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Best AL, Shukla R, Adamu AM, Martinez Tyson D, Stein KD, Alcaraz KI. Impact of caregivers' negative response to cancer on long-term survivors' quality of life. Support Care Cancer 2021; 29:679-686. [PMID: 32430602 PMCID: PMC7677161 DOI: 10.1007/s00520-020-05509-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 05/05/2020] [Indexed: 11/29/2022]
Abstract
Cancer survivors' quality of life (QoL) is consistently shown to be positively impacted by social support from family and friends, including informal caregivers. In contrast, a loved one's negative response to cancer can diminish survivors' QoL, and these negative responses can be more impactful than supportive behaviors. Nonetheless, negative caregiver response has not been extensively researched, and few studies have explored the potential interaction of negative caregiver response and perceived social support on survivors' QoL. Therefore, we examined direct effects of perceived negative caregiver response, and the potential moderating role of social support, on QoL in a population-based sample of cancer survivors (N = 7543) using generalized linear models. Findings indicate that survivors who rated their caregiver's response to their cancer diagnosis more negatively reported worse physical and mental health, even up to 10 years after their initial cancer diagnosis. Perceived social support was not significantly associated with physical health, but it was positively associated with mental health. However, social support was not shown to moderate the relationship between negative caregiver response and mental health. Findings suggest that positive support from others within a survivor's social network may not be enough to attenuate the negative effects of their primary caregiver's unsupportive behaviors. Accordingly, cancer survivorship research and practice must consider the critical role that negative caregiver responses have on survivors' QoL and develop strategies that focus on the survivor-caregiver dynamic.
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Affiliation(s)
- Alicia L Best
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
| | - Rujuta Shukla
- Henry M. Goldman School of Dental Medicine, Boston University, 100 E Newton Street, Boston, MA, 02118, USA
| | - Abdullahi Musa Adamu
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Dinorah Martinez Tyson
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Kevin D Stein
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA
| | - Kassandra I Alcaraz
- Behavioral and Epidemiology Research Group, American Cancer Society, 250 Williams Street NW, Atlanta, GA, 30303, USA
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Longitudinal associations between coping strategies, locus of control and health-related quality of life in patients with breast cancer or melanoma. Qual Life Res 2020; 29:1271-1279. [PMID: 31894505 DOI: 10.1007/s11136-019-02401-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2019] [Indexed: 11/12/2022]
Abstract
PURPOSE A diagnosis of breast cancer or melanoma is a traumatic life event that patients have to face. However, their locus-of-control (LOC) beliefs and coping strategies as well as the associations with health-related quality of life (HRQoL) changes over time are still not well known and rarely compared by cancer site. METHODS The objective of this longitudinal study was to assess the association of LOC (Cancer Locus-of-Control Scale) and coping (Brief Cope) changes, with change in HRQoL (EORTC QLQ-C30) over time in newly diagnosed breast cancer and melanoma patients at 1, 6, 12, and 24 month post-diagnosis. Mixed models were used to compare LOC and coping longitudinal changes as well as their associations with HRQoL changes in early-stage breast cancer and melanoma patients. RESULTS Overall, 215 breast cancer and 78 melanoma patients participated in the study. At baseline, HRQoL levels were often higher for breast cancer compared to melanoma patients. For breast cancer and melanoma patients, negative coping strategies and perceived control over the course of illness were negatively and positively associated with HRQoL changes, respectively. For breast cancer patients only, emotional coping and internal causal attribution were negatively associated with HRQoL changes. For both cancer sites, living with a partner correlated with worse HRQoL. CONCLUSIONS Understanding coping strategies and LOC beliefs used by patients soon after their cancer diagnosis and over the course of illness can help identifying psychological and supportive care to modify maladaptive thoughts and beliefs and promote more adaptive behaviors to ultimately improve patients' well-being and HRQoL.
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Stinesen Kollberg K, Wiley JF, Ross KM, Jorge-Miller A, Hammen C, Weihs KL, Stanton AL. Chronic Stress in Vocational and Intimate Partner Domains as Predictors of Depressive Symptoms After Breast Cancer Diagnosis. Ann Behav Med 2019; 53:333-344. [PMID: 29931262 PMCID: PMC6594296 DOI: 10.1093/abm/kay045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND After cancer diagnosis, depressive symptoms are elevated on average and decline over time, but substantial variability is apparent. Few studies have examined to what extent chronic stress in distinct life domains affects depressive symptoms. PURPOSE Chronic stress in vocational and intimate partner life domains, and their interaction, were tested as predictors of depressive symptoms after breast cancer diagnosis. METHODS Women (N = 460) completed validated interviews regarding chronic stress in specific life domains shortly after diagnosis and a measure of depressive symptoms every 6 weeks for 6 months. RESULTS In latent growth curve modeling analyses, greater chronic stress in work (b = 2.90; p < .001) and intimate partner domains (b = 1.38, p = .02) was associated with higher depressive symptoms at study entry (intercept), and greater work stress predicted faster recovery from depressive symptoms over time (b = -0.10; p = .01). The two domains of chronic stress also interacted significantly on depressive symptoms at study entry (b = -1.54; p < .02) and over time (b = 0.14; p < .001). Greater work stress was associated with higher depressive symptoms at study entry regardless of intimate partner stress, but greater intimate partner stress was associated with higher depressive symptoms when work stress was low. The decline over 6 months in initially elevated depressive symptoms predicted by high work stress was significantly steeper when intimate partner stress was low. CONCLUSIONS Targeting interventions to recently diagnosed breast cancer patients living with chronically stressful vocational and intimate partner life circumstances could be worthwhile.
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Affiliation(s)
- Karin Stinesen Kollberg
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
- Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Joshua F Wiley
- School of Psychological Sciences, Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
| | - Kharah M Ross
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
| | - Alexandra Jorge-Miller
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Constance Hammen
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
| | - Karen L Weihs
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
- Cancer Prevention and Control Program, University of Arizona Comprehensive Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
- Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
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Coker AL, Follingstad DR, Garcia LS, Bush HM. Intimate partner violence and women's cancer quality of life. Cancer Causes Control 2016; 28:23-39. [PMID: 27943059 DOI: 10.1007/s10552-016-0833-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 11/23/2016] [Indexed: 01/06/2023]
Abstract
PURPOSE Because intimate partner violence (IPV) may disproportionately impact women's quality of life (QOL) when undergoing cancer treatment, women experiencing IPV were hypothesized to have (a) more symptoms of depression or stress and (b) lower QOL as measured with the Functional Assessment of Cancer Therapy (FACT-B) and Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) Scales relative to those never experiencing IPV. METHODS Women, aged 18-79, who were included in one of two state cancer registries from 2009 to 2015 with a recent incident, primary, invasive biopsy-confirmed cancer diagnosis were recruited and asked to complete a phone interview, within 12 months of diagnosis. This interview measured IPV by timing (current and past) and type (physical, sexual, psychological), socio-demographics, and health status. Cancer registries provided consenting women's cancer stage, site, date of diagnosis, and age. RESULTS In this large cohort of 3,278 women who completed a phone interview, 1,221 (37.3%) disclosed lifetime IPV (10.6% sexual, 24.5% physical, and 33.6% psychological IPV). Experiencing IPV (particularly current IPV) was associated with poorer cancer-related QOL defined as having more symptoms of depression and stress after cancer diagnosis and lower FACIT-SP and FACT scores than women not experiencing IPV and controlling for confounders including demographic factors, cancer stage, site, and number of comorbid conditions. Current IPV was more strongly associated with poorer QOL. When compared with those experiencing past IPV (and no IPV), women with cancer who experienced current IPV had significantly higher depression and stress symptoms scores and lower FACIT-SP and FACT-G scores indicating poorer QOL for all domains. While IPV was not associated with being diagnosed at a later cancer stage, current IPV was significantly associated with having more than one comorbid physical conditions at interview (adjusted rate ratio = 1.35; 95% confidence interval 1.19-1.54) and particularly for women diagnosed with cancer when <55 years of age. CONCLUSIONS Current and past IPV were associated with poorer mental and physical health functioning among women recently diagnosed with cancer. Including clinical IPV screening may improve women's cancer-related QOL.
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Affiliation(s)
- Ann L Coker
- Center for Research on Violence Against Women, University of Kentucky, Lexington, KY, USA.
- Department of Obstetrics and Gynecology, College of Medicine, University of Kentucky, 800 Rose St C-361, Lexington, KY, 40536-0293, USA.
| | - Diane R Follingstad
- Center for Research on Violence Against Women, University of Kentucky, Lexington, KY, USA
| | - Lisandra S Garcia
- Department of Obstetrics and Gynecology, College of Medicine, University of Kentucky, 800 Rose St C-361, Lexington, KY, 40536-0293, USA
| | - Heather M Bush
- Center for Research on Violence Against Women, University of Kentucky, Lexington, KY, USA
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Coker AL, Follingstad DR, Garcia LS, Bush HM. Partner interfering behaviors affecting cancer quality of life. Psychooncology 2016; 26:1205-1214. [PMID: 27246006 PMCID: PMC5133183 DOI: 10.1002/pon.4157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 02/28/2016] [Accepted: 04/17/2016] [Indexed: 01/06/2023]
Abstract
Objective Because partners are an important and unpaid resource in cancer care, understanding how destructive, controlling or interfering partner behaviors influence women's cancer care may be particularly relevant for health care providers seeking to provide cancer care and enhance recovery. Using a new measure of partner interfering behaviors in cancer care (PIB‐C), we investigated whether women with a recent cancer diagnosis who additionally endorsed any PIB‐C would report (a) more symptoms of depression and stress, and (b) lower Functional Assessment of Cancer Therapy (FACT‐G) and lower Functional Assessment of Chronic Illness Therapy‐Spiritual Well‐being (FACIT‐SP) scale scores indicating poorer quality of life (QOL). Methods Women aged 18–79 included in cancer registries as having an incident, primary, biopsy‐confirmed cancer in the past 12 months were eligible for this study. Consenting women completed a phone interview 9–12 months following cancer diagnosis between 2009 and 2015. Interviews provided data to measure outcomes (perceived stress and depressive symptoms, FACIT‐SP and FACT‐G scores), partner supportive and interfering behaviors, and other potentially confounding factors. Results Of the 2376 women in a relationship at cancer diagnosis, 14.7% endorsed one or more of 14 PIB‐C items. Women endorsing any PIB‐C item reported more symptoms of depression and stress and lower FACT‐G and FACIT‐SP scores than partnered women reporting no PIB‐C even when controlling for partner supportive behaviors and lifetime intimate partner violence. Increasing PIB‐C scores were also correlated, in a dose–response pattern, with these same outcomes. Conclusions Partner interfering behaviors during cancer care impact patients' QOL across multiple domains. © 2016 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Ann L Coker
- University of Kentucky, College of Medicine, Department of Obstetrics and Gynecology, Lexington, USA
| | - Diane R Follingstad
- University of Kentucky, College of Medicine, Department of Psychiatry, Lexington, USA
| | - Lisandra S Garcia
- University of Kentucky, College of Medicine, Department of Obstetrics and Gynecology, Lexington, USA
| | - Heather M Bush
- University of Kentucky, College of Public Health, Department of Biostatistics, Lexington, USA
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