Experiences of women with breast cancer disclosing cancer-related cognitive impairment symptoms to health professionals: a Systematic review and meta-synthesis.

OBJECTIVE: Cancer-related cognitive impairment involves changes in cognitive domains among people diagnosed with cancer. This review aimed to explore and synthesize the experiences of women with breast cancer disclosing cancer-related cognitive impairment symptoms to health professionals. METHODS: A systematic review and meta-synthesis was conducted to generate synthesized findings from existing literature. Six databases were searched from inception until mid-October 2022, with eligible studies appraised using the QualSyst Quality Assessment Checklist. RESULTS: Three synthesized findings were generated from eight included studies. Findings highlight that women initiated conversations disclosing symptoms and frequently experienced dismissal or minimization from health professionals. Women rarely received information about cognitive impairment symptoms before treatment. Women reported that health professionals could be more involved in managing cognitive impairment symptoms. CONCLUSION: This meta-synthesis highlights the importance of health professionals providing information before treatment and following up on cognitive impairment symptoms.

Australian women's views concerning non-medical egg freezing and factors motivating freezing decisions.

OBJECTIVE: We aimed to determine women's views about egg freezing for non-medical reasons and the factors motivating freezing decisions. DESIGN: In this study, 514 women aged 18-44 years completed an online cross-sectional survey exploring fertility knowledge, reproductive intentions and views concerning non-medical egg freezing. METHODS: Data were analysed descriptively. Additionally, 14 variables noted as potential motivators in prior literature were entered into a multinomial regression to explore factors that would motivate women to consider freezing their eggs for non-medical reasons. RESULTS: Views concerning non-medical egg freezing were generally positive, with 61.3% of participants reporting that they would consider egg freezing ('Yes' or 'Maybe'). Factors motivating decisions to freeze varied among women who responded 'Yes', 'Maybe' and 'I don't know' to whether they would consider freezing. The availability of Medicare subsidization and the procedure not affecting future fertility were significant predictors for all three groups of women. CONCLUSIONS: Acceptability of egg freezing for non-medical reasons was moderate to high. However, there is a need for targeted fertility information to educate women about fertility and optimal times to conceive and freeze their eggs. Future research about views concerning non-medical egg freezing among diverse populations and examining the health economics of this procedure would be beneficial.

Consulting parents bereaved by childhood cancer: A qualitative study to improve bereavement services.

Twelve Australian parents bereaved by childhood cancer were interviewed about their experiences of, and preferences for, bereavement support, to inform recommendations to improve bereavement care. Reflexive thematic analysis resulted in five themes: Care, empathy, and connection assist with bereavement; Communication makes a difference; Early and ongoing support is desired; Gender matters when grieving the loss of a child; and The pull of peer support. Parents can be assisted through empathy, early and ongoing support, enhanced communication, peer support, and care that is inclusive of all genders. Parents in non-metropolitan areas require increased and flexible support options.

'I have no life and neither do the ones watching me suffer': women's experiences of transvaginal mesh implant surgery.

Objective: Many women are affected by pelvic floor disorders, such as stress urinary incontinence and pelvic organ prolapse. In recent years, these disorders have been treated with transvaginal mesh implant surgeries involving the vaginal insertion of woven netting. We explored women's experiences of transvaginal mesh implant surgery through a biopsychosocial lens. Design: We analysed women's submissions to an Australian Parliament Senate Inquiry on transvaginal mesh implant surgery using thematic analysis. Main Outcome Methods: One-hundred and fifty-three publicly available submissions detailing women's experiences of transvaginal mesh implant surgery to an Australian Parliament Senate Inquiry were analysed. Adverse and positive accounts were eligible for inclusion. Results: We generated nine themes in three categories relating to the Biopsychosocial Model: Physical Health - comprising three themes; Psychological Health - comprising two themes; and Social Wellbeing - comprising four themes. Physical, psychological and social experiences interacted, resulting in reduced quality of life for women. Conclusion: Most women who made submissions to an Australian government inquiry about transvaginal mesh implant surgery described devastating impacts on physical, psychological, and social wellbeing. We provide recommendations to guide psychologists in assisting women with adverse transvaginal mesh-related outcomes. Further research should explore women's long-term experiences of the various transvaginal mesh procedures.

Patients' perspectives about doctor-patient communication regarding transvaginal mesh implant surgery.

OBJECTIVES: Many women experience pelvic floor disorders which may require medical intervention such as transvaginal mesh implant surgeries (TVM; the abdominal or vaginal insertion of woven netting to support pelvic tissue). We examined women's perceptions of communication with their health professionals concerning TVM. DESIGN: We analysed 153 women's written submissions to an Australian Government Inquiry regarding their experiences of transvaginal mesh surgery to explore their perceptions of TVM-related doctor-patient communication. Data were analysed using deductive and inductive reflexive thematic analysis. RESULTS: Women expressed several challenges in their communication with their health professionals. Three themes regarding communication were generated: Insufficient information was abundant; Normalisation and minimisation of the procedure and risks; and, Desired communication interactions. CONCLUSIONS: According to women's accounts, doctor-patient communication was poor. Health professionals must be knowledgeable about medical procedures and their potential complications and provide their patients with adequate, accurate information to make informed choices about their health. Health professionals should also document informed consent. PRACTICE IMPLICATIONS: Health professionals should be well-informed about TVM, including best-practice treatments for pelvic floor disorders, indications for TVM, the risks, outcomes and potential complications from various forms of TVM, and ways to adequately communicate sufficient information to women.

News media stories about cancer on Facebook: How does story framing influence response framing, tone and attributions of responsibility?

This content analysis explored associations between the framing of cancer-related health news stories on Facebook and their corresponding comments. It was found that regardless of story framing the majority of responses involved users engaging in debate and discussion rather than sharing personal experiences. Furthermore, stories framed episodically had a greater proportion of both supportive and unsupportive comments than stories framed thematically. As predicted, episodic stories were associated with more attributions of responsibility directed towards the individual whereas thematic stories lead to more societal-level attributions of blame. Contrary to predictions, responses did not contribute towards the stigmatisation of lung cancer, instead more responses were aimed at reducing stigma for this illness. Within the findings strong beliefs about cancer treatment and management were also identified, which raises concern over the spread of misinformation. Overall, this research provided insight into the framing of cancer news and highlighted potential implications of Facebook comments.

Predictors of sun-related behaviors among young women: comparisons between outdoor tanners, fake tanners, and tan avoiders.

OBJECTIVE: Skin cancer incidence continues to rise as a tanned appearance remains desirable, particularly among young women. Fake tanning provides a tanned appearance without exposure to ultraviolet radiation. In order to advance our understanding of the factors that contribute to long-term behavior change, this study explores determinants associated with different types of tanning. PARTICIPANTS: The sample included 162 female students from the University of Adelaide, Australia, aged 18-26 years. Data were collected in July 2010. METHODS: The current study measured differences in skin type, skin cancer knowledge, unrealistic optimism, appearance motivation, and sun-protective and sun exposure behaviors amongst outdoor tanners, fake tanners, and tan avoiders through an online survey. RESULTS: Differences were observed for skin type, skin cancer knowledge, unrealistic optimism, sun protection, and sun exposure. CONCLUSIONS: A "one-size-fits-all" approach to skin cancer prevention may not be appropriate; type of tanning behavior may need to be considered in health promotion work.

Melanoma and its relationship with solarium use: health knowledge, attitudes and behaviour of young women.

Despite growing evidence of a relationship between solarium use and melanoma development, few studies have examined knowledge, attitudes and behaviour towards solarium use among young women. Females aged 18-26 years attended one of six focus groups (N = 27, seven solarium users and 20 non-users). Three specific themes were endorsed: (1) melanoma knowledge; (2) perceptions of melanoma risk and ways to encourage behaviour change; and (3) health promotion and government regulation. Many young women appear to lack knowledge about melanoma and its relationship with solarium use. Knowledge deficits are highlighted and implications for health prevention/promotion campaigns and future research are discussed.

A randomised pilot of a self-help workbook intervention for breast cancer survivors.

PURPOSE: The aim of this study is to evaluate the efficacy of a self-help workbook for improving adjustment for breast cancer survivors. METHODS: An RCT compared the workbook (n = 20) with no-workbook controls (n = 20). Coping, traumatic stress and quality of life were measured at baseline, then 3 and 6 months later. RESULTS: No interactions were found. A significant group main effect was found for venting coping; controls used less venting coping than workbook participants (p = 0.034). A significant time main effect was obtained for cognitive functioning (p = 0.003). Reliable change indices showed a trend towards a protective effect across all coping measures for workbook participants compared to controls. Qualitative feedback suggested that participants felt well supported by the intervention, but would have preferred receiving it during treatment. CONCLUSIONS: While trends showed some promise for improving coping, endorsement for the workbook was not obtained. The difficulties encountered in recruiting survivors and the resulting implications regarding the feasibility of offering self-help resources to this population are discussed.

The psychosocial concerns and needs of women recently diagnosed with breast cancer: a qualitative study of patient, nurse and volunteer perspectives.

OBJECTIVE: To qualitatively identify the concerns and needs of Australian women recently diagnosed with breast cancer. BACKGROUND: Breast cancer diagnosis can lead to impairment in multiple areas of psychosocial well-being, including physical, social and emotional functioning. Research has therefore begun to focus on identifying and addressing survivors' concerns and needs, with most research examining the time of treatment completion. However diagnosis and treatment are also key times of psychological need, and less is known about the psychosocial concerns and needs at these times. RESEARCH DESIGN: Seven focus group interviews were conducted examining three categories of participants: (i) patients diagnosed with early-stage breast cancer within the past 12 months, (ii) oncology nurses, and (iii) volunteers who work with cancer patients. Sampling was discontinued when informational redundancy was achieved. SETTING AND PARTICIPANTS: Thirty-four participants took part in one of seven focus group meetings held in a hospital patient resource room. RESULTS: A wide variety of psychosocial concerns and needs were discussed, and five specific areas of concern were identified: (i) coping with side-effects; (ii) dealing with self-concept change; (iii) stress and adjustment reactions; (iv) having to manage others' unhelpful beliefs, expectations and emotions; and (v) issues with survival and growth. There was a large degree of consistency in the concerns and needs identified by the different group categories. CONCLUSION: In general, the concerns and needs expressed were consistent with survivorship issues previously identified in the literature; however, several new insights were obtained. Clinical implications of these findings are discussed.

Longitudinal risk factors for adverse psychological functioning six months after coronary artery bypass graft surgery.

This research aimed to identify modifiable risk factors for poor psychological functioning six months post-operatively, using a chronic illness model to explain the relationships between risk factors. Consecutive elective CABG patients (N = 119) completed self-report measures including optimism, illness representations, self-rated health, social support, coping methods, depression, anxiety and PTSD symptomatology in a repeated measures design. Poor pre-operative psychological functioning was the strongest psychological risk factor for adverse psychological functioning six months post-operatively. Longitudinal support for the chronic illness model examined was limited. Further research to identify modifiable risk factors and pre-operative psychopathology screening to determine individuals at-risk of poor psychological outcome is recommended.

Psychological risk factors for cardiac-related hospital readmission within 6 months of coronary artery bypass graft surgery.

OBJECTIVE: The objective of this study was to examine the psychological risk factors for cardiac-related readmission within 6 months of coronary artery bypass graft surgery (CABG). METHODS: Consecutive patients awaiting elective CABG (N=119; 100 males and 19 females), with a mean age of 63.3 years, completed a battery of psychosocial measures in a three-stage repeated-measures design. Relevant medical data were also extracted from patients' medical records 6 months postoperatively to allow for the examination of potential covariates. RESULTS: Two psychological variables, increased postoperative anxiety and increased preoperative depression, were identified as risk factors for cardiac-related readmission independent of the only significant covariate identified, cardiopulmonary bypass time. CONCLUSION: Anxiety in the immediate postoperative period and, to a lesser extent, preoperative depression are important determinants of health care utilization postdischarge. Further research to clarify the psychological factors that are predictive of readmission, and that attempt to determine both the underlying cause of readmissions and potential mechanisms through which psychological factors act is recommended. Such research may highlight potential factors to target in interventions and the best time at which to intervene.

Application of a chronic illness model as a means of understanding pre-operative psychological adjustment in coronary artery bypass graft patients.

OBJECTIVES: To increase understanding of the factors associated with pre-operative psychological adjustment in coronary artery bypass graft (CABG) patients by assessing the utility of a chronic illness model developed by Scharloo, Kaptein, Weinman, Willems, and Rooijmans (2000). DESIGN: A cross-sectional design was employed. METHOD: Elective CABG patients (N=119) completed self-report measures of illness representation, self-rated health, social support, coping methods, and pre-operative adjustment (depression and post-traumatic stress disorder (PTSD) symptomatology) an average of 30 days prior to surgery. Hierarchical multiple regression was used to assess the mediational relationships proposed by the chronic illness model. RESULTS: Five 3-variable mediational chains were assessed. In all instances, the results conformed to the relationships suggested by the chronic illness model where the strength of the relationship between the independent and dependent variables was reduced when the mediator variable was controlled. However, a significant reduction of this relationship was found in three of the five chains examined. The most rigorous support for the model occurred, where increased use of avoidance coping mediated the relationship between poorer self-rated health and increased PTSD symptomatology, and also where increased use of avoidance coping partially mediated the relationship between a more negative illness representation and increased PTSD symptomatology, and poorer self-rated health and increased depression. CONCLUSIONS: The chronic illness model of Scharloo and colleagues shows potential in explaining pre-operative adjustment in CABG patients. Longitudinal examination of the model is recommended.

Psychological risk factors for increased post-operative length of hospital stay following coronary artery bypass graft surgery.

To date, researchers have examined the role of psychological factors in longer-term adaptation to coronary artery bypass graft surgery (CABG), but few have investigated the role of such factors in the immediate post-operative period. Thus, the current study examined psychological risk factors for increased post-operative length of hospital stay in 119 consecutive elective CABG patients (100 men and 19 women). When controlling for operative/post-operative factors, medical factors accounted for 24.5% of the variance. However, pre-operative psychological factors accounted for a further 4.4% of the variance, with increased depression and lower PTSD symptomatology identified as significant independent risk factors for longer post-operative length of hospital stay. Hence, while post-operative length of hospital stay is largely determined by medical factors, psychological factors also influence this outcome. Further research is required to replicate the current findings and to determine the mechanisms through which these variables may act.

The measurement of coping responses: validity of the Billings and Moos Coping Checklist.

OBJECTIVE: The primary aim of the study was to investigate the factor structure and psychometric properties of the modified Coping Checklist. METHODS: Self-report questionnaires asking about coping responses and mental health were administered to 515 undergraduate university students and to 119 patients awaiting elective coronary artery bypass graft surgery. Confirmatory (CFA) and exploratory factor analyses (PCA) were used to summarize and describe coping responses. RESULTS: CFA indicated that the subscale structure originally proposed for the Coping Checklist did not adequately fit the data. Subsequent PCA resulted in four factors: (1) Positive reappraisal; (2) Seeking support; (3) Avoidance; and (4) Information seeking. Internal consistencies ranged between .41 and .62 and 12-week test-retest reliability ranged between .59 and .71. Evidence for the concurrent validity of the solution generated by PCA was demonstrated by low to moderate correlations between the four factors identified and demographic and psychosocial measures. CONCLUSION: Even with modifications to the Coping Checklist, it is recommended that researchers investigate alternative methods of assessing coping responses in health psychology settings.