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Trabsa A, Casanovas F, Pérez V, Moreno A, Amann B, Mané A. Comparison of male and female non-refugee immigrants with psychosis: clinical, sociodemographic, and migration-related differences and impact on stress. Arch Womens Ment Health 2024; 27:679-692. [PMID: 38374484 PMCID: PMC11405427 DOI: 10.1007/s00737-024-01431-7] [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: 11/03/2023] [Accepted: 01/20/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE To compare social, clinical, and migration-related factors between male and female immigrants with psychotic disorders and to determine the association between these variables and stress in the last year. METHODS We administered the Holmes and Rahe Social Readjustment Scale to evaluate psychological stress in 99 non-refugee immigrants (26 women, 73 men) who presented ≥ one psychotic episode (ICD-10 criteria). We compared the two groups in terms of sociodemographic, clinical, cultural, and migration-related variables. A multivariable analysis using a linear regression model (stepwise method) was performed to evaluate potential associations between these variables and stress. RESULTS Women were more likely to be married and divorced, had less access to welfare payments, and lower unemployment and homeless rates than men. The most common psychiatric diagnosis was psychosis not otherwise specified with more women being affected (61.5% in women vs. 45.2% in men), but the diagnosis of schizophrenia was more common in men (38.4% vs 15.4%). Both groups exhibited very high levels of stress in the past year (mean total distress score > 300). In women, stress was significantly associated with age at first migration and be a racialized person. By contrast, among men stress was significantly associated with language barrier and comorbidity with a physical disorder. CONCLUSIONS The results of this study reveal important differences between men and women immigrants. These findings underscore the importance of understanding how gender-specific roles and social expectations intersect with the timing and nature of migration to influence stress levels differently in immigrant women and men with psychotic disorders.
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Affiliation(s)
- Amira Trabsa
- PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institute of Mental Health, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08019, Barcelona, Spain
- Hospital del Mar Medical Research Institute, C/del Aiguader 88, 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Francesc Casanovas
- Hospital del Mar Medical Research Institute, C/del Aiguader 88, 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Víctor Pérez
- Institute of Mental Health, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08019, Barcelona, Spain
- Hospital del Mar Medical Research Institute, C/del Aiguader 88, 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
- Centre Fòrum Research Unit, Hospital del Mar, C/Llull 410, 08019, Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Ana Moreno
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
- Centre Fòrum Research Unit, Hospital del Mar, C/Llull 410, 08019, Barcelona, Spain
| | - Benedikt Amann
- Institute of Mental Health, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08019, Barcelona, Spain
- Hospital del Mar Medical Research Institute, C/del Aiguader 88, 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
- Centre Fòrum Research Unit, Hospital del Mar, C/Llull 410, 08019, Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Anna Mané
- Institute of Mental Health, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08019, Barcelona, Spain.
- Hospital del Mar Medical Research Institute, C/del Aiguader 88, 08003, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain.
- Centre Fòrum Research Unit, Hospital del Mar, C/Llull 410, 08019, Barcelona, Spain.
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain.
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Rossetti S, Juul SJ, van der Kaaij MAE, Fortpied C, Meijnders P, Aleman BMP, Raemaekers JMM, Kluin-Nelemans HC, Spina M, Fermé C, Renaud L, Casasnovas O, Stamatoullas A, Plattel WJ, Hutchings M, Maraldo MV. Relationships, marriage, and partner abandonment among Hodgkin lymphoma survivors treated in nine EORTC-GELA Lymphoma Group trials. Leuk Lymphoma 2024:1-5. [PMID: 39133256 DOI: 10.1080/10428194.2024.2390565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/16/2024] [Accepted: 08/02/2024] [Indexed: 08/13/2024]
Affiliation(s)
- Sára Rossetti
- Department of Hematology, Center for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Sidsel J Juul
- Department of Clinical Oncology, Center for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | - Paul Meijnders
- Department of Radiation Oncology, Iridium Network, University of Antwerp, Antwerpen, Belgium
| | - Berthe M P Aleman
- Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - John M M Raemaekers
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hanneke C Kluin-Nelemans
- Department of Hematology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Michele Spina
- Division of Medical Oncology and Immunerelated tumors, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Loïc Renaud
- Department of Hemato-Oncology, Hôpital Saint-Louis, DMU DHI; Université de Paris, Paris, France
| | | | | | - Wouter J Plattel
- Department of Hematology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Martin Hutchings
- Department of Hematology, Center for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maja V Maraldo
- Department of Clinical Oncology, Center for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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VanLandingham HB, Ellison RL, Turchmanovych-Hienkel N, Alfonso D, Oh A, Kaseda ET, Basurto K, Tse PKY, Khan H. Neuropsychological assessment, intervention, and best practices for women with non-Central nervous system cancer: A scoping review of current standards. Clin Neuropsychol 2024; 38:1334-1365. [PMID: 38641949 DOI: 10.1080/13854046.2024.2343147] [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: 07/24/2023] [Accepted: 04/10/2024] [Indexed: 04/21/2024]
Abstract
Objective: Existing literature has sought to characterize the broad cognitive impact of non-central nervous system cancer and its treatment, including chemotherapy, radiation, surgery, and hormonal regulation. However, despite the frequency of women that are diagnosed with breast and gynecological cancer, there is limited research on the specific cognitive experiences of women undergoing cancer treatment. Presently, the current literature lacks concise guidance for neuropsychologists to support the cognitive health of women facing cancer, despite the acknowledged impact of cancer interventions and chronic illness on cognitive outcomes. Method: Applying scoping review criteria outlined by Peters et al. (2015) and adhering to Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a comprehensive examination of literature spanning multiple databases (Google Scholar, PubMed, PsychINFO) with a focus on the cognitive impact of cancer treatment on women. Conclusions: Women are subject to unique treatment-related outcomes due to the impact of hormonal alterations, differences in metabolization of certain chemotherapies, and psychosocial risk factors. Despite the known impact of cancer intervention, chronic illness, and cancer-related sequelae on cognitive outcomes, the current literature does not parsimoniously outline best practices for neuropsychologists to promote the health of women experiencing cancer. The current paper (1) provides an overview of the cognitive implications of cancer treatment with an intentional focus on cancers that are more prevalent in women versus men, (2) addresses the characteristics of this impact for women undergoing cancer intervention(s), and (3) provides possible intervention and treatment strategies for mental health providers and neuropsychologists.
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Affiliation(s)
- Hannah B VanLandingham
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Rachael L Ellison
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | | | - Demy Alfonso
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Alison Oh
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Erin T Kaseda
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Karen Basurto
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Phoebe K Y Tse
- Department of Psychology, The Chicago School, Chicago, IL, USA
| | - Humza Khan
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
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Praça MSL, de Sousa FTR, Cândido EB, Lamaita RM, Wender MCO, Silva AL. Beyond the diagnosis: gender disparities in the social and emotional impact of cancer. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S115. [PMID: 38865535 PMCID: PMC11164259 DOI: 10.1590/1806-9282.2024s115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 06/14/2024]
Affiliation(s)
- Mariana Seabra Leite Praça
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | | | - Eduardo Batista Cândido
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | - Rívia Mara Lamaita
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | - Maria Celeste Osório Wender
- Universidade Federal do Rio Grande do Sul, Department of Gynecology and Obstetrics – Porto Alegre (RS), Brazil
| | - Agnaldo Lopes Silva
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
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Kobritz M, Nofi CP, Egunsola A, Zimmern AS. Financial toxicity in early-onset colorectal cancer: A National Health Interview Survey study. Surgery 2024; 175:1278-1284. [PMID: 38378347 DOI: 10.1016/j.surg.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Financial toxicity is increasingly recognized as a devastating outcome of cancer treatment but is poorly characterized in patients with early-onset colorectal cancer. Young patients are particularly vulnerable to financial toxicity as they are frequently underinsured and may suffer significant disruptions to professional and financial growth. We hypothesized that financial toxicity associated with colorectal cancer treatment confers long-lasting effects on patients' well-being and disproportionately impacts patients diagnosed at <50 years of age. METHODS A retrospective cross-sectional analysis of the National Health Interview Survey from years 2019 to 2021 was performed. Patients with a history of colorectal cancer were included and stratified by age at diagnosis. Randomly selected age-matched controls with no cancer history were used for comparison. The primary endpoint was financial toxicity, as assessed by a composite score formulated from 12 National Health Interview Survey items. The secondary endpoint was food security assessed by the United States Department of Agriculture's food security scale, embedded in the National Health Interview Survey. RESULTS When compared to age-matched controls, patients with colorectal cancer experienced significant financial toxicity, as reflected by a composite financial toxicity score (P = .027). Within patients with colorectal cancer, female sex (adjusted odds ratio = 1.46, P = .046) and early-onset disease (adjusted odds ratio = 2.11, P = .002) were found to significantly increase the risk of financial toxicity. Patients with early-onset colorectal cancer more frequently experienced food insecurity (P = .011), delayed necessary medical care (P = .053), mental health counseling (P = .043), and filling prescriptions (P = .007) due to cost when compared to patients with average-onset colorectal cancer. CONCLUSION Colorectal cancer is associated with significant long-term financial toxicity, which disproportionately impacts patients diagnosed at <50 years of age. Targeted interventions are warranted to reduce financial toxicity for patients with high-risk colorectal cancer.
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Affiliation(s)
- Molly Kobritz
- Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; Department of Surgery, Northwell-North Shore/Long Island Jewish, Manhasset, NY.
| | - Colleen P Nofi
- Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; Department of Surgery, Northwell-North Shore/Long Island Jewish, Manhasset, NY
| | - Adekemi Egunsola
- Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; Department of Surgery, Northwell-North Shore/Long Island Jewish, Manhasset, NY
| | - Andrea S Zimmern
- Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; Department of Surgery, Northwell-North Shore/Long Island Jewish, Manhasset, NY
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Davidson CA, Booth R, Jackson KT, Mantler T. Toxic Relationships Described by People With Breast Cancer on Reddit: Topic Modeling Study. JMIR Cancer 2024; 10:e48860. [PMID: 38393769 PMCID: PMC10924256 DOI: 10.2196/48860] [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: 05/09/2023] [Revised: 12/18/2023] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Social support is essential to promoting optimal health outcomes for women with breast cancer. However, an estimated 12% of women with breast cancer simultaneously experience intimate partner violence (IPV; physical, psychological, or sexual abuse by an intimate partner). Women who experience IPV during breast cancer may lack traditional social support, and thus seek out alternative sources of support. Online community forums, such as Reddit, can provide accessible social connections within breast cancer-specific communities. However, it is largely unknown how women with breast cancer use Reddit to describe and seek support for experiences of IPV. OBJECTIVE This study aims to explore how patients with breast cancer describe toxic relationships with their partners and immediate family members on Reddit. METHODS This exploratory, cross-sectional, topic-modeling study analyzed textual data from 96 users in the r/breastcancer subreddit in February 2023. The meaning extraction method, inclusive of principal component analysis, was used to identify underlying components. Components were subjected to sentiment analysis and summative content analysis with emergent categorical development to articulate themes. RESULTS Seven themes emerged related to toxic relationships: (1) contextualizing storytelling with lymph nodes, (2) toxic behavior and venting emotions, (3) abandonment and abuse following diagnosis, (4) toxic relationships and social-related fears, (5) inner strength and navigating breast cancer over time, (6) assessing social relationships and interactions, and (7) community advice and support. Toxic relationships were commonly characterized by isolation, abandonment, and emotional abuse, which had profound emotional consequences for patients. Reddit facilitated anonymous venting about toxic relationships that helped patients cope with intense feelings and stress. Exchanging advice and support about navigating toxic relationships during breast cancer were core functions of the r/breastcancer community. CONCLUSIONS Findings emphasized the value of Reddit as a source of social support for patients with breast cancer experiencing toxic relationships. Clinicians who understand that many patients with breast cancer experience toxic relationships and considerable psychological sequelae are better prepared to support their patients' holistic well-being. Further investigation of Reddit as a possible resource for advice, information, and support has the potential to help inform clinical practice and subsequently, patient health outcomes.
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Affiliation(s)
- Cara Anne Davidson
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Richard Booth
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Kimberley Teresa Jackson
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Tara Mantler
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
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Lin CC, Her YN. Demoralization in cancer survivors: an updated systematic review and meta-analysis for quantitative studies. Psychogeriatrics 2024; 24:35-45. [PMID: 37877340 DOI: 10.1111/psyg.13037] [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: 02/10/2023] [Revised: 09/18/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Demoralization can cause impairments across all life aspects of cancer patients. Cancer patients are also vulnerable during their survivorship. The purpose of this review is to examine the risk of demoralization and associated risk factors among cancer survivors who have completed their primary anti-cancer treatment or time since diagnosis ≥5 years without recurrence. METHODS We searched databases of PubMed, Cochrane, Embase, PsycINFO and ClinicalTrial.gov to identify eligible studies which reported the demoralization level among cancer survivors. A random-effect meta-analysis model was used for calculating mean demoralization level. Heterogeneity was evaluated by I2 statistics. Funnel plots and Egger's regression tests were performed for checking publication bias. We used one-study-removed method for sensitivity analysis. Subgroup analysis was also done to examine the difference of demoralization level between cancer types. Meta-regression was performed to reveal risk factors of demoralization. RESULTS A meta-analysis of 12 articles involving 2902 cancer survivors was conducted. The mean demoralization score among cancer survivors was 25.98 (95% CI: 23.53-28.43). Higher demoralization level was seen in participants with older age, higher female ratio, higher married/living together status ratio and higher patient health questionnaire-9 score. The literature review revealed correlations between demoralization and suicide risk, anxiety and quality of life. No consistent correlation between demoralization and post-traumatic stress symptoms could be seen. CONCLUSIONS High demoralization level is noticed among cancer survivors. Risks for females, elder patients or breast cancer survivors are identified. More longitudinal or interventional studies for cancer survivors' demoralization are expected in the future.
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Affiliation(s)
- Cian-Cian Lin
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ning Her
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Yoder AK, Lakomy DS, Wu J, Andring LM, Corrigan KL, Fellman B, Jhingran A, Klopp AH, Colbert LE, Soliman PT, Frumovitz MM, Peterson SK, Lin LL. Comparing long-term sexual dysfunction across different uterine cancer treatment modalities. Brachytherapy 2024; 23:1-9. [PMID: 37914588 DOI: 10.1016/j.brachy.2023.09.008] [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: 04/25/2023] [Revised: 07/14/2023] [Accepted: 09/17/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION The objective of this study was to assess differences in long-term sexual and menopausal side effects after uterine cancer treatment among treatment modalities. METHODS AND MATERIALS This is a cross-sectional study that examined women treated for uterine cancer from 2006-2018. Eligible women included those who underwent a hysterectomy/bilateral salpino-oophorectemy alone (HS), with brachytherapy (BT), or with external beam radiation therapy (EBRT). A noncancer cohort of women who underwent a hysterectomy/BSO for benign indications were also identified (non-CA). To compare outcomes, we utilized a shortened form of the female sexual function index (FSFI) and the menopause survey, which consists of 3 subscales: hot flashes, vaginal symptoms, and urinary symptoms. Demographic, comorbidity, and other treatment variables were collected. Survey totals were compared across cohorts using ANOVA tests and logistic regression. RESULTS A total of 284 women completed the Menopause Survey (Non-CA 64, HS 60, BT 69, EBRT 91); 116 women reported sexual activity in the last 4 weeks and completed the FSFI (NC 32, HS 21, BT 31, EBRT 32). The mean FSFI score for the entire cohort was 11.4 (SD 4.16), which indicates poor sexual function. There was no significant difference between any cohort in the overall FSFI score (p = 0.708) or in any of the FSFI subscales (all p > 0.05). On univariate analysis, BT was associated with fewer menopausal hot flashes and vaginal symptoms compared to the non-CA cohort (p < 0.05), which did not persist on multivariable analysis. CONCLUSION There was no significant difference in sexual dysfunction or menopausal symptoms in those treated for uterine cancer with or without adjuvant radiation. Most patients reported poor sexual function.
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Affiliation(s)
- Alison K Yoder
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David S Lakomy
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO
| | - Juliana Wu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas School of Public Health, Houston, TX
| | - Lauren M Andring
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kelsey L Corrigan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Bryan Fellman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anuja Jhingran
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ann H Klopp
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lauren E Colbert
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Pamela T Soliman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael M Frumovitz
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lilie L Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
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Sharma A. Palliative Care and Care Partner Support in Neuro-oncology. Continuum (Minneap Minn) 2023; 29:1872-1895. [PMID: 38085902 DOI: 10.1212/con.0000000000001353] [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: 12/18/2023]
Abstract
ABSTRACT The journey for a patient with a brain tumor and their loved ones can be extremely challenging due to the high burden of physical symptoms and the emotional distress caused by the diagnosis. Optimizing quality of life by addressing symptoms and reducing this emotional distress can improve treatment tolerance and outcomes and alleviate care partner distress and burden. Symptoms in patients with central nervous system (CNS) tumors can vary in onset and intensity, ranging from headaches, seizures, and focal weakness to emotional distress and cognitive dysfunction. Additionally, care partners may demonstrate distress due to the high burden of care and need appropriate support structures and access to resources to alleviate this stress. Evidence-based recommendations are unfortunately limited given the lack of high-quality research in this area, but patients living with CNS tumors and their loved ones can benefit from early and routine symptom identification and management, compassionate and transparent communication, and practical guidance for the future. These principles are part of palliative care, a field of medicine focused on alleviating suffering in patients with serious, chronic illness. Clinicians involved in the care of patients with CNS tumors must be educated in these important primary palliative care principles. This article focuses on key symptom management, strategies for high-quality communication, a discussion of advance care planning, and an overview of end-of-life care.
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Chen MH, Epstein SF. Tailored to a Woman's Heart: Gender Cardio-Oncology Across the Lifespan. Curr Cardiol Rep 2023; 25:1461-1474. [PMID: 37819431 PMCID: PMC11034750 DOI: 10.1007/s11886-023-01967-7] [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] [Accepted: 09/08/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE OF REVIEW Females outnumber males among long-term cancer survivors, primarily as a result of the prevalence of breast cancer. Late cardiovascular effects of cancer develop over several decades, which for many women, may overlap with reproductive and lifecycle events. Thus, women require longitudinal cardio-oncology care that anticipates and responds to their evolving cardiovascular risk. RECENT FINDINGS Women may experience greater cardiotoxicity from cancer treatments compared to men and a range of treatment-associated hormonal changes that increase cardiometabolic risk. Biological changes at critical life stages, including menarche, pregnancy, and menopause, put female cancer patients and survivors at a unique risk of cardiovascular disease. Women also face distinct psychosocial and physical barriers to accessing cardiovascular care. We describe the need for a lifespan-based approach to cardio-oncology for women. Cardio-oncology care tailored to women should rigorously consider cancer treatment/outcomes and concurrent reproductive/hormonal changes, which collectively shape quality of life and cardiovascular outcomes.
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Affiliation(s)
- Ming Hui Chen
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Boston Children's Hospital/Dana Farber Cancer Institute, Boston, MA, USA.
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
| | - Sonia F Epstein
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
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11
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Ng JHY, Luk BHK, Lee NPM. Gender differences in cancer spousal caregiving: A systematic review. Palliat Support Care 2023; 21:880-889. [PMID: 37334489 DOI: 10.1017/s1478951523000731] [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: 06/20/2023]
Abstract
OBJECTIVES Cancer does affect not only the lives of the patients but also that of their spouses. The aims of this systematic review are to (i) explore the gender differences in the impact of caregiving for cancer on spousal caregivers, (ii) facilitate the conceptual understanding of gender differences in caregiving, and (iii) identify directions for future research and clinical practice targeting spousal caregivers. METHODS A comprehensive search was conducted of the electronic databases of MEDLINE, PsycINFO, EBSCO, and CINAHL Plus for papers published in English between 2000 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify, select, appraise, and synthesize the studies. RESULTS A total of 20 studies from seven countries were reviewed. Findings of the studies were presented using the biopsychosocial model. Spousal caregivers of cancer patients suffered from physical, psychological, and socioeconomic morbidities, with female spousal caregivers reporting a higher level of distress. The gendered positioning of spousal caregivers in the societal context had further brought about over-responsibility and self-sacrifice among women. SIGNIFICANCE OF RESULTS The gendered positions of cancer spousal caregivers further illustrated the gender differences in the caregiving experiences and consequences. Health-care professionals in routine clinical practice should be proactive in identifying physical, mental, and social morbidities among cancer spousal caregivers, particularly female ones, and providing timely interventions. Health-care professionals should recognize the pressing need for empirical research, political engagement, and action plans to address the health status and health-related behaviors of patients' spouses along the cancer trajectory.
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Affiliation(s)
- Janet H Y Ng
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Bronya H K Luk
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, China
| | - Natalie P M Lee
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, China
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12
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Yildiz S, Bildik G, Benlioglu C, Turan V, Dilege E, Ozel M, Kim S, Oktem O. Breast cancer treatment and ovarian function. Reprod Biomed Online 2023; 46:313-331. [PMID: 36400663 DOI: 10.1016/j.rbmo.2022.09.014] [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: 06/13/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 02/07/2023]
Abstract
The aim of this study was to provide an update on ovarian function and the mechanisms of gonadal damage after exposure to chemotherapy in breast cancer survivors. The alkylating agents are toxic to both primordial and growing follicles. However, anti-metabolite drugs are more likely to destroy preantral and antral follicles. Younger patients are more likely to have a higher ovarian reserve, and therefore, more likely to retain some residual ovarian function after exposure to gonadotoxic regimens. However, there can be significant variability in ovarian reserve among patients of the same age. Furthermore, patients with critically diminished ovarian reserve may continue to menstruate regularly. Therefore age and menstrual status are not reliable indicators of good ovarian reserve and might give a false sense of security and result in an adverse outcome if the patient is consulted without considering more reliable quantitative markers of ovarian reserve (antral follicle count and anti-Müllerian hormone) and fertility preservation is not pursued. In contrast to well-documented ovarian toxicity of older chemotherapy regimens, data for newer taxane-containing protocols have only accumulated in the last decade and data are still very limited regarding the impact of targeted therapies on ovarian function.
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Affiliation(s)
- Sule Yildiz
- The Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Koç University Hospital, Koç University School of Medicine, Istanbul, Turkey
| | - Gamze Bildik
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX 77054, USA
| | - Can Benlioglu
- Department of Obstetrics and Gynecology, Koç University Hospital, Istanbul, Turkey
| | - Volkan Turan
- Istanbul Tema Hospital, Assisted Reproduction Unit, Istanbul
| | - Ece Dilege
- Department of General Surgery, Koç University Hospital, Koç University School of Medicine, Istanbul, Turkey
| | - Melis Ozel
- Department of Gynecology and Obstetrics Klinikum Ingolstadt, Bavaria, Germany
| | - Samuel Kim
- Eden Centers for Advanced Fertility, Fullerton CA 92835, USA
| | - Ozgur Oktem
- The Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Koç University Hospital, Koç University School of Medicine, Istanbul, Turkey.
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Zhang X, Song Y, Wei Z, Chen X, Zhuang X, Yi L. The prevalence and risk factors of anxiety in multiple sclerosis: A systematic review and meta-analysis. Front Neurosci 2023; 17:1120541. [PMID: 37139531 PMCID: PMC10149809 DOI: 10.3389/fnins.2023.1120541] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/28/2023] [Indexed: 05/05/2023] Open
Abstract
Background Patients with multiple sclerosis (MS) suffer from repetitive neurological deterioration, while anxiety may play a significant role in the disease's progression. Objective To explore the prevalence of anxiety in MS and to investigate the risk factors related to anxiety in MS patients. Methods An analysis of four databases, PubMed, Web of Science, EMBASE, and Cochrane Library, has been conducted to determine the prevalence or risk factors for anxiety in MS published before May 2021. Results In total, 32 studies were found to be eligible. Anxiety prevalence was estimated to be 36% based on the pooled estimates [the 95% confidence interval (CI) = [0.30-0.42], I 2 = 98.4%]. Significant risk factors for developing of anxiety were as follows: age at survey [the weighted mean difference (WMD) = 0.96, 95% CI = [0.86-1.06], I 2 = 43.8%], female [the odd ratio (OR) = 1.78, 95% CI = [1.38-2.30], I 2 = 0%], living together (OR 2.83, 95% CI = [1.74-4.59], I 2 = 0%), past psychiatric history (OR 2.42, 95% CI = [1.56-3.75], I 2 = 0%), depression (OR 7.89, 95% CI = [3.71-16.81], I 2 = 0%), not taking MS medication (OR 2.33, 95% CI = [1.29-4.21], I 2 = 77.8%), relapsing-remitting MS (RRMS) (OR 1.50, 95% CI = [0.94-2.37], I 2 = 53.5%), and baseline Expanded Disability Status Scale (EDSS) (OR 0.84, 95% CI = [0.48-1.21], I 2 = 62.2%). Conclusion An estimated 36% of people with MS suffer from anxiety. And anxiety rates in MS patients are significantly associated with age, gender, living together, prior psychiatric history, depression, drug compliance, RRMS, and baseline EDSS. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=287069, identifier CRD42021287069.
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Affiliation(s)
- Xiaoyun Zhang
- Neurology Department, Peking University Shenzhen Hospital, Shenzhen, China
- Rehabilitation Department, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Ying Song
- Neurology Department, Peking University Shenzhen Hospital, Shenzhen, China
| | - Zhiqiang Wei
- Neurology Department, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiao Chen
- Neurology Department, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiaojia Zhuang
- Neurology Department, Peking University Shenzhen Hospital, Shenzhen, China
| | - Li Yi
- Neurology Department, Peking University Shenzhen Hospital, Shenzhen, China
- *Correspondence: Li Yi,
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[Partnership and family aspects of cancer]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:446-452. [PMID: 35181794 PMCID: PMC8979853 DOI: 10.1007/s00103-022-03495-1] [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: 10/11/2021] [Accepted: 01/21/2022] [Indexed: 11/02/2022]
Abstract
Cancer is not only a challenge for the patient, but can also be associated with psychosocial distress for relatives, especially partners and minor children. Although studies on the long-term effects of cancer on partners, the partnership, and child development are still rare, there are indications that the psychological distress on relatives may become chronic, and that parental illness is a risk factor for a child to develop mental disorders. In addition, a deterioration in partnership satisfaction also increases the risk of separation.Psycho-oncology care should therefore not only consider the patient's psychosocial burden but also that of the partner, as well as its effect on the partnership. Appropriate offers, for example to increase partnership and sexual satisfaction, communication, or dyadic coping, should be made. Children should also be treated as relatives in care. Focusing on both the child's distress and on improving the parent-child relationships and parenting behavior can help children to cope with parental illness in the long term. Thus, cancer should be viewed on the individual, dyadic, and family level, and psychosocial care services should be provided at all levels.
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Parkinson A, Brunoro C, Leayr J, Fanning V, Chisholm K, Drew J, Desborough J, Phillips C. Intertwined like a double helix: A meta-synthesis of the qualitative literature examining the experiences of living with someone with multiple sclerosis. Health Expect 2022; 25:803-822. [PMID: 35118764 PMCID: PMC9122458 DOI: 10.1111/hex.13432] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/16/2021] [Accepted: 12/31/2021] [Indexed: 12/01/2022] Open
Abstract
Background Multiple sclerosis (MS) is a chronic serious condition of uncertain course and outcome. There is relatively little literature on the experiences of people who live with a person with MS. They inhabit a locus of care that spans caring for (a relational act) and caring about (a moral stance, addressing fairness, compassion and justice) the person with MS. Methods Using the theoretical lens of personhood, we undertook a scoping review and meta‐synthesis of the qualitative literature on the experiences of people who live with a person with MS, focusing on the nature of, and constraints upon, caring. Results Of 330 articles, 49 were included in the review. We identified five themes. One of these—seeking information and support—reflects the political economy of care. Two are concerned with the moral domain of care: caring as labour and living with uncertainty. The final two themes—changing identities and adapting to life with a person with MS—point to the negotiation and reconstitution of personhood for both the person with MS and the people they live with. Conclusion People with MS are embedded in relational social networks of partners, family and friends, which are fundamental in the support of their personhood; the people who live with them are ‘co‐constituents of the patient's identity’ assisting them to make sense of their world and self in times of disruption due to illness. Support services and health care professionals caring for people with MS are currently very much patient‐centred; young people in particular report that their roles are elided in the health system's interaction with a parent with MS. There is a need to look beyond the person with MS and recognize the relational network of people who surround them and broaden their focus to encompass this network. Patient and Public Involvement Our research team includes four members with MS and two members with lived experience of living or working with people with MS. A third person (not a team member) who lives with a partner with MS provided feedback on the paper.
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Affiliation(s)
- Anne Parkinson
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Crystal Brunoro
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Jack Leayr
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Vanessa Fanning
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Katrina Chisholm
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Janet Drew
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Jane Desborough
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
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Linked Lives: Does Disability and Marital Quality Influence Risk of Marital Dissolution among Older Couples? SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11010027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Using fourteen waves of data from the Health and Retirement Study (HRS), a longitudinal panel survey with respondents in the United States, this research explores whether marital quality—as measured by reports of enjoyment of time together—influences risk of divorce or separation when either spouse acquires basic care disability. Discrete-time event history models with multiple competing events were estimated using multinomial logistic regression. Respondents were followed until they experienced the focal event (i.e., divorce or separation) or right-hand censoring (i.e., a competing event or were still married at the end of observation). Disability among wives was predictive of divorce/separation in the main effects model. Low levels of marital quality (i.e., enjoy time together) were associated with marital dissolution. An interaction between marital quality and disability yielded a significant association among couples where at least one spouse acquired basic care disability. For couples who acquired disability, those who reported low enjoyment were more likely to divorce/separate than those with high enjoyment; however, the group with the highest predicted probability were couples with low enjoyment, but no acquired disability.
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Returning to work after a sickness absence due to cancer: a cohort study of salaried workers in Catalonia (Spain). Sci Rep 2021; 11:23953. [PMID: 34907321 PMCID: PMC8671387 DOI: 10.1038/s41598-021-03368-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/30/2021] [Indexed: 01/06/2023] Open
Abstract
Cancer incidence and survival rates have increased in the last decades and as a result, the number of working age people diagnosed with cancer who return to work. In this study the probability of accumulating days of employment and employment participation trajectories (EPTs) in a sample of salaried workers in Catalonia (Spain) who had a sickness absence (SA) due to cancer were compared to salaried workers with SA due to other diagnoses or without SA. Each individual with SA due to cancer between 2012 and 2015 was matched by age, sex, and onset of time at risk to a worker with SA due to other diagnoses and another worker without SA. Accumulated days of employment were measured, and negative binomial models were applied to assess differences between comparison groups. Latent class models were applied to identify EPTs and multinomial regression models to analyse the probability of belonging to one EPT of each group. Men and women without SA or with SA due to other diagnoses had at least a 9% higher probability of continuing in employment compared to workers who had a SA due to cancer, especially among men without SA (adjusted IRR 1.27, 95% CI 1.06‒1.53). Men without SA had the highest probability of having high stable EPT compared to workers who had a SA due to cancer (adjusted RRR 3.21, 95% CI 1.87‒5.50). Even though workers with SA due to cancer continue working afterwards, they do it less often than matched controls and with a less stable employment trajectory. Health and social protection systems should guaranty cancer survivors the opportunity to continue voluntary participation in the labour market.
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Metsä-Simola N, Einiö E, Peltonen R, Martikainen P. Physical health conditions and subsequent union separation: a couple-level register study on neurological conditions, heart and lung disease, and cancer. J Epidemiol Community Health 2021; 75:674-680. [PMID: 33298578 DOI: 10.1136/jech-2020-215548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Studies that assess the role of physical health conditions on separation risk are scarce and mostly lack health information on both partners. It is unclear how the association between physical illness and separation risk varies by type of illness, gender of the ill spouse and age of the couple. METHODS We used Finnish register data on 127 313 couples to examine how neurological conditions, heart and lung disease, and cancer are associated with separation risk. The data included information on medication, hospitalisations, separations and sociodemographic characteristics. Marital and non-marital cohabiting couples aged 40-70 years were followed from 1998 to 2003 for the onset of health conditions and subsequent separation, and Cox regression was used to examine the associations. RESULTS Compared with healthy couples, the HR of separation was elevated by 43% for couples in which both spouses had a physical health condition, by 22% for couples in which only the male spouse had fallen ill, and by 11% for couples in which only the female had fallen ill. Among older couples, the associations between physical illness and separation risk were even clearer. The association with separation risk was strongest for neurological conditions, and after incidence of these conditions among males, separation risk increased over time. Adjustment for sociodemographic characteristics had little effect. CONCLUSIONS Our findings suggest that poor health may largely strain relationships through disability and associated burden of spousal care, and this should be taken into consideration when planning support services for couples with physical health conditions.
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Affiliation(s)
| | - Elina Einiö
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Riina Peltonen
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, University of Helsinki, Helsinki, Finland
- Laboratory of Population Health, Max-Planck-Institute for Demographic Research, Rostock, Germany
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Allen E, Renshaw K, Fredman SJ, Le Y, Rhoades G, Markman H, Litz B. Associations Between Service Members' Posttraumatic Stress Disorder Symptoms and Partner Accommodation Over Time. J Trauma Stress 2021; 34:596-606. [PMID: 33372361 DOI: 10.1002/jts.22645] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/24/2020] [Accepted: 11/29/2020] [Indexed: 11/10/2022]
Abstract
When service members manifest symptoms of posttraumatic stress disorder (PTSD), intimate partners may engage in behaviors to accommodate their partners' experiences (e.g., helping service members avoid situations that could make them uncomfortable, not expressing own thoughts and feelings to minimize PTSD-related conflict), which may inadvertently serve to maintain or increase PTSD symptoms over time. In a sample of 274 male service member/female civilian couples, we evaluated hypothesized bidirectional pathways between self-reported service member PTSD symptoms and partner accommodation, assessed four times over an approximately 18-month period. A random-intercept cross-lagged panel model disaggregating between and within effects revealed that, on average, couples in which the service member had higher levels of total PTSD symptoms also scored higher in partner accommodation, between-couple correlation, r = .40. In addition, at time points when service members' PTSD symptoms were higher relative to their own average symptom level, their partners' level of accommodation was also higher than their personal average, within-couple correlation r = .22. Longitudinally, service member PTSD symptom scores higher than their personal average predicted subsequent increases in partner accommodation, β = .19, but not vice versa, β = .03. Overall, the findings indicate both stable and time-specific significant associations between service member PTSD symptoms and partner accommodation and suggest that higher levels of PTSD symptoms are a significant driver of later increases in partner accommodation. These findings add further support for treating PTSD in an interpersonal context to address the disorder and concomitant relational processes that can adversely impact individual and relational well-being.
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Affiliation(s)
- Elizabeth Allen
- Department of Psychology, University of Colorado Denver, Denver, Colorado, USA
| | - Keith Renshaw
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
| | - Steffany J Fredman
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Yunying Le
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Galena Rhoades
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Howard Markman
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Brett Litz
- Departments of Psychiatry and Psychological and Brain Sciences, VA Boston Healthcare System and Boston University, Boston, Massachusetts, USA
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Nalbant B, Karger A, Zimmermann T. Cancer and Relationship Dissolution: Perspective of Partners of Cancer Patients. Front Psychol 2021; 12:624902. [PMID: 34093310 PMCID: PMC8177048 DOI: 10.3389/fpsyg.2021.624902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/28/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose Cancer can be a burden on the relationship and even lead to relationship dissolution. Previous studies about the impact of cancer on close relationships almost exclusively involve cancer patients. So far, little is known about the views of spouses. Therefore, this study focuses on partners or ex-partners of cancer patients. Methods In this cross-sectional study, N = 265 partners or ex-partners of cancer patients are examined regarding a possible separation, the reasons for separation and the influence of the cancer on the relationship. In addition, predictors of separation and the positive or negative perception of the impact of cancer on the relationship were investigated. Results The separation rate (23.4%) was marginally lower than in the general population in Germany (35.79%). The most frequent reason for separation was the death of the cancer patient (59.6%), followed by relationship problems (26.9%), and the cancer disease itself (9.6%). Among those who were separated, 57.4% reported that cancer contributed to the separation. On average, the influence of cancer on relationship dissolution is indicated with 82.9%. Also, for those who stayed together, 83.7% reported an impact of the cancer on the relationship, of which 55.9% reported a negative impact. Logistic regressions indicated that higher levels of depression were associated with greater odds of a more negative perception of the influence of cancer on the relationship, whereas a more satisfied relationship tended to be associated with a more positive perception. Those who had no psychological treatment in the past, lower anxiety levels and lower relationship satisfaction had an increased risk of separation. Overall, relationship satisfaction was significantly lower than in the general population in Germany. Conclusion In particular, psychological factors such as depression and anxiety as well as relationship satisfaction appear to be factors influencing separation and the perception of the influence of cancer on the relationship as positive or negative. Therefore, it seems to be reasonable to consider these aspects in the psychosocial support and also to include the partners in order to achieve a stable and satisfied relationship which has a positive effect on health and psychological well-being.
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Affiliation(s)
- Bahar Nalbant
- Department of Psychosomatics and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - André Karger
- Medical Faculty, Heinrich-Heine University, Institute for Psychosomatic Medicine and Psychotherapy, University Hospital, Düsseldorf, Germany
| | - Tanja Zimmermann
- Department of Psychosomatics and Psychotherapy, Hannover Medical School, Hanover, Germany
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Observational Evidence of the Need for Gender-Sensitive Approaches to Wildfires Locally and Globally: Case Study of 2018 Wildfire in Mati, Greece. SUSTAINABILITY 2021. [DOI: 10.3390/su13031556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study takes an equality justice perspective to compare resilience against the controlled management of wildfires, for an effective preparedness, which is a prerequisite for equitable mitigation. The objectives were (a) conceptualizing wildfire mitigation by exploring the ties with gender equality to wildfire hazards, (b) taking the case of wildfire 2018 in Mati, Greece, to contribute reducing the country’s gender inequality, and (c) increasing resilience to climate change hazards by considering lessons learnt. The authors underscore the benefits of a workshop-based and instrumental case study methodology for unravelling evidence on the need for gender-sensitive approaches and tools for future planning at local, regional, and global scales. The case study unravels women’s lack of preparedness to wildfires in Greece, their absence in decision-making for fire management, and the need for capacity building to transform communities’ resilience. The literature research and the specific interviews conducted helped bring awareness to the wildfire’s dynamics, in alignment with the fundamental aspect of gender equality, and to ground recommendations for socio-ecological resilience transition and gender-sensitive approaches in fire management, from reactive fire-fighting to proactive integration. Although in the geographical-context, the study can bring widespread geographical awareness, bringing insights for relevance to similar areas worldwide.
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Hunter R, Parry B, Thomas C. Fears for the future: A qualitative exploration of the experiences of individuals living with multiple sclerosis, and its impact upon the family from the perspective of the person with MS. Br J Health Psychol 2020; 26:464-481. [DOI: 10.1111/bjhp.12495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/10/2020] [Indexed: 12/15/2022]
Affiliation(s)
| | - Bryoni Parry
- Department of Psychology Swansea University Wales UK
| | - Ceri Thomas
- Department of Psychology Swansea University Wales UK
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D'Arrigo-Patrick E, Samman SK, Knudson-Martin C. Moving from "I" to "We": A Grounded Theory Analysis of Couple Therapy with Liver Patients and Their Partners. FAMILY PROCESS 2020; 59:1517-1529. [PMID: 32097502 DOI: 10.1111/famp.12528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Prior research indicates that couples who cope with chronic illness from a relational "we" orientation experience more positive outcomes than couples that cope individually; however, little prior research identifies clinical processes that promote reciprocity or how societal gender processes are involved. This grounded theory analysis of 25 videotaped therapy sessions with six heterosexual couples coping with chronic liver disease (LD) used a feminist-informed relational lens to focus on the clinical processes involved in shifting from an individual to a relational orientation. Findings identified three contextual barriers to attaining a "we orientation": (a) autonomy discourse, (b) illness-related power, and (c) gendered power. Analysis detailed therapist actions that decreased the impact of barriers to reciprocity and fostered relational coping. Clinical implications attend to complex intersections among gender, caregiving, and contextual barriers to reciprocity.
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Logue CA, Pugh J, Jayson G. Psychosexual morbidity in women with ovarian cancer. Int J Gynecol Cancer 2020; 30:1983-1989. [PMID: 33115791 PMCID: PMC7788483 DOI: 10.1136/ijgc-2020-002001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022] Open
Abstract
Increasing numbers of women are surviving for longer with epithelial ovarian cancer. Consequently, there is increased focus on long-term quality of life in national guidance. Psychosexual morbidity including vaginal dryness, pain during intercourse (dyspareunia), reduced libido, and negative perceived body image exacerbate stress and anxiety and impact intimate relationships. Although a priority for women with epithelial ovarian cancer, clinicians seldom discuss sexual problems. Therefore, psychosexual morbidity and the associated distress remain unaddressed. We synthesize evidence from primary qualitative and quantitative research studies exploring psychosexual morbidity in women with epithelial ovarian cancer to identify potential risk factors and common symptoms, to facilitate the identification and management of sexual problems in clinic. Literature (2008–19) from 10 databases identified 29 suitable publications (4116 patients). The papers were assessed to answer the question: “What are the key potential risk factors and presentations of psychosexual morbidity in women with epithelial ovarian cancer?” Current literature lacks consensus in defining clinically significant psychosexual morbidity in women with epithelial ovarian cancer. Discrepancies in measurement tools, questionnaires, and primary outcome measures confound result interpretation, limiting wider application. Key potential risk factors identified included: younger age (<53 years); pre-menopausal status at diagnosis; aim of treatment; extent of surgery; more courses of chemotherapy; cardiovascular co-morbidities; and anxiety and depression. Up to 75% of women with epithelial ovarian cancer reported adverse changes in their sex lives following diagnosis and, of the sexually active, vaginal dryness affected 81–87% and pain 77%. Other prevalent symptoms included: reduced sexual desire and activity, impaired orgasm, diminished perceived body image, and reduced partner intimacy. Psychosexual morbidity represents a significant unmet need for women with epithelial ovarian cancer. Effective treatment necessitates a multimodal approach encompassing medical, psychoeducational, and physiotherapy-based strategies. Future studies need agreement in their questionnaires, definitions, thresholds, and primary outcome measures for meaningful interstudy comparisons to be drawn.
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Affiliation(s)
- Chloe Alice Logue
- Gynaecological Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK
| | - Julia Pugh
- Gynaecological Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Gordon Jayson
- Gynaecological Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK .,Division of Cancer Sciences, University of Manchester Faculty of Biology, Manchester, UK
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Marital Status and Survival in Patients Diagnosed with Melanoma. Dermatol Res Pract 2020; 2020:2485401. [PMID: 32411190 PMCID: PMC7212327 DOI: 10.1155/2020/2485401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 01/06/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction Previous research suggests the presence of a spouse may considerably affect melanoma detection rates through more frequent examinations, better access to healthcare, and improved social support. Yet, the role of marital status on melanoma survival is currently unknown. The aim of this study is to assess whether marital status is associated with survival following melanoma diagnosis. Methods We performed secondary analysis of data from all participants of the Florida Cancer Data System (FCDS) and included adult melanoma patients diagnosed between 2001 and 2009 with follow-up information available until 2015. Marital status was categorized as single, married, divorced, or widowed. The primary outcome was survival interval after melanoma diagnosis, which was assessed according to the time from the date of diagnosis to the time of death or last contact. Cox proportional hazard models were used to assess the independent association between marital status and survival. Results We assessed data from 36,578 melanoma patients. Married patients were significantly more likely to survive than single patients (Hazard ratio (HR) = 0.65; 99% Confidence Interval (CI): 0.57–0.74; P < 0.001) after adjusting for age, sex, race, ethnicity, geographic location, insurance status, tobacco use, primary site, stage, and histology. There was no evidence of effect modification by gender (P=0.189). Conclusions Married patients, including both men and women, had a 35% reduction in the risk of death after melanoma diagnosis compared with single patients, and mechanisms independent of earlier detection, such as social support, may play a role in survival in patients with melanoma.
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Sharifi M, Neshat Doost HT, Shayegannejad V. 'I want to be with you, but I have MS': Challenges of interpersonal relationships from the MS patients' point of view. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1030-1037. [PMID: 32017315 DOI: 10.1111/hsc.12936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/04/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
Interpersonal relationships play an important role in adjustment to disease, coping and improving life quality after onset of Multiple sclerosis (MS). However, considering its specific nature, MS has a considerable effect on interpersonal relationships. Thus, this study was conducted to identify and describe effects of disease on interpersonal relationships through investigating lived experiences of patients. In this research, a total of 24 MS patients were selected through purposive sampling from individuals referred to the MS Clinic of Kashani Hospital in Isfahan, Iran, during 2016-2017, and then in-depth interviews were done with participants. After analysing interviews by Giorgi Descriptive Phenomenological Psychological Method, five main themes were obtained including 'Who is guilty?', 'The need for informed care', 'living with a secret', 'Change in relationships' and 'The Reality slap'. Content of experience for some of these themes was more influenced by nature of the disease, whereas some other themes were influenced more by patient's cultural context.
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Affiliation(s)
- Maryam Sharifi
- Department of Psychology, University of Isfahan, Isfahan, Islamic Republic of Iran
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Hammond NG, Stinchcombe A. Health Behaviors and Social Determinants of Migraine in a Canadian Population‐Based Sample of Adults Aged 45‐85 Years: Findings From the CLSA. Headache 2019; 59:1547-1564. [DOI: 10.1111/head.13610] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Affiliation(s)
| | - Arne Stinchcombe
- Department of Recreation and Leisure Brock University St. Catharines Canada
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Wagner B. Health Status and Transitions in Cohabiting Relationships of American Young Adults. JOURNAL OF MARRIAGE AND THE FAMILY 2019; 81:847-862. [PMID: 31772415 PMCID: PMC6879179 DOI: 10.1111/jomf.12572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study examines whether individual health predicts cohabitors' union transitions to marriage in American young adults. BACKGROUND Associations between health and subsequent marital transitions are well documented, but less is known about how health influences transitions of cohabiting relationships. As cohabitation has become a common relationship experience, understanding how health may influence cohabitors' union transitions is an important component of how health shapes relationship exposures more broadly. METHOD Data were taken from Waves III and IV of the National Longitudinal Study of Adolescent to Adult Health (http://www.cpc.unc.edu/projects/addhealth), including the supplemental collection of relationship partners conducted during Wave III. Competing risk regressions for the transition of cohabiting unions to marriage were estimated in two samples: one of individuals and a smaller one of cohabiting couples with information from both partners. RESULTS Healthier cohabiters are more likely to marry than are their less healthy counterparts, but only women's health is significantly associated with the transition to marriage. In the dyadic sample with information from both partners, the significant association between the female partner's health and the transition to marriage is robust to male partner characteristics, including health. CONCLUSION Health is an important predictor of cohabitation transitions in early adulthood, but these transitions may only be sensitive to the female partner's health.
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Affiliation(s)
- Brandon Wagner
- Department of Sociology, Anthropology, and Social Work, Texas Tech University. 63 Holden Hall, Lubbock, TX 79409;
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Kleine AK, Hallensleben N, Mehnert A, Hönig K, Ernst J. Psychological interventions targeting partners of cancer patients: A systematic review. Crit Rev Oncol Hematol 2019; 140:52-66. [DOI: 10.1016/j.critrevonc.2019.05.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 04/25/2019] [Accepted: 05/10/2019] [Indexed: 10/26/2022] Open
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Boele FW, Rooney AG, Bulbeck H, Sherwood P. Interventions to help support caregivers of people with a brain or spinal cord tumour. Cochrane Database Syst Rev 2019; 7:CD012582. [PMID: 31264707 PMCID: PMC6604115 DOI: 10.1002/14651858.cd012582.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The diagnosis and treatment of a brain or spinal cord tumour can have a huge impact on the lives of patients and their families with family caregiving often resulting in considerable burden and distress. Meeting the support needs of family caregivers is critical to maintain their emotional and physical health. Although support for caregivers is becoming more widely available, large-scale implementation is hindered by a lack of high-quality evidence for its effectiveness in the neuro-oncology caregiver population. OBJECTIVES To assess the effectiveness of supportive interventions at improving the well-being of caregivers of people with a brain or spinal cord tumour. To assess the effects of supportive interventions for caregivers in improving the physical and emotional well-being of people with a brain or spinal cord tumour and to evaluate the health economic benefits of supportive interventions for caregivers. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 7), MEDLINE via Ovid, and Embase via Ovid. We also handsearched relevant published conference abstracts (previous five years), publications in the two main journals in the field (previous year), searched for ongoing trials via ClinicalTrials.gov, and contacted research groups in the field. The initial search was in March 2017 with an update in August 2018 (handsearches completed in January 2019). SELECTION CRITERIA We included all randomised controlled trials (RCTs) where caregivers of neuro-oncology patients constituted more than 20% of the sample and which evaluated changes in caregiver well-being following any supportive intervention. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies and carried out risk of bias assessments. We aimed to extract data on the outcomes of psychological distress, burden, mastery, quality of patient-caregiver relationship, quality of life, and physical functioning. MAIN RESULTS In total, the search identified 2102 records, of which we reviewed 144 in full text. We included eight studies. Four interventions focused on patient-caregiver dyads and four were aimed specifically at the caregiver. Heterogeneity of populations and methodologies precluded meta-analysis. Risk of bias varied, and all studies included only small numbers of neuro-oncology caregivers (13 to 56 participants). There was some evidence for positive effects of caregiver support on psychological distress, mastery, and quality of life (low to very low certainty of evidence). No studies reported significant effects on caregiver burden or quality of patient-caregiver relationship (low to very low certainty of evidence). None of the studies assessed caregiver physical functioning. For secondary outcomes (patient emotional or physical well-being; health economic effects), we found very little to no evidence for the effectiveness of caregiver support. We identified five ongoing trials. AUTHORS' CONCLUSIONS The eight small-scale studies included employed different methodologies across different populations, with low certainty of evidence overall. It is not currently possible to draw reliable conclusions regarding the effectiveness of supportive interventions aimed at improving neuro-oncology caregiver well-being. More high-quality research is needed on support for family caregivers of people diagnosed, and living, with a brain or spinal cord tumour.
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Affiliation(s)
- Florien W Boele
- University of Leeds and Leeds Cancer CentreLeeds Institute of Health Sciences and Leeds Institute of Cancer and PathologyPOG, Level 3, Bexley WingSt James's Institute of OncologyLeedsUKLS9 7TF
| | - Alasdair G Rooney
- Edinburgh Centre for Neuro‐Oncology (ECNO)Department of Psychological MedicineWestern General HospitalCrewe Road SouthEdinburghScotlandUKEH4 2XU
| | - Helen Bulbeck
- brainstrustDirector of Services4 Yvery CourtCastle RoadCowesIsle of WightUKPO31 7QG
| | - Paula Sherwood
- University of PittsburghDepartment of Acute and Tertiary Care336 Victoria Building3500 Victoria StreetPittsburghMAUSA15261
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The long-term impact of multiple sclerosis on the risk of divorce. Mult Scler Relat Disord 2018; 24:145-150. [PMID: 30007180 DOI: 10.1016/j.msard.2018.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/11/2018] [Accepted: 07/01/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Several studies have investigated the impact of multiple sclerosis (MS) on the risk of divorce. However, current evidence is inconclusive and limited by e.g. small sample populations, short follow-up, and/or lack of a control group. The objective of this retrospective, observational study was to estimate the long-term impact of MS on the risk of divorce. METHODS Swedish patients diagnosed with MS between 1975 and 2012 were identified in a nationwide disease-specific register (the Swedish Multiple Sclerosis Registry) and matched with general population controls based on age, sex, region of residency, and marital status. We used survival analysis to estimate the cumulative incidence proportion of divorce after index (i.e. the MS diagnosis date). RESULTS Our final sample comprised 3998 patients and 15,992 general population controls (mean age 44 years; 73% female). Mean follow-up was 10 years (range: 1-37 years). Unadjusted Kaplan-Meier failure functions revealed no significant differences in the cumulative incidence proportion of divorce between patients and controls (log-rank test, p = 0.902), or women with MS and female controls (p = 0.157). In contrast, men with MS were estimated to have a notably higher incidence of divorce compared with male controls (p = 0.040). Cox proportional-hazards model outcomes showed that men with MS had a 21% higher risk (HR: 1.21, p = 0.032) of divorce across follow-up compared with male controls when controlling for age, region of residency, and year of diagnosis. No significant adjusted risk increase was found for women with MS. CONCLUSIONS We show that MS is associated with an increased risk of divorce among men, but not women. Our result should be helpful to inform health policy and clinical interventions, such as relationship counselling programs, and highlight the socio-economic burden of the disease.
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Turney K, Hardie JH. Health Limitations among Mothers and Fathers: Implications for Parenting. JOURNAL OF MARRIAGE AND THE FAMILY 2018; 80:219-238. [PMID: 38045484 PMCID: PMC10691852 DOI: 10.1111/jomf.12425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/18/2017] [Indexed: 12/05/2023]
Abstract
Despite good reasons to expect that poor health could impede parenting, relatively little research considers this possibility. This study uses data from the Fragile Families and Child Well-being Study (N=3,376) and propensity score matching to examine the relationship between maternal and paternal health limitations-health conditions that limit the amount or type of work one can do-and mother- and father-reported parenting stress, cooperation in parenting, and engagement with children. First, we find that mothers' and fathers' health limitations are associated with greater parenting stress. Second, we find evidence of spillover associations; compared to their counterparts, parents with health limitations report that their child's other parent exhibit less cooperation. Third, we find that the associations between health and parenting are not moderated by parents' co-residential status. Taken together, these findings inform the stress process perspective and its implications for family life.
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Affiliation(s)
- Kristin Turney
- Department of Sociology, University of California-Irvine, 3151 Social Science Plaza, Irvine, CA 92697
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Abstract
OBJECTIVE Sexual dysfunction can be a long-term issue for women with gynecologic cancer. This study assesses the extent of sexual and marital dysfunction women face following treatment of a gynecologic cancer. METHODS A cross-sectional study of women with gynecologic cancer was conducted using a 181-item survey. Sexual dysfunction was measured by change in the Female Sexual Function Index score; marital dysfunction was measured by change in Intimate Bond Measure from prediagnosis to posttreatment. Paired t tests and Fisher exact test were used to compare women with dysfunction to those without dysfunction. RESULTS Three hundred twenty women were enrolled (mean age, 56.0 [SD, 12.0] years). Among all women, sexual function declined from a score of 21.3 (SD, 10.4) prior to 15.3 (SD, 10.2) (P < 0.001), and sexual activity decreased from 6.1 (SD, 6.8) to 2.6 (SD, 4.9) times per month following treatment (P < 0.001). Among the 208 women who were sexually active at the time of study, sexual dysfunction after treatment was associated with younger age (50.9 [SD, 11.7] years to 57.3 [SD, 12.3] years), ovarian (40.7% vs 30.7%) or cervical (21.0% vs 10.2%) cancer diagnosis, chemotherapy treatment (72.8% vs 50.4%), and being in a relationship (97.3% vs 82.7%). Among women in relationships, 27% experienced marital dysfunction. CONCLUSIONS Women who are younger, have an ovarian or cervical cancer diagnosis, receive chemotherapy, or are in a committed relationship are at particularly high risk of sexual dysfunction. These women should be provided information about the risks associated with their cancer treatment.
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Moss HA, Samimi G, Havrilesky LJ, Sherman ME, Myers ER. Estimating the number of potential family members eligible for BRCA1 and BRCA2 mutation testing in a "Traceback" approach. Genet Epidemiol 2017; 42:117-122. [PMID: 29193313 DOI: 10.1002/gepi.22095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 09/28/2017] [Accepted: 10/10/2017] [Indexed: 11/11/2022]
Abstract
U.S. guidelines recommend BRCA1/2 mutation testing for women diagnosed with high-grade ovarian cancer (HGOC) to increase recognition of carriers, but most remain unidentified and at risk. Accordingly, an approach termed "Traceback" has been proposed in which probands are retrospectively identified by testing archived pathology specimens, and family members are traced to provide genetic counseling and testing. We used population-based data to estimate the number of family members who might be contacted through such a program. We used incidence data from the Surveillance, Epidemiology, and End Results (SEER) Program to estimate the number of women diagnosed with HGOC from 2005 to 2016, and census data to estimate the number of spouses, offspring, and siblings (both sexes). Using overall survival for HGOC from SEER and all-cause mortality rates from the Centers for Diseases Control and Prevention, we estimated the number of patients, spouses, offspring, and siblings of HGOC cases living in 2017. Due to the high mortality rate of HGOC, consent from living probands may be possible in only 42% of the cases; consent to test pathology specimens would need to be sought from next of kin for the remainder. In 2017, an estimated 406,919 living next of kin (spouses, siblings, offspring) would be available for potential consent. Testing archived ovarian cancer pathology specimens may enable the identification of BRCA1/2 mutation carriers, but consent from next of kin would be required in in 58% of cases. Although Traceback offers the possibility of identifying unaffected BRCA1/2 mutation carriers, pilot feasibility studies that include assessment of methods to secure consent are needed.
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Affiliation(s)
| | - Goli Samimi
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
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Anderson S, Keating NC, Wilson DM. Staying married after stroke: a constructivist grounded theory qualitative study. Top Stroke Rehabil 2017; 24:479-487. [PMID: 28693410 DOI: 10.1080/10749357.2017.1342335] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Marriages are one of the most powerful predictors of health and longevity, yet research in stroke has focused separately on survivors' experience of impairments and how spouses deal with caregiving. OBJECTIVES The purpose of this constructivist grounded theory study was to understand the key themes related to reconstruction or breakdown of marriages after stroke. METHODS In semi-structured interviews, 18 couples in long-term marriages discussed how their marriages were reconstructed or broke down after one member of the couple returned home after being hospitalized for a stroke. Constant comparison methods were used to compare the experiences of 12 couples in which both partners indicated their relationship was going well with 6 couples who either separated or remained in parallel marriages. RESULTS Analysis revealed an overarching process of reconstructing compatible role-identities and three themes related to the reconstruction or breakdown of the marital identity: feeling overwhelmed, resolving conflict, and perceiving value in the marriage. CONCLUSIONS Our findings highlight that marriages are contexts in which survivors and spouses can recalibrate their role-identities. Marriage relationships are not peripheral to survivors' and spouses' outcomes after stroke; rather, marriage is fundamental to the management of impairments and to the well-being of the couple.
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Affiliation(s)
- Sharon Anderson
- a Department of Human Ecology , University of Alberta , Edmonton , Alberta , Canada
| | - Norah C Keating
- b The Global Social Initiative on Ageing (GSIA), International Association of Gerontology and Geriatrics , Edmonton , Alberta , Canada.,c Centre for Innovative Ageing, Swansea University , Swansea , Wales , UK.,d Research on Aging, Policies and Practice (RAPP) , University of Alberta , Edmonton , Canada.,e Africa Unit for Transdisciplinary Health Research (AUTHeR) , North-West University , Potchefstroom , South Africa
| | - Donna M Wilson
- f Faculty of Nursing , University of Alberta , Edmonton , Alberta , Canada
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Boele FW, Bulbeck H, Browne C, Rooney AG, Sherwood P. Interventions to help support caregivers of people with a brain or spinal cord tumour. Hippokratia 2017. [DOI: 10.1002/14651858.cd012582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Florien W Boele
- University of Leeds and Leeds Cancer Centre; Leeds Institute of Health Sciences and Leeds Institute of Cancer and Pathology; POG, Level 3, Bexley Wing St James's Institute of Oncology Leeds UK LS9 7TF
| | - Helen Bulbeck
- brainstrust; Director of Services; 4 Yvery Court Castle Road Cowes Isle of Wight UK PO31 7QG
| | - Catherine Browne
- Institute of Technology; Health and Social Sciences; North Campus Dromtracker, Tralee County Kerry Ireland
| | - Alasdair G Rooney
- Edinburgh Centre for Neuro-Oncology (ECNO); Department of Psychological Medicine; Western General Hospital Crewe Road South Edinburgh Scotland UK EH4 2XU
| | - Paula Sherwood
- University of Pittsburgh; Department of Acute and Tertiary Care; 336 Victoria Building 3500 Victoria Street Pittsburgh USA 15261
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Boele FW, Grant R, Sherwood P. Challenges and support for family caregivers of glioma patients. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/bjnn.2017.13.1.8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Robin Grant
- Consultant neurologist, Edinburgh Centre for Neuro-Oncology
| | - Paula Sherwood
- Professor, University of Pittsburgh (Acute and Tertiary Care, School of Nursing)
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Giovannoni G. Should we rebrand multiple sclerosis a dementia? Mult Scler Relat Disord 2017; 12:79-81. [DOI: 10.1016/j.msard.2017.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 01/06/2017] [Accepted: 01/12/2017] [Indexed: 12/13/2022]
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Bondil P, Habold D, Carnicelli D. Cancer and sexuality: The couple, a decisive factor, too often neglected. SEXOLOGIES 2016. [DOI: 10.1016/j.sexol.2016.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Bondil P, Habold D, Carnicelli D. Cancer et sexualité : le couple, un déterminant trop souvent négligé. SEXOLOGIES 2016. [DOI: 10.1016/j.sexol.2016.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gender differences in associations between cancer-related problems and relationship dissolution among cancer survivors. J Cancer Surviv 2016; 10:865-73. [PMID: 26995006 DOI: 10.1007/s11764-016-0532-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Research suggests that a cancer diagnosis predicts marital dissolution more strongly for women survivors than men, but there is a paucity of research on potential processes underlying this vulnerability. The present cross-sectional study examined whether specific cancer-related problems were associated with the odds of relationship breakup following diagnosis and whether these relationships differed between male and female cancer survivors. METHODS A national cross-sectional quality of life study assessed self-reported cancer-related problems and relationship change among survivors who were either 2, 6, or 10 years post-diagnosis (n = 6099). RESULTS Bivariate analyses indicated that cancer-related problems (e.g., emotional distress) were greater for divorced/separated survivors compared to those with intact relationships and were greater for women versus men. Logistic regressions indicated that for both male and female survivors, lower income, younger age, and longer time since diagnosis were associated with greater odds of divorce or separation after diagnosis (ORs > 2.14, p < .01). For women only, greater emotional distress (OR = 1.14, p < 0.01) and employment and financial problems (OR = 1.23, p < 0.0001) were associated with greater odds of post-diagnosis divorce or separation. For men only, fear of cancer recurrence was associated with greater odds of divorce or separation (OR = 1.32, p < 0.001). CONCLUSION Female and male survivors differed in the extent to which emotional or financial/employment problems attributed to the cancer diagnosis were associated with the likelihood of reporting relationship dissolution. IMPLICATIONS FOR CANCER SURVIVORS Although directions of causality could not be ascertained, results suggest the possibility that helping male and female cancer survivors cope with specific cancer-related problems may benefit the quality and stability of their relationships with significant others following diagnosis.
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Lawson AK, Klock SC, Pavone ME, Hirshfeld-Cytron J, Smith KN, Kazer RR. Psychological Counseling of Female Fertility Preservation Patients. J Psychosoc Oncol 2015; 33:333-53. [PMID: 25996581 DOI: 10.1080/07347332.2015.1045677] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Young cancer patients are increasingly interested in preserving their fertility prior to undergoing gonadotoxic therapies. Although the medical safety and treatment protocols for fertility preservation have been well documented, limited research has addressed the emotional issues that arise in fertility preservation patients. We briefly review the literature on the psychosocial issues in adult female fertility preservation treatment and describe our experiences within this patient population. Our findings suggest that several important issues to be addressed during the psychological counseling of adult female fertility preservation patients include: (1) preexisting psychological distress in patients undergoing treatment, (2) choice of fertility preservation strategy in the face of an uncertain relationship future, (3) decision making regarding use of third-party reproduction (e.g., sperm/egg donation, gestational surrogacy), (4) treatment expectations regarding pregnancy and miscarriage, (5) ethical issues related to treatment including the creation, cryopreservation, and disposition of embryos/oocytes, and (6) decision regret from patients who declined fertility preservation.
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Affiliation(s)
- Angela K Lawson
- a Department of Obstetrics and Gynecology, Northwestern University , Chicago , IL , USA
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Karraker A, Latham K. In Sickness and in Health? Physical Illness as a Risk Factor for Marital Dissolution in Later Life. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2015; 56:420-35. [PMID: 26315504 PMCID: PMC4857885 DOI: 10.1177/0022146515596354] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The health consequences of marital dissolution are well known, but little work has examined the impact of health on the risk of marital dissolution. We use a sample of 2,701 marriages from the Health and Retirement Study to examine the role of serious physical illness onset in subsequent marital dissolution via either divorce or widowhood. We use a series of discrete time event history models with competing risks to estimate the impact of husband's and wife's physical illness onset on risk of divorce and widowhood. We find that only measures of wife's illness onset are associated with elevated risk of divorce, while measures of either spouse's illness onset is associated with elevated risk of widowhood. Further, in the case of heart problems, we find that this gender difference is statistically significant. These findings suggest health as a determinant of marital dissolution in later life via both biological and gendered social pathways.
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Affiliation(s)
- Amelia Karraker
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, USA
| | - Kenzie Latham
- Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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Boele FW, Klein M, Reijneveld JC, Verdonck-de Leeuw IM, Heimans JJ. Symptom management and quality of life in glioma patients. CNS Oncol 2015; 3:37-47. [PMID: 25054899 DOI: 10.2217/cns.13.65] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Symptoms of fatigue, cognitive deficits, depression and changes in personality and behavior are frequently reported in patients with glioma. These symptoms have a large impact on the everyday life of patients and their partners and can contribute to a decrease in quality of life. While guidelines are available for managing most of these symptoms, these guidelines are often not suitable for the brain tumor patient population, as this population has very specific problems and needs. Obtaining more evidence on the effectiveness of existing and new interventions targeting fatigue, cognitive deficits, depression, and changes in personality and behavior in this population is advised. Screening combined with adequate referral to supportive care professionals has the potential to decrease the disease burden of glioma patients and their partners.
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Affiliation(s)
- Florien W Boele
- Department of Medical Psychology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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Stutts LA, Bills SE, Erwin SR, Good JJ. Coping and posttraumatic growth in women with limb amputations. PSYCHOL HEALTH MED 2015; 20:742-52. [DOI: 10.1080/13548506.2015.1009379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lew-Starowicz M, Gianotten WL. Sexual dysfunction in patients with multiple sclerosis. HANDBOOK OF CLINICAL NEUROLOGY 2015; 130:357-70. [DOI: 10.1016/b978-0-444-63247-0.00020-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Uccelli MM. The impact of multiple sclerosis on family members: a review of the literature. Neurodegener Dis Manag 2014; 4:177-85. [PMID: 24832035 DOI: 10.2217/nmt.14.6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Multiple sclerosis (MS) is one of the most common neurological diseases in young adults and involves inflammatory demyelination of the CNS. MS typically manifests between 20 and 40 years of age, and can lead to significant disability in some cases. The disease course is unpredictable. MS has a significant impact on families, influencing their wellbeing and quality of life, often creating psychological stress in each family member as well as on family functioning in general. Common themes include the impact of the emotional state of the person with MS on family members, the role of the healthy parent on how children cope, the effect of a lack of information about MS, communication within the family and with healthcare professionals, and the importance of assessing and treating families as a dynamic unit in order to assure comprehensive intervention plans. The current literature review is based on 30 full research articles meeting inclusion criteria related to partners/couples, family caregivers, children with a parent with MS and parents of young children with MS.
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Affiliation(s)
- Michele Messmer Uccelli
- * Italian Multiple Sclerosis Society, Healthcare Professional & Client Programs, Via Operai 40, Genoa 16149, Italy;
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Song HY, Kwon JA, Choi JW, Kim SJ, Park EC. Gender Differences in Marital Disruption among Patients with Cancer: Results from the Korean National Health and Nutrition Examination Survey (KNHANES). Asian Pac J Cancer Prev 2014; 15:6547-52. [DOI: 10.7314/apjcp.2014.15.16.6547] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Galushko M, Golla H, Strupp J, Karbach U, Kaiser C, Ernstmann N, Pfaff H, Ostgathe C, Voltz R. Unmet needs of patients feeling severely affected by multiple sclerosis in Germany: a qualitative study. J Palliat Med 2014; 17:274-81. [PMID: 24527993 DOI: 10.1089/jpm.2013.0497] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The needs of patients feeling severely affected by multiple sclerosis (MS) have rarely been investigated. However this is essential information to know before care can be improved, including adding palliative care (PC) services where helpful. Since it remains unclear at what point specialized palliative care should begin for this patient group, this study focuses on needs in general. OBJECTIVE The objective was to explore the subjectively unmet needs of patients feeling severely affected by MS. METHODS The study used a qualitative cross-sectional approach for needs assessment. Fifteen patients self-reporting feeling severely affected by MS were recruited and interviewed using a combination of purposive and convenience sampling (five were accompanied by a caregiver relative). Interviews were recorded and transcribed verbatim, followed by qualitative content analysis. RESULTS Unmet needs were identified in the main categories "support of family and friends," "health care services," "managing everyday life," and "maintaining biographical continuity." Patients expressed the desire for more support from their families and to be viewed as distinct individuals. They see a substantial deficit in the physician-patient relationship and in the coordination of services. A decrease in expressed unmet needs was found for patients more severely affected and less socially integrated. CONCLUSIONS To address the unmet needs of severely affected MS patients, health care services need to be improved and linked with existing PC services. Special attention is required to form supporting professional-patient relationships. Multiprofessional services should be accessible for patients, while integrating relatives. All services should have an individual approach to provide needs-tailored support.
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Affiliation(s)
- Maren Galushko
- 1 Department of Palliative Medicine, University Hospital , Cologne, Germany
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Tompkins SA, Roeder JA, Thomas JJ, Koch KK. Effectiveness of a relationship enrichment program for couples living with multiple sclerosis. Int J MS Care 2014; 15:27-34. [PMID: 24453760 DOI: 10.7224/1537-2073.2012-002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Living with a chronic illness such as multiple sclerosis (MS) has significant psychosocial ramifications. In particular, the patient's relationship with a spouse or significant other is often negatively affected. Programs are needed to address the psychosocial challenges of the illness and help improve outcomes for both the person with MS and his or her romantic support partner. Relationship Matters (RM) is a relationship enrichment program that integrates information and resources of the National Multiple Sclerosis Society with empirically based marriage education. The purpose of this study was to examine the effectiveness of the RM program in increasing relationship satisfaction and aspects of health-related quality of life in couples living with MS over a 3-month follow-up period. Couples were given 8 hours of programming via in-person workshops disseminated across the country or teleconferences. A control group consisting of members of MS couples who did not receive the intervention was used for comparison. The results indicate that RM significantly improved relationship satisfaction over time compared with no intervention (P < .05). Additional findings include significant improvements in mental health-related quality of life as well as reported improvements in communication, conflict resolution, and ability to handle MS-specific relationship issues. Overall, these findings show that RM results in improved couple functioning and additional psychological health benefits for individuals with MS and their romantic support partners.
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Affiliation(s)
- Sara Anne Tompkins
- Madipen Consulting, LLC, Fort Collins, CO, USA (SAT); National Multiple Sclerosis Society, Denver, CO, USA (JAR, KKK); and Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA (JJT)
| | - Jessica Ann Roeder
- Madipen Consulting, LLC, Fort Collins, CO, USA (SAT); National Multiple Sclerosis Society, Denver, CO, USA (JAR, KKK); and Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA (JJT)
| | - Jenifer J Thomas
- Madipen Consulting, LLC, Fort Collins, CO, USA (SAT); National Multiple Sclerosis Society, Denver, CO, USA (JAR, KKK); and Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA (JJT)
| | - Kimberly K Koch
- Madipen Consulting, LLC, Fort Collins, CO, USA (SAT); National Multiple Sclerosis Society, Denver, CO, USA (JAR, KKK); and Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA (JJT)
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