Profiles of Posttraumatic Growth and Posttraumatic Stress Symptoms in Childhood Cancer Survivors.

The experience of childhood cancer (CC) could be a traumatic event that produces long-term emotional responses such as posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) in survivors. The relationship between both PTSS and PTG is not clear in CC survivors. Assessing challenges to core beliefs and rumination could give information regarding the different paths that lead to traumatic responses. Thus, this study aims to identify childhood cancer survivors' profiles from PTSS and PTG measures and to examine the pathways of relationships between PTSS and PTG, rumination, and challenge to core belief. Sixty-two CC survivors completed surveys on their childhood cancer experience, PTSS, PTG, challenge to core beliefs, and rumination. High PTG scores among childhood cancer survivors (Cluster 1), High PTSS scores among childhood cancer survivors (Cluster 2), and Childhood cancer survivors without changes (Cluster 3). Network analysis found that the challenge to core beliefs is the central point in the relationship between the variables, in a direct and positive relationship with PTG. We found an indirect path from challenge to core beliefs to PTSS, mediated by intrusive and deliberative ruminations. The combined findings suggested that there are different profiles related to trauma in CC survivors and the relationship between PTSS and PTG is mediated by the challenge to core beliefs and deliberative and intrusive rumination.

Illness perceptions in childhood cancer survivor and caregivers' dyads.

Surviving childhood cancer is a difficult experience for children and their caregivers, it can produce long-term emotional distress. Illness perceptions refer to the way people understand the different aspects related to illness from their individual and collective experiences. OBJECTIVE: to compare the illness perceptions of adolescent childhood cancer survivors and their caregivers and examine the relationship between illness perception of childhood cancer survivors, their caregivers, and sociodemographic, illness, and treatment variables. Forty-three survivor-caregiver dyads (the mean age of a survivor 17.05 years old; the mean age of caregivers 47.53 years old) participated in the study and answered the Brief Illness Perception Questionnaire (Brief IPQ) and Demographics data. RESULTS: Results showed significant differences in the illness perceptions of survivors and caregivers. Caregivers presented more negative cognitive perceptions than survivors (t = -6.701, p < 0.001), especially in the identity dimension (t = -4.327, p < 0.001), and more negative emotional perceptions than survivors (t = -4.132, p < 0.001), both in concern (t = -3.695, p < 0.001) and emotional representation (t = -3.466, p < 0.001). No significant correlations were found between survivors' and caregivers' illness perceptions and sociodemographic illness variables. CONCLUSION: These findings showed that even though dyads went through cancer together, survivors' and caregivers' perceptions of childhood cancer are different, indicating the need to better understand how children growing up with a chronic disease develop such illness perceptions and their experience.

Assessing the Relationship between PTSS in Childhood Cancer Survivors and Their Caregivers and Their Quality of Life.

Childhood cancer is a traumatic experience for survivors and their families. The experience of this disease affects survivors' and families' quality of life, even years after it occurs. The purpose of the present study was to assess if the caregivers' posttraumatic stress symptoms mediated the associations between survivors' posttraumatic stress symptoms and caregivers' quality of life, in a sample of 46 dyads of caregivers and childhood cancer survivors. Survivors and caregivers completed the PCL-5, and caregivers completed the WHOQOL-bref. Results showed that survivors' and caregivers' posttraumatic stress symptoms scores and caregivers' quality of life were associated. The caregivers' posttraumatic stress symptoms mediated the relationship between survivors' posttraumatic stress symptoms and caregivers' quality of life. Knowing posttraumatic stress symptoms direct and indirect effects on caregivers' quality of life contributes to understand their experience and to develop intervention strategies with this population.

Psychometric Properties of the Brazilian Version of the Revised Illness Perception Questionnaire for Healthy Women (IPQ-RH) / Propriedades Psicométricas da Versão Brasileira do Questionário de Percepção da Doença Revisado para Mulheres Saudáveis (IPQ-RH) / Propriedades Psicométricas de la Versión Brasileña del Cuestionario de Percepción de la Enfermedad Revisado para Mujeres Sanas (IPQ-RH)

Abstract The Common Sense Model refers to the association between disease perception and health behaviors. This study aimed to analyze the psychometric properties of the Revised Illness Perception Questionnaire for Healthy People - (IPQ-RH) in healthy women about breast cancer. A total of 321 women participated, with a mean age of 55.72 years old (SD = 10.75), users of Basic Health Units. Confirmatory factor analyzes (CFAs) were carried out and the McDonald's Omega and Cronbach's alpha coefficients were calculated. The results of the CFAs confirmed the structure of seven factors for the IPQ-RH (CFI = .92; TLI = .91; RMSEA = .03; SRMR = .06) and of two factors for the subscale of causes of the disease (CFI = .97; TLI = .97; RMSEA = .00; SRMR = .05). The instrument's reliability was, in general, satisfactory. The IPQ-RH has appropriate psychometric properties to investigate the illness perception in healthy women.

Resumo O Modelo do Senso Comum aponta para a associação entre a percepção da doença e comportamentos em saúde. Este estudo teve por objetivo examinar as propriedades psicométricas do Questionário de Percepção da Doença para Pessoas Saudáveis - Revisado (IPQ-RH) em mulheres saudáveis sobre o câncer de mama. Participaram 321 mulheres, com idade média de 55,72 anos (DP = 10,75), usuárias de Unidades Básicas de Saúde. Foram realizadas análises fatoriais confirmatórias (AFCs) e calculados os coeficientes Ômega de McDonald e alpha de Cronbach. Os resultados das AFCs confirmaram a estrutura de sete fatores para o IPQ-RH (CFI = .92; TLI = .91; RMSEA = .03; SRMR = .06) e de dois fatores para a subescala de causas da doença (CFI = .97; TLI = .97; RMSEA = .00; SRMR = .05). A fidedignidade do instrumento foi, em geral, satisfatória. O IPQ-RH apresenta propriedades psicométricas adequadas para investigar a percepção da doença em mulheres saudáveis.

Resumen El modelo del Senso Comum refiere que existe una asociación entre percepción dela enfermedad y conductas em salud. El objetivo de la investigación fue examinar las propiedades psicométricas del Cuestionário de Percepción de la Enfermedad para personas sanas - Revisado (IPQ-RH) en mujeres sanas con respecto al cáncer de mama. Participaron 321 mujeres, con edad media de 55,72 años (DP = 10,75), usuarias de la atención primaria en salud. Fueron realizadas análisis factoriales confirmatórias (AFCs) y calculados los coeficientes Omega de McDonald y alpha de Cronbach. Los resultados de las AFCs confirmaron la estructura de siete factores para el IPQ-RH (CFI = 0.92; TLI = 0.91; RMSEA = 0.03; SRMR = 0.06) y de dos factores para la subescala de las causas de la enfermedad (CFI = 0.97; TLI = 0.97; RMSEA = 0.00; SRMR = 0.05). La fiabilidad del cuestionario fue, en general, satisfactoria. El IPQ-RH presenta propiedades psicométricas adecuadas para investigar la percepción de la enfermedad en mujeres sanas.

Beliefs about childhood cancer: perceptions of survivors and mothers / Crenças sobre o câncer infantil: percepção de sobreviventes e mães / Creencias sobre el cáncer en niños: percepción de sobrevivientes y madres

Beliefs regarding a disease refer to mental schemes people construct based on their direct or indirect experiences and that are related to their health behavior and self-regulation. Such beliefs help childhood cancer survivors understand their behavior in their follow-up treatment. This study's purpose was to examine the beliefs concerning childhood cancer among 27 survivors and 49 mothers, who completed sociodemographic surveys and questionnaires addressing disease perceptions via an online platform. Results reveal that mothers, more frequently than survivors, perceived childhood cancer as a chronic disease with cyclical symptoms, with more negative consequences and emotional representations. The mothers also reported having greater understanding regarding the disease and more strongly believed in personal and treatment control in comparison to survivors. The conclusion is that the fact that survivors more positively perceived childhood cancer may indicate they re-signified their experiences in an adaptive manner.

As crenças sobre a doença referem-se a esquemas mentais que as pessoas constroem a partir de sua experiência direta ou indireta e que se relacionam com o seu comportamento em saúde e autorregulação. Em sobreviventes de câncer infantil, as crenças ajudam a compreender seus comportamentos no período pós-tratamento. Objetivou-se examinar as crenças sobre o câncer infantil em 27 sobreviventes e 49 mães que responderam a questionários sociodemográficos e de percepção da doença numa plataforma on-line. Os resultados apontaram que as mães perceberam o câncer infantil como uma doença crônica, com sintomas cíclicos, com consequências e representação emocional mais negativas que os sobreviventes. Ainda, as mães referiram compreender os aspectos relacionados à doença e acreditam no controle pessoal e do tratamento num nível mais elevado que os sobreviventes. Conclui-se que o fato de os sobreviventes perceberem o câncer infantil de maneira mais positiva pode indicar uma ressignificação da experiência de forma adaptativa.

Las creencias sobre la enfermedad se refieren a esquemas mentales que las personas construyen a partir de su experiencia directa o indirecta y que se relacionan con su conducta en salud y autorregulación. En sobrevivientes de cáncer en la niñez, sus creencias ayudan a comprender sus conductas en el periodo post-tratamiento. El objetivo fue examinar las creencias sobre el cáncer en la niñez en 27 sobrevivientes adultos jóvenes y 49 madres que contestaron a cuestionarios sociodemográfico y de percepción de la enfermedad en un sitio web. Los resultados mostraron que las madres percibieron el cáncer en la niñez como una enfermedad crónica, con síntomas cíclicos, con consecuencias y representación emocional más negativa que los sobrevivientes. Además, las madres refirieron comprender la enfermedad y creer en el control personal y del tratamiento a un nivel más alto que los sobrevivientes. Se concluye que el hecho de que los sobrevivientes perciban el cáncer en la niñez de manera más positiva pueda indicar una nueva significación de la experiencia de manera positiva.

Breast cancer prevention: what women think about the illness, its risks and self-care / Prevenção do câncer de mama: o que as mulheres pensam sobre a doença, seus riscos e autocuidado / Prevención del cancer de mama: qué piensan las mujeres sobre la enfermedad, sus riesgos y el autocuidado

Background: Early detection of breast cancer (BC) is important to reduce mortality rates. To prevent BC, women should adopt self-care behaviors. This study aimed at examining risk and illness perception and self-care of healthy women regarding breast cancer. Methods: Participants were 211 women (M=59.11 years, SD=8.54) and with no personal history of the illness, selected by convenience. Measures were a sociodemographic, clinical and health behavior questionnaire, illness perception and risk perception questionnaires. Nonparametric statistics (Spearman) was employed to analyze the relationship between illness perception, risk perception and sociodemographic variables. The open answers to the causes of the illness were classified according to the content analysis. Results: We found a relationship between risk and illness perception and self-care in healthy women regarding BC. It was identified that women had reasonable illness coherence (M=3.18) and considered the illness more timeline chronic than timeline acute (M=3.22), reasonable timeline cyclical (M=3.56), with severe consequences for health (M=4.22), and reasonably threatening (M=3.15). Conclusions: BC and risk perception and self-care are interrelated variables among healthy women.

Introdução: A detecção precoce do câncer de mama (CM) é importante para reduzir as taxas de mortalidade. Para preveni-lo, a mulher deve adotar comportamentos de autocuidado em saúde. Esse estudo objetiva examinar a percepção de risco, a percepção da doença e o autocuidado de mulheres saudáveis com relação ao CM. Método: Participaram 211 mulheres (M=59,11 anos; DP=8,54) sem histórico de CM selecionados por conveniência. Os instrumentos foram questionário de dados sociodemográficos, clínicos e de comportamento em saúde, questionários de percepção da doença e percepção de risco. Estatística não paramétrica (Spearman) foi utilizada para analisar a relação entre percepção da doença, percepção de risco e variáveis sociodemográficas. As respostas abertas sobre as causas da doença foram classificadas segundo análise de conteúdo. Resultados: Observou-se que existe relação entre a percepção de risco e da doença, e autocuidado em mulheres saudáveis. Identificou-se que as mulheres têm razoável percepção de entendimento da doença (M=3.18), a consideravam mais crônica que aguda (M=3.22), razoavelmente cíclica (M=3,56), com consequências graves à saúde (M=4,22), e relativamente ameaçadora (M=3,15). Conclusões: A percepção do CM, a percepção de risco e o autocuidado são variáveis inter-relacionadas em mulheres saudáveis.

Introducción: La detección precoz del câncer de mama (CM) es importante para reducir los índices de mortalidade. Para prevenirlo, la mujer debe adoptar conductas de autocuidado en salud. El objetivo es examinar la percepción de riesgo, la percepción de la enfermedad y el autocuidado de mujeres sanas con relación al CM. Método: Participaron 211 mujeres (M=59,11 años; DP=8,54), sin histórico de CM seleccionadas por conveniencia. Los instrumentos fueron cuestionário de datos sociodeográficos, clínicos y de conductas em salud, cuestionários de percepción de la enfermedad y percepción de riesgo. Estadística no paramétrica (Spearman) ha sido utilizada para examinar la relación entre percepción de la enfermedad, de riesgo y variables sociodemográficas. Las preguntas abiertas sobre las causas de la enfermedad fueron clasificadas a través de análisis de contenido. Resultados: Se observó que existe relación entre percepción de riesgo y de la enfermedady el autocuidado em mujeres sanas. Se identifico que las mujeres tienen razonable percepción de comprehensión de la enfermedad (M=3,18), la consideran más crónica que aguda (M=3,22), razonablemente cíclioca (M=3,36), con consecuencias graves a la salud (M=4,22) y relativamente amenazadora (M=3,15). Conclusiones: la percepción del CM, la percepción de riesgo y el autocuidado son variables inter-relacionadas em mujeres sanas.

Saúde mental e câncer infantil: a relação entre sintomas de TEPT de sobreviventes e mães / Mental health and childhood cancer: the relationship between PTSD symptoms in survivors

Vivenciar o adoecimento e o tratamento de câncer infantil pode ser uma experiência permeada por estresse para a criança e para as mães. Respostas emocionais negativas podem ocorrer durante o tratamento e também após a remissão clínica, incluindo o Transtorno de Estresse Pós-Traumático (TEPT). O objetivo do estudo foi examinar e comparar a sintomatologia de TEPT de mães e sobreviventes de câncer infantil. Metodologia: delineamento ex-post-facto. Participaram sobreviventes de câncer infantil (N=27, idade média = 23,1 anos) e mães de sobreviventes (N=49, idade média = 43,8). A coleta de dados foi realizada através de um link com um formulário eletrônico contendo a ficha de dados sociodemográficos e clínicos e o PCL-C. Os resultados revelaram diferença significativa na sintomatologia revivência (X2=4,494ª; p≤0,05) e excitabilidade (X2=4,055ª; p≤0,05) entre mães e sobreviventes, indicando uma maior frequência de mães que apresentam esses sintomas quando comparadas com os sobreviventes. Esses resultados apontam que prejuízos para a saúde mental podem ser maiores para as mães que para os sobreviventes. O fato da sintomatologia de revivência ser menor para os sobreviventes que para as mães pode indicar a sua relação com memória do evento traumático. É importante que sobreviventes e mães que passaram pela experiência do câncer na infância sejam acompanhados com atenção pela equipe multidisciplinar a fim de prevenir transtornos mentais como o TEPT.(AU)

Illness and treatment of childhod cancer can be an experience permeated by stress both for the cildren and their mothers. Negative emotional responses may occur during treatment, and also after clinical remission, including Post Traumatic Stress Disorder (PTSD). The aim of the study was to examine and compare the PTSD symptoms of mothers and survivors of childhood cancer. Methodology: ex-post-facto design. Participants were survivors of childhood cancer (N = 27, mean age = 23.1 years) and their mothers (N = 49, mean age = 43.8). The data collection was performed through a link with an electronic form containing the sociodemographic and clinical data sheet and the PCL-C. The results revealed a significant difference in the symptoms of reliving (X2 = 4,494ª; p≤0,05) and arousal (X2 = 4,055ª; p≤0,05) among mothers and survivors, indicating a higher frequency of mothers presenting these symptoms when compared with survivors. These results show that mental healt impairments may be greater for the mothers than for the survivors. The fact that the reliving symptomatology is lower for the survivora tham for the mothers may indicate its relation with the memory of the traymatic event. It is important that survivors and mothers who have had the experience of childhood cancer are closely followed by the multidisciplinary team to prevent mental disorders such as PTSD.(AU)

Causal attribution among women with breast cancer

Abstract Causal attribution among women with breast cancer was studied. The study included 157 women outpatients with breast cancer. A form for sociodemographic and clinical data and the Revised Illness Perception Questionnaire (IPQ-R) were used. The results showed that women attributed breast cancer primarily to psychological causes, which does not correspond to known multifactorial causes validated by the scientific community. Providing high quality, patient-centered care requires sensitivity to breast cancer women’s beliefs about the causes of their cancer and awareness of how it can influence patient’s health behaviors after diagnosis. If women with breast cancer attribute the illness to modifiable factors then they can keep a healthy lifestyle, improving their recovery and decrease the probability of cancer recurrence after diagnosis. (AU)