Total Pain and Fear of Recurrence in Post-Treatment Cancer Patients: Serial Mediation of Psychological Flexibility and Mentalization and Gender Moderation.

Background: The research indicates that painful experiences can significantly affect the fear of cancer recurrence among cancer survivors, which is a distressing concern that influences both physiological and psychological recovery. This cross-sectional study aims to advance our comprehension of the associations between total pain and the fear of recurrence in post-treatment cancer patients by examining two potential mediators: psychological flexibility and mentalization. Methods: Three hundred and thirty-five participants (aged 22 to 88, 49.1% female) who had finished their cancer treatment completed self-report assessments of total pain, their fear of recurrence, psychological flexibility, and mentalization. Results: The serial mediation analysis showed that all dimensions of total pain were positively and indirectly related to the fear of recurrence through psychological flexibility and mentalization in serial. Additionally, gender was found to moderate these serial mediational effects. Conclusions: In line with the psychological flexibility model, personal capacities to face difficult internal/external problems and interpret one's behavior in motivational terms can counterbalance a patient's negative emotions and feelings related to the illness. Gender factors also determine the way in which post-treatment cancer patients manage potential future anxiety and fears.

Perceived and Received Social Support and Illness Acceptance Among Breast Cancer Patients: The Serial Mediation of Meaning-Making and Fear of Recurrence.

BACKGROUND AND PURPOSE: The literature indicates connections between social support and acceptance of a personal diagnosis of breast cancer, but these relationships are likely to be mediated due to numerous connections between social support and illness acceptance with meaning-making and fear of recurrence. We decided to investigate whether meaning-making and fear of recurrence serially mediated the relationship between perceived and received social support and illness acceptance. METHODS: The current research examined 246 adult women patients with a breast cancer diagnosis who were undergoing radiotherapy/chemotherapy treatment in oncological hospitals. This cross-sectional study based on a mediational model was reported according to the STROBE checklist. RESULTS: Our results supported the mediational model in which meaning-making and fear of recurrence serially mediated the relationship of both perceived and received social support with illness acceptance. Furthermore, the mediating power of meaning-making was more significant than the fear of recurrence. CONCLUSION: Meaning structures and anxiety played an important mediating role in breast cancer patients. Finding additional meaning and goals and experiencing lower fear enables the patients to effectively make use of social support and accept their illness. PRACTICE IMPLICATIONS: The current study identified factors that increase illness acceptance among breast cancer patients as it showed that patients can gain a greater understanding of the nature of their illness by becoming more aware of their own goals and values and reduce anxiety by learning about their current state of the illness.

Breast cancer is the most common cancer in women in the world, and the hardships of the cancer experience are considered potentially traumatic events associated with psychological effects. One of the most important factors responsible for the patient's daily functioning is illness acceptance. Therefore, we investigated whether meaning-making and fear of recurrence serially mediated the relationship between perceived and received social support and illness acceptance. We examined 246 adult women patients with a breast cancer diagnosis. In our study, patients with breast cancer who received more social support had a better understanding of their illness and lower fear of recurrence. Moreover, women with breast cancer characterized by a sense of purpose and optimism experienced lower anxiety about a potential relapse of the disease. Meaning structures and anxiety played an important mediating role in breast cancer patients. Finding additional meaning and goals and experiencing lower fear enables the patients to make use of social support and accept their illness effectively.

Marital satisfaction, partner communication, and illness acceptance among couples coping with breast cancer: A dyadic approach.

OBJECTIVE: Associations between marital satisfaction and illness acceptance are mediated by different factors. This study examines whether partner communication mediates relationships between marital satisfaction and illness acceptance among couples coping with breast cancer within a dyadic approach. METHODS: One hundred and thirty-six couples were examined: 136 women with a diagnosis of breast cancer and their 136 spouses without a history of cancer. Questionnaires measuring marital satisfaction, partner communication, and illness acceptance were used. SEM analysis was applied to examine mediation effects. RESULTS: For the patients, marital satisfaction was positively associated with supportive self-communication, supportive partner communication, and illness acceptance. For the spouses, marital satisfaction was positively correlated with supportive self-communication and supportive partner communication, yet, it was negatively correlated with deprecating communication of both self and partner. The associations between marital satisfaction and illness acceptance were mainly mediated by supportive communication (self and partner). CONCLUSIONS: An examination of partner communication within a dyad is crucial for understanding relationships between marital satisfaction and illness acceptance in breast cancer patients. These relationships predominantly depend on the supportive communication of cognitive and emotional information between the spouses.

The perception of COVID-19, the Light Triad, harmony and ethical sensitivity in late adolescents: The role of meaning-making and stress.

The experiences of inner harmony and ethical sensitivity among late adolescents during the COVID-19 pandemic depend on the interplay of perceptive factors, personal resources and cognitive and stress mechanisms. Using a sample from Poland, the present study examined the relationships between the perceptions of COVID-19 and the Light Triad and the characteristics of inner harmony and ethical sensitivity from the mediational perspective of meaning-making and perceived stress. Three hundred and sixteen late adolescents were recruited in the cross-sectional study. They filled in questionnaires measuring the perception of COVID-19, the Light Triad, meaning-making, stress, inner harmony and ethical sensitivity, from April to September 2020. The perception of COVID-19 was negatively related to ethical sensitivity, whereas the Light Triad was positively related to inner harmony and ethical sensitivity. Perceived stress and meaning-making mediated the relationships between the perceptions of COVID-19, the Light Triad and the characteristic of inner harmony. Perception processes and the Light Triad dimensions directly influence ethical sensitivity, as well as indirectly affect inner harmony through meaning-making processes and perceived stress. This noticeably highlights the vital role played by meaning structures and emotional reactions in the experience of inner peace and calmness.

Risk Perception of COVID-19, Religiosity, and Subjective Well-Being in Emerging Adults: The Mediating Role of Meaning-Making and Perceived Stress.

The pressured experienced due to COVID-19 for young people has become clearly visible in the domain of well-being. Although the psychological effects of the COVID-19 pandemic on emerging adults have been examined, little is known about the role played by risk perception and religiosity for their well-being. In addition, the mediating effects of meaning-making and perceived stress still need to be investigated. A total of 316 emerging adults (143 males and 173 females) participated in the present study. Using structural equation modeling (SEM) analysis, we showed that the relationship of risk perception of COVID-19 and religiosity with subjective well-being was largely mediated by meaning-making and perceived stress. However, their mediational roles were different and depended on the interplay of perceptual and religious factors, which can be more fully understood within the meaning-making model. Emerging adults tend to rely on both their personal evaluation of COVID-related risks and religious beliefs to the extent that it helps them understand current life situations and restore cognitive and emotional balance.

Heat shock protein A2 is a novel extracellular vesicle-associated protein.

70-kDa Heat Shock Proteins (HSPA/HSP70) are chaperones playing a central role in the proteostasis control mechanisms. Their basal expression can be highly elevated as an adaptive response to environmental and pathophysiological stress conditions. HSPA2, one of poorly characterised chaperones of the HSPA/HSP70 family, has recently emerged as epithelial cells differentiation-related factor. It is also commonly expressed in cancer cells, where its functional significance remains unclear. Previously, we have found that proteotoxic stress provokes a decrease in HSPA2 levels in cancer cells. In the present study we found that proteasome inhibition-related loss of HSPA2 from cancer cells neither is related to a block in the gene transcription nor does it relate to increased autophagy-mediated disposals of the protein. Proteotoxic stress stimulated extracellular release of HSPA2 in extracellular vesicles (EVs). Interestingly, EVs containing HSPA2 are also released by non-stressed cancer and normal cells. In human urinary EVs levels of HSPA2 were correlated with the levels of TSG101, one of the main EVs markers. We conclude that HSPA2 may constitute basic components of EVs. Nevertheless, its specific role in EVs and cell-to-cell communication requires further investigation.

Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making.

Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies and meaning-making can serially mediate the relationship of threat appraisal and resilience with health behaviors in recovered COVID-19 patients. Self-report measures of threat appraisal, resilience, coping, meaning-making, and health behaviors were completed by 266 participants (aged 17 to 78, 51.5% female) who had recovered from COVID-19. The serial mediation analysis showed that the relationship of threat appraisal and resilience with health behaviors was mediated by problem-focused coping, meaning-focused coping, and meaning-making, but not by emotion-focused coping. These results suggest that associations among threat perception, resilience, and health behavior depend to some extent on the interplay of coping and meaning-making, which reveals their unique role in the process of recovery from COVID-19, with potential implications for health interventions.

Modeling psychological well-being among abdominal and pelvic cancer patients: The roles of total pain, meaning in life, and coping.

OBJECTIVE: Relationships between pain and well-being are mediated by a variety of factors. This study examines a serial mediating role of meaning in life and coping in the relationship of total pain with psychological well-being in abdominal and pelvic cancer (APC) patients. Total pain is understood in terms of physical, psychological, social, and spiritual components interacting upon one another. METHODS: Adult patients diagnosed with the APC (N = 333) who were undergoing radiotherapy/chemotherapy treatment in two inpatient units of university hospitals completed questionnaires measuring total pain, psychological well-being, meaning in life, and coping. SEM analysis was used to examine serial mediation effects. RESULTS: All the dimensions of total pain were negatively associated with presence of meaning, coping strategies, and psychological well-being. In contrast, the pain dimensions were positively associated with search for meaning. Presence of meaning, search for meaning, emotion- and meaning-focused coping were serial mediators in the relationship between total pain and psychological well-being. CONCLUSIONS: Our results strongly suggests that a holistic examination of pain among patients with cancer is important for several reasons. They also indicate that psychological well-being is significantly influenced by the serial interplay of personal meaning structures and coping abilities.

Total Pain and Illness Acceptance in Pelvic Cancer Patients: Exploring Self-Efficacy and Stress in a Moderated Mediation Model.

Cancer patients experience pain not only in its physical dimension, but also in a broader context that includes psychological, social, and spiritual aspects due to a higher level of anxiety and stress. The present prospective, longitudinal study examined the relationship between total pain and illness acceptance among pelvic cancer patients, taking into consideration the moderated mediation effects of self-efficacy and stress. The study involved a sample of pelvic cancer patients receiving radiotherapy treatment. Assessments were completed at T1 (before radiotherapy), T2 (after 3-4 weeks), and T3 (after radiotherapy) to assess the psychosocial dynamics of illness acceptance (N = 267). The more physical, psychological, social, and spiritual pain symptoms the patients experienced, the less they accepted negative health conditions and the effects of their illness. Stress moderated the indirect effect between total pain dimensions and illness acceptance through self-efficacy, but it did not moderate the relationship between total pain and illness acceptance. The relationships between total pain dimensions and illness acceptance thus depend on both the mediating effect of self-efficacy and the moderating effect of stress. This highlights the need to control one's motivation and behavior and manage emotional strain or tension.

Role of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio and platelets in prognosis of patients with prostate cancer.

The aim of the present analysis was to evaluate the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelets (PLT) and neutrophil level for their prognostic values in patients with prostate cancer who had been treated with radiotherapy. A retrospective analysis of 152 patients who were treated in the Radiotherapy Department at Maria Sklodowska-Curie National Research Institute of Oncology (Gliwice, Poland) between January 2012 and December 2014 was performed. The prognostic value (overall survival; OS) of the pre-treatment PLR, NLR, LMR, PLT, neutrophil level and other laboratory factors such as: leukocyte, lymphocyte, monocyte, hemoglobin, RBC, prostate-specific antigen level (PSA), Gleason score, age, smoking and comorbid condition were assessed using univariate analysis. The cut-off point was determined for NLR as 'elevated' at >4.66, LMR >3.26 and the PLR was considered 'elevated' at >89.6. Median follow-up was 4.9 years. The 5 and 7-year OS rates were 81.5 and 72.2%, respectively. In univariate analysis higher NLR (P=0.007), higher level of PLT (P=0.004), higher level of neutrophils (P=0.013), elevated level of leukocyte (P=0.043) and lymphocyte (P=0.043) were factors significantly associated with decreased OS. No difference was found for PLR (P=0.308) and LMR (P=0.109). The other factor associated with decreased OS were: higher Gleason score (>7; P=0.005), higher PSA level (>20 ng/dl; P=0.0001), smoking (P=0.003) and older age (>70 years; P=0.018). In multivariate analysis, NLR, LMR, leukocyte and RBC were independently associated with prognosis in patients with prostate cancer. Elevated pre-treatment NLR [hazard ratio (HR)=10.83; P=0.001), LMR (HR=3.14; P=0.007) and higher leukocyte level (HR=3.14; P=0.007) were independently associated with increased mortality risk. Overall, pre-treatment NLR, PLR, leukocyte and RBC levels were revealed to be independent prognostic factors.

Religiosity, Meaning-Making and the Fear of COVID-19 Affecting Well-Being Among Late Adolescents in Poland: A Moderated Mediation Model.

Adolescents have come to be greatly affected by the COVID-19 pandemic and the ensuing containment measures in recent months. The aim of the present study was to examine the relations among religiosity, meaning-making, fear of COVID-19, and subjective well-being within a moderated mediation model. Three hundred and sixteen late adolescents (173 women and 143 men) in Poland volunteered to take part in the study. The results show that meaning-making mediated relationships between religiosity and life satisfaction, religiosity and positive affect, and religiosity and negative affect. In addition, these mediation effects were moderated by the fear of COVID-19. Specifically, the indirect effects were stronger for adolescents with high fear than for those with low fear, which indicates that fear of COVID-19 serves as a 'warning' factor.

The Religious Meaning System and Resilience in Spouse Caregivers of Cancer Patients: A Moderated Mediation Model of Hope and Affect.

The character of the relationship between religiosity and resilience depends to a large extent on mediation and moderation mechanisms which rely on cognitive and emotional processes. Research conducted within hope theory and the broaden and build theory indicates that hope and affect can mediate and moderate this relationship. The present study explored whether the relationship of the religious meaning system with resilience in spouse caregivers of cancer patients can be mediated by hope and simultaneously moderated by positive and negative affect. A total of 241 spouse caregivers completed a set of questionnaires. The results revealed that hope mediated the relationship between the religious meaning system and resilience. Furthermore, positive affect but not negative affect moderated the indirect effect of the religious meaning system to resilience through hope.

Risk of Contracting COVID-19, Personal Resources and Subjective Well-Being among Healthcare Workers: The Mediating Role of Stress and Meaning-Making.

The latest research suggests that the relationships between the risk of contracting COVID-19, personal resources and subjective well-being have rather an indirect character and can include the occurrence of mediating factors related to meaning-making processes and stress experiences. Protection motivation theory offers a theoretical paradigm that enables these associations to be thoroughly investigated and understood. The current study aimed to examine the mediating roles of meaning-making and stress in the relationship of risk of contracting COVID-19 and personal resources (self-efficacy and meaning in life) with subjective well-being among healthcare workers. A total of 225 healthcare workers from hospitals, medical centres and diagnostic units completed a set of questionnaires during the first few months of the COVID-19 lockdown period (March-May 2020). The results revealed that greater self-efficacy and meaning in life were associated with higher cognitive and affective dimensions of subjective well-being, whereas a lesser risk of contracting COVID-19 was only associated with the higher affective dimension. The central finding demonstrated different mediating roles of stress and meaning-making in the relationship of risk of contracting COVID-19 and personal resources with the cognitive and affective dimensions of subjective well-being. This confirmed the applicability of meaning-oriented and stress management processes for understanding how healthcare workers' well-being is affected during the COVID-19 pandemic.

The role of meaning in gastric cancer patients: relationships among meaning structures, coping, and psychological well-being.

Background and Objectives: Research demonstrates that the experience of cancer invariably violates patients' meaning structures, prompting them to use coping strategies to alleviate stress and enhance well-being. The current study aimed to examine the mediating effects of coping strategies in the relationship between global and situational meaning and psychological well-being in gastric cancer patients. Design and Method: One hundred eighty-seven patients (96 women and 91 men) with gastric cancer completed questionnaires measuring meaning in life, changes of beliefs and goals, coping, and psychological well-being. Participants were between 27 and 82 years of age. They were diagnosed with gastric cancer from 1 to 3.2 years ago. Using Structural Equation Modeling, both the direct and indirect associations between meaning structures, coping, and psychological well-being were examined. Results: Meaning in life exerted significant indirect effects on psychological well-being through three coping strategies: problem-, emotion-, and meaning-focused. The relationship between changes of beliefs and goals and psychological well-being was also mediated by coping. Conclusions: Findings suggest that coping strategies are mediators in the relationship between global and situational meaning and psychological well-being. They also provide empirical evidence that in severe cancer-related stress conditions both meaning structures and coping strategies influence patients' psychological well-being.

Illness perception and affective symptoms in gastrointestinal cancer patients: A moderated mediation analysis of meaning in life and coping.

OBJECTIVE: The character of the mediational relations between illness perception and affective symptoms often depends on the coping strategies used by patients. For example, these relationships may be moderated by meaning in life that plays a buffering role against the negative consequences of cancer. This study examined moderated mediation effects of meaning in life and coping on the relationship between illness perception and affective symptoms in cancer patients. METHODS: In this cross-sectional research, 317 gastrointestinal cancer patients who were undergoing chemotherapy, radiotherapy, or combined therapy treatments were examined. They completed measures of illness perception, affective symptoms, meaning in life, and coping. Data were analyzed using SPSS software and the PROCESS macro. RESULTS: Illness perception was negatively associated with meaning in life and problem- and meaning-focused coping but was positively associated with affective symptoms: fear, depression, and irritability. Two coping strategies-problem- and meaning-focused-mediated the relationship between illness perception and affective symptoms. Meaning in life turned out to be a moderator of the indirect effects of illness perception on affective symptoms through problem- and meaning-focused coping. CONCLUSIONS: The relationship of illness perception with affective symptoms is embedded in moderated mediation effects of meaning in life and coping. It implies that emotional adjustment to the illness depends on the interplay between the ways in which cancer patients perceive their illness and the coping strategies used by them.