Perceived cognitive functioning in breast cancer patients treated with chemotherapy compared to matched healthy women: Evidence from a Portuguese study.

AIM: Cognitive concerns are one of the most frequently reported symptoms by breast cancer survivors. This study aimed to evaluate perceived cognitive functioning in Portuguese women with breast cancer treated with chemotherapy. METHODS: A cross-sectional study enrolling 146 women (73 with breast cancer and 73 healthy) was conducted from August to October 2017, invited to participate through online dissemination. Participants completed self-reported questionnaires to collect sociodemographic and clinical data and assess perceived cognitive functioning and psychological adjustment variables (anxiety and depression). RESULTS: Compared to healthy women, women with breast cancer showed significantly lower scores on the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) subscales and higher levels of depression. Both groups showed significant negative correlations between perceived cognitive functioning and anxiety and depression. Health status and depression seem to better explain perceived cognitive functioning, with health status adding significantly more explained variance beyond sociodemographic and psychological adjustment variables. CONCLUSION: The current findings provide evidence for the existence of more cognitive complaints among Portuguese women with breast cancer, compared to healthy individuals. Anxiety, depression, age and education also explain perceived cognitive functioning. Considering that health status and psychological adjustment seem to significantly explain perceived cognitive functioning, special attention should be given by health-care professionals, including nurses, to designing clinical interventions for breast cancer patients to help manage cognitive impairment.

Psychological morbidity, burden, and the mediating effect of social support in adult children caregivers of oncological patients undergoing chemotherapy.

OBJECTIVES: This study examines the association between psychological morbidity, social support, and demographic and clinical variables in adult children of cancer patients undergoing chemotherapy. Special attention was given to the variable level of parental dependency. The main predictors of caregiving burden were tested, as well as the mediating role of social support in the relationship between psychological morbidity and burden. METHODS: A total of 214 adult children caregivers of parents with cancer were recruited in Northern Portugal central hospitals. Caregivers completed Portuguese versions of the Depression Anxiety and Stress Scales, Impact of Event Scale-Revised, Satisfaction with Social Support Scale, and Burden Assessment Scale. RESULTS: Significant associations among psychological, demographic, and clinical variables were found. Adult children with a greater perception of parent's dependency showed more distress, higher posttraumatic stress disorder (PTSD) symptoms, greater caregiving burden, and less satisfaction with social support. Hierarchical regression analyses revealed the main predictors of caregiver burden to be as follows: being a woman, caregiving duration, having a dependent parent, more distress and PTSD symptoms, and poorer social support. Social support was found to be a partial mediator in the relationship between psychological morbidity and caregiver burden. CONCLUSIONS: Results underscore the importance of perceived parental dependency in offspring's caregivers. Findings support the multidimensional issues associated to burden in this specific population, stressing satisfaction with social support as an important mediator between distress/PTSD and burden. Implications for further research as well as limitations of the present study are discussed. Psychosocial interventions should focus on caregivers' social resources to facilitate psychological well-being.

Factors contributing to posttraumatic growth and its buffering effect in adult children of cancer patients undergoing treatment.

This study examined relationships among demographic, clinical, and psychosocial variables in adult children of cancer patients. Two hundred and fourteen participants completed measures of posttraumatic growth (PTG), distress, posttraumatic stress disorder (PTSD) symptoms, social support, and family functioning. Significant gender differences in all PTG dimensions were found, as well as associations among PTG, gender, parental dependency, distress, PTSD, and family functioning. Social support was not a mediator in the relationship between gender and PTG. Gender, education, disease duration, dependency, distress, and family flexibility predicted PTG. Finally, PTG had a moderating effect in the relationship between distress and PTSD/social support. These results may guide psychosocial interventions in this population.

Posttraumatic Stress Disorder Symptoms and Family Functioning in Adult Children Facing Parental Cancer: A Comparison Study.

This study analyzed posttraumatic stress disorder (PTSD) symptoms and family functioning in a sample of adult children caregivers of cancer patients and in a group of adult children of nonchronically ill parents. Participants completed measures of family functioning and PTSD symptoms. The parental cancer group was subdivided into PTSD subgroups, and significant differences, on family functioning, were found. In the parental cancer group, the predictors of PTSD symptoms were being a woman and having an enmeshed or chaotic family functioning. Chaotic functioning mediated the relationship between family communication/satisfaction and PTSD symptoms, in the parental cancer group. Finally, there was a higher prevalence of PTSD symptoms in the parental cancer group, and participants with a probable PTSD diagnosis showed higher levels of family imbalance. This study shows that adult children facing parental cancer, who have a poorer family balance, may benefit from interventions that target family functioning.

Growth and the cancer caregiving experience: psychometric properties of the Portuguese Posttraumatic Growth Inventory.

The purpose of the present study was to investigate the psychometric properties of the Portuguese version of the Posttraumatic Growth Inventory (PTGI) and relate posttraumatic growth with psychological morbidity. This is a cross-sectional study with a sample of 214 adult children of cancer patients. Additionally, a comparison group was recruited with 78 participants without a chronically ill parent. Measures of distress, posttraumatic stress disorder (PTSD) symptoms, and posttraumatic growth were collected. The original five-factor structure of the PTGI was maintained, with satisfactory internal consistency. The reorganization of the items in five factors was similar to the solution found in the original PTGI study, except for four items. Positive correlations between posttraumatic growth and PTSD symptoms/distress were significant. Women showed significantly higher posttraumatic growth. Adult children with parental cancer, and with probable PTSD, showed higher scores on the PTGI. Regression analysis revealed that PTSD symptoms were associated with higher posttraumatic growth, after controlling for demographic and clinical variables. Analysis with the comparison group showed that differences in posttraumatic growth were observed as a function of a shattered experience. This study confirmed the multidimensionality of the posttraumatic growth construct, underscoring the importance of considering the subjective nature of the shattered event, and the experience of emotional distress with parental cancer.