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Park JH, Chun M, Bae SH, Woo J, Chon E, Kim HJ. Factors influencing psychological distress among breast cancer survivors using machine learning techniques. Sci Rep 2024; 14:15052. [PMID: 38956137 PMCID: PMC11219858 DOI: 10.1038/s41598-024-65132-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: 04/24/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024] Open
Abstract
Breast cancer is the most commonly diagnosed cancer among women worldwide. Breast cancer patients experience significant distress relating to their diagnosis and treatment. Managing this distress is critical for improving the lifespan and quality of life of breast cancer survivors. This study aimed to assess the level of distress in breast cancer survivors and analyze the variables that significantly affect distress using machine learning techniques. A survey was conducted with 641 adult breast cancer patients using the National Comprehensive Cancer Network Distress Thermometer tool. Participants identified various factors that caused distress. Five machine learning models were used to predict the classification of patients into mild and severe distress groups. The survey results indicated that 57.7% of the participants experienced severe distress. The top-three best-performing models indicated that depression, dealing with a partner, housing, work/school, and fatigue are the primary indicators. Among the emotional problems, depression, fear, worry, loss of interest in regular activities, and nervousness were determined as significant predictive factors. Therefore, machine learning models can be effectively applied to determine various factors influencing distress in breast cancer patients who have completed primary treatment, thereby identifying breast cancer patients who are vulnerable to distress in clinical settings.
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Affiliation(s)
- Jin-Hee Park
- College of Nursing, Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Misun Chun
- Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Sun Hyoung Bae
- College of Nursing, Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Jeonghee Woo
- Management Team, Cancer Center, Gyeonggi Regional Cancer Center, Suwon, Republic of Korea
| | - Eunae Chon
- Management Team, Cancer Center, Gyeonggi Regional Cancer Center, Suwon, Republic of Korea
| | - Hee Jun Kim
- College of Nursing, Ajou University, 164, World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
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Qin F, Wei T, Zhao X, Yuan S, He Y, Chen M, Luo Z, Shi L, Li G. Relationship between family resilience and dyadic coping in colorectal cancer patients and their spouses, based on the actor-partner interdependence model. Eur J Oncol Nurs 2024; 70:102622. [PMID: 38795443 DOI: 10.1016/j.ejon.2024.102622] [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: 10/09/2023] [Revised: 05/07/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE To explore the relationship between dyadic coping and family resistance in colorectal cancer patients and their spouses. METHODS 178 pairs of colorectal cancer patients and their spouses hospitalized in a three tertiary hospital in Changsha were selected from July 2021 to March 2022. The Family Resilience Assessment Scale and the Dyadic Coping Inventory were used to investigate, which relationship was analyzed by APIM. RESULTS The total score of patients' dyadic coping was 121.51 ± 16.8, and spouses' score was 123.72 ± 16.6. The total score of family resilience was 176.42 ± 16.0, and spouses' score was 182.72 ± 17.03. There was a significant positive relationship between dyadic coping and family resistance of colorectal cancer patients and their spouses (r > 0.7, P < 0.001). The positive dyadic coping of colorectal cancer patients and their spouses had a positive effect on their own and their spouses' family resilience and the effect was the same. The negative dyadic coping of colorectal cancer patients and their spouses had a negative impact on their own family resilience, and the overall model showed a subject pattern. CONCLUSIONS The level of family resilience of colorectal cancer patients and their spouses was affected by the level of dyadic coping. Medical workers should regard patients and their spouses as a whole and formulate mutually supportive coping strategies with family as the center, so as to increase positive coping behavior and enhance their family's ability to cope with cancer.
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Affiliation(s)
- Fang Qin
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
| | - Tianqi Wei
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinyu Zhao
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Siyu Yuan
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan He
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Meifei Chen
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhaolun Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
| | - Guoxin Li
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Díaz-Heredia LP, Bueno-Robles LS, Bejarano Beltrán MP, Pardo Torres MP. Experiences of Women With Breast Cancer and Their Partners in Achieving Coherence as a Couple During the Disease Journey. Nurs Womens Health 2024; 28:135-142. [PMID: 38412974 DOI: 10.1016/j.nwh.2023.10.005] [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: 07/28/2023] [Revised: 10/17/2023] [Accepted: 01/19/2023] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To describe the experiences of female patients with breast cancer and their partners in achieving coherence as a couple during the disease journey. DESIGN Qualitative study. SETTING Colombia, South America. PARTICIPANTS Women diagnosed with breast cancer in the last 2 years and their intimate partners with whom they lived during the 6 months before study enrollment. In total, 16 heterosexual couples participated in individual interviews and focus groups. METHOD Interviews and focus groups were analyzed using content analysis. RESULTS Four themes were identified: The Diagnosis: A Moment That Destabilizes the Couple, Couple's Sexuality: Seeking the Best Conditions Between Desire and Reality, Generating Mutually Supportive Dynamics in the Face of Cancer, and The Transformation of a Negative Situation Into a Positive One and Achieving Coherence Within the Couple. The first theme represents the initial moment of uncertainty and emotional reactions due to the confirmation of the diagnosis of breast cancer. The second captures the physical and emotional effects in the couple's sexuality generated by the treatment and diagnosis as well as the strategies used to strengthen the couple's relationship. The third reflects how the couple's support is based on commitment, companionship, and the performance of daily actions. The last describes how the adaptation process allows couples experiencing the disease to achieve coherence. CONCLUSION These findings highlight that couples experiencing breast cancer can transform the negative situation into an opportunity to strengthen their relationship by achieving coherence. Future research is needed to investigate the antecedents, attributes, and outcomes related to couples' coherence. Moreover, health professionals should perform periodic assessments on the dynamics, coping strategies, and resources at couples' disposal to help promote couples' adaptation and coherence.
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Liu W, Lewis FM, Li M, Kantrowitz-Gordon I. Development of a common dyadic coping scale in couples facing breast cancer: the importance of open communication. J Psychosoc Oncol 2024:1-18. [PMID: 38240291 DOI: 10.1080/07347332.2024.2303523] [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: 02/28/2024]
Abstract
OBJECTIVE Couples' joint coping is important in managing the impact of breast cancer. However, measures assessing couples' communication as a way of coping are insufficient. This study aimed to generate a self-report valid and reliable measure of couples' coping with a particular focus on communication. METHOD We used baseline data of 343 couple dyads who participated in a randomized clinical trial targeting marital communication. Women were diagnosed with early-stage breast cancer in the past eight months; couples were married or in an intimate relationship for at least six months, could read and write English, and lived within 100 miles of the study center. An expert panel selected items with conceptual fit from the Mutuality and Interpersonal Sensitivity Scale (MIS) that was originally designed to evaluate marital communication about breast cancer. RESULTS Exploratory and confirmatory factor analyses supported a 12-item measurement model with four factors: Keeping the communication open with each other about breast cancer (4 items), Sharing a positive outlook on breast cancer (2 items), Avoiding discussion of negative thoughts and feelings about breast cancer (3 items), and Spending sufficient time together talking about breast cancer (3 items). Reliability ranged from 0.76 to 0.87 for women and 0.70 to 0.83 for spouses. CONCLUSION This new measure has potential application in clinical practice and future research to assess couple's joint coping efforts especially through communication.
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Affiliation(s)
- Wenjia Liu
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
| | - Frances Marcus Lewis
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
- Public Health Sciences and Clinical Sciences Divisions, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Min Li
- College of Education, University of Washington, Seattle, Washington, USA
| | - Ira Kantrowitz-Gordon
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
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Kelly KM, Rai P, Studts JL, Dickinson S, Henschel B, Dignan M, Chambers M, Hazard-Jenkins H. Communication with physicians and family about breast Cancer recurrence. PEC INNOVATION 2023; 3:100237. [PMID: 38148854 PMCID: PMC10750108 DOI: 10.1016/j.pecinn.2023.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/09/2023] [Accepted: 11/25/2023] [Indexed: 12/28/2023]
Abstract
Objective Adequate physician-patient communication about cancer recurrence is vital to quality of life and to informed decision-making related to survivorship care. The current study was guided by a cognitive-affective framework to examine communication with family and physicians about breast cancer recurrence risk. Methods A survey of recently-diagnosed, early-stage breast cancer patients in Appalachia investigated physician-patient and familial communication about breast cancer recurrence risk. Results Over 30% of participants reported not talking to family or physicians about breast cancer recurrence risk. Younger patients reported more conversations, and speaking with physicians was associated with greater perception risk factors associated with recurrence risk. Greater worry about recurrence was associated with more communication with family and plans to talk to family, physicians, and friends about recurrence risk in the future. Conclusion Additional supports for patients and physicians are needed to improve understanding of breast cancer recurrence risk and risk factors for recurrence. Innovation Family communication about breast cancer recurrence risk is understudied. The combination of physician and family communication adds novelty to our analysis.
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Affiliation(s)
- Kimberly M. Kelly
- Center for Innovation in Health Equity Research, University of Tennessee Health Science Center, 66 N. Pauline St, Memphis, TN, USA
- West Virginia University School of Pharmacy, HSC PO Box 9510, Morgantown, WV 26506, USA
| | - Pragya Rai
- Center for Innovation in Health Equity Research, University of Tennessee Health Science Center, 66 N. Pauline St, Memphis, TN, USA
| | - Jamie L. Studts
- University of Colorado School of Medicine, Aurora, CO 80045, USA
| | | | | | - Mark Dignan
- University of Kentucky, Lexington, KY 40505, USA
| | | | - Hannah Hazard-Jenkins
- West Virginia University School of Pharmacy, HSC PO Box 9510, Morgantown, WV 26506, USA
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Social Support in a Cancer Patient-Informal Caregiver Dyad: A Scoping Review. Cancers (Basel) 2023; 15:cancers15061754. [PMID: 36980639 PMCID: PMC10046409 DOI: 10.3390/cancers15061754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/08/2023] [Accepted: 03/11/2023] [Indexed: 03/15/2023] Open
Abstract
Social support that includes promoting healthy behaviours throughout the oncology pathway, from diagnosis to treatment to survival, can leverage existing support networks and improve the health of patients and family members in supportive roles. This scoping review aimed to identify and summarise the impact of social support on the patient-informal caregiver relationship during cancer treatment. Inclusion criteria were related to a high focus on dyadic cancer patient-informal caregiver relationships, considering a population of adult cancer patients in active hospitalisation on an oncology ward, and published between 2012 and 2022 to get a portrait of the literature that might influence the current practice. A systematic search using the “Population, Concept, and Context” framework was performed in PubMed, Web of Science, SCOPUS, EBSCO Medline, and CINAHL: 13 articles from the 16,425 pre-qualified articles published between 2012 and 2022. The narrative synthesis of the included studies highlighted that social support, encompassing its different forms within the context of dyads, is frequently associated with an enhanced quality of life, hope, and resilience of both patients and informal caregivers. However, it is important to recognize that the support interventions provided to patients, particularly caregivers, were frequently not thoroughly evaluated or explained, and the sample sizes of the included studies were often limited. Therefore, this review clarified the social and clinical potential of social support for the patient-informal caregiver relationship, paving the way for future robust studies that require to be powered and designed on specific outcomes to allow informing the practice on specific recommendations.
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Otto AK, Vadaparampil ST, Heyman RE, Ellington L, Reblin M. Spouse caregivers' identification of the patient as their primary support person is associated with better patient psychological well-being. J Psychosoc Oncol 2023; 41:137-149. [PMID: 35486591 DOI: 10.1080/07347332.2022.2067804] [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: 10/18/2022]
Abstract
Examine the impact of the primary-support person (PSP) role on advanced cancer patient and spouse caregiver psychological well-being, above and beyond the effects of relationship satisfaction. Secondary analysis of cross-sectional questionnaire data. 88 advanced cancer patient/spouse-caregiver dyads. Patients and caregivers independently completed measures assessing depression, anxiety, perceived stress, and relationship satisfaction, and identified their PSP. Patient and caregiver psychological well-being outcomes were regressed on patient and caregiver PSP variables in an actor-partner interdependence model. Half of patients identified their caregiver as PSP; 9% of caregivers identified their patient as PSP. When caregivers identified their patient as PSP, the patient reported better outcomes. No associations were seen for patient identification of caregiver as PSP or caregiver well-being. Clinicians can encourage patients to find ways to continue to focus on their relationship with the caregiver and help caregivers connect with other sources of support.
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Affiliation(s)
- Amy K Otto
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.,University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Richard E Heyman
- Family Translational Research Group, New York University Faculty of Health, New York, New York, USA
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Maija Reblin
- Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
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Sheikhnezhad L, Hassankhani H, Sawin EM, Sanaat Z, Sahebihagh MH. Blaming in Women with Breast Cancer Subjected to Intimate Partner Violence: A Hermeneutic Phenomenological Study. Asia Pac J Oncol Nurs 2023; 10:100193. [PMID: 37008540 PMCID: PMC10060106 DOI: 10.1016/j.apjon.2023.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
Objective The present study was conducted to determine the blaming experiences of women with breast cancer subjected to intimate partner violence (IPV). Methods This hermeneutic phenomenological study explored blaming experiences of women with breast cancer subjected to IPV. Nine women with a mean age of 47.5 years referred to oncology hospitals in Tabriz (Iran) were interviewed using semi-structured in-depth interviews. Data analysis was performed based on Van Manen's thematic analysis method. Results The main theme emerged from the data is "blaming as a shifting cognitive judgment" with three subthemes of patient blaming partner, partner blaming patient, and self-blame. Conclusions The findings of the present study revealed that cognitive judgment shifting could be emerged as different types of blaming in the patients with breast cancer exposed to IPV. It is suggested that oncology nurses heed the psychological needs of women with breast cancer through holistic nursing considering couple and family-centered care.
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Valente M, Chirico I, Girotti C, Ottoboni G, Chattat R. The Role of the Quality of Relationship in Couples Facing Treatment for Breast Cancer: A Qualitative Italian Study. Am J Clin Oncol 2023; 46:36-42. [PMID: 36562693 DOI: 10.1097/coc.0000000000000962] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Breast cancer is the leading cause of cancer death in women worldwide. Recently, the focus of research has shifted from psychiatric, psychological, and social consequences on the woman who gets sick from breast cancer to the impact on the couple. Indeed, the psychosocial perspective has developed the construct of the Quality of Relationship (QoR) that affects the quality of life of both members of the dyad. OBJECTIVE The aim of this study was to extend knowledge in this field by identifying and analyzing what dimensions of QoR may impact couples' psychosocial adjustment to breast cancer and related treatments. PATIENTS AND METHODS Semistructured interviews explored couples' experiences of breast cancer diagnosis and treatment. Transcripts were analyzed using inductive thematic analysis. RESULTS Twelve couples were interviewed. Results showed how the dimensions of psychosocial support, dyadic coping, communication, and intimacy are associated and define the construct of QoR, thus affecting the couples' adjustment to breast cancer diagnosis and to the disease pathway. CONCLUSION Assessment procedures of couple functioning since and after diagnosis could increase the appropriateness and benefits of integrating existing clinical practice in oncological settings.
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Affiliation(s)
- Marco Valente
- Department of Psychology, Alma Mater Studiorum-University of Bologna, Bologna, Italy
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Emotional processes in partners’ quality of life at various stages of breast cancer pathway: a longitudinal study. Qual Life Res 2022; 32:1085-1094. [PMID: 36418525 DOI: 10.1007/s11136-022-03298-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Several studies have shown that emotional competence (EC) impacts cancer adjustment via anxiety and depression symptoms. The objective was to test this model for the quality of life (QoL) of partners: first, the direct effect of partners' EC on their QoL, anxiety and depression symptoms after cancer diagnosis (T1), after chemotherapy (T2) and after radiotherapy (T3); Second, the indirect effects of partners' EC at T1 on their QoL at T2 and T3 through anxiety and depression symptoms. METHODS 192 partners of women with breast cancer completed a questionnaire at T1, T2 and T3 to assess their EC (PEC), anxiety and depression symptoms (HADS) and QoL (Partner-YW-BCI). Partial correlations and regression analyses were performed to test direct and indirect effects of EC on issues. RESULTS EC at T1 predicted fewer anxiety and depression symptoms at each time and all dimensions of QoL, except for career management and financial difficulties. EC showed different significant indirect effects (i.e. via anxiety or depression symptoms) on all sub-dimensions of QoL, except for financial difficulties, according to the step of care pathway (T2 and T3). Anxiety and depression played a different role in the psychological processes that influence QoL. CONCLUSION Findings confirm the importance of taking emotional processes into account in the adjustment of partners, especially regarding their QoL and the support they may provide to patients. It, thus, seems important to integrate EC in future health models and psychosocial interventions focused on partners or caregivers.
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Gil N, Fisher A, Beeken RJ, Pini S, Miller N, Buck C, Lally P, Conway R. The role of partner support for health behaviours in people living with and beyond cancer: A qualitative study. Psychooncology 2022; 31:1997-2006. [PMID: 36097392 PMCID: PMC9828063 DOI: 10.1002/pon.6032] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/16/2022] [Accepted: 09/05/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study aimed to qualitatively explore how partner support for health behaviours is perceived, received, and utilised in people living with and beyond cancer (LWBC). METHODS Semi-structured audio interviews were conducted with 24 participants, 15 men and nine women, living with and beyond breast, prostate, and colorectal cancer. Inductive and deductive Thematic Analysis was used to analyse the data. RESULTS Three key themes with six subthemes were identified relating to partner support for health behaviours: (1) Interdependence (Reciprocity, Overt Control, Influence & Motivation) (2) Concordance (Shared Attitudes & Health Beliefs, Shared Health Behaviour) and (3) Communal Coping (Communal Orientation towards Health and Decision Making, Co-operative Action in Health Behaviour). CONCLUSIONS Partner support plays a unique and significant role in the health behaviours of people LWBC. Partners play a collaborative role in managing health and facilitating health behaviours, while the high level of concordance in couples may represent a potential barrier to change via the reinforcement of maladaptive health beliefs and behaviours. IMPLICATIONS FOR CANCER SURVIVORS Overall, findings demonstrate that partners should be considered and included where possible when designing future behaviour change interventions for people LWBC.
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Affiliation(s)
- Natalie Gil
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Abigail Fisher
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Rebecca J. Beeken
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Simon Pini
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Natalie Miller
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Caroline Buck
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Phillippa Lally
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Rana Conway
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
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A Model of Social Support for a Patient–Informal Caregiver Dyad. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4470366. [PMID: 36246975 PMCID: PMC9553486 DOI: 10.1155/2022/4470366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/13/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022]
Abstract
Background Close persons (informal caregivers) are the most important providers of support indicated by cancer patients. Cancer affects couples as a codependent system. The aim of this study was to investigate the factors influencing the multidimensional aspect of social support in a cancer patient–informal caregiver dyad. Methods The research project was cross-sectional. The diagnostic survey method and the survey technique were used. The study was conducted using standardised research tools: BSSS, POS, SSCS, TIPI, ET, SPT, and the authors' own tool for sociodemographic assessment. Results Patients and caregivers experienced injustice, exclusion, and a sense of loss with a similar intensity. Statistically significant differences between the examined patients and their caregivers were obtained for the support currently received (p < 0.01), emotional support (p < 0.05), and the general level of protective buffering support (p < 0.001). A higher level of information support for caregivers increases the need for support and a sense of support for patients. Conclusion The quality of functioning and mental well-being of patients is directly influenced by the way their caregivers experience the situation of caring for them; negative or positive states of caregivers, affecting the condition of patients, may affect the course of treatment and contribute to or delay the improvement of the state of health. The subjective sense of support in patients during treatment depends on the need for help that is shown to their caregivers. The sense of support variable is subjective and sometimes disproportionate to the support received and given. Therefore, both the patient and their loved one should be provided with care during the treatment process. In the treatment process, both patients and their caregivers need more protective buffering support that allows them to overcome difficulties related to stress, anxiety, and insecurity, thus weakening their negative effects rather than functional support: emotional, information, instrumental, or material.
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Reese JB, Zimmaro LA, McIlhenny S, Sorice K, Porter LS, Zaleta AK, Daly MB, Cribb B, Gorman JR. Coping With Changes to Sex and Intimacy After a Diagnosis of Metastatic Breast Cancer: Results From a Qualitative Investigation With Patients and Partners. Front Psychol 2022; 13:864893. [PMID: 35465532 PMCID: PMC9019080 DOI: 10.3389/fpsyg.2022.864893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Prior research examining sexual and intimacy concerns among metastatic breast cancer (MBC) patients and their intimate partners is limited. In this qualitative study, we explored MBC patients' and partners' experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences. Methods We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software. Results Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: (1) the heavy disease/treatment burden leads to significant, long-term sexual concerns (e.g., loss of interest and vaginal dryness/discomfort) and consequent heightened emotional distress for both patients (e.g., guilt around not being able to engage in intercourse) and partners (e.g., guilt around pressuring the patient to engage in sexual activity despite pain/discomfort); (2) viewing the relationship as having "an expiration date" (due to expected earlier mortality) influences patients' and partners' concerns related to sex/intimacy and complicates coping efforts; and (3) information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences. Conclusion Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients' and partners' perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients' health and quality of life.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Lauren A. Zimmaro
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Sarah McIlhenny
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Kristen Sorice
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Laura S. Porter
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Alexandra K. Zaleta
- Research and Training Institute, Cancer Support Community, Philadelphia, PA, United States
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Beth Cribb
- Cancer Support Community of Greater Philadelphia, Philadelphia, PA, United States
| | - Jessica R. Gorman
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
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Malandrone F, Bevilacqua F, Merola M, Gallio N, Ostacoli L, Carletto S, Benedetto C. The Impact of Vulvar Cancer on Psychosocial and Sexual Functioning: A Literature Review. Cancers (Basel) 2021; 14:cancers14010063. [PMID: 35008225 PMCID: PMC8750175 DOI: 10.3390/cancers14010063] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The diagnostic and therapeutic pathway of vulvar cancer impacts severely on the psychosocial and psychosexual equilibrium of women affected by it. The current literature shows the presence of depressive and anxious symptoms in association with physical, psychological and behavioural alterations in sexuality as well as deterioration of partner relationship. The aim of this article is to highlight the difficulties and challenges faced by women diagnosed and treated for vulvar cancer to provide early recognition and appropriate assistance. By implementing an integrated care model, it should be possible to detect unmet needs and improve the quality of life of these women. Abstract Women who are diagnosed and treated for vulvar cancer are at higher risk of psychological distress, sexual dysfunction and dissatisfaction with partner relationships. The aim of this article is to provide a review of the psychological, relational and sexual issues experienced by women with vulvar cancer in order to highlight the importance of this issue and improve the quality of care offered to these patients. A review of the literature was performed using PubMed, CINAHL, PsycINFO, and the Cochrane Library. The results are presented as a narrative synthesis and highlight the massive impact of vulvar cancer: depressive and anxiety symptoms were more frequent in these women, and vulvar cancer may have a negative effect on sexuality from a physical, psychological and behavioural point of view. Factors that may negatively affect these women’s lives are shame, insecurity or difficulties in self-care and daily activities. This review highlights the psychosocial and psychosexual issues faced by women diagnosed and treated for vulvar cancer, although more studies are needed to better investigate this field of interest and to identify strategies to relieve their psychological distress. Care providers should implement an integrated care model to help women with vulvar cancer recognise and address their unmet needs.
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Affiliation(s)
- Francesca Malandrone
- Department of Clinical and Biological Sciences, University of Torino, 10043 Torino, Italy
| | - Federica Bevilacqua
- Gynaecology and Obstetrics 1, Department of Surgical Sciences, University of Torino, City of Health and Science, 10126 Torino, Italy
| | - Mariagrazia Merola
- Clinical Psychology Service, City of Health and Science, 10126 Torino, Italy
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, 10126 Torino, Italy
| | - Niccolò Gallio
- Gynaecology and Obstetrics 1, Department of Surgical Sciences, University of Torino, City of Health and Science, 10126 Torino, Italy
| | - Luca Ostacoli
- Department of Clinical and Biological Sciences, University of Torino, 10043 Torino, Italy
- Clinical Psychology Service, City of Health and Science, 10126 Torino, Italy
| | - Sara Carletto
- Clinical Psychology Service, City of Health and Science, 10126 Torino, Italy
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, 10126 Torino, Italy
| | - Chiara Benedetto
- Gynaecology and Obstetrics 1, Department of Surgical Sciences, University of Torino, City of Health and Science, 10126 Torino, Italy
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Bovbjerg ML. Current Resources for Evidence-Based Practice, November 2021. J Obstet Gynecol Neonatal Nurs 2021; 50:789-800. [PMID: 34653377 DOI: 10.1016/j.jogn.2021.10.001] [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: 11/29/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of autonomy and respect in maternity care and commentaries on reviews focused on whether to induce women who present with mild preeclampsia in the late preterm period and the extent to which urinary incontinence symptoms prevent women from participating in exercise. It also includes a brief update about the USPSTF guidelines on screening for gestational diabetes.
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