Personal Resources and Total Pain: Exploring the Multiple Mediation of Fear of Recurrence, Meaning-Making, and Coping in Posttreatment Cancer Patients.

BACKGROUND: People with cancer who have completed treatment still experience negative effects, such as an increased risk of experiencing cancer-related pain. Psychological factors tend to influence cancer patients' ability to cope with pain in various dimensions. Although personal resources are an important factor in buffering total pain, still little is known about the intervening variables and underlying mechanisms. PURPOSE: The current study examined the relationship between psychological flexibility, self-esteem, and total pain, while considering fear of recurrence, meaning-making, and coping as potential mediating factors. METHODS: Adults (N = 304) who completed medical treatment (radiotherapy, chemotherapy, and combined therapy) participated in this study. They completed questionnaires measuring the aforementioned variables. Structural equation models were used to examine mediation effects. RESULTS: Psychological flexibility, and partly self-esteem, were negatively related to the dimensions of total pain. However, to a large extent, these relationships were serially and parallelly mediated by fear of recurrence, meaning-making, and emotion-oriented coping. CONCLUSIONS: Consistent with the meaning-making model, cognitive (meaning-making), and affective (fear of recurrence and emotional coping) factors may be potential mechanisms underlying the association between psychological flexibility, self-esteem, and total pain in posttreatment cancer patients. In this study, they tended to interact in the area of physiological and psychosocial experiences of cancer-related pain.

A significant number of cancer patients who undergo medical treatment tend to experience pain as a consequence of medical and psychological factors. Personal resources such as psychological flexibility and self-esteem can play important roles in the pain experiences of cancer patients, including their physical, psychological, social, and spiritual symptoms. However, other factors related to anxiety and coping can also affect the relationships mentioned above. Therefore, we examined whether fear of recurrence, meaning-making, and coping serially mediated the relationships between psychological flexibility, self-esteem, and total pain in posttreatment cancer patients. A total of 304 cancer patients (159 women, 145 men) who had completed medical treatment participated in our study. Patients with higher psychological flexibility experienced lower physical, psychological, social, and spiritual pain, whereas patients with higher self-esteem felt only lower physical pain. Furthermore, posttreatment cancer patients characterized by well-defined goals and self-worth experienced lower fear of recurrence and were able to find meaning and emotionally cope with their daily predicament. As a consequence, they felt less total pain in physical, psychological, social, and spiritual dimensions. Experiencing lower fear of cancer recurrence combined with finding meaning and goals predisposes patients to more effectively deal with pain symptoms.

Perceived and Received Social Support and Illness Acceptance Among Breast Cancer Patients: The Serial Mediation of Meaning-Making and Fear of Recurrence.

BACKGROUND AND PURPOSE: The literature indicates connections between social support and acceptance of a personal diagnosis of breast cancer, but these relationships are likely to be mediated due to numerous connections between social support and illness acceptance with meaning-making and fear of recurrence. We decided to investigate whether meaning-making and fear of recurrence serially mediated the relationship between perceived and received social support and illness acceptance. METHODS: The current research examined 246 adult women patients with a breast cancer diagnosis who were undergoing radiotherapy/chemotherapy treatment in oncological hospitals. This cross-sectional study based on a mediational model was reported according to the STROBE checklist. RESULTS: Our results supported the mediational model in which meaning-making and fear of recurrence serially mediated the relationship of both perceived and received social support with illness acceptance. Furthermore, the mediating power of meaning-making was more significant than the fear of recurrence. CONCLUSION: Meaning structures and anxiety played an important mediating role in breast cancer patients. Finding additional meaning and goals and experiencing lower fear enables the patients to effectively make use of social support and accept their illness. PRACTICE IMPLICATIONS: The current study identified factors that increase illness acceptance among breast cancer patients as it showed that patients can gain a greater understanding of the nature of their illness by becoming more aware of their own goals and values and reduce anxiety by learning about their current state of the illness.

Breast cancer is the most common cancer in women in the world, and the hardships of the cancer experience are considered potentially traumatic events associated with psychological effects. One of the most important factors responsible for the patient's daily functioning is illness acceptance. Therefore, we investigated whether meaning-making and fear of recurrence serially mediated the relationship between perceived and received social support and illness acceptance. We examined 246 adult women patients with a breast cancer diagnosis. In our study, patients with breast cancer who received more social support had a better understanding of their illness and lower fear of recurrence. Moreover, women with breast cancer characterized by a sense of purpose and optimism experienced lower anxiety about a potential relapse of the disease. Meaning structures and anxiety played an important mediating role in breast cancer patients. Finding additional meaning and goals and experiencing lower fear enables the patients to make use of social support and accept their illness effectively.

The Role of Religious Comfort and Strain on Social Well-Being among Emerging Adults in Poland: Serial Mediation by Meaning Making Processes.

Religious struggles tend noticeably to influence the sphere of social well-being in emerging adulthood as individuals modify their religious beliefs and practices, form personal identity patterns, and rediscover new life purpose and values. The aim of the current study was to investigate whether meaning-making and meaning in life (presence and search) can serially mediate the hypothesized links between religious comfort vs. strain and social well-being. Self-report measures of religious struggles, meaning-making, meaning in life, and social well-being were completed by 368 emerging adults (aged 18 to 29, 52.2% female). The serial mediation analysis showed that the relationship between religious comfort vs. strain and social well-being was mediated by meaning-making and presence of meaning, but not by a search for meaning. These results suggest that religious struggles may represent unique aspects of developmental spiritual processes in emerging adulthood with implications for social well-being.

Marital satisfaction, partner communication, and illness acceptance among couples coping with breast cancer: A dyadic approach.

OBJECTIVE: Associations between marital satisfaction and illness acceptance are mediated by different factors. This study examines whether partner communication mediates relationships between marital satisfaction and illness acceptance among couples coping with breast cancer within a dyadic approach. METHODS: One hundred and thirty-six couples were examined: 136 women with a diagnosis of breast cancer and their 136 spouses without a history of cancer. Questionnaires measuring marital satisfaction, partner communication, and illness acceptance were used. SEM analysis was applied to examine mediation effects. RESULTS: For the patients, marital satisfaction was positively associated with supportive self-communication, supportive partner communication, and illness acceptance. For the spouses, marital satisfaction was positively correlated with supportive self-communication and supportive partner communication, yet, it was negatively correlated with deprecating communication of both self and partner. The associations between marital satisfaction and illness acceptance were mainly mediated by supportive communication (self and partner). CONCLUSIONS: An examination of partner communication within a dyad is crucial for understanding relationships between marital satisfaction and illness acceptance in breast cancer patients. These relationships predominantly depend on the supportive communication of cognitive and emotional information between the spouses.

Risk Perception of COVID-19, Religiosity, and Subjective Well-Being in Emerging Adults: The Mediating Role of Meaning-Making and Perceived Stress.

The pressured experienced due to COVID-19 for young people has become clearly visible in the domain of well-being. Although the psychological effects of the COVID-19 pandemic on emerging adults have been examined, little is known about the role played by risk perception and religiosity for their well-being. In addition, the mediating effects of meaning-making and perceived stress still need to be investigated. A total of 316 emerging adults (143 males and 173 females) participated in the present study. Using structural equation modeling (SEM) analysis, we showed that the relationship of risk perception of COVID-19 and religiosity with subjective well-being was largely mediated by meaning-making and perceived stress. However, their mediational roles were different and depended on the interplay of perceptual and religious factors, which can be more fully understood within the meaning-making model. Emerging adults tend to rely on both their personal evaluation of COVID-related risks and religious beliefs to the extent that it helps them understand current life situations and restore cognitive and emotional balance.

Modeling psychological well-being among abdominal and pelvic cancer patients: The roles of total pain, meaning in life, and coping.

OBJECTIVE: Relationships between pain and well-being are mediated by a variety of factors. This study examines a serial mediating role of meaning in life and coping in the relationship of total pain with psychological well-being in abdominal and pelvic cancer (APC) patients. Total pain is understood in terms of physical, psychological, social, and spiritual components interacting upon one another. METHODS: Adult patients diagnosed with the APC (N = 333) who were undergoing radiotherapy/chemotherapy treatment in two inpatient units of university hospitals completed questionnaires measuring total pain, psychological well-being, meaning in life, and coping. SEM analysis was used to examine serial mediation effects. RESULTS: All the dimensions of total pain were negatively associated with presence of meaning, coping strategies, and psychological well-being. In contrast, the pain dimensions were positively associated with search for meaning. Presence of meaning, search for meaning, emotion- and meaning-focused coping were serial mediators in the relationship between total pain and psychological well-being. CONCLUSIONS: Our results strongly suggests that a holistic examination of pain among patients with cancer is important for several reasons. They also indicate that psychological well-being is significantly influenced by the serial interplay of personal meaning structures and coping abilities.

Religiosity and social support in Polish older adults: the mediating role of wisdom. Perspectives on Lars Tornstam's theory of gerotranscendence.

Objectives: The purpose of this study was to examine whether wisdom is a mediator in the relationships between religious meaning system and social support among older adults. According to the theory of gerotranscendence, associations of religiousness and social support are complex and suggest the existence of wisdom in their internal structures.Method: The study included 466 persons aged 50-75. Three measures were used: Religious Meaning System Scale (RMSS), Three-Dimensional Wisdom Scale (3D-WS) and Berlin Social Support Scales (BSSS).Results: The analyses allowed for a partial verification of the hypothesis that wisdom is a mediator in the relationship between the religious meaning system and the multidimensional social support in late adulthood. It was confirmed that wisdom mediates the relationship between the religious meaning system and three out of the five dimensions of social support (perceived available support, actually received support and protective buffering support). Conclusion: These findings suggest that wisdom is an important element of religious meaning system and social support that is used by people as a part of their maturing into gerotranscendence to cope with life's difficulties and challenges.

Disclosure to God as a Mediator Between Private Prayer and Psychological Well-Being in a Christian Sample.

Although a number of studies have reported the psychological and physical benefits of prayer, only a few have examined the means by which prayer affects health. Winkeljohn Black et al. (J Relig Health 54(2):540-553, 2015. https://doi.org/10.1007/s10943-014-9840-4 ) found disclosure to God as a mediator in the relationship between prayer and mental health. In their study, the authors used Poloma and Pendleton's (Rev Relig Res 31(1):46-53, 1989. https://doi.org/10.2307/3511023, ) model of prayer. This study examined whether disclosure to God as a mediator can be upheld with Laird et al.'s (Int J Psychol Relig 14(4):251-272, 2004) prayer model. The study included 285 Polish adults (50.2% of women), aged between 18 and 60 years. The Multidimensional Prayer Inventory, the Revised Distress Disclosure Index, and the Psychological Well-Being Scale were applied to the research. The results showed that the prayer of thanksgiving correlated positively and the prayer of supplication negatively with well-being. Two indirect effects were significant, indicating disclosure to God as a mediator of the confession-well-being link and the supplication-well-being link.

Religiosity, Meaning-Making and the Fear of COVID-19 Affecting Well-Being Among Late Adolescents in Poland: A Moderated Mediation Model.

Adolescents have come to be greatly affected by the COVID-19 pandemic and the ensuing containment measures in recent months. The aim of the present study was to examine the relations among religiosity, meaning-making, fear of COVID-19, and subjective well-being within a moderated mediation model. Three hundred and sixteen late adolescents (173 women and 143 men) in Poland volunteered to take part in the study. The results show that meaning-making mediated relationships between religiosity and life satisfaction, religiosity and positive affect, and religiosity and negative affect. In addition, these mediation effects were moderated by the fear of COVID-19. Specifically, the indirect effects were stronger for adolescents with high fear than for those with low fear, which indicates that fear of COVID-19 serves as a 'warning' factor.

The Religious Meaning System and Resilience in Spouse Caregivers of Cancer Patients: A Moderated Mediation Model of Hope and Affect.

The character of the relationship between religiosity and resilience depends to a large extent on mediation and moderation mechanisms which rely on cognitive and emotional processes. Research conducted within hope theory and the broaden and build theory indicates that hope and affect can mediate and moderate this relationship. The present study explored whether the relationship of the religious meaning system with resilience in spouse caregivers of cancer patients can be mediated by hope and simultaneously moderated by positive and negative affect. A total of 241 spouse caregivers completed a set of questionnaires. The results revealed that hope mediated the relationship between the religious meaning system and resilience. Furthermore, positive affect but not negative affect moderated the indirect effect of the religious meaning system to resilience through hope.

Illness perception and affective symptoms in gastrointestinal cancer patients: A moderated mediation analysis of meaning in life and coping.

OBJECTIVE: The character of the mediational relations between illness perception and affective symptoms often depends on the coping strategies used by patients. For example, these relationships may be moderated by meaning in life that plays a buffering role against the negative consequences of cancer. This study examined moderated mediation effects of meaning in life and coping on the relationship between illness perception and affective symptoms in cancer patients. METHODS: In this cross-sectional research, 317 gastrointestinal cancer patients who were undergoing chemotherapy, radiotherapy, or combined therapy treatments were examined. They completed measures of illness perception, affective symptoms, meaning in life, and coping. Data were analyzed using SPSS software and the PROCESS macro. RESULTS: Illness perception was negatively associated with meaning in life and problem- and meaning-focused coping but was positively associated with affective symptoms: fear, depression, and irritability. Two coping strategies-problem- and meaning-focused-mediated the relationship between illness perception and affective symptoms. Meaning in life turned out to be a moderator of the indirect effects of illness perception on affective symptoms through problem- and meaning-focused coping. CONCLUSIONS: The relationship of illness perception with affective symptoms is embedded in moderated mediation effects of meaning in life and coping. It implies that emotional adjustment to the illness depends on the interplay between the ways in which cancer patients perceive their illness and the coping strategies used by them.

Religious comfort and anxiety in women with cancer: The mediating role of hope and moderating role of religious struggle.

OBJECTIVE: Religiosity is an important source of consolation among individuals suffering from cancer. However, religion does not always bring comfort. Religious struggles elicit stress. We examined whether religious comfort predicts anxiety in patients diagnosed as having cancer. Hope was examined as a mediator and religious struggle as a moderator in this relationship. METHODS: In this cross-sectional, descriptive-analytical research, 77 Polish women with cancer were selected using sequential convenience sampling. Data were collected using the Religious Comfort and Strain Scale, the Adult Hope Scale, and the State-Trait Anxiety Inventory. A statistical procedure using Pearson's correlation coefficient and multiple regression was employed. RESULTS: Religious comfort correlated negatively with anxiety (.007) and positively with hope (.006). Hope correlated negatively with anxiety (.011). Hope was a mediator in the relationship between religious comfort and anxiety: indirect effect (IE) = -0.07; 90% CI, -0.161 to -0.001. Patients who derive more comfort from religion feel stronger hope and, consequently, lower anxiety. The index of moderated mediation (IMM) was significant when we introduced fear-guilt as a moderator: IMM = 0.07; 90% CI, 0.001-0.007. Thus, the effect of religious comfort on anxiety reduction through hope is bigger if the experience of religious fear-guilt is smaller. CONCLUSIONS: Religion appears to protect against developing anxiety because it enhances hope. However, religious guilt can stop cancer patients from using their religious resources.

Sense of coherence mediates the relationship between the religious meaning system and coping styles in Polish older adults.

OBJECTIVES: The links between religiousness and coping are complex, and previous research indicates that they may be mediated by coherence-related structures. The aim of this study was to examine whether sense of coherence (SOC) is a mediator in the relationships between the religious meaning system and coping styles in Polish older adults. METHOD: In this study, 212 older adults (118 women and 94 men) participated. Their ages ranged from 65 to 79 years (M = 71.04; SD = 2.26). The group was a representative sample of Polish older adults in terms of social status, gender, and age. They completed three measures: the Religious Meaning System Questionnaire, the Sense of Coherence Scale (SOC-29), and the Coping Inventory for Stressful Situations. RESULTS: Findings showed that the religious meaning system had significant relationships with SOC and three coping styles: emotion-oriented coping, avoidance-oriented coping, and social diversion. In addition, SOC mediated the relations between the religious meaning system and three coping styles: the emotion-oriented, avoidance-oriented, and social diversion. CONCLUSIONS: The positive associations between meaning-oriented religiousness, SOC, and coping styles imply that their underlying mechanisms are based on the structures of significance and comprehension. The character of mediational relations (i.e. mediator vs. suppressor) depended on the emotional and social coping strategies used by older adults.

Religiousness, spirituality, and coping with stress among late adolescents: A meaning-making perspective.

The purpose of this study was to examine the associations between religiousness, spirituality (R/S), and coping among late adolescents within a meaning-making perspective. Specifically, global meaning and situational meaning were examined as potential mediators. Two hundred and twenty one Polish participants (115 women and 106 men) completed the Religious Meaning System Questionnaire, the Self-description Questionnaire of Spirituality, the Meaning in Life Questionnaire, and the Situational Meaning Scale. Results of SEM analysis showed that R/S had both direct and indirect effects on coping, suggesting that global meaning and situational meaning served as partial mediators among late adolescents. The mediating role of global meaning and situational meaning may be more fully understood within the framework of the meaning-making model. Consistent with the model, individuals with higher levels of R/S had a propensity to experience stronger global meaning in life and situational meaning, which in turn contributed to more frequent using coping styles.

The Role of Meaning in Life Within the Relations of Religious Coping and Psychological Well-Being.

The purpose of this study was to examine whether meaning in life understood in terms of presence, search, and personal meaning is a mediator in the relationships between religious coping and psychological well-being. Associations of religiousness and psychological well-being are complex and suggest the existence of meaning and purpose in their internal structures. Two studies were conducted. In Study 1, presence of meaning in life was a mediator between negative coping and psychological well-being in the scope of a total score and all its dimensions. Search for meaning in life did not mediate the above relations. In Study 2, personal meaning turned out to be a partial mediator between negative coping and psychological well-being. These findings suggest that meaning in life is a crucial element of religious coping and psychological well-being that is used by people as a part of their meaning system to cope with life's difficulties and challenges.

Total Pain and Fear of Recurrence in Post-Treatment Cancer Patients: Serial Mediation of Psychological Flexibility and Mentalization and Gender Moderation.

Background: The research indicates that painful experiences can significantly affect the fear of cancer recurrence among cancer survivors, which is a distressing concern that influences both physiological and psychological recovery. This cross-sectional study aims to advance our comprehension of the associations between total pain and the fear of recurrence in post-treatment cancer patients by examining two potential mediators: psychological flexibility and mentalization. Methods: Three hundred and thirty-five participants (aged 22 to 88, 49.1% female) who had finished their cancer treatment completed self-report assessments of total pain, their fear of recurrence, psychological flexibility, and mentalization. Results: The serial mediation analysis showed that all dimensions of total pain were positively and indirectly related to the fear of recurrence through psychological flexibility and mentalization in serial. Additionally, gender was found to moderate these serial mediational effects. Conclusions: In line with the psychological flexibility model, personal capacities to face difficult internal/external problems and interpret one's behavior in motivational terms can counterbalance a patient's negative emotions and feelings related to the illness. Gender factors also determine the way in which post-treatment cancer patients manage potential future anxiety and fears.

The perception of COVID-19, the Light Triad, harmony and ethical sensitivity in late adolescents: The role of meaning-making and stress.

The experiences of inner harmony and ethical sensitivity among late adolescents during the COVID-19 pandemic depend on the interplay of perceptive factors, personal resources and cognitive and stress mechanisms. Using a sample from Poland, the present study examined the relationships between the perceptions of COVID-19 and the Light Triad and the characteristics of inner harmony and ethical sensitivity from the mediational perspective of meaning-making and perceived stress. Three hundred and sixteen late adolescents were recruited in the cross-sectional study. They filled in questionnaires measuring the perception of COVID-19, the Light Triad, meaning-making, stress, inner harmony and ethical sensitivity, from April to September 2020. The perception of COVID-19 was negatively related to ethical sensitivity, whereas the Light Triad was positively related to inner harmony and ethical sensitivity. Perceived stress and meaning-making mediated the relationships between the perceptions of COVID-19, the Light Triad and the characteristic of inner harmony. Perception processes and the Light Triad dimensions directly influence ethical sensitivity, as well as indirectly affect inner harmony through meaning-making processes and perceived stress. This noticeably highlights the vital role played by meaning structures and emotional reactions in the experience of inner peace and calmness.

Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making.

Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies and meaning-making can serially mediate the relationship of threat appraisal and resilience with health behaviors in recovered COVID-19 patients. Self-report measures of threat appraisal, resilience, coping, meaning-making, and health behaviors were completed by 266 participants (aged 17 to 78, 51.5% female) who had recovered from COVID-19. The serial mediation analysis showed that the relationship of threat appraisal and resilience with health behaviors was mediated by problem-focused coping, meaning-focused coping, and meaning-making, but not by emotion-focused coping. These results suggest that associations among threat perception, resilience, and health behavior depend to some extent on the interplay of coping and meaning-making, which reveals their unique role in the process of recovery from COVID-19, with potential implications for health interventions.

[Differences in marital communication and parental attitudes between parents of healthy children and parents of children with type 1 diabetes]. / Róznice w komunikacji malzenskiej i postawach rodzicielskich miedzy rodzicami dzieci zdrowych a rodzicami dzieci chorych na cukrzyce typu 1.

AIM: The study investigated the differences between marital communication and parental attitudes in families of children with type 1 diabetes. METHOD: Three instruments were used: Communication in Marriage Questionnaire--versions for self assessment and for the assessment of spouse, Parental Attitude Scale (SPR) by Plopa--versions for fathers and for mothers, and self-constructed questionnaire examining socio-demographic status. Two groups of parents (120 persons) from the Opole and Silesia regions were selected: the study group (30 mothers and 30 fathers, staying in marital union, who bring up a diabetic child with at least 5 year period of the disease), and the control group (30 mothers and 30 fathers, staying in marital union, who bring up their offspring with no chronic disease). The children were from 5 to 18 years old. RESULTS: The analysis of the marital communication results indicated that the fathers of diabetics assess themselves to be less supportive towards their wives than the fathers from the control group. At the same time, they evaluate their wives' supportiveness, involvement and depreciation similarly to the fathers of healthy children and no significant differences were found between the groups of males in their partners' evaluation. Mothers form the study group evaluate themselves in terms of marital communication on an equal level as compared to mothers form the control group in all the three communication dimensions. However, they perceive their husbands to be less supportive and less involved in the marital relationship than the females from the control group do. Fathers of diabetics present a less accepting attitude towards their children than the fathers of healthy children. They also give their children more autonomy than the fathers from the control group and the mothers of diabetics, who are not different in this dimension from the mothers of healthy children. Diabetics' mothers accept their children less that the mothers of healthy children, but at the same time they are more protective towards their offspring than women form the control group. They are also more inconsequent towards their children than the fathers of diabetics and parents of healthy children. CONCLUSIONS: Statistically significant differences were found in some dimensions of marital communication and parental attitudes between diabetics' fathers and the fathers from the control groups as well as between the two groups of mothers. This indicates that there may be a relationship between the child's chronic and marital communication, as well as between the child's disease and parental attitudes, and thus between the disease and the functioning of the whole family system.

Total Pain and Illness Acceptance in Pelvic Cancer Patients: Exploring Self-Efficacy and Stress in a Moderated Mediation Model.

Cancer patients experience pain not only in its physical dimension, but also in a broader context that includes psychological, social, and spiritual aspects due to a higher level of anxiety and stress. The present prospective, longitudinal study examined the relationship between total pain and illness acceptance among pelvic cancer patients, taking into consideration the moderated mediation effects of self-efficacy and stress. The study involved a sample of pelvic cancer patients receiving radiotherapy treatment. Assessments were completed at T1 (before radiotherapy), T2 (after 3-4 weeks), and T3 (after radiotherapy) to assess the psychosocial dynamics of illness acceptance (N = 267). The more physical, psychological, social, and spiritual pain symptoms the patients experienced, the less they accepted negative health conditions and the effects of their illness. Stress moderated the indirect effect between total pain dimensions and illness acceptance through self-efficacy, but it did not moderate the relationship between total pain and illness acceptance. The relationships between total pain dimensions and illness acceptance thus depend on both the mediating effect of self-efficacy and the moderating effect of stress. This highlights the need to control one's motivation and behavior and manage emotional strain or tension.