"Not even my husband knows that I have this [breast cancer]": survivors' experiences in accessing, navigating and coping with treatment.

PURPOSE: Nigeria has the highest burden of breast cancer (BC) in Africa. While the survival rates for BC are over 90% in many high-income countries; low-and middle-income countries like Nigeria have 40% BC survival rates. Prior studies show that the burden and poor BC survival rates are exacerbated by both health system and individual level factors, yet there is a paucity of literature on the experiences of BC survivors in Nigeria. Hence, this study explored the divergent and convergent experiences of BC survivors in accessing, navigating, and coping with treatment. METHODS: Participants (N = 24, aged 35 to 73 years) were recruited and engaged in focus group discussions (group 1, n = 11; group 2, n = 13 participants). Transcripts were transcribed verbatim and analyzed with inductive thematic analysis. RESULTS: Four themes were identified: "I am carrying this [breast cancer] alone," "Living my life," "'God' helped me," and "A very painful journey." Participants described how they concealed their BC diagnosis from family and significant others while accessing and navigating BC treatment. Also, they adopted spiritual beliefs as a coping mechanism while sticking to their treatment and acknowledging the burden of BC on their well-being. CONCLUSIONS: Our findings explored the emotional burden of BC diagnosis and treatment and the willingness of the BC survivors to find meaning in their diagnosis. Treatment for BC survivors should integrate supportive care and innovative BC access tools to reduce pain and mitigate the burdens of BC. IMPLICATIONS FOR CANCER SURVIVORS: The integration of innovative technologies for venous access and other treatment needs of BC is crucial and will improve survivorship. Non-disclosure of BC diagnosis is personal and complicated; hence, BC survivors need to be supported at various levels of care and treatment to make meaningful decisions. To improve survivorship, patient engagement is crucial in shared decision-making, collaboration, and active participation in care.

Posttraumatic growth and health-related quality of life in cancer survivors: Does fatigue moderate the link?

Interest in post-traumatic growth (PTG) as a predictor of health-related quality of life (HRQoL) is currently gaining attention. However, current evidence is still inconclusive on the nature of this relationship. The first objective of this study was to investigate the relationship between PTG and global HRQoL among cancer survivors. We further investigated the moderating role of fatigue in the association between PTG and global HRQoL. In the FiX study (Fatigue in Germany - Examination of prevalence, severity, and state of screening and treatment) cancer-related fatigue (EORTC QLQ-FA12), PTG inventory and global HRQoL (EORTC QLQ-C30) were assessed four years after cancer diagnosis in 1316 cancer-free survivors (mean age = 67.28, SD = 11.05, 51.4% female). Multiple linear regression analysis and moderation analysis were performed. The results showed that PTG had a convex quadratic relationship with global HRQoL (p < 0.001). Contrary to our hypothesis, fatigue did not moderate the relationship between PTG (linear and quadratic terms) and global HRQoL, neither when considering the overall PTG score nor for any PTG subdimension. In conclusion, PTG has a convex quadratic relationship with long-term global HRQoL that was not modified by persisting fatigue. Future statistical models investigating PTG and global HRQoL should take this non-linear relationship into account. Aiming to increase PTG might contribute to, but is likely not sufficient for high levels of global HRQoL in cancer survivors in the long run.

Digital Dependency: How Parenting and Social Intelligence Shape Internet Addiction.

The global pandemic forced young adults and their parents to be together. This situation has equally exposed the weaknesses in the child-parent relationship. This study aimed to investigate the role of social intelligence in the relationship between parenting style and Internet addiction during the global COVID-19 pandemic. Seven hundred and seventy-four were sampled from a public university in southeast Nigeria. They comprised 373 females and 401 males aged 17-28 years, with a mean age of 21.61. The students responded to validated measures of parenting style inventory-II, the Tromsø social intelligence scale, and Young's Internet addiction test. The moderated multiple regression analysis results indicated that permissive parenting and social intelligence significantly predicted Internet addiction. Social intelligence moderated the relationship between authoritarian parenting style and Internet addiction. The moderation was that Internet addiction is significantly higher for individuals with low social intelligence and authoritarian parenting style than individuals with low social intelligence and higher authoritarian parenting style. Some implications of the findings include engaging parenting styles to encourage more physical interactions and enabling an environment for growth. Also, adopting techniques to increase social intelligence will help students adjust to any parenting style that may influence their psychological well-being.

Anxiety sensitivity and psychological distress among hypertensive patients: the mediating role of experiential avoidance.

Hypertension is often associated with adverse psychosocial outcomes and psychological factors have been advanced for better explanatory models and to enhance the development of effective interventions in the treatment of hypertensive patients. Although the link between anxiety sensitivity (AS) and poor mental health outcomes has been established, the mechanism through which it results in psychological distress (PD) is not yet well understood. In addition to investigating the direct associations of AS and experiential avoidance (EA) to PD, the present study examines whether AS predicts adverse mental health outcomes via EA. Hypertensive patients (N = 240; women = 135; Mean age = 41.09, SD = 9.11 years) drawn from cardiology unit of a Nigerian teaching hospital completed the following measures: Psychological Distress Scale, Anxiety Sensitivity Index - 3, and Acceptance and Action Questionnaire. Results showed that that greater AS and greater EA predicted increased PD, even when controlling for age and gender. The mediation hypothesis was further supported suggesting that the association between AS with increase in PD was a function of heightened EA. These findings are consistent with the notion that acceptance of daily experiences may serve to buffer against the potential adverse mental health outcomes and may be a critical target for interventions to ameliorate PD in patients with chronic health conditions such as hypertension. Psychological interventions that deals with experiential avoidance could be used in the management of distressed hypertensive patients.

Effectiveness of group cognitive-behavioral therapy on anxiety and depression in Nigerian breast cancer patients

Breast cancer patients are particularly weighed down by a variety of emotional distresses, including anxiety and depression. While the effects of Cognitive Behavioral Therapy (CBT) have been reported in most Western countries, less is known about the effectiveness of CBT in anxiety and depression among Nigerian women with breast cancer. The study investigated the effectiveness of a 12 weeks group CBT on anxiety and depression among Nigerian breast cancer patients. The study adopted randomized controlled Pre-test Post-test design. Thirty one women with breast cancer were randomly allocated to two groups: CBT Group (n= 16) and a Control Group (CG, n= 15). The CBT group received a 12-week 90-minute CBT session once a week, while the CG received a booklet containing information on cancer and how to cope with cancer. Assessments were carried out for both groups at baseline (pre-test), after the intervention (post-test) and 2-months Follow-Up with measures of Hospital Anxiety Depression Scale (HADS). The results showed that participants in the CBT Group had decreased in anxiety and depression significantly at post-test and 2-month follow-up compared to the participants in the CG. The implications of the study was discussed in line with the inclusion of psychological treatments such as CBT in the management of cancer patients in an oncology setting in Nigeria where such treatments are grossly lacking

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