Psycho-Oncology (Psycho Oncol)

Publications in this journal

• Article: Relationship between cancer-related fatigue and personality in patients with breast cancer after chemotherapy.

  Shu-Hong Wang, Guo-Ping He, Ping-Lan Jiang, Li-Li Tang, Xiao-Min Feng, Cui Zeng, Guo-Fei Wang
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  ABSTRACT: BACKGROUND: This study aimed to explore the relationship between cancer-related fatigue (CRF) and personality in patients with breast cancer after chemotherapy. METHODS: A cross-sectional study was conducted to study the relationship between CRF and personality in breast cancer patients after chemotherapy. CRF and personality were measured by the cancer fatigue score and the Eysenck Personality Questionnaire, respectively. RESULTS: A total of 300 breast cancer patients who had received chemotherapy were recruited to this study. Eysenck Personality Questionnaire scores of psychoticism, introversion, and extroversion in the patients were lower than the norm level (p < 0.01), but those of neuroticism and lie were higher than the norm level (p < 0.01). Multivariate analyses showed positive correlation between psychoticism and affective fatigue, neuroticism and total fatigue, and physical fatigue and cognitive fatigue. Multivariate analyses also showed negative correlation between introversion or extroversion and total fatigue, physical fatigue or affective fatigue, and lie and total fatigue or cognitive fatigue. CONCLUSIONS: There was CRF in patients with breast cancer after chemotherapy. Psychoticism, extroversion/introversion, neuroticism, and lie are correlated with CRF in breast cancer patients after chemotherapy. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 05/2013;
• Article: Chemotherapy-induced prospective memory impairment in patients with breast cancer.

  Huaidong Cheng, Zhen Yang, Biao Dong, Chanjuan Chen, Mingjun Zhang, Zhonglian Huang, Zhendong Chen, Kai Wang
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  ABSTRACT: OBJECTIVE: This study aimed to investigate the event-based prospective memory (EBPM) and time-based prospective memory (TBPM) in chemotherapy-induced cognitive impairment in patients with breast cancer. METHODS: Forty patients with breast cancer who underwent adjuvant chemotherapy and 40 age-matched and education-matched healthy women were administered with a battery of neuropsychological tests including EBPM and TBPM tasks. RESULTS: A significant difference between breast cancer patients and controls was found in the scores on the mini-mental state examination (t = -11.684, p < 0.01), verbal fluency test (t = -7.939, p < 0.01), and digit span (t = -2.538, p < 0.05). Compared with healthy controls, breast cancer patients exhibited a poorer performance on EBPM (t = -7.096, p < 0.01) but not on TBPM (t = -1.921, p > 0.05). CONCLUSIONS: Our results suggest that breast cancer patients who had undergone adjuvant chemotherapy show deficits in EBPM but not in TBPM. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 05/2013;
• Article: Structural equation modeling for implementation intentions, cancer worry, and stages of mammography adoption.

  Kei Hirai, Kazuhiro Harada, Aiko Seki, Miwa Nagatsuka, Hirokazu Arai, Ayako Hazama, Yoshiki Ishikawa, Chisato Hamashima, Hiroshi Saito, Daisuke Shibuya
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  ABSTRACT: OBJECTIVES: This study aimed to develop a structural model for mammography adoption in Japanese middle-aged women by using constructs from the transtheoretical model (TTM), the theory of planned behavior (TPB), implementation intentions, and cancer worry. METHODS: Questionnaires based on items including TTM, TPB, implementation intentions, cancer worry-related variables, and demographic variables were distributed to 1000 adult women aged 40 to 59 years, with 641 subjects being used in the final analysis (response rate = 64.1%). RESULTS: Regarding the stage of adoption, 79 participants (12.3%) were at the precontemplation stage, 30 (4.7%) were at the relapse stage, 142 (22.2%) were at the contemplation stage, 88 (13.7%) were at the action stage, and 302 (47.1%) were at the maintenance stage. Our model, derived from structural equation modeling, revealed that the stage of mammography adoption was significantly affected by goal intentions, implementation intentions, perceived barriers, history of breast cancer screening, and relative risk. A logistic regression analysis revealed that goal intentions and implementation intentions significantly predicted mammography uptake within 1 year. CONCLUSION: This study developed an integrated model constructed from TTM, TPB, implementation intentions, and cancer worry to account for mammography adoption in Japan, and also confirmed the predictive validity of the model. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 05/2013;
• Article: The influence of dispositional optimism on post-visit anxiety and risk perception accuracy among breast cancer genetic counselees.

  B M Wiering, A Albada, J M Bensing, M G E M Ausems, A M van Dulmen
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  ABSTRACT: OBJECTIVE: Much is unknown about the influence of dispositional optimism and affective communication on genetic counselling outcomes. This study investigated the influence of counselees' optimism on the counselees' risk perception accuracy and anxiety, while taking into account the affective communication during the first consultation for breast cancer genetic counselling. METHODS: Counselees completed questionnaires measuring optimism, anxiety and the perceived risk that hereditary breast cancer runs in the family before, and anxiety and perceived risk after the first consultation. Consultations were videotaped. The duration of eye contact was measured, and verbal communication was rated using the Roter Interaction Analysis System. RESULTS: Less-optimistic counselees were more anxious post-visit (β = -.29; p = .00). Counsellors uttered fewer reassuring statements if counselees were more anxious (β = -.84; p = .00) but uttered more reassurance if counselees were less optimistic (β = -.76; p = .01). Counsellors expressed less empathy if counselees perceived their risk as high (β = -1.51; p = .04). An increase in the expression of reassurance was related to less post-visit anxiety (β = -.35; p = .03). More empathy was related to a greater overestimation of risk (β = .92; p = .01). CONCLUSIONS: Identification of a lack of optimism as a risk factor for high anxiety levels enables the adaptation of affective communication to improve genetic counselling outcomes. Because reassurance was related to less anxiety, beneficial adaptation is attainable by increasing counsellors' reassurance, if possible. Because of a lack of optimally adapted communication in this study, further research is needed to clarify how to increase counsellors' ability to adapt to counselees. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: Couples facing advanced cancer: examination of an interdependent relational system.

  Chris Lo, Sarah Hales, Michal Braun, Anne C Rydall, Camilla Zimmermann, Gary Rodin
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  ABSTRACT: BACKGROUND: The relational impact of advanced cancer on both patients and spouse caregivers has rarely been examined simultaneously. This study describes a framework for understanding distress in each partner as a consequence of psychosocial characteristics, burden of disease or of caregiving, and the distress of the other person. A model focusing on the protective value of social relatedness was tested to illustrate the interdependence of patients and spouses in their mutual adaptation to disease. METHODS: A total of 278 advanced cancer patients and their spouse caregivers completed measures of psychological distress (e.g., depression), physical burden from cancer (e.g., symptom count), caregiving burden (i.e., time and task demand), and social relatedness (i.e., social support and attachment security). Structural equation modeling was used to extract latent factors associated with these constructs and to examine their interrelationships. RESULTS: The model fit was adequate. Patient distress was related to disease burden (standardized path coefficient = 0.52) and patient social relatedness (-0.32). Caregiver distress was related to caregiving burden (0.21) and caregiver social relatedness (-0.51). Caregiving burden was related to patient disease burden (0.43) and caregiver social relatedness (-0.37). Reciprocal pathways between patient and caregiver distress indicated that caregiver distress was influenced by patient distress (0.30) but not vice versa (0.12). CONCLUSIONS: These findings support the view that patients and caregivers constitute an interdependent relational system and interventions in this setting should take into account both interactions between patients and caregivers and the nature of their social relatedness. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: Psychosocial predictors of four health-promoting behaviors for cancer prevention using the stage of change of Transtheoretical Model.

  Jean H Choi, Kyong-Mee Chung, Keeho Park
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  ABSTRACT: OBJECTIVES: The present study aimed to examine whether demographic as well as psychosocial variables related to the five stages of change of the Transtheoretical Model can predict non-clinical adults' cancer preventive and health-promoting behaviors. This study specifically focused on cancer, one of the major chronic diseases, which is a serious threat of national health. METHODS: A total of 1530 adults participated in the study and completed questionnaires. Collected data were analyzed by using multinominal logistic regression. RESULTS: The significant predictors of later stages varied among the types of health-promoting behaviors. Certain cancer preventive health-promoting behaviors such as well-balanced diet and exercise were significantly associated with psychosocial variables including cancer prevention-related self-efficacy, personality traits, psychosocial stress, and social support. On the other hand, smoking cessation and moderate or abstinence from drinking were more likely to be predicted by demographic variables including sex and age. CONCLUSIONS: The present study found that in addition to self-efficacy-a relatively well-studied psychological variable-other personality traits and psychological factors including introversion, neuroticism, psychosocial stress, and social support also significantly predicted later stages of change with respect to cancer preventive health-promoting behaviors. The implications of this study are also discussed. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: A population-based study comparing HRQoL among breast, prostate, and colorectal cancer survivors to propensity score matched controls, by cancer type, and gender.

  Traci Lemasters, Suresh Madhavan, Usha Sambamoorthi, Sobha Kurian
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  ABSTRACT: BACKGROUND: Objectives were to compare health-related quality of life (HRQoL) between breast cancer survivors, prostate cancer survivors (PCS), and colorectal cancer survivors (CCS) to matched controls, stratified by short and long-term survivors, by cancer type, and gender. METHODS: By using the 2009 Behavioral Risk Factor Surveillance System, propensity scores matched three controls to adult survivors >1 year past diagnosis (N = 11,964) on age, gender, race/ethnicity, income, insurance status, and region of the USA Chi-square tests and logistic regression models compared HRQoL outcomes (life satisfaction, activity limitations, sleep quality, emotional support, general, physical, and mental health). RESULTS: Although all cancer survivors reported worse general health (p < 0.000) and more activity limitations (p < 0.004) than controls, these disparities decreased among long-term survivors. Short-term PCS and male CCS were more likely to report worse outcomes across additional domains of HRQoL than controls, but PCS were 0.61, 0.63, and 0.70 times less likely to report activity limitations, fair/poor general health, and 1-15 bad physical health days in the past month than male CCS. Breast cancer survivors and female CCS were 2.12 and 3.17, 1.58 and 1.86, and 1.49 and 153, respectively, times more likely to report rarely/never receiving needed emotional support, 1-15 bad mental health days in the past month, and not receiving enough sleep 1-15 days in the past month than PCS and male CCS. CONCLUSIONS: Cancer survivors experience worse HRQoL than similar individuals without a history of cancer and the severity of affected HRQoL domains differ by time since diagnosis, cancer type, and gender. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: The benefits of being self-determined in promoting physical activity and affective well-being among women recently treated for breast cancer.

  Jennifer Brunet, Shaunna M Burke, Catherine M Sabiston
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  ABSTRACT: PURPOSE: In this study, changes in motivational regulations in women following treatment for breast cancer were described. Changes in motivational regulations as predictors of subsequent change in light and moderate-to-vigorous physical activity (PA) and affect were also examined. METHODS: Women [n = 150; Mage = 54.41 (SD = 10.87) years] completed self-report questionnaires and wore an accelerometer for 7 days at Time 1 [M = 3.94 (SD = 3.08) months following primary treatment], as well as 3 (Time 2) and 6 (Time 3) months later. Data were analyzed using repeated-measures analysis of variance and path analysis using residual change scores. RESULTS: Identified regulation and self-determined motivation (i.e., combined intrinsic motivation and identified regulation) scores decreased over time (p < 0.05). In the path model [χ(2) (4) = 5.66, p = 0.22, root mean square error of approximation = 0.05 (90% CI: 0.0; 0.15), comparative fit index = 0.99, standardized root mean square of the residuals = 0.03], ΔTime1-2 in external regulation was associated with ΔTime2-3 in positive affect (β = -0.16), ΔTime1-2 in introjected (β = 0.25) and amotivation (β = 0.19) were related to ΔTime2-3 in negative affect, and ΔTime1-2 in self-determined motivation was related to ΔTime2-3 in positive affect (β = 0.40) and moderate-to-vigorous PA (β = 0.21). CONCLUSIONS: Changes in motivational regulations were related to changes in PA and affect in the aftermath of breast cancer. Given the benefits of self-determined motivation, additional research is needed to develop and test interventions aimed at enhancing this type of motivation. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: Changes in health-related quality of life by occupational status among women diagnosed with breast cancer-a population-based cohort study.

  Marie Høyer Lundh, Claudia Lampic, Karin Nordin, Johan Ahlgren, Leif Bergkvist, Mats Lambe, Anders Berglund, Birgitta Johansson
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  ABSTRACT: OBJECTIVE: To investigate whether longitudinal changes in health-related quality of life (HRQoL) among breast cancer patients vary by prediagnosis occupational status or postdiagnosis changes in working time. METHODS: We identified 1573 patients in the Breast Cancer Quality Register of Central Sweden and asked them to participate in a longitudinal questionnaire study. A total of n = 841 women completed three questionnaires within a mean time of 4, 16, and 38 months postdiagnosis. Generalized estimating equation models were used to examine changes in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the Breast Cancer-Specific Quality of Life Questionnaire subscales stratified by prediagnosis occupational status and postdiagnosis changes in working time. RESULTS: Over time, the proportion of employed women reporting good functioning increased more, and the proportion reporting a high level of symptoms decreased more compared with women on sick leave/disability pension and retirement pensioners (p < 0.001). The latter two also showed a worsening in several subscales (p < 0.05). Among employed women, more consistent improvements in role and social functioning were observed among those with an increase/no change in working time than among those who had decreased it or stopped working (p < 0.05). A decrease in the proportion reporting pain was observed among women with an increase/no change in working time compared with women with decreased working time, among whom the proportion reporting pain increased (p = 0.008). CONCLUSIONS: Being employed prediagnosis and resuming work to the same extent as prior to the breast cancer diagnosis are associated with consistent improvements in HRQoL. These results highlight the importance of interventions to improve HRQoL and policies to support return to work following diagnosis. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: Anti-Yo mediated paraneoplastic cerebellar degeneration in the context of breast cancer: a case report and literature review.

  Richard Garrett Key, James C Root
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  ABSTRACT: BACKGROUND: Paraneoplastic syndromes are of interest to psycho-oncologists because they may be misdiagnosed initially as primary psychiatric disorders and can have profound neuropsychiatric and psychosocial sequelae. Paraneoplastic cerebellar degeneration (PCD) is a paraneoplastic syndrome which destroys Purkinje cells of the cerebellum and causes trunk and limb ataxia, dysarthria, diplopia, and vertigo, which often precede the diagnosis of cancer. Anti-Yo PCD is a devastating syndrome that significantly worsens prognosis in terms of functional ability and survival. METHODS: We present the case of a woman with progressive cerebellar deficits, which were misdiagnosed for several months before breast cancer and anti-Yo antibodies were discovered. RESULTS: PCD may be misdiagnosed as a primary psychiatric disorder. Results of neuropsychological assessment in this case found subtle attentional dysfunction but relatively preserved cognitive functioning in other domains. DISCUSSION: The literature relating to PCD and psychiatric manifestations of cerebellar disease are reviewed. The limitations of our current understanding of non-motor cerebellar function are highlighted, asserting the need for further study in this area. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: Psychosocial support in patients with multiple myeloma at time of diagnosis: who wants what?

  Jette Lamers, Mechthild Hartmann, Hartmut Goldschmidt, Anette Brechtel, Jens Hillengass, Wolfgang Herzog
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  ABSTRACT: OBJECTIVE: The aim of this study was to examine interest in psychosocial interventions among patients with multiple myeloma at time of diagnosis as well as associated factors. METHODS: Patients with newly diagnosed multiple myeloma were recruited from our outpatient myeloma unit at the Heidelberg University Hospital. Patients completed questionnaires that included a checklist on desired psychosocial interventions and the Patient Health Questionnaire 9-item (PHQ-9) depression and Generalized Anxiety Disorder 7-item scale (GAD-7) anxiety scales. Medical data were extracted from the patients' electronic records. RESULTS: The survey was completed by 114 out of the 130 myeloma patients. Half of the patients (51%) desired psychosocial interventions. The most common preferences were relaxation techniques (21%), psychological counseling (20%), and peer support groups (18%). Approximately 24% of the patients reported symptoms of depression, and 8% reported symptoms of anxiety. Patients with symptoms of depression had twice as many preferences for psychosocial interventions as nondepressed patients. They more frequently desired individual psychotherapy (p = 0.035) and peer support groups (p = 0.015). In general, lower age was associated with greater interest in psychosocial interventions. Medical status was not strongly associated with interest in psychosocial interventions. CONCLUSIONS: A high percentage (51%) of patients with multiple myeloma has psychosocial intervention desires at the time of diagnosis. The greatest interest was found in depressed and younger patients. However, depressed patients do not prefer a single intervention form but rather show a broad variability of wishes, so 'one size does not fit all'. Therefore, to reach all patients in need, a choice of psychosocial interventions should be offered. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: A randomised, wait-list controlled trial: evaluation of a cognitive-behavioural group intervention on psycho-sexual adjustment for men with localised prostate cancer.

  Heather M Siddons, Addie C Wootten, Anthony J Costello
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  ABSTRACT: OBJECTIVE: To examine the effectiveness of a cognitive-behavioural therapy (CBT) group intervention to facilitate improved psycho-sexual adjustment to treatment side effects in prostate cancer survivors post-radical prostatectomy. METHODS: A randomised, wait-list controlled trial was conducted with a total of 60 men who participated in a manualised 8-week cognitive-behavioural group intervention 6 months to 5 years post-radical prostatectomy for localised prostate cancer. Participants completed standardised questionnaires pre-intervention and post-intervention, which assessed mood state, stress, general and prostate cancer anxiety, quality of life and areas of sexual functioning. RESULTS: Paired samples t-tests identified a significant improvement in sexual confidence, masculine self-esteem, sexual drive/relationship and a significant decline in sexual behaviour from pre-intervention to post-intervention. Hierarchical regression analyses revealed that after controlling for covariates, participation in the group intervention significantly improved sexual confidence, sexual intimacy, masculine self-esteem and satisfaction with orgasm. CONCLUSIONS: This group-based CBT intervention for men post-radical prostatectomy for localised prostate cancer shows promising results in terms of improving quality of life. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 04/2013;
• Article: Assessment of family psychosocial functioning in survivors of pediatric cancer using the PAT2.0.

  Jordan Gilleland, Bonney Reed-Knight, Sarah Brand, Anya Griffin, Karen Wasilewski-Masker, Lillian Meacham, Ann Mertens
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  ABSTRACT: BACKGROUND: This study aimed to examine clinical validity and utility of a screening measure for familial psychosocial risk, the Psychosocial Assessment Tool 2.0 (PAT2.0), among pediatric cancer survivors participating in long-term survivorship care. METHODS: Caregivers (N = 79) completed the PAT2.0 during their child's survivorship appointment. Caregivers also reported on family engagement in outpatient mental health treatment. Medical records were reviewed for treatment history and oncology provider initiated psychology consults. RESULTS: The internal consistency of the PAT2.0 total score in this survivorship sample was strong. Psychology was consulted by the oncology provider to see 53% of participant families, and families seen by psychology had significantly higher PAT2.0 total scores than families without psychology consults. PAT2.0 total scores and corresponding subscales were higher for patients, parents, and siblings enrolled in outpatient mental health services since treatment completion. Results were consistent with psychosocial risk categories presented within the Pediatric Psychosocial Preventative Health Model. Fifty-one percent of families presenting for survivorship care scored in the "universal" category, 34% scored in the "targeted" category, and 15% scored in the "clinical" category. CONCLUSIONS: Data indicate that the overall proportions of families experiencing "universal", "targeted", and "clinical" levels of familial distress may be constant from the time of diagnosis into survivorship care. Overall, the PAT2.0 demonstrated strong psychometric properties among survivors of pediatric cancer and shows promise as a psychosocial screening measure to facilitate more effective family support in survivorship care. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 03/2013;
• Article: Age-specific influences of emotional distress on performance status in cancer patients.

  Ji-Hyun Kim, Sujung Yoon, Wang-Youn Won, Chul Lee, Chang-Uk Lee, Kyo Young Song, Jung-Ah Min, In Kyoon Lyoo, Tae-Suk Kim
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  ABSTRACT: OBJECTIVE: Improving and maintaining performance status is an important part of cancer treatment because it may predict patients' survival. Several cancer-related medical conditions have been known to influence the functional performance of cancer patients. We here examined whether emotional distress would also contribute to performance decline of cancer patients. METHODS: With consecutive sampling, a total of 880 patients diagnosed as having cancer were recruited and evaluated on cancer-related variables, emotional distress, and performance status using the standardized instruments. RESULTS: Approximately 8.9% of participants showed compromised performance rated 2 or more on the Eastern Cooperative Oncology Group performance status scale. Emotional distress was strongly associated with compromised performance after controlling for demographic and cancer-related external risk factors. The effects of emotional distress on performance decline were likely to be remarkably greater in the younger age group (<45 years) than in old-aged cancer patients (≥65 years). CONCLUSIONS: Our results provide support for the independent effects of emotional distress on having a higher risk for performance decline in cancer patients. These effects seem to be age-dependent suggesting that special clinical attention to emotional distress may be required in younger patients with cancer. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 03/2013;
• Article: Worry about one's own children, psychological well-being, and interest in psychosocial intervention.

  Karin Stinesen-Kollberg, Thordis Thorsteinsdottir, Ulrica Wilderäng, Gunnar Steineck
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  ABSTRACT: BACKGROUND: This study investigated the association between worrying about own children and low psychological well-being during the year that follows breast cancer. METHODS: In an observational population-based study, we collected data from 313 women operated for breast cancer at Sahlgrenska University Hospital in Gothenburg, Sweden. RESULTS: Worrying about one's own children (3-7 on a 1-7 visual digital scale) was, among other variables, significantly associated with low psychological well-being 1 year after breast cancer surgery (relative risk 2.63; 95% CI 1.77-3.90; posterior probability value 98.8%). CONCLUSIONS: In this group of women operated for breast cancer, we found an association between worrying about one's own children and low psychological well-being. In a healthcare system where resources are scarce, it becomes imperative to identify to whom resources should be directed. Therefore, we may consider prioritizing psychological interventions for mothers with younger children and develop effective means to communicate about issues related to the children to increase chances of an effective, successful rehabilitation.Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 03/2013;
• Article: Exploring the influence of gender-role socialization and objectified body consciousness on body image disturbance in breast cancer survivors.

  Virginia M Boquiren, Mary Jane Esplen, Jiahui Wong, Brenda Toner, Ellen Warner
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  ABSTRACT: OBJECTIVE: This study aimed to explore the relationships between gender-role socialization, objectified body consciousness and quality of life in breast cancer (BC) survivors with body image (BI) disturbance post-treatment. METHODS: A total of 150 BC survivors participating in an ongoing randomized clinical trial of a group psychotherapy intervention for BI-related concerns completed a baseline battery of standardized measures including the following: Body Image Scale (BIS), Body Image after Breast Cancer Questionnaire (BIBCQ), Objectified Body Consciousness Scale (OBCS) measuring Body Shame and Surveillance, Gender-Role Socialization Scale (GRSS) measuring internalization of traditional gender roles and attitudes and the Functional Assessment of Cancer Therapy-Breast Quality-of-Life Instrument (FACT-B). Correlational analyses were conducted between the two BI questionnaires, the two primary psychosocial variables GRSS and OBCS, and FACT-B. Path analysis was conducted on a proposed theoretical model delineating pathways between the two primary psychosocial variables and BI disturbance. RESULTS: Significant positive correlations were found between the two BI scales and (a) GRSS (average r = 0.53, p < 0.000), (b) Body Shame (average r = 0.53, p < 0.000) and Surveillance (average r = 0.48, p < 0.000). The BIS and BIBCQ were negatively associated with the FACT-B (r = -0.62, -0.73, respectively; p < 0.000). Results from the path analysis demonstrated support for the proposed model. CONCLUSION: Breast cancer survivors who endorsed greater internalization of traditional gender roles and attitudes, who engaged in greater self-surveillance and experienced greater body shame, reported greater BI disturbance and poorer quality of life post-treatment. Women with these predispositions are likely to be more vulnerable for psychological distress and may experience poorer adjustment after BC treatment. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 03/2013;
• Article: Awareness of psychological and relationship problems amongst brain tumour patients and its association with carer distress.

  Holly E Andrewes, Katharine J Drummond, Mark Rosenthal, Andrew Bucknill, David G Andrewes
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  ABSTRACT: OBJECTIVE: The aim of this research was to investigate if brain tumour patients underestimate the severity of their impairments and the impact of this behaviour on carer distress . This study also aimed to identify the support services that patients and carers experiencing distress would find most beneficial. METHOD: A total of 32 post-surgery brain tumour patients, their carers, and a control group of 29 patients following surgery to extra-cerebral areas and their carers were recruited from outpatient clinics. Patients and carers rated the patient's psychological well-being and the impact of a range of changes since diagnosis/surgery. Patients and carers also rated their own level of distress and the support services they would find most beneficial. RESULTS: When compared with the control group, brain tumour patients were more likely to underestimate their psychological problems (p < 0.005) and the negative impact of changes to their emotional function (p < 0.05), interpersonal relationships (p < 0.05), cognition (p < 0.05) and coping skills (p<0.05). A multiple regression analysis showed that underestimation of psychological and interpersonal problems by brain tumour patients explained 35% of the variance in their carer's anxiety. CONCLUSION: The finding of reduced awareness or denial in brain tumour patients and its contribution to increased carer anxiety highlights the need for therapeutic interventions, which improve patient insight/denial and encourage patient and carer communication. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 03/2013;
• Article: If you had less than a year to live, would you want to know? A seven-country European population survey of public preferences for disclosure of poor prognosis.

  R Harding, V Simms, N Calanzani, I J Higginson, S Hall, M Gysels, A Meñaca, C Bausewein, L Deliens, P Ferreira, F Toscani, B A Daveson, L Ceulemans, B Gomes
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  ABSTRACT: OBJECTIVE: With increasing European cancer deaths, clinicians must manage information regarding poor prognosis. This study aimed to determine European citizens' preferences, within a scenario of serious illness such as cancer with less than a year to live, for information disclosure regarding poor prognosis, the likely symptoms and problems, and the care options available, to measure variations between countries and to identify factors associated with preferences. METHODS: A population-based cross-national telephone survey using random digit dialling in seven countries was conducted. RESULTS: Among 9344 respondents, data revealed an international preference (73.9%) to always be informed in the scenario of having a serious illness such as cancer with less than a year to live. This varied from 67.6% in Italy to 80.7% in Flanders. A minority (21.1%) did not want such information unless they ask, or at all. People younger than 70 years (OR 0.72, 95% CI 0.62-0.83, p < 0.001), men (OR 1.23, 95% CI 1.10-1.37, p < 0.001), those with experience of illness (OR = 1.20. 95% CI 1.01-1.43, p < 0.05) and with more education (OR = 1.20, 95% CI 1.09-1.32, p < 0.001) were more likely to want to know of limited time left. CONCLUSIONS: The models confirmed the influence of four factors in more than one country (age, gender, education and most concerning problem) and added 11 country-specific factors to which national policies and clinical practice should respond. These findings confirm a majority public preference to be informed in a scenario of poor prognosis. Policy clinical practice should facilitate elucidation and delivery of preferences. Evidence for effective communication skills-building interventions for clinicians is required. Copyright © 2013 John Wiley & Sons, Ltd.
  Psycho-Oncology 03/2013;