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Setzer M, Yan J, Erby L, Similuk M. Perceived control is significantly associated with psychological adaptation in individuals with known or suspected inborn errors of immunity. J Community Genet 2023; 14:639-647. [PMID: 37709977 PMCID: PMC10725379 DOI: 10.1007/s12687-023-00670-y] [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: 06/01/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023] Open
Abstract
Inborn errors of immunity (IEIs) are rare genetic disorders characterized by increased susceptibility to infection and immune system dysregulation. Despite the significant physical toll of IEIs, there is less information on clinical and patient-reported biopsychosocial outcomes and how these individuals psychologically adapt. We invited adults with IEIs or suspected IEIs (sIEIs) enrolled on a protocol at the National Institutes of Health to complete a cross-sectional survey measuring patient-reported biopsychosocial outcomes, psychological adaptation, and perceived control. We received responses from 312 individuals. Levels of adaptation to illness were similar to previously published cohorts of individuals with chronic health conditions. Participants reported significantly increased levels of anxiety, pain, sleep disturbance, and fatigue and significantly lower levels of physical functioning compared to the general population (p < 0.05). Multiple linear regression analysis indicated that perceived present control was significantly positively associated with adaptation (β = 0.26, p < 0.05). We found that perceived present control was significantly associated with psychological adaptation. Individuals with sIEIs in our sample struggled with poorer biopsychosocial outcomes than the general population, although these may not ultimately be directly related to psychological adaptation. Interventions to increase perceived control may be beneficial to this patient population. Clinicians should also consider screening and management for psychological and physical concerns including anxiety, depression, sleep disturbance, pain, and fatigue.
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Affiliation(s)
- Michael Setzer
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Jia Yan
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lori Erby
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Morgan Similuk
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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2
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Cohen JT, Beard RE, Cioffi WG, Miner TJ. Was It Worth It? Critical Evaluation of a Novel Outcomes Measure in Oncologic Palliative Surgery. J Am Coll Surg 2023; 236:1156-1162. [PMID: 36786475 DOI: 10.1097/xcs.0000000000000649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Patient selection for palliative surgery is complex, and appropriate outcomes measures are incompletely defined. We explored the usefulness of a specific outcomes measure "was it worth it" in patients after palliative-intent operations for advanced malignancy. STUDY DESIGN A retrospective review of a comprehensive longitudinal palliative surgery database was performed at an academic tertiary care center. All patients who underwent palliative-intent operation for advanced cancer from 2003 to 2022 were included. Patient satisfaction ("was it worth it") was reported within 30 days of operation after palliative-intent surgery. RESULTS A total of 180 patients were identified, and 81.7% self-reported that their palliative surgery was "worth it." Patients who reported that their surgery was "not worth it" were significantly older and were more likely to have recurrent symptoms and to need reoperation. There was no significant difference in overall, recurrence-free, and reoperation-free survival for patients when comparing "worth it" with "not worth it." Initial symptom improvement was not significantly different between groups. Age older than 65 years (hazard ratio 0.25, 95% CI 0.07 to 0.80, p = 0.03), family engagement (hazard ratio 6.71, 95% CI 1.49 to 31.8, p = 0.01), and need for reoperation (hazard ratio 0.042, 95% CI 0.01 to 0.16, p < 0.0001) were all independently associated with patients reporting that their operation was "worth it." CONCLUSIONS Here we demonstrate that simply asking a patient "was it worth it" after a palliative-intent operation identifies a distinct cohort of patients that traditional outcomes measures fail to distinguish. Family engagement and durability of an intervention are critical factors in determining patient satisfaction after palliative intervention. These data highlight the need for highly individualized care with special attention paid to patients self-reporting that their operation was "not worth it."
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Affiliation(s)
- Joshua T Cohen
- From the Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
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3
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Rahman R, Mamat P, Wang H, Nurtai M, Mahsut M, Ahmat Z, Siyit M, Shang H, Zhang X. Effect of personalized care based on OPT model on perceived control and quality of life among patients with breast cancer. Front Public Health 2023; 11:1149558. [PMID: 37139376 PMCID: PMC10149826 DOI: 10.3389/fpubh.2023.1149558] [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: 01/22/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Patients with breast cancer (BC) after surgery are prone to negative physiological and psychosocial discomforts which cause the poor quality of life (QoL) among the patients. Therefore, how to improve the disease management ability of BC patients and to alleviate these cancer-related negative experience are particularly important. This study purpose to explore the potential effects of personalized care based on OPT model on the perceived control and the QoL among patients with BC, and to provide effective clinical nursing intervention for BC patients. Methods In this study, nonsynchronous controlled experiments were carried out on patients with BC, and the patients were randomly allocated to the control (n = 40) and intervention (n = 40) groups. The patients in the control group were given routine care; while the patients in the intervention group were given personalized care based on OPT model. The perceived control ability and QoL of the two groups were measured before and after the intervention. Results There were no significant differences in the total score of cancer experience and control efficacy of BC patients between the control group (61.15 ± 5.659, 41.80 ± 4.702) and the intervention group (60.58 ± 7.136, 42.15 ± 5.550) before intervention (p > 0.05). After the intervention, the total score of cancer experience in the intervention group (54.80 ± 8.519) was significantly lower than that in the control group (59.575 ± 7.331), with significant differences (p < 0.05). The total score of control efficacy in the intervention group (49.78 ± 6.466) was significantly higher than that in the control group (43.32 ± 6.219), with significant differences (p < 0.05). Compared with the control group, patients in intervention groups showed significant improvement in QoL after the intervention (p < 0.05). Conclusion Personalized care based on OPT model plays a significant role in improving the level of perceived control and the QoL among patients with BC.Clinical Trial Registration:www.chictr.org.cn, ChiCTR2300069476.
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Affiliation(s)
- Rabigul Rahman
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
- *Correspondence: Rabigul Rahman,
| | - Parida Mamat
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Haiyan Wang
- Breast Surgical Department, Oncology Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Haiyan Wang,
| | - Mili Nurtai
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Maynur Mahsut
- Nursing Supervision Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Zulhumar Ahmat
- Intensive Care Unit (ICU), The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Mukadas Siyit
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hongmei Shang
- Breast Surgical Department, Oncology Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiaoyan Zhang
- Breast Surgical Department, Oncology Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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4
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Zhang D, Fan M, Meng L, Zheng X. Neuroticism and fear of COVID-19 during the COVID-19 pandemic: Testing the mediating role of intolerance of uncertainty and sense of control among Chinese high school students. Front Psychol 2022; 13:1010767. [PMID: 36544445 PMCID: PMC9760983 DOI: 10.3389/fpsyg.2022.1010767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022] Open
Abstract
Since the COVID-19 pandemic broke out in 2019, neuroticism has been proven a predictor of fear of COVID-19 infection. However, only few studies have been conducted on the factors affecting the relationship between neuroticism and this kind of fear. The present study is aimed at analyzing the role intolerance of uncertainty (IU) and sense of control (SOC) play in relation to neuroticism and the fear of COVID-19. We conducted a cross-sectional study in Guangdong and Guangxi provinces, China, and we collected complete datasets from 792 high school students. The main results can be described as follows: (a) individuals with high neuroticism tended to have higher intolerance of uncertainty (IU) and a lower sense of control (SOC); (b) IU and SOC played a mediating role between neuroticism and fear of COVID-19, and a serial mediation effect was found between these factors; (c) after controlling for both IU and SOC, the effect of neuroticism on fear was no longer significant. The results suggested a critical role of IU and sense of control in the causal relationship between neuroticism and fear.
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Affiliation(s)
- Donghuan Zhang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Min Fan
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Lingyi Meng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xifu Zheng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
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5
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Valued Outcomes in the Cancer Experience (VOICE)™: Development and validation of a multidimensional measure of perceived control. Palliat Support Care 2022; 21:465-476. [PMID: 36285508 DOI: 10.1017/s1478951522000724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Objective
Enhancing cancer patients’ sense of control can positively impact psychological well-being. We developed and assessed the psychometric properties of Valued Outcomes in the Cancer Experience (VOICE)TM, a measure of patients’ perceived control over key personal priorities within their cancer experience.
Methods
VOICE construction and testing were completed in three phases with separate participant samples: (1) item generation and initial item pool testing (N = 459), (2) scale refinement (N = 623), and (3) confirmatory validation (N = 515).
Results
A 21-item measure was developed that captures cancer patients’ sense of control in seven key domains: (1) Purpose and Meaning, (2) Functional Capacity, (3) Longevity, (4) Quality Care, (5) Illness Knowledge, (6) Social Support, and (7) Financial Capability. VOICE demonstrated adequate internal consistency (full-scale α = 0.93; factor α = 0.67–0.89) and adequate to strong convergent and discriminatory validity.
Significance of results
VOICE measures cancer patients’ perceived control across a diverse range of personal priorities, creating a platform for elevating patient perspectives and identifying pathways to enhance patient well-being. VOICE is positioned to guide understanding of the patient experience and aid the development and evaluation of supportive care interventions to enhance well-being.
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6
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Mullarkey M, Dobias M, Sung J, Ahuvia I, Shumake J, Beevers C, Schleider J. Web-Based Single Session Intervention for Perceived Control Over Anxiety During COVID-19: Randomized Controlled Trial. JMIR Ment Health 2022; 9:e33473. [PMID: 35230962 PMCID: PMC9007232 DOI: 10.2196/33473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Anxiety is rising across the United States during the COVID-19 pandemic, and social distancing mandates preclude in-person mental health care. Greater perceived control over anxiety has predicted decreased anxiety pathology, including adaptive responses to uncontrollable stressors. Evidence suggests that no-therapist, single-session interventions can strengthen perceived control over emotions like anxiety; similar programs, if designed for the COVID-19 context, could hold substantial public health value. OBJECTIVE Our registered report evaluated a no-therapist, single-session, online intervention targeting perceived control over anxiety in the COVID-19 context against a placebo intervention encouraging handwashing. We tested whether the intervention could (1) decrease generalized anxiety and increase perceived control over anxiety and (2) achieve this without decreasing social-distancing intentions. METHODS We tested these questions using a between-subjects design in a weighted-probability sample of US adults recruited via a closed online platform (ie, Prolific). All outcomes were indexed via online self-report questionnaires. RESULTS Of 522 randomized individuals, 500 (95.8%) completed the baseline survey and intervention. Intent-to-treat analyses using all randomized participants (N=522) found no support for therapeutic or iatrogenic effects; effects on generalized anxiety were d=-0.06 (95% CI -0.27 to 0.15; P=.48), effects on perceived control were d=0.04 (95% CI -0.08 to 0.16; P=.48), and effects on social-distancing intentions were d=-0.02 (95% CI -0.23 to 0.19; P=.83). CONCLUSIONS Strengths of this study included a large, nationally representative sample and adherence to open science practices. Implications for scalable interventions, including the challenge of targeting perceived control over anxiety, are discussed. TRIAL REGISTRATION ClinicalTrials.gov NCT04459455; https://clinicaltrials.gov/show/NCT04459455.
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Affiliation(s)
- Michael Mullarkey
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Mallory Dobias
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Jenna Sung
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Isaac Ahuvia
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Jason Shumake
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Christopher Beevers
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Jessica Schleider
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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7
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Warner EL, Basen-Engquist KM, Badger TA, Crane TE, Raber-Ramsey M. The Online Cancer Nutrition Misinformation: A framework of behavior change based on exposure to cancer nutrition misinformation. Cancer 2022; 128:2540-2548. [PMID: 35383913 DOI: 10.1002/cncr.34218] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients with cancer and caregivers increasingly use the internet to find health and lifestyle information, yet online recipes, diet, and nutrition content are unregulated and may be confusing or even misleading. We describe cancer-related nutrition and meal planning information from Pinterest. METHODS In June 2020, we searched Pinterest using "cancer recipe" and "recipe for cancer" at 3 times daily for 2 weeks. Duplicates were removed for a final sample of n = 103 pins. Each pin was coded for 58 variables including descriptives, cancer claims (eg, treatment, prevention, and cure), and nutrition claims (eg, "turmeric cures cancer"). We summarized each variable to describe the content of cancer nutrition claims on Pinterest and examined associations between claim types and contextual factors, including the use of academic citations, disclaimers, and personal anecdotes. RESULTS Pinners had on average 116,767 followers (range, 0-1.5 million). Almost half of content sites were for profit (48.5%) and 34% were selling a product. Health claims were common, with content that purported to prevent (41.8%), treat (27.2%), or cure (10.7%) cancer. Vague phrases such as "anti-cancer," "cancer-fighting," or "cancer-busting" were also used. The inclusion of validity indicators including academic citations, disclaimers, and personal anecdotes varied significantly by the types of claims made. Together, these analyses informed the development of a conceptual framework of cancer-related nutrition misinformation. CONCLUSIONS There are clear financial incentives for the promotion of cancer nutrition information online. More research is needed to understand how exposure to nutrition information can influence patient/caregiver behavior and downstream clinical and psychosocial outcomes.
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Affiliation(s)
- Echo L Warner
- University of Arizona Cancer Center, Tucson, Arizona.,University of Arizona College of Nursing, Tucson, Arizona
| | | | - Terry A Badger
- University of Arizona Cancer Center, Tucson, Arizona.,University of Arizona College of Nursing, Tucson, Arizona
| | - Tracy E Crane
- University of Arizona Cancer Center, Tucson, Arizona.,University of Arizona College of Nursing, Tucson, Arizona
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8
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Lingens SP, Schulz F, Müller I, Schulz H, Bleich C. Associations between self-efficacy, distress and anxiety in cancer patient-relative dyads visiting psychosocial cancer support services: Using actor-partner interdependence modelling. PLoS One 2021; 16:e0255318. [PMID: 34534225 PMCID: PMC8448356 DOI: 10.1371/journal.pone.0255318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients with cancer and their relatives often suffer from psychosocial burdens following a cancer diagnosis. Psychosocial cancer support services offer support for cancer patients and their relatives. Only a few studies have focused on associations of psychological factors within patient-relative dyads. This study aims to assess associations between the patients' or relatives' self-efficacy and their levels of distress and anxiety who seek help together at psychosocial cancer support centres. METHODS Participants were recruited at two psychosocial cancer support centres in a major city in Germany. Patients with cancer and their relatives seeking support together received the questionnaire before their first support session. Self-efficacy was assessed with the Pearlin sense of mastery scale, distress with the distress thermometer and anxiety with the General Anxiety Disorder questionnaire (GAD-7). For the analysis, the actor-partner interdependence model was applied. RESULTS The data analysis was based on 41 patient-relative dyads (patients: 39% women, mean age 53.5; relatives: 66% women, mean age 52.16). A significant actor effect from self-efficacy to distress was found for patients (r = -0.47) but not for relatives (r = -0.15). Partner effects from self-efficacy to distress were not significant (r = -0.03, r = -0.001). The actor effect from self-efficacy to anxiety for patients (r = -0.61) as well as relatives was significant (r = -0.62), whereas the partner effect was significant for patients (r = 0.16) but not for relatives (r = -0.46). CONCLUSION The results suggest that patients' and relatives' self-efficacy is associated with their distress and anxiety. Partner effects were visible for patients' self-efficacy and relatives' anxiety. These findings suggest that self-efficacy is an important factor for the psychological well-being of patients and relatives and that it may additionally be associated with the partners' well-being. Longitudinal research with larger samples is needed to support the findings.
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Affiliation(s)
- Solveigh P. Lingens
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Schulz
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Isabell Müller
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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9
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Bockholt M, Mehnert-Theuerkauf A, Vehling S. [Association of Illness Perceptions with Demoralization and Psychological Distress in Cancer: a Longitudinal Study]. Psychother Psychosom Med Psychol 2021; 71:464-472. [PMID: 34265855 DOI: 10.1055/a-1522-8500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Zusammenfassung
Hintergrund Diese Längsschnittstudie untersucht den Einfluss
der Ausprägung subjektiver Krankheitstheorien auf den zeitlichen
Verlauf von Demoralisierung, Depression und Angst bei Patienten mit einer
Krebserkrankung.
Methode Wir untersuchten n=307 Patienten mit gemischten
Tumordiagnosen und Erkrankungsstadien zu drei Messzeitpunkten:
während der ambulanten bzw. stationären Behandlung, nach 6
Monaten (n=213, 69%) sowie nach 12 Monaten (n=153,
50%). Subjektive Krankheitstheorien wurden anhand der Subskalen
Konsequenzen, Kontrolle, Behandlungskontrolle und Kohärenz des
Illness Perception Questionnaire (IPQ-R) erfasst. Psychische Belastung wurde
anhand der Demoralisierungsskala (DS) sowie der Module Depression und Angst
des Gesundheitsfragebogens für Patienten (PHQ-9 und GAD-7) erfasst.
Längsschnittliche Analysen erfolgten anhand von Varianzanalysen mit
Messwiederholung (MANOVA).
Ergebnisse Zu Studienbeginn nahmen 20% der Teilnehmer die
Erkrankung als mit einschneidenden Konsequenzen verbunden wahr
(12-Monats-Follow-up: 16%); 25% nahmen sie als
persönlich kontrollierbar (12-Monats-Follow-up: 17%),
42% als durch die medizinische Behandlung kontrollierbar
(12-Monats-Follow-up: 26%) und 24% als
kohärent/verstehbar wahr (12-Monats-Follow-up: 30%).
Zu Studienbeginn war die Wahrnehmung einschneidender Konsequenzen mit einer
signifikant höheren psychischen Belastung verbunden, von
Kontrollierbarkeit und Kohärenz mit einer signifikant geringeren
psychischen Belastung. Die Größe dieses Zusammenhangs war
jeweils am höchsten für Demoralisierung (Konsequenzen:
r=0,45, p<0,001, Kontrolle:
r=− 0,25, p<0,001, Behandlungskontrolle:
r=− 0,31, p<0,001, Kohärenz:
r=− 0,27, p<0,001). Keine der Subskalen
hatte einen signifikanten Einfluss auf die zeitliche Veränderung der
psychischen Belastung über den Verlauf von 12 Monaten
(d≤0,29, p≥0,09).
Diskussion Die subjektive Wahrnehmung einschneidender Konsequenzen,
geringer Kontrollierbarkeit sowie Verstehbarkeit der Erkrankung kann eine
wichtige Quelle für aktuell erlebte hohe Belastungen bei
Krebspatienten sein. Sie geht jedoch nicht zwangsläufig mit einem
weiteren Anstieg oder Abfall der psychischen Belastung einher. Ein
möglicher Grund könnte in den begrenzten
Möglichkeiten des eingesetzten IPQ-R liegen, adaptiv-angemessene von
maladaptiv-verzerrten Krankheitswahrnehmungen zu differenzieren.
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Affiliation(s)
- Malin Bockholt
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Anja Mehnert-Theuerkauf
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Sigrun Vehling
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.,II. Medizinische Klinik und Poliklinik (Onkologie, Hämatologie und Knochenmarktransplantation mit Abteilung für Pneumologie), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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10
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Lingens SP, Hagedoorn M, Zhu L, Ranchor AV, van der Lee M, Garssen B, Schroevers MJ, Sanderman R, Goedendorp MM. Trajectories of fatigue in cancer patients during psychological care. Psychol Health 2021; 37:1002-1021. [PMID: 33985383 DOI: 10.1080/08870446.2021.1916493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Psycho-oncological institutions offer specialized care for cancer patients. Little is known how this care might impact fatigue. This study aimed to identify fatigue trajectories during psychological care, examined factors distinguishing these trajectories and predicted fatigue severity after nine months of psychological care. DESIGN Naturalistic, longitudinal study of 238 cancer patients receiving psycho-oncological care in the Netherlands. Data were collected before initiation of psychological care (T1) and three (T2) and nine months (T3) afterwards. Latent class growth analysis, repeated measure analyses (RMA) and linear regression analysis were performed. MAIN OUTCOME MEASURES Fatigue severity: Checklist Individual Strength. RESULTS Three fatigue trajectories were identified: high- (30%), moderate- (62%) and low-level fatigue (8%). While statistically significant decreases in fatigue were found, this decrease was not clinically relevant. RMA showed main effects for time for fatigue trajectories on depression, anxiety, personal control and illness cognitions. Fatigue severity and physical symptoms at T1, but not demographic or clinical factors, were predictive of fatigue severity at T3. CONCLUSIONS Fatigue is very common during psycho-oncological care, and notably not clinically improving. As symptoms of fatigue, depression, anxiety and physical symptoms often cluster, supplementary fatigue treatment should be considered when it is decided to treat other symptoms first.
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Affiliation(s)
- Solveigh P Lingens
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lei Zhu
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marije van der Lee
- Centre for Psycho-Oncology, Helen Dowling Institute, Bilthoven, The Netherlands
| | - Bert Garssen
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Centre for Psycho-Oncology, Helen Dowling Institute, Bilthoven, The Netherlands
| | - Maya J Schroevers
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Martine M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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11
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Cohen JT, Fallon EA, Charpentier KP, Cioffi WG, Miner TJ. Improving the value of palliative surgery by optimizing patient selection: The role of long-term survival on high impact palliative intent operations. Am J Surg 2020; 221:1018-1023. [PMID: 32980077 DOI: 10.1016/j.amjsurg.2020.08.034] [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: 06/19/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND In order to better characterize outcomes of palliative surgery (PS), we evaluated patients that experienced top quartile survival to elucidate predictors of high impact PS. METHODS All PS performed on advanced cancer patients from 2003 to 2017 were identified from a PS database. RESULTS 167 patients were identified. Multivariate analysis demonstrated the ability to rise from a chair was independently associated with top quartile survival (HR 7.61, 95% CI 2.12-48.82, p=0.008) as was the need for re-operation (HR 2.81, 95% CI 1.26-6.30, p=0.0012). Patients who were able to rise from a chair had significantly prolonged overall survival (320 vs 87 days, p < 0.001). CONCLUSIONS Although not the primary goal, long-term survival can be achieved following PS and is associated with re-operation and the ability to rise from a chair. These patients experience the benefits of PS for a longer period of time, which in turn maximizes value and positive impact. SUMMARY Long-term survival and symptom control can be achieved in highly selected advanced cancer patients following palliative surgery. The ability of the patient to independently rise from a chair and the provider to offer a re-operation when indicated are associated with long-term survival following a palliative operation.
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Affiliation(s)
- Joshua T Cohen
- Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Eleanor A Fallon
- Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Kevin P Charpentier
- Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - William G Cioffi
- Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Thomas J Miner
- Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
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12
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Zaleta AK, Miller MF, Olson JS, Yuen EYN, LeBlanc TW, Cole CE, McManus S, Buzaglo JS. Symptom Burden, Perceived Control, and Quality of Life Among Patients Living With Multiple Myeloma. J Natl Compr Canc Netw 2020; 18:1087-1095. [PMID: 32755984 DOI: 10.6004/jnccn.2020.7561] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 03/19/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND New therapies for multiple myeloma (MM) have improved survival rates but often expose patients to heightened toxicities and prolonged treatment, leading to increasing complications and side effects. We evaluated the association between symptom burden, perceived control over illness, and quality of life (QoL) among a national sample of patients with MM. METHODS For this observational, cross-sectional study, we used data from the Cancer Experience Registry research initiative to examine symptom- and functioning-related concerns among 289 patients with MM across the illness trajectory. We applied hierarchical multiple linear regression analyses to explore associations between symptom burden and perceived control over illness with QoL indicators: depression, anxiety, and social satisfaction. RESULTS In our sample, 73% of participants with MM reported currently receiving treatment; 39% experienced relapse; 56% received 1 to 2 autologous transplants, 10% received ≥3 autologous transplants, and 4% received allogeneic and autologous transplants; 30% had not received a stem cell transplant. Average time since diagnosis was 4.4 years. The most highly endorsed concerns included eating and nutrition (61%), physical activity (59%), moving around (56%), fatigue (55%), pain (52%), and sleep (46%). Only 27% believed they had control over their disease, whereas 48% perceived having control over the physical side effects of MM. Approximately one-third of the variance in anxiety and depression and nearly two-thirds of variance in social satisfaction were explained by sociodemographic, clinical, and symptom burden variables. Perceived control over illness significantly predicted depression and anxiety, but not social satisfaction. Our results highlight substantial concern among patients with MM about physical symptoms and function. Additionally, greater symptom burden significantly accounted for poorer QoL, and lower perceived control over illness was linked to depression and anxiety. CONCLUSIONS Patients with MM and survivors experience substantive long-term QoL issues. Together, these findings point to the critical need for comprehensive symptom management, integrated palliative care, and enhancement of social and emotional support for individuals with MM.
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Affiliation(s)
- Alexandra K Zaleta
- Cancer Support Community, Research and Training Institute, Philadelphia, Pennsylvania
| | - Melissa F Miller
- Cancer Support Community, Research and Training Institute, Philadelphia, Pennsylvania
| | - Julie S Olson
- Cancer Support Community, Research and Training Institute, Philadelphia, Pennsylvania
| | - Eva Y N Yuen
- Cancer Support Community, Research and Training Institute, Philadelphia, Pennsylvania
| | - Thomas W LeBlanc
- Duke Cancer Institute, and.,Division of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, North Carolina
| | - Craig E Cole
- College of Human Medicine, Michigan State University, East Lansing, Michigan; and
| | - Shauna McManus
- Cancer Support Community, Research and Training Institute, Philadelphia, Pennsylvania
| | - Joanne S Buzaglo
- Cancer Support Community, Research and Training Institute, Philadelphia, Pennsylvania.,Now with Concerto HealthAI, Boston, Massachusetts
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13
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Chen S, Zheng S, Wang X, Zhang X, Fa T, Fu L, Zang X, Zhao Y. Linguistic and Psychometric Validation of the Chinese Version of the Control Attitudes Scale-Revised in Patients With Chronic Heart Failure. J Cardiovasc Nurs 2020; 36:349-356. [PMID: 32472800 DOI: 10.1097/jcn.0000000000000705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The concept of perceived control reflects the belief that one has resources needed to cope with negative events and the ability to positively influence consequences of those negative events. In patients with heart failure, perceived control is associated with a variety of health outcomes. Perceived control is commonly measured using the Control Attitudes Scale-Revised (CASR). There is no Chinese version of the CAS-R (CCAS-R). OBJECTIVE The purpose of this article was to perform linguistic validation and psychometric evaluation of the CCAS-R. METHODS The CAS-R was translated into Chinese according to Brislin's model. Then, a multicenter observational study was performed. Floor and ceiling effects, internal consistency, structural validity, and hypothesis testing were all assessed for psychometric validation of the CCAS-R. RESULTS A total of 227 patients with chronic heart failure were included. There were no ceiling or floor effects detected. Cronbach α was 0.94, indicating a high reliability. The results of the confirmatory factor analysis showed that the 1-factor structure as proposed by the original CAS-R fits the data well. The results of the principal component analysis suggested that the 1-factor structure was optimal as well, accounting for 71.6% of the total variance. The a priori hypothesis was supported by a statistically significant correlation between the CCAS-R and 3 theoretically related variables. CONCLUSION We developed a semantically equivalent version of the CAS-R in Chinese. The evaluation of the instruments' psychometric properties demonstrated that the CCAS-R has good reliability and validity for use in Chinese patients with chronic heart failure.
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Affiliation(s)
- Shixiang Chen
- Shixiang Chen, MD Doctoral Student, School of Nursing, Tianjin Medical University, China. Shinan Zheng, MD Nurse-in-charge, Stomatological Hospital of Tianjin Medical University. Xiaobing Wang, MD Master Student, School of Nursing, Tianjin Medical University, China. Xiaonan Zhang, MD Doctoral Student, School of Nursing, Tianjin Medical University, China. Tiane Fa, BD Director of Nursing, Nursing Department, Tianjin Chest Hospital, China. Li Fu, BD Director of Nursing, Nursing Department, The Second Hospital of Tianjin Medical University, China. Xiaoying Zang, PhD Associate Professor, School of Nursing, Tianjin Medical University, China. Yue Zhao, PhD Professor, School of Nursing, Tianjin Medical University, China
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14
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Breast Cancer Survivors' Perceptions of Prevention versus Control of Future Cancer Recurrence. Int J Breast Cancer 2019; 2019:2652180. [PMID: 31186965 PMCID: PMC6521556 DOI: 10.1155/2019/2652180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 03/15/2019] [Accepted: 04/14/2019] [Indexed: 12/31/2022] Open
Abstract
Background The Institute of Medicine has established Survivorship Care Planning as a critical component of cancer care to ensure that cancer survivors receive the appropriate follow-up care in a timely manner and support cancer survivors in dealing with the risk of recurrence, yet little is known about how cancer survivors think about preventing or controlling future cancer recurrence. This study sought to assess breast cancer women's perceived prevention and perceived control of future cancer recurrence. Methods Women with a history of breast cancer (n=114) were surveyed, and data were analyzed using concurrent mixed methods. Binary logistic regression models examined predictors of perceived prevention and perceived control of cancer recurrence. Results Most women perceived that they could control cancer recurrence (89%); few (30%) perceived that they could prevent cancer recurrence. Women reported components of the timeline (e.g., early diagnosis), identity (e.g., cancer in body), causes (e.g., hereditary), consequences (e.g., witness success), and cure/control (e.g., exercise) or lack of cure/control. Women who reported lack of control were less likely to perceive that they could control cancer recurrence. Women who reported causes were less likely to perceive that they could prevent or control cancer recurrence. Conclusions Women's perceptions about the prevention and control of cancer recurrence are important and different factors in the minds of women with breast cancer. Most women believed they could control cancer recurrence; however, few believed they could prevent cancer recurrence. Interventions to focus on control of cancer recurrence, focusing on evidence-based clinical and lifestyle interventions, are needed.
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15
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Rasmussen V, Forbes Shepherd R, Forrest LE, James PA, Young MA. Men's experiences of recontact about a potential increased risk of prostate cancer due to Lynch Syndrome: "Just another straw on the stack". J Genet Couns 2019; 28:750-759. [PMID: 30969465 DOI: 10.1002/jgc4.1110] [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: 10/08/2018] [Accepted: 02/08/2019] [Indexed: 01/15/2023]
Abstract
The practice of recontacting patients to provide new health information is becoming increasingly common in clinical genetics, despite the limited research to evidence the patient experience. We explored how men with Lynch Syndrome (LS) understand and experience being recontacted about a potential increased risk of prostate cancer. Sixteen men with LS (Meanage 51 years) were recruited from an Australian screening study to undergo a semi-structured interview. A modified grounded theory approach was used to guide data collection and thematic analysis. Qualitative coding was shared by the research team to triangulate analysis. The practice of recontact was viewed by participants as acceptable and was associated with minimal emotional distress. The majority of men understood that they may be above population risk of prostate cancer, although evidence was still emerging. Men reported high engagement with personal and familial health, including regular screening practices and familial risk communication. Findings suggest that men's carrier status and beliefs about the actionability of the new cancer risk information influence their response to recontact. Recontact practices that include the offer of risk management strategies may lead to improved patient outcomes (e.g., reduced cancer worry and increased health engagement), if perceived as valuable by recipients.
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Affiliation(s)
- Victoria Rasmussen
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Rowan Forbes Shepherd
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Laura Elenor Forrest
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Paul A James
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Mary-Anne Young
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Sydney, NSW, Australia
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16
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Gallagher MW, Long LJ, Richardson A, D'Souza JM. Resilience and Coping in Cancer Survivors: The Unique Effects of Optimism and Mastery. COGNITIVE THERAPY AND RESEARCH 2019; 43:32-44. [PMID: 31223177 PMCID: PMC6586435 DOI: 10.1007/s10608-018-9975-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Optimism and mastery are two cognitive traits that involve positive expectations for the future and that have been demonstrated to be important predictors of reduced anxiety as well as superior coping and physical health in many populations, including cancer survivors. There is limited research, however, examining the unique effects of these traits when examined simultaneously. The present cross-sectional study used structural equation modeling to examine the unique effects of optimism and mastery on emotion, coping, and health in 603 adult cancer survivors, and whether results were consistent in men and women. Results indicated that both optimism and mastery were associated with improved emotion, coping, and health and together accounted for a small to moderate amount of variance. Although the effects of optimism were generally greater, mastery also uniquely predicted most dependent variables and there was some evidence that gender influenced these effects, with optimism predicting health control more so in women and mastery predicting health control more so in men. These results demonstrate that it is important to examine both generalized positive expectancies such as optimism and positive expectancies regarding mastery when investigating resilience and emotional well-being in cancer survivors.
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17
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Raque-Bogdan TL, Hoffman MA, Joseph EC, Ginter AC, White R, Schexnayder K, Piontkowski S. Everything Is More Critical: A Qualitative Study of the Experiences of Young Breast Cancer Survivors. COUNSELING AND VALUES 2018. [DOI: 10.1002/cvj.12089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Mary Ann Hoffman
- Department of Counseling and Higher Education; University of Maryland, College Park
| | | | - Amanda C. Ginter
- Department of Family Studies and Community Development; Towson University
| | - Rachel White
- School of Medicine; University of Maryland; Baltimore
| | - Kelci Schexnayder
- Department of Environmental Science and Policy; University of Maryland, College Park
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18
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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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19
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Admiraal JM, van der Velden AWG, Geerling JI, Burgerhof JGM, Bouma G, Walenkamp AME, de Vries EGE, Schröder CP, Reyners AKL. Web-Based Tailored Psychoeducation for Breast Cancer Patients at the Onset of the Survivorship Phase: A Multicenter Randomized Controlled Trial. J Pain Symptom Manage 2017; 54:466-475. [PMID: 28711750 DOI: 10.1016/j.jpainsymman.2017.07.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 05/18/2017] [Accepted: 07/06/2017] [Indexed: 12/29/2022]
Abstract
CONTEXT Many breast cancer patients have unmet informational and psychosocial needs after treatment completion. A psychoeducational intervention may be well suited to support these patients. OBJECTIVES The purpose of this multicenter randomized controlled trial was to examine the effectiveness of a web-based tailored psychoeducational program (ENCOURAGE) for breast cancer patients, which aims to empower patients to take control over prevailing problems. METHODS Female breast cancer patients from two hospitals in The Netherlands who recently completed (neo-)adjuvant chemotherapy were randomly assigned to standard care or 12-week access to the ENCOURAGE program providing fully automated information problem-solving strategies, resources, and services for reported problems. At six and 12 weeks, patients completed self-report questions on optimism and control over the future (primary outcome), feelings of being informed, and acceptance of the illness. At baseline and 12 weeks, distress and quality of life questionnaires were completed. RESULTS About 138 patients were included. Almost all patients (67 of 69) visited ENCOURAGE as requested. No differences between the control and intervention group were observed for primary and secondary outcomes. An unplanned subgroup analysis showed that in clinically distressed patients (N = 57 at baseline; 41%), use of the ENCOURAGE program increased optimism and control over the future at 12 weeks more than in patients in the control group (Cohen's d = 0.65). CONCLUSION Although the effectiveness was not demonstrated, a subgroup of women treated for breast cancer can probably be supported by the program. The results of the present study are a starting point for further development and use of the program.
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Affiliation(s)
- Jolien M Admiraal
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette W G van der Velden
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Medical Oncology, Martini Hospital, Groningen, The Netherlands
| | - Jenske I Geerling
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johannes G M Burgerhof
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Grietje Bouma
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annemiek M E Walenkamp
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Carolien P Schröder
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anna K L Reyners
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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20
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Consent to Donate Surgical Biospecimens for Research: Perceptions of People With Colorectal Cancer. Cancer Nurs 2017; 39:221-7. [PMID: 26050142 DOI: 10.1097/ncc.0000000000000274] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Biospecimens for cancer research are commonly sought from people who undergo surgery for a new diagnosis of cancer, and the demand for these biospecimens is increasing. OBJECTIVE The objective of this study was to explore the perceptions of people with colorectal cancer regarding the impact of an opt-in model of consent for biospecimen donation. METHODS The qualitative method of Grounded Theory was used, and data were gathered through digitally recorded semistructured interviews with 18 participants. Data were analyzed using the constant comparative method to the descriptive level. RESULTS Four major categories were identified describing the response to the consent process used for donating tissue for research purposes. These were as follows: consent is "no big deal" compared with the diagnosis of cancer; helping others; trusting the surgeon; and information related to donation of biospecimens. CONCLUSIONS Results from this study indicate that the achievement of ideal informed and voluntary consent is difficult when patients are confronted with the trauma of newly diagnosed illness. Innovative approaches are implicated to obtain consent while protecting the autonomy and dignity of patients. IMPLICATIONS FOR PRACTICE The results from this study can contribute to further development of processes for the donation of biospecimens for research purposes that respect the needs and views of patients.
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21
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de Vries AM, Schulz T, Westerhuis R, Navis GJ, Niesing J, Ranchor AV, Schroevers MJ. Goal disturbance changes pre/post-renal transplantation are related to changes in distress. Br J Health Psychol 2017; 22:524-541. [PMID: 28544010 DOI: 10.1111/bjhp.12243] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 04/03/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Renal transplantation (RTx) is considered the treatment of choice for end-stage renal disease (ESRD) given its association with lower mortality, and improved overall quality of life and psychological functioning compared to dialysis. However, much less is known about which factors underlie these psychological improvements across RTx. Goal theory suggests that experienced disturbances in important goals are related to lower psychological functioning. This study aimed to (1) identify the most disturbed and most important goals for patients before RTx, (2) to examine changes in goal disturbance and goal importance pre/post-RTx, and (3) to examine whether changes in goal disturbance are associated with changes in psychological distress over time, and whether this relationship is mediated by changes in perceived control. METHODS In this longitudinal study, 220 patients completed questionnaires before and after RTx, including questionnaires to assess goals (GOALS questionnaire), psychological distress (GHQ-12), and perceived control (Mastery scale). RESULTS End-stage renal disease affected both general and disease-specific goals. Approximately 30% of the patients indicated to experience high or very high disturbance before transplantation. Goal disturbance generally decreased significantly pre- to post-RTx, whereas goal importance did not change significantly pre- to post-RTx. No mediation effect of perceived control was found. Instead, both changes in goal disturbance and perceived control showed independent effects on changes in distress. CONCLUSIONS Intervention strategies targeting attainable and realistic goal setting, and perceived control in RTx recipients who do not benefit optimally from RTx, might enhance psychological functioning in this population. Statement of contribution What is already known on this subject? Kidney transplantation improves patients' psychological functioning. Experienced disturbances in important life goals are related to lower psychological functioning in chronic illness. What does this study add? Goal disturbance decreases after renal transplantation, and this is related to a decrease in distress over time. Perceived control does not mediate the relationship between goal disturbance and distress pre/post-transplantation. Changes in perceived control have an additional main effect on changes in distress.
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Affiliation(s)
- Alicia M de Vries
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Torben Schulz
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands
| | | | - Gerjan J Navis
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Jan Niesing
- Department of Abdominal Surgery, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Maya J Schroevers
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands
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22
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What contributes to long-term quality of life in breast cancer patients who are undergoing surgery? Results of a multidimensional study. Qual Life Res 2017; 26:2189-2199. [DOI: 10.1007/s11136-017-1563-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 10/19/2022]
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Schulz T, Niesing J, Homan van der Heide JJ, Westerhuis R, Ploeg RJ, Ranchor AV. Changes of perceived control after kidney transplantation: a prospective study. J Adv Nurs 2017; 73:1712-1721. [PMID: 28122152 DOI: 10.1111/jan.13263] [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] [Accepted: 01/02/2017] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study was to determine if kidney transplantation is associated with increases of perceived control and how changes of perceived control affect the course of psychological distress until 1 year after transplantation. BACKGROUND Low levels of perceived control are associated with reduced well-being among dialysis patients. DESIGN Prospective longitudinal cohort study. METHODS Perceived control (Mastery Scale) and psychological distress (GHQ-12) were prospectively assessed before (T0; n = 470) and three (T1; n = 197), six (T2; n = 210) and twelve (T3; n = 183) months after transplantation. Differences between T1 and T0 perceived control were used to stratify the sample into three groups (control gain, stable control and control loss). Socio-demographic and clinical variables, including complications, were examined as potential correlates and the course of psychological was distress compared across groups. Data were collected between July 2008 - July 2013. RESULTS Perceived control showed a small increase overall, with 35·1%, 50·0% and 14·9% reporting gain, stable level and loss respectively. Patients with secondary schooling were overrepresented in the control loss group. The course of psychological distress varied across perceived control change groups, with patients in the control gain group experiencing a significant reduction in psychological distress. CONCLUSION A considerable number of patients report increased levels of perceived control after transplantation that are associated with a subsequent decrease in psychological distress. Results emphasize the importance of perceived control and could inform interventions to facilitate well-being after kidney transplantation.
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Affiliation(s)
- Torben Schulz
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Jan Niesing
- Department of Abdominal Surgery, University Medical Center Groningen, The Netherlands
| | | | | | - Rutger J Ploeg
- Nuffield Department of Surgical Sciences, Oxford Transplant Centre, Churchill Hospital, UK
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands
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24
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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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Quality of Life and Symptom Experience of Breast Cancer Patients Undergoing Chemotherapy. Holist Nurs Pract 2016; 30:193-200. [PMID: 27309408 DOI: 10.1097/hnp.0000000000000157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine the effect of educational interventions on breast cancer patients during chemotherapy, with a secondary aim of focusing on describing symptoms in patients during chemotherapy and their effects on the quality of life of patients with breast cancer undergoing chemotherapy. The study was quasi-experimental. A sample of 120 patients participated, of which 60 were in the experimental group and 60 were in the control group. Pre/posttest quality-of-life subgroups were compared in terms of their mean scores. In the posttest in the experimental group, mean scores of the Family subscale, Health and Functioning subscale, Psychological/Spiritual subscale, and Social and Economic subscale correlated negatively and the difference was statistically significant (P < .05).
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Yeh GY, Chan CW, Wayne PM, Conboy L. The Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure: Insights from a Qualitative Sub-Study from a Randomized Controlled Trial. PLoS One 2016; 11:e0154678. [PMID: 27177041 PMCID: PMC4866692 DOI: 10.1371/journal.pone.0154678] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 04/18/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF). SUBJECTS AND METHODS We randomized 100 patients with chronic systolic HF (NYHA Class 1-3, ejection fraction≤40%) to a 12-week group TC program or an education control. At 12-weeks, semi-structured interviews were conducted on a random subset (n = 32; n = 17 in TC, n = 15 in control), audiorecorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. We explored similarities and differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise Self Efficacy and Profile of Mood States). RESULTS The mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient's experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility). CONCLUSION Positive themes emerged from both groups, although there were qualitative differences in concepts of self-efficacy and perceived control between groups. Those in tai chi reported not only self efficacy and social support, but overall empowerment with additional gains such as internal locus of control, self-awareness and stress management. Future studies of mind-body exercise might further examine perceived control, self-efficacy, and locus-of-control as potential mediators of effect.
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Affiliation(s)
- Gloria Y. Yeh
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Caroline W. Chan
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Peter M. Wayne
- Osher Center for Integrative Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Lisa Conboy
- New England School of Acupuncture, Boston, Massachusetts, United States of America
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Predictors of initial levels and trajectories of anxiety in women before and for 6 months after breast cancer surgery. Cancer Nurs 2016; 37:406-17. [PMID: 24633334 DOI: 10.1097/ncc.0000000000000131] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The diagnosis of breast cancer, in combination with the anticipation of surgery, evokes fear, uncertainty, and anxiety in most women. OBJECTIVE Study purposes were to examine in patients who underwent breast cancer surgery how ratings of state anxiety changed from the time of the preoperative assessment to 6 months after surgery and to investigate whether specific demographic, clinical, symptom, and psychosocial adjustment characteristics predicted the preoperative levels of state anxiety and/or characteristics of the trajectories of state anxiety. INTERVENTIONS/METHODS Patients (n = 396) were enrolled preoperatively and completed the Spielberger State Anxiety inventory monthly for 6 months. Using hierarchical linear modeling, demographic, clinical, symptom, and psychosocial adjustment characteristics were evaluated as predictors of initial levels and trajectories of state anxiety. RESULTS Patients experienced moderate levels of anxiety before surgery. Higher levels of depressive symptoms and uncertainty about the future, as well as lower levels of life satisfaction, less sense of control, and greater difficulty coping, predicted higher preoperative levels of state anxiety. Higher preoperative state anxiety, poorer physical health, decreased sense of control, and more feelings of isolation predicted higher state anxiety scores over time. CONCLUSIONS Moderate levels of anxiety persist in women for 6 months after breast cancer surgery. IMPLICATIONS FOR PRACTICE Clinicians need to implement systematic assessments of anxiety to identify high-risk women who warrant more targeted interventions. In addition, ongoing follow-up is needed to prevent adverse postoperative outcomes and to support women to return to their preoperative levels of function.
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Inhestern L, Bultmann JC, Beierlein V, Möller B, Romer G, Muriel AC, Moore CW, Koch U, Bergelt C. Psychometric properties of the Parenting Concerns Questionnaire in cancer survivors with minor and young adult children. Psychooncology 2015; 25:1092-8. [PMID: 26677091 DOI: 10.1002/pon.4049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/02/2015] [Accepted: 11/12/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Although cancer patients with minor children have become more of a focus of psycho-oncological research, little is known about specific parenting concerns. Instruments to assess the concerns and worries of parents with cancer are rare. The Parenting Concerns Questionnaire (PCQ) addresses this issue. We analyzed parenting concerns in cancer survivors and evaluated the German version of the PCQ. METHODS A total of 1416 cancer survivors with minor and young adult children (≤21 years) were recruited in a register-based study. Descriptive analyses as well as reliability and validity analyses were conducted. We performed a confirmatory factorial analysis of the factor structure proposed by the authors of the original version on the PCQ. RESULTS Seventy-three percent of the cancer survivors were women, average age was 47.5 years (SD 5.9). Mean time since diagnosis was 44 months (SD 23.4). Between 18 and 31% of survivors reported that they were concerned about their children. The PCQ proved to be a reliable and valid instrument showing medium correlations with standardized measures in expected directions and discriminating between survivors with and without use of psychosocial support services. The factor structure was supported by the confirmatory factorial analysis. CONCLUSIONS Assessing parenting concerns gives an additional insight into the situation of parents with cancer. In our sample of cancer survivors, we identified one out of three survivors being concerned regarding the impact of their illness on their children. The PCQ can be considered as a valid and reliable instrument with regard to identifying concerned parents with cancer. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna C Bultmann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Volker Beierlein
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Möller
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Muenster, Muenster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Muenster, Muenster, Germany
| | | | | | - Uwe Koch
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Jassim GA, Whitford DL, Hickey A, Carter B. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev 2015:CD008729. [PMID: 26017383 DOI: 10.1002/14651858.cd008729.pub2] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer affecting women worldwide. It is a distressing diagnosis and, as a result, considerable research has examined the psychological sequelae of being diagnosed and treated for breast cancer. Breast cancer is associated with increased rates of depression and anxiety and reduced quality of life. As a consequence, multiple studies have explored the impact of psychological interventions on the psychological distress experienced after a diagnosis of breast cancer. OBJECTIVES To assess the effects of psychological interventions on psychological morbidities, quality of life and survival among women with non-metastatic breast cancer. SEARCH METHODS We searched the following databases up to 16 May 2013: the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL and PsycINFO; and reference lists of articles. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) search portal and ClinicalTrials.gov for ongoing trials in addition to handsearching. SELECTION CRITERIA Randomised controlled trials that assessed the effectiveness of psychological interventions for non-metastatic breast cancer in women. DATA COLLECTION AND ANALYSIS Two review authors independently appraised and extracted data from eligible trials. Any disagreement was resolved by discussion. Extracted data included information about participants, methods, the intervention and outcome. MAIN RESULTS Twenty-eight randomised controlled trials comprising 3940 participants were included. The most frequent reasons for exclusion were non-randomised trials and the inclusion of women with metastatic disease. A wide range of interventions were evaluated, with 24 trials investigating a cognitive behavioural therapy and four trials investigating psychotherapy compared to control. Pooled standardised mean differences (SMD) from baseline indicated less depression (SMD -1.01, 95% confidence interval (CI) -1.83 to -0.18; P = 0.02; 7 studies, 637 participants, I(2) = 95%, low quality evidence), anxiety (SMD -0.48, 95% CI -0.76 to -0.21; P = 0.0006; 8 studies, 776 participants, I(2) = 64%, low quality evidence) and mood disturbance (SMD -0.28, 95% CI -0.43 to -0.13; P = 0.0003; 8 studies, 1536 participants, I(2) = 47%, moderate quality evidence) for the cognitive behavioural therapy group than the control group. For quality of life, only an individually-delivered cognitive behavioural intervention showed significantly better quality of life than the control with an SMD of 0.65 (95% CI 0.07 to 1.23; P = 0.03; 3 studies, 141 participants, I(2) = 41%, very low quality evidence). Pooled data from two group-delivered studies showed a non-significant overall survival benefit favouring cognitive behavioural therapy compared to control (pooled hazard ratio (HR) 0.76, 95% CI 0.25 to 2.32; P = 0.63; 530 participants, I(2) = 84%, low quality evidence). Four studies compared psychotherapy to control with one to two studies reporting on each outcome. The four studies were assessed as high risk of bias and provided limited evidence of the efficacy of psychotherapy. Adverse events were not reported in any of the included studies. AUTHORS' CONCLUSIONS A psychological intervention, namely cognitive behavioural therapy, produced favourable effects on some psychological outcomes, in particular anxiety, depression and mood disturbance. However, the evidence for survival improvement is still lacking. These findings are open to criticism because of the notable heterogeneity across the included studies and the shortcomings of the included studies.
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Affiliation(s)
- Ghufran A Jassim
- Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
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Miaskowski C, Elboim C, Paul SM, Mastick J, Cooper BA, Levine JD, Aouizerat BE. Polymorphisms in Tumor Necrosis Factor-α Are Associated With Higher Anxiety Levels in Women After Breast Cancer Surgery. Clin Breast Cancer 2014; 16:63-71.e3. [PMID: 25813148 DOI: 10.1016/j.clbc.2014.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 12/09/2014] [Accepted: 12/16/2014] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Before and after breast cancer surgery, women have reported varying anxiety levels. Recent evidence has suggested that anxiety has a genetic basis and is associated with inflammation. The purposes of the present study were to identify the subgroups of women with distinct anxiety trajectories; to evaluate for differences in the phenotypic characteristics between these subgroups; and to evaluate for associations between polymorphisms in cytokine genes and subgroup membership. PATIENTS AND METHODS Patients with breast cancer (n = 398) were recruited before surgery and followed up for 6 months. The patients completed the Spielberger State Anxiety Inventory and provided a blood sample for genomic analyses. Growth mixture modeling was used to identify the subgroups of patients with distinct anxiety trajectories. RESULTS Two distinct anxiety subgroups were identified. The women in the higher anxiety subgroup were younger and had a lower functional status score. Two single nucleotide polymorphisms in tumor necrosis factor-α (rs1799964, rs3093662) were associated with the higher anxiety subgroup. CONCLUSION The results of the present exploratory study suggest that polymorphisms in cytokine genes could partially explain the interindividual variability in anxiety. The determination of phenotypic and molecular markers associated with greater levels of anxiety can assist clinicians to identify high-risk patients and initiate appropriate interventions.
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Affiliation(s)
| | | | - Steven M Paul
- School of Nursing, University of California, San Francisco, San Francisco, CA
| | - Judy Mastick
- School of Nursing, University of California, San Francisco, San Francisco, CA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, San Francisco, CA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Bradley E Aouizerat
- School of Nursing, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
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Limited association between perceived control and health-related quality of life in patients with heart failure. J Cardiovasc Nurs 2014; 29:227-31. [PMID: 23507705 DOI: 10.1097/jcn.0b013e31828b2b23] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Perceived control has been suggested as a modifiable factor associated with health-related quality of life (HRQOL). However, the relationship between perceived control and HRQOL has not been evaluated in patients with heart failure (HF). The purpose of this study was to determine whether perceived control independently predicts HRQOL in HF patients. METHODS A total of 423 HF patients were included. Hierarchical linear regression was performed to determine the independent association of perceived control to HRQOL after controlling for covariates. RESULTS Higher levels of perceived control were associated with better HRQOL in univariate analysis. However, this relationship was strongly attenuated after controlling for relevant demographic, clinical, and psychological factors; the variance in HRQOL explained by the addition of perceived control to this model was small (1.4%). CONCLUSIONS We found only a weak relationship between perceived control and HRQOL when considered in the presence of demographic, clinical, and psychological factors.
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The experience of cognitive change in women with breast cancer following chemotherapy. J Cancer Surviv 2014; 9:375-87. [DOI: 10.1007/s11764-014-0387-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 07/20/2014] [Indexed: 10/24/2022]
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Zhu L, Schroevers MJ, van der Lee M, Garssen B, Stewart RE, Sanderman R, Ranchor AV. Trajectories of personal control in cancer patients receiving psychological care. Psychooncology 2014; 24:556-63. [PMID: 25251894 DOI: 10.1002/pon.3688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 08/28/2014] [Accepted: 08/28/2014] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential patterns of psychological symptoms between trajectories. METHODS This naturalistic study focused on 241 cancer patients receiving psychological care at psycho-oncology institutions. Data were collected before the initiation of psychological care, and 3 and 9 months thereafter. Latent class growth analysis was applied to identify personal control trajectories. RESULTS Three personal control trajectories were identified: enduring improvement (41%), temporary improvement (50%), and deterioration (9%). Education and baseline physical symptoms distinguished these trajectories. In the whole group, improvements in personal control were associated with improvements in psychological symptoms. Patients at distinct trajectories reported different levels of psychological symptoms, but did not differ in their courses of psychological symptoms. Patients in the enduring and temporary control improvement groups experienced significant psychological symptoms reductions over time, whereas patients in the control deterioration group maintained high psychological symptoms. CONCLUSIONS Improvements in personal control seem to depend on initial control level: those who start with the highest control levels show subsequent improvements, whereas those with the lowest control levels show subsequent deterioration.
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Affiliation(s)
- Lei Zhu
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Champion VL, Ziner KW, Monahan PO, Stump TE, Cella D, Smith LG, Bell CJ, Von Ah D, Sledge GW. Development and psychometric testing of a breast cancer survivor self-efficacy scale. Oncol Nurs Forum 2014; 40:E403-10. [PMID: 24161644 DOI: 10.1188/13.onf.e403-e410] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe the development of a self-efficacy instrument that measures perceived ability to manage symptoms and quality-of-life problems resulting from the diagnosis and treatment of breast cancer. DESIGN Items were developed and content validity assessed. A 14-item scale was psychometrically evaluated using internal consistency reliability and several types of construct validity. SAMPLE 1,127 female breast cancer survivors (BCSs). METHODS Written consents were mailed to the research office. Data were collected via mail and telephone. MAIN RESEARCH VARIABLES Demographics, symptom bother, communication with healthcare provider, attention function, fear of recurrence, depression, marital satisfaction, fatigue, sexual functioning, trait and state anxiety, and overall well-being. FINDINGS Data demonstrated that the breast cancer self-efficacy scale (BCSES) was reliable, with an alpha coefficient of 0.89, inter-item correlations ranging from 0.3-0.6, and item-total correlation coefficients ranging from 0.5-0.73. Three of 14 items were deleted because of redundancy as identified through high (> 0.7) inter-item correlations. Factor analysis revealed that the scale was unidimensional. Predictive validity was supported through testing associations between self-efficacy and theoretically supported quality-of-life variables, including physical, psychological, and social dimensions, as well as overall well-being. CONCLUSIONS The BCSES demonstrated high internal consistency reliability, unidimensionality, and excellent content and construct validity. This scale should be integrated into interventions that target self-efficacy for managing symptoms in BCSs. IMPLICATIONS FOR NURSING Nurses working with BCSs may use this tool to assess areas in which survivors might need to build confidence to adequately cope with their specific survivorship concerns. KNOWLEDGE TRANSLATION The use of the BCSES can inform nurse researchers about the impact of an intervention on self-efficacy in the context of breast cancer survivorship, improving the ability to deliver effective interventions. The scale is brief and easy to administer. Results of this study demonstrate clear psychometric reliability and validity, suggesting that the BCSES should be put to use immediately in interventions targeting the quality of life of BCSs.
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Williams AM, Bulsara CE, Joske DJL, Petterson AS, Nowak AK, Bennett KS. An oasis in the hospital: the perceived benefits of a cancer support center in a hospital setting offering complementary therapies. J Holist Nurs 2014; 32:250-60. [PMID: 24651443 DOI: 10.1177/0898010114526951] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIMS The aim of this study was to explore and describe the experiences of persons attending a cancer support center, providing emotional support to cancer patients through self-selected complementary therapies offered free of charge through qualified volunteer therapists. A grounded theory methodology was used. Sources of data were 16 semistructured interviews with persons attending the center. Interviews were digitally recorded and transcribed verbatim. Analysis was conducted using the constant comparative method. FINDINGS The overarching theme that emerged in this study was the benefits attributed to attendance at the cancer support center. The center was described as an "oasis" in the hospital, and three aspects relating to this were identified: (a) facilitating comfort, (b) increasing personal control, and (c) helping make sense of the cancer experience. CONCLUSION A drop-in center offering complementary therapies appeared to enable coping with the diagnosis and treatment of cancer by facilitating comfort and increasing perceptions of personal control. The center also helped some participants to make sense of their experience with cancer. This research has provided a unique insight into the ongoing emotional needs of cancer patients, and directions for further development and research into the provision of holistic care for patients within a hospital setting.
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Affiliation(s)
- Anne M Williams
- Edith Cowan UniversitySolarisCare FoundationSir Charles Gairdner Hospital
| | | | - David J L Joske
- Sir Charles Gairdner HospitalSolarisCare FoundationUniversity of Western Australia
| | | | - Anna K Nowak
- Sir Charles Gairdner HospitalUniversity of Western Australia
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Danhauer SC, Russell GB, Tedeschi RG, Jesse MT, Vishnevsky T, Daley K, Carroll S, Triplett KN, Calhoun LG, Cann A, Powell BL. A longitudinal investigation of posttraumatic growth in adult patients undergoing treatment for acute leukemia. J Clin Psychol Med Settings 2013; 20:13-24. [PMID: 22739660 DOI: 10.1007/s10880-012-9304-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An acute leukemia diagnosis can be an extremely stressful experience for most patients. Posttraumatic growth (PTG) is positive psychological change experienced following a struggle with highly challenging life circumstances. The current study is the first longitudinal investigation of predictors of PTG and distress in adult acute leukemia patients undergoing induction chemotherapy. Findings suggest that these patients report PTG, and levels of PTG appear to increase over the weeks following leukemia diagnosis and induction chemotherapy. Variables associated with higher total PTG scores over time included greater number of days from baseline, younger age, and greater challenge to core beliefs. Variables associated with higher distress included greater number of days from baseline, greater perceived cancer threat, higher symptom severity, and lower spiritual well-being. Results underscore the critical role that examination of one's core beliefs may play in the development of PTG over time.
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Affiliation(s)
- Suzanne C Danhauer
- Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC, USA.
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Volker DL, Divin-Cosgrove C, Harrison T. Advance directives, control, and quality of life for persons with disabilities. J Palliat Med 2013; 16:971-4. [PMID: 23799252 DOI: 10.1089/jpm.2013.0008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Personal control over end-of-life (EOL) care via advance care planning is a key component of high-quality care. Although this desire for control has been well documented in some populations, EOL care issues are not well understood within the disabilities community. OBJECTIVE The objective for this study was to describe the relationships between individual demographic characteristics, health-related quality of life, health locus of control, and attitudes toward advance directives (ADs) in individuals who are disabilities activists. METHODS We surveyed 55 participants attending a disability conference. Instruments included a demographic data sheet, the Advance Directive Attitude Survey (ADAS), the Multidimensional Health Locus of Control scale, and the Functional Assessment of Non-Life Threatening Conditions quality of life (QOL) scale. RESULTS Most participants were Hispanic females with some college education. About 46% had a disability. Group means revealed a high level of QOL (M=75.72, SD=19.09) and a positive attitude about ADs (M=66.49, SD=8.03). On the Opportunities for Treatment Choices subscale of the ADAS, activists without disabilities (M=14.23) were more positive about their control over EOL decisions than were the activists with disabilities (M=12.97) [t(2,52)=2.116, p<0.05]. CONCLUSIONS Although participants were positive about ADs, differences in attitudes about control over opportunities for treatment choices between the nondisabled and disabled groups support previous findings that people with disabilities may have concerns regarding undertreatment for serious health conditions. Further study of EOL care issues for persons with disabilities is warranted.
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Affiliation(s)
- Deborah L Volker
- School of Nursing, University of Texas, Austin, Texas 78701, USA.
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Ho SSM, So WKW, Leung DYP, Lai ETL, Chan CWH. Anxiety, depression and quality of life in Chinese women with breast cancer during and after treatment: a comparative evaluation. Eur J Oncol Nurs 2013; 17:877-82. [PMID: 23727448 DOI: 10.1016/j.ejon.2013.04.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 04/16/2013] [Indexed: 01/24/2023]
Abstract
PURPOSE OF THE RESEARCH To compare the psychological health and quality of life (QoL) of women with breast cancer, and to determine the relationship between anxiety, depression and QoL during treatment and one year afterwards. METHODS AND SAMPLE For this secondary analysis, 269 women undergoing adjuvant therapy for breast cancer, and 148 women with breast cancer who had completed all treatment within the last year completed a self-report questionnaire covering the Hospital Anxiety and Depression Scale-Cantonese/Chinese version, Functional Assessment of Cancer Therapy-General, and demographic and clinical characteristics. KEY RESULTS The ongoing-therapy group showed higher levels of anxiety and depression and lower levels of all QoL dimensions than the post-therapy group. Linear regression results showed that both anxiety and depression were significantly related to physical and functional well-being, while depression was associated with social/family well-being in both groups. In the case of emotional well-being, anxiety had a strong significant association in both groups and depression a significant relationship only in the ongoing-therapy group. CONCLUSIONS The psychological health of women with breast cancer is affected during and after treatment. Psychological distress in these patients, including anxiety and depression, has independent associations with impaired emotional, functional, physical and social well-being. The results highlight the importance of timely detection of anxiety and depression, and their proper management, during the treatment and survivorship phases of the breast cancer trajectory.
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Affiliation(s)
- Simone S M Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, 7/F., Esther Lee Building, Shatin, New Territories, Hong Kong, China
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Mosher CE, Johnson C, Dickler M, Norton L, Massie MJ, DuHamel K. Living with metastatic breast cancer: a qualitative analysis of physical, psychological, and social sequelae. Breast J 2013; 19:285-92. [PMID: 23528206 DOI: 10.1111/tbj.12107] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Women with metastatic breast cancer face a wide range of medical, practical, and emotional challenges that impact their quality of life. Research to date, however, has not focused on the quality-of-life concerns of metastatic breast cancer patients with significant distress. The present study examined a range of concerns among distressed metastatic breast cancer patients, including physical and emotional distress, social functioning, and existential issues. Forty-four distressed women with metastatic breast cancer wrote their deepest thoughts and feelings regarding their illness. These essays were thematically analyzed for effects of the illness on quality of life. Three themes were identified in patients' essays. First, metastatic breast cancer and its treatment may result in a number of quality-of-life concerns, including physical symptom burden, emotional distress, body image disturbance, and disrupted daily activities. Second, social constraints on disclosure of cancer-related concerns may exacerbate patients' distress. Third, many women experience a heightened awareness of life's brevity and search for meaning in their cancer experience. Results highlight a range of quality-of-life concerns following a metastatic breast cancer diagnosis and suggest that addressing social constraints on cancer-related disclosure and the search for meaning may improve patients' psychological adjustment.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Evaluation of intrapsychic processes, anxiety, and depression in postmenopausal women affected by breast cancer: a case-control study. Support Care Cancer 2012; 21:1281-6. [PMID: 23262806 DOI: 10.1007/s00520-012-1659-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 11/05/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The study of intrapsychic modalities can help to understand the association between depression and breast cancer patients and what kind of intervention can be planned. There is evidence that breast cancer is associated with the development of depression. The study of intrapsychic modalities may explain this association. Therefore, we aimed at investigating the intrapsychic and interpersonal processes of the structure of personality, anxiety, and depression of postmenopause breast cancer women. METHODS All participants (n = 63) underwent the following tests: SASB questionnaire (Structural Analysis of Interpersonal Behavior), describing intrapsychic and interpersonal processes, validated on the basis of DSMIV, and the CDQ and ASQ questionnaires describing depression and anxiety. We compared two groups: breast cancer (n = 63) and a healthy control group of women without cancer (n = 83). RESULTS Patients with breast cancer presented medium to high levels of anxiety and depression and intrapsychic level showed that they had less autonomy in their choices with low acceptance of their own feelings and tendency to be depressed compared to the control group (Cl 1 autonomy F = 10.21, p < 0.05, Cl 2 autonomy and love F = 13.01, p < 0.001, Cl 3 love F = 10.50, p < 0.01, Cl 5 control F = 6.44, p < 0.05, Cl 6 control and hate F = 4.49, p < 0.05, ASQ F = 6.07, p < 0.05, and CDQ F = 6.24, p < 0.05). CONCLUSIONS Intrapsychic characteristics such as tendency to depression, inability to being in contact with their own feelings, may be linked to difficulties in facing treatment and their condition of illness. Knowledge of these modalities could allow to plan a psychotherapeutic and multidisciplinary intervention aimed at facing the different phases of medical treatment.
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Hoffman MA, Lent RW, Raque-Bogdan TL. A Social Cognitive Perspective on Coping With Cancer. COUNSELING PSYCHOLOGIST 2012. [DOI: 10.1177/0011000012461378] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
With increases in the number of cancer survivors, many persons now experience cancer as a chronic disease followed by adaptation to a new reality of what is normal in their lives. In response, cancer survivorship researchers have begun attending to the multidimensional needs of survivors, including the need to promote optimal psychological adaptation and health. Theoretical models of well-being that account for the complexity of survivorship issues are needed. We present a social cognitive model of restorative well-being as a framework for reviewing recent research on coping with early stage adult cancer (i.e., stages I and II) and optimizing post-treatment adjustment. We focus on research on cancer-related coping strategies, efficacy beliefs, personality traits, and environmental supports, which have been linked to adjustment outcomes and which may inform psychosocial interventions. By grounding this research in a theoretical base, we highlight the potential for counseling psychologists’ contributions to cancer survivorship research.
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Mazzotti E, Sebastiani C, Marchetti P. Patient perception of disease control and psychological distress. Cancer Manag Res 2012; 4:335-40. [PMID: 23055777 PMCID: PMC3468022 DOI: 10.2147/cmar.s35060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Risk perception and efficacy beliefs affect health behavior. The aim of this study was to measure cancer severity and curability (as proxy for risk perception and efficacy beliefs, respectively) and their association with clinical and psychosocial variables. Methods A consecutive sample of cancer patients were recruited and assessed for sociodemographic and medical data, patient perception of cancer severity and curability, and quality of life. The main outcome measures were the depression and anxiety components as measured by the Hospital Anxiety and Depression Scale (HADS). Results Subjective and objective measures of severity and curability were found to be associated. The perception of one’s own disease as severe and difficult to cure, as opposed to severe but curable, was strongly associated with depression (OR = 6.93; P = 0.048) when adjusted for potential confounding factors. Factors independently associated with anxiety were the perception of difficulty to cure (OR = 15.73; P = 0.018), having religious beliefs (OR = 49.74; P = 0.013), and metastasis (OR = 18.42; P = 0.015), when adjusted for sex, marital status, site of cancer, and time from diagnosis. Differences in curability beliefs did not affect any quality of life domain. Conclusion Patients and clinicians may have different perceptions of disease and treatment. The perception of control and curability must be taken into account to identify cancer patients who are suffering most and require special medical care, as these factors have an effect on depression and anxiety.
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Affiliation(s)
- Eva Mazzotti
- Division of Oncology and Dermatological Oncology, Istituto Dermopatico dell'Immacolata, Istituto di Ricerca e Cura a Carattere Scientifico, Rome, Italy
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Costa-Requena G, Rodríguez A, Fernández-Ortega P. Longitudinal assessment of distress and quality of life in the early stages of breast cancer treatment. Scand J Caring Sci 2012; 27:77-83. [DOI: 10.1111/j.1471-6712.2012.01003.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Volker DL, Wu HL. Cancer patients' preferences for control at the end of life. QUALITATIVE HEALTH RESEARCH 2011; 21:1618-31. [PMID: 21734224 PMCID: PMC3193884 DOI: 10.1177/1049732311415287] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The achievement of a death consistent with personal preferences is an elusive outcome for most people with cancer. Maintaining a sense of control is a core component of a dignified death; however, control might be a Western bioethical notion with questionable relevance to culturally diverse groups. Thus, the purpose of our study was to explore the meaning of control and control preferences in a group of racially and ethnically diverse patients with an advanced cancer diagnosis. Using a hermeneutic, phenomenological approach, we interviewed 20 patients with advanced cancer and uncovered two themes: (a) preferences for everyday control over treatment decisions, family issues, final days of life, and arrangements after death, vs. (b) awareness that cancer and death are controlled by a higher power. Although the sample included non-Hispanic Whites, African Americans, and Hispanics, participants shared common views that are characteristic of American cultural norms regarding the value of autonomy.
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Affiliation(s)
- Deborah L Volker
- University of Texas at Austin, School of Nursing, Austin, Texas 78701, USA.
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Evangelista AL, Santos EMM. Cluster of symptoms in women with breast cancer treated with curative intent. Support Care Cancer 2011; 20:1499-506. [DOI: 10.1007/s00520-011-1238-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 07/17/2011] [Indexed: 10/17/2022]
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Paredes T, Pereira M, Simões MR, Canavarro MC. A longitudinal study on emotional adjustment of sarcoma patients: the determinant role of demographic, clinical and coping variables. Eur J Cancer Care (Engl) 2011; 21:41-51. [PMID: 21812845 DOI: 10.1111/j.1365-2354.2011.01269.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present study examined change on emotional distress of sarcoma patients from the diagnostic to treatment phases, the distinct trajectories of adjustment and the influence of demographic, clinical and coping variables on anxiety and depression. Thirty-six sarcoma patients completed questionnaires on emotional distress (Hospital Anxiety and Depression Scale) and coping strategies (Brief Cope) at time of diagnosis, and again during treatment. No significant change in emotional distress levels was found from diagnostic to treatment phase, with mean anxiety and depression scores remaining below the clinical range. Over time, 52.8% and 66.7% of patients maintained non-clinical anxious and depressive symptoms respectively, and 25% and 11.1% remained with clinical anxiety and depression. Living with partner, less use of humour and more denial were associated with high emotional distress at time of diagnosis and during treatments, and high levels of distress at baseline were predictive of poorer emotional adjustment during treatments. Although sarcoma patients, in general, seem to exhibit good psychological adjustment, there is a significant minority that requires mental health services in order to help decrease their emotional distress following the diagnosis, and prevent psychological difficulties during treatments. Our findings are an important contribution to understanding the psychological adjustment of patients with a specific and rare type of cancer.
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Affiliation(s)
- T Paredes
- Institute of Cognitive Psychology, Vocational and Social Development, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
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Drageset S, Lindstrøm TC, Giske T, Underlid K. Being in suspense: women's experiences awaiting breast cancer surgery. J Adv Nurs 2011; 67:1941-51. [PMID: 21466581 DOI: 10.1111/j.1365-2648.2011.05638.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM This article is a report of a qualitative study of women's experiences after having received a breast cancer diagnosis and awaiting primary surgery. BACKGROUND Breast cancer is experienced as an important stressor and a major challenge. How women appraise the diagnosis affects their postsurgery adaptation. Although studies have documented the presurgery period as stressful, in-depth understanding of women's experiences while awaiting surgery studied during this stressful period is still needed. METHOD Twenty-one women with newly diagnosed breast cancer were interviewed individually the day before surgery at a Norwegian university hospital, between February 2006 and February 2007. Interviews were analysed using the qualitative meaning condensation method. FINDINGS Feeling healthy, but having to adapt to disease, waiting, uncertainty, having to tell and existential awareness were themes identified. Having to wait was experienced as frightening, painful, long and difficult - but also necessary. Some expressed apprehension because they could not do anything about their situation. Others emphasized that it was good to have some time between diagnosis and surgery to become personally prepared and spend time with loved ones. Informing others about the diagnosis was a great burden for most of them. Social networks could both give and crave support. CONCLUSION Healthcare professionals need to be sensitive to the individual experiences of women awaiting breast cancer surgery to give support to ease their situation. Setting the date for surgery will alleviate anxiety. Follow-up studies about the potential impact of presurgery experiences on later experiences of living with breast cancer and intervention studies are needed.
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Affiliation(s)
- Sigrunn Drageset
- Faculty of Health and Social Sciences, Bergen University College, Norway.
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Delgado-Sanz MC, García-Mendizábal MJ, Pollán M, Forjaz MJ, López-Abente G, Aragonés N, Pérez-Gómez B. Heath-related quality of life in Spanish breast cancer patients: a systematic review. Health Qual Life Outcomes 2011; 9:3. [PMID: 21235770 PMCID: PMC3031190 DOI: 10.1186/1477-7525-9-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 01/14/2011] [Indexed: 11/12/2022] Open
Abstract
Background Breast cancer is one of the oncological diseases in which health-related quality of life (HRQL) has been most studied. This is mainly due to its high incidence and survival. This paper seeks to: review published research into HRQL among women with breast cancer in Spain; analyse the characteristics of these studies; and describe the instruments used and main results reported. Methods The databases consulted were MEDLINE, EMBASE, PsycINFO, Dialnet, IBECS, CUIDEN, ISOC and LILACS. The inclusion criteria required studies to: 1) include Spanish patients, and a breakdown of results where other types of tumours and/or women from other countries were also included; and, 2) furnish original data and measure HRQL using a purpose-designed questionnaire. The methodological quality of studies was assessed. Results Spain ranked midway in the European Union in terms of the number of studies conducted on the HRQL of breast cancer patients. Of the total of 133 papers published from 1993 to 2009, 25 met the inclusion criteria. Among them, only 12 were considered as having good or excellent quality. A total of 2236 women participated in the studies analysed. In descending order of frequency, the questionnaires used were the EORTC, FACT-B, QL-CA-Afex, SF-12, FLIC, RSCL and CCV. Five papers focused on validation or adaptation of questionnaires. Most papers examined HRQL in terms of type of treatment. Few differences were detected by type of chemotherapy, with the single exception of worse results among younger women treated with radiotherapy. In the short term, better results were reported for all HRQL components by women undergoing conservative rather than radical surgery. Presence of lymphedema was associated with worse HRQL. Three studies assessed differences in HRQL by patients' psychological traits. Psychosocial disorder and level of depression and anxiety, regardless of treatment or disease stage, worsened HRQL. In addition, there was a positive effect among patients who reported having a "fighting spirit" and using "denial" as a defence mechanism. One study found that breast cancer patients scored worse than did healthy women on almost all SF-12 scales. Conclusion Research into health-related quality of life of breast-cancer patients is a little developed field in Spain.
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Affiliation(s)
- María Concepción Delgado-Sanz
- Department of Cancer and Environmental Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, Madrid, Spain
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Jassim GA, Whitford DL, Grey IM. Psychological interventions for women with non-metastatic breast cancer. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2010. [DOI: 10.1002/14651858.cd008729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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