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Mai Q, Liang X, Hu J, Meng X, Zhang Q, Wang C, Song Y. The effect of perceived stress on social isolation in young and middle-aged maintenance haemodialysis patients: A polynomial regression and response surface analysis. Stress Health 2024; 40:e3304. [PMID: 37583077 DOI: 10.1002/smi.3304] [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] [Received: 03/27/2023] [Revised: 07/06/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
Patients on maintenance haemodialysis (MHD) face social isolation due to the far-reaching effects of their disease and treatment. Based on the Transactional Model of Stress and Coping, we analysed the relationship between perceived stress and social isolation in patients, and the mediating role of internal health-related locus of control (IHLC) from the perspective of co-existence of perceived helplessness (HEL) and perceived self-efficacy (SEL). We used structured questionnaires to investigate 332 cases of young and middle-aged MHD patients in four tertiary hospitals in Guangdong, China. Polynomial regression and response surface analysis were conducted, along with tests of mediating effects on the data. The research was based on STROBE guidelines. The results showed that perceived stress is significantly and positively associated with social isolation. When the HEL and SEL of perceived stress were congruent, the joint effect of the two was in a positive curvilinear relationship to social isolation, when the two were incongruent, the risk of social isolation was lower for "low HEL-high SEL" patients compared to the "high HEL-low SEL" combination. The more congruent in HEL -SEL, the lower the risk of social isolation for the patients, with the IHLC playing a mediating role in this association. This study reveals that the coexistence of perceived stress's HEL and SEL affects social isolation through congruent and incongruent matching mechanism, providing additional explanations for the mechanism of occurrence of patients' social isolation.
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Affiliation(s)
- Qingxin Mai
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xingshan Liang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingyi Hu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangxin Meng
- Department of Nephrology, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Qiulin Zhang
- Department of Nephrology, Guangdong Second Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Chao Wang
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yang Song
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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2
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Scotto L, Pizzoli SFM, Marzorati C, Mazzocco K, Pravettoni G. The impact of prophylactic mastectomy on sexual well-being: a systematic review. Sex Med Rev 2024; 12:164-177. [PMID: 38185919 DOI: 10.1093/sxmrev/qead054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Considering the increasing women's awareness of health promotion and disease prevention programs, mutation carriers are inevitably asked to face important decisions concerning the possibility of undergoing prophylactic mastectomy. Risk-reducing mastectomy (RRM) has become increasingly more common, although it has a significant impact on women's quality of life and sexual well-being. OBJECTIVES The systematic review aims to evaluate the impact of RRM on the sexuality of women with breast cancer. METHODS According to Cochrane Collaboration guidelines and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, the study quantified the effects of frontline work on the mental health of healthcare workers. This review followed the PRISMA guidelines. Three databases were systematically searched from inception to December 2022. The expression ("sexuality" OR "sexual" OR "sex") AND ("prophylactic mastectomy" OR "risk-reducing mastectomy") was searched in PubMed, Ovid Medline, and Embase. Twenty-two articles published in English until 2022 were selected. RESULTS Two studies investigated sexual experience after risk-reducing surgeries as a single outcome, while other studies analyzed the relationship between sexuality and psychosocial outcomes, risk perception, and satisfaction. In all of the included studies, significant findings in sexual dysfunction were found. The most reported problems were related to sexual satisfaction and attractiveness, body image, and loss of femininity. Last, women reported changes in the relationship with their partners. CONCLUSION RRM has a major impact on body image that affects sexual functioning and quality of life. These implications must be considered during treatment selection.
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Affiliation(s)
- Ludovica Scotto
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
- Facoltà di Psicologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan, Italy
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Grabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
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3
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Masiero M, Filipponi C, Fragale E, Pizzoli SFM, Munzone E, Milani A, Guido L, Guardamagna V, Marceglia S, Prandin R, Prenassi M, Caruso A, Manzelli V, Savino C, Conti C, Rizzi F, Casalino A, Candiani G, Memini F, Chiveri L, Vitali AL, Corbo M, Grasso R, Didier F, Ferrucci R, Pravettoni G. Support for Chronic Pain Management for Breast Cancer Survivors Through Novel Digital Health Ecosystems: Pilot Usability Study of the PainRELife Mobile App. JMIR Form Res 2024; 8:e51021. [PMID: 38306176 PMCID: PMC10873797 DOI: 10.2196/51021] [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: 07/20/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Chronic pain is one of the most common and critical long-term effects of breast cancer. Digital health technologies enhance the management of chronic pain by monitoring physical and psychological health status and supporting pain self-management and patient treatment decisions throughout the clinical pathway. OBJECTIVE This pilot study aims to evaluate patients' experiences, including usability, with a novel digital integrated health ecosystem for chronic pain named PainRELife. The sample included patients with breast cancer during survivorship. The PainRELife ecosystem comprises a cloud technology platform interconnected with electronic health records and patients' devices to gather integrated health care data. METHODS We enrolled 25 patients with breast cancer (mean age 47.12 years) experiencing pain. They were instructed to use the PainRELife mobile app for 3 months consecutively. The Mobile Application Rating Scale (MARS) was used to evaluate usability. Furthermore, pain self-efficacy and participation in treatment decisions were evaluated. The study received ethical approval (R1597/21-IEO 1701) from the Ethical Committee of the European Institute of Oncology. RESULTS The MARS subscale scores were medium to high (range: 3.31-4.18), and the total app quality score was 3.90. Patients with breast cancer reported reduced pain intensity at 3 months, from a mean of 5 at T0 to a mean of 3.72 at T2 (P=.04). The total number of times the app was accessed was positively correlated with pain intensity at 3 months (P=.03). The engagement (P=.03), information (P=.04), and subjective quality (P=.007) subscales were positively correlated with shared decision-making. Furthermore, participants with a lower pain self-efficacy at T2 (mean 40.83) used the mobile app more than participants with a higher pain self-efficacy (mean 48.46; P=.057). CONCLUSIONS The data collected in this study highlight that digital health technologies, when developed using a patient-driven approach, might be valuable tools for increasing participation in clinical care by patients with breast cancer, permitting them to achieve a series of key clinical outcomes and improving quality of life. Digital integrated health ecosystems might be important tools for improving ongoing monitoring of physical status, psychological burden, and socioeconomic issues during the cancer survivorship trajectory. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/41216.
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Affiliation(s)
- Marianna Masiero
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Chiara Filipponi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Elisa Fragale
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Elisabetta Munzone
- Division of Medical Senology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Alessandra Milani
- Nursing School, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Luca Guido
- Division of Palliative Care and Pain Therapy, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Vittorio Guardamagna
- Division of Palliative Care and Pain Therapy, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Sara Marceglia
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Milan, Italy
| | - Roberto Prandin
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Milan, Italy
| | - Marco Prenassi
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Milan, Italy
| | - Annamaria Caruso
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Milan, Italy
- Nuvyta, Società a Responsabilità Limitata, Cologno Monzese, Italy
| | - Vania Manzelli
- Nuvyta, Società a Responsabilità Limitata, Cologno Monzese, Italy
| | - Chiara Savino
- Nuvyta, Società a Responsabilità Limitata, Cologno Monzese, Italy
| | | | | | | | - Giulia Candiani
- Agenzia di comunicazione scientifica Zadig, Società a Responsabilità Limitata, Società benefit, Milan, Italy
| | - Francesca Memini
- Agenzia di comunicazione scientifica Zadig, Società a Responsabilità Limitata, Società benefit, Milan, Italy
| | - Luca Chiveri
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Andrea Luigi Vitali
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Massimo Corbo
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Roberto Grasso
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Florence Didier
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Roberta Ferrucci
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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Post KE, Ahmad Z, Jankauskaite G, Centracchio J, Oswald L, Horick N, Park ER, Temel JS, Greer JA, Jacobs J. Managing Symptom Distress: Key Factors for Patients on Adjuvant Endocrine Therapy for Breast Cancer. J Pain Symptom Manage 2024; 67:88-97. [PMID: 37816436 PMCID: PMC10842924 DOI: 10.1016/j.jpainsymman.2023.10.001] [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] [Received: 06/07/2023] [Revised: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023]
Abstract
CONTEXT Patients with breast cancer taking adjuvant endocrine therapy (AET) experience significant symptoms impacting mood, quality of life (QOL), and AET adherence and satisfaction. OBJECTIVES The aim of this study was to examine the extent to which coping ability and self-efficacy for symptom management moderate the relationships between patients' symptom distress and their mood, QOL, and AET adherence and satisfaction. METHODS As part of a randomized controlled trial, participants completed baseline measures including: sociodemographics, symptom distress (breast cancer prevention trial symptom checklist), coping skills (measure of current status), self-efficacy (self-efficacy for managing symptoms), anxiety and depression (hospital anxiety and depression scale), QOL (functional assessment of cancer therapy - general), AET adherence (medication adherence report scale), and AET satisfaction (cancer therapy satisfaction questionnaire). We conducted moderated regression analyses to examine whether coping and self-efficacy moderated the associations of symptom distress with baseline measures. RESULTS Coping skills moderated the associations of symptom distress with depression and QOL. Among those with lower coping, higher symptom distress was associated with worse depression symptoms (p=.04) and worse QOL (p < 0.001). Self-efficacy moderated the associations of symptom distress with depression symptoms and AET adherence and satisfaction. Among those with higher self-efficacy, higher symptom distress was associated with worse depression symptoms (p < 0.001), worse AET adherence (p < 0.001), and less AET satisfaction (p = 0.01). CONCLUSION Coping skills may buffer the effect of AET symptom distress. Findings indicate the relationship between symptom distress and self-efficacy is more nuanced and requires further research to better understand.
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Affiliation(s)
- Kathryn E Post
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA.
| | - Zeba Ahmad
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Greta Jankauskaite
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Joely Centracchio
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Laura Oswald
- Moffitt Cancer Center (O.L.), Tampa, Florida, USA
| | - Nora Horick
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Elyse R Park
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Jennifer S Temel
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Joseph A Greer
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
| | - Jamie Jacobs
- Massachusetts General Hospital (P.K.E., A.Z., J.G., C.J., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA; Harvard Medical School (P.K.E., A.Z., J.G., H.N., P.E.R., T.J.S., G.J.A., J.J.), Boston, Massachusetts, USA
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Karademas EC, Roziner I, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Stamatakos G, Cardoso F, Frasquilho D, Kolokotroni E, Lemos R, Marzorati C, Mattson J, Pettini G, Spyropoulou E, Poikonen-Saksela P, Simos P. The mutual determination of self-efficacy to cope with cancer and cancer-related coping over time: a prospective study in women with breast cancer. Psychol Health 2023; 38:1635-1648. [PMID: 35147473 DOI: 10.1080/08870446.2022.2038157] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/10/2021] [Accepted: 12/28/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of this study was to examine the longitudinal impact of self-efficacy to cope with cancer on the cancer-related coping reactions of breast cancer patients and vice versa. DESIGN AND MAIN OUTCOMES MEASURES Data from the BOUNCE Project (https://www.bounce-project.eu/) were used to address the hypotheses. Participants (N = 403) were enrolled in the study a few weeks after surgery or biopsy. Coping self-efficacy was assessed at baseline and six months later (M6). Cancer-related coping was assessed three (M3) and nine months (M9) after baseline. The analyses were performed using structural equation modeling with Mplus 8.6. RESULTS Baseline coping self-efficacy predicted all M3 coping reactions, while M6 coping self-efficacy also predicted changes in all but one M9 coping reaction. Moreover, one of the M3 coping reactions, that is, hopelessness/helplessness, predicted the changes in M6 coping self-efficacy. The relation between coping self-efficacy and one coping reaction (i.e. cognitive avoidance) was rather weak. Stability paths from M3 to M9 coping reactions were moderate to high. CONCLUSION The relationship between self-efficacy to cope with cancer and cancer-related coping is complex. New theoretical models are needed to more accurately describe the diverse aspects of this association.
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Affiliation(s)
- E C Karademas
- Department of Psychology, University of Crete, Rethymno, Greece
- Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - I Roziner
- Department of Communication Disorders, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - K Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - R Pat-Horenczyk
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - B Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - A J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
- NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal
| | - G Stamatakos
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - D Frasquilho
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
| | - E Kolokotroni
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - R Lemos
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
| | - C Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - J Mattson
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - G Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - E Spyropoulou
- Department of Psychology, University of Crete, Rethymno, Greece
| | - P Poikonen-Saksela
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - P Simos
- Foundation for Research and Technology - Hellas, Heraklion, Greece
- Medical School, University of Crete, Rethymno, Greece
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6
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Bentley G, Zamir O, Dahabre R, Perry S, Karademas EC, Poikonen-Saksela P, Mazzocco K, Sousa B, Pat-Horenczyk R. Protective Factors against Fear of Cancer Recurrence in Breast Cancer Patients: A Latent Growth Model. Cancers (Basel) 2023; 15:4590. [PMID: 37760558 PMCID: PMC10526521 DOI: 10.3390/cancers15184590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/03/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
The current study aimed to examine the fear of cancer recurrence (FCR) trajectory and protective predictors in women coping with breast cancer (BC). The study's model investigated whether a higher coping self-efficacy and positive cognitive-emotion regulation at the time of the BC diagnosis would lead to reduced levels of FCR at six months and in later stages (12 and 18 months) post-diagnosis. The sample included 494 women with stages I to III BC from Finland, Italy, Portugal, and Israel. They completed self-report questionnaires, including the Fear of Cancer Recurrence Inventory (FCRI-SF), the Cancer Behavior Inventory-Brief Version (CBI-B), the Cognitive-Emotion Regulation Questionnaire (CERQ short), and medical-social-demographic data. Findings revealed that a higher coping self-efficacy at diagnosis predicted lower FCR levels after six months but did not impact the FCR trajectory over time. Surprisingly, positive cognitive-emotion regulation did not predict FCR levels or changes over 18 months. FCR levels remained stable from six to 18 months post-diagnosis. This study emphasizes the importance of developing specific cancer coping skills, such as coping self-efficacy. Enhancing coping self-efficacy in the first six months after BC diagnosis may lead to lower FCR levels later, as FCR tends to persist in the following year.
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Affiliation(s)
- Gabriella Bentley
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Osnat Zamir
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Rawan Dahabre
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Shlomit Perry
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Evangelos C. Karademas
- Department of Psychology, University of Crete and Foundation for Research and Technology, 70013 Heraklion, Greece
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center, University of Helsinki, 00100 Helsinki, Finland
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, 20139 Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20139 Milan, Italy
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, 1400-038 Lisboa, Portugal
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
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Erdemsoy Karahan B, Izgu N. Impact of symptom burden and self-efficacy on functional status in advanced breast cancer patients: A path analysis. Nurs Health Sci 2023; 25:354-364. [PMID: 37431570 DOI: 10.1111/nhs.13033] [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: 02/23/2023] [Revised: 06/01/2023] [Accepted: 06/17/2023] [Indexed: 07/12/2023]
Abstract
This correlational study aims at exploring the correlations between symptom burden, functional status, and self-efficacy in advanced breast cancer patients and to analyze their paths of influence. The study was performed with 122 patients with advanced breast cancer receiving outpatient chemotherapy between April 10, 2021 and April 29, 2022. Data were collected using a sociodemographic information form, the MD Anderson Symptom Inventory, the Functional Living Index-Cancer, and the Symptom Management Self-Efficacy Scale for Breast Cancer Related to Chemotherapy. Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests and path analysis were used for data evaluation. Less-educated individuals had a higher symptom burden and poorer self-efficacy. Low-income level was related to poor self-efficacy. Symptom severity did not directly influence functional status but affected it indirectly through self-efficacy, while symptom interference and self-efficacy had a direct impact on functional status. This study mainly concludes that symptom burden and self-efficacy affect functional status in advanced breast cancer patients receiving chemotherapy. Self-efficacy-enhancing interventions may be helpful strategies for symptom relief and improvement in functional status in this population.
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Affiliation(s)
- Beyza Erdemsoy Karahan
- Ankara University Faculty of Medicine, Cebeci Research and Education Hospital, Ankara, Turkey
| | - Nur Izgu
- Hacettepe University Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
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8
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Kourou K, Manikis G, Mylona E, Poikonen-Saksela P, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Mattson J, Roziner I, Pettini G, Kondylakis H, Marias K, Nuutinen M, Karademas E, Simos P, Fotiadis DI. Personalized prediction of one-year mental health deterioration using adaptive learning algorithms: a multicenter breast cancer prospective study. Sci Rep 2023; 13:7059. [PMID: 37120428 PMCID: PMC10148884 DOI: 10.1038/s41598-023-33281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
Identifying individual patient characteristics that contribute to long-term mental health deterioration following diagnosis of breast cancer (BC) is critical in clinical practice. The present study employed a supervised machine learning pipeline to address this issue in a subset of data from a prospective, multinational cohort of women diagnosed with stage I-III BC with a curative treatment intention. Patients were classified as displaying stable HADS scores (Stable Group; n = 328) or reporting a significant increase in symptomatology between BC diagnosis and 12 months later (Deteriorated Group; n = 50). Sociodemographic, life-style, psychosocial, and medical variables collected on the first visit to their oncologist and three months later served as potential predictors of patient risk stratification. The flexible and comprehensive machine learning (ML) pipeline used entailed feature selection, model training, validation and testing. Model-agnostic analyses aided interpretation of model results at the variable- and patient-level. The two groups were discriminated with a high degree of accuracy (Area Under the Curve = 0.864) and a fair balance of sensitivity (0.85) and specificity (0.87). Both psychological (negative affect, certain coping with cancer reactions, lack of sense of control/positive expectations, and difficulties in regulating negative emotions) and biological variables (baseline percentage of neutrophils, thrombocyte count) emerged as important predictors of mental health deterioration in the long run. Personalized break-down profiles revealed the relative impact of specific variables toward successful model predictions for each patient. Identifying key risk factors for mental health deterioration is an essential first step toward prevention. Supervised ML models may guide clinical recommendations toward successful illness adaptation.
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Affiliation(s)
- Konstantina Kourou
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece
| | - Georgios Manikis
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Eugenia Mylona
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center and Helsinki University, Helsinki, Finland
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
- Dept. of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
- NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Johanna Mattson
- Helsinki University Hospital Comprehensive Cancer Center and Helsinki University, Helsinki, Finland
| | - Ilan Roziner
- Dept. of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Greta Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Haridimos Kondylakis
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Kostas Marias
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | | | - Evangelos Karademas
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
- Dept. of Psychology, University of Crete, Rethymno, Greece
| | - Panagiotis Simos
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
- School of Medicine, University of Crete, Heraklion, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece.
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece.
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9
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Fahmer N, Faller H, Wöckel A, Salmen J, Heuschmann PU, Meng K. Patients' perceived challenges, competencies, and supportive care needs during acute clinical treatment of breast or gynecological cancer. Psychooncology 2023; 32:682-691. [PMID: 36790934 DOI: 10.1002/pon.6112] [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: 09/21/2022] [Revised: 12/15/2022] [Accepted: 02/07/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE This study aimed to examine challenges, competencies, and supportive care needs (SCN) of women with breast or gynecological cancer during acute cancer treatment and associations to other health-related variables. METHODS We surveyed 120 patients with breast or gynecological cancer at the end of acute cancer treatment, either directly after surgery or during adjuvant chemotherapy. We assessed challenges, subjective competencies, and SCN using a self-developed measure comprising 25 items referring to coping tasks assigned to six domains. In addition, patients' competencies and health literacy (HL) were assessed. RESULTS Most patients felt at least moderately challenged by coping tasks concerning psychological distress (e.g., dealing with fears and insecurities, 70.2%; coping with cancer diagnosis, 69.6%) and physical complaints (e.g., dealing with a reduced physical capacity, 56.6%). About 42.5%-71.4% of patients who evaluated coping tasks as highly challenging felt competent to deal with these challenges themselves. Less than half of patients reported SCN, mainly regarding psychological concerns. The extent of challenging coping tasks, patients' perceived ability to overcome challenges themselves, and SCN showed associations to patient competencies and HL. CONCLUSIONS SCN regarding psychological concerns and health behavior should be addressed in acute cancer care and rehabilitation programs. In addition, promoting HL might be essential in strengthening patients' subjective competencies related to various coping tasks.
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Affiliation(s)
- Natascha Fahmer
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Hermann Faller
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Achim Wöckel
- Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
| | - Jessica Salmen
- Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany.,Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany
| | - Karin Meng
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
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10
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Petruzzi A, Mancuso AM, Alfieri S, Esposito A, Infante G, Miceli R, Ospitali S, Ripamonti CI, Borreani C. Evaluation of the CNC ® prosthetic system in recurrent breast cancer patients with chemotherapy-induced alopecia: a pilot study. BMC Womens Health 2022; 22:492. [PMID: 36463143 PMCID: PMC9719124 DOI: 10.1186/s12905-022-02080-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Chemotherapy-induced alopecia (CIA), although generally reversible, is felt as extremely distressing by patients with breast cancer. A certified medical device (Capelli Naturali a Contatto®-CNC®) was produced to provide patients with a personalized scalp prosthesis, reproducing the patient's original hair, resistant to any type of everyday or sporting activity, and hairdressing. AIMS The present study aimed to evaluate the impact of the CNC® device on the patient's perception of their body image, psychological wellbeing, satisfaction, strengths and weakness of the CNC® device. METHOD A pilot study was carried out on 21 patients affected by CIA due to recurrent breast cancer. A mixed quantitative/qualitative method was used, including administering a questionnaire and a focus group. RESULTS Based on the Body Image Scale, body image perception improved after 3 and 6 months using the device in the 20 patients who answered the questionnaire. No significant change over time emerged for the six dimensions investigated by the Italian version of the Psychological Well-Being Scale. The thematic analysis of the focus groups showed six themes: definition of the prosthetic device, acceptance of the proposal, experience with the conventional wig, strengths, weaknesses, economic issues. CONCLUSION Compared to the previous experience of CIA and the standard wig, the use of the CNC® device improved everyday life and may be proposed to women undergoing chemotherapy and expecting alopecia to prevent discomfort, social embarrassment, and compromised body image.
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Affiliation(s)
| | | | - Sara Alfieri
- grid.417893.00000 0001 0807 2568Clinical Psychology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian 1, 20133 Milan, Italy
| | | | - Gabriele Infante
- grid.4708.b0000 0004 1757 2822Laboratory of Medical Statistics, Biometry and Epidemiology “G. A. Maccacaro”, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy ,grid.417893.00000 0001 0807 2568S.S. Biostatistics for Clinical Research, Department Epidemiology and Data Science Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosalba Miceli
- grid.417893.00000 0001 0807 2568S.S. Biostatistics for Clinical Research, Department Epidemiology and Data Science Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Carla Ida Ripamonti
- grid.417893.00000 0001 0807 2568Supportive Care in Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia Borreani
- grid.417893.00000 0001 0807 2568Clinical Psychology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian 1, 20133 Milan, Italy
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11
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Meng K, Fahmer N, Engehausen D, Hass HG, Reuss-Borst M, Duelli K, Wöckel A, Heuschmann PU, Faller H. Patientenkompetenz zur Krankheitsbewältigung – eine
qualitative Analyse bei Frauen mit Brustkrebs und gynäkologischen
Tumoren. Psychother Psychosom Med Psychol 2022; 73:187-196. [PMID: 36413985 DOI: 10.1055/a-1956-9153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Zusammenfassung
Ziel Die Studie exploriert Herausforderungen, persönliche
Kompetenzen und hilfreiche Unterstützung bei der
Krankheitsbewältigung von Patienteninnen mit Brustkrebs und
gynäkologischen Tumoren und wie die Patientenkompetenz als Zusammenspiel
dieser Faktoren gefördert werden kann.
Methodik Teilstrukturierte Leitfadeninterviews wurden mit 19 Patientinnen
im Akutsetting, 20 Rehabilitandinnen und 16 Teilnehmerinnen einer
Selbsthilfegruppe geführt und mittels qualitativer Inhaltsanalyse
ausgewertet.
Ergebnisse Die thematisierten Herausforderungen sind in die
Hauptkategorien – Diagnoseverarbeitung,
Behandlungs-/Rezidivängste, Krankheitsverarbeitung und
Adaptation, Sorgen um Angehörige, Reaktionen des sozialen Umfeldes,
Sorgen um den Arbeitsplatz – zusammengefasst. Die benannten
persönlichen Kompetenzen im Umgang mit diesen Herausforderungen sind den
folgenden Hauptkategorien zugeordnet: kognitionsbezogenes Coping,
handlungsbezogenes Coping, Selbstregulation Krankheitsverarbeitung,
Unterstützung einholen und annehmen, selbstbestimmte Kommunikation der
Erkrankung, hilfreiche Strategien identifizieren und anwenden,
krankheitsbezogene Erfahrung, günstige Lebensumstände, Offenheit
für Hilfsangebote. Hilfreiche emotionale, informationelle oder
instrumentelle Unterstützung wird durch Angehörige, Freunde,
Tiere, Arbeitskollegen/Arbeitgeber, Behandler, Rehabilitation,
Mitpatientinnen/Betroffene, Selbsthilfe und Beratungseinrichtungen
wahrgenommen.
Diskussion Die Frauen beschreiben eine Vielzahl an persönlichen
Kompetenzen, die einem bedürfnisorientierten, selbstgesteuerten
Bewältigungsprozess entsprechen. Die Individualität und
Komplexität des Zusammenspiels der Komponenten der Patientenkompetenz
unterstreicht die Relevanz von patientenorientierter Versorgung. Empowerment und
eine aktive Patientenrolle sind erforderlich, um bedürfnisbezogen
Bewältigungsfertigkeiten zu fördern. Unterstützung durch
Behandler oder das private Umfeld kann dabei Herausforderungen vermindern oder
Kompetenzen und deren Anwendung fördern.
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Affiliation(s)
- Karin Meng
- Institut für Klinische Epidemiologie und Biometrie,
Julius-Maximilians-Universität Würzburg, Würzburg,
Germany
| | - Natascha Fahmer
- Institut für Klinische Epidemiologie und Biometrie,
Julius-Maximilians-Universität Würzburg, Würzburg,
Germany
| | | | - Holger G. Hass
- Abteilung Onkologie, Dep. Innere Medizin, Klinik Gais AG, Gais,
Switzerland
- Institut für Rehabilitationsforschung und Survivorship
(IREFOS), Scheidegg, Germany
| | | | - Kristin Duelli
- Universitätsklinikum Würzburg Frauenklinik und
Poliklinik, Würzburg, Germany
| | - Achim Wöckel
- Universitätsklinikum Würzburg Frauenklinik und
Poliklinik, Würzburg, Germany
| | - Peter U. Heuschmann
- Institut für Klinische Epidemiologie und Biometrie,
Julius-Maximilians-Universität Würzburg, Würzburg,
Germany
- Zentrale für Klinische Studien, Universitätsklinikum
Würzburg, Würzburg, Germany
| | - Hermann Faller
- Institut für Klinische Epidemiologie und Biometrie,
Julius-Maximilians-Universität Würzburg, Würzburg,
Germany
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12
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Lemos R, Costa B, Frasquilho D, Almeida S, Sousa B, Oliveira-Maia AJ. Cross-Cultural Adaptation and Psychometric Evaluation of the Perceived Ability to Cope With Trauma Scale in Portuguese Patients With Breast Cancer. Front Psychol 2022; 13:800285. [PMID: 35250735 PMCID: PMC8889097 DOI: 10.3389/fpsyg.2022.800285] [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: 10/22/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background The impact of a cancer diagnosis may be traumatic, depending on the psychological resources used by patients. Appropriate coping strategies are related to better adaptation to the disease, with coping flexibility, corresponding to the ability to replace ineffective coping strategies, demonstrated to be highly related with self-efficacy to handle trauma. The Perceived Ability to Cope with Trauma (PACT) scale is a self-rated questionnaire that assesses the perceived ability to cope with potentially traumatic events, providing a measure of coping flexibility. The current study aimed at examining the psychometric properties of the PACT Scale in Portuguese patients with breast cancer. Methods The study included 172 patients recently diagnosed with early breast cancer. Participants completed a Portuguese version of the PACT scale, and instruments of self-efficacy for coping with cancer (Cancer Behavior Inventory-Brief Version—CBI-B), of quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30—QLQ-C30), and of psychological distress (Hospital Anxiety and Depression Scale—HADS) that were used as convergent and divergent measures, thus assessing construct validity. A confirmatory factor analysis (CFA) was performed to test the factor structure of the Portuguese version of PACT scale and reliabilities were examined. Results Results from the CFA confirmed the two-factor structure, consistent with the original Forward and Trauma focus subscales. The two subscales demonstrated high internal consistencies. Convergent and divergent validities were confirmed: the PACT scale was related to high self-efficacy to cope with cancer (CBI-B), to high perceived quality of life (QLQ-C30), and to low psychological distress (HADS). Discussion Overall, the current results support and replicate the psychometric properties of the PACT scale. The scale was found to be a valid and reliable self-reported measure to assess Portuguese breast cancer patients regarding beliefs about their capabilities in managing the potentially traumatic sequelae of cancer. The PACT is a simple and brief measure of coping flexibility to trauma, with potential relevance for application in clinical and research settings.
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Affiliation(s)
- Raquel Lemos
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.,ISPA - Instituto Universitário de Ciências Psicológicas, Sociais e da Vida, Lisbon, Portugal
| | - Beatriz Costa
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.,NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Diana Frasquilho
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Sílvia Almeida
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.,Graduate Programme in Clinical Psychology, Faculdade de Psicologia da Universidade de Lisboa, Lisbon, Portugal
| | - Berta Sousa
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.,Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.,Ph.D Programme in Health Data Science, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.,NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
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13
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Ellawindi MI, Shoman TH, Taher E, Gohar S, Shehata S. Effectiveness of Psychosocial Supportive Care Trial on Quality of Life among Breast Cancer Patients: An Interventional Study at the National Cancer Institute, Egypt. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Breast cancer (BC) patients suffer from many psychosocial problems due to their health condition and treatment side effects so they are in great need for psychosocial supportive care.
AIM: The aim of the study was to provide a comprehensive psych-social supportive health-care model for BC patients a step toward improving their quality of life (QOL).
PATIENTS AND METHODS: Random assignment was done for 185 patients with primary operated BC to a control or an intervention group. The researcher offered five daily successive psychosocial supportive care sessions for the patients in the intervention group. All patients were followed up for coping ability, mood and QOL 8 weeks after the intervention.
RESULTS: The intervention had statistically significant effects on psychological distress, depression, problem focused, and active emotional coping domain, while had not any statistically significant effects on avoidant emotional coping domain.
CONCLUSION: Psychosocial supportive developed health-care model decreased psychological distress, depression, and improved QOL among patients with primary BC.
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