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Shahrour L, Martinez J, Chicaiza A, Omar R, Bovbjerg K, Stanton AL, Valdimarsdottir H, Yanez B, Munshi P, Rowley SD, Rini C, Graves KD. Greater Social Isolation and Social Constraints Prior to Hematopoietic Stem Cell Transplant Are Associated with Greater Anxiety and Depressive Symptoms. Int J Behav Med 2024; 31:341-351. [PMID: 38017317 DOI: 10.1007/s12529-023-10232-8] [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] [Accepted: 10/04/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Hematopoietic stem cell transplantation (hereafter "HCT") is a physically and psychologically difficult treatment for patients with hematological cancers. This study examined relationships among patients' reports of pre-transplant social isolation, social constraints, and psychological distress. METHOD We used baseline data from a multisite randomized controlled trial evaluating the effects of expressive helping writing to reduce physical and emotional symptoms in HCT patients. We collected data prior to randomization and before either allogenic or autologous HCT using validated scales to assess social constraints, social isolation, anxiety, and depressive symptoms. We analyzed data using bivariate analysis and multivariate linear regression. We also explored whether social isolation mediated the effect of social constraints on both of our outcomes: anxiety and depressive symptoms. RESULTS Among 259 adults recruited prior to transplant, 43.6% were women (mean age = 57.42 years, SD = 12.34 years). In multivariate analysis controlling for relevant covariates, both social isolation (β = 0.24, p < 0.001) and social constraints (β = 0.28, p < 0.001) were associated with anxiety. When both social constraints and social isolation were in the model, only greater social isolation (β = 0.79, p < 0.001) was associated with depressive symptoms. Social isolation fully mediated the association between social constraints and anxiety and depressive symptoms. CONCLUSION For patients awaiting either allogenic or autologous HCT, the negative association between social constraints and anxiety and depressive symptoms may be related, in part, to the mechanism of perceived social isolation. Interventions prior to and during HCT are needed to support patients' psychological health and sense of social connectedness.
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Affiliation(s)
| | | | - Anthony Chicaiza
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
| | - Rahma Omar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katrin Bovbjerg
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Heiddis Valdimarsdottir
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Pashna Munshi
- MedStar Georgetown University Hospital, Washington, D.C, USA
| | - Scott D Rowley
- John Theurer Cancer Center, Hackensack Meridian Health, Hackensack, NJ, USA
| | - Christine Rini
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Kristi D Graves
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA.
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Blevins TR, Lo SB, Coker CA, Arrato NA, Reisinger SA, Shields PG, Andersen BL. COVID-19 or Cancer Stress? Anxiety and Depressive Symptoms in Patients with Advanced Lung Cancer. Int J Behav Med 2024; 31:325-330. [PMID: 37594667 PMCID: PMC11271711 DOI: 10.1007/s12529-023-10206-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] [Accepted: 07/18/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Of all cancer patients, those with lung cancer are among the highest risk for infection, pneumonia, hospitalization, and early death from COVID-19. As cancer stress is ubiquitous, this exploratory study examines patients' COVID-19 stress and cancer stress in relation to their depressive and anxiety symptoms. METHOD Newly diagnosed advanced lung cancer patients (N = 76) completed measures of cancer stress, COVID-19 illness perceptions and stress, and depressive and anxiety symptoms at a single monthly follow-up early in the pandemic (May 2020 to July 2020; Clinicaltrials.gov #NCT03199651). Hierarchical linear multiple regression analysis was used to identify the relationship of stressor variables to depressive and anxiety symptoms in this cross-sectional study. RESULTS Hierarchical linear models revealed cancer stress was a significant predictor of both depressive symptoms (F(14,30) = 5.327, p < 0.001, R2 = 0.71, adjusted R2 = 0.58) and anxiety symptoms (F(14,30) = 4.513, p < 0.001, R2 = 0.68, adjusted R2 = 0.53) for patients at the start of the COVID-19 pandemic. By contrast, COVID-19 stress was not a significant predictor of depressive (F(13,31) = 1.415 p = .21, R2 = .37, adjusted R2 = .11) or anxiety symptoms (F(13,31) = 1.23, p = .30, R2 = .34, adjusted R2 = - .07). CONCLUSIONS Advanced lung cancer patients during the early phase of the COVID-19 pandemic reported cancer stress as more important than COVID-19 stress in relation to their mental health. Empirically supported biobehavioral and cognitive behavioral treatments remain important to reducing psychological symptoms and enhancing patients' quality of life.
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Affiliation(s)
- Tessa R Blevins
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Stephen B Lo
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Clarence A Coker
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Nicole A Arrato
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Sarah A Reisinger
- Comprehensive Cancer Center, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Peter G Shields
- Comprehensive Cancer Center, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Barbara L Andersen
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA.
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Rezaee Vessal S, Partouche-Sebban J, Schiavone F. Reliving a traumatic experience through emotional creativity: the bright side of cancer during the COVID-19 pandemic. JOURNAL OF ORGANIZATIONAL CHANGE MANAGEMENT 2022. [DOI: 10.1108/jocm-11-2021-0348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
PurposeThe COVID-19 outbreak has undoubtedly affected overall mental health. Thus, researching resilience is important, as it has been previously discussed as a means to protect people from mental health problems. This study aims to clarify whether survivors of a traumatic event (i.e. cancer survivors) are more resilient to living through another traumatic experience, such as COVID-19, compared to those who have never had such an experience. The study also examines the role of emotional creativity in this process.Design/methodology/approachA quantitative research design was adopted. The data collection was performed through a survey (N = 338), which was conducted among two separate groups of participants. The first group (N = 152) included the survivors of a traumatic event (i.e. cancer survivors), and the second group (N = 186) included those who did not have such an experience.FindingsThe results demonstrate that living through a traumatic experience results in a higher level of resilience during another traumatic experience (i.e. COVID-19), which is the result of higher post-traumatic growth. Moreover, emotional creativity is discussed as an explanatory variable that explains a significantly higher level of post-traumatic growth among survivors of a traumatic event.Originality/valueThis research offers a better understanding of the effect of living through a traumatic event on post-traumatic growth and resilience in living through another traumatic experience. Moreover, post-traumatic growth is explained through emotional creativity improvement, which happens after experiencing a traumatic life event.
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Construction process and development stages of pandemic emotions questionnaire in cancer patients (PEQ-CP). BMC Psychol 2022; 10:226. [PMID: 36167563 PMCID: PMC9514172 DOI: 10.1186/s40359-022-00930-5] [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: 04/14/2022] [Accepted: 09/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background Despite the numerous tools built ad hoc to investigate the effects of the CoViD-19 pandemic on people, to date there are no known questionnaires that investigate the emotional experiences of cancer patients. This work aims to start a process of construction and validation of a tool that captures these aspects (Pandemic Emotions Questionnaire in Cancer Patients—PEQ-CP). Method A mixed method approach was used through three phases, each on a different sample: Phase 1: creation of items and checking of internal validity, through unstructured interviews and verification of the validity of content by "peers" and "experts"; Phase 2: exploration of the factorial structure of the scale through an exploratory factor analysis (EFA); Phase 3: confirmation of the factorial structure of the scale through a confirmatory factor analysis (CFA).
Results Phase 1 revealed 26 items that can be grouped into 4 theoretical dimensions. "Peers" and "experts" rated all items as understandable and relevant except one, which was reformulated. The EFA in the Phase 2 revealed a factorial structure with 14 items and three dimensions (Emotional Understanding, Communication of Emotions, Feelings the same as others), confirmed by the CFA in Phase 3. Conclusion Although further validation steps are required, the PEQ-CP showed good psychometric properties. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00930-5.
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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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Velasco-Durantez V, Jimenez-Fonseca P, Martín Abreu CM, Ghanem I, González Moya M, Asensio E, Corral MJ, Rodriguez-Gonzalez A, Gil-Raga M, Carmona-Bayonas A, Calderon C. Resilience, social support, and anxious preoccupation in patients with advanced cancer during COVID-19 pandemic. Cancer Invest 2022; 40:475-482. [PMID: 35468046 DOI: 10.1080/07357907.2022.2067864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study examines the mediating role of social support between anxious preoccupation and resilience in patients with cancer during COVID-19. NEOetic_SEOM is a prospective, multicenter study involving individuals with advanced, unresectable cancer who completed the following scales: Resilience (BCRS), Social Support (Duke-UNC-11), and anxious preoccupation subscale of the Mini-Mental Adjustment to Cancer (M-MAC) before starting antineoplastic treatment. Between March 2020 and July 2021, 507 patients (55% male; mean age, 65) were recruited. No differences in resilience were observed based on sociodemographic or clinical characteristics. Social support in people with advanced, unresectable cancer promotes both decreased anxious preoccupation and greater resilience.
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Affiliation(s)
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo Spain
| | - Carla M Martín Abreu
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Ismael Ghanem
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Elena Asensio
- Department of Medical Oncology, Hospital General Universitario de Elche, Elche Spain
| | - María J Corral
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Adan Rodriguez-Gonzalez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo Spain
| | - Mireia Gil-Raga
- Department of Medical Oncology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Alberto Carmona-Bayonas
- Department of Medical Oncology, Hospital General Universitario Morales Meseguer de Murcia, University of Murcia, IMIB, Murcia, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
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