Psychometric properties of the Dutch version of the posttraumatic growth inventory among cancer patients

In the current study, we investigated the psychometric properties of a Dutch translation of the posttraumatic growth inventory in a heterogeneous group of cancer patients. Its original five-factor structure was maintained. The internal consistency of the total scale, as well as its subdimensions, was satisfactory. As expected, the experience of posttraumatic growth was positively related to: emotional expression about the illness, openness to experience, and feelings of innerness. Furthermore, the scale appeared to be sensitive for the demographics age and gender. The experience of posttraumatic growth was not related to negative feelings such as avoidance, anxiety, depression, and neuroticism. Our Dutch translation of the instrument appeared to be a sound measure for the experience of posttraumatic growth in cancer patients.     

Cancer patients and positive sensory impressions in the hospital environment – a qualitative interview study

TIMMERMANN C., UHRENFELDT L. & BIRKELUND R. (2013) European Journal of Cancer Care 22 , 117–124 Cancer patients and positive sensory impressions in the hospital environment – a qualitative interview study This study explores how cancer patients experience the meaning of positive sensory impressions in the hospital environment such as architecture, decoration and the interior. Data were obtained at a general hospital in Denmark by interviewing six cancer patients at two different wards. The analysis process was guided by the hermeneutical–phenomenological theory of interpretation as presented by the French philosopher Paul Ricoeur. Two main themes were identified: to preserve identity and positive thoughts and feelings. The participants experienced that positive sensory impressions in the hospital environment had a significant impact on their mood, generating positive thoughts and feelings. A view to nature also helped them to forget their negative thoughts for a while. The possibility of having a view helped some cancer patients to connect with good memories and personal life stories that enabled them to recall some of their feelings of identity. This paper adds knowledge about how cancer patients experience sensory impressions in the hospital environment. An environment that provides homeliness and offers a view to nature seems to help some patients to preserve their identity. Furthermore, positive sensory impressions and the opportunity for recreation through environmental facilities strengthen the patient's positive thoughts and feelings.     

Positive feelings among terminally ill cancer patients

For a realistic perspective on what it is like to have cancer and be in the last months of life, it is necessary to also study the positive feelings people may still experience. We set out to describe positive feelings experienced by terminally ill patients. The Depression Adjective Checklist was completed by 96 cancer patients with an estimated life expectancy of less than 3 months. On average patients endorsed 30% (3.6/12) of the positive mood items, and 25% (5.4/22) of the negative mood items. The larger part of terminally ill cancer patients with an estimated life expectancy of less than 3 months reported one or more positive mood states. A positive mood state such as 'being interested' was endorsed by more than half (65%) of the patients, other positive feelings were endorsed by a substantial proportion of patients, for example: 38% of patients endorsed feeling 'jovial' and 35% reported being 'optimistic'. Although having incurable cancer often leads to feelings of depression, mood is variable and many patients experience at least some positive feelings.     

Measuring quality of life in oncology: is it worthwhile? I. Meaning,purposes and controversies

This is the first of a two-part paper on quality of life in cancer patients. This part examines some of the fundamental issues in health-related quality of life measurement with particular attention being given to cancer medicine, thus helping to focus the direction and methodological rigour required in future investigations. Relevant topics are discussed to illustrate the importance of quality of life measures in cancer care. A perspective on the meaning of 'outcome' and 'quality of life' are presented to demonstrate the controversies that exist in the field. It is concluded that despite methodological limitations, quality of life measures have a potential role in advancing cancer care.     

Finding meaning in suffering?—Meaning making and psychological adjustment over the course of a breast cancer disease

This study aimed to explore individual meaning systems in the course of a breast cancer disease to test the assumed positive relation between meaning and well‐being and to investigate the relationship between post‐traumatic growth and well‐being. A total of 65 patients with breast cancer were examined 1 year after initial treatment and another year follow‐up. Questionnaires addressed meaning in life (MLQ), anxiety and depression (HADS), satisfaction with life (SWLS), health‐related quality of life (EQ‐5D, EORTC) and post‐traumatic growth (PTGI). Personal meaning systems were assessed using a qualitative method. In the personal meaning systems with well‐being and relationships as the most frequently named meaning categories, the experienced gains far outweigh the losses sustained as a result of the disease. A stronger sense of meaning was related to lower levels of anxiety and depression, a higher level of satisfaction with life and better health‐related functioning. Well‐being and post‐traumatic growth were mostly independent. Reported losses were strongly related to a poorer well‐being. Cancer can induce a process of personal growth, and a strong sense of purpose could facilitate psychological adjustment. The often claimed correlation of post‐traumatic growth and a better psychological adjustment is still lacking clear evidence, whereas losses proofed to be crucial.     

Receiving a diagnosis of inoperable lung cancer: patients' perspectives of how it affects their life situation and quality of life

Lung cancer is a disease with many biomedical and psychological symptoms. The diagnosis and treatment of lung cancer induces adverse effects. Having an inoperable lung cancer there are few possibilities of being cured. Management of patients with inoperable disease is directed at relieving local or systemic symptoms. The purpose of this study is to describe how it affects the patients' life situation and quality of life. Data was collected by qualitative interviews where the patient's lived experiences were articulated. Twenty-three Swedish patients diagnosed and starting palliative treatment for inoperable lung cancer were interviewed. The interviews were audio-taped and transcribed verbatim. Data were interpreted trough interpretive phenomenology. Six themes were identified that were important for the informants' experience of their life situation and quality of life. The themes were: Experience of uncertainty; including time of waiting and thoughts, experience of hope; about a prolonged life, network as support; being treated as the person they are thoughts of death; is there time to conclude their lives?, feelings of shame and guilt; they have caused the disease by themselves and next of kin reactions; sadness, guilt, worries and anger. These six themes gave a structure presenting the essence: Living as usual. Maintaining independency and integrity were important, as well as maintaining status, being treated as the person they always had been and that they experience that they had a meaning to fulfill in life. They were living as usual. The findings of this study point out the importance of improving the care of people afflicted with lung cancer, as well as promoting support for the next of kin, since they are significantly important for these patients' experiences of quality of life. This knowledge and understanding will be useful for development of interventions and guidelines for treatment.     

Les résonances psychologiques de la fin des traitements

This article explores the various symptoms characteristic of post-traumatic depression in cancer patients following treatment. Patients in this depressive state initially describe feelings of a loss of purpose and meaning to life as well as a loss of the ability to experience happiness and self-confidence. Feelings associated with a guilty conscience and with a sense of isolation are sometimes evoked at a later stage. This article allows a distinction to be made between post-traumatic depression and difficulties associated with chronic depression. The unconscious mechanisms underpinning these depressive symptoms are subsequently explored from a dynamic perspective. These mechanisms correspond to the subject’s efforts following treatment to suppress the violent and anxiety-producing emotions that were previously repressed. In a third section, the article explores how the repercussions of cancer on the family and socio-professional environments act to reinforce the patient’s feelings of isolation and failure to be understood. Raising a patient’s awareness of the painful psychological repercussions that can occur when treatment is complete acts as a preventive measure. In conclusion, the article explores therapeutic methods that are effective in treating post-treatment depression in cancer patients.     

Sexual quality of life in women with newly diagnosed breast cancer

Sexual quality of life (QOL) is a significant concern for breast cancer survivors. This study investigated sexual quality of life in a sample of 191 newly diagnosed breast cancer patients. Sixty percent of the sample indicated disruption in their sexual quality of life. Sexual QOL during treatment was significantly more disrupted among women who received chemotherapy, were younger, had higher stage of disease, reported more depressive symptoms near time of diagnosis, and underwent a total mastectomy. Hierarchical linear regression was used to model sexual QOL and feelings of sexual attractiveness. Worse physical quality of life, chemotherapy, and depressive symptoms near time of diagnosis were associated with worse sexual QOL during treatment. An interaction between chemotherapy status and type of surgery, for feelings of sexual attractiveness, suggested that chemotherapy affected sexual attractiveness only among women who underwent a lumpectomy. These results add to growing evidence that sexual QOL is a multidimensional construct with aspects differentially affected by variables related to cancer survivorship.     

Communication and Cancer

Dealing with cancer involves a number of complex communication issues for patients, health professionals, and family members. This article examines over 200 clinical papers and research studies published between 1966 and 1986 that focus on communication dimensions of the cancer experience. The review analyzes communication issues from three p&spectives: the patient, the health orofessional. and the farnilv. The literature indicates that the major dommunicatibn issues for pkients are related to maintaining a sense of control, seeking information, disclosing feelings, and searching for meaning. For health professionals, the primary communication issues center on imparting information, communicating hope, and sharing control. The major issues facing family members pertain to the concealment of feelings, acquiring information, and coping with helplessness. The article also provides a methodological critique of the literature, citing strengths and weaknesses and pointing to directions for future research.     

中晚期肺癌患者生存质量的研究进展

生存质量是不同文化和价值体系中的个体对他们的目标、期望、标准以及所关心事情有关的生活状况的体验。本文通过文献回顾,对中晚期肺癌患者生存质量的评定量表、影响因素以及在临床研究中的应用做一概述,倡导为肺癌患者提供更多的关怀和照顾,提高生存质量。     

中晚期肺癌患者生存质量的研究进展

生存质量是不同文化和价值体系中的个体对他们的目标、期望、标准以及所关心事情有关的生活状况的体验。本文通过文献回顾,对中晚期肺癌患者生存质量的评定量表、影响因素以及在临床研究中的应用做一概述,倡导为肺癌患者提供更多的关怀和照顾,提高生存质量。     

Emotional control in Chinese female cancer survivors

Chinese persons are not known as strong in expressing emotions, especially negative ones. However, being diagnosed with cancer and going through treatment can be an emotionally traumatic experience and cancer patients are supposed to have a stronger need to express these negative feelings. The control of expression of negative emotions such as anger, anxiety and depression in Chinese female cancer survivors (n=139) was examined in the present study using the Chinese version of the Courtauld Emotional Control Scale (CECS). The reliability, internal consistency and validity of the Chinese CECS were comparable to the original English scale. Correlation analyses suggested that cancer survivors with higher emotional control tended to have higher stress, anxiety and depression levels and to adopt negative coping with cancer. Regression analysis showed that emotional control would positively predict stress level even after the effect of depressed mood was under control. Further investigations are suggested in order to elucidate the causal relationships and specific cultural factors affecting emotional control in Chinese cancer survivors and, most importantly, its effect on health outcomes.     

Adjustment to cancer: exploring patients' experiences of participating in a psychodramatic group intervention

The main purpose of the present study was to understand the subjective experience of patients adjusting to cancer by focusing on how that experience might be affected by participating in a psychodramatic group intervention. In‐depth interviews using an interpretative‐phenomenological approach were conducted with eight cancer patients involved in a psychodrama group. Four key themes were identified: (1) outside and inside relationships; (2) identities: nurturing other selves; (3) a feelings' gym: performing the internal world; and (4) many ends: mourning death and dying. Participation in cancer group using a psychodramatic approach provided positive results. In detail, the group setting: (1) favoured relationships in which it was possible to freely express oneself and (2) empowered patients in their feelings of being able to give and receive help; the psychodramatic approach: (1) supported the physical mobilisation of sense of agency and (2) permitted to deal with the grieving process. Cancer healthcare pathways would benefit from psychotherapeutic programmes using a similar approach, since psychodrama by actively involving body seems to works on areas that are often underwhelmed by other approaches, such as (i.e., physical mobilisation, body engagement, grieving adjustment). Psychodrama supports patients to achieve insights into their own possibilities to actively participate in their own life situations despite having cancer and undergoing treatment for it.     

A literature review of adolescence and cancer

Cancer is a relatively rare phenomenon in adolescents and a traumatic experience which arouses feelings of anger, anxiety, fear and sadness. For the adolescent with cancer, there are missed opportunities, not only in daily life but also through lost social events such as dances or football games with friends. Adolescent cancer patients may understand the implications of the diagnosis of cancer but lack the personal resources or life event experience which could equip them to cope and make sense of the many potential problems which may accompany cancer. This paper reviews and explores the literature associated with the adolescent with cancer.     

Music therapy in a comprehensive cancer center

The use of music as a therapeutic tool in health and medicine dates back to ancient times. In modern Western medicine, music therapy has been available since the 1950s and is now often incorporated into conventional medicine care. Music therapy is a common modality that is used in hospital settings as part of complementary and integrative medicine programs. It is also a key therapeutic tool used within most integrative medicine programs at large cancer centers in the United States. When used in conjunction with conventional cancer treatments, music therapy has been found to help patients promote a better quality of life; better communicate their fear, sadness, or other feelings; and better manage stress, while alleviating physical pain and discomfort. In this article, we review the literature on the value of integrating music therapy in cancer care and describe the experience of music therapy at a large comprehensive cancer center and the benefits that patients with cancer obtain from this service.     

Cancer patients' experience of positive and negative changes due to the illness: relationships with psychological well‐being,coping, and goal reengagement

Objective: Most studies in cancer patients on psychological changes focused on positive changes (so‐called ‘posttraumatic growth’), with surprisingly little attention on the possibility that patients may experience both positive and negative changes. This study investigated the relationship between positive and negative changes, and their association with positive and negative affect. We also examined the correlates of positive and negative changes, specifically the role of coping and goal reengagement. Methods: This cross‐sectional study was conducted in 108 patients. We used Pearson correlations and Regression analyses to examine the research questions. Results: Positive and negative changes were relatively unrelated to each other. More positive changes were related to more positive affect, whereas more negative changes were related to more negative affect and less positive affect. Approach coping by more positive reappraisal and goal reengagement was significantly associated with more positive changes. More use of avoidant coping by self‐distraction was related to more negative changes. Conclusions: Patients experienced both positive and negative changes as a result of cancer. These changes were significantly related to patients' well‐being, as well as to their coping and goal reengagement strategies. This knowledge may be incorporated in psychological interventions. Cancer patients can be assisted to learn to acknowledge both positive and negative changes in their life and to approach rather than avoid difficult situations. Patients may also be supported to engage in alternative meaningful goals in life. This is likely to help them find positive meaning. Copyright © 2010 John Wiley & Sons, Ltd.     

膀胱癌患者手术前后生命质量变化及影响因素分析

目的 膀胱癌(bladder cancer,BL)是泌尿系统常见的恶性肿瘤之一,手术是其主要治疗方法.通过分析比较BL患者手术前后生命质量变化及其影响因素,为临床工作开展针对性干预提供证据支持.方法 采用方便抽样方法选取2016-01-01-2017-02-01在山东大学附属省立医院泌尿外科住院的118例BL患者为研究对象.采用癌症患者生命质量测定量表体系中的BL量表QLICP-BL (V2.0)和Herth希望量表,调查118例接受BL手术患者手术前和手术后1个月的生命质量和希望水平,并分析一般人口资料和临床特征与生命质量的相关性.结果 患者手术前后生命质量总分分别为(74.97±11.92)和(74.70±11.51)分,差异无统计学意义,t=-0.39,P=0.694.生命质量中的共性模块(t=-2.09,P=0.039)以及躯体功能(t=-3.61,P＜0.001)、共性症状与副作用维度(t=-2.58,P=0.011)手术后得分显著低于手术前得分,差异均有统计学意义.家庭经济状况、希望水平总分、对现实和未来积极态度对BL患者生命质量具有显著影响.结论 BL患者手术前后生命质量整体处于中等偏上水平,术后早期总体生命质量下降不明显,希望水平对BL患者生命质量有积极作用,通过心理干预和行为指导提高患者希望水平能够改善患者的生命质量.     

The experience of fatigue and other symptoms in patients receiving chemotherapy

Fatigue has been recognized as the most frequently reported symptom of cancer and cancer therapy. There is a lack of research on such aspects as the pattern of fatigue which accompanies treatment, its exacerbating and relieving factors, the different mechanisms of fatigue and its relationship with the factors purported to be related to the fatigue experience. It has been suggested that cancer patients may be those best placed to reveal the likely causes of fatigue. As part of a larger study examining the pattern of fatigue in cancer patients who were undergoing a course of chemotherapy treatment, patients’perceptions of fatigue and tiredness and the nature, pattern and causes of fatigue in relation to cancer and its treatment were obtained. In addition to a diary, interviews were conducted at two time points, at the beginning and end of a cycle of chemotherapy, with over 100 cancer patients. Just under 90% of the sample reported fatigue at some point during a cycle of chemotherapy. The majority of the sample did not consider tiredness and fatigue to constitute the same feelings. Subjects attributed their fatigue to a combination of factors but most frequently mentioned treatment, changes in sleep patterns and other symptoms. Implications for practice and research are outlined.