Locally advanced breast cancer (LABC) and delayed care: a qualitative analysis of psychosocial factors

Beauty Therapy to Support Psychosocial Recovery from Oncological Care: A Qualitative Research on the Lived Experience of Women with Breast Cancer Treated with Chemotherapy

During the oncological care path, breast cancer patients treated with chemotherapy suffer from a number of psycho-physical changes, and appearance-related side effects are among the primary determinants of psychosocial impairment. Appropriate interventions are needed due to the fact that treatment-induced transformations have been associated with a decline in overall quality of life, interpersonal and sexual difficulties, and adverse effects on therapeutic adherence. In the framework of integrative oncology, beauty therapy is an affordable and straightforward intervention that could be used in the clinical management of breast cancer side effects. This study aims to comprehend the emotional and lived experiences of women undergoing chemotherapy after a brief beauty therapy intervention with licensed beauticians. The Interpretative Phenomenological Analysis was used as a methodological guideline. Sixteen women were purposefully recruited in a day hospital of a cancer unit, where the beauty therapy was implemented. At the end of the intervention, data were gathered using a semi-structured interview with open-ended questions. A thematic analysis was performed on verbatim transcriptions. Findings support the proposal of beauty therapy for patients undergoing chemotherapy. Assuming a relational viewpoint, beauty therapy could improve patients' feelings about themselves and the way they feel about others, even if they do not declare a specific interest in their outward appearance.

Exploring the connection between childhood trauma, dissociation, and borderline personality disorder in forensic psychiatry: a comprehensive case study

This case study examines the complex relationship between childhood trauma, dissociation, and Borderline Personality Disorder (BPD) within the context of forensic psychiatry. It focuses on a young murder defendant named "Paul," who has experienced various traumatic events, including childhood maltreatment and domestic violence. These experiences have led to dissociative states marked by high emotional intensity, particularly of an aggressive nature, and impaired impulse control, resulting in violent behavior during dissociative episodes. The study employs advanced assessment tools like Raven's Standard Progressive Matrices (SPM), the Millon Clinical Multiaxial Inventory-III (MCMI-III), and the Level of Service/Case Management Inventory (LS/CMI) to gain a comprehensive understanding of Paul's psychopathological condition, risk factors, and rehabilitation needs. The LS/CMI assessment highlights a high risk of recidivism, mainly influenced by family relationships, educational challenges, interpersonal connections, and aggressive tendencies. To address the multifaceted needs of individuals like Paul, the study emphasizes the importance of using transdiagnostic models for trauma and dissociation. This approach informs tailored treatment programs that include processing past traumatic experiences, improving self-identity, nurturing healthy relational patterns, and enhancing emotional regulation. Although this study is based on a single case, it serves as a model for integrating assessment tools and theoretical-clinical models in the field of forensic psychiatry. Understanding the intricate dynamics of childhood trauma, dissociation, and BPD is crucial for making informed decisions, conducting risk assessments, and developing rehabilitation programs within the justice system. Future research should expand the scope of cases and further validate assessment tools to advance our understanding of this complex relationship.

Psychosocial markers of pre-hospital delay in patients with diabetic foot: A cross-sectional survey

AIM

This study aimed to determine the psychosocial markers associated with pre-hospital delay among patients with diabetic foot (DF).

DESIGN

This study has a cross-sectional design.

METHODS

The participants completed a questionnaire including pre-hospital time, demographic characteristics, Social Support Rate Scale, Brief Illness Perception Questionnaire and Type D Personality Scale-14. Bivariate and multivariate analyses were conducted to explore independent associations with pre-hospital delay.

RESULTS

Only 1.8% (3/164) of participants arrived at the hospital for medical care in 24 h of symptom onset. Patients with low utilization of social support (p = 0.029), low negative illness perceptions (p = 0.014) and high levels of negative affectivity (p = 0.009) are likely to arrive late at the clinic. Medical staff should pay attention to identifying diabetic patients' Type D personalities and take actions to improve their social support as well as illness perception, so as to reduce the occurrence of hospital delay.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Psychosocial factors play a vital role in the delay in seeking medical treatment for patients with DF. Medical staff need to improve patients' illness perception as well as self-management ability through health education. Importantly, key family members provide an emotional and psychological support system for diabetic patients. Therefore, nurses need to work with family members together to give information and psychological support during family visits. Additionally, building and maintaining trust with patients is crucial to encouraging individuals to express their concerns and worries. In this case, nurses may identify patients' negative emotions and conduct timely intervention, so as to achieve favourable outcomes.

PATIENT OR PUBLIC CONTRIBUTION

This study used a convenience sample of 164 participants with DF recruited from the wound clinic of Northern Jiangsu People's Hospital and Yangzhou Hospital of TCM in China.

Implementing the framed portrait experience with Italian breast cancer survivors: a pilot study assessing short term effects of an existential approach to body image, coping skills, and self-efficacy

PURPOSE

Breast cancer (BC) and its treatments significantly impact the psychological wellbeing of women. Interventions offered during cancer survivorship have documented positive consequences for quality of life. However, limited evidence is available regarding the implementation of therapeutic photography. This study investigated the efficacy of the framed portrait experience (FPE) when implemented to BC survivors.

METHODS

A quasi-experimental study was conducted. Participants were enrolled in a non-randomized pre-post intervention with a comparison group. Forty BC survivors were recruited using a convenience sampling approach; of these, 20 were subsequently allocated to the intervention (FPE group) and 20 to the comparison group. Participants were assessed at pretest and posttest (3 weeks later) using self-reported measures of body image, coping, self-esteem, and self-efficacy. Independent samples t-tests compared group composition at pretest. Mixed between-within 2 × 2 repeated-measures ANOVAs examined pretest-posttest changes in the variables of interest.

RESULTS

No differences were detected between groups at pretest. A significant interaction effect on body image, problem-focused coping, emotion-focused coping, and in self-efficacy competence subscale (p < 0.05) was identified. Post hoc pairwise comparisons with the Bonferroni correction indicated improvement on these domains in the FPE group vs. comparison group. Additionally, significant main effects of time on self-efficacy total score and magnitude subscale (p < 0.05) were found.

CONCLUSIONS

Preliminary results support the efficacy of FPE, but further research is needed.

IMPLICATIONS FOR CANCER SURVIVORS

Existential approaches inclusive of self-portraits and illness narratives can be utilized to support BC survivors in the management of the psychological consequences of the illness.

Evaluating Somatic Experiencing® to Heal Cancer Trauma: First Evidence with Breast Cancer Survivors

Somatic Experiencing^® is a bio-psychological method for the treatment and prevention of trauma and chronic stress, which has never been investigated with breast cancer (BC) survivors. Eight weeks of web-based synchronous group sessions were structured between April and June 2022. Potential participants were recruited using a convenience sampling approach and through the collaboration of a public hospital in northern Italy and a non-profit association of BC women. Thirty-five eligible participants were enrolled and divided into an intervention group (n = 21) and a control group (n = 14). Anxiety, depression, distress (HADS), coping strategies (Mini-MAC), trauma reworking skills (PACT), and body image (BIS) were assessed at T0 and after 8 weeks (T1). Qualitative items concerning the most significant moments and learnings were completed at T1 by the intervention group. An independent t-test confirmed no between-group psychological differences at T0. As hypothesized, paired-sample t-tests showed decreases in anxiety, depression, distress (p < 0.05), and anxious preoccupation coping strategy (p < 0.001), but also improvements in forward focus (p < 0.05) and body image (p < 0.001) in the intervention group. The controls worsened over time with increases in hopeless/helplessness (p < 0.001) and avoidance (p < 0.05) coping strategies. Textual analyses extracted five dominant themes that summarized the meaning of the experience for participants. The preliminary results suggest the effectiveness of the intervention.

Symptom Experiences before Medical Help-Seeking and Psychosocial Responses of Patients with Esophageal Cancer: A Qualitative Study

Objective. The purpose of this study was to investigate patients with esophageal cancer symptom experiences before seeking medical help and psychosocial responses. Methods. Within one month of diagnosis, semistructured interviews were held with 14 adult patients with esophageal cancer. To fully comprehend the symptom experiences that patients with esophageal cancer had prior to seeking medical help and the psychosocial responses they had to these experiences, thematic analysis and interpretative phenomenological analysis were used. Results. Patients with esophageal cancer recounted their symptom experiences, and psychosocial responses were categorized into three main themes: physical, psychological, and social. Three subthemes were included in the physiological aspect: early symptoms (warning signs), specific symptoms (the catalyst for seeking medical help), and concurrent symptoms (masked side effects). Four subthemes were associated with psychological aspects: unfairness, regret, worry, and acceptance. Two subthemes were related to the social element, namely, dragging down one’s family and societal self-isolation. Conclusion. Due to the self-remitting nature of early symptoms, the normalization of their interpretation, and concealment by other illnesses, patients with esophageal cancer may delay medical help-seeking. The findings could serve as a reference for healthcare professionals to implement tailored psychosocial interventions and help patients identify symptoms early in order to seek medical help.