The association between metacognition, coping style and fear of cancer recurrence among postmastectomy patients: A cross sectional study

Effects of CBT-based interventions on health outcomes in breast cancer patients: a systematic review and Meta-analysis

PURPOSE

The systematic review and meta-analysis aimed to comprehensively evaluate the impact of cognitive-behavioral therapy (CBT)-based interventions on health outcomes in patients with breast cancer. Additionally, it assessed the implementation and sustainability of these interventions in clinical and healthcare settings.

METHODS

A search of electronic databases including PubMed, Web of Science, Cochrane Library, CINAHL, CNKI, and Wanfang Data Knowledge Service Platform was conducted for relevant studies published between July 2014 and July 2024. Standardized Mean Differences (SMD) with 95% Confidence Intervals (CIs) were used to determine the effects of the interventions. The pooled effect size was calculated using a random-effects model. The RE-AIM Framework was used to evaluate the potential implementation and sustainability of the interventions in real-world settings.

RESULTS

This systematic review incorporated 14 randomized controlled trials and quasi-experimental studies. We found that various CBT-based interventions had positive effects on fear of cancer recurrence (SMD = - 0.64; 95% CI [- 1.02, - 0.26]; P = 0.0011), anxiety (SMD = - 0.38; 95% CI [- 0.65, - 0.10]; P = 0.0068), depression (SMD = - 0.49; 95% CI [- 0.80, - 0.19]; P = 0.0017), mindfulness skills (SMD = 0.80; 95% CI [0.48, 1.13]; P < 0.0001), fatigue (SMD = - 0.37; 95% CI [- 0.59, - 0.15]; P = 0.0011), quality of life (SMD = 0.54; 95% CI [0.14, 0.93]; P = 0.0080), sleep (SMD = - 0.16; 95% CI [- 0.32, - 0.01]; P = 0.0398), positive psychology (SMD = 2.19; 95% CI [0.38, 4.00]; P = 0.0178) and spiritual well-being (SMD = 0.89; 95% CI [0.56, 1.21]; P < 0.0001). However, there was no significant effect on perceived stress in patients with breast cancer (SMD = - 0.70; 95% CI [- 1.44, 0.04]; P = 0.0634).

CONCLUSIONS

CBT-based interventions are effective in improving the health outcomes of patients with breast cancer. Rigorously designed randomized controlled trials are needed to validate CBT-based interventions (such as personalized, long-term, and diversified intervention strategies) to optimize psychological health interventions and enhance health outcomes for these patients.

The relationships among positive coping style, psychological resilience, and fear of falling in older adults

OBJECTIVES

Fear of falling is a psychological issue that adversely impacts the health of elderly individuals. The purpose of this study was to investigate the correlation among positive coping styles, psychological resilience, and fear of falling in older adults. The mediating role of psychological resilience was also investigated.

METHODS

A cross-sectional study was carried out from July 2023 to December 2023. There are 202 older adults from a tertiary hospital in Beijing, China, participated in this study. The general information questionnaire, the Simplified Coping Style Questionnaire, the Chinese version of the Connor-Davidson Resilience Scale, and the Falls Efficacy Scale-International were utilized. Descriptive statistics, Pearson correlation, and structural equation modeling were used for data analysis.

RESULTS

The prevalence of fear of falling in the elderly was 53.00%. Older individuals with a history of falls or fractures had a significantly higher fear of falling (P < 0.05). Fear of falling was inversely connected with psychological resilience and positive coping styles (P < 0.05). Positive coping styles were positively connected with psychological resilience (r = 0.638, P < 0.01). Structural equation modeling showed that psychological resilience fully mediated the effect of positive coping styles on fear of falling (indirect effect estimate = -0.126, 95% CI -0.036 to-0.225; total effect estimate = -0.121, 95% CI -0.028to -0.005).

CONCLUSION

Fear of falling was widespread among older adults and psychological resilience fully mediated the relationship between positive coping styles and fear of falling. Future interventions targeting the fear of falling should consider the enhancement of psychological resilience.

Association between family functioning and delay in seeking medical care of Chinese bladder cancer patients: the mediating effect of coping styles

PURPOSE

To explore the mechanism by which coping styles of bladder cancer patients influence the relationship between family functioning and delay in seeking medical care. This knowledge could provide a basis for developing interventions to address delayed medical care for patients with bladder cancer.

METHODS

A total of 312 patients with bladder cancer were investigated using the General Information Questionnaire, Questionnaire on the patient's medical condition, the Medical Coping Style Scale, and the Family Functioning Rating Scale.

RESULT

The median delay time for bladder cancer patients was 44.5 days, and the family functioning score at (124.50 ± 24.86), with the face dimension score at (1.66 ± 0.53), the recuse dimension score at (2.48 ± 0.66), and the yield dimension score at (1.34 ± 0.57). The total score of family functioning and each dimension were positively correlated with the delay time of medical care, the coping styles (face) were negatively correlated with the delay time of medical care, and the coping styles (recuse and yield) were positively correlated with it. The mediating effect model showed that family function had an indirect effect through coping styles (face, recuse, and yield), with a total effect of 0.369, and coping styles (face, recuse, and yield) had a mediating effect on the delay time of medical care (indirect effect sizes were 0.123, 0.096, and 0.114, respectively).

CONCLUSION

The coping styles of patients with bladder cancer play a mediating role between family functioning and the delay in seeking medical care. Medical staff should encourage bladder cancer patients to adopt a proactive coping approach and improve the support capacity of bladder cancer patients' families to effectively shorten the delay time.

Prediction of high-level fear of cancer recurrence in breast cancer survivors: An integrative approach utilizing random forest algorithm and visual nomogram

PURPOSE

This study is the first attempt to use a combination of regression analysis and random forest algorithm to predict the risk factors for high-level fear of cancer recurrence and develop a predictive nomogram to guide clinicians and nurses in identifying high-risk populations for high-level fear of cancer recurrence.

METHODS

After receiving various recruitment strategies, a total of 781 survivors who had undergone breast cancer resection within 5 years in four Grade-A hospitals in China were included. Besides demographic and clinical characteristics, variables were also selected from the perspectives of somatic, cognitive, psychological, social and economic factors, all of which were measured using a scale with high reliability and validity. This study established univariate regression analysis and random forest model to screen for risk factors for high-level fear of cancer recurrence. Based on the results of the multi-variable regression model, a nomogram was constructed to visualize risk prediction.

RESULTS

Fatigue, social constraints, maladaptive cognitive emotion regulation strategies, meta-cognition and age were identified as risk factors. Based on the predictive model, a nomogram was constructed, and the area under the curve was 0.949, indicating strong discrimination and calibration.

CONCLUSIONS

The integration of two models enhances the credibility of the prediction outcomes. The nomogram effectively transformed intricate regression equations into a visual representation, enhancing the readability and accessibility of the prediction model's results. It aids clinicians and nurses in swiftly and precisely identifying high-risk individuals for high-level fear of cancer recurrence, enabling the development of timely, predictable, and personalized intervention programs for high-risk patients.