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Bellizzi KM, Fritzson E, Ligus K, Park CL. Social Support Buffers the Effect of Social Deprivation on Comorbidity Burden in Adults with Cancer. Ann Behav Med 2024; 58:701-706. [PMID: 38935875 DOI: 10.1093/abm/kaae035] [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] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Adults with cancer have higher rates of comorbidity compared to those without cancer, with excess burden in people from lower socioeconomic status (SES). Social deprivation, based on geographic indices, broadens the focus of SES to include the importance of "place" and its association with health. Further, social support is a modifiable resource found to have direct and indirect effects on health in adults with cancer, with less known about its impact on comorbidity. PURPOSE We prospectively examined associations between social deprivation and comorbidity burden and the potential buffering role of social support. METHODS Our longitudinal sample of 420 adults (Mage = 59.6, SD = 11.6; 75% Non-Hispanic White) diagnosed with cancer completed measures at baseline (~6 months post-diagnosis) and four subsequent 3-month intervals for 1 year. RESULTS Adjusting for age, cancer type, and race/ethnicity, we found a statistically significant interaction between social support and the effect of social deprivation on comorbidity burden (β = -0.11, p = 0.012), such that greater social support buffered the negative effect of social deprivation on comorbidity burden. CONCLUSION Implementing routine screening for social deprivation in cancer care settings can help identify patients at risk of excess comorbidity burden. Clinician recognition of these findings could trigger a referral to social support resources for individuals high on social deprivation.
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Affiliation(s)
- Keith M Bellizzi
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT, USA
| | - Emily Fritzson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT, USA
| | - Kaleigh Ligus
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Bellizzi KM, Park CL, Lee JW, Harel O, Sanft T, Fritzson E, Salafia C, Ligus K, Gnall K, Magin ZE. Physical health and function trajectories in adults with cancer: psychosocial predictors of class membership. J Cancer Surviv 2024:10.1007/s11764-024-01540-3. [PMID: 38289507 DOI: 10.1007/s11764-024-01540-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/18/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE To prospectively examine different trajectories of recovery, across different aspects of physical health and function and to examine trajectory class membership. METHODS This prospective study enrolled 569 recently diagnosed adult cancer patients (Mage = 58.7) between 2019 and 2022 identified through the Rapid Case Ascertainment resource of The Yale Cancer Center. Patients were diagnosed with breast (63.8%), prostate (25.3%), or colorectal cancer (10.9%) within six-months of baseline assessment. Participants completed comprehensive psychosocial and health survey measures (SF-12) through REDCap at five time points. Growth mixture modeling examined unconditional distinct trajectories for four aspects of physical health and function. We fit logistic regression and multinomial logistic regression models to estimate associations between psychosocial predictors of trajectory class membership for each of the four aspects. RESULTS We identified distinct trajectories of physical health and function. Over one-third (38.4%) of the sample experienced low and declining scores in their ability to accomplish work/regular daily activities due to physical health. Over half (54.9%) demonstrate moderately stable general health with no improvement over time. A small but significant subset of the sample (3%, 5.7%, 5%) was in the moderate and declining groups with sharp decline in physical function, bodily pain, and general health, after treatment. Different predictors of trajectory class membership were also found. CONCLUSIONS Our results showed heterogeneity in physical health and function trajectories and different patterns of predictors for each aspect of physical health and function. Findings have the potential to inform screening and intervention efforts to help those who may need additional support.
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Affiliation(s)
- Keith M Bellizzi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06269, USA.
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Jung Wun Lee
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Ofer Harel
- Department of Statistics, University of Connecticut, Storrs, CT, 06269, USA
| | - Tara Sanft
- Department of Medicine (Medical Oncology), Yale School of Medicine, New Haven, CT, 06510, USA
| | - Emily Fritzson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Caroline Salafia
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Kaleigh Ligus
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Katherine Gnall
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Zachary E Magin
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
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Dubey A, Agrawal S, Agrawal V, Dubey T, Jaiswal A. Breast Cancer and the Brain: A Comprehensive Review of Neurological Complications. Cureus 2023; 15:e48941. [PMID: 38111443 PMCID: PMC10726093 DOI: 10.7759/cureus.48941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Breast cancer, one of the most prevalent malignancies globally, poses a substantial health burden with its diverse neurological complications. This comprehensive review examines the intricate landscape of breast cancer's neurological effects, encompassing brain metastases, non-metastatic complications, and their profound influence on the quality of life, prognosis, and survival of affected individuals. The mechanisms, clinical manifestations, and treatment modalities of brain metastasis and the critical role of interdisciplinary collaboration in their management are explored. Additionally, we address non-metastatic neurological complications, including paraneoplastic syndromes, treatment-related side effects, leptomeningeal carcinomatosis, and radiation-induced neurotoxicity, shedding light on the challenges they present and the importance of cognitive and emotional well-being. Prognostic factors and survival rates are discussed, emphasizing the complexity of variables impacting patient outcomes. Lastly, we underscore the vital role of collaborative care in addressing these multifaceted challenges, highlighting future research directions and the ongoing quest to enhance the quality of life for breast cancer patients.
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Affiliation(s)
- Akshat Dubey
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suyash Agrawal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Varun Agrawal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tanishq Dubey
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Arpita Jaiswal
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Elwood WN, Ferrer RA, Guida JL. Integrating behavioural, biomedical, and social processes in resilience and health research over the human lifecourse. Stress Health 2023; 39:28-32. [PMID: 37081600 DOI: 10.1002/smi.3249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Affiliation(s)
- William N Elwood
- Office of Behavioral and Social Sciences Research (OBSSR), Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute (NCI), Rockville, Maryland, USA
| | - Jennifer L Guida
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute (NCI), Rockville, Maryland, USA
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Salafia C, Bellizzi KM, Ligus K, Fritzson E, Park CL. Perceived negative consequences of cancer and psychological distress in survivors: the moderating role of social support. J Cancer Surviv 2023:10.1007/s11764-023-01444-8. [PMID: 37606815 PMCID: PMC11018111 DOI: 10.1007/s11764-023-01444-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/01/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE Many cancer survivors experience psychological distress at some point during their care. The degree to which individuals perceive negative consequences of cancer has been associated with psychological distress, including anxiety and depression. Identifying psychosocial factors that buffer the effects of illness perceptions on distress may provide a target for intervention to improve the psychological health of cancer survivors. As such, the present study aimed to examine whether social support moderates the relationship between perceived negative consequences of cancer and psychological distress. METHODS The current longitudinal study of 413 cancer survivors (64% female, 58% breast cancer, Mage = 59.68, SD = 11.41) examined social support as a potential moderator of the relationship, hypothesizing that greater overall perceived social support would buffer the relationship between perceived negative consequences of cancer and subsequent symptoms of anxiety and depression. RESULTS Perceived negative consequences of cancer predicted anxiety and depression over time (p < .05), but social support had a buffering effect on the perceived negative consequences of cancer-anxiety relationship (β = - .20, p < .001) as well as the perceived negative consequences of cancer-depression relationship (β = - .11, p < .05). CONCLUSION Results suggest that social support is a protective factor over time against the pathway of illness perceptions leading to psychological distress among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Interventions that improve social support in cancer survivors may attenuate psychological distress and help support these individuals in their survivorship journey.
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Affiliation(s)
- Caroline Salafia
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA.
| | - Keith M Bellizzi
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Kaleigh Ligus
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Emily Fritzson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, U-1020, Storrs, CT, 06269, USA
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Bellizzi KM, Ligus K, Fritzson E, Salafia C, Sanft T, Park CL. Disruption in Cancer Care During Early Survivorship due to the COVID-19 Pandemic and Patient Satisfaction with Telemedicine. Support Care Cancer 2023; 31:291. [PMID: 37084094 PMCID: PMC10119514 DOI: 10.1007/s00520-023-07767-7] [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: 10/12/2022] [Accepted: 04/17/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE The extent to which adults with cancer during early survivorship experienced disruptions in care due to COVID-19 pandemic, as well as their experiences with the transition to telemedicine, remains understudied. METHODS We examined cancer care disruption and satisfaction with telemedicine due to COVID-19 in 361 adults (Mage = 59.42, SD = 11.3) with breast, prostate or colorectal cancer during early survivorship. The Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) and patient self-report Cancer Care Disruption Index (CCDI) was administered via RedCap survey. RESULTS The most prevalent areas of patient-reported cancer care disruption included supportive care appointments canceled/postponed (57%), in-person appointments changed to virtual appointments (56%), social work services canceled (32%), palliative care appointments canceled/postponed (24%), elective surgeries related to cancer postponed (23%), and screening tests postponed (19%). Regarding patient satisfaction with telemedicine, 78.0% "agree" or "strongly agree" that they were satisfied with the overall telemedicine system. Most survivors reported satisfaction with their doctor dealing with problems (88.2%), doctors answering patient questions (92.7%), and engaged patients in care (86.1%), However, 49.3% of cancer patients disagreed that virtual visits are as satisfying as in-person visits and 35.6% were dissatisfied with the lack of physical contact during virtual visits. CONCLUSION The COVID-19 pandemic disrupted cancer survivorship care, with supportive care, social work services, and mode of delivery (in-person vs. virtual) particularly affected. The downstream impact of cancer care disruption in those living with cancer during the pandemic as well as the quality of telehealth modality as part of cancer survivorship care delivery await future investigation.
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Affiliation(s)
- Keith M Bellizzi
- University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269-1058, USA.
| | - Kaleigh Ligus
- University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269-1058, USA
| | - Emily Fritzson
- University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269-1058, USA
| | - Caroline Salafia
- University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269-1058, USA
| | - Tara Sanft
- Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Crystal L Park
- University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269-1058, USA
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Résilience et croissance post-traumatique : enjeux théoriques et cliniques. L'ÉVOLUTION PSYCHIATRIQUE 2023. [DOI: 10.1016/j.evopsy.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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