Perceived importance of affective forecasting in cancer treatment decision making.

PURPOSE: To examine whether adults with cancer view affective forecasting as important for treatment decisions, and to examine these perceptions among key subgroups. DESIGN: Adults with cancer (N = 376) completed a cross-sectional survey that included demographic and clinical characteristics, the IPIP five-factor personality measure, and a rating of the perceived importance of affective forecasting for cancer treatment decisions. Descriptive statistics characterized the importance of affective forecasting. Multivariate analyses examined whether health and personality variables were associated with affective forecasting importance. FINDINGS: Most participants (89.6%) identified affective forecasting as important for treatment decisions. Affective forecasting was more likely to be rated as important among patients with prostate cancer (p < .001), patients lower in neuroticism (p = .02), and patients higher in agreeableness (p = .004). Conclusions/Implications: Patients believe it is important to understand how treatments will impact their emotional well-being. Oncology clinicians should discuss with patients these consequences during healthcare decision-making.

Social support in cancer: How do patients want us to help?

Objective: Social support is fundamentally important to the well-being of patients with cancer, and informal caregivers often wish they had better insight into how to help. The aims of this study were to quantify the types of social support that patients qualitatively expressed as important, and examine whether demographics and mental health symptoms explained the type of support desired. Methods: A sample of 82 patients with cancer (Gender: 65.9% Male, Age: M = 57.5, Race/Ethnicity: 90.2% White, non-Latino/a) completed measures of demographics, health, anxiety, and depression, and responded to an open-ended question asking them to list three types of support that they desire from their caregivers. These responses were then reliably coded into 18 different categories. Results: Most commonly, participants expressed a desire for companionship (45%). Other common requests included empathy (33%), home care support (28%), information support (16%), being treated the same (15%), and help with appointments (13%). Patients who were more anxious were more likely to desire companionship (OR = 4.41, p = .033), and younger patients were more likely to desire home care support (OR = 7.24, p = .016). Conclusion: Findings have implications for providing individually-tailored social support to patients with cancer.

Statewide Differences in Personality Associated with Geographic Disparities in Access to Palliative Care: Findings on Openness.

Background: Geographic disparities in access to palliative care cause unnecessary suffering near the end-of-life in low-access U.S. states. The psychological mechanisms accounting for state-level variation are poorly understood. Objective: To examine whether statewide differences in personality account for variation in palliative care access. Design: We combined 5 state-level datasets that included the 50 states and national capital. Palliative care access was measured by the Center to Advance Palliative Care 2015 state-by-state report card. State-level personality differences in openness, conscientiousness, agreeableness, neuroticism, and extraversion were identified in a report on 619,387 adults. The Census and Gallup provided covariate data. Regression analyses examined whether state-level personality predicted state-level palliative care access, controlling for population size, age, gender, race/ethnicity, socioeconomic status, and political views. Sensitivity analyses controlled for rurality, nonprofit status, and hospital size. Results: Palliative care access was higher in states that were older, less racially diverse, higher in socioeconomic status, more liberal, and, as hypothesized, higher in openness. In regression analyses accounting for all predictors and covariates, higher openness continued to account for better state-level access to palliative care (ß = 0.428, p = 0.008). Agreeableness also emerged as predicting better access. In sensitivity analyses, personality findings persisted, and less rural states and those with more nonprofits had better access. Conclusions: Palliative care access is worse in states lower in openness, meaning where residents are more skeptical, traditional, and concrete. Personality theory offers recommendations for palliative care advocates communicating with administrators, legislators, philanthropists, and patients to expand access in low-openness states.