The mediating role of appraisal and coping in the relationship between optimism-pessimism and quality of life

Longitudinal data from 165 women diagnosed and treated for breast cancer were used to investigate if the relationship between optimism-pessimism and quality of life (QOL) is attributed to the appraisal and coping strategies. The women completed the Life Orientation Test-Revised (LOT-R), as a measurement of optimism-pessimism, the Mental Adjustment to Cancer (MAC) Scale, as a measure for coping, a VAS for appraisal and the EORTC QLQ-C30, as a measure for QOL at two time points: at diagnosis and 12-months after breast cancer surgery. Optimism-pessimism had both a direct and indirect influence on QOL. Two coping strategies were particularly strong mediators for the indirect influence: fighting spirit and hopeless/helpless. Optimists responded with fighting spirit, which had a positive effect on their QOL. On the other hand, pessimists responded with hopeless/helplessness, which had a negative effect on their QOL. The relationship between pessimism and QOL at time of diagnosis was also mediated by appraisal, such as threat. The two coping strategies remained fairly stable over the 12 months within the optimists and pessimists.The results suggest that the influence of optimism and pessimism on QOL appears to be mediated by coping both before and after treatment for breast cancer. Fighting spirit and hopeless/helplessness appear to reflect the characteristic coping strategies for optimists and pessimists.     

Positive psychological changes after breast cancer diagnosis and treatment: The role of trait resilience and coping styles

Abstract

Purpose: This study aimed to examine the relationships among trait resilience, coping styles, and perceived positive psychological changes in women’s lives after breast cancer diagnosis and treatment.

Design: The study adopted a cross-sectional design.

Sample/Method: A total of 201 participants diagnosed with stage I-IV breast cancer were recruited. The average time since diagnosis was 39.14 months. Four rating scales were used to assess the participants’ trait resilience, coping styles, perceived growth, and health-related quality of life. These are the Connor-Davidson Resilience Scale (CD-RISC), the Mini-Mental Adaptation to Cancer Scale (Mini-MAC), the Chinese Posttraumatic Growth Inventory (PTGI), and the Functional Assessment of Cancer Therapy Scale-Breast (FACT-B).

Findings: Hierarchical analysis showed that trait resilience significantly predicted high levels of perceived growth and health-related quality of life. This effect was moderated by Positive-Acceptance coping. The study also found that Negative-Affect coping had a direct effect on lowering health-related quality of life but had no influence on perceived growth.

Conclusions: These findings highlight the facilitating effect of trait resilience and Positive-Acceptance coping on the psychological well-being and perceived growth among breast cancer outpatients.

Implications: Trait resilience may be a protective, even facilitating factor of cancer adaptation. The knowledge that trait resilience offers a way to enhance wellness after cancer diagnosis and treatments may be useful in a clinical setting.     

乳腺癌患者的生命质量研究

乳腺癌严重威胁女性的生命健康,并严重影响患者的生命质量。近年来,乳腺癌患者的生命质量愈来愈倍受人们的关注。从生命质量的内容、测量工具以及影响因素等方面介绍乳腺癌患者生命质量的研究现状。     

乳腺癌患者的生命质量研究

乳腺癌严重威胁女性的生命健康,并严重影响患者的生命质量.近年来,乳腺癌患者的生命质量愈来愈倍受人们的关注.从生命质量的内容、测量工具以及影响因素等方面介绍乳腺癌患者生命质量的研究现状.     

大肠癌患者心理状况及应对方式对生存质量的影响

目的：探讨大肠癌患者不同的应对方式、心理状况对生存质量的影响,为采取相应的措施而提供科学依据。方法：于2014年11－2015年11月对某两所医院确诊住院的248例大肠癌患者应用癌症患者生存质量量表、医院焦虑抑郁量表评价及简单应对方式问卷进行调查评价。结果：大肠癌患者的生存质量各维度均处于中等偏下的水平;男性、居住于城市及经商的患者生存质量高于女性、居住于农村及其他职业的患者;无配偶只在躯体维度评分低于有配偶的,差异有统计学意义（P＜0．05）;采取积极应对方式的大肠癌患者的生存质量高于消极应对方式的患者,差异有统计学意义（P＜0．05）;消极应对方式和焦虑、抑郁是大肠癌患者生存质量的影响因素,差异有统计学意义（P＜0．05）。消极应对方式、焦虑、抑郁与QOL－LC总分呈负相关;积极应对方式与QOL－LC总分呈正相关。结论：医护人员应该关注患者的心理状态,鼓励其积极面对疾病,从而提高患者的生存质量。     

Impact of newly diagnosed breast cancer on quality of life among Chinese women

Background Being diagnosed with breast cancer is a very stressful event that has a profound impact on multiple aspects of a patient’s daily life. Little is known about the quality of life (QOL) of Chinese women with newly diagnosed breast cancer. Methods The authors evaluated QOL in 2,236 Chinese women with newly diagnosed breast cancer who were recruited into the Shanghai Breast Cancer Survival Study between April 1, 2002 and March 31, 2004. Patients’ QOL was assessed after cancer diagnosis (median time 6.4 months; range 3.6–11.1 months) by using the General Quality of Life Inventory. Multiple linear regression models were used to analyze the associations of QOL outcomes with medical and socio-demographic factors. Results Patients showed significantly worse overall QOL and perceived health status than healthy women, reflected mainly by lower QOL scores in physical and psychological well-being domains. Completion of radiotherapy, ever use of tamoxifen, being underweight, having an increased number of chronic diseases, and low household income were significantly associated with lower overall QOL scores after adjusting for other factors. Age at diagnosis was inversely associated with physical well-being, positively associated with material well-being, and had minimal influence on overall QOL. Stage of disease, chemotherapy, and education were only associated with certain domains, but had no influence on overall QOL. Estrogen receptor/progesterone receptor status and type of surgery or immunotherapy did not appear to be associated with QOL. Conclusions The findings of the present study provide important information on QOL and their correlates among Chinese women with newly diagnosed breast cancer and are helpful in developing treatment strategies accordingly.     

Spiritual health locus of control and life satisfaction among African American breast cancer survivors

Abstract

Purpose: To examine the relationships between spiritual health locus of control (SHLOC) and satisfaction with life in African American (AA) breast cancer survivors (BCS).

Methods: A total of 118 AABCS completed a mailed survey. Logistic regression models were used to examine relationships among variables of interest.

Results: Annual income and SHLOC were significantly associated with life satisfaction. In unadjusted analyses, high overall SHLOC increased the odds (odds ratio [OR]?=?2.8) of being satisfied with life. The adjusted relationships between SHLOC and life satisfaction differed by income level. Among survivors with lower incomes, high spiritual life/faith and God’s grace subscale scores increased the odds of life satisfaction, when compared to those with higher incomes.

Conclusions: Our data indicated that high overall SHLOC was significantly related to higher odds of life satisfaction. Further, SHLOC may serve as a resource to bolster life satisfaction, especially in low-income AA BCS.     

Third line chemotherapy in patients with metastatic breast cancer: an evaluation of quality of life and cost

Many patients with metastatic breast cancer receive several types of chemotherapy, although it is recognized that there is a declining probability of response. A major problem confronts oncologists in deciding when to recommend to patients that no further chemotherapy should be given. To address this problem we have assessed prospectively, healthrelated quality of life (HRQL) and costs of health care for 35 patients with metastatic breast cancer receiving third line chemotherapy in a representative clinical situation. HRQL and utilities were measured longitudinally using the EORTC QLQC30 questionnaire and the time tradeoff method. Patients received a median of 2 cycles of chemotherapy and lived a median of 4.3 months. Twelve patients (34%) had substantial (> 10 points) improvement in the Global QL subscale and more than 30% of patients had similar changes in emotional and social function. The median baseline utility score was 0.9 and utilities correlated poorly with HRQL subscale. Eighteen patients had measurable disease and one patients experienced a partial response. Grade 3/4 toxicity occurred in 30% of patients. The average cost of management from study entry to death was CDN$ 17,260 (~US$ 12,000). Sixteen percent of this cost was associated directly with chemotherapy while hospital admissions and outpatient visits accounted for 50% and 14% of the total cost respectively. We conclude that: (a) many patients receiving third line chemotherapy maintain or improve indices of HRQL despite short survival and a low response rate: this might be due to chemotherapy, paclebo effect, or a shift in frame of reference for HRQl; (b) patients were unwilling to trade quantity for quality of life; and (c) response rates and survival may be overestimated in patients selected for clinical trials.     

Diet quality is directly associated with quality of life in breast cancer survivors

Summary Purpose To determine whether there is a direct relationship between diet quality and quality of life in breast cancer survivors. Methods Subjects (n = 714) were members of the Health, Eating, Activity, and Lifestyle study, a study of breast cancer prognosis conducted in three areas of the western United States. Approximately 2 years after entry to this study, diet data were collecting using food frequency questionnaires. These data were used to classify diet quality using the Diet Quality Index. Approximately 10 months later, data on quality of life were gathered using the Medical Outcomes Study 36-Item short form health survey. Results After controlling for age, education, race/ethnicity, body mass index, stage of disease, and time from diagnosis to quality of life measurement, women with excellent diet quality had significantly better scores than women with poor diet quality for overall mental health functioning and for 3 of 4 mental health subscale scores and 2 of 4 physical health subscale scores. Conclusion Post-diagnosis diet quality is directly associated with subsequent mental and physical functioning in breast cancer survivors. This association is stronger for mental functioning than for physical functioning. The association remains strong after control for potential confounding variables.     

Association between physical activity and quality of life among Western Australian breast cancer survivors

Previous research has shown that physical activity (PA) may be beneficial to quality of life (QoL) in breast cancer survivors. Few studies however, have focused on the time period soon after the completion of adjuvant therapy or examined exercise issues separately for rural/urban or healthy weight/obese breast cancer survivors. Our study addressed these issues. Breast cancer survivors (N = 558) from the Western Australia Cancer Registry completed a survey that included the Godin Leisure Time Exercise Questionnaire (GLTEQ) and the Functional Assessment of Cancer Therapy-Breast (FACT-B) scale. Results showed that only 31% of breast cancer survivors were meeting the recommended PA guidelines post-treatment. Analysis of variance revealed that survivors meeting these guidelines reported higher scores on the FACT-B (mean difference 8.6; 95% CI = 5.0-12.1; p<0.001), the FACT-General (mean difference 6.3; 95% CI = 3.5-9.0; p<0.001), the trial outcome index (TOI; p<0.001), and several of the FACT-B subscales. Furthermore, healthy weight participants also reported higher scores than obese participants on the FACT-B (p = 0.058) and the breast cancer subscale (p = 0.033). There were no differences based on geographic location. We conclude that physically active and healthy weight breast cancer survivors report better QoL than their inactive and obese counterparts soon after completing adjuvant therapy.