Karry Weston’s research while affiliated with University of Missouri and other places

Purpose: Recommendations have been made for distress screening for all newly diagnosed cancer patients at their initial consult and along the cancer continuum. This review aims to synthesize the literature presenting distress trajectories of people living with cancer by describing distress trajectories by cancer site, assessment in the cancer continuum, by sex, and by instruments used. Methods: A systematic review identified 5,792 quantitative studies that included distress trajectories associated with people living with cancer. Databases searched included Ovid-Medline, Scopus, PubMed, Web of Science, JSTOR, ScienceDirect, Wiley Interscience, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. Data from 20 studies were extracted and summarized. Results: Among the 20 studies, the five trajectory types described are low remaining low, low worsening to clinically high, recovery (low to high and back down to low), clinically high improving to low, and clinically high remaining clinically high. Of the 1,625 people living with cancer, 16% (262 people living with cancer) had trajectories with distress measuring high on their final outcome measure. Only 9 out of 20 studies described the distress trajectory over the full cancer continuum, from diagnosis through treatment and into follow-up care. Conclusion: To advance current knowledge on ideal intervention times for clinicians in efficiently addressing distress among people living with cancer, distress measures collected throughout the cancer continuum for individual cancers are needed.

Objective To examine the influence of habitus on women's health behavior regarding breastfeeding and subsequent COVID‐19 vaccination. Design A qualitative descriptive design, guided by Pierre Bourdieu's concept of habitus. Sample Eighteen women who were postpartum, breastfeeding, and vaccinated against COVID‐ 19 either during pregnancy or while breastfeeding postpartum. Measures Individual semi‐structured interviews. Results Two major themes shaped participants’ habitus: health‐focused knowledge, and attitudes and beliefs. Attitudes and beliefs included five subthemes: (1) exposure/acceptance/expectations from family, (2) community acceptance of breastfeeding and COVID‐19 vaccination, (3) socioeconomic status, (4) easily accessed support, and (5) outside experiences and exposure. Discussion An individual's habitus impacts one's knowledge, attitudes, and beliefs and interacts with past behaviors when discussing options for infant feeding and health promoting behaviors such as vaccinations. A better understanding of how health care providers assess and utilize habitus in clinical management is needed.

A theory-generating qualitative metasynthesis was used to explore the questions: (a) How do mothers of low socioeconomic status in the United States express their attitudes and beliefs on breastfeeding? (b) How do mothers of low socioeconomic status in the United States describe the types of support received related to breastfeeding? Databases were searched from January 2000 to June 2022. Eleven qualitative studies were evaluated, and six themes were identified. A model was developed illustrating how the themes impact a mother’s decision to breastfeed. Positive factors included shared narratives, knowledge of breastfeeding physiology, and social network. However, more negative influences were heard such as opinions passed on from family and friends, lack of teaching and anticipatory guidance, limited support and follow up, and the perception of conflicting messages from health care professionals. This model identifies constructs that can be used as starting points for interventions, policy development and/or health promotion education.

Objective: The National Comprehensive Cancer Network (NCCN) distress thermometer (DT) was developed as a brief screening tool for detecting distress in cancer patients. Conceptually, distress was considered a more acceptable and inclusive term than other psychological terms such as depression or anxiety. It is used extensively in the United States and other English-speaking countries. We aim to describe the translation and validation methods of the DT and describe the recommended cutoff scores used to identify cancer patients experiencing clinically significant distress. Methods: Nine bibliographic databases were searched using keywords to identify original research studies for non-English speaking countries' cancer patients. Full articles were independently assessed for inclusion and data extraction by two authors. Results: The review of 4442 articles yielded 39 articles that validated the DT. We identified 20 languages in 25 countries. In all but one country, investigators were able to agree upon a word or phrase that meant distress in their native language that was subsequently validated against standardized instruments. Asian, Middle Eastern and European counties recommended cutoff score of 4 or 5 to identify clinically significant distress; however, European Union countries had a range of 2-7. Conclusions: Use of the translated DT with non-English speaking cancer patients provides a simple and quick tool to identify high distress. Similar to NCCN, the cutoff score of 4 or 5 was suggested by 78% of the studies; however, more studies of different types of cancer and within and among more countries will strengthen a recommended global DT cutoff score. This article is protected by copyright. All rights reserved.