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Finkelstein-Fox L, Bliss CC, Rasmussen AW, Hall DL, El-Jawahri A, Perez GK, Traeger LN, Comander AH, Peppercorn J, Anctil R, Noonan E, Park ER. Do cancer curvivors and metavivors have distinct needs for stress management intervention? Retrospective analysis of a mind-body survivorship program. Support Care Cancer 2023; 31:616. [PMID: 37801182 PMCID: PMC11210627 DOI: 10.1007/s00520-023-08062-1] [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: 01/05/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Cancer "curvivors" (completed initial curative intent treatment with surgery, radiation, chemotherapy, and/or other novel therapies) and "metavivors" (living with metastatic or chronic, incurable cancer) experience unique stressors, but it remains unknown whether these differences impact benefits from mind-body interventions. This study explored differences between curvivors and metavivors in distress (depression, anxiety, worry) and resiliency changes over the course of an 8-week group program, based in mind-body stress reduction, cognitive-behavioral therapy (CBT), and positive psychology. METHODS From 2017-2021, 192 cancer survivors (83% curvivors; 17% metavivors) completed optional online surveys of resiliency (CES) and distress (PHQ-8, GAD-7, PSWQ-3) pre- and post- participation in an established clinical program. Mixed effect regression models explored curvivor-metavivor differences at baseline and in pre-post change. RESULTS Compared to curvivors, metavivors began the program with significantly more resilient health behaviors (B = 0.99, 95% CI[0.12, 1.86], p = .03) and less depression (B = -2.42, 95%CI[-4.73, -0.12], p = .04), with no other significant differences. Curvivors experienced significantly greater reductions in depression (curvivor-metavivor difference in strength of change = 2.12, 95% CI [0.39, 3.83], p = .02) over the course of the program, with no other significant differences. Neither virtual delivery modality nor proportion of sessions attended significantly moderated strength of resiliency or distress change. CONCLUSION Metavivors entering this mind-body program had relatively higher well-being than did curvivors, and both groups experienced statistically comparable change in all domains other than depression. Resiliency programming may thus benefit a variety of cancer survivors, including those living with incurable cancer.
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Affiliation(s)
- Lucy Finkelstein-Fox
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA.
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Cayley C Bliss
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
| | - Autumn W Rasmussen
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
| | - Daniel L Hall
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Areej El-Jawahri
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Giselle K Perez
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Lara N Traeger
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Amy H Comander
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jeffrey Peppercorn
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Reid Anctil
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
| | - Elise Noonan
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Akkuş Y, Menekli T. Determining the Relationship Between Intolerance of Uncertainty and Attitudes Toward Complementary and Alternative Medicine in Patients With Cancer. Holist Nurs Pract 2023; 37:277-284. [PMID: 37595120 DOI: 10.1097/hnp.0000000000000600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
Disease-related uncertainty and the factors associated with uncertainty in patients with cancer have not been adequately investigated. This study aimed to determine the relationship between intolerance of uncertainty and attitudes toward complementary and alternative medicine (CAM) in patients with cancer. This cross-sectional descriptive study included 351 patients treated in the oncology clinic of a university hospital. All participants completed the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) and the 12-item Intolerance of Uncertainty Scale (IUS-12). Most patients (84.3%) said that they had information about CAM, 39.7% reported obtaining this information from their social environment, 83.2% said that they believed that CAM methods are effective, and 76.0% reported not telling health care professionals about their CAM use. Mean IUS-12 and HCAMQ total scores were 46.53 ± 2.05 and 32.11 ± 2.32, respectively, and showed a weak negative correlation. The patients in our study showed high intolerance of uncertainty and a moderately positive attitude toward CAM, and most patients did not notify health care professionals of their CAM use. Therefore, we recommend assessing intolerance of uncertainty and CAM use in this patient group. By identifying patients experiencing uncertainty and seeking different treatment, nurses can support patients physiologically, psychologically, and socially, and can explain the effects of CAM use.
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Affiliation(s)
- Yeliz Akkuş
- Department of Nursing, Health Science Faculty, Kafkas University, Kars, Turkey (Dr Akkuş); and Department of Nursing, Health Science Faculty, Turgut Ozal University, Malatya Turkey (Dr Menekli)
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Devlin EJ, Whitford HS, Peoples AR, Morrow GR, Katragadda S, Giguere JK, Naqvi B, Roscoe J. Psychological predictors of chemotherapy-induced nausea in women with breast cancer: Expectancies and perceived susceptibility. Eur J Cancer Care (Engl) 2021; 30:e13488. [PMID: 34323340 PMCID: PMC9022467 DOI: 10.1111/ecc.13488] [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: 03/25/2020] [Revised: 01/21/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
Objective Chemotherapy‐induced nausea is challenging to predict and treat. Research indicates that pretreatment psychological variables including patients' perceptions of their susceptibility to nausea, expectancies of treatment‐related nausea and nausea history (i.e., motion sickness, morning sickness and baseline levels of nausea) may aid in predicting nausea severity during chemotherapy. However, this research is dated and limited in quantity. We investigated whether psychological variables could improve prediction of nausea severity to inform interventions targeting chemotherapy‐induced nausea. Methods In this secondary analysis, a subgroup of women receiving chemotherapy (for the first time) for breast cancer completed pretreatment measures: perceived nausea susceptibility, nausea expectancies, nausea history and baseline nausea. They rated subsequent nausea severity across 4‐days, during treatment and posttreatment in a self‐report diary. Structural Equation Modelling was used to explore associations. Results Across the women (N = 481), perceived nausea susceptibility predicted subsequent nausea severity (β = 0.16), but nausea expectancies did not (β = 0.05). Nausea history variables demonstrated small‐moderate associations with perceived susceptibility (β = 0.21–0.32) and negligible‐small associations with nausea expectancies (β = 0.07–0.14). Conclusion Perceived nausea susceptibility appears to capture patients' nausea history, to a degree, and is related to nausea severity during treatment. This is an important variable to include in pretreatment prediction of patients at risk of severe nausea.
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Affiliation(s)
- Elise J Devlin
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Hayley S Whitford
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anita R Peoples
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.,Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Gary R Morrow
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
| | - Sreedhar Katragadda
- Southeast Clinical Oncology Research Consortium, Winston Salem, North Carolina, USA
| | - Jeffrey K Giguere
- NCORP of the Carolinas (Greenville Health System), Greenville, South Carolina, USA
| | - Bilal Naqvi
- Wisconsin NCI Community Oncology Research Program, Marshfield, Wisconsin, USA
| | - Joseph Roscoe
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
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Miceli J, Geller D, Tsung A, Hecht CL, Wang Y, Pathak R, Cheng H, Marsh W, Antoni M, Penedo F, Burke L, Ell K, Shen S, Steel J. Illness perceptions and perceived stress in patients with advanced gastrointestinal cancer. Psychooncology 2019; 28:1513-1519. [PMID: 31090125 PMCID: PMC6610754 DOI: 10.1002/pon.5108] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/29/2019] [Accepted: 05/07/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE According to the Common-Sense Model of Self-Regulation, when faced with a health threat, we make cognitive and emotional assumptions about the illness. The aims of this study were to (a) examine the role of sociodemographic and disease-specific factors on illness perception and perceived stress and (b) test the association between perceived stress and illness perception in participants diagnosed with gastrointestinal cancer. METHODS Participants completed a battery of questionnaires including a Sociodemographic and Disease-Specific Questionnaire, the Illness Perception Questionnaire, Brief Version (Brief-IPQ), and the Perceived Stress Scale (PSS-14). Descriptive statistics, Pearson correlations, analysis of variance (ANOVA), and linear regression were performed to test the hypotheses. RESULTS Of the 627 participants, the mean age was 62 years (SD = 11); the majority were male (63.3%) and Caucasian (90.9%). Younger (F3,625 = 5.80, P < .01) and divorced or never married participants reported higher levels of perceived stress when compared with older and married participants (F4,618 = 3.52, P < .01). Younger participants (18-74 years old) reported more negative illness perceptions than older participants (75 years and older) (F3,511 = 4.08, P < .01). A weak, positive relationship between perceived stress and illness perceptions was observed (r = 0.22, P < .01), and illness perceptions predicted 36.1% of the variance of perceived stress. CONCLUSIONS Our findings suggest that participants who negatively perceived their illness experienced greater levels of perceived stress. Interventions that aim to adjust patients' illness perceptions in order to facilitate a reduction of stress and improvement in quality of life are needed.
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Affiliation(s)
- Jessica Miceli
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - David Geller
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Allan Tsung
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Carol Lynn Hecht
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Yisi Wang
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ritambhara Pathak
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Hannah Cheng
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Wallis Marsh
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Michael Antoni
- Department of Psychology, University of Miami, Miami, FL
| | - Frank Penedo
- Department of Medical Social Sciences, Psychiatry and Behavioral Sciences and Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL
| | - Lora Burke
- School of Nursing, University of Pittsburgh, Pittsburgh, PA
| | - Kathleen Ell
- School of Social Work, University of Southern California, Los Angeles, CA
| | - Shutian Shen
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jennifer Steel
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
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