Psychology Health & Medicine最新文献

In Italy, breast cancer survivors are increasing. Body image is a complex posttreatment concern for breast cancer survivors, particularly younger women. This population reports higher levels of body-image concerns associated with higher psychological distress and lower quality of life. Body image concerns and factors that can impact the body image of older breast cancer survivors remain an important but under-explored research area. The purpose of this study is to examine the association of negative and positive body image with both well-being and psychological inflexibility in a sample of breast cancer survivors. 114 women who have completed breast cancer treatment (±5 years) completed a questionnaire to measure the research variables. Hierarchical regressions and indirect effects were performed. Functionality appreciation and body compassion accounted for a significant percentage of the variance of well-being (34%) and psychological inflexibility (50%) of the participants. The indirect effect of body dissatisfaction on well-being and psychological inflexibility through body compassion was significant. The results emphasise the relevance of the positive aspect of body image on well-being and psychological inflexibility. Functionality appreciation and body compassion contribute to understanding the health-status description of these women and could be considered in future health-promotion interventions aimed at reducing psychological distress associated with body image concerns in older breast cancer survivors.

This study aimed to explore the relationships between social capital, family functioning, and caregiver burden in caregivers of older adults with post-stroke dementia (PSD). A cross-sectional correlational study was conducted between November 2017 and April 2018 among 105 caregivers of older adults with PSD using a demographic questionnaire, the Social Capital Scale, Family APGAR Index (APGAR), and Caregiver Burden Inventory (CBI).An independent samples t-test was also utilized to compare caregiver burden based on demographic characteristics. Statistical analysis comprised Pearson correlation analysis and multiple regression analysis using SPSS version 22.0 to identify influencing factors. Significant negative correlations were found between caregiver burden and variables such as social capital (p < .001) and family functioning (p < .01). The results of the multivariate analysis revealed that social capital, physical condition, and duration of caregiving were the main influencing factors (β = 58.162, ΔR2 = 0.289, p < .001). These findings suggest that nurses should continue to prioritize the well-being of patients' families, and collaborative efforts should be made to establish care facilities that cater to both medical and social needs.

Sleep disorders are prevalent and interfering conditions that affect people living with HIV (PLWH) at higher rates than the general population. Lower quality sleep has been associated with poorer health-related quality of life and immune function in PWH, though sleep is typically assessed subjectively. The current study aimed to examine the association between objective sleep/wake patterns measured via actigraphy with HIV outcomes. Participants (N = 87) were recruited from a public, urban HIV clinic located in the Southeastern United States. Participants were instructed to wear actigraphy monitors for one week (Range: 5-8 days). Log viral load and absolute CD4 were obtained via medical chart review. Linear regression analyses predicting HIV RNA Viral Load (log transformed) and CD4 Count were employed with three actigraphy sleep variables: sleep efficiency, wake after sleep onset (WASO), and sleep quantity. Backward entry regression with both significant actigraphy predictors, sleep efficiency and WASO, included as predictors resulted in sleep efficiency remaining in the model and WASO being removed. Separate models revealed that each one-unit increase in sleep efficiency was associated with a b = 0.032-point decrease in the log-transformed HIV RNA viral load (p = 0.03) and for each one-unit increase in wake after sleep onset (WASO) was associated with a b = 0.35-point increase in the log-transformed HIV RNA viral load (p = 0.04). Sleep quantity, however, was not, and none were associated with absolute CD4 count. The findings add to the evidence for an association of objectively measured poorer sleep efficiency being associated with higher HIV RNA viral load. Implications for clinical practice include assessing and addressing sleep efficiency as part of comprehensive clinical HIV care.

The aim of this study was to evaluate the Turkish cultural and psychometric properties of the cancer fear scale developed by Feng et al. This methodological study was conducted between January and April 2024 with students from a university in eastern Turkey. Data were collected from two different sample groups (sample 1:350, sample 2:245). Personal information form and cancer fear scale were used. In the adaptation process of the scale, language validity, content validity, construct validity, and reliability were examined. Exploratory factor analysis, confirmatory factor analysis, measurement invariance and convergent-divergent validity were used to determine construct validity. Cronbach alpha internal consistency coefficient, test-retest and corrected item-total correlation were used for reliability. According to the results of exploratory factor analysis, it was determined that the fear of cancer scale had a two-factor structure with factor loadings between 0.58 and 0.70. As a result of the confirmatory factor analysis performed on the two-factor structure of the fear of cancer scale, it was determined that the model goodness-of-fit indices were acceptable and had an excellent fit. It has been determined that measurement invariance findings across genders support configural, metric and scalar invariance. The Cronbach alpha internal consistency coefficient of the fear of cancer scale was 0.93, and the corrected item total correlation values were between 0.45 and 0.73. The Turkish version of the fear of cancer scale was found to be a valid and reliable measurement tool.

Breast cancer is the leading cancer type among women globally, and its chemotherapy often results in multiple side effects, compromising the patient's quality of life. Our study aimed to analyze the impact of neoadjuvant chemotherapy on the quality of life in Brazilian women with breast cancer within the public health system. This research was a one-year, observational, longitudinal study, conducted at a charitable health facility, examining the effect of neoadjuvant chemotherapy on these women's quality of life. Sociodemographic and clinical data were extracted from medical records. Quality of life parameters were gauged using Portuguese-validated questionnaires: EORTC.QLQ - C30 version 3.0, EORTC.BR-23, Body Image Scale (BIS), BPI-SF pain scale, and Beck Depression Inventory (BDI). These tools were utilized at three intervals: before the start of systemic treatment, after three months (before initiating paclitaxel), and upon concluding neoadjuvant therapy. Qualitative variables were tested for normality using the Kolmogorov-Smirnov test. As the continuous variables referring to the questionnaires did not show normal distribution, non-parametric tests were used: Friedman tests for paired pairs, and Wilcoxon and Mann-Whitney tests for multiple comparisons. In all tests, the significance level adopted was 5%. The software used for the analysis was SPSS. Our findings revealed a decline in quality of life, observing deterioration in the role, social, and cognitive functioning domains. Additionally, symptoms like fatigue, hyporexia, constipation, and diarrhea became more pronounced during the treatment. The presence of minimal depressive symptoms, associated with systemic therapy side effects also contributed to this worsening. Notably, there were no improvements in any quality of life-related parameters, and no discernible differences were observed in pain levels or body image across the evaluated periods.

Active surveillance for prostate cancer monitors disease progression, with a view to actively treat only if progression is evident. Living with an untreated cancer can negatively impact psychological wellbeing. Partners can influence decisions to convert to active treatment in the absence of disease progression, it is, therefore, important to consider partner reactions and responses to prostate cancer treatment options. We explored the experiences of men on active surveillance and their partners and the impact partner feelings, responses and reactions to active surveillance have on the patient. Semi-structured personal communication were conducted with nine male-female couples (n = 18). All male participants were on active surveillance for prostate cancer. Data was analysed using an adapted version of the Collaco et al. (2021) Framework Method for dyadic data analysis. Dyads function as an interconnected unit with interlinked emotional responses. Differing feelings about active surveillance within the couple were common; men prioritised avoidance of active treatment side effects, partners prioritised minimising the chance of disease progression. Partner inclusion is important, but they sometimes felt excluded by their partners and/or health care professionals. More support is needed for this population. Dyadic support is bidirectional and complex with partners often less comfortable with active surveillance than their partners. More research is needed to explore how partners can be better included and supported.

Informal caregivers of older adults usually suffer from loneliness, which makes them vulnerable to reduced health outcomes. This study attempted to explore whether internet usage mitigates the effects of loneliness on subjective health among informal caregivers of older adults. A sample of 1089 informal caregivers (mean age = 58.0 ± 15.7 years, 60.3% females) providing unpaid cares for older adults in the United States were investigated. Their loneliness, subjective health, and utilization of caregiving-related online resources were measured. Descriptive statistics and correlation analyses were conducted to summarize the sample's characteristics and determine the relationships among the study variables, respectively. Finally, a multivariate regression analysis with an interaction term was performed to test the moderating effect of internet usage. Results indicated that loneliness was significantly negatively associated with subjective health. Furthermore, after controlling for demographic and caregiving-related factors, the moderating effect of internet usage on the link between loneliness and subjective health was significant, namely, the negative association between loneliness and subjective health was less pronounced at higher levels of internet usage. Hence, in addition to alleviating loneliness, providing caregiving-related online services and promoting positive utilization of resources on the internet may be potential intervention targets to improve informal caregivers' health.

People living with HIV/AIDS (PLWH) are living longer due to improvements in HIV care including antiretroviral therapy (ART). Even though ART improves HIV prognosis and life expectancy, its adherence is hindered by many factors. As the population of older adults living with HIV (OALH) continues to increase, it is important to understand the psychosocial factors that are associated with living with HIV to improve ART adherence. The aim of this study was to determine the association between coping strategies and ART adherence. Data were obtained from 91 OALH at an immunology clinic in Columbia, South Carolina via purposive sampling. The participants were at least 50 years or older and living with HIV. Coping was assessed using the Brief COPE Inventory. Crude and adjusted linear regression models, controlling for age, race, gender, and were used to determine the association between coping strategies and ART adherence. Subgroup analyses were done to determine if the association between coping and ART adherence varied by gender. The analyses were conducted in SAS version 9.4. The mean difference in ART adherence was statistically significant for race (p = 0.0292). There was a statistically significant association between religion and ART adherence (β = -0.718, p = 0.024). Males who use venting as a coping mechanism had higher ART adherence (β = 1.227, p = 0.048), and males who use behavioral disengagement had lower ART adherence (β = -1.624, p = 0.003) after adjusting for age and race. OALH who use religion as a coping strategy were less likely to adhere to ART treatment. Venting and behavioral disengagement tend to be associated with ART adherence among men. Qualitative research is needed to delve deeper into the relationship between religious coping and ART adherence, especially among OALH.

This study aimed to understand long-term coping responses of mothers (N = 287) receiving genetic counseling and testing (GCT) for hereditary breast/ovarian cancer (HBOC) syndrome. Psychological characteristics, including cancer-specific distress (Impact of Events Scale-Revised, α = .85) and coping (Brief COPE, α = .93) were assessed via structured personal communication, along with epidemiologic items assessing personal and family history of cancer. Genetic risk was determined by BRCA1/2 carriage. A principal component analysis was conducted on the coping measure to reduce its summary score to active coping (α = .91) with nine approach-oriented strategies responsive to stress. A multivariable regression model examined the main and interacting effects of clinical and psychological characteristics on maternal coping. Personal cancer history (F = 4.99, df = 1, p = .026), BRCA test result (F = 22.20, df = 1, p < .001), and cancer-specific distress (F = 17.80, df = 1, p < .001) were associated with greater engagement in active coping strategies. When controlling for cancer-specific distress, the interaction between personal cancer history and genetic test results was significant, such that women previously unaffected by cancer who received positive BRCA results reported the greatest levels of active coping (F = 7.92, p < .001). These findings indicate that previous cancer history, genetic risk, and psychological distress independently and jointly impact how women adapt to the threat of cancer over time.

Sexual minority men (SMM) are disproportionately impacted by HIV and thus, HIV related-health complications. HIV has been linked to earlier onset of multi-morbid chronic diseases and declines in physical and cognitive functioning attributable to chronic HIV immune activation and resulting inflammation. Inflammation has been targeted with mindfulness-based interventions (MBIs); however, hypothesized negative associations between mindfulness and inflammation need to be confirmed in SMM with HIV. This is a secondary data analysis of baseline data from a randomized clinical trial (RCT) of SMM living with HIV with biologically confirmed recent methamphetamine use (ARTEMIS). Mindfulness was assessed with the Five Factor Mindfulness Questionnaire (FFMQ). Inflammation was assessed via cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Separate adjusted (for age, viral load, CD4 count, and methamphetamine use) regression models evaluated associations between four facets of mindfulness (description, awareness, non-judgement, and non-reactivity) with IL-6 and TNF-α. The average age of the participants was 43.86 (SD = 8.95). Both description (b = .54, se = .24) and awareness (b = .50, se=.23) were positively associated with IL-6. All other associations between mindfulness and inflammation were non-significant in adjusted models. There was also some evidence to suggest that engagement in care moderated associations between description and non-reactivity with IL-6 (ΔR² = .03, F = 3.64), such that description and non-reactivity were each positively associated with inflammation among those who attended <100% of primary care appointments (b = 1.04, se=.34 and b = 1.23, se=.39, respectively), but was not associated with inflammation among those who attended 100% of appointments (b =.16, se=.32 and b=-.17, se=.40, respectively). There was also a significant interaction between 12-step program attendance and awareness with IL-6 (ΔR2= .03, F = 4.26), such that awareness was positively associated with inflammation among those who attended 12-step programming (b = 1.25, se = .41), but not associated with inflammation among those who did not (b = .22, se = .28). Further research is needed to understand how and under what circumstances mindfulness is associated with pro- versus anti-inflammatory processes.Trial Registration: NCT01926184.