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1.
Medicine (Baltimore) ; 100(9): e25024, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655973

RESUMEN

ABSTRACT: An irrational belief is the direct cause of negative emotions and behavioral disorders in patients with breast cancer. Thus, this article examines these patients' irrational beliefs, which helps improve the emotions and behavioral disorders of breast cancer patients. Chinese breast cancer patients have unique irrational beliefs due to the influence of Chinese traditional culture. To understand the irrational beliefs surrounding breast cancer diagnosis in young Chinese patients, we conducted an interpretative phenomenological study.Semi-structured interviews were conducted in young Chinese breast cancer patients. According to Colaizzi method modified by Edward and Welsh, transcribed interviews were analyzed to understand patients' irrational beliefs. Based on the theoretical framework, this study adopted interpretative phenomenology. Interpretive description was used to construct participants' experiences of irrational beliefs. Thematic sufficiency was confirmed after 17 interviews.Owing to the lack of knowledge about breast cancer, all participants were more susceptible to traditional Chinese culture, empiric theory, family reassurance, and healthcare providers' behaviors, leading to patients' irrational beliefs, negative emotions, and behavioral disorders.This research confirms that irrational beliefs in young Chinese breast cancer patients are profoundly influenced by traditional Chinese culture. Chinese healthcare providers can use this information to provide targeted nursing, supportive services, and research, and help women identify their beliefs and understand how these beliefs affect their health.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Cultura , Emociones/fisiología , Encuestas y Cuestionarios , Adulto , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/psicología , China/epidemiología , Femenino , Humanos , Morbilidad/tendencias
2.
Anticancer Res ; 41(3): 1671-1676, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33788764

RESUMEN

BACKGROUND/AIM: This study aimed to investigate the efficacy of first-line gemcitabine monotherapy for metastatic breast cancer (MBC) and its effect on health-related quality of life (HRQoL) compared with treatment of physician's choice (TPC). PATIENTS AND METHODS: We enrolled 96 patients into the first-line gemcitabine group (n=47) or other treatment of physician's choice (TPC) group (n=49) from May 2010 to April 2013. HRQoL was evaluated every 4 weeks. RESULTS: There was no significant difference in the median time to treatment failure (5.3 vs. 4.6 months, hazard ratio=0.87, p=0.546) and the incidence rates of grade 3/4 haematological toxicity (10.6% vs. 8.1%, p=0.677) and grade 3/4 non-haematological toxicity (4.2% vs. 8.1%, p=0.429) between the gemcitabine and TPC groups. Changes in HRQoL from baseline to 12 weeks were not significantly different. CONCLUSION: Gemcitabine achieves similar efficacy and HRQoL benefit to other chemotherapy and can be used as first-line treatment for MBC.


Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Desoxicitidina/análogos & derivados , Adulto , Anciano , Neoplasias de la Mama/patología , Neoplasias de la Mama/psicología , Desoxicitidina/efectos adversos , Desoxicitidina/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Metástasis de la Neoplasia , Médicos , Estudios Prospectivos , Calidad de Vida , Insuficiencia del Tratamiento
3.
Breast Cancer Res Treat ; 186(2): 577-583, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33598879

RESUMEN

PURPOSE: To identify factors associated with (perceived) access to health care among (ex-)breast cancer patients during the COVID-19 pandemic. METHODS: Cross-sectional study within a large prospective, multicenter cohort of (ex-)breast cancer patients, i.e., UMBRELLA. All participants enrolled in the UMBRELLA cohort between October 2013 and April 2020 were sent a COVID-19-specific survey, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. RESULTS: In total, 1051 (66.0%) participants completed the survey. During COVID-19, 284 (27.0%) participants reported clinically relevant increased levels of anxiety and/or depression, i.e., total HADS score ≥ 12. Participants with anxiety and/or depression reported statistically significant higher barriers to contact their general practitioner (47.5% vs. 25.0%, resp.) and breast cancer physicians (26.8% vs. 11.2%, resp.) compared to participants without these symptoms. In addition, a higher proportion of participants with anxiety and/or depression reported that their current treatment or (after)care was affected by COVID-19 compared to those without these symptoms (32.7% vs. 20.5%, resp.). Factors independently associated with symptoms of anxiety and/or depression during COVID-19 were pre-existent anxiety (OR 6.1, 95% CI 4.1-9.2) or depression (OR 6.0, 95% CI 3.5-10.2). CONCLUSION: During the COVID-19 pandemic, (ex-)breast cancer patients with symptoms of anxiety and/or depression experience higher barriers to contact health care providers. Also, they more often report that their health care was affected by COVID-19. Risk factors for anxiety and/or depression during COVID-19 are pre-existent symptoms of anxiety or depression. Extra attention-including mental health support-is needed for this group.


Asunto(s)
Ansiedad/psicología , Neoplasias de la Mama/psicología , Supervivientes de Cáncer/psicología , Depresión/psicología , Anciano , Ansiedad/epidemiología , Neoplasias de la Mama/epidemiología , Supervivientes de Cáncer/estadística & datos numéricos , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios
4.
Value Health ; 24(2): 303-312, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33518037

RESUMEN

BACKGROUND: Targeted genetic testing is a tool to identify women at increased risk of gynaecological cancer. OBJECTIVE: This systematic review evaluates the results and quality of cost-effectiveness modeling studies that assessed targeted genetic-based screen-and-treat strategies to prevent breast and ovarian cancer. METHODS: Using MEDLINE and databases of the Centre for Reviews and Dissemination, we searched for health economic modeling evaluations of targeted genetic-based screen-and-treat strategies to prevent inheritable breast and ovarian cancer (until August 2020). The incremental cost-effectiveness ratios (ICERs) were compared. Methodological variations were addressed by evaluating the model conceptualizations, the modeling techniques, parameter estimation and uncertainty, and transparency and validation of the models. Additionally, the reporting quality of each study was assessed. RESULTS: Eighteen studies met our inclusion criteria. From a payer perspective, the ICERs of (1) BRCA screening for high-risk women without cancer ranged from dominating the no test strategy to an ICER of $21 700/quality-adjusted life years (QALY). In studies that evaluated (2) BRCA cascade screening (ie, screening of women with cancer plus their unaffected relatives) compared with no test, the ICERs were between $6500/QALY and $50 200/QALY. Compared with BRCA alone, (3) multigene testing in women without cancer had an ICER of $51 800/QALY (one study), while for (4) multigene-cascade screening the ICERs were $15 600/QALY, $56.500/QALY, and $69 600/QALY for women in the United Kingdom, Norway, and the United States, respectively (2 studies). More recently published studies showed a higher methodological and reporting quality. CONCLUSIONS: Targeted BRCA or multiple gene screening is likely to be cost-effective. Methodological variations could be decreased by the development of a reference model, which may serve as a tool for validation of present and future cost-effectiveness models.


Asunto(s)
Neoplasias de la Mama/genética , Neoplasias de la Mama/psicología , Pruebas Genéticas/economía , Neoplasias Ováricas/genética , Neoplasias Ováricas/psicología , Proteína BRCA1/genética , Proteína BRCA2/genética , Análisis Costo-Beneficio , Femenino , Humanos
5.
J Surg Oncol ; 123(5): 1206-1214, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33577715

RESUMEN

PURPOSE: To evaluate the acceptability and impact of 3D-printed breast models (3D-BMs) on treatment-related decisional conflict (DC) of breast cancer patients. METHODS: Patients with breast cancer were accrued in a prospective institutional review board-approved trial. All patients underwent contrast-enhanced breast magnetic resonance imaging (MRI). A personalized 3D-BM was derived from MRI. DC was evaluated pre- and post-3D-BM review. 3D-BM acceptability was assessed post-3D-BM review. RESULTS: DC surveys before and after 3D-BM review and 3D-BM acceptability surveys were completed by 25 patients. 3D-BM were generated in two patients with bilateral breast cancer. The mean patient age was 48.8 years (28-72). The tumor stage was Tis (7), 1 (8), 2 (8), and 3 (4). The nodal staging was 0 (19), 1 (7), and 3 (1). Tumors were unifocal (15), multifocal (8), or multicentric (4). Patients underwent mastectomy (13) and segmental mastectomy (14) with (20) or without (7) oncoplastic intervention. Neoadjuvant therapy was given to seven patients. Patients rated the acceptability of the 3D-BM as good/excellent in understanding their condition (24/24), understanding disease size (25/25), 3D-BM detail (22/25), understanding their surgical options (24/25), encouraging to ask questions (23/25), 3D-BM size (24/25), and impartial to surgical options (17/24). There was a significant reduction in the overall DC post-3D-BM review, indicating patients became more assured of their treatment choice (p = 0.002). Reduction post-3D-BM review was also observed in the uncertainty (p = 0.012), feeling informed about options (p = 0.005), clarity about values (p = 0.032), and effective (p = 0.002) Decisional Conflict Scale subscales. CONCLUSIONS: 3D-BMs are an acceptable tool to decrease DC in breast cancer patients.


Asunto(s)
Neoplasias de la Mama/cirugía , Técnicas de Apoyo para la Decisión , Conocimientos, Actitudes y Práctica en Salud , Imagen por Resonancia Magnética/métodos , Mastectomía/estadística & datos numéricos , Participación del Paciente , Impresión Tridimensional/instrumentación , Adulto , Anciano , Neoplasias de la Mama/patología , Neoplasias de la Mama/psicología , Carcinoma Ductal de Mama/patología , Carcinoma Ductal de Mama/psicología , Carcinoma Ductal de Mama/cirugía , Carcinoma Intraductal no Infiltrante/patología , Carcinoma Intraductal no Infiltrante/psicología , Carcinoma Intraductal no Infiltrante/cirugía , Carcinoma Lobular/patología , Carcinoma Lobular/psicología , Carcinoma Lobular/cirugía , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Mastectomía/psicología , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos
6.
BMC Psychol ; 9(1): 26, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33557956

RESUMEN

BACKGROUND: Breast cancer is a common tumor in China and has become a public health problem in modern society. Stress plays an important role in the occurrence and progression of cancer. At present, the current situation of stress on breast cancer survivors (BCSs) in China has not been fully understood. This study aims to explore the stress and coping strategies of Chinese BCSs, which provide suggestions to help BCSs reduce stress. METHODS: Sixty-three BCSs from the Shanghai Cancer Rehabilitation Club in China were included in this study and were divided into eight focus groups. These were transcribed verbatim, coded using thematic analysis and analyzed using NVivo 11. RESULTS: Three themes were extracted from the data to address our research objectives: stress, coping strategies and expectations. The stress of BCSs included psychological stress, stress caused by physical pain, economic stress, stress caused by the change of life status, and stress caused by information overload; the coping strategies included self-strategies and help from others; from the perspective of the survivors, they put forward their expectations for both the society and themselves. CONCLUSIONS: This study shows that BCSs face a variety of stress. In the face of stress, BCSs need comprehensive support, including social and family support to cope with stressors. The findings from this study provide evidence for improving the quality of life among BCSs.


Asunto(s)
Adaptación Psicológica , Neoplasias de la Mama/psicología , Supervivientes de Cáncer/psicología , Calidad de Vida/psicología , Estrés Psicológico/psicología , Adulto , Anciano , Neoplasias de la Mama/etnología , China/epidemiología , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Motivación , Investigación Cualitativa
8.
Curr Oncol ; 28(1): 294-300, 2021 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-33430131

RESUMEN

BACKGROUND: The current Coronavirus disease 2019 (COVID-19) pandemic is a highly stressful event that may lead to significant psychological symptoms, particularly in cancer patients who are at a greater risk of contracting viruses. This study examined the frequency of stressors experienced in relation to the ongoing coronavirus pandemic and its relationship with psychological symptoms (i.e., anxiety, depression, insomnia, fear of cancer recurrence) in breast cancer patients. METHODS: Thirty-six women diagnosed with a non-metastatic breast cancer completed the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the COVID-19 Stressors Questionnaire developed by our research team. Participants either completed the questionnaires during (30.6%) or after (69.4%) their chemotherapy treatment. RESULTS: Results revealed that most of the participants (63.9%) have experienced at least one stressor related to the COVID-19 pandemic (one: 27.8%, two: 22.2%, three: 11.1%). The most frequently reported stressor was increased responsibilities at home (33.3%). Higher levels of concerns related to the experienced stressors were significantly correlated with higher levels of anxiety, depressive symptoms, insomnia, and fear of cancer recurrence, rs(32) = 0.36 to 0.59, all ps < 0.05. CONCLUSIONS: Cancer patients experience a significant number of stressors related to the COVID-19 pandemic, which are associated with increased psychological symptoms. These results contribute to a better understanding of the psychological consequences of a global pandemic in the context of cancer and they highlight the need to better support patients during such a challenging time.


Asunto(s)
Neoplasias de la Mama/complicaciones , Supervivientes de Cáncer/psicología , Pandemias , Estrés Psicológico/epidemiología , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , Ansiedad/psicología , Neoplasias de la Mama/inmunología , Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , /psicología , Supervivientes de Cáncer/estadística & datos numéricos , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Depresión/psicología , Miedo , Femenino , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/psicología , Cuestionario de Salud del Paciente/estadística & datos numéricos , Índice de Severidad de la Enfermedad , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Estrés Psicológico/diagnóstico , Estrés Psicológico/etiología , Estrés Psicológico/psicología
9.
Public Health ; 190: 152-159, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33419526

RESUMEN

OBJECTIVE: The objective of the study is to identify the barriers to UK Black, Asian and Minority Ethnic (BAME) women attending breast screening and subsequently, support the growing evidence base providing solutions to the public health problem of ethnic variation within screening attendance. STUDY DESIGN: A systematic review and thematic analysis of UK-based, qualitative studies concerning BAME women. METHODS: The methodology of this review is based on Cochrane guidelines. A search strategy was applied to Embase, PubMed and Medline. Predefined inclusion and exclusion criteria yielded 8 final articles which were appraised and thematically analysed. RESULTS: The main findings of the review revealed three overarching themes: knowledge-related, access-related and cultural-related factors. The emphasis of the importance of knowledge was highlighted by all studies identifying a lack of knowledge as a key barrier to screening attendance. CONCLUSIONS: BAME women have disproportionally lower breast screening attendance and a lack of knowledge is an essential barrier to overcome when addressing this health inequality.


Asunto(s)
Neoplasias de la Mama/psicología , Asistencia Sanitaria Culturalmente Competente , Grupos Étnicos/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud/etnología , Promoción de la Salud/métodos , Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Mamografía/psicología , Adulto , Afroamericanos , Grupo de Ascendencia Continental Africana , Grupo de Ascendencia Continental Asiática , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/etnología , Cultura , Detección Precoz del Cáncer , Grupos Étnicos/psicología , Femenino , Humanos , Aceptación de la Atención de Salud/etnología
11.
Phytomedicine ; 80: 153365, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33126168

RESUMEN

BACKGROUND: Medical adherence is often higher in clinical trials than in real world practice. The aim of this study was to investigate the effects of traditional Chinese medicine (TCM) on medical adherence to hormonal therapy (HT) and survival outcome in ER (+) breast cancer patients in Taiwan. SUBJECTS AND METHODS: Using a nationwide longitudinal population-based database, we enrolled patients with newly diagnosed ER-positive breast cancer who had received HT, and followed for up to 5 years (N = 872). Medication adherence in terms of medication possession ratios (MPR) and patient outcome were evaluated with or without TCM exposure. We applied logistic regression and Cox proportional hazards (PH) analysis to identify factors, including TCM exposure, associated with adherence to HT and mortality. RESULTS: MPR to HT in general decreased over the 5-year period post breast cancer diagnosis. Both TCM and MPR to HT ≥ 80% were significantly associated with reduced risk of breast cancer-associated mortality. Subgroup analysis revealed that TCM annual visits ≥ 3 times with CHP prescription 1~90 days per year affected mortality reduction most significantly (HR: 0.26; 95% CI = 0.08-0.83; p < 0.05) compared to other TCM use. In contrast, using TCM (either short-term or long-term) was not associated with MPR in HT. CONCLUSIONS: Our results supported the potential advantage of TCM on breast cancer-associated mortality, whereas TCM use does not compromise medical adherence to HT. This study offers important insights in integrative therapy for HT in patients with estrogen receptor (+) breast cancer.


Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/psicología , Cumplimiento de la Medicación/psicología , Medicina China Tradicional/psicología , Adulto , Anciano , Anciano de 80 o más Años , Medicamentos Herbarios Chinos/uso terapéutico , Femenino , Humanos , Cumplimiento de la Medicación/estadística & datos numéricos , Medicina China Tradicional/estadística & datos numéricos , Persona de Mediana Edad , Receptores Estrogénicos/metabolismo , Estudios Retrospectivos , Taiwán , Resultado del Tratamiento , Adulto Joven
12.
Br J Radiol ; 94(1117): 20200423, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32976025

RESUMEN

OBJECTIVE: The study aims to explore the perceptions of advanced practice radiographers (APRs) currently giving benign biopsy results to extend their role to deliver NHS Breast Screening Programme (NHSBSP) malignant outcomes. In the UK, APRs are appropriately trained to deliver results, yet traditionally have been cultured not to. Increasing pressures on NHSBSP units are a key driver for APR evolvement. A significant lack of published research provides the rationale for the study, combined with an identified service need. METHODS: Following ethical approval, a grounded theory design was applied to interview six APRs individually in a single breast screening unit. Extracted themes were considered during a subsequent focus group. RESULTS: Five core themes identified; (i) role of the APR, (ii) patient experience, (iii) efficiency, (iv) role boundaries, and (v) delivering results.The findings indicate the ambiguity of radiographers delivering results within their profession, outlining the potential impact on themselves and patients. Mammography APRs are skilled to deliver results, and whilst enforced barriers may restrict extension a supportive environment can overcome these. Additional training is necessary to implement the role in the screening service. CONCLUSION: Identified within their scope of practice; APRs have the ability with appropriate training and peer support to effectively deliver results with a patient-centred approach. ADVANCES IN KNOWLEDGE: This study has identified important enabling factors and challenges concerning role extension in the delivery of breast biopsy results. The apparent suitability of APRs to communicate results may address breast service pressures, with benefit to patients and the radiology profession.


Asunto(s)
Actitud del Personal de Salud , Neoplasias de la Mama/diagnóstico por imagen , Comunicación en Salud/métodos , Personal de Salud/psicología , Mamografía/psicología , Rol Profesional/psicología , Adulto , Biopsia , Neoplasias de la Mama/patología , Neoplasias de la Mama/psicología , Diagnóstico Diferencial , Femenino , Teoría Fundamentada , Humanos , Mamografía/métodos , Persona de Mediana Edad , Reino Unido
13.
Support Care Cancer ; 29(1): 193-201, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32337626

RESUMEN

PURPOSE: Evidence suggests that fruit and vegetable consumptions may improve mental health among general population. However, their associations among breast cancer survivors are unclear. We planned to investigate this association via a nationwide survey in the USA. METHODS: We identified 7988 breast cancer survivors from 2009 Behavioral Risk Factor Surveillance System (BRFSS). Fruit juice, fruit, and vegetable consumptions were categorized as ordinal variables to approximate tertiles. Survivors who were mentally unhealthy for at least 14 days in the past 30 days were defined as having frequent mental distress (FMD). Multivariable logistic regression treating FMD as the outcome was used to calculate adjusted odd ratios (aORs) and 95% confidence intervals (CIs) for exposures. Quadratic model was used to depict the dose-response pattern in primary analysis. Subgroup analyses by adverse lifestyle behaviors were conducted; Wald tests were used to examine if there were interactions between these factors and exposures in relation to FMD. RESULTS: Overall, 825 (10.3%) survivors had FMD. Mean age was 67.2 years, and 89.7% of survivors were white. Juice showed non-significant associations with FMD. Moderate (aOR = 0.81, 95% CI = 0.68-0.98) and high (aOR = 0.79, 95% CI = 0.63-0.98) fruit consumptions, as well as moderate vegetable consumption (aOR = 0.78, 95% CI = 0.64-0.94), were significantly and inversely associated with FMD. The dose-response curves were consistent with results in primary analysis. No interaction was identified for adverse lifestyle behaviors. CONCLUSION: Fruit and vegetable, but not fruit juice, show potential preventive effects against FMD among breast cancer survivors. The conclusion should be verified by studies with clear temporality in future.


Asunto(s)
Neoplasias de la Mama/psicología , Supervivientes de Cáncer/psicología , Conducta Alimentaria/psicología , Frutas , Distrés Psicológico , Verduras , Adulto , Anciano , Anciano de 80 o más Años , Mama/patología , Femenino , Conductas Relacionadas con la Salud , Humanos , Estilo de Vida , Modelos Logísticos , Trastornos Mentales , Salud Mental , Persona de Mediana Edad , Encuestas y Cuestionarios
14.
Support Care Cancer ; 29(1): 231-237, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32342222

RESUMEN

PURPOSE: Adequate adjustment to bodily changes during various phases of cancer treatment is important to patients' emotional well-being. The Body Image Scale (BIS) is a widely used tool for assessment of body image concerns in different cancer types. However, a cut point score indicative of clinically relevant body image concerns has not been established. The purpose of our study was to evaluate whether the previously suggested, but not validated, BIS cut point score of ≥ 10 is an adequate indicator of psychological distress. METHODS: In a prospective cross-sectional study, 590 adult patients were recruited from a psychiatric oncology clinic (November 2017-March 2018). Patient-reported body image concerns, depression, anxiety, and emotional distress were assessed with the BIS, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, and National Comprehensive Cancer Network Distress Thermometer, respectively. RESULTS: Almost half of the patients had a BIS score ≥ 10; these were more likely to be younger, female, Hispanic, and to have breast cancer than patients with a score < 10. BIS scores were positively associated with depression, anxiety, and distress scores. A BIS score ≥ 10 was a significant predictor of moderate depression and anxiety (odds ratios = 3.555 [95% CI 2.478-5.102] and 3.655 [2.493-5.358]; p < 0.001 for both). CONCLUSION: To our knowledge, this is the first study to have assessed the validity of the previously suggested clinically relevant BIS cut point score of ≥ 10 as an indicator of psychological distress. Our results suggest that a BIS score of ≥ 10 or higher should lead to follow-up on body image concerns and/or appropriate referral.


Asunto(s)
Imagen Corporal/psicología , Neoplasias de la Mama/psicología , Distrés Psicológico , Estrés Psicológico/psicología , Adulto , Anciano , Instituciones de Atención Ambulatoria , Ansiedad/psicología , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Persona de Mediana Edad , Apariencia Física/fisiología , Estudios Prospectivos , Encuestas y Cuestionarios
15.
Support Care Cancer ; 29(1): 239-246, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32346797

RESUMEN

PURPOSE: Breast cancer (BC) patients report complex negative emotions, including symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD). What's more, being diagnosed with cancer also has a negative impact on the patient's family such as additional financial burden and care needs, leading to higher levels of caregiver burden. This study aimed to explore whether dispositional mindfulness could alleviate multiple negative emotions of BC patients and to investigate the mediating effect of caregiver burden on the relationship between the patients' dispositional mindfulness and negative emotions. METHODS: A sample of 230 Chinese BC patients receiving chemotherapy and their caregivers voluntarily participated in the study by completing a set of questionnaires including the Mindfulness Attention Awareness Scale, the Caregiver Self-assessment Questionnaires, the General Anxiety Symptoms Scale, the Patient Health Questionnaire, and the PTSD Symptom Scale. Structural equation modeling was used to test the relationship between dispositional mindfulness, negative emotions, and caregiver burden. RESULTS: Dispositional mindfulness was significantly and negatively correlated with negative emotions, including anxiety, depression, and PTSD among the BC patients. Structural equation modeling showed that caregiver burden mediated the relation between patients' dispositional mindfulness and negative emotions. CONCLUSION: BC patients with higher levels of dispositional mindfulness showed less negative emotions. The results of the mediation analysis suggested that higher levels of dispositional mindfulness of breast cancer patients could decrease the caregivers' perceived burden and, in turn, relieve patients' negative emotions. Dispositional mindfulness was beneficial to breast cancer patients as well as their caregivers, indicating that mindfulness-based interventions targeting distress in patient-caregiver dyads would be more effective than what interventions for patients alone.


Asunto(s)
Neoplasias de la Mama/psicología , Cuidadores/psicología , Atención Plena/métodos , Pacientes/psicología , Adulto , Anciano , Ansiedad/psicología , Atención , Neoplasias de la Mama/tratamiento farmacológico , China , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Personalidad , Psicometría/métodos , Rol , Trastornos por Estrés Postraumático/psicología , Encuestas y Cuestionarios
16.
J Plast Reconstr Aesthet Surg ; 74(3): 463-474, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33309318

RESUMEN

INTRODUCTION: Post-mastectomy breast reconstruction (PMBR) is an important component of the multidisciplinary care of breast cancer patients. Despite the improved quality of life, significant racial disparities exist in the receipt of PMBR. Given the increasing population of Black, Asian and minority ethnic (BAME) women in UK, it is important to address this disparity. Our review aims to identify the barriers and facilitators influencing the uptake of PMBR in BAME women and raise awareness for physicians on interventions that could improve uptake of PMBR in BAME women. METHODS: The methodology outlined by the Cochrane guidelines was used to structure this systematic review. Systematic searches for qualitative studies on barriers and/or facilitators to PMBR in ethnic women published in English were conducted. The following databases were searched from their inception up to June 2019: MEDLINE, EMBASE, PubMed, Cochrane Library, Google Scholar and Scopus. Reference lists of all included articles and relevant systematic reviews were also hand-searched for possible additional publications. Publication year or status restrictions were not applied. Only full text articles published in English and by peer reviewed journals are included. Exclusion criteria were as follows: quantitative studies on barriers and/or facilitators to PMBR, abstracts, conference proceedings, non-English language and non-specific to BAME women. A thematic synthesis approach was used through the development of sub-themes and themes from the findings of the included qualitative studies. RESULTS: Five studies satisfied the inclusion and exclusion criteria. Three overarching themes emerged from our review: physician-associated factors (physician recommendations), patient-associated factors (knowledge, language, community and cultural, emotions, logistics, patient characteristics) and system-associated factors (insurance coverage, income status). CONCLUSION: Our systematic review suggests that there is a paucity of data in the literature on the barriers and facilitators to PMBR in BAME women. Considering the expanding population of BAME women and increasing breast cancer incidence, it is imperative that future research in this field is carried out. Physician and patient-associated factors were identified as the most important yet modifiable factors. Adopting a combination of culturally tailored interventions targeting these factors may help improve the access of PMBR in BAME women. REGISTRATION: Prospero ID: CRD42019133233.


Asunto(s)
Neoplasias de la Mama , Asistencia Sanitaria Culturalmente Competente/etnología , Mamoplastia , Aceptación de la Atención de Salud/etnología , Calidad de Vida , Neoplasias de la Mama/etnología , Neoplasias de la Mama/psicología , Neoplasias de la Mama/cirugía , Grupos Étnicos , Femenino , Humanos , Mamoplastia/métodos , Mamoplastia/psicología , Mastectomía/métodos
17.
Medicine (Baltimore) ; 99(50): e23273, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33327251

RESUMEN

This study aimed to analyze the moderation and moderation effects of resilience on the anxiety, depression impact on post-traumatic growth (PTG) among breast cancer patients undergoing chemotherapy based on structural equation modeling, and confirmed whether resilience was a mediating and regulating variable between anxiety, depression, and post-traumatic growth. In addition, whether anxiety and depression have different effects on PTG under different levels of psychological resilience.This cross-sectional study was conducted from November 2017 to January 2019, with subjects of 260 breast cancer patients undergoing chemotherapy in the department of breast and general surgery of a tertiary general hospital in Shanxi Province of China.Data were collected according to the General Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale, and the posttraumatic growth inventory. Estimated values of model path coefficients and significance test were performed to confirm the mediation effect. Hierarchical regression and simple slope test were used to analyze the regulation effect.Resilience showed significant correlations with anxiety, depression and PTG (all P < .01). Estimated values of model path coefficients and significance test results indicated that the mediating role of resilience was remarkable and it could regulate anxiety, depression, and PTG.The anxiety, depression and resilience affected their PTG of breast cancer patients during chemotherapy, suggesting the need to establish a cooperative mechanism based on the concept of multidisciplinary collaboration. Professional psychological intervention should be used to reduce anxiety and depression and to explore the potential of resilience to promote their PTG.


Asunto(s)
Ansiedad/etiología , Neoplasias de la Mama/psicología , Depresión/etiología , Crecimiento Psicológico Postraumático , Resiliencia Psicológica , Adulto , Ansiedad/psicología , Neoplasias de la Mama/tratamiento farmacológico , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Modelos Estadísticos , Escalas de Valoración Psiquiátrica , Encuestas y Cuestionarios
18.
BMC Bioinformatics ; 21(Suppl 16): 504, 2020 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-33323103

RESUMEN

BACKGROUND: With the rapid development of medical treatment, many patients not only consider the survival time, but also care about the quality of life. Changes in physical, psychological and social functions after and during treatment have caused a lot of troubles to patients and their families. Based on the bio-psycho-social medical model theory, mental health plays an important role in treatment. Therefore, it is necessary for medical staff to know the diseases which have high potential to cause psychological trauma and social avoidance (PTSA). RESULTS: Firstly, we obtained diseases which can cause PTSA from literatures. Then, we calculated the similarities of related-diseases to build a disease network. The similarities between diseases were based on their known related genes. Then, we obtained these diseases-related proteins from UniProt. These proteins were extracted as the features of diseases. Therefore, in the disease network, each node denotes a disease and contains the information of its related proteins, and the edges of the network are the similarities of diseases. Then, graph convolutional network (GCN) was used to encode the disease network. In this way, each disease's own feature and its relationship with other diseases were extracted. Finally, Xgboost was used to identify PTSA diseases. CONCLUSION: We developed a novel method 'GCN-Xgboost' and compared it with some traditional methods. Using leave-one-out cross-validation, the AUC and AUPR were higher than some existing methods. In addition, case studies have been done to verify our results. We also discussed the trajectory of social avoidance and distress during acute survival of breast cancer patients.


Asunto(s)
Neoplasias de la Mama/psicología , Trauma Psicológico/diagnóstico , Conducta Social , Programas Informáticos , Femenino , Humanos , Modelos Logísticos , Análisis Multivariante , Redes Neurales de la Computación , Calidad de Vida/psicología , Autoimagen
19.
PLoS One ; 15(12): e0244355, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33347475

RESUMEN

BACKGROUND: The current cancer care system must be improved if we are to have in-depth knowledge about breast cancer patients' experiences throughout all the stages of their disease. AIM: This study seeks to describe breast cancer patients' experience over the course of the various stages of illness by means of a journey model. METHODS: This is a qualitative descriptive study. Individual, semi-structured interviews will be administered to women with breast cancer and breast cancer survivors. Patients will be recruited from nine large hospitals in Spain and intentional sampling will be used. Data will be collected by means of a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data will be processed adopting a thematic analysis approach. DISCUSSION: The outcomes of this study will afford new insights into breast cancer patients' experiences, providing guidance to improve the care given to these individuals. This protocol aims to describe the journey of patients with breast cancer through the healthcare system to establish baseline data that will serve as the basis for the development and implementation of a patient-centered, evidence-based clinical pathway.


Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Supervivientes de Cáncer/psicología , Femenino , Humanos , Evaluación del Resultado de la Atención al Paciente , Atención Dirigida al Paciente , Investigación Cualitativa , Nivel de Atención , Encuestas y Cuestionarios
20.
Psicooncología (Pozuelo de Alarcón) ; 17(2): 239-253, jul.-dic. 2020.
Artículo en Español | IBECS | ID: ibc-199114

RESUMEN

OBJETIVO: El objetivo de la investigación fue determinar las relaciones entre el distrés psicológico, el miedo a la recurrencia del Cáncer (MRC) y la calidad de vida relacionada con la salud (CDVRS) en pacientes sobrevivientes de cáncer de mama venezolanas. MÉTODO: El estudio fue de corte correlacional y participaron 203 pacientes sobrevivientes de Cáncer de mama, de edades entre 24 y 75 años. Se emplearon las escalas de Ansiedad y Depresión Hospitalaria (HADS), de preocupaciones relacionadas con el Cáncer y de salud global SF - 12 versión 2. RESULTADOS: Se reportaron niveles bajos de distrés psicológico, aunque con predominio de niveles medios de ansiedad y de MRC. La prevalencia de ansiedad elevada fue de 23%, de depresión elevada de 7%, de distrés psicológico de 18% y de MRC de 36%. El distres psicológico y MRC correlacionaron de forma positiva y significativa, aunque con fuerza de baja a moderada. La CDVRS estuvo en un rango normal y correlacionó de forma inversa y significativa con el distrés psicológico así como también con el MRC. CONCLUSIÓN: El distrés psicológico se encuentra asociado, aunque no en gran magnitud, con el MRC y que ambos se asocian con un deterioro de la CDVRS en las pacientes sobrevivientes de Cáncer de mama venezolanas. Además, el MRC y la CDVRS correlacionaron de forma positiva, baja y significativa con el tiempo de supervivencia de las pacientes


The objetivo of the following study was to determine the relationships between psychological distress, fear of cancer recurrence (FCR) and health - related quality of life (HQoL) in Venezuelan breast cancer survivors. The study was with a correlational cut, 203 breast cancer survivors between the age of 24 and 75 participated. METHOD: The scales of Hospital Anxiety and Depression (HADS), Cancer- related Worry and Global Health SF - 12 version 2 were used. RESULTS: Low levels of psychological distress were reported, but with a predominance of means levels of anxiety and FCR. The prevalence of high anxiety was 23%, depression 7% an FCR 36%. Psychological distrees and FCR correlated positively and significantly, although with low to moderate. HQoL was in a normal range and correlated inversely and significantly with psychological distress, as well as with FCR. CONCLUSION: The psychological distress and MRC are associated, but although not in large magnitude, and that both are associated with a deterioration of HQoL in Venezuelan breast cancer survivors. FCR nd HQoL correlated positively and significantly with time survival of patients


Asunto(s)
Humanos , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Recurrencia Local de Neoplasia/psicología , Neoplasias de la Mama/psicología , Calidad de Vida/psicología , Estrés Psicológico , Depresión/psicología , Ansiedad/psicología , Miedo/psicología , Factores Socioeconómicos , Venezuela
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