Depression may mediate the relationship between sense of coherence and quality of life in lung cancer patients

Sense of Coherence and Health-Related Quality of Life in Patients with Multiple Sclerosis: The Role of Physical and Neurological Disability

Multiple sclerosis is a progressive demyelinating disease of the central nervous system that can lead to permanent disability and significantly impact the quality of life. The present study explores the relationship between neurological disability and disease symptoms, quality of life, and the level of sense of coherence, which is an important resource for coping with the disease. EDSS, GNDS, SOC-29, and MSIS-29 were used in the presented study. The study group consisted of 137 people diagnosed with multiple sclerosis. The study showed the correlation between most of the analyzed variables. Mood disability and fatigue were significant predictors of the sense of coherence and explained 34% of its variance. Physical disability and fatigue served as significant predictors of the physical aspect of quality of life, explaining 49% of its variance. Fatigue and sense of coherence were significant predictors of the psychological aspect of quality of life, explaining 47% of the variance. In studies on a group of people with multiple sclerosis, it is worth considering, in addition to the level of disability, also invisible symptoms, such as fatigue or mood disability, which are important for the quality of life and the level of resources. As this study suggests, a sense of coherence is a resource essential for the quality of life of people with disabilities.

The mediating role of psychological distress on the link between socio-ecological factors and quality of life of Filipino adults during COVID-19 crisis

Anchored on the Ecological Systems Theory, this study aimed to determine how psychological distress operates as an underlying mechanism in the impact of socio-ecological factors on the quality of life of Filipino adults during coronavirus disease 2019 (COVID-19) crisis. A cross-sectional online survey was conducted to assess perceptions of 401 adults on socio-ecological factors (i.e., safety at home, trust in public institutions, and financial difficulties), psychological distress, and quality of life during the early phase of COVID-19 community quarantine in the Philippines. Using latent variable path analysis, all three socio-ecological factors have significant direct effects on both psychological distress and quality of life. More importantly, the proposed model was confirmed in terms of a significant partial mediation of psychological distress on the impact of safety at home, trust in public institutions, and financial difficulties on the quality of life of Filipino adults. The study offers novel insights into the role of psychological distress as an underlying mechanism that operates on the influence of socio-ecological factors on the quality of life of adults during a global health crisis. Implications on psychological interventions and policies in preventing mental health problems vis-à-vis improving Filipinos' quality of life during the COVID-19 pandemic are discussed.

Fear of COVID-19 and Life Satisfaction: The Role of the Health-Related Hardiness and Sense of Coherence

Introduction: The COVID-19 pandemic is contributing to increased fear and anxiety throughout society, which may affect life satisfaction. Health-related hardiness and sense of coherence (SOC) are personal resources that help people adapt to difficult circumstances. The purpose of this study was to investigate the relationship between fear of COVID-19, SOC, health-related hardiness, and life satisfaction. Methods: A total of 907 Polish people (522 women and 385 men) participated in this study. The Fear of COVID-19 Scale (FOC-6), the Health-Related Hardiness Scale, the Sense of Coherence Scale (SOC-29), and the Satisfaction with Life Scale were used. Results: Correlation showed that fear of COVID-19 was negatively related to health-related hardiness, SOC, and life satisfaction. Health-related hardiness and SOC were positively related to life satisfaction. Both SOC and hardiness were mediators between fear of COVID-19 and life satisfaction during the current pandemic. Conclusion: SOC and health-related hardiness are personal resources that are important for dealing with the effects of the COVID-19 pandemic. According to our study, SOC and hardiness can mediate between fear of COVID-19 and life satisfaction. Presented cross-sectional results have to be verified in future longitudinal studies in order to strengthen the conclusions presented in this manuscript. This study verified the role of only two personal resources, so more research is needed on the role of other personal resources during COVID-19 pandemic.

Relation between personality dimensions and symptomatology of depression in skin cancer patients

BACKGROUND

Environmental psychological factors such as mood states can modify and trigger an organic response; depressive disorder is considered a risk factor for oncological development, leading to alterations both in the genesis and in the progression of the disease. Some authors have identified that personality relates to mood since a high score in neuroticism is associated with intense and long-lasting emotions of stress and therefore with the development of depressive behaviors. The objective of this study was to analyze the relationship between personality and depression in skin cancer patients.

METHODS

A total of forty-seven clinically and histopathologically diagnosed patients were scheduled for an hour-long interview, during which they provided informed consent and sociodemographic information. The psychological questionnaires applied were the revised Eysenck Personality Questionnaire and the clinical questionnaire for the diagnosis of the depressive syndrome.

RESULTS

The patient's mean age was 66.5 years (SD ± 12.4) and the majority were diagnosed with basal cell carcinoma (70.2%). The frequency of anxious/depressive symptoms was 42.5%, with an increase in depression scores in the female gender (p < 0.001). Furthermore, a difference was found in the neuroticism dimension related to gender, with higher values in women (p = 0.002). Depressive symptomatologic portraits were correlated with the dimensions of neuroticism (p < 0.001, r = 0.705), psychoticism (p = 0.003, r = 0.422) and lying (p = 0.028, r = - 0.321).

CONCLUSIONS

Our results support the hypothesis that personality dimensions are related to the presence of anxiety/depressive symptomatology in patients with skin cancer, especially in the female gender. Highlighting the need for future research that delves into the implications at the psychological level, the quality of life, and the biological mechanisms that link personality and depressive symptoms in the development and evolution of skin cancer.

A serial multiple mediator model of sense of coherence, coping strategies, depression, and quality of life among gynecologic cancer patients undergoing chemotherapy

PURPOSE

This study evaluated whether coping strategies (positive reframing, planning, and active coping) and depression mediate the relationship between sense of coherence (SOC) and quality of life (QoL) using a serial multiple mediator model in patients with gynecologic cancer who are undergoing chemotherapy.

METHODS

A sample of 148 participants, with a mean age of 52.17 years (range 20-75) and diagnosed with gynecological cancer (e.g., cervix, ovary and endometrium) was surveyed in a cross-sectional study. Data were collected using a structured self-reporting questionnaire. A serial multiple mediator model was analyzed to explain sequential causality among two mediators (coping strategy and depression) and to investigate the direct and indirect effects of the mediator model in SPSSWIN 26.0 and PROCESS macro program.

RESULTS

The conceptual serial mediation model of SOC, positive reframing, depression, and QoL revealed a significant positive total effect (coefficient c = 13.099, SE = 1.647, p < 0.001). The path through single mediation of positive reframing (Effect = 0.925) and depression (Effect = 5.942) and that through both mediators (Effect = 1.161) were statistically significant. The total indirect effect was also statistically significant (Effect = 8.028). Moreover, the conceptual serial mediation model on SOC, planning, depression, and QoL revealed a significant positive total effect (coefficient c = 13.099, SE = 1.647, p < 0.001). The path through both mediation of planning and depression (Effect = 1.162) and the total indirect effect were statistically significant (Effect = 8.172).

CONCLUSIONS

Helping patients with gynecologic cancer undergoing chemotherapy to strengthen SOC may improve QoL by equipping them with efficient positive reframing or planning strategies to reduce depression.

How does stress affect life satisfaction during the COVID-19 pandemic? Moderated mediation analysis of sense of coherence and fear of coronavirus

The aim of the present study was to determine the relationship between fear of COVID-19, stress, sense of coherence, and life satisfaction during the coronavirus pandemic. Participants were 907 Polish people (522 women and 385 men). We used the Perceived Stress Scale (PSS-10), Fear of COVID-19 Scale (FOC-6), Sense of Coherence Scale (SOC-29) and the Satisfaction with Life Scale. The relationship between stress and life satisfaction was mediated by the sense of coherence, and the relationship between stress and sense of coherence was moderated by fear of COVID-19. The fear of COVID-19 acted as a buffer in the relationship between stress and sense of coherence weakening the impact of stress on the sense of coherence. This study is the first to verify the proposed model of moderated mediation during the COVID-19 pandemic and was undertaken in a very large sample. This manuscript highlights the important role of the fear of COVID-19 and sense of coherence in our well-being. An individual's sense of coherence can affect their subjective well-being and help them to effectively manage stress and reduce anxiety.

Consideration of sense of coherence in a structured communication approach with stage IV lung cancer patients and their informal caregivers: a qualitative interview study

Objective

Salutogenetic aspects are valuable for consideration in patient-centred care of advanced oncological diseases with a limited life expectancy. The Milestone Communication Approach (MCA), involving physician-nurse tandems, addresses specific challenges and needs over the disease trajectory of patients with stage IV lung cancer and their informal caregivers. This study aims to explore patients’ and informal caregivers’ salutogenetic experiences with the MCA concept.

Methods

This qualitative study used face-to-face semi-structured interviews with patients and informal caregivers. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data were structured using Qualitative Content Analysis. The material was coded deductively into themes related to the components of sense of coherence (Aaron Antonovsky) and emerging sub-themes. All data was managed and organised in MAXQDA.

Results

In 25 interviews, sense of coherence was referred to with all three components: “Comprehensibility” was supported by information conveyed suitably for the patients; “meaningfulness” was addressed as accepting the situation; and “manageability” led to advance care planning the patients were comfortable with. Patients and informal caregivers experienced the interprofessional tandem as an added value for patient care.

Conclusions

Participants appreciate the MCA in its support for coping with a life-limiting disease. Considering salutogenetic aspects facilitates prognostic awareness and advance care planning. Nevertheless, individual needs of patients and informal caregivers require an individualised application of the MCA.

Quality of life of patients with lung cancer: A scoping review

Abstract Objective: To characterize scientific publications on the quality of life of people with lung cancer in order to explore current knowledge of the subject, with emphasis on assessment instruments and methodological aspects. Method: A scoping type literature review was performed. Articles were sought in the databases of the Virtual Health Library, in an integrative manner, with the descriptors: Quality of life and Lung Neoplasms, with no date of publication or language restrictions (n=138). The selection of articles was based on inclusion and exclusion criteria defined in the study proposal. Results: We included 18 publications published between 2006 and 2017, the majority (n = 10) of which had a cross-sectional design. Eight different instruments were used to evaluate the quality of life of patients with lung cancer, four of which were specific for people with cancer. There was a prevalence of the use of the European Organization for Research and Treatment of Cancer Care Quality of Life Questionnaire - EORTC QLQ-C30 (n=8). Prospective studies (n=8) assessed quality of life before and after chemotherapy, physical therapy or pulmonary resection. The studies adopted different methodologies and provided conflicting results of quality of life. Cross-sectional studies with comparatively healthy subjects found an inferior quality of life for people with lung cancer. Conclusion: The scoping review contributed to the identification of the multiple evaluated instruments, both generic and specific. It found a lack of homogeneity in the methodological approaches of the studies. Further prospective studies with a specific instrument and methodological standardization to evaluate the quality of life of people with lung cancer are recommended.

Overall and domain-specific life satisfaction when living with familial Alzheimer's disease risk: A quantitative approach

In this study, we explored life satisfaction and sense of coherence in relation to biopsychosocial variables in individuals at risk for the development of familial Alzheimer's disease. Forty nine individuals (response rate: 96%) were interviewed. Life satisfaction was found to be high for the majority of participants. Those who were older than the expected age of onset of disease, those <6 years' inclusion in the Familial Alzheimer's disease biomarker study, and males tended to experience positive psychological health. Sense of coherence was positively associated with satisfaction with life as a whole, psychological health, vocation, and economy. Women seem to be more vulnerable than men, and attention should be given to those who have not passed the age of expected symptom onset. Early and recurrent counseling and psychosocial support were found to be essential. Issues related to vocation and economy are areas of concern, and are closely associated with sense of coherence, life satisfaction, and psychological health. This study emphasizes the importance of professional teams working together with the patient and their families.

A Correlational Study of Spiritual Well-being and Depression in the Adult Cancer Patient

Depression in adult cancer patients has been widely studied, along with spiritual effects of traumatic events and even spiritual growth after a diagnosis of cancer. There has been limited research determining a direct correlation between spiritual well-being and depression in adult cancer patients. The purpose of this research study was to examine the relationship between spiritual well-being and depression in adult cancer patients. This was a descriptive correlational study using 59 patients older than 18 years from an outpatient cancer center. The researchers hypothesized that patients with a low spiritual well-being score would be more likely to have a high depressive symptom score, thus providing support for a correlation between cancer patient's spiritual well-being and risk of depression. Implications of this study lead to evidence for better screening processes for cancer patients regarding spiritual well-being.

Sense of coherence as a mediator of health-related quality of life dimensions in patients with breast cancer: a longitudinal study with prospective design

BACKGROUND

In our previous study, we found that the degree of sense of coherence (SOC) and baseline ratings of several dimensions of health-related quality of life (HRQoL) were the most important predictors of HRQoL changes 6 months after the pre-diagnosis period of breast cancer. To find a way to explain these findings, the aim of this study was to explore the mediating effect of the SOC between ratings of HRQoL dimensions before final diagnosis, and ratings of the same dimensions at the 6 months follow up, within a sample of women with breast cancer.

METHODS

A longitudinal study with a prospective design at baseline (T1) and 6 months later (T2) was conducted on 162 women with breast cancer. To measure HRQoL dimensions three different questionnaires, the European Organization for Research and Treatment of Cancer QLQ-30, the SF-12 Health Survey version 2 and the Health Index were applied at T1 and T2 to cover both diagnostic-specific and generic dimensions. Measurement of the SOC as a mediator was done by the SOC-13 scale.

RESULTS

Mediational analyses on eight significant pairs of HRQoL dimensions showed that the degree of SOC totally mediated variations of global quality of life (p < 0.001) as well as cognitive and social functioning (p <0.05) scores between T1 to T2. Changes in the scores of emotional functioning (p < 0.01), fatigue (p < 0.05), financial difficulties (p < 0.05), well-being (p < 0.001), and mental health component (p < 0.001) were partially mediated. The degree of SOC explained 16% to 45% of the variances in HRQoL dimensions at T2.

CONCLUSIONS

The mediating pathway of the SOC in the context of this study appears to be the key to understanding how a higher sense of coherence as an inner resource may serve as a protective psychological factor in the adaptation process of the patients. Clinicians might consider coherence-oriented structure of the SOC and the connection between the SOC and HRQoL data in intervention plans from the first visit onwards. It may assist the identification of women who are at greater risk for maladaptation to the breast cancer trajectory.

Concealment of lung cancer diagnosis: prevalence and correlates

BACKGROUND

Lung cancer has a commonly understood behavioral etiology. Thus, lung cancer patients are often blamed for their illness and may seek to avoid this blame by concealing their diagnosis from others. This study sought to determine the prevalence of concealment and identify demographic, clinical, and psychosocial correlates of concealment among lung cancer patients.

METHODS

A sample of 117 lung cancer patients receiving chemotherapy for non-small cell or small cell lung cancer was recruited and completed self-report demographic questionnaires, a measure of diagnosis concealment designed and pilot tested for this study, and standard measures of psychosocial variables. Clinical factors were assessed via a medical chart review.

RESULTS

Thirty participants (26%) reported concealing their diagnosis in the previous month, most frequently from casual friends and close friends. Reported reasons for concealment largely reflected concern for others. Univariate analyses indicated that those who concealed their lung cancer diagnosis reported more internalized shame related to their illness and use of positive reappraisal as a coping strategy (ps ≤ 0.02). In addition, those who concealed were more likely to have used alcohol in the previous month and have a more recent recurrence, among those who had a recurrence (ps ≤ 0.04). Multivariate analyses indicated that internalized shame and use of positive reappraisal accounted for significant unique variance in concealment above and beyond that accounted for by use of alcohol (ps < 0.05).

CONCLUSIONS

Future research should aim to replicate and extend these findings with longitudinal designs to elucidate the directionality of the associations observed in this study.

Family caregiver burden, skills preparedness, and quality of life in non-small cell lung cancer

PURPOSE/OBJECTIVES

To describe burden, skills preparedness, and quality of life (QOL) for caregivers of patients with non-small cell lung cancer (NSCLC), and describe how the findings informed the development of a caregiver palliative care intervention that aims to reduce caregiver burden, improve caregiving skills, and promote self-care.

DESIGN

Descriptive, longitudinal.

SETTING

A National Cancer Institute-designated comprehensive cancer center in southern California.

SAMPLE

163 family members or friends aged 18 years or older and identified by patients as being a caregiver.

METHODS

All eligible caregivers were approached by advanced practice nurses during a regularly scheduled patient clinic visit. Informed consent was obtained prior to study participation. Outcome measures were completed at baseline and repeated at 7, 12, 18, and 24 weeks. Descriptive statistics were computed for all variables, and one-way repeated-measures analysis of variance was used to test for change over time for all predictor and outcome variables.

MAIN RESEARCH VARIABLES

Caregiver burden, skills preparedness, psychological distress, and QOL.

FINDINGS

Caregivers were highly functional. Caregiver burden related to subjective demands increased significantly over time. Perceived skills preparedness was high at baseline but decreased over time. Psychological distress was moderate but increased in the study period. Overall QOL was moderate at baseline and decreased significantly over time. Psychological well-being had the worst QOL score.

CONCLUSIONS

Caregivers experienced high levels of caregiver burden and reported deteriorations in psychological well-being and overall QOL.

IMPLICATIONS FOR NURSING

Oncology nurses need to ensure that caregivers receive information that supports the caregiving role throughout the cancer trajectory.

KNOWLEDGE TRANSLATION

Although family caregivers are profoundly impacted by a loved one's lung cancer diagnosis, the literature about caregiver burden, skills preparedness, and QOL is limited. Current evidence suggests that family caregivers can be negatively impacted by a loved one's cancer diagnosis. Caregiver-specific support interventions are needed to eliminate the burden of caregiving in lung cancer.

Interdisciplinary palliative care intervention in metastatic non-small-cell lung cancer

OBJECTIVE

Challenges and barriers continue to hinder the integration of palliative care models into comprehensive, ambulatory oncology care. This article aims to describe how symptoms, distress, and quality of life (QOL) data from the usual care phase of a National Cancer Institute-supported Program Project informed the development of an interdisciplinary, tailored palliative care intervention for patients with metastatic non-small-cell lung cancer (NSCLC).

METHODS

Patients receiving usual care for metastatic NSCLC were recruited into this prospective longitudinal study over a 1-year period. A total of 130 patients with stage IV NSCLC were accrued, and 114 patients had evaluable data. Research nurses assisted patients in completing the clinical section of the data forms, and patients completed surveys and self-reports at baseline and 6, 12, and 24 weeks.

RESULTS

Patients ranged in age from 40 to 84 years, and 61% were Caucasian non-Hispanic. Sixty-six former (N = 59) and current smokers had an average of 38 pack-year history of smoking. The Karnofsky Performance Status, Instrumental Activities of Daily Living, and Cognitive scores deteriorated significantly (P = .001, .009, and .042, respectively). Social Activity was stable, whereas Social Support increased significantly. Overall symptom distress score and Total symptom score both significantly increased at 24 weeks (P = .003 and .017, respectively). Physical Well-Being decreased significantly (P = .036), whereas the Functional Assessment of Cancer Therapy-Lung, Functional Assessment of Chronic Illness Therapy-Spirituality Subscale, and Distress scores remained statistically stable over time.

CONCLUSIONS

Patients with metastatic NSCLC continue to experience high symptom burden and diminished physical well-being over time while receiving cancer treatments. An interdisciplinary palliative care intervention is currently being tested to improve symptom burden and overall QOL.

Affect mediates the association between mental adjustment styles and quality of life among Chinese cancer survivors

This study examined the association between mental adjustment styles and quality of life, and affect as a mediator among 238 Chinese cancer survivors. Regression analysis showed that quality of life was positively associated with fighting spirit and negatively associated with fatalism. Path analysis showed that greater fighting spirit was associated with more positive affect, which in turn was associated with higher quality of life. Greater fatalism was associated with less positive affect and more negative affect, which in turn was associated with lower quality of life. Findings suggest that positive affect and negative affect are important in understanding mental adjustment styles and its health implications.

Gender differences in perception of quality of life in adults with and without chronic health conditions: the role of depressive symptoms

Previous studies have shown that chronic conditions have a negative impact on quality of life. Furthermore, this impact appears to be different in males and females, but it is not yet clear what factors may mediate this relationship. Females with chronic health conditions had poorer quality of life in the physical and psychological domains as compared to males with chronic health conditions. The difference between male and female patients in the psychological domain disappeared when the analysis was adjusted for confounding factors such as age, presence of a chronic health condition, socioeconomic status, and depressive symptoms.