIMS Accumulating evidence showed that inflammation contributes markedly to cancer progression, with C-reactive protein (CRP) being one of the lengthily studied inflammation marker. For breast cancer (BCa), pre-treatment elevated CRP upon diagnosis was linked with increased mortality. This study aimed to identify factors predictive of elevated CRP in pre-treatment BCa population that can serve as potential therapeutic targets to reduce inflammation. METHODS This is a cross-sectional study using multiple logistic regression to identify predictors of elevated CRP among pre-treatment, newly diagnosed BCa patients. Studied variables were socio-demographic and medical characteristics, anthropometric measurements [body weight, Body Mass Index, body fat percentage, fat mass/fat free mass ratio, muscle mass, visceral fat], biochemical parameters [albumin, hemoglobin, white blood cell (WBC), neutrophil, lymphocyte], energy-adjusted Dietary Inflammatory Index, handgrip strength (HGS), scored Patient Generated-Subjective Global Assessment, physical activity level and perceived stress scale (PSS). RESULTS A total of 105 participants took part in this study. Significant predictors of elevated CRP were body fat percentage (OR 1.222; 95 % CI 1.099-1.358; p < 0.001), PSS (OR 1.120; 95 % CI 1.026-1.223; p = 0.011), low vs normal HGS (OR 41.928; 95 % CI 2.155-815.728; p = 0.014), albumin (OR 0.779; 95 % CI 0.632-0.960; p = 0.019), and WBC (OR 1.418; 95% CI 1.024-1.963; p = 0.036). CONCLUSION Overall, predictors of elevated CRP in pre-treatment, newly diagnosed BCa population were body fat percentage, PSS, HGS category, albumin and WBC.
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Affiliation(s)
- Wai Han Ng
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Selangor, Malaysia; Department of Dietetics and Food Service, Institut Kanser Negara, Ministry of Health, 4, Jalan P7, Presint 7, Putrajaya 62250, Malaysia
| | - Zalina Abu Zaid
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Selangor, Malaysia; Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, 43400 Selangor, Malaysia.
| | - Barakatun Nisak Mohd Yusof
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Selangor, Malaysia; Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, 43400 Selangor, Malaysia
| | - Syafinaz Amin Nordin
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Selangor, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Selangor, Malaysia
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Mai Q, Liang X, Hu J, Meng X, Zhang Q, Wang C, Song Y. The effect of perceived stress on social isolation in young and middle-aged maintenance haemodialysis patients: A polynomial regression and response surface analysis. Stress Health 2024; 40:e3304. [PMID: 37583077 DOI: 10.1002/smi.3304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/06/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
Patients on maintenance haemodialysis (MHD) face social isolation due to the far-reaching effects of their disease and treatment. Based on the Transactional Model of Stress and Coping, we analysed the relationship between perceived stress and social isolation in patients, and the mediating role of internal health-related locus of control (IHLC) from the perspective of co-existence of perceived helplessness (HEL) and perceived self-efficacy (SEL). We used structured questionnaires to investigate 332 cases of young and middle-aged MHD patients in four tertiary hospitals in Guangdong, China. Polynomial regression and response surface analysis were conducted, along with tests of mediating effects on the data. The research was based on STROBE guidelines. The results showed that perceived stress is significantly and positively associated with social isolation. When the HEL and SEL of perceived stress were congruent, the joint effect of the two was in a positive curvilinear relationship to social isolation, when the two were incongruent, the risk of social isolation was lower for "low HEL-high SEL" patients compared to the "high HEL-low SEL" combination. The more congruent in HEL -SEL, the lower the risk of social isolation for the patients, with the IHLC playing a mediating role in this association. This study reveals that the coexistence of perceived stress's HEL and SEL affects social isolation through congruent and incongruent matching mechanism, providing additional explanations for the mechanism of occurrence of patients' social isolation.
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Affiliation(s)
- Qingxin Mai
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xingshan Liang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingyi Hu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangxin Meng
- Department of Nephrology, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Qiulin Zhang
- Department of Nephrology, Guangdong Second Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Chao Wang
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yang Song
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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Hu W, Bao J, Yang X, Ye M. Psychometric evaluation of the Chinese version of the stressors in breast cancer scale: a translation and validation study. BMC Public Health 2024; 24:425. [PMID: 38336690 PMCID: PMC10858503 DOI: 10.1186/s12889-024-18000-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVE To translate the Stressors in Breast Cancer Scale (SBCS) from English to Chinese and assess its psychometric properties. METHODS The Brislin's translation model was applied to perform forward translation, back translation, cross-cultural adaptation, Whereas the Chinese version of the SBCS was formed by conducting pre-testing. A cohort of 878 breast cancer patients participated in this methodological study. Content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity were used to establish validity. Internal consistency reliability, split-half reliability, and test-retest reliability were used to establish reliability. RESULTS The final scale contained five dimensions and 24 items, including interpersonal relationship and healthcare strains, worries and concerns about the future, physical appearance and sex strains, daily difficulties and health. The average content validity index of the scale was 0.975. The goodness-of-fit index (χ2/DF = 2.416, RMSEA = 0.057, GFI = 0.896, CFI = 0.947, IFI = 0.947, and TLI = 0.939) indicated that the model was well-fitted. The composite reliability (CR) of the dimensions ranged from 0.825 to 0.934, the average variance extracted (AVE) ranged from 0.539 to 0.712, and the correlation coefficients of each dimension with the other dimensions were less than the square root of the AVE for that dimension. The Criterion-related validity was 0.511. The Cronbach's alpha was 0.938, and the dimensions ranged from 0.779 to 0.900. Split-half reliability was 0.853, with dimensions ranging from 0.761 to 0.892. Test-retest reliability was 0.855. CONCLUSIONS The Chinese version of the SBCS has good reliability and validity, which can be applied to the assessment of stressors in breast cancer patients in China.
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Affiliation(s)
- Wenqi Hu
- The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Jiahui Bao
- The First Affiliated Hospital of China Medical University, Liaoning, China
| | | | - Mao Ye
- The First Affiliated Hospital of China Medical University, Liaoning, China.
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7
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Marakshina J, Adamovich T, Vasin G, Ismatullina V, Lobaskova M, Malykh A, Kolyasnikov P, Tabueva A, Zakharov I, Malykh S. Factor structure and psychometric properties of the Perceived Stress Scale in Russian adolescents. Sci Rep 2024; 14:775. [PMID: 38191640 PMCID: PMC10774267 DOI: 10.1038/s41598-023-51104-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/30/2023] [Indexed: 01/10/2024] Open
Abstract
This study involved a psychometric analysis of the 10-item Perceived Stress Scale (PSS-10). To investigate the Russian version of the PSS-10 for adolescents, 3530 adolescents aged 13-17 years were recruited. Confirmatory factor analysis revealed that the data corresponded to the expected two-factor configuration. Psychometric properties and factor structure were evaluated. As expected, the PSS-10 included two factors: perceived helplessness and perceived self-efficacy. Internal consistency demonstrated acceptable values (Cronbach's alpha was 0.82 for perceived helplessness, 0.77 for perceived self-efficacy, and 0.80 for the overall PSS score). Measurement invariance across sexes was assessed, and configural and metric invariance were confirmed. The developed diagnostic tool can be used both in the school system to alleviate the negative consequences of academic stress in adolescents and, in the future, in other areas, particularly in clinical practice.
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Affiliation(s)
- Julia Marakshina
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Timofey Adamovich
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | | | - Victoria Ismatullina
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Marina Lobaskova
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Artem Malykh
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Pavel Kolyasnikov
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Anna Tabueva
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Ilya Zakharov
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Sergey Malykh
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia.
- Developmental Behavioral Genetics Lab, Federal Research Centre of Psychological and Interdisciplinary Studies, Moscow, Russia.
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Messineo L, Tosto C. Evaluation of the psychometric properties of the Italian version of the 10-item perceived stress scale in a sample of teachers. Front Psychol 2024; 14:1330789. [PMID: 38259559 PMCID: PMC10801019 DOI: 10.3389/fpsyg.2023.1330789] [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: 11/10/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
Background The 10-item Perceived Stress Scale is a widely used questionnaire for measuring perceived stress. Aim This study aimed to assess the psychometric properties of the Italian version of the 10-item Perceived Stress Scale in a sample of Italian teachers during the COVID-19 pandemic. Methods A cross-sectional study was performed. A sample of 1,179 teachers of pre-primary, primary, and secondary schools anonymously completed an online questionnaire. A Confirmatory Factor Analysis was performed to compare the fit of a two-factor model against a one-factor solution of the scale. Multigroup CFA was run to test the measurement invariance of the two-factor PSS-10 solution across gender. The internal reliability of the scale was evaluated using Cronbach's alpha and McDonald' omega coefficients. Convergent validity with measures of subjective well-being and self-reported health was evaluated. Results The results of the Confirmatory Factor Analysis showed that the two-factor structure of the 10-items Perceived Stress Scale provided a better fit to the data and supported the adequacy of the Italian version of the scale. The two-factor model showed measurement invariance across female and male groups, as result of the multigroup CFA. The scale proved to have good internal reliability. Correlation analyses with measures of the Positive Affect and Negative Affect Schedule and self-reported health supported convergent validity. Conclusion These results suggest that the Italian version of the 10-item Perceived Stress Scale has good psychometric properties and can be considered a valid and reliable instrument to assess perceived stress.
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Affiliation(s)
- Linda Messineo
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy
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Bock K, Peltzer J, Liu W, Colgrove Y, Smirnova I, Siengsukon C. Sleep quality and lymphedema in breast cancer survivors: a mixed method analysis. J Cancer Surviv 2024:10.1007/s11764-023-01516-9. [PMID: 38183577 DOI: 10.1007/s11764-023-01516-9] [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: 05/21/2023] [Accepted: 12/17/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE The purpose of this convergent mixed methods study was to assess the perceptions and characteristics of sleep in breast cancer survivors (BCSs) and elucidate perceptions of sleep among BCS with lymphedema. METHODS Participants were BCS with and without lymphedema. Both groups completed the Pittsburgh Sleep Quality Index (PSQI), PROMIS® Sleep Disturbance (8a short form), and wore an actigraph on their wrist to capture sleep/wake cycles for 7 days/nights while logging their sleep using a sleep diary. The coefficient of variation of sleep efficiency was calculated from the sleep diary to assess intraindividual variability. In addition, a subsample of BCS with lymphedema participated in a semi-structured qualitative interview. The qualitative data was analyzed separately, and the themes were applied to provide a more nuanced explanation of the quantitative outcomes. RESULTS The BCS with lymphedema (n=23) had a significant difference in PSQI (p=0.002), PROMIS® Sleep Disturbance (p=0.084), and sleep efficiency coefficient of variation (p=0.014) compared to BCS without lymphedema (n=23). There were no statistically significant differences between groups in the actigraphy results. BCS with lymphedema perceived that lymphedema management contributed to their sleep disturbance, further exacerbating their mind/body fatigue. CONCLUSION This study provides the foundation for future research to investigate the integration of sleep interventions with lymphedema management for holistic survivorship care for BCS with lymphedema. IMPLICATIONS FOR CANCER SURVIVORS An innovative sleep health intervention designed to consider the unique factors contributing to sleep disturbance in BCS with lymphedema will fill a gap in their post-cancer treatment quality of life.
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Affiliation(s)
- Karen Bock
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Jill Peltzer
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
| | - Wen Liu
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Yvonne Colgrove
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Irina Smirnova
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Catherine Siengsukon
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
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Mendis BILM, Palihaderu PADS, Karunanayake P, Satharasinghe DA, Premarathne JMKJK, Dias WKRR, Rajapakse IH, Hapugalle AS, Karunaratne WRSA, Binendra AGYN, Kumara KBPP, Prabhashwara GSD, Senarath U, Yeap SK, Ho WY, Dissanayake AS. Validity and reliability of the Sinhalese version of the perceived stress scale questionnaire among Sri Lankans. Front Psychol 2023; 14:1152002. [PMID: 37397314 PMCID: PMC10313401 DOI: 10.3389/fpsyg.2023.1152002] [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: 01/27/2023] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Despite the availability of validated psychometrics tools to assess depression, there has not been any validated and reliable tool established to test perceived stress among Sri Lankans. The objective of this study is to test the validity and reliability of the Sinhalese Version of the Sheldon Cohen Perceived Stress Scale. Materials and methods Standard and systematic procedures were adopted to translate the original English version of the Perceived Stress Scale-10 questionnaire into Sinhalese. Consecutive sampling was employed to recruit the Type 2 Diabetes mellitus (T2DM) sample (n = 321), and a convenient sampling was used to recruit the Age and Sex matched Healthy Controls (ASMHC) (n = 101) and the Healthy Community Controls (HCC) groups (n = 75). Cronbach alpha was used to assess internal consistency and reliability was determined using test-retest method utilizing Spearman's correlation coefficient. Sensitivity was evaluated by comparing the mean scores of the Sinhalese Perceived Stress Scale (S-PSS-10) and Sinhalese Patient Health Questionnaire (S-PHQ-9) scores. Post-hoc comparisons were done using Bonferroni's method. Mean scores were compared between the T2DM, ASMHC, and HCC groups using the independent t-test. Explanatory Factor Analysis (EFA) was conducted using the principal component and Varimax rotation while the Confirmatory Factor Analysis (CFA) was performed to assess the goodness-of-fit of the factor structure extracted from the EFA. Concurrent validity was assessed using the Pearson correlation between the S-PSS-10 and Patient Health Questionnaire measured by S-PHQ-9 (p < 0.05). Results Cronbach alpha values of the three groups T2DM, ASMHC and HCC were 0.85, 0.81, and 0.79, respectively. Results of the ANOVA test suggested that there was a significant difference in the mean scores between groups (p < 0.00). EFA analysis revealed the existence of two factors with eigenvalues greater than 1.0. The factor loadings for the items ranged from 0.71-0.83. The CFA analysis demonstrated a good model fit for the two-factor model S-PSS-10. The S-PSS-10 significantly correlated with S-PHQ-9, indicating an acceptable concurrent validity. Conclusion Findings revealed that the S-PSS-10 questionnaire can be used to screen perceived stress among the majority of the Sri Lankan Sinhalese-speaking population specially with chronic illnesses. Further studies with higher sample sizes across different populations would enhance the validity and reliability of S-PSS-10.
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Affiliation(s)
| | | | - Panduka Karunanayake
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Dilan Amila Satharasinghe
- Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | | | - Avanti Sulochana Hapugalle
- Department of North Indian Music, Faculty of Music, University of the Visual and Performing Arts, Colombo, Sri Lanka
| | | | | | | | | | - Upul Senarath
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Swee Keong Yeap
- China-ASEAN College of Marine Sciences, Xiamen University Malaysia, Sepang, Selangor, Malaysia
| | - Wan Yong Ho
- Division of Biomedical Sciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia
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Traoré S, Dahourou DL, Paré BC, Lompo YD, Kaboré WJ, Ouédraogo WLSAEA, Kambou DT, Salou WRA, Kaboré D, Ouédraogo A, Sia S, Zorné M, Ouoba B, Guira O. High stress related to COVID-19 among health workers in the Plateau Central healthcare region (BURKINA FASO): a cross-sectional study. Front Public Health 2023; 11:1162707. [PMID: 37342275 PMCID: PMC10277688 DOI: 10.3389/fpubh.2023.1162707] [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: 02/17/2023] [Accepted: 05/17/2023] [Indexed: 06/22/2023] Open
Abstract
Background The COVID-19 pandemic challenged the mental wellbeing of health workers. The objective of this study was to assess health workers' perceived stress during the response to COVID-19 in the Central Plateau region (Burkina Faso). Methods We conducted a cross-sectional study of health workers in the Central Plateau health region from September 20 to October 20, 2021. Agents' perceived stress was assessed by the Perceived Stress Scale (PSS-10). Factors associated with high stress (PSS-10 score ≥ 27) were identified by logistic regression. Results A total of 272 officers participated in the survey. The mean PSS-10 score was 29.3 points (standard deviation: 6.2). Three out of ten agents (68%) had a high level of stress. The main sources of stress were the risk of being exposed to contamination (70%) and being the source of contamination (78%). Working at the referral health center [adjusted odds ratio (aOR): 2.29; 95% confidence interval (95% CI): 1.19-4.41], the hospital as the main source of COVID-19 information (aOR: 1.17; 95% CI: 1.01-3.04), fear of COVID-19 patients being managed at one's center (aOR: 1.8; 95% CI: 1.06-3.07) were factors associated with high health worker stress levels during the first wave of COVID-19. Conclusion The COVID-19 pandemic caused high stress among health care workers in Burkina Faso. Psychological support for health center workers in responding to future epidemics would improve their mental health.
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Affiliation(s)
- Solo Traoré
- Department of Medicine and Medical Specialties, Ziniaré Regional Hospital, Plateau Central Healthcare Region, Ziniaré, Burkina Faso
| | - Désiré Lucien Dahourou
- Department of Biomedical and Public Health, Research Institute of Health Sciences, Ouagadougou, Burkina Faso
| | - Boyo Constant Paré
- Training and Research Unit in Health Sciences, Department of Public Health, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
| | - Yemboado Diedonné Lompo
- Gynecology and Obstetric Department of the Regional Hospital Center of Ziniaré, Plateau Central Healthcare Region, Ziniaré, Burkina Faso
| | - Wendlassida Josiane Kaboré
- Department of Medicine and Medical Specialties, Ziniaré Regional Hospital, Plateau Central Healthcare Region, Ziniaré, Burkina Faso
| | | | - Datouo Thomas Kambou
- Department of Medicine and Medical Specialties, Ziniaré Regional Hospital, Plateau Central Healthcare Region, Ziniaré, Burkina Faso
| | | | - Delphin Kaboré
- Zorgho Healthcare District, Plateau Central Healthcare Region, Zorgho, Burkina Faso
| | - Abdoulaye Ouédraogo
- Ziniaré Healthcare District, Plateau Central Healthcare Region, Ziniaré, Burkina Faso
| | - Siaka Sia
- Regional Healthcare Directorate of the Plateau Central Healthcare Region, Ziniaré, Burkina Faso
| | - Mady Zorné
- Head Directorate of the Regional Hospital Center of Ziniaré, Plateau Central Healthcare Region, Ziniaré, Burkina Faso
| | - Boezemwendé Ouoba
- Regional Healthcare Directorate of the Plateau Central Healthcare Region, Ziniaré, Burkina Faso
| | - Oumar Guira
- Training and Research Unit in Health Sciences, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
- Internal Medicine Department, Yalgado Ouédraogo University Hospital, Ouagadougou, Burkina Faso
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12
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Cerezo MV, Soria-Reyes LM, Pajares B, Gómez-Millán J, Blanca MJ. Development and psychometric properties of the Stressors in Breast Cancer Scale. Front Psychol 2023; 14:1102169. [PMID: 37057161 PMCID: PMC10086352 DOI: 10.3389/fpsyg.2023.1102169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/23/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundA diagnosis of breast cancer generates psychological stress, due not only to treatment and its side effects but also to the impact on different areas of the patient’s daily life. Although there are instruments for measuring psychological stress in the cancer context, there is currently no tool for assessing stressors specific to breast cancer.AimsThe aim of this study was to develop the Stressors in Breast Cancer Scale (SBCS).MethodA panel of experts evaluated the clarity and relevance of scale items, providing validity evidence based on test content. Psychometric properties of the scale were then analyzed.ResultsValidity evidence based on the internal structure of the SBCS was obtained through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), following a cross-validation strategy. The CFA supported a second-order factor model with five dimensions: physical appearance and sex strains, health and daily difficulties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future. This structure was invariant across two groups distinguished by time from cancer diagnosis (less than 3 and 3 years or more from diagnosis). Reliability, based on McDonald’s omega and Cronbach’s alpha coefficients, ranged from 0.83 to 0.89 for factor scores, and reached 0.95 for total scores. Validity evidence was also provided by correlations with depression, anxiety, perceived stress, and perceived health and quality of life.DiscussionThe results support the use of the SBCS for measuring stress as a stimulus in the breast cancer context. Implications for clinical practice and research are discussed.
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Affiliation(s)
- M. Victoria Cerezo
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Málaga, Spain
- *Correspondence: M. Victoria Cerezo,
| | - Lorena M. Soria-Reyes
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Málaga, Spain
| | - Bella Pajares
- Instituto de Investigaciones Biomédicas de Málaga, University of Malaga, Málaga, Spain
| | - Jaime Gómez-Millán
- Instituto de Investigaciones Biomédicas de Málaga, University of Malaga, Málaga, Spain
| | - María J. Blanca
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Málaga, Spain
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Soria-Reyes LM, Cerezo MV, Molina P, Blanca MJ. Life Satisfaction and Character Strengths in Women With Breast Cancer: Zest and Hope as Predictors. Integr Cancer Ther 2023; 22:15347354231197648. [PMID: 37799020 PMCID: PMC10559710 DOI: 10.1177/15347354231197648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/24/2023] [Accepted: 08/11/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Empirical evidence shows that life satisfaction is positively related to character strengths, and although this association has been observed in different populations, it is scarce in breast cancer patients. This study analyzes the relationship between character strengths and life satisfaction in Spanish women diagnosed with breast cancer. METHODS A sample of 117 women completed the Satisfaction with Life Scale (SWLS) and the Spanish version of the VIA Inventory of Strengths (VIA-IS). Correlation analysis and regression modeling were performed to determine which strengths predict life satisfaction. RESULTS The results of the correlation analysis showed that 15 strengths were positively and significantly associated with life satisfaction, with the highest correlations corresponding to zest, hope, curiosity, social intelligence, love, gratitude, and judgment. Regression modeling indicated that of these, zest and hope were key strengths for predicting life satisfaction. CONCLUSIONS These findings suggest that intervention programs based on the development of zest and hope could help to improve life satisfaction and, therefore, the psychological well-being of women with breast cancer.
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Tsegaye BS, Andegiorgish AK, Amhare AF, Hailu HB. Construct validity and reliability Amharic version of perceived stress scale (PSS-10) among Defense University students. BMC Psychiatry 2022; 22:691. [PMID: 36352366 PMCID: PMC9644475 DOI: 10.1186/s12888-022-04345-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/29/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Perceived stress scale (PSS) is the most widely used tool for assessing stressful life events and its management. However, its validity and Reliability in Ethiopian Amharic language is not assessed. OBJECTIVE To translate the perceived stress scale (version PSS-10) and assess its validity among Defense University students in Bishoftu, Ethiopia. METHOD From March to May 2020, an anonymous, self-managed questionnaire was used to collect the data on 758 undergraduate students of Defense University in Bishoftu, Ethiopia. Exploratory and Confirmatory factor analyses were employed to assess the factor structure and construct validity of Amharic version of the PSS-10. Composite reliability coefficient and Item total correlation were calculated to assess the internal consistency of Amharic version of the PSS-10. RESULT Exploratory factor analysis resulted in a two-dimensional PSS-10 with Eigenvalues of 3.4 and 1.6, which explained 50.7% of the variance. Confirmatory factor analysis indicates a good model fit of the two correlated factors (Comparative fit index (CFI) = 0.96 with root mean square error of approximation (RMSEA) = 0.04[0.03-0.06] and standardize root mean residual (SRMR) = 0.040). The internal consistency of PSS-10 and the Negative factor were in acceptable range, whereas the Positive factor was marginally acceptable (0.77, 0.78, and 0.68) respectively. CONCLUSION The Amharic translated version of PSS-10 was found to be a valid and reliable instrument to measure the perceived stress level among university students.
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Affiliation(s)
| | - Amanuel Kidane Andegiorgish
- grid.43169.390000 0001 0599 1243Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China ,Department of Epidemiology and Biostatistics, Asmara College of Health Sciences, School of Public Health, Asmara, Eritrea
| | | | - Habtamu Belay Hailu
- grid.510433.00000 0004 0456 257XDefence University, College of Health Sciences, Bishoftu, Ethiopia
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Malinauskas R, Malinauskas M, Malinauskiene V, Zabiela V. Perceived Stress in Relation to Demographics and Clinical Forms among Patients with Infective Endocarditis: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14073. [PMID: 36360948 PMCID: PMC9656878 DOI: 10.3390/ijerph192114073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Infective endocarditis (IE) is a disease of the endocardial surface of the heart, caused by infection of the native or prosthetic valve or an indwelling cardiac device. Apart from IE predisposing risk factors that include heart conditions and medical procedures, the novel trajectories from demographic factors to perceived stress conditions have been under investigation in recent years. The aim of the present study was to evaluate the associations between perceived stress and demographic characteristics as well as clinical forms of IE among survivors of IE in Kaunas, Lithuania. (2) Methods: A cross-sectional study among IE cases (n = 135) at the Lithuanian University of Health Sciences Kaunas Clinics Cardiology department during the period 2014-2017 was performed. Data about IE clinical features, sociodemographic characteristics and perceived stress level (Perceived Stress Scale (PSS-10)) upon diagnosis were collected. Package "SPSS 25.0" was used in the statistical analysis. Logistic regression analysis was performed including gender, previous occupation, place of residence and clinical forms of IE in the analysis of perceived stress among survivors of IE. The STROBE checklist for cross-sectional studies was used in this study. (3) Results: Perceived stress was experienced by 54.8 percent of the respondents. In the final model, the OR (odds ratio) of perceived stress for females was 2.07 as compared to men; for rural residents, the OR was 2.25 as compared to urban residents. These results were statistically significant. A tendency for increased OR of perceived stress for low-skilled workers as compared to high-skilled ones and classical IE clinical form as compared to non-classical form was observed, but these results were not statistically significant. (4) Conclusions: The present study is an attempt to focus the attention of IE researchers on the effects of psychological state in the disease development. Differences in perceived stress and some demographic characteristics, as well as tendencies of IE clinical forms, were observed among survivors of IE in Kaunas, Lithuania.
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Affiliation(s)
- Romualdas Malinauskas
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania
| | - Mindaugas Malinauskas
- Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eiveniu Street 2, LT-50161 Kaunas, Lithuania
| | - Vilija Malinauskiene
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania
| | - Vytautas Zabiela
- Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eiveniu Street 2, LT-50161 Kaunas, Lithuania
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Peterson AK, Eckel SP, Habre R, Yang T, Faham D, Amin M, Grubbs BH, Farzan SF, Kannan K, Robinson M, Lerner D, Al-Marayati LA, Walker DK, Grant EG, Breton CV, Bastain TM. Detected prenatal perfluorooctanoic acid (PFOA) exposure is associated with decreased fetal head biometric parameters in participants experiencing higher perceived stress during pregnancy in the MADRES cohort. ENVIRONMENTAL ADVANCES 2022; 9:100286. [PMID: 36507367 PMCID: PMC9731234 DOI: 10.1016/j.envadv.2022.100286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) are ubiquitous synthetic chemicals with long half-lives and are known to cross the placenta during pregnancy. We examined the influence of maternal PFAS levels on in utero fetal growth trajectories and assessed whether maternal stress modified these associations. METHODS Blood serum concentrations of five PFAS (PFOS, PFHxS, PFNA, PFOA, PFDA) were measured in 335 prenatal specimens (mean gestational age (GA): 21±9 weeks) in the MADRES cohort. Fetal growth outcomes (head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW)) were abstracted from ultrasound medical records and measured at the 3rd trimester study visit (N = 833 scans, GA range 10-42 weeks, mean 2.4 scans/participant). Adjusted linear mixed models with a GA quadratic growth curve were used for each PFAS exposure and growth outcome. PFOS and PFHxS were modeled continuously (100% sample detection), while PFOA, PFNA, and PFDA were modeled categorically (57-70% sample detection). Scores on the Perceived Stress Scale (PSS) measured in pregnancy were dichotomized at the median (<13 vs. ≥ 13) in stratified models. RESULTS Participants were on average 29±6 years old and predominately Hispanic (76%). Median serum concentrations of PFOS, PFHxS, PFNA, PFOA and PFDA were 1.34, 1.10, 0.07, 0.12, and 0.04 ng/mL, respectively. Participants with detected PFOA concentrations had fetuses with -2.5 mm (95% CI -4.2, -0.8) smaller HC and-0.7 mm (95% CI -1.3, -0.2) smaller BPD on average for a fixed GA than those without detected PFOA concentrations. In models stratified by PSS level, the effects of PFOA on fetal growth parameters were stronger and only significant in participants with higher stress levels (HC: β= -3.5, 95% CI -5.8, -1.4; BPD: β = -0.8, 95% CI -1.6, -1.1). CONCLUSIONS Prenatal PFOA exposure adversely impacted fetal head biometric parameters in participants experiencing higher stress during pregnancy.
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Affiliation(s)
- Alicia K. Peterson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Dema Faham
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Monica Amin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Brendan H. Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 2020 Zonal Ave, Los Angeles, CA 90033, USA
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, 145 East 32 Street, New York, NY 10016, USA
| | - Morgan Robinson
- Department of Pediatrics, New York University School of Medicine, 145 East 32 Street, New York, NY 10016, USA
| | - Deborah Lerner
- Eisner Health, 1530 S Olive St, Los Angeles, CA 90015, USA
| | - Laila A. Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 2020 Zonal Ave, Los Angeles, CA 90033, USA
| | - Daphne K. Walker
- Department of Radiology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave # 2315, Los Angeles, CA 90089, USA
| | - Edward G. Grant
- Department of Radiology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave # 2315, Los Angeles, CA 90089, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
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