Effect of a mentor-based, supportive-expressive program, Be Resilient to Breast Cancer, on survival in metastatic breast cancer: a randomised, controlled intervention trial.

BACKGROUND: Because of medical advances, metastatic breast cancer (MBC) is now viewed as a chronic disease, rather than an imminent death sentence. Helping women live with this disease requires more than a medical approach to symptoms. Thus, a mentor-based and supportive-expressive program 'Be Resilient to Breast Cancer' (BRBC) was designed to help Chinese women with MBC enhance their resilience levels, biopsychosocial functions, and potentially extend their life span. METHODS: A total of 226 women with MBC were randomly assigned, in a 1 : 1 ratio, to an intervention group (IG) that participated in BRBC or to a control group (CG) that received no intervention. Be Resilient to Breast Cancer was conducted for 120 min once a week. Primary outcomes were cancer-specific survival and secondary outcomes were resilience, Allostatic Load Index (ALI), anxiety, depression, and quality of life (QoL). The Cox proportional-hazards model was used for survival analysis and growth mixture models were performed for secondary outcomes. RESULTS: Be Resilient to Breast Cancer did not significantly prolong 3- or 5-year survival (median survival, 36.7 months in IG and 31.5 months in CG). The hazard ratio for death was 0.736 (95% CI, 0.525-1.133, P=0.076; univariate Cox model) and 0.837 (95% CI, 0.578-1.211, P=0.345; multivariate Cox analysis). The IG improved in anxiety (ES=0.85, P<0.001), depression (ES=0.95, P<0.001), QoL (ES=0.55, P<0.001), resilience (ES=0.67, P<0.001), and ALI (ES=0.90, P<0.001) compared to CG. CONCLUSIONS: BRBC does not improve survival of women with MBC in this study, though longer follow up is warranted. It positively impacts resilience, QoL, ALI, and emotional distress.

Psychometric properties of the Chinese version of the Parent Perception of Uncertainty Scale (PPUS) among parents of children with cancer diagnosis.

OBJECTIVE: Parents of children diagnosed with cancer often experience high levels of illness uncertainty. This study evaluated the psychometric properties of the Chinese Version of the Parent Perception of Uncertainty Scale for Childhood Cancer (PPUS-CC) in Mainland China. METHODS: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed using study population of 420 parents. The participants were also given the social support questionnaire and assessed using the Self-Rating Anxiety Scale, Zarit Burden Interview, and Self-Rating Depression Scale to test the association with PPUS-CC and obtain the cut-off of the scale. RESULTS: The Chinese version of PPUS-CC includes 14 items, and two factors were extracted by EFA, which could explain the 54.56% variances. The Cronbach's α of two factors ranged from 0.830 to 0.877. The dimensions of PPUS-CC show statistical association with other scales, and the cut-off is 42.5. CONCLUSION: The Chinese version of PPUS-CC, as a reliable, valid, and easy-to-use clinical tool, can be adapted in clinical settings as a screening tool to recognize parents with high-risk psychological problems.