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Sharif-Nia H, Froelicher ES, Hoseinzadeh E, Kaveh O, Fatehi R, Nowrozi P. Assessing the validity and reliability of the 10-item Persian version of the perceived stress scale in post-surgery patients. Front Psychiatry 2024; 15:1402122. [PMID: 38895033 PMCID: PMC11184503 DOI: 10.3389/fpsyt.2024.1402122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction The 10-item Perceived Stress Scale (PSS-10) is commonly used to measure stress levels in postoperative patients, as research shows that high levels of stress can affect postoperative outcomes. By using the PSS-10, healthcare providers can understand patients' psychological well-being before and after surgery, helping improve recovery and overall health. This study focuses on assessing the reliability and validity of the 10-item Persian version of the PSS (PSS-10-P) in postoperative patients. Methods In a methodological study conducted between October to December 2023, a sample of 400 patients who had undergone surgery in 17 Shahrivar Hospital, Amol, Iran were selected using a convenience sampling method. The PSS-10 scale utilized in the study was translated, and its psychometric properties were evaluated through assessments of construct validity, including exploratory (n = 200) and confirmatory (n = 200) factor analysis, convergent validity, and discriminant validity. Furthermore, the study examined the internal consistency of the scale to ensure its reliability. Results The mean age of the participants was 44.38 (SD= 13.49) years. The results of exploratory factor analysis with Promax rotation extracted two factors accounting for 83.82% of the variance comprising 10 items. After necessary modifications during CFA, the final model was approved. As for reliability, the Cronbach's alpha, CR, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. Conclusion According to these results, the Persian version of PSS-10 has a valid structure and acceptable reliability. This scale can be used by health professionals in many ways.
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Affiliation(s)
- Hamid Sharif-Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, School of Nursing, and Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Esmail Hoseinzadeh
- Department of Nursing, Faculty of Medical Sciences, Gorgan Branch, Islamic Azad University, Gorgan, Iran
| | - Omolhoda Kaveh
- Department of Nursing, Sari Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Fatehi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Poorya Nowrozi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Aßmann ES, Ose J, Hathaway CA, Oswald LB, Hardikar S, Himbert C, Chellam V, Lin T, Daniels B, Kirchhoff AC, Gigic B, Grossman D, Tward J, Varghese TK, Shibata D, Figueiredo JC, Toriola AT, Beck A, Scaife C, Barnes CA, Matsen C, Ma DS, Colman H, Hunt JP, Jones KB, Lee CJ, Larson M, Onega T, Akerley WL, Li CI, Grady WM, Schneider M, Dinkel A, Islam JY, Gonzalez BD, Otto AK, Penedo FJ, Siegel EM, Tworoger SS, Ulrich CM, Peoples AR. Risk factors and health behaviors associated with loneliness among cancer survivors during the COVID-19 pandemic. J Behav Med 2024; 47:405-421. [PMID: 38418709 DOI: 10.1007/s10865-023-00465-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 12/27/2023] [Indexed: 03/02/2024]
Abstract
Loneliness may exacerbate poor health outcomes particularly among cancer survivors during the COVID-19 pandemic. Little is known about the risk factors of loneliness among cancer survivors. We evaluated the risk factors of loneliness in the context of COVID-19 pandemic-related prevention behaviors and lifestyle/psychosocial factors among cancer survivors. Cancer survivors (n = 1471) seen at Huntsman Cancer Institute completed a survey between August-September 2020 evaluating health behaviors, medical care, and psychosocial factors including loneliness during COVID-19 pandemic. Participants were classified into two groups: 'lonely' (sometimes, usually, or always felt lonely in past month) and 'non-lonely' (never or rarely felt lonely in past month). 33% of cancer survivors reported feeling lonely in the past month. Multivariable logistic regression showed female sex, not living with a spouse/partner, poor health status, COVID-19 pandemic-associated lifestyle factors including increased alcohol consumption and marijuana/CBD oil use, and psychosocial stressors such as disruptions in daily life, less social interaction, and higher perceived stress and financial stress were associated with feeling lonely as compared to being non-lonely (all p < 0.05). A significant proportion of participants reported loneliness, which is a serious health risk among vulnerable populations, particularly cancer survivors. Modifiable risk factors such as unhealthy lifestyle behaviors and psychosocial stress were associated with loneliness. These results highlight the need to screen for unhealthy lifestyle factors and psychosocial stressors to identify cancer survivors at increased risk of loneliness and to develop effective management strategies.
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Affiliation(s)
- Elena S Aßmann
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- School of Medicine, Technical University of Munich, Munich, Germany
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Cassandra A Hathaway
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sheetal Hardikar
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Anne C Kirchhoff
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Pediatrics, Division of Hematology/Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Douglas Grossman
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Jonathan Tward
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA
| | - Thomas K Varghese
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - David Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jane C Figueiredo
- Department of Medicine, Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Adetunji T Toriola
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Anna Beck
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Courtney Scaife
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Christopher A Barnes
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Cindy Matsen
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Debra S Ma
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Howard Colman
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
| | - Jason P Hunt
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Kevin B Jones
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Orthopedics, University of Utah, Salt Lake City, UT, USA
| | - Catherine J Lee
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | | | - Tracy Onega
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Wallace L Akerley
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jessica Y Islam
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Amy K Otto
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Department of Public Health Sciences, University of Miami, Coral Gables, FL, USA
| | - Frank J Penedo
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, USA
| | - Erin M Siegel
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Anita R Peoples
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
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Kulbin K, Jõgi AL, Pulver A, Kask K. Heterogeneous trajectories of perceived stress and their associations with active leisure: a longitudinal study during the first year of COVID-19. Front Public Health 2024; 12:1327966. [PMID: 38784577 PMCID: PMC11112114 DOI: 10.3389/fpubh.2024.1327966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction There is a plethora of literature on the dynamics of mental health indicators throughout the COVID-19 pandemic, yet research is scarce on the potential heterogeneity in the development of perceived stress. Furthermore, there is a paucity of longitudinal research on whether active leisure engagement, which typically is beneficial in reducing stress, might have similar benefits during times of major disruption. Here we aimed to extend previous work by exploring the dynamics of change in stress and coping, and the associations with active leisure engagement over the first year of COVID-19. Methods Data from 439 adults (Mage = 45, SD = 13) in Estonia who participated in a longitudinal online study were analyzed. The participants were assessed at three timepoints: April-May 2020; November-December 2020; and April-May 2021. Results Mean stress and coping levels were stable over time. However, latent profile analysis identified four distinct trajectories of change in stress and coping, involving resilient, stressed, recovering, and deteriorating trends. Participants belonging to the positively developing stress trajectories reported higher active leisure engagement than those belonging to the negatively developing stress trajectories. Discussion These findings highlight the importance of adopting person-centered approaches to understand the diverse experiences of stress, as well as suggest the promotion of active leisure as a potentially beneficial coping resource, in future crises.
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Affiliation(s)
- Karel Kulbin
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Anna-Liisa Jõgi
- School of Educational Sciences, Tallinn University, Tallinn, Estonia
- Department of Teacher Education, University of Jyväskylä, Jyväskylä, Finland
| | - Aleksander Pulver
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Kristjan Kask
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
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Lee C, Wolever RQ, Min SH, Vorderstrasse AA, Yang Q. Network Psychometrics of the 10-Item Perceived Stress Scale Among Patients With High Cardiovascular and Type 2 Diabetes Risk Using Exploratory Graph Analysis. J Cardiovasc Nurs 2024; 39:E36-E43. [PMID: 37249540 DOI: 10.1097/jcn.0000000000000996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND No studies have explored the internal structure of the 10-item Perceived Stress Scale in patients with high cardiovascular and diabetes risk. OBJECTIVE We scrutinized the dimensionality of the scale in this patient group using exploratory graph analysis, a technique within the developing field of network psychometrics. METHODS Analyses were conducted on 200 primary care patients. A bootstrap version of exploratory graph analysis assessed the stability of the dimensions based on structural consistency, item stability, and network loadings. RESULTS Exploratory graph analysis revealed a 2-dimensional structure; structural consistency of the first dimension was high (0.863), whereas that for the second was low (0.667). Items belonging to the latter dimension did not cluster consistently with each other (ie, low item stability) and were not strongly associated with any particular dimension (ie, weak network loadings). CONCLUSION Exploratory graph analysis offers unique outputs, making it easy to assess the dimensional integrity of scales. Further research is warranted regarding the second dimension of the Perceived Stress Scale.
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Hu W, Bao J, Yang X, Ye M. Psychometric evaluation of the Chinese version of the stressors in breast cancer scale: a translation and validation study. BMC Public Health 2024; 24:425. [PMID: 38336690 PMCID: PMC10858503 DOI: 10.1186/s12889-024-18000-3] [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: 09/23/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVE To translate the Stressors in Breast Cancer Scale (SBCS) from English to Chinese and assess its psychometric properties. METHODS The Brislin's translation model was applied to perform forward translation, back translation, cross-cultural adaptation, Whereas the Chinese version of the SBCS was formed by conducting pre-testing. A cohort of 878 breast cancer patients participated in this methodological study. Content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity were used to establish validity. Internal consistency reliability, split-half reliability, and test-retest reliability were used to establish reliability. RESULTS The final scale contained five dimensions and 24 items, including interpersonal relationship and healthcare strains, worries and concerns about the future, physical appearance and sex strains, daily difficulties and health. The average content validity index of the scale was 0.975. The goodness-of-fit index (χ2/DF = 2.416, RMSEA = 0.057, GFI = 0.896, CFI = 0.947, IFI = 0.947, and TLI = 0.939) indicated that the model was well-fitted. The composite reliability (CR) of the dimensions ranged from 0.825 to 0.934, the average variance extracted (AVE) ranged from 0.539 to 0.712, and the correlation coefficients of each dimension with the other dimensions were less than the square root of the AVE for that dimension. The Criterion-related validity was 0.511. The Cronbach's alpha was 0.938, and the dimensions ranged from 0.779 to 0.900. Split-half reliability was 0.853, with dimensions ranging from 0.761 to 0.892. Test-retest reliability was 0.855. CONCLUSIONS The Chinese version of the SBCS has good reliability and validity, which can be applied to the assessment of stressors in breast cancer patients in China.
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Affiliation(s)
- Wenqi Hu
- The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Jiahui Bao
- The First Affiliated Hospital of China Medical University, Liaoning, China
| | | | - Mao Ye
- The First Affiliated Hospital of China Medical University, Liaoning, China.
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Yılmaz Koğar E, Koğar H. A systematic review and meta-analytic confirmatory factor analysis of the perceived stress scale (PSS-10 and PSS-14). Stress Health 2024; 40:e3285. [PMID: 37341705 DOI: 10.1002/smi.3285] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/16/2023] [Accepted: 06/11/2023] [Indexed: 06/22/2023]
Abstract
Stress is defined as a person's interaction with their environment that is thought to threaten or affect an individual's potential, resources, and well-being. The most popular instrument to assess perceived stress is the Perceived Stress Scale (PSS). Therefore, making a systematic review of studies testing the internal structure of PSS and conducting a Meta-Analytic Confirmatory Factor Analysis (MACFA) on the database created with the information obtained from these studies are the aims of this research. A total of 76 samples from 57 unique studies were included in this database using various inclusion criteria (total N for PSS-14 = 28,632, for PSS-10 = 46,053). The correlated two-factor model for PSS was confirmed by MACFA performed on the pooled correlation matrix generated by the random effects meta-analysis. Findings of dimensionality analyses, factor loadings, omega values, and measurement invariance showed that the model that best explained the factor structure of PSS was the correlated two-factor model. The strict measurement invariance of the PSS was achieved across age and clinical status, and the internal consistency was high according to the omega values. Several recommendations moving forward are discussed.
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Affiliation(s)
- Esin Yılmaz Koğar
- Faculty of Education, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Hakan Koğar
- Faculty of Education, Akdeniz University, Antalya, Turkey
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Pedersen HS, Christensen KS, Prior A, Christensen KB. The dimensionality of the Perceived Stress Scale: The presence of opposing items is a source of measurement error. J Affect Disord 2024; 344:485-494. [PMID: 37852582 DOI: 10.1016/j.jad.2023.10.109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/26/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION The Perceived Stress Scale (PSS) is a widely recognized patient-reported outcome measure designed to assess an individual's level of perceived stress. The PSS consists of ten items, with six items phrased negatively and four phrased positively. Most studies have found that the PSS consists of two dimensions, with negative and positive items forming separate dimensions. However, some studies suggest a one-dimensional construct. OBJECTIVE We aimed to investigate the dimensionality of the PSS and the impact of wording effects on the measurement properties of the scale. METHODS We tested a modified version of the PSS (mPSS), with negative wording of all items. In a Danish sample, respondents were randomized to answer the PSS or the mPSS. We used confirmative factor analysis and Rasch analysis to assess the validity and reliability of the two versions. The proportion of person misfit was also evaluated. RESULTS A total of 326 respondents completed the PSS, whereas 306 completed the mPSS. For the PSS, a two-factor model fitted the data best, and the first positively formulated item showed under-discrimination (Rasch model item fit rejected). The mPSS had higher measurement precision than the PSS, but evidence of local dependence was seen for both versions. Fewer respondents gave improbable responses to the mPSS compared to the PSS. LIMITATIONS Data comes from three different respondent samples. CONCLUSION The PSS was deemed essentially unidimensional, with the extra variance being attributed to the reversed items. To reduce response bias, clinicians and researchers may apply the mPSS.
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Affiliation(s)
- Henrik Schou Pedersen
- Research Unit for General Practice, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark.
| | - Kaj Sparle Christensen
- Research Unit for General Practice, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anders Prior
- Research Unit for General Practice, Aarhus, Denmark
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Xiao T, Zhu F, Wang D, Liu X, Xi SJ, Yu Y. Psychometric validation of the Perceived Stress Scale (PSS-10) among family caregivers of people with schizophrenia in China. BMJ Open 2023; 13:e076372. [PMID: 38035751 PMCID: PMC10689371 DOI: 10.1136/bmjopen-2023-076372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND The 10-item Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress that has been validated in various populations, yet with inconsistent results on its factor structure. The present study examines the reliability and validity of the PSS-10 in a population not previously examined: Chinese family caregivers of persons with schizophrenia, with a focus on factor analysis. METHODS A sample of 449 family caregivers of persons with schizophrenia was recruited for psychometric testing of the scale. The factor structure of PSS-10 was tested by randomly dividing the sample into two groups for both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The scale was further tested for internal consistency, test-retest reliability, convergent validity, discriminant validity and concurrent validity. RESULTS EFA extracted two factors: perceived helplessness with six negative phrasing items and perceived efficacy with four positive phrasing items. CFA confirmed the structure of two factors with satisfactory model fit indices. Convergent validity was supported by high standard regression weight (0.78-0.92), average variance extracted (AVE=0.79-0.81) and composite reliability (0.88-0.94), while discriminant validity was confirmed by higher AVE estimates than the squared interconstruct correlations. The PSS-10 showed good internal consistency and test-retest reliability, with Cronbach's alpha of 0.79 and intraclass correlation coefficient of 0.91, respectively. Concurrent validity was demonstrated by its significant positive correlations with stigma, depression and anxiety, as well as significant negative correlations with social support, family functioning and positive caregiving experiences. CONCLUSION The two-factor PSS-10 has good psychometric characteristics assessing the perceived stress of family caregivers of people with schizophrenia. The findings indicate that the PSS-10 can be used to measure perceived stress in future research and practice among caregivers of people with schizophrenia, and potentially, other caregiving samples.
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Affiliation(s)
- Tao Xiao
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feng Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Dan Wang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Xiang Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shi-Jun Xi
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Foshan Center for Disease Control and Prevention, Foshan, China
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
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Phansikar M, Gothe N, Hernandez R, Lara-Cinisomo S, Mullen SP. Feasibility and impact of a remote moderate-intensity yoga intervention on stress and executive functioning in working adults: a randomized controlled trial. J Behav Med 2023; 46:720-731. [PMID: 36754937 PMCID: PMC9908305 DOI: 10.1007/s10865-022-00385-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/09/2022] [Indexed: 02/10/2023]
Abstract
The feasibility of a moderate-intensity yoga intervention, delivered remotely via supervised and unsupervised sessions, and its psychosocial and cognitive effects have not been thoroughly investigated. This randomized controlled trial assessed feasibility and preliminary efficacy of an 8-week moderate-intensity yoga intervention (3×/week, 50 min) delivered remotely (vs. a waitlist control arm), on stress and cognitive functioning. Participants (n = 86) were low active, full-time working adults (81.40% female; Mage = 41 years) with symptoms of stress. Feasibility was assessed via adherence, enjoyment, and safety; stress and anxiety via self-report questionnaires; and executive functioning via neuropsychological tests. Overall attendance was 75.1%, 100% of participants enjoyed the intervention, and only one adverse event was reported. At follow-up, the yoga group had significantly lower stress and anxiety, and higher accuracy on working memory tasks. Remote moderate intensity yoga practice proved safe, enjoyable, and may reduce stress and improve cognitive functioning. This study was pre-registered on ClinicalTrials.gov (NCT04740229).
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Affiliation(s)
- Madhura Phansikar
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, USA
| | - Neha Gothe
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, USA
| | - Rosalba Hernandez
- School of Social Work, University of Illinois Urbana-Champaign, Champaign, USA
| | - Sandraluz Lara-Cinisomo
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, USA
| | - Sean P. Mullen
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, USA
- Center for Social & Behavioral Science, University of Illinois Urbana-Champaign, Champaign, USA
- Informatics Program, University of Illinois Urbana-Champaign, Champaign, USA
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Harris KM, Gaffey AE, Schwartz JE, Krantz DS, Burg MM. The Perceived Stress Scale as a Measure of Stress: Decomposing Score Variance in Longitudinal Behavioral Medicine Studies. Ann Behav Med 2023; 57:846-854. [PMID: 37084792 PMCID: PMC10498818 DOI: 10.1093/abm/kaad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The Perceived Stress Scale (PSS) is a widely used measure designed to assess perceptions of recent stress. However, it is unclear to what extent the construct assessed by the PSS represents factors that are stable versus variable within individuals, and how these components might vary over time. PURPOSE Determine the degree to which variability in repeated PSS assessments is attributable to between-person versus within-person variance in two different studies and populations. METHODS Secondary analyses utilized data from two studies with up to 13 PSS assessments: An observational study of 127 patients with heart failure followed over 39 months (Study 1), and an experimental study of 73 younger, healthy adults followed over 12 months (Study 2). Multilevel linear mixed modeling was used to estimate sources of variance in the PSS total and subscale scores across assessments. RESULTS Between-person variance accounted for a large proportion of the total variance in PSS total scores in Study 1 (42.3%) and Study 2 (51.1%); within-person variance comprised the remainder. Between-person variance was higher for shorter assessment periods (e.g., 1 week), and was comparable when examining only the first 12 months of assessments in each study (52.9% vs. 51.1%). CONCLUSIONS Within two samples differing in age and health status, between-person variance accounted for approximately half of the total variation in PSS scores over time. While within-person variance was observed, the construct assessed by the PSS may substantially reflect a more stable characteristic of how an individual perceives stressful life circumstances than previously appreciated.
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Affiliation(s)
- Kristie M Harris
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Allison E Gaffey
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joseph E Schwartz
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
- Department of Medicine, Columbia University, New York, NY, USA
| | - David S Krantz
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Matthew M Burg
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA
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Curyło M, Rynkiewicz-Andryśkiewicz M, Andryśkiewicz P, Mikos M, Lusina D, Raczkowski JW, Partyka O, Pajewska M, Sygit K, Sygit M, Cipora E, Kaczmarski M, Gawiński Ł, Banaś T, Strzępek Ł, Juszczyk G, Krzych-Fałta E, Bandurska E, Ciećko W, Zabojszcz M, Zdziarski K, Knyszyńska A, Kosior DA, Marczak M, Czerw A, Kozłowski R. Acceptance of Illness and Coping with Stress among Patients Undergoing Alcohol Addiction Therapy. J Clin Med 2023; 12:4767. [PMID: 37510882 PMCID: PMC10381120 DOI: 10.3390/jcm12144767] [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: 04/28/2023] [Revised: 06/30/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Acceptance of illness is a process in which a person with an illness accepts its presence and treats it as an integral part of their life. With regard to alcoholism, acceptance of illness is one of the important elements of the healing process. (2) Methods: The study group consisted of 104 residents in an addiction treatment ward. Questionnaires SOC-29, AIS and PSS-10 were used to check levels of coherence, stress and acceptance of illness. The analysis was based on regression analysis. Patient age was analysed as a moderator of correlations between perceived indicators. Moderation analysis was based on the simple moderation model. (3) Results: The level of perceived stress correlated negatively with all areas of the sense of coherence and with acceptance of illness. All areas of the sense of coherence correlated with acceptance of illness positively. (4) Conclusions: The acceptance of illness by the patient is a factor that can be motivating for further treatment, through a positive approach to illness and strengthening the sense of control in experiencing it. The combination of strengthening behavioural, cognitive and motivational resources can be used in the treatment of people experiencing the challenges of addiction to alcohol.
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Affiliation(s)
- Mateusz Curyło
- Department of Internal Medicine, Rehabilitation and Physical Medicine, Medical University of Lodz, 90-647 Lodz, Poland
- Medical Rehabilitation Department, The Ministry of the Interior and Administration Hospital, 30-053 Krakow, Poland
| | - Marlena Rynkiewicz-Andryśkiewicz
- Department of Treatment of Alcohol Abstinence Syndromes, Independent Public Healthcare Facility in Lezajsk, 37-300 Lezajsk, Poland
| | - Przemysław Andryśkiewicz
- Department of Treatment of Alcohol Abstinence Syndromes, Independent Public Healthcare Facility in Lezajsk, 37-300 Lezajsk, Poland
| | - Marcin Mikos
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland
| | - Dariusz Lusina
- Department of Orthopedics and Traumatology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Jan W Raczkowski
- Department of Internal Medicine, Rehabilitation and Physical Medicine, Medical University of Lodz, 90-647 Lodz, Poland
| | - Olga Partyka
- Department of Economic and System Analyses, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland
- Department of Health Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Monika Pajewska
- Department of Economic and System Analyses, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland
- Department of Health Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Katarzyna Sygit
- Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland
| | - Marian Sygit
- Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland
| | - Elżbieta Cipora
- Medical Institute, Jan Grodek State University in Sanok, 38-500 Sanok, Poland
| | - Mateusz Kaczmarski
- Medical Institute, Jan Grodek State University in Sanok, 38-500 Sanok, Poland
| | - Łukasz Gawiński
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland
| | - Tomasz Banaś
- Department of Radiotherapy, Maria Sklodowska-Curie Institute-Oncology Centre, 31-115 Cracow, Poland
| | - Łukasz Strzępek
- Clinical Department of General and Oncological Surgery, St. Raphael Hospital Krakow, 30-693 Krakow, Poland
| | - Grzegorz Juszczyk
- Department of Public Health, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Edyta Krzych-Fałta
- Department of Basic of Nursing, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Ewa Bandurska
- Center for Competence Development, Integrated Care and e-Health, Medical University of Gdansk, 80-204 Gdansk, Poland
| | - Weronika Ciećko
- Center for Competence Development, Integrated Care and e-Health, Medical University of Gdansk, 80-204 Gdansk, Poland
| | - Michał Zabojszcz
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
| | - Krzysztof Zdziarski
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Anna Knyszyńska
- Department of Humanities and Occupational Therapy, Pomeranian Medical University in Szczecin, 71-103 Szczecin, Poland
| | - Dariusz A Kosior
- Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Michał Marczak
- Collegium of Management, WSB University in Warsaw, 03-204 Warsaw, Poland
| | - Aleksandra Czerw
- Department of Economic and System Analyses, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland
- Department of Health Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Remigiusz Kozłowski
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland
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Heo SJ, Park SK, Jee YS. Effects of phytoncide on immune cells and psychological stress of gynecological cancer survivors: randomized controlled trials. J Exerc Rehabil 2023; 19:170-180. [PMID: 37435591 PMCID: PMC10331144 DOI: 10.12965/jer.2346150.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/23/2023] [Indexed: 07/13/2023] Open
Abstract
This study aimed to identify neuroendocrine substances and natural killer (NK) cells, including their subsets and receptors, to determine whether phytoncides scented in an urban hospital could help improve stress in cancer survivors. Fifty-five gynecological cancer survivors were assigned to either the control group (CG, n=28) or phytoncide group (PTG, n=27). The PTG meditated by lying down in a space scented with phytoncide for 1 hr a day, 5 days a week for 8 weeks. Stress levels in both groups were high prior to the experiment and decreased by 9.31%±45.98% (P=0.003) only in the PTG after the experiment. Although the parasympathetic nerve activity of the PTG increased, the epinephrine and cortisol levels were significantly (P<0.001) decreased by 5.29%±25.5% and by 24.94%±11.62%. Moreover, the PTG showed a significant increase in the levels of NK cell subsets after 8 weeks, whereas there was no improvement in the CG. In conclusion, phytoncide fragrance reduces stress, increases the number of NK cells and their family even in a nonforest environment, and improves innate immunocytes in gynecological cancer survivors; parasympathetic nerve activity and cortisol hormones play critical roles in this process. That is, a phytoncide essential oil helps to stimulate changes in immunocytes' mobility by affecting the human nervous and endocrine systems, thereby providing relief for psychological stress among cancer survivors who previously had cancer cells.
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Affiliation(s)
- Seung-Jae Heo
- Department of Physical Education, Chungnam National University, Daejeon,
Korea
| | - Sang-Kyun Park
- Department of Physical Education, Chungnam National University, Daejeon,
Korea
- Research Institute of Sports and Industry Science, Hanseo University, Seosan,
Korea
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, Seosan,
Korea
- Exercise Immunology Center, Seoul Songdo Hospital, Seoul,
Korea
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13
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Adler Jaffe S, Jacobson K, Farnbach Pearson AW, Baca LA, Dimauro N, Kano M. "Did I get into the twilight zone somehow?": sexual and gender minority cancer caregiver experiences during COVID. Cancer Causes Control 2023; 34:563-568. [PMID: 37145262 PMCID: PMC10161178 DOI: 10.1007/s10552-023-01708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
INTRODUCTION The COVID-19 pandemic created new challenges for cancer patients and caregivers. Little is known about the confluence of the pandemic and people with multiple marginalized identities, such as those in the Sexual and Gender Minority (SGM) community. METHODS We conducted a mixed-methods pilot study using semi-structured interviews to elicit experiences of cancer among a diverse population of SGM patients and caregivers and a matched set of cisgender heterosexual (cishet) individuals. Here, we present qualitative findings focused on caregiver experiences as ascertained from the broader study. RESULTS We discovered differences between SGM and cishet caregiving experiences, with SGM caregivers reporting less comfort in the cancer center environment; dissatisfaction with patient-provider communication; feeling excluded from their loved ones' care; and increased social isolation resulting from the caregiver experience. SGM and cishet caregivers described the detrimental impact of the pandemic. CONCLUSION Our data suggest SGM caregivers experience additional burdens to cancer caregiving when compared to cishet peers. Although SGM and cishet caregivers reported challenges stemming from the COVID-19 pandemic, challenges appeared greater and more acute for SGM caregivers. Pandemic-related findings point to overall gaps in SGM cancer caregiver supports that may be remedied by additional research and targeted intervention development.
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Affiliation(s)
- Shoshana Adler Jaffe
- University of New Mexico Comprehensive Cancer Center, 2325 Camino de Salud, Albuquerque, NM, 87131, USA.
| | - Kendal Jacobson
- University of New Mexico Comprehensive Cancer Center, 2325 Camino de Salud, Albuquerque, NM, 87131, USA
| | - Amy W Farnbach Pearson
- University of New Mexico Comprehensive Cancer Center, 2325 Camino de Salud, Albuquerque, NM, 87131, USA
| | - Lila A Baca
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Nina Dimauro
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Miria Kano
- University of New Mexico Comprehensive Cancer Center, 2325 Camino de Salud, Albuquerque, NM, 87131, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
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14
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Razzoli M, Nyuyki-Dufe K, Chen BH, Bartolomucci A. Contextual modifiers of healthspan, lifespan, and epigenome in mice under chronic social stress. Proc Natl Acad Sci U S A 2023; 120:e2211755120. [PMID: 37043532 PMCID: PMC10120026 DOI: 10.1073/pnas.2211755120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/24/2023] [Indexed: 04/13/2023] Open
Abstract
Sustained life stress and low socioeconomic status are among the major causes of aging-related diseases and decreased life expectancy. Experimental rodent models can help to identify the underlying mechanisms, yet very few studies address the long-term consequences of social stress on aging. We conducted a randomized study involving more than 300 male mice of commonly used laboratory strains (C57BL/6J, CD1, and Sv129Ev) chosen for the spontaneous aggression gradient and stress-vulnerability. Mice were exposed to a lifelong chronic psychosocial stress protocol to model social gradients in aging and disease vulnerability. Low social rank, inferred based on a discretized aggression index, was found to negatively impact lifespan in our study population. However, social rank interacted with genetic background in that low-ranking C57BL/6J, high-ranking Sv129Ev, and middle-ranking CD1 mice had lower survival, respectively, implying a cost of maintaining a given social rank that varies across strains. Machine learning linear discriminant analysis identified baseline fat-free mass as the most important predictor of mouse genetic background and social rank in the present dataset. Finally, strain and social rank differences were significantly associated with epigenetic changes, most significantly in Sv129Ev mice and in high-ranking compared to lower ranking subjects. Overall, we identified genetic background and social rank as critical contextual modifiers of aging and lifespan in an ethologically relevant rodent model of social stress, thereby providing a preclinical experimental paradigm to study the impact of social determinants of health disparities and accelerated aging.
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Affiliation(s)
- Maria Razzoli
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN55455
| | - Kewir Nyuyki-Dufe
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN55455
| | - Brian H. Chen
- FOXO Technologies Inc., Minneapolis, MN55401
- Division of Epidemiology, The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA92093
| | - Alessandro Bartolomucci
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN55455
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15
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Walsh EA, Boland CL, Popok PJ, Pedreira PB, Fox RS, Moreno PI, Yanez B, Penedo FJ. Marital status and perceived stress in men with advanced prostate cancer: A randomized-controlled trial of cognitive behavioral stress management. J Psychosom Res 2023; 167:111198. [PMID: 36812663 PMCID: PMC10023351 DOI: 10.1016/j.jpsychores.2023.111198] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Relationship status predicts numerous outcomes among medical populations. Few interventions evaluate the role of marital status on response to psychosocial treatment, and no such studies exist within advanced prostate cancer (APC). This study examined whether marital status modified the effect of a cognitive behavioral stress management (CBSM) intervention on perceived stress. METHODS Men with APC (N = 190) were randomized to 10-week CBSM or a health promotion (HP) intervention (#NCT03149185). The Perceived Stress Scale assessed perceived stress at baseline and 12-month follow-up. Medical status and sociodemographics were captured at enrollment. RESULTS Participants were mostly White (59.5%), non-Hispanic (97.4%), heterosexual (97.4%) men, 66.8% of whom were partnered. Neither condition nor marital status predicted perceived stress change at follow-up. However, a significant interaction was found between condition and marital status (p = 0.014; Cohen's f = 0.07), such that partnered men who received CBSM and unpartnered men who received HP reported greater reductions in perceived stress. CONCLUSION This is the first study to assess the impact of marital status on psychosocial intervention effects among men with APC. Partnered men derived greater benefit from a cognitive-behavioral intervention and unpartnered men equally benefitted from a HP intervention. Further research is necessary to understand the mechanisms underlying these relationships.
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Affiliation(s)
- Emily A Walsh
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America.
| | - Cody L Boland
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Paula J Popok
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Patricia B Pedreira
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Rina S Fox
- University of Arizona, College of Nursing, Tucson, AZ, United States of America
| | - Patricia I Moreno
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL, United States of America; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America; University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL, United States of America
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16
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Světlák M, Malatincová T, Halámková J, Barešová Z, Lekárová M, Vigašová D, Slezáčková A, Šumec R, Humpolíček P, Šedo J, Chládek J, Roman R, Gottwaldová J, Gescheidtová L, Čermáková Z, Thon V, Hrnčiříková I, Kazda T, Svoboda M. The effectiveness of three mobile-based psychological interventions in reducing psychological distress and preventing stress-related changes in the psycho-neuro-endocrine-immune network in breast cancer survivors: Study protocol for a randomised controlled trial. Internet Interv 2023; 32:100628. [PMID: 37273931 PMCID: PMC10235427 DOI: 10.1016/j.invent.2023.100628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/16/2023] [Accepted: 05/04/2023] [Indexed: 06/06/2023] Open
Abstract
Background A growing body of literature shows that psychological distress is not only a major threat to psychological well-being but can also have a significant impact on physical health. In cancer patients, it can negatively affect prognosis and posttreatment recovery processes. Since face-to-face psychological interventions are often inaccessible to cancer patients, researchers have recently been focusing on the effectiveness of eHealth adaptations of well-established approaches. In this context, there has been a call for high-quality randomised controlled trials that would allow for a direct comparison of different approaches, potentially addressing different needs and preferences of patients, and also for more systematic research focusing on how psychological interventions affect not only psychological but also biological markers of stress. Both of these questions are addressed in the present study. Methods A randomised controlled trial will be carried out to test and compare the effectiveness of three eight-week eHealth programmes for the mental health support of cancer patients. All programmes will be delivered through the same application for mobile devices MOU MindCare. N = 440 of breast cancer survivors will be recruited at the end of their adjuvant treatment (chemotherapy, radiotherapy, or both) and randomly assigned to one of the three interventions - Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca), Positive Psychology (PP), or Autogenic Training (AT) - or the treatment-as-usual (TAU) control group. Psychological and biological markers of stress and adaptive functioning will be assessed at baseline (T0), post-treatment (T1), three-month follow-up (T2), and nine-month follow-up (T3). Primary outcomes will include heart-rate variability and self-report measures of depression, anxiety, perceived stress, general quality of life, and positive mental health. Secondary outcomes will include the levels of serum cortisol and immunomarkers, sleep quality, fatigue, common health symptoms, and several transdiagnostic psychological variables that are expected to be specifically affected by the MBCT-Ca and PP interventions, including dispositional mindfulness, emotion regulation, self-compassion, perceived hope, and gratitude. The data will be analysed using the mixed model repeated measures (MMRM) approach. Discussion This trial is unique in comparing three different eHealth interventions for cancer patients based on three well-established approaches to mental health support delivered on the same platform. The study will allow us to examine whether different types of interventions affect different indicators of mental health. In addition, it will provide valuable data regarding the effects of stress-reducing psychological interventions on the biomarkers of stress playing an essential role in cancer recovery processes and general health.
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Affiliation(s)
- Miroslav Světlák
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
| | - Tatiana Malatincová
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
| | - Jana Halámková
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
| | - Zdeňka Barešová
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
| | - Monika Lekárová
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
| | - Dana Vigašová
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
| | - Alena Slezáčková
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
| | - Rastislav Šumec
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
- The First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Pekařská 53, 60500 Brno, Czech Republic
| | - Pavel Humpolíček
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
| | - Jiří Šedo
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
| | - Jan Chládek
- The First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Pekařská 53, 60500 Brno, Czech Republic
- Institute of Scientific Instruments, The Czech Academy of Sciences, Královopolská 147, 61264 Brno, Czech Republic
- Behavioural and Social Neuroscience Research Group, CEITEC–Central European Institute of Technology, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
| | - Robert Roman
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
- Behavioural and Social Neuroscience Research Group, CEITEC–Central European Institute of Technology, Masaryk University, Kamenice 5, 63900 Brno, Czech Republic
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic
| | - Jana Gottwaldová
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
| | - Lenka Gescheidtová
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
| | - Zdeňka Čermáková
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
| | - Vojtěch Thon
- Department of Studies Design and Data Management, RECETOX, Faculty of Science, Masaryk University, Kamenice 34, 62500 Brno, Czech Republic
| | - Iva Hrnčiříková
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
| | - Tomáš Kazda
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
| | - Marek Svoboda
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic
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Li S, Gao Y, Lin Y, Wu W, Fang Q, Ni X, Zhou Y, Hong M, Zhang R, Lou Y. Development and preliminary testing of the cancer-related fatigue comprehensive assessment scale in cancer survivors. J Clin Nurs 2023; 32:1186-1217. [PMID: 35285109 DOI: 10.1111/jocn.16272] [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: 09/07/2021] [Revised: 01/19/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Tailored management of cancer-related fatigue (CRF) is important for effective coping; however, it has been hindered by the lack of a comprehensive tool that assesses both symptoms and treatable influencing factors. AIMS AND OBJECTIVES The aim was to develop a cancer-related fatigue comprehensive assessment scale (CRF-CAS) and assess its psychometric properties. DESIGN This was a mixed-method study. METHODS The study included two phases which were conducted in Zhejiang Province, China. In phase one, a literature search, brainstorming sessions, Delphi studies, cognitive interviews and a pilot study were conducted to construct and revise CRF-CAS indicators. In phase two, a questionnaire-based survey was conducted among cancer survivors. Item analysis was used to select and optimize indicators. Cronbach's α was calculated for reliability analysis. Validity analysis included concurrent validity and structural validity. RESULTS A 93-item tool was initially constructed. Phase one ended with revision and optimization. The preliminary scale included five dimensions (CRF symptoms, physical activity, cognitive-emotional status, sleep status, nutritional status) and 30 items. The mean item-content validity index (I-CVI) and scale-level CVI universal agreement (S-CVI/UA) were .98, and the adjusted mean values of Kappa for indicators ranged from .91-1, as evaluated by the expert group. The Pearson correlation coefficient between the CRF-CAS and criterion scales ranged from .337-.862. Cronbach's α coefficient ranged from .624-.728. Respondents agreed that the scale was acceptable for administration and that it contributed to decision-making in fatigue management. Confirmatory factor analysis (CFA) indicated that the CRF-CAS fit well. CONCLUSIONS The construction process of the CRF-CAS, involving panel discussion and expert and participant evaluations, was shown to be scientific and feasible. The CRF-CAS had relatively good validity and reliability in version 5 of its preliminary scale, which requires further improvement in future studies.
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Affiliation(s)
- Shuaini Li
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China.,The Children's Hospital Zhejiang University School of Medicine (National Clinical Research Center for Child Health), Hangzhou, Zhejiang Province, China
| | - Yating Gao
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Ying Lin
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Wanying Wu
- Zhejiang Cancer Hospital (Cancer Hospital of the University of Chinese Academy of Sciences), Hangzhou, Zhejiang Province, China
| | - Qunying Fang
- Zhejiang Cancer Hospital (Cancer Hospital of the University of Chinese Academy of Sciences), Hangzhou, Zhejiang Province, China
| | - Xiaosha Ni
- Hangzhou Ninth People's Hospital, Hangzhou, Zheijiang province, China
| | - Yao Zhou
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Meirong Hong
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Ruolin Zhang
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Yan Lou
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
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18
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Cerezo MV, Soria-Reyes LM, Pajares B, Gómez-Millán J, Blanca MJ. Development and psychometric properties of the Stressors in Breast Cancer Scale. Front Psychol 2023; 14:1102169. [PMID: 37057161 PMCID: PMC10086352 DOI: 10.3389/fpsyg.2023.1102169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/23/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundA diagnosis of breast cancer generates psychological stress, due not only to treatment and its side effects but also to the impact on different areas of the patient’s daily life. Although there are instruments for measuring psychological stress in the cancer context, there is currently no tool for assessing stressors specific to breast cancer.AimsThe aim of this study was to develop the Stressors in Breast Cancer Scale (SBCS).MethodA panel of experts evaluated the clarity and relevance of scale items, providing validity evidence based on test content. Psychometric properties of the scale were then analyzed.ResultsValidity evidence based on the internal structure of the SBCS was obtained through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), following a cross-validation strategy. The CFA supported a second-order factor model with five dimensions: physical appearance and sex strains, health and daily difficulties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future. This structure was invariant across two groups distinguished by time from cancer diagnosis (less than 3 and 3 years or more from diagnosis). Reliability, based on McDonald’s omega and Cronbach’s alpha coefficients, ranged from 0.83 to 0.89 for factor scores, and reached 0.95 for total scores. Validity evidence was also provided by correlations with depression, anxiety, perceived stress, and perceived health and quality of life.DiscussionThe results support the use of the SBCS for measuring stress as a stimulus in the breast cancer context. Implications for clinical practice and research are discussed.
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Affiliation(s)
- M. Victoria Cerezo
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Málaga, Spain
- *Correspondence: M. Victoria Cerezo,
| | - Lorena M. Soria-Reyes
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Málaga, Spain
| | - Bella Pajares
- Instituto de Investigaciones Biomédicas de Málaga, University of Malaga, Málaga, Spain
| | - Jaime Gómez-Millán
- Instituto de Investigaciones Biomédicas de Málaga, University of Malaga, Málaga, Spain
| | - María J. Blanca
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Málaga, Spain
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Davis C, Turner-Cobb JM. The Perceived Stress Scale for Kids (PeSSKi): Initial development of a brief measure for children aged 7-11 years. Stress Health 2023; 39:125-136. [PMID: 35688796 PMCID: PMC10084385 DOI: 10.1002/smi.3174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 02/05/2023]
Abstract
Perceived stress, a known risk factor for poor health, has been extensively assessed in adult populations. Yet an equivalent assessment tool for measurement of global perceived stress in children is lacking. This study aimed to develop and provide initial validation of a scale to measure perceived stress in children aged 7-11 years. Using a two-phase design, we conducted semi-structured interviews with thirteen child-parent dyads for development of items. In a sample of 123 children (age range 7-11 years, Mage = 9 years 7 months, 54.5% male) we administered the resulting Perceived Stress Scale for Kids (PeSSKi). Exploratory factor analysis of the 10-item PeSSKi yielded support for both a one-factor and a two-factor solution (negative, positive item wording). The PeSSKi was associated positively with the Penn-State Worry Questionnaire for Children (r = 0.748, p < 0.001) and negatively with the Students' Life Satisfaction Scale (r = 0.381, p < 0.001) indicating strong convergent/divergent validity respectively. Girls showed higher scores on the PeSSKi than boys with no effects observed by age. Initial psychometrics suggest the PeSSKi provides a robust scale for assessment of perceived stress in children. Further validation is needed across different child populations, over time and with physical measures of stress and health outcomes.
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Soria-Reyes LM, Cerezo MV, Alarcón R, Blanca MJ. Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients. Stress Health 2023; 39:115-124. [PMID: 35657280 PMCID: PMC10084090 DOI: 10.1002/smi.3170] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/23/2022] [Accepted: 05/29/2022] [Indexed: 02/05/2023]
Abstract
Breast cancer diagnosis is one of the most difficult events that a woman can experience during her life and it usually produces high levels of stress. Global measures of perceived stress are useful for screening and for comparing stress levels between cancer patients and other clinical and nonclinical populations. One such instrument that is widely used is the Perceived Stress Scale (pss-10), but its psychometric properties have scarcely been analysed with breast cancer patients. The aim of this study was to provide validity evidence regarding the use of the 10-item version of the pss-10 as a tool for measuring perceived stress in this context. Participants were 215 Spanish breast cancer patients who completed the PSS-10 and the DASS-21, a measure of affective distress (depression, anxiety, and stress). The internal structure of the PSS-10 was examined through confirmatory factor analysis (CFA), and the reliability of test scores was estimated using McDonald's omega coefficient. Validity evidence based on relationships with other variables was also obtained using correlation analysis. The CFA supported a correlated two-factor structure: perceived helplessness (six negatively worded items) and perceived self-efficacy (four positively worded items). Reliability coefficients for scores on these two factors were 0.87 and 0.73, respectively. Scores on affective distress (DASS-21) were strongly and positively correlated with perceived helplessness and moderately and negatively correlated with perceived self-efficacy. The PSS-10 is an adequate tool for measuring perceived stress in the breast cancer context and it may be useful for identifying women at risk of psychological maladjustment.
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Affiliation(s)
| | | | - Rafael Alarcón
- Faculty of Psychology, University of Malaga, Malaga, Spain
| | - María J Blanca
- Faculty of Psychology, University of Malaga, Malaga, Spain
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Novak AM, Lev-Ari S. Resilience, Stress, Well-Being, and Sleep Quality in Multiple Sclerosis. J Clin Med 2023; 12:jcm12020716. [PMID: 36675644 PMCID: PMC9864697 DOI: 10.3390/jcm12020716] [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: 12/01/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
(1) Background: Multiple Sclerosis (MS) is a chronic, progressive, immune-mediated disorder that affects the Central Nervous System and is the most common cause of non-traumatic neurological disability in young adults. The study aimed to assess the levels of stress, resilience, well-being, sleep quality, and fatigue in Israeli people with MS (PwMS), and to examine the associations between these factors and the sociodemographic and clinical characteristics. These factors had never before been studied in conjunction in PwMS, nor had they been systematically addressed in Israel, the unique geopolitical situation of which may pose unique challenges. (2) Methods: This was a survey-based, cross-sectional study conducted through an Internet platform. (3) Results: Israeli PwMS who participated in the study were experiencing relatively high levels of stress and low resilience, poor sleep quality, and severe fatigue. The analysis revealed significant associations between resilience and stress, well-being, and anxiety, as well as stress and well-being, resilience, sleep quality, fatigue, and Clinically Isolated Syndrome (CIS). (4) Conclusions: the Israeli PwMS who participated in the study were experiencing higher levels of stress, lower resilience and worse sleep quality than PwMS in other countries, as compared to results previously reported in literature. The findings of this study ought to serve as a call to action for the MS care providers in Israel and warrant further research into the possible causes of the phenomenon and strategies to address it.
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Finnerty R, McWeeny S, Trainor L. Online group music therapy: proactive management of undergraduate students' stress and anxiety. Front Psychiatry 2023; 14:1183311. [PMID: 37151974 PMCID: PMC10160410 DOI: 10.3389/fpsyt.2023.1183311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction In alignment with the World Health Organization's (WHO) goal to provide comprehensive and integrated mental health services in community-based settings, this randomized control trial explored the efficacy of online group music therapy as a proactive intervention for reducing stress and anxiety in university students who do not necessarily have a diagnosis. Methods The study took place during COVID-19 restrictions. Students who volunteered were randomly assigned to 6 weeks of weekly (1) online active group music therapy, (2) online receptive group music therapy, (3) online group verbal therapy (standard of care), or (4) no-intervention (control group). Students rated their stress (Likert scale) and anxiety [State-Trait Anxiety Inventory, State version (STAI-S)], and provided heart rate variability (HRV) using a phone app, pre and post each therapy session. Results STAI-S and Likert stress scores significantly reduced from pre to post 45-min online music therapy sessions, with moderate evidence that these changes did not differ from the standard of care (verbal therapy). HRV results were not analyzed statistically as HRV collection was likely compromised due to challenges of remote collection. Students completed the Perceived Stress Scale (PSS) and provided a hair sample for cortisol analysis before and after the 6-week intervention. Changes in stress from week 1 to week 6 were not observed in the PSS measure; however, cortisol increased significantly in the control group as the term progressed, while it remained relatively stable in the therapy groups, suggesting therapy may lead to greater control of stress. Of participants' demographic characteristics, music sophistication, personality, and changes in quality of life, only the personality trait of conscientiousness correlated significantly with PSS, suggesting online group therapy may be beneficial for a wide range of university students. Discussion The results suggest group music therapy can be as effective as group verbal therapy. Further, the study indicates that online delivery can be achieved effectively, supporting the idea that remote therapy may be a viable option for other populations. While the study should be replicated with a larger multi-site sample, it provides one example toward achieving a health-promoting culture on university campuses, consistent with the mental health goals of the Okanagan Charter.
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Affiliation(s)
- Rachael Finnerty
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
- *Correspondence: Rachael Finnerty,
| | - Sean McWeeny
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Laurel Trainor
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
- McMaster Institute for Music and the Mind, Faculty of Science, McMaster University, Hamilton, ON, Canada
- Rotman Research Institute, Baycrest Hospital, Toronto, ON, Canada
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Kállay É. The Investigation of Major Predictors of Well-Being in a Sample of Romanian University Students in the Post-Covid-19 Period. STUDIA UNIVERSITATIS BABEȘ-BOLYAI PSYCHOLOGIA-PAEDAGOGIA 2022. [DOI: 10.24193/subbpsyped.2022.2.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
"The Coronavirus-induced pandemic has had a significant impact on the physical and psychological functioning of the entire world’s population. Research has indicated that besides the physical threat to health itself, the implications of constant uncertainty, separation from and/or loss of loved ones, loss of freedom to travel, shortage of food and financial resources, disruptions of usual life-routines, changing work and learning habits, further aggravate the effect of initial stressors, leading to increased levels of depressive symptoms, anxiety, PTSD, insomnia, lowered levels of well-being, and confusion. Unfortunately, just as the two-years long pandemic ended, the Ukrainian war started, and the Romanian population, since our country borders Ukraine, has experienced a novel type of stress, that of the possibility of being attacked, affected economically. Almost simultaneously, the online education has returned to classical form of teaching, amidst semester, being another stress factor for students. Our results indicated that the two-year long pandemic was considered as having the greatest impact by almost two-thirds of the students. Furthermore, the lack of self-efficacy component of perceived stress was a constant and strong predictor of all components of well-being (subjective and psychological), and perceived helplessness for subjective well-being. Regarding emotion regulation strategies refocus on planning, positive reevaluation, self- and other blame, withdrawal and actively approaching the source of stress proved to be the most important predictors. The results of our investigation may be beneficial for the tailoring of future prevention and intervention programs that would target the enhancement of psychological adaptation of students. Keywords: stress, depressive symptoms, uncertainty, emotion regulation strategies, subjective and psychological well-being, post COVID-19. "
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Dodd F, Kennedy D, Wightman E, Khan J, Patan M, Elcoate R, Jackson P. The chronic effects of a combination of herbal extracts (Euphytose ®) on psychological mood state and response to a laboratory stressor: A randomised, placebo-controlled, double blind study in healthy humans. J Psychopharmacol 2022; 36:1243-1256. [PMID: 35875924 PMCID: PMC9643820 DOI: 10.1177/02698811221112933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Global lifetime prevalence of anxiety disorders has been estimated at approximately 16.6%, with subclinical prevalence likely much higher. Herbal approaches to reduce anxiety may be as effective as pharmacological treatments and are less likely to be associated with adverse side effects. The herbal species, namely, valerian, passionflower, hawthorn and ballota, have a long history of use as anxiolytics in traditional medicine, further supported by recent pre-clinical and clinical trials. AIMS To assess the effects of chronic (14 days) supplementation with a multi-herb extract preparation (MHEP, Euphytose®) on psychological state and psychological and physiological stress responses during a laboratory stressor. METHODS In this crossover study, 31 healthy participants (aged 19-58 years) received a MHEP and placebo for 14 days with a 28-day washout. Anxiety (State-Trait Anxiety Inventory), mood and physiological measures of stress (heart rate, galvanic skin response, salivary α-amylase and cortisol levels) were measured before and after an Observed Multitasking Stressor. Cognitive performance was also assessed. RESULTS MHEP was associated with reduced tension-anxiety (p = 0.038), with participants showing an attenuated response to the observed multitasking psychosocial stressor following MHEP, evidenced by lower salivary α-amylase (p = 0.041) and galvanic skin response (p = 0.004). CONCLUSIONS The combination of herbal extracts contained within the MHEP reduced subjective anxiety in a healthy population and lowered electrodermal skin conductance and concentration of salivary α-amylase in response to a psychosocial stressor, compared to placebo. The study was registered on clinicaltrials.gov (identifier: NCT03909906).
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Affiliation(s)
- Fiona Dodd
- Department of Psychology, Brain,
Performance and Nutrition Research Centre, Northumbria University, Newcastle upon
Tyne, UK,Fiona Dodd, Department of Psychology,
Brain, Performance and Nutrition Research Centre, Northumbria University,
Newcastle upon Tyne NE1 8ST, UK.
| | - David Kennedy
- Department of Psychology, Brain,
Performance and Nutrition Research Centre, Northumbria University, Newcastle upon
Tyne, UK
| | - Emma Wightman
- Nutrition Trials at Northumbria
(NUTRAN) Northumbria University, Newcastle upon Tyne, UK
| | - Julie Khan
- Department of Psychology, Brain,
Performance and Nutrition Research Centre, Northumbria University, Newcastle upon
Tyne, UK
| | - Michael Patan
- Department of Psychology, Brain,
Performance and Nutrition Research Centre, Northumbria University, Newcastle upon
Tyne, UK
| | - Rian Elcoate
- Department of Psychology, Brain,
Performance and Nutrition Research Centre, Northumbria University, Newcastle upon
Tyne, UK
| | - Philippa Jackson
- Department of Psychology, Brain,
Performance and Nutrition Research Centre, Northumbria University, Newcastle upon
Tyne, UK
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25
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Mozumder MK. Reliability and validity of the Perceived Stress Scale in Bangladesh. PLoS One 2022; 17:e0276837. [PMID: 36301974 PMCID: PMC9612580 DOI: 10.1371/journal.pone.0276837] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
Abstract
With validation studies conducted all over the world, the 10-item Perceived Stress Scale (PSS-10) has become a robust and widely used instrument for assessing the appraisal of stress. The present study was aimed at validation and testing for psychometric properties of the PSS-10 on the Bangladeshi population. Three hundred and fifteen adult (aged 18-64 years) from eight divisional districts of Bangladesh participated in this study. A good fit of the two-factor structure of the scale was indicated by multiple indices (χ2/df, root mean square error of approximation, comparative fit index, and standardized root mean square residual) on confirmatory factor analysis. The full scale demonstrated internal consistency, test-retest reliability and construct validity. The two factors also demonstrated acceptable psychometric properties. The psychometric properties of the Bengali PSS-10 demonstrated in this study suggest the PSS-10 as a valid and reliable instrument for use in Bangladesh and among Bengali-speaking populations.
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26
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Lašaitė L, Navardauskaitė R, Semėnienė K, Verkauskienė R. Psychological stress, emotions, and quality of life in men and women with congenital adrenal hyperplasia. J Endocrinol Invest 2022; 45:1925-1934. [PMID: 35612812 DOI: 10.1007/s40618-022-01824-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/10/2022] [Indexed: 11/08/2022]
Abstract
AIM The aim was to assess perceived psychological stress, emotional state, and quality of life (QoL) in men and women with congenital adrenal hyperplasia (CAH) in comparison to age- and sex-matched control individuals. METHODS Participants: 26 patients with CAH (11 men, 15 women, age 14-48 years) and 26 age- and sex-matched control individuals without CAH. Psychological assessment: Perceived Stress Scale, Profile of Mood States2, and WHO Brief Quality of Life Questionnaire. RESULTS There were no significant differences in perceived stress, emotional state and QoL scores between men with CAH and control men. Perceived distress (median 14.0 score vs. 10.0 score, p = 0.020), tension-anxiety (median 9.0 score vs. 3.5 score, p = 0.026), depression-dejection (median 12.0 score vs. 5.0 score, p = 0.040), fatigue-inertia (median 13.0 score vs. 7.5 score, p = 0.007) were higher and environmental domain of QoL (median 16.0 score vs. 17.0 score, p = 0.001) was lower in women with CAH than in control women. CONCLUSION Women with congenital adrenal hyperplasia have higher perceived distress, tension-anxiety, depression dejection, fatigue-inertia, and worse environmental aspect of quality of life than age-matched control women, while perceived psychological stress, emotional state and quality of life in men with congenital adrenal hyperplasia do not differ from that of age-matched control men.
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Affiliation(s)
- L Lašaitė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eivenių 2, 50161, Kaunas, Lithuania.
| | - R Navardauskaitė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eivenių 2, 50161, Kaunas, Lithuania
| | - K Semėnienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eivenių 2, 50161, Kaunas, Lithuania
| | - R Verkauskienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eivenių 2, 50161, Kaunas, Lithuania
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Stress Estimation Model for the Sustainable Health of Cancer Patients. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3336644. [PMID: 35924111 PMCID: PMC9343204 DOI: 10.1155/2022/3336644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/25/2022] [Accepted: 07/06/2022] [Indexed: 11/26/2022]
Abstract
Good health is the most important and very necessary characteristic for stress-free, skillful, and hardworking people with a cooperative environment to create a sustainable society. Validating two algorithms, namely, sequential minimal optimization for regression (SMOreg) using vector machine and linear regression (LR) and using their predicted cancer patients' cases, this study presents a patient's stress estimation model (PSEM) to forecast their families' stress for patients' sustainable health and better care with early management by under-study cancer hospitals. The year-wise predictions (1998-2010) by LR and SMOreg are verified by comparing with observed values. The statistical difference between the predictions (2021-2030) by these models is analyzed using a statistical t-test. From the data of 217067 patients, patients' stress-impacting factors are extracted to be used in the proposed PSEM. By considering the total population of under-study areas and getting the predicted population (2021-2030) of each area, the proposed PSEM forecasts overall stress for expected cancer patients (2021-2030). Root mean square error (RMSE) (1076.15.46) for LR is less than RSME for SMOreg (1223.75); hence, LR remains better than SMOreg in forecasting (2011-2020). There is no significant statistical difference between values (2021-2030) predicted by LR and SMOreg (p value = 0.767 > 0.05). The average stress for a family member of a cancer patient is 72.71%. It is concluded that under-study areas face a minimum of 2.18% stress, on average 30.98% stress, and a maximum of 94.81% overall stress because of 179561 expected cancer patients of all major types from 2021 to 2030.
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Himbert C, Hathaway CA, Daniels B, Salas K, Ashworth A, Gigic B, Lin T, Viskochil R, Kirchhoff AC, Grossman D, Ose J, Tward J, Scaife C, Figueiredo JC, Toriola AT, Beck A, Shibata D, Gonzalez BD, Matsen C, Christenson C, Ma DS, Colman H, Hunt JP, Jones KB, Lee CJ, Larson M, Onega T, Akerley WL, Li CI, Schneider M, Penedo FJ, Siegel EM, Tworoger SS, Ulrich CM, Peoples AR. Factors associated with changes in exercise behaviors during the COVID-19 pandemic. Cancer Causes Control 2022; 33:939-950. [PMID: 35554777 PMCID: PMC9096745 DOI: 10.1007/s10552-022-01580-z] [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: 07/09/2021] [Accepted: 03/28/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE There is limited information on how the COVID-19 pandemic has changed health behaviors among cancer patients. We examined changes in exercise behaviors since the pandemic and identified characteristics associated with these changes among cancer patients. METHODS Cancer patients (n = 1,210) completed a survey from August to September 2020 to assess COVID-19 pandemic-related changes in health behaviors and psychosocial factors. Patients were categorized into three groups: exercising less, exercising did not change, and exercising more. Patient characteristics were compared by exercise groups. RESULTS One-third of the patients reported a decreased amount of regular exercise, while 10% reported exercising more during the pandemic. Patients who exercised less were more likely to be unemployed/retired and have poor health status and psychosocial stressors such as disruptions in daily life while less likely to be former smokers (all p < 0.05). In contrast, patients who exercised more were younger, had stage IV diagnosis, and also reported disruptions in daily life (all p < 0.05). Patients who were living in rural areas were also more likely not to experience changes in exercise habits (all p < 0.05), although rural-urban status was not identified as a strong predictor. CONCLUSION A significant proportion of cancer patients experienced changes in exercise habits, especially exercising less, during the first 6 months of the COVID-19 pandemic. Age, employment status, tumor stage, health status, smoking status, and psychosocial factors were associated with changes in exercise behaviors. Our results highlight the importance of promoting physical activity guidelines for cancer survivorship during the COVID-19 pandemic and may help improve the identification of cancer patients susceptible to exercising less.
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Affiliation(s)
- Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Cassandra A Hathaway
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Karen Salas
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | - Biljana Gigic
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Anne C Kirchhoff
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Pediatrics, Division of Hematology/Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jonathan Tward
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA
| | - Courtney Scaife
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Jane C Figueiredo
- Department of Medicine, Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Adetunji T Toriola
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Anna Beck
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - David Shibata
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Cindy Matsen
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | | | - Debra S Ma
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Howard Colman
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
| | - Jason P Hunt
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Kevin B Jones
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Orthopedics, University of Utah, Salt Lake City, UT, USA
| | - Catherine J Lee
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Tracy Onega
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Wallace L Akerley
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Martin Schneider
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank J Penedo
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, USA
| | - Erin M Siegel
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Anita R Peoples
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
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Kano M, Jaffe SA, Rieder S, Kosich M, Guest DD, Burgess E, Hurwitz A, Pankratz VS, Rutledge TL, Dayao Z, Myaskovsky L. Improving Sexual and Gender Minority Cancer Care: Patient and Caregiver Perspectives From a Multi-Methods Pilot Study. Front Oncol 2022; 12:833195. [PMID: 35600396 PMCID: PMC9120769 DOI: 10.3389/fonc.2022.833195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeUp to 1 million lesbian, gay, bisexual, and transgender (i.e., sexual and gender minority, SGM) individuals in the United States have histories of cancer. This medically underserved population is diverse, with complex sexualities and gender identities, and distinct health concerns. SGM persons experience disproportionate risks for, and rates of, anal, breast, cervical, colorectal, endometrial, lung, and prostate cancers, in addition to cancers affecting transgender persons who have undergone sex-reassignment. SGM individuals are linked by shared experiences of stigmatization as a minority population for which little cancer research has been conducted. SGM cancer patients frequently report reluctance to seek healthcare, have poorer outcomes following diagnosis, engage in elevated risk behaviors (i.e. smoking and alcohol use) even after cancer diagnosis, have difficulty making emotional adjustment to illness, and experience higher rates of psychological distress. They report less satisfaction with cancer care, deficiencies in patient-centeredness and shared decision-making, gaps in care, and social isolation. Minority stress resulting from experiences of anti-SGM sentiment and discrimination affects cancer patients and their informal cancer caregivers. Our paper presents findings from a pilot study to identify gaps and opportunities to improve cancer care for SGM patients and caregivers at the University of New Mexico Comprehensive Cancer Center.MethodsBetween June 2020 and July 2021, we used a multi-methods research design informed by ecological theory to collect qualitative and quantitative data regarding cancer patient and caregiver quality of life (QoL) and experiences of cancer and survivorship care. We used PROMIS measures distributed via REDCap to assess QoL (i.e., fatigue, pain interference, pain intensity, anxiety, depression, emotional support, social isolation, and companionship), and conducted in-depth semi-structured interviews. We recruited 10 SGM cancer patients and 8 heterosexual, cisgender (H/C) patient matches, and their self-identified informal cancer caregivers (n=36, dyad total n=18). Interviews ranged from 1 to 2 hours, were audio-recorded and transcribed for analysis. The study was approved by the University of New Mexico Human Research Protections Office Institutional Review Board.ResultsResults of the PROMIS QoL assessments indicated that SGM patients reported greater anxiety [mean (SD) = 54.5 (8.8)] and depression [mean (SD) = 49.3 (4.8)] than H/C patients [mean (SD)=51.6 (7.5) and 45.4 (6.8) respectively], while heterosexual, cisgender (H/C) patients reported higher fatigue [mean (SD) =52.04 (8.18)] and stronger pain intensity than SGM patients [mean (SD)=48.3 (9.1) and 37.8 (9.1) respectively]. SGM patients reported higher levels of social isolation [mean (SD) = 48.3 (7.3) vs. 42.1 (7.4) for H/C patients, whereas H/C patients reported more emotional support (mean (SD) =57.5 (9.3) vs. 53.0 (6.9)] and companionship [mean (SD) = 55.2 (8.6) vs. 51.5 (11.0)]. SGM and H/C differences in caregiver QoL were most notable with regards to higher levels of fatigue [mean (SD) = 47.1 (6.0) for SGM, and 42.4 (11.5) for H/C] and companionship [mean (SD) = 55.3 (6.0) for SGM, and 50.9 (5.5) for H/C]. Qualitative interviews supported our quantitative results. SGM patients and caregivers articulated experiences of anti-SGM stigma and discrimination contributing to minority stress that influenced their initial cancer care encounters. SGM dyads had more trepidation and/or medical mistrust during initial cancer care encounters when compared to H/C patients and caregivers. SGM patients questioned care that was not culturally responsive to SGM preferences, while H/C patients were more apt to identify gaps in communication and perceived lack of clarity regarding cancer care delivery. Although SGM patients experienced high satisfaction with their cancer care once they developed trust with their providers, they discussed desires to have more direct conversations with their oncologists about their sexual orientation and gender identities and sexual health. All patients and providers in the study (SGM and H/C) appreciated their oncology care teams. All patients and caregivers relied on social networks comprised of friends and family, although SGM patients and caregivers had smaller social networks and relied less on biological family, and single SGM individuals experienced challenges accessing cancer care and struggled with social isolation. We discovered too, that all caregivers, regardless of Sexual Orientation and Gender Identity (SOGI), perceived a lack of support and information pertaining to their loved one’s treatment, side effects and best way to provide care.ConclusionsThis study demonstrates that prior stigmatizing experiences contribute to minority stress and medical mistrust for SGM cancer patients and their informal caregivers across the cancer care experience. Findings point to specific gaps in SGM cancer patient care, including lack of conversation about patient SOGI, inadequate staff and oncology provider SGM specific knowledge and cultural competence/cultural humility training, and insufficient patient supports for those who lack social support during cancer care treatment. Further, this study reveals inadequacies in SGM specific support, and overall support services for informal cancer caregivers. Additional research is required to develop targeted interventions to address minority stress and clinic environment concerns to improve cancer care for SGM patients. Importantly, while there were differences between SGM and H/C experiences of cancer treatment, significant similarities also emerged. Caregiver expressed consensus about the current lack of support and guidance for informal caregivers of cancer patients. Future work should focus on providing caregiver-specific resources in the clinic setting and facilitating support groups for caregivers to network with one another, as well as for tailoring SGM specific caregiver support services. Our findings highlight areas for improving cancer care for the SGM community, as well as a broader population of patients and caregivers.
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Affiliation(s)
- Miria Kano
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
- *Correspondence: Miria Kano,
| | - Shoshana Adler Jaffe
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
| | - Stephanie Rieder
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
- Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM, United States
| | - Mikaela Kosich
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
| | - Dolores D. Guest
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
| | - Ellen Burgess
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
| | - Ariel Hurwitz
- University of New Mexico School of Medicine, Albuquerque, NM, United States
| | - Vernon Shane Pankratz
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
| | - Teresa L. Rutledge
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
- Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM, United States
| | - Zoneddy Dayao
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
| | - Larissa Myaskovsky
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, United States
- Center for Healthcare Equity in Kidney Disease (CHEK-D), University of New Mexico Health Sciences Center, Albuquerque, NM, United States
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Long Parma DA, Reynolds GL, Muñoz E, Ramirez AG. Effect of an anti-inflammatory dietary intervention on quality of life among breast cancer survivors. Support Care Cancer 2022; 30:5903-5910. [PMID: 35380268 PMCID: PMC10156067 DOI: 10.1007/s00520-022-07023-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Behavioral interventions have been used with breast cancer survivors (BCS) in cancer pain management and post-treatment quality of life (QOL) studies. We studied the effects of an anti-inflammatory dietary intervention on QOL in BCS. METHODS One hundred fifty-three overweight and obese (body mass index [BMI] ≥ 25 kg/m2), early stage (0-III), English-speaking BCS who had completed all cancer treatment 2 or more months prior to enrollment were recruited into a two-arm randomized controlled trial with a 2 (group) by 3 (time) repeated measures design. Intervention components included six monthly food-preparation workshops and twelve motivational interviewing telephone calls. Endpoints included the Perceived Stress Scale (PSS), the Functional Assessment of Cancer Therapy-General (FACT-G) and Breast Cancer (FACT-B), and the Center for Epidemiologic Studies Depression Scale (CES-D). Repeated measures analysis using PROC MIXED in SAS version 9.4 was used. RESULTS On repeated measures analysis (intent to treat), there were no differences between groups on any of the QOL outcomes except the PSS total scores. These were significantly different in the intervention group (IG; n = 76) compared to control group (CG; n = 77), showing a main effect of assignment but no effect of time and no interaction effects. CONCLUSION There was an impact on QOL as measured by the PSS between groups. The intervention reduced perceived stress at 6-month follow-up, but the effects dissipated by 12 months. Sources and stress and stress reduction should be a focus of future studies. Future research should also identify appropriate QOL measures that are sensitive to changes brought about by behavioral interventions.
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Affiliation(s)
- Dorothy A Long Parma
- Department of Population Health Sciences, Institute for Health Promotion Research, UT Health San Antonio, 7411 John Smith Dr. Suite 1000, San Antonio, TX, 78229, USA.
| | - Grace L Reynolds
- Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Edgar Muñoz
- Department of Population Health Sciences, Institute for Health Promotion Research, UT Health San Antonio, 7411 John Smith Dr. Suite 1000, San Antonio, TX, 78229, USA
| | - Amelie G Ramirez
- Department of Population Health Sciences, Institute for Health Promotion Research, UT Health San Antonio, 7411 John Smith Dr. Suite 1000, San Antonio, TX, 78229, USA
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Knoerl R, Mazzola E, Woods H, Buchbinder E, Frazier L, LaCasce A, Li BT, Luskin MR, Phillips CS, Thornton K, Berry DL, Ligibel JA. Exploring the Feasibility of a Mindfulness-Music Therapy Intervention to Improve Anxiety and Stress in Adolescents and Young Adults with Cancer. J Pain Symptom Manage 2022; 63:e357-e363. [PMID: 34896280 DOI: 10.1016/j.jpainsymman.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/18/2021] [Accepted: 11/28/2021] [Indexed: 10/19/2022]
Abstract
CONTEXT Adolescent and young adults (AYAs) with cancer experience significant psychological distress due to cancer treatment that can persist long after treatment. However, little is known regarding optimal interventions to support the psychosocial needs of AYAs with cancer. OBJECTIVE The overall objective of this single arm, longitudinal, pilot study was to determine the feasibility of implementing a mindfulness-based music therapy intervention to improve anxiety and stress in AYAs receiving cancer treatment. METHODS AYAs (15 - 39 years old) who were to receive cancer treatment for ≥ eight weeks were recruited from the pediatric, melanoma, sarcoma, breast, lymphoma, and leukemia oncology outpatient centers at Dana-Farber Cancer Institute. The music therapy intervention included four sessions of individual mindfulness-based music therapy in-person or using Zoom over twelve weeks. Prior to-and after the intervention period, participants completed the Patient-Reported Outcomes Measurement Information Anxiety 4a and Perceived Stress Scale. Changes in patient-reported outcomes are compared using Wilcoxon signed-rank tests. RESULTS Over ∼14 months, 37 of 93 eligible AYAs were enrolled to the study (39.8% consent rate). Overall, 27 of 37 (73%) participants (Median age=32; 56.8% Female) completed at least two music therapy sessions and the baseline measures and end of study measures. Participation in the mindfulness-based music therapy sessions resulted in significant pre-to-posttest improvements in perceived stress (median change: -4.0, P = 0.013) and non-significant changes in anxiety (median change: -1.9, P = 0.20). Satisfaction and acceptability were highly rated. CONCLUSIONS The delivery of a four-session mindfulness-based music therapy intervention to AYAs receiving chemotherapy was feasible and significantly improved perceived stress. These preliminary findings should be confirmed in a randomized controlled trial. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03709225.
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Affiliation(s)
- Robert Knoerl
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services (R.K., C.S.P.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
| | - Emanuele Mazzola
- Department of Biostatistics and Computational Biology (E.M.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Heather Woods
- The Leonard P. Zakim Center for Integrative Therapies and Healthy Living (H.W.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Elizabeth Buchbinder
- Department of Medical Oncology (E.B., A.L., M.R.L., J.A.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Lindsay Frazier
- Department of Pediatric Oncology (L.F.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ann LaCasce
- Department of Medical Oncology (E.B., A.L., M.R.L., J.A.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Belinda T Li
- School of Medicine (B.T.L.), Boston University, Boston, Massachusetts, USA
| | - Marlise R Luskin
- Department of Medical Oncology (E.B., A.L., M.R.L., J.A.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Carolyn S Phillips
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services (R.K., C.S.P.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Katherine Thornton
- Department of Medical Oncology (K.T.), Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Donna L Berry
- Biobehavioral Nursing and Health Informatics (D.L.B.), University of Washington, Seattle, Washington, USA
| | - Jennifer A Ligibel
- Department of Medical Oncology (E.B., A.L., M.R.L., J.A.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Peoples AR, Oswald LB, Ose J, Daniels B, Himbert C, Hathaway CA, Gigic B, Kirchhoff AC, Lin T, Grossman D, Tward J, Varghese TK, Figueiredo JC, Toriola AT, Beck A, Scaife C, Shibata D, LaStayo P, Gonzalez B, Salas K, Ashworth A, Matsen C, Christenson C, Ma DS, Colman H, Hunt JP, Jones KB, Lee CJ, Larson M, Onega T, Akerley WL, Li CI, Schneider M, Penedo FJ, Siegel EM, Tworoger SS, Ulrich CM. Impact of the COVID-19 pandemic on rural and urban cancer patients' experiences, health behaviors, and perceptions. J Rural Health 2022; 38:886-899. [PMID: 35243690 PMCID: PMC9115146 DOI: 10.1111/jrh.12648] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Purpose The COVID‐19 pandemic has disrupted many facets of life. We evaluated pandemic‐related health care experiences, COVID‐19 prevention behaviors and measures, health behaviors, and psychosocial outcomes among rural and urban cancer patients. Methods Among 1,472 adult cancer patients, who visited Huntsman Cancer Institute in the past 4 years and completed a COVID‐19 survey (August‐September 2020), we assessed the impact of the pandemic on medical appointments, prevention/health behaviors, and psychosocial factors, stratified by urbanicity. Findings Mean age was 61 years, with 52% female, 97% non‐Hispanic White, and 27% were residing in rural areas. Rural versus urban patients were more likely to be older, not employed, uninsured, former/current smokers, consume alcohol, and have pandemic‐related changes/cancellations in surgery appointments (all P<.05). Changes/cancellations in other health care access (eg, doctor's visits) were also common, particularly among urban patients. Urban versus rural patients were more likely to socially distance, use masks and hand sanitizer, and experience changes in exercise habits and in their daily lives (all P<.05). Less social interaction and financial stress were common among cancer patients but did not differ by urbanicity. Conclusions These findings suggest that the COVID‐19 pandemic had a substantial impact on cancer patients, with several challenges specific to rural patients. This comprehensive study provides unique insights into the first 6 months of COVID‐19 pandemic‐related experiences and continuity of care among rural and urban cancer patients predominantly from Utah. Further research is needed to better characterize the pandemic's short‐ and long‐term effects on rural and urban cancer patients and appropriate interventions.
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Affiliation(s)
- Anita R Peoples
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Laura B Oswald
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | | | - Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Cassandra A Hathaway
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | | | - Anne C Kirchhoff
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Pediatrics, Division of Hematology/Oncology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Dermatology, University of Utah, Salt Lake City, Utah, USA
| | - Jonathan Tward
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Radiation Oncology, University of Utah, Salt Lake City, Utah, USA
| | - Thomas K Varghese
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Jane C Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Adetunji T Toriola
- Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Anna Beck
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Courtney Scaife
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | - David Shibata
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Paul LaStayo
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Brian Gonzalez
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Karen Salas
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | | | - Cindy Matsen
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | | | - Debra S Ma
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Howard Colman
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA
| | - Jason P Hunt
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Kevin B Jones
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Orthopedics, University of Utah, Salt Lake City, Utah, USA
| | - Catherine J Lee
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | | | - Tracy Onega
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Wallace L Akerley
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Christopher I Li
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Frank J Penedo
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA.,Departments of Psychology and Medicine, University of Miami, Coral Gables, Florida, USA
| | - Erin M Siegel
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
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Gad KT, Lassen U, Duun-Henriksen AK, Dalton SO, Mau-Sørensen M, Bidstrup PE, Høeg BL, Rohrberg KS, Spanggard I, von Heymann A, Johansen C. Patients in phase 1 cancer trials: psychological distress and understanding of trial information. Acta Oncol 2022; 61:341-348. [PMID: 34709958 DOI: 10.1080/0284186x.2021.1993331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Psychological distress may be present among patients who are considering enrollment in phase 1 cancer trials, as they have advanced cancer and no documented treatment options remain. However, the prevalence of psychological distress has not been previously investigated in larger cohorts. In complex phase 1 cancer trials, it is important to ensure adequate understanding of the study premises, such as the undocumented effects and the risk of adverse events. MATERIALS AND METHODS In a prospective study, patients completed questionnaires at two time points. We investigated psychological distress, measured as stress, anxiety, and depression, among patients at their first visit to the phase 1 unit (N = 229). Further, we investigated the understanding of trial information among patients who were enrolled in a phase 1 cancer trial (N = 57). RESULTS We enrolled 75% of 307 eligible patients. We found a lower mean score of stress in our population compared to population norms, while the mean scores of anxiety and depression were higher. A total of 9% showed moderate to severe symptoms of anxiety and 11% showed moderate to severe symptoms of depression, which indicates higher levels than cancer patients in general. A total of 46 (81% of enrolled patients) completed questionnaires on trial information and consent. The understanding of the information on phase 1 cancer trials in these patients was slightly lower than the level reported for cancer trials in general. Some aspects relating to purpose, benefit, and additional risks were understood by fewer than half of the patients. CONCLUSION Our results suggest that distress is not as prevalent in the population of patients referred to phase 1 cancer trials as in the general cancer population. Although patients' understanding of trial information was reasonable, some aspects of complex phase 1 cancer trials were not easily understood by enrolled patients.
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Affiliation(s)
- Katrine T. Gad
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ulrik Lassen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Anne K. Duun-Henriksen
- Statistics and Data analysis, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne O. Dalton
- Survivorship & Inequality in Cancer, The Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Services, Zealand University Hospital, Naestved, Denmark
| | - Morten Mau-Sørensen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Pernille E. Bidstrup
- Survivorship & Inequality in Cancer, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Beverley. L. Høeg
- Statistics and Data analysis, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kristoffer S. Rohrberg
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Iben Spanggard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Annika von Heymann
- Late Effect Research Unit (CASTLE), Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christoffer Johansen
- Late Effect Research Unit (CASTLE), Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Clifford C, Paulk E, Lin Q, Cadwallader J, Lubbers K, Frazier LD. Relationships among adult playfulness, stress, and coping during the COVID-19 pandemic. CURRENT PSYCHOLOGY 2022:1-10. [PMID: 35221637 PMCID: PMC8860462 DOI: 10.1007/s12144-022-02870-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 11/08/2022]
Abstract
The COVID-19 pandemic created high levels of stress that negatively affect mental health and well-being. The stress and coping process is influenced by individual difference factors, such as personality, that impact perceptual processes and emotional reactions. Adult playfulness is a personality characteristic that may lead to better mental and physical health outcomes. We test a theoretical model to determine whether the two factors of perceived stress, perceived self-efficacy (PSE) and perceived helplessness (PH), mediate the relationship among playfulness and coping in adults (N = 694). Scores on the Perceived Stress Scale were high indicating high levels of pandemic-related stress. The SEM model demonstrated direct effects of playfulness on PSE, PH, adaptive, maladaptive, and supportive coping. Both dimensions of perceived stress were partial mediators in the relationship among playfulness and coping outcomes. Findings illustrate the pathways by which adult playfulness can amplify or attenuate the impact of stress perceptions on coping strategies. The importance of building psychological resources such as playfulness to boost adaptive outcomes in stressful situations such as the COVID-19 pandemic is discussed. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12144-022-02870-0.
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Affiliation(s)
| | - Ellis Paulk
- Department of Psychology, Florida International University, Miami, FL USA
| | - Qiyang Lin
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI USA
| | | | | | - Leslie D. Frazier
- Department of Psychology, Florida International University, Miami, FL USA
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35
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The Effect of Caring Ability on Perceived Stress Mediated by Resilience. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kassianos AP, Georgiou A, Kyprianidou M, Lamnisos D, Ļubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydin G, Chong YY, Chien WT, Cheng HY, Ruiz FJ, Garcia-Martin MB, Obando D, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Neto DD, da Silva AN, Monestès JL, Alvarez-Galvez J, Blarrina MP, Montesinos F, Salas SV, Őri D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Chatzittofis A, Konstantinou E, Economidou S, Gloster AT, Karekla M, Constantinidou A. Mental Health and Adherence to COVID-19 Protective Behaviors among Cancer Patients during the COVID-19 Pandemic: An International, Multinational Cross-Sectional Study. Cancers (Basel) 2021; 13:6294. [PMID: 34944913 PMCID: PMC8699048 DOI: 10.3390/cancers13246294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 12/23/2022] Open
Abstract
A population-based cross-sectional study was conducted during the first COVID-19 wave, to examine the impact of COVID-19 on mental health using an anonymous online survey, enrolling 9565 individuals in 78 countries. The current sub-study examined the impact of the pandemic and the associated lockdown measures on the mental health, and protective behaviors of cancer patients in comparison to non-cancer participants. Furthermore, 264 participants from 30 different countries reported being cancer patients. The median age was 51.5 years, 79.9% were female, and 28% had breast cancer. Cancer participants reported higher self-efficacy to follow recommended national guidelines regarding COVID-19 protective behaviors compared to non-cancer participants (p < 0.01). They were less stressed (p < 0.01), more psychologically flexible (p < 0.01), and had higher levels of positive affect compared to non-cancer participants. Amongst cancer participants, the majority (80.3%) reported COVID-19, not their cancer, as their priority during the first wave of the pandemic and females reported higher levels of stress compared to males. In conclusion, cancer participants appeared to have handled the unpredictable nature of the first wave of the pandemic efficiently, with a positive attitude towards an unknown and otherwise frightening situation. Larger, cancer population specific and longitudinal studies are warranted to ensure adequate medical and psychological care for cancer patients.
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Affiliation(s)
- Angelos P. Kassianos
- Department of Psychology, University of Cyprus, Nicosia 2109, Cyprus; (A.P.K.); (M.K.)
- Department of Applied Health Research, University College London, London WC1E 6BT, UK
| | - Alexandros Georgiou
- Bank of Cyprus Oncology Centre, Nicosia 2006, Cyprus; (A.G.); (E.K.); (S.E.)
| | - Maria Kyprianidou
- Department of Psychology, University of Cyprus, Nicosia 2109, Cyprus; (A.P.K.); (M.K.)
| | - Demetris Lamnisos
- Department of Health Sciences, European University of Cyprus, Nicosia 2109, Cyprus;
| | - Jeļena Ļubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Giovambattista Presti
- Human and Social Sciences Department, University of Enna Kore, 94100 Enna, Italy; (G.P.); (V.S.)
| | - Valeria Squatrito
- Human and Social Sciences Department, University of Enna Kore, 94100 Enna, Italy; (G.P.); (V.S.)
| | | | - Christiana Nicolaou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus;
| | | | - Gökçen Aydin
- Department of Psychological Counseling and Guidance, Hasan Kalyoncu University, Gaziantep 27010, Turkey;
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (Y.Y.C.); (W.T.C.); (H.Y.C.)
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (Y.Y.C.); (W.T.C.); (H.Y.C.)
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (Y.Y.C.); (W.T.C.); (H.Y.C.)
| | - Francisco J. Ruiz
- Department of Psychology, Universidad de La Sabana, Chia 140013, Colombia; (F.J.R.); (M.B.G.-M.); (D.O.); (M.A.S.-V.)
| | - Maria B. Garcia-Martin
- Department of Psychology, Universidad de La Sabana, Chia 140013, Colombia; (F.J.R.); (M.B.G.-M.); (D.O.); (M.A.S.-V.)
| | - Diana Obando
- Department of Psychology, Universidad de La Sabana, Chia 140013, Colombia; (F.J.R.); (M.B.G.-M.); (D.O.); (M.A.S.-V.)
| | - Miguel A. Segura-Vargas
- Department of Psychology, Universidad de La Sabana, Chia 140013, Colombia; (F.J.R.); (M.B.G.-M.); (D.O.); (M.A.S.-V.)
| | - Vasilis S. Vasiliou
- School of Applied Psychology, University College Cork (UCC), T23 XE10 Cork, Ireland;
| | - Louise McHugh
- School of Psychology, University College Dublin, D04 V1W8 Dublin 4, Ireland;
| | - Stefan Höfer
- Department of Medical Psychology, Medical University Innsbruck, 6020 Innsbruck, Austria;
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, 400015 Cluj-Napoca, Romania;
| | - David Dias Neto
- ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal;
- Applied Psychology Research Center Capabilities & Inclusion, 1149-041 Lisbon, Portugal
| | - Ana Nunes da Silva
- Department of Psychology, University of Lisbon, 1649-013 Lisbon, Portugal;
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, 11009 Cadiz, Spain;
| | | | - Francisco Montesinos
- Instituto ACT, 28049 Madrid, Spain; (M.P.B.); (F.M.)
- Department of Psychology, Universidad Europea de Madrid, 28049 Madrid, Spain
| | | | - Dorottya Őri
- Department of Mental Health, Heim Pal National Pediatric Institute, H-1089 Budapest, Hungary;
- Institute of Behavioral Sciences, Semmelweis University, H-1089 Budapest, Hungary
| | | | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, 40014 Jyväskylä, Finland;
| | - Iva Ivanović
- Department of Child Psychiatry, Institute for Children’s Diseases, Clinical Centre of Montenegro, 81000 Podgorica, Montenegro;
| | - David Gosar
- Department of Child, Adolescent and Developmental Neurology, University Children’s Hospital Ljubljana, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia;
| | - Frederick Dionne
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada;
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, NC 27708, USA;
| | | | | | - Sofia Economidou
- Bank of Cyprus Oncology Centre, Nicosia 2006, Cyprus; (A.G.); (E.K.); (S.E.)
| | - Andrew T. Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, 4055 Basel, Switzerland;
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia 2109, Cyprus; (A.P.K.); (M.K.)
| | - Anastasia Constantinidou
- Bank of Cyprus Oncology Centre, Nicosia 2006, Cyprus; (A.G.); (E.K.); (S.E.)
- Medical School, University of Cyprus, Nicosia 1678, Cyprus;
- Cyprus Cancer Research Institute, Nicosia 2109, Cyprus
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Exploring the impact of exercise and mind-body prehabilitation interventions on physical and psychological outcomes in women undergoing breast cancer surgery. Support Care Cancer 2021; 30:2027-2036. [PMID: 34648061 DOI: 10.1007/s00520-021-06617-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare the impact of exercise and mind-body prehabilitation interventions on changes in quality of life and cancer treatment-related symptoms in women with newly diagnosed breast cancer. METHODS The following describes a secondary analysis of a randomized window of opportunity trial (The Pre-Operative Health and Body Study). Forty-nine women were randomized to participate in either an exercise prehabilitation intervention or a mind-body prehabilitation intervention from the time of enrollment to surgery. Participants (N = 47) completed measures of quality of life, anxiety, depression, and stress at the time of enrollment (T1), post-intervention/surgery (T2), and one-month post-surgery (T3). Changes in outcome measures between groups were compared over time using longitudinal models. RESULTS Mind-body group participants experienced significant improvements in cognitive functioning in comparison to exercise group participants between T1 and T3 (difference in average change: -9.61, p = 0.04, d = 0.31), otherwise, there were no significant differences between groups. Within group comparisons demonstrated that both groups experienced improvements in anxiety (exercise: average change = -1.18, p = 0.03, d = 0.34; mind-body: average change = -1.69, p = 0.006, d = 0.43) and stress (exercise: average change = -2.33, p = 0.04, d = 0.30; mind-body: average change = -2.59, p = 0.05, d = 0.29), while mind-body group participants experienced improvements in insomnia (average change = -10.03, p = 0.04, d = 0.30) and cognitive functioning (average change = 13.16, p = 0.0003, d = 0.67). CONCLUSIONS Both prehabilitation interventions impacted cancer treatment-related symptoms. Further work in larger groups of patients is needed to evaluate the efficacy of prehabilitation interventions on quality of life in women with breast cancer. Pre-operative exercise and mind-body interventions may impact physical and/or psychological effects of cancer diagnosis and treatment in women with breast cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01516190. Registered January 24, 2012.
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Himbert C, Hathaway CA, Daniels B, Salas K, Ashworth A, Gigic B, Lin T, Viskochil R, Kirchhoff AC, Grossman D, Ose J, Tward J, Scaife C, Figueiredo JC, Toriola AT, Beck A, Shibata D, Gonzalez BD, Matsen C, Christenson C, Ma DS, Colman H, Hunt JP, Jones KB, Lee CJ, Larson M, Onega T, Akerley WL, Li CI, Schneider M, Penedo FJ, Siegel EM, Tworoger SS, Ulrich CM, Peoples AR. Impact of the COVID-19 pandemic on exercise habits among cancer patients. RESEARCH SQUARE 2021:rs.3.rs-704646. [PMID: 34580667 PMCID: PMC8475966 DOI: 10.21203/rs.3.rs-704646/v1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Purpose There is limited information on how the COVID-19 pandemic has changed health behaviors among cancer patients. We examined the impact of the pandemic on changes in exercise behaviors and identified characteristics associated with these changes among cancer patients. Methods Cancer patients (n = 1,361) completed a survey from August-September 2020 to assess COVID-19 pandemic-related changes in health behaviors and psychosocial factors. Patients were categorized into 3 groups: exercising less, exercising did not change, and exercising more. Patient characteristics were compared by exercise groups. Results One-third of the patients reported a decreased amount of regular exercise, while 11% reported exercising more during the pandemic. Patients who exercised less were more likely to be unemployed/retired, undergoing active treatment, and had increased pandemic-related alcohol consumption and psychosocial stressors such as loneliness and financial stress (all p < 0.05). In contrast, patients who exercised more were younger, female, full-time employed, did not consume alcohol, and had good health status and more social interactions (all p < 0.05). Patients who were living in rural areas and did not experience changes in daily life, were also more likely not to experience changes in exercise habits (all p < 0.05). Conclusion Our results indicate that a significant proportion of cancer patients experienced changes in exercise habits during the first 6 months of the COVID-19 pandemic. Age, sex, employment status, health status, alcohol consumption, and psychosocial factors were associated with changes in exercise behaviors. Providers should monitor for changes in health behaviors, such as exercise, because of their importance in improving cancer survivorship.
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Affiliation(s)
- Caroline Himbert
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | | | - Bailee Daniels
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Karen Salas
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Anjelica Ashworth
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Biljana Gigic
- Heidelberg University: Ruprecht Karls Universitat Heidelberg
| | - Tengda Lin
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Richard Viskochil
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Anne C Kirchhoff
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Douglas Grossman
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Jennifer Ose
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Jonathan Tward
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Courtney Scaife
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Jane C Figueiredo
- Cedars-Sinai Comprehensive Cancer Center: Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
| | | | - Anna Beck
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - David Shibata
- University of Tennessee Health Science Center Bookstore: The University of Tennessee Health Science Center VolShop Memphis
| | | | - Cindy Matsen
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Cristina Christenson
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Debra S Ma
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Howard Colman
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Jason P Hunt
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Kevin B Jones
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Catherine J Lee
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Mikaela Larson
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Tracy Onega
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Wallace L Akerley
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | | | | | | | | | | | | | - Anita R Peoples
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
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Juárez-García A, Merino-Soto C, Brito-Ortiz JF, Nava-Gómez ME, Monroy-Castillo A. Is it the perceived stress scale (PSS) Undimimensional and invariant? A Bifactor analysis in Mexican adults. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02067-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Slot A, Krog MC, Bliddal S, Olsen LR, Nielsen HS, Kolte AM. Feelings of guilt and loss of control dominate in stress and depression inventories from women with recurrent pregnancy loss. EUR J CONTRACEP REPR 2021; 27:153-158. [PMID: 34184606 DOI: 10.1080/13625187.2021.1943740] [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: 10/21/2022]
Abstract
PURPOSE Which feelings on the major depression inventory (MDI) and the perceived stress scale (PSS) are predominant among women with recurrent pregnancy loss (RPL)? MATERIALS AND METHODS Prospective cohort study of women with RPL referred to the tertiary RPL Unit at Copenhagen University Hospital, Rigshospitalet, Denmark, from 2010-2013. All women answered the MDI and PSS at time of referral. RESULTS In total, 298 women completed the MDI and the PSS, of which 162 had primary RPL and 136 secondary RPL. The most common feelings were low in energy (42%), loss of interest (35%), sadness (35%), and guilt (29%). Twenty-six (8.6%) women fulfilled the criteria for moderate to severe depression. Of the remaining 272 women, nine felt that life was not worth living. Among all women feeling angered of things outside their control (35%) and unable to control important things (27%) were predominant. Women with primary RPL compared to secondary RPL more often felt less self-confident and that life wasn't worth living (p = 0.007 and p = 0.002). CONCLUSIONS Feelings of guilt and loss of control were predominant in women with RPL. Women with primary RPL could represent a particularly sensitive group. Addressing these specific feelings could help treating the psychological aspects of RPL.
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Affiliation(s)
- Anna Slot
- Recurrent Pregnancy Unit Capital Region, Copenhagen University Hospital, Hvidovre Hospital and Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Christine Krog
- Recurrent Pregnancy Unit Capital Region, Copenhagen University Hospital, Hvidovre Hospital and Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sofie Bliddal
- Recurrent Pregnancy Unit Capital Region, Copenhagen University Hospital, Hvidovre Hospital and Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lis Raabaek Olsen
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark
| | - Henriette Svarre Nielsen
- Recurrent Pregnancy Unit Capital Region, Copenhagen University Hospital, Hvidovre Hospital and Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Hvidovre Hospital, Copenhagen, Denmark
| | - Astrid Marie Kolte
- Recurrent Pregnancy Unit Capital Region, Copenhagen University Hospital, Hvidovre Hospital and Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Zinchenko YP, Salagay OO, Shaigerova LA, Almazova OV, Dolgikh AG, Vakhantseva OV. Perception of stress by different categories of medical personnel during the first wave of the COVID‑19 pandemic in Russia. Public Health 2021. [DOI: 10.21045/2782-1676-2021-1-1-65-89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Relevance. In the context of the pandemic, the current psychological state and the likely delayed deterioration of the mental health of medical personnel, regardless of their professional duties, are of concern. Taking into account the stressful circumstances in which the pandemic has placed all medical workers, assessing the level of perceived stress, as well as identifying risk factors and factors that mitigate stress, is an urgent task, the solution of which will contribute to the effective organization of psychological support for medical personnel.Methods. The study used a shortened version of the Perceived Stress Scale (PSS10) as the main methodology – a tool designed to study a person's attitude to stressful situations and determine the degree to which life is assessed as stressful and uncontrolled (Cohen et al., 1988). The methodology is widely used by the scientific community, including during the pandemic, and the original English version of the PSS has been translated into many languages and adapted in different countries. The study was conducted through an online survey.Respondents. The study, conducted in the period from May 9 to June 26, 2020, when there was a steady increase in SARS-CoV 2 virus infections in Russia, involved 1,287 employees of medical institutions in various subjects of the federation (1,079 women and 208 men) aged 19 to 80 years. The sample of the study is represented by doctors, middle and junior medical staff, heads of medical departments and institutions, as well as volunteers.Results. A high average overall index of perceived stress among employees of medical institutions was revealed. The highest level of stress is observed in the youngest age group (from 19 to 30 years), and with age, the level of stress decreases. There were no differences in the level of stress between male and female health workers in any of the considered stress indicators. Protective factors against increased stress are the presence of children and living with family members or relatives, while the presence of a spouse / partner does not affect the overall indicator of perceived stress. From different categories of medical workers, the index of perceived stress is higher in managers and doctors compared to middle and junior medical personnel. There were no significant differences in the level of stress between the staff working and not working in the "red zone". Differences in the level of stress of medical workers depending on the current situation (the number of infected and dead) in the region of residence were revealed: the level of stress is higher for those specialists who are forced to work in stressful conditions due to the complex epidemiological situation. The relationship between different beliefs about COVID19 and the level of stress is shown: the level of stress is higher in those who take its danger more seriously. In terms of the sources of stress, the most likely predictors are anxiety about exposure to COVID19 at work and the likelihood of infecting loved ones, fear of catching it yourself and getting sick, inability to meet the usual personal needs and economic instability.Conclusions. Practical interventions, the provision of psychological support and the development of actions to reduce stress for staff during a pandemic, should take into account the role of factors in increasing stress among staff working in specific conditions and focus on the prevailing beliefs and stressors in specific categories of medical factors.
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Forner D, Murnaghan S, Porter G, Mason RJ, Hong P, Taylor SM, Bentley J, Hirsch G, Noel CW, Rigby MH, Corsten M, Trites JR, Taylor V, Kendell C, Jorgensen M, Urquhart R. Psychosocial Distress in Adult Patients Awaiting Cancer Surgery during the COVID-19 Pandemic. Curr Oncol 2021; 28:1867-1878. [PMID: 34068441 PMCID: PMC8161781 DOI: 10.3390/curroncol28030173] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023] Open
Abstract
Cancer causes substantial emotional and psychosocial distress, which may be exacerbated by delays in treatment. The COVID-19 pandemic has resulted in increased wait times for many patients with cancer. In this study, the psychosocial distress associated with waiting for cancer surgery during the pandemic was investigated. This cross-sectional, convergent mixed-methods study included patients with lower priority disease during the first wave of COVID-19 at an academic, tertiary care hospital in eastern Canada. Participants underwent semi-structured interviews and completed two questionnaires: Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS). Qualitative analysis was completed through a thematic analysis approach, with integration achieved through triangulation. Fourteen participants were recruited, with cancer sites including thyroid, kidney, breast, prostate, and a gynecological disorder. Increased anxiety symptoms were found in 36% of patients and depressive symptoms in 14%. Similarly, 64% of patients experienced moderate or high stress. Six key themes were identified, including uncertainty, life changes, coping strategies, communication, experience, and health services. Participants discussed substantial distress associated with lifestyle changes and uncertain treatment timelines. Participants identified quality communication with their healthcare team and individualized coping strategies as being partially protective against such symptoms. Delays in surgery for patients with cancer during the COVID-19 pandemic resulted in extensive psychosocial distress. Patients may be able to mitigate these symptoms partially through various coping mechanisms and improved communication with their healthcare teams.
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Affiliation(s)
- David Forner
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada;
| | - Sarah Murnaghan
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Geoffrey Porter
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
- Division of General Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Ross J. Mason
- Department of Urology, Dalhousie University, Halifax, NS B3H 2Y9, Canada;
| | - Paul Hong
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - S. Mark Taylor
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - James Bentley
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS B3H 2Y9, Canada;
| | - Gregory Hirsch
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
- Division of Cardiac Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Christopher W. Noel
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada;
- Department of Otolaryngology—Head & Neck Surgery, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Matthew H. Rigby
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Martin Corsten
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Jonathan R. Trites
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Victoria Taylor
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
| | - Cynthia Kendell
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Margaret Jorgensen
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Robin Urquhart
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
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Eubank JM, Burt KG, Orazem J. Examining the psychometric properties of a refined perceived stress scale during the COVID-19 pandemic. J Prev Interv Community 2021; 49:179-192. [PMID: 33855930 DOI: 10.1080/10852352.2021.1908873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The Perceived Stress Scale (PSS) measures general life stress and the Impact of Events Scale (IES) measures retrospective stress from a specific event; both have been validated across various audiences and settings. However, neither measure stress during an evolving public health crisis. The aim was to refine the PSS to measure stress during an event (e.g. COVID-19 pandemic) and examine its psychometric properties within a 4-year Hispanic-Serving Institution in the Bronx, NY. Three items from the IES were added to and one PSS item was removed from the PSS-10, creating a new PSS-12. Cronbach's α for the scale was 0.902 for faculty and 0.903 for students, indicating high internal consistency. Factor analyses also supported calculation of two subtotals similarly across groups. The PSS-12 is a valid instrument to measure perceived stress during a public health crisis, particularly among populations that already experience community health disparities.
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Affiliation(s)
- Jacob M Eubank
- Recreation Education and Therapy Program at Lehman College, City University of New York, New York, NY, USA
| | - Kate G Burt
- Dietetics, Food and Nutrition Program at Lehman College, City University of New York, New York, NY, USA
| | - John Orazem
- Department of Health Sciences at Lehman College, City University of New York, New York, NY, USA
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Özyürek P, Çevik C, Kılıç İ, Aslan A. Effects of Day and Night Shifts on Stress, Anxiety, Quality of Life, and Oxidative Stress Parameters in Nurses. Florence Nightingale Hemsire Derg 2021; 29:81-92. [PMID: 34263226 PMCID: PMC8137734 DOI: 10.5152/fnjn.2021.19141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 06/29/2020] [Indexed: 01/07/2023] Open
Abstract
AIM This study aimed to determine the effects of day and night shift work on stress, anxiety, quality of life, and oxidative stress parameters in nurses. METHOD This was a descriptive, cross-sectional study. The study was conducted between October 2014 and January 2015. The study sample included 60 nurses working in a university hospital who met the inclusion criteria (n=60). A questionnaire was used to evaluate stress, quality of life, satisfaction with life, and anxiety sensitivity, and blood samples were obtained. In blood samples, total oxidant status and total antioxidant status, cortisol, epinephrine, and norepinephrine levels were measured. Descriptive statistics, t test, analysis of variance, and correlation analysis were performed for statistical analyses. RESULTS These results revealed that the nurses employed in surgical clinics had a lower quality of life and higher anxiety sensitivity as compared to those employed in other clinics. In addition, significant relationships were detected between total oxidant status, total antioxidant status and cortisol levels and stress, quality of life, satisfaction with life, and anxiety sensitivity. TOS and TAS, epinephrine, norepinephrine, and cortisol levels; stress, quality of life, satisfaction with life, and anxiety sensitivity were similar between the nurses working daytime and in shifts. CONCLUSION As the stress level and anxiety sensitivity of the nurses increased, the total oxidant levels and cortisol levels increasedm and in contrast, the quality of life and overall satisfaction with life decreased.
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Affiliation(s)
- Pakize Özyürek
- Department of Nursing, Afyonkarahisar, University of Health Science, Faculty of Health Sciences, Afyonkarahisar, Turkey
| | - Cahide Çevik
- Department of Nursing, Afyonkarahisar, University of Health Science, Faculty of Health Sciences, Afyonkarahisar, Turkey
| | - İbrahim Kılıç
- Department of Biostatistics, Kocatepe University Faculty of Veterinary, Afyon Afyonkarahisar, Turkey
| | - Adem Aslan
- Department of Neurosurgery, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey
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Teresi JA, Ocepek-Welikson K, Ramirez M, Kleinman M, Ornstein K, Siu A, Luchsinger J. Evaluation of the measurement properties of the Perceived Stress Scale (PSS) in Hispanic caregivers to patients with Alzheimer's disease and related disorders. Int Psychogeriatr 2020; 32:1073-1084. [PMID: 32312342 PMCID: PMC8259452 DOI: 10.1017/s1041610220000502] [Citation(s) in RCA: 8] [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] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The Perceived Stress Scale (PSS) is the most widely used measure of perceived stress; however, minimal psychometric evaluation has been performed among Hispanic respondents, and even less among Hispanic caregivers to persons with Alzheimer's disease and related disorders (ADRDs). DESIGN Secondary data analysis. SETTING New York City, NY, USA. PARTICIPANTS A sample of 453 community dwelling Hispanic caregivers to patients with ADRD. MEASUREMENTS Latent variable models were used to evaluate the PSS. Exploratory and confirmatory factor analyses were used to examine unidimensionality. Differential item functioning (DIF) was examined for age, education, and language using the graded item response model. RESULTS The factor and bifactor analyses results supported essential unidimensionality of the item set; however, positively worded items were observed using response item theory to be less informative than the negatively worded items. Reliability estimates were high. Salient DIF was not observed for age, education, or language of interview using the primary DIF detection method. Sensitivity analyses using a second DIF detection method identified uniform language-DIF for the item, "In the last month, how often have you felt that you were on top of things?" However, the non-compensatory DIF value was below the threshold considered salient. CONCLUSIONS In summary, the 10-item PSS performed well in a sample of English- and Spanish-speaking Hispanic caregivers to patients with ADRD. Very little DIF, and none of high magnitude and impact, was observed. However, the negatively worded items, perhaps because they are more directly reflective of stress, were more informative. In the context of a short-form measure or computerized adaptive test, more informative items are those that would be selected for inclusion.
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Affiliation(s)
- Jeanne A Teresi
- Research Division, Hebrew Home at Riverdale, Riverdale, New York, NY, USA
- Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Analytic Core, Columbia University Alzheimer's Disease Resource Center for Minority Aging Research and Stroud Center, New York State Psychiatric Institute, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, USA
| | | | - Mildred Ramirez
- Research Division, Hebrew Home at Riverdale, Riverdale, New York, NY, USA
- Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Analytic Core, Columbia University Alzheimer's Disease Resource Center for Minority Aging Research and Stroud Center, New York State Psychiatric Institute, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, USA
| | - Marjorie Kleinman
- Analytic Core, Columbia University Alzheimer's Disease Resource Center for Minority Aging Research and Stroud Center, New York State Psychiatric Institute, New York, NY, USA
| | - Katherine Ornstein
- Department of Geriatrics and Palliative Medicine, Institute for Translational Epidemiology Mount Sinai School of Medicine, New York, NY, USA
| | - Albert Siu
- Department of Geriatrics and Palliative Medicine, General Internal Medicine, Health Evidence and Policy, Mount Sinai Medical Center, New York, NY, USA
| | - Jose Luchsinger
- Department of Medicine, Columbia University, New York, NY, USA
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Guo Q, Zheng Y, Shi J, Wang J, Li G, Li C, Fromson JA, Xu Y, Liu X, Xu H, Zhang T, Lu Y, Chen X, Hu H, Tang Y, Yang S, Zhou H, Wang X, Chen H, Wang Z, Yang Z. Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study. Brain Behav Immun 2020; 88:17-27. [PMID: 32416290 PMCID: PMC7235603 DOI: 10.1016/j.bbi.2020.05.038] [Citation(s) in RCA: 234] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 02/08/2023] Open
Abstract
Since the end of 2019, Corona Virus Disease 2019 (COVID-19) has been the cause of a worldwide pandemic. The mental status of patients with COVID-19 who have been quarantined and the interactions between their psychological distress and physiological levels of inflammation have yet to be analyzed. Using a mixed-method triangulation design (QUAN + QUAL), this study investigated and compared the mental status and inflammatory markers of 103 patients who, while hospitalized with mild symptoms, tested positive with COVID-19 and 103 matched controls that were COVID-19 negative. The severity of depression, anxiety, and post-traumatic stress symptoms (PTSS) was measured via an on-line survey. Using a convenience sampling technique, qualitative data were collected until the point of data saturation. In addition, a semi-structured interview was conducted among five patients with COVID-19. Peripheral inflammatory markers were also collected in patients, both at baseline and within ± three days of completing the on-line survey. Results revealed that COVID-19 patients, when compared to non-COVID controls, manifested higher levels of depression (P < 0.001), anxiety (P < 0.001), and post-traumatic stress symptoms (P < 0.001). A gender effect was observed in the score of "Perceived Helplessness", the subscale of PSS-10, with female patients showing higher scores compared to male patients (Z = 2.56, P = 0.010), female (Z = 2.37, P = 0.018) and male controls (Z = 2.87, P = 0.004). Levels of CRP, a peripheral inflammatory indicator, correlated positively with the PHQ-9 total score (R = 0.37, P = 0.003, Spearman's correlation) of patients who presented symptoms of depression. Moreover, the change of CRP level from baseline inversely correlated with the PHQ-9 total score (R = -0.31, P = 0.002), indicative of improvement of depression symptoms. Qualitative analysis revealed similar results with respect to patient reports of negative feelings, including fear, guilt, and helplessness. Stigma and uncertainty of viral disease progression were two main concerns expressed by COVID-19 patients. Our results indicate that significant psychological distress was experienced by hospitalized COVID-19 patients and that levels of depressive features may be related to the inflammation markers in these patients. Thus, we recommend that necessary measures should be provided to address depression and other psychiatric symptoms for COVID-19 patients and attention should be paid to patient perceived stigma and coping strategies when delivering psychological interventions.
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Affiliation(s)
- Qian Guo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yuchen Zheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jia Shi
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China; Graduate School, Nanjing University of Chinese Medicine, Nanjing 210046, China
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Guanjun Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Chunbo Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - John A Fromson
- Department of Psychiatry, Brigham & Women's Hospital, and Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Yong Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xiaohua Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Hua Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Tianhong Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yunfei Lu
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Xiaorong Chen
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Hao Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yingying Tang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Shuwen Yang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Han Zhou
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xiaoliang Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haiying Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Zongguo Yang
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
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Ruisoto P, López-Guerra VM, Paladines MB, Vaca SL, Cacho R. Psychometric properties of the three versions of the Perceived Stress Scale in Ecuador. Physiol Behav 2020; 224:113045. [PMID: 32619529 DOI: 10.1016/j.physbeh.2020.113045] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/16/2020] [Accepted: 06/29/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND . The Perceived Stress Scale (PSS) is the most well-known self-report measure to assess perceived psychological stress. OBJECTIVE . The objective of the study was to analyze the psychometric properties of three versions of the Perceived Stress Scale (PSS-4, PSS-10 and PSS-14) in Ecuador. METHODS . A sample of 7905 university students (46% men and 54% women) from Ecuador were surveyed using all three versions of PSS. RESULTS . All three versions showed a satisfactory adjustment with a bifactorial structure based on the item structure rather than underlying dimensions of psychological stress. The reliability was also adequate, with Alpha and Omega coefficients [α = 0.85 and ω = 0.80 for PSS-14; α = 0.85 and ω = 0.87 for PSS-10; α = 0.74 and ω = 0.78 for PSS-4] respectively. Psychological stress scores positively correlated with multiple health indicators such as loneliness, psychological inflexibility, alcohol consumption, and presence of anxiety and depression symptoms, and negatively with resilience. CONCLUSIONS . The use of PSS-10 based on its best goodness of fit and PSS-4 as the shortest version are recommended to measure psychological stress, rather than the original PSS-14 version. Psychological stress was significantly higher in women than men.
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Affiliation(s)
- Pablo Ruisoto
- Research Group in Stress, Learning and Health, Department of Health Sciences, Public University of Navarre, Spain.
| | | | - María B Paladines
- Department of Psychology, Technical Particular University of Loja, Ecuador
| | - Silvia L Vaca
- Department of Psychology, Technical Particular University of Loja, Ecuador
| | - Raúl Cacho
- Research Group in Stress, Learning and Health, Department of Health Sciences, Public University of Navarre, Spain
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Turoń-Skrzypińska A, Pawlukowska W, Szylińska A, Tomska N, Mikołajczyk-Kocięcka A, Ptak M, Dutkiewicz G, Rotter I. Assessment of the Relationship between Selected Factors and Stress-Coping Strategies in Handcyclists-A Preliminary Study. ACTA ACUST UNITED AC 2020; 56:medicina56050211. [PMID: 32349214 PMCID: PMC7279314 DOI: 10.3390/medicina56050211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Playing competitive sports is associated with stress, especially during the starting season. Disabled athletes are additionally burdened with physical and/or emotional factors, resulting from the trauma they have experienced. The aim of the work was to assess the relationship between strategies of coping with stress and the level of education, category of disability and its duration of handcyclists before the competition. Materials and Methods: 44 handcyclists with a mean age of 41.8 ± 11.6, from European countries, were divided according to the severity of mobility impairments, education and duration of the disability. The participants were asked to fill in the Mini-COPE Inventory for Measuring Coping with Stress, which provided answers in writing to some sociodemographic questions regarding age, sex, education, type of mobility impairment and duration of the disability. Results: The subjects who had suffered spinal injury at the cervical section obtained the lowest scores regarding their subjective assessment of their active stress management in difficult situations (p = 0.007). They scored the lowest, 1.5 points, when asked about acceptance in difficult circumstances compared to those with university education (p = 0.02). A statistically significant correlation was found to exist between education levels and positive revaluation, acceptance and seeking instrumental support. A negative correlation was observed between education and sustained use of psychoactive substances and denial. Conclusions: Highly educated cyclists with short-lasting disability, damage to the lower spine section or amputations tend to cope better with stress than other study participants.
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Affiliation(s)
- Agnieszka Turoń-Skrzypińska
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland; (A.T.-S.); (W.P.); (A.S.); (A.M.-K.); (M.P.); (I.R.)
| | - Wioletta Pawlukowska
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland; (A.T.-S.); (W.P.); (A.S.); (A.M.-K.); (M.P.); (I.R.)
| | - Aleksandra Szylińska
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland; (A.T.-S.); (W.P.); (A.S.); (A.M.-K.); (M.P.); (I.R.)
| | - Natalia Tomska
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland; (A.T.-S.); (W.P.); (A.S.); (A.M.-K.); (M.P.); (I.R.)
- Correspondence:
| | - Anna Mikołajczyk-Kocięcka
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland; (A.T.-S.); (W.P.); (A.S.); (A.M.-K.); (M.P.); (I.R.)
| | - Magdalena Ptak
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland; (A.T.-S.); (W.P.); (A.S.); (A.M.-K.); (M.P.); (I.R.)
| | - Grażyna Dutkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland; (A.T.-S.); (W.P.); (A.S.); (A.M.-K.); (M.P.); (I.R.)
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Liu X, Zhao Y, Li J, Dai J, Wang X, Wang S. Factor Structure of the 10-Item Perceived Stress Scale and Measurement Invariance Across Genders Among Chinese Adolescents. Front Psychol 2020; 11:537. [PMID: 32328009 PMCID: PMC7160845 DOI: 10.3389/fpsyg.2020.00537] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/06/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Chinese adolescents encounter a lot of stressors, such as academic burden and parental pressure. However, little is known about their perception of stress. The 10-item Perceived Stress Scale (PSS-10) is a widely used instrument to measure individuals' appraisal of global stress in academic research and clinical practice. The current study aimed to evaluate the best-fit factor structure model of the PSS-10 and the measurement invariance across genders in Chinese adolescents. METHODS A total of 1,574 Chinese senior high school students completed the PSS-10 (mean age = 15.26 ± 0.56 years, female = 54%). Confirmatory factor analysis (CFA) was conducted to determine the factor structure of the PSS-10. Multigroup CFA was carried out to test the measurement invariance of the PSS-10 across genders. A subsample (N = 1,060) answered additional questionnaires measuring stressful life events, anxiety, and depression to examine the convergent and concurrent validity of the PSS-10. RESULTS The two-factor model was supported [i.e., χ2 (34) = 332.224, p < 0.001; non-normal fit index (NNFI) = 0.901, comparative fit index (CFI) = 0.925, root mean square error of approximation (RMSEA) = 0.075, standardized root mean square residual (SRMR) = 0.051]. Importantly, the model exhibited strong measurement invariance across female and male groups. Furthermore, the PSS-10 had adequate convergent validity for stressful life events (number: r = 0.13, p < 0.001; impact: r = 0.23, p < 0.001) and could explain incremental variance in predicting anxiety (ΔR 2 = 0.13, β = 0.38, p < 0.001) and depression (ΔR 2 = 0.16, β = 0.41, p < 0.001), suggesting excellent concurrent validity. CONCLUSION A two-factor model best fits the structure of PSS-10 among Chinese adolescents, with strong measurement invariance between gender groups, demonstrating its validity for assessing perceived stress among Chinese adolescents.
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Affiliation(s)
- Xiqin Liu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajun Zhao
- School of Sociology and Psychology, Southwest Minzu University, Chengdu, China
| | - Jingguang Li
- College of Teacher Education, Dali University, Dali, China
| | - Jing Dai
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiuli Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Song Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
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Anwer S, Manzar MD, Alghadir AH, Salahuddin M, Abdul Hameed U. Psychometric Analysis of the Perceived Stress Scale Among Healthy University Students. Neuropsychiatr Dis Treat 2020; 16:2389-2396. [PMID: 33116538 PMCID: PMC7585521 DOI: 10.2147/ndt.s268582] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/31/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is a gradual increase in the prevalence of stress during professional courses. Previous studies reported a high incidence of stress among university students. The psychometric properties of the perceived stress scale-10 (PSS-10) have been established in different populations. The current study aimed to assess psychometric properties of the PSS-10 in Saudi university students. METHODS Healthy university students (n= 192) participated in this cross-sectional study. All the participants were explained about the aim and procedures of the study. Participants were requested to complete the English version of the PSS, the generalized anxiety disorder-7 (GAD-7), the sleep hygiene index (SHI), and demographic details. RESULTS The range of the PSS-10 total score was 0-35; 1% reported minimum score of 0, but none reported maximum score of 40. Therefore, there was no issue of ceiling or floor effect in the PSS-10 total score. Positive and significant correlations of the PSS total and the PSS Factor-1 (distress perception) with the GAD-7 total score, SHI item-8 and SHI item-13 score support its convergent validity. Negative or no correlation of the PSS Factor-2 score (coping perception) with the GAD-7 total score, SHI item-8 and SHI item-13 scores demonstrate its divergent validity. The internal homogeneity test indicated moderate to strong positive correlations (r=0.60-0.82) between the PSS Factors and the items loading on them. The internal consistency test showed a good agreement for the PSS Factor-1 and the PSS Factor-2 scores (Cronbach's alpha 0.78 and 0.71, respectively), suggesting an acceptable level of consistency. Factor analysis favored a 2-Factor model of the PSS in the Saudi students. CONCLUSION The current study supported the use of the PSS-10 to assess the perceived stress among Saudi university students.
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Affiliation(s)
- Shahnawaz Anwer
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Department of Building and Real Estate, Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Salahuddin
- Pharmacology Division, Department of BioMolecular Sciences, University of Mississippi, Oxford, MS, USA
| | - Unaise Abdul Hameed
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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