Psychological and somatic symptoms among breast cancer patients in four European countries : A cross-lagged panel model

Psychological and physical health among women with breast cancer are linked. However, more research is needed to test the interrelations between psychological and somatic symptoms, over time and throughout the different phases of breast cancer treatment, to determine when and which interventions should be prioritized. Six hundred and eighty nine women from four countries (Finland, Israel, Italy and Portugal) completed questionnaires during their first clinical consultation following diagnosis with breast cancer, and again after 3 and 6 months. The questionnaires included self-reported measures of psychological symptoms (Hospital Anxiety and Depression Scale; the Positive and Negative Affect Schedule Short Form) and somatic symptoms [selected items from the International European Organization for Research and Treatment of Cancer (EORTC) questionnaires]. Psychological and somatic symptoms were relatively stable across the three time-points. Cross-lagged paths leading from somatic to psychological symptoms (beta coefficients of 0.08-0.10), as well as vice-versa (beta 0.11-0.12), were found to be significant. No evidence was found for cross-cultural differences in mutual effects of psychological and somatic symptoms. The findings of this study call for tailoring personal interventions for breast cancer patients-either from a somatic perspective or a psychological perspective-and adjust them to the specific experiences of the individual patient.Peer reviewe

Trajectories of Quality of Life among an International Sample of Women during the First Year after the Diagnosis of Early Breast Cancer: A Latent Growth Curve Analysis

The current study aimed to track the trajectory of quality of life (QoL) among subgroups of women with breast cancer in the first 12 months post-diagnosis. We also aimed to assess the number and portion of women classified into each distinct trajectory and the sociodemographic, clinical, and psychosocial factors associated with these trajectories. The international sample included 699 participants who were recruited soon after being diagnosed with breast cancer as part of the BOUNCE Project. QoL was assessed at baseline and after 3, 6, 9, and 12 months, and we used Latent Class Growth Analysis to identify trajectory subgroups. Sociodemographic, clinical, and psychosocial factors at baseline were used to predict latent class membership. Four distinct QoL trajectories were identified in the first 12 months after a breast cancer diagnosis: medium and stable (26% of participants); medium and improving (47%); high and improving (18%); and low and stable (9%). Thus, most women experienced improvements in QoL during the first year post-diagnosis. However, approximately one-third of women experienced consistently low-to-medium QoL. Cancer stage was the only variable which was related to the QoL trajectory in the multivariate analysis. Early interventions which specifically target women who are at risk of ongoing low QoL are needed

Adolescent NSSI and recovery: the role of family functioning and emotion regulation

© The Author(s) 2016. We examined how family functioning and emotion regulation strategies relate to both a history of nonsuicidal self-injury (NSSI) and recovery from NSSI. Participants were 272 adolescents aged between 12 and 18 years (M = 14.50 years, SD = 1.46 years), of whom 17.6% reported a history of NSSI. As expected, poor family functioning was associated with engagement in NSSI. Among the emotion regulation variables, higher use of self-blame and lower use of refocus on planning was associated with NSSI. Self-blame and refocus on planning also mediated the relationship between family functioning and NSSI. Similarly, better family functioning and adaptive emotion regulation were related to recovery, while maladaptive emotion regulation was negatively related to recovery. Adaptive emotion regulation moderated the relationship between family functioning and NSSI recovery. We discuss how family-based interventions combined with emotion regulation education may help deter NSSI engagement

Unmet and under-met needs among Indian parents of children with neurological disorders

Background: Parents of children with neurological disorders commonly report having unmet needs related to their child's care. Mixed methods research is needed with parents of children with neurological disorders in India in order to: 1) quantify which needs are unmet and under-met, and 2) qualitatively explore how parents perceive their unmet and under-met needs. Methods: This concurrent mixed-methods study used a convergence model of triangulation design. Parents of children with neurological disorders receiving treatment in a children's hospital in Hyderabad, India completed questionnaires (n = 205) on unmet/under-met needs. Twenty-five of these parents then completed in-depth interviews exploring experiential aspects of unmet needs. Results: Quantitative analysis suggested that education about the child's illness and medical needs were the most frequent unmet needs. Parents needed their child's condition explained to them (91.7%) and greater continuity of their child's care (85.4%). Qualitative analysis suggested that parents reported struggling to find a specialist who was knowledgeable about their child's condition. Though parents living in rural areas quantitatively reported fewer unmet needs (child's medical care, care coordination, and communication) than parents living in the city (B = 0.92 [95%CI = 0.64,1.20] for medical care needs), the qualitative data showed this may be due to lower expectations from the health system. Conclusion: Parents of children with neurological disorders in India frequently report unmet and under-met needs. Practice implications: Community-based interventions coupled with training nurses on information provision could help bridge the gap between what is offered by hospital systems, and what is needed by parents, in terms of information and support. © 2021 Elsevier Inc

Longitudinal analysis of adolescent NSSI: the role of intrapersonal and interpersonal factors

Non-suicidal self-injury (NSSI) occurs in approximately 10 % of adolescents. To establish effective prevention and intervention initiatives, it is important to understand onset, maintenance and cessation of NSSI. We explored whether the relationships between interpersonal factors (i.e. attachment, social support) and NSSI were mediated by intrapersonal factors (i.e. emotion regulation, self-esteem, self-efficacy). Participants were 1973 students (1414 female and 559 male) aged between 12 and 18 years (M=13.89, SD=0.97) recruited from 40 Australian high schools. Participants completed a questionnaire at two time-points with a 12-month interval. At baseline, 8.3 % of adolescents engaged in NSSI, increasing to 11.9 % at follow-up. Family support was most salient in onset, maintenance and cessation of NSSI. Attachment anxiety was related to NSSI onset. Of the intrapersonal variables, self-esteem and self-efficacy were significant in predicting onset of NSSI. Self-esteem, self-efficacy and cognitive reappraisal mediated the relationship between attachment anxiety and NSSI onset. A combination of interpersonal and intrapersonal variables contributes to the onset, maintenance and cessation of NSSI in adolescence. Perceived family support appears to be an important safeguard against NSSI. Strategies targeting family functioning and teaching cognitive reappraisal techniques to adolescents may reduce the number engaging in NSSI

Grandparents of children with cancer: a controlled comparison of perceived family functioning.

PURPOSE Grandparents can be profoundly emotionally affected when a grandchild is diagnosed with cancer. They also often provide invaluable support for the family (e.g., caring for the sick child and/or siblings). Multigenerational family functioning may therefore change. Limited research has assessed grandparents' perspectives after their grandchild is diagnosed with cancer. In this study, we aimed to (1) assess differences in perceived family functioning among grandparents of a child with cancer and grandparents of healthy children and (2) assess the cancer-specific and demographic factors related to perceived family functioning in grandparents of a grandchild with cancer. PROCEDURE Grandparents of a child with cancer (n = 89) and grandparents of healthy children (n = 133) completed the general functioning, communication, and problem-solving scales of the Family Assessment Device. We used multilevel models with a random intercept to detect (1) between-group differences and (2) identify factors related to perceived family functioning among grandparents with a grandchild with cancer. RESULTS Grandparents with a grandchild with cancer reported poorer family functioning than grandparents with healthy grandchildren. Among the grandparents with a grandchild with cancer, impairments in family functioning were correlated with fewer years since diagnosis, providing care to their sick grandchild and/or siblings and living far away from the sick grandchild. CONCLUSIONS The detrimental impact of childhood cancer likely extends beyond the immediate family members. Including grandparents in interventions-beginning at diagnosis-to reduce distress and increase cohesion for families of a child with cancer is warranted, particularly for grandparents who provide care to their sick grandchild or siblings

Psychological outcomes, coping and illness perceptions among parents of children with neurological disorders

To assess the Common Sense Model among parents of children with neurological disorders, by determining the prevalence of symptoms of anxiety and depression, and how illness perceptions relate to symptoms of anxiety and depression both directly, and indirectly via coping. Design: 205 parents of children with neurological disorders in Hyderabad, India completed questionnaires. Main Outcome Measures: Hospital Anxiety and Depression Scale, Brief Illness Perception Questionnaire and Coping Health Inventory for Parents. We used multiple regressions and PROCESS for SPSS to assess direct and indirect relationships. Results: Mild to severe symptoms of anxiety (41.0%) and depression (39.5%) were common. Symptoms of anxiety and/or depression were related to perceived treatment control over the illness, perceived understanding of the illness, perceived personal control over the illness (anxiety only), and perceived timeline of the illness (depression only). The coping strategy ‘maintaining social support’ mediated the relationship between symptoms of depression and four illness perceptions: perceived consequences (95%CI=.03,-.21), timeline (95%CI=.01,-.25), perceived personal control (95%CI=.02-.24), and treatment control (95%CI=.01-.34). Conclusion: Our findings have implications for education interventions to improve community attitudes of child neurological disorders. Such interventions may allow families’ social networks to provide more support to parents, which could aid parents’ coping strategies

Indian physicians' attitudes and practice regarding menopause and its management: a focus group discussion

OBJECTIVES: To explore Indian physicians' attitudes and practice toward menopause and its management. To contribute to the larger project aimed at developing communication skills and decision aids for Indian physicians and women. METHODS: Using a cross-sectional design, purposive sampling, and a qualitative methodology, 10 Indian physicians (female, 6; male, 4; mean age, 51.5 years) who were practicing either endocrinology or gynecology were recruited to participate in a virtual focus group discussion. Questions explored physicians' attitudes toward menopause and their approach toward addressing menopause and related concerns with their patients. The focus group was analyzed using qualitative content analysis. RESULTS: Three main themes emerged: (1) "The only way to get over it is to accept it": Attitudes toward menopause, (2) "More than menopausal hormone therapy, it is empathy that's required": Physiological and psychological symptom management and (3) Matching the empathic intent with skills: A need for training in the management of menopause. CONCLUSIONS: The study findings underscore the need to introduce Indian physicians to empathic communication skills training, involve, and educate physicians about the international and national clinical guidelines regarding menopausal hormone therapy and alternative therapies, and techniques for distress screening and early referrals. VIDEO SUMMARY: http://links.lww.com/MENO/B17 . Copyright © 2022 by The North American Menopause Society

Pilot testing “Teach Ted”: A digital application for children undergoing blood tests and their parents

Objective: In this pilot study, we evaluated the acceptability and preliminary evidence of the impact of a new educational mobile application, “Teach Ted”, for children undergoing blood tests. Methods: Parents of children (4–10 years) completed questionnaires on anxiety and pain before their child had a blood test, and after using Teach Ted and receiving their blood test. Health professionals at each patient's blood test (e.g. technician/nurse) completed questionnaires on patient outcomes and procedure-related outcomes (e.g. time taken). Results: Nine parents and eight health professionals participated. All but one parent (n = 8/9) reported Teach Ted was useful. Seventy-eight percent (n = 7/9) reported they would use Teach Ted again. All health professionals who completed the acceptability measure (n = 3/3) strongly agreed that Teach Ted was relevant/helpful. Many parents perceived Teach Ted helped reduce their/child's anxiety (n = 3/5, 60% and n = 4/6, 67% respectively), although child's pain and child's/parent's anxiety remained similar before and after using Teach Ted (all p > 0.05). The average blood test duration was 7.6 min (range ≤1 to 22), which health professionals (n = 3/3) reported was not elongated by offering Teach Ted. Conclusions: Participants reported that Teach Ted was acceptable. Further evaluation of Teach Ted's impact on patient's outcomes are needed. Innovation: Teach Ted is an innovative mobile application with potential to educate young children about their upcoming procedure and mitigate negative outcomes