1
|
Zhou Y, Che CC, Chong MC, Zhao H. Development of a marital self-disclosure programme for alleviating the fear of cancer recurrence in patients with gastric cancer and undergoing chemotherapy: a modified Delphi method. Front Psychol 2024; 15:1340915. [PMID: 39040962 PMCID: PMC11262412 DOI: 10.3389/fpsyg.2024.1340915] [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: 11/20/2023] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
Aim This study aimed to develop a marital self-disclosure programme to alleviate the fear of cancer recurrence in patients with gastric cancer who are undergoing chemotherapy. Design Delphi method. Methods Data from available literature and stakeholder interviews were utilised to formulate the initial draft of a marital self-disclosure programme aimed to alleviate the fear of cancer recurring in patients with gastric cancer and undergoing chemotherapy. A panel of experts subsequently conducted a two-round modified Delphi method to finalise the programme. Results A total of 13 experts participated in the first round of consultation, while 11 experts were involved in the second round, as two experts withdrew due to unavailability. The response rates of both rounds of expert consultation were 100 and 84.62%, respectively, and the expert authority coefficients (Cr) of the programme were 0.83 and 0.84, respectively. The coordination coefficients of the expert opinions were 0.124 (χ2 = 61.214, p = 0.010) and 0.167 (χ2 = 69.668, p = 0.001) for each Delphi round. The average score of the second round was (4.545 ± 0.688) to (5.000 ± 0), with a full score ratio of 0.55-1.00. The coefficient of variation (CV) ranged from 0 to 0.031. Outcomes from both rounds of consultations were considered acceptable and credible. The finalised marital self-disclosure programme for alleviating the fear of cancer recurrence in patients with gastric cancer undergoing chemotherapy consists of two parts; disclosure guidance for patients and their spouse with nine items, and the structure and themes of marital self-disclosure with 31 items. Patient or public contribution After two rounds of expert consultations, the marital self-disclosure programme for patients with gastric cancer undergoing chemotherapy is suggested to be scientifically valid and reliable. This programme is anticipated to potentially support patients and their spouses effectively by providing a reliable intervention plan focused on alleviating the fear of cancer recurrence.
Collapse
Affiliation(s)
- Ye Zhou
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chong Chin Che
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Haiyan Zhao
- Nursing Department, Jingjiang People's Hospital, Taizhou, Jiangsu Province, China
| |
Collapse
|
2
|
Wu L, Chen X, Dong T, Yan W, Wang L, Li W. Self-disclosure, perceived social support, and reproductive concerns among young male cancer patients in China: A mediating model analysis. Asia Pac J Oncol Nurs 2024; 11:100503. [PMID: 39072257 PMCID: PMC11277813 DOI: 10.1016/j.apjon.2024.100503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/29/2024] [Indexed: 07/30/2024] Open
Abstract
Objective Many young male cancer patients experience reproductive concerns. Self-disclosure might be able to improve patients' perceived social support and reproductive concerns. Nevertheless, these relationships have not yet been confirmed among young male cancer patients. This study aims to investigate the level of reproductive concerns and to identify the mediating role of perceived social support between self-disclosure and reproductive concerns among young male cancer patients in China by developing a structural model. Methods This study was a quantitative, cross-sectional design. We used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines to report this study. A total of 369 young male cancer survivors were recruited by convenience sampling from two tertiary hospitals in Taiyuan, Shanxi, China. Data were collected using a "general data questionnaire", "distress disclosure index" (DDI), "perceived social support scale" (PSSS), and "reproductive concerns after cancer-male" (RCAC-M) via the WeChat mini program "Questionnaire Star" and paper questionnaire. Descriptive statistics, Pearson correlation analyses, and structural equation models were adopted to analyze the data. Results Reproductive concerns were at moderate levels and negatively associated with self-disclosure (r = -0.619, P < 0.01) and perceived social support (r = -0.599, P < 0.01). Self-disclosure indirectly influenced reproductive concerns (-0.328∼-0.159, P < 0.001) through perceived social support. Conclusions Self-disclosure and perceived social support are closely associated with reproductive concerns in young male cancer patients, and perceived social support is a mediator between self-disclosure and reproductive concerns. Healthcare providers could reduce reproductive concerns by enhancing self-disclosure and improving perceived social support. Trial registration This study was registered on ClinicalTrials.gov on June 13, 2023 (NCT05914181).
Collapse
Affiliation(s)
- Lihua Wu
- Department of Lymphoma, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China
| | - Xingyu Chen
- Department of Lymphoma, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China
| | - Tingting Dong
- Department of Lymphoma, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China
| | - Wei Yan
- Department of Lymphoma, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China
| | - Linying Wang
- Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China
| | - Wanling Li
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China
| |
Collapse
|
3
|
Lemmen J, Mageto S, Njuguna F, Midiwo N, Vik TA, Kaspers G, Mostert S. A caregivers' perspective on social reintegration and stigma of childhood cancer survivors in Kenya. Psychooncology 2024; 33:e6345. [PMID: 38708858 DOI: 10.1002/pon.6345] [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: 07/21/2023] [Revised: 04/10/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES Childhood cancer survivors' social reintegration may be hampered in low and middle-income countries. The nature and extent of social challenges and prejudices that survivors encounter in such settings are largely unknown. This study explores caregivers' perspectives on social reintegration and stigmatization of Kenyan childhood cancer survivors. METHODS Caretakers of childhood cancer survivors (<18 years) were interviewed using mixed-methods questionnaires during home or clinic visits between 2021 and 2022. Stigma was assessed with an adjusted Social Impact Scale and risk factors were investigated. RESULTS Caretakers of 54 survivors (median age 11 years) were interviewed. Families' income (93%) decreased since start of treatment. Caretakers (44%) often lost their jobs. Financial struggles (88%) were a burden that provoked conflicts within communities (31%). School fees for siblings became unaffordable (52%). Families received negative responses (26%) and were left or avoided (13%) by community members after cancer disclosure. Survivors and families were discriminated against because the child was perceived fragile, and cancer was considered fatal, contagious, or witchcraft. Survivors repeated school levels (58%) and were excluded from school activities (19%) or bullied (13%). Performance limitations of daily activities (p = 0.019), male sex (p = 0.032), solid tumors (p = 0.056) and a short time since treatment completion (p = 0.047) were associated with increased stigma. Caretakers recommended educational programs in schools and communities to raise awareness about cancer treatment and curability. CONCLUSIONS Childhood cancer survivors and their families experienced difficulties with re-entry and stigmatization in society. Increasing cancer and survivorship awareness in schools and communities should facilitate social reintegration and prevent stigmatization.
Collapse
Affiliation(s)
- Jesse Lemmen
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Susan Mageto
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Pharmacology, School of Health Sciences, Kisii University, Kisii, Kenya
| | - Festus Njuguna
- Department of Child Health and Pediatrics, Moi University, Eldoret, Kenya
| | - Nancy Midiwo
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Terry A Vik
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gertjan Kaspers
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Saskia Mostert
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| |
Collapse
|
4
|
Zhao H, Zhou Y, Che CC, Chong MC, Zheng Y, Hou Y, Chen C, Zhu Y. Marital Self-Disclosure Intervention for the Fear of Cancer Recurrence in Chinese Patients With Gastric Cancer: Protocol for a Quasiexperimental Study. JMIR Res Protoc 2024; 13:e55102. [PMID: 38684089 PMCID: PMC11091802 DOI: 10.2196/55102] [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: 12/02/2023] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Patients with gastric cancer experience different degrees of fear of cancer recurrence. The fear of cancer recurrence can cause and worsen many physical and psychological problems. We considered the "intimacy and relationship processes in couples' psychosocial adaptation" model. OBJECTIVE The study aims to examine the effectiveness of a marital self-disclosure intervention for improving the level of fear of cancer recurrence and the dyadic coping ability among gastric cancer survivors and their spouses. METHODS This is a quasiexperimental study with a nonequivalent (pretest-posttest) control group design. The study will be conducted at 2 tertiary hospitals in Taizhou City, Jiangsu Province, China. A total of 42 patients with gastric cancer undergoing chemotherapy and their spouses will be recruited from each hospital. Participants from Jingjiang People's Hospital will be assigned to an experimental group, while participants from Taizhou People's Hospital will be assigned to a control group. The participants in the experimental group will be involved in 4 phases of the marital self-disclosure (different topics, face-to-face) intervention. Patients will be evaluated at baseline after a diagnosis of gastric cancer and reassessed 2 to 4 months after baseline. The primary outcome is the score of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) for patients. The secondary outcomes are the scores of the FoP-Q-SF for partners and the Dyadic Coping Inventory. RESULTS Research activities began in October 2022. Participant enrollment and data collection began in February 2023 and are expected to be completed in 12 months. The primary results of this study are anticipated to be announced in June 2024. CONCLUSIONS This study aims to assess a marital self-disclosure intervention for improving the fear of cancer recurrence in Chinese patients with gastric cancer and their spouses. The study is likely to yield desirable positive outcomes as marital self-disclosure is formulated based on evidence and inputs obtained through stakeholder interviews and expert consultation. The study process will be carried out by nurses who have received psychological training, and the quality of the intervention will be strictly controlled. TRIAL REGISTRATION ClinicalTrials.gov NCT05606549; https://clinicaltrials.gov/study/NCT05606549. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55102.
Collapse
Affiliation(s)
- Haiyan Zhao
- Nursing Department, Jingjiang People's Hospital, Taizhou, China
| | - Ye Zhou
- Chinese Nursing Journals Publishing House Co, Ltd, Beijing, China
| | - Chong Chin Che
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yu Zheng
- Nursing Department, Jingjiang People's Hospital, Taizhou, China
| | - Yuzhu Hou
- Nursing Department, Jingjiang People's Hospital, Taizhou, China
| | - Canjuan Chen
- Nursing Department, Jingjiang People's Hospital, Taizhou, China
| | - Yantao Zhu
- Nursing Department, Jingjiang People's Hospital, Taizhou, China
| |
Collapse
|
5
|
Honda N, Shiroshita Y, Miyazaki A, Sobue I. Factors associated with cancer disclosure in adolescent and young adult cancer survivors: An integrative review from the social-ecological model perspective. Eur J Oncol Nurs 2024; 69:102542. [PMID: 38460390 DOI: 10.1016/j.ejon.2024.102542] [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: 05/26/2022] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE Young cancer survivors ("young survivors") may need to disclose their cancer experiences to reintegrate into society. In such cases, the recognition of social support through the disclosure of cancer experiences may prevent potential social disadvantages. This review aimed to describe the motivations, strategies and outcomes, and benefits and disadvantages of disclosure in young survivors based on the social-ecological model (SEM) to identify the support survivors need when disclosing their cancer experiences. METHODS Using the integrated review methodology, we systematically searched six databases in English and Japanese as well as searched the reference lists of the selected studies. The themes identified via thematic analysis were categorized within the SEM levels. RESULTS This review analyzed 14 studies and identified four themes, including "Motivation for Cancer Disclosure," "Barriers to Cancer Disclosure," "Consequences of Cancer Disclosure: Benefits," and "Consequences of Cancer Disclosure: Disadvantages." Motivations for young survivors to disclose their cancer involved post-cancer differences, perceptions, relationships, and social context. In navigating barriers, including self-stigma, peer exclusion, and discrimination, they employed strategies such as reassurance and information limitation. Tailored disclosure strategies at each SEM level offered social and psychological benefits, however, disadvantages, including stress, vulnerability, employment issues, and limited insurance coverage, were experienced by young survivors due to cancer disclosure. CONCLUSIONS To optimize the benefits of cancer disclosure for young survivors, addressing psychological burdens, enhancing disclosure skills, offering familial psychological support, and fostering public awareness of cancer are essential.
Collapse
Affiliation(s)
- Naoko Honda
- Department of Reproductive Health, Institute of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan.
| | - Yui Shiroshita
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Asuka Miyazaki
- Department of Reproductive Health, Institute of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan.
| | - Ikuko Sobue
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| |
Collapse
|
6
|
Reffner Collins MK, Lazard AJ, Hedrick McKenzie AM, Varma T. 'It's Nothing Like Cancer': Young Adults with Cancer Reflect on Memorable Entertainment Narratives. HEALTH COMMUNICATION 2024; 39:552-562. [PMID: 36746916 DOI: 10.1080/10410236.2023.2174403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
A cancer diagnosis in young adulthood disrupts the achievement of developmental milestones, and young adults struggle to make sense of their cancer experience due to a lack of opportunities to both openly talk about cancer and engage in reflective activities. However, entertainment narratives - or stories - may be an alternative to prompt these activities, as narratives can elicit self-expansion that may help fulfill intrinsic needs. One way to think about these narratives is as memorable messages. These messages stick with a person for a long period of time, have an anticipatory socialization effect, and may prompt the sense-making process through narrative communication. Little is known, though, about the use of entertainment narratives among young adults with cancer. We interviewed 25 young adults with cancer about entertainment narratives that were memorable during their cancer experience and how those narratives affected them. From these in-depth, semi-structured interviews, we found that entertainment narratives were generally helpful if they provided distraction from cancer, were relatable, and/or prompted participants to explore their emotions. We found that entertainment narratives were generally harmful if they worsened participants' emotional state, either by exacerbating fears of death and/or depicting cancer unrealistically. Our findings suggest that entertainment narratives are memorable messages, and that helpful messages increased feelings of competence and validation, which could promote psychological adaptation to the disease. Harmful messages increased fear and invalidated participants' difficult experiences, which could lead to greater illness centrality and internalized stigma. Implications for future research are discussed.
Collapse
Affiliation(s)
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina
| | | | - Tushar Varma
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
| |
Collapse
|
7
|
Wu W, Yackel HD, Salner A, Chen MH, Judge MP, Cong X, Xu W. Work-health balance of cancer survivors returning to work: A meta-ethnography. Eur J Oncol Nurs 2024; 68:102482. [PMID: 38070450 DOI: 10.1016/j.ejon.2023.102482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/17/2023] [Accepted: 11/19/2023] [Indexed: 02/18/2024]
Abstract
PURPOSE This meta-ethnography investigates the multifaceted health-related experiences of cancer survivors returning to work (RTW), recognizing the pivotal role of employment in overall well-being, particularly in the context of increasing cancer cases among working-age adults. METHOD Following the methodology of Noblit and Hare, a comprehensive literature search was conducted from 2013 to 2023 in databases including PubMed, Scopus, CINAHL, PsycINFO, and Embase. Qualitative studies assessing cancer survivors' experiences, motivation, concern, resilience, and need in the process of RTW were identified. Eligible studies were assessed for quality using the Critical Appraisal Skills Program Checklist, and their findings were subsequently synthesized. RESULTS Seventeen studies were included for analysis. The finding revealed five key themes: motivations (voluntary and involuntary), cancer-related concerns, resilience, needs for cancer healthcare support, and workplace accommodation. Voluntarily RTW was primarily linked to desires of normalcy, while involuntary RTW was often financially driven. Cancer survivors often face physical, psychological, and social challenges in the RTW process. Resilience played a crucial role in their readaptation to the workplace. Participants expressed the need for additional guidance from healthcare providers and tailored support from the workplace to facilitate a smoother RTW experience. CONCLUSION Cancer survivors aspire to be actively engaged, have their specific needs addressed, and achieve success in their return-to-work endeavors. Occupational guidance and accommodation from healthcare providers and employers play a pivotal role in empowering survivors to balance cancer and work, facilitating the return-to-work process, and enhancing the quality of survivorship.
Collapse
Affiliation(s)
- Weizi Wu
- School of Nursing, University of Connecticut, Storrs, CT, 06269, USA
| | | | - Andrew Salner
- Hartford HealthCare Cancer Institute, Hartford, CT, 06106, USA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT, 06269, USA
| | - Michelle P Judge
- School of Nursing, University of Connecticut, Storrs, CT, 06269, USA
| | - Xiaomei Cong
- Yale University School of Nursing, Orange, CT, 06477, USA
| | - Wanli Xu
- School of Nursing, University of Connecticut, Storrs, CT, 06269, USA.
| |
Collapse
|
8
|
Lee H, Jeong Y. Self-disclosure in Adult Patients With Cancer: Structural Equation Modeling. Cancer Nurs 2023:00002820-990000000-00194. [PMID: 37991473 DOI: 10.1097/ncc.0000000000001302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
BACKGROUND Health-related self-disclosure has been studied in various aspects, as has self-disclosure of cancer patients. However, any theoretical models that comprehensively include self-disclosure events, factors associated with self-disclosure, and the outcomes of self-disclosure of cancer patients have not yet been presented. OBJECTIVE The purpose of this study was to explore the relationships between self-disclosure, perception toward cancer, intention for self-disclosure, level and range of self-disclosure, social support, and well-being in adult patients with cancer. METHODS Data were collected from adult cancer patients via an online survey using self-report questionnaires and analyzed using structural equation modeling. The data from 359 participants were included in the final analysis. RESULTS Positive intention for self-disclosure was a significant predictor of both self-disclosure level and range, whereas negative perception toward cancer significantly decreased self-disclosure level. The self-disclosure level significantly improved both social support and well-being, whereas the self-disclosure range did not present a significant impact on social support and well-being. CONCLUSION Self-disclosure is closely associated with social support and well-being, and self-disclosure can be promoted by improving negative perceptions and positive intentions about self-disclosure. In addition, to improve the social support and well-being of cancer patients, it suggests increasing the self-disclosure depth level rather than widening the range of self-disclosure. IMPLICATIONS FOR PRACTICE The results of this study can be used as evidence for the development of nursing intervention programs to reduce negative perceptions toward cancer and improve positive intentions and levels of self-disclosure among cancer patients.
Collapse
Affiliation(s)
- Hyungran Lee
- Authors' Affiliations: College of Nursing Science, Kyung Hee University, Seoul, Korea
| | | |
Collapse
|
9
|
Andersen EM. As if I was a spacecraft returning to Earth's atmosphere. Expanding insights into illness narratives and childhood cancer through evocative autoethnography. Health (London) 2023:13634593231200123. [PMID: 37727064 DOI: 10.1177/13634593231200123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Today, a majority of children diagnosed with cancer are expected to grow up and live-hopefully until old age. Still, knowledge of the lived experience of childhood cancer survivors is sparse. In pursuit of knowledge expansion, by combining my intersecting roles as an academic, educational counselor, and childhood cancer survivor, I approach my personal illness narrative. By means of evocative autoethnography, I write intentionally vulnerably about my experiences and make them available for consideration. I explore my narrative through archives, artifacts, memories of the past, and conversations evoked in the present. I re-visit the cultural landscape of a southern Norwegian girl growing up in the 00s with cancer. Through this, my illness narrative presents as positioned, tangled, and interwoven with a developmental trajectory. Specific educational experiences seem to linger, and many are related to being absent from or re-entering school after the onset of illness. To grasp the intersecting and conflicting experiences of being very ill while also young, I suggest Erik Erikson's moratorium as a key concept. To complement Arthur Frank's illness narratives of restitution, chaos, and quest, I establish the moratorium narrative. As a fresh resource, the moratorium narrative underlines the need to make sensitive our academic community's gaze on illness trajectories unfolding in formative phases and illness narratives defined by growing up. By providing a point of recognition that prompts elaboration, this could also provide the young and very ill with a much-needed narrative space of opportunity, of which more narratives are invited and insisted upon.
Collapse
|
10
|
Soejima T, Tokita M, Kitao M. Impact of flexible work arrangements on job resignation after cancer diagnosis among Japanese young adult cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01421-1. [PMID: 37480472 DOI: 10.1007/s11764-023-01421-1] [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: 01/23/2023] [Accepted: 06/15/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Many workers had flexible work arrangements during the COVID-19 pandemic. This study aimed to identify the association between flextime and remote working and job resignation among Japanese young adult cancer survivors after diagnosis. METHODS This cross-sectional observational study was conducted using an online survey with 401 Japanese young adult cancer survivors diagnosed with adult-onset cancer and aged 20-39 years at the time of the survey in January 2022. A multivariable Cox regression analysis was performed to analyze the impact of flextime and remote working on job resignation. RESULTS In the sample, 264 participants (65.8%) were female, and 185 (46.1%) had been diagnosed with cancer between 1 and 5 years ago. After adjusting for potential confounders, the multivariable Cox regression analysis revealed that young adult cancer survivors using remote working only (HR 0.44, 95% CI 0.21-0.96, p = 0.04) and both flextime and remote working (HR 0.37, 95% CI 0.21-0.64, p < 0.01) experienced a lower risk of job resignation after cancer diagnosis compared to those who did not use flextime and remote working. CONCLUSIONS Young adult cancer survivors who used remote working only or remote working combined with flextime could reduce their risk of job resignation after a cancer diagnosis. IMPLICATIONS FOR CANCER SURVIVORS This study showed that having the option of remote working can be important for young adult cancer survivors' continuing employment. Furthermore, social welfare systems need to promote a workplace culture and climate that allows remote working.
Collapse
Affiliation(s)
- Takafumi Soejima
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-Ku, Kobe, Hyogo, 654-0142, Japan.
| | - Masahito Tokita
- Keio Research Institute at SFC, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan
| | - Mari Kitao
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-Ku, Kobe, Hyogo, 654-0142, Japan
| |
Collapse
|
11
|
Oh S, Lee H, Kim S, Kim S, Lyu CJ, Park CG, Kang HJ. Development and psychometric properties of the social adjustment scale for youth cancer survivors in South Korea. Asia Pac J Oncol Nurs 2023; 10:100241. [PMID: 37435599 PMCID: PMC10331412 DOI: 10.1016/j.apjon.2023.100241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/04/2023] [Indexed: 07/13/2023] Open
Abstract
Objective We developed a new scale-the Social Adjustment Scale for Youth Cancer Survivors-and examined its psychometric properties. Methods In the scale's development stage, preliminary items were constructed based on the results of a concept analysis of the hybrid model, literature review, and interviews. These items were then reviewed through content validity and cognitive interviews. In the validation stage, 136 survivors were recruited from two children's cancer centers in Seoul, South Korea. An exploratory factor analysis was performed to identify a set of constructs, and validity and reliability were tested. Results Starting with 70 items constructed through literature review and interviews with youth survivors, the final scale comprised 32 items. The exploratory factor analysis identified four domains-namely, role achievement in one's present position, harmony in relationships, disclosure and acceptance of cancer history, and preparation and expectation for future roles. Correlations with quality of life indicated good convergent validity (r = 0.82, P < 0.001). The Cronbach's α of the overall scale was 0.95, indicating excellent internal consistency; and the intraclass correlation coefficient was 0.94 (P < 0.001), suggesting high test-retest reliability. Conclusions The Social Adjustment Scale for Youth Cancer Survivors exhibited acceptable psychometric properties in measuring the social adjustment of youth cancer survivors. It can be used to identify youths facing difficulty in adjusting to society after treatment and to investigate the effect of interventions implemented to promote social adjustment among youth cancer survivors. Future research is needed to examine the applicability of the scale in patients across diverse cultural backgrounds and healthcare systems.
Collapse
Affiliation(s)
- Sumi Oh
- College of Nursing, Health and Nursing Research Institute, Jeju National University, Jeju Special Self-Governing Province, South Korea
| | - Hyejung Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Sue Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Sanghee Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Chuhl Joo Lyu
- Division of Pediatric Hemato-oncology, Yonsei University Health System, College of Medicine, Yonsei University, Seoul, South Korea
| | - Chang Gi Park
- Department of Population Health Nursing Science, College of Nursing, University of Illinois, Chicago, USA
| | - Hyoung Jin Kang
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, South Korea
| |
Collapse
|
12
|
Di Giuseppe G, Pagalan L, Jetha A, Pechlivanoglou P, Pole JD. Financial toxicity among adolescent and young adult cancer survivors: A systematic review of educational attainment, employment, and income. Crit Rev Oncol Hematol 2023; 183:103914. [PMID: 36706969 DOI: 10.1016/j.critrevonc.2023.103914] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/17/2022] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To identify, evaluate and summarize the evidence on educational attainment, employment status and income of AYAs surviving cancer. METHODS A search of six databases for articles published between 01/01/2010 and 03/31/2022 was performed. Articles with an AYA survivorship population, quantitative design and a cancer-free comparator group were included. Data extraction was conducted, and quality appraisal was completed using ROBINS-I. Results were summarized using a narrative synthesis. RESULTS A total of 2801 articles were identified, of which 12 were included. Among the limited evidence, educational attainment did not differ from cancer-free peers. Survivors were more likely to be unemployed, have lower incomes and require social security for income supplementation. Evidence suggested that females, diagnosis of brain cancer and the presence of late-effects were among the risk factors for severe outcomes. CONCLUSIONS Limited socioeconomic evidence exists for AYAs surviving cancer. Long-lasting financial toxicities occur and highlights a need for further investigation.
Collapse
Affiliation(s)
- Giancarlo Di Giuseppe
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Lief Pagalan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Arif Jetha
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Work & Health, Toronto, Ontario, Canada
| | | | - Jason D Pole
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Health Sciences Research, University of Queensland, Brisbane, Australia
| |
Collapse
|
13
|
Zhu H, Tao L, Hu X, Jiang X. Effects of self-disclosure and resilience on reproductive concern in patients of childbearing age with breast cancer: a cross-sectional survey study. BMJ Open 2023; 13:e068126. [PMID: 36750283 PMCID: PMC9906163 DOI: 10.1136/bmjopen-2022-068126] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVES To assess reproductive concerns in patients of childbearing age with breast cancer and examine the relationship between self-disclosure, resilience and reproductive concerns. DESIGN Cross-sectional survey. SETTING Five tertiary first-class general hospitals in Sichuan Province, Southwest China. PARTICIPANTS A total of 319 patients with breast cancer of reproductive age who were hospitalised in the breast oncology department participated in this study. MAIN OUTCOME MEASURES Primary outcomes were the relationship between resilience, self-disclosure and reproductive concerns, and mediating effect analyses. Secondary outcomes included the status of reproductive concerns. RESULTS The model accounted for 39.1% of the variance in reproductive concerns. Self-disclosure had a direct negative effect on reproductive concerns (β= -0.371, p=0.001). Resilience had a direct negative effect on reproductive concerns (β= -0.349, p=0.001) and a direct positive effect on self-disclosure (β=0.507, p=0.001). Furthermore, self-disclosure partially mediated the relation between resilience and reproductive concerns (β= -0.177; SE=0.041; 95% CI -0.261 to -0.104; p<0.050), with a bootstrap of 10 000 samples. CONCLUSIONS The findings suggest that self-disclosure and resilience may ease reproductive concern. Therefore, self-disclosure education and resilience-oriented interventions should be provided to patients of childbearing age with breast cancer, to reduce reproductive concerns.
Collapse
Affiliation(s)
- Hong Zhu
- West China School of Nursing, Sichuan University/Nursing Department, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Lin Tao
- Cancer Day-care Unit, Division of Medical Oncology, Cancer Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Xiaoxia Hu
- Department of Breast Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Xiaolian Jiang
- West China School of Nursing, Sichuan University West China Hospital, Chengdu, Sichuan, China
| |
Collapse
|
14
|
Tomas V, Ahmed H, Lindsay S. Unravelling the Complexities of Workplace Disclosure Among Persons with Non-Visible Disabilities and Illnesses: A Qualitative Meta-Ethnography. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:538-563. [PMID: 35038104 DOI: 10.1007/s10926-022-10023-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Deciding whether and how to disclose a disability at work for persons with non-visible disabilities and illnesses involve complex processes. Research has focused on antecedents and outcomes of disclosure. More research is needed to understand the lived experiences related to disclosure decision-making and actual navigation of disclosure and concealment at work. PURPOSE To understand the experiences of persons with non-visible disabilities and illnesses regarding workplace disclosure decision-making, navigating disclosure and/or concealment, and experiential differences across disability and illness types, ages, geographic locations, and genders. METHODS We conducted a qualitative meta-synthesis using Noblit and Hare's seven steps of meta-ethnography. Searches were conducted via six databases. Studies were analyzed to develop conceptual categories, third-order constructs (themes), and a line-of-argument with comparisons drawn from the disclosure decision making model, disclosure process model, and consideration of disability and illness types, genders, ages, and geographic locations. RESULTS Twenty-four studies were included involving 489 participants, aged 16 to 81, from nine countries, focusing on one non-visible disability or illness, or multiple. We developed four themes for the disclosure decision-making process (self- and other-focused, experiential, and environmental/workplace factors) and two themes for the disclosure/concealment event (disclosure/concealment logistics and timing) and noted emerging trends across ages, genders, disability and illness types, and geographic locations. CONCLUSIONS Knowledge obtained could be used among professionals who support persons with non-visible disabilities and illnesses to help them navigate disclosure at work, and to consider the role of age, genders, disability and illness types, and geographic locations on disclosure.
Collapse
Affiliation(s)
- Vanessa Tomas
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
| | - Hiba Ahmed
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Sally Lindsay
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
15
|
Hyseni F, Myderrizi A, Blanck P. Diversity and inclusion in the legal profession: disclosure of cancer and other health conditions by lawyers with disabilities and lawyers who identify as LGBTQ + . J Cancer Surviv 2022; 16:165-182. [PMID: 35107800 PMCID: PMC8809243 DOI: 10.1007/s11764-021-01143-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE Given the training and experience of lawyers, we assumed that a study of lawyers' willingness to disclose disability in the workplace would provide an example of the actions of a group knowledgeable about disability law. The current study accounts for the effect of visibility of disability, onset and type of disability, and whether the lawyer has made an accommodation request. We also investigate the role of other individual characteristics, such as sexual orientation, gender identity, race/ethnicity, age, and job-related characteristics, in willingness to disclose. METHODS We use data from the first phase of a longitudinal national survey of lawyers in the USA to estimate the odds of disclosing disability to co-workers, management, and clients using proportional odds models. RESULTS Lawyers with less visible disabilities, those with mental health disabilities, and those who work for smaller organizations have lower odds of disclosing to co-workers, management, and clients as compared to their counterparts. Attorneys who have requested accommodations are more willing to disclose as compared to those who have not, but only to co-workers and management. Women are less likely than men to disclose to management and clients. However, gender is not a significant determinant of disclosure to co-workers. Older attorneys are more likely to disclose to clients, whereas attorneys with children are less likely to disclose to co-workers. Lastly, lower perceived prejudice and the presence of co-workers with disabilities are associated with higher disclosure scores, but not for all groups. CONCLUSIONS Individuals who acquired a disability at a relatively early point in life and those with more visible disabilities are more likely to disclose. However, such willingness is affected by the intersection of disability with other individual and firm-level characteristics. IMPLICATIONS FOR CANCER SURVIVORS The findings imply that those with less visible disabilities and with health conditions acquired later in life are less likely to disclose. The relevance of the findings is heightened by the altered work conditions and demands imposed by the COVID-19 pandemic for cancer survivors.
Collapse
Affiliation(s)
- Fitore Hyseni
- Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, USA
| | - Arzana Myderrizi
- Rockefeller College of Public Affairs and Policy, State University of New York at Albany, Albany, USA
| | - Peter Blanck
- Burton Blatt Institute, Syracuse University, 950 Irving Avenue, Suite 446, Syracuse, NY 13244 USA
- Peter Blanck, University Professor & Chairman Burton Blatt Institute, Syracuse University, 950 Irving Avenue, Suite 446, Syracuse, NY 13244 USA
| |
Collapse
|
16
|
Llave K, Hoyt MA. Social constraints and cancer-related quality of life in single and partnered young adult testicular cancer survivors: a contextual approach. J Psychosoc Oncol 2022; 40:743-755. [PMID: 35068347 PMCID: PMC9308827 DOI: 10.1080/07347332.2021.2002995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To examine the context of relationship status on the link between friends/family social constraints (SCff) and cancer-related quality-of-life (QOL) among young adult testicular cancer survivors. Participants completed the Functional Assessment of Cancer Therapy (general version), the Social Constraints Scale (friends/family), and demographic questions. The sample included 162 young adult testicular cancer survivors. SCff, but not relationship status, significantly predicted QOL when controlling for age, time since diagnosis, education, and income. The SCff X relationship status interaction was significant such that SCff were more strongly related to lower QOL for single survivors than for partnered survivors. Focusing on friends and family support of young adult survivors, findings highlight the vulnerability of single survivors to social constraints within their diffuse social network. Interventions that target supportive exchanges in friends and family networks may be useful in improving QOL in single young adult cancer survivors.
Collapse
|
17
|
Du X, Wang D, Du H, Zou Q, Jin Y. The correlation between intimate relationship, self-disclosure, and adaptability among colorectal cancer enterostomy patients. Medicine (Baltimore) 2021; 100:e25904. [PMID: 34106651 PMCID: PMC8133169 DOI: 10.1097/md.0000000000025904] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
The postoperative physiological changes and psychological pressure of cancer patients affect the patient's adaptability to the disease, and thus affect the spousal intimate relationship. This study aimed to evaluate the correlation between spousal intimate relationship, self-disclosure, and adaptability among colorectal cancer (CCI) patients with enteric stoma.This cross-sectional study selected patients with CCI in Henan Province from February 2018 to October 2020. The Marital Adjustment Test (MAT), the Distress Disclosure Index scale, and the Ostomy adjustment inventory-20 scale were used to collect relevant data of the participants. A Pearson correlation analysis was used to test the correlation between variables, and multiple stepwise regression analysis was used to test the influence of general information on the intimate relationship, self-disclosure, and adaptability.Among the respondents, 42.6% had a spousal intimate relationship problem, 58.4% had a low or moderate level of self-disclosure, and 90.8% were at a low or moderate level of adaptation. Education background, self-care ability, and postoperative time were associated with a couple's intimate relationship. Average monthly household income, gender, and place of residence were associated with self-disclosure. Self-care ability, average monthly household income, postoperative time, and educational background were associated with adaptation.Healthcare workers should provide more health education training to guide CCI enterostomy patients to express their thoughts and feelings with each other increase self-disclosure, so as to enhance their intimate relationship then improve their adoption to ostomy, finally elevate their quality of life.
Collapse
Affiliation(s)
- Xixi Du
- General Surgery Department, Puyang People's Hospital, Puyang
- Faculty of Nursing and Health, Henan University, Kaifeng
- Faculty of Nursing, Mahidol University, Nakhon Pathom, Thailand
| | - Dongyang Wang
- Faculty of Nursing, Mahidol University, Nakhon Pathom, Thailand
| | - Huiyong Du
- General Surgery Department, Henan cancer hospital, Zhengzhou, China
| | - Qiyun Zou
- General Surgery Department, Puyang People's Hospital, Puyang
| | - Yan Jin
- Faculty of Nursing and Health, Henan University, Kaifeng
| |
Collapse
|