RESUMEN
PURPOSE: Uncertainty in the context of advanced cancer diagnosis often incurs significant psychological distress. The aims were to evaluate the incidence of psychological distress upon diagnosis of advanced cancer and to analyze whether the relationship between illness uncertainty and psychological distress can be mediated by coping strategies. METHODS: A multicenter, prospective, cross-sectional study was conducted in 15 medical oncology departments across Spain. Individuals with unresectable advanced cancer completed questionnaires on uncertainty (Michel Uncertainty of Illness Scale, coping strategies (Mental Adjustment to Cancer, M-MAC), and psychological distress (Brief Symptom Inventory, BSI-18) after the diagnostic and treatment appointment and before beginning systemic cancer treatment. RESULTS: 841 patients eligible for systemic treatment with palliative intent were included between February 2020 and April 2022. A total of 71.7% had clinically significant levels of psychological distress. Univariate analyses identified that the groups with less psychological distress were male (ηp2 = 0.016), married (ηp2 = 0.006), and had a better performance status (ηp2 = 0.007). The most widely used coping strategies were positive attitude and cognitive avoidance. A positive relationship was found between uncertainty, coping strategies, and psychological distress (p < 0.05). Participants who responded with anxious preoccupation suffered more helplessness and psychological distress, while those who responded with cognitive avoidance displayed greater positive attitude and lesser psychological distress. CONCLUSION: Patients with newly diagnosed unresectable advanced cancer frequently experience psychological distress in the face of uncertainty, potentially influenced by coping strategies like cognitive avoidance.
Asunto(s)
Neoplasias , Distrés Psicológico , Humanos , Masculino , Femenino , Estudios Prospectivos , Incertidumbre , Estudios Transversales , Adaptación Psicológica , Neoplasias/psicología , Estrés Psicológico/psicologíaRESUMEN
OBJECTIVE: The mental adjustment to a breast cancer diagnosis is traumatic and stressful, with wide-ranging differences in the responses observed in Indian women. We investigated the association between demographic features and perceived social support during the adjustment of patients to breast cancer. METHODS: A total of 393 patients with breast cancer were included in the study. The patients were evaluated for mental adjustment to cancer and perceived social support on the Mental Adjustment to Cancer Scale and Multidimensional Scale of perceived social support. Regression analysis and bivariate correlation were performed to discern significant demographic features and social support in association with the adjustment to having breast cancer. RESULTS: Multiple regression analysis revealed that mental adjustment factors accounted for 43% of the variance in fighting spirit and 41% of the variance in helplessness/hopelessness. The results of the multiple regression analysis suggested that age (t = -10.27, P < 0.000) and marital status (t = 3.03, P < 0.000) were predictive of patients' fighting spirit. Age was inversely (t = 9.81, P < 0.01) associated with fighting spirit, whereas family income (t = -3.82, P < 0.000) was inversely predictive of helplessness/hopelessness. Social support from significant others was predictive of a patient's fighting spirit and fatalism mental adjustment, while support from friends was predictive of helplessness/hopelessness. CONCLUSION: Demographic factors such as young age and high education are associated with good mental adjustment to breast cancer. Perceived support from significant others may fulfill the need for the socioemotional aspects of patient support that lead to the adjustment to a breast cancer diagnosis in patients.
Asunto(s)
Neoplasias de la Mama/psicología , Percepción Social , Apoyo Social , Adaptación Psicológica , Adulto , Afecto , Anciano , Femenino , Amigos , Humanos , India , Estado Civil , Persona de Mediana EdadRESUMEN
OBJECTIVE: Coping with cancer is an important determinant of psychological morbidity, quality of life, and treatment adherence in cancer patients. The aim of this study was to elucidate the association between the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and coping response to stress in patients diagnosed with advanced gastric cancer. METHODS: Ninety-one subjects (60 males, 31 females) recently diagnosed with advanced gastric cancer were recruited. Coping style and distress level were examined using the Mini-Mental Adjustment to Cancer (Mini-MAC) scale and Hospital Anxiety and Depression Scale, and genotyping was evaluated. To examine the temporal stability of the Mini-MAC scores, a 6-week follow-up evaluation was conducted in 72 patients, after completion of two chemotherapy cycles. RESULTS: Coping style to cancer significantly differed between the Met carriers of BDNF Val66Met and the Val/Val homozygotes. The Met carriers were significantly more anxious than the Val/Val homozygotes. CONCLUSION: The present findings suggest that the BDNF Val66Met polymorphism may be involved in individual coping responses to cancer. The Met allele of BDNF Val66Met may be predictive of an anxious coping style in patients with advanced cancer.
Asunto(s)
Adaptación Psicológica , Factor Neurotrófico Derivado del Encéfalo/genética , Polimorfismo de Nucleótido Simple , Neoplasias Gástricas/patología , Neoplasias Gástricas/psicología , Alelos , Ansiedad/genética , Femenino , Estudios de Seguimiento , Homocigoto , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/genéticaRESUMEN
PURPOSE: Previous studies have reported that over a third of cancer patients experience significant psychological distress with diagnosis and treatment of cancer. Mental adjustment to cancer as well as other biologic and demographic factors may be associated with their distress. We investigated the relationship between mental adjustment and distress in patients with thyroid cancer prior to thyroidectomy. MATERIALS AND METHODS: One hundred and fifty-two thyroid cancer patients were included in the final analysis. After global distress levels were screened with a distress thermometer, patients were evaluated concerning mental adjustment to cancer, as well as demographic and cancer-related characteristics. A thyroid function test was also performed. Regression analysis was performed to discern significant factors associated with distress in thyroid cancer patients. RESULTS: Our regression model was significant and explained 38.5% of the total variance in distress of this patient group. Anxious-preoccupation and helpless-hopeless factors on the mental adjustment to cancer scale were significantly associated with distress in thyroid cancer patients. CONCLUSION: Negative emotional response to cancer diagnosis may be associated with distress in thyroid cancer patients awaiting thyroidectomy. Screening of mental coping strategies at the beginning of cancer treatment may predict psychological distress in cancer patients. Further studies on the efficacy of psychiatric intervention during cancer treatment may be needed for patients showing maladaptive psychological responses to cancer.
Asunto(s)
Adaptación Psicológica , Estrés Psicológico/epidemiología , Neoplasias de la Tiroides/psicología , Adulto , Ansiedad , Femenino , Humanos , Masculino , Análisis de Regresión , Neoplasias de la Tiroides/cirugía , TiroidectomíaRESUMEN
PURPOSE: Previous studies have reported that over a third of cancer patients experience significant psychological distress with diagnosis and treatment of cancer. Mental adjustment to cancer as well as other biologic and demographic factors may be associated with their distress. We investigated the relationship between mental adjustment and distress in patients with thyroid cancer prior to thyroidectomy. MATERIALS AND METHODS: One hundred and fifty-two thyroid cancer patients were included in the final analysis. After global distress levels were screened with a distress thermometer, patients were evaluated concerning mental adjustment to cancer, as well as demographic and cancer-related characteristics. A thyroid function test was also performed. Regression analysis was performed to discern significant factors associated with distress in thyroid cancer patients. RESULTS: Our regression model was significant and explained 38.5% of the total variance in distress of this patient group. Anxious-preoccupation and helpless-hopeless factors on the mental adjustment to cancer scale were significantly associated with distress in thyroid cancer patients. CONCLUSION: Negative emotional response to cancer diagnosis may be associated with distress in thyroid cancer patients awaiting thyroidectomy. Screening of mental coping strategies at the beginning of cancer treatment may predict psychological distress in cancer patients. Further studies on the efficacy of psychiatric intervention during cancer treatment may be needed for patients showing maladaptive psychological responses to cancer.