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Sharif Nia H, She L, Froelicher ES, Hejazi S, Kohestani D, Hamidi S. The Farsi version of meaning of life in Iranian patients with cancer: A psychometric study. Chronic Illn 2023; 19:862-872. [PMID: 36631997 DOI: 10.1177/17423953221150686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Having meaning in life is a protective factor for psychological well-being. Accurate assessment of this construct needs a valid and reliable tool. PURPOSE This study aims to evaluate the psychometric properties of the Farsi version of the meaning of life questionnaire in patients with cancer. METHOD In this cross-sectional study, after translating the questionnaire to Farsi, in a sample of 212 patients with cancer, feasibility, content and convergent validity, exploratory and confirmatory factor analysis, internal consistency, stability, and responsiveness were evaluated. RESULTS The results show that the content validity ratio of all ten items was greater than 0.49. Also, the modified Kappa coefficient of each item was greater than 0.6. The maximum likelihood exploratory factor analysis extracted one factor, which explains 76.13% of the total variance of the sample. Item nine was removed. The confirmatory factor analysis results show that the one-factor model had good fit indices. The Cronbach's alpha, McDonald's omega, composite reliability, MaxR, and intraclass correlation coefficient were 0.96, 0.96, 0.96, 0.96, and 0.98, respectively. The questionnaires had responsiveness and its response time was 3 s. CONCLUSION AND POLICY SUMMARY The nine-item Farsi version of the meaning of life questionnaire has good validity and reliability and responsiveness.
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Affiliation(s)
- Hamid Sharif Nia
- Traditional and Complementary Medicine Research Center, Addiction Institute, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Long She
- Faculty of Business, Design and Arts, Swinburne University of Technology, Kuching, Sarawak, Malaysia
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, Department of Epidemiology & Biostatistics, Schools of Nursing and Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sima Hejazi
- Department of Nursing, Bojnurd Faculty of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Daniyal Kohestani
- School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Sajad Hamidi
- School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
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2
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Kero K, Podlesek A, Kavcic V. Meaning in challenging times: Sense of meaning supports wellbeing despite pandemic stresses. SSM - MENTAL HEALTH 2023:100226. [PMID: 37359070 PMCID: PMC10199818 DOI: 10.1016/j.ssmmh.2023.100226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 06/28/2023] Open
Abstract
The COVID-19 pandemic created stress and trauma for many individuals. Traumatic experiences often trigger reflection on meaning in life, with subsequent growth or despair. This study evaluates the role of meaning in life in buffering stressors in the early stages of the COVID-19 pandemic. The purpose of this study was to determine the extent to which the negative effects of COVID-19 stressors (self-perceived stress, emotional state, and cognitive adaptation to stress in the pandemic) are influenced by meaning in life in the context of the early stages of the pandemic. Further, this study described differences in meaning in life observed across demographic groups. Web-based surveys were completed by 831 Slovenian participants in April of 2020. Demographic data; perceptions of stressors related to lacking necessities, movement restrictions, and concerns at home; meaning in life; perceived overall health status; anxiety; emotional state; and perceived stress were measured. A moderately strong sense of meaning in life (M = 5.0, SD = 0.74, range 1-7) was reported by participants, and meaning in life was associated with enhanced wellbeing (B = 0.06-.28, p < .01). Both direct and indirect relationships were observed between stressors and wellbeing outcomes. The indirect effects of meaning in life were especially prominent in the relationship between stressors related to lacking necessities and concerns at home and outcomes of anxiety, perceived stress, and negative emotions, contributing 13-27% of the total observed effects. Increased meaning in life was observed across older age groups (F(5, 825) = 4.8, p < .001) and for those in partnered relationships (t(829) = -3.397, p <.001). A strong sense of meaning in life was associated with improved well-being, even for individuals who experienced pandemic-related stressors. Public health initiatives and media may help improve resilience to pandemic trauma by emphasizing the collective meaning in challenging situations.
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Affiliation(s)
- Katherine Kero
- Institute of Gerontology, Wayne State University, Detroit, MI, United States
| | - Anja Podlesek
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, MI, United States
- International Institute of Applied Gerontology, Ljubljana, Slovenia
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3
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Moreno PI, Horner FS, Torzewski JB, Thomas JL, Gradishar W, Victorson D, Penedo FJ. Study design and protocol for tailored Acceptance and Commitment Therapy (ACT) to optimize quality of life in women living with metastatic breast cancer. Contemp Clin Trials Commun 2022; 25:100870. [PMID: 34988336 PMCID: PMC8703025 DOI: 10.1016/j.conctc.2021.100870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/17/2021] [Accepted: 11/13/2021] [Indexed: 11/02/2022] Open
Abstract
Women living with metastatic (stage IV) breast cancer face unique challenges, including arduous treatments, side effects, chronic symptom burden, and emotional distress. Nevertheless, most research has paradoxically focused on optimizing quality of life in women with early-stage, non-metastatic breast cancer. Acceptance and Commitment Therapy (ACT) is an evidence-based, third-wave cognitive behavioral therapy that focuses on creating 'a life worth living' by promoting meaning and purpose and optimizing quality of life. ACT may be particularly well-suited for women with metastatic breast cancer as it addresses salient existential concerns, while allowing for the co-occurrence of feelings of grief and loss that are normal and expected when facing a life-limiting prognosis. This manuscript describes the rationale and study design of a pilot randomized controlled trial to develop and assess the feasibility and acceptability of a tailored ACT intervention for women living with metastatic breast cancer. Participants (N = 30) will be randomized 1:1 to either ACT, cognitive behavioral stress management (CBSM), or a usual care control. Both ACT and CBSM are 8-week, group-based interventions that will be delivered online. Primary outcomes are rates of acceptance, retention, and satisfaction. Preliminary effects on variables of interest, including meaning and purpose, psychological flexibility, and several domains of quality of life, will also be examined. Findings will inform the conduct of a full-scale randomized controlled trial of our tailored ACT intervention in women living with metastatic breast cancer.
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Affiliation(s)
- Patricia I. Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, USA
| | | | - Joanna B. Torzewski
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, USA
| | - Jessica L. Thomas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
| | - William Gradishar
- Department of Medicine, Division of Hematology and Oncology, Northwestern University Feinberg School of Medicine, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
| | - Frank J. Penedo
- Department of Psychology, University of Miami, USA
- Department of Medicine, University of Miami Miller School of Medicine, USA
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4
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Winger JG, Ramos K, Kelleher SA, Somers TJ, Steinhauser KE, Porter LS, Kamal AH, Breitbart WS, Keefe FJ. Meaning-Centered Pain Coping Skills Training: A Pilot Feasibility Trial of a Psychosocial Pain Management Intervention for Patients with Advanced Cancer. J Palliat Med 2022; 25:60-69. [PMID: 34388037 PMCID: PMC8721493 DOI: 10.1089/jpm.2021.0081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Pain from advanced cancer can greatly reduce patients' physical, emotional, and spiritual well-being. Objective: To examine the feasibility and acceptability of a behavioral pain management intervention, Meaning-Centered Pain Coping Skills Training (MCPC). Design: This trial used a single-arm feasibility design. Setting/Subjects: Thirty participants with stage IV solid tumor cancer, moderate-to-severe pain, and clinically elevated distress were enrolled from a tertiary cancer center in the United States. The manualized protocol was delivered across four 45- to 60-minute videoconference sessions. Measurements: Feasibility and acceptability were assessed through accrual, session/assessment completion, intervention satisfaction, and coping skills usage. Participants completed validated measures of primary outcomes (i.e., pain severity, pain interference, and spiritual well-being) and secondary outcomes at baseline, post-intervention, and four-week follow-up. Results: Eighty-eight percent (38/43) of patients who completed screening met inclusion criteria, and 79% (30/38) consented and completed baseline assessment. Sixty-seven percent (20/30) of participants were female (mean age = 57). Most participants were White/Caucasian (77%; 23/30) or Black/African American (17%; 5/30) with at least some college education (90%; 27/30). Completion rates for intervention sessions and both post-intervention assessments were 90% (27/30), 87% (26/30), and 77% (23/30), respectively. At the post-intervention assessment, participants reported a high degree of intervention satisfaction (mean = 3.53/4.00; SD = 0.46), and 81% (21/26) reported weekly use of coping skills that they learned. Participants also showed improvement from baseline on all primary outcomes and nearly all secondary outcomes at both post-intervention assessments. Conclusions: MCPC demonstrated strong feasibility and acceptability. Findings warrant further evaluation of MCPC in a randomized controlled trial. ClinicalTrials.gov Identifier: NCT03207360.
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Affiliation(s)
- Joseph G. Winger
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Address correspondence to: Joseph G. Winger, PhD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2200 West Main Street, Suite 340, Durham, NC 27705, USA
| | - Katherine Ramos
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Center for the Study of Human Aging and Development, Duke University, Durham, North Carolina, USA.,Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) for Health Services Research and Development, Durham VA Medical Center, Durham, North Carolina, USA.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Geriatric, Research, Education and Clinical Center (GRECC), Durham VA Medical Center, Durham, North Carolina, USA
| | - Sarah A. Kelleher
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Karen E. Steinhauser
- Center for the Study of Human Aging and Development, Duke University, Durham, North Carolina, USA.,Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) for Health Services Research and Development, Durham VA Medical Center, Durham, North Carolina, USA.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Laura S. Porter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Arif H. Kamal
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Cancer Institute, Duke University Health System, Durham, North Carolina, USA.,Duke Fuqua School of Business, Durham, North Carolina, USA
| | - William S. Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Francis J. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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5
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Spirituality in Coping with Pain in Cancer Patients: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9121671. [PMID: 34946397 PMCID: PMC8701851 DOI: 10.3390/healthcare9121671] [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: 10/29/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
Spirituality has been identified as an adaptive coping strategy and a predictor of better quality of life in cancer patients. Despite the relevance of spirituality in the health-disease process, it is noted that the assessment of the impact of spirituality in coping with pain is still incipient. The objective of this study is to assess the impact of spirituality in coping with pain in cancer patients. This quantitative cross-sectional study was carried out in a medium-sized hospital and a cancer patient support institution located in northeastern Brazil. A questionnaire with sociodemographic and clinical variables was used and the following instruments were applied: Visual Analogue Scale (VAS); Short-Form McGill Pain Questionnaire (SF-MPQ); Neuropathic Pain 4 Questions (DN4); Spiritual Wellbeing Scale (SWBS); WHOQOL Spirituality, Religiousness and Personal Beliefs (WHOQOL-SRPB). Most people with no pain had higher scores on the SWBS. Neuropathic pain was identified in 23 patients and was associated with the highest level of spirituality used as a way of coping with pain. As faith increases, pain decreases in intensity by 0.394 points. On the other hand, as inner peace increases, pain increases by 1.485 points. It is concluded that faith is a strategy for coping with pain, in particular neuropathic pain, minimizing its intensity. On the other hand, greater levels of inner peace allow to increase the awareness of the painful sensation. It is expected that these findings may be useful to integrate spirituality care in healthcare facilities as a resource for positive coping for people in the process of becoming ill, contributing to the therapeutic path and favouring a new meaning to the experience of the disease.
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6
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General Mental Health and Subjective Well-Being Among University Students: The Moderating Role of Personal Cultural Orientations. HUMAN ARENAS 2021. [DOI: 10.1007/s42087-021-00253-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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7
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Arslan G, Yıldırım M. Perceived risk, Positive Youth-Parent Relationships, and Internalizing Problems in Adolescents: Initial Development of the Meaningful School Questionnaire. CHILD INDICATORS RESEARCH 2021; 14:1911-1929. [PMID: 34400981 PMCID: PMC8358253 DOI: 10.1007/s12187-021-09841-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 06/01/2023]
Abstract
This novel paper aimed to develop the Meaningful School Questionnaire (MSQ) to assess meaning in life in school context and examined whether meaningful school serves as a moderator on the links between the coronavirus risk, youth-parent relationships, and internalizing problems. Participants included 383 adolescents (38.4% male; Mean = 14.23 ± 2.04). Factor analysis yielded a two-factor solution: purpose-enjoyment and responsible understanding. Meaningful school moderated the mediating effect of positive youth-parent relations on the association between coronavirus risk and internalizing problems. Findings suggest that students with greater life meaning exhibit more internalizing problems when coronavirus risk is high and positive youth-parent relationships is low. This evidence supports that life meaning is key to foster the psychological health of young people during the pandemic. Thus, meaning-based intervention strategies could be developed to improve youths' sense of life meaning and purpose in the school context, which in turn enhance their resilience to foster their mental health and flourishing. These programs could facilitate youths to cope with stressful experiences such as the coronavirus pandemic by promoting their protective and promotive resources.
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Affiliation(s)
- Gökmen Arslan
- Department of Psychological Counseling and Guidance, Mehmet Akif Ersoy University, Burdur, Turkey
| | - Murat Yıldırım
- Department of Psychology, Ağrı İbrahim Çeçen University, Ağrı, Turkey
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8
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Quiroga-Garza A, Cepeda-Lopez AC, Villarreal Zambrano S, Villalobos-Daniel VE, Carreno DF, Eisenbeck N. How Having a Clear Why Can Help Us Cope With Almost Anything: Meaningful Well-Being and the COVID-19 Pandemic in México. Front Psychol 2021; 12:648069. [PMID: 34093332 PMCID: PMC8175781 DOI: 10.3389/fpsyg.2021.648069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/26/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) has resulted in an increase in known risk factors for mental health problems. Mexico adopted lockdown and physical distancing as a containment strategy with potential consequences on day to day life, such as social isolation, loss of income and loneliness that can have important consequences in terms of mental health. Objective: We aimed to examine the effect of the initial phases of the COVID-19 pandemic on psychological distress, well-being and perceived physical health among Mexican-base respondents and to examine whether coping strategies would play a potential intermediating role in relation to these variables. Under the Existential Positive Psychology perspective, an emphasis was made on meaning-centered coping. Methods: A cross-sectional study was conducted between April 30 and June 16th 2020 among 604 Mexicans-base respondents of which 471 were women and 132 men. Data was collected by using online questionnaires. Psychological distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). The Brief COPE Inventory was used to assess problem-focused and emotion-focused coping strategies. We also used the Meaning-Centered Coping Scale (MCCS). PERMA-Profiler was used to assess well-being, perceived physical health, and loneliness. Profiler and Descriptive analyses and bivariate linear regression were performed to examine the association of variables. Results: 45.9% of the participants reported moderate to extremely severe psychological distress. Our results demonstrate that problem-focused and emotion-focused coping were positively related to psychological distress, whereas meaning-centered coping was negatively associated with distress. Furthermore, psychological distress played a potential negative role in the perceived physical health, while meaning-centered coping and well-being buffered the negative influence of psychological distress on perceived physical health (completely standardized indirect effect = -0.01, SE: 0.012, 95% CI [-0.065; -0.017]. Conclusion: Meaning-centered coping was found to suppress the negative influence of psychological distress on sensation of decreased physical health corroborating the critical role of meaning in life in promoting well-being. Future studies can further examine the value of the critical role of meaning in life in promoting well-being as a protective factor against severe distress during traumatic events. Findings of this study can be used to orient policies and interventions aimed to alleviate suffering in the midst of the COVID-19 pandemic.
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Affiliation(s)
| | - Ana C. Cepeda-Lopez
- Department of Basic Sciences, School of Medicine, Universidad de Monterrey, Monterrey, Mexico
| | | | | | - David F. Carreno
- Department of Psychology, Universidad de Almería, Almería, Spain
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9
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Nightingale G, Battisti NML, Loh KP, Puts M, Kenis C, Goldberg A, Haase KR, Krok-Schoen J, Liposits G, Sattar S, Stolz-Baskett P, Pergolotti M. Perspectives on functional status in older adults with cancer: An interprofessional report from the International Society of Geriatric Oncology (SIOG) nursing and allied health interest group and young SIOG. J Geriatr Oncol 2021; 12:658-665. [PMID: 33172805 PMCID: PMC8102651 DOI: 10.1016/j.jgo.2020.10.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
Abstract
Most adults with cancer are over 65 years of age, and this cohort is expected to grow exponentially. Older adults have an increased burden of comorbidities and risk of experiencing adverse events on anticancer treatments, including functional decline. Functional impairment is a predictor of increased risk of chemotherapy toxicity and shorter survival in this population. Healthcare professionals caring for older adults with cancer should be familiar with the concept of functional status and its implications because of the significant interplay between function, cancer, anticancer treatments, and patient-reported outcomes. In this narrative review, we provide an overview of functional status among older patients with cancer including predictors, screening, and assessment tools. We also discuss the impact of functional impairment on patient outcomes, and describe the role of individual members of an interprofessional team in addressing functional impairment in this population, including the use of a collaborative approach aiming to preserve function.
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Affiliation(s)
- Ginah Nightingale
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Nicolò Matteo Luca Battisti
- Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, Sutton, Surrey SM1 2JP, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, London SM2 5NG, United Kingdom
| | - Kah Poh Loh
- James P Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Annette Goldberg
- Department of Nutrition, Dana Farber Cancer Institute, Boston, MA, USA
| | - Kristen R Haase
- School of Nursing, University of British Columbia, Wesbrook Mall, Vancouver, British Columbia, Canada
| | - Jessica Krok-Schoen
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Gábor Liposits
- Department of Oncology, Regional Hospital West Jutland, Herning, Denmark
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Petra Stolz-Baskett
- Oncology Service, Nelson Hospital Nelson Marlborough Health, Nelson 7048, New Zealand
| | - Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical; Colorado State University, Fort Collins, CO, USA
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10
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Enhancing meaning in the face of advanced cancer and pain: Qualitative evaluation of a meaning-centered psychosocial pain management intervention. Palliat Support Care 2021; 18:263-270. [PMID: 32115006 DOI: 10.1017/s1478951520000115] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objectives of this study were to obtain patient evaluations of the content, structure, and delivery modality of Meaning-Centered Pain Coping Skills Training (MCPC), a novel psychosocial intervention for patients with advanced cancer and pain. MCPC aims to help patients connect with valued sources of meaning in their lives (e.g., family relationships), while providing training in evidence-based cognitive and behavioral skills (e.g., guided imagery) to reduce pain. METHODS Semi-structured interviews were conducted with 12 patients with stage IV solid tumor cancers and persistent pain. Transcripts were analyzed using methods from applied thematic analysis. RESULTS When evaluating MCPC's educational information and skills training descriptions, participants described ways in which this content resonated with their experience. Many coped with their pain and poor prognosis by relying on frameworks that provided them with a sense of meaning, often involving their personally held religious or spiritual beliefs. They also expressed a need for learning ways to cope with pain in addition to taking medication. A few participants offered helpful suggestions for refining MCPC's content, such as addressing common co-occurring symptoms of sleep disturbance and fatigue. Concerning MCPC's structure and delivery modality, most participants preferred that sessions include their family caregiver and described remote delivery (i.e., telephone or videoconference) as being more feasible than attending in-person sessions. SIGNIFICANCE OF RESULTS Participants were interested in an intervention that concurrently focuses on learning pain coping skills and enhancing a sense of meaning. Using remote delivery modalities may reduce access barriers (e.g., travel) that would otherwise prevent many patients from utilizing psychosocial services.
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11
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Meaningful Living to Promote Complete Mental Health Among University Students in the Context of the COVID-19 Pandemic. Int J Ment Health Addict 2020; 20:930-942. [PMID: 33169074 PMCID: PMC7609355 DOI: 10.1007/s11469-020-00416-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 01/07/2023] Open
Abstract
Maintaining positive mental health can be challenging during the COVID-19 pandemic which undoubtedly caused devastating consequences on people’s lives. There is need to determine factors contributing to mental health of people during the pandemic. The current study aims to examine the effect of meaning in life on complete mental health, which represents the presence of positive functioning and the absence of psychopathological symptoms. The participants of the study included 392 (70.9% female) undergraduate students, ranging in age from 18 to 43 years (M = 20.67 years, SD = 3.66) and they have predominantly been imposed stay-at-home orders for coronavirus right after announcement of COVID-19 restrictions in Turkey. Latent variable path analyses demonstrated significant paths from meaning in life to all components of psychological distress, positive mental health, and subjective well-being. Multi-group analysis showed significant gender differences across the study variables. These findings corroborate the critical role of meaning in life in promoting complete mental health and shed further light on why people high in meaning in life tend to have better mental health than those low in meaning in life within the context of COVID-19.
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12
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Lopez CJ, Pritlove C, Jones JM, Alibhai SMH, Sabiston CM, Chang E, Santa Mina D. "This is my home-based exercise": exploring environmental influences on home-based exercise participation in oncology. Support Care Cancer 2020; 29:3245-3255. [PMID: 33094360 DOI: 10.1007/s00520-020-05843-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/19/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Home-based exercise interventions offer many health benefits; however, the environments that constitute home-based exercise are not well-understood. The purpose of this study was to explore what constitutes the "home" for cancer survivors engaging in home-based exercise and identify factors of the environment that may impact exercise participation. METHODS We conducted a qualitative exploratory study of cancer survivors receiving a home-based exercise prescription to manage their cancer-related impairments. Semi-structured interviews included photo elicitation to actively involve participants in the interview process and provide opportunities to visually "observe" environments utilized for home-based exercise. RESULTS Sixteen participants were interviewed (n = 11 women, median age = 53.5, range = 26-74 years) and three themes emerged: (1) reasons for participating in a home-based exercise program; (2) physical environmental influences and preferences; and (3) social environmental influences and preferences. The ability to self-manage exercise and accommodate competing demands, having access to exercise facilities, feeling comfortable exercising without qualified supervision, and a desire for autonomy were reasons home-based exercise programs were preferred. Participants reported that the physical environment influenced their experience with home-based exercise and sub-themes related to a dynamic environment, indoor and outdoor characteristics, and aesthetics were identified. The social environment, with sub-themes associated with the presence of people, social climate, exercise modeling, connection, and exercise support, also related to exercise behavior. CONCLUSION The findings highlight the influence of the physical and social environment on exercise prescription engagement. They further indicate the need for exercise professionals to consider the environment for exercise when delivering home-based exercise interventions.
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Affiliation(s)
- Christian J Lopez
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St, Toronto, Ontario, M5S 2W6, Canada.,Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Cheryl Pritlove
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Jennifer M Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shabbir M H Alibhai
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St, Toronto, Ontario, M5S 2W6, Canada
| | - Eugene Chang
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St, Toronto, Ontario, M5S 2W6, Canada. .,Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. .,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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13
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Schnell T, Krampe H. Meaning in Life and Self-Control Buffer Stress in Times of COVID-19: Moderating and Mediating Effects With Regard to Mental Distress. Front Psychiatry 2020; 11:582352. [PMID: 33173525 PMCID: PMC7538834 DOI: 10.3389/fpsyt.2020.582352] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/28/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND As evidenced by several studies, mental distress increased substantially during the COVID-19 pandemic. In this period, citizens were asked to exercise a high degree of self-control with regard to personal and social health behavior. At the same time, we witnessed an increase of prosocial acts and shared creative expressions, which are known to serve as sources of meaning. Meaning in life and self-control are acknowledged psychological resources. Especially in times of crisis, meaning in life has been shown to be a crucial factor for resilience and coping. However, threatening and stressful situations can also jeopardize existential security and trigger crises of meaning. The present study aimed to document levels of acute COVID-19 stress and general mental distress in Germany and Austria during the lockdown and in the weeks thereafter. In order to identify potential risk factors related to demographics and living conditions, their associations with COVID-19 stress were analyzed exploratively. The primary objective of the study, however, was to investigate the buffering effect of two psychological resources-meaningfulness and self-control-with regard to the relation between acute COVID-19 stress and general mental distress. Finally, a potential aggravation of mental distress due to the occurrence of crises of meaning was examined. METHOD A cross-sectional survey was conducted online during lockdown (survey group 1) and the subsequent weeks characterized by eased restrictions (survey group 2). A total of N = 1,538 German-speaking participants completed a questionnaire battery including a novel measure of acute COVID-19 stress, meaningfulness and crisis of meaning (SoMe), self-control (SCS-KD), and a screening of general mental distress, measured by core symptoms of depression and anxiety (PHQ-4). In a first step, associations between living conditions, demographics, and COVID-19 stress were explored. Second, a moderation and a mediation model were tested. Meaningfulness, a measure of presence of meaning in life, as well as self-control were proposed to serve as buffers in a time of crisis, thus moderating the relation between acute COVID-19 stress and general mental distress (double moderation). Crisis of meaning, operationalizing an experienced lack of meaning in life, was proposed to mediate the relationship between acute COVID-19 stress and general mental distress, with an assumed moderation of the association between COVID-19 stress and crisis of meaning by survey group (lockdown versus eased restrictions after lockdown), and a hypothesized moderation of the link between crisis of meaning and general mental distress by self-control (dual moderated mediation). RESULTS COVID-19 stress was slightly right-skewed. Scores were higher during lockdown than in the weeks thereafter. The rate of clinically significant general mental distress was high, exceeding prevalence rates from both the general population and clinical samples of the time before the pandemic. In the weeks following the lockdown (group 2), general mental distress and crisis of meaning were significantly higher than during lockdown (group 1), whereas meaningfulness and self-control were significantly lower. Demographically, age had the strongest association with COVID-19 stress, with older participants perceiving less acute stress (r = -.21). People who were partnered or married suffered less from COVID-19 stress (η2 = .01). Living alone (η2 = .006), living in a room versus a flat or house (η2 = .008), and being unemployed due to the pandemic (η2 = .008) were related to higher experience of COVID-19 stress. COVID-19 stress and general mental distress were strongly related (r = .53). Both meaningfulness and self-control were negatively associated with general mental distress (r = -.40 and -.36, respectively). They also moderated the relationship between COVID-19 stress and general mental distress: When meaningfulness was high, high COVID-19 stress was related to substantially lower PHQ-4 scores than when meaningfulness was low. The same held for self-control: High scores of self-control were associated with lower PHQ-4 scores especially when COVID-19 stress was high. Crisis of meaning mediated the relationship between COVID-19 stress and PHQ-4. There was a higher likelihood of crises of meaning occurring when COVID-19 stress was high; crisis of meaning, in turn, was associated with general mental distress. Survey group moderated the first path of this mediation, i.e., the relationship between COVID-19 stress and crisis of meaning: High scores of COVID-19 stress were associated more strongly with crisis of meaning in the second survey group (after the lockdown). Self-control moderated the second path, i.e., the relationship between crisis of meaning and PHQ-4: When a crisis of meaning was present, self-control could buffer its effect on general mental distress. CONCLUSIONS Also in the present study among German-speaking participants, general mental distress was high. Scores were higher after than during the lockdown, indicating an ongoing destabilization for a significant part of the population. People who saw a meaning in their lives and who were capable of self-control reported substantially less mental distress. Meaningfulness and self-control also served as buffers between COVID-19 stress and general mental distress: When COVID-19 stress was high, the presence of meaningfulness and self-control accounted for lower general mental distress. Moreover, people who suffered strongly from COVID-19 stress were more likely to develop a crisis of meaning which, in turn, was associated with higher general mental distress. This suggests that ongoing anxiety and depression might (also) be based on existential struggles. Again here, self-control buffered the impact of crisis of meaning on general mental health. We conclude from these findings that public health policies can support citizens in coping with large-scale crises by enabling experiences of meaningfulness, e.g., through transparent and reliable modes of communicating goals and necessary intermediate steps. Moreover, health professionals are well advised to invite individuals to confront existential questions and struggles, and to encourage them to exercise self-control. The latter can be boosted by keeping higher-order goals salient-which again is inherently linked to an understanding of their meaning.
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Affiliation(s)
- Tatjana Schnell
- Existential Psychology Lab, Institute of Psychology, University of Innsbruck, Innsbruck, Austria
- Psychology of Religion, MF Norwegian School of Theology, Religion and Society, Oslo, Norway
| | - Henning Krampe
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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14
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Hermann M, Kühne F, Rohrmoser A, Preisler M, Goerling U, Letsch A. Perspectives of patients with multiple myeloma on accepting their prognosis-A qualitative interview study. Psychooncology 2020; 30:59-66. [PMID: 32864807 DOI: 10.1002/pon.5535] [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: 04/02/2020] [Revised: 08/04/2020] [Accepted: 08/18/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Prognostic awareness is essential for making treatment decisions in malignant diseases. Being confronted with a poor prognosis, however, can affect patients' mental health. Therefore, it is important to study coping in the context of malignant diseases. Acceptance is an adaptive coping strategy associated with less psychological distress. This study sought to explore the facilitators and barriers for prognostic acceptance in a sample in which both hope and uncertainty regarding prognosis are pronounced: multiple myeloma patients. METHODS In a German university hospital, 20 multiple myeloma patients participated in semistructured interviews. Following thematic content analysis by Kuckartz, the interview transcripts were coded for facilitators and barriers for prognostic acceptance. Additionally, patients completed questionnaires on prognostic awareness and sociodemographic characteristics. RESULTS Patients described the following facilitators for prognostic acceptance: social support, positive thinking, focusing on the Here and Now, proactive confrontation, having little to no symptoms, and being there for others. The indicated barriers were distressing physical symptoms and restricted functioning, social distress, and additional distress from other areas of life. CONCLUSIONS Patients reported a variety of factors-related to the social realm, symptom burden, and specific attitudes-that help or hinder them in accepting their prognosis. Oncologists and psycho-oncologists may support prognostic acceptance by encouraging patients to both actively deal with realistic information as well as enjoy pleasant and meaningful moments in the present during which the disease and its prognosis recedes into the background.
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Affiliation(s)
- Myriel Hermann
- Charité Comprehensive Cancer Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Psychology, Clinical Psychology and Psychotherapy, University of Potsdam, Potsdam, Germany
| | - Franziska Kühne
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Potsdam, Potsdam, Germany
| | - Amy Rohrmoser
- Charité Comprehensive Cancer Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martina Preisler
- Charité Comprehensive Cancer Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ute Goerling
- Charité Comprehensive Cancer Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Anne Letsch
- Charité Comprehensive Cancer Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Hematology and Oncology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Medicine II, Hematology and Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
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15
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Patients' experiences of family members' reactions to diagnosis of breast cancer and support in the management of breast cancer in Lagos, Nigeria. Palliat Support Care 2020; 19:592-597. [PMID: 32830624 DOI: 10.1017/s147895152000070x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objectives of this study are to describe patients' experiences of family members' reactions to diagnosis of breast cancer and investigate the role of family support in the management of breast cancer. METHOD The study used the descriptive qualitative method in data collection and analysis. Fifteen participants, who were undergoing either radiotherapy or chemotherapy treatment at a private hospital, consented and participated in the study. Data were content analyzed under two specific themes on family members' reactions and family support received. FINDINGS The findings show that some participants reported negative reactions of some family members, and this affected them negatively. While some participants received support from their families, others did not. SIGNIFICANCE OF FINDINGS The findings of our study show the critical role of family support in the management of breast cancer; therefore, family members should be encouraged to give breast cancer patient the necessary support to help them manage their sick role behavior since their illness has no cure.
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16
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Hata K, Ono H, Ogawa Y, Suzuki SI. The mediating effect of activity restriction on the relationship between perceived physical symptoms and depression in cancer survivors. Psychooncology 2020; 29:663-670. [PMID: 31984588 PMCID: PMC7216991 DOI: 10.1002/pon.5303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/07/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022]
Abstract
Purpose Several studies have explored factors causing depression in cancer survivors, including perceived physical symptoms. Another critical factor in the depression symptomatology of cancer survivors is activity restriction (AR). We investigated how AR mediate the effects of perceived pain and fatigue on depression in cancer survivors. Methods Cancer survivors (n = 61; mean age 56.16 years) that were recruited through cancer support groups in Japan participated in this study. Participants completed a battery of questionnaires comprising demographic and clinical information, the Pain Catastrophizing Scale, the Cancer Fatigue Scale, the Activity Restriction Scale for Cancer Patients, and the Hospital Anxiety and Depression Scale. Results Mediation analysis indicated that AR partially mediates the effect of pain on depression. Direct paths from pain to AR, AR to depression, and pain to depression were significant (P < .005). Moreover, indirect paths from pain to AR, AR to depression, and pain to depression were also significant at the 95% level [0.04‐0.13]. However, AR did not mediate the effect of fatigue on depression, and fatigue had a significant direct path to both AR and depression (P < .005). Conclusion This study aimed to explore the mediating effect of AR in the relationships of perceived pain and fatigue and depression in cancer survivors. We found that AR mediates perceived pain to depression, however not for perceived fatigue. In addition, because AR was experienced in the face of any survivorship period, AR may need to be treated as a long‐term effect of the cancer diagnosis
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Affiliation(s)
- Kotone Hata
- Graduate School of Human Sciences, Waseda University, Saitama, Japan.,Japan Society for the Promotion of Science, Research Fellow
| | - Haruka Ono
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
| | - Yuko Ogawa
- Department of Psycho-Oncology, National Cancer Center, Tokyo, Japan
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17
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Park CL, Pustejovsky JE, Trevino K, Sherman AC, Esposito C, Berendsen M, Salsman JM. Effects of psychosocial interventions on meaning and purpose in adults with cancer: A systematic review and meta-analysis. Cancer 2019; 125:2383-2393. [PMID: 31034600 PMCID: PMC6602826 DOI: 10.1002/cncr.32078] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 01/18/2019] [Accepted: 02/28/2019] [Indexed: 12/25/2022]
Abstract
Meaning and purpose in life are associated with the mental and physical health of patients with cancer and survivors and also constitute highly valued outcomes in themselves. Because meaning and purpose are often threatened by a cancer diagnosis and treatment, interventions have been developed to promote meaning and purpose. The present meta-analysis of randomized controlled trials (RCTs) evaluated effects of psychosocial interventions on meaning/purpose in adults with cancer and tested potential moderators of intervention effects. Six literature databases were systematically searched to identify RCTs of psychosocial interventions in which meaning or purpose was an outcome. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, rater pairs extracted and evaluated data for quality. Findings were synthesized across studies with standard meta-analytic methods, including meta-regression with robust variance estimation and risk-of-bias sensitivity analysis. Twenty-nine RCTs were identified, and they encompassed 82 treatment effects among 2305 patients/survivors. Psychosocial interventions were associated with significant improvements in meaning/purpose (g = 0.37; 95% CI, 0.22-0.52; P < .0001). Interventions designed to enhance meaning/purpose (g = 0.42; 95% CI, 0.24-0.60) demonstrated significantly higher effect sizes than those targeting other primary outcomes (g = 0.18; 95% CI, 0.09-0.27; P = .009). Few other intervention, clinical, or demographic characteristics tested were significant moderators. In conclusion, the results suggest that psychosocial interventions are associated with small to medium effects in enhancing meaning/purpose among patients with cancer, and the benefits are comparable to those of interventions designed to reduce depression, pain, and fatigue in patients with cancer. Methodological concerns include small samples and ambiguity regarding allocation concealment. Future research should focus on explicitly meaning-centered interventions and identify optimal treatment or survivorship phases for implementation.
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Affiliation(s)
| | - James E Pustejovsky
- Department of Educational Psychology, University of Texas at Austin, Austin, Texas
| | | | - Allen C Sherman
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Mark Berendsen
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - John M Salsman
- Wake Forest School of Medicine, Winston-Salem, North Carolina
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18
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Aliche JC, Ifeagwazi CM, Onyishi IE, Mefoh PC. Presence of Meaning in Life Mediates the Relations Between Social Support, Posttraumatic Growth, and Resilience in Young Adult Survivors of a Terror Attack. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2019.1624416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Ike E. Onyishi
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
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19
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Li PFJ, Wong YJ, Chao RCL. Happiness and meaning in life: Unique, differential, and indirect associations with mental health. COUNSELLING PSYCHOLOGY QUARTERLY 2019. [DOI: 10.1080/09515070.2019.1604493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- P. F. Jonah Li
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, IN, USA
| | - Y. Joel Wong
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, IN, USA
| | - Ruth C.-L. Chao
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
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20
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Moreno PI, Dooley LN, Bower JE. Unique associations of eudaimonic and hedonic wellbeing with psychosocial adjustment in breast cancer survivors. J Psychosoc Oncol 2019; 36:649-657. [PMID: 30862313 DOI: 10.1080/07347332.2018.1471564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Eudaimonic wellbeing (e.g., meaning, purpose in life) and hedonic wellbeing (e.g., happiness, life satisfaction) are related but conceptually distinct facets of wellbeing. Eudaimonic wellbeing is highly underexplored in cancer research despite its relevance to important existential concerns faced by cancer survivors. Therefore, this study examined the unique associations of eudaimonic and hedonic wellbeing with adjustment in breast cancer survivors. METHODS Women diagnosed with early-stage breast cancer within two years (N = 64) were recruited through the UCLA Tumor Registry and completed self-report questionnaires (Mental Health Continuum - Short Form Scale, Posttraumatic Growth Inventory, Social Provisions Scale, Quality of Life in Adult Cancer Survivors Scale, Center for Epidemiological Studies - Depression Scale, Pittsburgh Sleep Quality Index, Fatigue Symptom Inventory, Perceived Stress Scale). FINDINGS Controlling for their shared variance and covariates, eudaimonic wellbeing was uniquely associated with greater posttraumatic growth (β = 0.42, p = .026, R2 = .07), more reliable social support (β = 0.50, p = .010, R2 = .09), and marginally lower fear of recurrence (β = -0.40, p = .063, R2 = .06) while hedonic wellbeing was uniquely associated with lower sleep disturbance (β = -0.56, p = .004, R2 = .12), fatigue (β = -0.53, p = .003, R2 = .11), and depressive symptoms (β = -0.59, p < .001, R2 = .14). CONCLUSIONS Findings suggest eudaimonic wellbeing may confer quality of life benefits beyond symptom reduction in breast cancer survivors, while hedonic wellbeing is primarily associated with fewer behavioral symptoms.
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Affiliation(s)
- Patricia I Moreno
- a Department of Medical Social Sciences, Feinberg School of Medicine , Northwestern University , Chicago , Illinois , USA
| | - Larissa N Dooley
- b Department of Psychology , University of California , Los Angeles (UCLA), Los Angeles , California , USA
| | - Julienne E Bower
- b Department of Psychology , University of California , Los Angeles (UCLA), Los Angeles , California , USA.,c Department of Psychiatry & Biobehavioral Sciences , University of California , Los Angeles , California , USA.,d Cousins Center for Psychoneuroimmunology , University of California , Los Angeles , California , USA
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21
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Bekker CI, Deacon E, Segal D. Meaning in life experienced by parents of children living with diabetes. Health Psychol Open 2019; 6:2055102919832221. [PMID: 30858981 PMCID: PMC6402055 DOI: 10.1177/2055102919832221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In this study, nine parents of children living with well-controlled diabetes participated in semi-structured interviews to explore how they make meaning of living with a child with diabetes. Creating a state of normalcy that incorporates the diabetes care plan, empowering their children to successful transition to independent care, positive relationships with their medical team as well as acquiring and sharing diabetes-related knowledge and skills add to the meaning in life of these parents. Health practitioners should facilitate conversations with parents to help them realise their motivation for adhering to the diabetes care plan.
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22
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Ochoa Arnedo C, Sánchez N, Sumalla EC, Casellas-Grau A. Stress and Growth in Cancer: Mechanisms and Psychotherapeutic Interventions to Facilitate a Constructive Balance. Front Psychol 2019; 10:177. [PMID: 30778323 PMCID: PMC6369350 DOI: 10.3389/fpsyg.2019.00177] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 01/18/2019] [Indexed: 12/14/2022] Open
Abstract
Post-traumatic stress and growth are common responses to adverse life events such as cancer. In this article, we establish how cancer becomes a "fertile land" for the emergence of stress and growth responses and analyze the main mechanisms involved. Stress-growth responses on adjusting to cancer is potentially determined by factors like the phase of the illness (e.g., initial phases vs. period of survivorship), patient's coping strategies, meaning-making, and relationships with significant others. We also review the mechanisms of constructive and adaptative stress-growth balances in cancer to study the predictors, interrelated associations, triggering mechanisms, long-term results, and specific trajectories of these two responses to cancer. Finally, we update the evidence on the role of these stress-growth associations in psychologically adjusting to cancer. Together with this evidence, we summarize preliminary results regarding the efficacy of psychotherapeutic interventions that aim to facilitate a constructive psychological balance between stress and growth in cancer patients. Recommendations for future research and gaps in knowledge on stress-growth processes in this illness are also highlighted. Researchers are encouraged to design and use psychotherapeutic interventions according to the dynamic and changeable patients' sources of stress and growth along the illness. Relevant insights are proposed to understand the inconsistency of stress-growth literature and to promote psychotherapeutic interventions to facilitate a constructive balance between these key responses in cancer.
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Affiliation(s)
- Cristian Ochoa Arnedo
- Psycho-oncology Unit, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Barcelona, Spain
| | | | - Enric C Sumalla
- Psycho-oncology Unit, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Casellas-Grau
- Psycho-oncology Unit, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain
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23
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Liu Y, Usman M, Zhang J, Gul H. Making Sense of Chinese Employees' Suicidal Ideation: A Psychological Strain-Life Meaning Model. Psychol Rep 2018; 123:201-223. [PMID: 30439305 DOI: 10.1177/0033294118811096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Using the strain theory of suicide, this study examines how psychological strains influence suicide ideation via the mediating mechanism of the meaning in life. To check the hypothesized model, data were drawn from professional employees ( n=687) across six organizations of various business types to increase the variability of respondent perception and the generalizability of the study findings. The results showed significant correlations among psychological strains, meaning in life, and suicide ideation. Furthermore, this study provides evidence for the mediation effect of meaning in life in the relationship between psychological strain and suicide ideation. Implications and future directions are discussed.
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Affiliation(s)
- Yuxin Liu
- Business School, University of International Business and Economics, Beijing, China
| | - Muhammad Usman
- Business School, University of International Business and Economics, Beijing, China
| | - Jianwei Zhang
- School of Humanities and Social Science, Beijing Institute of Technology, Beijing, China
| | - Habib Gul
- Business School, University of International Business and Economics, Beijing, China
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24
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Goyal NG, Ip EH, Salsman JM, Avis NE. Spirituality and physical health status: a longitudinal examination of reciprocal effects in breast cancer survivors. Support Care Cancer 2018; 27:2229-2235. [PMID: 30317432 DOI: 10.1007/s00520-018-4494-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/03/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE This longitudinal study sought to examine the reciprocal relationship between spirituality and physical health status among breast cancer survivors. METHODS Breast cancer survivors (N = 634) completed baseline assessments (T1) within 8 months of breast cancer diagnosis and 12 (T2) and 18 months (T3) after their baseline assessment. Spirituality was assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) scale which consists of three subscales: meaning, peace, and faith. Physical health status was measured with the SF-36 Physical Component Summary (PCS). A cross-lagged structural equation model (SEM) was used to analyze the three-wave data to examine the reciprocal relationships between the observed variable, PCS, and the three subscales of the FACIT-Sp, treated as latent variables. RESULTS The cross-lagged SEM yielded an adequate fit to the data: RMSEA = .036, CFI = 0.97, TLI = 0.96. After controlling for relevant sociodemographic and cancer-related variables, only higher PCS at T2 predicted greater meaning at T3. PCS at T1 did not predict meaning at T2 and the reciprocal relationship of meaning predicting PCS was not significant. Neither peace nor faith was reciprocally related to PCS. CONCLUSIONS Results provide evidence of a unidirectional relationship between self-reported physical health status and subsequent meaning among breast cancer survivors during the period of early to later survivorship. Additional studies are needed that examine the longitudinal and directional relationships between spirituality and physical health among diverse samples of cancer survivors.
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Affiliation(s)
- Neha G Goyal
- Helen Diller Family Comprehensive Cancer Center, University of California - San Francisco, San Francisco, CA, 94143, USA
| | - Edward H Ip
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA
| | - Nancy E Avis
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
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Hamash KI, Umberger W, Aktas A, Walsh D, Cheruvu VK. The Effect of the Pain Symptom Cluster on Performance in Women Diagnosed with Advanced Breast Cancer: The Mediating Role of the Psychoneurological Symptom Cluster. Pain Manag Nurs 2018; 19:627-636. [PMID: 29937228 DOI: 10.1016/j.pmn.2018.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/28/2018] [Accepted: 05/10/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Pain, depression, anxiety, sleep disturbances, and constipation were reported in different symptom clusters at different stages of breast cancer. Managing symptom clusters rather than individual symptoms can improve performance status. AIM The study examined the effect of pain symptom cluster (pain and constipation) on performance when mediated by the psychoneurological symptom cluster (depression, anxiety, and sleep disturbances) using age as a moderator. DESIGN A secondary analysis. SETTINGS Palliative care center at a tertiary medical center in northeast Ohio. PARTICIPANTS Eighty-six women diagnosed with advanced breast cancer. METHOD A quantitative cross-sectional approach. RESULTS Ordinal logistic regression showed that pain symptom cluster did not have a significant mediation effect on performance. Odds ratio indicated that subjects with pain symptom cluster were 63% more likely to be bedridden (odds ratio = 1.63, confidence interval = .69-3.84). Women who reported pain symptom cluster were 5% more likely to have psychoneurological symptom cluster (odds ratio = 1.05, confidence interval = .400-2.774). Stratified analysis of age showed no differences in performance. Post-hoc analysis showed that the components of pain symptom cluster had a significant effect on psychoneurological symptom cluster (odds ratio: 3 [1.18-7.62]). CONCLUSIONS Pain, constipation, depression, anxiety, and sleep disturbances were highly prevalent in women with advanced breast cancer. However, they tended to cluster in different symptom clusters. Although some findings were not significant, they all supported the direction of the tested hypotheses. Variations in symptom clusters research, including methodology, instruments, statistical tests, and chosen symptom cluster correlation coefficient, should be addressed.
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Affiliation(s)
- Kawther Ismail Hamash
- From the Nursing Department, Indiana University-Fort Wayne (IUFW), Fort Wayne, IN, USA.
| | - Wendy Umberger
- College of Nursing, Kent State University, Kent, OH, USA
| | - Aynur Aktas
- Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA; The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Declan Walsh
- Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA; The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA; Faculty of Health Sciences, Trinity College, Dublin 2, Ireland
| | - Vinay K Cheruvu
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, Kent, OH, USA
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Loeffler S, Poehlmann K, Hornemann B. Finding meaning in suffering?-Meaning making and psychological adjustment over the course of a breast cancer disease. Eur J Cancer Care (Engl) 2018; 27:e12841. [DOI: 10.1111/ecc.12841] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2018] [Indexed: 01/07/2023]
Affiliation(s)
- S. Loeffler
- University Hospital Carl Gustav Carus; Dresden Germany
| | - K. Poehlmann
- Akademie für Allgemeine Psychotherapie (aap) private GmbH; Dresden Germany
| | - B. Hornemann
- University Hospital Carl Gustav Carus; University Cancer Center; Dresden Germany
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Casellas-Grau A, Ochoa C, Ruini C. Psychological and clinical correlates of posttraumatic growth in cancer: A systematic and critical review. Psychooncology 2017; 26:2007-2018. [PMID: 28317221 DOI: 10.1002/pon.4426] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 02/13/2017] [Accepted: 03/15/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The objective of this study is to describe major findings on posttraumatic growth (PTG) in cancer, by analyzing its various definitions, assessment tools, and examining its main psychological and clinical correlates. METHODS A search in relevant databases (PsycINFO, Pubmed, ProQuest, Scopus, and Web of Science) was performed using descriptors related to the positive reactions in cancer. Articles were screened by title, abstract, and full text. RESULTS Seventy-two met the inclusion criteria. Most articles (46%) focused on breast cancer, used the PTG inventory (76%), and had a cross-sectional design (68%). The PTG resulted inversely associated with depressive and anxious symptoms and directly related to hope, optimism, spirituality, and meaning. Illness-related variables have been poorly investigated compared to psychological ones. Articles found no relationship between cancer site, cancer surgery, cancer recurrence, and PTG. Some correlations emerged with the elapsed time since diagnosis, type of oncological treatment received, and cancer stage. Only few studies differentiated illness-related-life-threatening stressors from other forms of trauma, and the potentially different mechanisms connected with PTG outcome in cancer patients. CONCLUSIONS The evaluation of PTG in cancer patients is worthy, because it may promote a better adaption to the illness. However, many investigations do not explicitly refer to the medical nature of the trauma, and they may have not completely captured the full spectrum of positive reactions in cancer patients. Future research should better investigate issues such as health attitudes; the risks of future recurrences; and the type, quality, and efficacy of medical treatments received and their influence on PTG in cancer patients.
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Affiliation(s)
- Anna Casellas-Grau
- Hospital Duran i Reynals. Avinguda de la Gran Via, Institut Català d'Oncologia, Barcelona, Spain
| | - Cristian Ochoa
- Hospital Duran i Reynals. Avinguda de la Gran Via, Institut Català d'Oncologia, Barcelona, Spain.,Facultat de Psicologia. Edifici Ponent - Planta baixa, Universitat de Barcelona, Barcelona, Spain
| | - Chiara Ruini
- Department of Psychology, University of Bologna, Bologna BO, Italy
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Du H, Li X, Chi P, Zhao J, Zhao G. Meaning in life, resilience, and psychological well-being among children affected by parental HIV. AIDS Care 2017; 29:1410-1416. [PMID: 28343403 DOI: 10.1080/09540121.2017.1307923] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Meaning in life has been posited to improve psychological well-being. People facing adversities can reduce psychological distress through pursuing a sense of purpose in life. However, the effectiveness of meaning in life in promoting psychological well-being has been found varied, and what factors may affect the function of meaning in life remain unclear. In this paper, the authors suggest that resilience, the positive adaptation during or following significant adversity, can strengthen the protective effects of meaning in life on psychological well-being. To test this hypothesis, we analyzed data from a sample of 518 vulnerable children of parents living with HIV about their meaning in life, resilience, depression, and loneliness. Results showed that resilience moderated the relationship between meaning in life and depression, and between meaning in life and loneliness. Meaning in life was associated with lower levels of depression and loneliness among children high in resilience, in comparison to children low in resilience. Future interventions targeting meaning in life and well-being should consider children's resilience, which can allow for better individualization of the treatment.
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Affiliation(s)
- Hongfei Du
- a School of Psychology , South China Normal University , Guangzhou , China.,b Department of Psychology , University of Macau , Macau , Macao
| | - Xiaoming Li
- c Arnold School of Public Health , University of South Carolina , Columbia , USA
| | - Peilian Chi
- b Department of Psychology , University of Macau , Macau , Macao
| | - Junfeng Zhao
- d Institute of Behavior and Psychology , Henan University , Kaifeng , China
| | - Guoxiang Zhao
- d Institute of Behavior and Psychology , Henan University , Kaifeng , China
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Guerra MP, Lencastre L, Silva E, Teixeira PM. Meaning in life in medical settings: A new measure correlating with psychological variables in disease. COGENT PSYCHOLOGY 2017. [DOI: 10.1080/23311908.2017.1286747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Marina Prista Guerra
- Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal
| | - Leonor Lencastre
- Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal
| | - Eunice Silva
- Portuguese Institute of Oncology Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Pedro M. Teixeira
- Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal
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Xia HZ, Gao L, Wang Y, Song H, Shi BX. Development of the Chinese version of Meaning in Life Scale for cancer patients and psychometric evaluation. J Clin Nurs 2017; 26:3298-3304. [PMID: 27878884 DOI: 10.1111/jocn.13675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2016] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To develop a Meaning in Life Scale for cancer patients in Chinese version and to test the validity and reliability. BACKGROUND Meaning in life is a protective factor of psychological well-being and is negatively related to depression and demoralisation among cancer patients. The existing scales measuring meaning in life are mostly designed in English and there is no scale designed for Chinese cancer patients based on Chinese cultural background. DESIGN Process of instrument development and psychometric evaluation were used. METHODS Items were generated from literature review and a focus group interview. Delphi technique was used to test the content validity. Item analysis and exploratory factor analysis were performed with data from 251 cancer patients. The internal consistency of the scale was tested by Cronbach's alpha. RESULTS A 25-item Meaning in Life Scale in Chinese version with five domains was developed. The five factors explained 62·686% of the variance. The Cronbach's alpha for the total scale was 0·897. CONCLUSIONS The Meaning in Life Scale in Chinese version has acceptable internal consistency reliability and good content validity and acceptable construct validity. The content of the scale reflected the attitudes of cancer patients towards meaning in life based on Chinese cultural background. RELEVANCE TO CLINICAL PRACTICE The Chinese version of Meaning in Life Scale for Cancer Patients appears to be a new scale to assess meaning in life among Chinese cancer patients exactly and the concept of meaning in life presented in this scale provides new ideas of meaning intervention in routine clinical practice.
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Affiliation(s)
- Hao-Zhi Xia
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lei Gao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yang Wang
- Department of Breast, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hui Song
- Department of Breast, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Bao-Xin Shi
- School of Nursing, Tianjin Medical University, Tianjin, China
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George LS, Park CL. Does Spirituality Confer Meaning in Life Among Heart Failure Patients and Cancer Survivors? PSYCHOLOGY OF RELIGION AND SPIRITUALITY 2017; 9:131-136. [PMID: 35317284 PMCID: PMC8936578 DOI: 10.1037/rel0000103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The provision of a sense of meaning in life, especially during adverse life circumstances, is widely considered to be a central function of spirituality. However, limited empirical evidence exists for this notion. The present study employed cross-lagged panel analyses, in samples of 140 congestive heart failure patients and 161 cancer survivors, to examine whether spirituality can provide meaning in the context of serious illness. Survey data were collected at baseline and six (heart failure patients) or 12 months (cancer survivors) later. In both studies, cross-lagged paths showed that higher baseline spirituality predicted more positive change in meaning over time. These results support the widely held notion that spirituality can provide increased meaning in life among individuals dealing with substantial adversity.
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Positive psychological functioning in breast cancer: An integrative review. Breast 2016; 27:136-68. [DOI: 10.1016/j.breast.2016.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 03/29/2016] [Accepted: 04/02/2016] [Indexed: 01/03/2023] Open
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Xiao R, Lai QZ, Yang JP. [Reliability and validity of Meaningful Life Measure-Chinese Revised in Chinese college students]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2016; 37:499-504. [PMID: 28446403 PMCID: PMC6744089 DOI: 10.3969/j.issn.1673-4254.2017.04.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To test the reliability and validity of Meaningful Life Measure-Chinese Revised (MLM-CR) in Chinese college students. METHODS A total of 1035 college students were evaluated with MLM-CR, Satisfaction with Life Scale (SWLS), Purpose in Life (PIL) and Patient Health Questionnaire-2 (PHQ-2), and 120 of the students were examined with PIL-SF twice. RESULTS All the items in MLM-CR had good discrimination indexes (r=0.753-0.838, P<0.001). Confirmatory factor analysis confirmed the hypothesized five-factor model of MLM-CR (Χ2/df=3.4, GFI=0.946, AGFI=0.924, RMR=0.069, NFI=0.953, CFI=0.966, RMSEA=0.048). The total internal consistency reliability of MLM-CR was 0.942, and the alpha coefficients of the 5 dimensions ranged from 0.782 to 0.877; the total split-half reliability was 0.920, and the split-half reliability of the 5 dimensions ranged from 0.752 to 0.830; the total test-retest reliability was 0.871, and the test-retest reliability of the 5 dimensions ranged from 0.783 to 0.805. The criterion validity of MLM-CR in correlation with SWLS, PIL and PHQ-2 was 0.66, 0.755 and -0.388, respectively (P<0.01). The Average score of MLM-CR of the college students was 5.20∓0.90, and the scores were significantly higher in female students than in the male students (P<0.001). CONCLUSION MLM-CR has good psychometric properties for application in comprehensive evaluation of personal meaning in life.
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Affiliation(s)
- Rong Xiao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, China. E-mail:
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Cömert IT, Özyeşil ZA, Burcu Özgülük S. Satisfaction with Life, Meaning in Life, Sad Childhood Experiences, and Psychological Symptoms among Turkish Students. Psychol Rep 2016; 118:236-250. [PMID: 29693531 DOI: 10.1177/0033294115626634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the current study was to investigate the contributions of sad childhood experiences, depression, anxiety, and stress, existence of a sense of meaning, and pursuit of meaning in explaining life satisfaction of young adults in Turkey. The sample comprised 400 undergraduate students ( M age = 20.2 yr.) selected via random cluster sampling. There were no statistically significant differences between men and women in terms of their scores on depression, existence of meaning, pursuit of meaning, and life satisfaction scores. However, there were statistically significant differences between men and women on the sad childhood experiences, anxiety and stress. In heirarchical regression analysis, the model as a whole was significant. Depression and existence of meaning in life made unique significant contributions to the variance in satisfaction in life. Students with lower depression and with a sense of meaning in life tended to be more satisfied with life.
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Affiliation(s)
- Itır Tarı Cömert
- Psychology Department, Fatih Sultan Mehmet Vakıf University, Istanbul, Turkey
| | - Zümra Atalay Özyeşil
- Psychological Counseling and Guidance Department, MEF University Istanbul, Turkey
| | - S Burcu Özgülük
- Psychological Counseling and Guidance Department, MEF University Istanbul, Turkey
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Garland SN, Stainken C, Ahluwalia K, Vapiwala N, Mao JJ. Cancer-related search for meaning increases willingness to participate in mindfulness-based stress reduction. Integr Cancer Ther 2016; 14:231-9. [PMID: 25870034 DOI: 10.1177/1534735415580682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE A cancer diagnosis can prompt an examination and reevaluation of life's meaning, purpose, and priorities. There is evidence that mindfulness-based stress reduction (MBSR) may help facilitate the meaning-making process. This study examined the influence of meaning in life on willingness to participate (WTP) in MBSR and identified factors associated with the search for and/or presence of meaning. METHODS A cross-sectional survey study of 300 patients undergoing radiation therapy was conducted. WTP in MBSR was dichotomized into yes/no by asking, "Would you participate in an MBSR program if it was offered at the cancer center?" The search for, and the presence of, meaning were assessed using the Meaning in Life Questionnaire. RESULTS Eighty patients (27%) indicated WTP in MBSR. In a multivariate logistic regression model, search for meaning was the only significant predictor of WTP in MBSR (adjusted odds ratio [AOR] =1.04, P ≤ .001, 95% CI = 1.01-1.08). Identifying as non-white (adjusted β = 4.62; 95% CI = 2.22-7.02; P < .001), and reporting subclinical (adjusted β = 3.59; 95% CI = 0.84-6.34; P = .01) or clinical levels (adjusted β = 5.52; 95% CI = 2.41-8.63; P = .001) of anxiety were the strongest predictors of search for meaning. CONCLUSION Our study indicates that patients searching for meaning are receptive to MBSR. Nonwhite patients and those experiencing high levels of anxiety are most likely to endorse a search for meaning. Future research is needed to understand how best to support patients who are searching for meaning and remove barriers to evidence-based programs like MBSR.
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Affiliation(s)
| | | | | | | | - Jun J Mao
- University of Pennsylvania, Philadelphia, PA, USA
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Teques AP, Carrera GB, Ribeiro JP, Teques P, Ramón GL. The importance of emotional intelligence and meaning in life in psycho-oncology. Psychooncology 2015; 25:324-31. [PMID: 26257313 DOI: 10.1002/pon.3921] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 04/21/2015] [Accepted: 07/06/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Cancer was considered the disease of the 20th century, and the management, treatment, and adaptation of patients to general wellbeing were worldwide concerns. Emotional intelligence has frequently been associated with wellbeing and considered one important factor to optimal human functioning. The purpose of the present study was to test the differences regarding the relationship between emotional intelligence, purpose in life, and satisfaction with life between cancer and healthy people. METHODS This model was tested using structural path analysis in two independent samples. First, in a general Portuguese population without chronic disease, 214 participants (nmale = 41, nfemale = 173; Mage = 53). Second, in 202 patients with cancer (nmale = 40, nfemale = 162; Mage = 58.65). A two-step methodology was used to test the research hypothesis. RESULTS First, a confirmatory factor analysis supported the measurement model. All factors also show reliability, convergent, and discriminate validity. Second, the path coefficients for each model indicate that the proposed relationships differ significantly according to the groups. The perception capacities of emotional intelligence were more related to satisfaction with life and purpose in life in oncologic patients than in the general population without chronic disease, specifically emotional understanding and regulation. Likewise, the relationship between purpose in life and satisfaction with life in oncologic patients was significantly higher than for the general population. CONCLUSION The current findings thus suggest that emotional intelligence and purpose in life are potential components to promoting satisfaction in life in healthy people and more so in oncologic patients.
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Affiliation(s)
- Andreia Pereira Teques
- Faculty of Medicine, University of Salamanca, Department of Psychiatry and Medical Psychology, Salamanca, 4445-577, Spain
| | - Glória Bueno Carrera
- Faculty of Medicine, University of Salamanca, Department of Psychiatry and Medical Psychology, Salamanca, 4445-577, Spain
| | - José Pais Ribeiro
- Faculty of Psychology and Educational Sciences, University of Porto, Department of Psychology, Porto, Portugal
| | - Pedro Teques
- Sport Sciences School of Rio Maior, Polytechnic Institute of Santarem, Department of Sport Psychology, Santarém, Portugal
| | - Ginés Llorca Ramón
- Faculty of Medicine, University of Salamanca, Department of Psychiatry and Medical Psychology, Salamanca, 4445-577, Spain
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Winger JG, Adams RN, Mosher CE. Relations of meaning in life and sense of coherence to distress in cancer patients: a meta-analysis. Psychooncology 2015; 25:2-10. [PMID: 25787699 DOI: 10.1002/pon.3798] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 02/03/2015] [Accepted: 02/12/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Cancer patients report high rates of distress. The related constructs of meaning in life (MiL) and sense of coherence (SOC) have long been recognized as important factors in the psychological adjustment to cancer; however, both constructs' associations with distress have not been quantitatively reviewed or compared in this population. Informed by Park's integrated meaning-making model and Antonovsky's salutogenic model, the goals of this meta-analysis were the following: (1) to compare the strength of MiL-distress and SOC-distress associations in cancer patients; and (2) to examine potential moderators of both associations (i.e., age, gender, ethnicity, religious affiliation, disease stage, and time since diagnosis). METHODS A literature search was conducted using electronic databases. Overall, 62 records met inclusion criteria. The average MiL-distress and SOC-distress associations were quantified as Pearson's r correlation coefficients and compared using a one-way ANOVA. RESULTS Both MiL and SOC demonstrated significant, negative associations with distress (r = -0.41, 95% CI: -0.47 to -0.35, k = 44; and r = -0.59, 95% CI: -0.67 to -0.51, k = 18, respectively). Moreover, the MiL-distress association was significantly smaller than the SOC-distress association (Qb = 10.42, df = 1, p < 0.01). Neither association varied by the tested moderators. CONCLUSIONS Findings provide support for the clinical relevance of MiL and SOC across demographic and medical subgroups of cancer patients. The strength of the SOC-distress association suggests that incorporating aspects of SOC (e.g., the perceived manageability of life circumstances) into meaning-centered interventions may improve their effectiveness for distressed cancer patients.
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Affiliation(s)
- Joseph G Winger
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Rebecca N Adams
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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Abstract
Negative psychological states as well as happiness belong to universal human experience; however, research findings reveal interindividual and intercultural differences in their symptoms and effective ways of coping. The aim of this article is to analyze the experience of distress in a cultural perspective with special focus on the relationship with control cognitions. Models of agency and Michel’s theory of uncertainty are used to interpret differences in attitude toward ambiguity and subjective need of control, indicated by preliminary cross-cultural studies. Finally, practical implications of the findings are discussed, pointing out that effectiveness of commonly used psychological interventions, based on the change in control beliefs, may not be universal.
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Shao J, Zhang Q, Lin T, Shen J, Li D. Well-being of elderly stroke survivors in Chinese communities: mediating effects of meaning in life. Aging Ment Health 2014; 18:435-43. [PMID: 24188409 DOI: 10.1080/13607863.2013.848836] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study aims to examine the role of meaning in life as a mediator for the relationship of physical functioning, social support, and optimism with well-being among elderly Chinese stroke survivors. METHOD A cross-sectional study was conducted on 214 community-dwelling older stroke survivors (128 men and 86 women), ranging from 60 to 88 years. The physical functioning, social support, optimism, meaning in life, and subjective well-being of the participants were measured. RESULTS Structural equation modeling revealed that meaning in life fully mediates the relationship of physical functioning, social support, and optimism with subjective well-being. CONCLUSION This study examines the role of meaning in life in stroke experience from an existential perspective. The modifiable features of meaning in life may offer an intervening angle for improving the well-being of elderly stroke survivors.
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Affiliation(s)
- Jingjin Shao
- a Research Center of Mental Health Education , Southwest University , Chongqing , China
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Bryan CJ, Elder WB, McNaughton-Cassill M, Osman A, Hernandez AM, Allison S. Meaning in life, emotional distress, suicidal ideation, and life functioning in an active duty military sample. JOURNAL OF POSITIVE PSYCHOLOGY 2013. [DOI: 10.1080/17439760.2013.823557] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Step MM, Kypriotakis GM, Rose JH. An Exploration of the relative influence of patient's age and cancer recurrence status on symptom distress, anxiety, and depression over time. J Psychosoc Oncol 2013; 31:168-90. [PMID: 23514253 PMCID: PMC10161869 DOI: 10.1080/07347332.2012.761318] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Past research suggests that psychosocial responses to advanced or recurrent cancer vary by age. This study compares the relative influences of patients' age and recurrence status on indicators of symptom distress, anxiety, and depression following a diagnosis of advanced cancer. A prospective study of advanced cancer support provided patient outcome data reported at baseline, 3-, and 6-month intervals. Cohorts were defined by age group and recurrence status and latent growth curves fit to anxiety, depression, and symptom distress outcomes. Middle-age recurrent patients reported the highest symptom distress, depression, and anxiety across time points. Older recurrent patients fared worse at baseline than older nonrecurrent patients, but outcome scores converged across time points. Recurrent cancer presents a distinct challenge that, for middle-age patients, persists across time. It may be beneficial to develop targeted educational and support resources for middle-age patients with recurrent disease.
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Affiliation(s)
- Mary M Step
- Case Western Reserve University School of Medicine and Case Comprehensive Cancer Center Program on Aging and Cancer, Cleveland, OH, USA.
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Alquist JL, Ainsworth SE, Baumeister RF. Determined to conform: Disbelief in free will increases conformity. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2013. [DOI: 10.1016/j.jesp.2012.08.015] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shao J, Shen J, Zhang Q, Lin T. Meaning in life and well-being of older stroke survivors in Chinese communities: Mediating effects of mastery and self-esteem. Health (London) 2013. [DOI: 10.4236/health.2013.54098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bennett KS, Shepherd JM. Depression in Australian women: the varied roles of spirituality and social support. J Health Psychol 2012; 18:429-38. [PMID: 22679264 DOI: 10.1177/1359105312443400] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study investigated the influence of spirituality on depression in Western Australian women. Two hundred and seventy-eight women (aged 18-78) completed an online survey about factors relating to daily spiritual experience, depression, anxiety and social support. Significant correlations were found between spiritual experience and depression, whereby individuals who reported higher spirituality also reported higher rates of social support and lower levels of depression. A major finding from this study was that spirituality accounted for a significant proportion of variance in depressive symptoms beyond the mediating effect of social support.
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Affiliation(s)
- Kellie S Bennett
- School of Psychiatry & Clinical Neurosciences , University of Western Australia, Australia.
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Boyraz G, Lightsey OR. Can positive thinking help? Positive automatic thoughts as moderators of the stress-meaning relationship. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2012; 82:267-277. [PMID: 22506529 DOI: 10.1111/j.1939-0025.2012.01150.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The purpose of this study was to test whether positive automatic cognitions moderated the relationship between event stressfulness and meaning in life. Measures of these constructs were administered to 232 students and community-dwelling adults. Supporting hypotheses and the literature, positive automatic cognitions moderated the relationship between event stressfulness and meaning in life. For persons with high levels of positive thinking, greater event stressfulness was associated with higher meaning in life. For persons with low levels of positive thinking, greater event stressfulness was associated with lower meaning in life. These results were obtained when controlling for positive affect, as well as the positive affect × event stressfulness interaction. The positive cognitions × event stressfulness interaction accounted for 2.9% of variance, and the overall model accounted for 47% of the variance in meaning in life.
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Affiliation(s)
- Güler Boyraz
- Tennessee State University, 3500 John A. Merritt Blvd., Nashville, TN 37219, USA.
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Roiland RA, Heidrich SM. Symptom clusters and quality of life in older adult breast cancer survivors. Oncol Nurs Forum 2012; 38:672-80. [PMID: 22037330 DOI: 10.1188/11.onf.672-680] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To identify symptom clusters in older adult breast cancer survivors (ages 65-97 years) and examine whether symptom clusters are related to demographic, health, and quality-of-life variables. DESIGN Factor analysis to identify possible symptom clusters. The resulting clusters then were correlated with quality-of-life measures. SETTING Phone interviews between the participants and a trained research nurse. SAMPLE 192 breast cancer survivors (X age = 70). METHODS This was a secondary data analysis of the baseline measures of demographics, health history, symptom bother, and physical, mental, and existential dimensions of quality of life. Exploratory and confirmatory factor analyses were conducted as well as multiple indicator multiple cause modeling and partial correlation analyses to assess the relationships among clusters and demographic, health history, and quality-of-life measures. MAIN RESEARCH VARIABLES Self-reported symptom bother, demographics such as age and education level, health history, and quality of life. FINDINGS Seven clinically distinct symptom clusters tapping 36 different symptoms in older adult breast cancer survivors were found. These symptom clusters were significantly related to multiple dimensions of quality of life. CONCLUSIONS Older adult breast cancer survivors experience multiple concurrent symptoms that appear to cluster. Identifying symptom clusters helps to elucidate possible intersymptom relationships which may lead to the design of more effective symptom management interventions for older adult breast cancer survivors. IMPLICATIONS FOR NURSING Older adult breast cancer survivors should be assessed for a wide variety of symptoms if clinicians hope to identify and understand intersymptom relationships. Such assessment would enable more comprehensive symptom management.
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Affiliation(s)
- Rachel A Roiland
- John A Hartford Building Academic Geriatric Capacity scholar, University of Wisconsin-Madison, USA.
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47
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Brandstätter M, Baumann U, Borasio GD, Fegg MJ. Systematic review of meaning in life assessment instruments. Psychooncology 2012; 21:1034-52. [PMID: 22232017 DOI: 10.1002/pon.2113] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 11/15/2011] [Accepted: 11/22/2011] [Indexed: 11/11/2022]
Affiliation(s)
- Monika Brandstätter
- Interdisciplinary Center for Palliative Medicine; Ludwig Maximilians University Munich; Munich; Germany
| | - Urs Baumann
- Department of Psychology; Paris Lodron University; Salzburg; Austria
| | - Gian Domenico Borasio
- Centre Hospitalier Universitaire Vaudois, Service de Soins Palliatifs; University of Lausanne; Switzerland
| | - Martin Johannes Fegg
- Interdisciplinary Center for Palliative Medicine; Ludwig Maximilians University Munich; Munich; Germany
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48
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Groarke A, Curtis R, Kerin M. Global stress predicts both positive and negative emotional adjustment at diagnosis and post-surgery in women with breast cancer. Psychooncology 2011; 22:177-85. [PMID: 22006585 DOI: 10.1002/pon.2071] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 08/17/2011] [Accepted: 08/19/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Individual differences in stress appraisal, coping, optimism and social support have contributed to variability in adjustment to breast cancer, but less is known about their relative influence particularly at diagnosis. The purpose of this study was to compare the predictive role of these variables on both positive and negative adjustment in a sample of recently diagnosed women. METHOD Data was collected from 241 women at diagnosis and post-surgery (4 months later). They completed questionnaires which assessed global and cancer-specific stress, general and cancer-specific coping, emotional adjustment (depression, anxiety, positive and negative affect) at Times 1 and 2 and benefit finding at Time 2. RESULTS Hierarchical regression analyses (all p < 0.01) taking account of age and cancer related variables (disease stage and type of surgery) showed that stress appraisal was the strongest and most consistent predictor of adjustment. The coping strategies, while significant, were less powerful predictors of emotional adjustment, but they explained more variance than stress on benefit finding. Stress and coping outweighed the impact of social support and optimism. CONCLUSIONS Global appraisal of stress was the most powerful predictor in the model, and findings suggest that it contributes to patients' affective status, indicating that women should be screened as part of the diagnostic process to identify those at risk for poor adaptation to the illness.
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Vehling S, Lehmann C, Oechsle K, Bokemeyer C, Krüll A, Koch U, Mehnert A. Is advanced cancer associated with demoralization and lower global meaning? The role of tumor stage and physical problems in explaining existential distress in cancer patients. Psychooncology 2010; 21:54-63. [DOI: 10.1002/pon.1866] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Revised: 07/29/2010] [Accepted: 09/13/2010] [Indexed: 11/10/2022]
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50
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Visser A, Garssen B, Vingerhoets A. Spirituality and well-being in cancer patients: a review. Psychooncology 2010; 19:565-72. [PMID: 19916163 DOI: 10.1002/pon.1626] [Citation(s) in RCA: 156] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cancer places many demands on the patient and threatens the person's sense of meaning to life. It has been shown that cancer patients use their spirituality to cope with these experiences. The present literature review summarizes the research findings on the relationship between spirituality and emotional well-being. Special attention is given to the strength of the research findings. METHODS A literature search was performed in Pubmed and Web of Science. Spirituality does not necessarily coincide with religiosity. Therefore, studies were excluded that focused on religiosity. Forty publications met the inclusion criteria: Twenty-seven studies that investigated the relationship between spirituality and well-being, and 13 publications that explored the relationship between meaning in life and well-being. RESULTS The majority of the cross-sectional studies (31 of 36) found a positive association between spirituality and well-being. The four studies with a longitudinal design showed mixed results. The significance of the findings is challenged, because most spirituality questionnaires contain several items that directly refer to emotional well-being. CONCLUSIONS Despite that the majority of the studies concluded that spirituality was associated with higher well-being, no definitive conclusions on this relationship can be drawn due to major methodological shortcomings of these studies. Longitudinal research utilizing spirituality and well-being measures that do not overlap in content is recommended.
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Affiliation(s)
- Anja Visser
- Helen Dowling Institute, Centre for Psycho-Oncology, Ultrecht, The Netherlands.
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