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Yan K, Lengacher CA, Dandamrongrak C, Wang HL, Hanson A, Beckie T. The Effect of Self-efficacy-Enhancing Interventions on Quality of Life of Cancer Survivors: A Systematic Review. Cancer Nurs 2024:00002820-990000000-00264. [PMID: 38899949 DOI: 10.1097/ncc.0000000000001372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
BACKGROUND The influence of self-efficacy-enhancing interventions on quality of life (QOL) is not clear with recent randomized controlled trials (RCTs) because current reviews only evaluated self-efficacy as an outcome. OBJECTIVES We conducted a systematic review to examine the effect of self-efficacy-enhancing interventions on QOL among patients with cancer and to summarize the effective determinants for designing self-efficacy-enhancing interventions. METHODS A systematic search was performed on studies published from January 2003 to May 2023 using PubMed, CINAHL, PsycINFO, and Web of Science. Included studies were RCTs, adults diagnosed with cancer, interventions with explicit self-efficacy components, and QOL as the outcome. RESULTS Nineteen RCTs were included. Risk-of-bias assessment revealed 12 studies with some concerns and 7 with high risk of bias. The mean intervention adherence rate was 88.2%; the most frequently listed reason for dropout was medical conditions and mortality. Self-efficacy interventions were shown to significantly improve at least 1 subscale of QOL in 9 of 19 studies, of which 7 studies used Bandura's 4 sources of self-efficacy. The interventions with between-session intervals shorter than 2 weeks, of 12-week duration, and with an in-person delivery approach were the most effective. CONCLUSIONS Self-efficacy-enhancing interventions show potential beneficial effects on QOL among cancer survivors. Interventions that use Bandura's 4 sources of self-efficacy strategies and have between-session intervals shorter than 2 weeks, an in-person approach, and 12-week intervention duration are recommended. IMPLICATIONS FOR PRACTICE Properly designed self-efficacy-enhancing interventions can facilitate behavioral change and improve QOL in cancer survivors.
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Affiliation(s)
- Kailei Yan
- Author Affiliations: College of Nursing (Drs Beckie, Lengacher, and Yan and Ms Dandamrongrak) and Shimberg Health Sciences Library (Dr Hanson), University of South Florida, Tampa; and School of Nursing, The University of Alabama at Birmingham (Dr Wang)
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Kim SY, Kim H, Chee W, Im EO. Relationships Between Socio-behavioral Factors and the Symptoms Among Asian American Breast Cancer Survivors: A Structural Equation Modeling. Cancer Nurs 2024:00002820-990000000-00248. [PMID: 38656247 DOI: 10.1097/ncc.0000000000001354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Despite increased research on breast cancer survivors, little is known about how socio-behavioral factors influence the symptoms among racial/ethnic minority breast cancer survivors, particularly Asian American breast cancer survivors (AABCS). OBJECTIVE This study examined the relationship between multiple socio-behavioral factors in AABCS, including attitudes, perceived barriers, and social influences, and their symptom experiences, with an emphasis on the mediating effect of self-efficacy. METHODS This secondary analysis used data collected from 195 AABCS women recruited through online and offline communities from January 2017 to June 2020. Study variables were measured using validated instruments such as the Questions on Attitudes, Self-Efficacy, Perceived Barriers, and Social Influences; the Cancer Behavior Inventory; and the Memorial Symptom Assessment Scale-Short Form. For structural equation modeling based on Bandura's self-efficacy theory, mediation analysis was performed using SPSS version 26.0 and AMOS 28. RESULTS The overall fitness of the hypothetical model to the data is acceptable (χ2 = 51.36, P < .001; goodness-of-fit index = 0.95, adjusted goodness-of-fit index = 0.89, comparative fit index = 0.96, Tucker-Lewis index = 0.94, normed fit index = 0.94, and root-mean-square error of approximation index = 0.08). Both attitudes and social influences indirectly influenced symptom distress through self-efficacy (β = -0.054, P = .019, and β = -0.053, P = .017, respectively). Perceived barriers had indirect effects through self-efficacy (β = 0.121, P = .024) and significant direct effects (β = 0.605, P = .003) on symptom distress. CONCLUSIONS Our findings supported that the self-efficacy for coping mediated their symptom experience among AABCS. In addition, there were significant relationships among attitudes, perceived barriers, social influences, and symptom experience. IMPLICATIONS FOR PRACTICE Future theory-driven interventions need to consider self-efficacy and socio-behavioral factors in symptom management among AABCS.
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Affiliation(s)
- Seo Yun Kim
- Author Affiliations: Department of Nursing, Gangneung-Wonju National University (Dr S.Y. Kim), Gangwon-do; Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University (Dr H. Kim), Seoul, South Korea; and School of Nursing, The University of Texas at Austin (Drs Chee and Im)
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Qu HM, Zhong HY, Xiao T, Li YJ, Ren P, Chen XJ. Perceived control, self-management efficacy, and quality of life in patients treated with radiation therapy for breast cancer: a longitudinal study. Support Care Cancer 2024; 32:284. [PMID: 38607445 DOI: 10.1007/s00520-024-08485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/03/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE This longitudinal study aims to examine the present state of perceived control, self-management efficacy, and overall quality of life (QoL) in patients with breast cancer undergoing radiotherapy, and gain insight into the dynamic trends and factors that influence the quality of life experienced by patients during the course of radiotherapy. METHODS Participants completed the Cancer Experience and Efficacy Scale (CEES), Strategies Used by People to Promote Health (SUPPH), and Functional Assessment of Cancer Therapy- Breast (FACT-B). The data was analyzed using the software SPSS26.0. Repeated measures analysis of variance (ANOVA) and mixed-effects linear models were used to analyze trends in perceived control, self-management efficacy, and QoL at three-time points, as well as factors affecting QoL during radiotherapy. RESULTS Perceived control and self-management efficacy were associated with QoL over the course of the radiotherapy. Self-management efficacy (β = 0.30, P < 0.001), presence of chemotherapy (β = 18.33, P = 0.024), and duration of illness (β = 2.25, P = 0.028) had a positive effect on the change in QoL, while time (β = - 2.95, P < 0.001), cancer experience (β = - 0.46, P < 0.001), and type of medical insurance (β = - 2.77, P = 0.021) had the negative effect on the change in QoL. CONCLUSION The QoL, perceived control, and self-efficacy of patients with breast cancer show dynamic changes during radiotherapy. The higher the self-efficacy, the better the QoL, and the worse the QoL when the sense of disease control is poor. At the same time, more attention should be paid to the QoL of breast cancer radiotherapy patients with a long course of the disease, receiving chemotherapy, and different medical payment methods.
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Affiliation(s)
- Hai-Mei Qu
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Nursing, Xuanhan County People's Hospital, Dazhou, Sichuan, China
| | - Hong-Yue Zhong
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Tian Xiao
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Yan-Jun Li
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Nursing, Suining Central Hospital, Suining, Sichuan, China
| | - Pan Ren
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Xiao-Ju Chen
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China.
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Engelman B, Pratt-Chapman ML, Mead KH, Wang Y, Arem H. The association between a patient-centered quality of care index and self-efficacy among cancer survivors. J Cancer Surviv 2024:10.1007/s11764-024-01581-8. [PMID: 38589757 DOI: 10.1007/s11764-024-01581-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/30/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE The number of cancer survivors in the US surpassed 18.1 million in 2022 and this number continues to grow. Patient self-efficacy, a patient's confidence in his or her ability to self-manage symptoms and healthcare concerns, has been linked to improved health outcomes. We thus set out to examine the association between a patient-centered care quality index and self-efficacy among cancer survivors. METHODS Data from 777 survivors of breast, prostate, and colorectal cancers at 32 cancer centers nationwide were collected 6 months after an initial survivorship visit. Patients completed surveys assessing patient-centered care (36 items under seven factors) and individual self-efficacy (eight items). Multiple linear regression was used to examine the association between patient-centered care and patient self-efficacy, adjusting for demographics, cancer-related characteristics, and organizational characteristics of high-quality patient-centered survivorship care. RESULTS In descriptive analyses, there were no statistically significant differences in demographic or cancer-related characteristics between cancer survivors by quality of patient-centered care. In regression models, a one-unit increase in patient-centered care was associated with a 0.23 (95% CI 0.14-0.32) increase in mean self-efficacy compared to low quality of patient-centered care when adjusting for demographics, cancer-related characteristics, and indicators of high-quality survivorship care. Individually, four of the seven factors of quality patient-centered care were statistically significantly associated with greater self-efficacy. Having a medical home was associated with the greatest increase in self-efficacy among survivors. CONCLUSION Our findings indicate that higher quality patient-centered care is associated with greater cancer survivor self-efficacy. Given that self-efficacy is correlated with improved health outcomes and quality of life, this finding further supports the importance of high-quality patient-centered survivorship care. IMPLICATIONS OF CANCER SURVIVORS High-quality patient-centered survivorship care was associated with higher patient self-efficacy. This association should further be explored among cancer survivors with diverse characteristics.
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Affiliation(s)
- Brittany Engelman
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, 5 E. 98th St. B-12, New York, NY, 10029, USA.
| | - Mandi L Pratt-Chapman
- George Washington University Cancer Center, Washington, DC, USA
- Department of Medicine, George Washington University, School of Medicine and Health Sciences, Washington, DC, USA
| | - K Holly Mead
- School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Hannah Arem
- Medstar Health Research Institute, Healthcare Delivery Research, Washington, DC, USA
- Department of Oncology, Georgetown University, Washington, DC, USA
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Zhu J, Chen SH, Guo JY, Li W, Li XT, Huang LH, Ye M. Effect of digital storytelling intervention on resilience, self-efficacy and quality of life among patients with non-small cell lung cancer (NSCLC): A randomized controlled trial. Eur J Oncol Nurs 2024; 69:102535. [PMID: 38401347 DOI: 10.1016/j.ejon.2024.102535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/03/2024] [Accepted: 02/16/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE To verify and compare whether the digital stories could effectively improve the resilience, self-efficacy and quality of life of postoperative NSCLC patients. MATERIALS AND METHODS A total of 90 participants at baseline were randomly assigned to two groups, 45 patients per group. The intervention group received the digital storytelling intervention which includes 4 videos on different topics: positive psychological quality, cultivating healthy living habits, establishing good social support, and insisting on scientific exercise, whereas the control group received only routine care. The resilience, self-efficacy, and quality of life were assessed at baseline (T0) (within 3 days before surgery), immediately after intervention (T1), one month after intervention (T2), and three months after intervention (T3). A linear mixed effects model was used to test the effects of the digital storytelling interventions on resilience, self-efficacy, and quality of life. RESULTS The intervention group reported significantly greater improvements in resilience, self-efficacy, and quality of life (all P < 0.001) at follow-ups than the control group after controlling for age, gender, and education level as covariates. Moreover, the sensitivity analysis results are consistent with the per-protocol, that overall time × group interactions effects were significantly different in resilience, self-efficacy, and quality of life (all P < 0.001). CONCLUSION The digital storytelling intervention based on lung cancer survivors' experience can effectively improve resilience, self-efficacy and quality of life in postoperative lung cancer patients. More comprehensive researches are needed to evaluate the longer-term impacts of the DST and its feasibility for those with more advanced cancer.
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Affiliation(s)
- Jie Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China; Xiangya Nursing School of Central South University, Changsha, Hunan, 410013, China.
| | - Shi-Hao Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China; Xiangya Nursing School of Central South University, Changsha, Hunan, 410013, China.
| | - Jia-Yi Guo
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China; Xiangya Nursing School of Central South University, Changsha, Hunan, 410013, China.
| | - Wei Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China; Xiangya Nursing School of Central South University, Changsha, Hunan, 410013, China.
| | - Xu-Ting Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China; Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| | - Li-Hua Huang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China; Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| | - Man Ye
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China; Xiangya Nursing School of Central South University, Changsha, Hunan, 410013, China; Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
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Hsia HH, Tien Y, Lin YC, Huang HP. Factors Influencing Health Promotion Lifestyle in Female Breast Cancer Survivors: The Role of Health Behavior Self-Efficacy and Associated Factors. Semin Oncol Nurs 2024:151622. [PMID: 38522967 DOI: 10.1016/j.soncn.2024.151622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/21/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVES To examine the factors influencing health-promoting lifestyles and the changes in health behavior self-efficacy and health-promoting lifestyles among female breast cancer survivors over a 6-month period. METHODS A longitudinal design with purposive sampling was deployed. Data collection occurred at the baseline (T1), 3 months (T2), and 6 months (T3). In total, 53 breast cancer survivors agreed to participate. All participants completed the first two rounds of data collection, 49 participants completed data collection at the 6-month mark (T3). The Chinese versions of the Self-Rated Abilities for Health Practices Scale (SRAHP) and the Health-Promoting Lifestyle Profile (HPLP) were used. RESULTS Health behavior self-efficacy and health-promoting lifestyle scores increased over time. Age, impaired cardiac function, those taking a career break, psychological well-being, and responsible health practice in self-efficacy for health behaviors were significant predictors of health-promoting lifestyle. CONCLUSIONS Younger breast cancer survivors, those taking a career break, and those with poor health behavior self-efficacy were less likely to engage in a health-promoting lifestyle and may require guidance in improving overall health behaviors. IMPLICATIONS FOR NURSING PRACTICE Healthcare providers should not only be aware of the suboptimal health promotion lifestyle in breast cancer survivors but also focus on enhancing health behavior self-efficacy. This is particularly crucial for younger breast cancer survivors or those currently unemployed.
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Affiliation(s)
- Hui-Hsien Hsia
- Registered Professional Nurse, Department of Nursing, Taipei Municipal WanFang Hospital, Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taiwan
| | - Yun Tien
- Psychiatrist, Department of Psychiatry, Taoyuan Psychiatric Center, Taiwan
| | - Yung-Chang Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Hsiang-Ping Huang
- Associate Professor & Director, Department of Nursing, Chang Gung University of Science and Technology, Taiwan; Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan.
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Wang C, Wacharasin C, Hengudomsub P. Self-efficacy as mediators of the association between dyadic coping and quality of life among spousal caregiver of patients with cervical cancer. Asia Pac J Oncol Nurs 2024; 11:100354. [PMID: 38426044 PMCID: PMC10904169 DOI: 10.1016/j.apjon.2023.100354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/30/2023] [Indexed: 03/02/2024] Open
Abstract
Objective This study aims to explore the influence of dyadic coping (DC) on the quality of life (QoL) of spousal caregivers for patients with cervical cancer and to investigate the mediating role of self-efficacy in this relationship. Methods A convenience sample of 206 spouses of cervical cancer patients from five hospitals in Jiangsu Province, China, was included in the study. The participants completed three instruments: the 12-item Short-Form Health Survey, the General Self-Efficacy Scale, and the Dyadic Coping Inventory. Structural Equation Modeling (SEM) was used to analyze the mediating effect of self-efficacy in the DC and QoL relationship. Results The study found a positive correlation between self-efficacy and DC. Self-efficacy partially mediated the impact of DC on QoL, accounting for 16% of the total effect. Self-efficacy played a mediating role in facilitating the indirect positive effects of DC on QoL. Conclusions Spousal caregivers of cervical cancer patients frequently experience a relatively low QoL. The results suggest that interventions aimed at enhancing DC among spousal caregivers should incorporate strategies to improve self-efficacy, given its mediating role in the positive relationship between DC and QoL.
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Affiliation(s)
- Chuntao Wang
- Faculty of Nursing, Burapha University, Muang, Chonburi, Thailand
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, China
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Moore C, Gallagher P, Dunne S. Health literacy, eHealth literacy and their association with burden, distress, and self-efficacy among cancer caregivers. Front Psychol 2024; 15:1283227. [PMID: 38434952 PMCID: PMC10904647 DOI: 10.3389/fpsyg.2024.1283227] [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: 09/05/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose Health literacy skills are vital for cancer caregivers in helping cancer survivors to navigate their diagnosis, treatment, and recovery but little is known. This study explored health literacy and eHealth literacy among cancer caregivers and the relationship between health literacy/eHealth literacy and potential associated factors. Methods Informal caregivers who had cared for an individual with cancer completed a survey which collected demographic data and measured caregiver health literacy, eHealth literacy, self-efficacy, burden, and distress. Results Seven percent of caregivers had inadequate health literacy. Caregivers scored lowest on health literacy domains related to caregiver social support, information seeking and understanding care recipient preferences. eHealth literacy was associated with self-efficacy and burden while, different health literacy domains were associated with burden ('Understanding care recipient needs and preferences'), self-efficacy ('Cancer-related communication with the care recipient' and 'Understanding care recipients needs and preferences') and distress ('Proactivity and determination to seek information', 'Understanding care recipient needs and preferences', 'Understanding the healthcare system'). Conclusion Findings highlight key areas of need regarding cancer caregiver health literacy which future research can target. Given the observed relationship between aspects of health literacy and burden, distress and self-efficacy future work could be carried out on how to alleviate high levels of burden and distress and how to enhance self-efficacy among cancer caregivers by addressing health literacy skills. Implications for cancer survivors Findings from this study will inform the development of health literacy interventions to support caregivers to build their health literacy skills and enable this group to better support cancer survivors as a result.
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Affiliation(s)
- Chloe Moore
- School of Psychology, Dublin City University, Dublin, Ireland
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Low NJH, Leow DGW, Klainin-Yobas P. Effectiveness of Technology-Based Psychosocial Interventions on Psychological Outcomes Among Adult Cancer Patients and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2024; 40:151533. [PMID: 37977974 DOI: 10.1016/j.soncn.2023.151533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Technology-based psychosocial interventions (TBPIs) have increasingly gained intention. However, the effectiveness of TBPIs on psychological outcomes remains inconclusive. This review aimed to evaluate the effectiveness of TBPIs on health-related quality of life (HRQOL), coping, self-efficacy, and depression among adult cancer patients and caregivers. DATA SOURCES Randomised controlled trials (RCTs) evaluating the effectiveness of TBPIs targeting adult cancer patients, caregivers, or patient-caregiver dyads were included. English articles dated from 2012 to 2022 were retrieved from eight electronic databases, three clinical trial registries, and six grey literature databases. Two reviewers independently screened, appraised, and extracted data. The Cochrane risk of bias assessment tool and GRADE were used to appraise the methodological quality of included studies. Meta-analyses and subgroup analyses were undertaken with statistical pooling of standardized mean differences based on the random-effects model. CONCLUSION Totally, 37 RCTs were included in the review, with 35 trials for meta-analysis. Results demonstrated improvements in HRQOL, self-efficacy, and depression among cancer patients and caregivers with varying pooled effect sizes. Subgroup analyses suggested that dyadic TBPIs were more effective in improving HRQOL among cancer patients and caregivers, compared with those solely targeted at cancer patients or caregivers. IMPLICATION FOR NURSING PRACTICE Findings value-added to the existing evidence base on TBPIs. An interactive patient-caregiver dyadic program integrating TBPIs into routine oncology care is recommended to improve health outcomes for cancer patients and caregivers. Well-designed future RCTs are required to further evaluate the effectiveness of dyadic TBPIs, with emphasis on coping and self-efficacy outcomes among cancer patients and caregivers.
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Affiliation(s)
| | - Darryl Ge Wei Leow
- Staff Nurse, Woodlands Health Campus, Yishun Community Hospital, Singapore
| | - Piyanee Klainin-Yobas
- Associate Professor, Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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Furnham A, Cheng H. The Big-Five personality factors, cognitive ability, health, and social-demographic indicators as independent predictors of self-efficacy: A longitudinal study. Scand J Psychol 2024; 65:53-60. [PMID: 37525487 DOI: 10.1111/sjop.12953] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/02/2023]
Abstract
This study set out to examine to what extent a set of psychological, health and socio-demographic factors are associated with self-efficacy (SE) in a large sample of over 12,000 participants over a two-year period. We were interested in the correlates of self-efficacy (criterion variable) with gender, age, education and occupation, the Big-Five personality factors and cognitive ability, as well as mental and physical health (predictor variables). Regression analyses showed that four of the Big-Five personality factors (extraversion, neuroticism, conscientiousness, and openness), cognitive ability, mental and physical health, gender, education and occupation were all significant and independent predictors of self-efficacy, accounting for 23% of the variance of the outcome variable. Personality variables, particularly Neuroticism and Conscientiousness, were the most powerful predictors of SE two years later. The implications for encouraging SE in individuals are discussed.
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Affiliation(s)
| | - Helen Cheng
- Department of Psychology, University College London, London, UK
- ESRC Centre for Learning and Life Chances in Knowledge Economies and Societies, Institute of Education, University College London, London, UK
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Fethney J, Kim B, Boustany C, McKenzie H, Hayes L, Cox K, Simpson JM, Horvath LG, Vardy JL, McLeod J, Willcock S, Cook N, Acret L, White K. Evaluating a shared care pathway intervention for people receiving chemotherapy to reduce post-treatment unplanned hospital presentations: a randomised controlled trial. Support Care Cancer 2024; 32:77. [PMID: 38170289 PMCID: PMC10764538 DOI: 10.1007/s00520-023-08261-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The aim of this randomised controlled trial (RCT) was to explore whether a community nursing intervention for outpatients receiving systemic therapy reduced unplanned hospital presentations and improved physical and psychosocial health outcomes over the first three cycles of treatment compared to a control group receiving standard care. METHODS The number of and reasons for unplanned presentations were obtained for 170 intervention and 176 control group adult patients with solid tumours starting outpatient chemotherapy. Poisson regression was used to compare the number of presentations between the intervention and control groups. Patients self-completed the Hospital Anxiety and Depression Scale, the Cancer Behavior Inventory and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) at the start of the first four cycles. Linear regression techniques were used to compare quality of life outcomes. RESULTS The reduction in unplanned presentations in the intervention group relative to the control group was 12% (95% CI, - 25%, 37%; P = 0.48). At the start of cycle 4, there was no difference in anxiety (difference = 0.47 (95% CI, - 0.28, 1.22; P = 0.22)), depression (difference = 0.57 (95% CI, - 0.18, 1.31; P = 0.13)) or EORTC QLQ-C30 summary score (difference = 0.16 (95% CI, - 2.67, 3.00; P = 0.91)). Scores for self-efficacy as measured by the Cancer Behavior Inventory were higher in the intervention group (difference = 4.3 (95% CI, 0.7, 7.9; P = 0.02)). CONCLUSION This RCT did not demonstrate a benefit in reducing unplanned presentations to hospital. The trial identified improved cancer-based self-efficacy in patients receiving the intervention. TRIAL REGISTRATION Registered at Australian and New Zealand Clinical Trials Registry: ACTRN12614001113640, registered 21/10/2014.
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Affiliation(s)
- Judith Fethney
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia.
| | - Bora Kim
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia
- Cancer Care Research Unit, Sydney Local Health District, The University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Chantale Boustany
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia
- Cancer Care Research Unit, Sydney Local Health District, The University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Heather McKenzie
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia
| | - Lillian Hayes
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia
| | - Keith Cox
- Chris O'Brien Lifehouse, Sydney, Australia
| | - Judy M Simpson
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Lisa G Horvath
- Chris O'Brien Lifehouse, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Janette L Vardy
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Local Health District, Sydney, Australia
| | - Jodi McLeod
- Sydney District Nursing, Sydney Local Health District, Sydney, Australia
| | - Simon Willcock
- MQ Health, Macquarie University Hospital, Primary Care, Sydney, Australia
| | | | - Louise Acret
- Cancer Care Research Unit, Sydney Local Health District, The University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Kate White
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia
- Cancer Care Research Unit, Sydney Local Health District, The University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
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Ortiz M, Schröder ML, Brinkhaus B, Stöckigt B. Implementation of a Mindful Walking Intervention in Breast Cancer Patients After Their Primary Oncologic Treatment: Results of a Qualitative Study Within a Randomized Controlled Trial. Integr Cancer Ther 2024; 23:15347354241237972. [PMID: 38654515 PMCID: PMC11041535 DOI: 10.1177/15347354241237972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Breast cancer survivors often suffer from diagnosis- and therapy-related long-term side effects, such as cancer related fatigue, restricted stress resilience and quality of life. Walking as a physical activity and mindfulness practice have been shown to be helpful in studies. The aim of this study was to compare the individual experiences and subjectively perceived effects of walking in combination with mindfulness practice with moderate walking alone in breast cancer patients. This paper focuses on the qualitative results of a mixed-methods pilot study. METHODS Breast cancer patients who had finished their primary oncologic treatment at least 6 months ago were randomized to an 8-week group intervention program of either mindful walking or moderate walking. Within the qualitative study part, semi-structured focus group interviews (2 interviews per study arm) were conducted and analyzed using a qualitative content analysis approach. Audio recorded interviews were transcribed verbatim and pseudonymized. The subsequent data analysis was performed by using MAXQDA®. RESULTS A total of 51 women (mean age 55.8 [SD 10.9] years) were included in the RCT, among these 20 (mean age 56.7 [SD 12.0] years) participated in the focus group interviews (n = 11 patients of the mindful walking group; n = 9 patients of the walking group). Breast cancer patients in both groups described different effects in the complex areas of self-efficacy, coping, body awareness and self-reflection. While mindful walking primarily promoted body awareness and inner strength by mindfulness in breast cancer patients, moderate walking promoted self-efficacy by a confidence of their body and an easily integrated and accepted way of physical activity. CONCLUSIONS Study interventions and the study setting triggered processes and reflections on one's own health and situation. However, mindful walking and moderate walking seem to address different resources. This important knowledge may help oncologists and other therapists to assess what type of interventions can best meet the needs and requirements of individual patients. TRIAL REGISTRATION DKRS00011521; prospectively registered 21.12.2016; https://drks.de/search/de/trial/DRKS00011521.
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Affiliation(s)
- Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Maren Luise Schröder
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Barbara Stöckigt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
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Post KE, Ahmad Z, Jankauskaite G, Centracchio J, Oswald L, Horick N, Park ER, Temel JS, Greer JA, Jacobs J. Managing Symptom Distress: Key Factors for Patients on Adjuvant Endocrine Therapy for Breast Cancer. J Pain Symptom Manage 2024; 67:88-97. [PMID: 37816436 PMCID: PMC10842924 DOI: 10.1016/j.jpainsymman.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023]
Abstract
CONTEXT Patients with breast cancer taking adjuvant endocrine therapy (AET) experience significant symptoms impacting mood, quality of life (QOL), and AET adherence and satisfaction. OBJECTIVES The aim of this study was to examine the extent to which coping ability and self-efficacy for symptom management moderate the relationships between patients' symptom distress and their mood, QOL, and AET adherence and satisfaction. METHODS As part of a randomized controlled trial, participants completed baseline measures including: sociodemographics, symptom distress (breast cancer prevention trial symptom checklist), coping skills (measure of current status), self-efficacy (self-efficacy for managing symptoms), anxiety and depression (hospital anxiety and depression scale), QOL (functional assessment of cancer therapy - general), AET adherence (medication adherence report scale), and AET satisfaction (cancer therapy satisfaction questionnaire). We conducted moderated regression analyses to examine whether coping and self-efficacy moderated the associations of symptom distress with baseline measures. RESULTS Coping skills moderated the associations of symptom distress with depression and QOL. Among those with lower coping, higher symptom distress was associated with worse depression symptoms (p=.04) and worse QOL (p < 0.001). Self-efficacy moderated the associations of symptom distress with depression symptoms and AET adherence and satisfaction. Among those with higher self-efficacy, higher symptom distress was associated with worse depression symptoms (p < 0.001), worse AET adherence (p < 0.001), and less AET satisfaction (p = 0.01). CONCLUSION Coping skills may buffer the effect of AET symptom distress. Findings indicate the relationship between symptom distress and self-efficacy is more nuanced and requires further research to better understand.
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Affiliation(s)
- Kathryn E Post
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA.
| | - Zeba Ahmad
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Greta Jankauskaite
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Joely Centracchio
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Laura Oswald
- Moffitt Cancer Center (O.L.), Tampa, Florida, USA
| | - Nora Horick
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Elyse R Park
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Jennifer S Temel
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Joseph A Greer
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Jamie Jacobs
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
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14
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Li H, Lyu M, Wang A, Yin Y, Zhang J, Li P. Social Support and Life Satisfaction in Women With Cervical Cancer: A Serial Multiple Mediation Model. Cancer Nurs 2024; 47:64-71. [PMID: 36322694 DOI: 10.1097/ncc.0000000000001146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although the number of studies focusing on life satisfaction in women with cervical cancer is increasing, there are limited studies on the pathway between social support and life satisfaction in this population. OBJECTIVE This study explored the pathway between social support and life satisfaction in women with cervical cancer by examining the serial mediating effects of self-care self-efficacy, coping strategies, and depressive symptoms. METHODS In this cross-sectional study, a total of 292 women with cervical cancer completed a questionnaire for assessing social support, self-efficacy, coping strategies, depressive symptoms, and life satisfaction. Structural equation modeling was used to test the direct and/or indirect effects of the variables on life satisfaction. RESULTS Structural equation modeling analysis indicated that self-efficacy, coping strategies, and depressive symptoms mediates the effect of social support on life satisfaction. Direct paths from social support to life satisfaction, social support to self-efficacy, self-efficacy to coping strategies, coping strategies to depressive symptoms, and depressive symptoms to life satisfaction were significant ( P < .05). Moreover, indirect paths from social support to life satisfaction, self-efficacy to life satisfaction, and coping strategies to life satisfaction were also significant ( P < .05). CONCLUSIONS Self-care self-efficacy, coping strategies, and depressive symptoms are potential pathways through which social support may affect life satisfaction in women with cervical cancer. IMPLICATION Healthcare providers, family, and friends should offer more social support to the patients and make efforts to strengthen their self-care self-efficacy, facilitate active coping, and alleviate depressive symptoms to improve women's life satisfaction.
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Affiliation(s)
- Hui Li
- Author Affiliations: Department of Orthopedics, West China Hospital/Sichuan University West China School of Nursing, Sichuan University (Ms H. Li and Ms P. Li), Chengdu, Sichuan, PR China; Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore (Dr Lyu), Singapore, Singapore; School of Nursing, Fudan University (Dr Wang), Shanghai, PR China; Xiangya Nursing School, Central South University (Drs Yin and Zhang), Changsha, Hunan, PR China
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Romero-Ayuso D, Jara-Urzúa A, Ramírez-Ramírez R, Ortiz-Rubio A, Prieto-Moreno R, Triviño-Juárez JM. Relationship between engagement in meaningful activities, self-efficacy, and quality of life in healthy young adults: An exploratory study. Scand J Occup Ther 2023; 30:1330-1338. [PMID: 37262336 DOI: 10.1080/11038128.2023.2218573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The use of meaningful activities promotes health and well-being. There is no study with a healthy adult Spanish population that tries to determine how people engage in meaningful activities and the relationship between self-efficacy and quality of life. AIMS This study aimed to 1) confirm the construct validity of the Engagement in Meaningful Activities Survey (EMAS) with a healthy population; 2) evaluate the internal consistency of the EMAS for a non-clinical population, and 3) examine convergent validity with self-efficacy (General Self-Efficacy) and health-related quality of life. MATERIAL AND METHODS The methodology for construct validation and reliability of health questionnaires was conducted. A total of 177 non-clinical adults participated, between 18 and 60 years old. Confirmatory factor analysis was performed, and Cronbach's alpha was obtained to measure internal consistency for EMAS. A correlation analysis was performed with the other variables of interest: self-efficacy and quality of life. RESULTS The two-dimensional structure of the EMAS for the non-clinical adult population is confirmed: personal emotional competence versus the social experiential component. In addition, the results indicate a moderate association between engagement in meaningful activities and self-efficacy. CONCLUSION The EMAS is a valid questionnaire to be used in the Spanish adult population.
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Affiliation(s)
- Dulce Romero-Ayuso
- Department of Physical Therapy, Occupational Therapy Division, University of Granada, Granada, Spain
- Brain, Mind and Behaviour Research Center (CIMCYC), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
| | | | | | - Araceli Ortiz-Rubio
- Department of Physical Therapy, Occupational Therapy Division, University of Granada, Granada, Spain
| | - Rafael Prieto-Moreno
- PA-HELP 'Physical Activity for HEaLth Promotion' Research Group, 16741 Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - José Matías Triviño-Juárez
- Department of Radiology and Physical Medicine, Faculty of Medicine, University of Granada, Granada, Spain
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16
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Karademas EC, Roziner I, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Stamatakos G, Cardoso F, Frasquilho D, Kolokotroni E, Lemos R, Marzorati C, Mattson J, Pettini G, Spyropoulou E, Poikonen-Saksela P, Simos P. The mutual determination of self-efficacy to cope with cancer and cancer-related coping over time: a prospective study in women with breast cancer. Psychol Health 2023; 38:1635-1648. [PMID: 35147473 DOI: 10.1080/08870446.2022.2038157] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/10/2021] [Accepted: 12/28/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of this study was to examine the longitudinal impact of self-efficacy to cope with cancer on the cancer-related coping reactions of breast cancer patients and vice versa. DESIGN AND MAIN OUTCOMES MEASURES Data from the BOUNCE Project (https://www.bounce-project.eu/) were used to address the hypotheses. Participants (N = 403) were enrolled in the study a few weeks after surgery or biopsy. Coping self-efficacy was assessed at baseline and six months later (M6). Cancer-related coping was assessed three (M3) and nine months (M9) after baseline. The analyses were performed using structural equation modeling with Mplus 8.6. RESULTS Baseline coping self-efficacy predicted all M3 coping reactions, while M6 coping self-efficacy also predicted changes in all but one M9 coping reaction. Moreover, one of the M3 coping reactions, that is, hopelessness/helplessness, predicted the changes in M6 coping self-efficacy. The relation between coping self-efficacy and one coping reaction (i.e. cognitive avoidance) was rather weak. Stability paths from M3 to M9 coping reactions were moderate to high. CONCLUSION The relationship between self-efficacy to cope with cancer and cancer-related coping is complex. New theoretical models are needed to more accurately describe the diverse aspects of this association.
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Affiliation(s)
- E C Karademas
- Department of Psychology, University of Crete, Rethymno, Greece
- Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - I Roziner
- Department of Communication Disorders, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - K Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - R Pat-Horenczyk
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - B Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - A J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
- NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal
| | - G Stamatakos
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - D Frasquilho
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
| | - E Kolokotroni
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - R Lemos
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
| | - C Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - J Mattson
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - G Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - E Spyropoulou
- Department of Psychology, University of Crete, Rethymno, Greece
| | - P Poikonen-Saksela
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - P Simos
- Foundation for Research and Technology - Hellas, Heraklion, Greece
- Medical School, University of Crete, Rethymno, Greece
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17
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Karademas EC, Mylona E, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Oliveira J, Roziner I, Stamatakos G, Cardoso F, Kondylakis H, Kolokotroni E, Kourou K, Lemos R, Manica I, Manikis G, Marzorati C, Mattson J, Travado L, Tziraki-Segal C, Fotiadis D, Poikonen-Saksela P, Simos P. Well-being trajectories in breast cancer and their predictors: A machine-learning approach. Psychooncology 2023; 32:1762-1770. [PMID: 37830776 DOI: 10.1002/pon.6230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE This study aimed to describe distinct trajectories of anxiety/depression symptoms and overall health status/quality of life over a period of 18 months following a breast cancer diagnosis, and identify the medical, socio-demographic, lifestyle, and psychological factors that predict these trajectories. METHODS 474 females (mean age = 55.79 years) were enrolled in the first weeks after surgery or biopsy. Data from seven assessment points over 18 months, at 3-month intervals, were used. The two outcomes were assessed at all points. Potential predictors were assessed at baseline and the first follow-up. Machine-Learning techniques were used to detect latent patterns of change and identify the most important predictors. RESULTS Five trajectories were identified for each outcome: stably high, high with fluctuations, recovery, deteriorating/delayed response, and stably poor well-being (chronic distress). Psychological factors (i.e., negative affect, coping, sense of control, social support), age, and a few medical variables (e.g., symptoms, immune-related inflammation) predicted patients' participation in the delayed response and the chronic distress trajectories versus all other trajectories. CONCLUSIONS There is a strong possibility that resilience does not always reflect a stable response pattern, as there might be some interim fluctuations. The use of machine-learning techniques provides a unique opportunity for the identification of illness trajectories and a shortlist of major bio/behavioral predictors. This will facilitate the development of early interventions to prevent a significant deterioration in patient well-being.
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Affiliation(s)
- Evangelos C Karademas
- Department of Psychology, University of Crete, Rethymnon, Greece
- Foundation for Research and Technology-Hellas, Heraklion, Greece
| | - Eugenia Mylona
- Foundation for Research and Technology-Hellas, Heraklion, Greece
| | - Ketti Mazzocco
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Jose Oliveira
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ilan Roziner
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Georgios Stamatakos
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | | | - Eleni Kolokotroni
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | | | - Raquel Lemos
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
- ISPA-Instituto Universitário de Ciências Psicológicas, Sociais e da Vida, Lisboa, Portugal
| | - Isabel Manica
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - George Manikis
- Foundation for Research and Technology-Hellas, Heraklion, Greece
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Johanna Mattson
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Luzia Travado
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | | | - Dimitris Fotiadis
- Foundation for Research and Technology-Hellas, Heraklion, Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Panagiotis Simos
- Foundation for Research and Technology-Hellas, Heraklion, Greece
- Medical School, University of Crete, Rethymnon, Greece
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Skwirczyńska E, Cymbaluk-Płoska A, Wróblewski O. Psychological Associations of Stress with the Level of Health Locus of Control and Self-Efficacy in Patients with Ovarian Cancer. J Clin Med 2023; 12:6816. [PMID: 37959283 PMCID: PMC10650488 DOI: 10.3390/jcm12216816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/27/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this study was to analyze the locus of health control, self-efficacy and stress coping styles of female patients treated for ovarian cancer. Learning the styles of coping with stress in patients with ovarian cancer may contribute to improve their quality of life after cancer diagnosis. A series of Pearson's r-analyses was performed in the order to evaluate the hypotheses regarding the relationship between styles of coping with stress, the locus of health control and self-efficacy. A total of 151 female patients participated in this study. Standardized psychological questionnaires were used: the General Self-Efficacy Scale (GSES) to measure coping with difficult situations and obstacles, the Multi-Dimensional Health Locus of Control Scale (MHLC) to measure health control and the Convergence Insufficiency Symptom Survey (CISS) to measure stress coping styles. All questionnaires had an adaptation in Polish. Patients using task-focused and socializing styles had higher self-efficacy, whereas focusing on negative emotions resulted in lower self-efficacy. External locus of health control was related to a task-focused approach to treatment. On the other hand, the focus on negative emotions was related to the feeling that the fate of patients was decided by chance. Self-efficacy was positively associated with internal locus of health control and with external control, which means the influence of others. The results of our study indicate the need for a multidimensional approach to the treatment of female patients with ovarian cancer. The psychological condition of female patients has an ongoing relationship with their physical health.
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Affiliation(s)
- Edyta Skwirczyńska
- Department of the History of Medicine and Medical Ethics, Pomeranian Medical University, Rybacka 1, 70-204 Szczecin, Poland
| | - Aneta Cymbaluk-Płoska
- Clinical Department of Reconstructive and Oncological Gynecology, Pomeranian Medical University, 70-204 Szczecin, Poland; (A.C.-P.); (O.W.)
| | - Oskar Wróblewski
- Clinical Department of Reconstructive and Oncological Gynecology, Pomeranian Medical University, 70-204 Szczecin, Poland; (A.C.-P.); (O.W.)
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Sardessai-Nadkarni AA, Street RL. Understanding the pathways linking patient-centered communication to cancer survivors' emotional health: examining the mediating roles of self-efficacy and cognitive reappraisal. J Cancer Surviv 2023; 17:1266-1275. [PMID: 35167049 DOI: 10.1007/s11764-022-01170-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/10/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE Many cancer survivors commonly face psychological health issues upon cancer diagnosis, both during and after treatment. Patient-centered communication can play an important role in improving health outcomes among cancer survivors across the cancer continuum. The current study examined the influence of patient-centered communication on self-efficacy in managing health, cognitive reappraisal, and emotional distress among cancer survivors. METHODS The analysis was conducted on a subsample of 809 cancer survivors acquired from a nationally representative 2019 Health Information National Trends Survey 5 (Cycle 3). Multivariate regression analysis was conducted to explore the pathways through which patient-centered communication can be associated with cancer survivors' emotional distress, mediated by self-efficacy and cognitive reappraisal. RESULTS The results indicated that effective patient-centered provider communication led to higher self-efficacy in managing health, greater involvement in cognitive reappraisal, and decreased emotional distress among cancer survivors. Additionally, the results revealed that the effect of patient-centered communication that led to decreased emotional distress was fully mediated through self-efficacy and cognitive reappraisal. CONCLUSIONS Although patient-centered communication positively relates to various emotional health outcomes among cancer survivors, it does not affect their emotional health directly. Self-efficacy and cognitive reappraisal play a crucial role in explaining the underlying mechanisms of such effects. IMPLICATIONS FOR CANCER SURVIVORS Future interventions to promote patient-centered communication in cancer care should give more emphasis to managing patients' emotions. Providers should not only recognize, elicit, and respond to patient's emotions, but also develop emotional regulation skills among patients, and improve their ability to cope with emotional distress.
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Affiliation(s)
| | - Richard L Street
- Department of Communication, Texas A&M University, College Station, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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20
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Choi YY, Rha SY, Park JS, Song SK, Lee J. Cancer coping self-efficacy, symptoms and their relationship with quality of life among cancer survivors. Eur J Oncol Nurs 2023; 66:102373. [PMID: 37499402 DOI: 10.1016/j.ejon.2023.102373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE Cancer coping self-efficacy refers to an individual's confidence in dealing with challenges from cancer-related events, and a positive association with quality of life (QoL) has been demonstrated. Considering unresolved physical and psychological symptoms at the survivorship phase, which are known to worsen QoL, the association between cancer coping self-efficacy and QoL needs to be evaluated controlling for known contributing factors of QoL. This study aimed to describe cancer survivors' cancer coping self-efficacy, symptoms and their relationship with QoL. METHODS A descriptive correlational study was conducted. Participants were cancer survivors who completed intended treatment except for hormone therapy (N = 240). Cancer coping self-efficacy, symptoms, and QoL were measured. To evaluate the association of cancer survivors' cancer coping self-efficacy with QoL, correlation and multiple regression analysis were conducted. RESULTS Cancer coping self-efficacy demonstrated a significant positive association with QoL. Symptoms had a significant negative association with QoL. Fully active cancer survivors demonstrated significantly better QoL than those with functional deterioration. Self-efficacy for using spiritual coping had a significant positive association with QoL, along with symptoms and functional status, which explained 37.5% of QoL. CONCLUSIONS Cancer survivors' QoL was related to spiritual coping self-efficacy, symptoms and functional status. Improving spiritual coping self-efficacy and managing symptoms reflecting survivors' functional status need to be integrated into survivorship care.
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Affiliation(s)
- Yun Young Choi
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Sun Young Rha
- College of Medicine and Yonsei Cancer Center, Yonsei University, Seoul, South Korea; Yonsei Cancer Center, Seoul, South Korea
| | - Ji Soo Park
- College of Medicine and Yonsei Cancer Center, Yonsei University, Seoul, South Korea; Yonsei Cancer Center, Seoul, South Korea
| | | | - Jiyeon Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
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21
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Bentley G, Zamir O, Dahabre R, Perry S, Karademas EC, Poikonen-Saksela P, Mazzocco K, Sousa B, Pat-Horenczyk R. Protective Factors against Fear of Cancer Recurrence in Breast Cancer Patients: A Latent Growth Model. Cancers (Basel) 2023; 15:4590. [PMID: 37760558 PMCID: PMC10526521 DOI: 10.3390/cancers15184590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/03/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
The current study aimed to examine the fear of cancer recurrence (FCR) trajectory and protective predictors in women coping with breast cancer (BC). The study's model investigated whether a higher coping self-efficacy and positive cognitive-emotion regulation at the time of the BC diagnosis would lead to reduced levels of FCR at six months and in later stages (12 and 18 months) post-diagnosis. The sample included 494 women with stages I to III BC from Finland, Italy, Portugal, and Israel. They completed self-report questionnaires, including the Fear of Cancer Recurrence Inventory (FCRI-SF), the Cancer Behavior Inventory-Brief Version (CBI-B), the Cognitive-Emotion Regulation Questionnaire (CERQ short), and medical-social-demographic data. Findings revealed that a higher coping self-efficacy at diagnosis predicted lower FCR levels after six months but did not impact the FCR trajectory over time. Surprisingly, positive cognitive-emotion regulation did not predict FCR levels or changes over 18 months. FCR levels remained stable from six to 18 months post-diagnosis. This study emphasizes the importance of developing specific cancer coping skills, such as coping self-efficacy. Enhancing coping self-efficacy in the first six months after BC diagnosis may lead to lower FCR levels later, as FCR tends to persist in the following year.
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Affiliation(s)
- Gabriella Bentley
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Osnat Zamir
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Rawan Dahabre
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Shlomit Perry
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Evangelos C. Karademas
- Department of Psychology, University of Crete and Foundation for Research and Technology, 70013 Heraklion, Greece
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center, University of Helsinki, 00100 Helsinki, Finland
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, 20139 Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20139 Milan, Italy
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, 1400-038 Lisboa, Portugal
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
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22
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van Kooten RT, Schutte BAM, van Staalduinen DJ, Hoeksema JHL, Holman FA, van Dorp C, Peeters KCMJ, Tollenaar RAEM, Wouters MWJM. Patient perspectives on consequences of resection for colorectal cancer: A qualitative study. Colorectal Dis 2023; 25:1578-1587. [PMID: 37329241 DOI: 10.1111/codi.16637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/30/2023] [Accepted: 05/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Colorectal cancer is diagnosed in approximately 500,000 patients each year in Europe, leading to a high number of patients having to cope with the consequences of resection for colorectal cancer. As treatment options tend to grow, more information on the effects of these treatments is needed to engage in shared decision-making. This study aims to explore the impact of resection for colorectal cancer on patients' daily life. METHODS Patients (≥18 years of age) who underwent an oncological colorectal resection between 2018 and 2021 were selected. Purposeful sampling was used to include patients who differed in age, comorbidity conditions, types of (neo)adjuvant therapy, postoperative complications and the presence/absence of a stoma. Semi-structured interviews were conducted, guided by a topic guide. Interviews were fully transcribed and subsequently thematically analysed using the framework approach. Analyses were carried out using the following predefined themes: (1) daily life and activities; (2) psychological functioning; (3) social functioning; (4) sexual functioning; and (5) healthcare experiences. RESULTS Sixteen patients with a follow-up period of between 0.6 and 4.4 years after surgery were included in this study. Participants reported several challenges experienced because of poor bowel function, a stoma, chemotherapy-induced neuropathy, fear of recurrence and sexual dysfunction. However, they reported these as not interfering much with daily life. CONCLUSION Colorectal cancer treatment leads to several challenges and treatment-related health deficits. This is often not recognized by generic patient-reported outcome measures, but the findings on treatment-related health deficits presented in this study contain valuable insights which might contribute to improving colorectal cancer care, shared decision making and value-based health care.
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Affiliation(s)
- Robert T van Kooten
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Bianca A M Schutte
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Dorine J van Staalduinen
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Jetty H L Hoeksema
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Fabian A Holman
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Chantal van Dorp
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Koen C M J Peeters
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob A E M Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Michel W J M Wouters
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
- Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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23
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Licu M, Ionescu CG, Paun S. Quality of Life in Cancer Patients: The Modern Psycho-Oncologic Approach for Romania-A Review. Curr Oncol 2023; 30:6964-6975. [PMID: 37504364 PMCID: PMC10378343 DOI: 10.3390/curroncol30070504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
Quality of life (QOL) is an important indicator of human satisfaction and well-being. QOL is significantly and persistently affected for patients after a cancer diagnosis. Despite some evidence suggesting that psycho-oncologic interventions can provide lasting benefits, the inclusion of such interventions in cancer therapy is not universal. This article provides an overview of the known approaches to the evaluation of QOL in cancer patients and various interventions for improving patients' outcomes, with a focus on the eastern European regional and specific Romanian context. With a mortality rate above and cancer care performance below the EU average and unequally distributed, Romania urgently needs a national coordination program, which is discussed in our review, highlighting the main psychological tools needed for the assessment and the challenges involved in implementing the program. In the end, we suggest some directions for the future development of the psycho-oncologic approach in the context of social considerations, policy, and the unexpected financial challenges the nation provides.
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Affiliation(s)
- Monica Licu
- Department of Medical Ethics, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Claudiu Gabriel Ionescu
- Department of Medical Ethics, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Sorin Paun
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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24
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Perry LM, Peipert JD, Kircher SM, Cantoral J, Penedo FJ, Garcia SF. Adverse COVID-19 experiences and health-related quality of life in cancer survivors: indirect effects of COVID-19-related depression and financial burden. J Patient Rep Outcomes 2023; 7:71. [PMID: 37458820 DOI: 10.1186/s41687-023-00601-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 06/08/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Cancer survivors are at greater risk for poor health outcomes due to COVID-19. However, the pandemic's impact on patients' health-related quality of life (HRQoL) is not well known. This study hypothesized that cancer survivors' adverse COVID-19 experiences would be associated with worse HRQoL. Further, this association would be moderated by psychosocial resiliency factors (perceived social support, benefits, and ability to manage stress) and mediated by psychosocial risk factors (anxiety, depression; health, financial and social concerns). METHODS 1,043 cancer survivors receiving care at Northwestern Medicine completed a cross-sectional survey on COVID-19 practical and psychosocial concerns from 6/2021 to 3/2022. Participants reported on 21 adverse COVID-19 experiences (e.g., COVID-19 hospitalization, death of family/friends, loss of income, medical delays). The survey assessed 9 psychosocial factors related to COVID-19: anxiety, depression; health care, financial, and social disruptions; health care satisfaction; social support, perceived benefits, and stress management skills. The FACT-G7 assessed HRQoL. Hypotheses were tested in a structural equation model. The number of reported adverse COVID-19 experiences was the primary (observed) independent variable. The dependent variable of HRQoL, and the proposed mediating and moderating factors, were entered as latent variables indicated by their respective survey items. Latent interaction terms between the independent variable and each resiliency factor tested moderation effects. Analyses were adjusted for demographic and COVID-specific variables. RESULTS Participants were, on average, aged 58 years and diagnosed with cancer 4.9 years prior. They were majority female (73.3%), White (89.6%), non-Hispanic/Latino (94.5%), college-educated (81.7%), and vaccinated for COVID-19 (95.5%). An average of 3.8 adverse COVID-19 experiences were reported. Results of structural equation modeling demonstrated that the association between adverse COVID-19 experiences and HRQoL was explained by indirect effects through COVID-19-related depression (β = - 0.10, percentile bootstrap 95% CI - 0.15 to - 0.07) and financial concerns (β = - 0.04, percentile bootstrap 95% CI - 0.07 to - 0.01). Hypotheses testing moderation by resiliency factors were not significant. CONCLUSIONS Adverse COVID-19 experiences were associated with higher depression symptoms and financial concerns about COVID-19, and in turn, worse HRQoL. Oncology clinics should be cognizant of the experience of adverse COVID-19 events when allocating depression and financial support resources.
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Affiliation(s)
- Laura M Perry
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - John D Peipert
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sheetal M Kircher
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jackelyn Cantoral
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank J Penedo
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Sofia F Garcia
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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25
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de Vlaming IH, Schellekens MPJ, van der Lee ML. Intensity of mental health treatment of cancer-related psychopathology: the predictive role of Early Maladaptive Schemas. Support Care Cancer 2023; 31:325. [PMID: 37154974 PMCID: PMC10167132 DOI: 10.1007/s00520-023-07764-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE With the limited availability of mental healthcare, it is of utmost importance to provide care that matches the needs of patients: short if possible, but also more intense when necessary. This study explored whether Early Maladaptive Schemas (EMSs) play a predictive role in the intensity of needed mental health treatment of cancer-related psychopathology. METHODS EMSs were assessed before mental health treatment in 256 patients who sought help at a specialized mental health care centre for those affected by cancer in the Netherlands. Data about treatment indication and intensity of mental health treatment were collected. Univariate and multivariate logistic regression analysis were used to assess the predictive value of the EMSs total score and specific domains on treatment indication and treatment intensity. RESULTS The presence of more severe EMSs predicted an indication for a more intense mental health treatment before start of the treatment, and actual more intense mental health treatment. The domain Impaired Autonomy and Performance appeared to be conceptually close to the domain Disconnection and Rejection, we left the latter out in our multivariate analysis and then found that Impaired Autonomy was the best predictor of intensity of mental health treatment. CONCLUSION Our findings imply that assessing EMSs could help to identify patients who will receive more treatment time.
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Affiliation(s)
- Irene H de Vlaming
- Department of Scientific Research, Helen Dowling Institute, Bilthoven, The Netherlands
- Department of Medical Psychology, Alrijne Hospital, Leiden, The Netherlands
| | - Melanie P J Schellekens
- Department of Scientific Research, Helen Dowling Institute, Bilthoven, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Marije L van der Lee
- Department of Scientific Research, Helen Dowling Institute, Bilthoven, The Netherlands.
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.
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26
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Kourou K, Manikis G, Mylona E, Poikonen-Saksela P, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Mattson J, Roziner I, Pettini G, Kondylakis H, Marias K, Nuutinen M, Karademas E, Simos P, Fotiadis DI. Personalized prediction of one-year mental health deterioration using adaptive learning algorithms: a multicenter breast cancer prospective study. Sci Rep 2023; 13:7059. [PMID: 37120428 PMCID: PMC10148884 DOI: 10.1038/s41598-023-33281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
Identifying individual patient characteristics that contribute to long-term mental health deterioration following diagnosis of breast cancer (BC) is critical in clinical practice. The present study employed a supervised machine learning pipeline to address this issue in a subset of data from a prospective, multinational cohort of women diagnosed with stage I-III BC with a curative treatment intention. Patients were classified as displaying stable HADS scores (Stable Group; n = 328) or reporting a significant increase in symptomatology between BC diagnosis and 12 months later (Deteriorated Group; n = 50). Sociodemographic, life-style, psychosocial, and medical variables collected on the first visit to their oncologist and three months later served as potential predictors of patient risk stratification. The flexible and comprehensive machine learning (ML) pipeline used entailed feature selection, model training, validation and testing. Model-agnostic analyses aided interpretation of model results at the variable- and patient-level. The two groups were discriminated with a high degree of accuracy (Area Under the Curve = 0.864) and a fair balance of sensitivity (0.85) and specificity (0.87). Both psychological (negative affect, certain coping with cancer reactions, lack of sense of control/positive expectations, and difficulties in regulating negative emotions) and biological variables (baseline percentage of neutrophils, thrombocyte count) emerged as important predictors of mental health deterioration in the long run. Personalized break-down profiles revealed the relative impact of specific variables toward successful model predictions for each patient. Identifying key risk factors for mental health deterioration is an essential first step toward prevention. Supervised ML models may guide clinical recommendations toward successful illness adaptation.
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Affiliation(s)
- Konstantina Kourou
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece
| | - Georgios Manikis
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Eugenia Mylona
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center and Helsinki University, Helsinki, Finland
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
- Dept. of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
- NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Johanna Mattson
- Helsinki University Hospital Comprehensive Cancer Center and Helsinki University, Helsinki, Finland
| | - Ilan Roziner
- Dept. of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Greta Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Haridimos Kondylakis
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Kostas Marias
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | | | - Evangelos Karademas
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
- Dept. of Psychology, University of Crete, Rethymno, Greece
| | - Panagiotis Simos
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
- School of Medicine, University of Crete, Heraklion, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece.
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece.
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27
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Bourne JE, Foster C, Forte C, Aning J, Potter S, Hart EC, Armstrong MEG. Study protocol for two pilot randomised controlled trials aimed at increasing physical activity using electrically assisted bicycles to enhance prostate or breast cancer survival. Pilot Feasibility Stud 2023; 9:68. [PMID: 37095588 PMCID: PMC10124052 DOI: 10.1186/s40814-023-01293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 04/03/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND In 2020, 1.4 and 2.3 million new cases of prostate cancer and breast cancer respectively were diagnosed globally. In the UK, prostate cancer is the most common male cancer, while breast cancer is the most common female cancer. Engaging in physical activity (PA) is a key component of treatment. However, rates of PA are low in these clinical populations. This paper describes the protocol of CRANK-P and CRANK-B, two pilot randomised controlled trials, involving an e-cycling intervention aimed at increasing PA in individuals with prostate cancer or breast cancer respectively. METHODS These two trials are single-centre, stratified, parallel-group, two-arm randomised waitlist-controlled pilot trials in which forty individuals with prostate cancer (CRANK-P) and forty individuals with breast cancer (CRANK-B) will be randomly assigned, in a 1:1 allocation ratio, to an e-cycling intervention or waitlist control. The intervention consists of e-bike training with a certified cycle instructor, followed by the provision of an e-bike for 12 weeks. Following the intervention period, participants in the e-bike condition will be directed to community-based initiatives through which they can access an e-bike. Data will be collected at baseline (T0), immediately post intervention (T1) and at 3-month follow-up (T2). In addition, in the intervention group, data will be collected during the intervention and follow-up periods. Quantitative and qualitative methods will be used. The primary objectives are to determine effective recruitment strategies, establish recruitment and consent rates, adherence and retention in the study, and determine the feasibility and acceptability of the study procedures and intervention. The potential impact of the intervention on clinical, physiological and behavioural outcomes will be assessed to examine intervention promise. Data analyses will be descriptive. DISCUSSION The findings from these trials will provide information on trial feasibility and highlight the potential of e-cycling as a strategy to positively impact the health and behaviour of individuals with prostate cancer and breast cancer. If appropriate, this information can be used to design and deliver a fully powered definitive trial. TRIAL REGISTRATION CRANK-B: [ISRCTN39112034]. CRANK-P [ISRCTN42852156]. Registered [08/04/2022] https://www.isrctn.com .
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Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Chloe Forte
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Jonathan Aning
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK
| | - Shelley Potter
- Bristol Breast Care Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK
- Bristol Medical School, Translational Health Sciences, University of Bristol, 5 Tyndall Avenue, Bristol, BS8 1UD, UK
| | - Emma C Hart
- Biomedical Sciences Building, School of Physiology, Pharmacology & Neuroscience, University of Bristol, University Walk, Bristol, BS8 1TD, UK
| | - Miranda E G Armstrong
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
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28
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Murray C, Makinson J, Brown L, Allan J. Postcancer treatment support programme: an evaluation. BMJ Support Palliat Care 2023:spcare-2023-004188. [PMID: 37072154 DOI: 10.1136/spcare-2023-004188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/29/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVES As the number of people living beyond cancer treatment has increased, supportive post-treatment interventions have become increasingly important. The present study investigates whether participation in the Maggie's 'Where Now?' post-cancer support programme is associated with improvements in healthy eating, quality of life, self-efficacy (confidence) or cancer worry. METHODS In a pre-post design, 88 people who had completed cancer treatment and were enrolled in the 7-week 'Where Now?' programme at Maggie's centres across the UK rated their diet, activity, quality of life, self-efficacy and cancer worries before and after programme participation. Programme content was coded to identify the techniques used to create change ('behaviour change techniques'). RESULTS Programme participation was associated with significant improvements in general self-efficacy (p=0.01), self-efficacy about engaging in physical activity (p<0.01), quality of life (p<0.01) and cancer worry (p=0.04) but not with changes in healthy eating (p=0.23). CONCLUSION Participation in the 'Where Now?' programme is associated with significant improvements in several key psychological outcomes in people living beyond cancer. The techniques most commonly used in the programme to create change were giving participants instructions about how to perform a particular behaviour, encouraging problemsolving to overcome barriers and setting goals.
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Affiliation(s)
- Charlotte Murray
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Lauren Brown
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Julia Allan
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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29
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Ozkaraman A, Kazak A, Dudaklı N, Ozen H. Evaluation of the Effect of Self-Efficacy on Symptoms in Gastrointestinal Cancer Patients. J Palliat Care 2023; 38:207-214. [PMID: 36128832 DOI: 10.1177/08258597221125286] [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: 11/17/2022]
Abstract
Objective: The incidence of gastrointestinal cancer is increasing day by day and is among the highest 10 cancer types in the world. This study was conducted to evaluate the effects of self-efficacy of patients with gastrointestinal system cancer on symptom clusters. Methods: This cross-sectional study was conducted with 105 patients treated for gastrointestinal system cancer in a hospital located in the south of Turkey. In the study, patients over 18 years of age without hearing or speech impairment were included. To determine symptom clusters, Latent Profile Analysis and comparison of self-efficacy scale items by symptom clusters were performed with Chi-square, ANOVA, and Kruskal Wallis test. Results: The mean age of the patients was 58.83 ± 13.1 years; of the patients, 37.1% had colon ca, 21.9% had rectum ca. The patients had higher mean scores of fatigue, pain, feeling distressed, feeling sad, dry mouth, sleep disturbance, loss of appetite and nausea in the last week. The patients had higher mean scores of fatigue, pain, feeling distressed, feeling sad, dry mouth, sleep disturbance, loss of appetite and nausea in the last week. Three symptom clusters were determined by latent profile analysis; high, moderate, mild. It was determined that the level of self-efficacy was high in the symptom cluster which is low symptom severity and number of symptoms (p < .05). Conclusion: The number and the severity of symptoms are lower in patients with high self-efficacy perceptions.
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Affiliation(s)
- Ayşe Ozkaraman
- Department of Nursing, Faculty of Health Sciences, 53004Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Aysun Kazak
- Department of Medical Services and Techniques First and Emergency Aid Program, Vocational School of Health Services, 52983Mersin University, Mersin, Turkey
| | - Nuran Dudaklı
- Mersin City Training and Research Hospital, Psychiatry Clinic, Mersin, Turkey
| | - Hülya Ozen
- Department of Medical Informatics, Gulhane Faculty of Medicine, 574983University of Health Sciences, Ankara, Turkey
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Lingens SP, Schilling G, Schulz H, Bleich C. Effectiveness of brief psychosocial support for patients with cancer and their relatives: a quasi-experimental evaluation of cancer counselling centres. BMJ Open 2023; 13:e068963. [PMID: 36977537 PMCID: PMC10069588 DOI: 10.1136/bmjopen-2022-068963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the effectiveness of brief psychosocial support for patients with cancer and their relatives regarding their mental health. DESIGN Quasi-experimental controlled trial with measurements at three time points (baseline, after 2 weeks and after 12 weeks). SETTING The intervention group (IG) was recruited at two cancer counselling centres in Germany. The control group (CG) included patients with cancer or relatives who did not seek support. PARTICIPANTS In total, n=885 participants were recruited and n=459 were eligible for the analysis (IG, n=264; CG, n=195). INTERVENTION One to two psychosocial support sessions (approximately hour) provided by a psycho-oncologist or social worker. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was distress. The secondary outcomes were anxiety and depressive symptoms, well-being, cancer-specific and generic quality of life (QoL), self-efficacy and fatigue. RESULTS The linear mixed model analysis showed significant differences between IG and CG at follow-up for distress (d=0.36), p=0.001), depressive (d=0.22), p=0.005) and anxiety symptoms (d=0.22), p=0.003), well-being (d=0.26, p=0.002), QoL (QoL mental; d=0.26, p=0.003), self-efficacy (d=0.21, p=0.011) and QoL (global; d=0.27, p=0.009). The changes were not significant for QoL (physical; d=0.04, p=0.618), cancer-specific QoL (symptoms; d=0.13, p=0.093), cancer-specific QoL (functional; d=0.08, p=0.274) and fatigue (d=0.04, p=0.643). CONCLUSION The results suggest that brief psychosocial support is associated with the improvement of mental health of patients with cancer and their relatives after 3 months. TRIAL REGISTRATION NUMBER DRKS00015516.
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Affiliation(s)
- Solveigh Paola Lingens
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wang N, Wang M, Huang J, Allen J, Elder E, Fu L, Lu H, Creedy DK, Gamble J. Effects of the STress-And-coping suppoRT (START) intervention on depression and coping of Chinese women seeking a first-trimester abortion: A randomized controlled trial. J Affect Disord 2023; 324:121-128. [PMID: 36584700 DOI: 10.1016/j.jad.2022.12.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 10/31/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Abortion is a stressful life event associated with wide variability in women's perceptions and adjustment. There is scarce evidence on interventions to help women cope with abortion and achieve positive psychological health outcomes. This study tested the effect of a stress and coping theory-formed intervention (START) on depression and coping of Chinese women undergoing a first-trimester abortion. METHODS A randomized controlled trial was conducted at a Chinese metropolitan hospital. 110 participants were recruited and randomized to intervention group (START + standard care) or control group (standard care) with a 1:1 allocation ratio. The primary outcome was depression at two-week post-abortion. Surveys were completed by participants when they sought abortion services (baseline), two and six-week post-abortion. RESULTS At two-week post-abortion, women allocated to the intervention group compared to the control group, had significantly lower depression scores (aOR -2.81 [-4.12 to -1.50]), higher problem-focused coping (aOR 1.64 [0.36-2.93]), lower dysfunctional coping (aOR -2.29 [-3.69 to -0.89]), higher self-efficacy (aOR 3.17 [-0.42-5.94]), and higher personal growth scores (aOR 4.41 [0.30-8.53]). Lower depression scores at two-weeks were mediated by lower dysfunctional coping (mediated effect 0.96 [0.25, 1.74]; proportion of overall effect 36 % [9 %, 65 %]). CONCLUSION Chinese women allocated to receive START had lower depression and better coping at two-week post-abortion. This brief, online intervention contributed to women's self-efficacy and positive perceptions of social support, abortion experience, and personal growth. Maintenance of the effects need further research.
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Affiliation(s)
- Na Wang
- School of Nursing, Capital Medical University, 10 Xitoutiao Road, Fengtai District, Beijing 100069, China; School of Nursing and Midwifery, Griffith University Gold Coast Campus, Parklands Drive, Southport, Queensland 4215, Australia.
| | - Meng Wang
- Psychology Department, School of Education Science, Xinxiang University, 191 Jin-sui Road, Hong-qi District, Xinxiang City, Henan Province 453003, China.
| | - Jing Huang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London Waterloo Campus, 57 Waterloo Road, London SE18WA, United Kingdom.
| | - Jyai Allen
- School of Nursing and Midwifery, Griffith University Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia..
| | - Elizabeth Elder
- School of Nursing and Midwifery, Griffith University Gold Coast Campus, Parklands Drive, Southport, Queensland 4215, Australia.
| | - Li Fu
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Hong Lu
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia..
| | - Jenny Gamble
- School of Nursing and Midwifery, Griffith University Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia..
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Cheng HL, Leung DYP, Ko PS, Lam WM, Lam PT, Luk AL, Chung MW, Lam SC. Mediating role of self-efficacy between unmet needs and quality of life in palliative cancer caregivers. Psychooncology 2023; 32:457-464. [PMID: 36650108 DOI: 10.1002/pon.6099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 12/28/2022] [Accepted: 01/08/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Although unmet support needs are associated with health-related quality of life (HRQOL) in cancer caregivers, little is known about the mechanism underlying the relationship between two variables. The self-efficacy (SE) theory and literature suggest that caregiving SE is important in the perception of and reaction to caregiving demands, which in turn affects HRQOL. The aim of this study was to examine whether caregiving SE mediates the relationship between unmet support needs and HRQOL in family caregivers of palliative cancer patients. METHODS This secondary analysis used the data from 125 family caregivers of palliative cancer patients who were recruited from two public hospitals in Hong Kong. The caregivers completed a survey questionnaire that covered socio-demographic characteristics, unmet support needs, caregiving SE, and HRQOL. Parallel mediation analyses were conducted via SPSS PROCESS macro (Model 4) to test the hypothesized models. RESULTS The direct effect of unmet support needs on mental HRQOL was significant (effect = -0.49, 95% CI = -0.06 to -0.92). For the indirect effect, only caregiving SE in the domain of 'care for the care recipient' mediated the relationship between unmet support needs and mental HRQOL (effect = -0.32, 95% CI = -0.08 to -0.59). CONCLUSION The findings suggest that caregiving SE may function as a mechanism through which unmet support needs influence mental HRQOL in family caregivers of palliative cancer patients. Healthcare providers should consider developing supportive care interventions to improve caregivers' HRQOL by incorporating effective strategies to enhance SE and reduce unmet needs for this population.
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Affiliation(s)
- Hui-Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | | | - Po Shan Ko
- Nursing Services Division, United Christian Hospital, Kowloon, Hong Kong
| | - Wai Man Lam
- Department of Medicine, Haven of Hope Hospital, Kowloon, Hong Kong
| | - Po Tin Lam
- Department of Medicine and Geriatrics, United Christian Hospital, Kowloon, Hong Kong
| | - Andrew Leung Luk
- Nethersole Institute of Continuing Holistic Health Education, Hong Kong
| | - Ming Wai Chung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Maeir T, Nahum M, Makranz C, Tsabari S, Peretz T, Gilboa Y. Predictors of quality of life among adults with self-reported cancer related cognitive impairment. Disabil Rehabil 2023; 45:1056-1062. [PMID: 35297702 DOI: 10.1080/09638288.2022.2050954] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of the current study was to examine the unique contribution of personal and medical factors, objective and subjective cognition, and self-efficacy to the explained variance of quality of life (QoL) among survivors with self-reported cancer related cognitive impairment (CRCI). METHOD Seventy-three cancer survivors (non-central nervous system) with CRCI (mean age: 50.85 ± 10.82 years old, mean years post-treatment: 3 ± 2.7) participated in this cross-sectional study. QoL was assessed using the Functional Assessment of Cancer Therapy (FACT)-GP, while the cognitive function was assessed both objectively using tests of attentional control, speed of processing and sustained attention, and subjectively using the FACT-Cognition perceived cognitive impairments (FACTcog-PCI) subscale. Self-efficacy was assessed using the New General Self-Efficacy Scale (NGSE). RESULTS A hierarchical multiple linear regression analysis revealed that sustained attention, perceived cognitive impairment and self-efficacy, accounted for 54% of the variance of QoL (R2 = 0.543, p < 0.000), each providing a unique contribution to the explained variance (15-20% each) after controlling for age and gender. CONCLUSIONS Considering that these variables may be amenable to change, this model can serve as a conceptual framework for designing effective cognitive treatment options for CRCI. Clinical Trial Registration: ClinicalTrials.gov NCTImplication for rehabilitationCancer related cognitive impairment is characterized by difficulties in the speed of processing performance, severe perceived cognitive impairments, and relatively low general self-efficacy.Multi-dimensional assessments including subjective and objective cognition as well as self-efficacy should be administered to cancer survivors with cognitive complaints to understand the underlying mechanisms of their QoL.Integrative cognitive rehabilitation interventions that aim to improve QoL among people with cancer-related cognitive impairment should target sustained attention, perceived cognitive impairment, and self-efficacy.
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Affiliation(s)
- Talia Maeir
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Chen Makranz
- Department of Neurology and Oncology, The Gaffin Center for Neurooncology, Sharett Institute for Oncology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shani Tsabari
- Department of Neurology and Oncology, The Gaffin Center for Neurooncology, Sharett Institute for Oncology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tamar Peretz
- Hebrew University Medical School, Jerusalem, Israel
- Sharett Oncology Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Petersen MW, Carstensen TBW, Frostholm L, Wellnitz KB, Ørnbøl E, Jørgensen T, Eplov LF, Dantoft TM, Fink P. High Perceived Stress and Low Self-Efficacy are Associated with Functional Somatic Disorders: The DanFunD Study. Clin Epidemiol 2023; 15:407-419. [PMID: 37008745 PMCID: PMC10065012 DOI: 10.2147/clep.s399914] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
Objective Several psychological factors have been proposed to be associated with functional somatic disorders (FSD) including functional somatic syndromes, such as irritable bowel, chronic widespread pain, and chronic fatigue. However, large randomly selected population-based studies of this association are sparse. This study aimed to investigate the association between FSD and perceived stress and self-efficacy, respectively, and to investigate if FSD differed from severe physical diseases on these aspects. Methods This cross-sectional study included a random sample of the adult Danish population (n = 9656). FSD were established using self-reported questionnaires and diagnostic interviews. Perceived stress was measured with Cohen's Perceived Stress Scale and self-efficacy with the General Self-Efficacy Scale. Data were analysed with generalized linear models and linear regression models. Results FSD were associated with higher perceived stress and lower self-efficacy, especially for the multi-organ and the general symptoms/fatigue FSD types and for chronic fatigue. However, controlling for the personality trait neuroticism altered the associations with self-efficacy so it became insignificant. The analysis did not support an important interaction between perceived stress and self-efficacy on the likelihood of having FSD. Individuals with FSD presented levels of perceived stress that were not equal, ie higher, to those in individuals with severe physical diseases. Conclusion FSD were positively associated with perceived stress and negatively associated with self-efficacy. Our study may point to stress being part of the symptomatology of FSD. This underlines the severity of having FSD and stresses the relevance of the resilience theory in the understanding of the condition.
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Affiliation(s)
- Marie Weinreich Petersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
- Correspondence: Marie Weinreich Petersen, Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus, 8200, Denmark, Tel +45 7846 4310, Email
| | - Tina Birgitte Wisbech Carstensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
| | - Kaare Bro Wellnitz
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
| | - Eva Ørnbøl
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
| | - Torben Jørgensen
- Center for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Frederiksberg, Capital Region, Denmark
- Department of Public Health, Faculty of Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Center for Mental Health – CORE, Mental Health Centre Copenhagen, Copenhagen, Capital Region, Denmark
| | - Thomas Meinertz Dantoft
- Center for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Frederiksberg, Capital Region, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
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Skwirczyńska E, Chudecka-Głaz A, Wróblewski O, Tejchman K, Skonieczna-Żydecka K, Piotrowiak M, Michalczyk K, Karakiewicz B. Age Matters: The Moderating Effect of Age on Styles and Strategies of Coping with Stress and Self-Esteem in Patients with Neoplastic Prostate Hyperplasia. Cancers (Basel) 2023; 15:cancers15051450. [PMID: 36900243 PMCID: PMC10000508 DOI: 10.3390/cancers15051450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 03/02/2023] Open
Abstract
The aim of this study was to analyze coping mechanisms and their psychological aspects during the treatment of neoplastic prostate hyperplasia. We have analyzed strategies and styles of coping with stress and self-esteem of patients diagnosed with neoplastic prostate hyperplasia. A total of 126 patients were included in the study. Standardized psychological questionnaires were used to determine the type of coping strategy by using the Stress Coping Inventory MINI-COPE, while a coping style questionnaire was used to assess the type of coping style by using the Convergence Insufficiency Symptom Survey (CISS). The SES Self-Assessment Scale was used to measure the level of self-esteem. Patients using adaptive strategies of coping with stress in the form of active coping, seeking support and planning had higher self-esteem. However, the use of maladaptive coping strategies in the form of self-blame was found to cause a significant decrease in patients' self-esteem. The study has also shown the choice of a task-based coping style to positively influence one's self-esteem. An analysis related to patients' age and coping methods revealed younger patients, up to 65 years of age, using adaptive strategies of coping with stress to have a higher level of self-esteem than older patients using similar strategies. The results of this study show that older patients, despite the use of adaptation strategies, have lower self-esteem. This group of patients should receive special care both from family and medical staff. The obtained results support the implementation of holistic care for patients, using psychological interventions to improve patients' quality of life. Early psychological consultation and mobilization of patients' personal resources may allow patients to change stress coping methods towards more adaptive forms.
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Affiliation(s)
- Edyta Skwirczyńska
- Department of the History of Medicine and Medical Ethics, Pomeranian Medical University, Aleja Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
- Correspondence: ; Tel.: +48-508-359-596
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Oskar Wróblewski
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Karol Tejchman
- Department of General Surgery and Transplantology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | | | - Michał Piotrowiak
- Department of General Surgery and Transplantology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Kaja Michalczyk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Beata Karakiewicz
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University, 71-210 Szczecin, Poland
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36
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Okeke B, Hillmon C, Jones J, Obanigba G, Obi A, Nkansah M, Odiase N, Khanipov K, Okereke IC. The relationship of social determinants and distress in newly diagnosed cancer patients. Sci Rep 2023; 13:2153. [PMID: 36750604 PMCID: PMC9905536 DOI: 10.1038/s41598-023-29375-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
Patients with a new cancer diagnosis can experience distress when diagnosed. There are disparities in treatment of cancer patients based on social determinants, but minimal research exists on the relationship of those social determinants and distress after a new cancer diagnosis. Our goals were to determine the social determinants associated with distress after a new cancer diagnosis and determine the relationship of distress with outcome. Patients with a new cancer diagnosis at one institution from January 2019 to December 2020 were analyzed. Patients were given the National Comprehensive Cancer Network (NCCN) distress thermometer during their first visit. Demographics, tumor characteristics, clinical variables and survival were recorded. Patients were also asked to share specific factors that led to distress, including: (1) financial, (2) transportation, (3) childcare and (4) religious. A total of 916 patients returned distress thermometers. Mean age was 59.1 years. Females comprised 71.3 (653/916) percent of the cohort. On Dunn's multiple comparison, the following factors were associated with increased distress level: female (p < 0.01), ages 27 to 45 (p < 0.01), uninsured (p < 0.01) and unemployed (p < 0.01). Patients with higher distress scores also experienced worse overall survival (p < 0.05). Females, young patients, uninsured patients and unemployed patients experience more distress after a new cancer diagnosis. Increased distress is independently associated with worse overall survival. Social determinants can be used to predict which patients may require focused interventions to reduce distress after a new cancer diagnosis.
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Affiliation(s)
- Brandon Okeke
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Cheron Hillmon
- Department of Care Management, University of Texas Medical Branch, Galveston, TX, USA
| | - Jasmine Jones
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Grace Obanigba
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Ann Obi
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Meagan Nkansah
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Nicholas Odiase
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Kamil Khanipov
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, USA
| | - Ikenna C Okereke
- Department of Surgery, Henry Ford Health System, 2799 W. Grand Blvd, Detroit, MI, 48202, USA.
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Cavalieri S, Vener C, LeBlanc M, Lopez-Perez L, Fico G, Resteghini C, Monzani D, Marton G, Pravettoni G, Moreira-Soares M, Filippidou DE, Almeida A, Bilbao A, Mehanna H, Singer S, Thomas S, Lacerenza L, Manfuso A, Copelli C, Mercalli F, Frigessi A, Martinelli E, Licitra L. A multicenter randomized trial for quality of life evaluation by non-invasive intelligent tools during post-curative treatment follow-up for head and neck cancer: Clinical study protocol. Front Oncol 2023; 13:1048593. [PMID: 36798825 PMCID: PMC9927199 DOI: 10.3389/fonc.2023.1048593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/10/2023] [Indexed: 02/02/2023] Open
Abstract
Patients surviving head and neck cancer (HNC) suffer from high physical, psychological, and socioeconomic burdens. Achieving cancer-free survival with an optimal quality of life (QoL) is the primary goal for HNC patient management. So, maintaining lifelong surveillance is critical. An ambitious goal would be to carry this out through the advanced analysis of environmental, emotional, and behavioral data unobtrusively collected from mobile devices. The aim of this clinical trial is to reduce, with non-invasive tools (i.e., patients' mobile devices), the proportion of HNC survivors (i.e., having completed their curative treatment from 3 months to 10 years) experiencing a clinically relevant reduction in QoL during follow-up. The Big Data for Quality of Life (BD4QoL) study is an international, multicenter, randomized (2:1), open-label trial. The primary endpoint is a clinically relevant global health-related EORTC QLQ-C30 QoL deterioration (decrease ≥10 points) at any point during 24 months post-treatment follow-up. The target sample size is 420 patients. Patients will be randomized to be followed up using the BD4QoL platform or per standard clinical practice. The BD4QoL platform includes a set of services to allow patients monitoring and empowerment through two main tools: a mobile application installed on participants' smartphones, that includes a chatbot for e-coaching, and the Point of Care dashboard, to let the investigators manage patients data. In both arms, participants will be asked to complete QoL questionnaires at study entry and once every 6 months, and will undergo post-treatment follow up as per clinical practice. Patients randomized to the intervention arm (n=280) will receive access to the BD4QoL platform, those in the control arm (n=140) will not. Eligibility criteria include completing curative treatments for non-metastatic HNC and the use of an Android-based smartphone. Patients undergoing active treatments or with synchronous cancers are excluded. Clinical Trial Registration: ClinicalTrials.gov, identifier (NCT05315570).
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Affiliation(s)
- Stefano Cavalieri
- Head and Neck Medical Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,*Correspondence: Stefano Cavalieri,
| | - Claudia Vener
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Marissa LeBlanc
- Oslo Center for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway,Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Laura Lopez-Perez
- Universidad Politécnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Madrid, Spain
| | - Giuseppe Fico
- Universidad Politécnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Madrid, Spain
| | - Carlo Resteghini
- Head and Neck Medical Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy
| | - Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy,Department of Psychology, Educational Science and Human Movement (SPPEFF), University of Palermo, Palermo, Italy
| | - Giulia Marton
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | | | - Aitor Almeida
- Information Technology Programme Management Office, DOTSOFT, Thessaloniki, Greece
| | - Aritz Bilbao
- DeustoTech, Faculty of Engineering, Universidad de Deusto, Bilbao, Spain
| | - Hisham Mehanna
- Institute of head and neck studies and Education, University of Birmingham, Birmingham, United Kingdom
| | - Susanne Singer
- Division of Epidemiology and Health Care Research, JGU - Johannes Gutenberg University, Mainz, Germany
| | - Steve Thomas
- Division of Oral and Maxillofacial Surgery - Bristol Dental Hospital, University of Bristol - Bristol Medical School, Bristol, United Kingdom
| | - Luca Lacerenza
- Maxillo-Facial Surgery, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Alfonso Manfuso
- Maxillo-Facial Surgery, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Chiara Copelli
- Maxillo-Facial Surgery, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | | | - Arnoldo Frigessi
- Oslo Center for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway,Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Elena Martinelli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Isselhard A, Lautz Z, Töpper M, Rhiem K, Schmutzler R, Vitinius F, Fischer H, Berger-Höger B, Steckelberg A, Beifus K, Köberlein-Neu J, Stock S. Coping Self-Efficacy and Its Relationship with Psychological Morbidity after Genetic Test Result Disclosure: Results from Cancer-Unaffected BRCA1/2 Mutation Carriers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1684. [PMID: 36767056 PMCID: PMC9914784 DOI: 10.3390/ijerph20031684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
Women who are found to carry a BRCA1/2 pathogenic variant experience psychological distress due to an increased risk of breast and ovarian cancer. They may decide between different preventive options. In this secondary analysis of data collected alongside a larger randomized controlled trial, we are looking at 130 newly found BRCA1/2 pathogenic variant carriers and how their coping self-efficacy immediately after genetic test result disclosure is related to their psychological burden and status of preventive decision making. Participants received the Coping Self-Efficacy Scale, the Hospital Anxiety and Depression Scale, the Impact of Event Scale, the Decisional Conflict Scale, and the Stage of Decision-Making Scale after positive genetic test result disclosure. We found that women with higher coping self-efficacy showed fewer symptoms of anxiety or depression and were less affected by receiving the genetic test result in terms of post-traumatic stress. However, coping self-efficacy had no relationship with any decision-related criteria, such as decisional conflict or stage of decision making. This shows that despite its buffering capacity on psychological burden, possessing coping self-efficacy does not lead to more decisiveness in preference-sensitive decisions.
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Affiliation(s)
- Anna Isselhard
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, 50924 Cologne, Germany
| | - Zoe Lautz
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, 50924 Cologne, Germany
| | - Maren Töpper
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, 50924 Cologne, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer and Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, 50924 Cologne, Germany
| | - Rita Schmutzler
- Center for Hereditary Breast and Ovarian Cancer and Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, 50924 Cologne, Germany
| | - Frank Vitinius
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, 50924 Cologne, Germany
| | - Hannah Fischer
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, 50924 Cologne, Germany
| | - Birte Berger-Höger
- Institute for Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
- Institute for Health and Nursing Science, Faculty of Medicine Martin Luther University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Anke Steckelberg
- Institute for Health and Nursing Science, Faculty of Medicine Martin Luther University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Karolina Beifus
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, 42119 Wuppertal, Germany
| | - Juliane Köberlein-Neu
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, 42119 Wuppertal, Germany
| | - Stephanie Stock
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, 50924 Cologne, Germany
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Trost C, Heisinger S, Funovics PT, Windhager R, Hobusch GM, Stamm T. Patients' perception of changes and consequences after tumor resection : A qualitative study in Austrian patients with musculoskeletal malignancies. Wien Klin Wochenschr 2023:10.1007/s00508-022-02136-6. [PMID: 36595059 DOI: 10.1007/s00508-022-02136-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/24/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects and consequences of surgical treatment of patients with musculoskeletal malignancies on everyday life. METHODS A modified form of grounded theory was used for data collection and analysis. Data collection was systematic and analyzed simultaneously and 16 interviews were conducted: 2 narrative, 11 guided and 3 expert interviews (surgeon, physical therapist, support group). Data collection and analysis alternated until no new codes could be found. Once theoretical saturation was achieved, the main category was formed and described using the literature. RESULTS The main category results from the combination of all categories and leads to the core category. In the center is the affected person and in the immediate environment are the patient's relatives/partners. In the next instance the primary care physician is necessary to establish a sense of normalcy. This depends on the individuality of the person and the restored possibilities of movement. CONCLUSION Based on the results, the necessity of implementing psychosocial care involving the social environment is shown. The importance of relatives/partners for recovery is emphasized. Furthermore, the communication between the specialists and family physicians should be simplified.
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Affiliation(s)
- Carmen Trost
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Stephan Heisinger
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Philipp T Funovics
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Gerhard M Hobusch
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Tanja Stamm
- Institute for Outcomes Research, Medical University of Vienna, Vienna, Austria
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Duarte-Díaz A, Perestelo-Pérez L, Rivero-Santana A, Peñate W, Álvarez-Pérez Y, Ramos-García V, González-Pacheco H, Goya-Arteaga L, de Bonis-Braun M, González-Martín S, Ramallo-Fariña Y, Carrion C, Serrano-Aguilar P. The relationship between patient empowerment and related constructs, affective symptoms and quality of life in patients with type 2 diabetes: a systematic review and meta-analysis. Front Public Health 2023; 11:1118324. [PMID: 37139389 PMCID: PMC10150112 DOI: 10.3389/fpubh.2023.1118324] [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: 12/09/2022] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction The aim of this systematic review is to assess the relationship between patient empowerment and other empowerment-related constructs, and affective symptoms and quality of life in patients with type 2 diabetes. Methods A systematic review of the literature was conducted, according to the PRISMA guidelines. Studies addressing adult patients with type 2 diabetes and reporting the association between empowerment-related constructs and subjective measures of anxiety, depression and distress, as well as self-reported quality of life were included. The following electronic databases were consulted from inception to July 2022: Medline, Embase, PsycINFO, and Cochrane Library. The methodological quality of the included studies was analyzed using validated tools adapted to each study design. Meta-analyses of correlations were performed using an inverse variance restricted maximum likelihood random-effects. Results The initial search yielded 2463 references and seventy-one studies were finally included. We found a weak-to-moderate inverse association between patient empowerment-related constructs and both anxiety (r = -0.22) and depression (r = -0.29). Moreover, empowerment-related constructs were moderately negatively correlated with distress (r = -0.31) and moderately positively correlated with general quality of life (r = 0.32). Small associations between empowerment-related constructs and both mental (r = 0.23) and physical quality of life (r = 0.13) were also reported. Discussion This evidence is mostly from cross-sectional studies. High-quality prospective studies are needed not only to better understand the role of patient empowerment but to assess causal associations. The results of the study highlight the importance of patient empowerment and other empowerment-related constructs such as self-efficacy or perceived control in diabetes care. Thus, they should be considered in the design, development and implementation of effective interventions and policies aimed at improving psychosocial outcomes in patients with type 2 diabetes. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192429, identifier CRD42020192429.
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Affiliation(s)
- Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Department of Clinical Psychology, Psychobiology and Methodology, Universidad de La Laguna, (ULL), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
- *Correspondence: Lilisbeth Perestelo-Pérez
| | - Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Wenceslao Peñate
- Department of Clinical Psychology, Psychobiology and Methodology, Universidad de La Laguna, (ULL), Tenerife, Spain
| | - Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Himar González-Pacheco
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Libertad Goya-Arteaga
- Multiprofessional Unit of Family and Community Care of La Laguna-Norte, Tenerife, Spain
| | - Miriam de Bonis-Braun
- Multiprofessional Unit of Family and Community Care of La Laguna-Norte, Tenerife, Spain
| | | | - Yolanda Ramallo-Fariña
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Carme Carrion
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- eHealth Lab Research Group, School of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Pedro Serrano-Aguilar
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
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Adame H, Wettersten K, Schwinghamer A, Friesen-Janochoski A. Cancer-related fatigue as a mediator between self-efficacy and quality of life for adolescents and young adults impacted by cancer. J Psychosoc Oncol 2022; 41:502-517. [PMID: 36541375 DOI: 10.1080/07347332.2022.2147120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Adolescents and young adults are a unique subpopulation within oncology, with different and often unmet needs. The current study investigated the relationships between cancer-related self-efficacy, cancer-related fatigue, and quality of life, with the hypothesis that fatigue would mediate the negative relationship between self-efficacy and quality of life for adolescents and young adults impacted by cancer. METHODS Structural equation modeling was utilized to examine the pathways between these variables. RESULTS As predicted, results (n = 265, 92.8% female) demonstrated a strong positive relationship between self-efficacy and quality of life. Fatigue partially but significantly mediated the pathway between self-efficacy and quality of life. CONCLUSIONS It appears that cancer-related self-efficacy may work, at least in part, through the mediating variable of fatigue, to influence quality of life for adolescents and young adults.
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Effect of Telerehabilitation Versus In-Clinic Rehabilitation Delivery on Self-Efficacy in Breast Cancer–Related Lymphedema. REHABILITATION ONCOLOGY 2022. [DOI: 10.1097/01.reo.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Meng K, Fahmer N, Engehausen D, Hass HG, Reuss-Borst M, Duelli K, Wöckel A, Heuschmann PU, Faller H. Patientenkompetenz zur Krankheitsbewältigung – eine
qualitative Analyse bei Frauen mit Brustkrebs und gynäkologischen
Tumoren. Psychother Psychosom Med Psychol 2022; 73:187-196. [PMID: 36413985 DOI: 10.1055/a-1956-9153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Zusammenfassung
Ziel Die Studie exploriert Herausforderungen, persönliche
Kompetenzen und hilfreiche Unterstützung bei der
Krankheitsbewältigung von Patienteninnen mit Brustkrebs und
gynäkologischen Tumoren und wie die Patientenkompetenz als Zusammenspiel
dieser Faktoren gefördert werden kann.
Methodik Teilstrukturierte Leitfadeninterviews wurden mit 19 Patientinnen
im Akutsetting, 20 Rehabilitandinnen und 16 Teilnehmerinnen einer
Selbsthilfegruppe geführt und mittels qualitativer Inhaltsanalyse
ausgewertet.
Ergebnisse Die thematisierten Herausforderungen sind in die
Hauptkategorien – Diagnoseverarbeitung,
Behandlungs-/Rezidivängste, Krankheitsverarbeitung und
Adaptation, Sorgen um Angehörige, Reaktionen des sozialen Umfeldes,
Sorgen um den Arbeitsplatz – zusammengefasst. Die benannten
persönlichen Kompetenzen im Umgang mit diesen Herausforderungen sind den
folgenden Hauptkategorien zugeordnet: kognitionsbezogenes Coping,
handlungsbezogenes Coping, Selbstregulation Krankheitsverarbeitung,
Unterstützung einholen und annehmen, selbstbestimmte Kommunikation der
Erkrankung, hilfreiche Strategien identifizieren und anwenden,
krankheitsbezogene Erfahrung, günstige Lebensumstände, Offenheit
für Hilfsangebote. Hilfreiche emotionale, informationelle oder
instrumentelle Unterstützung wird durch Angehörige, Freunde,
Tiere, Arbeitskollegen/Arbeitgeber, Behandler, Rehabilitation,
Mitpatientinnen/Betroffene, Selbsthilfe und Beratungseinrichtungen
wahrgenommen.
Diskussion Die Frauen beschreiben eine Vielzahl an persönlichen
Kompetenzen, die einem bedürfnisorientierten, selbstgesteuerten
Bewältigungsprozess entsprechen. Die Individualität und
Komplexität des Zusammenspiels der Komponenten der Patientenkompetenz
unterstreicht die Relevanz von patientenorientierter Versorgung. Empowerment und
eine aktive Patientenrolle sind erforderlich, um bedürfnisbezogen
Bewältigungsfertigkeiten zu fördern. Unterstützung durch
Behandler oder das private Umfeld kann dabei Herausforderungen vermindern oder
Kompetenzen und deren Anwendung fördern.
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Affiliation(s)
- Karin Meng
- Institut für Klinische Epidemiologie und Biometrie,
Julius-Maximilians-Universität Würzburg, Würzburg,
Germany
| | - Natascha Fahmer
- Institut für Klinische Epidemiologie und Biometrie,
Julius-Maximilians-Universität Würzburg, Würzburg,
Germany
| | | | - Holger G. Hass
- Abteilung Onkologie, Dep. Innere Medizin, Klinik Gais AG, Gais,
Switzerland
- Institut für Rehabilitationsforschung und Survivorship
(IREFOS), Scheidegg, Germany
| | | | - Kristin Duelli
- Universitätsklinikum Würzburg Frauenklinik und
Poliklinik, Würzburg, Germany
| | - Achim Wöckel
- Universitätsklinikum Würzburg Frauenklinik und
Poliklinik, Würzburg, Germany
| | - Peter U. Heuschmann
- Institut für Klinische Epidemiologie und Biometrie,
Julius-Maximilians-Universität Würzburg, Würzburg,
Germany
- Zentrale für Klinische Studien, Universitätsklinikum
Würzburg, Würzburg, Germany
| | - Hermann Faller
- Institut für Klinische Epidemiologie und Biometrie,
Julius-Maximilians-Universität Würzburg, Würzburg,
Germany
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Du R, Wang X, Zhou H, Ma L, Larcher LM, Chen C, Wang T. The health-related quality of life of lung cancer patients with EGFR-TKI-related skin adverse drug reactions and its relationship with coping style and self-management. Support Care Cancer 2022; 30:9889-9899. [DOI: 10.1007/s00520-022-07451-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/03/2022] [Indexed: 11/20/2022]
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Cancer Patients’ Age-Related Benefits from Mobile Neurofeedback-Therapy in Quality of Life and Self-efficacy: A Clinical Waitlist Control Study. Appl Psychophysiol Biofeedback 2022; 48:217-227. [DOI: 10.1007/s10484-022-09571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
AbstractElectroencephalographic neurofeedback (EEG NF) can improve quality of life (QoL) and reduce distress by modifying the amplitude of selected brain frequencies. This study aims to investigate the effects of NF therapy on QoL and self-efficacy in cancer patients and to explore age-related reactions. In a waitlist control paradigm, psychometric data (EORTC QLQ-C30, General Self-Efficacy Scale) of 20 patients were collected at three different time points, each five weeks apart. An outpatient 10-session NF intervention (mobile) was conducted between the second and third measurement point. QoL and self-efficacy changed significantly over time (QoL: F(2,36) = 5.294, p < .05, η2 = .227; Self-efficacy: F(2,26) = 8.178, p < .05, η2 = .386). While QoL increased in younger patients, older patients initially showed a decrease in QoL, which then increased during intervention. Younger patients did not differ from older patients in QoL in both waitlist control (T0-T1) and intervention phase (T1–T2). QoL in older patients significantly differed between waitlist control and intervention phase (Z = − 2.023, p < .05, d = 1.085). Self-efficacy increased in both age categories. Younger and older patients did not differ in self-efficacy in waitlist control, but in intervention phase (F(1,16) = 7.014, p < .05, η2 = .319). The current findings suggest that NF therapy is a promising treatment modality for improving QoL in cancer patients. Our study reveals NF being a tool to influence self-efficacy, which should receive more appreciation in clinical care. However, the effect of NF in different age groups as well as the influence on further cancer-related symptoms should be investigated in future research.
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Quality of Life in Women With Breast Cancer Receiving Chemotherapy and the Moderating Role of Cortisol. Cancer Nurs 2022; 45:E856-E864. [PMID: 35324503 DOI: 10.1097/ncc.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Quality of life (QoL) is severely affected by breast cancer (BC) and its treatment, particularly chemotherapy treatment. Psychological morbidity, illness perceptions, and self-efficacy for coping are important variables that impact QoL during the treatment of BC. The impact of cortisol on QoL has been poorly studied. OBJECTIVE The aim of this study was to identify the contributing variables to QoL in women with BC receiving adjuvant chemotherapy, as well as the moderating role of cortisol in the relationship between treatment adverse effects and QoL. METHODS This cross-sectional study included 112 women with BC undergoing chemotherapy who answered the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, the Supplementary Questionnaire Breast Cancer Module, the Illness Perception Questionnaire, the Cancer Behavior Inventory-Brief Version, and the Hospital Anxiety and Depression Scale. In addition, salivary cortisol concentrations were also assessed. RESULTS The strongest contributor to lower QoL was treatment adverse effects. The illness perception and the cancer stage also contributed to a lower QoL. Nadir cortisol moderated the relationship between adverse effects and QoL. CONCLUSION Breast cancer chemotherapy and illness perceptions, even at the beginning of treatment, showed a great impact on QoL. IMPLICATIONS FOR PRACTICE It is important during chemotherapy to assess women's illness perceptions, as well as their stress levels to help women cope with the stress associated with treatment adverse effects. Monitoring cortisol is important as cortisol moderated the relationship between adverse effects and QoL. For those women struggling with stress, a reference to a mental health provider is warranted.
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Yin Y, Lyu M, Chen Y, Zhang J, Li H, Li H, Xia G, Zhang J. Self-efficacy and positive coping mediate the relationship between social support and resilience in patients undergoing lung cancer treatment: A cross-sectional study. Front Psychol 2022; 13:953491. [PMID: 36211943 PMCID: PMC9539761 DOI: 10.3389/fpsyg.2022.953491] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe prognosis of patients undergoing lung cancer treatment might be influenced by mental health status. Resilience is one of the important predictors to reflect the mental health status. It has been shown that patients with higher levels of social support, self-care self-efficacy, and positive coping have greater resilience. This study aimed to determine the mediating role of self-efficacy and positive coping in the relationship between social support and psychological resilience in patients with lung cancer.MethodThis is a cross-sectional study that was conducted in in the oncology departments and thoracic surgical wards of four tertiary hospitals in Hunan Province, China, between November 2016 and November 2017. Three hundred and three patients who were undergoing treatment for lung cancer volunteered their participation in the study. Participants completed questionnaires, including the Chinese version of the Perceived Social Support Seale Scale, the Chinese version of Strategies Used by People to Promote Health Scale, and the Chinese version of the Connor-Davidson Resilience Scale.ResultsMediation analysis indicated that self-care self-efficacy and social support partially mediate the effect of social support on resilience. Direct paths from social support to self-efficacy, self-efficacy to positive coping, positive coping to psychological resilience, self-efficacy to psychological resilience, and social support to psychological resilience were significant (p < 0.001). The indirect paths from social support to self-efficacy and self-efficacy to psychological resilience were also significant. The chain mediation from social support to self-efficacy, self-efficacy to positive coping, and positive coping to resilience were significant.ConclusionSelf-efficacy and positive coping play an important role in the relationship between social support and resilience in patients receiving cancer treatment. Social support not only directly influenced psychological resilience but also indirectly influenced psychological resilience through self-efficacy and positive coping.
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Affiliation(s)
- Yizhen Yin
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Mengmeng Lyu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiping Chen
- Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Jie Zhang
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Hui Li
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huiyuan Li
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Guili Xia
- Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
- Guili Xia,
| | - Jingping Zhang
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
- *Correspondence: Jingping Zhang,
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The Dyadic Effects of Self-Efficacy on Quality of Life in Advanced Cancer Patient and Family Caregiver Dyads: The Mediating Role of Benefit Finding, Anxiety, and Depression. JOURNAL OF ONCOLOGY 2022; 2022:3073358. [PMID: 37192963 PMCID: PMC10182880 DOI: 10.1155/2022/3073358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022]
Abstract
Objectives. To explore the dyadic interdependence of self-efficacy, benefit finding, anxiety, depression, and QOL in cancer patient (CP) and family caregiver (FC) dyads, and to ascertain the dyadic effects of self-efficacy on quality of life (QOL) in CP-FC dyads. Methods. Conducted from November 2014 to December 2015, participants comprised 772 CP-FC dyads. The study surveyed participant characteristics, self-efficacy, benefit finding, anxiety, depression, and QOL. Data were analyzed using Pearson’s correlation, T-test, and actor-partner interdependence mediation model (APIMeM). Results. CPs’ self-efficacy was positively correlated with both their own and FCs’ benefit finding and mental component summary (MCS), and negatively associated with anxiety and depression (all Ps < 0.01, |r| = 0.144∼0.432). However, CPs’ self-efficacy was only positively correlated with their own physical component summary (PCS) (r = 0.193), but not FCs’ PCS. The same profile was identified in FCs’ self-efficacy (all Ps < 0.01, |r| = 0.100∼0.468). FCs reported higher levels of self-efficacy and PCS compared to CPs (both Ps < 0.001). Significant positive correlations (r = 0.168–0.437) were identified among all paired variables in CP-FC dyads (all Ps < 0.001). To some extent, dyads’ self-efficacy influences dyads’ MCS and PCS through improving positive emotions (benefit finding) and relieving negative emotions (anxiety and depression). Conclusions. Study findings not only support the dyadic interdependence of self-efficacy, benefit finding, anxiety, depression, and QOL in CP-FC dyads but confirm the hypothesis that dyads’ self-efficacy may impact their MCS/PCS via an indirect approach to improve benefit finding and relieve anxiety and/or depression in CP-FC dyads.
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Farhadfar N, Weaver MT, Al-Mansour Z, Yi JC, Jim HSL, Loren AW, Majhail NS, Whalen V, Uberti J, Wingard JR, Lynch Kelly D, Syrjala KL. Self-Efficacy for Symptom Management in Long-Term Adult Hematopoietic Stem Cell Survivors. Transplant Cell Ther 2022; 28:606.e1-606.e8. [PMID: 35662590 PMCID: PMC10804384 DOI: 10.1016/j.jtct.2022.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
Abstract
Hematopoietic cell transplantation (HCT) survivors have a complex and multiphase recovery period. Health care delivery and psychosocial interventions for HCT survivors are challenging because many HCT recipients live great distances from the facility where they had their HCT. Therefore identifying factors associated with a patient's capability to self-manage symptoms is a significant focus of survivorship research. A patient's self-efficacy may be important for the successful management of major stressors associated with treatments and recovery. Here, we aimed to evaluate the impact of perceived self-efficacy on distress, quality of life (QoL), depression, and fatigue and identify the factors associated with lower self-efficacy. This cross-sectional study analyzed baseline data from a randomized controlled trial INSPIRE (NCT01602211) in adult (age 18 and older) survivors 2 to 10 years after HCT. Patients with recurrence or subsequent malignancy requiring cancer treatment during the 2 years before enrollment, inability to read and understand English, and lack of access to email and the Internet were excluded. Data included medical records and patient-reported outcomes including Cancer and Treatment Distress (CTXD) with 6 subscales, Patient Health Questionnaire depression scale (PHQ-8), Short Form 12 Health Survey (SF-12) physical function and mental function scores, Brief Fatigue Inventory (BFI) and Self-Efficacy. Pearson correlations were used to test bivariate associations for self-efficacy of CTXD, SF-12, BFI, and PHQ-8. General linear models were used to test the independent associations for CTXD and SF-12 outcomes with self-efficacy, controlling for selected sociodemographic and treatment covariates. Tenability of statistical model assumptions were examined, and no remediation was necessary. A total of 1078 HCT survivors were included in the analysis. Participants were 19 to 85 years (mean age 58), 53% male, and over 90% White and non-Hispanic. Only 16% reported living in a rural area. A majority received an autologous HCT (55%) and were less than 5 years from their first HCT (54%). Among the allogeneic HCT recipients, more than half (55%) had active chronic Graft-versus-Host (cGVHD) and nearly 40% were on active systemic treatment. The mean self-efficacy score was 3.01 (SD = 0.49). Female sex (P = .014), younger age at HCT, younger age at cGVHD presentation (P = .031), moderate to severe currently active cGVHD (P = .003) and household income less than $40,000 (P< .001) were associated with lower self-efficacy. In bivariate analyses, self-efficacy was negatively correlated with mean total distress (CTXD, r = -.5, P< .001) and each of the CTXD subscales. HCT survivors with higher self-efficacy also reported better physical (r 0.48, P< .001) and mental function on the SF-12 (r = 0.57, P< .001). Moreover, self-efficacy was negatively correlated with symptoms such as fatigue (r = -.44, P< .001) and depression (r = -.48, P< .001). In a regression model investigating the impact of self-efficacy on CTXD controlled for demographics and disease characteristics, lower self-efficacy was independently associated with higher distress (CTXD, β = -.232; 95% CI [-.294, -.169], P< .001). Moreover, there was a significant positive relationship between self-efficacy and both mental (β = 4.68; 95% CI [3.82, 5.54]; P< .001) and physical (β = 2.69; 95% CI [1.74, 3.64]; P< .001) components of QoL. Our study demonstrates that lower levels of self-efficacy reported by HCT survivors were independently associated with higher levels of symptoms such as fatigue and depression, lower QoL, and more cancer-related distress. Furthermore, self-efficacy was more likely to be impaired in females, younger adults, those with lower incomes, and survivors with active cGVHD. These findings support the value of self-management interventions focused on improving self-efficacy as having the potential to improve multiple symptoms and QoL in HCT survivors.
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Affiliation(s)
- Nosha Farhadfar
- Department of Medicine/Division of Hematology Oncology, University of Florida, Gainesville, Florida.
| | | | - Zeina Al-Mansour
- Department of Medicine/Division of Hematology Oncology, University of Florida, Gainesville, Florida
| | - Jean C Yi
- Biobehavioral Sciences Department, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | | | | | - Victoria Whalen
- Section of Oncology/Hematology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Joseph Uberti
- Department of Oncology, Karmanos Cancer Institute/Wayne State University, Detroit, MI, USA
| | - John R Wingard
- Department of Medicine/Division of Hematology Oncology, University of Florida, Gainesville, Florida
| | | | - Karen L Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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Panjwani AA, Southward MW, Fugate-Laus K, Carpenter KM. Coping self-efficacy, perceived helpfulness of coping, and distress: a longitudinal investigation of breast and gynecologic cancer patients undergoing chemotherapy. J Behav Med 2022; 45:868-881. [DOI: 10.1007/s10865-022-00345-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 06/27/2022] [Indexed: 10/15/2022]
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