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Núñez-Cortés R, Espin A, Calatayud J, Pérez-Alenda S, Cruz-Montecinos C, López-Bueno R, Vinstrup J, Jakobsen MD, Andersen LL. Can Vitality and Mental Health Influence Upper Extremity Pain? A Prospective Cohort Study of 1185 Female Hospital Nurses. Eur J Investig Health Psychol Educ 2023; 13:2192-2201. [PMID: 37887155 PMCID: PMC10606458 DOI: 10.3390/ejihpe13100154] [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: 08/28/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023] Open
Abstract
Musculoskeletal disorders of the upper extremity are among the most common occupational problems affecting nurses. The aim of this study was to analyze the prospective association between vitality and mental health and increased upper extremity pain intensity in female hospital nurses during a 1-year follow-up. A prospective cohort of 1185 female nurses from 19 hospitals in Denmark was conducted using baseline and 12-month follow-up questionnaires to identify potential associations between levels of vitality and mental health (SF-36 subscales) with pain intensity (0-10 scale) in the shoulder, elbow and hand/wrist regions. Associations were modeled using cumulative logistic regression. The fully adjusted model included the variables of age, baseline pain, body mass index, smoking status, years of occupation, leisure time physical activity level, number of daily patient transfers/handlings, as well as recognition and influence at work. The mean age was 48.3 (SD: 10.4) years. In the fully adjusted model, significant associations between low vitality levels and the odds of shoulder pain (OR = 1.96; 95%CI: 1.43-2.68) and hand/wrist pain (OR = 2.32; 95%CI: 1.58-3.42) were observed. Likewise, moderate levels of mental health was associated with increased odds of shoulder pain at follow-up (OR = 1.50; 95%CI: 1.16-1.93). These results provide an important incentive for nursing managers to assess vitality and mental health among hospital nurses and to consider this factor in prevention strategies to ensure good worker health and, by extension, high-quality care.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8370000, Chile;
| | - Ander Espin
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46011 Valencia, Spain
| | - Sofía Pérez-Alenda
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
| | - Carlos Cruz-Montecinos
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8370000, Chile;
- Division of Research, Development and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago 8370000, Chile
| | - Rubén López-Bueno
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Physical Medicine and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jonas Vinstrup
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
| | - Markus D. Jakobsen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
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Karp N, Yazdany J, Schmajuk G. Peer Support in Rheumatic Diseases: A Narrative Literature Review. Patient Prefer Adherence 2023; 17:2433-2449. [PMID: 37808273 PMCID: PMC10557966 DOI: 10.2147/ppa.s391396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Rheumatic diseases are a group of chronic conditions that are associated with significant morbidity, impaired physical function, psychosocial stress, and cost to the healthcare system. Peer support interventions have been shown to have a positive impact on health outcomes in several chronic conditions, but no review has specifically assessed the impact of peer support on rheumatic conditions. The aim of this narrative literature review was to understand how peer support has been applied in the field of rheumatology, with a specific focus on the impact of observational and randomized studies of direct peer support interventions on various outcome measures across rheumatic conditions. We also examined studies exploring patient attitudes and preferences toward peer support. The majority of studies included focused on peer support in rheumatoid arthritis and systemic lupus erythematosus. Generally, patients across the spectrum of rheumatic disease perceive peer support as a useful tool. Peer support interventions, while highly variable, were generally associated with positive impacts on health-related quality of life metrics (both perceived and measured), although these differences were not always statistically significant. Important limitations include variability in study design, selection bias among study participants, and short follow-up periods across most peer support interventions.
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Affiliation(s)
- Nathan Karp
- Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
| | - Jinoos Yazdany
- Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
- Institute for Health Policy Research, University of California, San Francisco, CA, USA
| | - Gabriela Schmajuk
- Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
- Institute for Health Policy Research, University of California, San Francisco, CA, USA
- Department of Medicine, Division of Rheumatology, San Francisco Veterans Affairs Health System, San Francisco, CA, USA
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McLeod J, Davis CG. Community peer support among individuals living with spinal cord injury. J Health Psychol 2023; 28:943-955. [PMID: 36924431 PMCID: PMC10467001 DOI: 10.1177/13591053231159483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Peer support is widely assumed to help individuals with spinal cord injury (SCI) adjust, yet the evidence is mixed. We propose that peer support may be more likely to promote adjustment when informal support is lacking. To test this hypothesis, 135 individuals living with SCI receiving peer support (46.7% female; Mage = 42.36, SD = 14.83) completed an online survey assessing aspects of and satisfaction with the peer support and family/friend support that they were receiving as well as measures of adjustment. Although those reporting receiving more peer support were not any better adjusted than those reporting less, individuals who were more satisfied with the peer support they received reported better adjustment. Moreover, the relation of satisfaction with peer support with depressive symptoms was dependent on the level of family/friend support. These findings suggest that peer support is most effective among those lacking support from family and friends.
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Cox-Martin E, Phimphasone-Brady P, Hoffecker L, Glasgow RE. Psychosocial Interventions for Pain Management in Breast Cancer Survivors: A RE-AIM Evaluation. J Clin Psychol Med Settings 2023; 30:182-196. [PMID: 35562602 DOI: 10.1007/s10880-022-09874-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 12/24/2022]
Abstract
Psychosocial interventions for breast-cancer-related pain are effective, yet over 45% of survivors continue to struggle with this often-chronic side effect. This study evaluated multilevel indicators that can influence successful translation of interventions into clinical practice. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was applied to evaluate reporting of individual and setting/staff-level intervention indicators. A systematic search and multi-step screening process identified 31 randomized controlled trials for psychosocial interventions for breast cancer-related pain. Average reporting of indicators for individual-level dimensions (Reach and Effectiveness) were 65.2% and 62.3%, respectively. Comparatively, indicators for setting/staff-level dimensions were reported at a lower average frequency (Implementation, 46.8%; Adoption, 15.2%; Maintenance, 7.7%). Low reporting of setting/staff-level dimensions suggests gaps in the sustained implementation of psychosocial interventions. Implementation science methods and frameworks could improve trial design and accelerate the translation of psychosocial interventions for breast cancer-related pain into clinical practice.
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Affiliation(s)
- Emily Cox-Martin
- VA Puget Sound Health Care System, 9600 Veterans Dr SW, Tacoma, WA, 98493, USA.
| | | | - Lilian Hoffecker
- Strauss Health Sciences Library, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Russell E Glasgow
- Department of Family Medicine, and ACCORDS Center, University of Colorado School of Medicine, Aurora, CO, USA
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Jassim GA, Doherty S, Whitford DL, Khashan AS. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev 2023; 1:CD008729. [PMID: 36628983 PMCID: PMC9832339 DOI: 10.1002/14651858.cd008729.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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. This review is an update of a Cochrane Review first published in 2015. OBJECTIVES To assess the effect of psychological interventions on psychological morbidities and quality of life among women with non-metastatic breast cancer. SEARCH METHODS: We searched the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov up to 16 March 2021. We also scanned the reference lists of relevant articles. SELECTION CRITERIA Randomised controlled trials that assessed the effectiveness of psychological interventions for women with non-metastatic breast cancer. DATA COLLECTION AND ANALYSIS Two review authors independently appraised, extracted data from eligible trials, and assessed risk of bias and certainty of the evidence using the GRADE approach. Any disagreement was resolved by discussion. Extracted data included information about participants, methods, the intervention and outcomes. MAIN RESULTS We included 60 randomised controlled trials comprising 7998 participants. The most frequent reasons for exclusion were non-randomised trials and the inclusion of women with metastatic disease. The updated review included 7998 randomised women; the original review included 3940 women. A wide range of interventions was evaluated. Most interventions were cognitive- or mindfulness-based, supportive-expressive, and educational. The interventions were mainly delivered face-to-face (56 studies) and in groups (50 studies) rather than individually (10 studies). Most intervention sessions were delivered on a weekly basis with an average duration of 14 hours. Follow-up time ranged from two weeks to 24 months. Pooled standardised mean differences (SMD) from baseline indicated that the intervention may reduce depression (SMD -0.27, 95% confidence interval (CI) -0.52 to -0.02; P = 0.04; 27 studies, 3321 participants, I2 = 91%, low-certainty evidence); anxiety (SMD -0.43, 95% CI -0.68 to -0.17; P = 0.0009; 22 studies, 2702 participants, I2 = 89%, low-certainty evidence); mood disturbance in the intervention group (SMD -0.18, 95% CI -0.31 to -0.04; P = 0.009; 13 studies, 2276 participants, I2 = 56%, low-certainty evidence); and stress (SMD -0.34, 95% (CI) -0.55 to -0.12; P = 0.002; 8 studies, 564 participants, I2 = 31%, low-certainty evidence). The intervention is likely to improve quality of life in the intervention group (SMD 0.78, 95% (CI) 0.32 to 1.24; P = 0.0008; 20 studies, 1747 participants, I2 = 95%, low-certainty evidence). Adverse events were not reported in any of the included studies. AUTHORS' CONCLUSIONS Based on the available evidence, psychological intervention may have produced favourable effects on psychological outcomes, in particular depression, anxiety, mood disturbance and stress. There was also an improvement in quality of life in the psychological intervention group compared to control group. Overall, there was substantial variation across the studies in the range of psychological interventions used, control conditions, measures of the same outcome and timing of follow-up.
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Affiliation(s)
- Ghufran A Jassim
- Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSI Bahrain), Busaiteen, Bahrain
| | - Sally Doherty
- Psychiatry, Royal College of Surgeons in Ireland- Medical University of Bahrain (RCSI Bahrain), Busaiteen, Bahrain
| | | | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
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Lopez-Olivo MA, Foreman JT, Leung C, Lin HY, Westrich-Robertson T, Hofstetter C, des Bordes JKA, Lyddiatt A, Leong A, Willcockson IU, Peterson SK, Suarez-Almazor ME. A randomized controlled trial evaluating the effects of social networking on chronic disease management in rheumatoid arthritis. Semin Arthritis Rheum 2022; 56:152072. [PMID: 35872394 PMCID: PMC9862615 DOI: 10.1016/j.semarthrit.2022.152072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/25/2022] [Accepted: 07/14/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Social networking has been shown to improve health outcomes in certain patient populations. While patients with rheumatoid arthritis (RA) increasingly use social networking to communicate with peers, the effects of these interactions are largely unknown. METHODS In a randomized controlled trial, we compared RA patients who participated in a social networking group moderated by peer leaders and who had access to a static website offering RA materials with a control group, who only had access to the website. The primary outcomes were patients' RA knowledge, self-efficacy and empowerment. Secondary outcomes included participation in desired health behaviors, and satisfaction with peer support, among others. Follow-up assessments were conducted at 3 and 6 months. Participants who never signed in were excluded from the primary analysis. RESULTS 105 participants were randomized to each group. Mean age was 52 (±12.4) and 92.4% were females. Knowledge scores improved in both groups, but only in the control group the differences observed at 3 and 6 months were significant (p≤0.02). Self-efficacy scores also improved in both groups, but only the differences observed at 6 months in the Facebook group were significant (p=0.02). When comparing groups, at 3 months the knowledge improvements observed in the control group were greater compared with those observed in the Facebook group (mean difference 0.4 versus 0.1; respectively, p=0.03). No other differences were observed in secondary outcomes between the 2 groups, except in peer support satisfaction. The Facebook® group reported greater peer support satisfaction in 3 out 5 subscales compared with the control group (p≤0.04). CONCLUSION Peer support satisfaction was higher in participants using an online social network, but this was not translated into greater disease knowledge or empowerment.
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Affiliation(s)
- Maria A Lopez-Olivo
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jessica T Foreman
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Cheuk Leung
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Heather Y Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | | | - Jude K A des Bordes
- Department of Family Medicine, McGovern Medical School, Houston, TX, United States
| | - Anne Lyddiatt
- Musculoskeletal Group, Cochrane Collaboration, Ontario, Canada
| | - Amye Leong
- Healthy Motivation and the Global Alliance for Musculoskeletal Health of the Bone and Joint Decade, Santa Barbara, CA, United States
| | - Irmgard U Willcockson
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Maria E Suarez-Almazor
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT. What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1264. [PMID: 36909883 PMCID: PMC9316011 DOI: 10.1002/cl2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions. Objectives The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and cost-effectiveness of the use of peer support in health and social care. Search Methods We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies. Selection Criteria Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role. Data Collection and Analysis Data were extracted on the type of peer support intervention and outcomes assessed in included studies. Standardised tools were used to assess study quality for all studies: assessing the methodological quality of systematic reviews 2 for systematic reviews; Cochrane risk of bias tool for randomised controlled trials; and consensus health economic criteria list for economic evaluations. Main Results We included 91 studies: 32 systematic reviews; 52 randomised controlled trials; and 7 economic evaluations. Whilst most included systematic reviews and economic evaluations were assessed to be of low or medium quality, the majority of randomised controlled trials were of higher quality. There were concentrations of evidence relating to different types of peer support, including education, psychological support, self-care/self-management and social support. Populations with long-term health conditions were most commonly studied. The majority of studies measured health-related indicators as outcomes; few studies assessed cost-effectiveness. Studies were unevenly distributed geographically, with most being conducted in the USA. Several gaps were evident regarding the delivery of peer support, particularly the integration of peers and professionals in delivering support and interventions of longer duration. Authors' Conclusions Although there is evidence available to inform the commissioning and delivery of peer support in health and social care, there are also clear gaps that need to be addressed to further support provision, particularly regarding cost-effectiveness. The effectiveness of peer support in different countries, with varying health and social care systems, is a priority for future research, as is the integration of peers with professionals in delivering peer support.
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Affiliation(s)
- Anna Price
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Siân de Bell
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Naomi Shaw
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Alison Bethel
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
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Improvement in quality of life and psychological well-being associated with a culturally based psychosocial intervention for Chinese American breast cancer survivors. Support Care Cancer 2021; 29:4565-4573. [PMID: 33481114 DOI: 10.1007/s00520-020-05942-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to investigate improvements in quality of life and psychological well-being among Chinese American breast cancer survivors who participated in a pilot community education and peer-mentor support program. METHODS One hundred and twenty-nine Chinese American breast cancer survivors who recently completed treatment participated in eight cohorts of the program, Joy Luck Academy, which included weekly education and peer-mentor support sessions. The education sessions covered topics designed to help participants adjust to new life after breast cancer treatment. The peer-mentor support component was designed to provide social support. Quality of life and psychological well-being (e.g., depressive symptoms, anxiety, and low- and high-arousal positive and negative affect) were assessed at baseline and immediately after the intervention. RESULTS Paired samples t tests indicated improvements in quality of life, low- and high-arousal positive affect, and reductions in depressive symptoms, anxiety, and low-arousal negative affect. CONCLUSION Our findings suggest that a psychosocial group intervention may improve quality of life and psychological well-being among Chinese American breast cancer survivors. Our intervention has the potential to be applied to other ethnic-minority cancer survivors. Future randomized controlled trials are warranted.
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Thomas TH, Donovan HS, Rosenzweig MQ, Bender CM, Schenker Y. A Conceptual Framework of Self-advocacy in Women With Cancer. ANS Adv Nurs Sci 2021; 44:E1-E13. [PMID: 33181568 PMCID: PMC7894983 DOI: 10.1097/ans.0000000000000342] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Researchers define self-advocacy as the ability of an individual with cancer to overcome challenges in getting their preferences, needs, and values met. While imperative in all health care settings, self-advocacy is especially important in cancer care. The goal of this article is to present a conceptual framework for self-advocacy in cancer. We review foundational studies in self-advocacy, define the elements of the conceptual framework, discuss underlying assumptions of the framework, and suggest future directions in this research area. This framework provides an empirical and conceptual basis for studies designed to understand and improve self-advocacy among women with cancer.
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Affiliation(s)
- Teresa H Thomas
- School of Nursing, University of Pittsburgh, Pennsylvania (Drs Thomas, Donovan, Rosenzweig, and Bender); and Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, Pennsylvania (Dr Schenker)
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Abbasi A, Ebrahimi H, Bagheri H, Basirinezhad MH, Mirhosseini S, Mohammadpourhodki R. A randomized trial of the effect of peer education on the sexual quality of life in patients with myocardial infarction. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 17:jcim-2019-0204. [PMID: 32701480 DOI: 10.1515/jcim-2019-0204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/31/2019] [Indexed: 11/15/2022]
Abstract
Background One of the factors associated with readmission is inappropriate sexual activity after myocardial infarction (MI). This study aimed to assess the effect of peer education on the sexual quality of life (SQOL) in patients with MI. Methods In this randomized controlled clinical trial, 70 patients with MI meeting the inclusion criteria were assigned to experimental or control groups using block randomization. Peer education for the intervention group was provided on the third day after MI. Education sessions lasted from 90 to 120 minutes. Data were collected using demographic, sexual quality of life-female (SQOL-F), and sexual quality of life-male (SQOL-M) questionnaires during the fourth week after MI. Results There was no significant difference between the two groups before the intervention in terms of demographic and SQOL. The mean of SQOL in the peer education group was significantly higher than the control group at the 4-week follow-up. Conclusions According to the results, using peer education is recommended for the sexual health care professionals.
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Affiliation(s)
- Ali Abbasi
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, 7th Sq., Shahroud, Iran
| | - Hossein Ebrahimi
- Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Bagheri
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, 7th Sq., Shahroud, Iran
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedmohammad Mirhosseini
- Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Mohammadpourhodki
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, 7th Sq., Shahroud, Iran
- Department of Nursing, Kashmar Center of Higher Health Education, Mashhad University of Medical Sciences, Mashhad, Iran
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Warmoth K, Yeung NCY, Xie J, Feng H, Loh A, Young L, Lu Q. Benefits of a Psychosocial Intervention on Positive Affect and Posttraumatic Growth for Chinese American Breast Cancer Survivors: A Pilot Study. Behav Med 2020; 46:34-42. [PMID: 30657442 PMCID: PMC6639149 DOI: 10.1080/08964289.2018.1541862] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 06/26/2018] [Accepted: 10/25/2018] [Indexed: 10/27/2022]
Abstract
Breast cancer survivors report persistent psychological and physical symptoms, which affect their quality of life and may challenge the recovery process. Due to social, cultural, and linguistic barriers, culturally sensitive care is largely unavailable for Chinese Americans, and their psychological needs are not often addressed. We aimed to investigate whether the Joy Luck Academy (JLA), a psychosocial intervention providing both information and peer support, was associated with positive adjustment among Chinese American breast cancer survivors. Thirty-nine Chinese American breast cancer survivors participated in a pilot psychosocial intervention. The educational materials and lectures were delivered in the participants' native language of Chinese. All of the educators and mentors shared the same linguistic and cultural background with the participants. The program utilized a community-based participatory research (CBPR) approach to further enhance the cultural sensitivity of the intervention. Participants' post-traumatic growth and positive affect were assessed before and after the intervention. The JLA showed an improvement in positive affect, and they had a greater appreciation for life. The intervention was found to be feasible, well-accepted, and beneficial for this population. Chinese American breast cancer survivors reported improved psychological health after attending the intervention. These findings encourage the development and implementation of psychosocial interventions for Chinese breast cancer survivors. Similar programs could be integrated into other ethnic or cultural communities.
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Affiliation(s)
- Krystal Warmoth
- University of Exeter Medical School, University of Exeter, Exeter, UK ()
| | - Nelson C. Y. Yeung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sino Building, Chung Chi Rd, Sha Tin, Hong Kong, China ()
| | - Jing Xie
- Culture & Health Research Center, University of Houston, Department of Psychology, Fred J. Heyne Building Rm 126, 3695 Cullen Boulevard, Houston, TX, USA 77204-5022 (; ; )
| | - Hannah Feng
- Culture & Health Research Center, University of Houston, Department of Psychology, Fred J. Heyne Building Rm 126, 3695 Cullen Boulevard, Houston, TX, USA 77204-5022 (; ; )
| | - Alice Loh
- Herald Cancer Association, Chinese Christian Herald Crusades, 715 E. Mission Road, San Gabriel, CA, USA 91776 (; )
| | - Lucy Young
- Herald Cancer Association, Chinese Christian Herald Crusades, 715 E. Mission Road, San Gabriel, CA, USA 91776 (; )
| | - Qian Lu
- Culture & Health Research Center, University of Houston, Department of Psychology, Fred J. Heyne Building Rm 126, 3695 Cullen Boulevard, Houston, TX, USA 77204-5022 (; ; )
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas ()
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Grossman D, Katz A, Lock K, Caraiscos VB. A Retrospective Study Reviewing Interprofessional Advance Care Planning Group Discussions in Pulmonary Rehabilitation: A Proof-of-Concept and Feasibility Study. J Palliat Care 2019; 36:219-223. [DOI: 10.1177/0825859719896421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Advance care planning (ACP) is a process of reflection and discussion wherein a patient, in consultation with a health-care provider, family, and/or loved ones, clarifies values and treatment preferences and establishes goals, including a plan for end-of-life (EOL) care. Advance care planning encompasses appreciating and understanding illness and treatment options, elucidating patient values and beliefs, and identifying a substitute decision maker (SDM) or designating a power of attorney (POA) for personal care. These discussions have proven to be effective in improving patient–family satisfaction, reducing anxiety regarding EOL care in patients and family members, and improving patient-centered care by empowering patients to direct their care at EOL. However, ACP conversations are often difficult to have due to the sensitive nature of such discussions. Objective: The aim of this study was to determine whether group facilitation for teaching and discussing ACP enhances participants’ understanding of ACP and allows them to feel comfortable and supported when discussing these sensitive issues. Methods: Patients who were registered in North York General Hospital’s (NYGH) pulmonary rehabilitation program from June 2016 until August 2017 were given the opportunity to attend two 1-hour sessions related to ACP. The first session was dedicated to educating patients on ACP, explaining the hierarchy of the SDM and the role of the POA for personal care. The second session, provided a short time later, was devoted to discussions of values, wishes, fears, and trade-offs for future medical and EOL care. These discussions led by the supportive care nurse practitioner and a physician who are members of the NYGH Freeman Palliative Care Team were held in a group-facilitated format. Anonymous feedback forms, including both qualitative and quantitative feedback, were completed by the participants and analyzed. Participants: Analysis of a sample of 30 participants who attended 1 or 2 of the ACP sessions revealed that 21 identified as female and 9 identified as male. The average age of the participants was 76 years. Findings: Participants felt the content was relevant to their needs and were comfortable asking questions with all feedback averages ranging from good to very good. Participants appreciated the opportunity to share their thoughts in an open and interactive format. Conclusion: Discussing issues relevant to ACP, including providing information about ACP, sharing fears, wishes, and tradeoffs, were well-received in a group-support environment. Future studies should assess the impact of ACP group discussion on the individual, such as identifying a POA, having discussions regarding wishes and values with the SDM/POA, and examining the clinical impact of such sessions.
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Affiliation(s)
- Daphna Grossman
- Freeman Centre for the Advancement of Palliative Care, North York General Hospital, Toronto, Ontario, Canada
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amanda Katz
- Sackler Faculty of Medicine, Tel Aviv University Israel, Tel Aviv, Israel
| | - Karen Lock
- Freeman Centre for the Advancement of Palliative Care, North York General Hospital, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Valerie B. Caraiscos
- Freeman Centre for the Advancement of Palliative Care, North York General Hospital, Toronto, Ontario, Canada
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Jalambadani Z, Borji A, Bakaeian M. Examining the effect of mindfulness-based art therapy (MBAT) on stress and lifestyle of Iranian pregnant women. J OBSTET GYNAECOL 2019; 40:779-783. [PMID: 31607191 DOI: 10.1080/01443615.2019.1652889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to determine the effect of mindfulness-based art therapy (MBAT) in decreasing stress and improving on pregnant women's life style in Neyshabur, Iran 2018. The participants of the present quasi-experimental study were 84 pregnant women. The findings showed that the MBAT group demonstrated a significant decrease in symptoms of distress and significant improvements in key aspects of the health-related style of life as measured by Health Promoting Lifestyle Profile-II questionnaire. Moreover, it was found that the MBAT intervention had a significant effect on improving lifestyle behaviours (p < .05). The highest mean score of lifestyle was for the sub-domain of nutrition (31.35 ± 5.34), while the lowest score was achieved by the sub-domains of physical activity (13.55 ± 1.89).The mean (SD) score of stress management was (19.12 ± 1.54). This investigation of MBAT provides initial encouraging data that support a possible future role for the intervention as a psychosocial option for decreasing symptoms of distress in pregnant women and improving their lifestyle.Impact statementWhat is already known on this subject? Mindfulness-based art therapy is a blend of basic meditation principles and art therapy. The results of this study showed that mindfulness-based art therapy (MBAT) could decrease the stress and improve lifestyle behaviours in pregnant women.What do the results of this study add? The results of the present study showed that mindfulness-based art therapy (MBAT) during pregnancy decreased the stress and improved life style. It is believed that changing lifestyle to include mind-body medicine such as MBAT in pregnant women will greatly reduce stress responses, and help protect pregnant women from disease during pregnancy.What are the implications of these findings for clinical practice and/or further research? The study showed the important role of mindfulness-based art therapy (MBAT) during pregnancy in reducing stress and improving life style.
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Affiliation(s)
- Zeinab Jalambadani
- Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Abasalt Borji
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mehdi Bakaeian
- Department of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Russell C, Dickson T, McKeganey N. Advice From Former-Smoking E-Cigarette Users to Current Smokers on How to Use E-Cigarettes as Part of an Attempt to Quit Smoking. Nicotine Tob Res 2019; 20:977-984. [PMID: 29065208 DOI: 10.1093/ntr/ntx176] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 07/31/2017] [Indexed: 11/14/2022]
Abstract
Introduction Substitution of e-cigarettes for tobacco smoking has the potential to prevent almost all the harm caused by smoking. Identifying strategies that may increase smokers' capability, opportunity and motivation to use e-cigarettes in place of tobacco cigarettes is vital. Former smokers who have successfully used e-cigarettes to quit smoking may be especially well qualified to increase current smokers' interest in switching and ability to switch to e-cigarettes. Methods A multi-national, self-selected sample of 4192 former smokers who quit smoking by using e-cigarettes were asked, via an online survey, the advice they would offer to smokers who are considering using e-cigarettes to support an attempt to quit smoking. Results Thematic analysis of participants' qualitative responses identified four emergent themes: (1) Find a combination of vaping device, flavors of e-liquid and nicotine strength that "works for you"; (2) Continuing to smoke for a while after starting to vape is OK; (3) Failure to quit smoking with the use of approved smoking cessation aids before success with e-cigarettes is common; and (4) Awareness of improved health and hygiene since switching to vaping. Conclusions Experienced vapers who used to smoke appear eager to give smokers advice and practical information about vaping that may assist attempts to switch from smoking to vaping. Encouraging cigarette smokers to interact with experienced vapers in places where vapers themselves once received advice and now give advice about vaping-vape shops and online discussion fora-may have significant potential to help more smokers to switch to e-cigarette use. Implications This study describes the advice that former-smokers who used e-cigarettes to quit smoking would offer to smokers who are considering using an e-cigarette to support an attempt to quit smoking. Vapers advised smokers to find the right combination of device, flavors and nicotine strength, continue to smoke and vape for a while if they wished, not be deterred by past failed attempts to quit smoking, and expect health to improve after they have switched to vaping. Encouraging smokers to interact with vaping peers in vape shops and in online vaping-dedicated discussion fora may help significantly more smokers switch to vaping.
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Affiliation(s)
- Christopher Russell
- Behavioural Research on Nicotine and Tobacco Use, Centre for Substance Use Research, Glasgow, UK
| | - Tiffany Dickson
- Behavioural Research on Nicotine and Tobacco Use, Centre for Substance Use Research, Glasgow, UK
| | - Neil McKeganey
- Behavioural Research on Nicotine and Tobacco Use, Centre for Substance Use Research, Glasgow, UK
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Jagielski CH, Tucker DC, Dalton SO, Mrug S, Würtzen H, Johansen C. Personality as a predictor of well-being in a randomized trial of a mindfulness-based stress reduction of Danish women with breast cancer. J Psychosoc Oncol 2019; 38:4-19. [DOI: 10.1080/07347332.2019.1626524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Christina H. Jagielski
- Department of Internal Medicine/Division of Gastroenterology, Michigan Medicine, Ann Arbor, MI, USA
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Diane C. Tucker
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Susanne O. Dalton
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Christoffer Johansen
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
- Late Effect Research Unit CASTLE, Finsen Center, Copenhagen, Denmark
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Jalambadani Z, Borji A. Effectiveness of Mindfulness-Based Art Therapy on Healthy Quality of Life in Women with Breast Cancer. Asia Pac J Oncol Nurs 2019; 6:193-197. [PMID: 30931365 PMCID: PMC6371662 DOI: 10.4103/apjon.apjon_36_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Objective: The purpose of this study was to determine the effectiveness of mindfulness-based art therapy (MBAT) in promoting quality of life in Neyshabur women with breast cancer. Methods: This study was an interventional design that was conducted on 124 women with breast cancer (any stage) in Iran 2018. One hundred and fourteen women with breast cancer were paired by age and randomized to either 12-week MBAT intervention group or a wait-list-control group. One hundred and fourteen women with breast cancer completed both the pre-and post-study measurements. As compared to the control group, the MBAT group demonstrated a significant decrease in symptoms of distress and significant improvements in key aspects of the health-related quality of life (as measured by the World Health Organization Quality-of-Life - BREF questionnaire). Results: The MBAT interventions had a significant effect on improving quality of life behaviors (P < 0.05). Among the dimensions of quality of life, the highest mean score was for subpsychological (18.14 ± 2.35), and the lowest score was achieved by the subdomains of social relationships (13.54 ± 1.12). The mean (standard deviation) scores of physical health and environment were 17.19 ± 3.55 and 16.10 ± 1.87, respectively. Conclusions: This investigation of MBAT provides initial encouraging data that support a possible future role for the intervention as a psychosocial option for decrease in symptoms of women with breast cancer and quality of life.
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Affiliation(s)
- Zeinab Jalambadani
- Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Abasalt Borji
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Lu Q, Tsai W, Chu Q, Xie J. Is expressive suppression harmful for Chinese American breast cancer survivors? J Psychosom Res 2018; 109:51-56. [PMID: 29773152 PMCID: PMC8054769 DOI: 10.1016/j.jpsychores.2018.03.171] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/31/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
Abstract
Emotion regulation strategies are important for cancer survivors' adjustment. Expressive suppression, defined as the active effort of inhibiting the expressive component of an emotional response, has been found to be a maladaptive emotion regulation strategy. These studies, however, have been limited to cross-sectional designs and primarily European American samples. Chinese culture encourages emotion suppression to preserve interpersonal harmony and therefore it may be important to test these emotion regulation processes with this population. This study aimed to examine the longitudinal effects of expressive suppression, ambivalence over emotional expression (i.e., inner conflict over emotional expression), and cognitive reappraisal on quality of life among Chinese American breast cancer survivors. 103 participants completed a questionnaire assessing expressive suppression, ambivalence over emotional expression, cognitive reappraisal, and quality of life at baseline and a questionnaire assessing quality of life eight weeks later. Consistent with our hypotheses, baseline ambivalence over emotional expression was associated with lower follow-up quality of life above and beyond the effect of expressive suppression. Furthermore, cognitive reappraisal moderated the relations between expressive suppression and follow-up quality of life, such that expressive suppression may be less detrimental for Chinese American breast cancer survivors who are able to regulate their emotions using cognitive reappraisal. Implications for informing interventions for Chinese American breast cancer survivors are discussed.
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Affiliation(s)
- Qian Lu
- Department of Psychology, University of Houston, Houston, USA; Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, USA.
| | - William Tsai
- Department of Psychology, California State University, San Marcos, USA
| | - Qiao Chu
- Department of Psychology, University of Houston, Houston, USA
| | - Jing Xie
- Department of Psychology, University of Houston, Houston, USA
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Vartolomei L, Shariat SF, Vartolomei MD. Psychotherapeutic Interventions Targeting Prostate Cancer Patients: A Systematic Review of the Literature. Eur Urol Oncol 2018; 1:283-291. [PMID: 31100249 DOI: 10.1016/j.euo.2018.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/28/2018] [Accepted: 04/17/2018] [Indexed: 11/15/2022]
Abstract
CONTEXT Psychological counseling is a rarely discussed need for patients diagnosed with prostate cancer (PCa). OBJECTIVE To systematically review studies that investigated the effectiveness and feasibility of professional psychotherapeutic support for PCa patients. EVIDENCE ACQUISITION A systematic search was carried out using electronic databases, including PubMed, Web of Science, PsycInfo, and the Cochrane library. The search was performed up to September 1, 2017; only articles published in English were considered. The combination of the search words "prostate cancer" with "psychotherapy" was used. Inclusion criteria were: (1) studies with psychotherapy interventions that included PCa patients; (2) patients with localized or advance disease; and (3) professional psychotherapeutic support. EVIDENCE SYNTHESIS We identified a total of ten studies (1067 participants). Six studies investigated cognitive behavioral therapy (CBT; 713 participants). Two studies used supportive psychotherapy (88 participants) and two used cognitive essential couple therapy (133 couples). Most studies came from the USA (5 studies). CBT seemed to be beneficial in African Americans, Hispanics, men with higher interpersonal sensitivity, and those with relatively high levels of stress in single studies. Couples therapies seemed beneficial for patients and their partners. Supportive psychotherapy was usually integrated into multimodal supportive treatments. CONCLUSIONS Despite the limitations of the available studies, there is promising early evidence that specialized psychotherapeutic support for PCa patients is feasible and beneficial. Psychological intervention can significantly improve PCa patients' wellbeing after therapy. Further multicenter randomized controlled trials should focus on assessing which patients need psychotherapeutic help and which are most likely to benefit from such support, and which type of interventions are the most appropriate for each patient. PATIENT SUMMARY We report on studies comparing psychological outcomes in prostate cancer patients treated with psychotherapeutic interventions. Psychotherapeutic support is feasible and improves overall wellbeing and cancer-related distress in some prostate cancer patients.
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Affiliation(s)
- Liliana Vartolomei
- Department of Urology, Medical University of Vienna, Austria; Department of Clinical Psychology, University Dimitrie Cantemir, Tirgu Mures, Romania
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Austria; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Weill Cornell Medical College, New York, NY, USA.
| | - Mihai Dorin Vartolomei
- Department of Urology, Medical University of Vienna, Austria; Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania
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Blois-Da Conceição S, Galiano A, Sagne A, Poussin M. Données actuelles et perspectives futures dans l’étude des liens entre soutien social et santé : vers une prise en compte des attitudes à l’égard du réseau de soutien en psychologie de la santé. PSYCHOLOGIE FRANCAISE 2017. [DOI: 10.1016/j.psfr.2016.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Faller H, Strahl A, Richard M, Niehues C, Meng K. The prospective relationship between satisfaction with information and symptoms of depression and anxiety in breast cancer: A structural equation modeling analysis. Psychooncology 2017; 26:1741-1748. [PMID: 28024096 DOI: 10.1002/pon.4358] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/15/2016] [Accepted: 12/22/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Previous research has demonstrated associations between satisfaction with information and reduced emotional distress in cancer patients. However, as most studies were cross-sectional, the direction of this relationship remained unclear. We therefore aimed to test whether information satisfaction predicted subsequent depression and anxiety levels, and, reciprocally, depression and anxiety levels predicted subsequent information satisfaction, thus clarifying the direction of impact. METHODS We performed a secondary analysis of a prospective cohort study with 436 female breast cancer patients (mean age 51 years). We measured information satisfaction with 2 self-developed items, symptoms of depression with the 2-item Patient Heath Questionnaire and symptoms of anxiety with the 2-item Generalized Anxiety Disorder Scale. We created 2 structural equation models, 1 for depression and 1 for anxiety, that examined the prediction of 1-year depression (or anxiety) levels by baseline information satisfaction and, in the same model, 1-year information satisfaction by baseline depression (or anxiety) levels (cross-lagged panel analysis). RESULTS Baseline information satisfaction predicted 1-year levels of both depression (beta = -0.17, P < .01) and anxiety (beta = -0.13, P < .01), adjusting for the baseline scores of the outcome variables. Conversely, baseline levels of depression (beta = -0.12, P < .05) and anxiety (beta = -0.16, P < .01) predicted 1-year information satisfaction, adjusting for its baseline score. CONCLUSION Our results suggest a bidirectional relationship between information satisfaction and symptoms of depression and anxiety. Thus, provision of information may reduce subsequent depression and anxiety, while reducing depression and anxiety levels may increase satisfaction with received information. Combining the provision of information with emotional support may be particularly beneficial.
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Affiliation(s)
- Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - André Strahl
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Matthias Richard
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Christiane Niehues
- Reha-Zentrum Ückeritz, Klinik Ostseeblick, Ückeritz, Germany`.,Deutsche Rentenversicherung Bund, Berlin, Germany
| | - Karin Meng
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
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Sherman AC, Mosier J, Leszcz M, Burlingame GM, Ulman KH, Cleary T, Simonton S, Latif U, Hazelton L, Strauss B. Group Interventions for Patients with Cancer and HIV Disease: Part I: Effects on Psychosocial and Functional Outcomes at Different Phases of Illness. Int J Group Psychother 2015; 54:29-82. [PMID: 14986573 DOI: 10.1521/ijgp.54.1.29.40376] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Group interventions for individuals facing cancer or HIV disease have drawn considerable attention among researchers and clinicians over the past 20 years. There is growing evidence that group services may be helpful, but which interventions are most effective for participants at which phases in the trajectory of disease has been less clear. Moreover, professionals working in different intervention settings (e.g., primary prevention vs. clinical care) and different disease sites (cancer vs. HIV disease) often have little awareness of relevant advances in other fields. Efforts to integrate findings in the literature may accelerate research and advance the standard of clinical care. The current article, the first in a series of four special reports, critically evaluates the efficacy of group interventions led by professional or trained facilitators for individuals confronted by cancer or HIV, across the spectrum of illness from elevated risk through advanced disease. We examine psychosocial and functional outcomes for different interventions directed toward different patient subgroups, trace common themes, highlight limitations, and offer recommendations for further research.
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Affiliation(s)
- Allen C Sherman
- Department of Otolaryngology, University of Arkansas for Medical Sciences, USA.
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Lu Q, You J, Man J, Loh A, Young L. Evaluating a culturally tailored peer-mentoring and education pilot intervention among Chinese breast cancer survivors using a mixed-methods approach. Oncol Nurs Forum 2015; 41:629-37. [PMID: 25355018 DOI: 10.1188/14.onf.629-637] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To evaluate a social support intervention that was culturally tailored for Chinese Americans who face many challenges because of cultural and linguistic barriers. DESIGN Intervention with a one-group pre- or post-test design, mixed methods, and a community-based participatory research (CBPR) approach. SETTING Southern California. SAMPLE 14 Chinese American breast cancer survivors post-treatment and eight breast cancer peer mentors. METHODS The intervention was a 10-week program to provide emotional and informational support through peer mentoring and education. Health outcomes were assessed before and after the intervention. Eight weekly process evaluations and two focus group interviews also were conducted. MAIN RESEARCH VARIABLES Depressive and anxiety symptoms. FINDINGS The program was associated with a decrease in depressive symptoms. Participants valued the program highly. Inductive analysis suggested possible mechanisms for effectiveness, such as reducing stigma, empowerment, and increased sense of belonging. CONCLUSIONS The peer-mentoring and education program has the potential to serve as a model intervention for ethnic minorities. Mixed methods and CBPR are valuable in evaluating pilot interventions with minorities. Focusing on relationships may be fruitful for designing novel interventions for cancer survivors from collectivistic cultures. IMPLICATIONS FOR NURSING Peer-mentoring and education programs can be integrated into communities and clinics to improve care for underserved minority cancer survivors and to reduce health disparities.
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Affiliation(s)
- Qian Lu
- Department of Psychology, University of Houston in Texas
| | - Jin You
- Department of Psychology, Wuhan University in China
| | - Jenny Man
- Department of Psychology, University of Houston
| | - Alice Loh
- Herald Cancer Association, San Gabriel, CA
| | - Lucy Young
- Herald Cancer Association, San Gabriel, CA
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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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Wang YC, Kraut RE, Levine JM. Eliciting and receiving online support: using computer-aided content analysis to examine the dynamics of online social support. J Med Internet Res 2015; 17:e99. [PMID: 25896033 PMCID: PMC4419194 DOI: 10.2196/jmir.3558] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/05/2014] [Accepted: 10/07/2014] [Indexed: 11/13/2022] Open
Abstract
Background Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites. Objective The first goal was to propose and test a model of the dynamic process through which participants in online support communities elicit and provide emotional and informational support. The second was to demonstrate the value of computer coding of conversational data using machine learning techniques (1) by replicating results derived from human-coded data about how people elicit support and (2) by answering questions that are intractable with small samples of human-coded data, namely how exposure to different types of social support predicts continued participation in online support communities. The third was to provide a detailed description of these machine learning techniques to enable other researchers to perform large-scale data analysis in these communities. Methods Communication among approximately 90,000 registered users of an online cancer support community was analyzed. The corpus comprised 1,562,459 messages organized into 68,158 discussion threads. Amazon Mechanical Turk workers coded (1) 1000 thread-starting messages on 5 attributes (positive and negative emotional self-disclosure, positive and negative informational self-disclosure, questions) and (2) 1000 replies on emotional and informational support. Their judgments were used to train machine learning models that automatically estimated the amount of these 7 attributes in the messages. Across attributes, the average Pearson correlation between human-based judgments and computer-based judgments was .65. Results Part 1 used human-coded data to investigate relationships between (1) 4 kinds of self-disclosure and question asking in thread-starting posts and (2) the amount of emotional and informational support in the first reply. Self-disclosure about negative emotions (beta=.24, P<.001), negative events (beta=.25, P<.001), and positive events (beta=.10, P=.02) increased emotional support. However, asking questions depressed emotional support (beta=–.21, P<.001). In contrast, asking questions increased informational support (beta=.38, P<.001), whereas positive informational self-disclosure depressed it (beta=–.09, P=.003). Self-disclosure led to the perception of emotional needs, which elicited emotional support, whereas asking questions led to the perception of informational needs, which elicited informational support. Part 2 used machine-coded data to replicate these results. Part 3 analyzed the machine-coded data and showed that exposure to more emotional support predicted staying in the group longer 33% (hazard ratio=0.67, P<.001), whereas exposure to more informational support predicted leaving the group sooner (hazard ratio=1.05, P<.001). Conclusions Self-disclosure is effective in eliciting emotional support, whereas question asking is effective in eliciting informational support. Moreover, perceptions that people desire particular kinds of support influence the support they receive. Finally, the type of support people receive affects the likelihood of their staying in or leaving the group. These results demonstrate the utility of machine learning methods for investigating the dynamics of social support exchange in online support communities.
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Affiliation(s)
- Yi-Chia Wang
- Language Technologies Institute, School of Computer Science, Carnegie Mellon University, Pittsburgh, PA, United States.
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Stagl JM, Bouchard LC, Lechner SC, Blomberg BB, Gudenkauf LM, Jutagir DR, Glück S, Derhagopian RP, Carver CS, Antoni MH. Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial. Cancer 2015; 121:1873-81. [PMID: 25809235 DOI: 10.1002/cncr.29076] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 08/07/2014] [Accepted: 08/26/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Breast cancer survivors experience long-term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered after surgery for early-stage breast cancer was previously associated with better QOL over a 12-month follow-up and with fewer depressive symptoms up to 5 years after study enrollment. This 8- to 15-year follow-up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8- to 15-year follow-up. METHODS Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies-Depression (CES-D) scale and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D scale and FACT-B over and above effects of confounding variables. RESULTS Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95% confidence interval [CI], 0.56-0.70) and better QOL (d, 0.58; 95% CI, 0.52-0.65) above the effects of the covariates. CONCLUSIONS Women who received CBSM after surgery for early-stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors.
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Affiliation(s)
- Jamie M Stagl
- Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
| | - Laura C Bouchard
- Department of Psychology, University of Miami, Coral Gables, Florida
| | - Suzanne C Lechner
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida.,Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Bonnie B Blomberg
- Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.,Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida
| | - Lisa M Gudenkauf
- Department of Psychology, University of Miami, Coral Gables, Florida
| | - Devika R Jutagir
- Department of Psychology, University of Miami, Coral Gables, Florida
| | - Stefan Glück
- Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Charles S Carver
- Department of Psychology, University of Miami, Coral Gables, Florida.,Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, Florida.,Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida.,Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
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Affiliation(s)
- Abby Barnwell
- Lead Colorectal/Stoma Nurse Specialist, University Hospitals, Coventry, England
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Group medical consultations in the follow-up of breast cancer: a randomized feasibility study. J Cancer Surviv 2015; 9:450-61. [DOI: 10.1007/s11764-014-0421-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/16/2014] [Indexed: 11/25/2022]
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Eficácia das intervenções psicológicas em grupo dirigidas a mulheres com cancro da mama: uma revisão sistemática. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rpsp.2015.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Reinhart R, D'Alimonte L, Osmar K, Court A, Szumacher E, Bristow B, Robson S, Dawdy K, Burnett J, Di Prospero L. Educating our patients collaboratively: a novel interprofessional approach. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:382-388. [PMID: 24532366 DOI: 10.1007/s13187-014-0623-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Providing cancer patients with more information regarding their treatments allows them to feel more in control, increases self efficacy, and can decrease anxiety. The aims of the present study were to develop an interprofessional group education session and to evaluate the usefulness and acceptability of this session. In addition, informational distress levels pre- and post-education were evaluated. A prostate radiation therapy (RT) education session was developed and facilitated by an interprofessional team. Topics discussed included how RT works, side effects and management, and support services available. Prior to the education session, participants reported their informational RT distress levels using the validated Distress Thermometer (DT). Post-education session, the DT was readministered. In addition, participants completed an acceptability survey to assess format, structure, and usefulness of the education session. Participants agreed that the session contained valuable and useful information helping them understand expectations during treatment, including resource availability, side effects and management, as well as procedural expectation during treatment. All stated they would recommend the session to other patients. The interprofessional nature of the sessions was deemed useful. Suggested areas for improvement included addition of a dietitian, information on long-term side effects, statistics of radiotherapy side effects, impact of radiotherapy on sexual function, and overall quality of life. The group education session significantly improved informational distress levels (p = 0.04). Educating prostate cancer patients utilizing an interprofessional group format can decrease anxiety and stress related to their RT treatment. Future development of group education sessions for other disease site groups may be valuable.
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Affiliation(s)
- Rebecca Reinhart
- Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
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Abstract
BACKGROUND Early detection and treatment have resulted in more women surviving breast cancer; increased survivorship has also increased the need for breast cancer support groups (BCSG). The ostensible goal of such groups is to provide support for the physical and emotional stressors that cancer survivors face, as well as provide information on coping and treatment options. OBJECTIVE Although scholars have examined the effects of support groups on their group members, the examination of group facilitator messages has been largely neglected. The goal of this study was to extend theory on group leader behavior, specifically investigating how member-leader messages create social support in support groups. METHODS The transcribed conversations of weekly meetings of a BCSG were examined using Interaction Process Analysis to discover how the member-leader facilitated the group's enactment and management of social support. RESULTS Across the meetings, task talk dominated (primarily statements of orientation or information). Furthermore, analysis of interaction sequences between the support group facilitator and other members revealed 2 broad categories of task-oriented facilitation techniques (changing the focus, clarification) and 1 category of socioemotional facilitation techniques (showing support). CONCLUSIONS Support group facilitators need the ability to facilitate both task and relational aspects of social support. IMPLICATIONS FOR PRACTICE Facilitator behaviors were highlighted as being instrumental to the creation of social support. The results from this study indicate that the ability to change the focus of interaction, to provide and require clarification on complex issues, and to show support through relational messages is needed in facilitator training.
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Salonen P, Rantanen A, Kellokumpu-Lehtinen PL, Huhtala H, Kaunonen M. The quality of life and social support in significant others of patients with breast cancer--a longitudinal study. Eur J Cancer Care (Engl) 2013; 23:274-83. [PMID: 24237363 DOI: 10.1111/ecc.12153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2013] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to evaluate prospectively the quality of life (QOL) and received social support from the network and nurses in significant others of breast cancer patients and identify factors predicting negative changes in their QOL within 6 months. The quasi-random longitudinal study conducted for the breast cancer patients and their significant others. Patients were quasi-randomised to supportive intervention group (via telephone at baseline and face-to-face at follow-up) and control group. This paper reports results of significant others (N = 165). The QOL data were collected using the Quality of Life Index - Cancer Version (QLI-CV). Support from network in aid increased the risk of negative changes in health and functioning. Retired significant others had a greater risk of more negative changes in their global and in socio-economic QOL than other. Relatives had a smaller risk to negative changes both in their global and in their family QOL than spouses/partners/boyfriends of patients with breast cancer. QOL of the significant others should be supported more intensively and enhanced by the use of individually tailored methods on the basis of significant others and their family needs.
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Affiliation(s)
- P Salonen
- Tauh Division of Administrative Services, Tampere University Hospital, Tampere, Finland
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Leng J, Lee T, Li Y, Stern C, Chen MH, Winkel G, Gany F. Support needs of Chinese immigrant cancer patients. Support Care Cancer 2013; 22:33-42. [PMID: 23982771 DOI: 10.1007/s00520-013-1950-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 08/13/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE To enable better psychosocial, informational, and practical support of Chinese patients with cancer, this study was conducted to identify the specific support needs of Chinese immigrant cancer patients. METHODS The Cancer Portal Project at Memorial Sloan-Kettering Cancer Center's Center for Immigrant Health and Cancer Disparities is a patient navigation program that assists underserved and minority cancer patients in obtaining social and economic assistance at ten New York City cancer clinics. This need assessment was conducted as part of the Portal Project. Sixty-four questions were added to the existing Portal Intake Form about the needs and preferences for Chinese-language support and survivorship services. Descriptive analysis was performed, as well as an exploratory principal component's factor analysis to determine if there were any patterns in the services and programs in which patients were interested. RESULTS Ninety-six patients were approached for participation; 59 agreed to participate. Eighty-eight percent of participants were born in China. Ninety-seven percent preferred to speak Mandarin, Cantonese, or Fujianese in the healthcare setting. When asked about general interest in support programs, 53 % of the participants were "very interested," 27 % were "maybe interested," and 17 % were "not interested." Programs in which more participants were "very interested" included those that would provide information about obtaining financial assistance (79 %) and social assistance (74 %), information on treatment options (67 %), help in coping with the burden of illness on the family (65 %), and information about general healthcare (63 %). The factor analysis resulted in the identification of five factors: social/financial/treatment and care issues, nutrition and exercise/networking/general health care, coping with fear and stress, herbs and dietary supplements, and acupuncture and acupressure. CONCLUSION In this study, 80 % of the participants expressed interest in programs tailored for Chinese cancer patients. The most frequently preferred topics for potential services were information-based. Findings provide a foundation for future research and the development of culturally and linguistically targeted support programs and interventions for this unique population.
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Affiliation(s)
- Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Center for Immigrant Health and Cancer Disparies, Memorial Sloan-Kettering Cancer Center, 300 E. 66th St., 15th Floor, New York, NY, 10065, USA,
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Kotzé SH, Mole CG. Talking about death: implementing peer discussion as a coping mechanism to overcome fears about dissection, death, and dying. ANATOMICAL SCIENCES EDUCATION 2013; 6:191-198. [PMID: 23208957 DOI: 10.1002/ase.1332] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 09/19/2012] [Accepted: 10/06/2012] [Indexed: 05/24/2023]
Abstract
Many studies have reported on the perceptions of medical students toward dissection. It is important to understand the feelings and symptoms experienced during dissection so that they can be adequately handled. Prior to dissection, first year students are given lectures on aspects of dissection, death and dying, and death rituals in various cultures. Two separate questionnaires, one given during the first week of dissection and another given one month into the program were then completed anonymously by dissection groups. The questions were designed to be open-ended, thereby encouraging group discussion amongst students. The questionnaires were used to determine the perception of students to dissection and to discover if these perceptions change during the dissection program. The first questionnaire revealed that students do experience fears and anxiety prior to and at the beginning of dissection; however, most of these fears dissipated by the time of the second questionnaire. One month into dissection students cited talking to peers as their main coping mechanism and fewer students mentioned emotional detachment from their cadaver as a coping mechanism, as was the case in the first questionnaire. Dissection was perceived as a positive experience by our student cohort and most students cited the main advantage of dissection as the ability to visualize organs in three dimensions. The comprehensive answers received from the students indicated that thorough discussion of feelings amongst peers occurred, introducing students to an important coping mechanism at an early stage of their learning.
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Affiliation(s)
- Sanet Henriët Kotzé
- Division of Anatomy and Histology, Department of Biomedical Sciences, Faculty of Health Sciences, University of Stellenbosch, Tygerberg 7505, South Africa.
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The efficacy of psychosocial intervention for pain in breast cancer patients and survivors: a systematic review and meta-analysis. Breast Cancer Res Treat 2013; 138:675-90. [PMID: 23553565 DOI: 10.1007/s10549-013-2503-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 03/23/2013] [Indexed: 12/18/2022]
Abstract
Persistent pain after breast cancer treatment is prevalent, and not all patients respond sufficiently to pharmacological treatment. Pain is recognized as a multi-dimensional phenomenon, which includes psychological and social components, and several clinical trials have investigated the efficacy of psychosocial interventions on pain in cancer patients and survivors. Our aim was to systematically review and quantify the existing research on the effect of psychosocial interventions on pain in breast cancer patients and survivors. Two independent raters reviewed 474 abstracts for eligibility, leading to the identification of 26 independent and eligible studies published between 1983 and 2012, which were assessed for their methodological quality and subjected to meta-analytic evaluation. A total of 1786 participants were included in the analyses. A statistically significant and robust overall effect size was found across all included studies (Hedges g = 0.37, 95 % CI: 0.20-0.40; p < 0.001). However, the effect size was considerably smaller (0.21), when adjusted for possible publication bias. Furthermore, the results were heterogeneous, and when exploring the sources of heterogeneity, studies of higher methodological quality were found to yield a more conservative effect size (g = 0.21, 95 % CI: 0.02-0.41) than studies of poorer quality (g = 0.65, 95 % CI: 0.25-1.04). The results also indicated that patient educational approaches yielded a larger effect size (g = 0.64) than relaxation-based interventions (g = 0.31, 95 % CI: -0.05-0.67) and supportive group therapy (g = 0.17, 95 % CI: 0.02-0.32). Taken together, while suggestive of psychosocial intervention as an effective tool in the management of pain among breast cancer patients and survivors, the results should be interpreted as preliminary. The methodological quality of the existing research varied considerably, and only few studies had selected patients on the basis of the presence of pain and included pain as the primary outcome.
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Björneklett HG, Rosenblad A, Lindemalm C, Ojutkangas ML, Letocha H, Strang P, Bergkvist L. Long-term follow-up of a randomized study of support group intervention in women with primary breast cancer. J Psychosom Res 2013; 74:346-53. [PMID: 23497838 DOI: 10.1016/j.jpsychores.2012.11.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 11/05/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Despite a fairly good prognosis, many breast-cancer patients suffer from symptoms such as anxiety, depression and fatigue, which may affect health-related quality of life and may persist for several years. The aim of the present study was to perform a long-term follow-up of a randomized study of support group intervention in women after primary breast cancer treatment. MATERIALS AND METHODS Three hundred and eighty two women with primary breast cancer were randomized to support group intervention or control group, 181 in each group. Women in the intervention group participated in 1 week of intervention followed by 4 days of follow-up 2 months later. This is a long-term follow-up undertaken, in average, 6.5 years after randomization. Patients answered the questionnaires the European Organisation for Research and Treatment of Cancer, quality of life questionnaire (EORTC QLQ-C30) and the breast cancer module questionnaire (BR 23), the hospital anxiety and depression scale (HAD) and the Norwegian version of the fatigue scale (FQ). RESULTS After adjusting for treatment with chemotherapy, age, marriage, education and children at home, there was a significant improvement in physical, mental and total fatigue (FQ), cognitive function, body image and future perspective (EORTC QLQ C30 and BR23) in the intervention group compared with controls. The proportion of women affected by high anxiety and depression scores were not significantly different between the groups. CONCLUSION Support intervention significantly improved cognitive function, body image, future perspective and fatigue, compared with to the findings in the control group.
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Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R. Effects of Psycho-Oncologic Interventions on Emotional Distress and Quality of Life in Adult Patients With Cancer: Systematic Review and Meta-Analysis. J Clin Oncol 2013; 31:782-93. [PMID: 23319686 DOI: 10.1200/jco.2011.40.8922] [Citation(s) in RCA: 496] [Impact Index Per Article: 45.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose This study aimed to evaluate the effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer. Methods Literature databases were searched to identify randomized controlled trials that compared a psycho-oncologic intervention delivered face-to face with a control condition. The main outcome measures were emotional distress, anxiety, depression, and quality of life. Outcomes were evaluated for three time periods: post-treatment, ≤ 6 months, and more than 6 months. We applied standard meta-analytic techniques to analyze both published and unpublished data from the retrieved studies. Sensitivity analyses and meta-regression were used to explore reasons for heterogeneity. Results We retrieved 198 studies (covering 22,238 patients) that report 218 treatment-control comparisons. Significant small-to-medium effects were observed for individual and group psychotherapy and psychoeducation. These effects were sustained, in part, in the medium term (≤ 6 months) and long term (> 6 months). Short-term effects were evident for relaxation training. Studies that preselected participants according to increased distress produced large effects at post-treatment. A moderator effect was found for the moderator variable “duration of the intervention,” with longer interventions producing more sustained effects. Indicators of study quality were often not reported. Small-sample bias indicative of possible publication bias was found for some effects, particularly with individual psychotherapy and relaxation training. Conclusion Various types of psycho-oncologic interventions are associated with significant, small-to-medium effects on emotional distress and quality of life. These results should be interpreted with caution, however, because of the low quality of reporting in many of the trials.
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Affiliation(s)
- Hermann Faller
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Michael Schuler
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Matthias Richard
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Ulrike Heckl
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Joachim Weis
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Roland Küffner
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
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Manne SL, Kashy DA, Rubin S, Hernandez E, Bergman C. Therapist and patient perceptions of alliance and progress in psychological therapy for women diagnosed with gynecological cancers. J Consult Clin Psychol 2012; 80:800-810. [PMID: 22746145 PMCID: PMC3763826 DOI: 10.1037/a0029158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The goal was to understand both therapist and patient perspectives on alliance and session progress for women in treatment for gynecological cancer. We used a longitudinal version of the one-with-many design to partition variation in alliance and progress ratings into therapist, patient/dyad, and time-specific components. We also evaluated therapist and patient characteristics that predict alliance and session progress. METHOD Two hundred and three women and their therapists completed measures of alliance and session progress across a 6-session course of treatment. Participants also completed preintervention measures of self-esteem, depression, cancer-specific distress, emotional expressivity, and use of protective buffering. RESULTS Patients reported higher alliance and greater progress than did therapists. When therapists reported particularly strong alliance with particular patients, those patients concurred. More experienced therapists reported higher alliances and more progress but their patients did not agree. Patients who began treatment in more difficult psychosocial circumstances tended to have less positive session outcomes on average but evidenced more improvement across therapy sessions. CONCLUSIONS Patients rated their alliance and progress more positively than did their therapists, although there was substantial relative agreement between therapists and patients. Alliance and progress improved over time, particularly among patients who evidenced higher levels of distress and poorer physical functioning. More experienced therapists were more confident in their abilities but their patients did not share this perception.
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Affiliation(s)
- Sharon L Manne
- Cancer Prevention and Control Program, Cancer Institute of New Jersey
| | | | - Stephen Rubin
- Division of Gynecological Oncology, Hospital of the University of Pennsylvania
| | - Enrique Hernandez
- Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine
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Salonen P, Tarkka MT, Kellokumpu-Lehtinen PL, Koivisto AM, Aalto P, Kaunonen M. Effect of social support on changes in quality of life in early breast cancer patients: a longitudinal study. Scand J Caring Sci 2012; 27:396-405. [DOI: 10.1111/j.1471-6712.2012.01050.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Heron-Speirs HA, Harvey ST, Baken DM. Moderators of psycho‐oncology therapy effectiveness: Addressing design variable confounds in meta‐analysis. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1468-2850.2012.01274.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hilgart JS, Coles B, Iredale R. Cancer genetic risk assessment for individuals at risk of familial breast cancer. Cochrane Database Syst Rev 2012; 2012:CD003721. [PMID: 22336791 PMCID: PMC7154385 DOI: 10.1002/14651858.cd003721.pub3] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The recognition of an inherited component to breast cancer has led to an increase in demand for information, reassurance, and genetic testing, which has resulted in the creation of genetic clinics for familial cancer. The first step for patients referred to a cancer genetic clinic is a risk assessment. OBJECTIVES To evaluate the impact of cancer genetic risk-assessment services on patients at risk of familial breast cancer. SEARCH METHODS The specialised register maintained by the Cochrane Breast Cancer Group was searched on 16th February 2005. We also searched MEDLINE, EMBASE, CINAHL, PsycLIT, CENTRAL, DARE, ASSIA, Web of Science, SIGLE and LILACS. The original searches covered the period 1985 to February 2005. We also handsearched relevant journals. For this review update the search was repeated through to April 2011. SELECTION CRITERIA We considered trials looking at interventions for cancer genetic risk-assessment services for familial breast cancer for inclusion. Trials assessed outcomes such as understanding of risk, satisfaction and psychological well-being. We excluded studies if they concerned cancers other than breast cancer or if participants were not at risk of inherited breast cancer. We also excluded trials concerning the provision of general cancer genetic information or education as this review was concerned with the delivery of genetic risk assessment. Participants could be individuals of any age or gender, with or without a known BRCA mutation, but without a previous history of breast cancer or any other serious illness. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data. Additional information was sought from investigators as necessary. Due to the heterogeneity of both the interventions and outcomes, we reported data descriptively. MAIN RESULTS In this review update, we included five new trials, bringing the total number of included studies to eight. The included trials (pertaining to 10 papers), provided data on 1973 participants and assessed the impact of cancer genetic risk assessment on outcomes including perceived risk of inherited cancer, and psychological distress. This review suggests that cancer genetic risk-assessment services help to reduce distress, improve the accuracy of the perceived risk of breast cancer, and increase knowledge about breast cancer and genetics. The health professional delivering the risk assessment does not appear to have a significant impact on these outcomes. AUTHORS' CONCLUSIONS This review found favourable outcomes for patients after risk assessment for familial breast cancer. However, there were too few papers to make any significant conclusions about how best to deliver cancer genetic risk-assessment services. Further research is needed assessing the best means of delivering cancer risk assessment, by different health professionals, in different ways and in alternative locations.
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Affiliation(s)
- Jennifer S Hilgart
- Institute of Medical Genetics, Cardiff University, Heath Park, Cardiff, Wales, UK, CF14 4XN
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Pinto AC, de Azambuja E. Improving quality of life after breast cancer: Dealing with symptoms. Maturitas 2011; 70:343-8. [DOI: 10.1016/j.maturitas.2011.09.008] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 09/22/2011] [Indexed: 11/16/2022]
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Simoni JM, Franks JC, Lehavot K, Yard SS. Peer interventions to promote health: conceptual considerations. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2011; 81:351-9. [PMID: 21729015 PMCID: PMC3607369 DOI: 10.1111/j.1939-0025.2011.01103.x] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Peers have intervened to promote health since ancient times, yet few attempts have been made to describe theoretically their role and their interventions. After a brief overview of the history and variety of peer-based health interventions, a 4-part definition of peer interveners is presented here with a consideration of the dimensions of their involvement in health promotion. Then, a 2-step process is proposed as a means of conceptualizing peer interventions to promote health. Step 1 involves establishing a theoretical framework for the intervention's main focus (i.e., education, social support, social norms, self-efficacy, and patient advocacy), and Step 2 involves identifying a theory that justifies the use of peers and might explain their impact. As examples, the following might be referred to: theoretical perspectives from the mutual support group and self-help literature, social cognitive and social learning theories, the social support literature, social comparison theory, social network approaches, and empowerment models.
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Affiliation(s)
- Jane M Simoni
- University of Washington, Seattle, WA 98195-1525 USA
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Schreiber JA. Image of God: Effect on Coping and Psychospiritual Outcomes in Early Breast Cancer Survivors. Oncol Nurs Forum 2011; 38:293-301. [DOI: 10.1188/11.onf.293-301] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Boesen EH, Karlsen R, Christensen J, Paaschburg B, Nielsen D, Bloch IS, Christiansen B, Jacobsen K, Johansen C. Psychosocial group intervention for patients with primary breast cancer: a randomised trial. Eur J Cancer 2011; 47:1363-72. [PMID: 21458989 DOI: 10.1016/j.ejca.2011.01.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Revised: 01/12/2011] [Accepted: 01/19/2011] [Indexed: 11/25/2022]
Abstract
PURPOSE To test the effectiveness of a psycho-educational group intervention to improve psychological distress measured by POMS TMD, Quality of Life measured by European Organisation for Research and Treatment of Cancer (EORTC), the core and breast cancer module, Mental Adjustment measured by MAC and marital relationship measured by BLRI in women with primary breast cancer conducted 10 weeks after surgery. A secondary outcome was 4-year survival. PATIENTS AND METHODS We randomly assigned 210 patients with primary breast cancer to a control or an intervention group. Patients in the intervention group were offered two weekly 6-h sessions of psycho-education and eight weekly 2-h sessions of group psychotherapy. All participants were followed up for Quality of Life, coping ability and social relations 1, 6 and 12 months after the intervention and on survival 4 years after surgical treatment. RESULTS No statistically significant effects of the intervention were found on any of the psychosocial questionnaire outcomes. There were not enough cases of death to analyse overall survival. The only statistically significant result was for patients who used anti depressive medication, for whom almost all measures improved over time, in both the control and intervention groups. CONCLUSION Psycho-education and group psychotherapy did not decrease psychological distress or increase Quality of Life, Mental Adjustment or improve marital relationship among patients with primary breast cancer.
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Affiliation(s)
- Ellen H Boesen
- Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
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Rottmann N, Dalton SO, Bidstrup PE, Würtzen H, Høybye MT, Ross L, Christensen J, Frederiksen K, Hansen DG, Johansen C. No improvement in distress and quality of life following psychosocial cancer rehabilitation. A randomised trial. Psychooncology 2011; 21:505-14. [DOI: 10.1002/pon.1924] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 12/03/2010] [Accepted: 12/27/2010] [Indexed: 12/24/2022]
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Chan CWH, Richardson A, Richardson J. Managing symptoms in patients with advanced lung cancer during radiotherapy: results of a psychoeducational randomized controlled trial. J Pain Symptom Manage 2011; 41:347-57. [PMID: 21131165 DOI: 10.1016/j.jpainsymman.2010.04.024] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Revised: 04/29/2010] [Accepted: 05/05/2010] [Indexed: 01/28/2023]
Abstract
CONTEXT Breathlessness, fatigue, and anxiety are distressing symptoms for patients with advanced lung cancer. Usually managed as isolated symptoms, they often can occur simultaneously. Previous research often has addressed management of discrete symptoms rather than considering them as a cluster, which, in reality, is the situation faced by patients. OBJECTIVES This study aimed to examine the effectiveness of a psychoeducational intervention (PEI) on the symptom cluster of anxiety, breathlessness, and fatigue, compared with usual care. METHODS A pretest/post-test, two-group, randomized, controlled trial was conducted. Education on symptom management and coaching in the use of progressive muscle relaxation were delivered to patients one week prior to commencing radiotherapy (RT), and repeated three weeks after beginning RT. Symptom data were collected at four time points: prior to the intervention, three weeks, six weeks, and 12 weeks postintervention. RESULTS One hundred forty lung cancer patients receiving palliative RT were recruited from a publicly funded hospital in Hong Kong. Doubly multivariate analysis of variance revealed a significant difference (time×group interaction effect, P=0.003) over time between the PEI and usual care control group on the pattern of change of the symptom cluster. Significant effects on the patterns of changes in breathlessness (P=0.002), fatigue (P=0.011), anxiety (P=0.001), and functional ability (P=0.000) also were found. CONCLUSION PEI is a promising treatment for relieving the symptom cluster and each of the individually assessed symptoms. More effort needs to be directed at studying impact of interventions on common symptom clusters.
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Affiliation(s)
- Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, SAR.
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Lemieux J, Goodwin PJ, Bordeleau LJ, Lauzier S, Théberge V. Quality-of-life measurement in randomized clinical trials in breast cancer: an updated systematic review (2001-2009). J Natl Cancer Inst 2011; 103:178-231. [PMID: 21217081 DOI: 10.1093/jnci/djq508] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Quality-of-life (QOL) measurement is often incorporated into randomized clinical trials in breast cancer. The objectives of this systematic review were to assess the incremental effect of QOL measurement in addition to traditional endpoints (such as disease-free survival or toxic effects) on clinical decision making and to describe the extent of QOL reporting in randomized clinical trials of breast cancer. METHODS We conducted a search of MEDLINE for English-language articles published between May-June 2001 and October 2009 that reported: 1) a randomized clinical trial of breast cancer treatment (excluding prevention trials), including surgery, chemotherapy, hormone therapy, symptom control, follow-up, and psychosocial intervention; 2) the use of a patient self-report measure that examined general QOL, cancer-specific or breast cancer-specific QOL or psychosocial variables; and 3) documentation of QOL outcomes. All selected trials were evaluated by two reviewers, and data were extracted using a standardized form for each variable. Data are presented in descriptive table formats. RESULTS A total of 190 randomized clinical trials were included in this review. The two most commonly used questionnaires were the European Organization for Research and Treatment of Cancer QOL Questionnaire and the Functional Assessment of Cancer Therapy/Functional Assessment of Chronic Illness Therapy. More than 80% of the included trials reported the name(s) of the instrument(s), trial and QOL sample sizes, the timing of QOL assessment, and the statistical method. Statistical power for QOL was reported in 19.4% of the biomedical intervention trials and in 29.9% of the nonbiomedical intervention trials. The percentage of trials in which QOL findings influenced clinical decision making increased from 15.2% in the previous review to 30.1% in this updated review for trials of biomedical interventions but decreased from 95.0% to 63.2% for trials of nonbiomedical interventions. Discordance between reviewers ranged from 1.1% for description of the statistical method (yes vs no) to 19.9% for the sample size for QOL. CONCLUSION Reporting of QOL methodology could be improved.
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Affiliation(s)
- Julie Lemieux
- Santé des populations: Unité de recherche en santé des populations (URESP), Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec (CHA), Service d'hémato-oncologie du CHA and Centre des Maladies du Sein Deschênes-Fabia du CHA, Quebec City, QC, Canada.
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Manne SL, Kissane DW, Nelson CJ, Mulhall JP, Winkel G, Zaider T. Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: a pilot study. J Sex Med 2011; 8:1197-209. [PMID: 21210958 DOI: 10.1111/j.1743-6109.2010.02163.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Few couple-focused interventions have been developed to improve distress and relationship outcomes among men diagnosed with localized prostate cancer and their partners. AIMS We examined the effects of a five-session Intimacy-Enhancing Therapy (IET) vs. Usual Care (UC) on the psychological and relationship functioning of men diagnosed with localized prostate cancer and their partners. Pre-intervention levels of psychological and relationship functioning were evaluated as moderators of intervention effects. METHODS Seventy-one survivors and their partners completed a baseline survey and were subsequently randomly assigned to receive five sessions of IET or UC (no treatment). Eight weeks after the baseline assessment, a follow-up survey was administered to survivor and partner. MAIN OUTCOME MEASURES Distress, well-being, relationship satisfaction, relationship intimacy, and communication were investigated as the main outcomes. RESULTS IET effects were largely moderated by pre-intervention psychosocial and relationship factors. Those survivors who had higher levels of cancer concerns at pretreatment had significantly reduced concerns following IET. Similar moderating effects for pre-intervention levels were reported for the effects of IET on self-disclosure, perceived partner disclosure, and perceived partner responsiveness. Among partners beginning the intervention with higher cancer-specific distress, lower marital satisfaction, lower intimacy, and poorer communication, IET improved these outcomes. CONCLUSIONS IET had a marginally significant main effect upon survivor well-being but was effective among couples with fewer personal and relationship resources. Subsequent research is needed to replicate these findings with a larger sample and a longer follow-up.
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Affiliation(s)
- Sharon L Manne
- University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School-The Cancer Institute of New Jersey Section of Population Studies, New Brunswick, NJ, USA.
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Walker LM, Bischoff TF, Robinson JW. Supportive expressive group therapy for women with advanced ovarian cancer. Int J Group Psychother 2010; 60:407-27. [PMID: 20590436 DOI: 10.1521/ijgp.2010.60.3.407] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Supportive Expressive Group Therapy (SEGT) has been shown to enhance the well-being of women with breast cancer. However, its applicability for other cancer populations has yet to be determined. Critics assert that cancer support groups may be harmful, especially for patients with advanced disease. Two qualitative studies were conducted to assess the application of SEGT to women with advanced ovarian cancer. In Study 1, a qualitative analysis was conducted on participant interviews designed to evaluate SEGT in ovarian cancer populations by exploring both positive and negative experiences associated with SEGT. In Study 2, interviews with SEGT participants and their health care professionals were conducted and analyzed using a grounded theory analysis. Interviews explored how SEGT affected patients' relationships with medical professionals. Results of Study 1 suggested that SEGT could be challenging to the participants in that it involved both the discussion of distressing emotions and the witnessing of group members' suffering and death. However, though painful, the women generally perceived these emotions as part of the process of coming to terms with their cancer, and thus found SEGT helpful. Results of Study 2 revealed that, if initially misdiagnosed, women typically experienced feelings of anger and a loss of trust in health care professionals. SEGT was helpful in resolving anger and restoring trust by facilitating communication and increasing understanding. Oncology professionals perceived SEGT as enhancing patients' ability to cope with cancer. Women with advanced ovarian cancer felt that the benefits of SEGT far outweighed the associated distress and potential for harm. The reported substantial positive outcomes countered criticisms that SEGT may have negative iatrogenic effects.
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