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Cho H, Kang D, Shin DW, Kim N, Lee SK, Lee JE, Nam SJ, Cho J. Social support during re-entry period and long-term quality of life in breast cancer survivors: a 10-year longitudinal cohort study. Qual Life Res 2024; 33:1287-1295. [PMID: 38321193 DOI: 10.1007/s11136-024-03599-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE This study evaluated the association between social support during the re-entry period and long-term health-related quality of life (HRQoL) in breast cancer survivors using a longitudinal cohort study. METHODS This is a prospective cohort study with 275 breast cancer survivors who reported HRQoL at 5 and 10 years after diagnosis. Social support for the re-entry period was measured 3 years after diagnosis using the Medical Outcome Study Social Support Survey (MOS-SSS). HRQoL was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and Breast Cancer-Specific Module (BR-23). Multivariable linear regression analysis was performed to evaluate HRQoL at 5 and 10 years after diagnosis by level of social support during the re-entry period. RESULTS The mean (SD) of social support during re-entry period was 68.5. The low social support (LSS, score < 55) group during the re-entry period had a significantly lower HRQoL (mean difference = - 12.93) compared to moderate or high social support (MHSS, score ≥ 55) group. 5 and 10 years after diagnosis, the LSS group continued to demonstrate lower HRQoL (5 years: - 7.17; 10 years: - 7.85) compared to the MHSS group. The LSS group were more likely to have lower role and social function scores, and higher fatigue, pain, and financial problems compared to the MHSS group at 10 years after diagnosis. CONCLUSIONS Breast cancer survivors who received lower social support during the re-entry period were more likely to experience poorer HRQoL in the long term than those who did not.
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Affiliation(s)
- Hyeonjin Cho
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
- Department of Family Medicine/Supportive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul, 06335, South Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
- Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Wook Shin
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
- Department of Family Medicine/Supportive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul, 06335, South Korea
| | - Nayeon Kim
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul, 06335, South Korea
- Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jeong Eon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Juhee Cho
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea.
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul, 06335, South Korea.
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.
- Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Yang Y, Lin Y, Sikapokoo GO, Min SH, Caviness-Ashe N, Zhang J, Ledbetter L, Nolan TS. Social relationships and their associations with affective symptoms of women with breast cancer: A scoping review. PLoS One 2022; 17:e0272649. [PMID: 35939490 PMCID: PMC9359609 DOI: 10.1371/journal.pone.0272649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Problems in affective and cognitive functioning are among the most common concurrent symptoms that breast cancer patients report. Social relationships may provide some explanations of the clinical variability in affective-cognitive symptoms. Evidence suggests that social relationships (functional and structural aspects) can be associated with patients' affective-cognitive symptoms; however, such an association has not been well studied in the context of breast cancer. PURPOSE The purpose of this scoping review was to address the following question: What social relationships are associated with affective-cognitive symptoms of women with breast cancer? METHODS This scoping review used the framework proposed by Arksey and O'Malley and PRISMA-Sc. Studies published by February 2022 were searched using four databases: MEDLINE (PubMed), Embase (Elsevier), PsycINFO (EBSCOhost), and Web of Science (Clarivate). All retrieved citations were independently screened and eligibility for inclusion was determined by study team members. Extracted data included research aims, design, sample, type and measures of social relationships (functional and structural), and the association between social relationships and affective-cognitive symptoms. RESULTS A total of 70 studies were included. Affective symptoms were positively associated with social support, family functioning, quality of relationships, social networks, and social integration, whereas the negative association was found with social constraints. CONCLUSION Our findings suggest positive social relationships may mitigate affective symptoms of women with breast cancer. Thus, health care providers need to educate patients about the importance of building solid social relationships and encourage them to participate in a supportive network of friends and family members.
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Affiliation(s)
- Yesol Yang
- Ohio State University Comprehensive Cancer Center-James, Columbus, Ohio, United States of America
| | - Yufen Lin
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States of America
| | | | - Se Hee Min
- School of Nursing, Duke University, Durham, North Carolina, United States of America
| | - Nicole Caviness-Ashe
- School of Nursing, Duke University, Durham, North Carolina, United States of America
| | - Jing Zhang
- College of Nursing, Ohio State University, Columbus, Ohio, United States of America
| | - Leila Ledbetter
- Duke University Medical Center Library, Durham, North Carolina, United States of America
| | - Timiya S. Nolan
- College of Nursing, Ohio State University, Columbus, Ohio, United States of America
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Yagil D, Goldblatt H, Cohen M. Family members' experiences of the return to work of cancer survivors. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:184-192. [PMID: 33852745 DOI: 10.1111/hsc.13388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 02/14/2021] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
Although family members play an important role in various aspects of coping with cancer and are significantly affected by it, little is known about their perspectives regarding return to work (RTW). This study explored attitudes and experiences of cancer survivors' family members related to cancer survivors' RTW. The present study consists of a qualitative research design, employing in-depth semistructured interviews with first-degree family members (N = 21) of cancer survivors who were approached through online social networks: spouses, children, parents and siblings. Grounded theory techniques were used for data analysis. Four themes emerged from the interviews: (a) the family's cautious voice in return-to-work decision making; (b) work-home imbalance; (c) inhibiting or promoting the effect of work on the recovery process and (d) expectations and appreciation of unconditional workplace support. The findings suggest that psychosocial and health care professionals should help family members play an active role in the decision of RTW. Professionals should also prepare family members for potential costs of RTW for the family and help them develop realistic expectations regarding workplace support of the cancer survivor.
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Affiliation(s)
- Dana Yagil
- Department of Human Services, University of Haifa, Haifa, Israel
| | - Hadass Goldblatt
- Department of Human Services, University of Haifa, Haifa, Israel
| | - Miri Cohen
- Department of Human Services, University of Haifa, Haifa, Israel
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Tessier S, Romo L, Zerhouni O. Impact of Advertising Campaigns Among Online Gamblers: The Role Perceptions of Social Support and Personality Traits. Front Psychiatry 2021; 12:599988. [PMID: 34764890 PMCID: PMC8576387 DOI: 10.3389/fpsyt.2021.599988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/07/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Few studies on problematic gamblers have focused on how environment and personality interact in gambling behavior. The aim of this research is to investigate how social support, dimensions of personality, and advertising campaigns are associated with gambling among problematic or moderate-risk gamblers and recreational gamblers and associated with online gambling (i.e., sport and poker). Methods: One hundred nine participants (45% problematic or moderate-risk gamblers) answered an online survey including social support, five factor models of personality, typology of gamblers, and several sociodemographic variables. Results: We found that problematic and moderate-risk gamblers were significantly more sensitive to gambling advertisements compared to light players. Social support was significantly lower among online gamblers compared to offline gamblers, but no association was found between social support and type of gamblers. Problematic and moderate-risk gamblers presented lower levels of extraversion compared with recreational gamblers. Notably, when the onset of gambling is before 18 years old, participants had more chances to recall more gambling advertisements as adults. Conclusion: We propose that future longitudinal research should focus on characteristics of online gamers particularly regarding social support to understand this low level of adequacy compared to offline gamblers.
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Affiliation(s)
- Samantha Tessier
- Département de Psychologie, Clinique Psychanalyse Développement, Nanterre, France
| | - Lucia Romo
- Département de Psychologie, Clinique Psychanalyse Développement, Nanterre, France
- AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France
| | - Oulmann Zerhouni
- Département de Psychologie, Laboratoire Parisien de Psychologie Sociale, Nanterre, France
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Social Disparities in Post-diagnosis Health Behaviors of Iranian Breast Cancer Survivors: The Mediating Role of Psychosocial Factors as Potential Buffering Agents. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.104760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Breast cancer (BC) is surging as a public health issue in Iran and engagement in positive health behaviors improves the odds of survival and reduces the risk of concomitant comorbidities in BC survivors. Objectives: The primary purpose of this study was to investigate the impact of socioeconomic inequalities on leisure-time physical activity (LTPA) and fruit and vegetable (F & V) consumption among Iranian BC survivors. Another objective of this study was to examine the role of psychosocial factors, such as stress, self-efficacy, and social support as mediators between socioeconomic status (SES) and these health behaviors. Few studies have investigated social disparities in the health behaviors of cancer survivors. Likewise, the mediating role of psychosocial factors in the SES-health behavior gradient has rarely been explored in the cancer context. Psychosocial factors might have positive implications for socioeconomically disadvantaged survivors. Methods: Cross-sectional data were obtained from 196 patients with BC by a telephone-administrated questionnaire. The Behavioral Risk Factor Surveillance System (BRFSS) 2013 was partially employed to measure exercise and F & V consumption. Cross-sectional analyses (correlation and logistic regression) were conducted to assess the relationship between SES, psychosocial factors, and health behaviors (P < 0.05). Results: Regarding LTPA and F & V consumption, more than half of the survivors complied with the recommended levels, consecutively. Both education and family income exhibited a positive association with LTPA and F & V consumption. Furthermore, self-efficacy and social support showed a positive relationship with LTPA and F & V consumption. Conclusions: The SES impacted health behaviors directly and via intermediary psychosocial factors. The results can inform future studies and interventions; psychosocial factors could buffer the effects of social inequalities on health behaviors. A key policy priority should, therefore, be planning and implementing psychosocial empowerment interventions to promote exercise and a healthy diet among impoverished cancer survivors.
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Abstract
OBJECTIVE Social support has been reported as beneficial for the psychological functioning of people coping with a disease. The objective of this study was to verify whether levels of perceived social support are associated with psychosocial functioning in women who have had a mastectomy and whether specific types of social support are linked to specific indices of functioning. METHOD Seventy women with a history of mastectomy completed questionnaires measuring their psychosocial functioning as related to their health status: Disease-Related Appraisal Scale, Acceptance of Life with the Disease Scale and Beck Depression Inventory. All participants also completed a measure of perceived social support (Disease-Related Social Support Scale). RESULTS Women who reported higher levels of perceived social support revealed statistically significantly lower levels of depressive symptoms, higher appraisals of their disease in terms of challenge and value, and lower appraisals of their disease in terms of obstacle/loss. Women with greater social support also revealed higher levels of acceptance of life with the disease compared to those with less social support. Regression analyses showed that spiritual support was the type of support that significantly accounted for the variance in the majority of functioning indices. Some indices of functioning were also significantly accounted for by emotional and instrumental support. SIGNIFICANCE OF THE RESULTS The process of psychological adjustment to a life-threatening disease such as breast cancer depends on multiple variables; however, social support, including spiritual support, seems to be one significant contributor to this process.
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Validation of the Brief Version of the Cancer Behavior Inventory in Breast Cancer Portuguese Patients. J Clin Psychol Med Settings 2021; 28:491-502. [PMID: 33811582 DOI: 10.1007/s10880-021-09773-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
Self-efficacy is a coping resource with a positive impact on well-being, quality of life, anxiety, and depression in cancer patients, even after treatment. This study focused on the validation of the Cancer Behavior Inventory-Brief Version (CBI-B) in Portuguese patients with breast cancer. The study included 115 patients with breast cancer receiving outpatient chemotherapy in four hospitals located in Portugal. Participants (N = 115) completed the translated version of the CBI-B in Portuguese and measures of quality of life (QLQ- C30), psychological distress (HADS), and illness perceptions (IPQ-B). Confirmatory factor analysis supported the four-factor original structure of the CBI-B. The Portuguese version of the CBI-B showed good psychometric properties as shown by measures of internal consistency (Cronbach's alpha = .88), test-retest reliability (intraclass correlation coefficient = .59), convergent validity with the QLQ-C30 (r = .43, p < .001), and divergent validity with the HADS (r = -.60, p < .001) and the IPQ-B (r = -.51, p < .001). The Portuguese version of the CBI-B is a valid and reliable instrument to evaluate the self-efficacy for coping in Portuguese breast cancer patients. Future studies should validate the CBI-B in patients with other types of cancer.
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Rajah HDA, Chan CMH, Kong YC, Wong LP, Bustaman RS, Ho GF, Lai KMY, Yip CH, Bhoo-Pathy N. Insights on emotional distress following cancer, sources of support and the unmet needs in a setting with limited supportive care services for people living with cancer. Support Care Cancer 2021; 29:5811-5819. [PMID: 33742239 DOI: 10.1007/s00520-021-06148-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/08/2021] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Delivery of supportive cancer care is often deemed a low priority in resource-limited settings. We aimed to explore the sources of emotional distress, the related support and the unmet needs of cancer survivors in Malaysia, where cancer survivorship services are presently limited. METHOD Twenty focus group discussions were conducted with 102 cancer patients from diverse ethnic and socioeconomic backgrounds. Thematic analyses were performed. RESULTS Patient narratives suggested that emotional distress arose from direct and indirect stressors. Direct stressors comprised physical and cognitive side effects of cancer surgery and therapies, and fear of recurrence. Indirect stressors included worry over dependent family members, financial distress following cancer, working with cancer and lack of practical support at home. Distress from altered physical appearances, fear of recurrence and lack of practical support were mainly raised by women, implying that men and women may have disproportionate emotional needs. Emotional support largely came from informal sources including self, family, friends and religion. While formal emotional support from professional counsellors and cancer support groups was acknowledged as important, it appeared to be largely lacking. Unmet needs in coping with fear of recurrence, financial distress, workplace discrimination and household chores were particularly highlighted. CONCLUSION The unmet needs revealed in this study provide insights to initiate actionable changes to improve the emotional wellbeing of people living with cancer in settings where cancer survivorship services are still in its infancy.
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Affiliation(s)
- Harenthri Devy Alagir Rajah
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.,Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Yek-Ching Kong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Li-Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Ros Suzanna Bustaman
- Department of Radiotherapy and Oncology, Kuala Lumpur Hospital, 50586, Kuala Lumpur, Malaysia
| | - Gwo-Fuang Ho
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | | | - Cheng-Har Yip
- Subang Jaya Medical Centre, 47500, Subang Jaya, Malaysia
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Nematollahi M, Mehdipour-Rabori R, Bagheryan B. Spirituality, a Path to Peace: The Experiences of Parents Who Have Children with Phenylketonuria. JOURNAL OF RELIGION AND HEALTH 2021; 60:374-388. [PMID: 31463830 DOI: 10.1007/s10943-019-00903-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Having a child with phenylketonuria is extremely stressful for the parents. These parents always look for solutions for negative effects of their child's disease. Parents' strategies are affected by various background factors and vary according to parents' culture, religion, education, etc. The present study was aimed at assessing the effect of spirituality on the life of parents with a PKU child, and the effect of child disease on the parents' spirituality. The study was conducted in Kerman, Iran, in 2018; 21 participants (14 mothers, 6 fathers with PKU children, and one nurse) were selected using purposive sampling. A semi-structured in-depth interview was conducted with the selected participants. The transcribed interviews were analyzed using conventional qualitative content analysis. One main theme and two categories emerged from the analyzed data. The main theme of the supportive role of spirituality consists of two categories: spiritual growth and grabbing to the string of spirituality. The first levels of spiritual growth include Modeling and considering Imams' lives, the increase in trust in God, the increase in mental and spiritual tolerance, and being close to God. The levels of Achieving spirituality include the remembrance of God, Thanking God, and giving donations. According to the results of this study, providing spiritual care by the nurses for the patient and their family is important. Nurses should pay attention to this subject because the patients and their family can achieve more relaxation and increased tolerance and higher satisfaction.
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Affiliation(s)
- Monirsadat Nematollahi
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Haft Bagh Alavi Highway, Kerman, Iran
| | - Roghayeh Mehdipour-Rabori
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Haft Bagh Alavi Highway, Kerman, Iran.
| | - Behnaz Bagheryan
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Haft Bagh Alavi Highway, Kerman, Iran
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Le NK, Gabrick KS, Chouairi F, Mets EJ, Avraham T, Alperovich M. Impact of socioeconomic status on psychological functioning in survivorship following breast cancer and reconstruction. Breast J 2020; 26:1695-1701. [DOI: 10.1111/tbj.13849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/03/2020] [Accepted: 04/08/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Nicole K. Le
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
- Department of Plastic Surgery Morsani College of Medicine University of South Florida Tampa FL USA
| | - Kyle S. Gabrick
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| | - Fouad Chouairi
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| | - Elbert J. Mets
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| | - Tomer Avraham
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| | - Michael Alperovich
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
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Pilevarzadeh M, Amirshahi M, Afsargharehbagh R, Rafiemanesh H, Hashemi SM, Balouchi A. Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis. Breast Cancer Res Treat 2019; 176:519-533. [PMID: 31087199 DOI: 10.1007/s10549-019-05271-3] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 05/04/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE Depression in patients with breast cancer imposes huge costs to patients, families, and healthcare systems. The present study aimed at evaluating the global prevalence depression among patients with breast cancer. METHODS In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from 1 January, 2000 until 30 March, 2019. The Hoy tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers. RESULTS Of 47,424 studies, 72 studies performed in 30 countries entered the final stage of analysis. The global prevalence of depression was 32.2%. Specifically, the prevalence of depression was highest in the Eastern Mediterranean region and twice as high in middle-income countries as compared to developed countries. CONCLUSIONS Regarding the high prevalence of depression in patients with breast cancer, it is vital to carry out screening within standard time periods and offer the necessary emotional support.
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Affiliation(s)
- Motahare Pilevarzadeh
- Department of Nursing Education, Nursing and Midwifery School, Jiroft University of Medical Sciences, Jiroft, Iran
| | | | | | - Hosein Rafiemanesh
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Mehdi Hashemi
- Clinical Immunology Research Center, Department of Internal Medicine, Hematology and Medical Oncology Ward, Ali-Ebne-Abitalelb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Abbas Balouchi
- Student Research Committee, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran
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Mai TTX, Choi JH, Lee MK, Chang YJ, Jung SY, Cho H, Lee ES. Prognostic Value of Post-diagnosis Health-Related Quality of Life for Overall Survival in Breast Cancer: Findings from a 10-Year Prospective Cohort in Korea. Cancer Res Treat 2019; 51:1600-1611. [PMID: 30999723 PMCID: PMC6790846 DOI: 10.4143/crt.2018.426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 04/10/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose We aimed to evaluate health-related quality of life (HRQOL) at 1-year post-diagnosis in breast cancer (BC) patients and its association with overall survival using data from the National Cancer Center Hospital. Materials and Methods Data of a BC cohort were first obtained between 2004 and 2006 and followed up. HRQOL was assessed using EORTC QLQ-C30 and BC specific module QLQ-BR23 few days after diagnosis and 1 year after that. We examined and compared the difference in the two HRQOL scores measured for each patient by the patient’s current survival status. The Cox proportional hazards model was fitted to evaluate the impact of HRQOL on survival, with adjustment for baseline HRQOL and other factors. Results Of 299 enrolled patients, 206 responded at 1-year post-diagnosis (80.6%) and were followed up for 11.6 years on average. At 1-year post-diagnosis, survivors had better HRQOL scores than those who died, although their health status was similar at baseline. Survivors reported significant increase 1 year after diagnosis in global health status and emotional scales. Between the groups, functional scales such as physical, role, and emotional were significantly different. Functional scales, including physical (adjusted hazard ratio [aHR], 0.70), role (aHR, 0.68), emotional (aHR, 0.72), and symptom scales, including fatigue (aHR, 1.34), dyspnea (aHR, 1.29), appetite loss (aHR, 1.24) were significantly associated with overall survival. Patients who were less worried about future health had favorable survival(aHR, 0.83). Conclusion Besides treatment-related symptoms, non-medical aspects at 1-year post-diagnosis, including functional well-being and future perspective, are predictive of long-term survival. Intervention to enhance physical, role, and emotional support for women soon after their BC diagnosis might help to improve disease survival outcomes afterwards.
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Affiliation(s)
- Tran Thi Xuan Mai
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Jin Hyuk Choi
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Myung Kyung Lee
- College of Nursing, Kyungpook National University, Daegu, Korea
| | - Yoon Jung Chang
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Hospice and Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - So-Youn Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Hyunsoon Cho
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Sook Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
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13
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The Effect of Personality, Social Support, and Life Events on Overall Survival in Breast Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.83625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chang HA, Barreto N, Davtyan A, Beier E, Cangin MA, Salman J, Patel SK. Depression predicts longitudinal declines in social support among women with newly diagnosed breast cancer. Psychooncology 2019; 28:635-642. [PMID: 30681222 DOI: 10.1002/pon.5003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/28/2018] [Accepted: 01/18/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Among breast cancer survivors, low social support is associated with adverse clinical and psychosocial outcomes. This study prospectively examined longitudinal trends in perceived social support in women with newly diagnosed breast cancer as a function of depression status prior to initiation of cancer treatment. METHODS One hundred ten patients with newly diagnosed breast cancer and 59 age-matched noncancer controls completed behavioral measures at four assessments: prior to treatment and at 1 month, 1 year, and 2 years post-treatment. Participants reported their perceived tangible and emotional/informational support using the Medical Outcomes Study Social Support Survey and were categorized as "depressed" or "non-depressed" based on the Brief Symptom Inventory-18 (BSI-18). Analyses first compared longitudinal trends in support between patients and controls and then examined differences in longitudinal trends as a function of depression status in patients only, controlling for key covariates. RESULTS Both tangible and emotional/informational support decreased among breast cancer patients but increased or remained unchanged among noncancer controls across the assessments. Among patients, depressed individuals experienced a significant decline in both tangible (P = 0.004) and emotional/informational support (P = 0.013) between 1 month and 1 year post-treatment, which remained unchanged between 1 year and 2 years post-treatment. In contrast, nondepressed individuals had stable levels across all assessments. Depressed patients also had lower levels of both support types compared with nondepressed patients across all assessments. CONCLUSIONS Breast cancer patients with depressive symptomatology have an elevated risk for declines in perceived social support over time.
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Affiliation(s)
- Howard A Chang
- Department of Population Sciences, City of Hope, Duarte, California
| | - Nicolas Barreto
- Department of Population Sciences, City of Hope, Duarte, California
| | - Arpine Davtyan
- Department of Population Sciences, City of Hope, Duarte, California
| | - Ellis Beier
- Department of Population Sciences, City of Hope, Duarte, California
| | - Marissa A Cangin
- Department of Supportive Care Medicine, City of Hope, Duarte, California
| | - Jaroslava Salman
- Department of Supportive Care Medicine, City of Hope, Duarte, California
| | - Sunita K Patel
- Department of Population Sciences, City of Hope, Duarte, California.,Department of Supportive Care Medicine, City of Hope, Duarte, California
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15
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Law E, Levesque JV, Lambert S, Girgis A. The "sphere of care": A qualitative study of colorectal cancer patient and caregiver experiences of support within the cancer treatment setting. PLoS One 2018; 13:e0209436. [PMID: 30586391 PMCID: PMC6306237 DOI: 10.1371/journal.pone.0209436] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/05/2018] [Indexed: 01/11/2023] Open
Abstract
Introduction Colorectal cancer is associated with considerable physical and psychosocial burden. Whilst social support is known to facilitate psychological adjustment to cancer, patients’ and caregivers’ experiences of social support within a treatment setting and their perceptions of the role of the treating team in providing this support is unknown. Specifically, there is a gap in the research that explores in detail who people affected by colorectal cancer consider to be supportive, and the function, timing and nature of this support, whilst receiving treatment. This study explored both patients’ and caregivers’ a) experiences of social support and how this relates to their experience of treatment; and b) what facilitates support in the treatment setting. Methods Individual interviews (N = 20) were conducted with patients diagnosed with colorectal cancer and caregivers of such patients. Audiotaped interviews were transcribed verbatim and analysed using the framework method. Results Three major themes emerged from the data: a) treating team as a source of support, highlighting the importance of connection with the treating team; b) changes in existing social supports, encompassing issues regarding distance in interpersonal relationships as a consequence of cancer; and c) differing dimensions of support, exploring the significance of shared experience, practical, financial, and emotional support. Conclusions Patients and caregivers perceived the treating team as a major source of support. Support from the treating team was particularly important in the context of the changes that occur as a result of a diagnosis of colorectal cancer and the effects of subsequent treatment. Incidental support from others encountered in the treatment setting was also experienced and was equally important to both patients and caregivers. This has implications for the way health care professionals respond to both patients and caregivers in the treatment setting in terms of communication, interventions and environment.
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Affiliation(s)
- Eleanor Law
- ACT Health, Canberra, Australia
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Liverpool, Australia
- South Western Sydney Clinical School, UNSW Medicine, The University of New South Wales, Liverpool, Australia
- * E-mail:
| | - Janelle V. Levesque
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Liverpool, Australia
- South Western Sydney Clinical School, UNSW Medicine, The University of New South Wales, Liverpool, Australia
| | - Sylvie Lambert
- Ingram School of Nursing, McGill University, Montreal, Canada
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Liverpool, Australia
- South Western Sydney Clinical School, UNSW Medicine, The University of New South Wales, Liverpool, Australia
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16
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Carreira H, Williams R, Müller M, Harewood R, Stanway S, Bhaskaran K. Associations Between Breast Cancer Survivorship and Adverse Mental Health Outcomes: A Systematic Review. J Natl Cancer Inst 2018; 110:1311-1327. [PMID: 30403799 PMCID: PMC6292797 DOI: 10.1093/jnci/djy177] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/08/2018] [Accepted: 08/31/2018] [Indexed: 01/02/2023] Open
Abstract
Background We aimed to systematically review the evidence on adverse mental health outcomes in breast cancer survivors (≥1 year) compared with women with no history of cancer. Methods Studies were identified by searching MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Social Sciences Citation Index, and through backward citation tracking. Two researchers selected the studies, extracted data, and assessed the risk of bias. Results Sixty studies were included. Of 38 studies of depression, 33 observed more depression in breast cancer survivors; this was statistically significant in 19 studies overall, including six of seven where depression was ascertained clinically, three of four studies of antidepressants, and 13 of 31 that quantified depressive symptoms. Of 21 studies of anxiety, 17 observed more anxiety in breast cancer survivors, statistically significant in 11 studies overall, including two of four with clinical/prescription-based outcomes, and in eight of 17 of anxiety symptoms. Breast cancer survivors also had statistically significantly increased symptoms/frequency of neurocognitive dysfunction (18 of 24 studies), sexual dysfunctions (5 of 6 studies), sleep disturbance (5 of 5 studies), stress-related disorders/PTSD (2 of 3 studies), suicide (2 of 2 studies), somatisation (2 of 2 studies), and bipolar and obsessive-compulsive disorders (1 of 1 study each). Studies were heterogeneous in terms of participants' characteristics, time since diagnosis, ascertainment of outcomes, and measures reported. Approximately one-half of the studies were at high risk of selection bias and confounding by socio-economic status. Conclusions There is compelling evidence of an increased risk of anxiety, depression and suicide, and neurocognitive and sexual dysfunctions in breast cancer survivors compared with women with no prior cancer. This information can be used to support evidence-based prevention and management strategies. Further population-based and longitudinal research would help to better characterize these associations.
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Affiliation(s)
- Helena Carreira
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rachael Williams
- Clinical Practice Research Datalink (CPRD), Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Martin Müller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - Rhea Harewood
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Susannah Stanway
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey, UK
| | - Krishnan Bhaskaran
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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17
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Nathoo D, Willis S, Tran WT. Distress Among Locally Advanced Breast Cancer Patients from Diagnosis to Follow-Up: A Critical Review of Literature. J Med Imaging Radiat Sci 2018; 49:325-336. [PMID: 32074060 DOI: 10.1016/j.jmir.2018.04.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This critical review used a systematic approach to explore the prevalence of distress among locally advanced breast cancer (LABC) patients along their treatment journey. This review explored the domains of distress (psychosocial, physical and/or practical) that are significant to this patient population and determined indications for psychosocial support throughout the patients' treatment. METHODS Electronic databases including CINAHL, EmBase, Medline PsycInfo, and gray literature were searched from the year 2000 to 2016, to produce relevant literature. A critical review was conducted on 73 articles meeting the inclusion and exclusion criteria. A narrative synopsis was used to summarize the findings under key themes. RESULTS The results indicate that 16/73 studies assessed for distress in all three domains of distress throughout the treatment course. A meta-analysis was not possible due to the methodological heterogeneity of the articles, the variation of assessment tools used, timing in which the assessments were done, and the different treatment modalities. Distress was prevalent from the time of diagnosis, through treatment, and into survivorship. Sexuality, body image, age, financial difficulty, family/social support, and informational needs were common themes that emerged among the LABC population in these studies. CONCLUSIONS Comprehensive assessments incorporating all three domains of distress with the appropriate tools will assist health care professionals throughout the complicated treatment trajectory of LABC patients in taking a more proactive approach in assisting patients' concerns and preventing undue or increase in psychological distress during or after active treatment. This will encourage effective patient-centered communication and supportive care referrals for a better patient experience.
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Affiliation(s)
- Dilshad Nathoo
- Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario.
| | | | - William T Tran
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario
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18
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Mosleh SM. Health-related quality of life and associated factors in Jordanian cancer patients: A cross-sectional study. Eur J Cancer Care (Engl) 2018; 27:e12866. [PMID: 29863298 DOI: 10.1111/ecc.12866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 03/06/2018] [Accepted: 04/25/2018] [Indexed: 11/29/2022]
Abstract
Understanding the factors associated with patients' health-related quality of life along with their social networks can help identify who may benefit from supportive programmes. This study sought to evaluate the impact of a cancer diagnosis on Jordanian cancer patients' health-related quality of life and its relationship with social support and emotional status. A descriptive design was utilized, and 226 clients were participated. Participants completed European Organization for Research and Treatment of cancer quality of life questionnaire (EORTC-version 3), the Hospice Comfort Questionnaire, and the Hospital Anxiety and Depression scale. The results revealed that participants demonstrated unsatisfactory quality of life and many complained of fatigue. A multiple linear regression analysis revealed that social support, hospitalization readmission and being a nonsmoker were significant predictors for poor global quality of life score. In addition, a high educational level, less rehospitalization and high anxiety and depression scores were significant predictors for comfort level. In conclusion, patients with cancer are at an elevated risk of impaired physical functioning and report unsatisfactory quality of life, particularly if they are anxious, depressed and lack social support. The associated factors with decreased quality of life or low comfort level could be amenable to change with appropriate interventions.
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Affiliation(s)
- Sultan M Mosleh
- Department of Adult Nursing, Faculty of Nursing, Mutah University, Karak, Jordan
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19
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Lee MK, Park SY, Choi GS. Association of support from family and friends with self-leadership for making long-term lifestyle changes in patients with colorectal cancer. Eur J Cancer Care (Engl) 2018; 27:e12846. [PMID: 29635763 DOI: 10.1111/ecc.12846] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 01/09/2023]
Abstract
The purpose of this study was to examine the association of support from family and friends for adoption of healthy eating habits and performing exercise with improvements of self-leadership in patients with colorectal cancer (CRC). This cross-sectional study examined 251 patients with CRC who received primary curative surgery in South Korea. Demographic and clinical information, receipt of social support for adoption of healthy eating habits and performing exercise and self-leadership were collected. Greater participation by family and the use of rewards for performance of exercise were associated with greater behavioural awareness and volition, greater task motivation and constructive cognition of self-leadership in patients. Patients exercising with friends had greater task motivation in self-leadership. The use of rewards by family was associated with performing and maintaining exercise programme for more than 6 months, and family encouragement to adopt healthy eating habits was associated with excellent quality of diet. Family support for exercising and adopting healthy eating habits had more wide-ranging benefits in self-leadership than support from friends; however, support from each group improved self-leadership. Support from family was valuable for increasing the actual performance of exercise and for helping patients with cancer to adopt healthy diets.
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Affiliation(s)
- M K Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea
| | - S Y Park
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - G-S Choi
- Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
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20
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Jang M, Kim J. A structural model for stress, coping, and psychosocial adjustment: A multi-group analysis by stages of survivorship in Korean women with breast cancer. Eur J Oncol Nurs 2018; 33:41-48. [DOI: 10.1016/j.ejon.2018.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 01/04/2018] [Accepted: 01/07/2018] [Indexed: 11/15/2022]
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21
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Cook SA, Salmon P, Hayes G, Byrne A, Fisher PL. Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature. Psychooncology 2018; 27:791-801. [PMID: 29318702 PMCID: PMC5873392 DOI: 10.1002/pon.4601] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 10/27/2017] [Accepted: 11/23/2017] [Indexed: 11/12/2022]
Abstract
Objective Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer‐term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later. Methods A systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty‐nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence. Results There was no consistent evidence that demographic, clinical, or social factors reliably predicted longer‐term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer‐term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta‐analytic techniques. Conclusions This review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed.
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Affiliation(s)
- Sharon A Cook
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Peter Salmon
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Gemma Hayes
- The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Angela Byrne
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Peter L Fisher
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK.,Nidaros DPS, Østmarka University Hospital, Trondheim, Norway
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22
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Haviland J, Sodergren S, Calman L, Corner J, Din A, Fenlon D, Grimmett C, Richardson A, Smith PW, Winter J, Foster C. Social support following diagnosis and treatment for colorectal cancer and associations with health-related quality of life: Results from the UK ColoREctal Wellbeing (CREW) cohort study. Psychooncology 2017; 26:2276-2284. [PMID: 29094430 PMCID: PMC6220760 DOI: 10.1002/pon.4556] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/11/2017] [Accepted: 09/09/2017] [Indexed: 01/09/2023]
Abstract
Objective Social support is acknowledged as important in cancer survivorship, but little is known about change in support after cancer diagnosis and factors associated with this, particularly in colorectal cancer. The CREW cohort study investigated social support up to 2 years following curative intent surgery for colorectal cancer. Methods A total of 871 adults recruited pre‐treatment from 29 UK centres 2010 to 2012 consented to follow‐up. Questionnaires at baseline, 3, 9, 15, and 24 months post‐surgery included assessments of social support (Medical Outcomes Study‐Social Support Survey, MOS‐SSS) and health‐related quality of life (HRQoL). Socio‐demographic, clinical and treatment details were collected. Longitudinal analyses assessed social support over follow‐up, associations with participant characteristics, and HRQoL. Results Around 20% were living alone and 30% without a partner. Perceived social support declined in around 29% of participants, with 8% of these reporting very low levels overall from baseline to 2 years (mean MOS‐SSS overall score < 40 on a scale from 0 to 100). Older age, female gender, greater neighbourhood deprivation, presence of co‐morbidities, and rectal cancer site were significantly associated with reductions in perceived support. Poorer HRQoL outcomes (generic health/QoL, reduced wellbeing, anxiety, and depression) were significantly associated with lower levels of social support. Conclusions Levels of social support decline following colorectal cancer diagnosis and treatment in nearly a third of patients and are an important risk factor for recovery of HRQoL. Assessment of support early on and throughout follow‐up would enable targeted interventions to improve recovery, particularly in the more vulnerable patient groups at risk of poorer social support.
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Affiliation(s)
- Joanne Haviland
- Institute of Cancer Research Clinical Trials and Statistics Unit, Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Samantha Sodergren
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jessica Corner
- Executive Office, University of Nottingham, Nottingham, UK
| | - Amy Din
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Deborah Fenlon
- College of Health and Human Sciences, Swansea University, Swansea, Wales, UK
| | - Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter W Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, UK
| | - Jane Winter
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
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23
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Thompson LMA, Bobonis Babilonia M. Distinguishing Depressive Symptoms From Similar Cancer-Related Somatic Symptoms: Implications for Assessment and Management of Major Depression after Breast Cancer. South Med J 2017; 110:667-672. [PMID: 28973709 DOI: 10.14423/smj.0000000000000705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Prevalence rates of major depressive disorder (MDD) following breast cancer diagnosis are estimated to be ~5% to >20%, and these rates range from slightly below to somewhat above the expected prevalence rate for MDD in the general population of women in the United States. Women with a history of MDD are at increased risk for recurrence of MDD after breast cancer and need to be monitored closely. To properly diagnose and treat MDD, healthcare providers must be able to recognize depressive symptoms and distinguish them from similar somatic symptoms that are associated with breast cancer and breast cancer treatment. The National Comprehensive Cancer Network and the American Society of Clinical Oncology have published guidelines for the screening, assessment, and care of adult cancer patients with depressive symptoms. Use of a standardized and validated screening measure may help healthcare providers identify patients in need of further assessment or treatment. Evidence-based nonpharmacological interventions such as cognitive behavioral therapy and antidepressant medications are recommended treatment options.
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Affiliation(s)
- Lora M A Thompson
- From the Supportive Care Medicine Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Margarita Bobonis Babilonia
- From the Supportive Care Medicine Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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24
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Syrowatka A, Motulsky A, Kurteva S, Hanley JA, Dixon WG, Meguerditchian AN, Tamblyn R. Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Res Treat 2017; 165:229-245. [PMID: 28553684 PMCID: PMC5543195 DOI: 10.1007/s10549-017-4290-9] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/10/2017] [Indexed: 12/12/2022]
Abstract
Purpose Unmanaged distress has been shown to adversely affect survival and quality of life in breast cancer survivors. Fortunately, distress can be managed and even prevented with appropriate evidence-based interventions. Therefore, the objective of this systematic review was to synthesize the published literature around predictors of distress in female breast cancer survivors to help guide targeted intervention to prevent distress. Methods Relevant studies were located by searching MEDLINE, Embase, PsycINFO, and CINAHL databases. Significance and directionality of associations for commonly assessed candidate predictors (n ≥ 5) and predictors shown to be significant (p ≤ 0.05) by at least two studies were summarized descriptively. Predictors were evaluated based on the proportion of studies that showed a significant and positive association with the presence of distress. Results Forty-two studies met the target criteria and were included in the review. Breast cancer and treatment-related predictors were more advanced cancer at diagnosis, treatment with chemotherapy, longer primary treatment duration, more recent transition into survivorship, and breast cancer recurrence. Manageable treatment-related symptoms associated with distress included menopausal/vasomotor symptoms, pain, fatigue, and sleep disturbance. Sociodemographic characteristics that increased the risk of distress were younger age, non-Caucasian ethnicity, being unmarried, and lower socioeconomic status. Comorbidities, history of mental health problems, and perceived functioning limitations were also associated. Modifiable predictors of distress were lower physical activity, lower social support, and cigarette smoking. Conclusions This review established a set of evidence-based predictors that can be used to help identify women at higher risk of experiencing distress following completion of primary breast cancer treatment. Electronic supplementary material The online version of this article (doi:10.1007/s10549-017-4290-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ania Syrowatka
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada. .,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
| | - Aude Motulsky
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Siyana Kurteva
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - James A Hanley
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | - William G Dixon
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK.,Health eResearch Centre, Farr Institute, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Ari N Meguerditchian
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada.,Department of Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Robyn Tamblyn
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
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25
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Lee MK. Disability and quality of life in community-dwelling elderly cancer survivors: Case-control study in the Korean population. Eur J Oncol Nurs 2016; 24:22-28. [PMID: 27697274 DOI: 10.1016/j.ejon.2016.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 07/20/2016] [Accepted: 08/06/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Advanced age is a significant risk factor for cancer and functional disabilities increase with age. The purpose of this case-control study of Korean individuals was to determine the effect of cancer and cancer treatment on functional disability and quality of life (QOL). Thus, we compared community-dwelling elderly cancer patients (ECPs) with individuals from the general elderly population (GEP) who never had diagnoses of cancer. METHODS We selected 1776 ECP who were at least 65 years-old from the 2008 Korean Community Health Survey data and used propensity score matching to randomly select 1766 individuals from the GEP who closely resembled the ECPs. Functional disability was measured using the Instrumental Activities of Daily Living (IADL) scale, and QOL was measured by the EuroQol Group EQ-5D. RESULTS ECPs were more dependent in preparation of food, doing laundry, and shopping (IADL scale), and in mobility and usual activities (EQ-5D). Although ECP had more problems with pain, discomfort, anxiety, and depression, they were more independent in self-care and handling of financial responsibilities. CONCLUSIONS ECPs had multiple physical and psychological symptoms that adversely affected functional disability and QOL, but higher functional ability, such as self-care and handling of financial responsibilities. Promotion of self-care by ECPs is pivotal for effective management in community practice.
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Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, 680 Gukchabosangro, Jung-gu, Daegu, 700-842, Republic of Korea.
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26
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Brandão T, Schulz MS, Matos PM. Psychological adjustment after breast cancer: a systematic review of longitudinal studies. Psychooncology 2016; 26:917-926. [PMID: 27440317 DOI: 10.1002/pon.4230] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/24/2016] [Accepted: 07/18/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Breast cancer (BC) can be a traumatic and stressful experience for women, but there are wide-ranging differences in the ways in which women respond and adapt to BC. This systematic review examines which sociodemographic, disease-related, and psychosocial factors near diagnosis predict later psychological adjustment to BC. METHODS Database searches were conducted in 9 different health-related databases from 2000 to December 2015 using relevant search terms. Full-text, peer-reviewed articles in English that analyzed potential predictors of psychological adjustment in longitudinal studies were considered for inclusion. RESULTS Of 1780 abstracts, 41 studies fulfilled inclusion criteria. Consistent sociodemographic and disease-related variable predictors of adjustment were income, fatigue, cancer stage, and physical functioning. Psychosocial factors, particularly optimism and trait anxiety, as well as perceived social support, coping strategies, and initial levels of psychological functioning, were found to be predictive of later depressive and anxiety symptoms, psychological distress, and quality of life for women with BC, in predictable ways. Other psychosocial variables, such as cognitive and body image factors, predicted psychological adjustment but were explored only by a few studies. CONCLUSIONS The majority of studies showed a significant relationship between psychosocial factors and psychological adjustment. These results point to specific sociodemographic, disease-related, and psychosocial factors that can help to identify women at the time of diagnosis who are at risk for long-term psychological challenges so they can be referred for psychological support that targets their specific needs and can improve their quality of life and mood and decrease indicators of anxiety, depression, and psychological distress.
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Affiliation(s)
- Tânia Brandão
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Center for Psychology, University of Porto, Porto, Portugal
| | - Marc S Schulz
- Department of Psychology, Bryn Mawr College, Bryn Mawr, PA, USA
| | - Paula Mena Matos
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Center for Psychology, University of Porto, Porto, Portugal
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Sharp L, Timmons A. Pre-diagnosis employment status and financial circumstances predict cancer-related financial stress and strain among breast and prostate cancer survivors. Support Care Cancer 2015; 24:699-709. [PMID: 26143038 DOI: 10.1007/s00520-015-2832-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Cancer may have a significant financial impact on patients, but the characteristics that predispose patients to cancer-related financial hardship are poorly understood. We investigated factors associated with cancer-related financial stress and strain in breast and prostate cancer survivors in Ireland, which has a complex mixed public-private healthcare system. METHODS Postal questionnaires were distributed to 1373 people diagnosed with cancer 3-24 months previously identified from the National Cancer Registry Ireland. Outcomes were cancer-related financial stress (impact of cancer diagnosis on household ability to make ends meet) and financial strain (concerns about household financial situation since cancer diagnosis). Modified Poisson regression was used to estimate relative risks (RR) for factors associated with cancer-related financial stress and strain. RESULTS Seven hundred forty survivors participated (response rate = 54 %). Of the respondents, 48 % reported cancer-related financial stress and 32 % cancer-related financial strain. Compared to those employed at diagnosis, risk of cancer-related financial stress was significantly lower in those not working (RR = 0.71, 95 % CI 0.58-0.86) or retired (RR = 0.48, 95 % CI 0.34-0.68). It was significantly higher in those who had dependents; experienced financial stress pre-diagnosis; had a mortgage/personal loans; had higher direct medical out-of-pocket costs; and had increased household bills post-diagnosis. For cancer-related financial strain, significant associations were found with dependents, pre-diagnosis employment status and pre-diagnosis financial stress; risk was lower in those with higher direct medical out-of-pocket costs. CONCLUSIONS Cancer-related financial stress and strain are common. Pre-diagnosis employment status and financial circumstances are important predictors of post-diagnosis financial wellbeing. These findings could inform development of tools to identify patients/survivors most in need of financial advice and support.
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Affiliation(s)
- Linda Sharp
- National Cancer Registry, Building 6800, Kinsale Road, Cork, Ireland. .,Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, Tyne and Wear, NE2 4AX, England, UK.
| | - Aileen Timmons
- National Cancer Registry, Building 6800, Kinsale Road, Cork, Ireland
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28
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Cancer-related fatigue and depression in breast cancer patients postchemotherapy: Different associations with optimism and stress appraisals. Palliat Support Care 2014; 13:1141-51. [PMID: 25201115 DOI: 10.1017/s147895151400087x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Symptoms of depression and cancer-related fatigue (CRF) are common among breast cancer patients postchemotherapy and may seriously impair quality of life (QoL). This study aimed to assess the relationship between depression and CRF in breast cancer patients postchemotherapy and to examine their relationships to optimism and to threat and challenge appraisals. METHOD Participants included 95 breast cancer patients (stages 1-3) 1 to 6 months after completion of chemotherapy. Patients submitted personal and medical details and completed the following: physical symptom questionnaires (EORTC QLQ-C30, and QLQ-BR23), a symptoms of depression questionnaire (CES-D), the Fatigue Symptom Inventory (FSI), the Life Orientation Test (LOT-R), and a stress appraisals questionnaire. RESULTS We found levels of depression, CRF, and appraisals of cancer as a threat to bemoderate and levels of optimism and appraisals of cancer as a challenge to be high. Depression and CRF were positively associated. A multivariate regression analysis revealed that 51% of the CRF variancewas explained; physical symptoms and threat appraisal were significantly associated with CRF. A 67% of the CRF variance of depression was explained; challenge and threat appraisals were significantly associated with depression [corrected]. SIGNIFICANCE OF RESULTS Although CRF and depression were often experienced simultaneously and both were found to be higher among individuals who gave higher appraisals of cancer as a threat, only depression was related to optimism and challenge appraisals, while CRF was related mainly to intensity of physical symptoms. The different pattern of associations between optimism and appraisals warrants further clinical attention as well as future study.
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29
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Huang CY, Hsu MC. Social support as a moderator between depressive symptoms and quality of life outcomes of breast cancer survivors. Eur J Oncol Nurs 2013; 17:767-74. [DOI: 10.1016/j.ejon.2013.03.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 03/10/2013] [Accepted: 03/20/2013] [Indexed: 12/24/2022]
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30
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A Randomized Trial of Dyadic Peer Support Intervention for Newly Diagnosed Breast Cancer Patients in Korea. Cancer Nurs 2013; 36:E15-22. [DOI: 10.1097/ncc.0b013e3182642d7c] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Sheppard VB, Llanos AA, Hurtado-de-Mendoza A, Taylor TR, Adams-Campbell LL. Correlates of depressive symptomatology in African-American breast cancer patients. J Cancer Surviv 2013; 7:292-9. [PMID: 23471730 DOI: 10.1007/s11764-013-0273-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 02/18/2013] [Indexed: 12/16/2022]
Abstract
PURPOSE This study assessed the levels of depressive symptomatology in African-American women with breast cancer compared to those of women without breast cancer and examined demographic, psychosocial, and clinical factors correlated with depression. METHODS A total of 152 African-American women were recruited from Washington, DC and surrounding suburbs. Breast cancer patients (n = 76 cases) were recruited from a health care center and women without cancer were recruited from health fairs (n = 76 comparison). We assessed depression, psychosocial variables (ego strength and social support), and sociodemographic factors from in-person interviews. Stage and clinical factors were abstracted from medical records. Independent sample t test, chi square test, analyses of variance, and multiple regression models were used to identify differences in depression and correlates of depression among the cases and comparison groups. RESULTS Women with breast cancer reported significantly greater levels of depression (m = 11.5, SD = 5.0) than women without breast cancer (m = 3.9, SD = 3.8) (p < 0.001). Higher cancer stage (beta = 0.91) and higher age (beta = 0.11) were associated with depression in the breast patients, explaining 84 % of the variance. In the comparison group, ego strength and tangible support were inversely associated with depressive symptoms, accounting for 32 % of the variance. CONCLUSIONS Women with more advanced disease may require interdisciplinary approaches to cancer care (i.e., caring for the whole person). IMPLICATIONS FOR CANCER SURVIVORS Depression is often underrecognized and undertreated in African-American breast cancer patients. Understanding the factors related to depression is necessary to integrate psychosocial needs to routine cancer care to improve survivors' quality of life.
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Affiliation(s)
- Vanessa B Sheppard
- Department of Oncology, Lombardi Comprehensive Cancer Center, 3300 Whitehaven St. NW, Washington, DC 20007, USA.
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32
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Sharp L, Carsin AE, Timmons A. Associations between cancer-related financial stress and strain and psychological well-being among individuals living with cancer. Psychooncology 2012; 22:745-55. [PMID: 22411485 DOI: 10.1002/pon.3055] [Citation(s) in RCA: 165] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 01/06/2012] [Accepted: 01/30/2012] [Indexed: 01/06/2023]
Affiliation(s)
| | - Anne-Elie Carsin
- National Cancer Registry; Cork Ireland
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- Hospital del Mar Research Institute (IMIM); Barcelona Spain
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