Relationships among personality, coping, and concurrent health-related quality of life in women with breast cancer

Indirect effects of health-related quality of life on suicidal ideation through psychological distress among cancer patients

The interrelationships of suicidal ideation, psychological distress, and impaired health-related quality of life (HRQoL) in cancer patients are complex and multifaceted. Limited empirical evidence exists on the indirect effects of impaired HRQoL on suicidal ideation through psychological distress among cancer patients. To fill this research gap, 250 cancer patients were recruited through a cross-sectional hospital-based research design. Structural equation model (SEM) results indicated that impaired HRQoL is a predictor of psychological distress (β = 0.153; p < 0.05), and psychological distress positively predicts suicidal ideation (β = 0.647; p < 0.000). The study found no direct effects of impaired HRQoL on suicidal ideation (β = -0.05; p = 0.223). Indirect effects of HRQoL on suicidal ideation was confirmed, showing a full-mediation effect β = 0.099 (SE = 0.048, CI = [0.030, 0.189], p < 0.05) (i.e. the pathway impaired HRQoL predict suicidal ideation is through psychological distress). Cognitive-behavioral therapy and other emotional support programs should be considered for cancer patients to mitigate psychological vulnerabilities linking impaired HRQoL to suicidal ideation.

The mediating effect of eHealth literacy on the relationship between health personality and quality of life in community-dwelling older adults

AIMS

To explore the relationship between health personality and quality of life among community-dwelling older adults and to examine the mediating effect of eHealth literacy on this relationship.

METHODS

A total of 413 community-dwelling older adults from central China were recruited from September 2022 to January 2023. A cross-sectional investigation was conducted using the Chinese versions of the Health Personality Assessment (HPA), eHealth Literacy Scale (eHEALS), and 12-item Short Form Health Survey (SF-12). Correlations between the three variables were examined by Pearson analysis, and mediation analysis was conducted to explore the direct, indirect, and total effects of the health personality on quality of life vis-à-vis eHealth literacy.

RESULTS

Health personality factors (including health neuroticism, health openness, and health conscientiousness), eHealth literacy, and quality of life are significantly correlated (P<0.05); eHealth literacy can play a significant mediating role in the relationship between health neuroticism (β= -0.256, 95 %CI: [-0.405, -0.119]), health openness (β = 0.488, 95 % CI: [0.343,0.652]), health conscientiousness (β= 0.489, 95 % CI: [0.354, 0.634]) and quality of life.

CONCLUSION

This study revealed that the effect of health personality factors (including health neuroticism, health openness, and health conscientiousness) on quality of life in older adults was mediated through eHealth literacy.

IMPACT

Individual personality is essential to understanding eHealth literacy and quality of life among community-dwelling older adults. It may be helpful to identify the health personality traits of older adults first, then implement targeted interventions accordingly to enhance eHealth literacy and ultimately improve quality of life.

The mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants: Cross-sectional study

PURPOSE

This study aimed to examine the relationship of stress, mental resilience, and coping style, and the mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants.

DESIGN AND METHODS

A cross-sectional design was used. A total of 231 parents of children with cochlear implants were recruited from May 1, 2022, to February 28, 2023 at a comprehensive tertiary hospital and a cochlear implant rehabilitation center in China. Parenting Stress Index-Short Form (PSI-SF), the Connor-Davidson Resilience Scale (CD-RISC) and the Simplified Coping Style Questionnaire(SCSQ) were used to measure stress, mental resilience, and coping style respectively.

RESULTS

The mean score observed for PSI-SF, CD-RISC, active coping, and passive coping was 87.85 ± 24.59, 55.63 ± 16.11, 21.36 ± 6.73, and 9.05 ± 4.52, respectively. Mental resilience was a significant mediator explaining the effect of stress on active coping (β = -0.294; 95% bias-corrected bootstrap CI: -0.358 to -0.164).

CONCLUSIONS

Attention should be paid to the status of stress, mental resilience and coping style in parents of children with cochlear implants. Mental resilience mediated stress and coping style.

PRACTICE IMPLICATIONS

This study provides a theoretical basis for establishing an active coping care program for parents of children with cochlear implants. There is a need to identify strategies that can help increase the level of mental resilience of parents of children with cochlear implants and more subjective and objective social support should be provided to reduce their stress and to encourage active coping style.

The mediating role of coping styles in illness perception and self-management in patients with obstructive sleep apnea

STUDY OBJECTIVES

Obstructive sleep apnea (OSA) has become a chronic disease that threatens human health. Self-management in patients with OSA can influence their quality of life, and illness perception and coping styles are relevant facilitators of self-management, but this specific relationship has not been adequately studied. The purpose of this study was to investigate the current status and relationship between illness perception, coping styles, and self-management behaviors in patients with OSA, and how coping styles mediate this relationship.

METHODS

This is a cross-sectional study. Conducted between September 2022 and March 2023, the study involved patients aged ≥18 years old in two hospitals who were diagnosed with OSA. The survey was conducted using the demographic characteristics questionnaire, the Brief Illness Perception Questionnaire, the Simple Coping Style Questionnaire, and the Self-management Behavior Questionnaire of patients with obstructive sleep apnea. Spearman's correlation analysis was used for correlation analysis and multiple linear regression and structural equation models were used for mediation effect testing.

RESULTS

There were 282 valid questionnaires, with a 94 % valid response rate. Higher levels of self-management behaviors were associated with low negative illness perceptions, high positive coping, and low negative coping. The study also demonstrated that the mediating effect accounted for 25.65 % (-0.049/-0.191) of the overall effect.

CONCLUSION

Illness perceptions in OSA patients were negatively related to positive coping styles, positively related to negative coping styles, and negatively related to self-management. This study suggests that coping styles of OSA patients mediate illness perception and self-management.

Global prevalence of sleep disturbances among breast cancer survivors: A systematic review with meta-analysis

Breast cancer is a common cancer in which patients are highly susceptible to different sleep disturbances. However, current evidence lacked consistency in methodologies in investigating the prevalence of sleep disturbances among breast cancer survivors. The review aims to (1) investigate the global prevalence of sleep disturbances among breast cancer survivors; and (2) investigate the factors influencing the prevalence estimates. A comprehensive search was conducted in 8 databases using a 3-step approach, up to January 2022. The Newcastle-Ottawa Scale and Cochrane risk of bias tool were used to evaluate the quality of individual studies. Meta-analysis, meta-regression, and subgroup analysis were performed using R software. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations criteria. A total of 51 studies were selected involving 28,036 breast cancer survivors across 17 countries. The global prevalence of poor sleep quality was 62%, different severities of insomnia were 3%-32%, and excessive daytime sleepiness was 24%. Subgroup analyses showed that a significantly higher prevalence of poor sleep quality was found in breast cancer survivors during treatment compared with pre- or post-treatment. No significant covariates were found in a series of meta-regression analyses. The majority (73.5%) of individual studies were high quality but the certainty of the evidence was low or very low according to Grading of Recommendations, Assessment, Development, and Evaluations criteria. More than half of breast cancer survivors have sleep disturbances, so developing a strategic intervention is warranted. Given the low or very low certainty of the evidence, a robust design for large-scale research is crucial in the future.

Personality trait associations with quality-of-life outcomes following bariatric surgery: a systematic review

BACKGROUND

Obesity can be a significant challenge to health and quality of life (QoL). Bariatric surgery assists with weight loss and may help improve QoL. However, not all patients benefit from surgery. Personality traits may be related to QoL outcomes after bariatric surgery, but these associations are unclear.

PURPOSE

This research reviews the published literature on the associations between personality and QoL among post-operative bariatric patients.

METHOD

Four databases (CINAHL Complete, Medline with Full Text, APA PsycINFO, and Scopus) were searched from inception until March 2022. Forward searching was conducted using Google Scholar, and backward reference citation searches were also performed.

RESULTS

Five studies met inclusion criteria yielding data from N = 441 post-bariatric patients including both pre/post and cross-sectional designs. Higher agreeableness was related to lower overall health-related QoL (HRQol) and gastric HRQol and positively associated with psychological HRQol. Higher emotional stability was positively related to overall HRQol. Higher impulsivity was negatively associated with mental HRQol and was unrelated to physical HRQol. Effects for the remaining traits were either mainly mixed or null.

CONCLUSION

Personality traits may be associated with HRQol outcomes. However, it is difficult to reliably discern the role of personality traits for HRQol and QoL outcomes given the methodological issues and few published studies. More rigorous research is needed to address these issues and clarify possible associations.

"All Hands on Deck": Psychological Characteristics of Women with Experience of Oncological Disease Participating in Sailing Cruise-A Pilot Study

BACKGROUND

In addition to searching for effective methods of treatment, interventions are sought to support well-being, quality of life, mental health, and recovery. Sailing has its specific features, including task orientation, challenges, contact with people, and nature. This specificity may be treated as a potential therapeutic factor, but it is also likely that people with certain psychological characteristics are involved in it. Therefore, the study aimed to assess some psychological features of women with cancer experience who decided to take part in the Onco-Cruise (Polish: Onko-Rejs).

METHODS

Participants were 56 women (M = 46.73; SD = 9.21). We used NEO-FFI, the Zimbardo Time Perspective Inventory, and The Multidimensional Health Locus of Control Scale.

RESULTS

Onco-Cruises participants were characterized by a high level of extraversion (M = 32.48; SD = 7.02; sten score M = 7.21; Mo = 7), openness (M = 31.50; SD = 6.31; sten score M = 7.41; Mo = 8), low neuroticism (M = 21.62; SD = 9.33; sten score M = 4.96), predominance of present hedonistic (M = 12.55, SD = 1.46) and future time perspective (M = 11.39; SD = 2.67), and the internal health locus of control (M = 23.25, SD = 5.43).

CONCLUSION

Group sailing can be favorable for broadly understood health and cancer recovery, but people who choose this activity have certain psychological predispositions, especially indicating high needs for stimulation. Permanent features should be taken into account when proposing various interventions for oncology patients to best suit them to their natural possibilities and preferences and, thus, make them most effective.

Referral process to further evaluate poor sleep in breast cancer survivors

OBJECTIVE

Breast cancer survivors (BCS) are twice as likely to report symptoms of poor sleep as those without cancer. However, sleep disorders are under-assessed and under-treated among BCS. The purpose of this study was to determine the portion of BCS who completed referral visits to a sleep specialist and identify the acceptability, facilitators, and barriers to the screening and referral process.

METHODS

BCS, who reported having sleep problems, completed questionnaires to screen for symptoms suggestive of sleep disorders. Those with symptoms suggestive of sleep apnea, movement disorders, narcolepsy, insomnia syndrome, or circadian disorders, they were referred to a sleep medicine physician or behavioral sleep medicine psychologist. Two months after the referral, participants were interviewed about their perceptions of the acceptability, barriers, and facilitators to sleep screenings and referrals.

RESULTS

Of 34 BCS assessed for eligibility, 29 were eligible and had sleep problems. Only eight of 29 participants (27.6%) completed the sleep referral process. Most thought the screening and referral process was acceptable. However, BCS identified barriers to completing the referral visit, including time, not seeing the need for treatment, insurance/sick leave concerns, and distance/transportation.

CONCLUSION

Adequate evaluation and treatment of sleep disorders in BCS are rare. Creative solutions to address barriers to timely sleep referrals are needed to reduce long-term negative consequences of inadequate sleep.

Exploring learning processes associated with a cancer pain self-management intervention in patients and family caregivers: A mixed methods study

AIM

Explore learning processes associated with a psychoeducational pain selfmanagement intervention.

BACKGROUND

Self-management of cancer pain is challenging for patients and their family caregivers (FCs). While psychoeducational interventions can support them to handle these tasks, it remains unclear how learning processes are hampered or facilitated.

METHODS

A convergent parallel mixed methods design with qualitative data collection embedded in a randomized controlled trial (RCT) was used. Outpatients with cancer and FCs were recruited from three Swiss university hospitals. The six-week intervention consisted of education, skills building, and nurse coaching. Quantitative data on pain management knowledge and self-efficacy were analyzed using multilevel models. Patients and FCs were interviewed post-RCT regarding their learning experiences. Qualitative data analysis was guided by interpretive description. Finally, quantitative and qualitative data were integrated using case level comparisons and a meta-matrix.

RESULTS

Twenty-one patients and seven FCs completed this study. The group-by-time effect showed increases in knowledge (p = 0.035) and self-efficacy (p = 0.007). Patients' and FCs' learning through experience was supported by an intervention nurse, who was perceived as competent and trustworthy. After the study, most intervention group participants felt more confident to implement pain self-management. Finally, data integration showed that declining health hampered some patients' pain self-management.

CONCLUSIONS

Competent and trustworthy nurses can support patients' and FCs' pain self-management by providing individualized interventions. Using a diary, jointly reflecting on the documented experiences, and addressing knowledge deficits and misconceptions through the use of academic detailing can facilitate patients' and FCs' learning of critical skills.

Cognitive behavioral therapy on personality characteristics of cancer patients

BACKGROUND

The main treatment methods for cancer include surgery, radiotherapy, chemotherapy, targeted drug therapy and so on. Patients often feel anger, anxiety, depression, and other negative psychological reactions in the process of treatment.

AIM

To explore the effects of cognitive behavioral therapy on the personality characteristics of cancer patients.

METHODS

According to the matching design requirements, 150 cancer patients were divided into 3 groups based on sex, age, condition, and cultural background. Patients in the control group received conventional treatment. Patients in experimental group 1 received an intervention based on conventional treatment combined with cognitive behavioral therapy. Patients in experimental group 2 received family members' participation in addition to the treatment given in experimental group 1. An Eysenck personality questionnaire was used to investigate all the patients before and after the intervention, and the scores for psychosis, introversion, neuroticism, and concealment degree were analyzed.

RESULTS

Compared with the control group, for experimental group 1 and experimental group 2 before and after the intervention, the four dimensions of mental quality, neuroticism, introversion and concealment degree all decreased, and the difference was statistically significant (P < 0.05). After the intervention, there were no obvious or statistically significant differences (P > 0.05) among the control group, experimental group 1, and experimental group 2 for two personality traits, psychoticism and neuroticism, both inside and outside degree and all four dimensions.

CONCLUSION

Simple cognitive behavioral therapy could not change the personality characteristics of cancer patients quickly, but the patients’ personality characteristics were significantly improved after treatment.

Clinical and Genetic Factors Associated With the Breast Cancer-Related Sleep Disorders: The "CAGE-Sleep" Study-A Cross-Sectional Study

CONTEXT

Despite being among the most reported concerns in breast cancer patients, sleep disturbances are still poorly assessed and managed in routine clinical practice. Correctly evaluating these symptoms and understanding the underlying clinical and genetic factors would help medical teams develop an adequate treatment strategy for each patient.

OBJECTIVES

1) To explore the severity of insomnia as well as sleep quality in a sample of Lebanese women with breast cancer undergoing chemotherapy; 2) To examine the correlation between sociodemographic, clinical, psychiatric (anxiety and depression), genetic factors, and alterations in sleep patterns.

METHODS

A cross-sectional study was carried out using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) (December 2017-June 2019; Ethical reference number: CEHDF1016). All patients gave their written consent and were genotyped for several polymorphisms in CLOCK, CRY2, PER2, COMT, DRD2, OPRM1, and ABCB1 genes using Lightcycler® (Roche).

RESULTS

Our sample included a total of 112 women. Almost half of the patients reported insomnia problems (with 20.5% moderate insomnia and 7.1% severe insomnia). Multivariable analyses taking the PSQI score as the dependent variable, showed that higher depression score and dyslipidemia (yes versus no) were significantly associated with higher PSQI scores (worse sleep quality), whereas having the DRD2 CT genotype versus CC and a higher chemotherapy cycle number were significantly associated with lower PSQI scores (better sleep quality). Depression was also significantly associated with higher ISI scores. When forcing all the genes in each model, the results remained the same except for depression that has been replaced by anxiety in the multivariable analysis.

CONCLUSION

Our study confirms the relationship between anxiety/depression, cycle number, dyslipidemia and DRD2 polymorphism with insomnia and highlights the importance of treating all associated factors to improve the overall QOL of patients.

Big Five Personality Model-based study of death coping self-efficacy in clinical nurses: A cross-sectional survey

Background

Specific personality traits may affect the ability of nurses to deal with patient death. The relationship between personality and death coping self-efficacy (DCS) has rarely been investigated in the palliative care setting. In this study, we explored the associations between different personality profiles and DCS in clinical nurses from general wards and ICU.

Methods

A cross-sectional survey of 572 Chinese nurses was conducted between August and September 2020, by way of a self-administered questionnaire.

Results

Among the Big Five Personality Traits, in nurses the score was highest for conscientiousness and lowest for neuroticism. With regard to DCS, nurses scored highly on the intention of hospice care. The Big Five Personality Traits were found to explain 20.2% of the overall variation in DCS. Openness, agreeableness and conscientiousness were significantly associated with DCS in nurses.

Conclusions

Nursing managers should pay attention to differences in personality characteristics and provide personalized and targeted nursing education. This should improve nurses’ DCS, enrich their professional development and promote high quality palliative care for patients and their families.

Association between illness perception and health behaviour among stroke patients: The mediation effect of coping style

AIMS

This study aims to explore illness perception and coping style in relation to health behaviour and the mediating role of coping style between illness perception and health behaviour among stroke patients.

DESIGN

Cross-sectional study.

METHODS

This survey was conducted with 515 stroke patients aged ≥18 years from September 2019 to January 2020 in Zhengzhou, China. The demographic and clinical characteristics questionnaire, Stroke Illness Perception Questionnaire-Revised, Simplified Coping Style Questionnaire, and Health Behavior Scale for Stroke Patients were included in this study. Data analysis was performed by correlation analysis, multiple linear regression analysis, and structural equation modelling.

RESULTS

The valid questionnaires were 495 (effective response rate: 96.1%). Low negative illness perception, high positive coping style, and low negative coping style are related to high level of health promoting behaviour (all p < 0.01). The results revealed that the effect of illness perception on health behaviour was partly mediated by coping style. It also confirmed that the mediation effect accounts for 43.7% (-0.169/-0.387) of the total effect.

CONCLUSION

Illness perception may influence health behaviour partly because of coping style.

IMPACT

This study implies that targeted interventions for stroke patients' illness perception are needed to motivate them to take proactive coping strategy to ultimately improve their health behaviours.

The Predictive Role of Body Image and Sexual Function in Quality of Life After Modified Radical Mastectomy Regarding the Mediating Role of Emotion; A Cross Sectional Study

Background: Mastectomy has negative effects on body image, sexual function, and quality of life (QOL). Additionally, maladaptive emotion regulation strategy is considered a trans-diagnostic mechanism underlying the psychiatric syndrome in these patients. Objectives: The predictive role of body image and sexual function in QOL regarding the mediating role of difficulty in emotion regulation has not been studied yet. Methods: In a correlational study, from March to December 2016, among patients undergoing modified radical mastectomy (MRM) at Early-stage Breast Cancer (BC), 90 patients were selected, using respondent-driven sampling (RDS). To collect the data, the Multidimensional Body-Self Relations Questionnaire (MBSRQ), the Persian language version of the Female Sexual Function Index (P-FSFI), QOL questionnaire, and Difficulties in Emotion Regulation Scales (DERS) were used. Data were analyzed through Pearson's correlation coefficient, regression analysis, and path analysis, using AMOS and SPSS software version 22 and the significance criterion was considered 0.05. Results: Data analysis showed a direct relationship between body image and sexual function with QOL, and it had an inverse relationship with difficulty in emotion regulation (P < 0.01). Also, body image, sexual function, and difficulty in emotion regulation were predictors of QOL (P < 0.01). Besides, in predicting QOL based on sexual function and body image, the difficulty in emotion regulation has a mediating role (P < 0.01). Conclusions: In patients with breast cancer under mastectomy, proper sexual function, sexual attraction depending on body image, and QOL were influenced by emotion regulation. Reducing the difficulty in emotion regulation through emotion-focused interventions can improve QOL in patients.