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Karademas EC, Roziner I, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Stamatakos G, Cardoso F, Frasquilho D, Kolokotroni E, Lemos R, Marzorati C, Mattson J, Pettini G, Spyropoulou E, Poikonen-Saksela P, Simos P. The mutual determination of self-efficacy to cope with cancer and cancer-related coping over time: a prospective study in women with breast cancer. Psychol Health 2023; 38:1635-1648. [PMID: 35147473 DOI: 10.1080/08870446.2022.2038157] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/10/2021] [Accepted: 12/28/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of this study was to examine the longitudinal impact of self-efficacy to cope with cancer on the cancer-related coping reactions of breast cancer patients and vice versa. DESIGN AND MAIN OUTCOMES MEASURES Data from the BOUNCE Project (https://www.bounce-project.eu/) were used to address the hypotheses. Participants (N = 403) were enrolled in the study a few weeks after surgery or biopsy. Coping self-efficacy was assessed at baseline and six months later (M6). Cancer-related coping was assessed three (M3) and nine months (M9) after baseline. The analyses were performed using structural equation modeling with Mplus 8.6. RESULTS Baseline coping self-efficacy predicted all M3 coping reactions, while M6 coping self-efficacy also predicted changes in all but one M9 coping reaction. Moreover, one of the M3 coping reactions, that is, hopelessness/helplessness, predicted the changes in M6 coping self-efficacy. The relation between coping self-efficacy and one coping reaction (i.e. cognitive avoidance) was rather weak. Stability paths from M3 to M9 coping reactions were moderate to high. CONCLUSION The relationship between self-efficacy to cope with cancer and cancer-related coping is complex. New theoretical models are needed to more accurately describe the diverse aspects of this association.
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Affiliation(s)
- E C Karademas
- Department of Psychology, University of Crete, Rethymno, Greece
- Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - I Roziner
- Department of Communication Disorders, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - K Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - R Pat-Horenczyk
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - B Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - A J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
- NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal
| | - G Stamatakos
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - D Frasquilho
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
| | - E Kolokotroni
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - R Lemos
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
| | - C Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - J Mattson
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - G Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - E Spyropoulou
- Department of Psychology, University of Crete, Rethymno, Greece
| | - P Poikonen-Saksela
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - P Simos
- Foundation for Research and Technology - Hellas, Heraklion, Greece
- Medical School, University of Crete, Rethymno, Greece
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2
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Lemos J, Xiao M, Castro Appiani LM, Katz P, Kamal RN, Shapiro LM. Are Patient-Reported Outcome Measures for Distal Radius Fractures Validated for Spanish and Culture? A Systematic Review. J Hand Surg Am 2023; 48:673-682. [PMID: 37191603 PMCID: PMC10330065 DOI: 10.1016/j.jhsa.2023.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) are used commonly to assess function to direct treatment and evaluate outcomes for patients with distal radius fractures. Most PROMs have been developed and validated in English with minimal report of the demographics of patients studied. The validity of applying these PROMs among Spanish-speaking patients is unknown. The purpose of this study was to evaluate the quality and psychometric properties of Spanish-language adaptations of PROMs for distal radius fractures. METHODS We conducted a systematic review to identify published studies of adaptations of Spanish-language PROMs evaluating patients with distal radius fractures. We evaluated the methodologic quality of the adaptation and validation using Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures, Quality Criteria for Psychometric Properties of Health Status Questionnaire, and the Consensus-based Standards for the Selection of Health Measurement Instruments Checklist for Cross-Cultural Validity. The level of evidence was evaluated based upon prior methodology. RESULTS Five instruments reported in eight studies were included: the Patient-Rated Wrist Evaluation (PRWE), Disability of Arm Shoulder and Hand, Upper Limb Functional Index, Lawton Instrumental Activities of Daily Living Scale, and Short Musculoskeletal Function Assessment. The PRWE was the most frequently included PROM. No study followed all six processes for adaptation or assessed all measurement properties. No study demonstrated the completion of more than eight of the 14 aspects of cross-cultural validity. The PRWE had moderate evidence to support half of the domains of measurement properties evaluating the level of evidence. CONCLUSIONS None of the five instruments identified received a good rating on all three checklists. Only the PWRE demonstrated moderate evidence on half of the measurement domains. CLINICAL RELEVANCE Given the lack of strong evidence to support the quality of these instruments, we recommend adaptation and testing of PROMs for this population before use. Currently, PROMs in Spanish-speaking patients should be used with caution so as not to perpetuate health care disparities.
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Affiliation(s)
- Jacie Lemos
- VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Michelle Xiao
- VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | | | - Patricia Katz
- Department of Medicine, University of California - San Francisco, San Francisco CA
| | - Robin N Kamal
- VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Lauren M Shapiro
- Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, CA.
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Kapoor R, Owusu-Agyemang P, Feng L, Cata JP. The Impact of the Need for Language Assistance Services on the Use of Regional Anesthesia, Postoperative Pain Scores and Opioid Administration in Surgical Oncology Patients. J Pers Med 2023; 13:jpm13030481. [PMID: 36983663 PMCID: PMC10051324 DOI: 10.3390/jpm13030481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/19/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
Language barriers can negatively impact the quality of healthcare. In surgical patients, limited English proficiency (LEP) can lead to disparities in acute postoperative pain management. Interpreters are often used for communication with LEP patients to help alleviate these disparities. We aimed to investigate the impact of the need for language assistance services (LAS) in acute postoperative pain management in patients undergoing oncologic surgery. We retrospectively collected data on adult patients undergoing open abdominal oncologic surgery between March 2016 and August 2021. The need for LAS, patient demographics, treatment and clinical outcomes were obtained from the patient's electronic medical record. The primary endpoint was pain intensity, while secondary endpoints included opioid use in PACU and regional anesthesia. Post-matching analysis (n = 590) demonstrated no significant difference in preoperative variables between patients needing LAS and those not needing LAS. The rate of regional use was slightly lower but not statistically significant in patients needing LAS. Patients needing LAS had significantly lower opioid consumption and reported lower pain intensity in PACU than subjects not requiring translation. In this study, LAS may have aided in the patient decision process regarding the acceptance of regional anesthesia. Although the need for LAS was associated with statistically significant lower pain intensity scores and a corresponding lesser opioid use than no LAS, the margin of differences, especially in pain intensity scores, may not be clinically significant. This may suggest that LAS allowed for better patient-provider communication and appropriate pain management.
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Affiliation(s)
- Ravish Kapoor
- Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Pascal Owusu-Agyemang
- Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lei Feng
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Juan P Cata
- Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Ng DWL, Fielding R, Tsang C, Ng C, Chan J, Or A, Kong IWM, Tang JWC, Li WWY, Chang ATY, Foo CC, Kwong A, Ng SSM, Suen D, Chan M, Chun OK, Chan KKL, Butow PN, Lam WWT. Study protocol of ConquerFear-HK: a randomised controlled trial of a metacognition-based, manualised intervention for fear of cancer recurrence among Chinese cancer survivors. BMJ Open 2023; 13:e065075. [PMID: 36669845 PMCID: PMC9872480 DOI: 10.1136/bmjopen-2022-065075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/30/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Fear of cancer recurrence (FCR) is a prevalent and frequently debilitating response to a cancer diagnosis, affecting a substantial proportion of cancer survivors. Approximately 30% of local Hong Kong Chinese cancer survivors in a recent survey reportedly experienced persistent high FCR over the first-year post-surgery. This was associated with lower levels of psychological well-being and quality of life. A manualised intervention (ConquerFear) developed primarily based on the Self-Regulatory Executive Function Model and the Rational Frame Theory, has been found to reduce FCR effectively among Caucasian cancer survivors. The intervention now has been adapted to a Chinese context; ConquerFear-HK. The primary aim of this study is to evaluate its efficacy vs a standard-survivorship-care control (BasicCancerCare) in FCR improvement in a randomised control trial (RCT). METHODS AND ANALYSIS In this RCT, using the sealed envelope method, 174 eligible Chinese cancer survivors will be randomised to either the ConquerFear-HK or BasicCancerCare intervention. Both interventions include six sessions over 10 weeks, which will be delivered via face to face or online by trained therapists. The ConquerFear-HK intervention incorporates value classification, metacognitive therapy, attentional training, detached mindfulness and psychoeducation; BasicCancerCare includes relaxation training, dietary and physical activity consultations. Participants will be assessed at prior randomisation (baseline; T0), immediately postintervention (T1), 3 months (T2) and 6 months postintervention (T3) on the measures of FCR (Fear of Cancer Recurrence Inventory) as a primary outcome; metacognition (30-item Metacognitions Quesionnaire) and cognitive attentional syndrome (Cognitive-attentional Syndrome Questionnaire) as process outcomes; psychological distress (Hospital Anxiety and Depression Scale), cancer-related distress (Chinese Impact of Events Scale), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire) and treatment satisfaction are secondary outcomes. ETHICS AND DISSEMINATION Ethics approval has been obtained from HKU/HA HKW Institutional Review Board (ref: UW19-183). The patients/participants provide their written informed consent to participate in this study. The study results will be disseminated through international peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER NCT04568226.
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Affiliation(s)
- Danielle Wing Lam Ng
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Richard Fielding
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Catherine Tsang
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Carmen Ng
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Joyce Chan
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Amy Or
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Izy Wing Man Kong
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Julia Wei Chun Tang
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wylie Wai Yee Li
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Amy Tien Yee Chang
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chi Choo Foo
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Simon Siu-Man Ng
- Department of Surgery, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Dacita Suen
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Miranda Chan
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Oi-Kwan Chun
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Karen Kar Loen Chan
- Department of Obstetric and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong
| | - Phyllis N Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Wendy Wing Tak Lam
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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Barriers and Facilitators of Pain Self-Management Among Patients with Cancer: An Integrative Review. Pain Manag Nurs 2023; 24:138-150. [PMID: 36653220 DOI: 10.1016/j.pmn.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Defining the main barriers and facilitators of cancer pain self-management are essential to improve patients' overall quality of life. AIM The main purpose of this review was to identify the main barriers and facilitators for cancer pain self-management. METHOD An integrative review guided by the five-stages framework that was identified by Souza et al. (2010) was used: (1) preparing the guiding question; (2) searching or sampling the literature; (3) data collection; (4) critical analysis of the studies; and (5) discussion of results. A comprehensive literature review was conducted using the electronic databases of PubMed/MEDLINE, CINAHL, Scopus, and Psych INFO. RESULTS Twenty-two studies were identified. The main facilitators that foster the process of cancer pain self-management were supportive ambiances including family caregivers as well as health care providers, active participation of patients with cancer in health care including self-discovery and self-awareness, acquiring pain knowledge, and using a pain diary. The main barriers include concerns regarding the use of pain medications, knowledge deficit, negative beliefs and attitudes, unsupportive ambiance, and psychological distress. Some patients' characteristics could be related to these barriers such as age, sex, race, marital status, educational level, level of pain, and presence of comorbidity. CONCLUSIONS Patients with cancer pain experience multiple barriers and facilitators when attempting to take on an active role in managing their pain.
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Fisher HM, Stalls J, Winger JG, Miller SN, Plumb Vilardaga JC, Majestic C, Kelleher SA, Somers TJ. Role of self-efficacy for pain management and pain catastrophizing in the relationship between pain severity and depressive symptoms in women with breast cancer and pain. J Psychosoc Oncol 2023; 41:87-103. [PMID: 35311481 PMCID: PMC9489816 DOI: 10.1080/07347332.2022.2046676] [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: 01/31/2023]
Abstract
PURPOSE This study evaluated the relationship between pain and depressive symptoms through pain self-efficacy and pain catastrophizing in breast cancer patients with pain. DESIGN Secondary analysis of a randomized trial investigating a cognitive-behavioral pain management protocol. SAMPLE Females (N = 327) with stage I-III breast cancer and report of at least moderate pain. METHODS Pain severity, pain self-efficacy, pain catastrophizing, and depressive symptoms were measured. The proposed model was assessed using structural equation modeling. RESULTS Higher pain severity was significantly related to lower pain self-efficacy and higher pain catastrophizing. Lower pain self-efficacy and higher pain catastrophizing were significantly related to more depressive symptoms. Higher pain severity was significantly associated with more depressive symptoms through lower pain self-efficacy and higher pain catastrophizing. The association between pain severity and depressive symptoms was not significant when specified as a direct effect. CONCLUSION Pain severity related to depressive symptoms in breast cancer patients via pain self-efficacy and pain catastrophizing. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Measurement of pain self-efficacy and pain catastrophizing should be incorporated into comprehensive pain assessments for women with breast cancer, as these variables may be relevant therapeutic targets. Psychosocial symptom management interventions should include strategies that increase pain self-efficacy and decrease pain catastrophizing because these pain-related cognitive variables appear to drive the relationship between pain severity and depressive symptoms.
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Affiliation(s)
- Hannah M. Fisher
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann Stalls
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Joseph G. Winger
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Shannon N. Miller
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | | | - Catherine Majestic
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Sarah A. Kelleher
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
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Schwartz H, Menza R, Lindquist K, Mackersie R, Fernández A, Stein D, Bongiovanni T. Limited English Proficiency Associated With Suboptimal Pain Assessment in Hospitalized Trauma Patients. J Surg Res 2022; 278:169-178. [DOI: 10.1016/j.jss.2022.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/22/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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Roberson PNE, Cortez G, Freeman T, Lloyd J, Tasman J, Woods SB. Relationship quality and psychophysiological distress for underserved breast cancer patients and their caregiver before treatment. Psychooncology 2022; 31:1904-1912. [PMID: 36116101 DOI: 10.1002/pon.6035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/21/2022] [Accepted: 07/24/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Breast cancer patients and caregivers experience biobehavioral reactivity (e.g., depression, anxiety, pain, fatigue) during breast cancer treatment which predicts cancer recurrence and mortality. High quality patient-caregiver relationships can mitigate this distress during treatment, but this association is unclear pre-treatment. Identifying early interventions that target high risk Appalachian patients could impact biobehavioral reactivity. METHODS We recruited 55 breast cancer patient-caregiver dyads to complete a self-report survey after diagnosis but before treatment. We used a series of Actor-Partner Interdependence Models to test the hypotheses that both patient and caregiver relationship quality would be linked to their own and their partners' biobehavioral reactivity. RESULTS Caregiver reported marital quality lower caregiver anxiety, patient anxiety, caregiver depression, patient depression, caregiver pain, and caregiver fatigue. Interestingly, patient-reported marital quality was linked with higher caregiver anxiety, higher patient anxiety, lower patient depression, and lower patient pain. Patients reported family quality was linked to lower patient and caregiver pain. CONCLUSIONS This study demonstrates that pre-treatment marital and family quality levels are directly related to psychophysiological measures in both the caregiver and the patient, though sometimes in unexpected directions. Additionally, our findings potentially reveal an opportunity to intervene at the time of diagnosis to improve relationship quality, impacting patient and caregiver psychophysiological outcomes.
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Affiliation(s)
| | - Gina Cortez
- Public Health, University of California, Los Angles, USA
| | - Teri Freeman
- Cancer Institute, University of Tennessee Medical Center, Knoxville, Tennessee, USA
| | - Jillian Lloyd
- Cancer Institute, University of Tennessee Medical Center, Knoxville, Tennessee, USA
| | - Jordan Tasman
- Department of Public Health, University of Tennessee, Knoxville, Tennessee, USA
| | - Sarah B Woods
- Family and Community Medicine, University of Texas Southwestern, Dallas, Texas, USA
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Rha SY, Song SK, Lee J. Self-efficacy for coping with cancer and quality of life in advanced gastric cancer patients. Eur J Oncol Nurs 2022; 58:102120. [DOI: 10.1016/j.ejon.2022.102120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 12/09/2022]
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Karademas EC, Simos P, Pat-Horenczyk R, Roziner I, Mazzocco K, Sousa B, Stamatakos G, Tsakou G, Cardoso F, Frasquilho D, Kolokotroni E, Marzorati C, Mattson J, Oliveira-Maia AJ, Perakis K, Pettini G, Vehmanen L, Poikonen-Saksela P. The Interplay Between Trait Resilience and Coping Self-efficacy in Patients with Breast Cancer: An International Study. J Clin Psychol Med Settings 2022; 30:119-128. [PMID: 35488971 DOI: 10.1007/s10880-022-09872-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 01/22/2023]
Abstract
The role of self-efficacy to cope with breast cancer as a mediator and/or moderator in the relationship of trait resilience to quality of life and psychological symptoms was examined in this study. Data from the BOUNCE Project ( https://www.bounce-project.eu/ ) were used. Women diagnosed with and in treatment for breast cancer (N = 484), from four countries, participated in the study. Trait resilience and coping self-efficacy were assessed at baseline (soon after the beginning of systemic treatment), and outcomes (quality of life, psychological symptoms) 3 months later. Hierarchical regression, mediation, moderation, and conditional (moderated) mediation and moderation analyses were performed to examine the study hypotheses. Coping self-efficacy mediated the impact of trait resilience. In addition, higher levels of resilience in combination with higher levels of coping self-efficacy were associated with better outcomes. Country of origin had no impact on these results. Overall, it seems that coping self-efficacy is a key factor that should be taken into account for research and intervention efforts in cancer.
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Affiliation(s)
- E C Karademas
- Department of Psychology, University of Crete, and Foundation for Research and Technology - Hellas, Rethymno, Greece.
| | - P Simos
- Medical School, University of Crete, and Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - R Pat-Horenczyk
- Department of Communication Disorders, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - I Roziner
- Department of Communication Disorders, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - K Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology & Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - B Sousa
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Champalimaud Research, Lisbon, Portugal
| | - G Stamatakos
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - G Tsakou
- SingularLogic S.A, Athens, Greece
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - D Frasquilho
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
| | - E Kolokotroni
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - C Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - J Mattson
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki University, Helsinki, Finland
| | - A J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, and NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - G Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - L Vehmanen
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki University, Helsinki, Finland
| | - P Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki University, Helsinki, Finland
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Clarke G, Chapman E, Crooks J, Koffman J, Ahmed S, Bennett MI. Does ethnicity affect pain management for people with advanced disease? A mixed methods cross-national systematic review of 'very high' Human Development Index English-speaking countries. BMC Palliat Care 2022; 21:46. [PMID: 35387640 PMCID: PMC8983802 DOI: 10.1186/s12904-022-00923-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Racial disparities in pain management have been observed in the USA since the 1990s in settings such as the emergency department and oncology. However, the palliative care context is not well described, and little research has focused outside of the USA or on advanced disease. This review takes a cross-national approach to exploring pain management in advanced disease for people of different racial and ethnic groups. METHODS Mixed methods systematic review. The primary outcome measure was differences in receiving pain medication between people from different racial and ethnic groups. Five electronic databases were searched. Two researchers independently assessed quality using JBI checklists, weighted evidence, and extracted data. The quantitative findings on the primary outcome measure were cross-tabulated, and a thematic analysis was undertaken on the mixed methods studies. Themes were formulated into a conceptual/thematic matrix. Patient representatives from UK ethnically diverse groups were consulted. PRISMA 2020 guidelines were followed. RESULTS Eighteen papers were included in the primary outcome analysis. Three papers were rated 'High' weight of evidence, and 17/18 (94%) were based in the USA. Ten of the eighteen (56%) found no significant difference in the pain medication received between people of different ethnic groups. Forty-six papers were included in the mixed methods synthesis; 41/46 (89%) were based in the USA. Key themes: Patients from different ethnically diverse groups had concerns about tolerance, addiction and side effects. The evidence also showed: cultural and social doctor-patient communication issues; many patients with unmet pain management needs; differences in pain assessment by racial group, and two studies found racial and ethnic stereotyping. CONCLUSIONS There was not enough high quality evidence to draw a conclusion on differences in receiving pain medication for people with advanced disease from different racial and ethnic groups. The mixed methods findings showed commonalities in fears about pain medication side effects, tolerance and addiction across diverse ethnic groups. However, these fears may have different foundations and are differently prioritised according to culture, faith, educational and social factors. There is a need to develop culturally competent pain management to address doctor-patient communication issues and patients' pain management concerns. TRIAL REGISTRATION PROSPERO- CRD42020167890 .
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Affiliation(s)
- Gemma Clarke
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK.
| | - Emma Chapman
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK
| | - Jodie Crooks
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK
| | - Jonathan Koffman
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, England, UK
| | - Shenaz Ahmed
- Division of Psychological & Social Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK
| | - Michael I Bennett
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK
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12
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Saab M, Hartmann M, Han X. Defense Mechanism Functioning in Patients With Breast Cancer: Using the Defense Mechanism Rating Scale. Front Psychol 2021; 12:666373. [PMID: 34456786 PMCID: PMC8385787 DOI: 10.3389/fpsyg.2021.666373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/05/2021] [Indexed: 02/04/2023] Open
Abstract
Background: Breast cancer (BC) is one of the highest incidence rates in Lebanon. Previous studies had focused scarcely on the unconscious protective shield of patients with BC or BC survivors against cancer, while only some studies had focused on the relationship between defense mechanisms (DMs) and high adaptation with the disease process and progress. Therefore, this study aimed to investigate the reaction of inpatients with BC toward the disease by measuring DMs in the Lebanon context. Methods: Seventy inpatients with BC were recruited randomly from six hospitals. Their DMs were measured using the Defense Mechanism Rating Scale. Moreover, the Relationship Anecdotes Paradigm (RAP) was used with three recent life vignettes of initial diagnosis, family, and daily life. The data were analyzed using repeated measure ANOVA, Wilcoxon rank-sum test, and Spearman's rank. Results: Patients with stage 2 BC used more high-adaptive defense levels than patients with stage 4 BC who used more minor image distorting defense levels. Moreover, patients with stage 2 BC used more self-observation and undoing, while patients with stage 4 BC used more devaluation. Conclusion: The severity of BC, the age of carriers, and the social status may lead to higher use of DMs, at the level of the individual defense and the hierarchal or the tripartite levels.
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Affiliation(s)
- Marwa Saab
- School of Psychology, Northeast Normal University, Changchun, China
| | - Matias Hartmann
- School of Psychology, Northeast Normal University, Changchun, China
| | - Xue Han
- School of Psychology, Northeast Normal University, Changchun, China
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13
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Bulls HW, Chang PH, Brownstein NC, Zhou JM, Hoogland AI, Gonzalez BD, Johnstone P, Jim HSL. Patient-reported symptom burden in routine oncology care: Examining racial and ethnic disparities. Cancer Rep (Hoboken) 2021; 5:e1478. [PMID: 34165256 PMCID: PMC8955049 DOI: 10.1002/cnr2.1478] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/07/2022] Open
Abstract
Background Racial and ethnic disparities are well‐documented in cancer outcomes such as disease progression and survival, but less is known regarding potential disparities in symptom burden. Aims The goal of this retrospective study was to examine differences in symptom burden by race and ethnicity in a large sample of cancer patients. We hypothesized that racial and ethnic minority patients would report greater symptom burden than non‐Hispanic and White patients. Methods and results A total of 5798 cancer patients completed the Edmonton Symptom Assessment Scale—revised (ESAS‐r‐CSS) at least once as part of clinical care. Two indicators of symptom burden were evaluated: (1) total ESAS‐r‐CSS score (i.e., overall symptom burden) and (2) number of severe symptoms (i.e., severe symptomatology). For patients completing the ESAS‐r‐CSS on multiple occasions, the highest score for each indicator was used. Zero‐inflated negative binomial regression analyses were conducted, adjusting for other sociodemographic and clinical characteristics. Symptomology varied across race. Patients who self‐identified as Black reported higher symptom burden (p = .016) and were more likely to report severe symptoms (p < .001) than self‐identified White patients. Patients with “other” race were also more likely to report severe symptoms than White patients (p = .032), but reported similar total symptom burden (p = .315). Asian and Hispanic patients did not differ from White or non‐Hispanic patients on symptom burden (ps > .05). Conclusion This study describes racial disparities in patient‐reported symptom burden during routine oncology care, primarily observed in Black patients. Clinic‐based electronic symptom monitoring may be useful to detect high symptom burden, particularly in patients who self‐identify their race as Black or other. Future research is needed to reduce symptom burden in racially diverse cancer populations.
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Affiliation(s)
- Hailey W Bulls
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA.,Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Pi-Hua Chang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.,School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Naomi C Brownstein
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida, USA.,Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jun-Min Zhou
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Peter Johnstone
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
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14
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Rich BJ, Schumacher LED, Sargi ZB, Masforroll M, Kwon D, Zhao W, Rueda-Lara MA, Freedman LM, Elsayyad N, Samuels SE, Abramowitz MC, Samuels MA. Opioid use patterns in patients with head and neck cancer receiving radiation therapy: Single-institution retrospective analysis characterizing patients who did not require opioid therapy. Head Neck 2021; 43:2973-2984. [PMID: 34143542 DOI: 10.1002/hed.26785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/06/2021] [Accepted: 06/07/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We had previously analyzed the variables that determine the rates of opioid use at 1-year postradiotherapy in patients with head and neck cancer. Here we analyze the variables associated with opioid abstinence during and in the 12 months after radiotherapy at our institution. METHODS We identified a cohort of patients with head and neck cancer who received radiotherapy as part of curative treatment at our institution. Logistic regression analyses were performed to determine socioeconomic and clinical factors associated with opioid abstinence. RESULTS The cohort included 376 patients. On multivariable analysis, patients from an upper-income class (p = 0.004), black race (p = 0.004), older (p = 0.008), with dependent children (p < 0.001) or receiving surgery (p = 0.002) were more likely to abstain from opioids, while patients using analgesic mouthwash (p = 0.009) or higher pain scale (p = 0.002) were less likely. CONCLUSION Socioeconomic and treatment characteristics are associated with opioid abstinence during and following radiation treatment in patients with head and neck cancer.
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Affiliation(s)
- Benjamin J Rich
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Leif-Erik D Schumacher
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Zoukaa B Sargi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Deukwoo Kwon
- Department of Public Health Sciences, Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Wei Zhao
- Department of Public Health Sciences, Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maria A Rueda-Lara
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Laura M Freedman
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nagy Elsayyad
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Stuart E Samuels
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Matthew C Abramowitz
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Michael A Samuels
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
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15
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Heydari F, Namvar D, Heydari F, Heydari F, Van P. Use of Interpreter Services Among Farsi-Speaking Podiatric Patients and Adherence to the Pain Management Plan. J Am Podiatr Med Assoc 2021; 111:442231. [PMID: 32756906 DOI: 10.7547/18-003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patients with limited English proficiency (LEP) encounter many health disparities and inequalities due to the lack of effective communication. The lack of effective communication places patients with LEP at higher risk for noncompliance with the treatment plan. Pain is one of the main common health issues, and patients with LEP have difficulties reporting their pain and adhering to the plan of care due to the lack of effective communication. METHODS We measured the effectiveness of using a professional interpreter during office visits for Farsi-speaking patients with LEP to improve pain management and adherence with follow-up visits. In this single-sample quasi-experimental study, 16 Farsi-speaking participants with LEP who visited a podiatric medical office for foot pain rated their pain level at the initial visit and after the intervention during the first follow-up visit. Participants were provided with a professional Farsi-speaking interpreter during the visit. RESULTS Overall, patients reported lower mean ± SD levels of pain during the follow-up visit (4.19 ± 2.29) than at the initial visit (6.56 ± 2.03). Of all of the participants, 75% attended the follow-up appointment, demonstrating that most of the participants adhered to the plan of care. CONCLUSIONS The use of a professional interpreter during an office visit for patients with LEP was associated with improved pain management outcomes and increased adherence to the treatment plan.
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16
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Orhurhu V, Khan F, Salisu Orhurhu M, Agudile E, Urits I, Hasoon J, Owais K, Chu R, Ogunsola D, Viswanath O, Yazdi C, Karri J, Hirji S, Gill J, Simopoulos T. Obesity Trends Amongst Hospitalized Patients with Spinal Cord Stimulator Implants. Adv Ther 2020; 37:4614-4626. [PMID: 32935285 DOI: 10.1007/s12325-020-01487-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Chronic pain remains an important public health problem as it continues to increase healthcare-related cost. Comorbidities like obesity have been associated with efficacy of spinal cord stimulator (SCS) therapy and worse outcomes. The goal of this study is to investigate the trends of obesity amongst hospitalized patients with SCS therapy as well as healthcare utilization outcomes. METHODS Using the International Classification of Diseases (ICD) ninth and tenth procedure and diagnosis code, we investigated the National Inpatient Sample (NIS) for patients with SCS implants between 2011 and 2015. Patients received a diagnosis of obesity based on the following categories: class I, II and III obesity. Age, gender, and comorbid conditions of patients with obesity were matched 1:1 on propensity score to those without obesity diagnosis. Our primary outcome was defined as trend of obesity diagnosis. Our secondary outcome, healthcare utilization, included in-hospital cost, length of stay, and discharge location. RESULTS Between 2011 and 2015, a total of 3893 patients with SCS implants were identified (average age 56 ± 15 years, 58% female, 0.70 ± 1.1 Charlson Comorbidity Index, CCI). Of this cohort, 640 patients were identified as obese. The proportion of patients with obesity diagnosis increased significantly from 13.75% in 2011 to 19.36% in 2015 (p < 0.001). After 1:1 matching on propensity score, 597 patients with obesity were successfully matched to 597 patients without obesity. The total hospital cost for SCS patients with obesity (median $104,845, IQR $74,648-144,292) was not significantly different from patients without obesity diagnosis (median $111,092, IQR $68,990-145,459) (p = 0.161). CONCLUSIONS The data from our study suggests that there is an increasing rate of obesity diagnosis amongst patients with SCS therapy. However, there was no difference in healthcare utilization between patients with and without obesity. Additional studies may provide more insight into our findings.
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Affiliation(s)
- Vwaire Orhurhu
- Department of Anesthesia, Critical Care and Pain Medicine, Division of Pain, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Faizan Khan
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mariam Salisu Orhurhu
- Department of Anesthesia, Critical Care and Pain Medicine, Division of Pain, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emeka Agudile
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ivan Urits
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jamal Hasoon
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Khurram Owais
- Department of Anesthesiology, Critical Care and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert Chu
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Dotun Ogunsola
- Department of Epidemiology and Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Omar Viswanath
- Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
| | - Cyrus Yazdi
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jay Karri
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Samir Hirji
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jatinder Gill
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Thomas Simopoulos
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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17
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Magaña D. Praying to win this battle: Cancer Metaphors in Latina and Spanish Women's Narratives. HEALTH COMMUNICATION 2020; 35:649-657. [PMID: 30810391 DOI: 10.1080/10410236.2019.1582310] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study closely examines 51 breast cancer narratives Latina and Spanish women wrote for other patients to illuminate how they conceptualize their health, with insights for addressing health disparities. Using discourse analysis of the role of language and culture in health care communication, this study focuses on the use of metaphors in the narratives. This provides revelations about the cultural and linguistic aspects of how the writers conceptualize their disease. Building on past research on metaphor use in cancer discourse in the English language, this study reveals the prevalence of metaphors comparing cancer to combat, or more generally, violence (e.g., "my battle against cancer"), or a journey (e.g., "my path with cancer"). Writers used this metaphorical language to offer advice to others with cancer and to mark their membership in a larger community of people with cancer. We also find that Spanish women use metaphors more frequently than Latinas and that they differed in their metaphorical portrayals of cancer. This research uncovers culturally embedded themes that are central to how women with cancer think about the disease, such as the prominence of spirituality in Latinas' metaphorical constructions, a pattern not evident in Spanish women's narratives.
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Affiliation(s)
- Dalia Magaña
- Department of Literature, Languages & Cultures, School of Social Sciences, Humanities & Arts, University of California
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18
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Mustajoki M, Forsén T, Kauppila T. Pain assessment in native and non-native language: difficulties in reporting the affective dimensions of pain. Scand J Pain 2019; 18:575-580. [PMID: 29990307 DOI: 10.1515/sjpain-2018-0043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/11/2018] [Indexed: 11/15/2022]
Abstract
Background and aims The language in assessing intensity or quality of pain has been studied but the results have been inconsistent. The physicians' language skills might affect the estimation of the severity of pain possibly leading to insufficient use of analgesics. Several interfering cultural factors have complicated studies aimed at exploring the language used to detect the quality of pain. We aimed to compare native and non-native language related qualitative aspects of pain chosen by Swedish speaking patients with diabetes. Methods In the study participated 10 Finnish and 51 Swedish speaking patients with diabetes. The Pain Detect-questionnaire was used for clarifying the patients' pain and the mechanism of their pain (neuropathic or not) and for assessing the intensity and quality of pain. In addition, the patients completed the short-form McGill Pain Questionnaire (sfMPQ) in Finnish (test I). After 30 min the subjects completed the sfMPQ a second time in their native language (test II). The Swedish speakers estimated their second language, Finnish, proficiency on a 5-graded scale. Results There were significantly more discrepancies between sfMPQ test I and test II among the Swedish speaking respondents who reported poor (hardly none) Finnish language proficiency compared with those with good Finnish proficiency. Discrepancies occurred especially between the affective qualities of pain. Conclusions Poor second language proficiency exposes Swedish speakers to pain communication difficulties related to the affective aspects of pain. Consequently, discordant language communication could cause underestimation of the severity of pain and pain undertreatment. Implications To ensure adequate pain treatment measuring the affective dimension of pain in the patient's native language is crucial.
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Affiliation(s)
- Marianne Mustajoki
- University of Helsinki, Department of General Practice and Primary Health Care, Kiskontie 23 B, 00280 Helsinki, Finland, Phone +358 503810837
| | - Tom Forsén
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland
| | - Timo Kauppila
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland
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19
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Amnie AG. An Investigation of Predictors of Self-efficacy to Cope with Stress and Implications for Health Education Practice. AMERICAN JOURNAL OF HEALTH EDUCATION 2018. [DOI: 10.1080/19325037.2018.1431165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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20
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A meta-analytic review of the relationship of cancer coping self-efficacy with distress and quality of life. Oncotarget 2018; 8:36800-36811. [PMID: 28404938 PMCID: PMC5482699 DOI: 10.18632/oncotarget.15758] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 01/25/2017] [Indexed: 12/27/2022] Open
Abstract
Self-efficacy for coping with cancer is a specific construct that refers to behaviors that occur in the course of dealing with a cancer diagnosis, cancer treatments, and transitioning to survivorship. One of the more widely used measures of self-efficacy for coping strategies with cancer is the Cancer Behavior Inventory. The following general questions provide a framework for this research: 1. Is self-efficacy for coping with cancer related to distress and quality of life of a cancer patient?. 2. Do self-efficacy for coping with cancer and the target psychological outcomes (i.e., distress and quality of life) change in longitudinal studies, with or without intervention? One-hundred eighty studies cited the different versions of the Cancer Behavior Inventory and 47 used the scale. Result showed an inverse relationship between self-efficacy for coping with cancer and distress, and a positive relationship between self-efficacy for coping with cancer and Quality of Life, both with a large effect size. The strong relationship of self-efficacy and outcomes, resulted of the specificity of the instrument, which targets specific coping strategies that are closely aligned with positive outcomes in adjusting to cancer. However, the results are consistent with the theory, which states that compared to those with low efficacy, highly efficacious people demonstrate less anxiety and better adjustment in stressful situations and consistent with prior results in which self-efficacy is positively related to quality of life.
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Samuel CA, Schaal J, Robertson L, Kollie J, Baker S, Black K, Mbah O, Dixon C, Ellis K, Eng E, Guerrab F, Jones N, Kotey A, Morse C, Taylor J, Whitt V, Cykert S. Racial differences in symptom management experiences during breast cancer treatment. Support Care Cancer 2017; 26:1425-1435. [PMID: 29150730 DOI: 10.1007/s00520-017-3965-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/07/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Racial disparities in cancer treatment-related symptom burden are well documented and linked to worse treatment outcomes. Yet, little is known about racial differences in patients' treatment-related symptom management experiences. Such understanding can help identify modifiable drivers of symptom burden inequities. As part of the Cancer Health Accountability for Managing Pain and Symptoms (CHAMPS) study, we examined racial differences in symptom management experiences among Black and White breast cancer survivors (BCS). METHODS We conducted six focus groups (n = 3 Black BCS groups; n = 3 White BCS groups) with 22 stages I-IV BCS at two cancer centers. Focus groups were audio-recorded and transcribed verbatim. Based on key community-based participatory research principles, our community/academic/medical partner team facilitated focus groups and conducted qualitative analyses. RESULTS All BCS described positive symptom management experiences, including clinician attentiveness to symptom concerns and clinician recommendations for pre-emptively managing symptoms. Black BCS commonly reported having to advocate for themselves to get information about treatment-related symptoms, and indicated dissatisfaction regarding clinicians' failure to disclose potential treatment-related symptoms or provide medications to address symptoms. White BCS often described dissatisfaction regarding inadequate information on symptom origins and clinicians' failure to offer reassurance. CONCLUSIONS This study elucidates opportunities for future research aimed at improving equity for cancer treatment-related symptom management. For Black women, warnings about anticipated symptoms and treatment for ongoing symptoms were particular areas of concern. Routine symptom assessment for all women, as well as clinicians' management of symptoms for racially diverse cancer patients, need to be more thoroughly studied and addressed.
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Affiliation(s)
- Cleo A Samuel
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA. .,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, 27599, USA.
| | - Jennifer Schaal
- The Partnership Project, 620 S. Elm St, Suite 381, Greensboro, NC, 27406, USA
| | - Linda Robertson
- Department of Medicine, University of Pittsburgh, 5150 Centre Avenue, POB 2 Room, 438, Pittsburgh, PA, 15232, USA
| | - Jemeia Kollie
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Stephanie Baker
- Department of Public Health Studies, Elon University, Campus Box 2337, Elon, NC, 27224, USA
| | - Kristin Black
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.,Cancer Health Disparities Training Program, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7440, Chapel Hill, NC, 27599-7440, USA
| | - Olive Mbah
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Crystal Dixon
- Department of Public Health Education, University of North Carolina at Greensboro, 437 Coleman Building, P.O. Box 26170, Greensboro, NC, 27402-6169, USA
| | - Katrina Ellis
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.,Cancer Health Disparities Training Program, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7440, Chapel Hill, NC, 27599-7440, USA
| | - Eugenia Eng
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.,Cancer Health Disparities Training Program, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7440, Chapel Hill, NC, 27599-7440, USA
| | - Fatima Guerrab
- Department of Public Health Education, North Carolina Central University, 1801 Fayetteville St, Durham, NC, 27701, USA
| | - Nora Jones
- Sisters Network Greensboro, P.O. Box 20304, Greensboro, NC, 27420, USA
| | - Amanda Kotey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Claire Morse
- Guilford College, 5800 W Friendly Ave, Greensboro, NC, 27410, USA
| | - Jessica Taylor
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Vickie Whitt
- Sisters Network Greensboro, P.O. Box 20304, Greensboro, NC, 27420, USA
| | - Samuel Cykert
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, 27599, USA.,School of Medicine, University of North Carolina at Chapel Hill, 5034 Old Clinic Building, CB#7110, Chapel Hill, NC, 27599, USA
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Apenteng BA, Hansen AR, Opoku ST, Mase WA. Racial Disparities in Emotional Distress Among Cancer Survivors: Insights from the Health Information National Trends Survey (HINTS). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:556-565. [PMID: 26801510 DOI: 10.1007/s13187-016-0984-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to examine the impact of race, cancer history, and their interaction on emotional distress among a nationally representative sample of US adults. Data utilized for this analysis were obtained from the first, second, and fourth iterations of the fourth cycle of the Health Information National Trends Survey (HINTS). The study sample included 3959, 3630, and 3677 respondents for the years 2011, 2012, and 2014, respectively, for a total sample size of 11,266. A multivariable ordered logistic regression model was used to assess the relationship between emotional distress, race, and cancer history. The effect of cancer history on emotional distress was found to be moderated by race. Specifically, emotional distress was significantly higher among African American cancer survivors. Factors found to be protective against emotional distress included healthy lifestyle, older age, and higher income. Factors associated with high levels of emotional distress included poor general health status, low self-efficacy, and being female. The authors recommend the design, advancement, and implementation of evidence-based culturally sensitive interventions aimed at effectively screening and managing psychological distress symptoms, particularly among African American long-term cancer survivor patient populations.
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Affiliation(s)
- Bettye A Apenteng
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA
| | - Andrew R Hansen
- Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA.
| | - Samuel T Opoku
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA
| | - William A Mase
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA
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Lu J, Zeng X, Liao J, Zhang Y, Yang L, Li Y, Lv J. Effectiveness of an Intervention to Promote Self-Efficacy on Quality of Life of Patients with Nasopharyngeal Carcinoma of the Zhuang Tribe Minority in Guangxi, China: A Prospective Study. Med Sci Monit 2017; 23:4077-4086. [PMID: 28832557 PMCID: PMC5578692 DOI: 10.12659/msm.903205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Nasopharyngeal carcinoma (NPC) is endemic in China and patient self-management is poor. Minorities may suffer from psychological problems during treatments for NPC. This study aimed to implement an intervention to promote self-efficacy of minority patients (Zhuang tribe, Guangxi, China) with NPC to improve their quality of life (QOL). Material/Methods This was a prospective study of 120 patients with NPC treated at the First Affiliated Hospital of Guangxi Medical University (Guangxi, China), randomized to conventional care (n=60, controls) or conventional care plus self-efficacy interventions based on health education, behavior therapy, and psychological intervention (n=60, self-efficacy group). Self-efficacy was evaluated using the general self-efficacy scale, and QOL using the EORTC QLQ-C30. The questionnaires were completed at discharge, at 6 months, and at 1 and 2 years. The primary outcome was QOL. Results There was no difference in QOL at baseline. From study start to hospital discharge, overall QOL scores decreased in both groups, but this decrease was more important in the control group (controls: −39.31 vs. self-efficacy: −27.04, P<0.05). After discharge, each functional field QOL scores and overall QOL increased with time in the 2 groups, and they were significantly higher in the self-efficacy group. Conclusions This intervention promoting self-efficacy could increase patients’ own potential and initiative, enhance their confidence and ability to solve health problems, improve their coping with adverse effects of treatments, and have positive effects on their QOL. Self-efficacy theory-based interventions could be worth popularization during the treatment and recovery of minority patients with NPC.
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Affiliation(s)
- Jiamei Lu
- Radiotherapy Division, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Xiaofen Zeng
- Radiotherapy Division, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Jinlian Liao
- Radiotherapy Division, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Yong Zhang
- Radiotherapy Division, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Li Yang
- Nursing Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Yuming Li
- Mental Health Division, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Jun Lv
- Radiotherapy Division, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
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Moghaddam Tabrizi F, Alizadeh S, Barjasteh S. Managerial Self-Efficacy for Chemotherapy-Related Symptoms and Related Risk Factors in Women with Breast Cancer. Asian Pac J Cancer Prev 2017; 18:1549-1553. [PMID: 28669166 PMCID: PMC6373813 DOI: 10.22034/apjcp.2017.18.6.1549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Breast cancer is one of the most important diseases affecting physical, psychological and social health
of women. This study aimed to determine managerial self-efficacy regarding chemotherapy-related symptoms and
related risk factors in Iranian patients. Materials and methods: This descriptive-analytical cross-sectional study was
conducted on 150 patients with breast cancer referred to medical centers of Urmia in 2016 with a convenience sampling
method . The data collection instrument was the symptom-management self-efficacy scale-breast cancer (SMSES-BC)
questionnaire whose validity and reliability was evaluated for the first time for Iranians. Data were analyzed using SPSS
software version 20. Results: Most of the patients were in the age range of 41-49 years. Lowest scores were in the areas
of emotional and interpersonal disorders and the highest scores in the area of managing chemotherapy-related symptoms.
The mean score of self-efficacy chemotherapy-related symptoms was 168.0±25.4. There were significant relationships
between age, education, economic status, marital status and life status and self-efficacy chemotherapy-related symptoms.
In addition, a positive significant correlation for each of the subscales. Conclusion: It should be noted that interventional
efforts for improving managerial self-efficacy of symptoms, especially management of interpersonal and emotional
disorders in these patients are necessary.
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Affiliation(s)
- Fatemeh Moghaddam Tabrizi
- Reproductive Health Research Center, Nursing and Midwifery Department, Urmia University
of Medical Sciences, Urmia, Iran.
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Merluzzi TV, Philip EJ, Heitzmann Ruhf CA, Liu H, Yang M, Conley CC. Self-efficacy for coping with cancer: Revision of the Cancer Behavior Inventory (Version 3.0). Psychol Assess 2017; 30:486-499. [PMID: 28504538 DOI: 10.1037/pas0000483] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Based on self-regulation and self-efficacy theories, the Cancer Behavior Inventory (CBI; Heitzmann et al., 2011; Merluzzi & Martinez Sanchez, 1997; Merluzzi, Nairn, Hegde, Martinez Sanchez, & Dunn, 2001) was developed as a measure of self-efficacy strategies for coping with cancer. In the latest revision, CBI-V3.0, a number of psychometric and empirical advances were made: (a) the reading level was reduced to 6th-grade level; (b) individual interviews and focus groups were used to revise items; (c) a new spiritual coping subscale was added; (d) data were collected from 4 samples (total N = 1,405) to conduct an exploratory factor analysis with targeted rotation, 2 confirmatory factor analyses, and differential item functioning; (e) item trimming was used to reduce the total number to 27; (f) internal consistency and test-retest reliability were computed; and (g) extensive validity testing was conducted. The results, which build upon the strengths of prior versions, confirm a structurally and psychometrically sound and unbiased measure of self-efficacy strategies for coping with cancer with a reduced number of items for ease of administration. The factors include Maintaining Activity and Independence, Seeking and Understanding Medical Information, Emotion Regulation, Coping With Treatment Related Side Effects, Accepting Cancer/Maintaining a Positive Attitude, Seeking Social Support, and Using Spiritual Coping. Internal consistency (α = .946), test-retest reliability (r = .890; 4 months), and validity coefficients with a variety of relevant measures indicated strong psychometric properties. The new 27-item CBI-V3.0 has both research utility and clinical utility as a screening and treatment-planning measure of self-efficacy strategies for coping with cancer. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Haiyan Liu
- Department of Psychology, University of Notre Dame
| | - Miao Yang
- Department of Psychology, University of Notre Dame
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Bozo Ö, Akıncı İ, Akyüz C. The Psychometric Properties of Cancer Behavior Inventory as a Predictor of Quality of Life in Turkish Cancer Patients. CURRENT PSYCHOLOGY 2017. [DOI: 10.1007/s12144-017-9609-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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García-Jimenez M, Santoyo-Olsson J, Ortiz C, Lahiff M, Sokal-Gutierrez K, Nápoles AM. Acculturation, inner peace, cancer self-efficacy, and self-rated health among Latina breast cancer survivors. J Health Care Poor Underserved 2016; 25:1586-602. [PMID: 25418229 DOI: 10.1353/hpu.2014.0158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cancer self-efficacy (CSE) and spiritual well-being (SWB) have been associated with better self-rated health (SRH) among breast cancer survivors (BCS), but have not been well studied among Latina BCS (LBCS). Multivariate logistic regression analyses of secondary data from a cross-sectional population-based telephone survey of 330 LBCS explored relationships of language acculturation, CSE, and SWB subdomains of inner peace and faith with SRH. English proficiency was associated with SRH, independent of other covariates (OR=2.26, 95% CI 1.15, 4.45). Cancer self-efficacy attenuated this effect and was positively associated with SRH (OR=2.24, 95% CI 1.22, 4.10). Adding inner peace (a SWB subscale) attenuated the association of CSE and SRH (OR=1.67, 95% CI 0.88, 3.18). Inner peace remained associated with SRH (OR= 2.44, 95% CI 1.30, 4.56), controlling for covariates. Findings support the importance of a sense of inner peace and control over breast cancer to LBCS’ perceived health.
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Foster C, Haviland J, Winter J, Grimmett C, Chivers Seymour K, Batehup L, Calman L, Corner J, Din A, Fenlon D, May CM, Richardson A, Smith PW. Pre-Surgery Depression and Confidence to Manage Problems Predict Recovery Trajectories of Health and Wellbeing in the First Two Years following Colorectal Cancer: Results from the CREW Cohort Study. PLoS One 2016; 11:e0155434. [PMID: 27171174 PMCID: PMC4865190 DOI: 10.1371/journal.pone.0155434] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/28/2016] [Indexed: 12/05/2022] Open
Abstract
Purpose This paper identifies predictors of recovery trajectories of quality of life (QoL), health status and personal wellbeing in the two years following colorectal cancer surgery. Methods 872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing, confidence to manage illness-related problems (self-efficacy), social support, co-morbidities, socio-demographic, clinical and treatment characteristics. Group-based trajectory analyses identified distinct trajectories and predictors for QoL, health status and wellbeing. Results Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2% wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing). Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors including disease characteristics, stoma, anxiety and social support. Conclusions Psychosocial factors including self-efficacy and depression before surgery predict recovery trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent of treatment or disease characteristics. This has significant implications for colorectal cancer management as appropriate support may be improved by early intervention resulting in more positive recovery experiences.
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Affiliation(s)
- Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- * E-mail:
| | - Joanne Haviland
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Jane Winter
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom
| | - Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Kim Chivers Seymour
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Lynn Batehup
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Jessica Corner
- Executive Office, University of Nottingham, Nottingham, NG7 2RD, United Kingdom
| | - Amy Din
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Deborah Fenlon
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Christine M. May
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom
| | - Peter W. Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
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Santos Salas A, Fuentes Contreras J, Armijo-Olivo S, Saltaji H, Watanabe S, Chambers T, Walter L, Cummings GG. Non-pharmacological cancer pain interventions in populations with social disparities: a systematic review and meta-analysis. SUPPORTIVE CARE IN CANCER : OFFICIAL JOURNAL OF THE MULTINATIONAL ASSOCIATION OF SUPPORTIVE CARE IN CANCER 2015. [PMID: 26556211 DOI: 10.1007/s00520‐015‐2998‐9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Global advances in pain relief have improved the quality of life of cancer populations. Yet, variation in cancer pain outcomes has been found in populations with social disparities compared to mainstream groups. Populations with social disparities bear an inequitable distribution of resources such as ethnic minorities, low income individuals, and women in vulnerable circumstances. RESEARCH PURPOSE A systematic review and meta-analysis of the effect of non-pharmacological cancer pain interventions in cancer populations with social disparities of income, ethnicity, or gender. METHODS Randomized controlled trials, controlled trials, and before and after studies were targeted through comprehensive multidatabase searches. Two reviewers independently screened titles/abstracts for potentially relevant studies and reviewed the full text of relevant articles for inclusion. Data were extracted from included studies by one reviewer and verified by another reviewer. Four reviewers independently completed quality assessment. Studies were grouped by intervention. Effects were evaluated for heterogeneity and pooled. RESULTS The search found 5219 potential records. Full text of 26 reports was evaluated. Three randomized controlled trials (RCTs) met inclusion criteria, targeting ethnic minorities and underserved populations and/or women. Interventions included education, coaching, and online support groups. Studies found no significant differences in pain reduction between intervention and control groups or between ethnic minorities and their counterparts. A high risk of bias was found in all studies. Meta-analysis found no statistically significant difference on pain intensity among underserved groups, ethnic minorities, or between ethnic minorities and white counterparts. CONCLUSION Results show the need to examine supportive care interventions particularly in populations with social disparities.
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Affiliation(s)
- Anna Santos Salas
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Jorge Fuentes Contreras
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Católica del Maule, Avda. San Miguel 3605, Talca, Chile
| | - Susan Armijo-Olivo
- Research Centre Faculty of Rehabilitation Medicine, 3-62 Corbett Hall, University of Alberta, 8205 114 Street, Edmonton, AB, T6G 2G4, Canada
| | - Humam Saltaji
- School of Dentistry, University of Alberta, 5-476 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Sharon Watanabe
- Department of Symptom Control and Palliative Care, Cross Cancer Institute and Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Room 2001, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada
| | - Thane Chambers
- John W. Scott Health Sciences Library, University of Alberta Libraries, Edmonton, AB, T6G 2R7, Canada
| | - Lori Walter
- UBC Okanagan Library, The University of British Columbia, Okanagan Campus, 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - Greta G Cummings
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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Santos Salas A, Fuentes Contreras J, Armijo-Olivo S, Saltaji H, Watanabe S, Chambers T, Walter L, Cummings GG. Non-pharmacological cancer pain interventions in populations with social disparities: a systematic review and meta-analysis. Support Care Cancer 2015; 24:985-1000. [PMID: 26556211 DOI: 10.1007/s00520-015-2998-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/26/2015] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Global advances in pain relief have improved the quality of life of cancer populations. Yet, variation in cancer pain outcomes has been found in populations with social disparities compared to mainstream groups. Populations with social disparities bear an inequitable distribution of resources such as ethnic minorities, low income individuals, and women in vulnerable circumstances. RESEARCH PURPOSE A systematic review and meta-analysis of the effect of non-pharmacological cancer pain interventions in cancer populations with social disparities of income, ethnicity, or gender. METHODS Randomized controlled trials, controlled trials, and before and after studies were targeted through comprehensive multidatabase searches. Two reviewers independently screened titles/abstracts for potentially relevant studies and reviewed the full text of relevant articles for inclusion. Data were extracted from included studies by one reviewer and verified by another reviewer. Four reviewers independently completed quality assessment. Studies were grouped by intervention. Effects were evaluated for heterogeneity and pooled. RESULTS The search found 5219 potential records. Full text of 26 reports was evaluated. Three randomized controlled trials (RCTs) met inclusion criteria, targeting ethnic minorities and underserved populations and/or women. Interventions included education, coaching, and online support groups. Studies found no significant differences in pain reduction between intervention and control groups or between ethnic minorities and their counterparts. A high risk of bias was found in all studies. Meta-analysis found no statistically significant difference on pain intensity among underserved groups, ethnic minorities, or between ethnic minorities and white counterparts. CONCLUSION Results show the need to examine supportive care interventions particularly in populations with social disparities.
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Affiliation(s)
- Anna Santos Salas
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Jorge Fuentes Contreras
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Católica del Maule, Avda. San Miguel 3605, Talca, Chile
| | - Susan Armijo-Olivo
- Research Centre Faculty of Rehabilitation Medicine, 3-62 Corbett Hall, University of Alberta, 8205 114 Street, Edmonton, AB, T6G 2G4, Canada
| | - Humam Saltaji
- School of Dentistry, University of Alberta, 5-476 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Sharon Watanabe
- Department of Symptom Control and Palliative Care, Cross Cancer Institute and Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Room 2001, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada
| | - Thane Chambers
- John W. Scott Health Sciences Library, University of Alberta Libraries, Edmonton, AB, T6G 2R7, Canada
| | - Lori Walter
- UBC Okanagan Library, The University of British Columbia, Okanagan Campus, 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - Greta G Cummings
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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Brown MJ, Serovich JM, Kimberly JA, Umasabor-Bubu O. Disclosure and Self-Efficacy Among HIV-Positive Men Who Have Sex with Men: A Comparison Between Older and Younger Adults. AIDS Patient Care STDS 2015; 29:625-33. [PMID: 26348705 PMCID: PMC4808275 DOI: 10.1089/apc.2015.0133] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Men who have sex with men (MSM) continue to be disproportionately affected by HIV in the US. HIV among older adults also continues to be an important public health problem. Age is associated with disclosure of HIV serostatus and self-efficacy for condom use. However, studies examining self-efficacy and disclosure among older MSM (age 50 and older) living with HIV are lacking. The aim of this study was to assess the associations between being 50 and older, and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices among HIV-positive MSM. Data were gathered from 340 participants at the baseline assessment of a longitudinal disclosure intervention study. Linear regression was used to determine the association between being older (age 50 and older) and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices. After adjusting for time since diagnosis and number of sexual partners, MSM aged 50 and older scored lower in disclosure behavior (β = -7.49; 95% CI: -14.8, -0.18) and in self-efficacy for negotiation of safer sex practices (β = -0.80; 95% CI: -1.57, -0.04) compared to MSM 18-34 years. Intervention and prevention programs should endeavor to improve disclosure and self-efficacy for negotiating safer sex practices among older HIV-positive MSM. More health care providers should initiate sexual health discussions, especially among older HIV-positive MSM populations, which may help to improve their disclosure behavior and self-efficacy for negotiating safer sex practices.
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Affiliation(s)
- Monique J. Brown
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida
| | - Julianne M. Serovich
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida
| | - Judy A. Kimberly
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida
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The Association between Patient-Reported Pain and Doctors' Language Proficiency in Clinical Practice. PAIN RESEARCH AND TREATMENT 2015; 2015:263904. [PMID: 26483976 PMCID: PMC4592902 DOI: 10.1155/2015/263904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/06/2015] [Indexed: 11/19/2022]
Abstract
Patients' limited literacy and language fluency of different kinds cause them problems in navigating the medical interview. However, it is not known how physicians' native language skills affect the reported intensity of pain among Finnish emergency patients. Data were collected with two consecutive questionnaires in 16 healthcare centres and outpatient departments along the Finnish coast. Swedish and Finnish speaking 18–65-year-old emergency patients were eligible for this study. Our patients were predominantly Finnish speakers. Patient-rated poor language skills in Finnish among the physicians in ED setting increased statistically significantly pain reported by the Finnish speaking patients and their dissatisfaction with the health service. These patients were also less motivated to adhere to the instructions given by their physician. Patients speaking various languages reported less degree of pain. Foreign physicians' poor language proficiency in Finnish was expected to explain only some of the patients' pain experience. Physicians' good native language skills may help to reduce pain experience. Despite concordant language communication, other unknown barriers in the interaction might reduce the magnitude of pain reported.
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Kochaki Nejad Z, Mohajjel Aghdam A, Hassankhani H, Asghari Jafarabadi M, Sanaat Z. Cancer-Related Self-Efficacy in Iranian Women With Breast Cancer. WOMEN’S HEALTH BULLETIN 2015. [DOI: 10.17795/whb-23248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Yeung NCY, Lu Q, Lin W. Specificity may count: not every aspect of coping self-efficacy is beneficial to quality of life among Chinese cancer survivors in China. Int J Behav Med 2014; 21:629-37. [PMID: 24570036 DOI: 10.1007/s12529-014-9394-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND General self-efficacy has been shown to be a protective factor of cancer survivors' quality of life (QoL). Coping self-efficacy includes multiple aspects, such as maintaining positive attitudes, regulating emotion, seeking social support, and seeking medical information. How these various aspects are related to multiple domains of QoL is unclear. PURPOSE This study examined the associations between different aspects of coping self-efficacy and QoL among Chinese cancer survivors. METHODS A sample of 238 Chinese cancer survivors (mean age = 55.7, 74.4 % female) in Beijing, China participated in the survey. Coping self-efficacy and QoL were measured by the Cancer Behavior Inventory and Quality of Life-Cancer Survivor Instrument. RESULTS After controlling for demographic and disease-related variables, hierarchical regression analyses showed that coping self-efficacy in accepting cancer/maintaining a positive attitude was positively associated with physical, psychological, and spiritual QoL. Self-efficacy in affective regulation was positively associated with psychological and social QoL, but negatively associated with spiritual well-being. Self-efficacy in seeking support was positively associated with spiritual well-being, but negatively associated with physical QoL. Self-efficacy in seeking and understanding medical information was negatively associated with psychological and social QoL. CONCLUSIONS Our findings imply the specificity of coping self-efficacy in predicting QOL. Our findings could be helpful for designing future interventions. Increasing cancer survivors' self-efficacies in accepting cancer/maintaining a positive attitude, affective regulation, and seeking support may improve cancer survivors' QoL depending on the specific domains.
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Affiliation(s)
- Nelson C Y Yeung
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204-5022, USA
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Kwok W, Bhuvanakrishna T. The relationship between ethnicity and the pain experience of cancer patients: a systematic review. Indian J Palliat Care 2014; 20:194-200. [PMID: 25191006 PMCID: PMC4154166 DOI: 10.4103/0973-1075.138391] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Cancer pain is a complex multidimensional construct. Physicians use a patient-centered approach for its effective management, placing a great emphasis on patient self-reported ratings of pain. In the literature, studies have shown that a patient's ethnicity may influence the experience of pain as there are variations in pain outcomes among different ethnic groups. At present, little is known regarding the effect of ethnicity on the pain experience of cancer patients; currently, there are no systematic reviews examining this relationship. Materials and Methods: A systematic search of the literature in October 2013 using the keywords in Group 1 together with Group 2 and Group 3 was conducted in five online databases (1) Medline (1946–2013), (2) Embase (1980–2012), (3) The Cochrane Library, (4) Pubmed, and (5) Psycinfo (1806–2013). The search returned 684 studies. Following screening by inclusion and exclusion criteria, the full text was retrieved for quality assessment. In total, 11 studies were identified for this review. The keywords used for the search were as follows: Group 1-Cancer; Group 2- Pain, Pain measurement, Analgesic, Analgesia; Group 3- Ethnicity, Ethnic Groups, Minority Groups, Migrant, Culture, Cultural background, Ethnic Background. Results: Two main themes were identified from the included quantitative and qualitative studies, and ethnic differences were found in: (1) The management of cancer pain and (2) The pain experience. Six studies showed that ethnic groups face barriers to pain treatment and one study did not. Three studies showed ethnic differences in symptom severity and one study showed no difference. Interestingly, two qualitative studies highlighted cultural differences in the perception of cancer pain as Asian patients tended to normalize pain compared to Western patients who engage in active health-seeking behavior. Conclusion: There is an evidence to suggest that the cancer pain experience is different between ethnicities. Minority patients face potential barriers for effective pain management due to problems with communication and poor pain assessment. Cultural perceptions of cancer may influence individual conceptualization of pain and affect health-seeking behavior.
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Affiliation(s)
- Wingfai Kwok
- School of Medicine, Cicely Sauders Institute, King's College London, London, United Kingdom
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Canivet D, Delvaux N, Gibon AS, Brancart C, Slachmuylder JL, Razavi D. Improving communication in cancer pain management nursing: a randomized controlled study assessing the efficacy of a communication skills training program. Support Care Cancer 2014; 22:3311-20. [PMID: 25099306 DOI: 10.1007/s00520-014-2357-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/21/2014] [Indexed: 12/30/2022]
Abstract
PURPOSE Effective communication is needed for optimal cancer pain management. This study assessed the efficacy of a general communication skills training program for oncology nurses on communication about pain management. METHODS A total of 115 nurses were randomly assigned to a training group (TG) or control group (CG). The assessment included the recording of interviews with a simulated cancer patient at baseline for both groups and after training (TG) or 3 months after baseline (CG). Two psychologists rated the content of interview transcripts to assess cancer pain management communication. Group-by-time effects were measured using a generalized estimating equation. RESULTS Trained nurses asked the simulated patient more questions about emotions associated with pain (relative rate [RR] = 4.28, p = 0.049) and cognitions associated with pain treatment (RR = 3.23, p < 0.001) and used less paternalistic statements about cancer pain management (RR = 0.40, p = 0.006) compared with untrained nurses. CONCLUSIONS The general communication skills training program improved only a few of the communication strategies needed for optimal cancer pain management in nursing. General communication skills training programs should be consolidated using specific modules focusing on communication skills related to cancer pain management.
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Affiliation(s)
- Delphine Canivet
- Université Libre de Bruxelles, 50 Avenue F.D. Roosevelt, 1050, Brussels, Belgium
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Jimenez N, Jackson DL, Zhou C, Ayala NC, Ebel BE. Postoperative pain management in children, parental English proficiency, and access to interpretation. Hosp Pediatr 2014; 4:23-30. [PMID: 24435597 PMCID: PMC4231782 DOI: 10.1542/hpeds.2013-0031] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND AND OBJECTIVE Patients with limited English proficiency (LEP) are at risk for undertreated pain. The goal of this study was to examine the association between parental language proficiency, interpreted care, and postsurgical pediatric pain management. METHODS This was a retrospective matched cohort study among children <18 years of age. Children of LEP and English-proficient (EP) parents were matched according to age group, surgical procedure, and admission date. Mean number of daily pain assessments and mean daily pain scores were compared between language groups. We also compared the association between pain scores and type of medication given (opioid versus nonopioid). Within the LEP group, similar analyses compared pain assessment and treatment of children whose families received ≥ 2 professional interpretations per day versus those who received lower rates of interpretation. RESULTS A total of 474 children (237 LEP and 237 EP) were included in the study. Children of LEP parents had fewer pain assessments (mean: 7 [95% confidence interval: 2-13] vs 9 [95% confidence interval: 4-15]; P = .012), and higher levels of pain recorded before receiving opioid analgesics, compared with children of EP parents (P = .003). Within the LEP group, children with ≥ 2 interpretations per day had lower pain scores after medication administration (P < .05) and were more likely to receive opioids at pain levels similar to those of EP families. CONCLUSIONS Children of LEP parents received fewer pain assessments and were less likely to receive opioid analgesics for similar levels of pain compared with children of EP parents. More frequent use of professional interpreters when assessing pain may aid in reducing the gap in pain management between LEP and EP pediatric patients.
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Affiliation(s)
- Nathalia Jimenez
- Department of Anesthesiology, University of Washington, Seattle, Washington
| | - Douglass L. Jackson
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
- Centers for Diversity and Health Equity, Seattle Children’s Research Institute, Seattle, Washington
| | - Chuan Zhou
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
- Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington
| | - Nelly C. Ayala
- School of Public Health, University of Washington, Seattle, Washington
| | - Beth E. Ebel
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
- Centers for Diversity and Health Equity, Seattle Children’s Research Institute, Seattle, Washington
- Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington
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Baker TA, O'Connor ML, Krok JL. Experience and knowledge of pain management in patients receiving outpatient cancer treatment: what do older adults really know about their cancer pain? PAIN MEDICINE 2013; 15:52-60. [PMID: 24118873 DOI: 10.1111/pme.12244] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE An individual's ability to effectively manage their cancer pain is influenced by knowledge and perceptions regarding the pain experience. While significance of the physician's knowledge of cancer pain management has been reported, much less is known how a patient's knowledge may influence their ability to optimally manage their pain. The purpose of this study is to determine the influence health and social factors have on the knowledge and experience of cancer pain among older adults. DESIGN A prospective cross-sectional study of older Black and White patients presenting for outpatient cancer treatment. METHODS Participants were surveyed on questions assessing pain severity, knowledge and experience of pain, self-efficacy for pain treatment, satisfaction with pain treatment, and additional social, health, and demographic characteristics. A series of hierarchical regression models were specified to examine predictors of cancer pain knowledge and experience. RESULTS Education, race, and trust were significant predictors of pain knowledge, whereas self-efficacy for pain, pain interference, and pain severity were indicators of the experience of cancer pain. CONCLUSIONS Knowledge and experience of (cancer) pain are contingent upon a myriad of social and clinical factors that are not exclusive but rather coexisting determinants of health. Understanding older adults' knowledge of pain may begin to diminish the imparities in the diagnosis and treatment of pain among this growing diverse population of older adults. It may similarly allow for programs to be tailored to fit the specific needs of the patient in the treatment and management of their cancer pain.
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Affiliation(s)
- Tamara A Baker
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
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Yeung NCY, Lu Q. Affect as a mediator between self-efficacy and quality of life among Chinese cancer survivors in China. Eur J Cancer Care (Engl) 2013; 23:149-55. [PMID: 24028476 DOI: 10.1111/ecc.12123] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2013] [Indexed: 11/30/2022]
Abstract
Previous studies have shown that self-efficacy influences cancer survivors' quality of life. As most of the relevant findings are based on Caucasian cancer survivors, whether the same relationship holds among Asian cancer patients and through what mechanism self-efficacy influences quality of life are unclear. This study examined the association between self-efficacy and quality of life among Chinese cancer survivors, and proposed affect (positive and negative) as a mediator between self-efficacy and quality of life. A sample of 238 Chinese cancer survivors (75% female, mean age = 55.7) were recruited from Beijing, China. Self-efficacy, affect (positive and negative) and quality of life were measured in a questionnaire package. Self-efficacy was positively associated with quality of life and positive affect, and negatively associated with negative affect. Path analyses revealed the direct effect from self-efficacy to quality of life and the indirect effects from self-efficacy to quality of life through positive affect and negative affect. The beneficial role of self-efficacy in Chinese cancer survivors' quality of life and the mediating role of affect in explaining the relationship between self-efficacy and quality of life are supported. Future interventions should include self-care and affect regulation skills training to enhance cancer survivors' self-efficacy and positive affect, as this could help to improve Chinese cancer survivors' quality of life.
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Affiliation(s)
- N C Y Yeung
- Department of Psychology, University of Houston, Houston, TX, USA
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Kayser K, Acquati C, Tran TV. No patients left behind: a systematic review of the cultural equivalence of distress screening instruments. J Psychosoc Oncol 2013; 30:679-93. [PMID: 23101551 DOI: 10.1080/07347332.2012.721489] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Despite the widespread use of distress screening instruments in cancer care, the reliability and validity of these instruments for a diverse population of cancer patients have not been well established. This is a systematic review of the conceptual and statistical equivalence of screening instruments of 148 psycho-oncology studies that included distress screening instruments. The findings indicate that screening measures of distress have comparable reliability, sensitivity, and specificity for White, Latino, and Asian samples. However, it is unclear if equivalent psychometrics are found among minority ethnic groups (e.g., African American) and immigrants within countries. Given the ethnic diversity among cancer patients and the lack of representation of this diversity in the current research, it is critical that researchers begin to include cancer patients of minority ethnic/racial groups in their samples so that health care providers can screen for distress with cultural sensitivity.
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Affiliation(s)
- Karen Kayser
- Kent School of Social Work, University of Louisville, Louisville, KY 40292, USA.
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Myers SB, Manne SL, Kissane DW, Ozga M, Kashy DA, Rubin S, Heckman C, Rosenblum N, Morgan M, Graff JJ. Social-cognitive processes associated with fear of recurrence among women newly diagnosed with gynecological cancers. Gynecol Oncol 2013; 128:120-127. [PMID: 23088925 PMCID: PMC3534914 DOI: 10.1016/j.ygyno.2012.10.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 10/04/2012] [Accepted: 10/13/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This cross sectional study aimed to characterize fears of recurrence among women newly diagnosed with gynecologic cancer. The study also evaluated models predicting the impact of recurrence fears on psychological distress through social and cognitive variables. METHODS Women (N=150) who participated in a randomized clinical trial comparing a coping and communication intervention to a supportive counseling intervention to usual care completed baseline surveys that were utilized for the study. The survey included the Concerns about Recurrence Scale (CARS), Beck Depression Inventory (BDI), Impact of Event Scale (IES), and measures of social (holding back from sharing concerns and negative responses from family and friends) and cognitive (positive reappraisal, efficacy appraisal, and self-esteem appraisal) variables. Medical data was obtained via medical chart review. RESULTS Moderate-to-high levels of recurrence fears were reported by 47% of the women. Younger age (p<.01) and functional impairment (p<.01) correlated with greater recurrence fears. A social-cognitive model of fear of recurrence and psychological distress was supported. Mediation analyses indicated, that as a set, the social and cognitive variables mediated the association between fear of recurrence and both depression and cancer-specific distress. Holding back and self-esteem showed the strongest mediating effects. CONCLUSION Fears of recurrence are prevalent among women newly diagnosed with gynecologic cancer. Social and cognitive factors play a role in women's adaptation to fears and impact overall psychological adjustment. These factors may be appropriate targets for intervention.
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Jimenez N, Moreno G, Leng M, Buchwald D, Morales LS. Patient-reported quality of pain treatment and use of interpreters in spanish-speaking patients hospitalized for obstetric and gynecological care. J Gen Intern Med 2012; 27:1602-8. [PMID: 22782281 PMCID: PMC3509300 DOI: 10.1007/s11606-012-2154-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 05/07/2012] [Accepted: 06/19/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Assessment and treatment of pain are based largely on patient's self reports. Patients with limited English proficiency (LEP) may have difficulties communicating their pain symptoms in the presence of language barriers. OBJECTIVE To determine whether interpreter use was associated with quality of acute pain treatment among Latina patients with limited English proficiency. DESIGN Secondary analysis of two cross-sectional surveys. PARTICIPANTS One hundred and eighty-five Latino female patients hospitalized for obstetric and gynecological care who required interpreter services. Patients were classified into two groups according to interpreter availability ('Always' and 'Not Always' available). MAIN MEASURES Quality of pain treatment was measured by patient report of 1) overall level of pain control during hospitalization; 2) timeliness of pain treatment; and 3) perceived provider helpfulness to treat pain. KEY RESULTS Patients who always received interpreters were more likely to report higher levels of pain control (P=0.02), timely pain treatment (P=0.02), and greater perceived provider helpfulness to treat their pain (P=0.005), compared with patients who not always received interpreters. CONCLUSION Use of interpreters by LEP patients was associated with better patient reports on quality of pain treatment, and may also improve clinical interactions related to pain.
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Affiliation(s)
- Nathalia Jimenez
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98105, USA.
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Baker P, Beesley H, Dinwoodie R, Fletcher I, Ablett J, Holcombe C, Salmon P. 'You're putting thoughts into my head': a qualitative study of the readiness of patients with breast, lung or prostate cancer to address emotional needs through the first 18 months after diagnosis. Psychooncology 2012; 22:1402-10. [PMID: 22890719 DOI: 10.1002/pon.3156] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 07/09/2012] [Accepted: 07/20/2012] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To investigate the readiness of patients to address emotional needs up to 18 months following a diagnosis of breast, lung or prostate cancer. METHOD Patients (N = 42) attending pre-treatment, treatment and follow-up clinics were provided with information designed to help them manage their emotional reactions to cancer. Patients were interviewed 3-4 weeks later about their emotional experience of cancer and their attitudes towards managing emotional problems. Qualitative data analysis followed a constant comparative approach. RESULTS Patients early in the cancer trajectory, who had not yet been engaged in chemotherapy or radiotherapy, described emotional distress as a temporary and understandable reaction that did not warrant professional intervention. They valued knowing that support was available, but did not want to use it, and were reluctant to acknowledge or address emotional needs. Conversely, patients currently or recently engaged in treatment readily acknowledged their emotional needs and welcomed help to address these. CONCLUSIONS Drawing on social cognitive and other theories, we suggest that engagement in physical treatment and care allows patients to address emotional needs following a cancer diagnosis. Guidance that emotional needs should routinely be assessed and addressed at key points in the cancer trajectory should therefore be implemented cautiously when patients are only recently diagnosed; psychological intervention may be less appropriate at this time than later.
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Affiliation(s)
- Paul Baker
- Division of Clinical Psychology, University of Liverpool, Liverpool, UK
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Arthur K, Belliard JC, Hardin SB, Knecht K, Chen CS, Montgomery S. Practices, attitudes, and beliefs associated with complementary and alternative medicine (CAM) use among cancer patients. Integr Cancer Ther 2012; 11:232-42. [PMID: 22313741 DOI: 10.1177/1534735411433832] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The high prevalence of complementary and alternative medicine (CAM) use among cancer patients (40%-83%) receiving conventional treatment and the complex relationship between the psychosocial factors that may contribute to or result from CAM use requires further understanding. The authors conducted a descriptive mixed-methods pilot study to understand CAM practices, attitudes, and beliefs among cancer patients at the Loma Linda University Medical Center. METHODS This was the qualitative phase of the study, and no hypotheses were set. A total of 23 face-to-face interviews were conducted, and thematic coding was used to analyze 22 interview transcriptions. There were 14 CAM users (64%) and 8 nonusers (36%). FINDINGS The themes present among those who used CAM were the following: physicians viewed as one aspect of health care options, a holistic view on well-being, satisfaction with CAM use, and 3 key coping methods (confrontive, supportive, and optimistic) to confront cancer. Themes were not independent of each other. Two themes were present among nonusers; nonusers trusted their physician and were more likely to express evasive coping methods. DISCUSSION Perceptions and behavioral patterns are complex predictors of CAM use. A better understanding of CAM, medical pluralism, and the perceptions of patients would help health care providers deliver a better quality of care. The promotion of integrative care may help health care providers better identify medical pluralism and would shift focus to patient-centered care.
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Park H, Kim MT. Impact of social role strain, depression, social support and age on diabetes self-efficacy in Korean women with type 2 diabetes. J Cardiovasc Nurs 2012; 27:76-83. [PMID: 21558865 PMCID: PMC4512290 DOI: 10.1097/jcn.0b013e318214d9d9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study describes levels of role strain, diabetes mellitus (DM)-related self-efficacy, depression, and social support in middle-aged Korean women with type 2 DM. Using a cross-sectional correlational survey design, we examined the relationships among these constructs in a purposive sample of 154 Korean women (40-65 years old) residing in Cheon-An, a midsized city in South Korea, who had had a diagnosis of type 2 DM for 6 or more months. Our findings indicated that significant numbers of these women are experiencing significant role strain (52.43 [SD, 8.81]) and are at risk for clinical depression (30%). In bivariate analysis, the level of role strain was negatively associated with diabetes self-efficacy (r = -0.27, P < .01), whereas social support was positively associated with diabetes self-efficacy (r = 0.22, P < .05). A multivariate analysis confirmed that social role strain (β = -.33, P = .00), social support (β = 0.19, P = .05), and age (β = 0.19 P = .03) were statistically significant predictors of DM-related self-efficacy. These findings highlight the importance of social role strain in managing DM and point to the need for appropriate interventions that incorporate the ways to relieve the role strain experienced by this highly vulnerable population.
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Affiliation(s)
- Hyunjeong Park
- College of Nursing, The Catholic University of Korea, Seoul, Korea.
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46
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Demoralization syndrome among cancer outpatients in Taiwan. Support Care Cancer 2011; 20:2259-67. [DOI: 10.1007/s00520-011-1332-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 11/11/2011] [Indexed: 10/15/2022]
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Abstract
Cancer pain is a complex and multidimensional experience that affects and is affected by psychological and social factors. This article reviews recent research that points to a number of key psychosocial factors associated with pain, including psychological distress, coping, and social support, as well as the impact of socioeconomic factors on barriers to pain management. We also review recent research suggesting that psychosocial interventions, including education, coping-skills training, and hypnosis, may be useful adjuncts to medical management of pain. Clinical implications and recommendations for future research are discussed.
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Reyes-Gibby CC, Anderson KO, Shete S, Bruera E, Yennurajalingam S. Early referral to supportive care specialists for symptom burden in lung cancer patients: a comparison of non-Hispanic whites, Hispanics, and non-Hispanic blacks. Cancer 2011; 118:856-63. [PMID: 21751190 DOI: 10.1002/cncr.26312] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 05/09/2011] [Accepted: 05/10/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Effective management of symptoms in cancer patients requires early intervention. This study assessed whether the timing of referral to the Supportive Care Center (SCC) and symptom burden outcome varied by race or ethnicity in lung cancer patients who had been seen at a tertiary cancer center. METHODS Non-Hispanic white (n = 752), Hispanic (n = 111), and non-Hispanic black (n = 117) patients with nonsmall cell lung cancer comprised this sample. Data on sociodemographic factors, stage of disease, comorbid conditions, and symptom severity (pain, depressed mood, fatigue) served as potential predictor variables. RESULTS Whereas the mean time (15 months; median = 7 months) from initial presentation at the cancer center to referral to the SCC did not vary by race or ethnicity, we found that Hispanics and non-Hispanic blacks had higher symptom burden when they first presented at the cancer center than non-Hispanic whites. Severe pain, depressed mood, and fatigue were significant predictors for early referral (<7 months) of non-Hispanic whites, but only severe fatigue (P <.05) was predictive of early referral for Hispanics and non-Hispanic blacks. Furthermore, while the proportion of non-Hispanic white patients reporting severe pain, depressed mood, and fatigue significantly decreased (P <.001) at first follow-up visit after referral to the SCC; among Hispanics, improvement was only observed for depressed mood. No improvement in any of these symptoms was observed for non-Hispanic blacks. CONCLUSIONS Whereas the timing of referral to supportive services did not vary by race, disparities in symptom burden outcomes persisted. Additional studies are needed to validate our findings.
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Affiliation(s)
- Cielito C Reyes-Gibby
- Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
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Sohl SJ, Schnur JB, Sucala M, David D, Winkel G, Montgomery GH. Distress and emotional well-being in breast cancer patients prior to radiotherapy: an expectancy-based model. Psychol Health 2011; 27:347-61. [PMID: 21678183 PMCID: PMC3299868 DOI: 10.1080/08870446.2011.569714] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Understanding precursors to distress and emotional well-being (EWB) experienced in anticipation of radiotherapy would facilitate the ability to intervene with this emotional upset (i.e. higher distress, lower EWB). Thus, this study tested an expectancy-based model for explaining emotional upset in breast cancer patients prior to radiotherapy. Women affected by breast cancer (N = 106) were recruited and participants completed questionnaires prior to commencing radiotherapy. Structural equation modelling was used to test a cross-sectional model, which assessed the ability of dispositional optimism (Life Orientation Test-Revised - two factors), response expectancies (Visual Analog Scale items), medical (type of surgery, cancer stage and chemotherapy history) and demographic (age, race, ethnicity, education and marital status) variables to predict both EWB (Functional Assessment of Chronic Illness Therapy - Emotional Well-being Subscale) and distress (Profile of Mood States - short version). The model represented a good fit to the data accounting for 65% of the variance in EWB and 69% in distress. Significant predictors of emotional upset were pessimism, response expectancies, Latina ethnicity, cancer stage and having had a mastectomy. These variables explained a large portion of emotional upset experienced prior to radiotherapy for breast cancer and are important to consider when aiming to reduce distress and improve EWB in this context.
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Affiliation(s)
- Stephanie J Sohl
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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Ayala-Feliciano M, Pons-Valerio JJ, Pons-Madera J, Acevedo SF. The Relationship between Visuospatial Memory and Coping Strategies in Breast Cancer Survivors. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2011; 5:117-30. [PMID: 21695096 PMCID: PMC3117625 DOI: 10.4137/bcbcr.s6957] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: In the US there are over 2.5 million breast cancer survivors (BCSs), most of whom have required some type of intensive treatment. How individuals cope with the treatment process may relate to why neurocognitive problems arise. Method: We explored the impact of treatment for breast cancer (BC) on performance of the Memory Island task, both on working memory and on the general index of cognitive performance in relation to coping strategies of BCSs compared to age-matched controls. Results: The evidence obtained suggests a reduced performance in visuospatial memory in BCSs. Those who used emotional coping strategies displayed reduced performance in visuospatial learning and immediate memory. Those women who used problem-focused coping strategies performed better in those tasks measuring psychomotor speed, general intelligence, and delayed visuospatial memory. Conclusions: It is concluded that further investigation of the relationship between coping strategies and performance on visuospatial tasks may provide useful information on residual levels of neurocognitive deficits and psychosocial adaptation in BCSs.
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