The role of resilience and coping strategies as predictors of well-being in breast cancer patients.

PURPOSE: This study investigated the role of resilience and coping strategies on breast cancer patients' well-being using a structural equation model. To achieve this objective, a model previously developed by Mayordomo's group was partially replicated using a longitudinal study design in an oncological sample. METHODS: The study was a longitudinal observational survey. Patients with breast cancer were recruited (N = 166). Resilience was measured with the Mexican Resilience Measurement Scale, coping strategies with the Forms of Coping and Dimensions Scale and perception of the psychological well-being with a short-form of Ryff's Scales of Psychological Well-Being at the start and end of adjuvant chemotherapy (T1 and T2 respectively). RESULTS: The results showed stability in the variables over time and revealed differences with respect to Mayordomo's model. The best predictor of well-being at T2 was well-being at T1. In addition, the model indicated that resilience had a direct impact on well-being through problem-focused coping. Indeed, resilience and problem-focused coping best explained well-being at T2. CONCLUSIONS: Both at the start and end of adjuvant chemotherapy for breast cancer, problem-focused coping positively predicted resilience, which in turn was a positive predictor of well-being. On the other hand, emotion-focused coping showed no association with resilience or well-being. As part of the multidisciplinary cancer team, oncology nurses have a key role to play in promoting resilience and problem-focused coping as an important goal of psychosocial interventions in breast cancer patients.

Differences in Quality of Life and Emotional Well-being in Breast, Colon, and Lung Cancer Patients During Outpatient Adjuvant Chemotherapy: A Longitudinal Study.

BACKGROUND: Adjuvant chemotherapy used at each cancer site may affect quality of life (QoL) and emotional well-being (affect) of cancer patients differently; however, these differences between groups have not been studied. OBJECTIVES: The aim of this study was to assess differences in QoL and affect by cancer site at the start of outpatient adjuvant chemotherapy, whether QoL and affect change during this treatment, and whether adverse effects influence these variables. METHODS: A multicenter longitudinal descriptive study was conducted with 247 participants with breast, colon, or lung cancer at the beginning (T1) and end of treatment (T2). We used the SF-12 Health Survey, Positive and Negative Affect Scale, and an "ad hoc" adverse effects questionnaire. RESULTS: At the start of chemotherapy, the lung group had poorer Physical Component Summary and poorer positive and negative affect ( P < .05) scores. In the end-of-treatment comparisons, breast and colon cancer patients' status had worsened, whereas lung cancer patients had tended to stabilize, although they remained the most vulnerable. Adverse effect severity was significant for Physical Component Summary ( r = -0.13, P = .035), with decreases in positive affect ( r = -0.17, ß = -.16) and increases in negative affect ( r = 0.15, ß = .14). CONCLUSIONS: Changes in QoL and emotional state differ between groups, implying a need for varying levels of follow-up and emotional support. Patients with lung cancer seem particularly vulnerable. IMPLICATIONS FOR PRACTICE: Cancer nurses could strengthen the assessment of patients undergoing chemotherapy using more sensitive instruments such as the Positive and Negative Affect Scale and considering differences by cancer site, to provide care tailored to individual patient needs and preferences.

Effect of a PBL teaching method on learning about nursing care for patients with depression.

BACKGROUND: Depression is a worldwide public health problem that requires the attention of qualified health professionals. The training of skilled nurses is a challenge for nursing instructors due to the complexity of this pathology. OBJECTIVES: The aim was to analyse the declarative and argumentative knowledge acquired about depression by students receiving traditional expository instruction versus students receiving problem-based learning instruction. METHODS: Quasi-experimental study with pre-test and post-test design in experimental and control group to measure differences in the improvement of declarative and argumentative knowledge. Non parametric tests were used to compare the scores between the experimental group and the control group, and between the pre-test and post-test in each group. 114 students participated in the study. Implementation of the study took place during the 2014-2015 academic year in the third year of the Nursing undergraduate degree courses in the University of the Basque Country (UPV/EHU) as part of the Mental Health Nursing subject. RESULTS: The data indicated that there were no statistically significant differences between the two methodologies in regard to declarative knowledge in the care of patients with depression. Nevertheless, the argumentative capacity of the experimental group improved significantly with the problem-based learning methodology (p=0.000). CONCLUSIONS: The results of the implementation indicated that problem-based learning was a satisfactory tool for the acquisition of argumentative capacity in depression nursing care. Still, working examples of teaching sequences that bridge the gap between general clinical practice and classroom practice remain an important goal for continuing research in nursing education.

Evolution of post-traumatic growth during the first 12 months of dialysis: A longitudinal study.

BACKGROUND: Initiating dialysis can produce psychological benefits. These positive changes, most frequently referred to as posttraumatic growth (PTG), have not previously been explored in these patients. OBJECTIVE: To identify patterns in the temporal course of PTG in patients during their first 12 months of dialysis, and to relate to perceived stress. DESIGN: A prospective, longitudinal, observational study. SETTING AND METHODS: The sample included 98 patients, aged from 18 to 70 years, who commenced dialysis in the nine nephrology units of the Basque Country, Spain. Three assessments were carried out at 1, 6 and 12 months, using a PTG questionnaire and the Perceived Stress Scale. ANOVAs with post-hoc analysis were performed to identify significant differences between the groups. RESULTS: Four groups were established based on the observed changes in PTG over time: high, increasing, decreasing and low PTG. Maintaining high PTG and decreasing PTG levels was associated with moderate levels of perceived stress. CONCLUSION: Four different patterns of PTG have been identified, contributing to our understanding of the dynamics of the process of growth and enabling us to identify patients who may be more vulnerable.