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Martinez-Calderon J, Casuso-Holgado MJ, Cano-García FJ, Heredia-Rizo AM. Integrative model for self-perception of well-being in cancer. Disabil Rehabil 2024; 46:2441-2448. [PMID: 37303159 DOI: 10.1080/09638288.2023.2222645] [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: 11/04/2022] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE Continual illness uncertainty can affect how people perceive and interpret their well-being. Some cognitive and spiritual factors may be involved in the management of disruptive thoughts and emotions that can emerge during the experience of cancer. MATERIAL AND METHODS An evidence-based integrative model was developed to evaluate and show the role that mindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life play in the self-perception of well-being in individuals with cancer. This evidence-based integrative model was conducted using relevant and selected studies. RESULTS An integrative model for self-perception of well-being has been proposed. This model integrates evidence-based findings and provides clear principles for clinicians and researchers. This integrative model proposes that mindfulness, acceptance, self-efficacy perception, and uncertainty can predict how people with cancer perceive their well-being. The model also posits that meaning and purpose in life can act as mediators or moderators of this prediction. CONCLUSIONS This integrative model involves the multidimensionality of human beings and facilitates the understanding of some key factors for the design of therapeutic approaches such as Acceptance & Commitment Therapy or Meaning-Centered Psychotherapy.IMPLICATIONS FOR REHABILITATIONMindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life can be highly relevant for clinical oncology.An integrative model is proposed to understand the combined influence of these factors on patients with cancer.This model may favor a better integration of well-known interventions, such as Mindfulness-based approaches, Acceptance and Commitment Therapy (ACT), and Meaning-Centered Psychotherapy (MCP).
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | | | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
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Parviniannasab AM, Dehghani F, Hosseini SA. The mediating role of hope in the relation between uncertainty and social support with self-management among patients with ESKD undergoing hemodialysis. BMC Nephrol 2024; 25:129. [PMID: 38609885 PMCID: PMC11010407 DOI: 10.1186/s12882-024-03558-2] [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: 12/23/2023] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Self-management behaviours are critical for patients requiring regular hemodialysis (HD) therapy. This study aimed to test the relationship between social support, uncertainty and self-management among HD patients and to explore whether hope plays a mediating role. METHODS In a cross-sectional study, a convenience sample of 212 HD patients from two hospitals completed the Perceived Social Support Scale (PSSS), Herth Hope Index (HHI), Short form Mishel Uncertainty in Illness Scale (SF-MUIS), and hemodialysis Self-Management Instrument (HD-SMI). Data were analysed using structural equation modelling. RESULTS The main finding indicated that social support positively affected self-management (β = 0.50, t = 4.97, p < 0.001), and uncertainty negatively affected self-management (β =-0.37, t=-4.12, p = < 0.001). In mediational model analysis, the effect of social support on self-management was fully mediated [(β = 0.12; 95% BC CI (0.047, 0.228)] by hope. Also, the effect of uncertainty on self-management was fully mediated [(β=- 0.014; 95% BC CI (-0.114, -0.003)] by hope. CONCLUSIONS "Considering factors influencing self-management in HD patients is crucial for improving quality of life. Receiving support and informational resources can not only foster hope but also reduce their uncertainty, thus aiding in enhancing clinical outcomes, quality of life, and reducing complications. "Health care providers, especially nurses were advised to accept the existence of uncertainty, help patients make optimal use of support resources, and give more importance to disambiguation to reassure them. Therefore, well-designed interventions that enhance social support and hope and reduce uncertainty may help improve self-management behaviour in HD patients.
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Affiliation(s)
| | - Fatemeh Dehghani
- Bachelor of Science in Nursing, Larestan University of Medical Sciences, Larestan, Iran
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Wu S, Guo X, Tang H, Li Y, Dong W, Lu G, Hou C, Chen C. The Relationship Between Illness Uncertainty and Social Support Among Cancer Patients: A Meta-analysis. Cancer Nurs 2024:00002820-990000000-00223. [PMID: 38447045 DOI: 10.1097/ncc.0000000000001328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND As a common psychological problem in cancer patients, illness uncertainty has attracted wide attention from scholars. Some studies have pointed out that the level of social support may affect illness uncertainty in patients with cancer, but the results of these studies remain controversial. OBJECTIVE The aim of this study was to evaluate the correlation between illness uncertainty and social support in patients with cancer using meta-analysis. METHODS PubMed, Web of Science, EMBASE, EBSCO, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and VIP Citation Database were searched for articles published up to 2022. The screening of the literature, data extraction, and quality assessment of the included studies were performed independently by 2 researchers. Stata 17.0 software was used to analyze the overall and moderation effects. RESULTS Notably, 41 studies involving 5403 patients were included. The results showed that the illness uncertainty of adults with cancer was moderately negatively correlated with social support (r = -0.33). Country, publication year, cancer type, and instrument used to measure social support moderated the association between illness uncertainty and social support. CONCLUSION Improving the level of social support can reduce illness uncertainty experienced by adults with cancer to a certain extent. IMPLICATIONS FOR PRACTICE This review provides a clear direction for implementing precise interventions to reduce illness uncertainty among adults with cancer. Furthermore, patients with cancer with high morbidity and mortality rates deserve greater attention from healthcare personnel and family caregivers.
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Affiliation(s)
- Sijia Wu
- Author Affiliations: Institute of Nursing and Health, School of Nursing and Health (Mss Wu, Guo, Tang, Li, Dong, and Hou, and Dr Chen); and Institute of Business Administration, School of Business (Dr Lu), Henan University, Kaifeng, China
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Nabi Foodani M, Abbasi Dolatabadi Z, Rahbariyan A, Rasti A, Jafaryparvar Z, Zakerimoghadam M. Perceived Stress and Level of Uncertainty Among Hospitalized COVID-19 Patients. SAGE Open Nurs 2024; 10:23779608241234980. [PMID: 38476571 PMCID: PMC10929029 DOI: 10.1177/23779608241234980] [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: 11/02/2023] [Revised: 01/11/2024] [Accepted: 02/02/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Disease uncertainty refers to the inability to assign meaning to events related to the illness. Uncertainty of the disease can affect various aspects of human life such as psychological aspects. Objectives This study aims to examine the relationship between disease uncertainty and perceived stress in COVID-19 patients. Methods An analytical cross-sectional study was conducted on 212 hospitalized COVID-19 patients who were initially admitted to the intensive care units (ICUs) and later transferred to general wards within the same hospitals. Three instruments were utilized to collect data for this study. The Demographic Information Questionnaire, Mishel Uncertainty in Illness Scale (MUIS) for disease uncertainty, and Perceived Stress Questionnaire. For data analysis, both descriptive and inferential statistics were employed using IBM SPSS Statistics version 25. Results The Pearson correlation coefficient matrix results showed a positive and significant relationship between uncertainty about the illness (P < .001, r = 0.829), ambiguity (P < .001, r = 0.795), complexity (P < .001, r = 0.835), inconsistency or instability (P < .001, r = 0.787), and unpredictability (P < .001, r = 0.776) with perceived stress in COVID-19 patients transferred from the intensive care units. Conclusion Based on the findings of the current study, both uncertainty and perceived stress are elevated among COVID-19 patients, and a significant and direct relationship exists between these two variables. Healthcare providers, particularly nurses, should address the uncertainties surrounding emerging diseases, both at the hospital and community levels.
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Affiliation(s)
- Mahdi Nabi Foodani
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Abbasi Dolatabadi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Rahbariyan
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Rasti
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zakiyeh Jafaryparvar
- Ph.D. Candidate of Nursing Research, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Zakerimoghadam
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Tan H. The mediating role of anxiety in disease uncertainty and acute stress in acute ischaemic stroke patients in the post-epidemic era. Front Psychiatry 2023; 14:1218390. [PMID: 37915800 PMCID: PMC10616834 DOI: 10.3389/fpsyt.2023.1218390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/01/2023] [Indexed: 11/03/2023] Open
Abstract
Objective To analyse the influencing factors of anxiety, disease uncertainty and acute stress response in patients with acute ischaemic stroke, and to verify the mediating role of anxiety in the post-epidemic era. Methods 240 patients with acute ischaemic stroke were selected from a tertiary hospital in Wuhan City and investigated by questionnaire and convenience sampling methods. Results The total anxiety score, disease uncertainty and acute stress reaction were at moderate levels. Anxiety was positively correlated with illness uncertainty, and anxiety and acute stress response were negatively correlated. Multiple linear regression analysis showed that Sickness uncertainty, acute stress response, age, and work status influenced anxiety. Anxiety mediated the prediction of Sickness uncertainty and acute stress response, with the mediating effect accounting for 35.6% of the total effect. Conclusion Disease uncertainty in patients with acute ischaemic stroke in the post-epidemic era directly affects the acute stress response and indirectly through anxiety.
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Affiliation(s)
- Hui Tan
- Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University/Quzhou Hospital of Traditional Chinese Medicine, Quzhou, China
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Guan T, Chapman MV, de Saxe Zerden L, Sharma A, Chen DG, Song L. Correlates of illness uncertainty in cancer survivors and family caregivers: a systematic review and meta-analysis. Support Care Cancer 2023; 31:242. [PMID: 36977804 DOI: 10.1007/s00520-023-07705-7] [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: 11/01/2022] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE Illness uncertainty is widely recognized as a psychosocial stressor for cancer survivors and their family caregivers. This systematic review and meta-analysis aimed to identify the sociodemographic, physical, and psychosocial correlates that are associated with illness uncertainty in adult cancer survivors and their family caregivers. METHODS Six scholarly databases were searched. Data synthesis was based on Mishel's Uncertainty in Illness Theory. Person's r was used as the effect size metric in the meta-analysis. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS Of 1116 articles, 21 articles met the inclusion criteria. Of 21 reviewed studies, 18 focused on cancer survivors, one focused on family caregivers, and 2 included survivors and family caregivers. Findings identified distinct correlates for illness uncertainty in cancer survivors, including sociodemographic factors (e.g., age, gender, race), stimuli frame (e.g., symptom, family history of cancer), structure providers (e.g., education), coping, and adaptation. Notable effect sizes were observed in the correlations between illness uncertainty and social support, quality of life, depression, and anxiety. Caregivers' illness uncertainty was associated with their race, general health, perception of influence, social support, quality of life, and survivors' prostate-specific antigen levels. Insufficient data precluded examining effect size of correlates of illness uncertainty among family caregivers. CONCLUSION This is the first systematic review and meta-analysis to summarize the literature on illness uncertainty among adult cancer survivors and family caregivers. Findings contribute to the growing literature on managing illness uncertainty among cancer survivors and family caregivers.
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Affiliation(s)
- Ting Guan
- Syracuse University, School of Social Work, 226 White Hall, Syracuse, Syracuse, NY, 13244, USA.
| | - Mimi V Chapman
- University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, NC, USA
| | - Lisa de Saxe Zerden
- University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, NC, USA
| | - Anjalee Sharma
- School of Medicine Johns Hopkins University, Baltimore, MD, USA
| | - Ding-Geng Chen
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
- Department of Statistics, University of Pretoria, Pretoria, South Africa
| | - Lixin Song
- UT Health San Antonio, School of Nursing, San Antonio, TX, USA
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Hao R, Zhang M, Zuo J, Qi Y, Hu J. Contribution of coping style to the association between illness uncertainty and demoralisation in patients with breast cancer: a cross-sectional mediation analysis. BMJ Open 2023; 13:e065796. [PMID: 36927587 PMCID: PMC10030480 DOI: 10.1136/bmjopen-2022-065796] [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] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVE Demoralisation is a common psychological issue in patients with cancer and aggravates depression, reduces the quality of life and even causes suicidal ideation. There is a lack of knowledge about illness uncertainty, coping style and demoralisation in patients with breast cancer. The current study explored the relationship between illness uncertainty and demoralisation among those patients, as well as the potential mediating role of coping style. DESIGN A cross-sectional study. SETTING Participants were recruited from the Breast Tumor Center in a tertiary hospital in Shijiazhuang, Hebei province. PARTICIPANTS A total of 211 patients with breast cancer completed the survey. OUTCOME MEASURES A total of 211 patients with breast cancer completed the Mishel's Uncertainty in Illness Scale, Trait Coping Style Questionnaire and the Mandarin version of Demoralization Scale (DS-MV). RESULTS Of the patients, 47.40% exhibited symptoms of demoralisation (DS-MV>30), and the mean of demoralisation score was (29.55±13.21). The results demonstrated that illness uncertainty and negative coping styles were positively related to demoralisation (p<0.001), while active coping styles were negatively related to demoralisation (p<0.001). Importantly, coping styles could partially mediate the relationship between illness uncertainty and demoralisation (p<0.01). CONCLUSION Our study illustrated that illness uncertainty was associated with demoralisation in patients with breast cancer, and coping style acted as a mediator in this relationship. The findings highlighted the critical role of reducing negative coping styles to the early prevention and efficient treatment of demoralisation among those patients.
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Affiliation(s)
- Ran Hao
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Meng Zhang
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China
- Critical Medicine, Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jinfan Zuo
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yixin Qi
- Department of Breast Center, The Fourth Hospital of Hebei Medical University Cancer Institute, Shijiazhuang, Hebei, China
| | - Jie Hu
- Department of Science and Technology, Hebei Medical University, Shijiazhuang, Hebei, China
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Zou G, Simons A, Toland S. An exploration of the effects of information giving and information needs of women with newly diagnosed early-stage breast cancer: A mixed-method systematic review. Nurs Open 2022; 9:2586-2601. [PMID: 34313018 PMCID: PMC9584490 DOI: 10.1002/nop2.994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/16/2021] [Accepted: 07/10/2021] [Indexed: 02/05/2023] Open
Abstract
AIM To review the information needs of women with newly diagnosed early-stage breast cancer and the effects of information giving by measuring patient-reported outcomes. DESIGN A mixed-method systematic review using PRISMA guidelines. METHODS The major electronic nursing databases were searched from inception until 31 December 2019 using key terms. Included studies were assessed using the Crowes Critical Appraisal Tool. RESULTS Four quantitative studies and two qualitative studies, comprising of 537 participants (age range from 25 to 98 years), were included for the ultimate qualitative synthesis of this review. There was high-level evidence that demonstrated the prevalence of these groups of women's information needs and their improvement in fighting spirit and decrease in helplessness/hopelessness for information giving interventions; low-level evidence of long-term adjustment and well-being improvement; and limited evidence indicating that inadequate information, including restricted information, too much information and conflicting information could cause some ramifications.
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Affiliation(s)
- Guanfa Zou
- The First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Alison Simons
- Faculty of Health, Education and Life SciencesSchool of Nursing and MidwiferyBirmingham City UniversityBirminghamUK
| | - Samantha Toland
- Faculty of Health, Education and Life SciencesSchool of Nursing and MidwiferyBirmingham City UniversityBirminghamUK
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Unmet Care Needs and Uncertainty in Patients Newly Diagnosed with Breast Cancer. Healthcare (Basel) 2022; 10:healthcare10112148. [PMID: 36360489 PMCID: PMC9691238 DOI: 10.3390/healthcare10112148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 11/17/2022] Open
Abstract
Breast cancer is the most common cancer in women in the world. Statistics revealed the number of breast cancer patients less than 40 years of age increased over time. Clinical studies found there is a trend of yearly illness happening in younger patients, whose needs related to the illness are different from older patients. The purpose of this study was to explore the uncertainty and needs of patients in different age groups who were newly diagnosed with breast cancer. A descriptive cross-sectional survey study was adopted to recruit 128 patients. The Mishel’s Uncertainty in Illness Scale (MUIS, Chinese version) and the Cancer Needs Questionnaire (short-form, CNQ-SF) were used to collect data. The results revealed that a patient’s age and religion negatively correlated with illness uncertainty. A patient’s age, educational level, work or not, and children’s age correlated with needs for care. Age, illness uncertainty, and educational level were important predictors of the needs of care, with an explanatory power of 29.0%. In Conclusion, patients ≤40 years of age had greater illness uncertainty and needs for care than those who were >40 years of age. For younger patients newly diagnosed with cancer, medical professionals should take the initiative to provide detailed and complete information on breast cancer treatment plans, prognosis, and home self-care, which helps clarify the possible future treatments and results and further enables patients to acquire self-care skills and knowledge.
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Djambazov S, Giammanco MD, Gitto L. Econometric analysis of oncology patients' Health-Related Quality of Life determinants in Bulgaria. Cent Eur J Public Health 2022; 30:160-165. [DOI: 10.21101/cejph.a7095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 07/27/2022] [Indexed: 11/15/2022]
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Objectification and ambiguity of body image in women with Polycystic Ovary Syndrome: A mixed-method study. J Affect Disord 2022; 310:296-303. [PMID: 35561883 DOI: 10.1016/j.jad.2022.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The manifestations of Polycystic Ovary Syndrome (PCOS), including acne, hirsutism, obesity, uncertain fertility, etc., can make women anxious, worried, or even depressed with their appearance and body. However, little relevant research has been conducted in the Chinese context. This mixed-method study aimed to understand how women with PCOS in China perceive their bodies and to examine the association between body image and depression. METHODS First, 101 PCOS patients participated in a survey using the Body Surveillance subscale of the Objectified Body Consciousness Scale, the Short-form Mishel Uncertainty in Illness Scale, the Appearance Anxiety Scale, and the Beck Depression Inventory-II, which measured participants' self-objectification, illness ambiguity, appearance anxiety, and depression, respectively. Second, fifteen women joined face-to-face semi-structured in-depth interviews, investigating their illness ambiguity, objectified experience, and behaviors to pursue beauty. RESULTS Results indicated a high level of self-objectification, illness ambiguity, appearance anxiety, and depression among women with PCOS in China and supported the significant associations among the outcomes. Qualitative findings presented a body image of the precarious body, indiscernible identity, and distraught mind. LIMITATIONS A convenient sampling method was used. The generalization of the study results needs further validation. Future longitudinal studies are necessary to clarify the causal relationships among outcomes. CONCLUSIONS This study presented women's body image with PCOS and found the negative impact of body image on their depression levels. This study was of both theoretical and practical significance. Appropriate mind-body therapies were suggested for them.
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Uncertainty and the unmet informational needs of patients with cancer of unknown primary (CUP): a cross-sectional multi-site study. Support Care Cancer 2022; 30:8217-8229. [PMID: 35804177 PMCID: PMC9512714 DOI: 10.1007/s00520-022-07228-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/13/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to determine the healthcare experiences, quality of life, and psychosocial needs of patients with cancer of unknown primary (CUP) early after diagnosis; comparing their experiences to patients with advanced cancer of a known primary (non-CUP control patients) and published general population reference data where available. METHODS This study was a cross-sectional, multi-site study comparing CUP patients (n = 139) compared to non-CUP controls (n = 45). Demographic, clinical information and patient-reported outcome questionnaire data were collected at baseline. RESULTS Differences in healthcare experienced were found between CUP and non-CUP controls with CUP patients reporting higher scores for unmet medical communication/information needs compared with non-CUP control patients (p = 0.013) as well as greater uncertainty in illness (p = 0.042). Whilst no differences were found between CUP and non-CUP controls on the EORTC and PROMIS measures, of those that 'received written information about your cancer…' and asked '…how useful was it?' fewer CUP patients reported finding the information useful 40% vs 61%, and more were likely to not have received written information at all 59% vs 32%; (p = 0.002). Additionally, of those that found information about their cancer online, fewer patients with CUP reported finding it useful 32% vs 48% control patients (p = 0.005). CONCLUSIONS CUP patients have unmet medical communication/information needs and greater uncertainty in illness but do not differ in health-related quality of life domains compared to patients with advanced cancer of a known primary.
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Huang WJ, Liang YY, Yang Q, Ma X. Nocturnal enuresis in children: Parents' perspectives. Nurs Open 2022; 9:2335-2341. [PMID: 35661439 PMCID: PMC9374395 DOI: 10.1002/nop2.1243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/21/2022] [Accepted: 05/06/2022] [Indexed: 02/05/2023] Open
Abstract
AIM Parents of children with nocturnal enuresis (NE) may have uncertainty and anxiety. This study aimed to investigate the level of uncertainty and anxiety in the parents of children with NE and analyse its influencing factors. DESIGN We conducted a descriptive cross-sectional study among the parents of children with NE in China. METHODS A general information questionnaire, the Parent Perception of Uncertainty Scale (PPUS), and the Self-Rating Anxiety Scale (SAS) were used. Multiple linear regression analysis was used to identify factors influencing the parental uncertainty level independently. RESULTS A total of 247 valid questionnaires were collected. The PPUS score of children with NE was 81.18 ± 10.82, and the anxiety self-rating scale score was 41.86 ± 9.20. Parents' working status, the family's per capita monthly income, and the children's treatment time were the main influencing factors of parental illness uncertainty.
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Affiliation(s)
- Wen-Jiao Huang
- West China School of Nursing/Department of Pediatric Surgery, Sichuan University, Chengdu, China
| | - Yuan-Yuan Liang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Yang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Ma
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
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Søiland H, Janssen EAM, Helland T, Eliassen FM, Hagland M, Nordgård O, Lunde S, Lende TH, Sagen JV, Tjensvoll K, Gilje B, Jonsdottir K, Gudlaugsson E, Lode K, Hagen KB, Gripsrud BH, Lind R, Heie A, Aas T, Austdal M, Egeland NG, Bernklev T, Lash TL, Skartveit L, Kroksveen AC, Oltedal S, Kvaløy JT, Lien EA, Sleire L, Mellgren G. Liquid biopsies and patient-reported outcome measures for integrative monitoring of patients with early-stage breast cancer: a study protocol for the longitudinal observational Prospective Breast Cancer Biobanking (PBCB) study. BMJ Open 2022; 12:e054404. [PMID: 35487718 PMCID: PMC9058781 DOI: 10.1136/bmjopen-2021-054404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Breast cancer is still the most common malignancy among women worldwide. The Prospective Breast Cancer Biobank (PBCB) collects blood and urine from patients with breast cancer every 6 or 12 months for 11 years from 2011 to 2030 at two university hospitals in Western Norway. The project aims to identify new biomarkers that enable detection of systemic recurrences at the molecular level. As blood represents the biological interface between the primary tumour, the microenvironment and distant metastases, liquid biopsies represent the ideal medium to monitor the patient's cancer biology for identification of patients at high risk of relapse and for early detection systemic relapse.Including patient-reported outcome measures (PROMs) allows for a vast number of possibilities to compare PROM data with biological information, enabling the study of fatigue and Quality of Life in patients with breast cancer. METHODS AND ANALYSIS A total of 1455 patients with early-stage breast cancer are enrolled in the PBCB study, which has a one-armed prospective observational design. Participants consent to contribute liquid biopsies (i.e., peripheral blood and urine samples) every 6 or 12 months for 11 years. The liquid biopsies are the basis for detection of circulating tumour cells, circulating tumour DNA (ctDNA), exosomal micro-RNA (miRNA), miRNA in Tumour Educated Platelet and metabolomic profiles. In addition, participants respond to 10 PROM questionnaires collected annually. Moreover, a control group comprising 200 women without cancer aged 25-70 years will provide the same data. ETHICS AND DISSEMINATION The general research biobank PBCB was approved by the Ministry of Health and Care Services in 2007, by the Regional Ethics Committee (REK) in 2010 (#2010/1957). The PROM (#2011/2161) and the biomarker study PerMoBreCan (#2015/2010) were approved by REK in 2011 and 2015 respectively. Results will be published in international peer reviewed journals. Deidentified data will be accessible on request. TRIAL REGISTRATION NUMBER NCT04488614.
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Affiliation(s)
- Håvard Søiland
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Emiel A M Janssen
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway
| | - Thomas Helland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Finn Magnus Eliassen
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Magnus Hagland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Oddmund Nordgård
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
- Department of Chemistry, Bioscience, University of Stavanger, Stavanger, Norway
| | - Siri Lunde
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Tone Hoel Lende
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Jørn Vegard Sagen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Kjersti Tjensvoll
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Bjørnar Gilje
- Department of Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Kristin Jonsdottir
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Einar Gudlaugsson
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
| | - Kirsten Lode
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| | - Kari Britt Hagen
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway
| | - Birgitta Haga Gripsrud
- Faculty of Health Sciences Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| | - Ragna Lind
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Anette Heie
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway
| | - Turid Aas
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway
| | - Marie Austdal
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Nina Gran Egeland
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Tomm Bernklev
- Central Hospital in Vestfold, Tønsberg, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Timothy L Lash
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Linn Skartveit
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | | | - Satu Oltedal
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Jan Terje Kvaløy
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Mathematics and Physics, Department of Mathematics and Natural Science, University of Stavanger, Stavanger, Norway
| | - Ernst A Lien
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Linda Sleire
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Gunnar Mellgren
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Laboratory Medicine and Pathology, Haukeland University Hospital, Bergen, Norway
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Yu Z, Sun D, Sun J. Social Support and Fear of Cancer Recurrence Among Chinese Breast Cancer Survivors: The Mediation Role of Illness Uncertainty. Front Psychol 2022; 13:864129. [PMID: 35369168 PMCID: PMC8966644 DOI: 10.3389/fpsyg.2022.864129] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/24/2022] [Indexed: 12/01/2022] Open
Abstract
Objective To examine the relations between social support, illness uncertainty (IU), and fear of cancer recurrence (FCR). Methods Using data from a convenience sample of 231 breast cancer survivors in China to perform structural equation modeling with bootstrapping estimation. Participants were recruited from a general hospital in Shenyang, China. Participants completed the Perceived Social Support Scale, Mishel Uncertainty in Illness Scale, and Fear of Cancer Recurrence Inventory- Shorter Form. Results The majority of breast cancer survivors have FCR (67.5%). FCR was significantly negatively associated with social support, and was significantly positively associated with IU (both P < 0.01). Moreover, IU was found to mediate the relationship between social support and FCR (standardized indirect effect = -0.18; bias-corrected 95% confidence interval: -0.255, -0.123). Conclusion The findings support the final model. Good social support can directly mitigate FCR, while illness uncertainty can play a mediation role between social support and FCR. Further studies should be conducted to explore effective interventions for social support and IU to ultimately mitigate FCR in cancer survivors.
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Affiliation(s)
- Zhichao Yu
- Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, China
| | - Di Sun
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Jia Sun
- Department of Obstetrics, Shengjing Hospital of China Medical University, Shenyang, China
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16
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Rogers CC, Pope S, Whitfield F, Cohn WF, Valdez RS. The lived experience during the peri-diagnostic period of breast cancer: A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:547-585. [PMID: 34210570 DOI: 10.1016/j.pec.2021.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The aim of this scoping review is to provide an overview of the existing research that investigates the lived experience during the peri-diagnostic period of breast cancer. METHODS Nine databases were searched for relevant literature between January 2007 and April 2019. Data were extracted and categorized using deductive and inductive approaches. RESULTS A majority of the 66 studies included used qualitative methods to retrospectively explore the treatment decision making process of female breast cancer patients. Patients experienced uncertainty, emotional distress, and a need for more information from providers and relied on social support and family guidance during this period. CONCLUSIONS The results of this review show that the burdens experienced during the peri-diagnostic period parallel those in later periods of cancer care. However, these burdens are prompted by different circumstances. More research is needed to explore the lived experience during this period through the use of mixed-methods and by recruiting a diverse sample with regards to role in the breast cancer experience, age, gender, race, and ethnicity. PRACTICE IMPLICATIONS Interventions positioned at earlier points in the breast cancer experience should provide informational support, which could be delivered through shared decision making models. Additional support could be facilitated by patient navigation programs and health information technology.
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Affiliation(s)
- Courtney C Rogers
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Shannon Pope
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Francesca Whitfield
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Wendy F Cohn
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Rupa S Valdez
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States.
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Cal A, Aydin Avci I. Turkish adaptation of the Mishel uncertainty in illness scale-community form. Perspect Psychiatr Care 2021; 57:2006-2013. [PMID: 34121185 DOI: 10.1111/ppc.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The study aims to conduct the Turkish validity and reliability study of the Mishel uncertainty in illness scale-community form. DESIGN AND METHODS This is a study with a methodological design. It was carried out in a family health center in a province in the Black Sea Region between May and October 2019. The sample of the study consisted of 479 individuals with chronic diseases. The data were analyzed with exploratory and confirmatory factor analysis. FINDINGS The Cronbach's alpha was found to be 0.79. The fit indices of the 20-item scale with three-factor structure are at an acceptable level (root mean square error of approximation: 0.056; comparative fit index: 0.926; incremental fix index: 0.927; goodness of fit index: 0.918; Tucker-Lewis index: 0.915; adjusted goodness of fit index: 0.896; χ2 /SD: 2.481, p < 0.001). PRACTICE IMPLICATIONS The level of uncertainty revealed by the scale gives information about the chronic disease management of individuals.
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Affiliation(s)
- Ayse Cal
- Department of Nursing, Ankara Medipol University School of Health Sciences, Ankara, Turkey
| | - Ilknur Aydin Avci
- Department of Public Health Nursing, Ondokuz Mayıs University Health School, Samsun, Turkey
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McKay SC, Lembach H, Hann A, Okoth K, Anderton J, Nirantharakumar K, Magill L, Torlinska B, Armstrong M, Mascaro J, Inston N, Pinkney T, Ranasinghe A, Borrows R, Ferguson J, Isaac J, Calvert M, Perera T, Hartog H. Health-related quality of life, uncertainty and coping strategies in solid organ transplant recipients during shielding for the COVID-19 pandemic. Transpl Int 2021; 34:2122-2137. [PMID: 34378227 PMCID: PMC8420473 DOI: 10.1111/tri.14010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/22/2021] [Accepted: 08/05/2021] [Indexed: 11/27/2022]
Abstract
Strict isolation of vulnerable individuals has been a strategy implemented by authorities to protect people from COVID‐19. Our objective was to investigate health‐related quality of life (HRQoL), uncertainty and coping behaviours in solid organ transplant (SOT) recipients during the COVID‐19 pandemic. A cross‐sectional survey of adult SOT recipients undergoing follow‐up at our institution was performed. Perceived health status, uncertainty and coping strategies were assessed using the EQ‐5D‐5L, Short‐form Mishel Uncertainty in Illness Scale (SF‐MUIS) and Brief Cope, respectively. Interactions with COVID‐19 risk perception, access to health care, demographic and clinical variables were assessed. The survey was completed by 826 of 3839 (21.5%) invited participants. Overall, low levels of uncertainty in illness were reported, and acceptance was the major coping strategy (92%). Coping by acceptance, feeling protected, self‐perceived susceptibility to COVID‐19 were associated with lower levels of uncertainty. Health status index scores were significantly lower for those with mental health illness, compromised access to health care, a perceived high risk of severe COVID‐19 infection and higher levels of uncertainty. A history of mental health illness, risk perceptions, restricted healthcare access, uncertainty and coping strategies was associated with poorer HRQoL in SOT recipients during strict isolation. These findings may allow identification of strategies to improve HRQoL in SOT recipients during the pandemic.
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Affiliation(s)
- Siobhan C McKay
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom.,Department of Academic Surgery, University of Birmingham, Edgbaston, Birmingham, B15 2TH, United Kingdom
| | - Hanns Lembach
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
| | - Angus Hann
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
| | - Kelvin Okoth
- Birmingham Centre for Observational and Prospective Studies (BiCOPS), University of Birmingham, Edgbaston, Birmingham, B15 2TH, United Kingdom
| | - Joy Anderton
- Patient Research Partner, Liver & Gastro-Intestinal Patient and Public Involvement Group, Birmingham Biomedical Research Centre, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Birmingham Centre for Observational and Prospective Studies (BiCOPS), University of Birmingham, Edgbaston, Birmingham, B15 2TH, United Kingdom
| | - Laura Magill
- Birmingham Centre for Observational and Prospective Studies (BiCOPS), University of Birmingham, Edgbaston, Birmingham, B15 2TH, United Kingdom
| | - Barbara Torlinska
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TH, United Kingdom
| | - Matthew Armstrong
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
| | - Jorge Mascaro
- Cardiothoracic Surgery Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
| | - Nicholas Inston
- Renal Surgery Unit, Queen Elizabeth Hospital Birmingham Mindelsohn way, Birmingham, United Kingdom
| | - Thomas Pinkney
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TH, United Kingdom
| | - Aaron Ranasinghe
- Cardiothoracic Surgery Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
| | - Richard Borrows
- Renal Surgery Unit, Queen Elizabeth Hospital Birmingham Mindelsohn way, Birmingham, United Kingdom
| | - James Ferguson
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
| | - John Isaac
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TH, United Kingdom
| | - Thamara Perera
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
| | - Hermien Hartog
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn way, Birmingham, B152GW, United Kingdom
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Lan CF, Nie CL, Lin YJ. Uncertainty in illness and the coping styles of severe patients with COVID-19: Current status and correlation. Epidemiol Infect 2021; 149:1-22. [PMID: 34233777 PMCID: PMC8365106 DOI: 10.1017/s0950268821001448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 06/06/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to investigate the characteristics of uncertainty in illness and the coping styles of patients with severe coronavirus 2019 (COVID-19) and to explore their relationship to provide effective guidance for clinical nursing. A cross-sectional survey was used to investigate 56 severe patients with COVID-19 in a designated hospital in Wuhan. A general information questionnaire, the Mishel Uncertainty in Illness Scale for Adults (MUIS-A) and the Medical Coping Modes Questionnaire (MCMQ) were used to collect the data. A statistical analysis was performed. The total score of the MUIS-A was a 66.29 ± 17.25 which was at a low level, while the total score of the MCMQ was 54.16 ± 6.39. The scores of facing and avoiding were significantly higher than those in the norm. The difference in the yielding dimension of patients with different family economic situations was statistically significant. The total score of MUIS-A correlated negatively with the coping style of facing and avoiding and positively correlated with the coping style of yielding. The coping style of patients was one of the factors influencing uncertainty in illness. Nursing staff need to pay close attention to the psychological state of their patients, understand their coping styles and actively correct negative coping styles to reduce the uncertainty in illness and promote physical as well as mental recovery.
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Affiliation(s)
- Cai-Feng Lan
- Department of Gynecology, Fujian Medical University Union Hospital, Fuzhou350001, China
| | - Cai-Ling Nie
- Department of Gynecology, Fujian Medical University Union Hospital, Fuzhou350001, China
| | - Yan-Juan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou350001, China
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Badr H, Oluyomi A, Adel Fahmideh M, Raza SA, Zhang X, El-Mubasher O, Amos C. Psychosocial and health behavioural impacts of COVID-19 pandemic on adults in the USA: protocol for a longitudinal cohort study. BMJ Open 2020; 10:e044642. [PMID: 33371050 PMCID: PMC7757396 DOI: 10.1136/bmjopen-2020-044642] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/07/2020] [Accepted: 11/26/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Although social distancing may help contain the spread of COVID-19, the social isolation and loneliness it causes can heighten stress, contribute to unhealthy lifestyle behaviours and have deleterious effects on social relationships. This ongoing longitudinal cohort study aims to (1) characterise the psychological, social and health behavioural impacts of the COVID-19 pandemic over a 12-month period in the USA; (2) determine whether these impacts differ for certain subgroups based on sociodemographics and other individual-level factors; and (3) explore whether there are modifiable factors (eg, coping, social support) that moderate the effects of the pandemic over time. METHODS AND ANALYSIS Adults (aged ≥18 years) who were fluent in either English or Spanish were recruited via social media and invited to complete an online survey during the 8-week period from 13 April to 8 June 2020 (baseline). Follow-up surveys will be conducted 6 and 12 months after baseline. Data transformations, non-parametric tests or other alternative methods will be used when appropriate. Descriptive statistics and cross-sectional analyses will be performed. Longitudinal associations will be analysed using multilevel modelling with time-variant and time-invariant predictors of change in trajectory over the study period. ETHICS AND DISSEMINATION Research ethics approval was received from the Baylor College of Medicine Institutional Review Board (H-47505). Overall, this study will provide timely information that can be used to inform public health messaging strategies and guide development of assessment tools and interventions to support vulnerable individuals dealing with the long-term impacts of the COVID-19 pandemic.
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Affiliation(s)
- Hoda Badr
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Abiodun Oluyomi
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Maral Adel Fahmideh
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Syed Ahsan Raza
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Xiaotao Zhang
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ola El-Mubasher
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Christopher Amos
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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Guan T, Guo P, Judge Santacroce S, Chen DG, Song L. Illness Uncertainty and Its Antecedents for Patients With Prostate Cancer and Their Partners. Oncol Nurs Forum 2020; 47:721-731. [PMID: 33063780 DOI: 10.1188/20.onf.721-731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Guided by Mishel's uncertainty in illness theory, patterns of change in uncertainty were explored over time for patients with prostate cancer and their partners. In addition, the relationships between uncertainty and its antecedents were examined, and the role effects (patient versus partner) on these relationships were assessed. SAMPLE & SETTING This study is a secondary analysis of the longitudinal data collected from a randomized clinical trial. METHODS & VARIABLES The current authors fitted multiple-level models that included time-invariant baseline variables (sociodemographics and cancer factors) and time-varying variables (uncertainty, symptoms, and social support) measured at baseline and at 4, 8, and 12 months thereafter. RESULTS No statistically significant patterns of change in uncertainty over time were detected. Partners reported greater uncertainty than patients. Higher uncertainty was associated with more general and prostate cancer-specific symptoms, recurrent and advanced prostate cancer, higher prostate-specific antigen level, and lower social support. More urinary symptoms were associated with greater uncertainty in patients than in partners. IMPLICATIONS FOR NURSING Uncertainty management can be tailored for and target symptom management and social support.
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Affiliation(s)
- Ting Guan
- University of North Carolina at Chapel Hill
| | - Peiran Guo
- University of North Carolina at Chapel Hill
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22
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Lembo RJ, Gullick J, Chow CK, Figtree GA, Kozor R. A Study of Patient Satisfaction and Uncertainty in a Rapid Access Chest Pain Clinic. Heart Lung Circ 2020; 29:e210-e216. [DOI: 10.1016/j.hlc.2020.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 12/22/2019] [Accepted: 01/31/2020] [Indexed: 11/26/2022]
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23
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Diabetic Foot Ulcer Patients' Uncertainty Regarding Their Prognosis: A Q-Methodological Study. J Wound Ostomy Continence Nurs 2020; 46:531-538. [PMID: 31738306 DOI: 10.1097/won.0000000000000597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this qualitative study was to identify the subjective patient perspectives toward the uncertainty regarding diabetic foot ulcer (DFU) prognosis. DESIGN Q-methodology, which is a qualitative method for analyzing subjective viewpoints, was used. SUBJECTS AND SETTING Forty patients with DFUs who were admitted to the diabetic wound center of a university hospital in Seoul, South Korea. METHODS Data were collected on the subjective viewpoint of patients regarding their DFU prognosis uncertainty and analyzed by the software program PQMethod 2.35 using a principal component analysis and varimax rotation. RESULTS This study revealed 4 factors characterizing patient subjective experience related to DFU prognosis: confusion from a lack of knowledge, concerns about a negative future, overdependence on information, and expectations for a positive outlook about favorable results. CONCLUSION The findings of this study suggest various intervention methods for patients with DFU facing uncertainty about their prognosis based on the 4 viewpoints identified. The identification of the factor causing uncertainty and integration of all uncertainty factors are expected to be used as the basis for reducing patients' uncertainty and helping nurses care for patients more effectively.
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Lyhne JD, Smith A‘B, Frostholm L, Fink P, Jensen LH. Study protocol: a randomized controlled trial comparing the efficacy of therapist guided internet-delivered cognitive therapy (TG-iConquerFear) with augmented treatment as usual in reducing fear of cancer recurrence in Danish colorectal cancer survivors. BMC Cancer 2020; 20:223. [PMID: 32178640 PMCID: PMC7076981 DOI: 10.1186/s12885-020-06731-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/09/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cognitive therapy has been shown to reduce fear of cancer recurrence (FCR), mainly in breast cancer survivors. The accessibility of cognitive behavioural interventions could be further improved by Internet delivery, but self-guided interventions have shown limited efficacy. The aim of this study is to test the efficacy of a therapist guided internet-delivered intervention (TG-iConquerFear) vs. augmented treatment as usual (aTAU) in Danish colorectal cancer survivors. METHODS/DESIGN A population-based randomized controlled trial (RCT) comparing TG-iConquerFear with aTAU (1:1) in n = 246 colorectal cancer survivors who suffer from clinically significant FCR (Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) ≥ 22 and semi-structured interview). Evaluation will be conducted at 2 weeks, 3 and 6 months post-treatment and between-group differences will be evaluated. Long-term effects will be evaluated after one year. Primary outcome will be post-treatment FCR (FCRI-SF). Secondary outcomes are global overall health and global quality of life (Visual Analogue Scales 0-100), bodily distress syndrome (BDS checklist), health anxiety (Whiteley-6), anxiety (SCL4-anx), depression (SCL6-dep) and sickness absence and health expenditure (register data). Explanatory outcomes include: Uncertainty in illness (Mishels uncertainty of illness scale, short form, MUIS), metacognitions (MCQ-30 negative beliefs about worry subscale), and perceived risk of cancer recurrence (Visual analogue Scale 1-100). DISCUSSION This RCT will provide valuable information on the clinical and cost-effectiveness of TG-iConquerFear vs. aTAU for CRC survivors with clinical FCR, as well as explanatory variables that may act as outcome moderators or mediators. TRIAL REGISTRATION ClinicalTrials.gov; NCT04287218, registered 25.02.2020. https://clinicaltrials.gov/ct2/results?cond=&term=NCT04287218&cntry=&state=&city=&dist=.
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Affiliation(s)
- Johanne Dam Lyhne
- Department of Clinical Oncology, University Hospital of Southern Denmark, Vejle, Beriderbakken 4, 7100 Vejle, Denmark
| | - Allan ‘ Ben’ Smith
- Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW 2170 Australia
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Nørrebrogade 44, bygn. 4, 1, 8000 Aarhus C, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Nørrebrogade 44, bygn. 4, 1, 8000 Aarhus C, Denmark
| | - Lars Henrik Jensen
- Department of Clinical Oncology, University Hospital of Southern Denmark, Vejle, Beriderbakken 4, 7100 Vejle, Denmark
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Factors Associated With Uncertainty in Patients Scheduled to Undergo Hematopoietic Stem Cell Transplantation. Cancer Nurs 2019; 43:E335-E341. [PMID: 31652135 DOI: 10.1097/ncc.0000000000000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. OBJECTIVE To identify the frequency of uncertainty and its associated factors in adults scheduled to undergo hematopoietic stem cell transplantation. METHODS In this cross-sectional study with analytical purposes, information on sociodemographic and clinical variables was collected. Fifty patients were diagnosed with lymphoma, myeloma, or leukemia from a high-complexity hospital. Mishel's Scale of Uncertainty in Illness validated in Spanish was applied. A multivariate analysis was performed through logistic regression. RESULTS Approximately 74% of participants had a high level of uncertainty. The education level (odds ratio [OR], 4.1; 95% confidence interval [CI], 1.11-15.3), family history of cancer (OR, 30.7; 95% CI, 2.7-349), and previous radiotherapy treatment (OR, 0.04; 95% CI, 0.004-0.48) were associated with the uncertainty level. CONCLUSIONS Uncertainty is experienced by patients with hematologic cancer, and factors associated should be recognized to diminish the negative effects produced by this. IMPLICATIONS FOR PRACTICE This experience of uncertainty and its associated factors must be visible in patients scheduled to undergo transplantation. This allows nurses to carry out interventions that have an impact on the cognitive ability mediated by information and education. Reducing the effects that uncertainty has on the overall experience of patients, it is vital for nursing.
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Uncertainty and Quality of Life in Women With Breast Cancer: Moderating Role of Coping Styles. Cancer Nurs 2019; 41:484-490. [PMID: 29489477 DOI: 10.1097/ncc.0000000000000552] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The negative relationship between uncertainty and quality of life is well reported in the literature. Also, there is abundant research linking coping strategies to cancer patients' quality of life. However, there exists a paucity of information on the moderating effect of coping styles on the relationship between uncertainty and quality of life in cancer patients. OBJECTIVE The aim of this study was to examine whether uncertainty in illness is negatively correlated with quality of life and whether this relationship is moderated by coping strategies, namely, problem-focused, avoidant, and active emotional coping. METHODS A convenience sample of 135 Malaysian women with breast cancer participated in the study. Participants completed measures of uncertainty in illness, quality of life, and coping styles. RESULTS Uncertainty in breast cancer was negatively related to quality of life (β = -0.379, P < .001), and active emotional coping was found to moderate this negative relationship (β = 0.155, P < .05). The model explained 22.20% of the variance of quality of life. CONCLUSION Lack of information about breast cancer, treatment, hospitalization, and disease recurrence is related to poorer quality of life. However, this negative relationship becomes weaker when active emotional coping strategies are used. IMPLICATIONS FOR PRACTICE Nurses and health providers should help patients reduce their uncertainty in illness by providing them information on breast cancer or referring them to relevant sources. Moreover, they could reduce the deleterious effect of uncertainty on quality of life by encouraging patients to use more active emotional coping strategies.
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Mori M, Fujimori M, van Vliet LM, Yamaguchi T, Shimizu C, Kinoshita T, Morishita-Kawahara M, Inoue A, Inoguchi H, Matsuoka Y, Bruera E, Morita T, Uchitomi Y. Explicit prognostic disclosure to Asian women with breast cancer: A randomized, scripted video-vignette study (J-SUPPORT1601). Cancer 2019; 125:3320-3329. [PMID: 31206639 DOI: 10.1002/cncr.32327] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/31/2019] [Accepted: 04/30/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Nondisclosure of a poor prognosis to patients with advanced cancer remains a typical practice in Asia. Although the importance of prognostic communication has increasingly been recognized worldwide, little is known about whether explicit prognostic disclosure positively affects Asian patients with advanced cancer. The objective of this study was to examine the effects of explicit prognostic communication on patients with cancer recurrence. METHODS In this randomized, video-vignette study, Japanese women with breast cancer who had undergone curative surgery viewed videos of prognostic communication between a patient with recurrent, incurable breast cancer and her oncologist. The videos differed only in the presence or absence of explicit prognostic disclosure. The primary outcome was participants' uncertainty (rated from 0 to 10), and the secondary outcomes included anxiety (measured on the State-Trait Anxiety Inventory-State: range, 20-80), satisfaction (Patient Satisfaction Questionnaire; range 0-10), self-efficacy (range, 0-10), and willingness to discuss advance care planning (range, 1-4). RESULTS In total, 105 women participated (mean ± SD age, 53.8 ± 8.2 years). After viewing the video with more versus less explicit disclosure, participants showed significantly lower uncertainty (mean ± SE scores, 5.3 ±0.2 vs 5.7 ± 0.2, respectively; P = .032) and higher satisfaction (5.6 ± 0.2 vs 5.2 ± 0.2, respectively; P = .010) without increasing anxiety (changes in scores on the State-Trait Anxiety Inventory-State: 0.06 ± 0.5 vs 0.6 ± 0.5, respectively; P = .198). No significant differences were observed in self-efficacy (5.2 ± 0.2 vs 5.0 ± 0.2, respectively; P = .277) or willingness to discuss advance care planning (2.7 ± 0.1 vs 2.7 ± 0.1, respectively; P = .240). CONCLUSIONS Explicit prognostic disclosure prompted better outcomes than nondisclosure in Japanese women with breast cancer. When asked about the prognosis by Asian patients with cancer, clinicians may be encouraged to respect their wishes and explicitly discuss the prognosis if deemed appropriate.
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Affiliation(s)
- Masanori Mori
- Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Japan.,Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Maiko Fujimori
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.,Division of Cohort Consortium Research, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Liesbeth M van Vliet
- Department of Communication, Nivel-Netherlands Institute for Health Services Research, Utrecht, Netherlands.,Department of Health, Medical, and Neuropsychology, Leiden University, Leiden, Netherlands
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Chikako Shimizu
- Department of Breast Medical Oncology, National Center for Global Health and Medicine, Shinjuku-ku, Japan
| | - Takayuki Kinoshita
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Miki Morishita-Kawahara
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Hironobu Inoguchi
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka Matsuoka
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Eduardo Bruera
- Department of Palliative Care and Rehabilitation Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Yosuke Uchitomi
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.,Innovation Center for Supportive, Palliative, and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
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Al-Yateem N, Brenner M, Alrimawi I, Al-Shujairi A, Al-Yateem S. Predictors of uncertainty in parents of children living with chronic conditions. Nurs Child Young People 2019:e1102. [PMID: 31468904 DOI: 10.7748/ncyp.2019.e1102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Uncertainty in illness implies no meaning has been attributed to an illness event. Although many studies focus on this issue in adults, there is limited research into children with chronic illnesses. Parental uncertainty has been associated with increased risk of post-traumatic stress, which can in turn adversely affect child and parent coping strategies. AIM To identify the characteristics of parents who are at greater risk of uncertainty and the associated characteristics of their children's chronic illnesses. METHOD An exploratory, cross-sectional study design was adopted across three different sites in the United Arab Emirates. Data were collected from parents who accompanied their children, who were receiving treatment, using a validated, culturally adapted Parent Perception of Uncertainty Scale. RESULTS Scores for illness uncertainty ranged from 86.5 to 92.6, on a scale of 31-155, with higher scores indicating greater uncertainty. The highest scores were found in parents of children being cared for in ward settings who had previously been hospitalised, parents of children up to two years of age or those approaching adolescence, fathers, and parents whose first language was Arabic. CONCLUSION The groups of parents with the highest illness uncertainty may benefit most from interventions to improve communication and psychological support.
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Affiliation(s)
- Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, adjunct lecturer and researcher, School of Nursing, Midwifery and Indigenous Health, Faculty of Science, Charles Sturt University and Research Institute for Medical and Health Science, University of Sharjah, United Arab Emirates
| | - Maria Brenner
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Ireland
| | | | - Arwa Al-Shujairi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Hagen KB, Aas T, Kvaløy JT, Søiland H, Lind R. Adherence to adjuvant endocrine therapy in postmenopausal breast cancer patients: A 5-year prospective study. Breast 2019; 44:52-58. [PMID: 30641300 DOI: 10.1016/j.breast.2019.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/20/2018] [Accepted: 01/07/2019] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Adjuvant endocrine therapy (ET) in breast cancer reduces recurrence risk and increases overall survival. The aim of the study was to quantify non-adherence and discontinuation to ET in postmenopausal women with breast cancer, and identify possible clinical or social risk factors. METHODS Women with hormone-receptor positive breast cancer (N = 138), mean age 58 (SD 9.3) years, filled in 4 questionnaires within 1-12, 24, 36 and 48-60 months after surgery; Subjective Health Complaints Inventory (SHC), Functional Assessment of Cancer Therapy-Social Support Subscale (FACT-ES), and Quality of Patient Information Questionnaire (QPI).
Adherence to Tamoxifen (Tam) or Aromatase Inhibitors (AI) was examined using self-reported adherence and data from the Norwegian Prescription Database (NorPD) [corrected]. Kaplan-Meier curves and Cox proportional hazards regression models estimated adherence to ET. RESULTS The estimate of discontinued ET within 60 months was 38%. Self-reported discontinuation was 7% compared with 25% from the NorPD. Being overweight or obese were significantly time dependent factors predictive for discontinuing ET, p = 0.025. CONCLUSION Closer follow-ups, tailor-made information about the proven benefits of ET, and keeping a normal body mass index (BMI) may improve adherence to ET in postmenopausal women with breast cancer.
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Affiliation(s)
- Kari Britt Hagen
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | - Turid Aas
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway.
| | - Jan Terje Kvaløy
- Research Department, Stavanger University Hospital, Stavanger, Norway; Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway.
| | - Håvard Søiland
- Department for Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Ragna Lind
- Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Medicine, Haukeland University Hospital, Bergen, Norway.
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Uncertainty and Quality of Life in Systemic Lupus Erythematosus: A Cross-sectional Study. Rehabil Nurs 2019; 44:2-10. [DOI: 10.1097/rnj.0000000000000118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pahlevan Sharif S, Ahadzadeh AS, Perdamen HK. Uncertainty and quality of life of Malaysian women with breast cancer: Mediating role of coping styles and mood states. Appl Nurs Res 2017; 38:88-94. [PMID: 29241526 DOI: 10.1016/j.apnr.2017.09.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/08/2017] [Accepted: 09/23/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE This study aimed to investigate the relationship between uncertainty in illness and quality of life, and examine the mediating role of coping strategies and mood states in this relationship among breast cancer patients. METHODS A convenience sample of 135 Malaysian women with breast cancer completed questionnaires measuring uncertainty in illness, mood states (i.e. anxiety and depression), quality of life, and copying styles. RESULTS The results showed an inverse correlation between uncertainty and quality of life after controlling for the effects of age, cancer stage and time since diagnosis. Moreover, the negative association between illness uncertainty and quality of life was mediated by coping strategies and mood states. CONCLUSION The findings revealed that breast cancer patients experiencing a high level of uncertainty more likely use avoidant and less likely use active emotional coping strategies which in turn amplifies anxiety and depression and undermines their quality of life. While some interventions to reduce the adverse consequences of uncertainty are recommended, the findings indicated the need for targeted psychological interventions seeking to gradually shift cancer patients' coping strategies from avoidant to active emotional coping.
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Affiliation(s)
- Saeed Pahlevan Sharif
- Taylor's Business School, Taylor's University Lakeside Campus, No. 1 Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia.
| | - Ashraf Sadat Ahadzadeh
- Mass Communication Department, Faculty of Social Sciences and Liberal Arts, UCSI University, Jalan Menara Gading, Taman Connaught, 56000 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia.
| | - Harjit Kaur Perdamen
- Prince Court Medical Centre, 2D, Level 2, 39, Jalan Kia Peng, 50450 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia.
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Evaluating the Reliability and Validity of the Arabic Version of the Parents Perceptions of Uncertainty Scale (A-PPUS). J Pediatr Nurs 2017; 36:179-185. [PMID: 28888500 DOI: 10.1016/j.pedn.2017.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 06/24/2017] [Accepted: 06/24/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Uncertainty often accompanies illness and may be a major aversive component of the patients' treatment process. There is evidence that parental uncertainty has a negative impact on their own and on their child's coping strategies and may affect family functioning. Key to the provision of competent care, to address uncertainty, is the use of an appropriate validated assessment tool to understand key parental concerns. The 'Parent Perception of Uncertainty Scale' (PPUS) has been widely used for this purpose. AIM This study reports on the validity and reliability testing of the Arabic version of the Parents Perception of Uncertainty Scale (A-PPUS). METHODS The scale was translated to Arabic using the translation-back-translation method. Appropriate statistical tests were performed including measurements of internal consistency, item to total scale correlation, and univariate and multivariate analyses. RESULTS The study included 240 parents of children with chronic illnesses. Cronbach's alpha coefficient of the whole scale was 0.93. All the items were positively correlated to the total score. The univariate and multivariate analysis supported the previous tests and the assertion that the Arabic version of the PPUS provided a relevant measure of the uncertainty level. CONCLUSION This study has identified that the A-PPUS is a reliable tool for parent report of their uncertainty, in the UAE and Arabic population.
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Locus of control, quality of life, anxiety, and depression among Malaysian breast cancer patients: The mediating role of uncertainty. Eur J Oncol Nurs 2017; 27:28-35. [PMID: 28279393 DOI: 10.1016/j.ejon.2017.01.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 01/31/2017] [Accepted: 01/31/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE The main objective of this study was to investigate the mediating role of uncertainty in the relationship between locus of control with quality of life, anxiety, and depression. METHODS A descriptive and correlational survey was conducted in a private hospital in Kuala Lumpur, Malaysia. A convenience sample of 118 Malaysian breast cancer patients voluntarily participated in the study and responded to a set of questionnaires including: socio-demographic questionnaire, the short form of Locus of Control Scale, the Functional Assessment of Cancer Therapy-Breast (FACT-B), the Hospital Anxiety and Depression Scale (HADS), and the Short-Form Mishel Uncertainty in Illness Scale (SF-MUIS). RESULTS The results revealed that breast cancer patients with higher internal locus of control and lower external locus of control experience a higher quality of life, lower anxiety, and lower depression. Also, uncertainty mediated the relationship between locus of control with quality of life and depression (quasi-significant). CONCLUSIONS The findings indicated the need for early, targeted psychological interventions seeking to gradually shift cancer patients' locus of control from external to internal in order to improve their quality of life and reduce their depression and anxiety. Moreover, health care providers by providing relevant information to cancer patients, especially for externally oriented patients, can reduce their uncertainty which in turn would improve their quality of life.
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Al-Yateem N, Docherty C, Altawil H, Al-Tamimi M, Ahmad A. The quality of information received by parents of children with chronic ill health attending hospitals as indicated by measures of illness uncertainty. Scand J Caring Sci 2017; 31:839-849. [PMID: 28156023 DOI: 10.1111/scs.12405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 10/06/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND The effectiveness of communication can be defined in terms of one of its outcomes: the uncertainty that it eliminates. Clear unambiguous communication is important for the parents of children to help them understand problems, explore alternative solutions and help make decisions. Persistent uncertainty is known to produce anxiety, unpredictable responses, emotional distress and poor quality of life. The uncertainty experienced by parents is one indicator of quality in the healthcare system which could have diagnostic and predictive value. AIM To assess the uncertainty experienced by parents of children with chronic conditions in the United Arab Emirates (UAE). DESIGN An exploratory descriptive, cross-sectional design was chosen across different sites in the UAE. METHODS Data were collected from parents accompanying children receiving treatment either as an inpatient or outpatient, using the previously validated, culturally adapted 'Parent Perception of Uncertainty Scale' (PPUS). RESULTS Most study participants experienced moderate or high levels of uncertainty. Parents who did not speak the local language, whose child was less than 1 year old or who was acutely ill had significantly more uncertainty than others, as did those parents whose child was approaching adolescence and puberty. CONCLUSIONS As only 5% of all participants reported low levels of uncertainty this should be of major concern as both an indicator of the quality of communication between health professionals and parents, and of the adverse health effects and poor quality of life experienced by parents of patients with chronic illness.
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Affiliation(s)
- Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Charles Docherty
- Department of Nursing, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hanan Altawil
- Department of Nursing, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Muna Al-Tamimi
- Department of Nursing, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Alaa Ahmad
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Rao RM, Vadiraja HS, Nagaratna R, Gopinath KS, Patil S, Diwakar RB, Shahsidhara HP, Ajaikumar BS, Nagendra HR. Effect of Yoga on Sleep Quality and Neuroendocrine Immune Response in Metastatic Breast Cancer Patients. Indian J Palliat Care 2017; 23:253-260. [PMID: 28827927 PMCID: PMC5545949 DOI: 10.4103/ijpc.ijpc_102_17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Studies have shown that distress and accompanying neuroendocrine stress responses as important predictor of survival in advanced breast cancer patients. Some psychotherapeutic intervention studies have shown have modulation of neuroendocrine-immune responses in advanced breast cancer patients. In this study, we evaluate the effects of yoga on perceived stress, sleep, diurnal cortisol, and natural killer (NK) cell counts in patients with metastatic cancer. Methods: In this study, 91 patients with metastatic breast cancer who satisfied selection criteria and consented to participate were recruited and randomized to receive “integrated yoga based stress reduction program” (n = 45) or standard “education and supportive therapy sessions” (n = 46) over a 3 month period. Psychometric assessments for sleep quality were done before and after intervention. Blood draws for NK cell counts were collected before and after the intervention. Saliva samples were collected for three consecutive days before and after intervention. Data were analyzed using the analysis of covariance on postmeasures using respective baseline measure as a covariate. Results: There was a significant decrease in scales of symptom distress (P < 0.001), sleep parameters (P = 0.02), and improvement in quality of sleep (P = 0.001) and Insomnia Rating Scale sleep score (P = 0.001) following intervention. There was a decrease in morning waking cortisol in yoga group (P = 0.003) alone following intervention. There was a significant improvement in NK cell percent (P = 0.03) following intervention in yoga group compared to control group. Conclusion: The results suggest modulation of neuroendocrine responses and improvement in sleep in patients with advanced breast cancer following yoga intervention.
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Affiliation(s)
- Raghavendra Mohan Rao
- Department of Complementary and Alternative Medicine, Healthcare Global, Bengaluru, Karnataka, India
| | - H S Vadiraja
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - R Nagaratna
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - K S Gopinath
- Department of Surgical Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - Shekhar Patil
- Department of Medical Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - Ravi B Diwakar
- Department of Medical Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - H P Shahsidhara
- Department of Medical Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - B S Ajaikumar
- Department of Radiation Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - H R Nagendra
- Department of Research and Development, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
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Hagen KB, Aas T, Kvaløy JT, Eriksen HR, Søiland H, Lind R. Fatigue, anxiety and depression overrule the role of oncological treatment in predicting self-reported health complaints in women with breast cancer compared to healthy controls. Breast 2016; 28:100-6. [DOI: 10.1016/j.breast.2016.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 04/24/2016] [Accepted: 05/13/2016] [Indexed: 10/21/2022] Open
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Effect of a multidiscipline mentor-based program, Be Resilient to Breast Cancer (BRBC), on female breast cancer survivors in mainland China-A randomized, controlled, theoretically-derived intervention trial. Breast Cancer Res Treat 2016; 158:509-22. [PMID: 27400910 DOI: 10.1007/s10549-016-3881-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
Abstract
To reduce the risk of adjustment problems for breast cancer patients in mainland China, we examined the efficacy of a multidiscipline mentor-based program, Be Resilient to Breast Cancer (BRBC), delivered after breast surgery to (a) increase protective factors of social support, hope for the future, etc.; (b) decrease risk factors of Physical and Emotional Distress; and (c) increase outcomes of Resilience, Transcendence and Quality of Life (QOL). A multisite randomized controlled trial was conducted at 6 specialist cancer hospitals. 101 and 103 breast cancer patients were allocated to intervention group (IG) and control group (CG), respectively, and 112 general females (without breast cancer) were allocated to the norm group (NG). Participants completed measures that were related to latent variables derived from the Resilience Model for Breast Cancer (RM-BC) at baseline (T1), 2 months (T2), 6 months (T3), and 12 months (T4) after intervention. At T2, the IG reported significantly lower Depression (ES = 0.65,P = 0.0019) and Illness Uncertainty (ES = 0.57, P = 0.004), better Hope (ES = 0.81, P < 0.001) and QOL (ES = 0.60, P = 0.002) than did the CG. At T3, the IG reported significantly lower Anxiety (ES = 0.74, P < 0.001), better Social Support (ES = 0.51,P = 0.009), Transcendence (ES = 0.87, P < 0.001), and Resilience (ES = 0.83, P < 0.001) compared with the CG. At T4, the IG reported better Resilience though not significant (P = 0.085) and better Transcendence (P = 0.0243) than did the NG. The BRBC intervention improves the positive health outcomes and decreases the risk factors of illness-related distress of breast cancer patients during the high-risk cancer treatment.
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“I just have to move on”: Women's coping experiences and reflections following their first year after primary breast cancer surgery. Eur J Oncol Nurs 2016; 21:205-11. [DOI: 10.1016/j.ejon.2015.10.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 12/20/2022]
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Jeon S, Park H. Effect of Preoperative Education using Multimedia on Pain, Uncertainty, Anxiety and Depression in Hysterectomy Patients. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2016; 22:39-47. [PMID: 37684842 DOI: 10.4069/kjwhn.2016.22.1.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/06/2016] [Accepted: 03/12/2016] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to examine the effect of preoperative education using multimedia on level of pain, uncertainty, anxiety and depression in hysterectomy patients. METHODS A non-equivalent control group, with a pretest-posttest design was used in this study. The level of post operation pain, pre and post operation uncertainty, anxiety and depression of both the groups was measured. The experimental group was provided with preoperative education using multimedia on the preoperative day at the hospital. The control group was only given usual care. Data were analyzed using SPSS/WIN version 22.0 program. RESULTS Experimental group showed lower level of post-operation pain in 1 hour (t=-5.08, p<.001) and 24 hours (t=-5.20, p<.001) but not 48 hours (t=-0.91, p=.368). Uncertainty showed significant interaction effect of Group by Time (F=4.16, p=.018). CONCLUSION Preoperative education using multimedia for patients with hysterectomy would be effective in lowering patients' level of pain, uncertainty, anxiety and depression.
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Affiliation(s)
- Sooran Jeon
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Hyojung Park
- College of Nursing, Ewha Womans University, Seoul, Korea
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