Sense of coherence and distress in cancer patients and their partners.
ABSTRACT Strong sense of coherence (SOC) is assumed to promote and protect health in stressful situations, such as a serious illness. There is, however, surprisingly little research-based discussion on the SOC-distress association in cancer patients and especially in their partners. The aim of this study was to clarify these issues. The associations between SOC, depression, and anxiety were studied in 123 cancer couples. Data were collected with self-report questionnaires at the time of diagnosis, 8 and 14 months later. The predictors of follow-up distress and possible mediators of the cross-lagged longitudinal data were analysed with SEM. No gender differences in the patients' study variables were found, but the female partners displayed more distress symptoms than their male counterparts. The results supported the SOC theory. Strong SOC alleviated the development of distress. In addition, patient SOC tended to strengthen during the follow-up. No direct crossover between baseline SOC and follow-up distress was found. However, all patient and partner variables at the 14-month follow-up were related to each other, but not at baseline. This could indicate a gradual crossover process of the shared experience. Special attention in clinical practice should be given to the psychological well-being of cancer patients' partners, especially female partners.
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ABSTRACT: The aim of this study was to investigate the relationship of hostility and anger expression to sense of coherence (SOC) and their role as predictors of health-related quality of life (HQL). It was hypothesised that SOC would mediate the impact of hostility and anger on HQL. This is a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial, which evaluates different treatment strategies to prevent cardiovascular disease in hypertensive patients. At baseline, SOC was assessed with a short form measure, and hostility-anger with the Cynical Distrust scale and with the Anger Expression scales. HQL was assessed at 6 months with the RAND-36. The sample comprised of 774 subjects (77.5% men). Results showed that strong SOC associates with ability to control expression of anger and with low levels of suppressed or openly expressed anger. Anger control and SOC were related to good HQL; cynicism, anger-out, and anger-in correlated negatively with HQL. Path models revealed that SOC was the strongest predictor of HQL while hostility and anger lost their direct impact on HQL. Given the significant associations of hostility and anger with SOC, it is concluded that the salutogenic theory of Antonovsky (A. Antonovsky, Health, Stress, and Coping: New Perspectives on Mental Health and Physical Well-Being, Jossey-Bass Inc, San Francisco, 1979) should be extended to include hostility-related constructs. The impact of hostility and anger on HQL is, to a great extent, mediated through SOC, which implies that in future studies, the role of hostility as a risk factor of ill health should be reconsidered from the SOC theory perspective.Journal of Psychosomatic Research 08/2006; 61(1):33-9. · 3.27 Impact Factor
Article: Anxiety in cancer patients.[show abstract] [hide abstract]
ABSTRACT: Anxiety is common in cancer patient populations, and must often initially be recognized and managed by cancer care professionals. This article reviews the recent oncology and mental health literature on anxiety. The aim is to help those involved in cancer patient care who are not specialists in mental health to understand the nature of anxiety, and discriminate morbid from normal anxiety. We review recent research into the association of anxiety with events during diagnosis and management of cancer, highlighting the importance of the meaning of events to an individual as an important factor in making people anxious. Lastly we review management strategies which might be used by cancer care professionals, in particular the importance of an awareness of specific patterns of communication which may alleviate or maintain anxiety for some cancer patients.British Journal of Cancer 12/2000; 83(10):1261-7. · 5.08 Impact Factor
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ABSTRACT: We aimed to estimate the prevalence and types of anxiety disorders diagnosed according to standardized criteria in cancer patients, to compare screening tools in detecting them, and to examine their demographic, oncologic, and psychosocial associations. In this cross-sectional observational study of 178 subjects with lymphoma, renal cell carcinoma, malignant melanoma, or plasma cell dyscrasia, we related responses to questionnaires (administered by computer touch-screen) measuring psychological symptoms, quality of life (QOL), and social support to standardized psychiatric interviews and cancer management. Forty-eight percent of subjects reported sufficient anxiety for anxiety disorder to be considered. At subsequent diagnostic interview, 18% fulfilled International Classification of Disorders, 10th Revision criteria for anxiety disorder, including 6% of patients who reported low levels of anxiety by questionnaire. When subjects reported anxiety by questionnaire, if disruptive somatic anxiety was present, this increased the probability of diagnosable anxiety disorder from.31 to.7. The most accurate screening questionnaires were the trait scale of the State-Trait Anxiety Inventory and the Hospital Anxiety and Depression scale. Female sex and negative aspects of social support were associated with anxiety disorder in multivariate analyses. Anxiety disorder was independently associated with a deficit in QOL, particularly insomnia. Anxiety symptoms are common in cancer patients. Screening by questionnaire seems to assess anxiety symptoms adequately but discriminates abnormal anxiety inadequately. To improve this, we may need to use criteria such as disruption from anxiety, as illustrated by the impact of anxiety disorders on QOL. There seem to be few oncologic variables that could target screening for anxiety disorders.Journal of Clinical Oncology 08/2002; 20(14):3137-48. · 18.04 Impact Factor