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Ma Y, Chen S, Dong H, Guo R, Liu R, Xie J, Sun Z. Relationship Between Resilience, Social Support, Existential Well-Being and Negative Emotions in Cervical Cancer Patients: a Mediation Analysis. J Cancer 2024; 15:3418-3426. [PMID: 38817854 PMCID: PMC11134424 DOI: 10.7150/jca.91260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/13/2024] [Indexed: 06/01/2024] Open
Abstract
Background: The patients of cervical cancer have more negative emotions and lower quality of life. The aim of this study was to explore the relationships between existential well-being (EWB), social support, resilience, negative emotions in patients with cervical cancer, and to examine whether resilience mediates the associations between EWB or social support and negative emotions. Material and methods: This study enrolled patients with cervical cancer who were treated at the Tianjin Medical University Cancer Institute and Hospital in China during 2012-2019. The Hospital Anxiety and Depression Scale (HADS), the Resilience Scale of 14 items (RS-14) and the McGill Quality of Life Questionnaire (MQOL) were utilized to assess patient's anxiety, depression, resilience, social support and EWB via telephone. Spearman's correlation analyses were used to assess bivariate correlations, and mediation analyses were applied to examine whether resilience mediated the relationship between social support or EWB and negative emotions. Results: A total of 150 (92.0%) out of 163 eligible patients completed the questionnaires. EWB and social support were negatively correlated with anxiety (r=-0.560 and r=-0.561) and depression (r=-0.508 and r=-0.526), and positively correlated with resilience (r=0.691 and r=0.652). Resilience was negatively associated with anxiety (r=-0.545) and depression (r=-0.505). Negative direct effects of social support on anxiety and EWB on anxiety and depression were statistically significant (P<0.05). Resilience played a partial mediating role in the relationship between EWB and depression (β=-0.085, 95%CI: -0.150 to -0.020), accounting for 37.12% of the total effect. It also served as a partial mediator in the association between EWB and anxiety (β=-0.061, 95%CI: -0.107 to -0.015), explaining 34.46% of the overall effect. Additionally, resilience partially mediated the connection between social support and depression (β=-0.173, 95%CI: -0.312 to -0.053), explicating 57.48% of the total effect. Conclusions: A combination of existential, supportive and resilient interventions may help reduce psychological distress and improve quality of life among cervical cancer patients, thereby promoting both physical and psychological health.
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Affiliation(s)
- Yaomei Ma
- Department of Gynecological Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Shiyue Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Hanyu Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Ruimeng Guo
- Department of Gynecological Oncology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Ruoyan Liu
- Department of Gynecological Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Juan Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Zhuoyu Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
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Liang M, Zhong T, Knobf MT, Chen L, Xu M, Cheng B, Pan Y, Zhou J, Ye Z. Sentinel and networked symptoms in patients with breast cancer undergoing chemotherapy. Eur J Oncol Nurs 2024; 70:102566. [PMID: 38513452 DOI: 10.1016/j.ejon.2024.102566] [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: 02/08/2024] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE It was designed to identify the symptom clusters and sentinel symptoms among patients with breast cancer receiving chemotherapy at the community level, and to explore core and bridge symptoms at the global level. METHODS A cross-sectional survey was conducted using the MD Anderson Symptom Inventory. Patients with breast cancer receiving chemotherapy, recruited from the "Be Resilient to Breast Cancer" project between January 2023 and December 2023, were included in the study. Symptom clusters and their sentinel symptoms were identified using exploratory factor analysis and Apriori algorithm. Core and bridge symptoms were identified using network analysis. RESULTS A total of 468 patients with breast cancer participated in the current study. At the community level, three symptom clusters and their corresponding sentinel symptoms were identified: a gastrointestinal symptom cluster (with nausea as the sentinel symptom), a psycho-sleep-related symptom cluster (with distress as the sentinel symptom), and a neurocognition symptom cluster (with dry mouth as the sentinel symptom). At the global level, fatigue emerged as the core symptom, while disturbed sleep and lack of appetite as bridge symptoms. CONCLUSION Addressing nausea, distress, and dry mouth are imperative for alleviating specific symptom clusters at the community level. Furthermore, targeting fatigue, disturbed sleep, and lack of appetite are crucial to break the interactions among diverse symptoms at the global level.
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Affiliation(s)
- Minyu Liang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Tong Zhong
- Tumor Radiotherapy Department, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, Guangdong Province, China
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Lisi Chen
- Department of Medical Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, China
| | - Min Xu
- Galactophore Department, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, China
| | - Beibei Cheng
- Thyroid and Breast Department, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, Guangdong Province, China
| | - Yichao Pan
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China
| | - Jian Zhou
- Galactophore Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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Li S, Jiang Y, Yuan B, Wang M, Zeng Y, Knobf MT, Wu J, Ye Z. The interplay between stigma and sleep quality in breast cancer: A cross-sectional network analysis. Eur J Oncol Nurs 2024; 68:102502. [PMID: 38194900 DOI: 10.1016/j.ejon.2023.102502] [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: 11/16/2023] [Revised: 12/16/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE Stigma, a subjective internal shame, arises from the association of cancer with death. Sleep quality can be considered a product of stigma. However, the extent of overlap or difference between the two remains unclear. METHODS In total, 512 survivors with breast cancer were recruited from the "Be Resilient to Breast Cancer" project between May and August 2023. This study estimated the stigma, sleep quality, and their relationship by conducting a cross-sectional network analysis. The social impact scale and Pittsburgh Sleep Quality Index scale were employed in this study. RESULTS The core symptom for stigma from the network analysis was alienation by people (Strength = 1.213, Betweenness = 13, Closeness = 0.00211). The core symptom for sleep quality were the sleep quality (Str = 1.114, Bet = 17, Clo = 0.01586). Regarding the combination network, results showed that self-isolation and daytime dysfunction were the bridge nodes and that daytime dysfunction was positively associated with feeling less capable than before (according to self) (r = 0.15). CONCLUSION Our study demonstrates the core symptoms in different symptomatic networks, which can be targeted for treatment personalization and aid in the improvement of sleep quality and stigma in breast cancer patients.
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Affiliation(s)
- Shuhan Li
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Yingting Jiang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Bixia Yuan
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Minyi Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Yihao Zeng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Jiahua Wu
- Department of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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4
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Liang MZ, Tang Y, Chen P, Tang XN, Knobf MT, Hu GY, Sun Z, Liu ML, Yu YL, Ye ZJ. Brain connectomics improve prediction of 1-year decreased quality of life in breast cancer: A multi-voxel pattern analysis. Eur J Oncol Nurs 2024; 68:102499. [PMID: 38199087 DOI: 10.1016/j.ejon.2023.102499] [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: 12/05/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Whether brain connectomics can predict 1-year decreased Quality of Life (QoL) in patients with breast cancer are unclear. A longitudinal study was utilized to explore their prediction abilities with a multi-center sample. METHODS 232 breast cancer patients were consecutively enrolled and 214 completed the 1-year QoL assessment (92.2%). Resting state functional magnetic resonance imaging was collected before the treatment and a multivoxel pattern analysis (MVPA) was performed to differentiate whole-brain resting-state connectivity patterns. Net Reclassification Improvement (NRI) as well as Integrated Discrimination Improvement (IDI) were calculated to estimate the incremental value of brain connectomics over conventional risk factors. RESULTS Paracingulate Gyrus, Superior Frontal Gyrus and Frontal Pole were three significant brain areas. Brain connectomics yielded 7.8-17.2% of AUC improvement in predicting 1-year decreased QoL. The NRI and IDI ranged from 20.27 to 54.05%, 13.21-33.34% respectively. CONCLUSION Brain connectomics contribute to a more accurate prediction of 1-year decreased QoL in breast cancer. Significant brain areas in the prefrontal lobe could be used as potential intervention targets (i.e., Cognitive Behavioral Group Therapy) to improve long-term QoL outcomes in breast cancer.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xiao Na Tang
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, China
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mei Ling Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, China
| | - Zeng Jie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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Liu S, Huang R, Li A, Yu S, Yao S, Xu J, Tang L, Li W, Gan C, Cheng H. Effects of the CALM intervention on resilience in Chinese patients with early breast cancer: a randomized trial. J Cancer Res Clin Oncol 2023; 149:18005-18021. [PMID: 37980293 DOI: 10.1007/s00432-023-05498-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE Resilience is an important regulating factor for anxiety and depression in breast cancer. The Managing Cancer and Living Meaningfully (CALM) intervention has been confirmed to improve anxiety and depression in patients, but the role of resilience is still unclear. This study explores this issue. METHODS In this study, a cohort of 124 patients diagnosed with breast cancer was recruited and randomly assigned to either the intervention group (IG) or the control group (CG). In addition, we enrolled a group of cancer-free women (regular control group) and assessed their resilience. All patients were evaluated using the Connor-Davidson Resilience Scale (CD-RISC), Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy (FACT-B) and Perceived Stress Scale (PSS) at different time points. The primary outcomes were resilience, quality of life, anxiety, depression, and perceived stress. A repeated measures ANOVA was used to compare the scores of the IG and CG groups. The relationship between resilience and quality of life was analyzed using Pearson's correlation test. The paired-sample t-test was used to compare the changes in each score at different time points. RESULTS The intervention group showed significant differences in resilience, adamancy, optimism, tenacity, anxiety, depression, perceived stress and QOL scores before and after 6, 12, and 24 weeks (F = 17.411, F = 226.55, F = 29.096, F = 50.67, F = 82.662, F = 105.39, F = 62.66, F = 72.43, F = 34.561, respectively; P < 0.001). Compared to the control group, the intervention group demonstrated significant improvement in resilience and quality of life (t = -11.517, p < 0.001; t = - 4.929, p < 0.001), as well as a significant reduction in anxiety, depression, and perceived stress scores (t = 5.891, p < 0.001; t = 2.654, p < 0.001; t = 4.932, p < 0.001). In the intervention group, a significant positive correlation was observed between resilience in breast cancer survivors and quality of life (QOL) scores. (before CALM treatment: r = 0.3204, P = 0.0111; after 6 weeks: r = 0.3619, P = 0.0038; after 12 weeks: r = 0.3355, P = 0.0077; after 24 weeks: r = 0.2801, P = 0.0274). CONCLUSIONS A positive impact of the CALM intervention can be seen in improved resilience and reduced anxiety and depression, supporting its use as an effective psychological management tool and intervention strategy in the early stages of long-term breast cancer recovery.
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Affiliation(s)
- Shaochun Liu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Runze Huang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Anlong Li
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Sheng Yu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Senbang Yao
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Jian Xu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Lingxue Tang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Wen Li
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Chen Gan
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Huaidong Cheng
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
- Shenzhen Clinical Medical School of Southern Medical University, Guangzhou, China.
- Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China.
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6
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Ang WR, Ang WHD, Cham SQG, de Mel S, Chew HSJ, Devi MK. Effectiveness of resilience interventions among cancer patients - A systematic review, meta-analysis, and meta-regression of randomised controlled trials. Eur J Oncol Nurs 2023; 67:102446. [PMID: 37879194 DOI: 10.1016/j.ejon.2023.102446] [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: 08/08/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE This systematic review, meta-analysis and meta-regression aimed to (1) evaluate the effects of resilience interventions on cancer patients' resilience and posttraumatic growth and (2) identify essential contents and features of resilience interventions. METHODS A systematic review, meta-analysis, and meta-regression analyses were conducted. Published and unpublished randomised controlled trials evaluating the effects of resilience interventions among cancer patients were retrieved from nine databases, trial registries, and grey literature. The mean and standard deviation scores were used to compute the effect sizes. RESULTS 23 randomised controlled trials comprising 3287 cancer patients were included. The random effects model found that resilience interventions had beneficial impacts on patients' resilience, posttraumatic growth, quality of life, anxiety, and depressive symptoms with moderate to large effects. The subgroup analyses concluded that theoretically guided interventions that adopted synchronous communication delivered physically had greater effect sizes. Interventions comprising skills that promote patients' cognitive flexibility, self-efficacy, self-esteem, self-regulation, and coping had greater effect in comparison with interventions lacking these components. The meta-regression analyses revealed that sample size has a significant effect on posttraumatic growth scores. More well-designed trials are needed to confirm the effects of resilience interventions. CONCLUSIONS There is merit in utilizing resilience interventions to improve cancer patients' resilience and psychological well-being. Resilience interventions should be incorporated into the routine care for cancer patients and survivors.
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Affiliation(s)
- Wee Rong Ang
- Department of Nursing, Woodlands Health, National Healthcare Group, Singapore.
| | - Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Swss Qynn Grace Cham
- Division of Oncology Nursing, National University Cancer Institute, Singapore, National University Health System, Singapore.
| | - Sanjay de Mel
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, National University Health System, Singapore.
| | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - M Kamala Devi
- School of Medicine, Dentistry and Nursing, University of Glasgow.
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Li S, Wang X, Wang M, Jiang Y, Mai Q, Wu J, Ye Z. Association between stigma and sleep quality in patients with breast cancer: A latent profile and mediation analysis. Eur J Oncol Nurs 2023; 67:102453. [PMID: 37951070 DOI: 10.1016/j.ejon.2023.102453] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE This study aims to identify the heterogeneity in the stigma experienced by patients with breast cancer and examine the mediation effect of resilience on the relation between stigma and sleep quality. METHOD A total of 396 patients with breast cancer were enrolled from Be Resilient to Breast Cancer (BRBC) program between January and April 2023. Participants completed the Social Impact Scale, the 10-item Connor-Davidson Resilience Scale, and the Pittsburgh Sleep Quality Index Scale. Latent profile analysis (LPA) and mediation analysis were conducted to analyze the data. RESULTS LPA categorized stigma into three subgroups, namely low-stigma (21.9%), moderate-stigma (64.9%), and high-stigma (13.2%). Mediation analysis revealed a fully mediated effect in the comparison between low-stigma and moderate-stigma groups (standard error [SE] = 0.13, 95%CI = 0.06,0.56), whereas a partially mediated effect was observed in the comparison between low-stigma and high-stigma groups (SE = 0.18, 95%CI = 0.39,1.10). CONCLUSIONS Stigma is a significant factor to sleep quality in breast cancer and resilience could act as a robust buffer against stigma resulting in improved sleep quality. Resilience-based interventions might be helpful in this population.
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Affiliation(s)
- Shuhan Li
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Minyi Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Yingting Jiang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Qingxin Mai
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Jiahua Wu
- Department of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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Liang MZ, Liu ML, Tang Y, Molassiotis A, Knobf MT, Chen P, Hu GY, Sun Z, Yu YL, Ye ZJ. Heterogeneity in resilience patterns and its prediction of 1-year quality of life outcomes among patients with newly diagnosed cancer: An exploratory piecewise growth mixture model analysis. Eur J Oncol Nurs 2023; 66:102374. [PMID: 37499404 DOI: 10.1016/j.ejon.2023.102374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE This study was designed to explore the impact of a new cancer diagnosis on resilience of patients and whether the resilience patterns could predict Quality of Life (QoL) in the first year. METHODS An exploratory linear piecewise growth mixture modeling (PGMM) with one hypothetical dot (3 months since diagnosis, T1) was employed to identify different resilience patterns and growth in 289 patients with different cancer diagnoses at five assessment occasions (T0-T4). Logistic regression analysis was performed to select potential predictors and receiver operating characteristic (ROC) curve analysis was utilized to test PGMM's discriminative ability against 1-year QoL. RESULTS Five discrete resilience trajectories with two growing trends were identified, including "Transcendence" (7.3%), "Resilient" (47.4%), "Recovery" (18.7%), "Damaged" (14.9%) and "Maladaption" (11.8%). Advanced stage, colorectal cancer, and receiving surgery therapy were significant predictors of negative resilience trajectories ("Damaged" or "Maladaption"). Discriminative ability was good for PGMM (AUC = 0.81, 95%CI, 0.76-0.85, P < 0.0001). CONCLUSION Heterogeneity is identified in resilience growth before and after 3 months since diagnosis. 26.7% newly diagnosed patients need additional attention especially for those with advanced colorectal cancer and receiving surgery therapy.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, China
| | - Mei Ling Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, China
| | - Zeng Jie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
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9
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Keane D, Phillips G, Mitchell N, Connolly RM, Hegarty J. Improving quality of life and symptom experience in patients with metastatic breast cancer: A systematic review of supportive care interventions. Psychooncology 2023; 32:1192-1207. [PMID: 37434307 DOI: 10.1002/pon.6183] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE The prognosis for individuals with metastatic breast cancer (MBC) has improved in recent decades. This expanding cohort has unique psychological and psychosocial needs, yet targeted supportive care interventions are underdeveloped. This systematic review seeks to summarise the available evidence on the effectiveness of supportive care interventions in improving quality of life and symptom experience of individuals living with MBC so that services can be developed to address the unmet needs of this cohort in future. METHODS Academic Search Complete, CINAHL, ERIC, Medline and SocINDEX were searched for publications investigating the effect of supportive care interventions specifically targeted at addressing the quality of life or symptom experience of individuals living with MBC. Three reviewers independently screened and selected studies. Quality appraisal and assessed risk of bias were carried out. RESULTS The search yielded 1972 citations. Thirteen studies met the inclusion criteria. Interventions included psychological (n = 3), end of life discussion and preparation (n = 2), physical activity (n = 4), lifestyle (n = 2), and medication self-management support (n = 2). Three studies reported significant improvement in quality of life, two of which reported improved symptom experience in at least one symptom. Three further physical activity interventions showed improvement in at least one of the symptoms investigated. CONCLUSION Studies reporting a statistically significant effect on quality of life and improved symptom experience were extremely heterogenous. We can tentatively suggest that multimodal and frequently administered interventions are effective, with physical activity interventions positively impacting on symptom experience, however further research is required.
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Affiliation(s)
- Danielle Keane
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Grace Phillips
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | | | - Roisin M Connolly
- Cancer Research @UCC, College of Medicine & Health, University College Cork, Cork, Ireland
- Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
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Rooney AG, Hewins W, Walker A, Mackinnon M, Withington L, Robson S, Torrens C, Hopcroft LEM, Clark A, Anderson G, Bulbeck H, Dunlop J, Welsh M, Dyson A, Emerson J, Cochrane C, Hill R, Carruthers J, Day J, Gillespie D, Hewitt C, Molinari E, Wells M, McBain C, Chalmers AJ, Grant R. Lifestyle coaching is feasible in fatigued brain tumor patients: A phase I/feasibility, multi-center, mixed-methods randomized controlled trial. Neurooncol Pract 2023; 10:249-260. [PMID: 37188163 PMCID: PMC10180387 DOI: 10.1093/nop/npac086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background There are no effective treatments for brain tumor-related fatigue. We studied the feasibility of two novel lifestyle coaching interventions in fatigued brain tumor patients. Methods This phase I/feasibility multi-center RCT recruited patients with a clinically stable primary brain tumor and significant fatigue (mean Brief Fatigue Inventory [BFI] score ≥ 4/10). Participants were randomized in a 1-1-1 allocation ratio to: Control (usual care); Health Coaching ("HC", an eight-week program targeting lifestyle behaviors); or HC plus Activation Coaching ("HC + AC", further targeting self-efficacy). The primary outcome was feasibility of recruitment and retention. Secondary outcomes were intervention acceptability, which was evaluated via qualitative interview, and safety. Exploratory quantitative outcomes were measured at baseline (T0), post-interventions (T1, 10 weeks), and endpoint (T2, 16 weeks). Results n = 46 fatigued brain tumor patients (T0 BFI mean = 6.8/10) were recruited and 34 were retained to endpoint, establishing feasibility. Engagement with interventions was sustained over time. Qualitative interviews (n = 21) suggested that coaching interventions were broadly acceptable, although mediated by participant outlook and prior lifestyle. Coaching led to significant improvements in fatigue (improvement in BFI versus control at T1: HC=2.2 points [95% CI 0.6, 3.8], HC + AC = 1.8 [0.1, 3.4], Cohen's d [HC] = 1.9; improvement in FACIT-Fatigue: HC = 4.8 points [-3.7, 13.3]; HC + AC = 12 [3.5, 20.5], d [HC and AC] = 0.9). Coaching also improved depressive and mental health outcomes. Modeling suggested a potential limiting effect of higher baseline depressive symptoms. Conclusions Lifestyle coaching interventions are feasible to deliver to fatigued brain tumor patients. They were manageable, acceptable, and safe, with preliminary evidence of benefit on fatigue and mental health outcomes. Larger trials of efficacy are justified.
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Affiliation(s)
- Alasdair G Rooney
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- The Robert Fergusson Unit, Royal Edinburgh Hospital, Edinburgh, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - William Hewins
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Amie Walker
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Neuro-Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Mairi Mackinnon
- Neuro-Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Lisa Withington
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Sara Robson
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Claire Torrens
- Nursing, Midwifery, and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Lisa E M Hopcroft
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
| | - Antony Clark
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
| | | | | | - Joanna Dunlop
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
- Community Rehabilitation and Brain Injury Service, Livingston, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Michelle Welsh
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Aimee Dyson
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Julie Emerson
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Robert Hill
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
| | - Jade Carruthers
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
| | - Julia Day
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
- Community Rehabilitation and Brain Injury Service, Livingston, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - David Gillespie
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | - Emanuela Molinari
- Institute of Neurosciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Mary Wells
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Catherine McBain
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Anthony J Chalmers
- Neuro-Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
- Institute of Neurosciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Robin Grant
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
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11
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Ye ZJ. Editorial: Resilience in chronic disease, volume II. Front Psychiatry 2023; 14:1209709. [PMID: 37304437 PMCID: PMC10248497 DOI: 10.3389/fpsyt.2023.1209709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 06/13/2023] Open
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12
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Sihvola SP, Kiwanuka F, Kvist TA. Promoting resilience among adult cancer patients: An integrative review of patient education methods. Eur J Oncol Nurs 2023; 64:102342. [PMID: 37290158 DOI: 10.1016/j.ejon.2023.102342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 04/12/2023] [Accepted: 04/29/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE To explore the essential elements of patient education methods for promoting resilience among adult cancer patients. METHODS The PubMed, Scopus, CINAHL and PsycInfo databases were searched fromJanuary 2010 to April 2021. The outcome of interest was resilience. The integrative review applied the PRISMA statement guidelines. RESULTS Nine studies were identified, which formed three main patient education strategies that fell under categories: 1. Provision of illness-related information 2. Learning self-management skills 3. Provision of emotional support and the adjustment process. The key elements include promotion of positive factors, easing patients' mental burden, highlighting the importance of illness-related information, developing self-management skills, and emotional support. Interventions prepared patients for the future, enhanced their understanding of illness and recovery process, and comfort in physical and mental aspects of life, and improved their resilience. CONCLUSIONS Resilience among cancer patients is a process that helps them adjust to live with cancer. The provision of psychosocial support and illness-related information, as well as learning self-management skills, are essential elements of patient education interventions that aim to improve resilience among adult cancer patients.
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Affiliation(s)
| | - Frank Kiwanuka
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland.
| | - Tarja Anneli Kvist
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland.
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13
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Wang C, Malaktaris A, McLean CL, Kelsven S, Chu GM, Ross KS, Endsley M, Minassian A, Liu L, Hong S, Lang AJ. Mitigating the health effects of systemic racism: Evaluation of the Race-Based Stress and Trauma Empowerment intervention. Contemp Clin Trials 2023; 127:107118. [PMID: 36796623 PMCID: PMC10389054 DOI: 10.1016/j.cct.2023.107118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Disparities in physical and mental health among Black, Indigenous, and People of Color (BIPOC) are well-documented and mirrored in the Veteran population. Chronic stress due to racism and discrimination is one possible mechanism driving these negative health outcomes. The Race-Based Stress and Trauma Empowerment (RBSTE) group is a novel, manualized, health promotion intervention designed to address the direct and indirect impacts of racism among Veterans of Color. This paper describes the protocol of the first pilot randomized controlled trial (RCT) of RBSTE. This study will examine the feasibility, acceptability, and appropriateness of RBSTE compared to an active control (an adaptation of Present-Centered Therapy; PCT) in a Veterans Affairs (VA) healthcare setting. A secondary aim is to identify and optimize strategies for holistic evaluation. METHODS Veterans of Color (N = 48) endorsing perceived discrimination and stress will be randomized to RBSTE or PCT; both groups will be delivered in 8 weekly, 90-min virtual group sessions. Outcomes will include measures of psychological distress, discrimination and ethnoracial identity, holistic wellness, and allostatic load. Measures will be administered at baseline and post-intervention. CONCLUSION This study will inform future interventions targeting identity-based stressors and represents an important step in advancing equity for BIPOC in medicine and research. CLINICAL TRIAL REGISTRATION NUMBER NCT05422638.
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Affiliation(s)
- Clarice Wang
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Anne Malaktaris
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Caitlin L McLean
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Skylar Kelsven
- University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Gage M Chu
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Keisha S Ross
- VA St. Louis Health Care System, 915 N. Grand Blvd, St. Louis, MO 63106, USA.
| | - Maurice Endsley
- VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA.
| | - Arpi Minassian
- University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Lin Liu
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Suzi Hong
- University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Ariel J Lang
- University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
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14
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Stabellini N, Cullen J, Bittencourt MS, Moore JX, Cao L, Weintraub NL, Harris RA, Wang X, Datta B, Coughlin SS, Garcia J, Shanahan J, Hamerschlak N, Waite K, Fillmore NR, Terris M, Montero AJ, Barnholtz-Sloan JS, Guha A. Allostatic load and cardiovascular outcomes in males with prostate cancer. JNCI Cancer Spectr 2023; 7:7031248. [PMID: 36752520 PMCID: PMC10005613 DOI: 10.1093/jncics/pkad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/23/2022] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death in men with prostate cancer (PC). Accumulated stress plays an important role in CVD development. The cumulative burden of chronic stress and life events can be measured using allostatic load (AL). METHODS The initial cohort included males aged 18 years and older diagnosed with PC (2005-2019). AL was modeled as an ordinal variable (0-11). Fine-Gray competing risk regressions measured the impact of precancer diagnosis AL and postdiagnosis AL in 2-year major cardiac events (MACE). The effect of AL changes over time on MACE development was calculated via piecewise Cox regression (before, and 2 months, 6 months, and 1 year after PC diagnosis). RESULTS We included 5261 PC patients of which 6.6% had a 2-year MACE. For every 1-point increase in AL before and within 60 days after PC diagnosis, the risk of MACE increased 25% (adjusted hazard ratio [aHR] =1.25, 95% confidence interval [CI] = 1.18 to 1.33) and 27% (aHR = 1.27, 95% CI = 1.20 to 1.35), respectively. Using AL as a time-varying exposure, the risk of MACE increased 19% (aHR = 1.19, 95% CI = 1.11 to 1.27), 22% (aHR = 1.22, 95% CI = 1.14 to 1.33), 28% (aHR = 1.28, 95% CI = 1.23 to 1.33), and 31% (aHR = 1.31, 95% CI = 1.27 to 1.35) for every 1-point increase in AL before, 2 months after, 6 months after, and 1 year after PC diagnosis, respectively. CONCLUSION AL and its changes over time are associated with MACE in PC patients, suggesting a role of a biological measure of stress as a marker of CVD risk among men with PC.
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Affiliation(s)
- Nickolas Stabellini
- Graduate Education Office, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jennifer Cullen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Marcio S Bittencourt
- Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Justin X Moore
- Cancer Prevention, Control, & Population Health Program, Department of Medicine, Medical College of Georgia at Augusta University, GA, USA
| | - Lifen Cao
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Neal L Weintraub
- Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA.,Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Ryan A Harris
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, GA, USA.,Sport and Exercise Science Research Institute, Ulster University, Jordanstown, Northern Ireland, UK
| | - Xiaoling Wang
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Biplab Datta
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.,Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - Steven S Coughlin
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.,Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - Jorge Garcia
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - John Shanahan
- Cancer Informatics, Seidman Cancer Center at University Hospitals of Cleveland, Cleveland, OH, USA
| | - Nelson Hamerschlak
- Oncohematology Department, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Kristin Waite
- Trans-Divisional Research Program (TDRP), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nathanael R Fillmore
- Cooperative Studies Program (CSP) Informatics Center, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Martha Terris
- Urology Section, Department of Surgery, Veterans Affairs Medical Centers, Augusta, GA, USA.,Division of Urologic Surgery, Department of Surgery, Medical College of Georgia, Augusta, GA, USA
| | - Alberto J Montero
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Jill S Barnholtz-Sloan
- Trans-Divisional Research Program (TDRP), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.,Center for Biomedical Informatics and Information Technology (CBIIT), National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Avirup Guha
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Cardio-Oncology Program, Ohio State University, OH, USA.,Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia, Augusta University, Augusta, GA, USA
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15
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George T, Shah F, Tiwari A, Gutierrez E, Ji J, Kuchel GA, Cohen HJ, Sedrak MS. Resilience in older adults with cancer: A scoping literature review. J Geriatr Oncol 2023; 14:101349. [PMID: 35970715 PMCID: PMC10089682 DOI: 10.1016/j.jgo.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/01/2022] [Accepted: 07/26/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Resilience, the ability to respond to stressors by maintaining or rapidly returning to normal homeostasis, serves as a new paradigm to improve the care of older adults. However, resilience research in oncology is nascent. We aimed to describe the current research landscape on physical, cognitive, and psychosocial resilience in older cancer patients. MATERIALS AND METHODS We searched PubMed/MEDLINE from inception to January 28, 2022 for records with the terms "resilient OR resilience OR resiliency." We included studies that focused on persons over age 65 with cancer and assessed physical, cognitive, or psychological resilience. We excluded studies that did not report original data; did not have the full text available; assessed resilience on fewer than three time points; and published in non-English languages. Definitions and measures of resilience were extracted and categorized using qualitative analysis. RESULTS Of 473 articles screened, we found 29 articles that met criteria for inclusion in our review. There was a high degree of heterogeneity in the definitions and measures of resilience. Resilience was defined as robustness/resistance to decline (n = 11), recovery from trauma/stressor (n = 7), and adaptive and proactive coping behaviors (n = 6). Ten papers did not define resilience. 21 studies utilized longitudinal analysis, five studies used randomized and nonrandomized control trials, and four studies assessed pre-post analysis. Stressors included cancer diagnosis (n = 18), chemotherapy (n = 3), radiation (n = 3), acute illness (n = 3), surgery (n = 2), and hematopoietic cell transplant (n = 1). DISCUSSION Evidence for predictors and determinants of resilience in older adults with cancer is limited by the absence of standardized definitions and measurements. There is a fundamental need for a more precise definition, measures, and understanding of the physiologic mechanisms underlying the response to the physical, cognitive, and psychosocial stressors of cancer and its treatments.
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Affiliation(s)
- Thomas George
- Department of Internal Medicine, NYC Health and Hospitals/Coney Island, Brooklyn, NY, USA
| | - Farah Shah
- Department of Internal Medicine, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Abhay Tiwari
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Eutiquio Gutierrez
- Department of Internal Medicine, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Jingran Ji
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - George A Kuchel
- Department of Medicine, Division of Geriatric Medicine, University of Connecticut School of Medicine, Farmington, CT, USA; UConn Center for Aging, University of Connecticut Health, Farmington, CT, USA
| | - Harvey J Cohen
- Department of Medicine, Geriatric Medicine Division, Duke University School of Medicine, Durham, NC, USA; Duke Center for the Study of Aging and Human Development Center, Duke University School of Medicine, Durham, NC, USA
| | - Mina S Sedrak
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA; Center for Cancer and Aging, City of Hope, Duarte, CA, USA.
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16
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Liang MZ, Chen P, Knobf MT, Molassiotis A, Tang Y, Hu GY, Sun Z, Yu YL, Ye ZJ. Measuring resilience by cognitive diagnosis models and its prediction of 6-month quality of life in Be Resilient to Breast Cancer (BRBC). Front Psychiatry 2023; 14:1102258. [PMID: 36873211 PMCID: PMC9978149 DOI: 10.3389/fpsyt.2023.1102258] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Objective The application of advanced Cognitive Diagnosis Models (CDMs) in the Patient Reported Outcome (PRO) is limited due to its complex statistics. This study was designed to measure resilience using CDMs and its prediction of 6-month Quality of Life (QoL) in breast cancer. Methods A total of 492 patients were longitudinally enrolled from Be Resilient to Breast Cancer (BRBC) and administered with 10-item Resilience Scale Specific to Cancer (RS-SC-10) and Functional Assessment of Cancer Therapy-Breast (FACT-B). Generalized Deterministic Input, Noisy "And" Gate (G-DINA) was performed to measure cognitive diagnostic probabilities (CDPs) of resilience. Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) were utilized to estimate the incremental prediction value of cognitive diagnostic probabilities over total score. Results CDPs of resilience improved prediction of 6-month QoL above conventional total score. AUC increased from 82.6-88.8% to 95.2-96.5% in four cohorts (all P < 0.001). The NRI ranged from 15.13 to 54.01% and IDI ranged from 24.69 to 47.55% (all P < 0.001). Conclusion CDPs of resilience contribute to a more accurate prediction of 6-month QoL above conventional total score. CDMs could help optimize Patient Reported Outcomes (PROs) measurement in breast cancer.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, Guangdong, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - M. Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guang Yun Hu
- School of Nursing, Army Medical University, Chongqing, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yuan Liang Yu
- Mental Health Education and Counseling Center, South China University of Technology, Guangzhou, Guangdong, China
| | - Zeng Jie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- *Correspondence: Zeng Jie Ye,
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17
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Beatty L, Kemp E, Butow P, Girgis A, Hulbert-Williams N, Kaambwa B, Schofield P, Turner J, Woodman R, Boyle F, Daly A, Jones A, Kiely B, Zdenkowski N, Koczwara B. Finding My Way-Advanced: can a web-based psychosocial intervention improve the mental quality of life for women with metastatic breast cancer vs attention-control? Study protocol of a randomised controlled trial. BMC Cancer 2022; 22:1353. [PMID: 36566189 PMCID: PMC9789659 DOI: 10.1186/s12885-022-10410-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/05/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Women living with metastatic breast cancer (MBC) are at risk of significantly impaired quality of life (QOL), symptom burden, distress and fear of progression, and unmet needs, yet they face barriers to accessing evidence-based psychosocial treatments. Our group therefore developed Finding My Way-Advanced (FMW-A), a web-based self-guided psychosocial program for women with MBC. This study aims to assess its efficacy in improving mental and other QOL domains, distress, fear of progression, unmet needs, and health service utilisation. METHODS The multi-site randomised controlled trial (RCT) will enrol 370 Australian participants. Eligible participants are adult (18 years +) women diagnosed with MBC, with a life expectancy of 6 months or more, with sufficient English-language literacy to provide informed consent. Participants will be identified, screened and referred from one of 10 Australian sites, or via self-referral in response to advertisements. Participants complete four online questionnaires: prior to accessing their program ('baseline'), 6 weeks later ('post-intervention'), then 3 months and 6 months post-intervention. Consenting participants will be randomised to either FMW-A (intervention), or Breast Cancer Network Australia's (BCNA) online/app resource My Journey (minimal intervention attention-control). This is a single-blind study, with randomisation computer-generated and stratified by site. FMW-A is a 6-module program addressing some of the most common issues experienced by women with MBC, with BCNA control resources integrated within the 'resources' section. All modules are immediately accessible, with an additional booster module released 10 weeks later. The primary outcome is mental QOL; statistical criteria for superiority is defined as a 4-point difference between groups at post-treatment. Secondary outcomes include other QOL domains, distress, fear of progression, health service use, intervention adherence, and user satisfaction. DISCUSSION This will be the first adequately powered RCT of a self-directed online intervention for women with MBC. If efficacious, FMW-A will help address two national key priorities for management of MBC - enhancing QOL and reducing symptom burden. FMW-A has the potential to address unmet needs and overcome access barriers for this overlooked population, while reducing health system burden. TRIAL REGISTRATION The study was registered prospectively with the ANZCTR on 29/10/2021. Trial ID ACTRN12621001482853p. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382714&isReview=true.
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Affiliation(s)
- Lisa Beatty
- grid.1014.40000 0004 0367 2697Flinders University, Adelaide, Australia
| | - Emma Kemp
- grid.1014.40000 0004 0367 2697Flinders University, Adelaide, Australia
| | - Phyllis Butow
- grid.1013.30000 0004 1936 834XUniversity of Sydney, Sydney, Australia
| | - Afaf Girgis
- grid.1005.40000 0004 4902 0432University of NSW, Sydney, Australia
| | | | | | - Penelope Schofield
- grid.1027.40000 0004 0409 2862Swinburne University, Melbourne, Australia ,grid.1055.10000000403978434Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Jane Turner
- grid.1003.20000 0000 9320 7537University of Queensland, St Lucia, Australia
| | - Richard Woodman
- grid.1014.40000 0004 0367 2697Flinders University, Adelaide, Australia
| | | | - Anthony Daly
- grid.492269.20000 0001 2233 2629Cancer Council South Australia, Adelaide, Australia
| | - Amanda Jones
- Southern Adelaide Local Health Network, Bedford Park, Australia
| | - Belinda Kiely
- grid.460708.d0000 0004 0640 3353Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, Australia
| | - Nicholas Zdenkowski
- grid.266842.c0000 0000 8831 109XUniversity of Newcastle, Newcastle, Australia
| | | | - Bogda Koczwara
- grid.1014.40000 0004 0367 2697Flinders University, Adelaide, Australia ,Southern Adelaide Local Health Network, Bedford Park, Australia
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18
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Beese S, Postma J, Graves JM. Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192417006. [PMID: 36554888 PMCID: PMC9779615 DOI: 10.3390/ijerph192417006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods. METHODS This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews. RESULTS The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden. CONCLUSIONS The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.
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Affiliation(s)
- Shawna Beese
- College of Agricultural, Human, and Natural Resources Sciences, Washington State University, Pullman, WA 99164, USA
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Julie Postma
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Janessa M. Graves
- College of Nursing, Washington State University, Spokane, WA 99202, USA
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Liang M, Chen P, Molassiotis A, Jeon S, Tang Y, Hu G, Zhu Y, Sun Z, Yu Y, Knobf TM, Ye Z. Measurement invariance of the 10-item resilience scale specific to cancer in Americans and Chinese: A propensity score-based multidimensional item response theory analysis. Asia Pac J Oncol Nurs 2022; 10:100171. [PMID: 36632445 PMCID: PMC9827362 DOI: 10.1016/j.apjon.2022.100171] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Little is known about the measurement invariance (MI) of resilience instruments in cancer care. This study was designed to examine MI of 10-Item Resilience Scale (RS-SC-10) in Americans and Chinese with cancer using propensity score-based multidimensional item response theory (MIRT) analysis. Methods A sample of 924 patients were enrolled in the Be Resilient to Cancer trial involving 1 hospital in America and 3 hospitals in China. Data were collected from the RS-SC-10 and Hospital Anxiety and Depression Scale. Propensity score matching and MIRT were performed to evaluate Differential Item Function. Integrated Discrimination Improvement and Net Reclassification Improvement were used to indirectly estimate the MI through incremental prediction ability of MIRT-based score over total score. Results RS-SC-10 retained 10 items with monotonous thresholds and its original two-factor structure. Nonuniform Differential Item Function was recognized in Item 4 (P = 0.0011, Δ%β1 = 4.15%) and Item 8 (P = 0.0017, Δ%β1 = 5.99%). Net Reclassification Improvement ranged from 9.04% to 35.01%, and Integrated Discrimination Improvement ranged from 8.82% to 20.60%. Conclusions Although partial MI has been identified between Americans and Chinese, RS-SC-10 remains a critical indicator to emotional distress in cancer care.
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Affiliation(s)
- Muzi Liang
- Guangdong Academy of Population Development, Guangzhou, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Alex Molassiotis
- College of Arts, Humanities & Education, University of Derby, Derby, UK
| | | | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China
| | | | - Yunfei Zhu
- Shenzhen People's Hospital, Shenzhen, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuanling Yu
- South China University of Technology, Guangzhou, China
| | - Tish M. Knobf
- School of Nursing, Yale University, Orange, CT, USA,Corresponding authors.
| | - Zengjie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, China,Corresponding authors.
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20
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Gu R, Chen H, Wang X, Jin X, Jiang F, Zhao W, Yun J, Zhou J, Wang H. The mediating role of appraisal on health-related quality of life in adolescent and young adult cancer survivors. Qual Life Res 2022; 32:1069-1084. [PMID: 36260164 DOI: 10.1007/s11136-022-03269-x] [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: 10/03/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer survivors (first diagnosed with cancer at age 15-39) are distinct within the cancer community due to their unique challenges and diverse psycho-behavioral characteristics. This study aimed to analyze psycho-behavioral pathways and further explore the mediating role of cognitive appraisals on AYA cancer survivors' quality of life (QoL). METHODS Three hundred and eighty-nine AYA cancer survivors were eligible for analyses and recruited to self-administer questionnaires on QoL (the Chinese version of EORTC Quality of Life Questionnaire-C30 v3.0), resilience, coping, and appraisal on site. This study performed structural equation modeling (SEM) to examine pathways on QoL based on the Rapkin & Schwartz QoL Appraisal Model. RESULTS The average age of participants (47.6% female) was 32.7 ± 4.1 years. The SEM results closely fit the measured data (RMSEA = 0.053, GFI = 0.955, CFI = 0.964, SRMR = 0.052). The final model showed direct negative effects of later clinical-stage, more comorbidities, and more Acceptance-Resignation coping on QoL; indirect positive effects of better resilience on QoL through less Acceptance-Resignation coping (β = 0.286, P = 0.002). Appraisal mediated the effects of treatment and resilience on QoL (β = -0.024, P = 0.038). Further, Calm, Peaceful, and Active appraisal patterns were associated with improved Cognitive Functioning (β = 0.119, P = 0.009). CONCLUSION Appraisal, coping, and resilience could significantly mediate the effects of cancer and its treatment on the QoL of AYA cancer survivors. Future interventions targeting cognitive appraisals and psycho-behaviors will be helpful. Figuring out what matters to such a unique population and how they appraise a cancer diagnosis through treatment trajectories could help nurses adjust support.
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Affiliation(s)
- Renjun Gu
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Hao Chen
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Xian Wang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Xiaoyuan Jin
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Fengyang Jiang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Wenhe Zhao
- Department of Tumor Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Jingyi Yun
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Jie Zhou
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Hongmei Wang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China.
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21
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Allostatic Load and Breast Cancer: a Systematic Review of the Literature. CURRENT BREAST CANCER REPORTS 2022. [DOI: 10.1007/s12609-022-00455-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Liang MZ, Tang Y, Knobf MT, Molassiotis A, Chen P, Hu GY, Sun Z, Yu YL, Ye ZJ. Resilience index improves prediction of 1-year decreased quality of life in breast cancer. J Cancer Surviv 2022; 17:759-768. [PMID: 35932356 DOI: 10.1007/s11764-022-01239-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/20/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Resilience is important in cancer survivorship and has great potential to predict long-term quality of life (QoL) in breast cancer. The study was designed to develop a new prediction model to estimate pretest probability (PTP) of 1-year decreased QoL combing Resilience Index (RI) and conventional risk factors. METHODS RI was extracted from 10-item Resilience Scale Specific to Cancer (RS-SC-10) based on the Principal Component Analysis (PCA). Patients were enrolled from Be Resilient to Breast Cancer (BRBC) and the prediction model was developed based on a sample of 506 consecutive patients and validated in an internal cohort (N1 = 314) and two external cohorts (N2 = 223 and N3 = 189). Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) were utilized to estimate the incremental value of RI. RESULTS RI improved prediction above conventional risk factors. AUC increased from 0.745 to 0.862 while IDI and NRI were 8.39% and 18.44% respectively (P < 0.0001 for all). Five predictors were included in the final model: RI, age, N stage, M stage, and baseline QoL. The new model demonstrated good calibration ability in the internal and external cohorts resulting in C-indexes of 0.862 (95%CI, 0.815-0.909), 0.828 (95%CI, 0.745-0.910), 0.880 (95%CI, 0.816-0.944), and 0.869 (95%CI, 0.796-0.941). CONCLUSION RI contributed to a more accurate estimation for PTP of 1-year decreased QoL above conventional risk factors and could help optimize decision making of treatment for breast cancer. IMPLICATIONS FOR CANCER SURVIVORS A promising prognostic indicator of RI could improve QoL-related management in Chinese patients with breast cancer.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, 06477, USA
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, Guizhou Province, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, 400038, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, 510641, Guangdong Province, China
| | - Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
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Wu X, Lu Y, Zhang Q, Wang H, Sun X, Han H, Ye Z. Stress/Resource Complex, Sense of Coherence and Professional Identity Among Nursing Students: A Latent Profile and Mediation Analysis. Psychol Res Behav Manag 2022; 15:2409-2420. [PMID: 36065461 PMCID: PMC9440726 DOI: 10.2147/prbm.s378088] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/23/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose Sense of coherence is significant to mental health and professional development in nursing students. However, the association among stress/resource complex, sense of coherence, and professional identity is less explored in nursing students. This study was designed to identify latent subtypes of stress/resource complex and to evaluate the mediating role of sense of coherence between stress/resource complex types and professional identity in nursing students. Participants and Methods A total of 595 nursing students were recruited from Be Resilient to Nursing Career (BRNC) between October and December 2021 and administered with 10-item Connor-Davidson Resilience Scale, General Self-efficacy Scale, 10-item Chinese Perceived Stress Scale, 13-item Sense of Coherence Scale, and Professional Identity Questionnaire for Undergraduate Students. Latent profile analysis and mediation analysis were performed. Results Three latent subtypes of stress/resource complex were identified: Flexibility (14.8%), Ordinary (44.2%), and Maladjustment (41.0%). Nursing students with role model were prone to Ordinary (OR = 1.48, 95% CI 1.03–2.13, p = 0.035) and Flexibility (OR = 1.92, 95% CI 1.17–3.16, p = 0.011). The association between stress/resource complex types and professional identity was mediated by sense of coherence (P < 0.05). Conclusion There exists heterogeneity in nursing students’ stress/resource complex. The association between stress/resource complex subtypes and professional identity was mediated by sense of coherence.
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Affiliation(s)
- Xiaona Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Yingzi Lu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Qishan Zhang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Huiyuan Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Xiaoming Sun
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Hui Han
- School of Marine Finance and Economics, Qingdao Engineering Vocational College, Qingdao, People’s Republic of China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Correspondence: Zengjie Ye, School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, People’s Republic of China, Tel +15914411786, Email
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Chen IH, Niu SF, Yeh YC, Chen IJ, Kuo SF. Psychological distress among immigrant women who divorced: Resilience as a mediator. Arch Psychiatr Nurs 2022; 39:1-6. [PMID: 35688538 DOI: 10.1016/j.apnu.2021.11.006] [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: 01/07/2021] [Accepted: 11/17/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to investigate relationships among the demands of immigration, resilience, and psychological distress in divorced immigrant women, and determine the mediating effects of resilience on the relationship between demands of immigration and psychological distress. DESIGN The cross-sectional study included 117 women who had immigrated and married Taiwanese men but later got divorced. METHODS The Chinese health questionnaire-12 scale, the resilience scale-Chinese version, and the demands of immigration (DI) scale were used to measure in this study. A multiple regression and Sobel test were used to examine whether resilience mediated the relationship between demands of immigration and psychological distress. FINDINGS In this study, 47% of the divorced immigrant women were experiencing psychological distress, and 25.6% exhibited high levels of demands of immigration. Women with psychological distress had higher demand scores (t = 2.592, p = 0.011) and lower resilience scores (t = -3.965, p < 0.001) compared to women without psychological distress. The demands of immigration negatively predicted resilience (t = -3.050, p = 0.003). Finally, resilience mediated the association of demands of immigration with psychological distress (z = 2.497, p = 0.0125). CONCLUSIONS Relationships among the demands of immigration, resilience, and psychological distress in divorced immigrant women were demonstrated in this study. Resilience played an important role in the relationship between demands of immigration and psychological distress. CLINICAL RELEVANCE Tailored programs that foster resilience to reduce risks of demands of immigration and psychological distress in this vulnerable population should be developed.
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Affiliation(s)
- I-Hui Chen
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.
| | - Shu-Fen Niu
- Department of Nursing, Shin Kong Wu Ho-Su Memorial Hospital, 95 Wen Chang Road, Taipei 11101, Taiwan; Department of Nursing, Fu Jen Catholic University, 510 Zhong-Zheng Road, New Taipei City 242062, Taiwan.
| | - Yueh-Chen Yeh
- Department of Nursing, National Taichung University of Science and Technology, 193, Sec. 1, San-Min Road, Taichung City 40343, Taiwan.
| | - I-Ju Chen
- Physical Education Office & Department of Healthcare Administration, Asia University, 500 Lioufeng Rd., Wufeng Dist., Taichung City 41354, Taiwan.
| | - Shu-Fen Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.
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Psychological interventions targeting patients with metastatic cancer and prolonged survival expectancies: advances and challenges. Curr Opin Oncol 2022; 34:256-264. [PMID: 35703243 DOI: 10.1097/cco.0000000000000838] [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 OF REVIEW The purpose of this article is to review the formats and techniques of psychological interventions designed for patients with metastatic cancer and prolonged survival expectancies. RECENT FINDINGS Fifteen interventional studies were selected for this article. One group of psychological interventions focused primarily on patients' adaptation by increasing their knowledge, developing patients' stress management skills, promoting their open communication with healthcare providers, and helping them deal with existential concerns. Another group of interventions focused on patients with moderate and high levels of distress. These interventions provided specific techniques to manage anxiety, depression, fear of cancer progression, and existential distress. Interestingly, interventions targeting distressed patients are not necessarily longer or more intensive than interventions targeting adaptation. The interventions were examined in few randomized controlled trials, and incorporated a broad range of techniques, making comparison of their efficacy difficult. No intervention specifically targeted patients newly diagnosed with metastatic cancer. SUMMARY On the basis of this review, we proposed suggestions according to patients' levels of distress, which differ in intensity, format, techniques, and tools offered. These suggestions may be relevant for the future development and assessment of interventions targeting patients with newly diagnosed metastatic cancer and prolonged survival expectancies.
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Mei X, Wang H, Wang X, Wu X, Wu J, Ye Z. Associations among neuroticism, self-efficacy, resilience and psychological distress in freshman nursing students: a cross-sectional study in China. BMJ Open 2022; 12:e059704. [PMID: 35697443 PMCID: PMC9196198 DOI: 10.1136/bmjopen-2021-059704] [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: 11/23/2022] Open
Abstract
OBJECTIVES The current study examines the mediating roles of resilience and self-efficacy and the moderating role of gender in the association between neuroticism and psychological distress in Chinese freshman nursing students (FNSs). METHODS A total of 1220 FNSs were enrolled from the Be Resilient to Nursing Career (ChiCTR2000038693) Programme and the following instruments were administered to them: NEO Five-Factor Inventory, General Self-Efficacy Scale, Connor-Davidson Resilience Scale and Kessler Psychological Distress Scale. A moderated mediation analysis and a generalised additive model analysis were performed. RESULTS The direct and indirect effects of neuroticism on psychological distress were significantly mediated by self-efficacy (B = 0.200, 95% CI 0.001 to 0.039), resilience (B = 0.021, 95% CI 0.007 to 0.038) and the interaction between self-efficacy and resilience (B = 0.016, 95% CI 0.005 to 0.028). The interactions between neuroticism and gender (β = 0.102, 95% CI 0.001 to 0.203, p<0.05) and between resilience and gender were significant (β = 0.160, 95% CI 0.045 to 0.275, p<0.01). A non-linear and positive association was confirmed between neuroticism and psychological distress. CONCLUSIONS Self-efficacy and resilience significantly mediate the relationship between neuroticism and psychological distress. Gender moderates the relationships between neuroticism and resilience and between resilience and psychological distress.
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Affiliation(s)
- Xiaoxiao Mei
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Huiyuan Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaona Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jieyi Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Blessin M, Lehmann S, Kunzler AM, van Dick R, Lieb K. Resilience Interventions Conducted in Western and Eastern Countries-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6913. [PMID: 35682495 PMCID: PMC9180776 DOI: 10.3390/ijerph19116913] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/26/2022]
Abstract
Previous research has demonstrated the efficacy of psychological interventions to foster resilience. However, little is known about whether the cultural context in which resilience interventions are implemented affects their efficacy on mental health. Studies performed in Western (k = 175) and Eastern countries (k = 46) regarding different aspects of interventions (setting, mode of delivery, target population, underlying theoretical approach, duration, control group design) and their efficacy on resilience, anxiety, depressive symptoms, quality of life, perceived stress, and social support were compared. Interventions in Eastern countries were longer in duration and tended to be more often conducted in group settings with a focus on family caregivers. We found evidence for larger effect sizes of resilience interventions in Eastern countries for improving resilience (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI] 0.28 to 0.67; p < 0.0001; 43 studies; 6248 participants; I2 = 97.4%). Intercultural differences should receive more attention in resilience intervention research. Future studies could directly compare interventions in different cultural contexts to explain possible underlying causes for differences in their efficacy on mental health outcomes.
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Affiliation(s)
- Manpreet Blessin
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Sophie Lehmann
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Angela M. Kunzler
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
| | - Rolf van Dick
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, 55131 Mainz, Germany
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Carlos RC, Obeng-Gyasi S, Cole SW, Zebrack BJ, Pisano ED, Troester MA, Timsina L, Wagner LI, Steingrimsson JA, Gareen I, Lee CI, Adams AS, Wilkins CH. Linking Structural Racism and Discrimination and Breast Cancer Outcomes: A Social Genomics Approach. J Clin Oncol 2022; 40:1407-1413. [PMID: 35108027 PMCID: PMC9851699 DOI: 10.1200/jco.21.02004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/03/2021] [Accepted: 01/10/2022] [Indexed: 01/23/2023] Open
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Chen HL, Wang HY, Lai SF, Ye ZJ. The Associations Between Psychological Distress and Academic Burnout: A Mediation and Moderation Analysis. Psychol Res Behav Manag 2022; 15:1271-1282. [PMID: 35614879 PMCID: PMC9126292 DOI: 10.2147/prbm.s360363] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Psychological distress is reported to be associated with academic burnout in students while the mediation and moderation effect of resilience and personality are less explored. Purpose The current study was designed to estimate the mediating effect of resilience and the moderation effect of personality between psychological distress and academic burnout. Participants and methods A total of 613 students were enrolled from two medical universities between December 2020 and January 2021. They were administered with Academic Burnout Scale, 10-item Kessler Psychological Distress Scale (K10), Connor-Davidson Resilience Scale (CD-RISC-10) and NEO Five-Factor Inventory (NEO-FFI). Latent profile analysis and moderated mediation analysis were performed. Results Three personalities were identified and named as resilient (13.4%), over-controlled (50.2%) and under-controlled (36.4%). Resilience significantly mediated the relationship between psychological distress and academic burnout while personality significantly moderated the relationship between psychological distress and resilience. Conclusion Resilience and personality may be two important mediators between psychological distress and academic burnout. More attentions should be paid to students with under-controlled personality and resilience-enhancing interventions could be developed to prevent or alleviate academic burnout in future research.
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Affiliation(s)
- Hui Ling Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Hui Yuan Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Sheng Feng Lai
- School of Nursing, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Zeng Jie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Correspondence: Zeng Jie Ye, School of Nursing, Guangzhou University of Chinese Medicine, Out Ring Road No. 262, Panyu District, Guangzhou, 510006, People’s Republic of China, Tel +86 15914411786, Email
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Stacy M, Schulkin J. Suicide: Allostatic regulation and resilience. Psychoneuroendocrinology 2022; 139:105691. [PMID: 35218982 DOI: 10.1016/j.psyneuen.2022.105691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
Abstract
Suicide is a complex public health problem that is the result of a number of intertwined biopsychosocial factors. The diathesis-stress model suggests that suicide is the result of an interaction between genetic vulnerability and environmental stressors. Chronic stress and trauma contribute to biologic adaptations, including hypothalamus-pituitary-adrenal axis dysregulation, that contribute to the degradation of regulatory mechanisms and promote wear and tear the body, represented by allostatic load (AL). AL has been associated with a number of negative outcomes, including mental health problems and suicide. Fortunately, there are pharmacological and non-pharmacological interventions that are effective at reducing AL and reversing its effects. Thus, AL may provide a construct for supporting early risk identification, prevention, and treatment of suicide. AL biomarkers that are amenable to measurable change, effective treatments to reduce AL and perhaps help prevent suicide, and how to best tailor them to the individual and societal levels are important avenues of therapeutic inquiry.
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Affiliation(s)
- Meaghan Stacy
- Department of Psychiatry, Yale University School of Medicine, 300 George St., Suite 901, New Haven, CT 06511, USA.
| | - Jay Schulkin
- School of Medicine, University of Washington, 1959 Pacific St NE, Seattle, WA 98105, USA.
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Mei XX, Wu XN, Wang HY, Wu JY, Wang XQ, Ye ZJ. Heterogeneity in Psychological Resilience and Mental Health among Newly Graduated Nursing Students: A Latent Profile and Generalized Additive Model Analysis. Psychol Res Behav Manag 2022; 15:597-606. [PMID: 35300205 PMCID: PMC8922342 DOI: 10.2147/prbm.s348661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/25/2022] [Indexed: 02/02/2023] Open
Abstract
Background Psychological resilience is important to mental health and professional development in newly graduated nursing students (NGNSs). However, the association between psychological resilience and mental health in NGNSs is less explored. Purpose The current study was designed to determine mental health profiles measured by the Kessler 10 scale (K10) and evaluate the non-linear association between psychological resilience and mental health in NGNSs. Methods A total of 472 NGNSs from the Be Resilient to Nursing Career program were assessed using the K10 and ten-item Connor–Davidson Resilience Scale (CD-RISC 10). Latent profile analysis and generalized additive model analysis were performed. Results A four-class model based on the K10 was identified: lowest (28.0%), lower-middle (36.4%), upper-middle (26.1%), and highest (9.5%) subgroups. Academic degree and psychological resilience were significant indicators of mental health profiles. Psychological resilience was negatively and nonlinearly correlated with mental health when the CD-RISC 10 score was >17. Conclusion There exists heterogeneity in NGNSs’ mental health. The negative and nonlinear association between psychological resilience and mental health can only be confirmed in NGNSs with moderate and high resilience levels.
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Affiliation(s)
- Xiao Xiao Mei
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Xiao Na Wu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Hui Yuan Wang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Jie Yi Wu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Xin Qin Wang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
- Correspondence: Zeng Jie Ye, People’s Republic of China, Tel +86 15914411786, Email
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Misiak B, Stańczykiewicz B, Pawlak A, Szewczuk-Bogusławska M, Samochowiec J, Samochowiec A, Tyburski E, Juster RP. Adverse childhood experiences and low socioeconomic status with respect to allostatic load in adulthood: A systematic review. Psychoneuroendocrinology 2022; 136:105602. [PMID: 34861465 DOI: 10.1016/j.psyneuen.2021.105602] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 12/25/2022]
Abstract
Early-life psychosocial stress primes a number of health risk behaviors, and contributes to the development of various mental and somatic disorders in adulthood. It has been reported that adverse childhood experiences (ACEs) and low socioeconomic status (SES) might be associated with allostatic load (AL) in adulthood. In turn, elevated AL index has been found to predict a number of unfavorable health outcomes. Therefore, we aimed to perform a systematic review of studies investigating the association of ACEs and childhood SES with AL in adult populations. Independent online searches covered the publication period up to 20th Jun 2021. A total of 27 studies were included in qualitative synthesis. The majority of eligible studies showed that ACEs (14 out of 19 studies recording ACEs, 73.7%) and low childhood SES (11 out of 12 studies recording childhood SES, 91.7%) are associated with elevated AL in adults. However, several processes were found to mediate or moderate this association. These include educational attainments, social support, health behaviors, adult stress, post-traumatic stress disorder, coping strategies and aging. Moreover, a substantial methodological heterogeneity of approaches to calculating the AL index was observed. Apart from reports from overlapping samples, none of eligible studies used the same set of biomarkers. Findings from this systematic review imply that early-life psychosocial stress might have a lasting impact on biological dysregulations captured by the AL index. Future studies need to explore whether the association between early-life stress and the AL index accounts for the development of specific health outcomes.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland.
| | - Bartłomiej Stańczykiewicz
- Department of Nervous System Diseases, Wroclaw Medical University, Bartla 5 Street, 51-618 Wroclaw, Poland
| | - Andrzej Pawlak
- Department of Nervous System Diseases, Wroclaw Medical University, Bartla 5 Street, 51-618 Wroclaw, Poland
| | | | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-457 Szczecin, Poland
| | - Agnieszka Samochowiec
- Department of Clinical Psychology, Institute of Psychology, University of Szczecin, Krakowska 69 Street, 71-017 Szczecin, Poland
| | - Ernest Tyburski
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-457 Szczecin, Poland; SWPS University of Social Sciences and Humanities, Institute of Psychology, Kutrzeby 10 Street, 61-719 Poznan, Poland
| | - Robert-Paul Juster
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, 7331 Hochelaga, FS-145-12, Montreal, Canada
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Ye ZJ. Editorial: Resilience in Chronic Disease. Front Psychiatry 2022; 13:846370. [PMID: 35237198 PMCID: PMC8882836 DOI: 10.3389/fpsyt.2022.846370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Zeng Jie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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Mei X, Mei R, Liu Y, Wang X, Chen Q, Lei Y, Ye Z. Associations among fear of childbirth, resilience and psychological distress in pregnant women: A response surface analysis and moderated mediation model. Front Psychiatry 2022; 13:1091042. [PMID: 36590638 PMCID: PMC9797834 DOI: 10.3389/fpsyt.2022.1091042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Prenatal psychological distress is prevalent during pregnancy. This study aimed to estimate the associations among fear of childbirth, resilience and psychological distress. METHODS A total of 1,060 Chinese pregnant women were enrolled from Be Resilient to Postpartum Depression (ChiCTR2100048465) and the following instruments were administered to them: Childbirth Attitudes Questionnaire, Connor-Davidson Resilience Scale, Perceived Social Support Scale, General Self-Efficacy Scale, Adverse Childhood Experience scale and Hospital Anxiety and Depression Scale. A dominance, a response surface analysis and a moderated mediation analysis were performed. RESULTS In terms of psychological distress, resilience and fear of childbirth could explain 41.6% (0.148/0.356) and 33.1% (0.118/0.356), respectively. Pregnant women with high resilience-low fear of childbirth had significantly lower levels of psychological distress than those with low resilience-high fear of childbirth. The indirect effects of fear of childbirth on psychological distress through resilience was significantly (B = 0.054, 95% CI 0.038 to 0.070). The interactions between fear of childbirth and adverse childhood experiences (β = 0.114, 95% CI -0.002 to 0.231, p = 0.054) and between resilience and adverse childhood experiences (β = -0.118, 95% CI -0.222 to -0.012, p < 0.05) were significant. CONCLUSION Resilience, fear of childbirth and adverse childhood experiences may be three important factors to psychological distress in Chinese pregnant women.
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Affiliation(s)
- Xiaoxiao Mei
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ranran Mei
- Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuling Liu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qianwen Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Youjin Lei
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Liang MZ, Tang Y, Chen P, Liang J, Sun Z, Hu GY, Yu YL, Ye ZJ. New resilience instrument for family caregivers in cancer: a multidimensional item response theory analysis. Health Qual Life Outcomes 2021; 19:258. [PMID: 34794439 PMCID: PMC8600888 DOI: 10.1186/s12955-021-01893-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/07/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Resilience instruments specific to family caregivers (FCs) in cancer are limited. This study was designed to validate the 10-item Resilience Scale Specific to Cancer (RS-SC-10) in FCs using multidimensional item response theory (MIRT) analysis. METHODS 382 FCs were enrolled from Be Resilient to Cancer Program (BRCP) and administered with RS-SC-10 and 36-item Short Form Health Survey (SF-36). MIRT was performed to evaluate item parameters while Generalized Additive Model (GAM) and Latent Profile Analysis (LPA) were performed to test the non-linear relationship between resilience (RS-SC-10) and Quality of Life (QoL, SF-36). RESULTS RS-SC-10 retained 10 items with high multidimensional discrimination, monotonous thresholds and its original two-factor structure (Generic and Shift-Persist). Four latent resilience subgroups were identified and a non-linear dose-response pattern between resilience and QoL was confirmed (per-SD increase OR = 1.62, 95% CI 1.16-2.13, p = 0.0019). CONCLUSION RS-SC-10 is a brief and suitable resilience instrument for FCs in cancer. The resilience screening of patients and FCs can be performed simultaneously in clinical practice.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China
| | - Jian Liang
- Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, 400038, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, 510641, Guangdong Province, China
| | - Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
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Guidi J, Lucente M, Sonino N, Fava GA. Allostatic Load and Its Impact on Health: A Systematic Review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:11-27. [PMID: 32799204 DOI: 10.1159/000510696] [Citation(s) in RCA: 363] [Impact Index Per Article: 121.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. OBJECTIVE To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. METHODS PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. RESULTS A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. CONCLUSIONS The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.
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Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy,
| | | | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy.,Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
| | - Giovanni A Fava
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
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Abstract
PURPOSE OF REVIEW Depression is a prevalent comorbidity in cancer that significantly increases the risk for numerous negative health outcomes. This review updates the current evidence base for management of depression in cancer, highlighting new research directions based on the inflammatory hypothesis of depression. RECENT FINDINGS Research on pharmacotherapy and psychotherapy for depression in cancer has shown mixed efficacy partly because of methodological issues arising from the phenomenology of depression in cancer. After decades of stagnancy, more recent high-quality clinical trials are beginning to provide an evidence base to guide treatment. Inflammatory cytokine-associated depression is a subtype of depression that may have particular relevance in cancer, opening new avenues to explore therapeutic targets and biobehavioral impacts of interventions, which may improve cancer outcomes. SUMMARY The continuum of severity in cancer-related depression is important to consider in management approaches. Choice of treatment should be personalized to the patient and their symptom profile as there is currently insufficient evidence to recommend any particular medication or psychotherapy over another. Psychological interventions should be considered first line for mild-to-moderate depression, and pharmacological treatment added for more severe depression, which can be optimally delivered within a collaborative care model. VIDEO ABSTRACT http://links.lww.com/YCO/A62.
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Affiliation(s)
- Aliza A Panjwani
- Division of Psychosocial Oncology, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
| | - Madeline Li
- Division of Psychosocial Oncology, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
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Individual Resilience Interventions: A Systematic Review in Adult Population Samples over the Last Decade. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147564. [PMID: 34300018 PMCID: PMC8307772 DOI: 10.3390/ijerph18147564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/31/2022]
Abstract
Resilience interventions have been gaining importance among researchers due to their potential to provide well-being and reduce the prevalence of mental disorders that are becoming an increasing concern, especially in Western countries, because of the costs associated. The purpose of this systematic review is to identify the intervention studies carried out in the last decade in adult population samples, evaluate their methodological quality and highlight the trends of these types of interventions. This review was performed using systematic literature searches in the following electronic databases: B-on, PubMed, PsycNet and Science Direct. The application of eligibility criteria resulted in the inclusion of 38 articles, of which 33 were randomized controlled trials and the other five were nonrandomized controlled studies. Although most studies showed statistical significance for their results, these were constrained by the great heterogeneity of the studies, the lack of power of the samples and their fair methodological quality. Therefore, it is important to consolidate the theoretical basis and standardize certain methodologies so that the effects of the interventions can be compared through a meta-analysis.
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Abstract
BACKGROUND The treatment-related decision-making process is a highly emotional time for parents of children with incurable cancer, and they tend to continue the cancer-directed treatment even when they realize that there is no cure for their child. OBJECTIVE To evaluate whether parents involved in different treatment decisions regretted their treatment decision after their child's death. METHODS We collected prospective data from 418 parents of children who died of incurable cancer after receiving cancer care at 1 of 4 hospitals. We assessed parent decisional regret and its association with the type of treatment decision made (non-cancer-directed vs cancer-directed). Propensity score-matched analysis (at a ratio of 1:1) was performed. RESULTS One hundred forty-eight parents (35.4%) reported heightened regret. Two isonumerical arms with 103 (non-cancer-directed) and 103 (cancer-directed) resulted after propensity score matching. Parents with a cancer-directed treatment decision (relative risk, 1.53; 95% confidence interval, 1.24-1.90; P = .002) were more likely to report decisional regret compared with those with a non-cancer-directed decision. CONCLUSION Bereaved parents with a cancer-directed treatment decision are more likely to experience increased regret for their decision than bereaved parents involved in a non-cancer-directed treatment decision. IMPLICATIONS Shared-decision aids should be prepared for young parents with low education to improve disease-related knowledge, accurate risk perceptions, and options congruent with parents' values.
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Mathew A, Doorenbos AZ, Li H, Jang MK, Park CG, Bronas UG. Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis. Biol Res Nurs 2021; 23:341-361. [PMID: 33138637 PMCID: PMC8755951 DOI: 10.1177/1099800420969898] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Individuals with cancer experience stress throughout the cancer trajectory. Allostatic load (AL), a cumulative multi-system measure, may have a greater value in stress assessment and the associated biological burden than individual biomarkers. A better understanding of the use of AL and its operationalization in cancer could aid in early detection and prevention or alleviation of AL in this population. PURPOSE To consolidate findings on the operationalization, antecedents, and outcomes of AL in cancer. METHODS Seven databases (CINAHL, Ovid MEDLINE, Web of Science, APA PsycInfo, Scopus, Embase, and Cochrane CENTRAL) were searched for articles published through April 2020. The NIH tools were used to assess study quality. RESULTS Twelve studies met inclusion criteria for this review. Although variability existed in the estimation of AL, biomarkers of cardiovascular, metabolic, and immune systems were mostly used. Associations of AL with cancer-specific variables were examined mostly utilizing population-databases. Significant associations of AL with variables such as cancer-related stress, positive cancer history, post traumatic growth, resilience, tumor pathology, and cancer-specific mortality were found. Mini meta-analysis found that a one-unit increase in AL was associated with a 9% increased risk of cancer-specific mortality. CONCLUSION This review reveals heterogeneity in operationalization of AL in cancer research and lack of clarity regarding causal direction between AL and cancer. Nevertheless, AL holds a significant promise in cancer research and practice. AL could be included as a screening tool for high-risk individuals or a health outcome in cancer. Optimal standardized approaches to measure AL would improve its clinical utility.
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Affiliation(s)
- Asha Mathew
- College of Nursing, University of Illinois, Chicago, IL, USA
- College of Nursing, Christian Medical College, Vellore, India
| | - Ardith Z. Doorenbos
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Hongjin Li
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Min Kyeong Jang
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Chang Gi Park
- College of Nursing, University of Illinois, Chicago, IL, USA
- Department of Population Health Nursing Science, Office of Research Facilitation, Chicago, IL, USA
| | - Ulf G. Bronas
- College of Nursing, University of Illinois, Chicago, IL, USA
- Laboratory of Vascular and Cognitive Health, Chicago, IL, USA
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Stringer-Reasor EM, Elkhanany A, Khoury K, Simon MA, Newman LA. Disparities in Breast Cancer Associated With African American Identity. Am Soc Clin Oncol Educ Book 2021; 41:e29-e46. [PMID: 34161138 DOI: 10.1200/edbk_319929] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Persistent disparities in the burden of breast cancer between African Americans and White Americans have been documented over many decades. Features characterizing breast cancer in the African American community include a 40% higher mortality rate, younger age distribution, greater advanced-stage distribution, increased risk of biologically aggressive disease such as the triple-negative phenotype, and increased incidence of male breast cancer. Public health experts, genetics researchers, clinical trialists, multidisciplinary oncology teams, and advocates must collaborate to comprehensively address the multifactorial etiology of and remedies for breast cancer disparities. Efforts to achieve breast health equity through improved access to affordable, high-quality care are especially imperative in the context of the COVID-19 pandemic and its disproportionately high economic toll on African Americans.
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Affiliation(s)
- Erica M Stringer-Reasor
- Division of Hematology Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Ahmed Elkhanany
- Division of Hematology Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Katia Khoury
- Division of Hematology Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Melissa A Simon
- Department of Obstetrics and Gynecology and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Lisa A Newman
- Department of Surgery, Weill Cornell Medicine/New York Presbyterian Hospital Network, New York, NY
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Lai J, Song H, Ren Y, Li S, Xiao F. Effectiveness of Supportive-Expressive Group Therapy in Women with Breast Cancer: A Systematic Review and Meta-Analysis. Oncol Res Treat 2021; 44:252-260. [PMID: 33910215 DOI: 10.1159/000515756] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/09/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Breast cancer is the most frequently diagnosed cancer among women and ranks second in terms of global incidence. Depression, anxiety, and poor quality of life (QoL) are prevalent in women with breast cancer. Supportive-expressive group therapy (SEGT) can potentially benefit these patients. OBJECTIVE This systematic review and meta-analysis evaluated the effectiveness of SEGT for women with breast cancer, by focusing on survival, QoL, anxiety, and depression as outcomes. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted. The databases PubMed, Web of Science, Cochrane Library, Embase, CINHAL, and PsycInfo in English, and Sinomed, CNKI, CQVIP, and Wanfang in Chinese, were searched from inception up to May 2020 for relevant full-text articles using "SEGT," "breast cancer," and related terms as keywords. Randomized controlled trials (RCTs) comparing SEGT with baseline conditions of patients with breast cancer were included in the analysis. RESULTS Ten studies with a total of 2,879 subjects were analyzed. Overall group differences were found for survival (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.72-0.94; p = 0.004), short-term QoL (mean difference [MD] 8.02, 95% CI 4.85-11.20; p < 0.00001), long-term QoL (MD 11.30, 95% CI 6.75-15.84; p < 0.00001), Profile of Mood States score (POMS) score (MD -0.43, 95% CI -0.72 to -0.13; p = 0.005), anxiety (standardized MD [SMD] -0.30, 95% CI -0.49 to -0.10; p = 0.003), and depression (SMD -0.47, 95% CI -0.66 to -0.29; p < 0.00001). CONCLUSIONS SEGT is effective in improving QoL and psychosocial status in breast cancer patients, but there is no convincing evidence that it has an impact on survival.
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Affiliation(s)
- Jiawei Lai
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China, .,School of Nursing, Southern Medical University, Guangzhou, China,
| | - Huijuan Song
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Ren
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuang Li
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China.,School of Nursing, Southern Medical University, Guangzhou, China
| | - Feng Xiao
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China.,School of Nursing, Southern Medical University, Guangzhou, China
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Ye ZJ, Zhang Z, Tang Y, Liang J, Sun Z, Hu GY, Liang MZ, Yu YL. Resilience patterns and transitions in the Be Resilient To Breast Cancer trial: an exploratory latent profile transition analysis. Psychooncology 2021; 30:901-909. [PMID: 33689199 DOI: 10.1002/pon.5668] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Be Resilient to Breast Cancer (BRBC), a theoretically-derived, resilience-based, culturally-tailored, supportive-expressive group therapy (SEGT), has been developed to help promote patients' resilience in breast cancer. Data from patients receiving BRBC intervention was utilized to explore and define characteristics of resilience patterns and their transitions over time. METHODS Resilience was used as a primary outcome and 391 patients completed Resilience Scale Specific to Cancer at enrollment (T0), 2 months (T1), 6 months(T2), and 12 months (T3) after intervention. latent profile transition analysis was performed to model the change in resilience and predict positive transitioning probabilities between resilience patterns (from one pattern to another pattern with a higher level) over time. RESULTS One hundred and forty four resilience patterns were identified after BRBC intervention. 33.1%, 50.3%, and 40.5% of patients experienced positive resilience transitions from T0 to T1, T1 to T2, and T2 to T3, respectively. Patients with middle age, unmarried status, higher education level, and less advanced tumor stage were more likely to experience positive resilience transitions. CONCLUSION Different transitions of resilience patterns are observed after BRBC intervention. Age, marital status, education, and tumor stage may be four factors affecting the efficacy of SEGT intervention in breast cancer.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zhang Zhang
- Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Jian Liang
- Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, China
| | - Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, Guangdong Province, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, Guangdong Province, China
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Ye ZJ, Zhang Z, Tang Y, Liang J, Zhang XY, Hu GY, Sun Z, Liang MZ, Yu YL. Minimum clinical important difference for resilience scale specific to cancer: a prospective analysis. Health Qual Life Outcomes 2020; 18:381. [PMID: 33298059 PMCID: PMC7724855 DOI: 10.1186/s12955-020-01631-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The minimum clinical important differences (MCIDs) of resilience instruments in patients with cancer have not been comprehensively described. This study was designed to evaluate MCIDs of 10-item and 25-item resilience scales specific to cancer (RS-SC-10 and RS-SC-25). METHODS From June 2015 to December 2018, RS-SCs were longitudinally measured in 765 patients with different cancer diagnoses at baseline (T0) and 3 months later (T1). The EORTC QLQ-C30, Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale, and Allostatic Load Index were measured concurrently as anchors. Anchor-based methods (linear regression, within-group), distribution-based methods(within-group), and receiver operating characteristic curves (ROCs, within-subject) were performed to evaluate the MCIDs. RESULTS 623 of 765 (84.1%) patients had paired RS-SCs scores. Moderate correlations were identified between the change in RS-SCs and change in anchors (r = 0.38-0.44, all p < 0.001). Linear regression estimated + 8.9 and - 6.7 as the MCIDs of RS-SC-25, and + 3.4 and - 2.5 for RS-SC-10. Distribution-based methods estimated + 9.9 and - 9.9 as the MCIDs of RS-SC-25, and + 4.0 and - 4.0 for RS-SC-10. ROC estimated + 5.5 and - 4.5 as the MCIDs of RS-SC-25, and + 2.0 and - 1.5 for RS-SC-10. CONCLUSIONS The most reliable MCID is around 5 points for RS-SC-25 and 2 points for RS-SC-10. RS-SCs are more responsive to the worsening status of resilience in patients with cancer and these estimates could be useful in future resilience-based intervention trials.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
| | - Zhang Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - Jian Liang
- Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - Xiao Ying Zhang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 510275, Guangdong Province, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, 400038, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
| | - Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, 510641, Guangdong Province, China
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Aizpurua-Perez I, Perez-Tejada J. Resilience in women with breast cancer: A systematic review. Eur J Oncol Nurs 2020; 49:101854. [PMID: 33120216 DOI: 10.1016/j.ejon.2020.101854] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Resilience refers to a dynamic process that promotes a successful adaptation to cancer-related adversity. The aim of this systematic review was to identify the biopsychosocial factors involved in the resilience of women with breast cancer and to integrate evidence on the interventions that can contribute to significantly enhancing it. METHOD Three databases were searched. In all, 923 articles were identified and, of these, 39 peer-reviewed articles were included. RESULTS Resilience was associated with multiple clinical, sociodemographic, social, psychological and physiological variables, with psychological factors being the most important contributors to the development of resilience. Some protective factors were identified, such as social support, several dimensions of quality of life (QOL) and adaptive coping strategies. Psychological distress was the variable most frequently linked to reductions in resilience, finding a bidirectional relationship between them. Resilience-promoting interventions were found to be effective in improving participants' psychological well-being. CONCLUSION Resilience is a relevant factor related with several sociodemographic, clinical, psychosocial and physiological variables in women with breast cancer. However, limitations such as the wide variability of instruments used together with the heterogeneity and small size of the samples restrict the generalizability of our conclusions.
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Affiliation(s)
- Ibane Aizpurua-Perez
- Department of Basic Psychological Processes and their Development, University of the Basque Country, San Sebastian, Spain.
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46
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Kerr P, Kheloui S, Rossi M, Désilets M, Juster RP. Allostatic load and women's brain health: A systematic review. Front Neuroendocrinol 2020; 59:100858. [PMID: 32758482 DOI: 10.1016/j.yfrne.2020.100858] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 01/11/2023]
Abstract
Allostatic load represents the 'wear and tear' of chronic stress on the brain and body that may differ between men and women. A small but growing number of studies are assessing allostatic load in relation to mental health. The objective of this systematic review was to (1) assess sex differences in allostatic load and (2) identify allostatic load associations that are specific to women. We systematically searched for allostatic load studies that included psychosocial causes and/or psychiatric consequences. Our search focused on allostatic load studies that disaggregated by sex and that include women. Sixty-two studies were included in this systematic review. First, men appear to have higher allostatic load than women. Second, women show gender-specific variation for numerous factors such as age, race/ethnicity, adversities, social support, and health behaviors that influence associations between allostatic load and mental health. Recommendations are made to guide researchers advance sex and gender approaches.
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Affiliation(s)
- Philippe Kerr
- Center on Sex*Gender, Allostasis and Resilience, Canada; Center for Studies on Human Stress, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Sarah Kheloui
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Mathias Rossi
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Marie Désilets
- Research Center of the Montreal Mental Health University Institute, Canada
| | - Robert-Paul Juster
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada.
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Abstract
Allostatic load (AL) is the manifestation of cumulative responses to chronic stress exposure. Numerous studies have shown the importance of AL in understanding disease risks. Yet little is known about existing interventions that target AL specifically. We aimed to address this gap by identifying interventions targeting AL and determining the success of these interventions in improving biological functioning. We searched five electronic databases using variations of two concepts: AL and programs or interventions. We included original research reports that focused on AL as an outcome. We excluded work that focused on a single indicator, not written in English or did not implement an intervention. The Template for Intervention Description and Replication checklist guided our intervention critique and synthesis. Six articles were included, with sample size across the interventions ranging between 2 and 733. Despite inconsistencies in the selection of AL indicators and scoring of AL, all four body systems were represented in all the studies. Four interventions showed significant improvement in Al (as indicated by a decrease in AL score) as early as 7 weeks. More interventions targeting Al are needed. The reduction in AL scores among four of the six interventions suggests that Al could be a biological outcome measure that is sensitive to change in response to interventions. This has significant clinical and research implications. Future studies are needed to examine whether AL serves as a mediator in the effects of the intervention on improving clinical manifestations of diseases.
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Affiliation(s)
- Marie-Anne S. Rosemberg
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | | | - Yang Li
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
| | - Julia S. Seng
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Resilience During Pregnancy by Race, Ethnicity and Nativity: Evidence of a Hispanic Immigrant Advantage. J Racial Ethn Health Disparities 2020; 8:892-900. [PMID: 32808195 DOI: 10.1007/s40615-020-00847-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
The similar socioeconomic position of black and Hispanic women coupled with better birth outcomes among Hispanic women is termed the "Hispanic Paradox." However, birth outcome disparities among Hispanic women exist by maternal nativity. Persistent unequal exposure over time to stressors contributes to these disparities. We hypothesized that variation in maternal resilience to stressors also exists by race, ethnicity, and nativity. We utilized data from the Spontaneous Prematurity and Epigenetics of the Cervix study in Boston, MA (n = 771) where resilience was measured mid-pregnancy using the Connor Davidson Resilience Scale 25. We assessed resilience differences by race/ethnicity, by nativity then by race, ethnicity, and nativity together. We also assessed the risk of low resilience among foreign-born women by region of origin. We used Poisson regression to calculate risk ratios for low resilience, adjusting for maternal age, education, and insurance. Resilience did not differ significantly across race/ethnicity or by foreign-born status in the overall cohort. US-born Hispanic women were more likely to be in the low resilience tertile compared with their foreign-born Hispanic counterparts (adjusted RR 3.52, 95% CI 1.18-10.49). Foreign-born Hispanic women also had the lowest risk of being in the low resilience tertile compared with US-born non-Hispanic white women (aRR 0.33, 95% CI 0.11-0.98). Resilience did not differ significantly among immigrant women by continent of birth. Overall, foreign-born Hispanic women appear to possess a resilience advantage. Given that this group often exhibits the lowest rates of adverse birth outcomes, our findings suggest a deeper exploration of resilience among immigrant Hispanic women.
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Resilience process and its protective factors in long-term survivors after lung cancer surgery: a qualitative study. Support Care Cancer 2020; 29:1455-1463. [PMID: 32683484 DOI: 10.1007/s00520-020-05633-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/13/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Resilience was correlated with psychological outcomes and quality of life in lung cancer patients. But the resilience process and its protective factors remained uncertain. PURPOSE To investigate and analyze resilience process and its protective factors in long-term survivors after lung cancer surgery. METHODS This qualitative study included 19 patients who had survived at least 5 years after lung cancer surgery. Colaizzi's method of phenomenology was used for data analysis. RESULTS Analysis of this study was divided into the resilience process and protective factors. The resilience process was summarized into three stages, including initial stress, adaptation to disease, and personal growth. Five themes were regarded contributing to their own resilience in this process, including excellent psychological qualities, good social support, regular lifestyle and exercise, participating in social activities, and Chinese medicine. CONCLUSION This study showed the dynamic process of resilience and its protective factors in long-term survivors after lung cancer surgery. Future studies could identify average length of time of each stage and how patients transfer between stages during resilience process. Besides, interventions could be carried out to educate patients diagnosed with cancer about normal stages of change in body and resilience through time and strategies on adaptation and adjustment of lung cancer.
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Ye ZJ, Zhang Z, Zhang XY, Tang Y, Chen P, Liang MZ, Sun Z, Yu YL. State or trait? Measuring resilience by generalisability theory in breast cancer. Eur J Oncol Nurs 2020; 46:101727. [PMID: 32339909 DOI: 10.1016/j.ejon.2020.101727] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Whether resilience should be conceptualised as a state or trait is debated. The precise distinction between state versus trait aspects of resilience can help identify dynamic targets for resilience-based intervention trials involving cancer patients. This study was designed to disentangle the state and trait components of resilience in patients with breast cancer with the help of Generalisability Theory (GT) methods. METHODS The relative contributions of state (temporary) and trait (enduring) aspects of resilience were calculated using a 10-item Resilience Scale Specific to Cancer (RS-SC-10) and GT methods. In all, 391 patients were enrolled from the 'Be Resilient to Breast Cancer ' (BRBC) trial, and data from 317 patients (81.7%) were collected at baseline, 3 months, 6 months, and 12 months after the intervention. RESULTS The subscale of Generic Elements demonstrated high generalisability value (relative G-coefficient = 0.81) across different occasions and captured 79% of the variance attributed to enduring aspects of resilience. The subscale of Shift-Persist showed low generalisability value (relative G-coefficient = 0.31) and identified 59% of the variance attributed to temporary aspects of resilience. The GT studies suggested that 5-7 items per scale and three measurement occasions were adequate for score reliability evaluation. CONCLUSION Resilience should be conceptualised as a state-trait mixed psychological variable in breast cancer patients. The subscale of Shift-Persist in RS-SC-10 is amenable to intervention and could be utilised as a primary outcome in resilience-based intervention trials. CLINICAL TRIAL REGISTRATION None.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China.
| | - Zhang Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, 510060, China
| | - Xiao Ying Zhang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong Province, 510275, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, 550025, China
| | - Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, Guangdong Province, 510600, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510405, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, Guangdong Province, 510641, China
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