Phenylketonuria patients' and their parents' acceptance of the disease: multi-centre study.

PURPOSE: Phenylketonuria (PKU) still poses a therapeutic challenge for patients and medical professionals. The aim of the study was to assess both patients' and their parents' acceptance of the disease. METHODS: The study included 218 PKU patients and 178 parents of PKU children who were enrolled in the study on the basis of questionnaire data. RESULTS: Regarding attitude towards the disease, our study demonstrated that 63 (28.9 %) PKU patients did not accept the disease. Patients who found accepting the disease difficult, more frequently perceived themselves as inferior/different in comparison with their peers. In total, 36 % of patients did not want their friends to be aware of their condition, while only 18 % of parents believed that their children's peers should not know about their disease. In total, 42 % of parents wanted to talk to other parents of PKU children and only 13 % to a doctor. Only 20 % of patients saw the need to discuss their condition with a doctor. In total, 8 % of children, regardless of age, and 14 % of parents preferred to talk to a psychologist. CONCLUSION: Our data demonstrated that disease acceptance played an essential role in patients' social integration. The study also indicated the need to overcome communication barriers between patients and their healthy peers and for patients to find the courage to be open about the disease. The importance of support groups for PKU families and the significance of strict cooperation between patients and their families with PKU treatment teams were also revealed.

Factors affecting self-esteem and disease acceptance in patients from infertile couples.

Introduction: Infertility has been diagnosed in millions of people around the world and is described as a complex medical, mental, and social problem that affects many aspects of life. The aim of the study was to extract the determining factors and the level of self-esteem and the degree of acceptance of the disease in infertile patients and to find differences between women and men in this aspect. Methods: A total 456 patients (235 women and 221 men) from infertile couples participated in a cross-sectional study. To collect data a Personal Information Form (PIF), Rosenberg Self-Esteem Scale (SES), and Acceptance of Illness Scale (AIS) were used. Results: The overall self-esteem score for the whole sample was 30.50 (15 ± 30) points and for acceptance of the disease 32.4 (8 ± 40) points. In the study group, men obtained a slightly higher level of self-esteem than women (31.00 vs. 30.04 points). Additionally, men had a higher level of acceptance of the disease (33.12 vs. 31.80) than women. Socio-demographic factors such as age and level of education had impact on scores SES and AIS. Clinical factors did not determine the results of SES and AIS, both in the overall sample and in the female and male groups. Conclusion: Self-esteem in patients from infertile couples increases with age and level of education. There are also significant differences between women and men, i.e., positive correlations between the level of education and self-esteem in men and the degree of acceptance of the disease in women.

Experience of Disease Acceptance in Chinese Patients with Newly Diagnosed Crohn's Disease: A Descriptive Qualitative Study.

Background: High levels of disease acceptance are important predictors of improved psychological well-being, treatment outcomes, and enhanced quality of life. Relatively few studies have focused on the process of disease acceptance in patients with Crohn's disease (CD), particularly those who are newly diagnosed. Purpose: To explore the disease acceptance process in newly diagnosed CD patients. Patients and Methods: A descriptive qualitative approach was employed. Sixteen CD patients from 2 tertiary hospitals in Hangzhou, Zhejiang were recruited through purposive sampling using a maximum variation strategy. Semi-structured interviews were conducted. The interviews were transcribed verbatim and analysed using conventional content analysis. Results: Five phases of the psychosocial process of the "acceptance journey" of newly diagnosed CD patients emerged from the data analysis: (1) praying for the illness to not be CD; (2) not being able to accept CD; (3) having to accept CD; (4) knowing that CD should be acceptable; and (5) starting to accept CD. Patients at the stage of "starting to accept CD" are more proactive and motivated to face the disease, and their overall acceptance of the disease is higher than that of the previous stages. However, by the end of the interview, 2 patients remained at the stage of "having to accept CD", and 3 patients remained at the stage of "knowing that CD should be acceptable". Two patients entered the stage of "starting to accept CD" and then reverted back to one of the previous stages. Conclusion: The "acceptance journey" of newly diagnosed CD patients is dynamic, individual and reversible. Traditional Chinese cultural values such as respect for authority, the philosophy of wu-wei and family responsibility contribute to the acceptance of CD in Chinese patients. Hence, there is a need to provide early and culturally tailored psychological support or interventions according to the stages of acceptance.

Quality of life and its selected determinants in the group of patients with surgically treated spinal tumors.

Introduction: Spinal metastases are a common manifestation of advanced neoplastic disease. Destructive neoplastic lesions within the axial skeleton cause unrelieved pain and nervous system disorders involving spinal stenosis and other neural structures. The development of new systemic therapies, radiotherapy and minimally invasive spinal surgeries has increased patients' quality of life by minimising pain and neurological disorders due to vertebral neoplastic infiltration. The aim of the study was to assess the patients' quality of life before and after spine stabilisation surgery with spinal cord decompression to relieve the pressure associated with neoplastic destruction. Materials and Methods: The study involved 115 subjects with spinal metastases in the preoperative period and 3-4 months after the surgery based on the inclusion criteria (metastatic spinal tumour, sensorimotor dysfunction). The data were collected using the following tools: the Rotterdam Symptom Checklist (RSCL-Rotterdam Symptom Checklist), Acceptance Illness Scale (AIS scale), Activities of Daily Living Scale (ADL scale) and Visual Analogue Scale (VAS). The correlation coefficient was calculated using Spearman's rho assuming the significance level at α = 0.05 (p<0.05). Results: A higher quality of life was found after surgery (p<0.001) in terms of experiencing physical symptoms (30.7 ± 11.96 points before surgery vs. 20.91 ± 13.00 points after surgery) and psychological symptoms (43.98 ± 14.82 points before surgery vs. 31.35 ± 14.86 points after surgery). The activity level of the subjects also improved (p<0.001; 36.56 ± 22.43 points to 43.55 ± 20.40 points). The level of disease acceptance in the study group was higher after the surgery compared to the preoperative assessment. The subjects with a high level of disease acceptance presented a higher quality of life postoperatively. The independence of the subjects in performing everyday activities after the operation influenced the quality of life, in terms of somatic symptoms (p=0.006), mental symptoms (p=0.001) and activity (p<0.001). Along with the improvement in functional capacity, the quality of life in terms of symptoms and activity levels increased. Conclusion: The study showed that spinal cord decompression surgery improves the quality of life of patients by reducing neurological dysfunction, increasing the acceptance of the disease and the ability to perform activities of daily living (ADL). Sociodemographic variables did not affect the quality of life of the respondents.

The Significance of Adaptation and Coping with Disease among Patients with Diagnosed Gynaecological Cancer in the Context of Disease Acceptance.

Uterine/endometrial and ovarian tumours are among the most common gynaecological cancers. Adaptation to cancer encompasses a variety of complex behavioural, cognitive, and emotional processes. The purpose of mental adaptation is to alleviate emotional discomfort and regain mental stability. The aim of the study was to assess the influence of adaptation and coping with gynaecological cancer on the level of disease acceptance among the studied women. The study included 81 patients diagnosed with gynaecological cancer. Mental adaptation to cancer was measured using the Min-Mac scale, disease acceptance was measured using the AIS and the level of adaptation was measured using the CAPS. The average AIS score was 26.65 ± 8.85 points. Adaptation and coping methods did not vary significantly depending on the diagnosed type of cancer. The constructive style of fighting the disease prevailed (45.11 ± 6.01). The AIS scores correlated significantly and positively with the intensity of the constructive style of mental adaptation, and negatively with the intensity of the destructive style. The studied group of patients with gynaecological cancer displayed a moderate level of disease acceptance, the constructive style of adaptation was the most prevalent, and the location of the cancer did not have an effect on coping mechanisms.

The Impact of the Epidemiological Situation Resulting From COVID-19 Pandemic on Selected Aspects of Mental Health Among Patients With Cancer-Silesia Province (Poland).

Objective: The study aimed to assess the level of disease acceptance as well as the wellbeing and emotions that accompany cancer patients during the COVID-19 pandemic. Materials and Methods: The study involved 1,000 patients of the oncology centers (Silesia, Poland). The following questionnaires were used for the study: WHO-5-Well-Being Index, BDI-Beck Depression Inventory, disease acceptance scale, and proprietary multiple-choice questions regarding the impact of the epidemic situation on the respondents' lives so far. The questionnaire study was conducted twice: in March-October 2020 (the beginning of the COVID-19 pandemic in Poland) and March-October 2021 (renewed tightening of sanitary restrictions in Poland). The differences between the given periods were statistically analyzed. Results: At the time of the study, the respondents felt mainly anxiety related to the possibility of contracting COVID-19, the possibility of infecting a loved one, or staying in quarantine. Anxiety was also caused by the vision of poorer access to health services. Along with the duration of the epidemic, the acceptance of neoplastic disease has decreased and the incidence of depressive symptoms has increased. Conclusion: The wellbeing of the respondents deteriorated significantly during the pandemic. The respondents, in their daily functioning, were mainly accompanied by anxiety. The risk of depression has increased and the acceptance of the disease has decreased significantly.

Oncological patient management on the territory: the results of a survey in the north-west of Italy.

Objective: To investigate the role of community pharmacists in the therapeutic process of oncological patients and to assess these patients' state of acceptance of their disease and their relationship with their therapies, we performed a survey in some oncological clinics in Turin (north-west of Italy). Methods: The survey was carried out in a three months' period by means of a questionnaire. The questionnaire was administered on paper to oncological patients that attended 5 oncological clinics in Turin. The questionnaire was self-administered. Results: 266 patients filled out the questionnaire. More than half of patients reported that their cancer diagnosis interfered with normal life very much or extremely and almost 70% of patients reported that they were accepting of what happened and were trying to fight back. 65% of patients answered that it is important or very important that pharmacists are aware of their health status. About 3 out of 4 patients thought that pharmacists giving information on medicines purchased and on how to use them is important or very important and that it is important to receive information concerning health and the effects of medication taken. Conclusion: Our study underlines the role of territorial health units in the management of oncological patients. It can be said that the community pharmacy is certainly a channel of election, not only in cancer prevention but also in the management of those patients who have already been diagnosed with cancer. More comprehensive and specific pharmacist training is necessary for the management of this type of patient. Furthermore, it is necessary to improve the awareness of this issue in community pharmacists at the local and national levels by creating a network of qualified pharmacies developed in collaboration with oncologists, GPs, dermatologists, psychologists and cosmetics companies.

Long-term outcome in patients with myasthenia gravis: one decade longitudinal study.

INTRODUCTION: Even treated, myasthenia gravis (MG) continues to represent a significant burden and might continuously affect patients' quality of life (QoL). The aim of our longitudinal study was to analyze QoL in a large cohort of MG patients after a 10-year follow-up period. METHODS: This study comprised 78 MG patients (60% females, 50 ± 16 years old at baseline, 70% AchR positive) who were retested after 10 years. Disease severity was evaluated by MGFA classification. QoL was assessed using SF-36 questionnaire and Myasthenia Gravis-specific Questionnaire (MGQ). Hamilton rating scales for depression and anxiety (HDRS and HARS), Multidimensional Scale of Perceived Social Support (MSPSS) and Acceptance of Illness Scale (AIS) were also used. RESULTS: Similar percentage of patients was in remission at both time points (42% and 45%). However, at baseline all patients were treated, while 32% were treatment-free at follow-up. SF-36, MGQ, MSPSS and AIS scores were similar at baseline and retest. Mean HDRS and HARS scores worsened during time (p < 0.05), although percentage of patients with depression and anxiety did not change significantly. Significant predictors of worse SF-36 score at retest were depression (ß = - 0.45, p < 0.01), poor disease acceptance (ß = - 0.44, p < 0.01) and older age (ß = - 0.30, p < 0.01). Significant predictors of worse MGQ score at retest were poor disease acceptance (ß = - 0.40, p < 0.01), retirement (ß = - 0.36, p < 0.01), lower education (ß = 0.25, p < 0.01), and depression (ß = - 0.18, p < 0.05). CONCLUSIONS: Although after 10 years, a significant number of MG patients were in remission, their QoL was still reduced. Neurologists should be aware that patients' perception of poor QoL may persist even if MG is well treated from a physician's perspective.

The relationship between illness identity and the self-management of Inflammatory Bowel Disease.

OBJECTIVES: The psychological impact of Inflammatory Bowel Disease (IBD) can be profound, leading to challenges with illness self-management. One such impact can be an identity discrepancy, where illness identity is rejected as part of the self. The aim of this study is to examine the relationship between illness identity and self-management of IBD. DESIGN: A mixed-methods approach was taken using an online survey with 167 participants living with IBD. METHODS: The Illness Identity Questionnaire and Patient Activation Measure were utilized to ascertain the correlational relationship between illness identity and self-management, triangulated with a thematic analysis of two open-ended questions on this topic. RESULTS: The results revealed a statistically significant relationship after controlling for possible confounders of age, illness duration, illness severity, and number of comorbidities. Positive illness identity types (acceptance and enrichment) had a moderate, positive correlation with self-management. Negative identity types (rejection and engulfment) had a weak, negative correlation. This was supported by three main themes found from a thematic analysis and provided further insight into this relationship. Theme 1: negotiating with self as a process of acceptance; Theme 2: resigned acceptance that protects sense of self; and Theme 3: Self-management expands from behavioural strategies to psychological processes through acceptance. CONCLUSIONS: These results suggest that the more illness is accepted into a sense of self, the better an individual is able to self-manage IBD as more psychological resources are activated. These findings provide individuals and clinicians alike insight into utilizing identity change to improve the overall self-management of IBD.

The impact of socio-demographic and clinical factors on the quality of life and disease acceptance in patients with Crohn's disease.

<b>Introduction:</b> Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract characterized by periodsof remission and exacerbations of varying severity. The symptoms include: abdominal pain, diarrhea, flatulence, nausea, lossof appetite, weight loss, weakness, and changes in body temperature. Treatment is based on a combination of nutritional treatment and pharmacotherapy. Sometimes surgery can be necessary. The quality of life and disease acceptance are essential elements of the functioning of people with CD. </br> </br> <b>Aim:</b> The aim of the study is to analyze the factors affecting the quality of life and the level of disease acceptance in patients suffering from Crohn's disease </br></br> <b> Material and methods:</b> The study was conducted in a group of 46 patients diagnosed with Crohn's disease. The study was carried out using the proprietary questionnaire, AIS, and WHOQOL-BREF. </br></br> <b>Results:</b> The study group was dominated by young people. The average age of respondents was 34.28. The quality of life and the level of CD patients' disease acceptance were at an average level. The average score obtained by respondents in the Acceptanceof Illness Scale (AIS) was 28.37. The study revealed a significant impact of disease acceptance level on the respondents' assessment of quality of life.</br> </br> <b> Conclusions:</b> Patients' quality of life and level of disease acceptance are influenced by demographic factors and the clinical course of disease. Older patients after several surgeries for CD should receive more intensive psychological care. Health educationof patients with CD regarding disease, self-care, and skillful support are key in increasing the assessment of quality of life and the level of disease acceptance. Further research is required in a larger group of patients with CD subject to surgical treatment.

Does the Rural Environment Influence Symptomatology and Optimize the Effectiveness of Disease Acceptance? A Study Among Women With Fibromyalgia.

The present study aims to explore whether the symptoms associated with fibromyalgia are contextually influenced by the area of residence (rural/urban). Furthermore, it is analyzed whether the effect of the acceptance of the disease on the emotional, cognitive and physical symptoms is moderated by the patients' place of residence. Using a cross-sectional design, a total of 234 women with fibromyalgia (mean age = 56.91 years; SD = 8.94) were surveyed, of which 55.13% resided in rural areas and 44.87% in urban areas. Self-reported questionnaires were used to assess pain severity, anxiety and depression, functional limitation, physical and mental fatigue and acceptance of the disease. The results show significant differences in acceptance (p = 0.040), pain (p < 0.001), and physical and mental fatigue (p = 0.003 and p = 0.004, respectively) between patients from rural and urban areas. The rural area patients presented higher levels of acceptance and pain and lesser levels of physical and mental fatigue compared to the urban area. The moderation analysis add that, only in patients from the rural area, the variables of physical symptoms (pain, functional limitation, and physical fatigue) were significantly and negatively associated with acceptance. This study addresses for the first time the role of the place of residence in suffering from fibromyalgia, suggesting that the rural or urban environment plays a relevant role in the severity and/or management of symptoms in fibromyalgia women. Limitations and practical implications are also discussed.

Disease acceptance and social support in patients with peripheral vascular diseases treated in the surgical ward.

AIM: The purpose of this study is a comparative analysis of the degree of disease acceptance and social support in patients with peripheral vascular diseases and other medical conditions treated in surgery ward. DESIGN: A cross-sectional study. METHODS: This cross-sectional study compares disease acceptance and social support in a group of 212 patients with peripheral vascular diseases and other conditions treated in surgery ward. A standardized Acceptance of Illness Scale (AIS) and Social Support Scale were used to collect the research data. RESULTS: Overall, on the AIS, 14% of patients with surgical diseases and 34% of patients with vascular diseases had a low disease acceptance rate. A high level of support was demonstrated in 41% of study participants with surgically treated diseases and in 17% of participants with vascular diseases.

Pain Control, Acceptance and Adjustment to the Disease among Patients with Ovarian, Endometrial and Breast Cancer in Poland.

BACKGROUND: Breast, ovarian, and endometrial cancer are among the most common causes of morbidity and mortality of women in Poland. In 2016, breast cancer was the most common cause of morbidity and the second leading cause of cancer deaths in women, endometrial cancer was the third most common cause of morbidity and the seventh leading cause of death, and ovarian cancer was the fifth most common cause of morbidity and the fourth leading cause of cancer deaths in women. The aim of the study was to assess the strategy of pain control, acceptance of the cancer and adjustment to life with disease in women with ovarian cancer, endometrial and breast cancer. This study shows how level of pain control, acceptance, and adjustment can differ among patients with the three kinds of cancer and which factors have the most influence on patients' adjustment to the disease. METHODS: The study was carried out with 481 patients diagnosed with ovarian cancer, endometrial and breast cancer. In the study BPCQ, CSQ, AIS and Mini-MAC questionnaires were used. RESULTS: In the BPCQ questionnaire the highest result was acquired in the scope of the impact of doctors (M = 16.45, SD = 4.30), differentiated by cancer location and socio-economic variables. In the CSQ test, the highest result was achieved by praying/hoping, differentiated by cancer location and socio-economic variables. The average AIS acceptance score was M = 27.48 (SD = 7.68). The highest result of the Mini-Mac scale was obtained by patients in the area of fighting spirit (M = 22.94, SD = 3.62), and these results depended on socio-economic and treatment-related variables but were not differentiated by cancer location. CONCLUSIONS: Patients attribute the highest importance in the disease to the influence of physicians, praying/hoping, and fighting spirit. The awareness of the pain management strategies of patients with cancer allows appropriate psychological support to be designed for specific groups of patients.

Factors determining acceptance of disease and its impact on satisfaction with life of patients with peripheral artery disease.

AIMS AND OBJECTIVES: Analysis of factors determining acceptance of disease and satisfaction with life in patients with peripheral artery disease. BACKGROUND: Peripheral artery disease is more common in older patients and is associated with increased morbidity and mortality due to cardiovascular diseases and the risk of amputation. The acceptance of disease is one of the most important factors for adjusting to life with a chronic disease. DESIGN: A cross-sectional survey study. Patients' questionnaires. METHOD: The participants were patients with peripheral artery disease (N = 72). The study included the use the standardized research tools the Acceptance of Illness Scale (AIS) and the Satisfaction with Life Scale (SWLS). RESULTS: The highest acceptance of disease was observed for patients with higher education, while the lowest was found for patients with the greatest limitation of physical mobility. CONCLUSIONS: The education level and physical fitness of patients had significant impact on disease acceptance.

Influence of Pain on the Quality of Life and Disease Acceptance in Patients with Complicated Diabetic Foot Syndrome.

OBJECTIVE: The aim of the study was to evaluate the relationship between pain and quality of life and illness acceptance, anxiety and depression in a group of patients with complicated diabetic foot syndrome, following lower limb amputation. PATIENTS AND METHODS: The studies were carried out in three stages: 7 days, 6 months and 12 months after surgery in a group of 100 patients after amputation of the lower limb due to complications resulting from type 2 diabetes. The study was performed using standardised instruments: WHOQOL-BREF, the Acceptance of Illness Scale (AIS), the Hospital Anxiety and Depression Scale (HADS), and the Visual Analog Scale (VAS) for pain intensity assessment. RESULTS: Pain occurred in the examined patients throughout the study. The greatest intensity of pain was observed in the postoperative period and significantly weakened over time. Pain intensity was significantly associated with worse overall QoL perceived (-0.255, p=0.011/-0.283, p=0.005) and QoL scores in the physical and psychological domains at the first and second stage of the study (physical domains -0.257, p=0.011/-0.219, p=0.03 and psychological -0.22, p=0.029/-0.24/0.018). The intensity of pain negatively correlates with the acceptance of the disease in all three stages of the study, the greater the severity of pain, the lower the acceptance of illness (-0.298, p=0.003/-0.326, p=0.001/-0.26, p=0.009). The occurrence of anxiety and depression is highly dependent on the severity of pain, especially at the first and second stage of the study (anxiety 0.203, p=0.045/0.257, p=0.01, depression 0.299, p=0.003/0.253, p=0.012). The stronger the pain, the greater the severity of mood disorders. CONCLUSION: Pain and its severity are associated with QoL in the patients with complicated diabetic foot syndrome following lower limb amputation. Disease acceptance was lower in patients experiencing more severe pain at all stages of the study. There is an association of pain with the occurrence of anxiety and depression in amputees, especially 6 months after surgery.

Disease Acceptance and Eudemonic Well-Being Among Adults With Physical Disabilities: The Mediator Effect of Meaning in Life.

The acceptance of disability is recognized as one of the most frequently mentioned factors that plays a particularly significant role in subjective well-being. However, so far, only a very small amount of research has been undertaken to clarify how and why acceptance of illness relates to eudemonic well-being. Hence, comprehension of the direct and indirect effects underlying this relationship seems essential for interventions that increase the recovery of people with impairments and enhance their quality of life. The current research was aimed at investigating the association between acceptance of illness, meaning in life, and eudemonic well-being, as well as the possible mediatory effect of meaning in life on the relationship between acceptance of illness and well-being. The sample consisted of 102 participants (71% women) aged between 20 and 64 years. The respondents had a range of different impairments (e.g., cerebral palsy, neurological disorders, spinal muscular atrophy, and sight defects). The Acceptance of Illness Scale, the Meaning in Life Questionnaire, and the Ryff Scales of Psychological Well-Being were used. It was confirmed that acceptance of illness correlated positively and significantly with the presence of meaning, self-acceptance, positive relations, environmental mastery, personal growth, general well-being, cohesion, flexibility, communication, and family satisfaction. The presence of meaning mediated the relationship between acceptance of illness and general well-being with its four other dimensions: self-acceptance, environmental mastery, purpose in life, and personal growth. Conversely, the search for meaning did not have any mediatory effect on this relationship.

Learning to live with multiple sclerosis cognitive impairment and how it influences readiness for group cognitive intervention.

BACKGROUND: Up to 65% of people with multiple sclerosis (MS) have cognitive impairment that negatively affects quality of life, social functioning, and work. Evidence is building to suggest cognitive rehabilitation is a helpful intervention strategy, and that a group approach can be effective for individuals with MS. Further exploration of how to maximize the potential of group cognitive interventions is warranted. OBJECTIVE: To describe how the psychological process of learning to live with MS-related cognitive changes influences participation in a group cognitive intervention. METHODS: A qualitative design with interpretive description approach was used to ask consumers with MS the important features of a group cognitive intervention. Ten females with self-reported physician-diagnosed MS participated in two focus groups. Focus groups were audio recorded and transcribed. Inductive analysis resulted in content and process categories and themes. RESULTS: The focus groups echoed the processes and relationships that occur in a group intervention program. The main three themes represented stages in a process of learning to live with cognitive changes. The three themes were: 1) coming to know yourself with cognitive changes, 2) learning to cope with cognitive changes and 3) living a changed life. Relationships exist between these stages and the extent to which an individual will benefit from a group cognitive intervention program. CONCLUSIONS: Knowledge of group process and the psychological processes involved in behavioral change are essential skills for facilitating a cognitive intervention group for people with MS.

Acceptance of Cancer in Patients Diagnosed with Lung, Breast, Colorectal and Prostate Carcinoma.

BACKGROUND: The ability to accept illness is a major issue in the life of a person with cancer. Acceptance of disease is simultaneously conducted at two levels: the emotional and cognitive-behavioral one. It is consequential to cancer affecting numerous aspects of patient's life, i.e. the physical, mental, social and the spiritual area. The aim of the study was to verify the influence of socioeconomic factors on acceptance of illness in patients suffering from breast, lung, colorectal and prostate carcinoma. METHODS: The study included 902 patients treated on an outpatient basis at the Center of Oncology, the Maria Sklodowska-Curie Institute in Warsaw, in the year 2013. The Paper and Pencil Interview (PAPI) technique was applied. The questionnaire comprised basic demographic questions (socioeconomic factors) and Acceptance of Illness Scale (AIS) test estimating the level of disease acceptance in patients. RESULTS: Prostate carcinoma patients scored highest (30, 39), whereas lung carcinoma patients scored lowest (23, 17) concerning illness acceptance according to the AIS scale. In all cases, linear dependence between the net income-per-household-member and the AIS score could be observed. Another diversification factor in the case of prostate carcinoma patients was the level of education. Yet one more dependence could be observed between the level of illness acceptance and chemotherapy over the course of past twelve months. CONCLUSION: The degree of disease acceptance is subject to a type of carcinoma. Patient income is an economic factor significantly affecting the acceptance of illness score.

Development and initial validation of the Cardiovascular Disease Acceptance and Action Questionnaire (CVD-AAQ) in an Italian sample of cardiac patients.

Psychological inflexibility refers to the attempt to decrease internal distress even when doing so is inconsistent with life values, and has been identified as a potential barrier to making and maintaining health behavior changes that are consistent with a heart-healthy lifestyle. Disease- and behavior-specific measures of psychological inflexibility have been developed and utilized in treatment research. However, no specific measure has been created for patients with heart disease. Thus, the CardioVascular Disease Acceptance and Action Questionnaire (CVD-AAQ) was developed. The present study is aimed to evaluate the psychometric properties of the CVD-AAQ and to explore its association with measures of psychological adjustment and cardiovascular risk factors in an Italian sample of 275 cardiac patients. Exploratory factor analysis showed a structural one-factor solution with satisfactory internal consistency and test-retest reliability. The relation with other measures was in the expected direction with stronger correlations for the theoretically consistent variables, supporting convergent and divergent validity. CVD-AAQ scores were associated with general psychological inflexibility, anxiety and depression and inversely correlated with psychological well-being. Moreover, the results showed that CVD-AAQ scores are associated with two relevant risk factors for cardiac patients, namely low adherence to medication and being overweight. In sum, results suggest that the CVD-AAQ is a reliable and valid measure of heart disease-specific psychological inflexibility with interesting clinical applications for secondary prevention care.