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Henneghan AM, Van Dyk KM, Haywood D, Patel M, Franco-Rocha OY, Bang S, Longley T, Tasker R, Kaufmann T, Paolillo EW, Moore RC, Hart NH. Characterizing cancer-related cognitive impairments and impact on quality of life in women with metastatic breast cancer. Breast Cancer Res Treat 2025; 209:125-138. [PMID: 39269553 DOI: 10.1007/s10549-024-07479-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 08/25/2024] [Indexed: 09/15/2024]
Abstract
PURPOSE Little is known about cancer-related cognitive impairments (CRCI) in women with metastatic breast cancer (MBC). The purpose of this study is to (1) comprehensively describe CRCI and any associated psychosocial and behavioral symptoms, (2) determine observable sociodemographic and clinical risk factors for CRCI, and (3) explore cognitive and psychosocial predictors of quality of life and social functioning in women living with MBC. METHODS Using a cross-sectional design, women with MBC completed assessments (objective and subjective measures of CRCI including 3 open-ended questions, measures of psychosocial and behavioral factors, and assessments of quality of life and social function), and data were analyzed using descriptive statistics, qualitative content analysis, correlation analyses, t tests, analysis of variance, and linear regression models. RESULTS Data from 52 women were analyzed. 69.2% of the sample reported clinically significant CRCI and 46% of the sample scored < 1 standard deviation below the standardized mean on one or more cognitive tests. Those with triple-negative MBC (compared to HER2+), recurrent MBC (compared to de novo), and no history of chemotherapy had worse subjective CRCI, and those without history of surgery and older age had worse objective CRCI. Subjective CRCI, but not objective CRCI, was significantly associated with quality of life and social functioning. CONCLUSION Subjective and objective CRCI are likely a common problem for those with MBC. Subjective CRCI is associated with poorer quality of life and lower social functioning. Healthcare providers should acknowledge cognitive symptoms, continually assess cognitive function, and address associated unmet needs across the MBC trajectory.
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Affiliation(s)
- Ashley M Henneghan
- School of Nursing, University of Texas at Austin, Austin, TX, USA.
- Dell Medical School, University of Texas at Austin, Austin, TX, USA.
| | - Kathleen M Van Dyk
- Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Darren Haywood
- Faculty of Health, Human Performance Research Centre, INSIGHT Research Institute, , University of Technology Sydney (UTS), Sydney, NSW, Australia
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Mansi Patel
- Department of Neuroscience, College of Natural Sciences, University of Texas at Austin, Austin, TX, USA
| | | | - Soyeong Bang
- School of Nursing, Columbia University, New York, NY, USA
| | | | - Rebecca Tasker
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Tara Kaufmann
- Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Emily W Paolillo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Raeanne C Moore
- UC San Diego Health Sciences, University of California San Diego, San Diego, CA, USA
| | - Nicolas H Hart
- Faculty of Health, Human Performance Research Centre, INSIGHT Research Institute, , University of Technology Sydney (UTS), Sydney, NSW, Australia
- School of Medical and Health Sciences, Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Faculty of Health, Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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Henneghan AM, Paolillo EW, Van Dyk KM, Franco-Rocha OY, Bang S, Tasker R, Kaufmann T, Haywood D, Hart NH, Moore RC. Feasibility and psychometric quality of smartphone administered cognitive ecological momentary assessments in women with metastatic breast cancer. Digit Health 2025; 11:20552076241310474. [PMID: 39758254 PMCID: PMC11696949 DOI: 10.1177/20552076241310474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Accepted: 12/04/2024] [Indexed: 01/07/2025] Open
Abstract
Objective Metastatic breast cancer (MBC) is associated with burdensome side effects, including cognitive changes that require ongoing monitoring. Cognitive ecological momentary assessments (EMAs) allow for assessment of individual cognitive functioning in natural environments and can be administered via smartphones. Accordingly, we sought to establish the feasibility, reliability, and validity of a commercially available cognitive EMA platform. Methods Using a prospective design, clinical cognitive and psychosocial assessments (cognitive batteries; patient reported outcomes) were collected at baseline, followed by a 28-day daily EMA protocol that included self-ratings for symptoms and mobile cognitive tests (memory, executive functioning, working memory, processing speed). Satisfaction and feedback questions were included in follow-up data collection. Feasibility data were analyzed using mixed descriptive methods. Test-retest reliability was examined using intraclass correlation coefficients (ICCs) for each EMA, and Pearson's correlation were used to evaluate convergent validity between cognitive EMAs and baseline clinical cognitive and psychosocial variables. Results Fifty-one women with MBC (n = 51) completed this EMA study. High satisfaction (median 90%), low burden (median 19%), high adherence rates (mean 94%), and 100% retention rate were observed. ICCs for cognitive tests of working memory, executive function, and processing speed were robust (>0.90) and ICC for memory tests acceptable (>0.66). Other correlational findings indicated strong convergent validity for all cognitive and psychosocial EMAs. Conclusion Cognitive EMA monitoring for 28 days is feasible and acceptable in women with MBC, with specific cognitive EMAs (mobile cognitive tests; cognitive function self-ratings) demonstrating strong reliability and validity.
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Affiliation(s)
- Ashley M Henneghan
- School of Nursing, University of Texas at Austin, Austin, TX, USA
- Dell Medical School, Department of Oncology, University of Texas at Austin, Austin, TX, USA
| | - Emily W Paolillo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Kathleen M Van Dyk
- Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Soyeong Bang
- School of Nursing, Columbia University, New York, NY, USA
| | - Rebecca Tasker
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Tara Kaufmann
- Dell Medical School, Department of Oncology, University of Texas at Austin, Austin, TX, USA
| | - Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
| | - Raeanne C Moore
- UC San Diego Health Sciences, University of California San Diego, San Diego, CA, USA
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Galin M, de Girolamo L, Clarisse B, Segura-Djezzar C, Glöckner F, Elia C, Réhel S, Clochon P, Doidy F, Chavant J, Etard O, Viader F, Grellard JM, Lequesne J, Joly F, Eustache F, Martin T, Giffard B, Quarck G, Perrier J. Exploration of effects of galvanic vestibular stimulation on circadian rhythms and its associations with sleep and spatial memory in patients with breast cancer: The ICANSLEEP-2 protocol. PLoS One 2024; 19:e0306462. [PMID: 39083526 PMCID: PMC11290633 DOI: 10.1371/journal.pone.0306462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Patients with breast cancer (BC) exhibit circadian rhythm disruptions, mainly of rest-activity rhythm (RAR), of which sleep is an essential component, and cortisol rhythm. Sleep complaints such as insomnia and cognitive impairments are prevalent in BC. In general population, sleep is known to contribute greatly to cognition. Thus, improving RAR (and particularly sleep) could help limiting cognitive impairments in BC patients. It has recently been suggested that, in addition to its essential role in spatial memory, the vestibular system contributes to RAR synchronization. Its stimulation could therefore limit both sleep disturbances and spatial memory deficits in BC. OBJECTIVES The main aim of the ICANSLEEP-2 study is to assess the effects of galvanic vestibular stimulation (GVS) on circadian rhythms. The secondary aim is to assess whether GVS improves sleep and spatial memory in BC patients. METHODS Two groups with insomnia complaints (Insomnia Severity Index > 7) will be included: a patients' group with BC (n = 50) and a healthy control group without history of cancer (n = 25). There will be two assessment sessions, before and after 2 weeks of GVS. Patients will be randomly assigned to either a GVS group or a sham group (noneffective stimulation). Controls will receive GVS. GVS effects will be quantified and compared between groups. Assessments will include actigraphy, salivary cortisol, polysomnography, a cognitive test battery (including a computer-based task for spatial memory) and validated questionnaires (for psychological functioning and sleep complaints). DISCUSSION Current methods for improving sleep in BC have had controversial outcomes regarding sleep structure. We expect GVS to offer a new mean of directly targeting RAR disruptions in BC patients, with beneficial effects on sleep structure. Given the crucial impact of sleep on cognitive functioning, notably spatial memory, improving sleep of BC patients should enhance their cognitive functioning. ETHICS AND DISSEMINATION This study received ethical approval from the Ile de France IV institutional review board on 19 April 2022 (no. ID-RCB: 2022-A00437-36). The findings yielded by this protocol will be presented at various conferences and in peer-reviewed journals. CLINICALTRIALS.GOV REGISTRATION NUMBER NCT05414357.
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Affiliation(s)
- Melvin Galin
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Laura de Girolamo
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | | | | | - Franka Glöckner
- Faculty of Psychology, Chair of Lifespan Developmental Neuroscience, TU Dresden, Dresden, Germany
| | - Clara Elia
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Stéphane Réhel
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Patrice Clochon
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Franck Doidy
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Julien Chavant
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Olivier Etard
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Fausto Viader
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | | | - Justine Lequesne
- Clinical Research Department, François Baclesse Center, Caen, France
| | - Florence Joly
- Clinical Research Department, François Baclesse Center, Caen, France
- Cancer and Cognition Platform, French League Against Cancer, Caen, France
- Cancer Prevention and Treatment (ANTICIPE) Research Unit, INSERM, Normandy University, Caen, France
| | - Francis Eustache
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Tristan Martin
- Movement – Interactions, Performance (MIP) Team, Faculty of Sciences and Technologies, Le Mans University, Le Mans, France
| | - Bénédicte Giffard
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
- Cancer and Cognition Platform, French League Against Cancer, Caen, France
| | - Gaëlle Quarck
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Joy Perrier
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
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Han B, Yan J, Xiong R, Wang M, Liu J, Jia L, Dou J, Liu X, Fan H, Li J, Zhang C, Sun X, Du H, Ma Y, Teng S, Jiang N, Lu G. The relationship between psychological distress and cognitive failure among breast cancer survivors: a network analysis. Front Psychol 2024; 15:1420125. [PMID: 39055990 PMCID: PMC11271155 DOI: 10.3389/fpsyg.2024.1420125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Background Psychological distress is highly prevalent and has a severe impact on the quality of life among breast cancer survivors. This type of distress is associated with cognitive failure. However, previous studies have focused solely on the total scale scores of these two concepts while ignoring the unique relationship between specific components. In the present study, we utilized network analysis to explore the relationship between psychological distress and cognitive failure in breast cancer survivors. Methods The network analysis approach was adopted to estimate the regularized partial correlation network in a cross-sectional sample of 409 breast cancer survivors. All participants were assessed using the Depression Anxiety Stress Scale and the Cognitive Failure Questionnaire. The Gaussian Graphical Model was employed to estimate the network, centrality indices, and edge weights, providing a description of the characteristics of the network. Results The results indicated that anxiety-stress and depression-stress were the strongest edges in the community of psychological distress. Distractibility-memory was the strongest edge in the community of cognitive failure. Distractibility and memory were the most central nodes, with the highest expected influence in the network. Depression and motor coordination acted as important bridge nodes with the highest bridge expected influence. Conclusion Distractibility and memory in cognitive failure played important roles in activating and maintaining the relationship network. Motor coordination was identified as the crucial pathway for the impact of cognitive failure on psychological distress. Interventions targeting these specific issues might be more effective in improving cognitive failure and reducing psychological distress among breast cancer survivors.
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Affiliation(s)
- Bingxue Han
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Jialin Yan
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Ruoyu Xiong
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Miaomiao Wang
- College of Teacher Education, Weifang University, Weifang, Shandong, China
| | - Jinxia Liu
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Liping Jia
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Jinhua Dou
- Student Affairs Department, Shandong Second Medical University, Weifang, Shandong, China
| | - Xiaoli Liu
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Huaju Fan
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Jianying Li
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Caiyun Zhang
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Xiuhong Sun
- Department of Thyroid and Breast Surgery, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China
| | - He Du
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Yufeng Ma
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Shuai Teng
- Psychological Counseling Center, Weifang University, Weifang, Shandong, China
| | - Nengzhi Jiang
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Guohua Lu
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
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Chen F, Li C, Zhu J, Zhao Y, Zhang P, Gao J, Yang Y, Guo L. The Mediating Effect of Coping Style in the Relationship Between Sleep Quality and Perceived Cognitive Impairment Among Breast Cancer Patients: A Cross-sectional Study. Cancer Nurs 2024:00002820-990000000-00253. [PMID: 38830054 DOI: 10.1097/ncc.0000000000001371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
BACKGROUND Perceived cognitive impairment is a significant symptom experienced by breast cancer patients and may be affected by sleep quality. Coping styles have potential relevancies with both sleep quality and perceived cognitive impairment. However, the empirical evidence supporting their association among breast cancer patients is limited. OBJECTIVE This study explored the associations between sleep quality, coping styles, and perceived cognitive impairment and tested the mediating role of coping styles in breast cancer patients. METHODS A total of 294 breast cancer patients were included in this cross-sectional study. Patients were assessed using the Pittsburgh Sleep Index Scale, the Simplified Coping Styles Questionnaire, and the Functional Assessment of Cancer Therapy-Cognitive Functioning (Version 3) Scale. The data were analyzed using SPSS and Process macros. RESULTS The direct effect of sleep quality on reported cognitive impairment was significant (β = -0.245, P < .001). Furthermore, sleep quality was found to have a significant indirect effect on perceived cognitive impairment through positive coping style (β = -0.026, P < .05) and negative coping style (β = -0.131, P < .05). CONCLUSIONS Our research suggests that sleep quality has both a direct effect on perceived cognitive impairment and an indirect effect through positive and negative coping styles in breast cancer patients. Moreover, negative coping style had a more pronounced mediating effect than positive coping style. IMPLICATIONS FOR PRACTICE Clinical medical staff could reduce the perceived cognitive impairment of breast cancer patients by improving their sleep quality and encouraging them to adopt a more positive coping style.
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Affiliation(s)
- Fan Chen
- Author Affiliations: College of Nursing and Rehabilitation, North China University of Science and Technology (Mss Chen, Zhu, and Zhang, and Dr Zhao); Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital (Mr Li); and Department of Intensive Care Medicine, Zunhua People's Hospital (Ms Gao), Tangshan; Department of Geriatric, Affiliated Hospital of Hebei University (Ms Yang), Baoding; and Department of Cardiology, No. 2 Hospital of Hebei Medical University (Ms Guo), Shijiazhuang, Hebei, PR China
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Sahu M. Twin studies as an innovative approach to address research questions in cancer care within primary care settings. Fam Med Community Health 2024; 12:e002623. [PMID: 38341219 PMCID: PMC10862323 DOI: 10.1136/fmch-2023-002623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
This paper proposes the utilisation of twin studies as a novel and powerful methodological approach to investigate critical research questions pertaining to cancer prevention, screening, diagnosis, treatment and survivorship within primary care contexts. The inherent genetic similarity between monozygotic (MZ) (identical) twins provides a unique opportunity to disentangle genetic and environmental influences on cancer-related outcomes. MZ twins share virtually identical genetic makeup, offering a unique opportunity to discern the relative contributions of genetic and environmental factors to cancer-related outcomes. In contrast, dizygotic (DZ) twins, also known as fraternal twins, develop from two separate eggs fertilised by two different sperm and share on average 50% of their genetic material, the same level of genetic similarity found in non-twin siblings. Comparisons between MZ and DZ twins enable researchers to disentangle hereditary factors from shared environmental influences. This methodology has the potential to advance our understanding of the multifaceted interplay between genetic predisposition, lifestyle factors and healthcare interventions in the context of cancer care. This paper outlines the rationale, design considerations and potential applications of twin studies in primary care-based cancer research.
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Affiliation(s)
- Monalisha Sahu
- Department of Occupational Health, All India Institute of Hygiene and Public Health, Kolkata, India
- Department of Preventive & Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, India
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7
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Guseva Canu I, Bovio N, Arveux P, Bulliard JL, Fournier E, Germann S, Konzelmann I, Maspoli M, Rapiti E, Grzebyk M. Breast cancer and occupation: Non-parametric and parametric net survival analyses among Swiss women (1990-2014). Front Public Health 2023; 11:1129708. [PMID: 37089493 PMCID: PMC10115164 DOI: 10.3389/fpubh.2023.1129708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/14/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction Occupation can contribute to differences in risk and stage at diagnosis of breast cancer. This study aimed at determining whether occupation, along with skill level and the socio-professional category, affect the breast cancer survival (BCS) up to 10 years after diagnosis. Materials and methods We used cancer registry records to identify women diagnosed with primary invasive breast cancer in western Switzerland over the period 1990-2014 and matched them with the Swiss National Cohort. The effect of work-related variables on BCS was assessed using non-parametric and parametric net survival methods. Results Study sample included 8,678 women. In the non-parametric analysis, we observed a statistically significant effect of all work-related variables on BCS. Women in elementary occupations, with low skill level, and in paid employment not classified elsewhere, had the lowest BCS, while professionals, those with the highest skill level and belonging to top management and independent profession category had the highest BCS. The parametric analysis confirmed this pattern. Considering elementary occupations as reference, all occupations but Craft and related trades had a hazard ratio (HR) below 1. Among professionals, technicians and associate professionals, and clerks, the protective effect of occupation was statistically significant and remained unchanged after adjustment for age, calendar period, registry, nationality, and histological type. After adjusting for tumor stage, the HRs increased only slightly, though turned non-significant. The same effect was observed in top management and independent professions and supervisors, low level management and skilled laborers, compared to unskilled employees. Conclusion These results suggest that work-related factors may affect BCS. Yet, this study was conducted using a limited set of covariates and a relatively small study sample. Therefore, further larger studies are needed for more detailed analyses of at risk occupations and working conditions and assessing the potential interaction between work-related variables and tumor stage.
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Affiliation(s)
- Irina Guseva Canu
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bovio
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Patrick Arveux
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Jean-Luc Bulliard
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Neuchâtel and Jura Cancer Registry, Neuchâtel, Switzerland
| | - Evelyne Fournier
- Geneva Cancer Registry, University of Geneva, Geneva, Switzerland
| | - Simon Germann
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | | | | | | | - Michel Grzebyk
- Department of Occupational Epidemiology, National Research and Safety Institute (INRS), Vandoeuvre lès Nancy, France
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8
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Wang W, Cao Y. How individual social capital affects residents' satisfaction with medical services: Based on the evidence from urban residents in China. Front Psychol 2022; 13:1077144. [PMID: 36571017 PMCID: PMC9780447 DOI: 10.3389/fpsyg.2022.1077144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Residents' satisfaction with medical services has commonly been treated as both a medical and psychosocial process. The influence of psychosocial factors on residents' satisfaction with medical treatment is generally considered as important as that of medical factors. However, the effect of individual social capital on residents' satisfaction after medical treatment-an important psychosocial variable that may influence health status and access to medical services-has not received sufficient attention. Methods This study used the questionnaire survey data of urban residents in eight Chinese cities in 2014 to investigate how individual social capital affects residents' satisfaction with medical services over the past year. Results The results revealed a negative impact of individual social capital on residents' overall satisfaction with medical services. In addition, the use of individual social capital significantly improved residents' satisfaction with medical resources and significantly reduced residents' satisfaction with the medical system. Moreover, the negative impact of individual social capital on residents' overall satisfaction with medical services was greater for individuals with a lower likelihood of using this capital, which may lead to unequal allocation of medical resources and long-term life satisfaction. Discussion The heterogeneous impact and mechanism of individual social capital on residents' satisfaction with medical services was confirmed under the premise of self-selection bias.
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