How physicians respond to the emotional expressions of people with cancer / Cómo responden los médicos a las expresiones emocionales de las personas con cancer

The aim of this study is to examine patient emotional cues to oncologists’ responses and explore the association between the concerns and emotional cues during the consultation and the physicians’ response to them throughout treatment, satisfaction, and the assessment of the patients’ perception of the established communication. Method: Cross-sectional design, involved 12 adults patients undergoing cancer treatment and eight physicians in the study. The twelve video-recorded medical consultations were coded (349 cues/concern) using the Verona coding definitions of emotional sequences (VR-CoDES). Results: A strong association between explicit with reducing space responses and the physiological symptoms cues (x²=6.029; p=0.014), and related to the repetition cue of the content by the patient (x²=5.599; p=0.018) was observed. Patients expressed fewer non-verbal behaviors (for example, crying, silence, silent pauses), as they had been undergoing treatment for a longer time, therefore, provided with more empathic responses from physicians. Conclusion: The identification of emotions can help physicians to further explore patients’ underlying cues that reveal emotional distress concerning illness and treatment in a less explicit way. There is a need for improvement in the physician’s ability to recognize patients’ concerns and to provide space for patients to have comprehensive health care, considering the severity of cancer disease and its negative emotional impacts for patients (AU)

El objetivo de este estudio es examinar cómo los oncólogos responden a las preocupaciones emocionales de las personas con cáncer durante el tratamiento, relacionarlas con la satisfacción y evaluar las percepciones de comunicación de los pacientes. Diseño transversal, en el que participaron 12 pacientes adultos en tratamiento oncológico y ocho médicos en el estudio. Las doce consultas médicas grabadas en vídeo se codificaron (349 pistas/inquietudes) utilizando las definiciones de codificación de secuencias emocionales de Verona (VR-CoDES). Hubo fuerte asociación entre respuestas explícitas con reducción de espacio y claves de síntomas fisiológicos (x²=6,029; p=0,014), y relacionada con la repetición de claves de contenido por parte del paciente (x²=5,599; p=0,018). Los pacientes expresaron menos comportamientos no verbales (por ejemplo, llanto, silencio, pausas silenciosas) ya que habían estado en tratamiento por más tiempo y, por lo tanto, tenían respuestas más empáticas por parte de los médicos. La identificación de las emociones puede ayudar a los médicos a explorar más a fondo las pistas subyacentes de los pacientes que revelan angustia emocional por la enfermedad y el tratamiento de una manera menos abierta. Existe la necesidad de mejorar la capacidad del médico para reconocer las preocupaciones de los pacientes y hacer espacio para que los pacientes tengan una atención integral en salud, considerando la gravedad de la enfermedad oncológica y sus impactos emocionales negativos para los pacientes (AU)

Illness perceptions in childhood cancer survivor and caregivers' dyads.

Surviving childhood cancer is a difficult experience for children and their caregivers, it can produce long-term emotional distress. Illness perceptions refer to the way people understand the different aspects related to illness from their individual and collective experiences. OBJECTIVE: to compare the illness perceptions of adolescent childhood cancer survivors and their caregivers and examine the relationship between illness perception of childhood cancer survivors, their caregivers, and sociodemographic, illness, and treatment variables. Forty-three survivor-caregiver dyads (the mean age of a survivor 17.05 years old; the mean age of caregivers 47.53 years old) participated in the study and answered the Brief Illness Perception Questionnaire (Brief IPQ) and Demographics data. RESULTS: Results showed significant differences in the illness perceptions of survivors and caregivers. Caregivers presented more negative cognitive perceptions than survivors (t = -6.701, p < 0.001), especially in the identity dimension (t = -4.327, p < 0.001), and more negative emotional perceptions than survivors (t = -4.132, p < 0.001), both in concern (t = -3.695, p < 0.001) and emotional representation (t = -3.466, p < 0.001). No significant correlations were found between survivors' and caregivers' illness perceptions and sociodemographic illness variables. CONCLUSION: These findings showed that even though dyads went through cancer together, survivors' and caregivers' perceptions of childhood cancer are different, indicating the need to better understand how children growing up with a chronic disease develop such illness perceptions and their experience.

Physicians privilege responding to emotional cues in oncologic consultations: A study utilizing Verona Coding Definitions of Emotional Sequences.

The aim of this study was to describe emotional cues and concerns expressed by cancer patients and their physicians using video-recorded regular oncology consultations. The consultations were divided into units of analysis and coded according to the Verona Coding Definitions of Emotional Sequences system. The study design was mixed, descriptive, and exploratory. Twelve patients and eight oncologists participated in the study. The patients expressed 349 cues/concerns during the 12 consultations. The majority (68.8%) of the content consisted of non-explicit description of physiological and stress episodes in the disease and treatment. Physicians demonstrated that they recognized fewer underlying cues than those related to physiological complaints.

To disclose or not to disclose? Communication between mothers with cancer and their young children / ¿Revelar o no revelar? Comunicación entre madres con cáncer y sus hijos pequeños

Objective: Understand how mothers with cancer communicate about the disease with their children. Method: We used qualitative methods. Ten mothers participated in a semi-structured interview about their experiences of disclosing the disease to their young children. The interviews were audio recorded and transcribed. Results: Two main themes emerged, including three sub-themes for the second theme: 1) The cancer was disclosed to the children; 2) The cancer was not disclosed to the children; 2.1 Did not tell her child and has no intention to do so; 2.2 Did not tell her child but plans to do so in the future; and 2.3 Did not tell her child but believes her child knows about the disease. Mothers who succeed in maintain a sincere dialogue with their children show a strong affective closeness with their children. Conclusions: The findings may be useful for understanding and planning communication strategies that favor the mother-child bond and that positively contribute to the treatment of mothers with cancer

Objectivo: comprender cómo madres con cáncer se comunican sobre su enfermedad con sus hijos. Método: diseño cualitativo. Diez madres participaron de una entrevista semi-estructurada sobre sus experiencias de revelación de la enfermedad a sus hijos pequeños. Las entrevistas fueron grabadas en audio y transcritas. Resultados: dos temas principales fueron identificados, y el segundo tema contiene tres sub-temas: 1) el cáncer fue revelado a los niños; 2) el cáncer no fue revelado a los niños; 2.1 no reveló al niño y no hay la intención de hacerlo; 2.2 no reveló al niño pero hay planos de hacerlo en el futuro; y 2.3 reveló al niño pero cree que él sabe sobre la enfermedad. Las madres que lograron mantener un diálogo sincero con sus niños fuerte cercanía afectiva con sus hijos. Conclusiones: Los hallazgos pueden ser útiles para comprender y planear estrategias de comunicación que favorezcan el vínculo madre-hijo y que contribuyan de manera positiva al tratamiento de las madres con cáncer

Early detection of breast cancer: the role of risk perception and family history / Detección precoz del cáncer de mama: el papel de la percepción de riesgo y la historia familiar

Background: Breast cancer is the neoplasm with the highest mortality rates among Brazilian women. Family history plays an important role in tracking the illness because its analysis reveals possible genetic risks. Objective: The aim of this study is to compare the risk perception and self-care for breast cancer among healthy women with and without family history. Method: The study included 211 women (mean age = 59.11 years, SD = 8.54) of which 55 (26.4%) had a family history of the illness. The instruments used were a sociodemographic and health behavior questionnaire and a risk perception questionnaire. Results and Conclusions: The results showed no significant differences in risk perception and self-care behavior among women with and without breast cancer history, signaling the need of guidelines for psychologists to act in breast cancer prevention among women with a family history, encompassing understanding of the risk factors and causes of the illness as well as women’s responsibility in tracking (AU)

Introducción: el cáncer de mama es el segundo tipo de neoplasia con más mortalidad entre las mujeres brasileñas. La historia familiar tiene un papel importante, pues su análisis permite identificar posibles riesgos genéticos. Objectivo: comparar la percepción de riesgo y el autocuidado del cáncer de mama en mujeres sanas con y sin historia familiar de la enfermedad. Método: Participaron 211 mujeres (edad media = 59,11 años, DT= 8,54), de las cuales 55 (26,4%) tenían historia familiar de la enfermedad. Los instrumentos utilizados fueron un cuestionario sociodemográfico y de conductas de salud y un cuestionario de percepción de riesgo. Resultados y Conclusiones: Los resultados mostraron que no existían diferencias significativas en la percepción de riesgo y conductas de autocuidado entre mujeres con y sin historia familiar de cáncer de mama, lo que señala la necesidad de protocolos de trabajo para los psicólogos en la prevención del cáncer de mama en mujeres con historia familiar de enfermedad oncológica, lo que incluye la comprensión de los factores de riesgo y las causas de la enfermedad, así como su responsabilidad en el seguimiento (AU)

Causal attribution to cervical cáncer / Atribución causal del cáncer cervical

This study aimed to examine the causal attribution for cervical cancer for women with and without the disease. Seventy-eight (78) users from the public healthcare system participated, which were divided into: a clinical group (CG) of women with cervical cancer and a non-clinical group (NCG) of women without cervical cancer. A Form covering sociodemographic and clinical data was utilized along with the Portuguese version of the Illness Perception Questionnaire for ill patients and healthy people. The responses were grouped into six categories: 1) Psychological attributions; 2) Behavioral risk factors; 3) Biological factors; 4) Bad luck; 5) Lack of resources; 6) Chemical agents. The CG attributed more emotional causes to the Cervical Cancer while the NCG more causes associated with behavioral risk factors. These results suggest that women with cancer may blame themselves for the illness. Distorted beliefs about the etiology of cervical cancer can harm preventative conduct and self-care practices

El estudio buscó examinar la atribución de causas del cáncer cervical de mujeres con y sin la enfermedad. Participaron setenta y ocho (78) usuarias del sistema público de salud, que fueron divididas en: grupo clínico (GC) de mujeres con cáncer cervical, y grupo no-clínico (GNC) de mujeres sin cáncer cervical. Fue utilizado un cuestionario de datos sociodemográficos y clínicos y la versión en portugués del Illness Perception Questionnaire para pacientes enfermos y personas sanas. Las respuestas fueron agrupadas en seis categorías: 1) Atribuciones psicológicas; 2) Factores de riscos comportamentales; 3) Factores biológicos; 4) Mala suerte; 5) Falta de recursos; 6) Agentes químicos. El GC atribuyó más causas emocionales al cáncer cervical, mientras el GNC atribuyó más causas asociadas a factores de risco comportamentales. Los resultados sugieren que mujeres con cáncer pueden culparse a sí mismas por la enfermedad. Creencias equivocadas sobre la etiología del cáncer cervical pueden perjudicar conductas de prevención y prácticas de autocuidado

Illness perceptions in brazilian women with cervical cancer, women with precusory lesions and healthy women

Purpose: to compare the perceptions about cervical cancer in: 1) women with cervical cancer, 2) women with precursory lesions; and 3) healthy women. Participants were 150 adult women from southern Brazil. Measures: Sociodemographic and Clinical Data sheet, Illness Perception Questionnaire - Revised and Illness Perception Questionnaire for healthy people. Results showed significant differences between groups in the dimensions of timeline cyclic and identity, indicating that healthy women perceived more symptoms, but as more cyclical (acute/chronic) compared to the other two groups. With regard to the causes of illness, women with cancer more often attributed it to their emotional state/stress/concerns than healthy women or those with precursory lesions (AU)

Objetivo: comparar las percepciones sobre el cáncer de cuello uterino en: 1) las mujeres con cáncer de cuello uterino, 2) las mujeres con lesiones precursoras, y 3) las mujeres sanas. Los participantes fueron 150 mujeres adultas procedentes del sur de Brasil. Medidas: Formulario de datos sociodemográficos y clínicos, Illness Perception Questionnaire - Revised and Illness Perception Questionnaire for healthy people Los resultados mostraron diferencias significativas entre los grupos en las dimensiones curso cíclico e identidad, lo que indica que las mujeres sanas perciben más síntomas, pero dependen más del curso cíclico (agudo/crónico) en comparación con los otros dos grupos. Con respecto a las causas de enfermedad, las mujeres con cáncer lo atribuyen con más frecuencia a su estado emocional/estrés/preocupaciones que las mujeres sanas o con lesiones precursoras (AU)

Qualidade de vida e auto-imagem de pacientes com câncer de cabeça e pescoço / Quality of life and self-image in patients with head and neck cancer

O câncer de cabeça e pescoço refere-se a tumores malignos de pele que atinge pessoas de todas as idades. O tratamento envolve cirurgias, quimioterapia e radioterapia. Objetivo: examinar a auto-imagem e a qualidade de vida de pacientes que tiveram câncer de cabeça e pescoço. Participantes: 28 pacientes, entre 30 e 73 anos. Instrumentos: Avaliação da Qualidade de Vida da OMS - versão breve e Escala de Avaliação com a Satisfação Corporal. Resultados: qualidade de vida total e suas subescalas correlacionaram-se positivamente com auto-imagem, com exceção da subescala relações sociais. A auto-imagem foi uma variável preditora significativa da qualidade de vida total e das dimensões física, psicológica e meio-ambiente. Conclusão: a qualidade de vida desses pacientes está intimamente ligada à auto-imagem.

Head and neck cancer refers to skin tumors that affect people of all ages. Treatments for this type of disease include surgeries, chemotherapy and radiotherapy. Purpose: to examine self-image and quality of life of patients who had head and neck cancer. Participants: 28 patients between 30 - 73 years. Instruments: Instrument for Assessing Quality of Life of the WHO - and the brief version of Evaluation Scale with Body Satisfaction. Results: Total quality of life and their subscales was positively correlated with self-image, with the exception of social relations subscale. Self-image was a significant predictor of total quality of life and physical psychological and environment dimension. Conclusion: quality of life was closely linked with self-image in these patients.

Competencia social y problemas emocionales/ conductuales en niños trasplantados de órganos sólidos / Social competence and emotional/behavioral problems in children who have undergone solid organ transplantation

El objetivo del presente estudio fue evaluar en niños con órganos trasplantados la competencia social y los problemas emocionales/conductuales y, complementariamente, la influencia de algunas variables clínicas y socio-demográficas en su adaptación psicológica. Los padres/madres de 48 niños trasplantados y de 88 niños sin problemas de salud completaron el “Listado de comportamientos infantiles 6-18” (Child Behavior Checklist 6-18, CBCL) que evalúa competencia social y problemas emocionales/conductuales, y un conjunto de datos socio-demográficos y clínicos. Los resultados mostraron que los niños trasplantados presentaron peor competencia social de manera significativa que los niños sin problemas de salud. Por otro lado, las niñas revelaron menos competencia social de manera significativa, especialmente en las actividades escolares, más problemas de conducta interiorizada, particularmente ansiedad/depresión, y más conducta agresiva que las niñas sin problemas de salud. Los análisis de regresión jerárquica mostraron que los problemas de rechazo contribuyeron para explicar los trastornos somáticos de manera significativa. Los resultados obtenidos sugieren la importancia de algunas variables clínicas en la adaptación psicológica de pacientes pediátricos con órganos trasplantados (AU)

This study aims to assess social competence and emotional/behavioral problems and to examine the influence of some clinical and socio-demographic variables on psychological adaptation in transplanted children. Parents of 48 transplanted children and 88 healthy children aged 5-12 completed the Child Behavior Checklist 6-18 (CBCL) which measures social competence and emotional/behavioral problems, and a group of clinical and socio-demographic data. Findings showed that transplanted boys presented significantly less social competence than healthy boys. In contrast, transplanted girls revealed significantly less social competence, especially in school activities, more internalizing behavior problems, particularly in anxiety/depression, and aggressive behavior than healthy girls. Hierarchical regression analysis demonstrated that rejection problems are significant to explain somatic complaints. Our data suggest the importance of some clinical variables on psychological adaptation in children who have undergone organ transplantation