Coping strategies and psychosocial resources among women living with metastatic breast cancer: A qualitative study

Objective: Despite more women living with metastatic breast cancer (MBC), this population is underrepresented in cancer survivorship research. Few studies have assessed how women with MBC cope with their cancer experience. This qualitative study describes the coping strategies and psychosocial resources utilized by women living with MBC.Methods: Twenty-two women with MBC participated in four focus groups. Transcripts were analyzed using a general inductive approach. Codes derived from participants' responses were subsequently condensed into themes.Results: We identified 12 coping strategies and psychosocial resources and grouped them into five themes: Behavioral Coping Strategies (i.e. stress management, active coping and planning); Cognitive Coping Strategies and Psychological Resources (i.e. cognitive reappraisal, optimism, mindfulness, positive thinking, and religious coping); Existential Approach-Oriented Coping (i.e. acceptance, values-based living, and identity integration); Avoidance (i.e. avoidant coping); and Interpersonal Resources and Seeking Social Support (i.e. social support).Conclusions: Women living with MBC utilize several engagement and disengagement coping strategies, as well as intrapersonal and interpersonal resources. This study provides useful perspectives of women living with MBC that may inform the development of psychosocial interventions. Further research is needed to assess coping strategies and psychosocial resources across different subgroups of MBC patients and determine their impact on cancer outcomes.

Acute and subacute postsurgical pain in women with breast cancer: incidence and associations with biopsychosocial predictors-a secondary analysis of a randomized controlled trial

Introduction

Women who undergo breast cancer surgery risk suffering from postsurgical pain long after their surgery. Still, research on postsurgical pain in the subacute phase has been neglected.

Objective

This study aims to investigate the incidence, intensity, unpleasantness, and presurgical predictors of acute and subacute postsurgical pain after breast cancer surgery.

Methods

The study used an observational design through secondary analyses of the control group in a randomized controlled trial. Data from 102 women undergoing breast cancer surgery were included. Levels of acute and subacute pain intensity and unpleasantness were measured using 100 mm Visual Analogue Scales on the day of surgery and 4 weeks postsurgery. Linear regression analyses were performed to identify presurgical biopsychosocial predictors of acute and subacute postsurgical pain.

Results

Average levels of postsurgical pain intensity and unpleasantness were as follows: 22.7 mm for acute pain intensity, 19.0 mm for acute pain unpleasantness, 10.3 mm for subacute pain intensity, and 11.7 mm for subacute pain unpleasantness. Pain expectancy predicted acute pain intensity (R² = 0.04, p = 0.047) and acute unpleasantness (R² = 0.06, p = 0.02). Perceived social support inversely predicted acute pain unpleasantness (R² = 0.04, p = 0.014).

Conclusion

Mild and moderate acute pain intensity and unpleasantness are common after breast cancer surgery, whereas levels of subacute pain intensity and unpleasantness are low. Pain expectancy predicts acute postsurgical pain intensity and unpleasantness, whereas expected social support inversely predicts acute postsurgical pain unpleasantness.

Goals of care communication and higher-value care for patients with advanced-stage cancer: A systematic review of the evidence

CONTEXT

Goals-of-care communication (GOCC) is recommended to increase the value of cancer care near the end of life (EOL).

OBJECTIVES

Conduct a systematic review of the evidence that GOCC is associated with higher-value care.

METHODS

We searched PubMed, Scopus, Ovid MEDLINE, EMBASE, EMB Reviews, CINAHL, and PsycInfo from inception to July 2019. We analyzed the population,design, and results and the authors' definitions of GOCC. Risk of bias was assessed.

RESULTS

Thirty-two articles were selected. Ten articles reported results from 8 interventions; 17 characterized participants' perspectives; and 5 were retrospective The topics, behaviors, timing, and anticipated outcomes of GOCC varied significantly and were indistinguishable from practices such as advance care planning. GOCC typically focused on treatment outcomes rather than patients' goals. Four of 5 interventions increased evidence of GOCC after clinician training. Only one reported improved patient outcomes.

CONCLUSION

No consensus exists about what GOCC entails. There is limited evidence that GOCC increases the value of EOL care.

PRACTICE IMPLICATIONS

Future studies should focus on how to engage patients in conversations about their personal goals and integrate their goals into care planning. Clinicians can encourage GOCC by explaining how patients' goals influence decisions especially as treatment options become limited.

Exploring the needs and experiences of palliative home care from the perspectives of patients with advanced cancer in China: a qualitative study

PURPOSE

The needs and experiences of palliative home care for patients with advanced cancer have received little research attention. We aimed to explore the needs and experiences of palliative home care among patients with advanced cancer in China.

METHODS

This qualitative study was conducted using semi-structured interviews with patients with advanced cancer. Participants (n = 15) were recruited from an oncology palliative care unit and a hospice outpatient unit, and were selected using purposive sampling from October 2019 to March 2020. Interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis. Two researchers coded the interviews independently in NVivo 12 and developed major themes and subthemes by inductive and constant comparison.

RESULTS

Five themes were identified: (1) physical need; (2) psychological experience; (3) spiritual need; (4) social need; and (5) information need. Patients need to manage their symptoms (especially cancer pain), prolong life as long as possible, reconstruct their attitudes to adapt to their roles, be socially supported, be respected, maintain spiritual peace, and obtain more information about illness and home care.

CONCLUSIONS

The current palliative home care services are imperfect, and patients face substantial challenges, including physical symptoms, psychological/spiritual distress, and inadequate social support and information. Our findings may provide evidence and a reference for the development of palliative home care in China.

Psychometric Validation of the Persian Version of the COVID-19-Related Psychological Distress Scale and Association with COVID-19 Fear, COVID-19 Anxiety, Optimism, and Lack of Resilience

The outbreak of the coronavirus disease-2019 (COVID-19) has resulted in a global health crisis. The COVID-19 pandemic has caused psychological distress, both in infected and uninfected individuals. The present study evaluated the validity and factor structure of the COVID-19-Related Psychological Distress Scale (CORPDS) among the general public of the Persian-speaking population. The original version of the CORPDS was translated and back-translated into Persian, followed by a pilot study. A total sample (n = 623) completed an online survey including the CORPDS, Fear of COVID-19 Scale (FCV-19S), Coronavirus Anxiety Scale (CAS), Kessler Psychological Distress Scale (K10), Life Orientation Test-Revised (LOT-R), and Brief Resilience Scale (BRS). The Persian CORPDS had very good internal consistency and moderate test-retest reliability after 4 weeks. Maximum likelihood confirmatory factor analysis (CFA) was conducted to test construct validity (χ²/df = 2.39, CFI = 0.95, SRMR = 0.046, PCLOSE = 0.67 > 0.05, RMSEA = 0.047, 90% CI [0.038, 0.056]). Measurement invariance was performed across gender, including configural invariance, metric invariance, scalar invariance, and error variance invariance, and yielded further support for the two-factor structure of the CORPDS. The CORPDS correlated with the score on the K10 (r = 0.46, p < 0.01, 95% CI [0.43, 0.48]), CAS (r = 0.43, p < 0.01, 95% CI [0.37, 0.45]), FCV-19S (r = 0.29, p < 0.01, 95% CI [0.27, 0.32]), LOT-R (r = − 0.19, p < 0.01, 95% CI [− 0.15, − 0.24]) and BRS (r = − 0.56, p < 0.01, 95% CI [− 0.50, − 0.61]). Resilience was associated with lower psychological distress (β = − 0.54, SE = 0.05, p < 0.001). The findings provide evidence that CORPDS is a reliable and valid instrument for assessing psychological distress generated by COVID-19 among a healthy Persian-speaking population.

Personality Profiles and Psychological Adjustment in Breast Cancer Patients

Dispositional personality characteristics may play a role in psychosocial adjustment to any disease, including cancer.

PURPOSE

The purpose of this study is to identify personality profiles in breast cancer patients and to determine whether these profiles are associated with psychological adjustment or psychopathology.

METHODS

Participants were 109 women (mean age, 52.01) diagnosed with breast cancer. They completed the Millon Clinical Multiaxial Inventory-III (MCMI-III), the Life Orientation Test-Revised (LOT-R), the Satisfaction with Life Scale, and the Positive and Negative Affect Scales.

RESULTS

The analysis revealed two different personality profiles: (a) one group, comprising 38.23% of the sample, was characterized by paranoid, negativistic, and dependent personality traits and was considered as a "vulnerable group"; and (b) another group (61.77%) was characterized by compulsive, histrionic, and narcissistic personality traits and was considered as a "psychologically adjusted group". The vulnerable group scored higher than the psychologically adjusted group on all clinical syndromes, with scores above 60 on the anxiety, somatoform, dysthymic, and bipolar scales (score on anxiety being above 75); in contrast, the psychologically adjusted group did not reach a base rate score of 60 on any of the clinical syndromes, showing no manifestations of psychopathology. Additionally, the vulnerable group scored lower than the psychologically adjusted group on optimism, life satisfaction, and positive affect, but higher on negative affect.

CONCLUSIONS

The results suggest that personality traits could affect the psychological adjustment of breast cancer survivors. We discuss the implications of belonging to each group and highlight the importance of early identification of vulnerable women in order to facilitate clinical and psychological support.

Adapting and avoiding coping strategies for women with ovarian cancer during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has resulted in unprecedented challenges for people living with cancer, impacting not only physical health but psychological well-being. The psychological response affects the individual as well as the community and can persist long after the outbreak. We aim to assess coping strategies employed by women with ovarian cancer during the COVID-19 pandemic.

METHODS

Women with a current or prior diagnosis of ovarian cancer completed an online survey which included a query about coping strategies during the COVID-19 pandemic. The survey was distributed from March 30th through April 13, 2020 through survivor networks and social media.

RESULTS

Six hundred and three women visited the survey website during the study period and 555 (92.0%) completed the survey. Four hundred and eight (73.5%) provided information on coping strategies utilized during COVID-19. Among those who responded, the median age was 58 years (range 20-85) and 150 participants (40.8%) were undergoing active cancer treatment. Commonly utilized adaptive coping strategies included emotional support (159, 39.0%), self care (148, 36.3%), hobbies (139, 34.1%), planning (87, 21.3%), positive reframing (54, 13.2%), religion (50, 12.3%) and instrumental support (38, 9.3%). Many participants also relied on avoidance coping strategies including self distraction (111, 27.2%) and substance use (19, 4.7%).

CONCLUSIONS

Most ovarian cancer survivors are using adaptive, problem-focused coping strategies during the COVID-19 pandemic, however many are practicing avoidance strategies as well. As coping mechanisms profoundly impact quality of life, oncology providers must assist patients in identifying coping strategies that optimize physical and psychological well-being.

Contingent hope theory: The developmental exploration of hope and identity reconciliation among young adults with advanced cancers

OBJECTIVE

The diagnosis of an advanced cancer in young adulthood can bring one's life to an abrupt halt, calling attention to the present moment and creating anguish about an uncertain future. There is seldom time or physical stamina to focus on forward-thinking, social roles, relationships, or dreams. As a result, young adults (YAs) with advanced cancer frequently encounter existential distress, despair, and question the purpose of their life. We sought to investigate the meaning and function of hope throughout YAs' disease trajectory; to discern the psychosocial processes YAs employ to engage hope; and to develop a substantive theory of hope of YAs diagnosed with advanced cancer.

METHOD

Thirteen YAs (ages 23-38) diagnosed with a stage III or IV cancer were recruited throughout the eastern and southeastern United States. Participants completed one semi-structured interview in-person, by phone, or Skype, that incorporated an original timeline instrument assessing fluctuations in hope and an online socio-demographic survey. Glaser's grounded theory methodology informed constant comparative methods of data collection, analysis, and interpretation.

RESULTS

Findings from this study informed the development of the novel contingent hope theoretical framework, which describes the pattern of psychosocial behaviors YAs with advanced cancer employ to reconcile identities and strive for a life of meaning. The ability to cultivate the necessary agency and pathways to reconcile identities became contingent on the YAs' participation in each of the psychosocial processes of the contingent hope theoretical framework: navigating uncertainty, feeling broken, disorienting grief, finding bearings, and identity reconciliation.

SIGNIFICANCE OF RESULTS

Study findings portray the influential role of hope in motivating YAs with advanced cancer through disorienting grief toward an integrated sense of self that marries cherished aspects of multiple identities. The contingent hope theoretical framework details psychosocial behaviors to inform assessments and interventions fostering hope and identity reconciliation.

Understanding and Addressing the Role of Coping in Palliative Care for Patients With Advanced Cancer

Advanced cancer, with its considerable physical symptoms and psychosocial burdens, represents an existential threat and major stressor to patients and their caregivers. In response to such stress, patients and their caregivers use a variety of strategies to manage the disease and related symptoms, such as problem-focused, emotion-focused, meaning-focused, and spiritual/religious coping. The use of such coping strategies is associated with multiple outcomes, including quality of life, symptoms of depression and anxiety, illness understanding, and end-of-life care. Accumulating data demonstrate that early palliative care, integrated with oncology care, not only improves these key outcomes but also enhances coping in patients with advanced cancer. In addition, trials of home-based palliative care interventions have shown promise for improving the ways that patients and family caregivers cope together and manage problems as a dyad. In this article, we describe the nature and correlates of coping in this population, highlight the role of palliative care to promote effective coping strategies in patients and caregivers, and review evidence supporting the beneficial effects of palliative care on patient coping as well as the mechanisms by which improved coping is associated with better outcomes. We conclude with a discussion of the limitations of the state of science, future directions, and best practices on the basis of available evidence.

A New Brief Scale to Measure Optimism

This research was done to find if using maximum likelihood could reduce the Interactive Optimism Scale-Garcia to a new valid and reliable shorter version. There were 502 adults: 263 women and 239 men (M_age = 34.67, SD = 12.27). It was used in confirmatory factor analysis. A four-item scale is obtained, having excellent goodness of fit: [χ²/df = .609, GFI (Jöreskog and Sörbom's Goodness-of-Fit Index) = .999, NFI (Normed Fit Index) = .999, CFI (Bentler's Comparative Fit Index) = 1.000, RMSEA (Steiger-Lind root mean square error of approximation) = .000 (90% CI = .0001, .077); SRMR (standardized root mean square residual) = .007], as well as factorial invariance across sexes; the scale has good internal consistency (ω = .869, α = .858, ordinal α = .906). Brief Interactive Optimism Scale-G correlates significantly with self-esteem (r = .779, p < . 01, 95% CI [.816, .736]), depression (r = -.810, p < .01, 95% CI [.843, .772]), and psychopathy (r = -.670, p < . 01, 95% CI [.723, .611]). In conclusion, Brief Interactive Optimism Scale-G is a good option for measuring optimism in Mexicans.

Hope-related goal cognitions and daily experiences of fatigue, pain, and functional concern among lung cancer patients

PURPOSE

Cross-sectional research suggests that thinking about multiple ways to reach goals (hope pathways) and the belief that one can reach them (hope agency) may be adaptive for lung cancer patients. We examined the between-person and within-person associations among aspects of hope agency and pathways thinking, daily fatigue, pain, and functional concerns (e.g., sense of independence, usefulness) among lung cancer patients during active treatment.

METHODS

Data from a daily diary study were used to examine relations among hope agency, hope pathways, fatigue, pain, and functional concern in 50 patients with advanced lung cancer. Participants were accrued from one outpatient cancer center and completed the study between 2014 and 2015.

RESULTS

Adjusting for covariates and the previous day's symptoms or concern, patients who engaged in higher pathways thinking reported lower daily symptoms, whereas those who engaged in higher agency thinking reported less functional concern. Within-person increases in pathways thinking were associated with less daily fatigue, pain, and functional concern; within-person increases in agency thinking were associated with less daily fatigue and pain. Models examining symptoms and concerns as predictors of hope suggested within-person increases in functional concern and fatigue and pain were related to lower agency and pathways thinking the same day. Patients with higher fatigue and pain did not report lower agency or pathways thinking, but patients with more functional concern did.

CONCLUSIONS

Increases in hope pathways thinking may be associated with lower symptoms and better functioning in lung cancer patients. This suggests that it is important to determine the efficacy of interventions that emphasize the pathways the component of hope.

How Does Negative Career Feedback Affect Career Goal Disengagement? The Mediating Roles of Career Planning and Psychological Well-Being

The social cognitive model of career self-management postulates that negative career feedback will prompt individuals to reconsider career goals, and a study by Hu, Hood, and Creed reported a positive relationship between negative career feedback and goal disengagement. Drawing on this model, we theorized that negative career feedback will trigger cognition in the form of career planning and affect in the form of well-being and that career planning and well-being in turn will inform the decision to reengage or disengage from career goals. Using data collected through surveys from faculty members (Study 1) and managers (Study 2) from Pakistan, we found strong support for the mediating influence of career planning and psychological well-being. Interestingly, and contrary to expectation, negative career feedback negatively related to career goal disengagement. Using a two-study constructive replication format enhances confidence that our results are repeatable and not artifactual to particular samples and/or settings. We discuss implications of results for theory and offer suggestions for future research.

Acculturation and quality of life among Chinese American breast cancer survivors: The mediating role of self-stigma, ambivalence over emotion expression, and intrusive thoughts

OBJECTIVES

Highly acculturated Chinese American breast cancer survivors have greater access to health care providers, are English language proficient, and have more knowledge about the health care system. However, less is known about the potential psychosocial factors that may account for the health benefits of acculturation. As such, the current study seeks to understand how mainstream acculturation is associated with higher quality of life by investigating self-stigma, ambivalence over emotion expression (AEE), and intrusive thoughts, as serial mediators among Chinese breast cancer survivors.

METHODS

One hundred twelve Chinese American breast cancer survivors completed a self-reported questionnaire with these trait variables.

RESULTS

We found support for a serial multiple mediation hypothesis in which mainstream acculturation was indirectly associated with quality of life through self-stigma, AEE, and intrusive thoughts. Specifically, mainstream acculturation was associated with lower self-stigma, which, in turn, was associated with lower AEE and intrusive thoughts and subsequently resulted in lower quality of life among Chinese American breast cancer survivors.

CONCLUSIONS

The findings suggest that psychosocial factors are important mechanisms through which acculturation is associated with quality of life among Chinese American breast cancer survivors. As Chinese immigrants acculturate to mainstream American culture, they may benefit from the reduced public stigma toward breast cancer and incorporate new post-immigration knowledge about cancer that protects them from high levels of self-stigma. This, in turn, may lead Chinese American breast cancer survivors to experience lower AEE and intrusive thoughts and subsequently experience higher quality of life.

A longitudinal evaluation of psychosocial changes throughout orthognathic surgery

Background

Jaw correction surgery can cause significant psychosocial impacts on patients. This prospective study investigated the longitudinal changes of psychosocial characteristics of patients with dentofacial deformities after jaw correction surgery and the factors that predict the psychological resilience in Hong Kong Chinese undergoing jaw correction surgery.

Methods

A longitudinal cohort study was conducted on 92 Hong Kong Chinese patients (32 males, 60 females; mean age = 24.75 ± 5.65 years), who had jaw correction surgery as treatment for their dentofacial deformities, from 1^st June 2011 to 30^th June 2015. Self-completed psychological inventories including Brief Symptom Inventory, Life Orientation Test, and the Adult Trait Hope Scale were used to measure distress, optimism, and hope levels respectively. Patients completed the inventories in five time points: the surgical consent signing day (usually two to three months before the surgery) (T1); one day before operation (T2), first to second post-operative week (T3), third post-operative month (T4) and sixth post-operative month (T5).

Results

Latent class growth analysis revealed two outcome trajectory classes: a resilience trajectory (n = 45, 48.9%) and a chronic dysfunction trajectory (n = 14, 15.2%). Another 33 (35.9%) showed erratic trajectory patterns that would not be classified into any categories. The psychological distress levels of patients in the resilience trajectory group, on average, were below the clinical threshold of the Brief Symptom Inventory at all time points. However, the opposite result was obtained for patients in the chronic dysfunctional group. Patients exhibiting a resilience trajectory pattern, when compared to those showing a chronic dysfunction pattern, had higher optimism (t(57) = 3.69, p < .0001) and hope (t(57) = 2.46, p < .05) levels at T1. Logistic regression analyses were conducted to compare the relative power of optimism and hope levels at T1 to predict resilience or chronic dysfunctional group membership. A test of the full model against a constant only model was statistically significant (χ²(2) = 24.096, p < .01). Preoperative baseline optimism (B = —.276, p < .05) but not hope (B = —.25, ns) was a significant variable to classify the outcome trajectories for psychological distress.

Conclusions

Most patients were resilient to dentofacial deformities jaw correction surgery. About 15% exhibited a chronic distress pattern. An optimistic view about the surgery may enhance resilience. Pre-surgical counselling or educational sessions to facilitate a realistic positive outlook about the operation would be beneficial.

Personal goal-setting among women living with breast cancer: protocol for a scoping review

BACKGROUND

Breast cancer and its treatment can have many physical and psychological effects on affected women. Women's personal goals may provide insight into their priorities and motivations in the context of breast cancer. Incorporating personal goal-setting into support and care interventions may have an effect on psychological well-being. This protocol describes our scoping review methods, the aim of which is to examine and map the existing evidence on personal goal-setting among women with a breast cancer diagnosis.

METHODS

Our scoping review will search for published, full-length articles, where personal goal-setting is a major component of the study, and the study population is females with breast cancer. MEDLINE, PsycInfo, CINAHL, EMBASE, the Cochrane Library, and AMED databases will be searched. Two independent reviewers will conduct all screening and extract data. Descriptive information about the studies, participants, any interventions, measurement tools, outcomes, and results will be reported.

DISCUSSION

The results from this review will chart the literature, contributing to optimizing the incorporation of personal goal-setting approaches into effective interventions for the care and support of women with breast cancer.

Distress Among Locally Advanced Breast Cancer Patients from Diagnosis to Follow-Up: A Critical Review of Literature

OBJECTIVE

This critical review used a systematic approach to explore the prevalence of distress among locally advanced breast cancer (LABC) patients along their treatment journey. This review explored the domains of distress (psychosocial, physical and/or practical) that are significant to this patient population and determined indications for psychosocial support throughout the patients' treatment.

METHODS

Electronic databases including CINAHL, EmBase, Medline PsycInfo, and gray literature were searched from the year 2000 to 2016, to produce relevant literature. A critical review was conducted on 73 articles meeting the inclusion and exclusion criteria. A narrative synopsis was used to summarize the findings under key themes.

RESULTS

The results indicate that 16/73 studies assessed for distress in all three domains of distress throughout the treatment course. A meta-analysis was not possible due to the methodological heterogeneity of the articles, the variation of assessment tools used, timing in which the assessments were done, and the different treatment modalities. Distress was prevalent from the time of diagnosis, through treatment, and into survivorship. Sexuality, body image, age, financial difficulty, family/social support, and informational needs were common themes that emerged among the LABC population in these studies.

CONCLUSIONS

Comprehensive assessments incorporating all three domains of distress with the appropriate tools will assist health care professionals throughout the complicated treatment trajectory of LABC patients in taking a more proactive approach in assisting patients' concerns and preventing undue or increase in psychological distress during or after active treatment. This will encourage effective patient-centered communication and supportive care referrals for a better patient experience.

Predicting symptoms of anxiety and depression in patients living with advanced cancer: the differential roles of hope and optimism

PURPOSE

Psychological distress is related to poorer functioning and reduced quality of life in patients with advanced cancer and may have untoward influences on treatment decisions. Current research on factors associated with this distress is limited, making targeted interventions to reduce it suboptimal. We examined the relationships between two goal-related expectancies and two of the most common symptoms of psychological distress in patients living with advanced cancer: anxiety and depressive symptoms.

METHODS

Patients with advanced gastrointestinal cancer, colorectal cancer, lung cancer, or melanoma (N = 84) completed measures of anxiety, depressive symptoms, optimism, hope, and prediction for 12-month survival. Oncologists provided prediction for patient 12-month survival and patient performance status.

RESULTS

Hope, but not optimism, was associated with less severe depressive symptoms (β = - 0.42). Conversely, optimism, but not hope, was associated with less severe anxiety symptoms (β = - 0.36).

CONCLUSIONS

Hope and optimism appear to be associated with different aspects of psychological distress in patients living with advanced cancer. This may be explained by different appraisals of the uncertainty and distress that are associated with living with advanced-stage cancer. Hope- or optimism-focused interventions can be tailored to help alleviate specific aspects of psychological distress among these patients.

Daily diary study of hope, stigma, and functioning in lung cancer patients

OBJECTIVE

Given its lethality, associated stigma, and symptom burden, a lung cancer diagnosis poses a substantial challenge for patients. The goal of this study was to examine how daily hope, defined as goal-directed effort and planning to meet goals, and daily stigma were related to same- and next-day functioning in lung cancer patients receiving cancer treatment.

METHODS

Fifty lung cancer patients (39 non-small-cell stages IIIa-IV; 11 limited and extensive small cell) completed a baseline questionnaire and 21 daily diaries (n = 1,042) assessing hope, stigma, physical symptoms, treatment factors, and functioning. Hypotheses were tested in same- and next-day models with multilevel modeling.

RESULTS

Patients who reported more daily hope reported higher social and role functioning in same- and next-day models. On days that patients reported more hope than usual (compared with their own across-day average), they had higher social, role, and physical functioning; this effect did not carry into the next day. Treatment days were associated with lower social and role functioning when patients reported lower hope and associated with higher functioning when patients reported higher hope. Within-person hope was not predicted by disease symptoms. On days that patients reported more stigma than usual, they reported lower social and role functioning.

CONCLUSIONS

Hope is associated with functioning in lung cancer patients, regardless of physical symptoms from disease and treatment. Hope and stigma may therefore be appropriate intervention targets to support daily social and role functioning during lung cancer treatment. (PsycINFO Database Record

Population-based norms of the Life Orientation Test-Revised (LOT-R)

Background/Objective: The most common used instrument to measure optimism, both in psychological and medical research, is the Life Orientation Test- Revised (LOT-R). A multi-countries study using the future item from the LOT-R, found that level of optimism varied between countries. The provision of population-based norms is necessary, since norms enable the application of the LOT-R in individual diagnosis to compare individuals or special patient groups' scores with reference data. Method: A representative population based survey was conducted in 2014-2015. Norwegian aged 18-94 years (N = 1,792) completed questionnaires assessing sociodemographic, optimism and health and quality of life. Results: The mean age was 53.2 (SD = 16.6) and 53% were women. Mean LOT-R score was 17.2 (SD 3.0). There were marginal age and no gender differences. Although optimism was associated with sociodemographic variables, these were considered negligible due to small effect size. Norm data are given for the entire population. Optimism was associated with better health and quality of life. Conclusions: This study provides age and gender specific norm values from a representative sample of the Norwegian population. The normative data may be used in comparisons of optimism between individuals or between different samples of patients or sub-groups of people.

Psychological adjustment after breast cancer: a systematic review of longitudinal studies

OBJECTIVES

Breast cancer (BC) can be a traumatic and stressful experience for women, but there are wide-ranging differences in the ways in which women respond and adapt to BC. This systematic review examines which sociodemographic, disease-related, and psychosocial factors near diagnosis predict later psychological adjustment to BC.

METHODS

Database searches were conducted in 9 different health-related databases from 2000 to December 2015 using relevant search terms. Full-text, peer-reviewed articles in English that analyzed potential predictors of psychological adjustment in longitudinal studies were considered for inclusion.

RESULTS

Of 1780 abstracts, 41 studies fulfilled inclusion criteria. Consistent sociodemographic and disease-related variable predictors of adjustment were income, fatigue, cancer stage, and physical functioning. Psychosocial factors, particularly optimism and trait anxiety, as well as perceived social support, coping strategies, and initial levels of psychological functioning, were found to be predictive of later depressive and anxiety symptoms, psychological distress, and quality of life for women with BC, in predictable ways. Other psychosocial variables, such as cognitive and body image factors, predicted psychological adjustment but were explored only by a few studies.

CONCLUSIONS

The majority of studies showed a significant relationship between psychosocial factors and psychological adjustment. These results point to specific sociodemographic, disease-related, and psychosocial factors that can help to identify women at the time of diagnosis who are at risk for long-term psychological challenges so they can be referred for psychological support that targets their specific needs and can improve their quality of life and mood and decrease indicators of anxiety, depression, and psychological distress.

Optimism's Explicative Role for Chronic Diseases

The increasing interest about dispositional optimism's role in health status and its positive modulating effect on health outcomes has led to a remarkable scientific production in the last decade. To date lot is known for which diseases optimism is relevant, instead much less is known about how optimism interacts with other factors, both biological and psychological, in determining health status. The aim of this mini review is to explore the literature derived from clinical and experimental research assessing the associations between dispositional optimism and health status. Dispositional optimism can be considered as facet of personality that is cognitive in nature which holds the global expectation that the future will be plenty of good events. Optimists view desired goals as obtainable, so they often confront adversities in active manners resulting in perseverance and increased goal attainment. Only studies that explicitly included optimism and health outcomes, as measurable variables, and that reported a clear association between them have been reviewed. Cancer, cardiovascular disease, respiratory failure, and aging with multimorbidity were considered. Among the possible explicative hypotheses, two seem to best describe results: optimism may have a direct effect on the neuroendocrine system and on immune responses, and it may have an indirect effect on health outcomes by promoting protective health behaviors, adaptive coping strategies and enhancing positive mood. The research on optimism and health status has already shed light on important mechanisms regarding chronic diseases' management, however, further studies are needed to deepen the knowledge.