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Lu Q, Liu Q, Fang S, Ma Y, Zhang B, Li H, Song L. Relationship between fear of progression and symptom burden, disease factors and social/family factors in patients with stage-IV breast cancer in Shandong, China. Cancer Med 2024; 13:e6749. [PMID: 38457242 PMCID: PMC10923048 DOI: 10.1002/cam4.6749] [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: 11/23/2022] [Revised: 09/13/2023] [Accepted: 09/30/2023] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE To assess fear of progression (FoP)'s relationship with symptom burden and disease and social/family factors, as well as, determine the status of FoP in women with stage-IV breast cancer in Shandong, China. METHODS Two hundred and sixteen women were recruited from the department of breast cancer internal medicine, Shandong Cancer Hospital and Institute. Data for this observational study were collected between October 2020 and January 2021 using the MD Anderson Symptom Inventory, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and a participant information scale. SPSS 23.0 was used for statistical analysis. RESULTS After excluding invalid responses, the data of 200 participants were analysed. The average total FoP-Q-SF score was 29.39 ± 9.39 (95% confidence interval, 21.81-27.64). The FoP level among the participants was relatively low. For disease and social/family factors, FoP statistically significantly differed by satisfaction with family emotional support and the Eastern Cooperative Oncology Group (ECOG) score. The ECOG score was positively correlated with FoP. Furthermore, symptom burden was positively correlated with FoP. CONCLUSIONS Among patients with stage-IV breast cancer, satisfaction with family emotional support, ECOG score and symptom burden play key roles in FoP. Interventions, including providing appropriate emotional support from family, improving physical fitness and relieving symptom burden, must be considered in future studies, which may improve patients' overall physical and mental status and provide a supportive therapeutic environment.
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Affiliation(s)
- Qianrun Lu
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Qiuyue Liu
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Shu Fang
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Yujin Ma
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Baoxuan Zhang
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Huihui Li
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Lihua Song
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
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Dunsmore VJ, Neupert SD. Coping With 'Scanxiety': Within-Person Processes in Lung Cancer. Psychol Rep 2023:332941231164336. [PMID: 36964680 PMCID: PMC10629386 DOI: 10.1177/00332941231164336] [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] [Indexed: 03/26/2023]
Abstract
Background: Patients with early-stage lung cancer undergo potentially curative therapy, and continue to undergo regularly scheduled CT scans to determine if cancer has reappeared, spread, or stayed the same. This process can be fraught with anxiety, coined 'Scanxiety'. The present study examined how coping and scan-related anxiety fluctuate within-person before one's scan. Method: Twenty five individuals with lung cancer who had received curative intent treatment (M age = 62.33, [SD = 8.10], 96% women, 80% white) participated in the study, which had two parts. First, participants provided information about proactive coping and scan-related anxiety every 30 days. Next, a daily diary study was implemented for 7 consecutive days before their CT scan, as well as the day of their CT scan, where participants reported on their daily anticipatory coping and scan-related anxiety. The 25 participants provided 59 monthly and 146 daily surveys for analysis. Results: Multilevel models revealed significant main effects of monthly proactive coping on monthly scan-related anxiety, as well as daily anticipatory coping on daily scan-related anxiety. On months when participants decreased their use of proactive coping, they also reported decreases in scan-related anxiety for that month. On days when participants reported decreases in outcome fantasy and stagnant deliberation, they reported decreases in scan-related anxiety for that day. Finally, a significant interaction was found such that on days when middle-aged adults reported increases in problem analysis, they also reported increases in scan-related anxiety for that day. Conclusion: These findings are the first to characterize how participants' coping and scanxiety fluctuate in the months and days prior to their CT scans. Results indicated that focusing on the present may be more beneficial in reducing scan-related anxiety rather than thinking about the future. Future work should implement strategies to reduce scanxiety by focusing on the present among those with lung cancer.
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Affiliation(s)
- Victoria J Dunsmore
- Department of Psychology, 6798North Carolina State University, Raleigh, NC, USA
- Lineberger Comprehensive Cancer Center, 2331UNC, Chapel Hill, NC, USA
| | - Shevaun D Neupert
- Department of Psychology, 6798North Carolina State University, Raleigh, NC, USA
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Knauer K, Bach A, Schäffeler N, Stengel A, Graf J. Personality Traits and Coping Strategies Relevant to Posttraumatic Growth in Patients with Cancer and Survivors: A Systematic Literature Review. Curr Oncol 2022; 29:9593-9612. [PMID: 36547168 PMCID: PMC9776882 DOI: 10.3390/curroncol29120754] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
The possibility of positive psychological changes after cancer, namely, posttraumatic growth, is a growing field of research. Identifying personality traits and coping strategies related to posttraumatic growth may help find vulnerable individuals as well as promote helpful coping strategies to help more patients make positive changes at an early stage. The aim of this systematic literature review is to provide an overview of the quantitative data on coping strategies and personality traits associated with posttraumatic growth in patients with cancer and cancer survivors as well as the methods used in included studies. A systematic literature search was conducted using five databases (PubMed, PubPsych, PsycInfo, Web of Science, and PSYNDEXplus). The 70 reports of included studies assessed posttraumatic growth using questionnaires in a sample of patients with cancer or survivors. In addition, associations with a personality trait or coping strategy had to be examined cross-sectionally or longitudinally. All 1698 articles were screened for titles and abstracts by two authors, after which disputed articles were reviewed by a third author. Afterwards, articles were screened for full texts. Most studies had a cross-sectional design and used a sample of patients with breast cancer. Coping strategies have been researched more than personality factors. The personality traits of resilience, hardiness, dispositional positive affectivity, and dispositional gratitude seem to be related to posttraumatic growth, while the Big Five personality traits (openness to experience, conscientiousness, extraversion, agreeableness, neuroticism) have been less researched and/or seem to be unrelated. The use of social support, religious coping, positive reframing, and reflection during illness as coping strategies seems to be related to posttraumatic growth. The findings can be used for the development of interventions. Future studies should investigate associations longitudinally.
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Affiliation(s)
- Klara Knauer
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
- Correspondence:
| | - Anne Bach
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
| | - Norbert Schäffeler
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
| | - Andreas Stengel
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany
| | - Johanna Graf
- Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Section Psychooncology, University Hospital Tübingen, 72070 Tübingen, Germany
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4
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Wan X, Huang H, Peng Q, Zhang Y, Hao J, Lu G, Chen C. The relation between coping style and posttraumatic growth among patients with breast cancer: A meta-analysis. Front Psychol 2022; 13:926383. [PMID: 36248465 PMCID: PMC9556874 DOI: 10.3389/fpsyg.2022.926383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/12/2022] [Indexed: 12/05/2022] Open
Abstract
Posttraumatic growth (PTG) has been correlated with coping style among patients with breast cancer. However, to date, there is no consensus on the extent to which coping style is associated with PTG in patients with breast cancer. Therefore, we performed a meta-analysis to quantitatively synthesize previous findings. Based on the PRISMA method, this study employed a random effects model using the Stata software (version 16.0) to calculate the pooled correlation coefficient and examined a range of moderators: cancer stage, publication type, participants’ age, and coping style measurement tools. Relevant studies, published from inception to 9 March 2022, were identified through a systematic search in PubMed, Embase, Web of Science, PsycINFO, WANFANG DATA, Chinese National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (VIP) databases. Finally, 20 studies involving 3,571 breast cancer patients were included in this investigation. The results showed a high positive relation between confrontation coping and PTG and a moderate positive relation between avoidance coping and PTG (confrontation: r = 0.456; avoidance: r = 0.291). Additionally, a moderate negative relation was identified between acceptance–resignation coping and PTG (r = –0.289). Publication type and coping style measurement tools moderated the relation between coping style and PTG among breast cancer patients. The findings indicated that breast cancer patients should either confront the disease or avoid coping with it according to their disease state, which would facilitate better growth. More studies, especially, large prospective studies, are warranted to verify our findings.
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Affiliation(s)
- Xiao Wan
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Haitao Huang
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Qianwen Peng
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Yiming Zhang
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Jiwei Hao
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
- *Correspondence: Jiwei Hao,
| | - Guangli Lu
- School of Business, Institute of Business Administration, Henan University, Kaifeng, China
- Guangli Lu,
| | - Chaoran Chen
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
- Chaoran Chen,
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Fu X, Sun J, Wang X, Cui M, Zhang Q. Research Progress on Influencing Factors and Intervention Measures of Post-traumatic Growth in Breast Cancer Patients. Front Public Health 2022; 10:927370. [PMID: 35801243 PMCID: PMC9253388 DOI: 10.3389/fpubh.2022.927370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/09/2022] [Indexed: 12/01/2022] Open
Abstract
Breast cancer is the highest incidence of female malignant tumor in the world, and it shows an increasing trend year by year. It poses a great threat to women's life and health and has become a public health issue of global concern. Paying attention to the psychological response of cancer patients is of definite value in helping patients cope with the disease, return to society, reshape an active and healthy life, and improve their quality of life with cancer. In recent years, researchers have increasingly focused on the positive changes experienced by cancer patients from the perspective of positive psychology, namely post-traumatic growth. It is of great significance to explore individual and social resources to help patients grow and improve their survival ability and quality of life by paying attention to the potential resources and positive forces in the process of patients' fighting against diseases. This paper summarizes the influencing factors and intervention measures of post-traumatic growth of breast cancer patients, providing ideas and reference for clinical medical staff to carry out relevant intervention.
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Affiliation(s)
| | | | | | | | - Qiang Zhang
- Department of Breast Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
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Chi D, de Terte I, Gardner D. Posttraumatic Growth and Posttraumatic Stress Symptoms in People with HIV. AIDS Behav 2022; 26:3688-3699. [PMID: 35666361 PMCID: PMC9550787 DOI: 10.1007/s10461-022-03697-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/27/2022]
Abstract
Receiving a diagnosis of HIV can be challenging. People with HIV (PWH) can experience high levels of distress, as well as some positive psychological changes associated with post-traumatic growth. However, the mechanisms which underlying the association of a highly stressful event (i.e., being diagnosed with HIV) and posttraumatic growth (PTG) and posttraumatic stress symptoms (PTSS) are under-explored, and this is the focus of the study. Cross-sectional survey data were provided by 77 PWH living in New Zealand. An analysis examined the roles of deliberate rumination and coping strategies as serial mediators of the associations between event centrality and PTG and PTSSs. The relationships between event centrality and PTG and PTSSs were found to be sequentially mediated by deliberate rumination and avoidance coping, but not by deliberate rumination and active coping. Further analyses explored active coping and deliberate rumination as parallel mediators, with avoidance coping as a subsequent mediator, between event centrality and PTG and PTSSs. However, these analyses were not supported. The findings indicate that the more participants appraised the HIV diagnosis as central, the greater PTG they perceived; however, the more they deliberately ruminated on it, and the more avoidance coping they adopted, the less PTG and greater PTSSs they perceived. Future studies need to explore the relationships of event centrality and coping and their associations with PTG and PTSSs.
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Affiliation(s)
- Danni Chi
- School of Psychology, Massey University, Wellington, New Zealand. .,Clinical Psychology Centre, Ningbo Kangning Hospital, Ningbo, China.
| | - Ian de Terte
- School of Psychology, Massey University, Wellington, New Zealand
| | - Dianne Gardner
- School of Psychology, Massey University, Palmerston North, New Zealand
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7
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Xu Q, Wu Y, Ji M, Wang M, Pan C, Ma J, You X. Proactive Coping and Mental Health Among Airline Pilots During China's Regular Prevention and Control of COVID-19: The Role of Perceived Stress and Social Support. Front Public Health 2022; 10:890145. [PMID: 35655460 PMCID: PMC9152254 DOI: 10.3389/fpubh.2022.890145] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/25/2022] [Indexed: 11/27/2022] Open
Abstract
Mental health has always been a prominent public health concern, and it has become more important in the wake of the COVID-19 pandemic. The mental health of airline pilots plays a significant role in their occupational health and overall performance. It is also vital for ensuring the safe operation of aircrafts. Therefore, it is crucial to identify the factors that may improve the mental health of pilots. This study investigates the relationship between proactive coping, perceived stress, social support, and mental health among airline pilots during China's regular prevention and control of COVID-19. Using a sample consisting of 285 Chinese commercial airline pilots, we tested a moderated mediation model to explore whether, how, and when proactive coping affects the mental health of pilots. The results show that proactive coping has a direct and positive effect on pilots' mental health, as well as an indirect effect on mental health through its influence on perceived stress. Social support was found to weaken the relationship between perceived stress and mental health. It also weakened the indirect relationship between proactive coping and mental health through perceived stress. These findings advance our understanding of the underlying mechanisms that affect the mental health of pilots. It also provides empirical evidence for effective mental health interventions for airline pilots during regular prevention and control of COVID-19.
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Affiliation(s)
- Quan Xu
- School of Psychology, Shaanxi Normal University, Xi'an, China.,Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, Xi'an, China
| | - Yaoliang Wu
- School of Psychology, Shaanxi Normal University, Xi'an, China.,Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, Xi'an, China
| | - Ming Ji
- School of Psychology, Shaanxi Normal University, Xi'an, China.,Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, Xi'an, China
| | - Mengyun Wang
- School of Psychology, Shaanxi Normal University, Xi'an, China.,Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, Xi'an, China
| | - Chao Pan
- School of Psychology, Shaanxi Normal University, Xi'an, China.,Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, Xi'an, China.,School of Computer Science and Technology, Xidian University, Xi'an, China
| | - Jie Ma
- Flight Department, China Eastern Airline Ltd. Anhui Branch, Hefei, China
| | - Xuqun You
- School of Psychology, Shaanxi Normal University, Xi'an, China.,Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, Xi'an, China
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Kesh Kumar S, Bharti DA. Depression, Anxiety and Stress Among Arsenic-Induced Cancer Patients in Indo-Gangetic Plains of Bihar: Role of Proactive Coping. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021:272684X211033460. [PMID: 34256635 DOI: 10.1177/0272684x211033460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Arsenic induced cancer is a major public health issue in Indo-Gangetic plains of Bihar, India where 22 out of 38 districts report arsenic contamination of groundwater. Its psychological aspect is under studied in contrast to the physiological and social. This baseline correlational survey research explores the relationship and role of proactive coping on depression, anxiety and stress among this population. Depression, anxiety and stress were assessed in 77 consenting arsenic induced cancer patients with depression, anxiety and stress scales. Proactive Coping was assessed with proactive coping inventory. Results demonstrated negative association and influence of proactive coping on stress, anxiety and depression. Avoidance coping associated positively with depression and reflective coping predicted for depression and anxiety. The findings advocate for more research attention on psychological aspects of arsenic induced cancer. Timely psychological interventions to build proactive coping are warranted to alleviate depression, anxiety and stress among this population.
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Affiliation(s)
- Shishu Kesh Kumar
- Department of Psychological Sciences, Central University of South Bihar, Gaya, 206411, India
| | - Das Ambika Bharti
- Department of Psychological Sciences, Central University of South Bihar, Gaya, 206411, India
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9
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Shi G, Shi T, Liu Y, Cai Y. Relationships between dyadic coping, intimate relationship and post-traumatic growth in patients with breast cancer: A cross-sectional study. J Adv Nurs 2021; 77:4733-4742. [PMID: 34227131 DOI: 10.1111/jan.14946] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 12/11/2022]
Abstract
AIM To investigate the relationships and pathways between dyadic coping, intimate relationship and post-traumatic growth (PTG) in Chinese patients with breast cancer. DESIGN A cross-sectional study. METHODS Between November 2019 and November 2020, 133 patients with breast cancer who received therapy in tertiary grade-A hospitals at Dalian, China completed questionnaires including demographic and clinical questionnaires, Locke-Wallace Marriage Adjustment Test, Chinese version of the Dyadic Coping Inventory and Chinese version of the Post-traumatic Growth Inventory. Structural equation modelling was used to analyse the pathways. RESULTS Dyadic coping was positively interrelated with PTG and intimate relationship (r = .355, p < .01; r = .213, p < .05); intimate relationship was negatively interrelated with PTG (r = -.207, p < .05). The structural equation model demonstrated adequate fit. Dyadic coping and intimate relationship directly affected PTG (β = .469, p < .05; β = -.309, p < .05). Dyadic coping indirectly affected PTG through intimate relationship (β = -.066, p < .05). CONCLUSIONS Dyadic coping was a stimulus factor, but intimate relationship was an obstructive factor in enhancing PTG for the Chinese patients with breast cancer. Furthermore, intimate relationship may have significant mediating effects in the link between dyadic coping and PTG. Strategies that improve dyadic coping level and avoid excessive intimacy relationships between couples contribute to the development of PTG among patients with breast cancer. IMPACT The research provides new ideas and intervention entry points for global nurses and psychotherapists so that they can enact and implement targeted PTG intervention plans for patients with breast cancer worldwide.
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Affiliation(s)
- Genya Shi
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tieying Shi
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yu Liu
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yingjie Cai
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China.,Nursing Department, Chiba University, Chiba, Japan
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Mendonça AB, Pereira ER, Magnago C, Medeiros AYBBV, Silva RMCRA, Martins ADO, Meira KC. Suffering experiences of people with cancer undergoing chemotherapy: A meta-ethnographic study. Nurs Health Sci 2021; 23:586-610. [PMID: 33817939 DOI: 10.1111/nhs.12839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022]
Abstract
This meta-ethnography had the objectives of identifying, evaluating, and summarizing the findings of qualitative studies regarding the suffering experiences of people undergoing chemotherapy, as well as developing an explanatory conceptual structure regarding what affects these experiences. A systematic literature review was carried out, covering the past 10 years, in the following databases: CINAHL, Embase, Medline, LILACS and Scopus. By using meta-ethnographic synthesis methods, the following themes were found: the pain of loss; evaluating, measuring, and neutralizing the threat; and social contours of suffering. The experience of living with cancer and undergoing chemotherapy was synthesized into a theoretical-explanatory model with a structure that resembles barbed-wire loops. The model expresses people's suffering experiences as marked by the feeling of loss, restraint of emotions, and resilience. While transcendent movements broke the cycle of suffering, resilience emerged as a learning experience that made patients more resistant to the pain of loss. The results indicated a complex and diverse set of factors that influence suffering, which confirmed that experiences are individual, comprehensive, and continuously reinterpreted.
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Affiliation(s)
- Angelo Braga Mendonça
- Healthcare Sciences Program, School of Nursing, Universidade Federal Fluminense, Niterói, Brazil
| | - Eliane Ramos Pereira
- Healthcare Sciences Program, School of Nursing, Universidade Federal Fluminense, Niterói, Brazil
| | - Carinne Magnago
- Public Health Faculty, Universidade de São Paulo, Niterói, Brazil
| | | | | | | | - Karina Cardoso Meira
- Health Sciences School, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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