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Hinnen C, von Haeseler E, Tijssens F, Mols F. Adverse childhood events and mental health problems in cancer survivors: a systematic review. Support Care Cancer 2024; 32:80. [PMID: 38175303 PMCID: PMC10766658 DOI: 10.1007/s00520-023-08280-7] [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: 04/24/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The purpose of this study was to systematically review the literature on the association between adverse childhood events (ACEs) and mental health problems in cancer survivors. METHODS This review was conducted in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Four databases (PubMed, PsychINFO, Web of Science, and Cochrane) were searched on 27-08-2023. RESULTS Of the 1413 references yielded by the literature search, 25 papers met inclusion criteria and were reviewed. Most studies were performed in the USA, most included breast cancer survivors, and the number of included participants ranged between 20 and 1343. ACEs were relatively prevalent, with self-report rates ranging between 40 and 95%. Having been exposed to ACEs was a risk factor for heightened levels of emotional distress, anxiety, depressive symptoms, and fatigue during cancer treatment. Results varied depending on the variables included, and per subscale, but were consistent across different cultures and heterogenous patient groups. CONCLUSION The association between ACE and mental health outcomes was significant in most studies. In order to improve treatment for this vulnerable population, it may be necessary to screen for ACEs before cancer treatment and adjust treatment, for example, by means of trauma-informed care (TIC), which recognizes and responds to the impact of trauma on individuals seeking healthcare.
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Affiliation(s)
- Chris Hinnen
- Department of Psycho-Oncology, LUMC Oncology Center, Leiden, the Netherlands.
- Department of Medical Psychology, Spaarne Gasthuis, Haarlem, the Netherlands.
| | - Emma von Haeseler
- Department of Psycho-Oncology, LUMC Oncology Center, Leiden, the Netherlands
| | - Frederiek Tijssens
- Department of Psycho-Oncology, LUMC Oncology Center, Leiden, the Netherlands
| | - Floortje Mols
- Department of Medical and Clinical Psychology, CoRPS - Center of Research On Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, the Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
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Li Y, Dong F, Herbell K. Adverse Childhood Experiences, Depression, and Intimate Partner Violence Among Chinese Immigrant Women: Mediation by Social and Partner Support. Nurs Res 2023; 72:338-346. [PMID: 37625175 DOI: 10.1097/nnr.0000000000000677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with an increased risk of depression and intimate partner violence (IPV). Social support and partner support may help explain this association. Few researchers have focused on Chinese immigrant women, who are less likely than native-born women to seek help for mental health challenges and IPV. OBJECTIVE The purpose of this study was to examine the mediation effects of social and partner support on the relationship between (a) ACEs and (b) depressive symptoms and IPV among Chinese immigrant women living in the United States. METHODS This is a secondary analysis of data from 475 Chinese immigrant women recruited online. Depressive symptoms, IPV, ACEs, perceived social support, and perceived partner support were measured cross-sectionally. Mediation analyses were conducted to test the mediating role of social and partner support on the associations between ACEs and depressive symptoms and IPV. RESULTS Social support and partner support fully mediated the relationship between ACEs and depressive symptoms. However, partner support only partially mediated the relationship between ACEs and IPV. DISCUSSION ACEs indirectly affect depressive symptoms by undermining both general perceptions of support and perceived partner support. The findings of this study underscore the critical influence of a lack of partner support in mediating the effects of ACEs on Chinese immigrant women's risk of IPV. Promoting strong existing support networks, creating new support resources, and improving partner relationships are important targets for interventions to mitigate the effects of ACEs on depression and IPV in Chinese immigrant women.
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Alvarez-Pardo S, Romero-Pérez EM, Camberos-Castañeda N, de Paz JA, Horta-Gim MA, González-Bernal JJ, Mielgo-Ayuso J, Simón-Vicente L, Fernández-Solana J, González-Santos J. Quality of Life in Breast Cancer Survivors in Relation to Age, Type of Surgery and Length of Time since First Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16229. [PMID: 36498299 PMCID: PMC9741017 DOI: 10.3390/ijerph192316229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 05/11/2023]
Abstract
(1) Background: Quality of life assessment is a critical aspect of breast cancer patient outcomes, as diagnosis, prognosis and treatment can have a major impact on quality of life. The aim of this study was to describe the characteristics of the sample and to verify the relationship between quality of life (QOL) in women diagnosed with breast cancer (BC) and their age, type or surgery and time since treatment; (2) Methods: a cross-sectional, descriptive study was conducted with 183 women diagnosed with BC, aged 30−80 years in Mexico. Women’s QOL was assessed using two questionnaires, The European Organization for Research and Treatment of Cancer-Quality of Life Core Questionnaire (EORTC QLQ-C30) and The Breast Cancer Module (EORTC QLQ-BR23). (3) Results: the results show significant differences in several items when the variable age is taken into account, indicating that younger women have poorer social and sexual function, as well as poorer sexual enjoyment and lower expectations of the future. The type of surgery also indicates a significantly better QOL in those women who receive conservative treatment versus a mastectomy; the time elapsed since surgery does not show any significant results, except for sexual functioning and breast-related symptoms where >5 years implies better scores on the items. (4) Conclusions: in conclusion, it is important to take into account the characteristics of women with BC, particularly at the time of treatment, in order to mitigate the impact of the disease on their QOL with the help of a multidisciplinary team.
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Affiliation(s)
| | | | | | | | | | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
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4
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Castro-Figueroa EM, Acevedo KI, Peña-Vargas CI, Torres-Blasco N, Flores I, Colón-Echevarria CB, Maldonado L, Rodríguez Z, Aquino-Acevedo AN, Jim H, Lazaro MI, Armaiz-Peña GN. Depression, Anxiety, and Social Environmental Adversity as Potential Modulators of the Immune Tumor Microenvironment in Breast Cancer Patients. Med Sci (Basel) 2021; 9:46. [PMID: 34205709 PMCID: PMC8293308 DOI: 10.3390/medsci9020046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Mounting data suggest that exposure to chronic stress is associated with worse breast cancer outcomes. This study aimed to explore the impact of social environmental adversity (SEA, e.g., child abuse, crime, sexual, and physical violence), depressive symptomatology, and anxiety on immune cell infiltration into the breast tumor microenvironment. Methods: Participants (n = 33) completed a series of surveys assessing depression and anxiety symptoms, adverse childhood events (ACE), and trauma history. Tumor-associated macrophages (CD68+), B cells (CD19+), and T cells (CD3+) were identified by immunohistochemical analyses of formalin-fixed paraffin-embedded tumor samples and quantified. Spearman rank tests were used to explore the relationships between the variables studied. Results: Exposure to SEA was high (ACE = 72%, exposure to crime = 47%, and exposure to physical/sexual assault = 73%) among participants. Moreover, 30% reported a comorbid history of depression and ACE; 39% reported one or more traumatic events, and clinically significant depression symptomatology, while 21% reported trauma history and significant anxiety symptomatology. Increased tumor-infiltrating B cells were significantly correlated with exposure to crime, anxiety symptoms, and exposure to an ACE. The ACE plus anxiety group presented the highest infiltration of B cells, T cells, and macrophages. Conclusion: These findings support a role for SEA, anxiety symptoms, and depression as potential modulators of the immune tumor microenvironment in breast cancer.
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Affiliation(s)
- Eida M. Castro-Figueroa
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
- Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA
| | - Karina I. Acevedo
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
| | - Cristina I. Peña-Vargas
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
- Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA
| | - Normarie Torres-Blasco
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
- Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA
| | - Idhaliz Flores
- Division of Women’s Health, Ponce Research Institute, Ponce, PR 00716, USA; (I.F.); (G.N.A.-P.)
- Division of Microbiology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA
| | - Claudia B. Colón-Echevarria
- Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.B.C.-E.); (A.N.A.-A.)
| | - Lizette Maldonado
- Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA; (L.M.); (Z.R.)
| | - Zindie Rodríguez
- Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA; (L.M.); (Z.R.)
| | - Alexandra N. Aquino-Acevedo
- Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.B.C.-E.); (A.N.A.-A.)
| | - Heather Jim
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA;
| | - María I. Lazaro
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
| | - Guillermo N. Armaiz-Peña
- Division of Women’s Health, Ponce Research Institute, Ponce, PR 00716, USA; (I.F.); (G.N.A.-P.)
- Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.B.C.-E.); (A.N.A.-A.)
- Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA; (L.M.); (Z.R.)
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Struck S, Stewart-Tufescu A, Asmundson AJN, Asmundson GGJ, Afifi TO. Adverse childhood experiences (ACEs) research: A bibliometric analysis of publication trends over the first 20 years. CHILD ABUSE & NEGLECT 2021; 112:104895. [PMID: 33388607 DOI: 10.1016/j.chiabu.2020.104895] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/26/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The relative health and robustness of a field of research can be approximated by assessing peer reviewed journal publication trends for articles pertinent to the field. To date, there have been no such assessments of the burgeoning research on adverse childhood experiences (ACEs). OBJECTIVE The overall goal of this study was to examine ACEs research trends using bibliometric methods. More specifically, we sought to describe observed publication trends of the ACEs literature from its inception in the late 1990s. We also analyzed the nature of ACEs publications with regard to key characteristics of main outcomes, levels of analysis, and populations of primary focus. METHODS A search was conducted using Scopus to identify English language papers on ACEs published in peer-reviewed journals between 1998 and 2018. The primary field of research was determined by having independent raters code the title of the publishing journal into distinct categories. Main research outcomes were similarly coded. RESULTS A total of 789 articles on ACEs appearing in 351 different academic journals were published between 1998 and 2018. There was considerable growth in the number of ACEs papers published over the past several years. General medicine and multidisciplinary research were the most frequent of 12 primary fields of research characterizing ACEs research. Of 16 primary outcomes on which ACEs research focused, the most common were mental health and physical health. CONCLUSION Significant growth in ACEs research over the past several years suggest the field is thriving. Observed publication trends and publication characteristics are discussed briefly.
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Affiliation(s)
- Shannon Struck
- S113-750 Bannatyne Avenue, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0W5, Canada.
| | - Ashley Stewart-Tufescu
- S113-750 Bannatyne Avenue, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0W5, Canada.
| | - Aleiia J N Asmundson
- Department of Psychology, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA, 15282, United States.
| | - Gordon G J Asmundson
- Department of Psychology and Anxiety and Illness Behaviours Lab, University of Regina, Regina, Canada.
| | - Tracie O Afifi
- S113-750 Bannatyne Avenue, Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Manitoba, R3E 0W5, Canada.
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Liu Z, Doege D, Thong MSY, Arndt V. The relationship between posttraumatic growth and health-related quality of life in adult cancer survivors: A systematic review. J Affect Disord 2020; 276:159-168. [PMID: 32697695 DOI: 10.1016/j.jad.2020.07.044] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 06/04/2020] [Accepted: 07/05/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Studies have reported mixed findings on the relationship between posttraumatic growth (PTG) and health-related quality of life (HRQOL) in cancer survivors. This review aims to give an overview of these studies and to identify potential study- and sample-level factors that could contribute to the heterogeneity of those findings on the relationship between PTG and HRQOL in cancer survivors. METHODS Multiple electronic databases were systematically searched using the concepts 'posttraumatic growth', 'cancer', and 'health-related quality of life'. Eligible studies (published until 2018) were reviewed, quality-assessed, and effect sizes were extracted and synthesized. RESULTS Of the 37 included articles, 22 received a rating of 'weak', 11 'moderate' and 4 'strong' in study quality assessment. The overall sample comprised 7954 individuals, mean age of 55.30 years, >50% females, predominantly breast cancer, and survivors mainly within 5 years post-diagnosis. The synthesized results revealed a positive association between PTG and HRQOL (Fisher's z= 0.16) on a total scale, with significant high heterogeneity (I2=75%). Variations in HRQOL measurement and methodological inconsistency contributed to study-level differences of effect sizes. Sample-level characteristics such as geographic region, smaller sample sizes (n < 100) and so on contributed to heterogeneity. LIMITATIONS Studies assessing the relationship between PTG and HRQOL were heterogeneous, of weak study quality generally, and results were difficult to combine. CONCLUSIONS Most studies found a positive relationship between the factors suggesting that PTG may play a role for successful coping following cancer. However, studies of higher quality and longitudinal design are needed.
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Affiliation(s)
- Zhunzhun Liu
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009 Heidelberg, Germany; Medical Faculty of Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Daniela Doege
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009 Heidelberg, Germany
| | - Melissa S Y Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009 Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009 Heidelberg, Germany.
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Çömez S, Karayurt Ö. The effect of web-based training on life quality and spousal adjustment for women with breast cancer and their spouses. Eur J Oncol Nurs 2020; 47:101758. [DOI: 10.1016/j.ejon.2020.101758] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 11/26/2019] [Accepted: 04/02/2020] [Indexed: 01/12/2023]
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Li Y, Bloom T, Herbell K, Bullock LFC. Prevalence and risk factors of intimate partner violence among Chinese immigrant women. J Adv Nurs 2020; 76:2559-2571. [PMID: 32686152 DOI: 10.1111/jan.14458] [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: 11/02/2019] [Revised: 04/12/2020] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Abstract
AIMS To investigate the prevalence and risk factors of intimate partner violence among Chinese immigrant women residing in the USA. DESIGN A cross-sectional study using the online survey approach. METHODS A total of 475 Chinese immigrant women were recruited online between April-June 2019. We measured past year intimate partner violence, sociodemographic, relationship-related and immigration-related factors, religion, social support, acculturation, adverse childhood experiences, and gender role beliefs. RESULTS Twenty-one percent of Chinese immigrant women experienced past year intimate partner violence. Younger age, cohabiting relationship, lower levels of relationship satisfaction and social support, older age at arrival, longer length of stay, religious belief, and adverse childhood experiences were associated with the occurrence of intimate partner violence. CONCLUSION Chinese immigrant women experience higher rates of intimate partner violence compared with other populations of women. Future research is still needed to elucidate abused Chinese immigrant women's violence experiences, help-seeking behaviours, availability of resources and needs for services to tailor prevention and intervention programs culturally. IMPACT The findings added to our understanding of intimate partner violence among this largest Asian immigrant group. Modifiable risk factors such as social support should be targeted in future preventions and interventions for abused Chinese immigrant women residing in the USA.
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Affiliation(s)
- Yang Li
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Tina Bloom
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
| | - Kayla Herbell
- College of Nursing, The Ohio State University, Columbus, OH, USA
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Ho GWK, Chan ACY, Chien WT, Bressington DT, Karatzias T. Examining patterns of adversity in Chinese young adults using the Adverse Childhood Experiences-International Questionnaire (ACE-IQ). CHILD ABUSE & NEGLECT 2019; 88:179-188. [PMID: 30513406 DOI: 10.1016/j.chiabu.2018.11.009] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 11/12/2018] [Accepted: 11/19/2018] [Indexed: 05/15/2023]
Abstract
Ample evidence supports significant and enduring associations between adverse childhood experiences (ACEs) and negative outcomes later in life. Subsets of ACEs (e.g. childhood maltreatment and household dysfunction) have been examined in Chinese populations, but no known study has comprehensively examined the full constellation of different types of ACEs or patterns of ACE exposure in Chinese samples. As a direct response to the call to establish a global ACEs surveillance framework, this study provides the first translation and validation of the World Health Organization ACE - International Questionnaire (ACE-IQ). Further, patterns of ACE exposure were identified through latent class analysis. The 29-item ACE-IQ was translated and back-translated from English to traditional Chinese to measure exposure to 13 categories of ACEs. The Chinese ACE-IQ demonstrated good content validity; the ACE-IQ domain subscales also showed satisfactory test-retest reliability and semantic equivalence. In a sample of 433 Chinese young adults, three patterns of ACE exposure were uncovered: Low ACEs (65.82%), Household Violence (24.94%), and Multiple ACEs (9.24%). Concurrent exposure to physical abuse, domestic violence, and emotional abuse (i.e. Household Violence) was a novel pattern found in this study sample, and suggests there may be traditional Chinese norms that potentiate risks for violent household environments in the absence of other household risk factors. Findings underscore the importance of examining ACE exposure within local contexts, as children's adverse experiences may be idiosyncratic to geographic, social, and cultural norms.
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Affiliation(s)
- Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Athena C Y Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Wai-Tong Chien
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
| | | | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, United Kingdom; Rivers Centre for Traumatic Stress, NHS Lothian, United Kingdom
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Abstract
OBJECTIVE To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer. DESIGN Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468). METHODS According to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies. RESULTS Fifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being. CONCLUSIONS In Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients' HRQL.
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Affiliation(s)
- Peh Joo Ho
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Sofie A M Gernaat
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Surgery, National University of Singapore, Singapore
| | - Helena M Verkooijen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Imaging Division, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Wang S, Li Y, Li C, Qiao Y, He S. Distribution and Determinants of Unmet Need for Supportive Care Among Women with Breast Cancer in China. Med Sci Monit 2018; 24:1680-1687. [PMID: 29561832 PMCID: PMC5877206 DOI: 10.12659/msm.905282] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background The aim of this study was to determine the need for supportive care among women suffering from breast cancer in China and to identify its potential determinants to inform the development of effective and efficient healthcare services across different settings. Material/Methods In a tertiary-care hospital in Weifang, China, between July 2015 and January 2016, all women attending the Breast Cancer Clinic for regular physical examinations after treatment for breast cancer were consecutively recruited. The 34-item Supportive Care Needs Survey tool (Chinese version) (SCNS-SF34-C) was used to assess the unmet needs among participants. Results Among 264 recruited patients, based on at least single-item endorsement, 60.2% had moderate to high level of need for supportive care, while only 13.3% expressed no need. Lack of information regarding health systems was the most common domain with moderate to high unmet needs, more so among rural patients (8 vs. 5 out of 10). In each information-related domain, huge unmet need was observed among all patients irrespective of urban or rural residence. Both overall and individual information-related domain-specific unmet needs were significantly higher among rural patients as opposed to their urban counterparts. Multiple regression analyses revealed a significant rural-urban variation of unmet needs. Moreover, education and post-diagnosis time duration were negatively associated with unmet needs while stage of cancer was positively associated with these unmet needs. Conclusions There is a huge burden of unmet needs for information on the healthcare system among breast cancer survivors in China. Rural residence, less education, advanced stage of cancer, and shorter duration since diagnosis were the identified determinants requiring targeted intervention.
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Affiliation(s)
- Shouhua Wang
- Department of Oncology, The Affiliated Hospital of Weifang Medical College, Weifang, Shandong, China (mainland)
| | - Yanqing Li
- Department of Oncology, The Affiliated Hospital of Weifang Medical College, Weifang, Shandong, China (mainland)
| | - Chaozhuo Li
- Department of Clinical Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China (mainland)
| | - Yijun Qiao
- Department of Outpatient, Weifang Military Hospital of Shandong Province, Weifang, Shandong, China (mainland)
| | - Shuling He
- Department of Gynecology and Obstetrics, The People's Hospital of Wulian County, Wulian, Shandong, China (mainland)
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Bandinelli LP, Levandowski ML, Grassi-Oliveira R. The childhood maltreatment influences on breast cancer patients: A second wave hit model hypothesis for distinct biological and behavioral response. Med Hypotheses 2017; 108:86-93. [PMID: 29055407 DOI: 10.1016/j.mehy.2017.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 08/04/2017] [Accepted: 08/06/2017] [Indexed: 12/20/2022]
Abstract
Stress and cancer are two complex situations involving different biological and psychological mechanisms. Their relationship have long been studied, and there is evidence of the impact stress has on both, development and disease progression. Furthermore, early stress has been studied as an important factor associated to this relationship, since its impacts on the immune, endocrine and cognitive development throughout life is already known. Therefore, understanding early stress as a first wave of stress in life is necessary in order to explore a possible second wave hit model. From this perspective, we believe that breast cancer can be understood as a second wave of stress during development and that, in addition to the first wave, can cause important impacts on the response to cancer treatment, such as increased chances of disease progression and distinct behavioral responses. In this article we propose a second wave hit hypothesis applied to breast cancer and its implications on the immune, endocrine and cognitive systems, through mechanisms that involve the HPA axis and subsequent activations of stress responses.
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Affiliation(s)
- Lucas Poitevin Bandinelli
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul (PUCRS), RS, Brazil; Post-Graduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre (PUCRS), RS, Brazil
| | - Mateus Luz Levandowski
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul (PUCRS), RS, Brazil; Post-Graduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre (PUCRS), RS, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul (PUCRS), RS, Brazil; Post-Graduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre (PUCRS), RS, Brazil.
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Strand EB, Brandt J, Rogers K, Fonken L, Chun R, Conlon P, Lord L. Adverse Childhood Experiences among Veterinary Medical Students: A Multi-Site Study. JOURNAL OF VETERINARY MEDICAL EDUCATION 2017; 44:260-267. [PMID: 28346049 DOI: 10.3138/jvme.0816-123r] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This research explores Adverse Childhood Experiences (ACEs) among veterinary medical students across six academic institutions of veterinary medicine, and their relationship with depression, stress, and desire to become a veterinarian. Between April 1, 2016, and May 23, 2016, 1,118 veterinary medical students in all 4 years of the curriculum (39% response rate) completed an anonymous web-based questionnaire about ACEs, depression using the Center for Epidemiological Studies Depression scale (CESD), stress using the Perceived Stress Scale (PSS), and the age at which they wanted to become a veterinarian. Sixty-one percent (677) of respondents reported having at least one ACE. The most prevalent ACE reported was living with a household member with a mental illness (31%). Students who had experienced four or more ACEs had an approximately threefold increase in signs of clinical depression and higher than average stress when compared to students who had experienced no ACEs. The number of ACEs showed an overall graded relationship to signs of clinical depression and higher than average stress. There was no statistically significant relationship between age at which a student wanted to become a veterinarian and exposure to ACEs. Veterinary students report being exposed to ACEs before age 18 at a rate similar to that of other population-based studies. These findings do not suggest that veterinary students enter the veterinary medical education system more at risk for poor mental health due to ACEs than the general population.
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Gradl G, Postl LK, Lenze U, Stolberg-Stolberg J, Pohlig F, Rechl H, Schmitt-Sody M, von Eisenhart-Rothe R, Kirchhoff C. Long-term functional outcome and quality of life following rotationplasty for treatment of malignant tumors. BMC Musculoskelet Disord 2015; 16:262. [PMID: 26403306 PMCID: PMC4582635 DOI: 10.1186/s12891-015-0721-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 09/16/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Malignant bone tumors of the lower extremity are more frequently found in children and adolescents than in adults. Modern treatment regimens led to high limb salvage rates and offer the choice between endoprosthetic replacement and rotationplasty in many cases. Rotationplasty has proven to be an effective, highly functional option in short- and mid-term studies. Aim of this study was to assess long-term results regarding quality of life and functionality after rotationplasty and to compare the obtained results to a representative healthy German sample cohort. METHODS In total 12 patients who underwent rotationplasty between 1991 and 2001 were enrolled in this study. After physical examination, they were evaluated regarding health related quality of life, functional outcome and psychosocial status. While quality of life was mainly assessed using the SF-36 (The Short Form (36) Health Survey v2), functional outcome was measured using the musculoskeletal tumor society score (MSTS) as well as the Tegner activity level scale. RESULTS Average age at the time of surgery was 19 ± 10 year. and 32 ± 11 year. at the time of follow up. Mean follow-up was 14 ± 9 years. The SF-36 scores accounted for 80.4 ± 15.7 regarding physical functioning, for 78.1 ± 24.1 regarding the physical role functioning, for 74.1 ± 17.6 regarding bodily pain and for 71.8 ± 26.1 regarding general health. SF-36 score for vitality was 75.0 ± 12.8, for social functioning 98.9 ± 3.6, 88.2 ± 23.9 for emotional role functioning and 89.6 ± 10.1 for the mental health. Comparison to a representative German sample cohort revealed significantly higher patient's scores for vitality, social functioning and mental health (p < 0.05). The overall MSTS resulted in an average of 64 ± 12 % and the Tegner activity level scale accounted for 4.1 ± 0.6 pts. CONCLUSIONS The presented long-term results indicate that rotationplasty provides a high quality of life. Patients are satisfied with a good functional outcome regarding activities of daily life and even sports.
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Affiliation(s)
- Guntmar Gradl
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany.
| | - Lukas K Postl
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. .,Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.
| | - Ulrich Lenze
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany.
| | - Josef Stolberg-Stolberg
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany.
| | - Florian Pohlig
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany.
| | - Hans Rechl
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany.
| | - Markus Schmitt-Sody
- Department of Orthopedics, Klinikum der Universitaet Muenchen, Ludwig-Maximilians-Universitaet, Munich, Germany.
| | - Ruediger von Eisenhart-Rothe
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany.
| | - Chlodwig Kirchhoff
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. .,Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.
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