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Lee HP, Hsu WY, Liu YH, Chang YC, Cheng SM, Chiang HH. Sense of Coherence as a Mediator Between Functional Status and Health-Related Quality of Life in Patients With Heart Failure. J Nurs Res 2024; 32:e311. [PMID: 38190326 DOI: 10.1097/jnr.0000000000000590] [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: 01/10/2024] Open
Abstract
BACKGROUND Poor functional status relating to heart failure (HF) negatively affects health-related quality of life (HRQOL). Patients with HF, especially those with New York Heart Association (NYHA) Class III or IV HF, often exhibit poor HRQOL because of physical limitations and HF-related symptoms. Although sense of coherence (SOC) has been reported to be a determinant of HRQOL, its role as a mediator between functional status and HRQOL remains unclear, and few studies have explored the prevalence of HF in patients in NYHA Classes I and II. PURPOSE This study was designed to investigate SOC as a mediator between different functional status classes and HRQOL in patients with HF. METHODS A cross-sectional study was conducted on patients with HF recruited from a hospital in northern Taiwan from April 2020 to September 2020. The Minnesota Living with Heart Failure Questionnaire and a questionnaire on sociodemographic characteristics; functional classification in terms of NYHA Classes I, II, and III; and SOC were administered. The PROCESS v3.5 (by Andrew F. Hayes) macro was applied to analyze the effects, and Model 4 was used to examine the mediating role of SOC on the relationship between NYHA functional class and HRQOL. RESULTS Of the 295 participants, SOC was found to mediate the effects of functional status on HRQOL more significantly in patients in Class II than those in Class III but not more significantly in patients in Class I than those in Class III. A weaker mediating effect of SOC was noted on the relationship between functional status and HRQOL in patients with HF in NYHA Class II than those in Class III. CONCLUSIONS In patients with HF, poor functional status often reduces HRQOL significantly. SOC mediates the relationship between functional status and HRQOL more significantly in those in NYHA Class II than those in Class III. Nursing staff should work to increase patients' SOC by strengthening their coping capacity and improving their functional status to improve their HRQOL.
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Affiliation(s)
| | | | - Yu-Hsuan Liu
- MSN, RN, Lecture, School of Nursing, Hsin-Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | - Yue-Cune Chang
- PhD, Professor, Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Shu-Meng Cheng
- MD, Professor, Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Hsun Chiang
- PhD, RN, Professor, School of Nursing, National Defense Medical Center, Taipei, Taiwan
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Piegza M, Dębski P, Bujak K, Jaworska I, Gorczyca P, Pudlo R, Żerdziński M, Piegza J. Cognitive functions and sense of coherence in patients with carotid artery stenosis-Preliminary report. Front Psychiatry 2023; 14:1237130. [PMID: 37817831 PMCID: PMC10560880 DOI: 10.3389/fpsyt.2023.1237130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/11/2023] [Indexed: 10/12/2023] Open
Abstract
Background There is scarcely any data in the available literature on the relationship between sense of coherence (SOC) and cognitive functioning, and no information on the relationship between SOC and cognitive parameters in patients with carotid atherosclerosis. Aim The aim of this paper was to determine the relationship of SOC measured prior to carotid artery stenting (CAS) with neurocognitive functioning in patients with carotid atherosclerosis 12 months after CAS. Methods A total of 35 patients with carotid atherosclerosis completed the SOC-29 Orientation to Life Questionnaire (SOC-29) and completed a cognitive test battery twice, i.e., before (baseline-T1) and 12 months after stent implantation (follow-up-T2). Selected cognitive functions such as memory, attention, perception, visuospatial and executive functions and non-verbal fluency were assessed. Results One year after the procedure, patients with a higher SOC and sense of manageability present better performance in visual memory. Higher SOC and sense of meaningfulness are positively related to the speed of understanding the changing rules of card sorting (WCST). Conclusion Higher overall SOC and a component of sense of meaningfulness and manageability may be related to better cognitive functioning 1 year after the procedure.
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Affiliation(s)
- Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Gory, Poland
| | - Paweł Dębski
- Institute of Psychology, Faculty of Social Sciences and Humanities, Humanitas University in Sosnowiec, Sosnowiec, Poland
| | - Kamil Bujak
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Piotr Gorczyca
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Gory, Poland
| | - Robert Pudlo
- Department of Psychoprophylaxis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Gory, Poland
| | - Maciej Żerdziński
- Faculty of Medicine, Academy of Silesia, Katowice, Poland
- Department of Psychiatry, Dr. Krzysztof Czuma’s Psychiatric Center, Katowice, Poland
| | - Jacek Piegza
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
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Ośmiałowska E, Staś J, Chabowski M, Jankowska-Polańska B. Illness Perception and Quality of Life in Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14051214. [PMID: 35267522 PMCID: PMC8909179 DOI: 10.3390/cancers14051214] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary The declining average age of cancer patients may become a serious problem for health care systems and societies in general in the near future. For this reason, there is a need to fully understand the factors determining health-related quality of life in breast cancer patients, beyond clinical characteristics and sociodemographic factors. In our study, we aimed to demonstrate the relationship between illness perception and quality of life in breast cancer patients. The results of our study confirm the beneficial effect of positive illness perception on the intensity of symptoms related to cancer and treatment, as well as functional domains of EORTC QLQ-C30. Abstract Introduction. In 2020, breast cancer was the most frequently diagnosed malignancy worldwide. The QoL level plays a role in assessing the effectiveness of the diagnosis and therapy and is a significant prognostic factor. The subject that is relatively less often addressed in the literature is the impact of psycho-social factors and health-related beliefs on QoL in breast cancer patients. The aim of the study was to assess the association of illness perception, the sense of coherence, and illness acceptance with QoL in breast cancer patients. Methods. The study included 202 women (mean age 53.0 ± 10.3) treated surgically for breast cancer at the Lower Silesian Oncology Centre. The following standardized questionnaires were used: Acceptance of Illness Scale (AIS), Mental Adjustment to Cancer (Mini-MAC), Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BR23), The Multidimensional Essence of Disease and Illness Scale (MEDIS), and Life Orientation Test (LOT-R). Results. There is a statistically significant association between illness acceptance and QoL. There is a statistically significant association between the sense of coherence (life optimism—LOT-R) and QoL among breast cancer patients. There is a statistically significant association between illness perception and QoL. There was a statistically significant correlation between the increasing importance of illness as a dysfunction, decreasing QoL, and increasing intensity of symptoms and complaints. Conclusions. Patients with a high level of illness acceptance, with an optimistic disposition, and with a positive illness perception have better QoL within all the functional domains and experience lower intensity of cancer- and treatment-related symptoms as compared to those with low level of illness acceptance, with moderate optimism or a pessimistic disposition, and with neutral or negative illness perception.
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Affiliation(s)
- Edyta Ośmiałowska
- Division of Anesthesiologic and Surgical Nursing, Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland;
| | - Jakub Staś
- Student Research Group No. 180, Faculty of Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland;
| | - Mariusz Chabowski
- Division of Anesthesiologic and Surgical Nursing, Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland;
- Department of Surgery, 4th Military Teaching Hospital, 5 Weigla Street, 50-981 Wrocław, Poland
- Correspondence: ; Tel.: +48-261-660-247; Fax: +48-261-660-245
| | - Beata Jankowska-Polańska
- Innovation and Research Center, 4th Military Teaching Hospital, 5 Weigla Street, 50-981 Wrocław, Poland;
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Enoksson M, Hultsjö S, Wärdig RE, Strömberg S. Experiences of how brief admission influences daily life functioning among individuals with borderline personality disorder (BPD) and self-harming behaviour. J Clin Nurs 2021; 31:2910-2920. [PMID: 34854159 DOI: 10.1111/jocn.16118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 12/20/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to explore experiences of how brief admission influences daily life functioning among individuals with borderline personality disorder (BPD) and self-harming behaviour. BACKGROUND Brief admission (BA) is a crisis nursing intervention designed to reduce long hospitalisations and the risk of suicide. The intention of the intervention is to develop autonomy and to encourage the patient to take responsibility for and control over their own care and treatment. There are studies in the area that target individuals with psychosis and bipolar disorders, but no previous studies have been found examining how BA impacts upon daily life functioning among people with BPD who self-harm. DESIGN A descriptive qualitative design was chosen. METHODS Data were collected using qualitative individual interviews with 16 patients with BPD and self-harming behaviour who had been assigned to BA. The data were analysed using conventional content analysis. The study was conducted in accordance with COREQ guidelines. RESULTS The results show that BA was perceived as a functioning nursing intervention that promoted self-determination and self-care. This contributed to increased security in daily life. BA made it possible for individuals to maintain everyday routines, employment and relationships more easily. CONCLUSIONS Our findings suggest that BA was experienced to have a positive impact on daily life functioning. RELEVANCE TO CLINICAL PRACTICE Brief admission enabled the balance of power to be shifted from the nurse to the patient, and provides conditions for patients to take responsibility for their mental condition and to become aware of early signs of deterioration, in line with the basic ideas of person-centred care.
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Affiliation(s)
- Maria Enoksson
- Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden
| | - Sally Hultsjö
- Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden.,Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Rikard Erik Wärdig
- Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Sandra Strömberg
- Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden
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Brandão ML, Fritsch TZ, Toebe TRP, Rabin EG. Association between spirituality and quality of life of women with breast cancer undergoing radiotherapy. Rev Esc Enferm USP 2021; 55:e20200476. [PMID: 34464432 DOI: 10.1590/1980-220x-reeusp-2020-0476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/22/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To verify whether there is an association between spirituality/religiosity and quality of life of women with breast cancer undergoing radiotherapy. METHOD Cross-sectional, quantitative study performed between May and July 2019 in an Oncology Hospital of Porto Alegre state, Brazil. A sociodemographic questionnaire and the instruments EORTC-QLQ-C30 and WHOQOL-SRPB were applied. The data were verified through Shapiro-Wilk test, Pearson correlation coefficient, and Spearman. RESULTS The sample comprised 108 women with a mean age of 56, predominantly white, married, and with incomplete primary education. A positive correlation between "Overall quality of life score" with all facets of spirituality, as well as a negative correlation for the symptoms "Fatigue", "Insomnia", and "Diarrhea" with some aspects of spirituality, such as "Faith", were observed. CONCLUSION The statistical significance of the correlation has positively associated spirituality/religiosity and quality of life in women with breast cancer undergoing radiotherapy. Understanding spirituality as a preponderant factor in quality of life contributes to positive nursing care interference, with individualized orientation and care to each woman.
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Affiliation(s)
- Mayara Lindner Brandão
- Universidade Federal de Ciências da Saúde de Porto Alegre, Residência Multiprofissional Integrada em Saúde, Porto Alegre, RS, Brazil
| | - Thais Zilles Fritsch
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Thayla Rafaella Pasa Toebe
- Universidade Federal de Ciências da Saúde de Porto Alegre, Residência Multiprofissional Integrada em Saúde, Porto Alegre, RS, Brazil
| | - Eliane Goldberg Rabin
- Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Enfermagem, Porto Alegre, RS, Brazil
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Sense of coherence as a mediator between perceived stress and depression in newly diagnosed breast cancer patients: a cross-sectional study. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Harry N. Call centre agents’ emotional intelligence as predicators of their exhaustion and professional efficacy: The moderating effect of meaningfulness. SA JOURNAL OF INDUSTRIAL PSYCHOLOGY 2021. [DOI: 10.4102/sajip.v47i0.1819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Zamanian H, Amini-Tehrani M, Mahdavi Adeli A, Daryaafzoon M, Arsalani M, Enzevaei A, Farjami M. Sense of coherence and coping strategies: How they influence quality of life in Iranian women with breast cancer. Nurs Open 2021; 8:1731-1740. [PMID: 33608988 PMCID: PMC8186695 DOI: 10.1002/nop2.814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/26/2020] [Accepted: 01/29/2021] [Indexed: 12/15/2022] Open
Abstract
Aim To investigate the mediation/moderation effect between Coping Behaviors (CBs) and Sense of Coherence (SOC) in the prediction of health‐related quality of life (HRQoL) in breast cancer patients. Design Cross‐sectional. Methods A total of 221 patients were included in this study. The 13‐item Orientation to Life Questionnaire, Brief COPE and Functional Assessment of Cancer Therapy—Breast were investigated. Pearson's correlation coefficient and mediation/moderation analysis were performed. Results Significant correlations were observed for SOC, active coping, acceptance, positive reframing (PR), planning, use of emotional support (UES), use of instrumental support, behaviour disengagement and self‐blame with HRQoL. Except for planning and acceptance, SOC partially mediated the CBs' effect on HRQoL. The UES and PR's effects on HRQoL were significant at lower SOC levels and diminished at higher SOC levels. Conclusion Practitioners can incorporate SOC and adaptive CBs, including PR and UES, into the rehabilitation programmes to improve HRQoL in patients.
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Affiliation(s)
- Hadi Zamanian
- School of Health, Department of Health Promotion and Education, Qom University of Medical Sciences, Qom, Iran
| | - Mohammadali Amini-Tehrani
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.,Health Psychology and Behavior Medicine Research Group, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mona Daryaafzoon
- Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Mahnaz Arsalani
- Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Anahita Enzevaei
- Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Farjami
- Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran
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Mirsoleymani S, Matbouei M, Vasli P, Marzaleh MA, Rohani C. The Role of Family Caregiver's Sense of Coherence and Family Adaptation Determinants in Predicting Distress and Caregiver Burden in Families of Cancer Patients. Indian J Palliat Care 2021; 27:47-53. [PMID: 34035617 PMCID: PMC8121216 DOI: 10.4103/ijpc.ijpc_112_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/14/2020] [Indexed: 11/18/2022] Open
Abstract
Background: Most cancer patients' families suffer from maladaptation which increases family distress and caregiving burden. This study was conducted to explore the relationship between these maladaptation indicators, and the sense of coherence (SOC) of family caregivers alongside other family resilience determines among family caregivers of cancer patients. Methods: A total of 104 family caregivers of cancer patients were included in this cross-sectional study. They answered three questionnaires to assess family resilience factors: Family Inventory of Resources for Management (FIRM), Family Crisis Oriented Personal Evaluation Scales (F-COPES), and SOC scale. In addition, family maladaptation factors were determined by two instruments, including Family Distress Index (FDI) and Caregiver Burden Inventory (CBI). Results: The results of this study showed that the FIRM and the SOC together were responsible for 35% and 43% of the variances in FDI and CBI scores, respectively (P < 0.001). “Reframing”, the subscale of the F-COPES, significantly predicted the variances of FDI (β = −0.26, P = 0.01) and CBI scores (β = −0.21, P = 0.04). Moreover, “Mastery and health”, the subscale of the FIRM, significantly predicted the variances of FDI (β = −0.38, P < 0.01) and CBI scores (β = −0.21, P = 0.02). Conclusions: Family caregiver's SOC alongside other family resilience determinants plays a significant role in alleviating family distress and caregiver burden. It is suggested that palliative care providers consider family caregivers' SOC in developing a psychological intervention plan to improve family resilience in families of cancer patients.
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Affiliation(s)
- Seyedreza Mirsoleymani
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Mahsa Matbouei
- Department of Community Health Nursing, Shahid Beheshti University of Medical Sciences, School of Nursing and Midwifery, Tehran, Iran.,Department of Student Research Committee, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Tehran, Iran
| | - Parvaneh Vasli
- Department of Community Health Nursing, Shahid Beheshti University of Medical Sciences, School of Nursing and Midwifery, Tehran, Iran
| | - Milad Ahmadi Marzaleh
- Research Center for Health Management of Mass Gathering, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran.,Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran.,Student Research Committee, Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.,Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Fars, Iran
| | - Camelia Rohani
- Department of Community Health Nursing, Shahid Beheshti University of Medical Sciences, School of Nursing and Midwifery, Tehran, Iran.,Ersta Sköndal Bräcke University College, Campus Ersta, Stockholm, Sweden
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Räsänen P, Muotka J, Lappalainen R. Examining mediators of change in wellbeing, stress, and depression in a blended, Internet-based, ACT intervention for university students. Internet Interv 2020; 22:100343. [PMID: 32995301 PMCID: PMC7508697 DOI: 10.1016/j.invent.2020.100343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/15/2020] [Accepted: 08/07/2020] [Indexed: 11/30/2022] Open
Abstract
A coach-guided Acceptance and Commitment Therapy (ACT) intervention that uses a blended approach of two face-to-face and five online sessions (iACT; N = 33) has been found to be more effective than a waiting-list control condition (WLC; N = 35) at enhancing the wellbeing of university students while also reducing stress and depression. The present study explored possible mediators of change that may account for the outcomes of the study. Mediation analyses revealed that changes in the non-reactivity subscale of mindfulness mediated changes in wellbeing, depression, and stress in the iACT group. In addition, changes in the sense of coherence subscale of meaningfulness mediated changes in all outcomes. Psychological flexibility and cognitive defusion did not mediate changes in outcomes. The results suggest that the use of practices focusing on non-reactivity, meaning the ability to allow thoughts and feelings to come and go without getting carried away by them, is especially important for enhancing the wellbeing of university students. A focus on enhancing meaningfulness also plays a significant role in reducing psychological distress. These findings provide a first step toward understanding the potential mechanisms of change taking place in brief, Internet-supported, blended ACT programs.
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Affiliation(s)
| | - Joona Muotka
- Department of Psychology, University of Jyväskylä, Finland
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Hiensch AE, Bolam KA, Mijwel S, May AM, Wengström Y. Sense of coherence and its relationship to participation, cancer-related fatigue, symptom burden, and quality of life in women with breast cancer participating in the OptiTrain exercise trial. Support Care Cancer 2020; 28:5371-5379. [PMID: 32140973 PMCID: PMC7546973 DOI: 10.1007/s00520-020-05378-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/24/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE This study examined the Sense of Coherence (SOC) of patients participating in the randomized controlled 'Optimal Training for Women with Breast Cancer' (OptiTrain) study and assessed how patient characteristics were associated with SOC. Secondary aims were to assess the association between SOC and patients' participation in this study and to determine whether SOC moderates the effect of the 16-week exercise intervention on fatigue, quality of life (QoL), and symptom burden in women with breast cancer undergoing chemotherapy. METHODS Modified Poisson regression analyses were conducted to determine the relative risk of weak-normal SOC versus strong SOC in terms of exercise session attendance, study and intervention dropout, and long absence rates. Analyses of covariance were performed to assess whether SOC moderated the effect of the exercise intervention (pinteraction ≤ 0.10). RESULTS Two hundred and forty women with early breast cancer (mean age 53 ± 10) participated in the OptiTrain study. Women with strong SOC reported less fatigue, lower symptom burden, and higher QoL. Women with weak-normal SOC were significantly more likely to drop out from the OptiTrain study and tended to have slightly poorer exercise session attendance. Women with breast cancer and weaker SOC benefitted as much from the exercise intervention, in terms of fatigue and QoL, as those with stronger SOC (pinteraction > 0.10). CONCLUSIONS Strong SOC appears to be associated with a more positive subjective state of health. Women with weak-normal SOC may need additional support to encourage participation and adherence in exercise trials. Assessing SOC may assist clinicians to identify and provide extra support for participants with weak SOC, who may be less inclined to participate in exercise programs.
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Affiliation(s)
- Anouk E Hiensch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Kate A Bolam
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sara Mijwel
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
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Lashani F, Rohani C, Estebsari F, Nasiri M. Exploring the relationship between sexual function, sense of coherence, and well-being in a sample of Iranian breast cancer survivors. Support Care Cancer 2020; 29:3191-3199. [PMID: 33090269 DOI: 10.1007/s00520-020-05831-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/13/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE This study was aimed at exploring the type and role of relationships between sexual function, sense of coherence (SOC), and well-being in a sample of Iranian breast cancer survivors. METHODS In this cross-sectional study with correlational design, data were collected from 181 survivors by consecutive sampling. They answered demographic and clinical information sheet, the SOC scale, the Female Sexual Function Index (FSFI), and the Health Index (HI). The data were analyzed using SPSS version 20. RESULTS The mean age of survivors was 47.04 ± 9.05 years. Most survivors were menopausal (51.9%) and underwent mastectomy (69.1%), and 12 months or more had passed since their treatment ended (71.2%). Sexual function was positively correlated with the level of SOC (r = 0.20) and the HI (r = 0.33). Also, there was a positive correlation between the level of SOC and the HI (r = 0.51). The results of logistic regression analyses showed the protective role of the SOC (OR: 0.95; 95% CI: 0.92-0.97) and the HI (OR: 0.87; 95% CI: 0.79-0.96) for women's sexual function. According to these results, the mediating role of the SOC was assessed between the variables of the HI and the FSFI. The SOC revealed a complete mediating effect in this relationship. CONCLUSIONS The mediator role of the SOC between survivors' well-being and their sexual function helps nurses and clinicians to understand how the SOC can be used as a screening test to detect survivors who are at risk of sexual problems and to plan for salutogenic interventions.
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Affiliation(s)
- Fatemeh Lashani
- Community Health Nursing, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Community Health Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr and Neiaiesh Highway, Opposite to Rajaee Heart Hospital, Tehran, 1996835119, Iran. .,Department of Health Care Sciences, Palliative Research Center, Ersta Sköndal Bräcke University College, Box 11189, Campus Ersta, Stigbergsgatan 30, SE-100 61, Stockholm, Sweden.
| | - Fatemeh Estebsari
- Community Health Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr and Neiaiesh Highway, Opposite to Rajaee Heart Hospital, Tehran, 1996835119, Iran
| | - Malihe Nasiri
- Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Cecon N, Pfaff H, Lee S, Dresen A. A salutogenic model predicting the need for psycho-oncological care and its utilisation-The role of generalised resistance resources and sense of coherence. Eur J Cancer Care (Engl) 2020; 30:e13335. [PMID: 33015897 DOI: 10.1111/ecc.13335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/13/2020] [Accepted: 08/07/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although many cancer patients experience psychological distress, not all affected patients utilise psycho-oncological care. We aim to examine the role of generalised resistance resources (GRRs) and sense of coherence (SOC) in predicting cancer patient needs for psycho-oncological care and its utilisation. A salutogenic prediction model was conceptualised and statistically tested. METHODS Survey data (response rate 88.94%) from 2270 breast cancer patients one year after treatment in one of 88 certified hospitals in North Rhine-Westphalia, Germany, were analysed. Structural Equation Modelling analysis was performed. RESULTS 21.6% of patients (n = 485; N = 2249) felt they currently needed psycho-oncological care, of which 61.6% currently utilised it (n = 299, N = 485). 42.2% (n = 953, N = 2259) had the need for psycho-oncological care in the previous 12 months, of which 58.0% (n = 553, N = 953) utilised it. Several GRRs directly predict the need for psycho-oncological care and SOC, as well as indirectly predict the utilisation of psycho-oncological care. Past utilisation significantly affects current need and utilisation. The model shows good model fit. CONCLUSIONS Generalised resistance resources and SOC affect the utilisation of psycho-oncological care. Therefore, measuring key GRRs and SOC during cancer treatment should be integrated into patient care as a salutogenic approach, to identify resources and vulnerabilities on an individual level.
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Affiliation(s)
- Natalia Cecon
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Susan Lee
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Antje Dresen
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany
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Márquez-Palacios JH, Yanez-Peñúñuri LY, Salazar-Estrada JG. Relación entre sentido de coherencia y diabetes mellitus: una revisión sistemática. CIENCIA & SAUDE COLETIVA 2020; 25:3955-3967. [DOI: 10.1590/1413-812320202510.34312018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 01/08/2019] [Indexed: 11/22/2022] Open
Abstract
Resumen El objetivo fue sintetizar las mejores evidencias científicas sobre el efecto del sentido de coherencia en el desarrollo de la enfermedad, tratamiento e indicadores biomédicos de control metabólico y desarrollo de complicaciones de personas en riesgo de desarrollar diabetes y en diabéticos. El método utilizado fue la revisión sistemática. Búsqueda y selección por dos revisores independientes en las bases de datos Scopus, Web of Science, PubMed, Ebsco, Science Direct y manuales, disponibles hasta 2017, en español e inglés, en población con edad superior a 18 años. De un total de 154 estudios, 20 artículos fueron incluidos en la revisión sistemática. Más de la mitad de los estudios utilizaron la versión SOC-13 para la verificación del sentido de coherencia y el indicador de control metabólico más frecuente fue la hemoglobina glucosilada. Además, 14, de los 20 estudios, encontraron una relación estadísticamente significativa entre el sentido de coherencia y la diabetes. Se concluye que el sentido de coherencia tiene una fuerte correlación con la diabetes en las diferentes fases de la enfermedad y está relacionado con la reducción del riesgo para el desarrollo de la enfermedad, la reducción de los valores de hemoglobina glucosilada y la aparición de complicaciones de la diabetes mellitus.
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16
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Sharma A, Chhabra KG, Agarwal S, Bhansali S, Singh P, Nagrale RG. Association between health-related quality of life and sense of coherence among health professionals working in primary health centers consuming tobacco in Jaipur, India. J Family Med Prim Care 2020; 9:2963-2968. [PMID: 32984156 PMCID: PMC7491764 DOI: 10.4103/jfmpc.jfmpc_155_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/13/2020] [Accepted: 03/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Health-related quality of life (HRQOL) and senses of coherence (SoC) can be affected by the use of tobacco. Hence, the aim of the present study was to explore the association between HRQOL and SoC among health professionals working in primary health centers (PHCs) consuming Tobacco. Materials and Methods: It was a cross-sectional descriptive study where sampling technique used was systematic stratified random sampling. Jaipur District has 37 PHCs retrieved from site of NRHM Rajasthan. A close-ended questionnaire was prepared to conduct the interview. Results: Majority of study participants (57; 37.01%) were of 36–40 years of age. Males respondents (86; 55.85%) consuming tobacco were more in number than female respondents. Majority of study subjects (91; 59.09%) consumed smoked kind of tobacco, in which most contributed were nurses (49; 62.82%). On applying a linear regression model, it was determined that all subscale of SF-36 was significantly (P ≤ 0.000) associated with SoC. Conclusion: From above, it was concluded that there was a strong association between HRQOL and SoC among health professionals working in primary health centers consuming tobacco.
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Affiliation(s)
- Ashish Sharma
- Department of Home Science, University of Rajasthan, Jaipur, Rajasthan, India
| | - Kumar Gaurav Chhabra
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, DMIMS (Deemed to be University), Sawangi, (Meghe) Wardha, Maharashtra, India
| | - Sunita Agarwal
- Department of Home Science, University of Rajasthan, Jaipur, Rajasthan, India
| | - Suman Bhansali
- Department of Preventive and Social Medicine, S.N Medical College, Jodhpur, Rajasthan, India
| | - Pooja Singh
- Department of Pedodontics and Preventive Dentistry, K.S.D Jain Dental College and Hospital, Kolkata, West Bengal, India
| | - Renuka G Nagrale
- Department of Public Health Dentistry, M A Rangoonwala College of Dental Sciences and Research Centre, Azam Campus 2390-B, K.B, Hidayatulla Rd, Camp, Pune, Maharashtra, India
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17
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Bickel KE, Levy C, MacPhee ER, Brenner K, Temel JS, Arch JJ, Greer JA. An Integrative Framework of Appraisal and Adaptation in Serious Medical Illness. J Pain Symptom Manage 2020; 60:657-677.e6. [PMID: 32446974 PMCID: PMC7483912 DOI: 10.1016/j.jpainsymman.2020.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
Multiple randomized clinical trials have demonstrated that palliative care improves the quality of life of individuals with serious medical illness. Research also suggests that in patients with advanced cancer, palliative care's focus on symptom management, coping with illness, goals of care, and treatment decisions may be associated with improved patient quality of life in part by increasing patients' use of active (vs. passive) and approach-oriented (vs. avoidant) coping strategies. However, without a framework outlining the process that individuals with serious medical illness and their loved ones undergo, it is challenging to discern exactly where, how, and why palliative care may affect the serious medical illness experience. To address this gap, we propose a clinically applicable framework, derived from existing theory and research in the social and behavioral sciences. This framework, called the Integrative Framework of Appraisal and Adaptation in Serious Medical Illness, describes how patients and their loved ones cognitively and emotionally process the various events that may occur as they navigate serious medical illness and the end of life. The framework also describes how individuals and their loved ones use that event processing to determine next steps, while considering the impact of their surrounding external environment, their individual social roles, and their connections on this decision making. The framework presented in this article is intended to improve our ability to understand and care for individuals with serious medical illness and their loved ones, while stimulating further discussion and research to test and refine these ideas.
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Affiliation(s)
- Kathleen E Bickel
- VA Eastern Colorado Healthcare System, University of Colorado School of Medicine, Aurora, Colorado, USA.
| | - Cari Levy
- Palliative Medicine Section Chief, VA Eastern Colorado Healthcare System, Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Research, Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Edward R MacPhee
- Psychiatry Section Chief, VA Eastern Colorado Healthcare System, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Keri Brenner
- Medicine-Section of Palliative Care, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Jennifer S Temel
- Medicine, Harvard Medical School, Cancer Outcomes Research & Education Program, Massachusetts General Hospital Cancer Center, Thoracic Oncology, Boston, Massachusetts, USA
| | - Joanna J Arch
- Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Joseph A Greer
- Psychology, Harvard Medical School, Center for Psychiatric Oncology & Behavioral Science, Cancer Outcomes Research & Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
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Tsiligianni I, Sifaki-Pistolla D, Gergianaki I, Kampouraki M, Papadokostakis P, Poulonirakis I, Gialamas I, Bempi V, Ierodiakonou D. Associations of sense of coherence and self-efficacy with health status and disease severity in COPD. NPJ Prim Care Respir Med 2020; 30:27. [PMID: 32555199 PMCID: PMC7303183 DOI: 10.1038/s41533-020-0183-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/04/2020] [Indexed: 11/18/2022] Open
Abstract
Sense of coherence and self-efficacy has been found to affect health-related quality of life in chronic diseases. However, research on respiratory diseases is limited. Here we report findings on quality of life (QoL) of COPD patients and the associations with coherence and self-efficacy. This study consists of the Greek national branch of the UNLOCK study, with a sample of 257 COPD patients. Coherence and self-efficacy are positively inter-correlated (Pearson rho = 0.590, p < 0.001). They are negatively correlated with the quality of life (CAT) [Pearson rho: coherence = −0.29, p < 0.001; self-efficacy = −0.29, p < 0.001) and mMRC (coherence = −0.37, p < 0.001; self-efficacy rho = −0.32, p < 0.001)]. Coherence is inversely associated with (Global Initiative for Chronic Obstructive Lung Disease) GOLD 2018—CAT and GOLD 2018—mMRC classification and “having at least one exacerbation in the past year”. Findings are stressing the need for their incorporation in primary health care and COPD guidance as it maybe that enhancing coherence and self-efficacy will improve QoL.
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Affiliation(s)
- Ioanna Tsiligianni
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Herkalion, Crete, Greece.
| | - Dimitra Sifaki-Pistolla
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Herkalion, Crete, Greece.,Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Irini Gergianaki
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Herkalion, Crete, Greece
| | | | | | | | - Ioannis Gialamas
- Primary Care Practice, Health Center of Sitia, Sitia General Hospital, Lasithi, Crete, Greece
| | | | - Despo Ierodiakonou
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Herkalion, Crete, Greece.,Heraklion University Hospital, Heraklion, Crete, Greece
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A Pilot Randomized Trial Assessing the Effect of a Psychoeducational Intervention on Psychoneuroimmunological Parameters Among Patients With Nonmetastatic Breast Cancer. Psychosom Med 2020; 81:165-175. [PMID: 30489436 DOI: 10.1097/psy.0000000000000656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of this study was to determine a potential benefit of the specific psychoeducational intervention "Learning to Live with Cancer" (LTLWC) for patients with operated nonmetastatic breast cancer, with respect to psychological variables and endocrine and immune parameters. METHODS Fifty-two postmenopausal women with operated stage I to III breast cancer were randomized to either a breast cancer intervention group (BCIG, n = 30) who immediately began participating in the LTLWC intervention program or to a breast cancer control group (BCCG, n = 22). Matched healthy women were asked to participate as a noncancer comparison group (n = 26). All participants were evaluated at three different time points (t1-t3) using a set of standardized questionnaires and blood samples were taken to analyze immune cell subsets and stress hormone levels. RESULTS A significant reduction in trait anxiety/State Trait Anxiety Inventory score was observed in the BCIG (t1: median = 35.0 [interquartile range = 28.0-38.0] versus t3: median = 26.0 [interquartile range = 18.5-37.0], p = .0001) compared with the BCCG (t1: median = 41.0 [interquartile range =32.75-49.0]; t3: median = 38.5 [interquartile range = 30.75-46.5], p = .01524; p interaction = .001). In parallel, a significant rise of serotonin levels (t1: median = 66.5 ng/ml [interquartile range = 11.50-106.00] versus t3: median = 80.5 ng/ml [interquartile range =59.00-118.00], p = .00008) as well as a significant reduction of the elevated number of Treg cells at baseline (t1: median = 4.45% [interquartile range = 4.00-5.33] versus t3: median = 2.80% [interquartile range = 2.68-3.13], p < .00001) were observed in the BCIG versus no change in the BCCG. A significant statistical association between reduced trait anxiety and decreased Treg cell number could be demonstrated in the BCIG (r = .62, p < .01). CONCLUSIONS The observed results of this study provide preliminary support for the efficacy of the LTLWC program in significantly improving psychoneuroimmunological parameters in patients with nonmetastatic breast cancer.
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20
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Prieto-Callejero B, Rivera F, Andrés-Villas M, Gómez-Salgado J. Influence of the Sense of Coherence, the Doctor-Patient Relationship, Optimism and Non-Haematological Adverse Reactions on Health-Related Quality of Life in Patients with Breast Cancer. J Clin Med 2019; 8:E2043. [PMID: 31766496 PMCID: PMC6947165 DOI: 10.3390/jcm8122043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/27/2019] [Accepted: 11/18/2019] [Indexed: 11/28/2022] Open
Abstract
Breast cancer is the most common malignant tumour in women around the world. The objective of this study was to quantify the number of non-haematological adverse reactions associated with chemotherapy, as well as to assess the effect of the sense of coherence, optimism-pessimism and the quality of the doctor-patient relationship on the quality of life of breast cancer patients. To this end, a cross-sectional descriptive study was conducted involving 110 breast cancer patients who were treated with docetaxel, epirubicin, and cyclophosphamide during the period 2012-2014. The difference in the quality of life in patients who have five or fewer toxicities compared to those with more than six is highlighted. This difference is not as important when comparing patients with 6 to 10 toxicities and those with more than 10. The multivariate model used in this study corroborates the direct implication of the sense of coherence on the quality of life and adds the number of adverse reactions as a new construct. This has virtually the same impact on the quality of life of these patients, but in reverse. In conclusion, to improve the quality of life of breast cancer patients it would be necessary to have an impact on the number of adverse reactions involved in chemotherapeutic treatment, as well as on psychological interventions, with the sense of coherence as a possible starting point.
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Affiliation(s)
| | - Francisco Rivera
- Department of Experimental Psychology, Faculty of Psychology, University of Seville, 41018 Seville, Spain
| | - Montserrat Andrés-Villas
- Department of Social, Developmental and Educational Psychology, Faculty of Education Sciences, University of Huelva, 21071 Huelva, Spain;
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, University School of Social Work, University of Huelva, 21071 Huelva, Spain;
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 091650, Ecuador
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Jabłoński MJ, Mirucka B, Streb J, Słowik AJ, Jach R. Exploring the relationship between the body self and the sense of coherence in women after surgical treatment for breast cancer. Psychooncology 2018; 28:54-60. [PMID: 30286514 DOI: 10.1002/pon.4909] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/14/2018] [Accepted: 10/01/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Analysis of the relationship between the body self (BS) and the sense of coherence (SOC) in women after breast surgery due to cancer in comparison with a control group. METHODS A cross-sectional study in a group of 78 women using the body-self questionnaire (BS-Q), and the life orientation questionnaire (SOC-29). Statistics based on the IBM SPSS v.25. RESULTS Multivariate analysis of variance (MANOVA) has shown significant differences based on groups in experiencing intimacy, manifesting femininity, body acceptance, and manageability. In particular, manifesting femininity and body acceptance showed a big effect size (0.30 < partial ɳ2 < 0.32). Correlation analysis between the BS-Q and SOC-29 subscales and Fisher's r to z transformation determines that the differences between groups were significant in favour of healthy women in two sets of variables: experiencing intimacy/meaningfulness and attitude to food and weight/manageability. CONCLUSIONS Breast cancer survivors are at greater risk of developing decreased body acceptance and problems in intimacy, and have less correlation than the healthy control group between manageability and meaningfulness with an appropriate attitude to food and intimate relationship with their partner, respectively. A higher manifestation of femininity in the treated group can be considered a positive but socioculturally conditioned coping strategy.
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Affiliation(s)
- Marcin J Jabłoński
- Institute of Psychology, Faculty of Philosophy, The Jesuit University Ignatianum, Cracow, Poland
| | - Beata Mirucka
- Department of General and Clinical Psychology, Faculty of Pedagogy and Psychology, The University of Bialystok, Bialystok, Poland
| | - Joanna Streb
- Department of Oncology, Jagiellonian University Medical College, Cracow, Poland
| | - Agnieszka J Słowik
- Department of Oncology, Jagiellonian University Medical College, Cracow, Poland
| | - Robert Jach
- Department of Gynaecology and Oncology, Jagiellonian University Medical College, Cracow, Poland
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Mc Gee SL, Höltge J, Maercker A, Thoma MV. Sense of Coherence and Stress-Related Resilience: Investigating the Mediating and Moderating Mechanisms in the Development of Resilience Following Stress or Adversity. Front Psychiatry 2018; 9:378. [PMID: 30186189 PMCID: PMC6110848 DOI: 10.3389/fpsyt.2018.00378] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 07/30/2018] [Indexed: 01/26/2023] Open
Abstract
Background: Trauma, stress, and adversity are well-known for having lasting negative effects on health. Yet, not all individuals go on to develop psychopathology or impaired health. However, little is known about the underlying mechanisms which influence the development of stress-related resilience. Sense of coherence-revised (SOC-R) may play a role in this process, as it is formed through overcoming stress or adversity. It may also influence the steeling effect, which suggests that previous exposure to moderate adversity increases resilience to later adversities. Objectives: This study aimed to examine the mediating and moderating roles of SOC-R in the relationship between stress or adversity, and psychological health and well-being. It further aimed to investigate the role of SOC-R in steeling processes. Methods: The study used a longitudinal design, with data collection at baseline and one-year follow-up. Participants included (N = 238) Swiss older adults (Mage = 68.3 years). Standardized questionnaires assessed early-life adversity, recent chronic stress, SOC-R, and current health and well-being. Mediation and moderation analyses examined the mechanisms underpinning stress-related resilience and curvilinear associations assessed steeling. Results: Results showed that the Manageability subscale of SOC-R significantly moderated the relationship between chronic stress and general mental health (b = 0.04, 95% CI [0.007, 0.082], t = 2.32, p < 0.05). Furthermore, SOC-R significantly mediated the relationship for general mental health (GMH) and satisfaction with life (SWL) with childhood emotional neglect (GMH: b = -0.056, 95% BCa CI [-0.126, -0.002]; SWL: b = -0.043, 95% BCa CI [-0.088, -0.004]), childhood physical neglect (GMH: b = -0.100, 95% BCa CI [-0.232, -0.002]; SWL: b = -0.081, 95% BCa CI [-0.181, -0.002]), and chronic stress (GMH: b = -0.052, 95% BCa CI [-0.100, -0.001]; SWL: b = -0.055, 95% BCa CI [-0.097, -0.020]). No curvilinear associations were observed between stress or adversity and SOC-R. Conclusions: This study expands on the limited research on stress-related resilience by examining the role of SOC-R in the interactions between adversity, stress, and health. Future research should examine SOC-R in samples with a greater range and different types of adversity. Overall, findings suggest that SOC-R is an important mechanism underpinning the development of stress-related resilience.
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Affiliation(s)
- Shauna L. Mc Gee
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging', University of Zürich, Zurich, Switzerland
| | - Jan Höltge
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging', University of Zürich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging', University of Zürich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging', University of Zürich, Zurich, Switzerland
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Lindblad C, Langius-Eklöf A, Petersson LM, Sackey H, Bottai M, Sandelin K. Sense of coherence is a predictor of survival: A prospective study in women treated for breast cancer. Psychooncology 2018. [PMID: 29528529 DOI: 10.1002/pon.4702] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Sense of coherence (SOC) reflects a person's overall orientation to life. Sense of coherence guides the person in finding and utilizing resources to maintain health and manage stress. Previously, we demonstrated SOC's stability over time among breast cancer (BC) patients, and in the present article, SOC's predictive value for survival is tested. METHODS A cohort of 487 women underwent surgery for invasive BC and completed preoperatively the SOC-13 within a multicenter trial. Hazard ratios (HRs) were performed to identify significant independent predictors and their association with increase in SOC. RESULTS Over a median follow-up time of 10 years, patients with a higher SOC had 63% lower risk of BC progression (HR 0.63; 95% CI, 0.11 to 0.85, P .03), 80% lower risk of BC mortality (HR 0.80; 95% CI, 0.38 to 0.96, P .00), and 80% lower risk of all-cause mortality (HR 0.80; 95% CI, 0.47 to 0.93, P .00) than patients with a lower SOC. The mortality risk declined by 2.3% for every 1-unit increase in SOC, both for BC mortality (HR 0.98; 95% CI, 0.96 to 0.99, P .01) and for all-cause mortality (HR 0.98; 95% CI, 0.96 to 0.99, P .00). The risk of progression declined by 1.4% for every 1-unit increase in SOC (HR 0.99; 95% CI, 0.97 to 1.00, P .03). CONCLUSIONS This study provides evidence of SOC's predictive value for disease progression and BC-caused and all-cause mortality. Sense of coherence provides a complement when designing individual plans that aims to support patients during their treatment.
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Affiliation(s)
- Carina Lindblad
- Department of Physiology and Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lena-Marie Petersson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Helena Sackey
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Sandelin
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Postolică R, Enea V, Dafinoiu I, Petrov I, Azoicăi D. Association of sense of coherence and supernatural beliefs with death anxiety and death depression among Romanian cancer patients. DEATH STUDIES 2018; 43:9-19. [PMID: 29393825 DOI: 10.1080/07481187.2018.1430083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of this cross-sectional study was to examine the association of supernatural beliefs and sense of coherence with death anxiety and death depression in a Romanian sample of cancer patients. We found support for the terror management theory worldview defence hypothesis postulating the presence of a curvilinear relation between death anxiety and supernatural beliefs among cancer patients. Results conformed to an inverted U-shape quadratic regression, indicating that cancer patients who scored moderately on supernatural beliefs were afraid of death the most, while death anxiety was lowest for the extreme atheists and extreme believers in supernatural entities.
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Affiliation(s)
- Roxana Postolică
- a Regional Institute of Oncology , Iasi , Romania
- b Faculty of Medicine, Department of Oncogenetics , "Grigore T. Popa" University of Medicine and Pharmacy of Iasi , Iasi , Romania
| | - Violeta Enea
- c Faculty of Psychology and Education Sciences, Department of Psychology , "Alexandru Ioan Cuza" University of Iasi , Iasi , Romania
| | - Ion Dafinoiu
- c Faculty of Psychology and Education Sciences, Department of Psychology , "Alexandru Ioan Cuza" University of Iasi , Iasi , Romania
| | - Iuliana Petrov
- c Faculty of Psychology and Education Sciences, Department of Psychology , "Alexandru Ioan Cuza" University of Iasi , Iasi , Romania
| | - Doina Azoicăi
- b Faculty of Medicine, Department of Oncogenetics , "Grigore T. Popa" University of Medicine and Pharmacy of Iasi , Iasi , Romania
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Malm D, Fridlund B, Ekblad H, Karlström P, Hag E, Pakpour AH. Effects of brief mindfulness-based cognitive behavioural therapy on health-related quality of life and sense of coherence in atrial fibrillation patients. Eur J Cardiovasc Nurs 2018; 17:589-597. [PMID: 29493266 DOI: 10.1177/1474515118762796] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effects of a brief dyadic cognitive behavioural therapy (CBT) programme on the health-related quality of life (HRQoL), as well as the sense of coherence in atrial fibrillation patients, up to 12 months post atrial fibrillation. METHODS A longitudinal randomised controlled trial with a pre and 12-month post-test recruitment of 163 persons and their spouses, at a county hospital in southern Sweden. In all, 111 persons were randomly assigned to either a CBT ( n=56) or a treatment as usual (TAU) group ( n=55). The primary outcome was changes in the HRQoL (Euroqol questionnaire; EQ-5D), and the secondary outcomes were changes in psychological distress (hospital anxiety and depression scale; HADS) and sense of coherence (sense of coherence scale; SOC-13). RESULTS At the 12-month follow-up, the CBT group experienced a higher HRQoL than the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group -0.015; P=0.02). The sense of coherence improved in the CBT group after the 12-month follow-up, compared to the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group -0.16; P=0.04). The association between the intervention effect and the HRQoL was totally mediated by the sense of coherence ( z=2.07, P=0.04). CONCLUSIONS A dyadic mindfulness-based CBT programme improved HRQoL and reduced psychological distress up to 12 months post atrial fibrillation. The sense of coherence strongly mediated the HRQoL; consequently, the sense of coherence is an important determinant to consider when designing programmes for atrial fibrillation patients.
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Affiliation(s)
- Dan Malm
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.,2 Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Bengt Fridlund
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Helena Ekblad
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Patric Karlström
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.,2 Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Emma Hag
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.,2 Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Amir H Pakpour
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.,3 Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Finck C, Barradas S, Zenger M, Hinz A. Quality of life in breast cancer patients: Associations with optimism and social support. Int J Clin Health Psychol 2017; 18:27-34. [PMID: 30487907 PMCID: PMC6220926 DOI: 10.1016/j.ijchp.2017.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/17/2017] [Indexed: 02/08/2023] Open
Abstract
Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms.
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Affiliation(s)
- Carolyn Finck
- Departamento de Psicología, Universidad de los Andes, Bogotá, Colombia
| | - Susana Barradas
- Programa de Psicología, Facultad de Ciencias Sociales y Humanas, Universidad Externado de Colombia, Bogotá, Colombia
| | - Markus Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Germany.,Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
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27
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Pasek M, Dębska G, Wojtyna E. Perceived social support and the sense of coherence in patient-caregiver dyad versus acceptance of illness in cancer patients. J Clin Nurs 2017; 26:4985-4993. [PMID: 28793381 DOI: 10.1111/jocn.13997] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acceptance of illness is a significant determinant of further coping with a disease. Development of illness acceptance may be associated with the sense of coherence and perception of social support. Cancer is an example of a crisis situation, which affects both the patient and his/her close relatives. Consequently, acceptance of illness may be influenced by factors originating from both sides of caregiver-patient dyad. The aim of this study was to analyse direct and indirect interrelationships between perceived support and the sense of coherence in patient-caregiver dyad, and acceptance of illness in cancer patients. DESIGN Cross-sectional study. METHODS The study included 80 dyads composed of cancer patients and their caregivers. Only cancer patients undergoing oncological treatment at the time of the study, for at least 3 months but no longer than 12 months, were enrolled. All subjects completed perceived support subscale included in the Berlin Social Support Scales, sense of coherence-29 questionnaire to determine the sense of coherence and Acceptance of Illness Scale. RESULTS Compared to cancer patients, their caregivers presented with significantly lower levels of perceived social support and weaker sense of coherence. The sense of coherence in caregivers and patients was determined by their perceived support levels. The sense of coherence in caregivers turned out to be a key resource influencing acceptance of illness in cancer patients, both directly and indirectly, via their perceived social support and their sense of coherence. CONCLUSIONS The sense of coherence, an intrinsic psychological factor determined by social support, is an important determinant of illness acceptance. Functioning of cancer patients is also modulated by psychosocial characteristics of their caregivers. RELEVANCE TO CLINICAL PRACTICE Greater support offered to caregivers may substantially strengthen the sense of coherence in caregivers and cancer patients and, therefore, may improve the functioning of patient-caregiver dyad in a situation of neoplastic disease.
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Affiliation(s)
- Małgorzata Pasek
- Maria Sklodowska-Curie Memorial Institute of Oncology, Kraków, Poland
| | - Grażyna Dębska
- Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
| | - Ewa Wojtyna
- University of Silesia in Katowice, Katowice, Poland
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Corbett T, Groarke A, Walsh JC, McGuire BE. Cancer-related fatigue in post-treatment cancer survivors: application of the common sense model of illness representations. BMC Cancer 2016; 16:919. [PMID: 27884127 PMCID: PMC5123423 DOI: 10.1186/s12885-016-2907-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 10/28/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cancer-related fatigue (CrF) is a common and disruptive symptom that may be experienced during and after cancer. Research into the subjective experience of fatigue in this group is required. The common sense model of self-regulation of health and illness (SRM) addresses personal beliefs or mental representations-whether medically sound or unsubstantiated- that a person holds about a health issue. The current study assesses if the SRM could be used as a theoretical framework for organizing the experiences of people with CrF, with a view to identifying methods to address fatigue in cancer survivors. METHOD Four focus groups were held with a total of 18 cancer survivors who reported they experienced 'significant fatigue or reduced energy.' A thematic analysis was conducted within the framework of the SRM. RESULTS Findings were aligned with the SRM, with participants discussing fatigue with reference to representation, coping, and appraisal of symptoms. In particular, the wider social context of CrF was frequently addressed. Perceived inadequacies in support available to those with lingering fatigue after the completion of cancer treatment were highlighted by the participants. CONCLUSION This study explored the subjective experience of fatigue after cancer using the SRM. CrF should be approached as a complex psychosocial issue and considered from the patient perspective to facilitate better understanding and management of symptoms. The SRM is an applicable framework for identifying modifiable factors that could lead to improved coping with CrF in post-treatment cancer survivors.
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Affiliation(s)
- Teresa Corbett
- School of Psychology, National University of Ireland Galway, Galway, Ireland.
| | - AnnMarie Groarke
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jane C Walsh
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Brian E McGuire
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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Brandão T, Schulz MS, Matos PM. Psychological adjustment after breast cancer: a systematic review of longitudinal studies. Psychooncology 2016; 26:917-926. [PMID: 27440317 DOI: 10.1002/pon.4230] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/24/2016] [Accepted: 07/18/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Breast cancer (BC) can be a traumatic and stressful experience for women, but there are wide-ranging differences in the ways in which women respond and adapt to BC. This systematic review examines which sociodemographic, disease-related, and psychosocial factors near diagnosis predict later psychological adjustment to BC. METHODS Database searches were conducted in 9 different health-related databases from 2000 to December 2015 using relevant search terms. Full-text, peer-reviewed articles in English that analyzed potential predictors of psychological adjustment in longitudinal studies were considered for inclusion. RESULTS Of 1780 abstracts, 41 studies fulfilled inclusion criteria. Consistent sociodemographic and disease-related variable predictors of adjustment were income, fatigue, cancer stage, and physical functioning. Psychosocial factors, particularly optimism and trait anxiety, as well as perceived social support, coping strategies, and initial levels of psychological functioning, were found to be predictive of later depressive and anxiety symptoms, psychological distress, and quality of life for women with BC, in predictable ways. Other psychosocial variables, such as cognitive and body image factors, predicted psychological adjustment but were explored only by a few studies. CONCLUSIONS The majority of studies showed a significant relationship between psychosocial factors and psychological adjustment. These results point to specific sociodemographic, disease-related, and psychosocial factors that can help to identify women at the time of diagnosis who are at risk for long-term psychological challenges so they can be referred for psychological support that targets their specific needs and can improve their quality of life and mood and decrease indicators of anxiety, depression, and psychological distress.
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Affiliation(s)
- Tânia Brandão
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Center for Psychology, University of Porto, Porto, Portugal
| | - Marc S Schulz
- Department of Psychology, Bryn Mawr College, Bryn Mawr, PA, USA
| | - Paula Mena Matos
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Center for Psychology, University of Porto, Porto, Portugal
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