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Skojec TA, Davidson TM, Kelechi TJ. The relationship between uncertainty in illness and psychological adjustment to chronic illness. J Health Psychol 2024:13591053241249861. [PMID: 38761058 DOI: 10.1177/13591053241249861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2024] Open
Abstract
Using Mishel's Uncertainty in illness theory, this integrative review sought to identify how uncertainty in illness and psychological adjustment to illness are associated with chronic illness to guide development of interventions to support psychological adjustment. A search was conducted via EBSCOHost to answer the question "What is the relationship between uncertainty in illness and psychological adjustment to chronic illness?" Two key factors were identified as having an impact on psychological adjustment to chronic illness in the presence of uncertainty in illness including uncertainty appraisal and the type of coping strategies used in response to the appraisal. Individuals with a chronic illness diagnosis are more likely to experience increased levels of uncertainty in illness and decreased psychological adjustment to illness. A better understanding of these two concepts is important to augment and or guide the development of interventions to support psychological adjustment.
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Wang S, Deng Y, Zhang Y, Guo VY, Zhang B, Cheng X, Xin M, Hao Y, Hou F, Li J. The role of illness-related cognition in the relationships between resilience and depression/anxiety in nasopharyngeal cancer patients. Cancer Med 2023; 12:21408-21418. [PMID: 37991167 PMCID: PMC10726906 DOI: 10.1002/cam4.6688] [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: 08/04/2023] [Revised: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE Resilience has been reported as an important predictor of better mental health and prognoses in cancer patients, while its mechanisms were not clearly elucidated. In this study, we surveyed a large sample of nasopharyngeal carcinoma patients to investigate the mediating role of illness-related cognition (illness perception, stigma and meaning in life) on the associations between resilience and symptoms of anxiety and depression. METHODS This cross-sectional study involved 773 participants diagnosed with nasopharyngeal carcinoma. Participants completed a self-reported structured questionnaire to assess their illness perception, stigma and meaning in life, resilience and symptoms of anxiety and depression. Structural equation models (SEM) were employed to explore the relationship between resilience and symptoms of anxiety and depression in the entire sample, as well as in two subgroups: Subgroup I (0-1 year since diagnosis), and Subgroup II (over 1 year since diagnosis). RESULTS In the entire sample, after adjusting for potential confounders, illness perception, stigma and meaning in life were found to mediate the protective effect of resilience on symptoms of depression (mediating effect proportion: 65.25%) and anxiety (mediating effect proportion: 67.63%). In Subgroup I, direct effects were dominant in the associations between resilience and symptoms of anxiety (mediating effect proportion: 37.95%) and depression (mediating effect proportion: 29.13%). However, in Subgroup II, the associations between resilience and symptoms of anxiety (mediating effect proportion: 98.92%) and depression (mediating effect proportion: 81.04%) were completely mediated. CONCLUSIONS Our study suggests that direct and indirect effects of resilience on depression and anxiety dominate in early periods (0-1 year) and long-term periods (over 1 year) following the cancer diagnosis, respectively. The findings indicate that comprehensive intervention considering both the direct effect of resilience in early stages (e.g., health education prescription and social support groups) and the indirect effects of illness cognition in long-term periods (e.g., cognitive behavioral therapies) are likely to yield the most favorable outcomes for cancer patients.
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Affiliation(s)
- Shenghao Wang
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Yang Deng
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Yuan Zhang
- Sun Yat‐sen Global Health InstituteSun Yat‐sen UniversityGuangzhouChina
- Department of Radiation OncologySun Yat‐sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouChina
| | - Vivian Yawei Guo
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Bo Zhang
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Xi Cheng
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Meiqi Xin
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHong KongChina
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response Peking UniversityBeijingChina
- Key Laboratory of Epidemiology of Major Diseases (Peking University)Ministry of EducationBeijingChina
| | - Fengsu Hou
- Sun Yat‐sen Global Health InstituteSun Yat‐sen UniversityGuangzhouChina
- Department of Public HealthShenzhen Kangning HospitalShenzhenChina
| | - Jinghua Li
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
- Sun Yat‐sen Global Health InstituteSun Yat‐sen UniversityGuangzhouChina
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Tian Q, Zhang C, Guo P, Xu M, Yu S, Liu Y, Cao M, Yu L, Yang S, Zhang W. Cognitive appraisal of health and its influencing factors among pregnant women with gestational diabetes mellitus: A cross‐sectional study. J Obstet Gynaecol Res 2023. [DOI: 10.1111/jog.15635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/28/2023] [Indexed: 04/04/2023]
Affiliation(s)
- Qi Tian
- School of Nursing Jilin University Changchun Jilin China
| | - Chunmiao Zhang
- Department of Obstetrics and Gynecology The Second Hospital of Jilin University Changchun Jilin China
| | - Pingping Guo
- School of Nursing Jilin University Changchun Jilin China
| | - Mengmeng Xu
- School of Nursing Jilin University Changchun Jilin China
| | - Shuanghan Yu
- School of Nursing Jilin University Changchun Jilin China
| | - Yantong Liu
- School of Nursing Jilin University Changchun Jilin China
| | - Minglu Cao
- School of Nursing Jilin University Changchun Jilin China
| | - Lin Yu
- School of Nursing Jilin University Changchun Jilin China
| | - Shu Yang
- School of Nursing Jilin University Changchun Jilin China
| | - Wei Zhang
- School of Nursing Jilin University Changchun Jilin China
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Gusler S, Guler J, Petrie R, Marshall H, Cooley D, Jackson Y. Adversity Interpreted: A Scoping Review of Adversity Appraisal Measurement. TRAUMA, VIOLENCE & ABUSE 2022; 23:1111-1133. [PMID: 33511918 DOI: 10.1177/1524838020985544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although evidence suggests that individuals' appraisals (i.e., subjective interpretations) of adverse or traumatic life events may serve as a mechanism accounting for differences in adversity exposure and psychological adjustment, understanding this mechanism is contingent on our ability to reliably and consistently measure appraisals. However, measures have varied widely between studies, making conclusions about how best to measure appraisal a challenge for the field. To address this issue, the present study reviewed 88 articles from three research databases, assessing adults' appraisals of adversity. To be included in the scoping review, articles had to meet the following criteria: (1) published no earlier than 1999, (2) available in English, (3) published as a primary source manuscript, and (4) included a measure assessing for adults' (over the age of 18) subjective primary and/or secondary interpretations of adversity. Each article was thoroughly reviewed and coded based on the following information: study demographics, appraisal measurement tool(s), category of appraisal, appraisal dimensions (e.g., self-blame, impact, and threat), and the tool's reliability and validity. Further, information was coded according to the type of adversity appraised, the time in which the appraised event occurred, and which outcomes were assessed in relation to appraisal. Results highlight the importance of continued examination of adversity appraisals and reveal which appraisal tools, categories, and dimensions are most commonly assessed for. These results provide guidance to researchers in how to examine adversity appraisals and what gaps among the measurement of adversity appraisal which need to be addressed in the future research.
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Affiliation(s)
| | | | | | | | - Daryl Cooley
- Pennsylvania State University, State College, PA, USA
| | - Yo Jackson
- Pennsylvania State University, State College, PA, USA
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Zou W, Zhang Y, Gong L, Zhang M, Wu X, Xie J, Zhang M. Factors associated with psychosocial adjustment in working-age colorectal cancer survivors: A cross-sectional study. Asia Pac J Oncol Nurs 2022; 9:100057. [PMID: 35647223 PMCID: PMC9130516 DOI: 10.1016/j.apjon.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/25/2022] [Indexed: 12/05/2022] Open
Abstract
Objective This study aimed to describe the level of psychosocial adjustment and identify factors associated with psychosocial adjustment in working-age colorectal cancer survivors. Methods This cross-sectional study involved 212 colorectal cancer survivors visiting a cancer clinic at a specialized oncology hospital in China. Socio-demographic characteristics, disease-related characteristics, status of returning to work, Work Ability Index scores, M. D. Anderson Symptom Inventory for Gastrointestinal Cancer scores, and self-reported Psychological Adjustment to Illness Scale scores were collected from all participants. Data analyses included descriptive statistics, independent t-test, one-way analysis of variance, correlation analysis, and multiple linear regression analysis, which were performed using the Statistical Package for the Social Sciences version 25.0 (IBM Corporation, Armonk, NY, USA). Results Participants reported a medium level of psychosocial maladjustment (35.73 ± 19.68), with 19.3% of participants experiencing severe maladjustment, 29.7% experiencing moderate maladjustment, and 50.9% experiencing mild maladjustment, respectively. Age, gender, marital status, having a child, education level, having a stoma, comorbidities, return to work, work ability, and symptom distress were entered into a multiple linear regression analysis. The strongest factor influencing the level of psychosocial adjustment was work ability (β = −0.393, P < 0.001), followed by symptom distress (β = 0.380, P < 0.001) and an education level of college or above (β = 0.150, P = 0.027). These variables accounted for 46.1% of the variance in psychosocial adjustment. Conclusions Colorectal cancer survivors with low work ability, high symptom distress, and an education level of college or above are at a high risk for psychosocial maladjustment. Nursing interventions for psychosocial adjustment should attach increased importance to the work status and symptom distress of colorectal cancer survivors.
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Yan MH, Fan Y, Chen M, Zhang J. The mediating role of self-efficacy in the association between perceived stigma and psychosocial adjustment: a cross-sectional study among nasopharyngeal cancer survivors. Psychooncology 2022; 31:806-815. [PMID: 34981579 DOI: 10.1002/pon.5865] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/17/2021] [Accepted: 12/06/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aims to examine the levels of and associations between perceived stigma, self-efficacy, and psychosocial adjustment (PA) among nasopharyngeal carcinoma (NPC) survivors, and to identify the mediating role of self-efficacy between stigma and PA and explore the influencing factors of PA. METHODS A cross-sectional survey was conducted and 307 NPC survivors were recruited by convenience sampling method in Southern China from July 2019 to January 2020. Data analyses were performed with the SPSS WIN 25.0 program and PROCESS macro version 3.3. RESULTS Stigma and self-efficacy were positively associated with PA among Chinese NPC survivors. Tumor-free survival time, late toxicities (fatigue, dizziness and headache, and hearing loss), stigma, and self-efficacy entered the final regression model and explained 55.9% of the variance of PA. The total and direct effects of stigma on PA and its subscales were significant (p < 0.05). Positive indirect effects were found for stigma on PA via self-efficacy (point estimate = 0.159, SE = 0.032, 95% CI [0.102 to 0.229]). CONCLUSIONS Stigma and self-efficacy are significantly associated with PA, and self-efficacy is also a mediating variable between stigma and PA among NPC survivors. Medical staff could improve the PA of NPC survivors by alleviating their stigma, enhancing their self-efficacy, and relieving their late toxicities (fatigue, dizziness and headache, and hearing loss).
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Affiliation(s)
- Ming-Hui Yan
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yuying Fan
- Department of Nasopharyngeal Carcinoma, Cancer Centre, Sun Yat-sen University, Guangzhou, China
| | - Minlin Chen
- Department of Nasopharyngeal Carcinoma, Cancer Centre, Sun Yat-sen University, Guangzhou, China
| | - June Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Azarbarzin M, Ghamary L, Nabi Foodani M, Sadeghi N. Relationship between perception of family and friends' support and psychosocial adaptation in adolescents suffering from cancer. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2022. [DOI: 10.4103/jnms.jnms_61_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Kessler TA. The Role of Cognitive Appraisal in Quality of Life Over Time in Patients With Cancer. Oncol Nurs Forum 2020; 47:292-304. [PMID: 32301930 DOI: 10.1188/20.onf.292-304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To better understand how personal factors, contextual factors, and cognitive appraisals predict quality of life. SAMPLE & SETTING 81 patients with a new diagnosis of cancer were recruited from two oncologists' offices in the midwestern United States. METHODS & VARIABLES A longitudinal design was used to collect data at three time points. RESULTS Individuals identified a variety of primary appraisals at the same time and more consistently identified their cancer as a challenge rather than a harm/loss or a threat. The greatest variation in appraisals and quality of life occurred about six months after diagnosis. Hierarchical regression analyses demonstrated that age and primary and secondary appraisals explained a significant amount of variance in quality of life at all three time points. IMPLICATIONS FOR NURSING Interventions to improve quality of life for individuals newly diagnosed with cancer are needed and may be more helpful if they target cognitive appraisals. Nurses should assess what matters to the individual; it is important to evaluate how each person appraises a cancer diagnosis so providers can support coping and adjustment from diagnosis through individual treatment trajectories.
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Psychological Support. Radiat Oncol 2019. [DOI: 10.1007/978-3-319-52619-5_114-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Jang M, Kim J. A structural model for stress, coping, and psychosocial adjustment: A multi-group analysis by stages of survivorship in Korean women with breast cancer. Eur J Oncol Nurs 2018; 33:41-48. [DOI: 10.1016/j.ejon.2018.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 01/04/2018] [Accepted: 01/07/2018] [Indexed: 11/15/2022]
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A meta-analytic review of the relationship of cancer coping self-efficacy with distress and quality of life. Oncotarget 2018; 8:36800-36811. [PMID: 28404938 PMCID: PMC5482699 DOI: 10.18632/oncotarget.15758] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 01/25/2017] [Indexed: 12/27/2022] Open
Abstract
Self-efficacy for coping with cancer is a specific construct that refers to behaviors that occur in the course of dealing with a cancer diagnosis, cancer treatments, and transitioning to survivorship. One of the more widely used measures of self-efficacy for coping strategies with cancer is the Cancer Behavior Inventory. The following general questions provide a framework for this research: 1. Is self-efficacy for coping with cancer related to distress and quality of life of a cancer patient?. 2. Do self-efficacy for coping with cancer and the target psychological outcomes (i.e., distress and quality of life) change in longitudinal studies, with or without intervention? One-hundred eighty studies cited the different versions of the Cancer Behavior Inventory and 47 used the scale. Result showed an inverse relationship between self-efficacy for coping with cancer and distress, and a positive relationship between self-efficacy for coping with cancer and Quality of Life, both with a large effect size. The strong relationship of self-efficacy and outcomes, resulted of the specificity of the instrument, which targets specific coping strategies that are closely aligned with positive outcomes in adjusting to cancer. However, the results are consistent with the theory, which states that compared to those with low efficacy, highly efficacious people demonstrate less anxiety and better adjustment in stressful situations and consistent with prior results in which self-efficacy is positively related to quality of life.
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Fitch MI, Maamoun J. Besoins en soins de soutien non comblés et désir de recevoir de l’aide de patients recevant de la radiothérapie : répercussions sur l’infirmière en oncologie. Can Oncol Nurs J 2016; 26:60-67. [PMID: 31148694 DOI: 10.5737/236880762616067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Margaret I Fitch
- Professeure, Faculté des sciences infirmières, Université de Toronto, Toronto, ON Courriel:
| | - John Maamoun
- Radiothérapeute, Service de radiothérapie, Centre de cancérologie Odette, Centre des sciences de la santé Sunnybrook, Toronto, ON
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Fitch MI, Maamoun J. Unmet supportive care needs and desire for assistance in patients receiving radiation treatment: Implications for oncology nursing. Can Oncol Nurs J 2016; 26:53-59. [PMID: 31148742 DOI: 10.5737/236880762615359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Unmet supportive care needs can contribute to emotional distress and reduced quality of life for cancer patients. We undertook a supportive care needs assessment for patients undergoing radiation therapy to provide a basis for program planning. A self-report supportive care needs survey was completed by a convenience sample of 115 patients on days five, seven and 16 during their course of radiation. The most frequently identified physical unmet needs at all three times were fatigue (33%-49%), dry and itchy skin (24%-37%), and sleep difficulties (23%-30%). The number of patients citing these unmet needs increased significantly over the study time period. Within the emotional domain, worry (34.5%) was cited most frequently on day five. The number of individuals expressing worry did not decrease significantly by day 16. Across all domains and individual items, there was wide variation in the percentage of individuals who had an unmet need and also indicated they wanted help with that unmet need. This pattern remained consistent over time. This study emphasizes the need for a defined or intentional process to assess supportive care needs and patient desire for assistance or help with unmet needs.
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Affiliation(s)
- Margaret I Fitch
- Professor, Faculty of Nursing, University of Toronto, Toronto, ON,
| | - John Maamoun
- Radiation Therapist, Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
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Park HJ, Kim K, Kim JS. Factors that Influence Korean Breast Cancer Patients to Undergo Cancer Rehabilitation Therapy. ASIAN ONCOLOGY NURSING 2015. [DOI: 10.5388/aon.2015.15.2.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hui-jeong Park
- Department of Nursing, Graduate School of Chung-Ang University, Seoul, Korea
| | - Kyunghee Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
| | - Ji-su Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
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Chien CH, Chuang CK, Liu KL, Huang XY, Liu HE. Psychosocial adjustments in patients with prostate cancer from pre-diagnosis to 6 months post-treatment. Int J Nurs Pract 2014; 22:70-8. [DOI: 10.1111/ijn.12360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ching-Hui Chien
- College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - Cheng-Keng Chuang
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Kuan-Lin Liu
- Division of Urology; Department of Surgery; College of Medicine; Chang Gung Memorial Hospital; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Xuan-Yi Huang
- College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - Hsueh-Erh Liu
- College of Medicine; School of Nursing; Chang Gung University; Tao-Yuan Taiwan
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Hess CB, Chen AM. Measuring psychosocial functioning in the radiation oncology clinic: a systematic review. Psychooncology 2014; 23:841-54. [PMID: 24846702 DOI: 10.1002/pon.3521] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 02/05/2014] [Accepted: 02/24/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND This paper aimed to systematically review the (1) prevalence, (2) risk factors, (3) interventions, and (4) measurement instruments associated with psychosocial function decline in radiation therapy (RT) patients. METHODS A MEDLINE systematic literature review was performed to identify studies monitoring psychosocial function among RT patients as a primary endpoint. RESULTS Fifty-seven and 22 risk factors for RT-related psychosocial function decline were identified and refuted, respectively, in 93 eligible studies representing 12,808 patients. Median prevalences of psychosocial function decline prior to, during, and following RT were 20%, 36%, and 25%. Prior to RT, anxiety was more prevalent than depression (20% vs 15%), but dropped following completion of RT, whereas median depression levels remained elevated (17% vs. 27%). Of the 79 identified risk factors, 17 were reported as predictive of psychosocial decline by two or more more studies, and five had robust support: (1) physical symptoms, (2) time point during RT, (3) chemotherapy reception, (4) female gender, and (5) younger age. Three interventions were consensually reported to improve psychosocial function: psychotherapy, nursing consultation/patient education, and self-management training. Eighty-six different assessment tools were used to monitor RT-related psychosocial function decline with the Hospital Anxiety and Depression Scale (25.8%) and the psychiatric interview (22.6%) being the most utilized. The distress thermometer has been used in 5 studies (5.4%) to date. CONCLUSION Psychosocial function declines in approximately one-third of RT patients. Anxiety can dissipate after initiation of RT, whereas depression can persist throughout and after RT. Severe physical symptoms and time-related factors most robustly predict psychosocial function decline, which can be improved by psychotherapy and interventions aimed to improve patient education.
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Affiliation(s)
- Clayton B Hess
- The Pennsylvania State University College of Medicine, Hershey, PA, USA; The University of Texas Southwestern-Austin Transitional Residency Program, Austin, TX, USA; Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
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Partners' long-term appraisal of their caregiving experience, marital satisfaction, sexual satisfaction, and quality of life 2 years after prostate cancer treatment. Cancer Nurs 2014; 36:104-13. [PMID: 22728952 DOI: 10.1097/ncc.0b013e3182567c03] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Partners of men treated for prostate cancer report more emotional distress associated with a diagnosis of prostate cancer than the men report; the duration of distress for partners is seldom examined. OBJECTIVES The purpose of this study was to determine the long-term effects of prostate cancer treatment on partners' appraisal of their caregiving experience, marital satisfaction, sexual satisfaction, and quality of life (QOL) and factors related to these variables. METHODS This exploratory study evaluated QOL among spouses of prostate cancer survivors at 24 months after treatment. Partners completed a battery of self-report questionnaires in a computer-assisted telephone interview. RESULTS The sample consisted of 121 partners with average age of 60 years. There was a significant relationship between partners' perceptions of bother about the man's treatment outcomes and negative appraisal of their caregiving experience and poorer QOL. Younger partners who had a more negative appraisal of caregiving also had significantly worse QOL. CONCLUSIONS Men's treatment outcomes continued to bother the partner and resulted in more negative appraisal and lower QOL 2 years after initial prostate cancer treatment. Younger partners may be at greater risk of poorer QOL outcomes especially if they have a more negative view of their caregiving experience. IMPLICATIONS FOR PRACTICE Findings support prior research indicating that prostate cancer affects not only the person diagnosed with the disease but also his partner. Partners may benefit from tailored interventions designed to decrease negative appraisal and improve symptom management and QOL during the survivorship period.
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Maamoun J, Fitch MI, Di Prospero L. The Evaluation of a New Supportive Care Screening Tool for Radiation Therapy Patients. J Med Imaging Radiat Sci 2013; 44:141-149. [PMID: 31052038 DOI: 10.1016/j.jmir.2013.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 02/28/2013] [Accepted: 03/11/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Individuals undergoing radiation therapy for cancer may experience a wide range of supportive care needs that are frequently not addressed. A screening tool was designed and tested for psychometric properties (technical characteristics) to assist radiation therapists to quickly identify those patients who require additional intervention during the course of their radiation treatment, allowing early and timely referral and facilitating the provision of quality, in-depth, and patient-centred supportive care. METHODOLOGY A comprehensive and itemized screening tool was designed to identify the patient concerns and distress level, capture the patient desire to be helped with specific concerns, and inform the centre of alternative help provided. The tool was administered simultaneously with the standardized instrument quality-of-life questionnaire. One hundred and fifteen radiation therapy patients completed both instruments on three occasions; the first two were 2 days apart, and the third, 2 weeks later. To test the new tool for reliability and sensitivity, the agreement between the responses on the first two occasions and those between the first and third occasions were analysed for both instruments. Correlations between the responses on the two instruments were also examined for concurrent validity. RESULTS McNemar's test and the simple kappa coefficient both showed high agreement between item scores on the new screening tool when the first and the second occasions were compared. When the first and the third occasions were compared, the former test showed a shift from high agreement to lesser agreement across the item scores. The latter showed a shift in more than 97.7% of the items from a higher agreement to a lesser agreement. The new tool's sensitivity to change was further reinforced by the data from the validated quality-of-life questionnaire, which showed a similar change over time; the Pearson product moment correlation coefficient fell on average from 0.75 to 0.58 for the first and the second comparisons respectively, with all P values less than .0001. Concurrent validity was found to be acceptable. CONCLUSIONS The new screening tool was found to be reliable and sensitive, with acceptable validity. It is anticipated that the screening intervention will allow radiation therapists to standardize and formalize their approach to supportive care in radiation therapy outpatient clinics and enhance their capacity to identify and address patient concerns in a timely manner.
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Affiliation(s)
- John Maamoun
- Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
| | - Margaret I Fitch
- Department of Oncology Nursing, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Di Prospero
- Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
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Bigatti SM, L. Steiner J, Miller KD. Cognitive Appraisals, Coping and Depressive Symptoms in Breast Cancer Patients. Stress Health 2012; 28:355-61. [PMID: 22888085 PMCID: PMC4105002 DOI: 10.1002/smi.2444] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 07/13/2012] [Accepted: 07/20/2012] [Indexed: 11/11/2022]
Abstract
Depression in breast cancer patients and survivors is related to negative disease outcomes and worse quality of life. Factors that explain this depression can serve as targets of intervention. This study, guided by the Transactional Theory of Stress, examined the relationship between cognitive appraisals, coping strategies and depressive symptoms in a group of women with mostly advanced-stage breast cancer (N = 65), who scored mostly within the normal range for depressive symptoms. Path analysis was used to determine the relationships among variables, measured with the Cognitive Appraisals of Illness Scale, the Ways of Coping Questionnaire and the Center for Epidemiological Studies Depression Scale. The results of the path analysis showed that higher appraisals of harm/loss and greater use of escape-avoidance coping predicted higher depressive symptoms. These findings enhance the prediction of depression among breast cancer patients and suggest the need to examine cognitive appraisals when attempting to understand depressive symptoms.
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Kim HY, So HS. [A structural model for psychosocial adjustment in patients with early breast cancer]. J Korean Acad Nurs 2012; 42:105-15. [PMID: 22410607 DOI: 10.4040/jkan.2012.42.1.105] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984). METHODS Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version. RESULTS Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer. CONCLUSION The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.
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Affiliation(s)
- Hye Young Kim
- Department of Nursing, Gwangju Women's University, Gwangju, Korea
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