Patient-reported stressful events and coping strategies in post-menopausal women with breast cancer

Stressful life events and heart disease and stroke: A study among Portuguese older adults

The link between stressful life events (SLE) and cardiovascular diseases (CVD) remains underexplored. This study aimed to examine the association between SLE and the diagnosis of heart disease or stroke, among older adults. Data from 678 participants from the population-based cohort EPIPorto, with ≥60 years and complete information regarding SLE and heart disease or stroke, were analysed. Stressful life events were measured through the 'Stressful Life Events Screening Questionnaire'. A previous diagnosis of heart disease or stroke was self-reported. Adjusted odds ratios (OR) with the respective 95% confidence intervals were computed through logistic regression. Almost a fourth of the participants never experienced any SLE throughout life, 30.0% experienced at least one event, 17.5% experienced two and 27.7% had experienced three or more SLE. A dose-effect association between SLE and the diagnosis of heart disease or stroke was observed, statistically significant for those who had at least 3 types of SLE, independently of confounders (≥3SLE vs. 0SLE: OR = 2.00; 95% CI: 1.12-3.57). This cross-sectional study suggests that cumulative exposure to different types of SLE during the life course was associated with a higher likelihood of having a diagnosis of heart disease or a stroke at a later age. Future longitudinal studies should better deepen this association, particularly by evaluating which type of SLE is more related to a higher prevalence of heart disease and stroke, and how the timing of the SLE influence this relation.

Fear of cancer recurrence and coping attitudes of breast cancer survivors

OBJECTIVE

This study aimed to determine the fear of cancer recurrence levels and coping orientation of breast cancer survivors.

METHODS

This descriptive exploratory study was conducted using a web-based online survey. This article is written using the STROBE checklist. The study was completed with 204 women participants. Data were collected using the 'Demographic and Clinical Information Form', 'Fear of Cancer Recurrence Inventory (FCRI)' and 'Coping Orientation to Problems Experienced Inventory-Revised (COPE-R)'.

RESULTS

FCRI total score average within the scope of the study was calculated as 42.00 ± 18.88. Women's COPE-R total score average is 80.62 ± 13.20. There was a positive correlation between FCRI total score and COPE-R (r = 0.183, p = 0.009). According to the results of multiple linear regression analysis, age, education level, CAM usage, getting psychological support and COPE-R subscales (accommodation, avoidance, self-punishment) were associated with FCRI total score.

CONCLUSIONS

The fear of cancer recurrence experienced by breast cancer survivors was associated with their coping orientation. Determining the fear of cancer recurrence level and coping orientation of breast cancer survivors by healthcare professionals will guide the reduction of women's fear of cancer recurrence and further the development of adaptive coping orientation.

Spirituality, Religiosity and Coping Strategies Among Spanish People Diagnosed with Cancer

The present study evaluates the influence of spirituality/religiosity (S/R) on the coping strategies used by people with cancer (breast and prostate) compared with those without cancer, in a sample of 445 Spanish participants (160 with cancer and 285 without). Significant interactions between the presence of cancer and S/R are observed in the use of coping strategies such as religion, humor and disconnection. Spirituality as a predictor variable through the use of religion as a strategy, increased the explanatory capacity of age by 58.9% (β = .794) while praying/talking to God predicts the use of this strategy with a β = .383. In people with cancer, active coping was predicted by spirituality (β = .327). However, spirituality was a negative predictor of maladaptive coping, with a beta coefficient equal to .383. The data suggest that patients' beliefs need to be considered by health care professionals when designing interventions.

Coping strategies among patients with malignant lymphoma- a qualitative study from the perspectives of Swedish patients

PURPOSE

There is a dearth of research on coping strategies of patients with malignant lymphoma. The aim of this article is to explore how these patients cope with cancer in everyday life.

METHOD

Semi-structured interviews were conducted with nine patients in Sweden. A thematic analysis was made, inspired by Antonovsky's theory of sense of coherence. The SRQR checklist was used.

RESULTS

Patient's coping strategies are shown within three themes: 'Life experiences supported coping strategies during treatment', 'Between completed treatment and (possible) cure', and 'Illness brought closeness and distance in social relationships'. Three different coping strategies were identified during treatment: trying to control the situation, seeing opportunities in difficulties, and doing other activities to limit thoughts about disease and treatment. Four different coping strategies were identified after treatment ended, namely projecting responsibility and anger onto the healthcare system, maintaining the outer facade as a strong person who had control over the situation, talking about disease, side effects and emotions and putting the focus on the future, and managing life by anticipating death. Family =and friends were a part of patients' coping strategies, but to different extents and in different ways. Diagnosis and treatment for malignant lymphoma brought closeness and distance in social relationships.

CONCLUSION

Patients with malignant lymphoma cope with cancer in different ways in everyday life influenced by their life experiences and life conditions. Further research should focus on cancer patients' coping strategies in a relational perspective, as coping and coping opportunities are embedded in social context and social relationships.

Timing and Mode of Breast Care Nurse Consultation From the Patient's Perspective

OBJECTIVES

To understand what, if any, differences exist in the perception of a breast care nurse (BCN) consultation between women who experienced a preoperative, face-to-face counseling and education opportunity with a BCN, and those who required a telephone consultation or were unable to experience a preoperative BCN consultation.

SAMPLE & SETTING

A convenience sample of women in a private hospital in Western Australia who had breast surgery for breast cancer, BRCA gene mutation, or breast cancer risk reduction, and who experienced face-to-face contact, telephone contact, or no preoperative contact with a BCN.

METHODS & VARIABLES

A single-center, mixed-methods, descriptive study comparing timing and mode of consultation.

RESULTS

Women who experienced a timely face-to-face consultation with a BCN in the preoperative period reported that they received superior education and emotional and practical support than women who experienced a telephone consultation or postoperative consultation with a BCN.

IMPLICATIONS FOR NURSING

When a patient's circumstances allow, a consultation with a BCN in the preoperative period should be offered. Ideally, this consultation should be conducted face-to-face to provide the education and psychosocial and practical support that patients undergoing breast surgery require. When this is not possible, a telephone consultation should be offered, as opposed to waiting until after surgery.

Differential psychological effects of cognitive-behavioral stress management among breast cancer patients with high and low initial cancer-specific distress

OBJECTIVE

Cognitive-behavioral stress management (CBSM) improves adaptation to primary treatment for breast cancer (BCa), evidenced as reductions in distress and increases in positive affect. Because not all BCa patients may need psychosocial intervention, identifying those most likely to benefit is important. A secondary analysis of a previous randomized trial tested whether baseline level of cancer-specific distress moderated CBSM effects on adaptation over 12 months. We hypothesized that patients experiencing the greatest cancer-specific distress in the weeks after surgery would show the greatest CBSM-related effects on distress and affect.

METHODS

Stages 0-III BCa patients (N = 240) were enrolled 2-8 weeks after surgery and randomized to either a 10-week group CBSM intervention or a 1-day psychoeducational (PE) control group. They completed the Impact of Event Scale (IES) and Affect Balance Scale (ABS) at study entry, and at 6- and 12- month follow-ups.

RESULTS

Latent Growth Curve Modeling across the 12-month interval showed that CBSM interacted with initial cancer-related distress to influence distress and affect. Follow-up analyses showed that those with higher initial distress were significantly improved by CBSM compared to control treatment. No differential improvement in affect or intrusive thoughts occurred among low-distress women.

CONCLUSION

CBSM decreased negative affect and intrusive thoughts and increases positive affect among post-surgical BCa patients presenting with elevated cancer-specific distress after surgery, but did not show similar effects in women with low levels of cancer-specific distress. Identifying patients most in need of intervention in the period after surgery may optimize cost-effective cancer care.