Psychological Disorders and Psychosocial Resources of Patients with Newly Diagnosed Bladder and Kidney Cancer: A Cross-Sectional Study

Social support and quality of life in oncology patients with post-traumatic stress disorder: a cross-sectional study

BACKGROUND

The potential mediating role of social support in the connection between post-traumatic stress disorder (PTSD) and quality of life among patients with cancer has not been explored in the currently available literature.

AIMS

This study aimed to explore the mediating role of social support in the relationship between PTSD and quality of life among oncology patients.

METHODS

A cross-sectional study was conducted among 343 cancer patients across three tertiary hospitals in Oman. Data were collected using validated, self-administered questionnaires. Mediation analysis was performed using the Sobel test.

FINDINGS

The average patient age was 47.3 years (SD 13.5) and 247 (72%) were female. Patients with PTSD had a lower perceived social support (mean 66.0; SD 10.8) and a poorer quality of life than those without PTSD. Social support played a mediating role in the relationship between PTSD and quality of life (P<0.01).

CONCLUSION

Social support has emerged as a crucial mediator that potentially buffers the adverse effects of PTSD. Integrating educational programmes, healthcare provider training and technology-enabled support systems such as online support groups can help build a stronger social support framework. Policymakers and healthcare organisations should prioritise social support initiatives to enhance the wellbeing of patients with PTSD and cancer.

Cognitive function moderates the mediation of resilience in the relationship between perceived receipt of filial piety and loneliness among community-dwelling older adults with multiple long-term conditions

Given the rapidly aging population and the changes in traditional family bonds, new challenges arise for filial piety in the loneliness among older adults with multiple long-term conditions (MLTCs). This study aimed to examine the PRFP-loneliness relationship, explore whether resilience mediates the association between PRFP and loneliness, and investigate whether cognitive function moderates the indirect or direct effects of the mediation model among Chinese older adults with MLTCs. A total of 635 older adults with MLTCs were recruited in Shenyang City, China. Participants completed self-report questionnaires on PRFP, resilience, loneliness and cognitive function. A moderated mediation model was conducted using Hayes' PROCESS macro for SPSS. PRFP had a significant negative effect on loneliness and resilience partially mediated the PRFP-loneliness relationship. Cognitive function moderated the indirect effect of PRFP on loneliness via resilience. Specifically, the conditional indirect effect of PRFP on loneliness diminished as the level of impaired cognitive function increased. Interventions aimed to improving resilience and cognitive function may help strengthen the link between PRFP and loneliness among older adults with MLTCs. However, we should suggest a cautious application of this research when translated to the geographic and cultural diversity of older adults.

The influential factors of depression among caregivers of children with Cleft Lip and/or Palate: a path analysis based on diathesis-stress theoretical model

BACKGROUND

Depression is the most common psychological phenomenon among caregivers of children with Cleft Lip and/or Palate and affects the quality of life, treatment satisfaction, children's self-esteem and parent-child relationship. However, Existing studies have limited explanations for the mechanisms that lead to depression in caregivers of children with Cleft Lip and/or Palate. The present study aimed to identify factors influencing depression among caregivers of children with Cleft Lip and/or Palate and to provide a reference point and new ideas for future research.

METHODS

This cross-sectional study investigated 248 caregivers at two Cleft Lip and/or Palate treatment centers in China, spanning from April 2019 to July 2020. The diathesis-stress model was used to construct the model, and data analysis was conducted using SPSS 26.0 and AMOS 25.0. Path analysis was employed to test the hypothetical model, and the fit of the model was evaluated using Chi-Square/degree of freedom, Goodness-of-Fit Index, Normed Fit Index, Relative Fit Index, Incremental Fit Index, Tacker-Lewis Index, Comparative Fit Index and Root Mean Square Error of Approximation.

RESULTS

The study found that the average level of depression among caregivers of children with Cleft Lip and/or Palate was 4.83 (4.79). Additionally, 43.5% of caregivers exhibited depressive symptoms. The fit of the modified path model was found to be satisfactory, with the following indices: Chi-Square/degree of freedom = 1.881, Goodness-of-Fit Index = 0.986, Normed Fit Index = 0.973, Relative Fit Index = 0.919, Incremental Fit Index = 0.987, Tucker-Lewis Index = 0.960, Comparative Fit Index = 0.987, and Root Mean Square Error of Approximation (RMSEA) = 0.060. The results indicated that parenting stress had the greatest direct impact on depression, followed by hope. Indirect effects on depression were observed for optimism, resilience, and coping, which were mediated through perceived social support and parenting stress.

CONCLUSIONS

This study suggests that depression in caregivers of children with Cleft Lip and/or Palate was leadingly influenced by parenting stress and hope. Strategies aimed at the key factors are expected to decrease depression.

The prevalence of anxiety symptoms/disorders in cancer patients: a meta-analysis

OBJECTIVE

Cancer can have negative effects on mental health. The aim of this study was to investigate the prevalence of anxiety symptoms/disorders in cancer patients' worldwide using meta-analysis.

METHODS

The study population was cancer patients who had cancer at the time of the study. The outcome studied in this study was anxiety symptoms/disorders. PubMed and Scopus were searched based on the syntax of keywords, this search was limited to articles published in English until September 2021. For this meta-analysis, data on the prevalence of anxiety were first extracted for each of the eligible studies. The random-effects method was used for the pool of all studies. Subgroup analysis was performed based on sex, anxiety disorders, cancer site, and continents. Heterogeneity in the studies was also assessed.

RESULT

After evaluating and screening the studies, eighty-four studies were included in the meta-analysis. Prevalence of anxiety symptoms/disorders in cancer patients showed that this prevalence is 23% (I2 = 99.59) in the 95% confidence interval between 22-25%. This prevalence was 20% (I 2 = 96.06%) in the 95% confidence interval between 15-24% in men and this prevalence is 31% (I 2 = 99.72%) in the 95% confidence interval between 28-34% in women. The highest prevalence of anxiety was in patients with ovarian, breast, and lung cancers.

DISCUSSION

It showed a high prevalence of anxiety symptoms/disorders in cancer patients, in addition to therapeutic interventions for cancer, the necessary interventions should be made on the anxiety of these patients. Methodological limitation was the heterogeneity between the studies included in the meta-analysis. Some types of cancer sites could not be studied because the number of studies was small or the site of cancer was not identified.

The mediating effect of positive expectations in the relationship between social support and post-traumatic stress disorder symptoms among parents of children with acute lymphoblastic leukemia

PURPOSE

Parents of children with cancer are exposed to risks of developing post-traumatic stress disorder (PTSD) symptoms, but few studies have explored PTSD symptoms of Chinese parents of children with acute lymphoblastic leukemia (ALL). Our study aimed to examine the association between social support and PTSD symptoms and to examine the mediating effect of positive expectations in this relationship among parents of children with ALL.

METHODS

A cross-sectional study was conducted of consecutive parents of children with ALL in the Shengjing Hospital of China Medical University. A total of 177 parents eligible for this study completed questionnaires on PTSD symptoms, perceived social support, optimism and general self-efficacy anonymously. Asymptotic and resampling strategies were used to examine how positive expectations mediated the association between perceived social support and PTSD symptoms.

RESULTS

Mean score of PTSD symptoms was 37.64 ± 14.44; 29.4% of the sample scored 44 and above, 19.8% scored 50 and above. After adjusting for covariates, perceived social support was negatively associated with the total score of PTSD symptoms (β = -0.209, p < 0.01). Positive expectations were found to mediate the relationship between perceived social support and PTSD symptoms, especially for the symptoms of avoidance and hyperarousal.

CONCLUSIONS

Optimism and general self-efficacy fully mediated the association between perceived social support and PTSD symptoms. Therefore, social support and positive expectations should be included in PTSD preventions and treatments targeting Chinese parents of children with ALL.

Trait Mindfulness and Social Support Predict Lower Perceived Stress Burden in Patients Undergoing Radiation Therapy

Purpose

Cancer diagnosis and treatment, including radiation therapy (RT), cause significant patient stress. Mindfulness and social support have been shown to help manage the psychological effects of cancer treatment. The objective of our study was to determine the sociodemographic and clinical factors associated with stress burden in patients receiving RT.

Methods and Materials

Patients receiving RT for cancer at a single institution were given a 3-section survey to complete during the first on-treatment visit. The survey included the Perceived Stress Scale, Medical Outcomes Study Social Support Survey, and Mindfulness Attention Awareness Scale, which were used to measure stress, social support, and trait mindfulness, respectively. Linear regression analysis was performed to determine associations between perceived stress and age, patient sex, race and ethnicity, treatment intent, disease site, trait mindfulness, and social support. Factors significant in univariable analysis were analyzed with a multivariable analysis.

Results

A total of 93 patients undergoing RT at a tertiary care academic institution were recruited from July to September 2019. Median scores for Perceived Stress Scale, Medical Outcomes Study Social Support Survey, and Mindfulness Attention Awareness Scale were 14.6 (range, 0-31; SD, 6.9), 4.2 (range, 1-5; SD, 1.0), and 5.1 (range, 3.1-6.0; SD, 0.8), respectively. On univariable analysis, mindfulness and social support were associated with decreased stress burden, and female sex and palliative intent were associated with increased stress burden. These factors all maintained significance in multivariable analysis.

Conclusions

These results suggest measures to improve mindfulness and perceived social support, such as mindfulness meditation and psychoeducational approaches, may lessen the stress burden and improve quality of life for patients undergoing RT. Future studies should analyze the longitudinal impact of individual patient characteristics, including patient sex and treatment intent, to better understand their effects on psychological maladjustment during cancer care.

Psychosocial distress and psychosocial resources in couples facing non-melanoma skin cancers and malignant melanoma

BACKGROUND

Skin cancer is the most common cancer worldwide and comprises various non-melanoma skin cancer (NMCS) diagnoses and malignant melanoma (MM). It places a psychological burden on patients and their spouses. The present study aims to investigate psychological distress, temporal changes of psychosocial resources (PR), as well as dyadic dynamics of psychological distress and PR in patients with NMSC or MM and their spouses.

METHODS

Fifty-four heterosexual couples with different skin cancers, diagnosed within the previous 12 months, participated in this quantitative cross-sectional study. Patients and spouses provided information about depression and anxiety (Hospital Anxiety and Depression Scale), PR within the last four weeks and last three years (Essen Resource Inventory), and partnership quality (Partnership Questionnaire, short version). Dyadic dynamics were analyzed with multiple regression analyses.

RESULTS

We found similar distress levels in patients and spouses, as well as in patients with different skin cancers. Spouses from patients with MM reported significant higher distress levels than spouses from patient with NMSC. Patients' depression predicted spouses' depression, and spouses' anxiety predicted patients' anxiety. In patients, we found associations between personal resources (within the last four weeks and three years) and depression, and an association between patients' social resources (within the last three years) and spouses' depression.

CONCLUSIONS

The psychological interdependencies between patients' and spouses' depression and anxiety highlight the importance of considering psychological distress in patients with different skin cancers from a dyadic perspective in clinical contexts. Further, personal resources were indicated as a "distress buffer" for patients' mental health. Our results underline the importance of couple interventions that activate PR in patients with cancer and their spouses.

Effects of sleep disturbance, cancer-related fatigue, and psychological distress on breast cancer patients' quality of life: a prospective longitudinal observational study

More attention has gone to researching the cancer-related fatigue (CRF)-sleep disturbance (SD)-psychological distress (PD) symptom cluster in breast cancer patients during the chemotherapy period, but the change trend and heterogeneous development track in the whole treatment stage remain unclear, and it is also unclear whether the appearance of and changes in one symptom cause changes in other symptoms and quality of life (QoL). This study, using breast cancer patients' data collected through a validated questionnaire, examined the relationships between SD, CRF, PD, and QoL using latent growth modeling analyses. CRF developmental trajectories showed an upward trend over five surveys (slope = 0.649, P < 0.001); PD showed a significant weakening trend (slope = - 0.583, P < 0.001); SD showed an increasing trend (slope = 0.345, P < 0.001), and QoL showed a statistically significant weakening trend (slope = - 0.373, P < 0.001). The initial CRF (coefficient = - 0.233, P < 0.01), PD (coefficient = - 0.296, P < 0.01), and SD (coefficient = - 0.388, P < 0.001) levels had a statistically significant negative effect on initial QoL level. The linear development rate of PD was statistically significant and negatively affected that of QoL (coefficient = - 0.305, P < 0.05), whereas the quadratic development rate of SD negatively affected that of QoL (coefficient = - 0.391, P < 0.05). Medical staff should identify the change characteristics of different variables based on SD, CRF, PD, and QoL change trajectories, and advance the intervention time, as changes in variables affect other variables' subsequent changes.

Personality functioning, positive outlook for the future, and simple and complex post-traumatic stress disorder

Posttraumatic Stress Disorder (PTSD) and its complex form (C-PTSD) are psychopathological conditions that are related to several personality traits. In particular, the current study aims to investigate the associations of impairment of personality functioning (IPF) and positive outlook for the future (POF) with PTSD and C-PTSD. A sample of 304 Brazilian adults responded to an online survey. IPF was measured according to the alternative model for personality disorders, POF was operationalized using optimism and hope scales, and PTSD and C-PTSD were measured using the ICD-11 model. Data analysis included correlation, structural equation models, multivariate analysis of variance, and multinomial logistic regression. The results showed that IPF and POF were moderately correlated with PTSD and C-PTSD in positive and negative directions, respectively. IPF and POF were more strongly associated with C-PTSD than PTSD. From the categorical approach to psychopathology, IPF and POF were shown to be associated only with C-PTSD. This is the first study that provides empirical data on the association of IPF and POF with both forms of PTSD. Understanding the associations between pathological and resilient personality domains and PTSD and C-PTSD symptoms can support the development of effective interventions.

Prevalence, Predictors, and the Role of Social Support in Posttraumatic Stress Disorder Among Cancer Patients in Oman

BACKGROUND

Cancer, regardless of type, presents a formidable life challenge affecting patients' psychological well-being. Many perceive cancer diagnosis and treatment as traumatic.

OBJECTIVES

This study aimed to estimate posttraumatic stress disorder (PTSD) prevalence in Omani adult cancer patients, identify predictors, and probe its correlation with social support.

METHODS

This cross-sectional study enrolled 343 adult cancer patients undergoing treatment from 3 hospitals in the Middle East country of Oman. Posttraumatic stress disorder was assessed via the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and perceived social support was measured using the Multidimensional Scale of Perceived Social Support.

RESULTS

The prevalence of PTSD among Omani adult cancer patients was 27.4%. Enhanced social support correlated with lower PTSD risk (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93-0.97; P < .001). Predictors included shorter time since diagnosis (OR, 0.98; 95% CI, 0.97-0.99; P = .017), no psychiatric referral (OR, 0.46; 95% CI, 0.23-0.96; P = .04), and insufficient social support (OR, 0.96; 95% CI, 0.94-0.98; P < .001).

CONCLUSIONS

Social support significantly mitigates PTSD risk. Routine assessment and psychiatric referrals, especially for recent diagnoses, can enhance patients' lives. Reevaluating the PTSD diagnostic cutoff score (33) merits consideration for improved clinical use.

IMPLICATIONS FOR PRACTICE

Early PTSD assessment, particularly for low-social support new-diagnosed patients, is crucial for timely intervention. Psychiatric referrals can guide specialized treatments. Stressing social support's role can guide healthcare providers, including oncology nurses, in supporting patients effectively.

Study on anxiety, depression, and subjective wellbeing of patients with bladder cancer in their different chemotherapy stages

Aims and objectives

This study aims to explore the changes in anxiety, depression, and subjective wellbeing in patients with bladder perfusion during different stages of their chemotherapy, and analyze the correlation among their anxiety, depression, and subjective wellbeing.

Methods

A total of 174 patients with bladder cancer who received bladder perfusion chemotherapy were selected. The questionnaire survey was conducted with SAS, SDS, and GWB. The patients were surveyed and the data were analyzed.

Results

The results of patients' anxiety, depression, and subjective wellbeing show a dynamic change trend. The change is most obvious after 1 month of chemotherapy and tends to be flat after 3 months of chemotherapy. The scores of anxiety, depression, and subjective wellbeing in patients with bladder perfusion at different stages are statistically significant (P < 0.05). There is a negative correlation among anxiety, depression, and subjective wellbeing in patients (r = -0.605, 0.601).

Conclusion

Patients' emotions change obviously in the first 3 months of their chemotherapy. Clinical workers can take active intervention measures in this period, guide patients to relieve their anxiety and depression, increase their subjective wellbeing level, and improve their quality of life, which is helpful to ensure the successful completion of chemotherapy.

The Role of Mental Adjustment in Mediating Post-Traumatic Stress Disorder Symptoms and Social Support in Chinese Ovarian Cancer Patients: A Cross-Sectional Study

Background

Post-traumatic stress disorder (PTSD) can manifest in individuals following a traumatic event. There is a paucity of studies focusing on PTSD symptoms in ovarian cancer (OC) patients. This study aimed to investigate the association of social support, mental adjustment and PTSD symptoms in Chinese OC patients with a view to exploring whether mental adjustment could mediate the relationship.

Methods

A cross-sectional study was conducted from January 2015 to December 2016. A total of 171 OC subjects were recruited and the effective response rate was 81.3%. The PTSD Checklist-Civilian Version (PCL-C), Mini-Mental Adjustment to Cancer scale (Mini-MAC) and Duke-UNC Functional Social Support Questionnaire were disseminated to the patients. The Chinese Mini-MAC was used in this study focusing on three components, namely negative emotion, positive attitude, and cognitive avoidance. Hierarchical linear regression analyses were employed to investigate the association of social support and PTSD symptoms, and the role of mental adjustment in their mediation.

Results

The prevalence of PTSD symptoms was 17.3% in OC patients. PTSD symptoms were negatively related with both social support and positive attitude, and positively associated with negative emotion and cognitive avoidance. Social support was negatively associated with negative emotion and cognitive avoidance, and positively related with positive attitude. In addition, negative emotion and positive attitude mediated the association between social support and PTSD symptoms.

Conclusion

PTSD symptoms in OC patients should be paid attention to. Social support and mental adjustment were positive resources associated with PTSD symptoms. Moreover, mental adjustment could mediate the relation between social support and PTSD symptoms in OC patients. Therefore, intervention management that focusing on improving perceived social support as well as strengthening mental adjustment, especially negative emotion and positive attitude, may be useful for reducing PTSD symptoms in this context.

Mental Health in Urologic Oncology

This article is a systematic review of mental health in urologic oncology patients with prostate cancer (PCa), bladder cancer (BC), renal cell carcinoma (RCC), testicular cancer (TC), or penile cancer (PeCa). For all pathologies, a focus on increasing quality of life post-treatment demonstrated a positive impact in reducing Mental Health Illness (MHI) prevalence. Cancer specific mental health care may be given to patients to reduce suicide risk in BC patients and sexual identify and masculinity counseling may improve mental health for TC or PeCa patients. In order to better accommodate patient’s mental health needs when undergoing GU cancer treatment, we recommend incorporation of mental health metrics such as questionnaires to assess early treatment of MHI, a greater emphasis on psychosocial support with the patient’s loved ones, peers, and healthcare team, alongside advising healthy habits such as exercise which has been shown to drastically reduce MHI incidence across all pathologies. We hope that these measures conducted by urologists and oncologists, alongside possible coordination with psychiatrists and psychologists for psychotherapy, psychopharmacology, and neuro-stimulation treatment modems may be helpful in the long term to reduce MHI incidence in urology oncology patients. Given the higher incidence of MHI in oncology patients and in the patient population after the Covid-19 pandemic, MHI awareness in the sphere of urologic oncologic treatment continues to be crucial when creating a collaborative treatment platform for patients.

Variation of Anxiety and Depression During a 3-Year Period as Well as Their Risk Factors and Prognostic Value in Postoperative Bladder Cancer Patients

Background

Anxiety and depression are commonly recognized and prognostically relevant in cancer patients. The aim of this study was to explore the 3-year longitudinal changes in anxiety and depression, their risk factors, and prognostic value in patients with bladder cancer.

Methods

Hospital Anxiety and Depression Scale for anxiety (HADS-A) and depression (HADS-D) scores of 120 postoperative bladder cancer patients and 100 healthy controls (HCs) were assessed. Additionally, the HADS-A and HADS-D scores of bladder cancer patients were determined at 1 year, 2 years, and 3 years post surgery.

Results

HADS-A score (7.7 ± 3.0 vs. 4.8 ± 2.6), anxiety rate (38.3% vs. 9.0%), HADS-D score (7.7 ± 3.3 vs. 4.3 ± 2.6), depression rate (40.0% vs. 11.0%), as well as anxiety degree and depression degree, were all increased in bladder cancer patients compared with HCs (all P &lt; 0.001). Besides, the HADS-A score gradually increased from baseline to 3 years (P = 0.004), while the anxiety rate, HADS-D score, and depression rate did not change significantly (all P &gt; 0.050). Gender, tumor size, marriage status, hypertension, diversity, and lymph node (LN) metastasis were associated with anxiety or depression in patients with bladder cancer (all P &lt; 0.050). Anxiety was associated with shortened overall survival (OS) (P = 0.024) but did not link with disease-free survival (DFS) (P = 0.201); depression was not correlated with either DFS or OS (both P &gt; 0.050).

Conclusion

The prevalence and severity of anxiety and depression are high in patients with bladder cancer, which are influenced by gender, tumor features, marriage status, and hypertension; in addition, their correlation with survival is relatively weak.

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.

Examining the Relationship between Depression, Anxiety and Stress in Kidney Cancer Patients

Cancer of the kidney is one of the 10 most common cancers found globally. Overall, it is the fourth most common cancer in men and the eighth most common cancer in women. Many kidney cancer patients experience psychologic problems and reactions. The present study examined relationship between anxiety, depression, and perceived stress symptoms in kidney cancer patients. Cross-sectional data were obtained from the patients diagnosed with kidney cancer. All participants completed sociodemographic form, Hospital Anxiety and Depression form, and Perceived Stress Scale. Statistical analysis was exercised using the Student's t-test, Chi-squared test (χ²), Fischer's exact test, ANOVA, Mann-Whitney U test, and Kruskal-Wallis one-way variance analysis. A total of 250 patients participated in the study. The mean age was 57.4 years (SD 6.4, range = 25-76 years). The majority of patients were males (73%) and married (218). Anxiety symptoms were determined in 91.2% patients, depression symptoms in 87.2% patients, and perceived stress symptoms in 93.6% patients. The mean scores of Hospital Depression and Anxiety Scale (HADS)-Anxiety, HADS-Depression, and HADS-Perceived Stress were significantly different between age (P < 0.05), gender (P < 0.05), and income groups (P < 0.001). Kidney cancer patients showed poorer psychologic health. The overall levels of anxiety, depression, and perceived stress symptoms were higher among the studied kidney cancer patients. Findings of the current study could improve both psychologic well-being of patients and health-related quality of life.

The development and validation of the psychological capital questionnaire for patients with Cancer the psychological capital questionnaire

Background

Studies increasingly show that positive psychological constructs affect the mental health of cancer patients. However, most scales that measure hope, resilience, optimism and self-efficacy have been developed based on general populations. The aim of our study was to develop a psychological capital (PsyCap) questionnaire for patients with cancer (PCQ-C) to gauge their mental state more accurately.

Methods

The items for the scale were selected by comprehensive literature review and semi-structured interviews, and the relevant terms were screened by an expert panel. A pilot study was then conducted on 202 patients to reduce the item pool, and the reliability and validity of the scale were evaluated using 500 completed questionnaires. The test-retest reliability was then assessed using a subsample of 100 patients. Finally, the completed questionnaires of 229 patients with breast cancer were used to assess the criterion validity of the PCQ-C, including measures of depression and anxiety.

Results

Item reduction and exploratory factory analysis resulted in 24 items for self-efficacy, hope, resilience and optimism, accounting for 56.72% of the variance. The Cronbach’s alpha for the scale was 0.886, and the test-retest reliability was 0.825. PsyCap showed a significant negative correlation with both depression (r = − 0.631, P < 0.01) and anxiety (r = − 0.601, P < 0.01).

Conclusion

The PCQ-C can objectively evaluate PsyCap in cancer patients and exhibits good psychometric properties.

The Significant Role of Depression in Elderly Patients with Bladder Cancer

Background

Considering the relatively high 5-yr survival rate (76.9%) for bladder cancer (BC), its overall prevalence will probably continue to increase. Therefore, it is important to understand the effects of BC diagnosis and management, including psychological sequelae.

Objective

To determine the prevalence of depression among elderly patients with BC and identify patient characteristics associated with depression.

Design setting and participants

Survey responses from a population-based sample of 5787 patients older than 65 yr with a history of BC were retrieved from the Surveillance, Epidemiology and End Results-Medicare Health Outcomes Survey registry, spanning 1999-2014.

Outcome measurements and statistical analysis

The primary outcome measured is the prevalence of a positive depression screen. Cancer characteristics and demographic, socioeconomic, health-related, and activities of daily living (ADL)-related data were reviewed. Univariate analysis was conducted to identify correlation between a positive depression screen and patient characteristics. Multivariate analysis was performed to identify independent predictors of depression.

Results and limitations

The prevalence of a positive depression screen was 14.0%. Poor general health (p <  0.001), impairment of ADL (p <  0.001), greater number of comorbidities (p <  0.001), and income <$30 000 (p <  0.001) were identified as correlates of depression. Univariate analysis found no association between a positive depression screen and time since the initial cancer diagnosis (p =  0.858) or cancer stage (p =  0.90). Multivariate analysis showed higher levels of education (p =  0.0097), increasing age (p =  0.0027), and marriage (p <  0.0001) were protective against the development of depression. Limitations include the lack of consideration of treatment outcomes and whether patients have active disease or only a history of cancer.

Conclusions

Depression affects a substantial percentage (14%) of elderly patients with BC. Poor general health and impaired ability to complete ADL were the greatest risk factors for depression. Acknowledgment of sociodemographic factors may improve awareness of depression in patients with BC and a potential need for psychosocial support.

Patient summary

Depression affects a significant proportion of patients with bladder cancer. Social and demographic factors influence a patient's risk of depression. Acknowledgment of these factors may improve the detection of depression and a possible need for intervention.

Anxiety, depression and urological cancer outcomes: A systematic review

PURPOSE

The interplay between physical and mental aspects of a cancer diagnosis are well recognised. However, little consensus exists on the impact of depression and anxiety on urological cancer outcomes. Therefore, this systematic review aimed to investigate the relationship between these conditions and functional or oncological outcomes in urological malignancy.

MATERIALS AND METHODS

A systematic search was conducted using PubMed, Embase, PsycINFO and Global Health databases up to June 2020. Studies evaluating the relationship of anxiety and depression disorders or symptoms on functional and mortality outcomes were included. Outcome measures included validated urinary, sexual, body image questionnaire scores and all-cause or disease-specific mortality.

RESULTS

Of 3,966 studies screened, 25 studies with a total of 175,047 urological cancer patients were included. Significant anxiety and depressive symptoms and disorders were found to impact functional outcomes in several cancer types. A consistent negative association existed for sexual function in prostate, testicular and penile cancer patients. Additionally, poorer urinary function scores were seen in prostate cancer, with increased body image issues in testicular and prostate cancer. Importantly, both overall and disease-specific mortality outcomes were poorer in bladder and prostate cancer patients.

CONCLUSIONS

Co-existing depression and anxiety appears to be negatively associated with functional and mortality outcomes in urological cancers. This appears especially evident in male cancers, including prostate and testicular cancer. Although not proving causation, these findings highlight the importance of considering mental wellbeing during follow-up for early recognition and treatment. However, current evidence remains heterogenous, with further studies required exploring patients at risk.

Effects of high quality nursing in patients with lung cancer undergoing chemotherapy and related influence on self-care ability and pulmonary function

OBJECTIVE

To explore the effects of high quality nursing in patients with lung cancer undergoing chemotherapy and related influence on self-care ability and pulmonary function.

METHODS

108 patients with lung cancer were grouped as the control group (54 cases, received routine nursing) and the observation group (54 cases, received high quality nursing including health education, psychological nursing, diet intervention, pain nursing and complication nursing). The psychology, self-care ability, pulmonary function, quality of life and complications before and after the intervention were compared.

RESULTS

After 2 months of intervention, peak expiratory flow (PEF), percentage of forced vital capacity (FVC%) and the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) of the two groups were all largely increased, and the observation group had even higher indexes than the control group (all P<0.05). Compared with before intervention, Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) scores of the two groups both decreased after 2 months of intervention, and the observation group had lower score than the control group. The score of Exercise of Self-care Agency (ESCA) Scale and the quality of life questionnaire-C30 formulated by the European Organization for research and treatment of cancer (EORTC QLQ-C30) in the two groups were both elevated after the intervention and the observation group had higher scores than the control group (all P<0.05). The observation group had much lower total incidence of adverse reactions than the control group during chemotherapy (P<0.05).

CONCLUSION

High quality nursing for patients with lung cancer undergoing chemotherapy effectively alleviates the bad mood and improves the quality of life and lung function, which is worthy of clinical application.

The Mediating Role of Hope in the Relationship Between Perceived Stress and Post-Traumatic Stress Disorder Among Chinese Patients with Oral Cancer: A Cross-Sectional Study

PURPOSE

Cancer diagnosis and treatment are long-term traumatic stressors. Depression and anxiety are known to be prevalent in patients with cancer, but post-traumatic disorder (PTSD) has been overlooked frequently in this population. This study aimed to estimate the prevalence of PTSD and examined the mediating role of hope in the relationship between perceived stress and PTSD symptoms in Chinese patients with oral cancer.

METHODS

A total of 230 oral cancer patients were recruited to complete a questionnaire including the Posttraumatic Stress Checklist-Civilian Version (PCL-C), the Perceived Stress Scale-10 (PSS-10) and the Herth Hope Index (HHI). Analysis of variances (ANOVA)/t-test, Person's r and hierarchical linear regression analysis methods were conducted to assess the associations among perceived stress, hope and PTSD symptoms. Asymptotic and resampling strategies were used to explore the mediating role of hope.

RESULTS

The prevalence of PTSD symptoms was 6.05% in Chinese patients with oral cancer. Perceived stress was positively related to PTSD symptoms, explaining 39.9% of the variance. In addition, hope was negatively related to PTSD symptoms, explaining 5.9% of the variance. Besides, the proportion of mediation of hope was 30.06%.

CONCLUSION

Perceived stress was positively associated with PTSD symptoms, and hope was negatively associated with PTSD symptoms. Furthermore, hope played partial mediating role in the relationship between perceived stress and PTSD symptoms. Thus, more attention should be paid to patients' PTSD status, and take measures is to relieve stress and increase hope.

Effects of social support, hope and resilience on depressive symptoms within 18 months after diagnosis of prostate cancer

Background

The prevalence of depression symptoms and related modifiable factors in prostate cancer (PCa) are not well evaluated. We aimed to assess the effects of perceived social support, hope and resilience on depressive symptoms within 18 months after diagnosis of PCa, and to evaluate the role of hope and resilience as mediators of that relationship.

Method

A cross-sectional study was analyzed in consecutive inpatients with PCa during the months of January 2018 and August 2019. A total of 667 patients eligible for this study completed questionnaires on demographic and clinic variables, Center for Epidemiologic Studies Depression Scale, Multidimensional Scale of Perceived Social Support, Adult Hope Scale, and Resilience Scale (14 items). All registered patients were all volunteers and anonymous. Depressive symptoms, perceived social support, hope and resilience were measured anonymously. Out of 667 patients, a total of 564 effective respondents (< 30% missing data) became our subjects. Hierarchical linear regression was used to identify the factors associated with depressive symptoms. Asymptotic and resampling strategies were used to conduct the mediating effects of hope and resilience.

Results

The prevalence of depressive symptoms was 65.9% in PCa patients. Hierarchical regression analyses indicated that perceived social support, hope, and resilience together accounted for 27.5% variance of depressive symptoms. Support from family, hope, and resilience significantly associated with depressive symptoms, respectively. Hope (a*b = − 0.0783, BCa95% CI: − 0.134 to − 0.0319, p < 0.05), and resilience (a*b = − 0.1315, BCa95% CI: − 0.1894 to − 0.0783, p < 0.05) significantly mediated the association between perceived social support and depressive symptoms.

Conclusions

The high prevalence of depressive symptoms among PCa patients should receive more attention. Perceived social support, hope and resilience could be positive resources for combating depressive symptoms, and hope and resilience mediated the association between perceived social support and depressive symptoms. Enhancing social support, particularly the support form family, and improving patients’ outlook and resilience may be potential targets for future psychosocial interventions aimed at reducing depressive symptoms.

Anxiety and depression symptoms among ovarian cancer patients in China: a cross-sectional study†

Objective

To investigate the prevalence of cancer-related depression and anxiety in western China among patients with ovarian cancer and analyze their influencing factors.

Methods

In this prospective cross-sectional study, qualified patients were asked to fill in questionnaires. Multivariate analysis and binary logistic regression analysis were used to test the associations among symptoms of depression and anxiety, coping styles, and influencing factors.

Results

A total of 270 ovarian cancer inpatients who met the criteria for participation in the study completed the questionnaires. The levels of depression and anxiety that prevailed in ovarian cancer patients were 47.03% and 57.77%, respectively. Among them, 90.38% of cancer-related anxiety patients and 91.33% of cancer-related depression patients showed mild symptoms. The chi-square test showed that there were statistically significant differences (P < 0.05) in the fields of education level and income. T-test showed that cancer-related depression and anxiety were associated with coping style, and the difference had statistical significance (P < 0.05). Furthermore, multivariate analysis showed that the education level and coping style were the independent influencing factors of depression and anxiety.

Conclusions

The present study suggested that about half of the ovarian cancer patients had with depression and anxiety symptoms. The majority of the cancer-related depression and symptoms were mild. Educational level and coping style should be considered during the interventions of cancer-related depression and anxiety.

Resilience and Related Factors: A Comparison of Fathers and Mothers of Patients With Cleft Lip and/or Palate in China

Background: Resilience has become a hot spot in the field of positive psychology to study life-change events. However, there were little information on resilience among the fathers and mothers of patients with cleft lip and/or palate respectively. The present study aimed to explore and compare the level and potential influential factors associated with resilience among fathers/mothers of patients with cleft lip and/or palate in China. Method: A cross-sectional study was carried out between April 2019 and July 2020 among fathers/mothers of patients with cleft lip and/or palate in two cleft lip and/or palate treatment centers in China. Sixty Nine fathers and 179 mothers of patients with cleft lip and/or palate were interviewed with a questionnaire on demographic variables and the Resilience Scale-14 (RS-14), Herth Hope Index (HHI), Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Parenting Stress Index-Short Form (PSI-SF) and Coping Health Inventory for Parents (CHIP). T-test/univariate one-way ANOVA, Pearson's r, hierarchical linear regression analysis were conducted to explore the influential factors of resilience. Results: Fathers of patients with cleft lip and/or palate had a higher level of resilience (77.77 ± 14.18) than mothers (74.52 ± 14.33) though without significance. Resilience was positively associated with hope, perceived social support, optimism and coping and negatively correlated with parenting stress both in the fathers and the mothers. Hierarchical linear regression analysis showed that hope (β = 0.400, P < 0.01), coping (β = 0.281, P < 0.05), job status, medical payments (β = -0.240, P < 0.05) were found to be associated with resilience among the fathers of patients with CL/P, and all four variables in the model could explain 42.8% of the variance in resilience; Hope (β = 0.225, P < 0.05), perceived social support (β = 0.194, P < 0.05), the age of patients (β = 0.189, P < 0.05) were found to be associated with resilience among the mothers, and all three variables in the model could explain 27.6% of the variance in resilience. Conclusion: Our study showed that, in China, fathers of patients with cleft lip and/or palate had a higher level of resilience than mothers though without significance. Hope was the only communal variable strongly associated with resilience among both the fathers and the mothers; besides, coping, job status and medical payments were found to be associated with resilience among the fathers; while perceived social support and the age of patients were found to be associated with resilience among the mothers. The results suggest that enhance hope in parents of patients with cleft lip and/or palate might greatly help improve their resilience. Besides, fathers and mothers need specific intervention to prompt their resilience.

Barriers to sexual recovery in women with urologic cancers

Sexual health concerns are prevalent and distressing in oncology patients and survivors. While urologic cancers are more prevalent in men, women often have more advanced disease at initial diagnosis, require more advanced surgical resection, and experience higher postoperative complication rates, as well as morbidity and mortality. Women with urologic cancers undergo treatment that is highly likely to impact their sexual function and well-being, however, attention to sexual recovery in this patient population has been limited. Barriers to sexual recovery in women with urologic cancers are biopsychosocial in nature and include complications related to treatment procedures, cancer-related distress, sexual anxiety and avoidance, partner and relational dynamics, and sexual communication skills. Healthcare providers do not adequately address sexual difficulties for these patients and their partners. Sexual minority women and transgender patients with urologic cancer have unique psychosocial and sexual health needs though, due to a lack of research, these remain poorly understood. More research is needed to pinpoint the sexual health needs of this specific oncology population and to explore how various treatment options, such as pelvic organ-sparing cystectomy, can impact sexual health outcomes. Evidence-based and multidisciplinary oncologic and survivorship care, which includes licensed mental health providers, certified sex therapists, and other sexual health experts, is essential for assisting women in their sexual recovery following urologic cancer.

Trait resilience and mental health in older adults: A meta-analytic review

OBJECTIVES

This study aims to systematically review research on the association between resilience as a personality trait and mental health in older adults and to meta-analytically quantify this relation.

METHODS

We included studies assessing older adults (mean age 60 years or older), measuring trait resilience with a version of the Resilience Scale (RS) by Wagnild and Young and mental health. We conducted a comprehensive search in Medline, Web of Science, PsycInfo, PubPsych, ProQuest Dissertations and Theses Full Text database and the theses database of the German National Library for eligible studies. Study data on associations between resilience and mental health were aggregated using a random-effects model.

RESULTS

Twenty-seven studies with 13 444 participants were included. Trait resilience and mental health were strongly interrelated (r = 0.40, 95% CI [0.36; 0.44]) with substantial heterogeneity (I²  = 83%). Published studies revealed larger associations between resilience and mental health (r = 0.41 [0.37; 0.45]) than unpublished studies (r = 0.25 [0.11; 0.38]).

CONCLUSIONS

Higher levels of resilience are associated with better mental health in older persons. Because associations were solely assessed cross-sectionally, longitudinal studies are highly needed to draw causal inferences. © 2020 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

Association between selective serotonin reuptake inhibitors and kidney cancer risk: A nationwide population-based cohort study

The association between selective serotonin reuptake inhibitor (SSRI) exposure and cancer incidence has been investigated; however, no epidemiological study has investigated the association between exposure to individual SSRIs and kidney cancer incidence. The aim of this study is to examine whether SSRI use affected the risk of kidney cancer. We conducted a population-based retrospective cohort study using data from Taiwan's National Health Insurance Research Database. After adjusting for sex, age, urbanization level, comorbidity and medication use through propensity score matching, we identified 222 024 SSRI users and 221 361 SSRI nonusers. A robust Cox proportional hazards model was used to examine the associations between use of individual SSRIs and the risk of kidney cancer with 1- and 2-year induction periods. The result showed that SSRI users tended to be associated with a lower risk of kidney cancer with a 2-year induction period than nonusers; however, the association was not statistically significant (adjusted hazards ratio [aHR] = 0.88, 95% confidence interval [CI] = 0.77-1.01). We further examined the effects of individual SSRIs and observed a significantly lower risk of kidney cancer associated with the use of citalopram (aHR = 0.67, 95% CI = 0.47-0.96) and paroxetine (aHR = 0.75, 95% CI = 0.58-0.97) with the 2-year induction period. These findings support that SSRIs are associated with decreased kidney cancer risk and indicate that citalopram and paroxetine have protective effects in depressed patients with kidney cancer.

Prevalence and predictors of anxiety and depressive symptoms among patients diagnosed with oral cancer in China: a cross-sectional study

BACKGROUND

Anxiety and depression are common mental health problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. The present study aims to explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms.

METHOD

A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. Two hundred thirty patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms.

RESULTS

The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Social isolation dimension of stigma (β = 0.436, OR = 1.547, CI:1.211 ~ 1.975), optimism (β = - 0.276, OR = 0.759, CI:0.624 ~ 0.922), and perceived stress (β = 0.217, OR = 1.243, CI:1.092 ~ 1.414) were predictors of anxiety symptoms. Marriage (β = 1.648, OR = 5.198, CI:1.427 ~ 18.924), positive readiness and expectancy dimension of hope (β = - 0.505, OR = 0.604, CI:0.395 ~ 0.923), social isolation dimension of stigma (β = 0.314, OR = 1.368, CI:1.054 ~ 1.776) and perceived stress (β = 0.273, OR = 1.314, CI:1.134 ~ 1.524) were predictors of depressive symptoms among oral cancer patients.

CONCLUSION

The prevalence of anxiety symptoms and depressive symptoms was high among oral cancer patients in China. The communal predictors of anxiety and depressive symptoms in patients with oral cancer were levels of perceived stress and social isolation of stigma. In addition, optimism was a predictor of anxiety symptoms and hope was a predictor of depressive symptoms.

TRIAL REGISTRATION

2015-16, registered 20 Dec 2015.

The Association Between Resilience and Mental Health in the Somatically Ill

BACKGROUND

Resilience refers to an individual's positive adaptation to the experience of adversity. The maintenance of mental health is commonly considered a sign of successful coping with adverse conditions. The goal of the present meta-analysis was to investigate the association between resilience and mental health in patients with a somatic illness or health problem.

METHODS

Studies were included if they reported measures of association between resilience, as assessed using a version of Wagnild and Young's Resilience Scale, and self-reported mental health. A systematic literature search was conducted in the Medline, Web of Science, PsycInfo, PubPsych, and ProQuest databases and in the dissertation catalogue of the German National Library. In addition, a manual search was carried out. The study was registered with PROSPERO (registration number: CRD42017054822).

RESULTS

55 studies involving a total of 15 003 patients were included in the meta-analysis. Assuming a random-effects model, the weighted mean Pearson correlation between resilience and mental health was r = 0.43 (95% confidence interval [0.39; 0.48], p<0.001). This association was robust, although the heterogeneity among individual effect sizes was substantial (I2 = 89.6%). Correlations tended to be weaker in unpublished studies than in published ones.

CONCLUSION

Despite substantial heterogeneity across studies, the findings suggest a strong association between resilience and mental health in the somatically ill. In clinical practice, a lack of resilience as a resource for successful coping might indicate a need for psychosocial support during treatment for somatic illness.

Resilience and associated factors among Chinese patients diagnosed with oral cancer

Background

Resilience has been linked to psychological adaptation to many challenging life events. The present study aims to explore the level of resilience in oral cancer patients and the key factors associated with resilience, and to evaluate the relationship between resilience and anxiety.

Methods

A multiple center cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in the Stomatology Hospital of China Medical University and Department of Stomatology, Shengjing Hospital of China Medical University. Two hundred and thirty oral cancer patients replied to the questionnaires on resilience, hope, perceived social support, optimism, perceived stress and anxiety which were measured with Resilience Scale-14 (RS-14), Herth Hope Index (HHI), Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10) and Zung Self-Rating Anxiety Scale (SAS), respectively. Univariate one-way ANOVA/t-test, Pearson’s r and hierarchical linear regression analysis were conducted to explore the influence factors of resilience and the relationship between resilience and anxiety.

Results

The level of resilience was 67.93 ± 12.65. Resilience was positively correlated with hope, optimism and perceived social support, and negatively correlated with perceived stress. Hierarchical linear regression analysis showed that hope (β = 0.386, P < 0.01), optimism (β = 0.190, P < 0.01) and education (β = 0.175, P < 0.01) were positively associated with resilience. The three variables in combination could explain 48.9% of the total variance in resilience. Higher level of resilience was associated less anxiety symptoms (X² = 39.216, p = 0.000); and there was linear trend between resilience level and anxiety level among patients with oral cancer (X² = 35.624, p = 0.000).

Conclusion

Patients with oral cancer in China had moderate level of resilience. Hope, optimism and education were positively and significantly associated with resilience, indicating that higher level of hope, optimism and education may improve resilience in oral cancer patients, which in turn may help alleviate anxiety symptoms in patients.

Systematic Review: Depression and Anxiety Prevalence in Bladder Cancer Patients

Background:

Depression affects more than 300 million people of all ages worldwide. In patients with cancer the reported prevalence is up to 24%.

Objective:

To systematically review the literature to report the prevalence of depression and anxiety among patients with bladder cancer (BC).

Methods:

Web of Science, MEDLINE/PubMed, and The Cochrane Library were searched between January and March 2018 using the terms “bladder carcinoma OR bladder cancer AND depression OR anxiety”.

Results:

Thirteen studies encompassing 1659 patients with BC were included. Six studies assessed depression prior and after treatment at 1, 6 and 12 months. Three were conducted in the US, one each in Turkey, Sweden/Egypt and China. Four studies showed a reduction of depression after radical cystectomy (RC) at 1, 6 and 12 months, respectively. Contrary, two studies showed no significant difference in depression between baseline and follow-up. Four studies investigated anxiety; they reported a slight reduction in anxiety score compared to baseline. Seven additional studies reported the prevalence of depression and anxiety (five studies) among patients with BC at a specific time-point. Studies were conducted in Sweden (2), Italy, Greece, US, China and Spain. Pretreatment depression rates ranged from 5.7 to 23.1% and post-treatment from 4.7 to 78%. Post-treatment anxiety rates ranged from 12.5 to 71.3%.

Conclusions:

The prevalence of reported depression and anxiety among BC patients is high with large geographic heterogeneity. Gender and geriatric specific screening and management for anxiety and depression should be implemented to alleviate suffering.

Psychosocial Distress in Bladder Cancer Stratified by Gender, Age, Treatment, and Tumour Stage

OBJECTIVES

Cancer patients have to cope with anxieties -concerning their prognosis, potential recurrence/progression, and treatment-associated sequelae. Stress-related psychosocial factors influence survival and disease-related mortality in cancer patients. Despite improvements in diagnosis and treatment, bladder cancer (BC) remains characterized by high rates of recurrence and progression. We screened -pre-therapeutically the stress level of BC patients stratified by gender, disease state, treatment, and other factors by -self-administered validated questionnaires to integrate them into psychosocial support as needed.

METHODS

A cross-sectional analysis of distress and need of psychosocial care was done in 301 patients undergoing treatment for BC by 2 questionnaires (Distress Thermometer [DT] and Hornheider Screening Instrument).

RESULTS

Of the 301 patients, 230 patients underwent transurethral resection for a first -diagnosis, 63 for recurrent disease, 37 had progressive disease, and 25 had advanced metastatic disease and eventually died of BC. The mean stress level in all patients was 4.6. Twenty-eight percent of the patients expressed a need for psychosocial support. In patients with progressive disease, significantly higher stress scores were seen as well as a higher need of psychosocial care (5.4 and 41%).

CONCLUSIONS

The median DT-level of 4.6 indicates moderate psychosocial stress in BC patients. From a stress level of 5, the recommendations of a psycho-oncological supervision are pronounced, so that our study showed that early systematic evaluation of psychosocial needs in BC patients is important.

Perceived stress and its associated demographic-clinical characteristics and positive expectations among Chinese cervical, kidney, and bladder cancer patients

PURPOSE

Positive expectations about personal abilities and future outcomes are important in shaping human behavior and emotion, which may influence the psychological adjustment in cancer patients. We aimed to assess two basic kinds of perceived stress in Chinese cancer patients and to investigate their associations with demographic-clinical characteristics and positive expectations.

METHODS

A multi-center, cross-sectional study was conducted in consecutive cervical, kidney, and bladder cancer inpatients from three general hospitals in Liaoning province from February 2013 to August 2014. A total of 790 patients eligible for this study completed questionnaires on demographic-clinical variables, optimism, general self-efficacy, perceived global, and cancer-related stress anonymously. Hierarchical regression analyses were conducted to examine the relationships between optimism, general self-efficacy, and perceived stress, after controlling for possible covariates.

RESULTS

Mean score of perceived global stress was 17.85 (SD 4.43). Mean score of perceived cancer-related stress was 37.15 (SD 12.66); 38.1% of the sample scored 44 and above, 20.1% scored 50 and above. Education, physical activity, cancer stage, and time since diagnosis were significantly associated with perceived stress. Optimism and general self-efficacy accounted for an additional variance in perceived global (14.9%) and cancer-related stress (16.9%), and both of them were independent and protective variables of perceived stress.

CONCLUSIONS

This study recognized cancer patients at risk for high levels of perceived stress and extended the understanding of the association between positive expectations and perceived global and cancer-related stress. Enhancing or maintaining optimism and general self-efficacy might be potential targets for future psychosocial interventions aimed at relieving perceived stress in cancer patients.

Sleep Disturbance Mediates the Association of Post-Traumatic Stress Disorder Symptoms and Pain in Patients With Cancer

BACKGROUND

Sleep disturbance is a common complaint of patients with cancer and is well established in both pain conditions and post-traumatic stress disorder (PTSD). An estimated one-third of patients with cancer develop symptoms of PTSD at some point in their treatment. However, few studies have evaluated the contributions of PTSD and sleep disturbance to pain processes in cancer populations. The current study used mediation models to test the hypothesis that sleep disturbance would mediate the relationships between PTSD symptoms and pain intensity and PTSD symptoms and pain interference in a sample of patients with cancer.

METHODS

A cross-sectional, retrospective chart review was conducted of the electronic medical records of 85 adult patients with cancer (89.4% female; 59% white; 42% metastatic) who sought individual psychosocial support services at our institution.

RESULTS

Post-traumatic stress disorder symptoms, sleep disturbance, pain intensity, and pain interference were all positively correlated ( P < .01). Clinical levels of PTSD symptoms were reported by 30% to 60% of the sample. Even after controlling for metastatic disease, race, and cancer type, sleep disturbance mediated the relationships between PTSD symptoms and pain intensity ( B = 0.27; 95% CI: 0.10-0.44) and PTSD symptoms and pain-related interference ( B = 0.58; 95% CI: 0.28-0.87).

CONCLUSIONS

The relationships among PTSD symptoms, pain intensity, and pain interference could be explained by co-occurring sleep disturbance. Given the high frequency of PTSD symptoms among patients with cancer and PTSD's known links to sleep problems and pain, clinicians should be attentive to the role that traumatogenic processes may play in eliciting sleep and pain-related complaints among patients with cancer.

Prevalence and its associated psychological variables of symptoms of depression and anxiety among ovarian cancer patients in China: a cross-sectional study

Background

It is well known that cancer patients tend to have high levels of perceived stress and symptoms of depression and anxiety. However, there is less study on the association between perceived stress and symptoms of depression and anxiety among ovarian cancer patients in China. And the mediating effect of hope and resilience needs to be further studied. In this study, we aim to examine the prevalence of depression and anxiety symptoms, to analyze the association between perceived stress and symptoms of depression and anxiety, and to test whether hope and resilience mediate the association of perceived stress with symptoms of depression and anxiety among Chinese patients with ovarian cancer.

Method

A total of 220 questionnaires were distributed and collected from the First Affiliated Hospital of China Medical University and Shengjing Hospital of China Medical University. All participants in this study were ovarian cancer inpatients. After excluding the incomplete questionnaires, 198 questionnaires were valid for the analysis. Qualified patients were asked to response to the questionnaires including Hospital anxiety and depression scale (HADS), perceived stress scale (PSS-10), and the Herth hope scale and the resilience scale. Hierarchical regression analyses were used to test the associations among perceived stress, symptoms of depression and anxiety, and hope and resilience. Bootstrapping method was conducted to examine whether the indirect effect of hope and resilience was significant respectively.

Results

The prevalence of symptoms of depression and anxiety in ovarian cancer patients was 47.0% and 51.5% respectively. Perceived stress correlated significantly with symptoms of depression (r = 0.709, P < 0.01) and anxiety (r = 0.660, P < 0.01). Hope (a*b = 0.155, BCa 95% CI: 0.094, 0.223) partly mediated the association between perceived stress and symptoms of depression; similarly, hope (a*b = 0.129, BCa 95% CI: 0.048, 0.205) partly mediated the effect of perceived stress on symptoms of anxiety. However, resilience (a*b = 0.004, BCa 95% CI: -0.030, 0.040) did not mediate the association between perceived stress and symptoms of depression. And resilience (a*b = 0.041,BCa 95% CI: -0.013, 0.098) did not mediate the association between perceived stress and symptoms of anxiety.

Conclusions

The present study suggests that perceived stress might be one of the impact factors of symptoms of depression and anxiety, while hope might ease symptoms of depression and anxiety. In view of the role of hope, medical workers and patient caregivers should pay more attention to hope, and then to intervene perceived stress among patients with ovarian cancer.

Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model

Post-traumatic stress disorder (PTSD) symptoms can develop after person experiences one or more traumatic events. Little research, however, has been done on PTSD symptoms of patients with ovarian cancer. The present study aimed to estimate the prevalence of PTSD symptoms in patients with ovarian cancer in China; the effects of demographic and clinical variables on PTSD symptoms; multiple mediation roles in the association between social support and PTSD symptoms in patients with ovarian cancer in China. We collected demographic and clinical information of patients with ovarian cancer in the first and second hospitals of China Medical University between January 1, 2014 and December 31, 2015. Qualified patients were asked to complete the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Duke-UNC Functional Social Support Questionnaire, Herth Hope Index (HHI), and Resilience Scale-14 (RS-14). 201 patients provided responses. We performed hierarchical linear regression to assess the correlation between social support and PTSD symptoms and bootstrapping to test the mediating role of hope and resilience as potential mediators. After controlling demographic and clinical characteristics, social support negatively correlated with PTSD symptoms (β = -0.406, P < 0.01). Social support explained 14.7% of the variance in PTSD symptoms. Hope and resilience explained 17.0% of the variance in PTSD symptoms. The proportion of the hope mediating effect was 43.37% for social support and the proportion of the resilience mediating effect was 10.64% for social support. Hope and resilience partly mediated the correlation between social support and PTSD symptoms despite accounting for different proportions of the mediating effect. Future intervention plans should pay more attention to social support as well as hope and resilience to prevent, relieve and treat PTSD symptoms.

Associations of perceived social support and positive psychological resources with fatigue symptom in patients with rheumatoid arthritis

Objective

This study aimed to assess the association between perceived social support (PSS) and fatigue and the roles of hope, optimism, general self-efficacy and resilience as mediators or moderators on PSS-fatigue association among Rheumatoid Arthritis (RA) patients in China.

Methods

A multi-center, cross-sectional study was conducted withinpatients diagnosed with RA in northeast China, in which 305 eligible inpatients were enrolled. The Multidimensional Fatigue Inventory, Multidimensional Scale of Perceived Social Support, Herth Hope Index, Life Orientation Test Revised, General Self-Efficacy Scale and Ego-Resiliency Scale were completed. The associations of PSS, hope, optimism, general self-efficacy and resilience with fatigue and the moderating roles of these positive psychological constructs were tested by hierarchical linear regression. Asymptotic and resampling strategies were utilized to assess the mediating roles of hope, optimism, general self-efficacy and resilience.

Results

The mean score of the MFI was 57.88 (SD = 9.50). PSS, hope, optimism and resilience were negatively associated with RA-related fatigue, whereas DAS28-CRP was positively associated. Only resilience positively moderated the PSS-fatigue association (B = 0.03, β = 0.13, P<0.01). Hope, optimism and resilience may act as partial mediators in the association between PSS and fatigue symptoms (hope: a*b = -0.16, BCa 95%CI: -0.27, -0.03; optimism: a*b = -0.20, BCa 95%CI: -0.30, -0.10; resilience: a*b = -0.12, BCa 95%CI: -0.21–0.04).

Conclusions

Fatigue is a severe symptom among RA patients. Resilience may positively moderate the PSS-fatigue association. Hope, optimism and resilience may act as partial mediators in the association. PSS, hope, optimism and resilience may contribute as effective recourses to alleviate fatigue, upon which PSS probably has the greatest effect.

Moderating role of self-efficacy on the associations of social support with depressive and anxiety symptoms in Chinese patients with rheumatoid arthritis

PURPOSE

Rheumatoid arthritis (RA) is significantly associated with depression and anxiety. Social support and self-efficacy are the coping resources of psychological distress. However, little research is available on the interaction of social support and self-efficacy in RA patients. This study aimed to identify the prevalence of depressive and anxiety symptoms and to examine whether or not self-efficacy moderates the associations of social support with depressive and anxiety symptoms in Chinese RA patients.

METHODS

A multicenter, cross-sectional study was conducted in northeast of China from December 2014 to January 2016. A total of 297 RA patients completed the Center for Epidemiologic Studies Depression Scale, Zung Self-Rating Anxiety Scale, Multidimensional Scale of Perceived Social Support and General Self-Efficacy Scale. The associations of social support, self-efficacy and social support × self-efficacy interaction with depressive and anxiety symptoms were examined by hierarchical regression analysis. If the interaction was statistically significant, simple slope analysis was conducted.

RESULTS

The prevalence of depressive symptoms was 58.2%, while 47.5% RA patients had anxiety symptoms. Social support and social support × self-efficacy interaction were significantly associated with depressive symptoms. Social support, self-efficacy and their interaction were significantly associated with anxiety symptoms. The association between social support and depressive symptoms was gradually reduced in the low (1 standard deviation [SD] below the mean, B=-0.614, β=-0.876, P<0.001), mean (B=-0.395, β=-0.563, P<0.001) and high (1 SD above the mean, B=-0.176, β=-0.251, P=0.002) groups of self-efficacy. For anxiety symptoms, the association was also gradually reduced in the low (B=-0.527, β=-0.774, P<0.001), mean (B=-0.288, β=-423, P<0.001) and high (B=-0.049, β=-0.071, P=0.447) groups of self-efficacy.

CONCLUSION

There was a high prevalence of depressive and anxiety symptoms in Chinese RA patients. Self-efficacy could attenuate the associations of social support with depressive and anxiety symptoms. Adequate social support and self-efficacy intervention should be provided to alleviate psychological distress.