17 research outputs found
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Relationship between social support, quality of life, and Th2 cytokines in a biobehavioral cancer survivorship trial.
ObjectiveBenefits of social support (SS) during cancer survivorship are complex. This study examines change in SS over time in cervical cancer (CXCA) survivors who have completed definitive treatment and how changing SS impacts quality of life (QOL) and T-helper type 2 (Th2) cytokines.MethodsWe conducted a randomized trial in 204 CXCA survivors to test if psychosocial telephone counseling (PTC) could improve QOL compared to usual care (UC). Although PTC did not target SS, data were collected at baseline, 4 and 9 months post-enrollment using the Medical Outcomes Survey Social Support scale. Biospecimens were collected to investigate associations with patient-reported outcomes. Data were analyzed using multivariate linear models and stepwise regression.ResultsParticipants' mean age was 43. PTC participants experienced increasing SS compared to UC at 4 months (PTC-UC = 5.1; p = 0.055) and 9 months (PTC-UC = 6.0; p = 0.046). Higher baseline SS and increasing SS were independently associated with improved QOL at 4 and 9 months after adjusting for patient characteristics (p < 0.05). Differences between study arms were not statistically significant. Improvements in QOL at 4 months were observed with increases in emotional/informational and tangible SS. Increasing SS predicted significant longitudinal decreases in IL-4 and IL-13 at 4 months that were larger in the PTC arm (interactions p = 0.041 and p = 0.057, respectively).ConclusionImproved SS was significantly associated with improved QOL independent of patient characteristics and study arm. Decreasing Th2 cytokines with increasing SS and QOL are consistent with a biobehavioral paradigm in which modulation of the chronic stress response is associated with shifts in immune stance
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Validation of PROMIS emotional distress short form scales for cervical cancer.
ObjectivesCervical cancer patients are at high risk for emotional distress. In this study we evaluate the PROMIS emotional distress-Depression and -Anxiety Short Forms for assessing depression and anxiety in a cervical cancer population.MethodsA 15-item questionnaire was used in a cervical cancer biobehavioral randomized clinical trial, testing psychosocial telephone counseling (PTC) against usual care (UC). It was administered to 204 patients prior to randomization, four months post-enrollment, and nine months post-enrollment, together with legacy measures of depression. The short forms were evaluated in patients participating in this study over three time points for internal consistency, convergent validity, and responsiveness to change over time.ResultsOverall, 45% and 47% of patients scored in the moderate to severe range for anxiety and depression, respectively. Internal consistency coefficients were ≥ 0.95 at baseline, 4 months, and 9 months for depression and anxiety. The average inter-item correlation was 0.65 and 0.73 at baseline assessment for depression and anxiety, respectively. The depression short form T-score was correlated with legacy distress scales ranging from 0.44-0.76, and the anxiety short form ranging from 0.45-0.78. The depression short form demonstrated sensitivity to change as patients randomized to the counseling intervention reported greater improvement over time in depression (p = 0.014), and a nonsignificant improvement in anxiety, compared to the patients receiving usual care.ConclusionsThe PROMIS depression and anxiety short forms reliably and validly assess cervical cancer-specific emotional distress, capture salient features of distress in this population, and perform as well or better than legacy measures
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Supportive use of social media among parents of childhood cancer survivors
Childhood cancer survivors (CCS) face a lifetime of significantly elevated risks for chronic and life-threatening illnesses. The unknown challenges of survivorship contribute to elevated levels of emotional distress for parents of CCS. With few clinical supportive resources available, parents of CCS are more frequently turning to online social media for peer support. Because social media have become increasingly important to parents, they represent a critical context in which parents access and share CCS-related support. To date, little research exists on the supportive use of social media among parents of CCS. Thus, an explanatory sequential mixed- methods design was used to (1) examine the relation between social media use of parents (age >18) of young CCS (age <13; >1 year out of treatment), parent social media peer relationships— operationalized as a composite measure, online social integration (OSI)—and parent emotional distress; (2) describe the parent transition into survivorship and identify potential points for social media interventions in that transition; and (3) identify and describe the experiences of seeking, joining, and interacting in cancer-related social media platforms. Quantitative results showed that social media use was positively associated with OSI (rs = 0.29; p<0.01), and also positively associated with parent depression when controlling for OSI (β = .28, p < 0.01). However, bootstrapping mediation analyses provided evidence that OSI competitively mediates the relationship between social media and depression among parents (c = -.12, 95% CI -0.03, -0.21) in such a way that it offsets the potentially deleterious relationships between social media use and depression. Qualitative findings first showed that parents experienced the transition off cancer treatment as uniquely distressing and ideal for supportive interventions because it represents a disruption of the hard-won safety represented by regular clinical relationships. Second, parents shared a common process of supportive social media use that culminated in sharing informational, emotional, appraisal, and experiential support with experientially similar parents on disease-specific Facebook groups. The findings from this research provide a foundation for developing and evaluating targeted, low-cost, and exportable social media interventions that improve survivorship outcomes for parents and children affected by cancer
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Supportive use of social media among parents of childhood cancer survivors
Childhood cancer survivors (CCS) face a lifetime of significantly elevated risks for chronic and life-threatening illnesses. The unknown challenges of survivorship contribute to elevated levels of emotional distress for parents of CCS. With few clinical supportive resources available, parents of CCS are more frequently turning to online social media for peer support. Because social media have become increasingly important to parents, they represent a critical context in which parents access and share CCS-related support. To date, little research exists on the supportive use of social media among parents of CCS. Thus, an explanatory sequential mixed- methods design was used to (1) examine the relation between social media use of parents (age >18) of young CCS (age <13; >1 year out of treatment), parent social media peer relationships— operationalized as a composite measure, online social integration (OSI)—and parent emotional distress; (2) describe the parent transition into survivorship and identify potential points for social media interventions in that transition; and (3) identify and describe the experiences of seeking, joining, and interacting in cancer-related social media platforms. Quantitative results showed that social media use was positively associated with OSI (rs = 0.29; p<0.01), and also positively associated with parent depression when controlling for OSI (β = .28, p < 0.01). However, bootstrapping mediation analyses provided evidence that OSI competitively mediates the relationship between social media and depression among parents (c = -.12, 95% CI -0.03, -0.21) in such a way that it offsets the potentially deleterious relationships between social media use and depression. Qualitative findings first showed that parents experienced the transition off cancer treatment as uniquely distressing and ideal for supportive interventions because it represents a disruption of the hard-won safety represented by regular clinical relationships. Second, parents shared a common process of supportive social media use that culminated in sharing informational, emotional, appraisal, and experiential support with experientially similar parents on disease-specific Facebook groups. The findings from this research provide a foundation for developing and evaluating targeted, low-cost, and exportable social media interventions that improve survivorship outcomes for parents and children affected by cancer
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Validation of PROMIS emotional distress short form scales for cervical cancer.
ObjectivesCervical cancer patients are at high risk for emotional distress. In this study we evaluate the PROMIS emotional distress-Depression and -Anxiety Short Forms for assessing depression and anxiety in a cervical cancer population.MethodsA 15-item questionnaire was used in a cervical cancer biobehavioral randomized clinical trial, testing psychosocial telephone counseling (PTC) against usual care (UC). It was administered to 204 patients prior to randomization, four months post-enrollment, and nine months post-enrollment, together with legacy measures of depression. The short forms were evaluated in patients participating in this study over three time points for internal consistency, convergent validity, and responsiveness to change over time.ResultsOverall, 45% and 47% of patients scored in the moderate to severe range for anxiety and depression, respectively. Internal consistency coefficients were ≥ 0.95 at baseline, 4 months, and 9 months for depression and anxiety. The average inter-item correlation was 0.65 and 0.73 at baseline assessment for depression and anxiety, respectively. The depression short form T-score was correlated with legacy distress scales ranging from 0.44-0.76, and the anxiety short form ranging from 0.45-0.78. The depression short form demonstrated sensitivity to change as patients randomized to the counseling intervention reported greater improvement over time in depression (p = 0.014), and a nonsignificant improvement in anxiety, compared to the patients receiving usual care.ConclusionsThe PROMIS depression and anxiety short forms reliably and validly assess cervical cancer-specific emotional distress, capture salient features of distress in this population, and perform as well or better than legacy measures
A Multi-Modal Family Peer Support-Based Program to Improve Quality of Life among Pediatric Brain Tumor Patients: A Mixed-Methods Pilot Study
Background: Pediatric brain tumor (PBT) survivors and their families are at risk for diminished psychosocial and quality of life outcomes. Community-based programs that leverage peer support in the context of integrative modalities such as traditional Chinese medicine (TCM) represent a promising avenue for meeting the multidimensional needs of survivors and their families. Methods: Parents and children were enrolled in a 12-week program that included weekly group TCM, a moderated private Facebook support group designed through social support and modeling theory, and weekly parent-only health behavior education and yoga. Process measures and quantitative and qualitative survey data was collected to gauge participant adherence, acceptability, and satisfaction, as well as exploratory outcomes. Results: Eleven parents completed surveys at all time points. Six of nine families attended at least 80% of the group TCM sessions, and eight of nine families interacted in the Facebook support group at least five days a week. Parents reported high levels of satisfaction and perceived benefits for the program. Baseline emotional distress, health behaviors, and QoL measurements improved during the three-month intervention. Qualitative data indicated parents perceived both in-person and the Facebook group peer support contributed to the benefits of the program. Conclusion: This feasibility study demonstrated that a multimodal peer support-based intervention that included in-person and online group interaction is feasible and acceptable to parents of pediatric brain tumor patients. Further research on interventions for caregivers that include in-person and online group-based peer support is warranted, with the goal of exploring similar outcomes in other childhood cancer diagnoses