Relationships among hope, psychological well-being and health-related quality of life in childhood cancer survivors

Fatalism and depressive symptoms among Chinese college students: Mediation models of locus of control and positive coping

Fatalistic voluntarism and classic fatalism have opposite effects on depression. This study attempted to measure fatalistic voluntarism with the magnanimity of Taoist values and examined the internal mechanism by which classic fatalism and magnanimity influenced depression. A total of 525 Chinese college students effectively completed self-reported questionnaires. Results showed that classic fatalism is positively correlated with depression, and magnanimity is negatively correlated with depression. Furthermore, classic fatalism and magnanimity can influence depression in Chinese college students through serial mediation by locus of control and positive coping. These findings illuminate the mediating role of locus of control and positive coping, providing specific ways to use two different belief systems, which can help reduce depressive symptoms among college students. In addition, our study may provide some ideas for the development of local culture in the promotion of mental health in different regions.

Effects of Group Exercise Intervention on Quality of Life and Physical Parameters in Patients with Childhood Cancer: A Systematic Review

BACKGROUND

Although the survival rates of childhood cancer are increasing, children diagnosed as having cancer experience psychological and physical problems and a declining quality of life (QOL).

METHODS

A systematic review of PubMed databases was conducted up to September 2023 to identify studies reporting the effects of group exercise intervention in children with cancer. The inclusion criteria were pre-specified, including children aged ≤19 years old who received group exercise intervention and interventional studies written in English. Studies involving non-exercise intervention or non-group intervention were excluded.

RESULTS

Five studies were included in the present review. In three studies, QOL and physical parameters were improved after group exercise intervention, and in two studies, only physical parameters were improved. Improvements in QOL were achieved through psychosocial variables, improved scores of subscales of pain and hurt, nausea, and procedure-related anxiety, and reduced cancer-related fatigue. All studies had high numbers of participants who completed the intervention. However, all studies showed a high risk of bias regarding the selection of the reported results, and most studies showed a high risk of bias regarding deviations from the intended intervention and outcome measurement.

CONCLUSION

The reviewed studies showed that group exercise intervention for children with cancer could improve their QOL and/or physical parameters.

Indirect effects of health-related quality of life on suicidal ideation through psychological distress among cancer patients

The interrelationships of suicidal ideation, psychological distress, and impaired health-related quality of life (HRQoL) in cancer patients are complex and multifaceted. Limited empirical evidence exists on the indirect effects of impaired HRQoL on suicidal ideation through psychological distress among cancer patients. To fill this research gap, 250 cancer patients were recruited through a cross-sectional hospital-based research design. Structural equation model (SEM) results indicated that impaired HRQoL is a predictor of psychological distress (β = 0.153; p < 0.05), and psychological distress positively predicts suicidal ideation (β = 0.647; p < 0.000). The study found no direct effects of impaired HRQoL on suicidal ideation (β = -0.05; p = 0.223). Indirect effects of HRQoL on suicidal ideation was confirmed, showing a full-mediation effect β = 0.099 (SE = 0.048, CI = [0.030, 0.189], p < 0.05) (i.e. the pathway impaired HRQoL predict suicidal ideation is through psychological distress). Cognitive-behavioral therapy and other emotional support programs should be considered for cancer patients to mitigate psychological vulnerabilities linking impaired HRQoL to suicidal ideation.

Longitudinal assessment of mental health after a flood: roles of social support, hope, recovery stressors, and prior lifetime trauma

OBJECTIVES

Severe weather events have mental health consequences for survivors that may change over time. We assessed post-flood mental health longitudinally in three groups of mostly middle-aged and older adults who varied in current and prior severe weather experiences.

METHOD

Predictors of central interest were age, perceived social support, state hope (including agency and pathways), recovery stressors, and prior lifetime trauma. Criterion variables included symptoms of depression, post-traumatic stress disorder (PTSD), and worry.

RESULTS

Analyses of variance yielded significant Disaster Exposure Group x Wave interactions for depression and PTSD symptoms. Those with flooded homes and properties had elevated symptoms at Wave 1 which were reduced at Wave 2. Older age was associated with fewer symptoms of depression, PTSD, and worry. Recovery stressors and lifetime trauma predicted more PTSD symptoms. Greater agency predicted less PTSD and depression symptoms, whereas pathways predicted less worry.

CONCLUSION

These data show that mental health symptoms may decrease over time for those directly impacted by severe flooding. State hope appears to contribute to better mental health after exposure to a devastating flood. Implications for understanding the dynamic relationships among risk variables and positive factors that promote post-disaster mental health in the years after a flood are considered.

On a pathway to resigned acceptance: Patients' experiences of living with symptom clusters in oral cancer

PURPOSE

Patients treated for oral cancer experience multiple concurrent symptoms. A larger mixed-methods study was conducted among patients who were treated with surgery alone or in combination with other modalities. The aim of the qualitative strand was to explore the experiences of living with symptom clusters.

METHODS

A phenomenological design was used to explore the lived experiences. Participants were recruited for the larger study from two outpatient units of a tertiary teaching hospital (N = 300). After completion of a survey, a maximum variation purposive subsample of 20 participants was drawn from the larger sample and were interviewed in-depth about their experiences. Thematic analysis was conducted.

FINDINGS

All participants experienced multiple concurrent symptoms, commonly including chewing difficulties + dry mouth + speech difficulties; chewing difficulties + dry mouth + diminished taste; and chewing difficulties + dry mouth + speech difficulties + trismus. Analysis of their experiences of living with these symptom clusters revealed six themes: Acknowledged Disruptions, Inner Dialogue, Shifting Expectations, Floods of Emotions, Exercising Control over Life, and Resigned Acceptance. These themes portrayed that time and living with symptom clusters lead to what we describe as a pathway to resigned acceptance. This pathway is intermingled with disruptions, self-reflections on 'why me' and karma, negative emotions, and failed expectations regarding symptom recovery. Attempts to exercise control over their lives were also revealed through coping strategies, watchful living, future planning, and being health advocates. On realizing with time that further symptom alleviation is unlikely, and considering symptom-cluster experiences as being written in their fate, they move towards a state of resigned acceptance. However, unlike passive acceptance, their belief in fate was accompanied with resilience, evidenced by their ongoing efforts to explore pragmatic ways to live with symptom clusters.

CONCLUSIONS

Findings provide key insights into patient perspectives which most often remain unexpressed in clinical settings. Further research is required to explore watchful living, fate as a coping strategy, and intertwining of faith, fate, and karma.

Transition from disease to survival: accounts of adolescents who have experienced cancer

OBJECTIVE

to understand the transition from disease to survival of adolescents who had experienced cancer.

METHOD

qualitative study, developed with the theoretical framework of symbolic interactionism, conducted with 14 adolescent cancer survivors treated at an outpatient clinic after cancer therapy, in the city of São Paulo. Individual in-depth interviews were performed and recorded, and the data were analyzed and interpreted using the methodological framework of the thematic analysis.

RESULTS

four themes were identified: going back to school, being able to live like other adolescents, living in the present moment, and seeking a purpose in life.

CONCLUSION

the transition from disease to cancer survival was full of insecurities, difficulties, and challenges. After the disease, survivors acquire new values and new priorities in life, a reconstruction of the self. They also feel thankful to God and the people who were part of their treatment journey.

HIGHLIGHTS

(1) Cancer survivors need long-term follow-up.(2) Health professionals are not prepared to support survivors.(3) Adolescents see survival as a new opportunity and feel gratitude.(4) Adolescents seek meaning in their survival.(5) Support planning is important to help in the transition period.

The Correlation Between Quality of Life and Positive Psychological Resources in Cancer Patients: A Meta-Analysis

Purpose

This study aimed to assess the evidence of the association between positive psychological resources and quality of life in patients with cancer.

Methods

Electronic searching was performed to retrieve articles from PubMed, Web of Science, Embase, CNKI, and CBM (from inception to 7 April 2022). Summary correlation coefficient (r) values were extracted from each study, and 95% CIs were calculated by the random-effect model. Subgroup and sensitivity analyses were performed to investigate potential heterogeneity.

Results

In total, sixty-six articles were included in the present study. The pooled r for resilience was 0.71 (95%CI: 0.55, 0.87), hope 0.50 (95%CI: 0.43, 0.56), self-efficacy 0.53 (95%CI: 0.46, 0.61), self-esteem 0.46 (95%CI: 0.28, 0.63), and optimism 0.30 (95%CI: 0.19, 0.40). For subgroup analysis, no significant differences were found between minors and adults.

Conclusion

This study indicated that resilience, hope, optimism, self-esteem, and self-efficacy were positively correlated with quality of life in patients with cancers. Therefore, intervention programs should be focused on increasing state-like positive psychological resources to improve the quality of life in patients with cancer.

Associations of Physical Activity and Handgrip Strength with Different Domains of Quality of Life in Pediatric Cancer Survivors

There is a paucity of evidence about the associations of physical activity (PA) and handgrip strength (HGS) within different domains of quality of life (QoL) in Chinese pediatric cancer survivors. We, therefore, conducted this multicenter cross-sectional study aimed to investigate whether increased PA level and HGS are associated with higher scores in different QoL domains (i.e., physical, emotional, social, and school functioning) in pediatric cancer survivors. PA was assessed with a validated self-reported PA rating scale. In total, 191 Chinese pediatric cancer survivors aged 9 to 16 years were included in the analysis. Results showed that engaging in a higher level of PA was significantly associated with improved QoL in different domains, including physical (β = 0.543, p < 0.001), emotional (β = 0.449, p < 0.001), social (β = 0.434, p < 0.001), and school functioning (β = 0.407, p < 0.001). Greater HGS was also associated with better physical (β = 0.230, p ≤ 0.001) and emotional (β = 0.261, p ≤ 0.001) functioning. Findings from this study provide evidence of the significant beneficial impact of regular PA on pediatric cancer survivors’ QoL along their survivorship trajectory.

Experience of childhood cancer: A narrative inquiry

PURPOSE

To more fully understand the possible impact of childhood cancer on a young person's life through their own story.

DESIGN AND METHODS

Using Connelly and Clandinin's narrative inquiry method, a participant named Noelle was engaged in a series of narrative interviews and a creative self-expression activity about her cancer experience when she was 12. Her story was examined through the three-dimensional space of experience (person, place, and time), and analyzed using Erikson's Psychosocial Stages of Development framework theoretical lens.

RESULTS

Two significant narrative patterns emerged: identity and relationships. Although the physical effects of the cancer were successfully treated, the impact of this disease impacted Noelle's own psychosocial development as she was trying to evolve her relationships with peers and family, while grappling with her new identity as a cancer patient.

PRACTICE IMPLICATIONS

Healthcare professionals need to intentionally increase their sensitivity to adolescent patients' lived experience of cancer. More specifically, there is a need for further education of healthcare professionals on the psychosocial impact of cancer in both the immediate and long-term trajectory of the cancer disease process.

A transição da doença para a sobrevivência: relatos de adolescentes que vivenciaram o câncer

Resumo Objetivo: conhecer a transição da doença para a sobrevivência de adolescentes que vivenciaram o câncer. Método: estudo de abordagem qualitativa, desenvolvido por meio do referencial teórico Interacionismo Simbólico, realizado com 14 adolescentes sobreviventes de câncer atendidos em um ambulatório de pacientes fora de terapia na cidade de São Paulo (SP). Foram realizadas e gravadas entrevistas individuais e em profundidade e os dados foram analisados e interpretados pelo referencial metodológico da análise temática. Resultados: quatro temas foram identificados: voltando para a escola; podendo viver como outros adolescentes; vivendo o agora e buscando um propósito na vida. Conclusão: a transição da doença para a sobrevivência do câncer se revelou cheia de inseguranças, dificuldades e desafios. Após a doença, os sobreviventes adquirem novos valores e novas prioridades de vida; uma reconstrução do self; além do sentimento de gratidão a Deus e às pessoas que participaram da trajetória percorrida durante o tratamento.

La transición de la enfermedad a la supervivencia: testimonios de adolescentes que han sufrido cáncer

Resumen Objetivo: conocer la transición entre la enfermedad y la supervivencia de adolescentes que han sufrido cáncer. Método: estudio con enfoque cualitativo, desarrollado a través del referencial teórico del Interaccionismo Simbólico, realizado con 14 adolescentes supervivientes de cáncer atendidos en un ambulatorio, sin terapia, de la ciudad de São Paulo (SP). Se realizaron y grabaron entrevistas en profundidad individuales y los datos fueron analizados e interpretados utilizando el marco metodológico de análisis temático. Resultados: se identificaron cuatro temas: regreso al colegio; poder vivir como otros adolescentes; viviendo el presente y buscando un propósito en la vida. Conclusión: la transición entre la enfermedad y la supervivencia del cáncer se mostró llena de inseguridades, dificultades y desafíos. Después que termina la fase de la enfermedad, los supervivientes adquieren nuevos valores y prioridades en la vida; una reconstrucción del Self; además del sentimiento de gratitud hacia Dios y las personas que participaron del camino recorrido durante el tratamiento.

Physical activity for pediatric cancer survivors: a systematic review of randomized controlled trials

Purpose

To collate evidence and evaluate the effects of physical activity interventions on physical activity level among pediatric cancer survivors who had completed active cancer treatment.

Methods

Relevant published studies were identified in May 2020 via five databases and reference checking. Searches were limited to randomized controlled trials or controlled clinical trials, published in English involving pediatric cancer survivors aged 18 years or below. Interventions were related to promote physical activity among the survivors. Included studies were assessed using the revised version of the Cochrane’s Risk of Bias Tool.

Results

Eight randomized controlled trials (620 pediatric cancer survivors and 53 caregivers of pediatric cancer survivors) were included. All studies investigated interventions for pediatric cancer survivors to increase their physical activity level. The interventions used varied across the eight included studies: three mHealth—medical and public health practice supported by mobile devices; two eHealth—the use of information and communication technologies to improve health care; two adventure-based training; and one educational program. Measures of physical activity level also varied: five used various objective measurements (i.e., accelerometer, pedometer, multisensory activity monitor); three used different self-reported questionnaires. Owing to high variability of the interventions and measures, it was impossible to perform meta-analysis. Overall, eHealth and mHealth interventions showed effectiveness and feasibility to promote physical activity among pediatric cancer survivors.

Conclusions

eHealth and mHealth interventions appear to be increasingly important strategies to promote physical activity among pediatric cancer survivors.

Implications for Cancer Survivors

Future larger-scale studies using a core-set of assessment tools are warranted to further promote regular physical activity in pediatric cancer survivors.