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Yeh YC, Kuo SF, Lu CH. The relationships between stress, coping strategies, and quality of life among gynecologic cancer survivors. Nurs Health Sci 2023; 25:636-645. [PMID: 37852298 DOI: 10.1111/nhs.13056] [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] [Received: 06/11/2023] [Revised: 09/05/2023] [Accepted: 09/22/2023] [Indexed: 10/20/2023]
Abstract
Many studies have reported that gynecologic cancer diagnosis, surgery, adjuvant therapy, and survivorship can be extremely stressful for many people during their cancer journey, and most cancer survivors have experienced stress after cancer, which impacts their quality of life. Importantly, healthy stress management will assist patients in overcoming obstacles in their lives and enhance both the quality of life and the cancer adjustment process. This study aimed to investigate the relationships between stress, coping strategies, and quality of life among gynecologic cancer survivors and to assess the mediating effects of coping on the relationship between quality of life and stress. A series of regression models and Sobel test were conducted to investigate whether coping strategies mediated the relationship between stress and quality of life. Stress was a predictor of quality of life. Acceptance was the mediator between stress and quality of life. Tailored programs that foster coping strategies, such as the strategy of acceptance, to reduce stress and maintain quality of life in this vulnerable group need to be developed.
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Affiliation(s)
- Yueh-Chen Yeh
- Department of Nursing, College of Health, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Shu-Fen Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chien-Hsing Lu
- Department of Gynecology and Obstetrics, Taichung Veterans General Hospital, Taichung, Taiwan
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Ganguly A, Bengtsen E. Pancreatic cancer, depression, and spirituality in therapy: "Unio Mystica" and "Achrayut," 2 case reports. Palliat Support Care 2023; 21:953-956. [PMID: 37334481 DOI: 10.1017/s1478951523000767] [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: 06/20/2023]
Abstract
OBJECTIVES Pancreatic cancer is a major site of gastrointestinal tumors and remains a leading cause of cancer death in adults in the United States. There is also a strong association between pancreatic cancer and depression. When struggling with cancer, along the different phases of illness, a human being is confronted with manifold issues, which might profoundly interfere with their sense of meaning and purpose. METHODS From this standpoint, several different therapeutic techniques have been designed to manage the psychological needs of the patients. Here we provide 2 clinical scenarios, where there was a strong religious correlation to the therapeutic techniques employed with patients suffering from pancreatic cancer. RESULTS The 2 cases described showed some improvement in their overall life view and could recalibrate their expectations based on a strong religious foundation. SIGNIFICANCE OF RESULTS The role of religion and spirituality in health has also received increasing attention in literature. Religion and spirituality can help patients with cancer find meaning in their illness, provide comfort in the face of existential fears, and receive support from a community of like-minded individuals. In effect, they also provide evidence toward the scope of and integrating the domain of spirituality into holistic cancer care.
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Affiliation(s)
- Amvrine Ganguly
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erik Bengtsen
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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Martino ML, Lemmo D, Testoni I, Iacona E, Pizzolato L, Freda MF, Neimeyer RA. Anticipatory Mourning and Narrative Meaning-Making in the Younger Breast Cancer Experience: An Application of the Meaning of Loss Codebook. Behav Sci (Basel) 2022; 12:bs12040093. [PMID: 35447665 PMCID: PMC9025731 DOI: 10.3390/bs12040093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 11/30/2022] Open
Abstract
Breast cancer (BC) in women under 50 is a potentially traumatic experience that can upset a woman’s life during a crucial phase of her lifespan. Anticipatory mourning linked to the diagnosis of BC can produce a series of inevitable losses similar to those of the bereaved. Narration can be one tool to construct meaning, to grow through the experience, and reconfigure time perspectives during and after the illness. The aim of this study was to apply the Meaning of Loss Codebook (MLC) to the narrative context of young women with BC. An ad hoc narrative interview was administered to 17 women at four times during the first year of treatment. A thematic analysis was performed using the MLC, adopting a bottom-up and top-down methodology. The results highlight the MLC’s usefulness in capturing the experiences of the women, allowing for a greater appreciation of the nuances of the meanings embodied in their narratives. The thematic categories grounded in the MLC cover the whole experience of BC during the first year of treatment, attesting to the possibility of extending the use of the MLC to observe the longitudinal elaboration of the psychic experience of BC in addition to its established validity in the context of bereavement and loss.
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Affiliation(s)
- Maria Luisa Martino
- Department of Humanities, Federico II University, 80133 Naples, Italy; (D.L.); (M.F.F.)
- Correspondence: ; Tel.: +39-0812535517
| | - Daniela Lemmo
- Department of Humanities, Federico II University, 80133 Naples, Italy; (D.L.); (M.F.F.)
| | - Ines Testoni
- FISPPA Department, University of Padua, 35131 Padova, Italy; (I.T.); (E.I.); (L.P.)
- Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
| | - Erika Iacona
- FISPPA Department, University of Padua, 35131 Padova, Italy; (I.T.); (E.I.); (L.P.)
| | - Laura Pizzolato
- FISPPA Department, University of Padua, 35131 Padova, Italy; (I.T.); (E.I.); (L.P.)
| | - Maria Francesca Freda
- Department of Humanities, Federico II University, 80133 Naples, Italy; (D.L.); (M.F.F.)
| | - Robert A. Neimeyer
- Department of Psychology, University of Memphis, Memphis, TN 38152, USA;
- Portland Institute for Loss and Transition, Portland, OR 97219, USA
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Zeng X, Sui M, Liu R, Qian X, Li W, Zheng E, Yang J, Li J, Huang W, Yang H, Yu H, Luo N. Assessment of the health utility of patients with leukemia in China. Health Qual Life Outcomes 2021; 19:65. [PMID: 33639980 PMCID: PMC7913428 DOI: 10.1186/s12955-021-01711-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 02/18/2021] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES This study aimed to assess the health utility of leukemia patients in China using the EQ-5D-5L, compare it with the population norms, and identify the potential factors associated with health utility. METHODS A hospital based cross-sectional survey was conducted in three tertiary hospitals from July 2015 to February 2016. A total of 186 patients with leukemia completed the EQ-5D-5L and their health utility scores were calculated using the Chinese value set. EQ-5D-5L utility and dimensions scores of leukemia patients were compared with China's population norms using Kruskal-Wallis test and chi square test. Potential factors associated with health utility were identified using Tobit regression. RESULTS The mean EQ-5D-5L utility scores of patients with leukemia, grouped by either gender or age, were significantly lower than those of the general population (p < 0.001). The same results were found for individual dimensions of EQ-5D-5L, where leukemia patients reported more health problems than the general population (p < 0.001). The utility score of leukemia patients was found to be significantly related to medical insurance, religious belief, comorbidities, social support and ECOG performance status. CONCLUSION This study indicated that leukemia patients have worse health status compared to the general population of China and that multiple factors affect the health utility of the patients. The utility scores reported in this study could be useful in future cost-utility analysis.
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Affiliation(s)
- Xueyun Zeng
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Mingjie Sui
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Rui Liu
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Xinyu Qian
- National University Singapore Saw Swee Hock School of Public Health, Singapore, 117549, Singapore
| | - Wenfeng Li
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Erwei Zheng
- First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Jinjin Yang
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Jinmei Li
- Public Health Education and Information Center of Heilongjiang Province, Harbin, 150063, China
| | - Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, 150086, China.
| | - Hongbin Yang
- Department of Medical Oncology, Third Affiliated Hospital of Harbin Medical University, Harbin, 150081, China.
| | - Hongjuan Yu
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China. .,Southern University of Science and Technology Hospital, Shenzhen, 518055, China.
| | - Nan Luo
- National University Singapore Saw Swee Hock School of Public Health, Singapore, 117549, Singapore
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Schmidt C, Eickmeyer J, Henningsen M, Weber A, Pleimann A, Koehler S. Medical students' personal experiences, religion, and spirituality explain their (dis)comfort with a patient's religious needs. CANADIAN MEDICAL EDUCATION JOURNAL 2020; 11:e29-e38. [PMID: 32821300 PMCID: PMC7417830 DOI: 10.36834/cmej.69217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Physicians often avoid discussing patients' religious and spiritual concerns, even though most patients (i.e., 50-94%) want integrated care. To address this gap, medical students interviewed a Standardized Patient (SP) who was upset because the daughter did not confront her fiancée about converting to Orthodox Judaism. Students reflected on how their own religion and spirituality affected engaging with their patient. METHODS With a 97% response rate, 231 first-year medical students responded to open-ended questions about their patient encounter. For this quantitative content analysis, we used inductive reasoning, identifying three themes: (1) impact of students' own religion on their comfort, (2) change in comfort, and (3) their learning. We used deductive reasoning to compare qualitative results from half of the students who began the curriculum with a questionnaire about their own spirituality with the other students completing afterwards. RESULTS Most students said being religious positively influenced their comfort, whether they were also Orthodox Jewish or from a different religion. Among uncomfortable students (6.5%), some attributed this to not being religious. Some students (4.8%) grew more comfortable discussing the religious issue, and 18.2% became uncomfortable due to lacking knowledge of Orthodox Judaism and the awkwardness of the topic. Students who had completed the questionnaire beforehand gave more comments about connecting with their patients than students who completed the questionnaire afterwards (X2=11.047, p<.001). CONCLUSIONS Students' own religion influenced their comfort with discussing religious concerns, with some feeling more connected and others becoming uncomfortable. This finding helps inform medical educators about teaching mind-body-spirit care.Résumé.
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Affiliation(s)
- Cindy Schmidt
- Kansas City University of Medicine and Biosciences, Missouri, USA
| | - Joseph Eickmeyer
- Kansas City University of Medicine and Biosciences, Missouri, USA
- St. Luke’s Des Peres Hospital, Missouri, USA
| | | | - Alex Weber
- St. Luke’s Tri-County Family Medicine, Missouri, USA
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Park CL, Waddington E, Abraham R. Different dimensions of religiousness/spirituality are associated with health behaviors in breast cancer survivors. Psychooncology 2018; 27:2466-2472. [PMID: 30092113 DOI: 10.1002/pon.4852] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/19/2018] [Accepted: 07/30/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Religiousness/spirituality (R/S) may influence cancer survivors' health through multiple pathways. We aimed to examine one potentially key pathway that has seldom been examined: relationships between survivors' R/S and their health behaviors. METHODS The present study investigated links between four core dimensions of R/S (beliefs, behaviors, identity, and coping) and three health behaviors (fruit/vegetable consumption, physical activity, and maintenance of a healthy weight) in 172 breast cancer survivors. RESULTS Both spiritual identity and use of religious coping were positively related to fruit and vegetable intake, while private prayer was marginally positively related. Both service attendance and religious identity (marginally) were related to engaging in less physical activity, while private prayer was positively related. Afterlife beliefs and private prayer were positively associated with BMI. CONCLUSIONS R/S has complex but meaningful associations with health behaviors in breast cancer survivors. More research is needed to understand these relationships and to determine whether different dimensions of R/S may play useful roles in lifestyle change interventions.
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Sexual quality of life evaluation after treatment among women with breast cancer under 35 years old. Support Care Cancer 2018; 27:879-885. [DOI: 10.1007/s00520-018-4374-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/24/2018] [Indexed: 11/27/2022]
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Abstract
BACKGROUND Colon and/or rectum cancer (CRC) patients use various strategies to cope with their condition, and these can vary between age groups. OBJECTIVES The aims of this study were to investigate differences between psychosocial/spiritual variables and coping strategies in CRC patients of different age groups (younger vs older) and to identify the predictors of coping for both age groups. METHODS A cross-sectional descriptive study was conducted at 3 outpatient clinics in Korea. The Hospital Anxiety and Depression Scale, Social Support Scale, and Self-Transcendence Scale were used to measure psychosocial and spiritual variables; the Mini-Mental Adjustment to Cancer Scale was used to assess cancer-specific coping strategies. RESULTS Both younger and older patients who were psychologically distressed used more maladaptive coping. Individuals who received less social support from healthcare providers used more maladaptive coping strategies. For younger patients, self-transcendence was the only significant predictor of both adaptive and maladaptive coping strategies; for older patients, Hospital Anxiety and Depression Scale score was the only significant predictor of maladaptive coping. CONCLUSION Differences in psychological distress, social support, and self-transcendence due to age are important protective or risk factors for the use of coping strategies among CRC patients. IMPLICATIONS FOR PRACTICE Considering our findings, we encourage healthcare professionals to be aware of patients' coping strategies and take them into account when planning age-specific interventions related to coping, before hospital discharge.
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Lai C, Luciani M, Di Mario C, Galli F, Morelli E, Ginobbi P, Aceto P, Lombardo L. Psychological impairments burden and spirituality in caregivers of terminally ill cancer patients. Eur J Cancer Care (Engl) 2018; 27:e12674. [DOI: 10.1111/ecc.12674] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- C. Lai
- Dynamic and Clinical Psychology; Sapienza University of Rome; Rome Italy
| | - M. Luciani
- Psychiatry and Psychology Institute; Catholic University of Sacred Heart; Rome Italy
| | - C. Di Mario
- Dynamic and Clinical Psychology; Sapienza University of Rome; Rome Italy
| | - F. Galli
- Dynamic and Clinical Psychology; Sapienza University of Rome; Rome Italy
| | - E. Morelli
- U.O. di Cure Palliative, Fondazione Sanità e Ricerca; Rome Italy
| | - P. Ginobbi
- U.O. di Cure Palliative, Fondazione Sanità e Ricerca; Rome Italy
| | - P. Aceto
- Department of Anaesthesiology and Intensive Care; Catholic University of Sacred Heart; Rome Italy
| | - L. Lombardo
- U.O. di Cure Palliative, Fondazione Sanità e Ricerca; Rome Italy
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Abstract
Spirituality has been identified as an important dimension of quality-of-life. The objective of this study was to review the literature on quality-of-life and spirituality, their association, and assessment tools. A search was conducted of the keyterms 'quality-of-life' and 'spirituality' in abstract or title in the databases PsycINFO and PubMed/Medline between 1979-2005, complemented by a new search at PUBMED from 2006-2016. Quality-of-life is a new concept, which encompasses and transcends the concept of health, being composed of multiple domains: physical, psychological, environmental, among others. The missing measure in health has been defined as the individual's perception of their position in life in the context of culture and value system in which they live and in relation to their goals, expectations, standards, and concerns. There is consistent evidence of an association between quality-of-life and religiosity/spirituality (R/S), through studies with reasonable methodological rigour, using several variables to assess R/S (e.g. religious affiliation, religious coping, and prayer/spirituality). There are also several valid and reliable instruments to evaluate quality-of-life and spirituality. Further studies are needed, however, especially in Brazil. Such studies will provide empirical data to be used in planning health interventions based on spirituality, seeking a better quality-of-life. In the last 10 years, research is consistently growing about quality-of-life and spirituality in many countries, and also in many areas of health research.
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Affiliation(s)
- Raquel Gehrke Panzini
- a Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre-RS , Brazil
| | - Bruno Paz Mosqueiro
- a Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre-RS , Brazil
| | - Rogério R Zimpel
- a Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre-RS , Brazil
| | - Denise Ruschel Bandeira
- b Department of Psychology , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre-RS , Brazil
| | - Neusa S Rocha
- a Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre-RS , Brazil
| | - Marcelo P Fleck
- a Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre-RS , Brazil
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Jim HSL, Pustejovsky JE, Park CL, Danhauer SC, Sherman AC, Fitchett G, Merluzzi TV, Munoz AR, George L, Snyder MA, Salsman JM. Religion, spirituality, and physical health in cancer patients: A meta-analysis. Cancer 2015; 121:3760-8. [PMID: 26258868 DOI: 10.1002/cncr.29353] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 01/21/2015] [Accepted: 02/10/2015] [Indexed: 12/15/2022]
Abstract
Although religion/spirituality (R/S) is important in its own right for many cancer patients, a large body of research has examined whether R/S is also associated with better physical health outcomes. This literature has been characterized by heterogeneity in sample composition, measures of R/S, and measures of physical health. In an effort to synthesize previous findings, a meta-analysis of the relation between R/S and patient-reported physical health in cancer patients was performed. A search of PubMed, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library yielded 2073 abstracts, which were independently evaluated by pairs of raters. The meta-analysis was conducted for 497 effect sizes from 101 unique samples encompassing more than 32,000 adult cancer patients. R/S measures were categorized into affective, behavioral, cognitive, and 'other' dimensions. Physical health measures were categorized into physical well-being, functional well-being, and physical symptoms. Average estimated correlations (Fisher z scores) were calculated with generalized estimating equations with robust variance estimation. Overall R/S was associated with overall physical health (z = 0.153, P < .001); this relation was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z = 0.167, P < .001), functional well-being (z = 0.343, P < .001), and physical symptoms (z = 0.282, P < .001). Cognitive R/S was associated with physical well-being (z = 0.079, P < .05) and functional well-being (z = 0.090, P < .01). 'Other' R/S was associated with functional well-being (z = 0.100, P < .05). In conclusion, the results of the current meta-analysis suggest that greater R/S is associated with better patient-reported physical health. These results underscore the importance of attending to patients' religious and spiritual needs as part of comprehensive cancer care.
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Affiliation(s)
- Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - James E Pustejovsky
- Department of Educational Psychology, University of Texas at Austin, Austin, Texas
| | - Crystal L Park
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Suzanne C Danhauer
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Allen C Sherman
- Behavioral Medicine Division, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - George Fitchett
- Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois
| | - Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana
| | - Alexis R Munoz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Login George
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Mallory A Snyder
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - John M Salsman
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
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13
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Santos D, Vieira E. Les scripts de la sexualité chez les femmes brésiliennes vivant avec un cancer du sein. SEXOLOGIES 2014. [DOI: 10.1016/j.sexol.2013.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Santos D, Vieira E. Sexual scripts among Brazilian women living with breast cancer. SEXOLOGIES 2014. [DOI: 10.1016/j.sexol.2013.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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