Psychosocial factors and health behavior among Korean adults: a cross-sectional study

Objective: This study was an attempt to identify associations between health behavior, such as smoking,alcohol consumption, healthy diet, and physical activity, and psychosocial factors. Methods: This crosssectionalstudy was conducted among 1,500 participants aged between 30 and 69 years, selected from apopulation-based database in October 2009 through multiple-stratified random sampling. Information wascollected about the participants’ smoking and drinking habits, dietary behavior, level of physical activity,stress, coping strategies, impulsiveness, personality, social support, sense of coherence, self-efficacy, healthcommunication, and sociodemographics. Results: Agreeableness, as a personality trait, was negativelyassociated with smoking and a healthy diet, while extraversion was positively associated with drinking. Thetendency to consume a healthy diet decreased in individuals with perceived higher stress, whereas it increasedin individuals who had access to greater social support. Self-efficacy was found to be a strong predictor ofall health behaviors. Provider-patient communication and physical environment were important factorsin promoting positive healthy behavior, such as consumption of a healthy diet and taking regular exercise.Conclusions: Psychosocial factors influence individuals’ smoking and drinking habits, dietary intake, andexercise patterns.     

永久性肠造口患者知觉压力状况及影响因素的调查研究

目的:探讨永久性肠造口患者知觉压力状况及影响因素。方法:采用便利抽样法,选取156例结直肠癌永久性肠造口患者,采用一般资料调查表、知觉压力量表、应对自我效能量表、罗森伯格自尊量表、社会支持评定量表、医学应对方式问卷及医院焦虑抑郁量表进行调查。结果:永久性肠造口患者知觉压力得分为（30.34±4.59）分,处于较高水平。多元逐步回归分析结果显示,屈服、抑郁、自尊、社会支持、应对自我效能及回避进入回归方程,共解释总变异的88.2%。结论:永久性结肠造口患者知觉压力问题值得关注,需要采取必要的干预措施,医护人员应建立有效的社会支持系统,提高患者自尊与自我效能水平从而积极应对以缓解知觉压力水平,提高患者生存质量。     

Stress, self-efficacy and quality of life in cancer patients

The purpose of the study was to examine the effect of different stressors on various domains of quality of life (QOL) in cancer patients. The study focused on testing a model describing interrelations between two kinds of stress antecedents, two mediating variables--perceived stress and self-efficacy--and QOL. The participants were 60 cancer patients of both genders and various diagnoses. They were administered questionnaires of background information, QOL, perceived stress and general self-efficacy. Two stress indices were defined empirically: health stress (based on advanced disease stage, long disease duration, and undergoing treatment) and social stress (based on unemployment, recent immigration, and older age). Confirmatory factor analysis enabled defining five factors of QOL. Hierarchical regression analyses showed that the index of social stress was related to more QOL scales than the index of health stress and very few interactions with the mediating variables. Structural equation modeling provided a more comprehensive and accurate view. It showed that the index of health stress affected QOL mainly through perceived stress, and that self-efficacy affected QOL by reducing perceived stress and increasing QOL. The major conclusions are that QOL is affected negatively by both health stresses and social stresses, but the former are mediated primarily by the experience of perceived stress.     

Breast cancer and problems with medical interactions: relationships with traumatic stress, emotional self-efficacy, and social support

This investigation examined relationships between breast cancer patients' psychosocial characteristics (impact of the illness, traumatic stress symptoms, emotional self-efficacy, and social support) and problems they perceived in their medical interactions and their satisfaction with their physicians. Participants were 352 women enrolled in a multicenter trial of the effects of group therapy for women with recently diagnosed primary breast cancer. The findings reported here are from a cross-sectional analysis of baseline data gathered prior to randomization. Problems interacting with physicians and nurses were associated with greater levels of cancer-related traumatic stress (p < 0.01), less emotional self-efficacy for cancer (p < 0.05), less satisfaction with informational support from family, friends, and spouse, and a tendency to perceive those sources of support as more aversive (p < 0.05). Women who were less satisfied with emotional support from their family, friends and spouse were less likely to feel satisfied with their physicians (p < 0.05). These patient characteristics identify women with primary breast cancer who are likely to experience difficulty in their interactions with nurses and physicians and to be less satisfied with their physicians.     

Association of psychological vulnerability factors to post-traumatic stress symptomatology in mothers of pediatric cancer survivors

The current study investigated whether individual differences in coping style, lifetime experience of traumatic events, perceived social support, and perceived social constraints were associated with symptoms of post-traumatic stress among 72 mothers of children who had successfully completed cancer treatment. Results suggested that more perceived social constraints and less perceived belonging support were associated with significantly more post-traumatic stress symptomatology, and this association was present after controlling for the effects of child age. Monitoring coping style and lifetime traumatic events were not significantly predictive of post-traumatic stress symptoms. The results of this study indicate that a sense of belonging to a social network as well as comfort expressing cancer-related thoughts and feelings to friends and family may play a key role in mothers' long-term adjustment to this extremely difficult life experience.     

The role of religious coping in adjustment to cancer

This study tested a model of adjustment to cancer in which social support, disease impact, and religious coping were hypothesized to have an impact on adjustment to cancer that was mediated by self-efficacy. Two hundred and ninety-two people with cancer completed questionnaires. Three analyses were undertaken: first, the structure of the Religious Problem Solving Scale was assessed by a factor analysis in which two factors emerged, Deferring-Collaborative and Self-Directing; second, the resulting factors' relationships to outcome measures were assessed through correlational and regression analyses; third, a mediated model of coping was tested with self-efficacy as a mediating variable between religious coping and adjustment. The Deferring-Collaborative factor had positive relationships with most of the variables and was partially mediated by self-efficacy. The results indicate that religious coping has no relationship to quality of life, a positive relationship with adjustment, and was more important in this study than available social support.     

Barriers to physical activity and healthy diet among breast cancer survivors: A multilevel perspective

Cancer survivors engage in suboptimal levels of health behaviours and report many barriers to health behaviours, but we lack a solid understanding of the different levels of barriers and how they relate to enacted health behaviours. To address these issues, we conducted mixed‐method research in 97 breast cancer survivors. Participants' barriers to physical activity (PA) and healthy diet, asked as an open‐ended question, were coded as individual‐level, social‐level, and organisational/environmental‐level for each health behaviour. Moderate‐to‐vigorous PA and fruit and vegetable (F&V) intake were assessed. Most participants perceived at least one PA (72.7%) and diet (64.9%) individual‐level barrier (e.g. physical symptoms/injury); only 15.2% (PA) and 15.6% (diet) reported at least one social‐level barrier (e.g. family obligations). About 28.8% (PA) and 29.9% (diet) perceived at least one organisational/environmental‐level barrier (e.g. job demand, cost of F&V). Survivors perceiving individual‐level dietary barriers consumed less F&V (?.65 servings/day) than those not perceiving dietary barriers at this level. Survivors perceiving social‐level dietary barriers reported marginally lower F&V intake (?.65 servings/day) than their counterparts. Those perceiving organisational/environmental‐level PA barriers reported marginally fewer minutes (?44.30/week) of moderate‐to‐vigorous PA than their counterparts. Barriers at multiple levels should be addressed to improve health behaviours among breast cancer survivors.     

基于Watson关怀理论护理改善肺癌患者癌因性疲乏的研究

目的 探讨基于Watson关怀理论护理改善肺癌患者癌因性疲乏的作用.方法 选取2018年1月至2019年1月间陕西省西安市中医医院收治的行同步放化疗的132例非小细胞肺癌患者.根据采用的护理方法 不同进行分组,其中,采用常规护理干预的66例患者纳入对照组,采用基于Watson关怀理论护理干预的66例患者纳入观察组.比较...     

Resilience and well-being in palliative care staff: a qualitative study of hospice nurses' experience of work

Although working with cancer patients is considered stressful, palliative care staff experience similar levels of psychological distress and lower levels of burnout than staff working in other specialties. There are few empirical studies in palliative care to explain this. Since working in a stressful job does not inevitably lead to psychological distress, the antecedent factors that promote resilience and maintain a sense of well-being are worthy of study.This qualitative study used interpretative phenomenological analysis (IPA) to describe hospice nurses' experiences of work. During the analysis, themes emerged relating to the underlying interpersonal factors that influenced the nurses' decisions to begin and continue working in palliative care, and their attitudes towards life and work.The emergent themes were compared with the theoretical personality constructs of hardiness and sense of coherence, and this comparison highlighted many similarities. The nurses showed high levels of commitment, and imputed a sense of meaning and purpose to their work. An area of divergence was their response to change, and this is discussed in relation to hardiness and sense of coherence. The implications for staff well-being, and for staff training and support, which, in turn, may impact on the quality of patient care, are discussed.     

Social support adequacy and depression in older patients with metastatic cancer

Although the highest proportion of cancer patients are over 55 years, the psychosocial aspects of cancer in this age group has received little systematic attention. Many older patients who report psychological distress, especially depressive symptoms, also report a perception of inadequate social support. The primary aim of this study was to examine the relationship between perceived adequacy of social support and depression in a group of older patients with metastatic cancer. The association of social support network variables (e.g. number in household, etc.) with depression was also evaluated. A second study aim was to evaluate the reliability and validity of a measure of social support adequacy, that had been originally developed with college students, for its usefulness with a cancer population. The measure of perceived adequacy of social support used in this study was found to be a reliable and valid measure with older cancer patients. Total perceived adequacy and each of three subtypes (significant other, family and friends) were significantly associated with lower levels of depression. In a multiple regression procedure, both perceived adequacy and network characteristics were significantly associated with less depression. These findings suggest that older cancer patients who are depressed may be good candidates for psychosocial interventions aimed at improving social support and subsequently quality of life.     

Stress and burnout in oncology

This article identifies the professional stressors experienced by nurses, house staff, and medical oncologists and examines the effect of stress and personality attributes on burnout scores. A survey was conducted of 261 house staff, nurses, and medical oncologists in a cancer research hospital, and oncologists in outside clinical practices. It measured burnout, psychological distress, and physical symptoms. Each participant completed a questionnaire that quantified life stressors, personality attributes, burnout, psychological distress, physical symptoms, coping strategies, and social support. The results showed that house staff experienced the greatest burnout. They also reported greater emotional exhaustion, a feeling of emotional distance from patients, and a poorer sense of personal accomplishment. Negative work events contributed significantly to level of burnout; however, having a "hardy" personality helped to alleviate burnout. Nurses reported more physical symptoms than house staff and oncologists. However, they were less emotionally distant from patients. Women reported a lower sense of accomplishment and greater distress. The four most frequent methods of relaxing were talking to friends, using humor, drinking coffee or eating, and watching television. One unexpected finding was that the greater the perception of oneself as religious, the lower the level of burnout. Thus, while the rewards of working in oncology are usually sufficient to keep nurses and doctors in the field, they also experience burnout symptoms that vary by gender and personal attributes. House staff are most stressed and report the greatest and most severe symptoms of stress. Interventions are needed that address the specific problems of each group.     

Quality of Life in Cervical Cancer Survivors and Healthy Women: Thai Urban Population Study

Background : To determine a baseline quality of life (QoL) in cervical cancer survivors compared to that of healthy subjects in the tertiary Thammasat University Hospital, Thailand. Materials and Methods: The investigation was conducted at the outpatient gynecological department of Thammasat University Hospital between January and June 2016. A total of 192 women were entered into the study (97 cervical cancer survivors; 37 after radical hysterectomy (RH), 43 with concurrent chemoradiation (CRT), and 17 featuring both RH and CRT; and 95 control subjects from the same outpatient department with no history of malignancy). Participant QoL was assessed using a Thai version of the EORTC-QLQ-C30 (European Organization for Research Treatment of Cancer Quality-of-Life) and a general survey for the assessment of sociodemographic data was also conducted. Results: There were significant differences in physical, role, emotional and social functions between cervical cancer survivor and control groups. Global health, fatigue, pain, appetite loss, and financial difficulties also demonstrated statistically significant variation. Cervical cancer survivors treated by RH had higher scores for emotional and social function and global health than the control group. Moreover, they had less appetite loss, fatigue and financial difficulties. However, patients treated with CRT experienced more pain than the control group. All cervical cancer survivors had lower physical function scores than the control group. Conclusion: Quality of life in cervical cancer survivors is better than in healthy peers in some domains. Cervical cancer survivors treated with RH may have a better QoL than healthy peers. Early detection for early stage cervical cancer remains most important because treatment in early stages does not cause lowering of the QoL.     

Predictors of quality of life in newly diagnosed melanoma and breast cancer patients.

BACKGROUND: Quality of life (QoL) is a multidimensional construct, and several psychosocial and medical factors can predict a patient's QoL. We investigated the impact of factors in the psychological stress processes on QoL 3 months after diagnosis of melanoma or breast cancer. PATIENTS AND METHODS: In consecutive melanoma and breast cancer patients with localized disease, cancer-specific social support, coping with cancer, personality trait anger expression, non-cancer stress, sociodemographic variables, cancer and treatment variables, and QoL (evaluated as self-reported psychological and physical symptoms, self-perceived QoL, and depression) were assessed with validated quantitative questionnaires. The associations between QoL and the other factors were investigated with multivariate methods. RESULTS: Only a few factors differed between melanoma and breast cancer, in terms of treatment modalities and gender. The amount of received social support was higher among breast cancer patients. The predicting power of psychological stress factors on all the QoL measures was strong, but differed between the treatment groups (surgery only versus adjuvant treatment). Psychosocial factors were the strongest predictors of QoL, not cancer type or treatment. Behavioral Escape-Avoidance coping was associated with worse QoL. However, non-cancer life stresses showed the strongest QoL-decreasing influence. QoL-enhancing factors, including social support, were seen clearly only within the breast cancer patients receiving adjuvant treatment. CONCLUSIONS: QoL of newly diagnosed cancer patients is highly associated with psychosocial factors. Non-cancer life stresses seem to be very important in the QoL of newly diagnosed cancer patients. Adjuvant treatment may comprise supportive psychosocial factors that enhance QoL in cancer.     

Randomized clinical trial of a family intervention for prostate cancer patients and their spouses

BACKGROUND: Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life. The objective of this study was to determine whether a family-based intervention could improve appraisal variables (appraisal of illness or caregiving, uncertainty, hopelessness), coping resources (coping strategies, self-efficacy, communication), symptom distress, and quality of life in men with prostate cancer and their spouses. METHODS: For this clinical trial, 263 patient-spouse dyads were stratified by research site, phase of illness, and treatment; then, they were randomized to the control group (standard care) or the experimental group (standard care plus a 5-session family intervention). The intervention targeted couples' communication, hope, coping, uncertainty, and symptom management. The final sample consisted of 235 couples: 123 couples in the control group and 112 couples in the experimental group. Data collection occurred at baseline before randomization and at 4 months, 8 months, and 12 months. RESULTS: At 4-month follow-up, intervention patients reported less uncertainty and better communication with spouses than control patients, but they reported no other effects. Intervention spouses reported higher quality of life, more self-efficacy, better communication, and less negative appraisal of caregiving, uncertainty, hopelessness, and symptom distress at 4 months compared with controls, and some effects were sustained to 8 months and 12 months. CONCLUSIONS: Men with prostate cancer and their spouses reported positive outcomes from a family intervention that offered them information and support. Programs of care need to be extended to spouses who likely will experience multiple benefits from intervention.     

A Low Fat Diet Rich in Fruits and Vegetables May Reduce the Risk of Developing Prostate Cancer

Background: Diet has been implicated in prostate cancer risk and there is evidence of risk reduction with a ‍healthy diet. The objective of this population-based case control study was to examine whether a low fat diet rich in ‍fruits and vegetables can reduce the risk of developing prostate cancer in Mumbai, India. Methods: Included in this ‍study were microscopically proved cases of prostate cancer diagnosed during 1998 to 2000 and registered by Bombay ‍Population Based Cancer Registry (n=594). The controls were healthy men belonging to the resident general population ‍of Mumbai, India. Two controls for each case matched by age and place of residence were selected as the comparison ‍group. Data on oil/fat consumption, fruits and vegetable consumption and other probable confounding factors were ‍obtained by structured face-to-face interview. After exclusions, 390 cases and 780 controls were available for final ‍analysis and confounding was controlled by multiple logistic regression. Results: 58.7% of the control group consumed ‍more than 3 kg of fruits and vegetables per week compared to 52.1% of the case group. Controlling for age and ‍probable confounding factors, a statistically significant protective effect for prostate cancer was observed for those ‍who consumed fruits and vegetables 2 to 3 kg (OR 0.5, 95%CI 0.3-0.8) and more than 3 kg (OR 0.4, 95% CI 0.3-0.6) ‍per week compared to those who consumed less than 2 kg per week. The linear trend for the protective effect was ‍highly significant with increase in the consumption of fruits and vegetables (p = 0.001). Even though not statistically ‍significant, oil/fat consumption showed an elevated risk (OR 1.7, 95%CI 0.9-3.3) for those who consumed more than ‍2kg of oil/fat per month compared to those who consumed less than 1kg. Conclusion: The findings from this study ‍support the hypothesis that a low fat diet rich in fruits and vegetables may reduce the risk of prostate cancer.     

Quality of life in older people with cancer -- a gender perspective

The aim of this study was to investigate quality of life (QoL) and its association with sense of coherence (SOC), complaints, comorbidity, social resources, perceived economic situation and receiving help for daily living, investigating differences between women and men aged 75 and above with cancer and comparing women and men aged 75 and above without cancer. A further aim was to identify which of these factors were associated with low QoL in older people with cancer. The sample consisted of women (n = 74) and men (n = 76) with the inclusion criteria aged 75 and above and a cancer disease, and a matched comparison group of women (n = 64) and men (n = 74) without cancer. EORTC QLQ C-30, SF-12 and SOC-13 were used. Women with cancer were more vulnerable than their male counterparts in QoL, SOC, perceived economic situation and social resources. Factors associated with low QoL in older people with cancer were receiving help for daily living, comorbidity, degree of complaints and pain. From a caring perspective the findings suggest a focus on symptoms and treatment, to acquire an understanding of how a cancer disease, comorbidity and various complaints affect QoL and independence in older women and men and to intervene accordingly. It also suggests that socio-economic and social problems and needs influence their treatment and care and therefore should be in focus.     

Experiences of Turkish Women with Breast Cancer During the Treatment Process and Facilitating Coping Factors

Background: Breast cancer is the most common type of cancer among women in Turkey and around theworld. Treatment adversely affects women’s physical, psychological, and social conditions. The purpose of thisstudy was to identify the experiences of Turkish women with breast cancer and the facilitating coping factorswhen they receive chemotherapy. Methods: A phenomenological approach was used to explain the experiencesand facilitating factors of breast cancer patients during the treatment period. Data were collected throughindividual semi-structured interviews. The sample comprised 11 women with breast cancer receiving treatment.Results: At the end of the interviews conducted with women with breast cancer, two main themes were identified:adjustment and facilitating coping factors. The adjustment main theme had two sub-themes: strains and coping.Women with breast cancer suffer physical and psychological strains as well as stress related to social and healthsystems. While coping with these situations, they receive social support, turn to spirituality and make new sensesof their lives. The facilitating coping factors main theme had four sub-themes: social support, disease-relatedfactors, treatment-related factors and relationships with nurses. It has been determined that women receivinggood social support, having undergone preventive breast surgery and/or getting attention and affection fromnurses can cope with breast cancer more easily. Conclusions: Women with breast cancer have difficulty in allareas of their lives in the course of the disease and during the treatment process. Therefore, nurses should provideholistic care, teaching patients how to cope with the new situation and supporting them spiritually. Since familysupport is very important in Turkish culture, patients’ relatives should be informed and supported at every stageof the treatment.     

Religious beliefs,social support,self‐efficacy and adjustment to cancer

Purpose: Religious beliefs have received relatively little attention in research on coping with cancer. In this study, the relationship of religious beliefs and perceived social support with adjustment to cancer was studied in a coping model that included self‐efficacy for coping as a mediator. Of particular interest was the relationship between religious beliefs and social support. Method: Data were collected from 164 in‐treatment cancer patients. They completed measures of religious beliefs, social support, physical functioning, self‐efficacy for coping, and adjustment. A model comparison approach was used to assess the fit of models that included or excluded the contribution of religious beliefs while testing the relationship between religious beliefs and social support. Results: Religious beliefs were more strongly connected to perceived social support than with other constructs. Importantly, a coping model that included religious beliefs fit the data significantly better than a model without paths related to religious beliefs. Self‐efficacy partially mediated the relation of age, physical functioning, and perceived support to adjustment, but not religious beliefs. Discussion: Religious beliefs may not directly affect self‐efficacy and adjustment; however, cancer patients who have religious beliefs may experience an enhanced sense of social support from a community with whom they share those beliefs. Copyright © 2009 John Wiley & Sons, Ltd.