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: Life-threatening diseases like malignant tumours are associated with considerable existential distress. Little is known about the factors that promote resilience within these individuals. This longitudinal qualitative partner study aimed to analyse resilience as per Antonovsky's sense of coherence. Eight patients with malignant melanoma and their partners were interviewed. They were asked about their coping strategies, attitudes towards the meaning of life and their cancer, and comprehension of what is happening to them. The questions were asked shortly after their diagnosis was made and 6 months later. All interviews were audio-taped and later transcribed and analysed according to the method of qualitative content analysis described by P. Mayring. At baseline, the majority of statements made (261; patients = 141/spouses = 120) related to coping/manageability of disease, with only 26 statements (patients = 15/spouses = 11) related to meaning and 127 (patients = 64/spouses = 63) to comprehension. There were no significant differences between the responses of patients and their partners and no significant changes in the number of statements during the 6-month interview. The most significant theme that emerged was manageability of disease, with distraction the most commonly utilised coping skill. The comprehension and meaning themes were far less prevalent. Hence, support should focus on disease and situational manageability.European Journal of Cancer Care 08/2014; · 1.76 Impact Factor
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ABSTRACT: Head and Neck (H&N) cancers are a diverse group of malignant tumors arising in the mouth, nose, pharynx and larynx. They are the 8th most common cancers in the world. Individuals who receive a diagnosis of these cancers often have enormous unmet informational needs. In spite of a large quantity of literature advocating the necessity to move from “one size fits all” to a tailored approach while providing information to cancer patients, the majority of hospitals provide information in an ad hoc manner. The primary aim of this study was to investigate the impacts of a multimedia based tailored information service on H&N cancer patients' anxiety, depression, satisfaction and cancer knowledge ratings. Our secondary aim was to describe and compare the experiences of H&N cancer patients’ receiving information concerning their cancer and treatment at two hospitals with different approaches to deliver information. We used an embedded mixed methods research design within a non-randomized controlled trial within which we nested a qualitative study to address the aforementioned secondary aims. The project was conducted with stage III and IV H&N cancer patients at the participating hospitals. Ethical approval was obtained from the Institutional Review Board and the Research Ethics Boards of the participating hospitals. The test hospital delivered the Multimode Comprehensive Tailored Information Package (MCTIP) and the control hospital received the normal care. A total of 103 individuals with H&N cancer took part in the quantitative study, out of which 96 participants completed baseline and all follow up evaluations. In the qualitative study, a subsample of 11 participants of the main study and 2 Nurse Pivots took part. Quantitative and qualitative data were collected concurrently. Our study findings show that the participants who received the test intervention experienced significantly lower levels of anxiety, had higher levels of cancer knowledge, were better satisfied with the information they received and had a good information provision experience in comparison to the subjects who received the normal care. Therefore, we conclude that MCTIP is a potentially beneficial adjuvant in H&N cancer care.02/2013, Degree: PhD, Supervisor: Dr. Paul J Allison
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ABSTRACT: Abstract Objective: Social support and hope are considered positive, important contributors to psychological well-being for women with breast cancer and their spouses. Few studies examine the role of age in relation to these variables. The current study compares the relationship between social support, hope and depression among different age groups of women with advanced breast cancer and their healthy spouses. Design: Cross-sectional sample of 150 women with advanced breast cancer and their spouses. Main outcome measures: Social support, hope, depression and socio-demographic data. Analysis included comparison of these variables between groups of older and younger patients and their spouses. Structural Equation Modelling (SEM) was used to examine hope as a mediator of the relationship between social support and depression within each group (older and younger patients and spouses). Results: Older patients and spouses reported lower levels of depression than younger ones. SEM showed that social support related directly to depression among younger women and older spouses, while hope was directly related to depression among older women and younger spouses and acted as a mediator between social support and depression. Conclusions: Theoretical, empirical and clinical implications regarding the understanding of the role of age in coping with cancer are discussed.Psychology and Health 05/2014; · 2.13 Impact Factor