Illness perception and sense of well-being in breast cancer patients

Health-Related Quality of Life and Disease Acceptance Among Women with Breast Cancer Pre- and Post-Neoadjuvant Chemotherapy

Background/Objective: The study aimed to evaluate disease acceptance and quality of life in women with breast cancer before and after receiving neoadjuvant chemotherapy. Methods: The study included 211 women diagnosed with breast cancer who underwent neoadjuvant treatment. The following measures were utilized: the EORTC QLQ-C30 and QLQ-BR23 modules for quality of life assessment, the Acceptance of Illness Scale (AIS) questionnaire for evaluating disease acceptance, and a proprietary questionnaire. Assessments were conducted one week before the first chemotherapy session and three weeks after completing the chemotherapy. Statistical analysis was performed using STATISTICA v. 13. Results: The respondents exhibited an average acceptance of their disease, both before (28.2 pts) and after chemotherapy (25.5 pts). A decline in disease acceptance was observed in nearly 59.2% of the patients following chemotherapy. Higher levels of disease acceptance were associated with a better quality of life. The quality of life for the studied women decreased after neoadjuvant chemotherapy, particularly in the following areas: physical functioning (p = 0.0000), social functioning (p = 0.0000), body image assessment (p = 0.0000), sexual satisfaction (p = 0.0000), nausea and vomiting (p = 0.0000), fatigue (p = 0.0000), loss of appetite (p = 0.0000), insomnia (p = 0.0000), pain (p = 0.0000), hair loss (p = 0.0000), and side effects of systemic treatment (p = 0.0000). Conclusions: Post-neoadjuvant chemotherapy, a decline in disease acceptance and quality of life was observed among women with breast cancer in comparison with their pre-treatment status. Higher levels of disease acceptance were associated with a better quality of life. These findings may facilitate the creation of a more tailored care approach for women during and after chemotherapy.

Healthy Cows, Happy Farmers? Exploring the Dynamics of Mastitis and Farmer Well-Being

Clinical mastitis, a prevalent production disease in the dairy industry, causes significant pain and swelling in dairy cows' udders. While previous research highlights a symbiotic relationship between humans and animals, particularly in terms of health, this study investigates how animal health, specifically clinical mastitis, influences farmers' well-being. Acknowledging farmers' pivotal role in mitigating animal health problems, we examined the human-animal relationship by exploring how dairy cow health relates to the psychological well-being of dairy farmers. This was performed by investigating the connection between animal and farmer health and whether it is mediated by farmers' perceptions of mastitis as a production disease and their sense of control over the situation. For the current study, we combined and matched data from a large questionnaire study covering dairy farmer's well-being (n = 356) with data on dairy cow herd health. For statistical analyses we used the PROCESS macro for serial multiple mediator analysis, an analysis that allows for the estimation of the effect of multiple mediators in a causal chain. We found that farmers' well-being is indirectly related to animal health though their illness perception (P < 0.05) and perceived self-efficacy (P < 0.001), underscoring the importance of cultivating awareness and control over mastitis occurrences. For these estimations, we controlled for the effect of farm size, expected income from dairy production, marital status, and cohabitation status of the farmer, as well as age and gender. Our results indicate that maintaining healthy animals with minimal mastitis incidents, coupled with farmers' perceived self-efficacy, is positively related with farmer well-being.

Does Illness Perception Predict Hopelessness and Death Anxiety in Palliative Care Patients?

Illness perception is crucial in how patients navigate health challenges. Investigating if it predicts hopelessness and death anxiety is vital, especially in palliative care where these burdens are common. This descriptive, cross-sectional study was conducted with 129 patients receiving treatment in the palliative care clinics of a university hospital. Patient Identification Form, Illness Perception Questionnaire, Beck Hopelessness Scale, and Death Anxiety Scale were used as data collection tools. The findings revealed that patients generally have a negative perception of their illness, with moderate levels of hopelessness and high levels of death anxiety. A statistically significant positive correlation was observed between illness perception, death anxiety, and hopelessness. Furthermore, illness perception was found to predict 80.1% of the variation in hopelessness levels and 64.7% of the variation in death anxiety levels among patients. These findings underscore the importance of addressing psychological factors as part of comprehensive palliative care management.

Baduanjin exercise for negative emotion of patients undergoing chemotherapy: a systematic review and meta-analysis

INTRODUCTION

Baduanjin was also called Eight Brocades (EB), a branch of Qigong exercise, is classified as a mild-to-moderate intensity aerobic exercise. It has been theorized that regular practice of EB can alleviate anxiety and depression in patients undergoing chemotherapy; however, there are currently no comprehensive quantitative reviews on the efficacy of EB for this population. Therefore, this meta-analysis aims to investigate the effects of EB on chemotherapy-treated patients.

METHODS

Eight electronic databases were searched from their inception until February 15, 2024, to identify relevant studies. The inclusion and exclusion criteria were applied to filter the retrieved studies. Outcomes were various quantitative assessments. This systematic review was registered in the PROSPERO Registry (registration number CRD42023466630).

RESULTS

Nine randomized controlled trials (RCTs) met eligibility criteria (n = 704). The meta-analysis results demonstrated that EB significantly reduced levels of anxiety and depression. Subgroup analysis revealed that the intervention frequency of 1 time/day had a greater effect on the improvement of negative emotions, compared with 2 times/day and 5 times/week. The intervention duration of 4 weeks showed more efficacy in reducing depression scores than 12 weeks or 16 weeks; however, no statistical difference was observed for anxiety scores.

CONCLUSION

EB exercise can reduce depression and anxiety symptoms in chemotherapy-treated patients. However, the results should be interpreted with caution as existing methodological limitations. The findings provided insights into the development of public health initiatives to improve the negative emotion among chemotherapy-treated patients by EB exercise.

Illness perception and intimate relationships in patients with cervical cancer: the mediating role of dyadic coping

BACKGROUND AND OBJECTIVES

A good intimate relationship (IR) can relieve the psychological distress of patients with cervical cancer and promote a sense of well-being during stressful times. Researchers have found that IR is related to illness perception (IP) and dyadic coping (DC). Therefore, this study aimed to (1) describe the IR of patients with cervical cancer, (2) identify the relationships and pathways among IP, DC and IR in patients with cervical cancer and (3) explore the mediating role of DC between IP and IR in cervical cancer patients.

METHODS

A total of 175 patients with cervical cancer were recruited at a tertiary hospital in China from September 2021 to January 2023. The data were collected through a general demographic and disease-related information questionnaire, the Locke-Wallace Marriage Adjustment Test, the Revised Illness Perception Questionnaire of Cervical Cancer and the Dyadic Coping Inventory.

RESULTS

The mean score for intimate relationships was 107.78 (SD = 23.99, range 30-154). Pearson's correlation analysis revealed that intimate relationships were positively correlated with IP (personal control) and DC (stress communication, supportive DC, delegated DC and common DC) and were negatively correlated with IP (consequence, timeline acute/chronic, timeline cyclical and emotional representation) and negative DC. As for the results of the structural equation model, DC fully mediated the influencing effects of both positive and negative IP on IR.

CONCLUSIONS

The level of IR of patients with cervical cancer in China should be improved. DC has a significant mediating effect on the link between the IP and IR.

Illness perception: A bibliometric study

Illness perception is a crucial area of study that has seen significant growth and development over the years. This study conducts a comprehensive bibliometric and network analysis of illness perception research, capturing its evolution from 1975 to 2023. Utilizing 1813 publications from the Scopus database, authored by 5428 researchers, we identify key scholars and influential articles in the field. Our analysis includes various bibliometric networks such as citation, co-citation, collaboration, and keyword co-occurrence networks, along with the presentation of intellectual structure maps. Major research areas include the role of illness perception in mental health conditions like depression, coping mechanisms, quality of life, and chronic illnesses like diabetes, as well as the influence of lay beliefs on health behaviors, and the impact of illness beliefs on conditions like Myocardial Infarction and stroke. The results show a growing academic interest in understanding how illness perceptions shape healthcare outcomes and behaviors.

The Role of Illness Perception and Self-Efficacy in Determining Quality of Life among Cancer Patients

BACKGROUND

The quality of life for people with chronic illnesses like cancer has been shown to be significantly impacted by self-efficacy and perceptions of their illness.

OBJECTIVES

This study investigates the relationship between cancer patients' perceptions of their illness, their self-efficacy beliefs, and their quality of life.

METHOD

Conducted from December 2022 to February 2023, this research involved 120 adults undergoing cancer treatment. We utilized the Illness Perception Questionnaire (IPQ), the Arabic version of the Cancer Behavioral Inventory Brief (CBI-B), and the Arabic EORTC QLQ-C30, alongside clinical data collection. Statistical analyses included Pearson correlation and descriptive statistics.

RESULTS

Breast cancer emerged as the most common type among participants. A positive correlation was found between self-efficacy and quality of life, as measured by the EORTC QLQ-C30, particularly in relation to symptom management. Interestingly, all dimensions of illness perception correlated with quality of life, except for control and concerns.

CONCLUSIONS

The findings underscore the vital role of nurses and healthcare providers in aiding cancer patients to develop and utilize self-management strategies effectively. The study reveals that a patient's capacity to manage their illness is significantly influenced by their confidence, understanding of their condition, and overall quality of life. Addressing these aspects can greatly enhance healthcare professionals' contribution to improving the resilience and well-being of individuals battling cancer.

Return to work, work productivity loss and activity impairment in Chinese breast cancer survivors 12-month post-surgery: a longitudinal study

Introduction

Existing evidence of returning-to-work (RTW) after cancer comes predominately from Western settings, with none prospectively examined since the initial diagnostic phase. This study prospectively documents RTW-rate, time-to-RTW, work productivity loss, and activity impairment, within the first-year post-surgery among Chinese women with breast cancer (BCW) and identify potential causal co-variants.

Methods

This observational longitudinal study followed 371 Chinese BCW who were employed/self-employed at the time of diagnosis at 4-week post-surgery (baseline). RTW-status and time-to-RTW were assessed at baseline (T1), 4-month (T2), 6-month (T3), and 12-month (T4) post-baseline. WPAI work productivity loss and activity impairment were assessed at T4. Baseline covariates included demographics, medical-related factors, work satisfaction, perceived work demand, work condition, RTW self-efficacy, B-IPQ illness perception, COST financial well-being, EORTC QLQ-C30 and QLQ-BR23 physical and psychosocial functioning, and HADS psychological distress.

Results

A 68.2% RTW-rate (at 12-month post-surgery), prolonged delay in RTW (median = 183 days), and significant proportions of T4 work productivity loss (20%), and activity impairment (26%), were seen. BCW who were blue-collar workers with lower household income, poorer financial well-being, lower RTW self-efficacy, poorer job satisfaction, poorer illness perception, greater physical symptom distress, impaired physical functioning, and unfavorable work conditions were more likely to experience undesired work-related outcomes.

Discussion

Using a multifactorial approach, effective RTW interventions should focus on not only symptom management, but also to address psychosocial and work-environmental concerns. An organizational or policy level intervention involving a multidisciplinary team comprising nurses, psychologists, occupational health professionals, and relevant stakeholders in the workplace might be helpful in developing a tailored organizational policy promoting work-related outcomes in BCW.

Posttraumatic growth and illness perception in survivors of adolescent and young adult cancer

BACKGROUND

Adolescents and young adults (AYAs) are diagnosed with cancer during a challenging period of life. We aimed to (1) describe positive changes (posttraumatic growth; PTG) and illness perception, and (2) determine associations between PTG and illness perception, sociodemographic, and cancer-related characteristics in Swiss AYA cancer survivors.

METHODS

We conducted a population-based survey among AYA cancer survivors diagnosed 1990-2005 at age 16-25 years, who had survived ≥ 5 years. We used the Posttraumatic Growth Inventory (PTGI) and the Brief Illness Perception Questionnaire (BIPQ). Data were analyzed using descriptive statistics and linear regressions.

RESULTS

Among 389 contacted survivors, 160 responded (61.3% male; mean age = 34 years, SD = 5.8). The mean PTG sum score was 54.63 (SD = 20.24; range: 8-101). Survivors reported high PTG especially in the domains Appreciation of life (mean = 3.23; 95% confidence interval, 3.05-3.40), Personal strength (2.94; 2.77-3.12), and Relating to others (2.57; 2.40-2.74). Neither sociodemographic nor cancer-related characteristics were associated with PTG. Survivors who perceived follow-up care as helpful (p < 0.001) and those with high concerns about the consequences of the illness (p < 0.001) reported higher PTG.

CONCLUSIONS

Finding ways to promote PTG and to identify and address maladaptive illness perceptions may help survivors transform their experience into something meaningful for their future life.

Effect of mindfulness-based therapy on spiritual well-being in breast cancer patients: a randomized controlled study

BACKGROUND

Spiritual well-being is directly related to the quality of life in breast cancer patients. Mindfulness-based therapy interventions can decrease distress levels in women with breast cancer, while improving spiritual well-being.

OBJECTIVE

To investigate the effect of mindfulness-based therapy on spiritual well-being in breast cancer patients.

METHODS

This randomized controlled clinical trial was conducted in accordance with the Consolidated Standards of Reporting Trials. A total of 70 participants were enrolled from September, 2021 to July, 2022. Primary outcome included spiritual well-being, and secondary outcome included quality of life. The data were collected using the Patient Sociodemographic and Medical Data Form and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (SpWB) (FACIT-Sp Version 4). In the statistical analysis, the independent sample t test and paired sample t test were used to examine the intervention effect on primary and secondary outcomes, according to numbers, percentage, mean, standard deviation, and conformity to normal distribution.

RESULTS

The average age of the therapy group was 42.22 ± 6.86, and the control group was 41.64 ±  6.04. The average score of meaning (12.25 ± 3.03), overall score average of the spiritual well-being (31.56 ± 8.90), the emotional well-being (13.46 ± 5.78) and physical well-being (16.71 ± 5.59), and overall average score of the quality of life (66.98 ± 17.72) of the therapy group was statistically significantly higher (p < 0.05).

CONCLUSION

The mindfulness-based training may enhance the spiritual well-being and quality of life of breast cancer patients. Nurses should be encouraged for mindfulness-based training sessions to make it a widespread practice, and to regularly evaluate the results.

TRIAL REGISTRATION

NCT05057078 (date: September 27, 2021).

Resilience among women with breast cancer surviving longer than five years: The relationship with illness perception and body image

PURPOSE

This study aimed to investigate the correlations and identify the relationships between the resilience, perception of illness and body image of women with breast cancer in the 5-year-or-above survivorship.

METHODS

We used convenient sampling to recruit from an outpatient department 106 women with breast cancer. The inclusion criteria were participants aged >20 years currently in a stable condition and were able to understand the Chinese language. Those women with mental health illness were excluded. All participants completed questionnaires on the following: demographic information, revision of illness perception (IPQ-R), body image scale (BIS), Eysenck personality questionnaire (EPQ), and resilience scale (RS). We conducted the structural equation modeling (SEM) to explore the factor structure.

RESULTS

SEM results showed a good fit to the data (comparative fit index = 0.97, Tucker-Lewis index = 0.94). Findings F indicated the existence of significant relationships between resilience and either illness perception or body image. Personality had a direct association with illness perception (β = 0.73, P < 0.05). Body image had an indirect effect on the relationship between resilience and illness perception (coefficient = -2.52; 95% bootstrapping CI = -31.36, -0.62).

CONCLUSIONS

Results indicated that illness perception is a crucial predictor for better resilience as mediated through body image. To provide adequate information to women with breast cancer can improve their perception of breast cancer more positively. Hence, their body image and their way of coping with survival life turn better.

How Do Healthy Women Perceive the Risk of Breast Cancer? The Role of Illness Perceptions and Compared Risk between Portugal and the U.A.E

(1) Background: Breast cancer (BC) shows significant epidemiological differences between Eastern and Western countries. These may arise from socio-cultural factors influencing how healthy young women perceive this condition, their risk of getting cancer, and the implications for preventive screening behaviors. In this study, the illness perceptions, individual risk perception, compared risk, and beliefs about preventive behaviors for BC of female university students were compared using an anonymous online survey between a European country (Portugal) and the United Arab Emirates. (2) Method: A structural equation model (SEM) was developed to investigate the hypothetical relationship between illness perceptions and compared risk as predictors of perceived risk for BC. (3) Results: There were significant differences between the study variables. The SEM was invariant, but the differences between regression coefficients in both countries were highly statistically significant. Mediation analyses revealed a significant indirect effect of compared risk on individual risk and a significantly stronger direct effect for the Emirati sample. (4) Conclusions: These findings suggest that cultural research may help to explain factors that may shape social comparison of individual risk characteristics and influence perceived risk. Moreover, providing culturally appropriate strategies to be designed and implemented can promote early detection behaviors for BC.

Research on body image cognition, social support and illness perception in breast cancer patients with different surgical methods

In parallel with the rapid rise in breast cancer incidence, there is also a noticeable rise in the number of patients who experience persistent negative body image cognition after breast cancer surgery. This study aimed to explore the differences in illness perception, social support, and body image cognition among breast cancer patients with different surgical methods, and the correlation, regression, and mediation among the three variables. The Brief Illness Perception Questionnaire (BIPQ), the Social Support Rating Scale (SSRS) and the Body Image Cognition after Breast Cancer Questionnaire (BIBCQ) were used to evaluate breast cancer patients’ illness perception, social support and body image cognition. Data analyses were performed by descriptive statistics, independent samples t-test, analysis of variance (ANOVA), Pearson correlation, and linear regression. The mediation was explored by the PROCESS V3.3. The study found that breast cancer patients undergoing radical mastectomy (RM) and modified radical mastectomy (MRM) demonstrated more negative illness perception, body image cognition, and lower social support compared with the patients receiving nipple-sparing mastectomy (NSM; p < 0.05). The subscale cognitive representation (CR) of BIPQ was strongly positively correlated with BIBCQ (p < 0.05). Illness perception positively predicted body image cognition (p < 0.01), while social support negatively predicted body image cognition. Social support partially mediated illness perception and body image cognition, exhibiting a positive role in post-operative body image cognition.

Illness Perception and Quality of Life in Patients with Breast Cancer

Simple Summary

The declining average age of cancer patients may become a serious problem for health care systems and societies in general in the near future. For this reason, there is a need to fully understand the factors determining health-related quality of life in breast cancer patients, beyond clinical characteristics and sociodemographic factors. In our study, we aimed to demonstrate the relationship between illness perception and quality of life in breast cancer patients. The results of our study confirm the beneficial effect of positive illness perception on the intensity of symptoms related to cancer and treatment, as well as functional domains of EORTC QLQ-C30.

Abstract

Introduction. In 2020, breast cancer was the most frequently diagnosed malignancy worldwide. The QoL level plays a role in assessing the effectiveness of the diagnosis and therapy and is a significant prognostic factor. The subject that is relatively less often addressed in the literature is the impact of psycho-social factors and health-related beliefs on QoL in breast cancer patients. The aim of the study was to assess the association of illness perception, the sense of coherence, and illness acceptance with QoL in breast cancer patients. Methods. The study included 202 women (mean age 53.0 ± 10.3) treated surgically for breast cancer at the Lower Silesian Oncology Centre. The following standardized questionnaires were used: Acceptance of Illness Scale (AIS), Mental Adjustment to Cancer (Mini-MAC), Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BR23), The Multidimensional Essence of Disease and Illness Scale (MEDIS), and Life Orientation Test (LOT-R). Results. There is a statistically significant association between illness acceptance and QoL. There is a statistically significant association between the sense of coherence (life optimism—LOT-R) and QoL among breast cancer patients. There is a statistically significant association between illness perception and QoL. There was a statistically significant correlation between the increasing importance of illness as a dysfunction, decreasing QoL, and increasing intensity of symptoms and complaints. Conclusions. Patients with a high level of illness acceptance, with an optimistic disposition, and with a positive illness perception have better QoL within all the functional domains and experience lower intensity of cancer- and treatment-related symptoms as compared to those with low level of illness acceptance, with moderate optimism or a pessimistic disposition, and with neutral or negative illness perception.

Effectiveness of Baduanjin Exercise on Quality of Life and Psychological Health in Postoperative Patients With Breast Cancer: A Systematic Review and Meta-analysis

Background:

Baduanjin exercise is a traditional Chinese Qigong exercise. This study aimed to investigate the effects of Baduanjin exercise on the quality of life and psychological status of postoperative patients with breast cancer.

Methods:

A systematic review and meta-analysis were conducted. Eight databases were searched from inception to December 15, 2021, restricting the language to English and Chinese. RevMan5.3 software was employed for data analysis. This study was registered in PROSPERO, number CRD 42020222132.

Results:

A total of 7 randomized controlled trials (RCTs) with 450 postoperative breast cancer patients with or without Baduanjin exercise were collected. Compared with the group without Baduanjin, those who practiced Baduanjin showed significant improvement in quality of life (WMD = 5.70, 95% CI 3.11-8.29, P < .0001). Subgroup analysis showed significant improvement in physical (WMD = 1.83, 95% CI 1.13-2.53, P < .00001) and functional well-being (WMD = 1.58, 95% CI 0.77-2.39, P = .0001), which were measured by the functional assessment of cancer therapy-breast (FACT-B). Subgroup analysis also showed that role-physical (WMD = 11.49, 95% CI 8.86-14.13, P < .00001) and vitality (WMD = 8.58, 95% CI 5.60-11.56, P < .00001) were significantly increased, as measured by a 36-item Short Form survey (SF-36). In terms of psychological health, Baduanjin exercise reduced patients’ anxiety (WMD = −8.02, 95% CI −9.27 to −6.78, P < .00001) and depression (WMD = −4.45, 95% CI −5.62 to −3.28, P < .00001).

Conclusions:

Baduanjin is an effective exercise, which can significantly improve the quality of life and psychological health of breast cancer patients after operation.

A Machine Learning Approach to Predict Stress Hormones and Inflammatory Markers Using Illness Perception and Quality of Life in Breast Cancer Patients

Psychosocial factors have become central concepts in oncology research. However, their role in the prognosis of the disease is not yet well established. Studies on this subject report contradictory findings. We examine if illness perception and quality of life reports measured at baseline could predict the stress hormones and inflammatory markers in breast cancer survivors, one year later. We use statistics and machine learning methods to analyze our data and find the best prediction model. Patients with stage I to III breast cancer (N = 70) were assessed twice, at baseline and one year later, and completed scales assessing quality of life and illness perception. Blood and urine samples were obtained to measure stress hormones (cortisol and adrenocorticotropic hormone (ACTH) and inflammatory markers (c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and fibrinogen). Family quality of life is a strong predictor for ACTH. Women who perceive their illness as being more chronic at baseline have higher ESR and fibrinogen values one year later. The artificial intelligence (AI) data analysis yields the highest prediction score of 81.2% for the ACTH stress hormone, and 70% for the inflammatory marker ESR. A chronic timeline, illness control, health and family quality of life were important features associated with the best predictive results.

Relationship between illness perception, fear of progression and quality of life in interstitial lung disease patients: A cross-sectional study

AIMS AND OBJECTIVES

This study aimed to investigate whether fear of progression mediates the association between illness perception and quality of life among interstitial lung disease patients.

BACKGROUND

So far, the physiological treatment of interstitial lung disease is limited. In addition to immunosuppressants such as glucocorticoids, two anti-fibrosis drugs (pirfenidone and nintedanib) have shown moderately beneficial effects on slowing the progression of interstitial lung disease fibrosis. However, none of these drugs has shown reliable or strong beneficial effects on improving quality of life. Psychological care and mental health support strategies focusing on improving patients' quality of life are particularly important.

DESIGN

A cross-sectional study.

METHODS

A convenience sample of patients suffering from interstitial lung disease were enrolled from August to December 2019. Data including sociodemographic and clinical characteristics, illness perception, fear of progression and quality of life were collected. The descriptive analysis and Pearson correlations were analysed by SPSS 26.0 (IBM Corp.). PROCESS v3.4 (by Andrew F. Hayes) macro was applied to analyse the mediating effects. We used the STROBE checklist to report the results.

RESULTS

Both illness perception and fear of progression were correlated with quality of life. Fear of progression mediated the association between illness perception and quality of life. The indirect effect was 0.121, and the proportion of intermediary effect in the main effect was 26.36%.

CONCLUSION

Interstitial lung disease patients experience relatively poor quality of life and fear of progression exerts a mediating role between illness perception and quality of life.

RELEVANCE TO CLINICAL PRACTICE

This study alerts medical staff to pay attention to negative illness perception and excessive fear, which is helpful to formulate effective interventions to manage interstitial lung disease patients' quality of life.

Development and factor structure of the perceptions of concussion inventory for athletes (PCI-A)

Purpose: This study evaluated the factor structure of the Perceptions of Concussion Inventory for Athletes (PCI-A) using exploratory factor analytic (EFA) techniques in a sample of collegiate student-athletes. Perception differences by sex and sport-related concussion (SRC) risk level were explored.Methods: This cross-sectional-design study included 298 male and 183 female collegiate student-athletes from 18 sports at six institutions. Participants completed a demographic and concussion history survey, and the PCI-A.Results: The EFA revealed a 6-factor solution (Anxiety, Effects, Clarity, Treatment, Control, and Symptom Variability) that accounted for 56.1% of the variance in responses. Female collegiate student-athletes displayed statistically higher levels of Anxiety, Clarity, Symptom Variability, and Control than males. Lower concussion risk sport athletes reported statistically higher levels of anxiety surrounding SRC and concerns relating to the long-term and major effects of an SRC.Conclusions: This study provides evidence that the PCI-A is an acceptable measure to examine the perceptions of collegiate student-athletes regarding SRC. The findings supported a six-factor structure of the PCI-A in the current study for collegiate student-athletes compared to the seven-factor structure indicated in previous research. The findings reveal sex and concussion risk sport differences in PCI-A responses.

Predicting Pain Trajectories in the One Year Following Breast Cancer Diagnosis-An Observational Study

The impact of psychosocial vulnerability on pain in the year following breast cancer diagnosis has been little studied. To identify a score of psychosocial vulnerability (cognitive, emotional, quality of life and precariousness parameters) as a predictor of a pain trajectory, we conducted an observational prospective study and included women with newly diagnosed breast cancer. One year follow-up with 3 visits (day of breast cancer diagnosis; 6 and 12 months) aimed to identify distinct pain-time trajectories. Baseline psychosocial vulnerability was characterized by z-score transformation, a higher score representing a more vulnerable patient. A total of 89 patients were included (59.3 ± 10.7 years). Two trajectories of pain were identified-"Transient Pain trajectory" (TP) (39/89 patients) and "Persistent Pain trajectory" (PP) (50/89). A significant difference of pain over time between trajectories (PP vs. TP at 6 months: 2.23 ± 0.23 vs. 0.27 ± 0.09, p < 0.001) was observed. Psychosocial vulnerability showed a large effect size (d, -0.82; 95% CI, -1.25 to -0.38; p < 0.001) and a higher score in "Persistent pain trajectory" (PP vs. TP: 0.12 ± 0.36 vs. -0.14 ± 0.26, p < 0.001). A predictive vulnerability marker of pain development is proposed and could be used at cancer diagnosis to orientate the care pathway of patients experiencing breast cancer.