What Matters Most? Predictors of Quality of Life and Life Satisfaction Among Young Breast Cancer Survivors

BACKGROUND: Younger breast cancer survivors face unique challenges, and research is needed to better understand how to optimize their quality of life (QoL) and satisfaction with life (SwL). OBJECTIVE: The aim of this study was to examine a biopsychosocial model of QoL and SwL in young breast cancer survivors. Biological, psychological, and social/practical factors were hypothesized to be associated with both distressing and adaptive reactions during survivorship, which in turn were hypothesized to be associated with QoL and SwL. METHODS: Young (age = 19-45 years at diagnosis) breast cancer survivors (N = 284) completed an online survey assessing demographic and biopsychosocial factors, QoL, and SwL. Latent variables were created for adaptive and distressing reactions, and structural equation modeling was used to test the hypothesized relationships. RESULTS: The model fit the data (χ2(100) = 332.92, P \u3c .001, comparative fit index = 0.86, root mean square error of approximation = 0.09, standardized root mean square residual = 0.05) and accounted for large proportions of variance in QoL (R2 = 0.86) and SwL (R2 = 0.62). Social support, parenting concerns, and fertility concerns each significantly predicted adjustment. Adaptive reactions positively predicted SwL (β = 0.58, P \u3c .001) but not QoL. Distressing reactions negatively predicted SwL (β = -0.26, P \u3c .01) and QoL (β = -0.87, P \u3c .001). CONCLUSIONS: Adjustment in survivorship mediated the association of social support, parenting concerns, and fertility concerns on QoL and SwL in young breast cancer survivors. IMPLICATIONS FOR PRACTICE: To support the psychological adjustment of young breast cancer survivors, attention should be given to survivors\u27 social context including survivors\u27 available social support and their concerns about fertility and parenting

What Matters Most? Predictors of Quality of Life and Life Satisfaction Among Young Breast Cancer Survivors

BACKGROUND: Younger breast cancer survivors face unique challenges, and research is needed to better understand how to optimize their quality of life (QoL) and satisfaction with life (SwL). OBJECTIVE: The aim of this study was to examine a biopsychosocial model of QoL and SwL in young breast cancer survivors. Biological, psychological, and social/practical factors were hypothesized to be associated with both distressing and adaptive reactions during survivorship, which in turn were hypothesized to be associated with QoL and SwL. METHODS: Young (age = 19-45 years at diagnosis) breast cancer survivors (N = 284) completed an online survey assessing demographic and biopsychosocial factors, QoL, and SwL. Latent variables were created for adaptive and distressing reactions, and structural equation modeling was used to test the hypothesized relationships. RESULTS: The model fit the data (χ2(100) = 332.92, P \u3c .001, comparative fit index = 0.86, root mean square error of approximation = 0.09, standardized root mean square residual = 0.05) and accounted for large proportions of variance in QoL (R2 = 0.86) and SwL (R2 = 0.62). Social support, parenting concerns, and fertility concerns each significantly predicted adjustment. Adaptive reactions positively predicted SwL (β = 0.58, P \u3c .001) but not QoL. Distressing reactions negatively predicted SwL (β = -0.26, P \u3c .01) and QoL (β = -0.87, P \u3c .001). CONCLUSIONS: Adjustment in survivorship mediated the association of social support, parenting concerns, and fertility concerns on QoL and SwL in young breast cancer survivors. IMPLICATIONS FOR PRACTICE: To support the psychological adjustment of young breast cancer survivors, attention should be given to survivors\u27 social context including survivors\u27 available social support and their concerns about fertility and parenting

Optimism, distress, and immunologic status in HIV-infected gay men following hurricane andrew

This study investigated how dispositional optimism relates to psychological and immunologic status in 40 HIV-infected gay men residing in areas of South Florida hard hit by Hurricane Andrew. In the months following the storm, participants’ levels of psychological distress (hurricane-related and overall distress) and antibody titers to several herpesviruses (Herpes Simplex Virus-2, Epstein-Barr Virus [EBV], Cytomegalovirus, and Human Herpes Virus-6 [HHV-6]) were measured. Overall, participants had elevated mean levels of hurricane-specific and general distress. Higher levels of optimism were related to lower levels of depression, overall distress, and hurricane-specific posttraumatic stress disorder symptoms. After controlling for nonspecific polyclonal B cell activation, greater optimism was also associated with lower levels of circulating antibodies to EBV and HHV-6, suggesting better cellular immunologie control over these viruses among optimists. Regression analyses showed that the relation between optimism and lower EBV titers was partially mediated by the lower depression levels experienced by optimists

Effects of stress management on testosterone levels in women with early-stage breast cancer

We examined the effects of a10-week, group-based cognitive-behavioral stressman-agement (CBSM) intervention on serum testosterone levels in women with Stage 1or 2 breast cancer. At 4 to 8 weeks postsurgery, participants were randomized to CBSM (n = 24) or to a wait-list control group (n = 10). Free and total testosterone was assessed via radioimmunoassay before and after the study period. The participants also completed a questionnaire assessing the degree to which living with breast cancer had led to social and emotional benefits in their life. We observed significant decreases in testosterone levels in the CBSM group and no change in the controls. Decreasesintes-tosterone were related to increases in positive contributions. These findings suggest that a short-term psychological intervention can help modulate androgen functioning, and these changes are related to enhanced benefit finding observed among women with breast cancer participating in CBSM

Distress among caregivers of phase I trial participants: a cross-sectional study

Purpose The number of patients with cancer enrolling in phase I trials is expected to increase as these trials incorporate patient selection and exhibit greater efficacy in the era of targeted therapies. Despite the fact that people with advanced cancer often require a caregiver, little is known about the experience of caregivers of people enrolling in oncology phase I clinical trials. We conducted a cross-sectional study assessing the distress and emotion regulation of caregivers of phase I trial participants to inform the design of future interventions targeting the unique needs of this population. Methods Caregivers of oncology patients were approached at the patient's phase I clinical trial screening visit. Caregiver participants completed a one-time survey incorporating validated instruments to comprehensively assess distress and emotion regulation. Basic demographic information about both the caregiver and patient was collected. Results Caregivers exhibited greater distress than population norms. Emotion regulation was also moderately impaired. Respondents identified positive aspects of caregiving despite exhibiting moderate distress. Conclusion Enrollment of a patient in a phase I clinical trial is a time of stress for their caregivers. This pilot study demonstrates the feasibility of engaging caregivers of phase I trial participants and the need to better support them through this component of their caregiving experience. © 2014 Springer-Verlag Berlin Heidelberg