The effectiveness of a rehabilitation programme for Chinese cancer survivors: A pilot study

Cancer survivors have experienced high stress which impairs psychological functioning and decreases quality of life (QOL). This study aims to assess the mediating effect of self‐efficacy on mood disturbance and QOL, and determine the effectiveness of a 12 week rehabilitation programme to improve self‐efficacy as well as improve mood disturbance and QOL in Chinese cancer survivors. A total of 47 cancer patients were randomly assigned into the experimental (n = 24) and control (n = 23) groups. The participants in the experimental group received cancer‐related education, progressive muscle relaxation and emotional support. Self‐reported questionnaires, including General Self‐efficacy Scale (GSES), Profile of Mood States Scale–Short Form (POMS‐SF) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ‐C30) were collected in pre‐ and post‐intervention. Findings from this study indicated that self‐efficacy was a complete mediator between mood disturbance and QOL, and the 12 week rehabilitation programme had a positive effect on self‐efficacy, mood disturbance and QOL for Chinese cancer survivors.     

健康教育对乳腺癌患者负性情绪、社会支持及生活质量的影响

目的 探讨健康教育对乳腺癌患者负性情绪、社会支持和生活质量的影响.方法 将90例乳腺癌化疗患者,随机分为观察组和对照组各45例.对照组进行常规健康教育,观察组同时实施患者和家属个性化的健康教育,包括心理沟通、心理疏导和生活指导.采用Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)和生活质量指数评定量表(QOL)分别于入院时和入院后第4周对2组患者进行评分.结果 健康教育前,观察组与对照组焦虑、抑郁、社会支持和生活质量评分比较无显著差异.健康教育后,焦虑、抑郁、社会支持和生活质量各指标评分观察组显著优于对照组.结论 对腺癌患者和家属同步实施健康教育,可改善患者的负性情绪、提高患者的社会支持水平,全面提高患者的生活质量.     

健康教育对乳腺癌患者负性情绪、社会支持及生活质量的影响

目的探讨健康教育对乳腺癌患者负性情绪、社会支持和生活质量的影响。方法将90例乳腺癌化疗患者,随机分为观察组和对照组各45例。对照组进行常规健康教育,观察组同时实施患者和家属个性化的健康教育,包括心理沟通、心理疏导和生活指导。采用Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）、社会支持评定量表（SSRS）和生活质量指数评定量表（QOL）分别于入院时和人院后第4周对2组患者进行评分。结果健康教育前,观察组与对照组焦虑、抑郁、社会支持和生活质量评分比较无显著差异。健康教育后,焦虑、抑郁、社会支持和生活质量各指标评分观察组显著优于对照组。结论对乳腺癌患者和家属同步实施健康教育,可改善患者的负性情绪、提高患者的社会支持水平,全面提高患者的生活质量。     

Differences in quality of life between American and Chinese breast cancer survivors

Objective

It has been speculated that cancer survivors in Asia may have lower quality of life (QOL) compared with their Western counterparts. However, no studies have made international comparisons in QOL using a comprehensive measure. This study aimed to compare Chinese breast cancer survivors’ QOL with US counterparts and examine if demographic and medical factors were associated with QOL across groups.

Method

The sample consisted of 159 breast cancer patients (97 Chinese and 62 American) who completed the Functional Assessment for Cancer Therapy Breast Cancer (FACT-B) scale before the start of radiotherapy in Shanghai, China and Houston, USA.

Results

Higher income was associated with higher QOL total scores in both Chinese and American cancer patients, but QOL was not significantly associated with other factors including age, education, disease stage, mastectomy, and chemotherapy. Consistent with hypotheses, compared to their US counterparts, Chinese breast cancer survivors reported lower QOL and all four subdimensions including functional well-being (FWB), physical well-being (PWB), emotional well-being (EWB), and social well-being (SWB); they also reported more breast cancer-specific concerns (BCS). Differences were also clinically significant for Functional Assessment for Cancer Therapy General (FACT-G) scale total scores and the FWB subscale. After controlling for demographic and medical covariates, these differences remained except for the SWB and BCS. Furthermore, Chinese breast cancer survivors receiving chemotherapy reported significantly lower FACT-G scores than those who did not, but this difference did not emerge among US breast cancer survivors.

Discussion

Chinese breast cancer survivors reported poorer QOL on multiple domains compared to US women. Findings indicate that better strategies are needed to help improve the QOL of Chinese breast cancer survivors, especially those who underwent chemotherapy.

     

Differences in depression,anxiety, and quality of life between women with and without breast pain prior to breast cancer surgery

Purpose of the researchLittle is known about the relationships between pain, anxiety, and depression in women prior to breast cancer surgery. The purpose of this study was to evaluate for differences in anxiety, depression, and quality of life (QOL) in women who did and did not report the occurrence of breast pain prior to breast cancer surgery. We hypothesized that women with pain would report higher levels of anxiety and depression as well as poorer QOL than women without pain.Methods and sampleA total of 390 women completed self-report measures of pain, anxiety depression, and QOL prior to surgery.Key resultsWomen with preoperative breast pain (28%) were significantly younger, had a lower functional status score, were more likely to be Non-white and to have gone through menopause. Over 37% of the sample reported clinically meaningful levels of depressive symptoms. Almost 70% of the sample reported clinically meaningful levels of anxiety. Patients with preoperative breast pain reported significantly higher depression scores and significantly lower physical well-being scores. No between group differences were found for patients' ratings of state and trait anxiety or total QOL scores.ConclusionsOur a priori hypotheses were only partially supported. Findings from this study suggest that, regardless of pain status, anxiety and depression are common problems in women prior to breast cancer surgery.     

Efficacy of therapeutic group by telephone for women with breast cancer

A pilot study was conducted to test the efficacy of a therapeutic group by telephone conference call for women with breast cancer. Sixty-six women with stage I or stage II breast cancer consented to participate in the study. Participants were randomly assigned to a usual psychosocial care or intervention group, using a permuted block method. Only 2 of 68 patients dropped out of the study, which included 27% African Americans. Assessments at 3 time periods (pretest, immediately after the intervention, and 3 months after the group ended) included evaluation of quality of life (QOL), mood, and immune function. ttests were performed to determine if differences on important variables existed at pretest. The intervention group had worse QOL and mood scores than did the control group on the pretests. A mixed-model repeated-measures procedure controlling for pretest differences was used to analyze data. A significant Group by Time interaction was found for spiritual well-being and mood. These differences were not in the expected direction. The intervention group showed improvement in QOL and mood during the intervention, but showed decompensation following the intervention. Conversely, the control group demonstrated stable or declining scores. This intervention is feasible and practical for women with breast cancer, especially African American participants. The puzzling results suggest several areas for future research, including a better conceptual fit with outcome measures, increasing dosage, and exploration of the value of emotional expression.     

Age-specific correlates of quality of life in Chinese women with cervical cancer

Goals of work  The objective of the study was to examine quality of life (QOL) and its age-specific factors in cervical cancer patients at different stages of life. Materials and methods  One hundred and seventy-three Chinese patients with cervical cancer were surveyed by telephone. QOL was assessed with the WHO Quality of Life Scale—Chinese/Hong Kong (HK) version (WHOQOL-BREF-HK) and compared across age groups. Using multiple regression analyses, demographic and medical factors that were independently associated with QOL outcomes in each age group were identified. Main results  The age groups did not differ in the level of QOL, except for the social relationship domain. Older patients reported poorer social functioning than younger patients. Different factors were associated with QOL outcomes in different age groups. For patients in young adulthood, employment and education level were positively associated with QOL. For patients in midlife adulthood, time since diagnosis and stage of cancer were positively associated with QOL. For patients in aging adulthood, QOL was negatively associated with age, physical morbidity, and a history of termination of pregnancy. However, having a partner and possessing religious belief were positively associated with QOL. Conclusions  Patient’s age had a significant impact on the experience of QOL. Older patients had poorer social relationships than younger patients. Religion seemed to have a protective effect against poor social functioning in aging patients.     

Body esteem and mood among sedentary and active breast cancer survivors

OBJECTIVES: To assess mood states and body esteem in 2 groups of breast cancer survivors, regular exercisers and sedentary women, and to examine these variables among younger and older women in each group. PATIENTS AND METHODS: Between 1998 and 2002, we conducted a cross-sectional study among early-stage breast cancer survivors at the Miriam Hospital in Providence, RI, comparing 40 women who reported regular exercise with 79 sedentary women. We used multivariate and univariate analyses to compare the exercisers with sedentary women on fitness, physical activity, and questionnaire measures of body esteem and mood. Analyses were repeated after the 2 groups were subdivided by age (< 50 years vs > or = 50 years). RESULTS: Regular exercisers (mean +/- SD age, 54.57 +/- 9.18 years) reported significantly more positive attitudes toward their physical condition and sexual attractiveness; significantly less confusion, fatigue, depression, and total mood disturbance; and higher vigor than sedentary women (mean +/- SD age, 52.33 +/- 9.11 years). Both younger and older exercisers had higher physical condition scores than their sedentary peers. Older exercisers reported higher vigor and less confusion, anger, fatigue, depression, and total mood disturbance than sedentary women, regardless of age. Younger exercisers reported higher vigor than their sedentary peers and less confusion than older sedentary women. CONCLUSIONS: In this largely white sample of well-educated women, breast cancer survivors who exercised (particularly older women) reported higher body esteem and better mood than sedentary breast cancer survivors.     

Demographic,medical, and psychosocial correlates to CAM use among survivors of colorectal cancer

Goals of work Complementary and alternative medicines (CAM) use among cancer patients is becoming more prevalent; however, our understanding of factors contributing to patients’ decisions to participate in CAM is limited. This study examined correlates of CAM use among colorectal cancer (CRC) survivors, an understudied population that experiences many physical and psychological difficulties. Materials and methods The sample was 191, predominantly white, CRC survivors (mean age = 59.9 ± 12.6) who were members of a colon disease registry at a NYC metropolitan hospital. Participants completed assessments of sociodemographic characteristics, psychosocial factors [e.g., psychological functioning, cancer specific distress, social support (SS), quality of life (QOL)], and past CAM use (e.g., chiropractic care, acupuncture, relaxation, hypnosis, and homeopathy). Main results Seventy-five percent of participants reported using at least one type of CAM; most frequently reported was home remedies (37%). Younger (p < 0.01) or female patients (p < 0.01) were more likely to participate in CAM than their older male counterparts. Among psychosocial factors, poorer perceived SS (p = 0.00), more intrusive thoughts (p < 0.05), and poorer overall perceived QOL (p < 0.05) were associated to CAM use. In a linear regression model (including age, gender, SS, intrusive thoughts, and perceived QOL), only age remained a significant predictor of CAM use. Conclusion These findings demonstrate that CAM use is prevalent among CRC survivors and should be assessed routinely by providers. CAMs may serve as a relevant adjunct to treatment among CRC patients as well as an indication of need for additional SS, especially among younger patients.     

农民工家庭乳腺癌患者术后焦虑、抑郁状况及影响因素研究

目的 了解农民工家庭乳腺癌患者术后焦虑、抑郁的状况及影响因素,为针对性的护理措施提供依据.方法 采用抑郁自评量表(SDS)和焦虑自评量表(SAS),以方便抽样的方法选取73例农民工乳腺癌术后患者为研究对象作为对照组,以同样方法选取95例当地城市乳腺癌术后患者作为对照组.分别于术后5～7 d对两组患者的焦虑和抑郁状况进行问卷调查结果进行比较.结果 农民工家庭乳腺癌患者术后焦虑、抑郁得分均高于城市乳腺癌患者;不同文化程度、家庭类型、家庭收入的农民工家庭乳腺癌患者的焦虑、抑郁程度不同.结论 农民工家庭乳腺癌术后患者存在较高的焦虑、抑郁情绪,应加强对她们的健康教育,引导其走出心理误区,指导其有效利用社会保障及支持系统,建立宣泄情绪、情感的正常渠道.     

Efficacy of an insomnia intervention on fatigue, mood and quality of life in breast cancer survivors

Title. Efficacy of an insomnia intervention on fatigue, mood and quality of life in breast cancer survivors Aim. This paper is a report of a study to describe the efficacy of cognitive behavioural therapy for insomnia on fatigue, mood and quality of life in breast cancer survivors. Background. Women who receive primary treatment for breast cancer often complain of insomnia. Rarely evaluated in insomnia intervention studies is the effect of cognitive behavioural treatment on the psychosocial outcomes of fatigue, mood and quality of life. Method. Data were collected between December 2002 and March 2004 with 72 women who were at least 3 months post‐completion of primary treatment without current evidence of disease. Women were randomly assigned to either the cognitive behavioural therapy for insomnia group, which received stimulus control instructions, sleep restriction therapy and sleep education and hygiene, or the component control group which received sleep education and hygiene only. The 10‐week study consisted of 2 weeks of pre‐treatment, 6 weeks of treatment and 2 weeks of post‐treatment. Fatigue, mood and quality of life were measured at pre‐ and post‐treatment. Findings. Women receiving cognitive behavioural therapy for insomnia had significant improvements in fatigue, trait anxiety, depression and quality of life. The component control group also had statistically significant increases in quality of life, with a trend suggestive of lower depression at post‐treatment. Conclusion. Globally, as the number of survivors in this population continues to grow, it is imperative that nurses continue testing interventions that may positively affect quality of life and the commonly experienced symptoms of fatigue, anxiety and depression.     

Quality of life in Chinese women with gynaecological cancers

 Sixty-two Hong Kong Chinese women with gynaecological cancers participated in this cross-sectional study to assess their quality of life (QOL). Chinese versions of the World Health Organisation Quality of Life Measure – abbreviated version, the Profile of Mood States, and the Sexual Relationships subscale of the Psychosocial Adjustment to Illness Scale were used. Qualitative data were collected about the meaning of QOL and the areas of life most affected by the cancer and its treatments. The overall QOL was found to be moderate (mean 92.4, SD 16.34), with the domains of psychological health and social relationships most affected. The distressed facets of life were related to pain, dependency, finances, sexuality, psychological health and spirituality. Mobility, accepting one's outlook, social support and "eating" were areas considered by these women to contribute to a better QOL. The meaning of QOL was described in terms of happiness and material resources. The overall mood score was found to be impaired (mean 43.84, SD 32.31), with relatively high scores for depression, anger and tension. Depression could explain 45% of the variance in the QOL. Despite some missing data, sexual relationships among the respondents were moderately affected, with reduced sexual desire and activity. However, the patients' relationships with their husbands were minimally affected, suggesting the men's understanding and support in the cancer trajectory of their wives. Areas of life that may need further support, such as sexual functioning and psychosocial adjustment, could be improved by the use of sex therapy or group support interventions. Limitations of the present study and suggestions for future research are discussed. Published online: 10 May 2000     

Perceived cognitive functioning in breast cancer patients treated with chemotherapy compared to matched healthy women: Evidence from a Portuguese study

Aim

Cognitive concerns are one of the most frequently reported symptoms by breast cancer survivors. This study aimed to evaluate perceived cognitive functioning in Portuguese women with breast cancer treated with chemotherapy.

Methods

A cross-sectional study enrolling 146 women (73 with breast cancer and 73 healthy) was conducted from August to October 2017, invited to participate through online dissemination. Participants completed self-reported questionnaires to collect sociodemographic and clinical data and assess perceived cognitive functioning and psychological adjustment variables (anxiety and depression).

Results

Compared to healthy women, women with breast cancer showed significantly lower scores on the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) subscales and higher levels of depression. Both groups showed significant negative correlations between perceived cognitive functioning and anxiety and depression. Health status and depression seem to better explain perceived cognitive functioning, with health status adding significantly more explained variance beyond sociodemographic and psychological adjustment variables.

Conclusion

The current findings provide evidence for the existence of more cognitive complaints among Portuguese women with breast cancer, compared to healthy individuals. Anxiety, depression, age and education also explain perceived cognitive functioning. Considering that health status and psychological adjustment seem to significantly explain perceived cognitive functioning, special attention should be given by health-care professionals, including nurses, to designing clinical interventions for breast cancer patients to help manage cognitive impairment.     

心理自助教育对乳腺癌术后患者生活质量的影响

目的探讨心理自助教育对提高乳腺癌术后患者生活质量的干预效果。方法将147例行乳腺癌改良根治术的患者随机分为实验组（n=76）和对照组（n=71）。对照组采用常规护理和健康教育,实验组在此基础上统一由经过培训的心理专科护士进行心理自助教育。分别于术后1周和术后3个月采用欧洲癌症研究与治疗组织研制的生活质量核心量表（QLQ—C30）测评其生活质量,比较两组患者干预前后生活质量的差异。结果经心理自助教育后,实验组患者总生活质量的评分从（58．67±22．82）分上升至（74．78±17．49）分;对照组患者随着病程的延长,总生活质量的评分从（55．25±19．71）分下降至（47．07±22．21）分,差异均有统计学意义（P〈0．05）。结论心理自助教育可以提高乳腺癌术后患者生活质量。     

Prostate cancer in African Americans: relationship of patient and partner self-efficacy to quality of life

This study examined the relationship between patient and partner ratings of self-efficacy for symptom control and quality of life (QOL) among 40 African American prostate cancer survivors and their intimate partners. Data analyses revealed that cancer survivors who had rated their self-efficacy for symptom control higher reported better QOL related to urinary, bowel, and hormonal symptoms and better general health QOL (i.e., better physical functioning and better mental health). Data analyses also revealed that partners who rated their self-efficacy for helping the patient manage symptoms as higher reported better QOL (i.e., less negative mood and less caregiver strain). Finally, exploratory analyses indicated that higher self-efficacy in patients was associated with less anxiety and caregiver strain in partners, and higher self-efficacy in partners was associated with better adjustment to bowel and hormonal symptoms and better mental health in patients. The clinical implications of these findings are discussed and future directions for research on self-efficacy in African American prostate cancer survivors are identified.     

亲情延续护理干预对胃癌化疗病人负性情绪及生活质量的影响

[目的]探讨亲情延续护理干预对胃癌化疗病人负性情绪及生活质量的影响。[方法]将84例胃癌化疗病人随机分为观察组及对照组各42例,对照组给予常规护理,观察组给予亲情护理干预,分别于干预前后应用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及胃癌生活质量量表(QOL-C 30)对两组病人负性情绪及生活质量进行评价。[结果]观察组病人干预后HAMA、HAMD评分分别为11.57分±2.65分、10.24分±2.91分,显著低于对照组(P0.05);观察组病人干预后角色功能、躯体功能、情绪功能、社会功能及认知功能评分显著高于对照组(P0.05),而疲乏、恶心呕吐、疼痛评分低于对照组(P0.05)。[结论]亲情护理干预能有效改善胃癌化疗病人负性情绪,提高病人生活质量。     

Influence of symptoms,lung function,mood, and social support on level of functioning of patients with COPD

To explain how symptoms, lung function, mood, and social support affect level of functioning, patients (N = 143) with chronic obstructive pulmonary disease (COPD) completed measures assessing their symptoms (Bronchitis-Emphysema Symptom Checklist), mood (Profile of Mood States), social support (Personal Resource Questionnaire), and functioning (Sickness Impact Profile). Those who were receiving oxygen therapy (n = 52) had significantly lower FEV, scores and experienced significantly poorer functioning than those who were not receiving oxygen therapy (n = 91). Results of path analyses indicated that symptoms and mood directly, and social support indirectly, influenced the functioning of those who were not receiving oxygen. For those who were receiving oxygen, only symptoms directly, and FEV, indirectly, influenced their functioning. These models need to be confirmed using other samples of patients with COPD. ©1995 John Wiley & Sons, Inc.     

多学科协作健康教育对乳腺癌放化疗患者自我效能和心理状况的影响

目的探讨多学科协作健康教育对乳腺癌放化疗患者自我效能和心理状况的影响。方法将200例乳腺癌放化疗患者按住院时间随机分为观察组(2019年1月—2019年6月)102例和对照组(2018年7月—2018年12月)98例,对照组实施常规健康教育,观察组实施多学科协作健康教育,采用自我效能评价量表(GSES)、焦虑和抑郁自评量表(SAS、SDS)对两组患者干预前后自我效能感、心理状态进行评价。结果两组干预前后自我效能评分、焦虑和抑郁评分差异均有统计学意义(P<0.05);干预后,观察组自我效能评分高于对照组(P<0.05),焦虑及抑郁评分均低于对照组(P<0.05)。结论多学科协作健康教育能有效提高乳腺癌放化疗患者自我效能感,改善患者焦虑、抑郁状况。