Obstacles and facilitators of cancer-related dyadic efficacy experienced by couples coping with non-metastatic cancers

IntroductionCancer-related dyadic efficacy is an individual’s confidence to work together with a partner to conjointly manage the effects of cancer and its treatment. In other health contexts, higher levels of dyadic efficacy have been associated with fewer symptoms of psychological distress and higher ratings of relationship satisfaction. The aim of the current study was to explore patient and partner perspectives on what obstructs and facilitates cancer-related dyadic efficacy.MethodsThese aims were accomplished through a secondary analysis of data collected as a part of a collective qualitative case study. Participants (N = 17 participants) were patients undergoing treatment or recently completed treatment (within 6 months) for a non-metastatic cancer and their partners. To enable in-depth discussions among participants, data was collected through five focus groups. Participants described obstacles and facilitators of dyadic efficacy as dimensions of a common influence. Consistent with these descriptions, reflexive thematic analysis was used to identify influences on cancer-related dyadic efficacy and their subsequent obstructive and facilitative dimensions.ResultsFour main categories of influence with the potential to obstruct or facilitate cancer-related dyadic efficacy were identified along with their subthemes: appraisals of the couple relationship (quality and togetherness), communication (pattern and interest in information), coping (strategy and evaluation), and responses to change (in tasks and roles and sex life). Eight obstructive and seven facilitative dimensions of these subthemes were described.Discussion: This first analysis of obstacles and facilitators of couples’ cancer-related dyadic efficacy capitalized on the experiential expertise of individuals with cancer and their partners. These thematic results are instructive for the design of dyadic efficacy-enhancing interventions for couples coping with cancer

The role of self-compassion in buffering symptoms of depression in the general population

Self-compassion, typically operationalized as the total score of the Self-Compassion Scale (SCS; Neff, 2003b), has been shown to be related to increased psychological well-being and lower depression in students of the social sciences, users of psychology websites and psychotherapy patients. The current study builds on the existing literature by examining the link between self-compassion and depressive symptomatology in a sample representative of the German general population (n = 2,404). The SCS subscales of self-judgment, isolation, and over-identification, and the “self-coldness”, composite score, which encompass these three negative subscales, consistently differed between subsamples of individuals without any depressive symptoms, with any depressive syndromes, and with major depressive disorder. The contribution of the positive SCS subscales of self-kindness, common humanity, and mindfulness to the variance in depressive symptomatology was almost negligible. However, when combined to a “self-compassion composite”, the positive SCS subscales significantly moderated the relationship between “self-coldness” and depressive symptoms in the general population. This speaks for self-compassion having the potential to buffer self-coldness related to depression—providing an argument for interventions that foster self-caring, kind, and forgiving attitudes towards oneself

Examination of the association of sex and race/ethnicity with appearance concerns: A Scleroderma Patient-centered Intervention Network (SPIN) cohort study

Objective: Appearance concerns are common in systemic sclerosis (SSc) and have been linked to younger age and more severe disease. No study has examined their association with sex or race/ethnicity. Methods: SSc patients were sampled from the Scleroderma Patient-centered Intervention Network Cohort. Presence of appearance concerns was assessed with a single item, and medical and sociodemographic information were collected. Results: Of 644 patients, appearance concerns were present in 72%, including 421 of 565 women (75%), 42 of 79 men (53%), 392 of 550 patients who identified as White (71%), 35 of 41 who identified as Black (85%), and 36 of 53 who identified as another race/ethnicity (68%). In multivariate analysis, women had significantly greater odds of reporting appearance concerns than men (odds ratio (OR)=2.97, 95% confidence interval (CI)=1.78-4.95,

The Scleroderma Patient-centered Intervention Network (SPIN) Cohort : protocol for a cohort multiple randomised controlled trial (cmRCT) design to support trials of psychosocial and rehabilitation interventions in a rare disease context

Introduction: Psychosocial and rehabilitation interventions are increasingly used to attenuate disability and improve health-related quality of life (HRQL) in chronic diseases, but are typically not available for patients with rare diseases. Conducting rigorous, adequately powered trials of these interventions for patients with rare diseases is difficult. The Scleroderma Patient-centered Intervention Network (SPIN) is an international collaboration of patient organisations, clinicians and researchers. The aim of SPIN is to develop a research infrastructure to test accessible, low-cost self-guided online interventions to reduce disability and improve HRQL for people living with the rare disease systemic sclerosis (SSc or scleroderma). Once tested, effective interventions will be made accessible through patient organisations partnering with SPIN. Methods and analysis: SPIN will employ the cohort multiple randomised controlled trial (cmRCT) design, in which patients consent to participate in a cohort for ongoing data collection. The aim is to recruit 1500– 2000 patients from centres across the world within a period of 5 years (2013–2018). Eligible participants are persons ≥18 years of age with a diagnosis of SSc. In addition to baseline medical data, participants will complete patient-reported outcome measures every 3 months. Upon enrolment in the cohort, patients will consent to be contacted in the future to participate in intervention research and to allow their data to be used for comparison purposes for interventions tested with other cohort participants. Once nterventions are developed, patients from the cohort will be randomly selected and offered interventions as part of pragmatic RCTs. Outcomes from patients offered interventions will be compared with outcomes from trial-eligible patients who are not offered the interventions. Ethics and dissemination: The use of the cmRCT design, the development of self-guided online interventions and partnerships with patient organisations will allow SPIN to develop, rigourously test and effectively disseminate psychosocial and rehabilitation interventions for people with SSc.(undefined

Validation of the Body Concealment Scale for Scleroderma (BCSS): Replication in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort

© 2016 Elsevier Ltd Body concealment is an important component of appearance distress for individuals with disfiguring conditions, including scleroderma. The objective was to replicate the validation study of the Body Concealment Scale for Scleroderma (BCSS) among 897 scleroderma patients. The factor structure of the BCSS was evaluated using confirmatory factor analysis and the Multiple-Indicator Multiple-Cause model examined differential item functioning of SWAP items for sex and age. Internal consistency reliability was assessed via Cronbach's alpha. Construct validity was assessed by comparing the BCSS with a measure of body image distress and measures of mental health and pain intensity. Results replicated the original validation study, where a bifactor model provided the best fit. The BCSS demonstrated strong internal consistency reliability and construct validity. Findings further support the BCSS as a valid measure of body concealment in scleroderma and provide new evidence that scores can be compared and combined across sexes and ages

Les stratégies d’adaptation associées à la dépression et leur évolution au cours d’un traitement cognitif

Background: Cognitive therapy (CT) aims to help patients recover from depression by teaching them to restructure their distorted thinking and to resolve practical problems in their lives. While studies have examined the role of cognitive variables in the treatment of depression, less research has focused on coping. Objectives: This study aimed to investigate the role of coping in depression, and changes in coping over the course of CT. Methods: Early and late therapy sessions were selected for 45 participants who received CT. Depression was assessed using the Beck Depression Inventory, and coping was assessed using the Coping Patterns Rating Scale. Results: Results indicated that information seeking, problem solving, and helplessness were the most prevalent coping strategies early in therapy; threat-based coping was correlated with depression; accommodation increased with therapy; and change in threat coping was correlated with change in depression. Conclusions: Findings indicate the importance of threat-based coping and of accommodation and delegation in depression and recovery from depression. Research and clinical implications are discussed.Contexte : La thérapie cognitive vise à aider les patients à se remettre de la depression en leur apprenant à restructurer leurs distorsions cognitives et à résoudre des problems pratiques. Bien que des études aient examiné le rôle de plusieurs variables cognitives dans le traitement de la dépression, trop peu de recherche a mis l’accent sur les strategies d’adaptation (coping). Objectifs : Cette étude visait à étudier les stratégies d’adaptation associées à la dépression, ainsi que les changements observés au cours d’une thérapie cognitive. Méthode : Les séances de thérapie cognitive en début et en fin de traitement de 45 participants ont été analysées. La dépression a été évaluée en utilisant l’inventaire de dépression de Beck, et les strategies d’adaptation ont été évaluées en utilisant le CopingPatterns Rating Scale. Résultats : Les résultats indiquent que la recherche d’information, la résolution de problèmes, et l’impuissance sont les stratégies d’adaptation les plus utilisées au début de la thérapie; que l’adaptation fondée sur la menace est corrélée avec la dépression; que l’accommodation augmente avec la thérapie; et que le changement dans les stratégies associées à une perception de menace est corrélé avec le changement dans la dépression. Conclusions : Les résultats indiquent l’importance de l’adaptation fondée sur la menace, de l’accommodation, et de la délégation dans la dépression et le rétablissement subséquent. Les implications cliniques et pour la recherche sont discutées

We think we can: development of the Dyadic Efficacy Scale for Cancer

Background: Measurement advances are needed to enable the study of dyadic-level processes impacting couples coping with cancer. This study sought to develop and empirically examine a Dyadic Efficacy Scale for Cancer (DESC). Cancer-related dyadic efficacy is an individual's confidence to work together with a partner to cope with cancer and its treatment. Methods: The DESC was developed using an exploratory sequential mixed methods design. This paper outlines the psychometric evaluation phase. Individuals with cancer (N = 261) and their partners (N = 217) completed 50 items. Item-level analyses reduced this set to 26 items. Using the dyad as the unit of analysis, confirmatory factor analysis with mirrored patient and partner bifactor structure tested for the presence of a general factor and 3 secondary factors, that is, illness intrusions, patient affect, partner affect. Results: Goodness-of-fit indices supported the identified model, χ2(1170) = 2090, P < .001; RMSEA = .05, P = .14, 90% CI .05–.06; SRMR = .05; CFI = .90. Multidimensionality differed for patients and partners. A general dyadic efficacy factor and secondary factors for managing affect were present for both dyad members, whereas the secondary factor of managing illness intrusions was confirmed for patients only. The model explained 72% and 64% of the variance in patients’ and partners’ dyadic efficacy. Evidence of convergent validity was presented. Conclusions: This study is the first to provide a tool to assess dyadic efficacy among couples coping with cancer. The assessment of cancer-related dyadic efficacy enables new discoveries into couples’ adjustment to cancer

Validation of the English and French versions of the Brief Health Care Climate Questionnaire

Patient autonomy is a central value in medicine and critical component of adherence to medical advice. This article reports on a validation of the 6-item version of the Health Care Climate Questionnaire (HCCQ), a measure of autonomy support in health care settings, in a sample of 242 melanoma patients. The HCCQ showed excellent internal consistency ( α  = .91), structural validity (Tucker–Lewis index = .99; comparative fit index = .99; root mean square error of approximation = .06, 90 per cent confidence interval (.00, .11); standardized root mean square residual = .02; χ 2 (8, N  = 235) = 13.99, p  = .08) and construct validity (92.31% of hypothesized correlations with other measures confirmed). Acceptable 3-month test–retest reliability was observed ( r  = .55, p  < .001; intraclass correlation coefficient ( A , 1) = .54, p  < .001). The French version was found equivalent to the English version