Investigation of Factors Associated with Psychological Symptoms and Posttraumatic Growth in Women with Breast Cancer

Breast cancer is a traumatic experience. Those diagnosed with breast cancer often experience psychological symptoms such as depression, anxiety, and stress. However, traumatic experiences do not only cause psychological symptoms, but also can lead to positive changes named as posttraumatic growth (PTG). In the present study, it was aimed to examine both the psychological symptom (depression, anxiety, stress) and PTG levels of women with breast cancer and the relationship of these variables with core beliefs challenge and rumination types. Sociodemographic and Cancer-Related Information Form, Depression Anxiety Stress Scale-21, Posttraumatic Growth Inventory, Core Beliefs Inventory, and Event-Related Rumination Inventory were applied to 201 women with breast cancer diagnosis (Mage = 47.81, SD = 8.58), mediation relations of variables were examined with Process Macro. As a result of the analysis, it was determined that the psychological symptom levels of the majority of the participants were low and their PTG levels were above medium. It was determined that core beliefs challenge positively predicted depression, anxiety, stress, and PTG. Intrusive rumination mediated the relationship between core beliefs challenge and depression, anxiety and stress; deliberate rumination mediated the relationship between core beliefs challenge and PTG. In other words, as the core belief challenge of the participants increase, both psychological symptom and PTG levels increase. In addition, those who use intrusive rumination experience more psychological symptom, and those who use deliberate rumination experience more PTG. The present study reveals the importance of cognitive processes in understanding the psychological symptoms and PTG in women with breast cancer. Keywords: Breast cancer, psychological symptom, posttraumatic growth, core belief challenge, event-related rumination

Symptom clusters in patients with colorectal cancer after colostomy: a longitudinal study in Shanghai

Objective Research is lacking regarding the experiences of patients after colostomy, which is needed so as to take necessary specific actions. In this study, we aimed to describe the trajectory of symptom clusters experienced by patients after colostomy over time. Methods This was a longitudinal observational study using data from 149 patients with colorectal cancer after colostomy. We investigated symptoms and symptom clusters at 2 weeks, 1 month, 3 months, 6 months, and 1 year after colostomy. Results Four main symptom clusters were identified, including a psychological symptom cluster, digestive and urinary symptom cluster, lack of energy symptom cluster, and pain symptom cluster in patients after colostomy in the first year after surgery. We further explored the symptom trajectory. Conclusions We explored symptom clusters and the trajectory of symptom resolution in patients after colostomy during the first year after surgery. Four stages were proposed to describe the different statuses of symptom clusters experienced by patients. Our findings may provide insight into how to improve symptom management and postoperative quality of life for patients after colostomy.

What Happens Next? Conducting Research With Cancer Survivors Who Discontinue Their Post-Treatment Care

Due to improvements in screening, diagnosis, and treatment, more cancer patients are surviving and living longer. For them, survivorship care provides critical support: surveillance and screening for recurrence and new cancers; physical and psychological symptom management; social and financial management support; management of other chronic conditions; and preventive health and health promotion support. Yet, our pilot data indicates that a substantial number of survivors discontinue their survivorship care with the treating oncology team, a team that often provides critical multidisciplinary support and expertise. While it is important to understand the experiences, outcomes, and needs of these survivors, they can be challenging to engage in research. In this presentation, we will discuss survivors who discontinue, why they might do so, and methods for engaging them in research, drawing upon our work with head and neck cancer survivors.

The Influence of Staff-Resident Interactions on Resistiveness to Care Behavior in Assisted Living

Resistiveness to care (RTC) is a behavioral and psychological symptom of dementia that is common among dementia residents in assisted living facilities. RTC encompasses verbal and nonverbal behaviors that oppose care, such as crying, grabbing, hitting, or yelling, among many other resistive behaviors. The quality of care interactions which can be positive, neutral or negative, have been associated with increased RTC. The purpose of this study was to test the association between quality of care and RTC. This was a secondary data analysis using baseline data from the Function-Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT) implementation study. Controlling for cognition, age, gender, medication use, and comorbidities, it was hypothesized that quality of care interactions would be associated with resistiveness to care. A linear regression analysis was conducted to test the hypothesis. The sample included 794 participants the majority of whom were white women with a mean age of 89.48 (SD=7.61). The mean RTC was .09 (SD=.41, range 0-13) and the mean quality of care interactions were 5.96 (SD=1.44, range 0-7). Based on the regression analysis there was no significant association between quality of care and RTC. These findings may be due to the high quality of care provided and limited RTC in this sample. Ongoing research is needed, however, to continue to explore these relationships and assure that all RTC is being reported among staff and that there is no evidence of negative quality of care interactions in these settings.

Clinical Analysis of Risk Factors of Postoperative Psychiatric Disorders in Patients With Adult Craniopharyngioma

Objective: To analyze the risk factors relative to postoperative psychiatric disorders in adult patients with craniopharyngioma.Methods: A retrospective case-control study design was used in this study. The Neuropsychiatric Inventory–Questionnaire (NPI-Q) assessment tool was used to assess psychiatric disorders in postoperative patients with craniopharyngioma at Beijing Tiantan Hospital from January 2018 to December 2020. The relationship between the psychiatric disorders and basic demographic data as well as several risk factors, such as the tumor characteristics (tumor location, tumor size, pathological finding of the tumor, etc.) and treatment-related factors (the extent of the resection), were analyzed.Results: A total of 173 patients were included in this study. The prevalence of psychiatric disorders was 14.5% among adult craniopharyngioma patients. Irritability represented the most common type of psychological symptom (64%, n = 16), followed by agitation (36%, n = 9), and delusions (28%, n = 7). The risk factors relative to postoperative psychiatric disorders that were identified were a tumor volume larger than 7 cm3 (HR = 3.292, P = 0.042), tumor location (P = 0.003), hypothalamic invasion (HR = 9.766, P = 0.036), and gross-total resection (HR = 0.085, P = 0.042).Conclusion: Neurocognitive assessment and intervention before and after surgery are important in patients with larger tumors, invading the third ventricle, and tumors with hypothalamic invasion. Prediction of these risk factors is essential for the treatment.

Longitudinal Follow-Up of Death Anxiety and Psychophysical-Symptom Experience of Participants in the Silent Mentor Program

This study assessed death anxiety (Death Anxiety Questionnaire, DAQ) and psychophysical- (psychological and physical) symptom experience following cadaveric dissection among the Silent Mentor Program (SMP) participants before thawing (T1), after the suturing, dressing and coffining session (T2), and one month post-program (T3). There was a significant decline in the total DAQ score comparing T1 and T2 ( t = 7.69, p < 0.001) and T2 and T3 ( t = 5.00, p < 0.001) and T1 and T3 (t = 10.80, p < 0.001). There was a significant reduction in total psychological-symptom score comparing T1 and T2 ( t = 4.92, p < 0.001) and between T1 and T3 ( t = 4.85, p < 0.001). However, for the physical-symptom experience, a significant increase in the physical-symptom score between T1 and T2 ( t = –3.25, p = 0.001) was reported but the scores reduced significantly one month after the program (T2–T3; t = 4.12, p < 0.001). The mentoring concept of the SMP program has beneficial effects on improving attitude towards death and psychophysical-symptom experience associated with cadaver dissection.

The German version of the Body Image Scale: Validation among a sample of cancer survivors

Objective: To translate the cancer-specific Body Image Scale (BIS) into German and to validate the translated version by assessing its psychometric properties. Methods: The state-of-the-art translation of the BIS was tested in (i) a psychosocial cancer counselling center in Leipzig and (ii) oncological wards in Berlin, Germany. Composite reliability and factor structure were investigated using confirmatory factor analysis. Item response theory (IRT)-based analyses were performed. Convergent validity was assessed via correlation with another body image questionnaire (BAS) as well as psychological symptom burden (PHQ-9, GAD-2 and DT). Psychosocial and clinical group differences were assessed using t-tests. Results: 677 patients participated (response rate 78%). Composite reliability was 0.92 and the average variance extracted was above 50%. All items had a discriminating power above the established threshold of b = 0.5 and showed optimal discriminatory power at relatively high severity levels of body image disturbance (BID) (b = 0.89-2.06). Test information was highest in patients with moderate BID ( = 1.36). The BIS was negatively correlated with the BAS (r = -0.62, p &lt; 0.001) and positively with psychological symptom burden (e.g. PHQ-9: r = 0.49, p &lt; 0.001). Patients who were younger, female, had undergone chemotherapy and those who were distressed by fatigue, their appearance or sexual problems had significantly higher BID. Conclusions: The German version of the BIS is a valid tool to assess BID in patients with cancer. Normative data are needed to better interpret individual scores within the clinical context.

Multidimensional Symptom Burden among Patients with Hemodialysis in Indonesia

Patients with hemodialysis commonly experience multiple symptoms. Most of the previous studies analyzedthe symptoms as one dimension such as the severity dimension. Conducting the comprehensive symptomassessment among patients with hemodialysis is necessary to gain a better understanding of the symptom burden.The aim of this study was to identify symptom burden among patients with hemodialysis comprehensively.This study was a descriptive study. A convenience sample of 320 patients undergoing hemodialysis was recruitedfrom the dialysis units at two referral hospitals in Indonesia (Fatmawati Hospital and Cipto MangunkusumoNational Hospital). Indonesian Version of Chronic Kidney Disease – Symptom Burden Index (CKD-SBI) wasused. For the data analysis, descriptive analysis was used. Total 320 subjects were collected. This study foundthat lack of energy was the highest physical symptom burden under 4 dimensions: occurrence 269 (84.0%),severity (mean = 4.28, SD = 3.08), distress (mean = 4.42, SD = 3.09), and frequency (mean = 4.41, SD = 3.27).Furthermore, decreased interest in sex was the highest psychological symptom burden under for dimensions:occurrence 210 (65.6%), severity (mean = 3.39, SD = 3.38), distress (mean = 2.92, SD = 2.99), frequency(mean = 3.70, SD = 3.65). Lack of energy and decreased interest in sex were consistently the highest symptomburden among patients with hemodialysis. Creating appropriate interventions and managing the symptomsexperienced by patients with hemodialysis comprehensively is very important to improve their quality of life.