Psychosocial factors associated with posttraumatic stress and growth in Australian women with ovarian cancer.

The study examined psychosocial factors (quality of life, depression, anxiety, optimism, coping, and social support) in relation to symptoms of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in 108 women diagnosed with ovarian cancer. Canonical correlational analysis showed that both PTSD and PTG were related to poorer quality of life, lack of social supports, and avoidant coping styles. However, higher PTG was also associated with the use of meaning and social support to cope with their experience. The findings highlight both negative and positive posttraumatic outcomes but longitudinal studies are now needed to more fully evaluate these relationships.

Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis.

OBJECTIVE: The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations. METHOD: A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlation between PTSS and PTG. RESULTS: Post-traumatic stress symptoms were associated with depression (r = 0.56), anxiety (r = 0.65), distress (r = 0.62), social support (r = -0.33), and physical quality of life (r = -0.44). PTG was associated with age (r = -0.08), gender (r = -0.15), distress (r = -0.16), depression (r = -0.06), social support (r = 0.30), optimism (r = 0.27), positive reappraisal (r = 0.46), spirituality (r = 0.33), and religious coping (r = 0.36). There was a small positive relationship between PTSS and PTG (r = 0.13). CONCLUSIONS: Post-traumatic stress symptoms and PTG appear to be independent constructs, rather than opposite ends of a single dimension. This is reflected in a small relationship between these variables and different psychosocial correlates. PTSS were strongly associated with variables reflecting a general state of negative affect. Optimism, spirituality, and positive coping styles were associated with PTG. It remains unclear how they are associated with PTSS, given the lack of relevant studies. Longitudinal research is required to examine how psychosocial factors influence the relationship between PTSS and PTG.

Symptoms of posttraumatic stress in Australian women with ovarian cancer.

OBJECTIVE: The aim of the study was to assess the prevalence and nature of symptoms of posttraumatic stress disorder (PTSD) in women with ovarian cancer. A further aim was to examine the demographic, medical and psychosocial factors associated with PTSD symptoms. METHOD: One hundred and eight women with ovarian cancer were assessed for PTSD, quality of life, depression, anxiety, posttraumatic growth, optimism, coping and social support. RESULTS: Clinically significant symptoms were experienced by 9.25% of participants for PTSD, 5.6% for depression and 13.9% for anxiety. Poorer quality of life was associated with total PTSD symptoms, and avoidance and intrusive symptoms. Depression was associated with avoidance and intrusive symptoms. Anxiety was associated with total, avoidance, intrusive and hyperarousal symptoms. Finally, coping by substance use/self-blame was associated with total, avoidance and hyperarousal PTSD symptoms. CONCLUSIONS: Levels of PTSD in women with ovarian cancer were equivalent to that of the general population. Poorer quality of life, depression, anxiety and maladaptive coping, characterised by avoidance, substance use and self-blame, were associated with increased symptoms of PTSD.

General practice and preventive health care: a view through the eyes of community members.

OBJECTIVE: To identify barriers to, and enablers of, the uptake of preventive care in general practice from the perspective of community members, and to explore their sense of the effectiveness of that care. DESIGN, PARTICIPANTS AND SETTING: Qualitative study involving 18 focus groups comprising 85 community members aged over 25 years, from two areas of metropolitan Melbourne that were identified as being of high and low socioeconomic status (SES). The study was performed between 25 May and 9 December 2010. Groups were stratified by age, sex and location (high or low SES). MAIN OUTCOME MEASURES: Factors related to practitioners, patients and structure and organisation that may act as barriers to and/or enablers of preventive care in general practice. RESULTS: Participants saw preventive care as legitimate in general practice when it was associated with concrete action or a test, but rated their general practitioners as poor at delivering prevention. Trust, rapport and continuity of care were viewed as enablers for participants to engage in prevention with their GP. Barriers to participants seeking preventive care through their GPs included lack of knowledge about what preventive care was relevant to them, consultations focused exclusively on acute-care concerns, time pressures and the cost of consultations. CONCLUSIONS: A disconnect exists between patient perceptions of prevention in general practice and government expectations of this sector at a time when general practice is being asked to increase its focus and effectiveness in this field.