Implications of Ethnic Group Origin for Israeli Women’s Mental Health

Emotional Processing, Coping, and Cancer-Related Sickness Symptoms in Breast Cancer Survivors: Cross- Sectional Secondary Analysis of the REPAT Study

Purpose

The study aims to provide a better understanding of the relationship between emotional processing, coping, and cancer-related sickness symptoms.

Methods

The study used a cross-sectional, secondary analysis of data from 179 Israeli Jewish women who were breast cancer survivors (BCS) 3 to 18 months after completing primary treatment and who participated in a larger randomized controlled trial (REPAT study). Data were collected at baseline. Participants completed questionnaires measuring emotion acceptance, situational approach, avoidance coping, and cancer-related sickness symptoms (depression, fatigue, and pain) and a performance measure of emotional awareness. Hierarchical linear regressions were performed, controlling for background variables.

Results

Participants experienced significant clinical depression (51.7%), cancer-related fatigue (CRF, 78.8%), pain interference (78%), and pain intensity (66%) levels. There were strong correlations between cancer-related symptoms. After controlling for confounders, emotional processing (acceptance) was negatively associated with depression, and avoidance coping was positively associated with depression, CRF, and pain interference (i.e., higher use of avoidance related to higher cancer-related symptoms; higher acceptance was associated with lower depression). Emotional awareness and coping by approaching emotions were not related to cancer-related symptoms.

Conclusions

The BCS posttreatment period presents the challenge of dealing with elevated cancer-related symptoms. Regardless, BCS who used high emotional processing levels-especially acceptance of emotion and lower reliance on avoidance to cope-experienced fewer cancer-related symptoms.

Implications for Cancer Survivors

Professionals should recognize the potential role of emotional processing and avoidant coping relative to cancer-related symptoms and recognize their patterns in posttreatment patients.

Impacts of Urban Terror Attacks on Turkish Mothers' Daily Experiences

This phenomenological study aims to provide a deeper understanding of the day-to-day experiences of Turkish women with caregiving responsibilities in terms of (a) how they respond to and regulate their lives around the fear of terror, (b) how their caregiving roles affect their reactions, and (c) how they cope with terrorism induced distress in their day-to-day life. A total of 21 women were interviewed for the study about their daily experiences following terrorist attacks that occurred in their urban hometowns. The qualitative analysis program called Atlas.ti was utilized for the coding procedure. Four main themes (the nature of the terrorist attacks, reactions to the event, coping strategies, and the role of the media) and several subcategories emerged from the data. The participants were emotionally affected by these events as they were shocked and confused, their sense of security was shaken, and they felt anxious not only during the events but they also continued to perceive such danger days or weeks after the events. All participating mothers reported some degree of shock, anxiety, fear, threat, risk alertness, and a shaken sense of security even though none of the mothers themselves or their loved ones were direct victims of the events. Overall, the results reveal that Turkish mothers feel terror threat perception and security-related stress even around 6 months after the events. Having a caregiving responsibility exacerbates the women's distress level. The unpredictability, uncertainty, and physical proximity/familiarity of the location of the event appear to have vital impacts on participants' cognitive, emotional, and behavioral reactions as well as in their coping. Similarly, the media, including social media, play significant roles in meaning making and responses as well as the coping process. The results were discussed in the light of the related literature.

Cancer-related fatigue and depression in breast cancer patients postchemotherapy: Different associations with optimism and stress appraisals

OBJECTIVE

Symptoms of depression and cancer-related fatigue (CRF) are common among breast cancer patients postchemotherapy and may seriously impair quality of life (QoL). This study aimed to assess the relationship between depression and CRF in breast cancer patients postchemotherapy and to examine their relationships to optimism and to threat and challenge appraisals.

METHOD

Participants included 95 breast cancer patients (stages 1-3) 1 to 6 months after completion of chemotherapy. Patients submitted personal and medical details and completed the following: physical symptom questionnaires (EORTC QLQ-C30, and QLQ-BR23), a symptoms of depression questionnaire (CES-D), the Fatigue Symptom Inventory (FSI), the Life Orientation Test (LOT-R), and a stress appraisals questionnaire.

RESULTS

We found levels of depression, CRF, and appraisals of cancer as a threat to bemoderate and levels of optimism and appraisals of cancer as a challenge to be high. Depression and CRF were positively associated. A multivariate regression analysis revealed that 51% of the CRF variancewas explained; physical symptoms and threat appraisal were significantly associated with CRF. A 67% of the CRF variance of depression was explained; challenge and threat appraisals were significantly associated with depression [corrected].

SIGNIFICANCE OF RESULTS

Although CRF and depression were often experienced simultaneously and both were found to be higher among individuals who gave higher appraisals of cancer as a threat, only depression was related to optimism and challenge appraisals, while CRF was related mainly to intensity of physical symptoms. The different pattern of associations between optimism and appraisals warrants further clinical attention as well as future study.

Individual, family, social, and cultural predictors of depressed mood in former Soviet immigrant couples

Gender differences in predictors of depression for married couples from the former Soviet Union were examined in a cross-sectional, descriptive analysis. Data were collected during a longitudinal study of post-migration health and adaptation. The sample included 308 men and women (154 couples), ages 40-79, who had lived in the US for an average of 6 years. Generativity, marital satisfaction and communication, social support, immigration challenges, and alienation were independent predictors of depressed mood. A gender interaction was found for generativity, indicating that diminished opportunities to guide the next generation and be productive members of society may have been more depressing for women. Interventions should attend to gender differences in developmental needs, reduce immigration-related challenges, and strengthen family and social support.

Health care for the poor—An exploration of primary-care physicians’ perceptions of poor patients and of their helping behaviors

This paper explores the ways in which primary-care physicians in Israel perceive and help poor patients. Our findings are based on a qualitative study that utilized a focus group and in-depth interviews with 16 primary-care physicians who qualified both in Israel and in the former Soviet Union, and who work in community clinics one Health Maintenance Organization serving poor populations of diverse cultural, ethnic and socioeconomic backgrounds (immigrants from the former Soviet Union and from Ethiopia, Bedouin, ultra-orthodox Jews, the chronic poor, and the 'new' poor). It was found that the physicians presume causality between poverty and health, identify and distinguish between different types of poverty, and make associations based on the type of poverty and type of patient problem. Their thinking on poverty is patient-oriented rather than socially oriented. An analysis of these findings resulted in a conceptualization of five types of physician helping behavior: emotional and personal instrumental, reinforcing socially desirable behavior, preferential help and bending the rules, rights realization and working the system, and minimal community involvement. The components of this conceptual model depict and chart issues affecting the helping behavior of the primary-care physician, i.e., type of poverty, type of problem, administrative context and, particularly, physician attributes, such as gender and country where notable. Our findings reveal little social consciousness on the part of the physicians, and we conclude with remarks on the potential for change in this area.