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Positive Psychological Functioning in Breast Cancer. An Integrative Review.
Abstract
This integrative review aimed to analyze the research into positive psychological functioning after breast cancer, and to integrate the most relevant findings relating to sociodemographic, medical and psychosocial factors. Relevant outcomes were identified from electronic databases (Medline, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, and Wiley Online Library) up to July 2015. A Google search was performed to identify unindexed literature. Dissertations and theses were searched on Proquest Dissertations and Theses, DIALNET and TDX. Selection criteria included empirical studies assessing relationships between breast cancer and positive functioning, without restrictions on type of participants. In total, 134 studies met the inclusion criteria. The sociodemographic, medical, and psychosocial characteristics associated with well-being, posttraumatic growth, finding benefit and meaning were being young, undergoing chemotherapy, and having social support. The last two of these characteristics were time-oriented. The culture of the different samples and positive dispositional characteristics like optimism had an influence on the women's coping styles. Socioeconomic status and level of education were also associated with positive psychological functioning. The perceived impact of breast cancer on patient, as well as the perceived support from significant others can result in better functioning in women with breast cancer. The results highlight that oncology health professionals should take into account not only the individual and medical characteristics, but also the stage of the oncological process and the psychosocial environment of patients in order to promote their positive functioning.
... It reflects an individual's general perception and his or her internal feelings, which involves inner stability and confidence [34]. We propose that sense of coherence is a mediator of the effects of social support on depressive and anxiety symptoms based on the concept of positive psychology [29,30,33], which refers to an individual's ability to adapt positively to the environment when coping with negative events such as trauma and to mobilize psychological resources to face stress with a positive coping attitude, thus reducing negative effects. Many factors influence SOC, including social support. ...
... Higher SOC is associated with higher mental health, higher affective well-being, and lower depression levels. In the past few years, with the development of positive psychology, many academics have begun to pay attention to positive psychological changes in individuals after experiencing traumatic events [33]. SOC could act as a positive coping resource for cancer patients with depression [45]. ...
Background
Depression and anxiety symptoms are two common psychological disturbances in cervical cancer patients. We tested whether sense of coherence (SOC) mediates the association of perceived social support (PSS) with depression and anxiety symptoms among cervical cancer patients in China.
Methods
We conducted a survey involving 294 cervical cancer patients aged ≥ 18 years from July to December 2020 at three hospitals in Liaoning Province, China; 269 patients completed the survey. We included a demographic questionnaire, the Multidimensional Scale of Perceived Social Support (MSPSS), Antonovsky’s Sense of Coherence Scale, the Hamilton Depression Rating Scale, and the Zung Self-Rating Anxiety Scale (SAS) in this study. We used hierarchical regression analysis to examine the relationship among PSS, SOC, and symptoms of depression and anxiety. We used asymptotic and resampling strategies to explore the mediating effect of SOC.
Results
PSS was negatively associated with depressive symptoms (r = − 0.439, P < 0.01) and anxiety symptoms (r = − 0.325, P < 0.01). SOC was negatively related to depressive symptoms (r = − 0.627, P < 0.01) and anxiety symptoms (r = − 0.411, P < 0.01). SOC partially mediated the association between PSS and depressive symptoms (a*b = − 0.23, BCa95% CI: [− 0.31, − 0.14]) and anxiety symptoms (a*b = − 0.15, BCa95% CI: [− 0.23, − 0.08]). The proportions of the mediating effect accounting for SOC were 49.78% and 41.73% for depressive symptoms and anxiety symptoms, respectively.
Conclusion
The study showed that SOC could mediate the association between PSS and symptoms of depression and anxiety. This suggests that SOC might serve as a potential target for intervention in symptoms of depression and anxiety that accompany cervical cancer.
... De hecho, para algunos autores, aspectos como haber experienciado altos niveles de estrés y otras variables que indicarían un fuerte impacto negativo en la calidad de vida de las pacientes con cáncer, estarían relacionados y mediarían en una posterior valoración positiva o crecimiento personal (Casellas-Grau et al., 2016;Groarke et al., 2016). Ello explicaría, por ejemplo, que el 50% de las pacientes de cáncer de mama metastásico de larga duración consideraran que el cáncer les había aportado un valor positivo a sus vidas a pesar de la situación médica, y de que, en un tercio de ellas, el apoyo social era precario y no compartía su malestar con nadie (Falo, Villar, Rodríguez, Mena y Font, 2014). ...
... Estos resultados coinciden con la apreciaciónde Armor y Taylor (1998) según los cuales cuando la situación es negativa y contraria a nuestras expectativas, podrían aumentar las actitudes de crecimiento personal y sentido ante la situación amenazante como forma de autoregulación, incluso aunque disminuyan las expectativas de resultado positivo. Igualmente, se ha observado que un individuo se hace más resistente a los estresores intensos, cuando la persona que sufre el estresor percibe, además de los aspectos y consecuencias negativas, algún o algunos elementos positivos en lo que está sucediendo(Casellas et al., 2016;Vázquez et al., 2006). Atendiendo a los resultados valorados en este objetivo, hemos elaborado un perfil de las pacientes en función de su situación médica: -Más de la mitad de las pacientes en tratamiento del cáncer de mama tienden a valorar su pasado de forma positiva, tienen expectativas positivas de resultado y autoeficacia, encuentran y valoran aspectos positivos ante su situación médica; pero en menor medida que las pacientes en intervalo libre y con trastorno adaptativo. ...
Introduction: Breast cancer is the most diagnosed oncology pathology in Spain and the western world. One of the most significant aspects and suffering a strong deterioration is the emotional aspect, with the appearance of anxiety, sadness, fear, anger, loss of self-esteem, difficulties in relation to the environment or loss of feeling of control in the situation. Quality of life is an important concept to consider, in order to evaluate both the psychosocial status of the patients and the effectiveness of the treatments and the adaptation to the oncological situation. Among the characteristics that could dampen the impact of cancer and its treatment on the lives of patients, is optimism.
Objective: The aim of the thesis is to study the influence of dispositional optimism and some of its strategic cognitive mechanisms on the quality of life of breast cancer patients at different times of the disease.
Results The results show relationships between dispositional optimism and patients' quality of life: patients in the same medical situation, if they are optimistic, have less loss of quality of life. However, the influence of dispositional optimism diminishes when the medical situation is objectively more stressful, and then some of the resources of the optimistic personality will become more important: recalling the past in a positive way, develop expectations of a positive solution to the disease, perception of Control over the situation and evaluate positive aspects of the medical situation. It would seem that for the emotional and social well-being of the patients it would be more important to be optimistic than the medical situation. Conclusion: The data obtained in the present research support the hypothesis that the emotional and social well-being of the patients depends more on the optimism than on the medical situation in which they are.
Spanish abstract
Introducción: El cáncer de mama es la patología oncológica más diagnosticada en España y el mundo occidental. Su diagnóstico y tratamiento suponen una situación estresante que puede durar meses o incluso cronificarse cuando aparecen recidivas. Las diferentes fases de la enfermedad desencadenan distintas consecuencias físicas, emocionales y sociales que afectan a la vida diaria de las personas. Uno de los aspectos más significativos y que sufre un fuerte deterioro es el aspecto emocional, con la aparición de ansiedad, tristeza, miedo, rabia, pérdida de autoestima, dificultades de relación con el entorno o pérdida de sensación de control ante la situación. La adaptación pues, a una situación de estrés como el cáncer de mama, las reacciones emocionales, cognitivas y conductuales a los resultados, al dolor, a los tratamientos y a las pérdidas, se evalúan mediante la percepción subjetiva que la persona tiene de ella misma y de la situación. La calidad de vida es un importante concepto a considerar, para evaluar tanto el estado psicosocial de los enfermos como la eficacia de los tratamientos y la adaptación a la situación oncológica. Entre las características que podrían amortiguar el impacto del cáncer y su tratamiento en la vida de las pacientes, se halla el optimismo. Objetivo: El objetivo de la tesis es estudiar la influencia del optimismo disposicional y algunos de sus mecanismos cognitivos estratégicos en la calidad de vida de las pacientes de cáncer de mama, en diferentes momentos de la enfermedad. Resultados: Los resultados muestran relaciones entre el optimismo disposicional y la calidad de vida de las pacientes: pacientes en la misma situación médica, si son optimistas, tienen menos pérdida de calidad de vida. Sin embargo la influencia del optimismo disposicional disminuye cuando la situación médica es objetivamente más estresante, y entonces adquiere mayor importancia la utilización de estrategias optimistas como: recordar el pasado de forma positiva, desarrollar expectativas de solución positiva ante la enfermedad, la percepción de control sobre la situación y valorar aspectos positivos ante la situación médica. Conclusión: Los datos obtenidos en la presente investigación apoyan la hipótesis de que el bienestar emocional y social de las pacientes depende más del optimismo que de la situación médica en que se encuentran.
... This is consistent with previous studies revealing that support from relatives is more evident at diagnosis and during the treatment period (surgery, chemotherapy, and radiotherapy) than during hormone therapy and remission. 13,28,29 Relatives want to return to a normal life and see the side effects of hormone therapy less. 13,29 In addition, for partners, these difficulties are more substantial in the hormone therapy and follow-up stages and are greater at every treatment time because relatives and health professionals are focused on the patient. ...
... Each active treatment (chemotherapy with or without Trastuzumab; Trastuzumab with or without hormone therapy; hormone therapy only), due to the specific side effects it entails, has daily repercussions for patients and partners, particularly chemotherapy. 28,32 Overall, emotional distress was more pronounced in the patients under chemotherapy and their partners than in the post-chemotherapy groups, in accordance with previous studies showing a decline in emotional distress in the year following the start of active treatment. 32 The way women cope with the disease in its early stages, according to their personal and social resources, appears decisive for their later adjustment. ...
Purpose: This study aimed to compare the self-reported perceptions of the repercussions of the disease and its treatments and emotional distress in young women with breast cancer and their partners.
Design: Cross-sectional study using self-reported questionnaires.
Sample: 491 couples in which women were aged <45 years when diagnosed with non-metastatic breast cancer in four different groups of treatment: during chemotherapy with or without Trastuzumab; under Trastuzumab with or without hormone therapy; during hormone therapy; and during the follow-up period.
Methods: Patients and partners completed a questionnaire assessing their self-reported perceptions of the disease and treatments (Patient YW-BCI and Partner YW-BCI for the partners) and their emotional distress (CESD; STAI).
Findings: Patients reported more difficulties than partners in the management of child(ren) and everyday life, body image and sexuality, negative affectivity about the disease and apprehension about the future, career management, and finances. While the difficulties were generally more marked in the chemotherapy and Trastuzumab groups than in the hormone therapy and follow-up groups, the negative affectivity about the disease and apprehension about the future was high in all four groups, especially in patients. The partners reported more difficulties in sharing with close relatives, and even more in those groups reflecting the latest treatment phases. No difference appeared between patients and partners in couple cohesion and deterioration of relationships with relatives. Partners were less anxious than patients but as depressed as them.
Conclusions: Difficulties of patients and partners seem particularly severe in the early care pathway, maybe reflecting better adjustment in women under surveillance and their partners. A longitudinal study will substantiate this finding and enable a better identification of some explanatory processes of these differences and similarities in the daily self-reported repercussions of the disease throughout the cancer care pathway.
Implications for psychosocial oncology: It seems important to support young women with breast cancer and their partners, as our results evidence distress in both and differences according to the type of treatment the woman is currently receiving. Healthcare providers need consistent methods to identify and respond to couples’ distress and reduce significant disparities in support.
... Several studies determine the results of the quality of life of breast cancer patients, namely positive feelings felt by breast cancer sufferers, which are meant to be feelings of patience, optimism and peace. The condition and condition of breast cancer sufferers such as increased thinking ability and patient concentration are classified as good, components of self-esteem include self-confidence and hope, components of self-image include changes in body shape, and negative feelings felt by sufferers such as anxiety, sadness, and fear (20)(21)(22)(23). ...
Introduction: Anxiety is a serious problem in cancer patient’s sufferers, especially breast cancer undergoing chemotherapy. It has an impact on reducing the quality of life and the success of treatment. A breast cancer sufferer start to experience psychological disorders from the diagnosis is established, undergoing treatment, during and after treatment, both surgery and chemotherapy. Anxiety is generally develop base on fearness about bad future, such as losing family support or even death. Listening to murrotal chanting will stimulate the brain to release Gamma Amino Butyric Acid (GABA), encephalin, or beta endorphin which lead to eliminate anxiety, depression and stress neurotransmitters, resulting in calmness feeling. Method: This research is a case control study with quasi-experimental design. Total of 30 respondents who were breast cancer chemotherapy patients at Ibnu Sina Hospital of Makassar, divided into two groups. The first group received voice recording of the Murrotal Al-Quran for 30 minutes with the same Qori and surah (Al-Ikhlas, Al-Falaq and An-nas) while the other group were treated with 0,5 mg alprazolam tablets. Interviews and measurements of anxiety level were measured using the Hamilton Anxiety Rating Scale carried out before and 60 minutes after treatment in both groups. Purposive sampling technique were used to collect data and analysed with Wilcoxon test. Result: Significant anxiety levels improvements take place in both treatment groups (p<0.05), without any significant differences (p=0,13). Murrotal listening has the same effect as anti-anxiety drugs. The advantage of murrotal listening compared with medication are: easy administration method, no side effects and does not require a doctor's prescription, and get a spiritual reward. Conclusion: Murrotal listening has a good inpact in improving anxiety level of breast cancer patients undergoing chemotherapy.
... Previous research has also shown that people with higher levels of resilience are more capable of managing negative emotions such as sadness and anxiety (Pozzar et al., 2023). Patients with high levels of resilience showed a more positive outlook on life in terms of coping strategies, which helped them cope with the emotional challenges associated with cancer diagnosis and treatment (Babić et al., 2020) (Casellas-Grau et al., 2016). This suggests that improving resilience may be an important strategy for reducing post-operative sadness, synergistically reducing other symptom burdens and improving patient recovery outcomes in adult cancer patients. ...
Aim
To assess early postoperative core symptoms in oesophageal cancer patients and their relationship with resilience.
Background
Patients with oesophageal cancer face a high number of severe symptoms in the early post‐operative period and require the development of an effective symptom management programme. Identifying core symptoms through network analysis helps in accurate patient care.
Design
A multicentre cross‐sectional study.
Methods
A cross‐sectional survey was conducted from August 2022 to August 2023 at three hospitals in Anhui Province, China. A total of 469 patients were recruited for this study and 418 (89.1%) patients completed this investigation. Using network analysis to find early post‐operative core symptoms in oesophageal cancer patients. Multiple linear regression was used to analyse resilience factors affecting core symptoms.
Results
Sadness was the most core symptom in oesophageal cancer patients in the early post‐operative period (rs = 1.41), followed by incision pain and difficulty breathing while resting (rs = 1.20, rs = 1.08). Resilience was significantly associated with patients' feelings of sadness, with optimism having the greatest impact on sadness (p < .01).
Conclusion
Sadness is the most core symptom in patients in the early post‐operative period and special attention should be paid to improving their level of resilience. Local symptoms and dysfunction in the early post‐operative period should be treated in a synergistic manner.
Impact
This study identifies core symptoms and their relationship to resilience in patients with oesophageal cancer in the early post‐operative period. Symptoms as the main core symptom in patients in the early post‐operative period, which was sadness and was significantly associated with resilience. Precise interventions can be made to target patients' core post‐operative symptoms, which can help improve the effectiveness of symptom management.
Reporting Method
We have complied with the relevant EQUATOR research reporting checklist.
Patient or Public Contribution
No patient or public contribution in the study.
... Unfortunately, these responsibilities can result in adverse consequences, encompassing physical, psychological, social, and economic tolls [16] . While cancer constitutes a crisis in the lives of the patient's family members, and caregiving for these patients proves to be a multifaceted and evolving endeavour [17] , research demonstrates that certain families have successfully navigated these challenges, gaining new social support resources [18,19] , effectively managing stressful situations and their adverse effects [20] . Consequently, for them, caring for the patient has become a positive and enriching experience [21] . ...
Background
This systematic review aimed to investigate resilience and its related factors in caregivers of adult patients with cancer.
Materials and Methods
A systematic search of online electronic databases including Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) was performed using keywords extracted from Medical Subject Headings such as “Psychological Resilience”, “Caregiver”, and “Cancer” from the earliest to June 6, 2023. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool).
Results
A total of 2735 caregivers of cancer patients participated in 15 studies. The majority of the studies found that caregivers of cancer patients had high levels of resilience. Factors related to the resilience of cancer patients’ caregivers included caregivers’ social support, caregivers’ quality of life, patients’ resilience, caregivers’ family function, patients’ performance, caregivers’ age, caregivers’ health status, caregivers’ self-esteem, caregivers post-traumatic growth, caregivers religious, caregivers hope, caregivers positive affect, patients age, patients social support, patients resilience support, patients quality of life, caregivers’ anxiety, caregivers’ depression, caregivers’ burden, caregivers level of education, caregivers financial problem, caregivers memory, caregivers negative affect, caregivers post-traumatic stress disorder, maternal distress, and patients post-traumatic stress disorder.
Conclusion
Therefore, healthcare administrators and policymakers can enhance the resilience of caregivers and the quality of care they provide by instituting ongoing training initiatives focused on evaluating mental well-being and implementing coping strategies for managing stress and depression.
... Those who adapted their lifestyle could recover quicker after receiving the treatments. [10,11] Studies examined factors in uencing breast cancer survivors' PWB, including stress, [12,13] self-e cacy, [14,15] social support, [16,17] and resilience. [14,18] Stress is a personal perception reacting to stimuli, which causes physical changes and physiological imbalance between biology and biochemistry in response to those stimuli. ...
Background
Breast cancer is the most common cancer diagnosed in women with health problems. Studies showed that breast cancer affects women’s mental health and lifestyle after receiving treatment. This study aimed to investigate four key factors (stress, social support, self-efficacy, mindfulness, and resilience) influencing psychological well-being among breast cancer survivors.
Methods
A predictive descriptive research design was conducted and guided by the resilience framework. Eligible criteria included breast cancer survivors receiving care at an outpatient clinic in a tertiary hospital. A convenience sampling was utilized and data were collected by self-administered questionnaires. Data analyses included univariate statistics and multiple linear regression.
Results
Totally, 123 participants were recruited. Stress, social support, and resilience explained 43% of the variance in psychological well-being among breast cancer survivors. Resilience (=.33), stress =-.27), and social support=.26) were significant predictors of psychological well-being and resilience was the strongest predictor.
Conclusions
Psychological factors related to post-disease wellness should be incorporated into interventions. Behaviors that promote resilience and social support and decrease stress levels should be incorporated into activities and programs to enhance breast cancer survivors’ psychological well-being in the future.
... Differences in these adaptive and maladaptive adjustment indicators in both psychological and biological domains triggered by the diagnosis of cancer may be partially attributed to individual differences in ascertaining the meaning of the cancer experience and identifying the growth and implications of the challenges. Although different terminologies have been used (Casellas-Grau et al., 2016;Zoellner & Maercker, 2006), we will use the term benefit finding to refer to such meaning-making and growth phenomena. Among healthy and medical populations, the associations between benefit finding and psychological markers have been inconsistent. ...
Objective:
This study examined the unique associations of different dimensions of the resilience factor, benefit finding, on concurrent and prospective psychological and biological adjustment outcomes over the first year after a colorectal cancer diagnosis.
Methods and measures:
Individuals newly diagnosed with colorectal cancer (n = 133, mean age = 56 years old, 59% female, 46% Hispanic) completed questionnaires assessing the multidimensional aspects of benefit finding around 4 months post-diagnosis (T1). Psychological (depressive symptoms and life satisfaction) and biological [C-reactive protein (CRP) and interleukin-10 (IL-10)] adjustments were assessed at T1 and one-year post-diagnosis (T2).
Results:
Structural equation modeling revealed that at T1, greater reprioritization was concurrently related to higher depressive symptoms (p=.020). Lower acceptance, lower empathy, and greater positive self-view predicted higher life satisfaction at T2 (ps<.010). Additionally, lower empathy and greater family valuation predicted higher CRP at T2 (ps<.004), whereas greater positive self-view predicted higher IL-10 at T2 (p=.039). Greater overall benefit finding was associated with lower IL-10 at T1 (p=.013).
Conclusion:
Various aspects of benefit finding differentially relate to psychological and inflammatory markers during the first year after diagnosis in persons with colorectal cancer. Interventions designed to specifically enhance positive self-view may promote both the psychological and biological health of individuals with cancer.
... Triggering events include severe life-threatening incidents and seismic experiences that have a life-changing influence [1]. Such events include natural disasters, accidents, illnesses, and relationship issues; PTG can be experienced by those who directly experience adversity, as well as those who witness it [2][3][4][5][6][7]. Many studies have used homogenous samples of people exposed to a specific type of adversity: natural disaster, serious illness, war, and violence, among others. ...
A Japanese version of the short form of the expanded Posttraumatic Growth Inventory (PTGI-X-SF-J) was developed in this study, as the extended version captures broader, more diverse personal growth perspectives, such as existential spiritual growth. We collected cross-sectional data from 408 (first sample) and 284 (second sample) Japanese university students using the expanded version of the Posttraumatic Growth Inventory (PTGI-X-J). Exploratory factor analysis (EFA) was performed with the first sample and confirmatory factor analysis (CFA) with the second; reliability and validity were examined. The short-form version resulting from the EFA and CFA comprised 10 items and five factors. Cronbach’s alpha for the PTGI-X-SF-J total and subscale scores ranged from 0.671 to 0.875. The intraclass correlation coefficient for the total and subscale scores between the PTGI-X-J and PTGI-X-SF-J ranged from 0.699 to 0.821. Regarding external validity, no significant correlation was found between posttraumatic growth and posttraumatic stress disorder checklists. Due to its brevity, the PTGI-X-SF-J can help assess diverse spiritual and existential personal growth experiences among clients, patients, and trauma survivors while reducing physical and psychological burdens.
... The detection of abnormalities in mammography can be described as two steps: (1) detection of a potential abnormal region of interest (ROI); (2) classification of abnormalities according to image characteristics or likelihood of malignancy (6,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). However, the performance of abnormality detection models has been described broadly -across multiple imaging features, breast densities, and patient demographics without the ability to evaluate performance on individual subgroups, largely due to the lack of available granular datasets that include these features (20,21). This may lead to potential bias and unintended harm from AI models that to be underperformed for certain patient subgroups (e.g., race and age) (22,23), cancer subtypes, or imaging findings (24). ...
Purpose: To analyze the demographic and imaging characteristics associated with increased risk of failure for abnormality classification in screening mammograms. Materials and Methods: This retrospective study used data from the Emory BrEast Imaging Dataset (EMBED) which includes mammograms from 115,931 patients imaged at Emory University Healthcare between 2013 to 2020. Clinical and imaging data includes Breast Imaging Reporting and Data System (BI-RADS) assessment, region of interest coordinates for abnormalities, imaging features, pathologic outcomes, and patient demographics. Multiple deep learning models were developed to distinguish between patches of abnormal tissue and randomly selected patches of normal tissue from the screening mammograms. We assessed model performance overall and within subgroups defined by age, race, pathologic outcome, and imaging characteristics to evaluate reasons for misclassifications. Results: On a test set size of 5,810 studies (13,390 patches), a ResNet152V2 model trained to classify normal versus abnormal tissue patches achieved an accuracy of 92.6% (95% CI = 92.0-93.2%), and area under the receiver operative characteristics curve 0.975 (95% CI = 0.972-0.978). Imaging characteristics associated with higher misclassifications of images include higher tissue densities (risk ratio [RR]=1.649; p=.010, BI-RADS density C and RR=2.026; p=.003, BI-RADS density D), and presence of architectural distortion (RR=1.026; p<.001). Conclusion: Even though deep learning models for abnormality classification can perform well in screening mammography, we demonstrate certain imaging features that result in worse model performance. This is the first such work to systematically evaluate breast abnormality classification by various subgroups and better-informed developers and end-users of population subgroups which are likely to experience biased model performance.
... Tomando como referencias estos modelos teóricos, el funcionamiento psicológico positivo se define de las siguientes formas. Por un lado, se afirma que tiene que ver con la calidad de respuesta que se tiene ante los estímulos externos, está relacionado con características disposicionales positivas como el optimismo, la esperanza y la resiliencia, encontrando sentido a las condiciones adversas (Casellas et al, 2016). Para otros, el funcionamiento psicológico positivo se puede definir como una alta frecuencia de experiencias subjetivas positivas, como ser desafiado, experimentar autonomía, sentirse bien y ejercitar fortalezas humanas como el coraje, la sabiduría y el sentido del humor (Kashdan, 2002). ...
Ante la diversidad de problemas que han afectado el bienestar y salud mental de la población, especialmente el funcionamiento psicológico, y teniendo limitación para acceder a trabajos donde se explique qué papel desempeña la resiliencia en el funcionamiento psicológico positivo en mujeres, el estudio de estas variables es relevante. En tal sentido, esta investigación tuvo como objetivo determinar en qué medida la resiliencia explica el funcionamiento psicológico positivo, fue un estudio de tipo aplicado con un diseño correlacional causal, participaron 169 mujeres de la ciudad de Piura, Perú, seleccionadas mediante un muestreo no probabilístico por criterios, se administraron dos cuestionarios con escala tipo Likert. Mediante las correlaciones bivariadas se encontraron valores significativos de 0.69, y al realizar el proceso de regresión lineal se encontró un R cuadrado de 0.51 y en los coeficientes del modelo de regresión lineal entre resiliencia y funcionamiento psicológico se obtuvieron valores significativos de 0.000. Mediante estos hallazgos se concluye que la resiliencia predice y actúa como mediador en las características del funcionamiento psicológico positivo en este grupo de mujeres, por lo tanto, toda intervención que se realice tendrá resultados satisfactorios brindado adecuadas estrategias de afrontamiento.
... In the past few years, scholars worldwide have actively explored the factors that influence PTG in breast cancer patients and found that social support is one of the psychosocial elements that is beneficial to the experience of PTG (Casellas-Grau et al., 2016;Hasson-Ohayon et al., 2016;Shen et al., 2016;Li, 2017). Although there is no single definition of social support, it usually refers to the support behaviors that individuals obtain from other individuals and social networks (Heller et al., 1986). ...
Posttraumatic growth (PTG) is consistently reported to be associated with social support among people with breast cancer. But so far there is no consensus on the size and direction to which social support are related to PTG in people with breast cancer. Thus, a meta-analysis was performed by us to quantitatively synthesize the previous results. This meta-analysis followed the PRISMA 2020 guidelines. We searched PubMed, PsycINFO, Web of Science, Embase, Chongqing VIP Information Co., Ltd. (VIP), China National Knowledge Infrastructure (CNKI), and WANFANG DATA databases prior to 1 June 2022. A random effects model of Stata software (version 17.0) was employed to compute the pooled association coefficient and examine a series of moderating factors: economic level, publication type, region, year of publication, participants’ age, and social support measurement tools. Ultimately, 31 studies including 6,380 breast cancer patients were identified. This meta-analysis offers evidence of a highly positive correlation between PTG and social support among people with breast cancer (r = 0.425). Economic level, region, and social support measurement tools moderated the link between PTG and social support among people with breast cancer. Whether variables such as disease stage, time since diagnosis, and disease treatment moderate the link between PTG and social support among people with breast cancer can be further investigated in the future.
... Cancer-related correlates (e.g., treatment and presence of metastases) and poor mental health concerning the emotional variables are more connected with PTSS. Coping strategies and resilience as the ability to overcome tough situations, religiosity and belief as engagement in religion, and self-transcendence as the ability of a person to look beyond their own existence and find a higher purpose in life, seem to be important for PTG development [18][19][20][21][22][23][24][25]. Knowledge about the s and different predictors can therefore help in choosing appropriate interventions when adapting to the situation associated with cancer [19]. ...
Purpose
Cancer is a stressful life event that can lead to specific posttraumatic reactions. Posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) are two main posttraumatic reactions that are related to each other, and both have different correlates.
Methods
The linearity of the relationship between PTG and PTSS and the different socio-demographic, cancer-related, emotional, and psychological correlates were analyzed in patients with cancer (N = 126).
Results
The relationship between PTG and PTSS was found to be more curvilinear than linear. PTSS was more strongly related to psychological factors (e.g., anxious preoccupation, hope-helplessness, and resilience) while PTG was strongly related to existential factors (e.g., self-transcendence and religiosity).
Conclusion
The results show that cancer-related PTSS and PTG are specifically related constructs which are related differently to particular correlates. Specifically, the greatest differences were observed in the psychological variables. In the early phases, therapeutic interventions focused on variables related to PTSS can lead to the reduction of PTSS. In follow-up phases, the therapeutic intervention focused on the increase of the level of variables related to PTG can help the development of PTG.
... 7,8 Ability to cope with stressful situation tends to the development of confidence in oneself. 29,30 The mean (SD) score for appreciation of life was 8.56 (2.30). A possible explanation for the high score in the domain of appreciation of life is that when patients tend to come out of the adversity successfully, they start appreciating life. ...
Introduction Breast cancer survivors (BCS) may experience a cascade of negative
reactions during the entire treatment process in the form of psychiatric morbidity.
However, exposure to a traumatic event also has the fertile ground for the potential to
catalyze a host of positive changes, including development in personal, interpersonal,
and spiritual levels, commonly referred to as posttraumatic growth (PTG). PTG is
defined as “positive psychological change experienced due to a struggle with highly
challenging life circumstances.”
Objective This study aims to measure the prevalence and correlates of PTG among
BCS.
Materials and Methods It was a cross-sectional study carried in a tertiary care center
of North India from January 2021 to April 2021. Total 700 BCS were approached and
screened using the purposive sampling technique. Data were analyzed using the
Statistical Package for Social Sciences, version 20.
Results The mean age (standard deviation [SD]) of the patients was 43.14 (8.53)
years. The mean (SD) PTG score was 37 (13.66). Among the subdomain of PTG, most
respondents showed growth in personal strength, relating to others, followed by an
appreciation of life, spiritual change, and less growth in new possibilities. PTG was
found to be significantly positively correlated with treatment completion time
(r ¼ 2.260, p ¼ 0.02) and negatively correlated with depression, anxiety, and stress
(r ¼–0.152, p ¼ 0.04; r ¼–0.145, p ¼ 0.05; r ¼–0.162, p ¼ 0.02).
Conclusion Psychological morbidities must be addressed along with medical treatment of breast cancer so that growth post trauma can be further facilitated.
... 7,8 Ability to cope with stressful situation tends to the development of confidence in oneself. 29,30 The mean (SD) score for appreciation of life was 8.56 (2.30). A possible explanation for the high score in the domain of appreciation of life is that when patients tend to come out of the adversity successfully, they start appreciating life. ...
Introduction Breast cancer survivors (BCS) may experience a cascade of negative reactions during the entire treatment process in the form of psychiatric morbidity. However, exposure to a traumatic event also has the fertile ground for the potential to catalyze a host of positive changes, including development in personal, interpersonal, and spiritual levels, commonly referred to as posttraumatic growth (PTG). PTG is defined as “positive psychological change experienced due to a struggle with highly challenging life circumstances.”
Objective This study aims to measure the prevalence and correlates of PTG among BCS.
Materials and Methods It was a cross-sectional study carried in a tertiary care center of North India from January 2021 to April 2021. Total 700 BCS were approached and screened using the purposive sampling technique. Data were analyzed using the Statistical Package for Social Sciences, version 20.
Results The mean age (standard deviation [SD]) of the patients was 43.14 (8.53) years. The mean (SD) PTG score was 37 (13.66). Among the subdomain of PTG, most respondents showed growth in personal strength, relating to others, followed by an appreciation of life, spiritual change, and less growth in new possibilities. PTG was found to be significantly positively correlated with treatment completion time (r = 2.260, p = 0.02) and negatively correlated with depression, anxiety, and stress (r = –0.152, p = 0.04; r = –0.145, p = 0.05; r = –0.162, p = 0.02).
Conclusion Psychological morbidities must be addressed along with medical treatment of breast cancer so that growth post trauma can be further facilitated.
... Optimism has also been positively associated with active coping strategies, planning, acceptance of the real situation and humor coping and negatively with avoidance coping strategies such as denial and behavioral disengagement, in women with breast cancer (Carver, 2015). Also, the more optimistic women adopted the fighting spirit strategy while the more pessimistic ones used the hopeless/helpless strategy (Casellas-Grau et al., 2016). ...
Background
body image; breast neoplasms; adaptation psychological; optimism; psychological distress
Participants and procedure
This cross-sectional study included eighty-seven women with breast cancer undergoing chemotherapy, who answered in-struments that assessed sociodemographic and clinical issues, optimism, coping, concerns with body image and psycholog-ical distress. Bayesian statistics were performed to test the indirect effect model that included also the moderator effects.
Results
Lower optimism, lower use of humor, and higher denial and illness duration predicted lower body image and higher dis-tress. Longer illness duration was associated with higher distress. Body image had an indirect effect in the relationship between optimism and distress; between denial coping and distress; between humor coping and distress and between illness duration and distress. Being submitted to surgery but not the type of surgery was a moderator in the indirect effect model.
Conclusions
Body image is critical to psychological distress. Future interventions for women with breast cancer should consider body image as a target, in order to promote adaptive coping strategies specially when women have had surgery.
... Lesion detection from mammograms is an important image processing task; the CAD system further analyzes these detected lesions. This task is very much challenging due to anatomical variability of masses like size, shape, as well as the location of a lesion in a mammogram [7,10]. Earlier CAD systems used to do manual detection by handcrafted features to identify doubtful masses using conventional machine learning approaches [7,[11][12][13][14]. ...
Advances in deep learning networks, especially deep convolutional neural networks (DCNNs), are causing remarkable breakthroughs in radiology and imaging sciences. These advances have influenced the development of computer-aided diagnosis (CAD). This study presents applications of DCNNs for computer-aided breast cancer diagnosis. We discuss the recent breakthrough, achievements, and notable advances in CAD for breast cancer. Various key and novel insights and challenges on the use of DCNNs for mammogram analysis have been presented in the paper. The latest deep learning toolkits and libraries that are available and insights for using them have been elaborated. We also point out the possible limitations in the use of DCNNs for breast cancer detection. Finally, give some ideas of future research which can address the existing limitations.
... An integrative review of the many criteria involved in the positive trajectory after breast cancer concludes that optimism is central to positive psychological functioning. 16 However, half of breast cancer survivors are weakly optimistic about their future and then experience few favorable physical health and psychosocial outcomes. 17,18 Knowing these psychological dynamics, the entire subjective trajectory and not only the perception of the future therefore has vast implications for improving the resilience and some cognitive, physical and emotional QOL aspects of women after breast cancer. ...
Background
In cancer research, studying the quality of life trajectory helps us understand the complaints but also the cognitive, physical, and emotional aspects that can evolve positively. Examining both the suffering and the improvements expressed by the patients facilitates their care and their recovery knowing that an optimistic perception of the future is important for adaptative functioning after cancer. Through retrospective, present and prospective measures, we sought to characterize the subjective trajectory perceived by women with breast cancer about their cognitive, emotional and physical states, as it relates to quality of life.
Methods
Nine hundred ninety women survivors of breast cancer (after curative treatments) described, on the appropriate scales, their perceived cognitive, emotional and physical states over three periods of time: from past care (i.e., retrospective analysis) to the future (i.e., projective analysis), including the present period, as a function of their treatment (chemotherapy vs. no chemotherapy) and surgery (lumpectomy vs. mastectomy) using ANCOVA.
Results
The 732 women who had received chemotherapy perceived the most significant consequences, regardless of the type of surgery (η²= .01). Moreover, all survivors expressed an optimistic perception of the change in their states in the anticipated future as a normative optimistic perception.
Conclusions
Results are discussed in terms of the benefits of specific and early interventions that enable patients to cope better with the disease and its treatments by taking into account their more or less optimistic perception of the future.
... Notably, all participants in this study tended to seek psychosocial support from their significant others, whom they relied on to cope with the challenges and stress of illness. Similarly, previous research showed that patients' significant others were sources of great support throughout their illness [18]. In China, because of a lack of social worker resources, caregiving tasks for cancer patients are mainly carried out by family members. ...
PurposeThis study aims to explore the barriers that adult patients with hematologic neoplasms experience when seeking psychosocial support.MethodsA descriptive qualitative approach was used to investigate the experiences of patients with hematologic neoplasms. Face-to-face, semi-structured, in-depth individual interviews were conducted between June and October 2020 with 17 patients diagnosed with hematologic neoplasms. The interviews were audio-recorded and transcribed verbatim. A thematic analysis was performed to identify the essential themes.ResultsSeventeen patients aged 28–67 years completed the interviews. Two themes and six subthemes were identified that describe barriers to seeking psychosocial support. Internal barriers included limited communication, negative emotions, social avoidance, and focusing on treatment rather than psychosocial needs; external barriers included traditional cultural influences and lack of professional support.Conclusions
Significant others were the key source for psychosocial support for patients with hematologic neoplasms. Tackling diverse barriers to accessing psychosocial support remains a challenge for these patients. Healthcare providers should continually assess and provide effective support.
... issues. Thus, PTG can be experienced not only by the person who has directly experienced the event but also by his/her family members and those who witnessed it [2][3][4][5][6][7]. Previous studies have demonstrated that the degree of PTG is associated with posttraumatic stress disorder (PTSD) symptoms [8,9], social support [10][11][12], and coping strategies [13]. ...
Background
The 10-item short form of the Posttraumatic Growth Inventory (PTGI-SF) has been utilized worldwide. However, there is no Japanese version. Furthermore, the PTGI-SF does not capture a broader category of existential spiritual growth that has been incorporated in the more recent Expanded version of the PTG Inventory (PTGI-X). Thus, we developed a Japanese version of the Short Form (PTGI-X-SF-J), which reflects more diverse perspectives on existential and spiritual growth.
Methods
A cross-sectional study using questionnaires was conducted in Japan. The first sample consisted of 408 university students, and the second sample comprised 284 university students. Exploratory factor analysis was performed using data from the first sample. Confirmatory factor analysis was conducted, and reliability and validity were confirmed using the second sample.
Results
The PTGI-X-SF-J is composed of 10 items including two items from each of the five subscales of the PTGI-X, similar to the original version of the PTGI-SF, and this model fits the data well. Items concerning existential/spiritual change in the PTGI-X-SF-J were “I feel more connected with all of existence” and “I have a greater sense of harmony with the world,” which were not included in the original PTGI-SF. The score of the PTGI-X-SF-J was significantly correlated with the scores of the Core Beliefs Inventory and the Event Related Rumination Inventory-Deliberate; however, no correlation was observed with the scores of the PTSD Checklist for DSM-5.
Conclusions
We developed the PTGI-X-SF-J using 10 items to measure PTG among people whose first language is Japanese and confirmed its factor structure, reliability, and validity. The PTGI-X-SF-J is useful for assessing PTG more efficiently and accurately as it considers more diverse spiritual/existential experiences of personal growth and reduces physical and psychological burdens due to its brevity.
... 19 In breast cancer survivors for example, optimism, hope, and social support are associated with wellbeing, and positivity and optimism associated with post-traumatic growth. 20 Therefore, identifying a readily accessible means to promote cancer survivors' wellbeing has the potential to inform interventions for survivors' overall physical and psychological functioning. To date, the role of key wellbeing domains in cancer survivors' physical and mental health has not been examined regarding a relatively low-cost/low tech potential interventional resource, and common household member that many Australians consider supportive of their QoL: their companion animals. ...
Purpose
Australian cancer survivors have multiple wellbeing support needs, and Australians frequently keep pets, a practice associated with physical and mental health benefits. This mixed-methods study explores the influence of relationships of PERMA (positive emotion, engagement, relationships, meaning, and accomplishment) wellbeing domains and pet ownership on cancer survivors’ physical and mental wellbeing and quality of life.
Methods
A convenience sample of Australian cancer survivors (N = 162) were surveyed, recording demographic, pet ownership, PERMA wellbeing, physical and mental health characteristics, and support needs. Quality of life and health scores were predicted from PERMA domains and pet ownership.
Results
Pet ownership was highly prevalent in participating cancer survivors, predicting increased mental health scores. No associations were seen for physical health. Cancer survivors sought instrumental pet care support and pet-owner relationship maintenance during survivorship.
Implications: Pet ownership may be leverageable in interventions for mental health and wellbeing improvement during cancer recovery. Research should next clarify pet ownership prevalence in this population.
... In terms of emotional management, emotional expression has been associated with a good cancer adaptation (Brandão et al., 2015), confidence in one's social support network, seeking resources and a good emotional functioning in women with breast cancer (Casellas-Grau et al., 2016). ...
Self-efficacy is a coping resource with a positive impact on well-being, quality of life, anxiety, and depression in cancer patients, even after treatment. This study focused on the validation of the Cancer Behavior Inventory-Brief Version (CBI-B) in Portuguese patients with breast cancer. The study included 115 patients with breast cancer receiving outpatient chemotherapy in four hospitals located in Portugal. Participants (N = 115) completed the translated version of the CBI-B in Portuguese and measures of quality of life (QLQ- C30), psychological distress (HADS), and illness perceptions (IPQ-B). Confirmatory factor analysis supported the four-factor original structure of the CBI-B. The Portuguese version of the CBI-B showed good psychometric properties as shown by measures of internal consistency (Cronbach’s alpha = .88), test–retest reliability (intraclass correlation coefficient = .59), convergent validity with the QLQ-C30 (r = .43, p < .001), and divergent validity with the HADS (r = -.60, p < .001) and the IPQ-B (r = -.51, p < .001). The Portuguese version of the CBI-B is a valid and reliable instrument to evaluate the self-efficacy for coping in Portuguese breast cancer patients. Future studies should validate the CBI-B in patients with other types of cancer.
... However, despite the negative impact of cancer diagnosis and treatment, in clinical practice, we could meet many optimistic long-term survivors after lung cancer surgery with good quality of life and positive personalities such as hopefulness, gratitude, and perseverance. It is reported that positive psychological well-being could improve the quality of life and extend survival in diseased populations [5,6]. Thus, studies in positive psychology during survivorship are helpful in improving psychological status, quality of life, and even survivorship in patients diagnosed with lung cancer. ...
Background
Resilience was correlated with psychological outcomes and quality of life in lung cancer patients. But the resilience process and its protective factors remained uncertain.PurposeTo investigate and analyze resilience process and its protective factors in long-term survivors after lung cancer surgery.Methods
This qualitative study included 19 patients who had survived at least 5 years after lung cancer surgery. Colaizzi’s method of phenomenology was used for data analysis.ResultsAnalysis of this study was divided into the resilience process and protective factors. The resilience process was summarized into three stages, including initial stress, adaptation to disease, and personal growth. Five themes were regarded contributing to their own resilience in this process, including excellent psychological qualities, good social support, regular lifestyle and exercise, participating in social activities, and Chinese medicine.Conclusion
This study showed the dynamic process of resilience and its protective factors in long-term survivors after lung cancer surgery. Future studies could identify average length of time of each stage and how patients transfer between stages during resilience process. Besides, interventions could be carried out to educate patients diagnosed with cancer about normal stages of change in body and resilience through time and strategies on adaptation and adjustment of lung cancer.
... 22 In recent years, with the development of positive psychology, many scholars began to explore the positive psychological changes of individuals after traumatic events. 23 As a part of positive psychology, resilience can effectively reduce the risk of mental illness. 24 Some studies have shown that there is a positive correlation between the level of psychological resilience of patients and the quality of life. ...
Purpose
We aim to test whether resilience mediates the association of fear of progression (FoP) with quality of life (QoL) among ovarian cancer patients in China.
Methods
We collected 230 questionnaires from the First Affiliated Hospital of China Medical University in Liaoning Province, and 209 completed the questionnaire survey. The survey instrument consisted of four questionnaires: a sociodemographic and clinical characteristics questionnaire, the Functional Assessment of Cancer Therapy general instrument, the Fear of Progression Questionnaire-Short Form and the Connor-Davidson Resilience Scale. Hierarchical regression analysis was used to examine the relationship among FoP, resilience, and QoL, including physical well-being, social well-being, emotional well-being, and functional well-being. We used asymptotic and resampling strategies to examine the indirect effect of resilience.
Results
FoP was negatively associated with resilience (r=−0.543, P<0.01) and QoL (physical well-being: r=−0.537, P<0.01; social well-being: r=−0.426, P<0.01; emotional well-being: r=−0.487, P<0.01; functional well-being: r=−0.529, P<0.01). Resilience was positively related with QoL (physical well-being: r=0.449, P<0.01; social well-being: r=0.548, P<0.01; emotional well-being: r=0.430, P<0.01; functional well-being: r=0.655, P<0.01). Resilience partly mediated the association between FoP and physical well-being (a×b=−0.05, BCa 95% CI: −0.09, −0.02), social well-being (a×b=−0.21, BCa 95% CI: −0.29, −0.14), emotional well-being (a×b=−0.05, BCa 95% CI: −0.08, −0.02), and functional well-being (a×b=−0.24, BCa 95% CI: −0.32, −0.17). The proportion of the mediating effect accounted for by resilience were 22.57%, 57.22%, 26.02%, 53.42% for physical well-being, social well-being, emotional well-being and functional well-being, respectively.
Conclusion
The study showed that resilience could mediate the association between fear of progression and quality of life. It suggests that resilience might provide a potential target for intervention in quality of life with ovarian cancer.
... Asimismo, los resultados de nuestro trabajo indican que el optimismo se relaciona con una mejor calidad de vida, coincidiendo con el estudio de Smith y colaboradores (29) . La importancia del componente "benefit finding", especialmente entre el grupo de pacientes con tratamiento activo, coincide con una de las conclusiones de la revisión de Casellas et al. sobre el funcionamiento psicológico positivo en pacientes con cáncer de mama (30) . Por otra parte, el componente "atribución de responsabilidad" pese a mostrarse como un factor coherente en la escala de optimismo estratégico, no se relaciona significativamente con ninguna de las subescalas de calidad de vida, lo que indicaría que no parece ser una estrategia adecuada para preservarla: Sentirse más culpable o responsable por la situación no se relaciona con el bienestar en ninguna de las tres situaciones de salud consideradas. ...
Objetivo: Elaborar un instrumento que nos permita evaluar algunas estrategias cognitivas que formarían parte de las personas optimistas ante una dificultad de salud como el cáncer de mama. Método: 96 pacientes, de ellas 30 se encontraban en una fase de intervalo libre del cáncer de mama, 35 recibiendo tratamiento activo para el cáncer de mama y 31 tenían un diagnóstico de trastorno adaptativo sin historial médico oncológico. Se han comparado los mecanismos cognitivos del instrumento para valorar el optimismo estratégico entre los grupos de salud; se ha efectuado el análisis factorial del instrumento y se ha observado la relación de éste con variables como la calidad de vida y el optimismo disposicional en cada grupo. Resultados: el análisis factorial muestra cuatro componentes del total de ítems del optimismo estratégico: 1) Expectativas de resultado positivo y percepción de control ante la dificultad de salud; 2) Valoración positiva del pasado en el momento actual de salud; 3) Benefit finding a raíz de la enfermedad; y 4 ) Responsabilidad/culpabilidad por la situación de salud. La varianza total explicada por los factores es del 70,67%. Los factores del optimismo estratégico estarían relacionados con una mejor calidad de vida de las pacientes (p<0,01; r= 0,591), mostrando relaciones variables en función de la gravedad de la situación médica. Conclusión: el instrumento aportado para evaluar el optimismo estratégico permite identificar estilos cognitivos, relacionados con el mantenimiento de la calidad de vida en cáncer de mama, que pueden ser de utilidad para potenciar las terapias psicológicas de apoyo.
... 7,8 These LTCs are hypothesized to comprise the process of psycho-social-spiritual healing 9 and are similar to other concepts described in the literature, such as posttraumatic growth and benefit finding. [10][11][12] Gender is an important factor in psychosocial and spiritual distress and well-being in patient populations. Women with various cancer types and chronic illnesses (such as HIV) report high levels of anxiety, depression, and posttraumatic stress symptoms compared to men. ...
Background:
Many individuals exhibit significant distress in response to serious and/or life-limiting illness. However, there are others who make life-transforming changes, which involve healing experiences in the psychological, social, and spiritual domains of life regardless of illness outcome. The aim of the present study is to determine if there are any differences in psycho-social-spiritual healing between genders.
Materials and Methods:
The NIH Healing Experiences in All Life Stressors (NIH-HEALS), a 35-item measure of psycho-social-spiritual healing, is composed of three factors: Connection, Reflection & Introspection, and Trust & Acceptance. NIH-HEALS and a demographic questionnaire were administered to 193 patients with serious and/or life-limiting illness at the National Institutes of Health Clinical Center.
Results:
In response to NIH-HEALS, men and women significantly differed on the Reflection & Introspection factor. Women reported increased enjoyment of mind-body practices (p < 0.001), compassion (p = 0.005), gratitude (p = 0.014), and a desire to be more positive (p = 0.044) compared to men. Men rated their pain levels (p = 0.035) and severity of illness (p = 0.016) higher and their overall level of health (p = 0.010) poorer compared to women. Women's responses to items regarding compassion (rs = 0.37, p < 0.001) and gratitude (rs = 0.24, p = 0.015) correlated positively with better overall health ratings.
Conclusion:
Men and women show some differences in their self-reported psycho-social-spiritual healing, which may have implications when designing interventions aimed at promoting a healing experience in the context of serious and life-limiting illness.
... Personal charactesristics have also been explored as underlying mechanisms of the stress/growth relationship. A recent systematic review (Casellas- Grau et al., 2016) concluded that, in breast cancer, the age of patients had a distinctive role in triggering high levels of stress, but also, promoting posttraumatic growth. The explanation that sustains this paradoxical relationship is the perception of cancer as more disruptive and aggressive among younger women than in their older peers ( Kangas et al., 2005;Ochoa et al., 2013;Sharp et al., 2018). ...
Post-traumatic stress and growth are common responses to adverse life events such as cancer. In this article, we establish how cancer becomes a “fertile land” for the emergence of stress and growth responses and analyze the main mechanisms involved. Stress-growth responses on adjusting to cancer is potentially determined by factors like the phase of the illness (e.g., initial phases vs. period of survivorship), patient’s coping strategies, meaning-making, and relationships with significant others. We also review the mechanisms of constructive and adaptative stress-growth balances in cancer to study the predictors, interrelated associations, triggering mechanisms, long-term results, and specific trajectories of these two responses to cancer. Finally, we update the evidence on the role of these stress-growth associations in psychologically adjusting to cancer. Together with this evidence, we summarize preliminary results regarding the efficacy of psychotherapeutic interventions that aim to facilitate a constructive psychological balance between stress and growth in cancer patients. Recommendations for future research and gaps in knowledge on stress-growth processes in this illness are also highlighted. Researchers are encouraged to design and use psychotherapeutic interventions according to the dynamic and changeable patients’ sources of stress and growth along the illness. Relevant insights are proposed to understand the inconsistency of stress-growth literature and to promote psychotherapeutic interventions to facilitate a constructive balance between these key responses in cancer.
... Breast cancer is currently one of the most common malignant tumors in women (Casellas-Grau et al. 2016;Zavos and Valachis 2016). As estimated using cancer statistics, in 2018, there were 266 120 new cases of breast cancer and 40 920 deaths due to breast cancer (Siegel et al. 2018). ...
Long noncoding RNA HOTTIP (HOXA transcript at the distal tip) has recently been reported to have a role in the proliferation of various cancer cells, yet its role in cell migration, invasiveness, and the EMT (epithelial–mesenchymal transition) in breast cancer and the potential mechanisms remain unknown. Breast cancer cell lines MDA-MB-231 and MDA-MB-468 were transfected with shRNA (short hairpin RNA) that specifically targeting HOTTIP. We observed a remarkable decrease in migration and invasiveness in these two breast cancer cell lines after knock-down of HOTTIP by shHOTTIP. We also demonstrated that the EMT of these two breast cell lines was suppressed after HOTTIP knock-down, as evidenced by increased E-cadherin levels, and decreased levels of N-cadherin, Snail, and Twist. Moreover, HOTTIP silencing also suppressed tumor metastasis in nude mice in vivo. In addition, we found that the expression of β-catenin was significantly decreased in breast cancer cells after knock-down of HOTTIP. In a further rescue experiment using overexpression of β-catenin, the rates of cell migration, invasiveness, and EMT of HOTTIP-silenced breast cancer cells were promoted, disclosing a potential role of the Wnt–β-catenin signaling pathway in this process. Overall, we discovered the positive regulatory function of HOTTIP in the migration, invasiveness, and EMT of breast cancer cells, via regulating the Wnt–β-catenin pathway.
... *p < 0.05 **p < 0.01 ***p < 0.001 F I G U R E 2 Trimmed model for the direct and indirect effects of family resilience on PTG, QOL and caregiver burden. *p < 0.05, **p < 0.01, ***p < 0.001; PTG: post-traumatic growth; QOL: survivors of breast cancer had positive psychological outcomes(Casellas-Grau et al., 2016;Walsh, 2003). In the present study, families with survivors of breast cancer had a relatively high level of family resilience, and the survivors of breast cancer had a high level of PTG. ...
Walsh's family resilience theory indicated that families could foster resilient outcomes among their members when they are facing changes or crises. However, little is known about family resilience and psychological well‐being among Chinese breast cancer survivors and their caregivers. Therefore, this study aimed to examine the direct and indirect relationships between family resilience, breast cancer survivors' post‐traumatic growth (PTG), quality of life (QOL), and their principal caregivers' caregiver burden. A total of 108 breast cancer survivors/principal caregivers pairs completed a cross‐sectional questionnaire survey in a comprehensive cancer of a public hospital in Shandong Province, China. The structural equation modelling (SEM) results showed that family resilience had direct and indirect effects on QOL and caregiver burden, and it was positively related to the PTG of the survivors. The survivors' PTG was positively related to their QOL, and their QOL was negatively associated with caregiver burden. Therefore, a better understanding of how family resilience contributes to PTG and QOL of the survivors and caregiver burden could help clinicians tailor interventions to enhance interventions aimed at improving both survivors' and caregivers' well‐being.
Objective: The primary aim of this study was to examine predicting the effect of stress, social support, self-efficacy, and resilience on psychological well-being in breast cancer survivors Materials and Methods: This predictive analysis for the descriptive cross-sectional study was conducted by the theoretical underpinning of resilience and population consisted of eligible breast cancer survivors receiving care at an outpatient clinic within a tertiary hospital setting. The data collecting was proceeded through self-administered questionnaires in line with convenient sampling. The analytical approach encompassed descriptive statistics, Pearson’s correlation coefficient, and multiple linear regression. Results: Emanating from the study included the recruitment of 123 participants, with stress, social support, and resilience collectively elucidating 43% of the variance in psychological well-being among breast cancer survivors. Notably, resilience emerged as the most influential predictor (β=.33), followed by stress (β=-.27) and social support (β=.26), all of which significantly contributed to the prediction of psychological well-being. Conclusion: Resilience, stress, and social support were three predictors of psychological well-being among survivors of breast cancer in this study. Recommendations extend to the integration of strategies that foster resilience and social support, while concurrently mitigating stress levels through activities and programs aimed at augmenting the psychological well-being of breast cancer survivors in the future.
Introduction
Cancer, a life-threatening chronic disease, is the leading cause of death in Korea, accounting for 27% of all deaths in 2020. Due to advancements in medical technology and early detection of cancer in Korea, the 5-year relative survival rate reached 70.7% (2015–2019), highlighting remarkable progress over the past decades. Although cancer has been seen as a traumatic event, cancer survivors also go through a subjective process of self-maturation, which is called post-traumatic growth (PTG). Because research on PTG among Korean cancer survivors has not been systematically synthesised, a scoping review on this topic will provide a better understanding of the positive psychological changes that occur as a patient moves through the illness trajectory of cancer from a Korean cultural perspective. The purpose of this study was to describe the protocol of a scoping review regarding PTG in Korean cancer survivors.
Methods and analysis
The scoping review framework suggested by Arksey and O’Malley and the manual refined by the Joanna Briggs Institute for scoping reviews will be used with the six framework guidelines developed by Levac et al. Searched databases will include Ovid-MEDLINE, PubMed, Embase, CINAHL, Cochrane Library and PsycInfo, as well as Korean databases, examining all articles published between 2012 and 2023 in Korean or English on PTG in Korean cancer survivors. Extracted data will be collated, charted and summarised.
Ethics and dissemination
Because the scoping review methodology undertakes a secondary analysis of collected data from previous research studies, this study does not require ethical approval. The results of this scoping review will be disseminated through presentations at conferences and publication in a scientific journal.
Führen Depression, Angst und chronischer/traumatischer Stress zu erhöhten somatischen Krankheitsrisiken, und umgekehrt, bewirken klinisch manifeste somatische Erkrankungen ein höheres Inzidenzrisiko für koexistente affektive und Stress-bezogene Störungen? Und wie wirken sich diese psychischen Komorbiditäten auf die Dynamik des Krankheitsgeschehens, auf die Morbidität und die gesundheitsbezogene Lebensqualität, auf das Mortalitäts- und das Suizidrisiko aus? Depression, Angst und chronischer/traumatischer Stress sind als systemische Störungen der evolutionären Stresssysteme einer Organismus-internen Regulation von Homöostase und Allostase zu konzipieren. Auf einer Verhaltensebene sind sie häufig mit gesundheitsschädlichen Lebensstilen verbunden, die ebenfalls somatische Krankheitsrisiken vermitteln. Körperliche Erkrankungen erfordern wiederum komplexe psychologische Prozesse der Auseinandersetzung mit existentiellen Krisen, belastenden körperlichen Symptomen und nachteiligen Krankheitsfolgen. Dieser Bewältigungsprozess kann adaptiv, aber auch maladaptiv verlaufen. Somatische Krankheiten und ihre spezifischen Therapien wirken in ihren systemischen Auswirkungen eigenständig auf zentralnervöse Regelkreise zurück und können affektive sowie kognitive Vulnerabilitätsrisiken induzieren. Es ist eine „psycho-somatische“ und auch eine „somato-psychische Perspektive“ innerhalb eines biopsychosozialen Modells einzunehmen.
This cross-sectional study examined colorectal cancer (CRC) survivors’ symptom and symptom cluster characteristics (occurrence, frequency, and severity), positive psychology (benefit-finding and post-traumatic growth), and quality of life (QoL), and determined whether positive psychology moderates symptoms and QoL relationship during acute cancer survivorship, time from diagnosis to treatment completion. A total of 117 CRC survivors completed demographics, symptoms, QoL, and positive psychology questionnaires. Descriptive statistics, multiple linear regression, and moderation analyses were performed. Participants reported high QoL (94%, M = 5.15) and moderate-high positive psychology (75%, M = 3.21). Nineteen symptoms and five symptom clusters were inversely related to QoL ( p < .05). Positive psychology ( M = ~≥3.24) moderated the relationship of QoL ( p < .05) with symptoms occurrence ( n = 10), symptom severity ( n = 1), and with the generalized symptom cluster (weakness, fatigue, dizziness, drowsy, sleep disturbances, and pain). Positive psychology aids in symptom management and improves QoL. Nurses are poised to identify, prevent, promote, and advocate self-management skills to improve health-related outcomes.
Objective:
Because of Covid 19, it has become necessary to revise the treatment of cancer patients ("how" and "when"). That has had important psychological repercussions. The purpose of this study is the evaluation of the impact of Covid19 in terms of Post-Traumatic Stress Disorder and Depression and the potential association with coping strategies.
Methods:
We conducted an exploratory study with 106 patients undergoing treatment, using following questionnaires: Screening Questionnaire for Disaster Mental Health (SQD) and Mini-Mental Adjustment to Cancer (Mini-MAC).
Results:
Only 25.5% of our sample showed symptoms of PTSD and 6.6% revealed a probable presence of depression. In addition, it came up a significant correlation between SQD_P and the coping styles "Hopelessness" (r = 0.41 p <.001) and "Anxious Preoccupation" (r = 0.45, p <.001). A strong correlation also emerged between non-Covid 19 patients and PTSD (r = 0.29, p = .002).
Conclusions:
Our preliminary data did not reveal a prevalence of PTSD, but the persistence of the health emergency requires to focus future research on protective and risk factors related to PTSD and psychological distress in cancer patients, in order to reduce the mental health burden of Covid19. This article is protected by copyright. All rights reserved.
Purpose
Colorectal cancer (CRC) survivors are living longer; therefore, factors that improve outcomes, like symptom management and quality of life (QoL), have increasingly become important. This study examined CRC survivors' symptom(s) characteristics, positive psychology (benefit finding and post-traumatic growth), and QoL, and determined whether positive psychology mediates symptom(s) and QoL relationship during acute cancer survivorship.
Methods
A cross-sectional study of 117 CRC survivors was conducted at a National Cancer Institute-Designated Cancer Center. Data were collected by demographic questionnaire, Therapy-Related Symptom Checklist, QoL Inventory, and positive psychology assessed by Carver Benefit-Finding Scale and Post-Traumatic Growth Inventory. Descriptive statistics, between-group differences, multiple linear regression, and mediation analyses were performed.
Results
Top common symptoms were peripheral neuropathy, fatigue/feeling sluggish, skin changes, sleep disturbances, and weakness. Psychological distress symptoms were reported in 38.46% of CRC survivors, and moderate-to-high positive psychology (3.21 ± 1.09) and QoL (5.15 ±0 .52) levels were reported during acute cancer survivorship. Significant (p < 0.05) relationships were observed between QoL and (a) number of symptoms, (b) psychological distress symptoms, (c) benefit finding, (d) post-traumatic growth, and (e) positive psychology. Positive psychology partially mediated the relationship between symptom frequency and QoL (p < 0.05).
Conclusion
Our study's findings suggest that CRC survivors positively cope with their cancer and treatment, and positive psychology partially mediates the relationship between symptoms frequency (almost daily and daily vs. random) and QoL across acute cancer survivorship. Identifying how CRC survivors adjust to their cancer may help healthcare teams provide tailored self-management skills to promote QoL and reduce symptom burden throughout cancer survivorship.
The latissimus dorsi myocutaneous flap was one of the first methods of oncology breast reconstruction described. However, the standard latissimus dorsi flap alone often does not provide sufficient volume for breast reconstruction, it may have not been the first choice anymore. The design of an extended latissimus dorsi flap has involved including the parascapular and scapula fat fascia in addition to the lumbar fat for additional volume. The main advantage of the extended latissimus dorsi flap is that it can provide autogenous tissue to restore breast volume, it is suitable for Asian women whose breasts are not too large. The author reported the first case of breast reconstruction after mastectomy using the extended latissimus dorsi flap at Viet Duc University Hospital with a 5-year follow up and literature review. Keywords: Extended latissimus flap, breast reconstruction, breast cancer.
The article reveals the conceptualization of the notion of positive psychological functioning of a person. It has been shown that the beginning of the conceptualization of this issue falls on the formation of the humanistic paradigm in psychology, but still the concept of positive functioning is defined ambiguously and is used unsystematically. Therefore, the purpose of the article is to clarify the concept of positive psychological functioning. The two-factor structure of positive functioning has been theoretically substantiated.
This study was conducted as a descriptive study to determine the use of complementary
methods for women with breast cancer receiving paclitaxel chemotherapy protocol. The aim
of this study is to determine the relationship between the symptom and quality of life of
patients who use or do not use complementary methods. Sample of this study using purpose
sampling method, included total 135 breast cancer patients who were receiving paclitaxel
chemotherapy treatment at Dr. Abdurrahman Yurtaslan Ankara Oncology Training and
Research Hospital in between september 2017 and february 2018. For data collection;
Descriptive Information Form, "Nightingale Symptom Assessment Scale" and "Ferrans and
Powers Quality of Life Scale" was used. For the patients using a complementary method;
"Complementary Methods Evaluation Form" was used for assessing complementary methods.
At the end of the study; it was found that 33.3% of the women with breast cancer who were
included in the study were referred to CAM. It was found that the patients have mostly
mucositis (%28.9), taste change (%24.4), and fatigue (%13.4). It was detected that 71.1% of
the patients use herbal products and the most commonly used product is honey (22.2%). There
was no significant relationship between chronic disease, BMI values, age groups, cure cycle,
cancer stage, and NSAS scores according to CAM use status of the patients (p>0.05).
According to the use of CAM, there was a significant relationship between NSAS scores and
the education groups of the patients (p<0.05). According to the use of CAM; a significant
relation between satisfaction and significance scores was found in examining the Ferrans and
Powers Quality of Life scale scores (p<0.05). In our study, honey, lemon and black mulberry
were frequently used as CAM methods and it was found that for patients using CAM,
psychological/religious beliefs and the concept of the family were more important than those
who did not. According to study results, it is recommended to conduct further studies that can
reveal the use of CAM in the Turkish population.
In Mexico, healthy lifestyle has a low prevalence. The importance of a healthy lifestyle lies in avoiding the emergence of a chronic non-communicable disease. Thus, university administrative personnel are a vulnerable population due to working conditions that prevent them from having a healthy lifestyle, so it is necessary to analyze psychological variables that can explain how to promote and develop a healthy lifestyle. The purposes of this study were to identify relationships among lifestyle (LS) and positive psychological functioning (PPF) and their differences by gender in the administrative staff; a cross-sectional and correlational study was conducted. University administrative staff (n = 102), were recruited using the snowball sampling method, forming a non-probabilistic sample, completed the Fantastic Lifestyle Questionnaire and the Positive Psychological Functioning Scale. LS has a statistically significant correlation with PPF (r = .355, p = .001); in addition, it is worth pointing out that showing a low level of PPF implies a lower probability of having a healthy LS (Ψ = 28.333, 4.965-161.675). Results suggest the relevance of interventions to develop psychological resources in people seeking the adoption of a healthy LS.
PurposeFor the purpose of accurate and efficient mass detection in full-field digital mammograms, we propose a method for automated mass detection that consists of two stages: suspicious region localization and false-positive (FP) reduction, by classifying these regions into mass and non-mass regions (normal tissues).Methods
In the first stage, the density of the wavelet coefficients based on Quincunx Lifting Scheme (DWC-QLS) is used to find suspicious regions (regions of interest, ROIs) in full mammograms. In the second stage, a patch-based CNN classifier is developed as an FP reduction to classify the suspicious regions. The main aim of this stage is to reduce the false-positive suspicious regions while keeping the true-positive suspicious regions. To further improve the performance of the FP reduction, the effectiveness of different transfer learning strategies is further explored and the best fine-tuning strategy in training InceptionV3 model is determined experimentally.ResultsThe experimental results show that the proposed method can achieve an overall performance of 0.98 TPR @1.43 FPI on the INbreast database. In addition, the suggested segmentation method detects the mass location with 100% sensitivity and average of 5.4 false positives per image.Conclusions
Based on the obtained results, the introduced method was able to successfully detect and classify suspicious regions in digital mammograms and provide better TPR and FPI results in comparison with other state-of-the-art method.
Abstract
Objective: To revise the psychological well-being scale for cancer patients and development of psychometric properties of revised measure.
Study Design: Cross-sectional study.
Place and Duration of Study: Study was carried out at department of Psychology, University of Gujrat, Pakistan over duration of seven months started from Aug 2017 to Feb 2018. Data collected from three different cancer hospitals of Lahore including Shaukat Khanum Memorial Cancer Hospital and Research Centre and Mayo Hospital Oncology department and Institute of Nuclear Medicine & Oncology. Total 255 cancer patients were included in this phase.
Methodology: Sample was selected through the purposive non-probability sampling. Initially, 53 items scale in Urdu language was qualitatively evaluated by 7 subject experts that turned into 51 items after evaluation. Amended scale of 51 items administered on targeted population. Data was analyzed through the descriptive and inferential statistics. Item total correlation method was used to figure out the most correlated items with the following administration of exploratory factor analysis. Scale reliability was explored through Alpha Reliability measure and through the Split half Reliability.
Results: Exploratory factor analysis was carried out for structure detection and data reduction and resulted in to 37 items with four subscales (Familial Support, Feeling of Worry, Cognitive Functioning, and Learned Helplessness). Further item-total correlation was computed to figure out the internal consistency of scale. Alpha reliability coefficient and split half reliability was 0.90 and 0.70 respectively.
Conclusion: After revision, 53 items psychological wellbeing scale turned into 37 items scale with categorization of mild, moderate and severe level of psychological wellbeing in cancer patients.
Keywords: Alpha reliability split half reliability, Cancer patients, Exploratory factor analysis, Psychological well-being
Abstract
Purpose
Family caregivers are critical sources of support to cancer survivors, but they also need to cope with the distress brought by the caregiving process. This study ascertained the resilience levels of the family caregivers of cancer survivors and then examined the relations between resilience, caregiver burden, and quality of life.
Method
This descriptive cross-sectional study was conducted between June and October 2019. The participants were recruited from the oncology ward of a hospital in Turkey. The Connor-Davidson Resilience Scale, Zarit Burden Interview, and Caregiver Quality of Life Index- Cancer were used to collect data from 210 family caregivers of cancer survivors.
Results
The caregivers reported low levels of resilience (49.63 ± 16.30, range = 0–100), which we found to be associated with great caregiver burden (range = −0.39 to −0.63, all P < 0.01 or 0.05) and poor quality of life (range = 0.31–0.75, all P < 0.01 or 0.05). The findings showed that resilience negatively mediated the caregiver burden (β = 0.203; 95% CI, - 0.374–0.018) and positively predicted the QoL (β = 0.431; 95% CI, 0.683–0.207). The total effects of CDRS on burden and QoL were 0.203 (CI = - 0.374–0.018) and 0.431 (CI = - 0.683–0.207) respectively.
Conclusions
The present findings underscore the direct and indirect predicting role of resilience on QoL and caregiver burden. The family caregivers reported low levels of resilience, which in turn was associated with greater caregiver burden and poorer QoL.
Background
This study investigated the role of posttraumatic growth (PTG) in moderating the associations between parenting efficacy and psychological distress, and between fear of cancer recurrence (FCR) and psychological distress, in mothers who are breast cancer survivors.
Methods
In this cross-sectional study, mothers who were breast cancer survivors (N=91) completed the Depression, Anxiety and Stress Scale (DASS-21), Cancer-Related Parenting Self-Efficacy (CaPSE), Concerns About Cancer Recurrence (CARS) and Posttraumatic Growth Inventory Short Form (PTGI-SF). Multiple hierarchical linear regressions and simple-slope tests were used to examine the main effects of the predictors (CaPSE and CARS) and moderator (PTGI-SF), and interaction effects of CaPSExPTGI-SF and CARSxPTGI-SF. The analyses were repeated for each outcome variable: Depression, Anxiety and Stress.
Results
Higher CARS significantly predicted higher Depression, Anxiety and Stress, and lower CaPSE significantly predicted higher Depression and Stress. Significant CaPSExPTGI-SF and CARSxPTGI-SF interactions predicted Depression. Simple-slopes tests indicated a significant positive association between CARS and Depression for mothers with high levels of PTG, but not with low levels of PTG. A negative association was indicated between CaPSE and Depression for mothers with low levels of PTGI-SF, though neither slope was significant.
Limitations
Our results are only generalisable to mothers with similar socio-demographic backgrounds.
Conclusions
PTG may serve as both a protective and a risk factor for depression in mothers who are breast cancer survivors. Debate remains whether PTG is best conceptualised as a perceived positive outcome or an ongoing coping mechanism in the face of parenting challenges and cancer-related threats such as FCR.
Objective
This study aimed to identify communication preferences for receiving a cancer diagnosis in South Korean patients and explore differences depending on cancer stage—with or without recurrence/metastasis.
Methods
A total of 312 patients from five cancer centers in South Korea completed the Korean version of the Measure of Patients’ Preferences questionnaire, Mini‐Mental Adjustment to Cancer scale, Insomnia Severity Index, and Hospital Anxiety and Depression Scale.
Results
Among patients without recurrence/metastasis, four factors were indicated: “additional information,” “medical information,” “emotional support,” and “supportive environment.” Among patients with recurrence/metastasis, five factors were indicated: “medical information and explanation,” “emotional support,” “supportive environment,” “additional information,” and “informing family.” In the group without recurrence/metastasis, a positive attitude was a significant predictor of the preference for all four factors and a lower anxiety level was a predictor of the preference for additional information. Patients who reported a high level of anxious preoccupation preferred supportive environments. In the group with recurrence/metastasis, patients who showed a high level of cognitive avoidance preferred to receive medical and additional information and emotional support.
Conclusions
Cancer patients’ preferences for communication when receiving bad news differ whether recurrence/metastasis or not in South Korea. Especially, patients with recurrence/metastasis preferred a clear explanation of medical information and physicians informing patients’ family about their diagnosis and prognosis. Thus, physicians should take patients’ medical and psychological characteristics into consideration when delivering the news regarding their condition.
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This book presents cutting-edge research and applications of deep learning in a broad range of medical imaging scenarios, such as computer-aided diagnosis, image segmentation, tissue recognition and classification, and other areas of medical and healthcare problems. Each of its chapters covers a topic in depth, ranging from medical image synthesis and techniques for muskuloskeletal analysis to diagnostic tools for breast lesions on digital mammograms and glaucoma on retinal fundus images. It also provides an overview of deep learning in medical image analysis and highlights issues and challenges encountered by researchers and clinicians, surveying and discussing practical approaches in general and in the context of specific problems. Academics, clinical and industry researchers, as well as young researchers and graduate students in medical imaging, computer-aided-diagnosis, biomedical engineering and computer vision will find this book a great reference and very useful learning resource.
For computer-aided diagnosis (CAD), detection, segmentation, and classification from medical imagery are three key components to efficiently assist physicians for accurate diagnosis. In this chapter, a completely integrated CAD system based on deep learning is presented to diagnose breast lesions from digital X-ray mammograms involving detection, segmentation, and classification. To automatically detect breast lesions from mammograms, a regional deep learning approach called You-Only-Look-Once (YOLO) is used. To segment breast lesions, full resolution convolutional network (FrCN), a novel segmentation model of deep network, is implemented and used. Finally, three conventional deep learning models including regular feedforward CNN, ResNet-50, and InceptionResNet-V2 are separately adopted and used to classify or recognize the detected and segmented breast lesion as either benign or malignant. To evaluate the integrated CAD system for detection, segmentation, and classification, the publicly available and annotated INbreast database is used over fivefold cross-validation tests. The evaluation results of the YOLO-based detection achieved detection accuracy of 97.27%, Matthews’s correlation coefficient (MCC) of 93.93%, and F1-score of 98.02%. Moreover, the results of the breast lesion segmentation via FrCN achieved an overall accuracy of 92.97%, MCC of 85.93%, Dice (F1-score) of 92.69%, and Jaccard similarity coefficient of 86.37%. The detected and segmented breast lesions are classified via CNN, ResNet-50, and InceptionResNet-V2 achieving an average overall accuracies of 88.74%, 92.56%, and 95.32%, respectively. The performance evaluation results through all stages of detection, segmentation, and classification show that the integrated CAD system outperforms the latest conventional deep learning methodologies. We conclude that our CAD system could be used to assist radiologists over all stages of detection, segmentation, and classification for diagnosis of breast lesions.
Objective
To systematically review findings of the impact of cancer diagnosis and treatment on mothers' psychological wellbeing, roles and identity; and to explore the psychosocial factors that contribute to mothers' psychological wellbeing.
Methods
Six databases were searched for research articles and theses exploring the association between the impact of cancer diagnosis and treatment on mothers' psychological wellbeing, identity and role; and the psychosocial factors contributing to mothers' psychological distress regardless of their cancer type and stage. The Mixed‐Method Appraisal Bias Tool was used to assess the selected studies' methodological quality.
Results
A total of 30 qualitative, quantitative and mixed‐method studies were deemed eligible for inclusion. Most studies reported that mothers experienced significant psychological distress, changes to or loss of parenting efficacy, maternal identity and role. Psychosocial factors that contributed to mothers' distress included mothers' young age, presence of metastases, lower parenting efficacy, fear of cancer recurrence, higher illness intrusiveness and lack of appropriate support. Four main themes emerged from the qualitative studies: psychological impact of cancer on mothers, changes in maternal identity and role, relationship changes and concerns for their children, and meaning‐making in cancer experience.
Conclusions
Changes in mothers' psychological wellbeing, role and identity occurred across cancer diagnoses, treatment and recovery trajectories. The evidence suggests that mothers may benefit from continued and tailored psychosocial support to cope with these challenges, even after treatment is completed. Further studies with improved methodological quality are needed to explore these issues in depth.
Background:
Women with breast cancer are the largest group of female survivors of cancer. There is limited information about the long-term quality of life (QOL) in disease-free breast cancer survivors.
Methods:
Letters of invitation were mailed to 1336 breast cancer survivors who had participated in an earlier survey and now were between 5 and 10 years after their initial diagnosis. The 914 respondents interested in participating were then sent a survey booklet that assessed a broad range of QOL and survivorship concerns. All P values were two-sided.
Results:
A total of 817 women completed the follow-up survey (61% response rate), and the 763 disease-free survivors in that group, who had been diagnosed an average of 6.3 years earlier, are the focus of this article. Physical well-being and emotional well-being were excellent; the minimal changes between the baseline and follow-up assessments reflected expected age-related changes. Energy level and social functioning were unchanged. Hot flashes, night sweats, vaginal discharge, and breast sensitivity were less frequent. Symptoms of vaginal dryness and urinary incontinence were increased. Sexual activity with a partner declined statistically significantly between the two assessments (from 65% to 55%, P =.001). Survivors with no past systemic adjuvant therapy had a better QOL than those who had received systemic adjuvant therapy (chemotherapy, tamoxifen, or both together) (physical functioning, P =.003; physical role function, P =.02; bodily pain, P =.01; social functioning, P =.02; and general health, P =.03). In a multivariate analysis, past chemotherapy was a statistically significant predictor of a poorer current QOL (P =.003).
Conclusions:
Long-term, disease-free breast cancer survivors reported high levels of functioning and QOL many years after primary treatment. However, past systemic adjuvant treatment was associated with poorer functioning on several dimensions of QOL. This information may be useful to patients and physicians who are engaging in discussion of the risks and benefits of systemic adjuvant therapy.
The aim of the investigation was to know the degree of relation and the predictive capacity that the psychological variables, have to the quality of life in patients with breast cancer. 50 women in different phases of treatment participated. The Life Quality Inventory and Health (InCaViSa), the Coping Strategies Scale MOOS, the Resiliency Scale SV-RES, and the Multidimensional Scale of Religiousness/Spirituality were applied. A positive and significant relation between the quality of life with the coping and the resiliency was confirmed. The coping style by logical analysis and fortress predicted the quiality of life. The conclusion is that the coping and the resiliency included in intervention programs can increase the quality of life in patients with breast cancer.
The aim of the investigation was to know the degree of relation and the predictive capacity that the psychological variables, have to the quality of life in patients with breast cancer. 50 women in different phases of treatment participated. The Life Quality Inventory and Health (InCaViSa), the Coping Strategies Scale MOOS, the Resiliency Scale SV-RES, and the Multidimensional Scale of Religiousness/Spirituality were applied. A positive and significant relation between the quality of life with the coping and the resiliency was confirmed. The coping style by logical analysis and fortress predicted the quiality of life. The conclusion is that the coping and the resiliency included in intervention programs can increase the quality of life in patients with breast cancer.
Objetivo: Las enfermedades graves como el cáncer pueden vivirse como experiencias traumáticas y/o como impulso para realizar cambios vitales positivos (ej. crecimiento postraumático).
El programa de psicoterapia positiva grupal para supervivientes de cáncer que realizamos integra ambos elementos, trauma y crecimiento. Los objetivos del programa no son sólo la reducción de emociones negativas (malestar emocional o sintomatología postraumática) sino el trabajo con emociones positivas y la facilitación de crecimiento postraumático.
Método: Los elementos de trabajo psicoterapéutico que han mostrado evidencia en la consecución de estos objetivos y que componen los módulos de este programa son: favorecer la expresión y procesamiento emocional, entrenar habilidades de regulación emocional y estrategias de afrontamiento, trabajo con elementos facilitadores del crecimiento postraumático y confrontación con los aspectos existenciales y espirituales que surgen tras el diagnóstico y tratamiento oncológico. Además de estos aspectos psicoterapéuticos, complementamos el programa con otros factores relevantes en la adaptación psicosocial tras la enfermedad como: el fomento de estilos de vida saludables, la adherencia a los tratamientos oncológicos, la reinserción laboral y los comportamientos solidarios.
Resultados: Los resultados preliminares del programa muestran mayor reducción de sintomatología postraumática y mayor crecimiento postraumático en el programa de psicoterapia positiva en el seguimiento a 3 meses al compararlo con un programa anterior centrado únicamente en la reducción de malestar emocional.
The purpose of the current study was to test the curvilinear associations between experiences of stress and posttraumatic growth among female breast cancer survivors. Participants (n = 193; 86% Caucasian; 80% diagnosed with Stage I or II cancer) completed self-report questionnaires assessing sociodemographic and medical information, perceived general stress, cancer- specific stress, and posttraumatic growth. Two hierarchical regression models tested the associations between general and cancer-specific stress and posttraumatic growth. After controlling for the effects of age, education, and time since diagnosis, there was a significant curvilinear effect of general stress on posttraumatic growth. Moderate levels of general stress were associated with the greatest posttraumatic growth. Cancer-specific stress was not associated with posttraumatic growth. These findings suggest that stress can be adaptive in the aftermath of cancer treatments, and different manifestations of stress may require individualized intervention. Future research studies are needed to better understand and contextualize these findings among other cancer populations.
Breast cancer and its treatment, including mastectomy, can cause feelings of mutilation, depreciation in the value of the body, reduction in attractiveness, and lead to mental disorders and hopelessness.
The present study aimed to determine the relationship between appreciating the body, hope and mental health in women with breast cancer after mastectomy.
This study was a descriptive study of 100 breast cancer patients who had undergone mastectomy and referred to the Sayed Al-Shohada Medical Center in Isfahan, Iran. The subjects were selected by convenient sampling. Data gathering tools were the Body Esteem Scale (BES), Herth Hope Index (HHI), and Symptom Checklist 25 (SCL-25) mental health questionnaire. Data analysis was performed using SPSS software.
Most of the patients had low body esteem. There was a significant direct linear relationship between body esteem and hope and mental health. This relationship was stronger between valuing the body and hope.
Body esteem has a significant linear relationship with hope and mental health.
This longitudinal waitlist-controlled study evaluated the effects of Mindfulness-Based Stress Reduction (MBSR) on spirituality, posttraumatic growth (PTG), and mindfulness in cancer patients. The study also assessed whether increased mindfulness mediated the effects of MBSR on spirituality and PTG. Patients were either registered for immediate participation in MBSR (n = 135), or were naturally waiting for the next program (n = 76). Participants completed questionnaires pre-, mid-, and post-MBSR, or waiting period. Hierarchical linear modeling (HLM) was employed to assess changes over time as a function of condition (MBSR vs. waitlist). Mediation was tested using linear regression and bootstrapping. MBSR participants demonstrated increased spirituality, PTG, and mindfulness, relative to controls. Change in all mindfulness facets mediated the effect of MBSR on spirituality and PTG. The development of mindfulness skills through MBSR may facilitate a sense of meaning, peacefulness, connectedness, and personal growth in cancer patients. This investigation contributes to an emerging focus on determining ‘how’ mindfulness-based interventions work.
While there is an abundance of cancer survivorship research among various racial/ethnic groups, there is a paucity of research on survivors of African descent. To date, the meaning of survivorship has not been reported exclusively among African American breast cancer survivors (AABCS).
The purpose was to describe and understand the meaning of survivorship among community-dwelling AABCS, mostly recruited from breast cancer support groups.
Using a qualitative descriptive approach, an open-ended questionnaire explored the meaning of survivorship among 155 AABCS. An analysis of the content was performed.
Among AABCS, survivorship meant having a strong spiritual base, thriving, being resilient, and being altruistic. The survivors self-identified with and embraced the term survivor.
These results provide an important understanding of the perspectives and meaning of survivorship among AABCS and may assist in developing cancer survivorship care plans that are relevant, responsive, patient centered, and culturally appropriate.
© The Author(s) 2014.
Objective
This study investigated the mediating effects of the internal psychological factors of self-esteem and optimism on the relationship between breast cancer patients' quality of life in terms of symptoms and functioning and depressive symptoms.
Methods
The study centered on 384 breast cancer patients who had within a 24-month period received diagnosis of 0-4 stage cancer and had medical treatment. To achieve the study's purpose, the study made use of EORTC QLQ BR23, CES-D, and the Self-Esteem and Optimism Scales.
Results
Findings revealed that breast cancer patients' quality of life was negatively impacted by self-esteem and optimism, and that self-esteem and optimism impacted negatively on depressive symptoms. Analyses showed that when breast cancer patients' quality of life affects depressive symptoms, the full mediation effect of self-esteem was statistically significant. Also, findings revealed there to be a significant partial mediation effect due to optimism.
Conclusion
Study findings demonstrated that enhancing self-esteem is crucial in the psychological intervention of depressive symptoms because self-esteem functioned as the main causal factor accounting for all variation when breast cancer patients' quality of life affected depressive symptoms. In addition, results suggested that optimism is also vital to psychological intervention because it functioned as partial cause of heightened depressive symptoms when breast cancer patients' quality of life affected depressive symptoms.
Introduction:
Breast cancer is the most common cancer among Jordanians. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. To the best of our knowledge, there is no published quantitative data on the quality of life and psychological well-being of breast cancer patients in Jordan. The objective of this study was to obtain such data and assess predictors with calculated scores.
Methods:
In this cross-sectional study conducted among breast cancer patients in Jordan diagnosed in 2009 and 2010, assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). Clinical, demographic and psychosocial indicators that could predict patient quality of life scores were collected.
Results:
The number of patients interviewed was 236 (mean age=50.7±10.7 years). The mean Global Health score for the QLQ-C30 was 63.7±20.2 SD. Among functional scales, "social functioning" scored the highest (mean=78.1±28.6 SD), whereas "emotional functioning" scored the lowest (mean=59.0±SD 33.5). For the QLQ-BR23, the worst scores within the functional scales were for "body image" (mean=52.1±36.8 SD) and "future perspective" (mean=52.9±38.5 SD) . The worst symptom was "upset by hair loss" (mean=69.8±43.0). The mean HADS scores was 18.±9.0 SD. Out of study participants, 53% scored abnormal on the anxiety scale and 45% on the depression scale. Severe depression and severe anxiety were detected among 8% and 14% of study participants, respectively. Statistically significant predictors for individual scores were similar to those reported in published studies, such as the presence of recurrence since baseline, family history of cancer, low educational status, current social problems, extent of the disease, presence of financial difficulties, and employment status.
Conclusions and recommendations:
Breast cancer survivors in Jordan have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at hospitals of the Ministry of Health in Jordan.
Background:
Younger survivors (YS) of breast cancer often report more survivorship symptoms such as fatigue, depression, sexual difficulty, and cognitive problems than older survivors (OS). This study sought to determine the effect of breast cancer and age at diagnosis on quality of life (QoL) by comparing 3 groups: 1) YS diagnosed at age 45 years or before, 2) OS diagnosed between 55 and 70, and 3) for the YSs, age-matched controls (AC) of women not diagnosed with breast cancer.
Methods:
Using a large Eastern Cooperative Oncology Group (ECOG) database, 505 YS were recruited who were aged 45 years or younger when diagnosed and 622 OS diagnosed at 55 to 70 years of age. YS, OS, and AC were compared on physical, psychological, social, spiritual, and overall QoL variables.
Results:
Compared to both AC and to OS, YS reported more depressive symptoms (P = .005) and fatigue (P < .001), poorer self-reported attention function (P < .001), and poorer sexual function (P < .001) than either comparison group. However, YS also reported a greater sense of personal growth (P < .001) and perceived less social constraint (P < .001) from their partner than AC.
Conclusions:
YS reported worse functioning than AC relative to depression, fatigue, attention, sexual function, and spirituality. Perhaps even more important, YS fared worse than both AC and OS on body image, anxiety, sleep, marital satisfaction, and fear of recurrence, indicating that YS are at greater risk for long-term QoL problems than survivors diagnosed at a later age.
In the present study we investigated the relationship between quality of life (QOL) of women with breast cancer, optimism and coping strategies. Twenty-five women with breast cancer were asked to answer a series of instruments: WHOQOL-BREF, LOT-R, CSI and a questionnaire to collect sociodemographic and health data. Correlations were found between each of the independent variables (optimism and coping strategies) with QOL and between the independent variables. A multiple regression analysis showed that the strongest predictor of QOL is the coping, specifically two coping strategies, social support and self-criticism, which together account for a 50.7% of the variance of the QOL. We discuss the theoretical and practical implications of these results in the development of multidisciplinary interventions, as well as the limitations of this study and suggestions for future research.
Religion and spirituality are much studied coping mechanisms; however, their relationship to changes in behaviors, relationships, and goals is unclear. This study explored the impact of a breast cancer diagnosis on religion/faith and changes in behaviors, relationship, or goals. In this qualitative study, women, who participated in a larger, quantitative study, completed written responses to questions regarding the role of religion/faith in their lives, the impact of their diagnosis on their image of God and on faith/religious beliefs, and any changes in behaviors, relationships, or life goals were examined. Based on previous findings noting differences in psychological outcomes based on a higher (HE) or lesser (LE) engaged view of God, 28 (14 HE; 14 LE) women were included in the analysis. Awareness of life and its fleeting nature was common to all. Ensuing behaviors varied from a need to focus on self-improvement-egocentrism (LE)-to a need to focus on using their experiences to help others-altruism (HE). Study results suggest that seemingly small, but highly meaningful, differences based on one's worldview result in considerably different attitudinal and behavioral outcomes.
Posttraumatic growth (PTG) is defined as 'positive psychological change experienced as a result of a struggle with highly challenging life circumstances'. The current study examined change in PTG over 2 years following breast cancer diagnosis and variables associated with PTG over time.
Women recently diagnosed with breast cancer completed surveys within 8 months of diagnosis and 6, 12, and 18 months later. Linear mixed effects models were used to assess the longitudinal effects of demographic, medical, and psychosocial variables on PTG as measured by the Posttraumatic Growth Inventory (PTGI).
A total of 653 women were accrued (mean age = 54.9, SD = 12.6). Total PTGI score increased over time mostly within the first few months following diagnosis. In the longitudinal model, greater PTGI scores were associated with education level, longer time since diagnosis, greater baseline level of illness intrusiveness, and increases in social support, spirituality, use of active-adaptive coping strategies, and mental health. Findings for the PTGI domains were similar to those for the total score except for the Spiritual Change domain.
PTG develops relatively soon after a breast cancer diagnosis and is associated with baseline illness intrusiveness and increases in social support, spirituality, use of active-adaptive coping strategies, and mental health. Copyright © 2013 John Wiley & Sons, Ltd.
Despite the increasing number of studies documenting the positive effects of gratitude in coping with traumatic events and facilitating psychological well-being, none is addressed to patients with life-threatening illnesses such as cancer. The aims of this study are to examine the role of gratitude in a breast cancer sample and its correlations with post-traumatic growth, psychological well-being, and distress; and to compare patients reporting higher levels of gratitude (High Gratitude Individuals, HGI) versus those reporting lower levels (Low Gratitude Individuals, LGI). 67 breast cancer patients were assessed with: (1) Gratitude Questionnaire; (2) Post-traumatic Growth Inventory (PTGI); (3) Psychological Well-being Scales (PWBS) (4) Symptom Questionnaires (SQ); and were divided into: (1) High Gratitude Individuals—HGI (n = 27); (2) Low Gratitude Individuals—LGI (n = 40). Bivariate correlations between questionnaires and ANOVA between-group were calculated. Gratitude was significantly and positively correlated to all of PTGI scales, to PWBS positive relations, to SQ relaxation and contentment, and negatively related to anxiety, depression, and hostility-irritability. HGI and LGI reported significant differences on the PTGI and SQ dimensions, but not on PWB scales, with HGI displaying higher levels of PTGI, positive affect and lower symptomatology. Also in breast cancer patients gratitude is strongly associated to post-traumatic growth, reduced distress and increased positive emotions, but surprisingly not to psychological well-being. Since the majority of patients reported low gratitude levels, the results suggest the importance of developing interventions to clinically increase them also in oncology.
Couples share distress as well as potential personal growth (PG) after a cancer diagnosis. It is essential for professionals to learn more about the ways couples cope together with adversity. Dyadic results may help to understand controversial results in the PG literature and inform clinicians in optimizing psychological support for couples.
We examine the temporal and dyadic development of PG among patients and their intimate partners. In addition, life threat is examined as a potential factor influencing PG after cancer diagnosis.
We assessed PG using the Personal Growth Inventory in a clinically representative, mixed-type and mixed-stage cancer cohort (N = 154 couples) 6 and 12 months after cancer diagnosis. Medical data on cancer diagnoses and treatments were collected from physicians. Actor-partner interdependence models were applied.
PG was reported by patients and their partners. Women (either as patients or partners) reported more PG than male patients or partners. PG remained relatively stable over 6 months and was related to whether the patient was receiving curative or palliative treatment. Female patients experienced less PG 6 months after the cancer diagnosis and if treatment was curative. Male patients experienced less PG if their partners experienced PG, and the treatment was curative.
Dyadic growth is a phenomenon not limited to breast cancer or female patient couples and may represent a form of dyadic coping. Patients and partners seem to develop individual and dyadic growth, depending on a combination of gender and life threat. Psycho-oncology services may want to promote both couple level coping and support in order to optimize cancer care.
Positive psychology is an emerging area of empirical study, not only in clinical, but also in health psychology. The present systematic review aims to synthesize the evidence about the positive psychology interventions utilized in breast cancer.
Relevant studies were identified via Pubmed, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, Wiley Online Library, TDX, and DIALNET databases (up to April 2013). Only those papers focused on interventions related to positive psychology and carried out on breast cancer patients were included.
Of the 7266 articles found through databases, 16 studies were finally included in this review. Five groups of therapies were found: mindfulness-based approaches, expression of positive emotions, spiritual interventions, hope therapy, and meaning-making interventions. These specific interventions promoted positive changes in breast cancer participants, such as enhanced quality of life, well-being, hope, benefit finding, or optimism. However, the disparity of the interventions and some methodological issues limit the outcomes.
Some studies provided relevant evidence about the clear development of positive aspects from the breast cancer experience. Positive interventions applied to patients and survivors of breast cancer were found to be able to promote positive aspects. A global consensus of a positive therapies classification is needed to take one more step in structuring positive psychology. Copyright © 2013 John Wiley & Sons, Ltd.
Cancer patients experience positive as well as adverse consequences from cancer diagnosis and treatment. The work reported here was part of an effort to characterize the experiences of benefit finding in breast cancer patients. A sample of 230 early-stage breast cancer patients completed a set of benefit finding items in the year post-surgery. This measure was then related to measures of concurrent coping, several aspects of psychosocial well-being, demographic variables, and several other personality traits. Benefit finding related positively to trait optimism, and to positive reframing and religious activity as coping reactions. Benefit finding related inversely to emotional distress, but was relatively unrelated to other measures of well-being.
Breast cancer presents both danger and opportunity. Most survivors report perceptions of benefits or posttraumatic growth (PTG), in the aftermath of the struggle of the with breast cancer. This study identified social context variables associated with personal growth among 72 married, early-stage survivors. Bivariate analyses revealed that the more women perceived their husbands as supportive, the more they reported PTG. Likewise, women reporting contact with a breast cancer survivor who perceived benefits from the experience (PTG model) noted significantly greater PTG than women who did not have such contact. Additional analyses found that level of education and time since diagnosis were inversely related to survivors' PTG. A multiple regression analysis identified contact with a PTG model and education as best predictors of survivors' PTG. These results suggest that future research should explore the possibility that psychosocial treatment of breast cancer survivors is more effective when a model of growth is present.
The diagnosis of cancer has the potential to elicit positive change (posttraumatic growth [PTG]) through the experience of trauma and adversity. However, psychology and clinical practices and most recently positive psychology have been criticized for their indifference toward the influence of the body on positive psychological functioning. The aim of this study was to broaden the understanding of PTG, including its process and outcomes, using interpretive phenomenological analysis. Ten female breast cancer survivors, from an already existing study, participated in an individual, open-ended interview. These were transcribed verbatim and analyzed for themes that reflected the women’s experience of growing from adversity. The role of the body was found to be a vital component to the process and outcomes of PTG and was deconstructed into three smaller themes: fear of new body, negative effects of chemotherapy on the body (fatigue, loss of desire), and reconnection with body (cocoon to butterfly, listening to body, body as a barometer/monitoring). In addition, the analysis revealed how these 10 women perceived the body as an integral component to their self-identity and how this affected their achievement of PTG. Future research should begin to acknowledge and conduct further study into the neglected role of the body as a contributor or determinant of the PTG process.
This study of a breast cancer patient with cancer-related fatigue (CaRF) and depression investigated the bidirectional cause-effect relations between cellular immune activity, fatigue and mood during 'life as it is lived'. The 49-year-old patient (breast cancer diagnosis 5 years earlier, severe CaRF and increase in depressiveness since then) collected her entire urine for 28 days in 12-h intervals (from 8 p.m. to 8 a.m. and from 8 a.m. to 8 p.m.; total: 55 measurements) for the determination of urinary neopterin (immune activation marker) and creatinine levels using HPLC. Furthermore, she completed questionnaires twice each day (at approx. 8 a.m. and 8 p.m.), which yielded information on mood (3-Skalen-Eigenschaftswörterliste [EWL]) and fatigue levels (visual analog scale [VAS]). Cross-correlational analyses showed complex connections between urinary neopterin concentrations and mood and fatigue in terms of direction of effect, temporal delay and response pattern. Increases in urinary neopterin levels significantly preceded increases in fatigue intensity with a temporal delay of 60-72h (lag 5: r=0.298; p=0.027), whereas increases in positive mood co-occurred with neopterin level increases (lag 0: r=+0.302; p=0.025) and preceded decreases in neopterin concentrations with a temporal delay of 132-144h (lag 11: r=-0.323; p=0.017). These results confirm and extend our previous findings and show that in order to obtain an adequate understanding of the dynamic relations among cancer-related variables, the characteristics of everyday-life conditions need to be considered.
Purpose
This study assessed the levels of depressive symptomatology in African-American women with breast cancer compared to those of women without breast cancer and examined demographic, psychosocial, and clinical factors correlated with depression.
Methods
A total of 152 African-American women were recruited from Washington, DC and surrounding suburbs. Breast cancer patients (n = 76 cases) were recruited from a health care center and women without cancer were recruited from health fairs (n = 76 comparison). We assessed depression, psychosocial variables (ego strength and social support), and sociodemographic factors from in-person interviews. Stage and clinical factors were abstracted from medical records. Independent sample t test, chi square test, analyses of variance, and multiple regression models were used to identify differences in depression and correlates of depression among the cases and comparison groups.
Results
Women with breast cancer reported significantly greater levels of depression (m = 11.5, SD = 5.0) than women without breast cancer (m = 3.9, SD = 3.8) (p < 0.001). Higher cancer stage (beta = 0.91) and higher age (beta = 0.11) were associated with depression in the breast patients, explaining 84 % of the variance. In the comparison group, ego strength and tangible support were inversely associated with depressive symptoms, accounting for 32 % of the variance.
Conclusions
Women with more advanced disease may require interdisciplinary approaches to cancer care (i.e., caring for the whole person).
Implications for Cancer Survivors
Depression is often underrecognized and undertreated in African-American breast cancer patients. Understanding the factors related to depression is necessary to integrate psychosocial needs to routine cancer care to improve survivors’ quality of life.
The objectives of this study were to describe the quality of life of African American women with breast cancer and test a model of factors that may affect their quality of life. A stress‐coping framework that included person (demographics, current concerns, and optimism), social resources (family functioning), and illness‐related factors (symptom distress, medical characteristics), as well as appraisal of illness and quality of life, was used to guide this exploratory, cross‐sectional study. Participants included 98 African American women who were approximately 4 years postdiagnosis. The women reported a fairly high quality of life, were generally optimistic, and had effective family functioning. Although symptom distress was generally low, a sizable number of women reported problems with energy loss, sleep disturbances, and pain. The model explained 75% of the variance in quality of life, with appraisal, family functioning, symptom distress, and recurrence status each explaining a significant amount of the variance. Current concerns had an indirect effect on quality of life that was mediated by appraisal. These findings underscore the importance of helping women foster a positive appraisal of their illness, manage current concerns, maintain family functioning, and reduce symptom distress, because each of these factors indirectly or directly affects their quality of life. © 1999 John Wiley & Sons, Inc. Res Nurs Health 22:449–460, 1999
Severe diseases such as cancer although generate high stress and emotional distress in survivors and their significant others, can also be a stimulus to promote posttraumatic growth. The mechanisms of this post-traumatic growth (vicarious vs secondary) in significant others have not been studied. This review examines the evidence and relationship between posttraumatic growth in cancer survivors and their significant others, mainly in their partners and parents, regarding these vicarious or secondary growth transmission mechanisms. We conclude that, in general, posttraumatic growth in significant others is a vicarious experience closely linked to the cancer survivor's growth. However, being a woman, mother or suffer an advanced cancer facilitate secondary posttraumatic growth processes insignificant others.
This article describes the concept of posttraumatic growth, its conceptual foundations, and supporting empirical evidence. Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an incr