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PURPOSE: The objective of this study was to investigate the relationship among hopelessness, anxiety, and depression, with spiritual well-being in patients and family caregivers. METHODS: A cross-sectional survey was administered to patients (n = 57) and caregivers (n = 57) that incorporated assessments that measured spiritual well-being, depression, anxiety, hopelessness, quality of life, family relationship, burden, fatalism, religiosity, and distress. Logistic regression and cross-tabulation analyses were conducted to examine the relationship between hopelessness, anxiety, and depression, with spiritual well-being. Logistic regression was used to quantify the impact of spiritual well-being on anxiety, depression, and hopelessness. Additionally, cross-tabulations with chi-square tests were conducted to explore associations between severity of hopelessness and severity of anxiety and depression. RESULTS: Logistic regression analyses showed negative associations between spiritual well-being and mental health outcomes, although not all findings were statistically significant. Among caregivers, a significant negative relationship was observed for depression (B = - 0.161, p = 0.022). Hopelessness also exhibited a negative association with spiritual well-being among caregivers (B = - 0.099, p = 0.054) and patients (B = - .152, p = 0.038). Cross-tabulations highlighted significant associations in the severity of hopelessness symptoms with anxiety and depression levels among caregivers (p < .001). CONCLUSION: Results reveal a relationship among psychosocial symptoms among Latino patient-caregivers coping with cancer. By emphasizing spiritual well-being, hopelessness, and anxiety and involving family patients and caregivers in the treatment process as a unit of care. Also, it indicates the need to develop culturally tailored interventions that aim to provide valuable assistance to Latino patients and caregivers coping with cancer.
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Cuidadores , Neoplasias , Humanos , Estudos Transversais , Qualidade de Vida , Capacidades de Enfrentamento , Hispânico ou LatinoRESUMO
Introduction: During the COVID-19 pandemic, nursing personnel presented a higher prevalence of fear of contagion, anxiety symptoms, depression, and burnout syndrome. However, the variables associated with these conditions in Mexico are unknown. Objective: To determine the clinical, sociodemographic, and psychological variables associated with fear of contracting COVID-19 and burnout syndrome in nursing personnel. Methods: The study was a cross-sectional correlational study. It included 423 Mexican nursing professionals, working in public and private institutions, of different specialties aged 18-61 years (M = 36 years), the sampling was non-probabilistic by convenience. The instruments used were: COVID-19 fear scale, Maslach Burnout Inventory, Generalized Anxiety Disorder Scale-7 and Patient Health Questionnaire-9. Multinomial logistic regression models were used to analyse the results. Results: The factors associated with fear of contagion were anxiety symptoms (Odds Ratio [OR]: 7.806, p < 0.05), caring for patients with COVID-19 (OR: 5.460, p < 0.05, 0.001) and mild emotional exhaustion (OR: 5.181, p < 0.05). The syndrome dimensions were: depressive symptoms (OR: 12.062; 7.667, p < 0.05), fear of contagion (OR: 4.978; 4.913; 4.921; 4.921, p < 0.01), marital status (OR: 3.404; 3.219, p < 0.05) and young age (OR: 1.064; 1.084, p < 0.05). Conclusions: The factors associated with fear of contagion and burnout syndrome found were having clinical psychological symptoms, as well as being young, being single, being married and being in the health system caring for patients with COVID-19.
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Background: Family and meaning-making resources are culturally congruent and help support Latinx coping with cancer. Objectives: To explore Latinx advanced cancer patients' perspectives on the role of family and meaning/purpose in adjustment to advanced cancer. Methods: A qualitative study was conducted. In-depth interviews were performed and transcripts were analyzed using the method from applied thematic analysis. Setting/Subject: Participants were patients with any advanced cancer diagnosis, recruited from Memorial Sloan Kettering Cancer Center (MSKCC), New York; Lincoln Medical Center (LMC), New York; and Ponce Health Science University (PHSU), Puerto Rico. Measurements: Sociodemographic and semistructured interview. Results: N = 24 in-depth interviews were completed by Latinx advanced cancer patients (Stage III and IV). When evaluating patients' perspectives on the role of family and meaning/purpose in adjustment to advanced cancer, the team generated three categories: (1) family support, (2) family communication, and (3) include support for the family. Many patients reported the importance of family as a source of meaning and social support in the process of cancer diagnosis and treatment. They also reported communication as central to process information and planning. Also, participants describe their desire to incorporate family members into therapy and for encouraging them to seek counseling. Conclusions: Results highlight the need to include syntonic cultural values such as family and meaning for Latinx individuals coping with advanced cancer in psychological interventions.
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There is a known end-of-life related disparity among Latino individuals, and there is a need to develop culturally sensitive interventions to help patients and caregivers cope with advanced cancer. Latino patients and caregivers coping with advanced cancer were asked to list important end-of-life topics to culturally inform a psychosocial intervention adaptation process. A qualitative study was conducted, and semi-structured interviews were performed, audio-recorded, and transcribed. Recordings and transcriptions were reviewed and analyzed using thematic content coding. The semi-structured interview described and demonstrated intervention components and elicited feedback about each. Free listing method was used to assess important topics among Latino advanced cancer patients (n = 14; stage III and IV) and caregivers. Patients and caregivers were given a list of 15 topics and asked which topics they deemed important to integrate into the intervention. Overall, more than half of the participants considered it important to include 13 of the 15 topics related to daily activities (eight subcategories), psychosocial support (three subcategories), discussing diagnosis and support (three subcategories), and financial difficulties (one subcategory). Patient-caregivers reported importance in most end-of-life topics. Future research and intervention development should include topics related to psychosocial support, daily activities, discussing diagnosis and support, and financial difficulties.
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Cuidadores , Neoplasias , Adaptação Psicológica , Cuidadores/psicologia , Morte , Hispânico ou Latino , Humanos , Neoplasias/terapia , Pesquisa QualitativaRESUMO
INTRODUCTION: Literature suggests couple-based interventions that target quality of life and communication can lead to positive outcomes for patients with cancer and their partners. Nevertheless, to date, an intervention to address the needs of Latino families coping with advanced cancer has not been developed. Meta-analytic evidence suggests that culturally adapted evidenced-based intervention targeting a specific cultural group is four times more effective. Our goal is to culturally adapt a novel psychosocial intervention protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). We hypothesised that combine two evidence-based interventions and adapting them, we will sustain a sense of meaning and improving communication as patients approach the end of life among the patient-caregiver dyad. METHODS AND ANALYSIS: To culturally adapt CASA, we will follow an innovative hybrid research framework that combines elements of an efficacy model and best practices from the ecological validity model, adaptation process model and intervention mapping. As a first step, we adapt a novel psychosocial intervention protocol entitled protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). The initial CASA protocol integrates two empirically based interventions, meaning-centred psychotherapy and couple communication skills training. This is an exploratory and prepilot study, and it is not necessary for a size calculation. However, based on recommendations for exploratory studies of this nature, a priori size of 114 is selected. We will receive CASA protocol feedback (phase 1b: refine) by conducting 114 questionnaires and 15 semistructured interviews with patients with advanced cancer and their caregivers. The primary outcomes of this study will be identifying the foundational information needed to further the develop the CASA (phase IIa: proof-of-concept and phase IIb: pilot study). ETHICS AND DISSEMINATION: The Institutional Review Board of Ponce Research Institute approved the study protocol #1907017527A002. Results will be disseminated through peer-reviewed publications.
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Psicoterapia , Qualidade de Vida , Adaptação Psicológica , Hispânico ou Latino , Humanos , Projetos Piloto , Psicoterapia/métodosRESUMO
Background: Anxiety and depression symptoms are known to increase cancer symptom burden, yet little is known about the longitudinal integrations of these among Hispanic/Latinx patients. The goal of this study was to explore the trajectory and longitudinal interactions among anxiety and depression, cancer symptom burden, and health-related quality of life in Hispanic/Latinx cancer patients undergoing chemotherapy. METHODS: Baseline behavioral assessments were performed before starting chemotherapy. Follow-up behavioral assessments were performed at 3, 6, and 9 months after starting chemotherapy. Descriptive statistics, chi-square tests, Fisher's exact tests, and Mann-Whitney tests explored associations among outcome variables. Adjusted multilevel mixed-effects linear regression models were also used to evaluate the association between HADS scores, follow-up visits, FACT-G scale, MDASI scale, and sociodemographic variables. RESULTS: Increased cancer symptom burden was significantly related to changes in anxiety symptoms' scores (adjusted ß^ = 0.11 [95% CI: 0.02, 0.19]. Increased quality of life was significantly associated with decreased depression and anxiety symptoms (adjusted ß^ = -0.33; 95% CI: -0.47, -0.18, and 0.38 adjusted ß^= -0.38; 95% CI: -0.55, -0.20, respectively). CONCLUSIONS: Findings highlight the need to conduct periodic mental health screenings among cancer patients initiating cancer treatment.
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The purpose of this pilot study was to assess the feasibility and acceptability of a mobile smoking cessation intervention in Puerto Rico. This was a single-arm pilot study with 26 smokers in Puerto Rico who were enrolled in Decídetexto, a mobile smoking cessation intervention. Decídetexto incorporates three integrated components: (1) a tablet-based software that collects smoking-related information to develop an individualized quit plan, (2) a 24-week text messaging counseling program with interactive capabilities, and (3) pharmacotherapy support. Outcome measures included self-reported 7-day point prevalence abstinence at Months 3 and 6, pharmacotherapy adherence, satisfaction with the intervention, and changes in self-efficacy. The average age of the participants was 46.8 years (SD 12.7), half of them (53.8%) were female. Most participants (92.3%) smoked daily and half of them (53.8%) used menthol cigarettes. All participants requested nicotine patches at baseline. However, only 13.0% of participants used the patch >75% of days. At Month 3, 10 participants (38.4%) self-reported 7-day point prevalence abstinence (88.5% follow-up rate). At Month 6, 16 participants (61.5%) self-reported 7-day point prevalence abstinence (76.9% follow-up rate). Most participants (90%, 18/20) reported being satisfied/extremely satisfied with the intervention at Month 6. Self-efficacy mean scores significantly increased from 40.4 (SD 12.1) at baseline to 57.9 (SD 11.3) at Month 3 (p < 0.01). The study suggests that Decídetexto holds promise for further testing among Puerto Rican smokers.
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Abandono do Hábito de Fumar , Envio de Mensagens de Texto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Porto Rico , FumarRESUMO
Hispanics are the largest U.S. immigrant group and Mexican Americans are the largest U.S. Hispanic population. Hispanics, particularly Mexican Americans, are among the highest risk groups for obesity, placing them at increased risk for cardiovascular disease and certain types of cancer. Obesity lifestyle interventions incorporating Motivational Interviewing techniques and specific adaptations for the population of interest can have a significant impact on reducing health risks. This paper presents a community-engaged, culturally-sensitive nutrition and dietary counseling intervention conducted between 2016 and 2018 at the Consulate General of Mexico in New York City and reports preliminary findings regarding participant satisfaction and self-reported changes in eating and exercise habits. In addition, it describes the community and academic partners' roles and processes in program development, discusses strengths and challenges posed by a multi-sector partnership and describes adaptations made using the Behavioral Model for Vulnerable Populations to increase the program's sustainability and potential for scalability.
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Emigrantes e Imigrantes , Hispânico ou Latino , Humanos , Americanos Mexicanos , México , Obesidade/prevenção & controleRESUMO
INTRODUCTION: Cancer patient satisfaction with the healthcare team is of great relevance for assessing the quality of the care provided by the health system. In Mexico, no valid and reliable tool is available to assess this construct. OBJECTIVE: To validate the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction (FACIT-TS-PS) instrument, version 4, in cancer patients. METHOD: Cross-sectional design, non-probability convenience sampling. The sample consisted of 200 cancer-diagnosed patients, with mean age of 45.86 ± 15.01 years. Exploratory and confirmatory factor analyses were conducted. RESULTS: The exploratory factor analysis identified four factors, with a Cronbach alpha of 0.945, and an explained variance of 68.15 %. The confirmatory factor analysis indicated that the proposed theoretical model adjusts to the data with an error close to zero and, in addition, it is balanced and carefully measures overall patient satisfaction with the treatment. CONCLUSION: FACIT-TS-PS was shown to be a valid and reliable instrument for use in clinical care and research in Mexican cancer patients. Its use is recommended in the evaluation of oncology multidisciplinary healthcare teams in Mexico.
INTRODUCCIÓN: La satisfacción del paciente oncológico con el equipo de salud es de relevancia para evaluar la calidad de la atención del sistema de salud. En México no se dispone de una herramienta válida y confiable para evaluar este constructo. OBJETIVO: Validar el Instrumento de Evaluación de Funcionalidad en el Tratamiento para Enfermedades Crónicas-Satisfacción con el Tratamiento-Satisfacción del Paciente (FACIT-TS-PS) versión 4, en pacientes mexicanos con cáncer. MÉTODO: Diseño transversal, muestreo no probabilístico, por disponibilidad. La muestra consistió en 200 pacientes diagnosticados con cáncer, con edad promedio de 45.86 ± 15.01 años. Se realizó un análisis factorial exploratorio y confirmatorio. RESULTADOS: Se identificaron cuatro factores con un alfa de Cronbach de 0.945 y una varianza explicada de 68.15 %. El análisis factorial confirmatorio indicó que el modelo teórico propuesto se ajusta a los datos con error próximo a cero y que, además, es equilibrado y mide cuidadosamente la satisfacción global del paciente con el tratamiento. CONCLUSIÓN: FACIT-TS-PS mostró ser un instrumento válido y confiable para su uso en la atención clínica e investigación dirigida a pacientes mexicanos con cáncer. Se recomienda su utilización en la evaluación de equipos de salud multidisciplinarios en oncología en México.
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Neoplasias/terapia , Equipe de Assistência ao Paciente , Satisfação do Paciente , Qualidade da Assistência à Saúde/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pessoal Técnico de Saúde , Doença Crônica , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Modelos Teóricos , Neoplasias/psicologia , Relações Enfermeiro-Paciente , Relações Médico-Paciente , Relações Profissional-Paciente , Adulto JovemRESUMO
Resumen Introducción: La satisfacción del paciente oncológico con el equipo de salud es de relevancia para evaluar la calidad de la atención del sistema de salud. En México no se dispone de una herramienta válida y confiable para evaluar este constructo. Objetivo: Validar el Instrumento de Evaluación de Funcionalidad en el Tratamiento para Enfermedades Crónicas-Satisfacción con el Tratamiento-Satisfacción del Paciente (FACIT-TS-PS) versión 4, en pacientes mexicanos con cáncer. Método: Diseño transversal, muestreo no probabilístico, por disponibilidad. La muestra consistió en 200 pacientes diagnosticados con cáncer, con edad promedio de 45.86 ± 15.01 años. Se realizó un análisis factorial exploratorio y confirmatorio. Resultados: Se identificaron cuatro factores con un alfa de Cronbach de 0.945 y una varianza explicada de 68.15 %. El análisis factorial confirmatorio indicó que el modelo teórico propuesto se ajusta a los datos con error próximo a cero y que, además, es equilibrado y mide cuidadosamente la satisfacción global del paciente con el tratamiento. Conclusión: FACIT-TS-PS mostró ser un instrumento válido y confiable para su uso en la atención clínica e investigación dirigida a pacientes mexicanos con cáncer. Se recomienda su utilización en la evaluación de equipos de salud multidisciplinarios en oncología en México.
Abstract Introduction: Cancer patient satisfaction with the healthcare team is of great relevance for assessing the quality of the care provided by the health system. In Mexico, no valid and reliable tool is available to assess this construct. Objective: To validate the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction (FACIT-TS-PS) instrument, version 4, in cancer patients. Method: Cross-sectional design, non-probability convenience sampling. The sample consisted of 200 cancer-diagnosed patients, with mean age of 45.86 ± 15.01 years. Exploratory and confirmatory factor analyses were conducted. Results: The exploratory factor analysis identified four factors, with a Cronbach alpha of 0.945, and an explained variance of 68.15 %. The confirmatory factor analysis indicated that the proposed theoretical model adjusts to the data with an error close to zero and, in addition, it is balanced and carefully measures overall patient satisfaction with the treatment. Conclusion: FACIT-TS-PS was shown to be a valid and reliable instrument for use in clinical care and research in Mexican cancer patients. Its use is recommended in the evaluation of oncology multidisciplinary healthcare teams in Mexico.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Qualidade da Assistência à Saúde/normas , Satisfação do Paciente , Neoplasias/terapia , Relações Médico-Paciente , Relações Profissional-Paciente , Doença Crônica , Estudos Transversais , Análise Fatorial , Pessoal Técnico de Saúde , México , Modelos Teóricos , Neoplasias/psicologia , Relações Enfermeiro-PacienteRESUMO
INTRODUCTION: The COVID-19 pandemic can have important psychosocial consequences in the population. OBJECTIVE: To determine the levels of anxiety, depression and self-care symptoms during the COVID-19 pandemic in the general population. METHOD: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and Visual analog scale for self-care behaviors were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. RESULTS: Out of 1508 included participants, 20.8% had symptoms of severe anxiety, while 27.5% showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were risk factors for developing symptoms of anxiety and depression; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. CONCLUSION: A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public health problem, and implementation of programs for their care is therefore recommended.
INTRODUCCIÓN: La pandemia por COVID-19 puede tener consecuencias psicosociales importantes en la población. OBJETIVO: Determinar los niveles de síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en población general. MÉTODO: Encuesta en línea distribuida durante tres semanas mediante muestreo no probabilístico. Se empleó el Cuestionario sobre la Salud del Paciente PHQ-9, la Escala del Trastorno de Ansiedad Generalizada GAD-7 y la Escala análoga visual de conductas de autocuidado. Se realizaron análisis descriptivos y de comparación entre los grupos con ansiedad y depresión. RESULTADOS: Se incluyeron 1508 participantes, 20.8 % presentó síntomas de ansiedad grave y 27.5 %, síntomas de depresión grave. Ser mujer, soltero(a) no tener hijos, presentar comorbilidad médica y antecedentes de atención a la salud mental estuvieron relacionados con la presencia de mayores niveles de síntomas de ansiedad y depresión; 66 a 80 % de la población cumplía con las recomendaciones de autocuidado. Se identificó la necesidad de recibir atención de salud mental. CONCLUSIÓN: Se observó mayor número de individuos con síntomas de ansiedad y depresión moderadas a graves que en otras pandemias. Los efectos psicológicos de la pandemia de COVID-19 se consideran un problema de salud mental pública emergente, por lo que se recomienda la implementación de programas para su atención.
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Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Pneumonia Viral/epidemiologia , Autocuidado/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Infecções por Coronavirus/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/psicologia , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
Abstract Introduction: The COVID-19 pandemic can have important psychosocial consequences in the population. Objective: To determine the levels anxiety and depression symptoms and self-care behaviors during the COVID-19 pandemic in the general population. Method: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and a self-care behaviors visual analogue scale were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. Results: Out of 1508 included participants, 20.8 % had symptoms of severe anxiety, while 27.5 % showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were associated with the presence of higher levels of anxiety and depression symptoms; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. Conclusion: A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public mental health problem, and implementation of programs for their care is therefore recommended.
Resumen Introducción: La pandemia por COVID-19 puede tener consecuencias psicosociales importantes en la población. Objetivo: Determinar los niveles de síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en población general. Método: Encuesta en línea distribuida durante tres semanas mediante muestreo no probabilístico. Se empleó el Cuestionario sobre la Salud del Paciente PHQ-9, la Escala del Trastorno de Ansiedad Generalizada GAD-7 y la Escala análoga visual de conductas de autocuidado. Se realizaron análisis descriptivos y de comparación entre los grupos con ansiedad y depresión. Resultados: Se incluyeron 1508 participantes, 20.8 % presentó síntomas de ansiedad grave y 27.5 %, síntomas de depresión grave. Ser mujer, soltero(a) no tener hijos, presentar comorbilidad médica y antecedentes de atención a la salud mental estuvieron relacionados con la presencia de mayores niveles de síntomas de ansiedad y depresión; 66 a 80 % de la población cumplía con las recomendaciones de autocuidado. Se identificó la necesidad de recibir atención de salud mental. Conclusión: Se observó mayor número de individuos con síntomas de ansiedad y depresión moderadas a graves que en otras pandemias. Los efectos psicológicos de la pandemia de COVID-19 se consideran un problema de salud mental pública emergente, por lo que se recomienda la implementación de programas para su atención.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Ansiedade/epidemiologia , Pneumonia Viral/epidemiologia , Autocuidado/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Fatores Sexuais , Inquéritos e Questionários , Fatores de Risco , Infecções por Coronavirus/psicologia , Pandemias , COVID-19RESUMO
In Puerto Rico, cancer incidence increases significantly, and is accompanied with a greater risk of experiencing high levels of depressive symptoms, emotional distress, and reduced quality of life when compared to other minority ethnic groups. Studies suggest that interventions to attend distress in Latino patient population would benefit from including components that seek to improve patients' spiritual well-being. The purpose of this study is to identify the level of comprehension and acceptance of Meaning-Centered Psychotherapy (MCP) concepts. A mixed method design was conducted with in-depth interviews and open pilot data. A total of nine participants with advanced or metastatic cancer were sampled from an Oncology Clinic in the south of Puerto Rico. Six semi-structured interviews and six ethnographic notes with audiotape sessions were selected and transcribed. All material was analyzed, resulting in a sample of six semi-structured interview and six ethnographic note peer sessions. Patients showed low comprehension of the MCP concepts of meaning, the finite, and legacy. Patients showed low acceptance of death and its related concepts. They also reported high acceptance of integrating family members to their therapy. In order to tailor the intervention and improve comprehension, the content should include examples, shorter questions, and brief definitions. Additionally, there is a need to address death and its related concepts in end of life.
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BACKGROUND: Meaning-centered psychotherapy (MCP) is a structured psychotherapeutic intervention that aims to improve existential and spiritual well-being in patients with advanced cancer. To validate it, several efficacy studies with predominantly non-Hispanic white patients have been done. Puerto Ricans residing on the island are a largely overlooked segment of the US Latinx population. They have a strong national identity and are embedded in a collectivist culture which shares the Spanish language, cultural traditions, and an emphasis on familism, a cultural factor that values the role of the family in ensuring the well-being of its members. OBJECTIVE: The purpose of this study is to present a case study focused on a Puerto Rican advanced cancer patient who underwent MCP to assess the comprehension and acceptance of the MCP intervention. METHOD: We used a mixed-methods study design that included the taking of ethnographic notes, and pre- and post-test assessments of the scores the patient received on all the measures (using validated scales). The ethnographic notes were analyzed to determine the participant's comprehension and acceptance of the MCP intervention. Content analysis was performed on the ethnographic notes by three independent coders using a deductive coding approach. Pre- and post-interview assessments were conducted to explore changes in distress, spiritual well-being, and self-perceived quality of life. RESULTS: A Latino patient with stage III cancer, low income, and low literacy skills showed low comprehension of the concepts of meaning, the finite, legacy, and moderate comprehension and acceptance of the concepts of the search for hope, purpose in life, connecting with life, courage, life's limitations, and sources of meaning. However, the patient showed high comprehension of death and dying (i.e., meaningful death). The patient showed low acceptance of death and dying concepts and high acceptance of the integration of family members into the therapy. SIGNIFICANCE OF RESULTS: Additional studies are needed to address cultural themes and to improve the comprehensibility and acceptance of the manual's content and the central MCP concepts. The findings suggest that MCP has the potential of being a feasible form of psychotherapy for Latinx patients suffering from distress, low spiritual well-being, and low self-perceived QOL.
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Neoplasias/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Psicoterapia/normas , Adaptação Psicológica , Idoso , Compreensão , Humanos , Masculino , Neoplasias/complicações , Cuidados Paliativos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Psicoterapia/métodos , Porto Rico/etnologia , Pesquisa QualitativaRESUMO
OBJECTIVE: The purpose of this study was to describe the preferences, the use, satisfaction of mental health services (MHS) among a sample of Puerto Rican patients with cancer undergoing oncology treatment. METHODS: A convenience sample of 120 patients diagnosed with cancer was recruited. Self-report questionnaires assessed socio-demographic and background questions, and the Mental Health Service Preference, Utilization and Satisfaction Questionnaire (MHSPUS). The Socio-demographic and Background Questionnaire inquired about participants' demographic and socioeconomic characteristics, and included questions such as history of psychiatric diagnosis and spiritual practices. Univariate and Chi square analyses were used for descriptive purposes. Logistic regressions were used to explore associations between sociodemographic factors and MHS preferences and use. RESULTS: The majority of the sample were females (53.8%), 61 and older (53.8%), and married or living with partner (57.1%), and reported an income equal to or less than $12,000 per year (44.4%), which places them under the US federal poverty line. Most of the participants (66.7%) reported being receptive to seeking services. Findings showed a significant association between living situation and past (p < .05) and lifetime use (p < .05) of MHS and past use of MHS. Participants living alone were more like to have used MHS in the past and during their lifetime. Adjusted logistic regression analyses revealed that living with someone was a protective factor for not using MHS in their lifetime (OR = 0.28; C1 = 0.08-0.95). Participants preferred to receive MHS at the oncology clinic, preferably on the date of their oncology appointments and during morning hours. CONCLUSION: Findings support the integration of mental health services within the oncology practice setting.
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Transtornos Mentais/complicações , Serviços de Saúde Mental , Neoplasias/complicações , Satisfação do Paciente , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/terapia , Satisfação Pessoal , Porto Rico/epidemiologia , Autorrelato , Fatores Sexuais , Fatores Socioeconômicos , Adulto JovemRESUMO
Latinos are a diverse population comprised of multiple countries of origin with varying cultural profiles. This study examines differences in colonoscopy completion across place of birth and migration-related factors in a sample of predominantly Dominican and Puerto Rican Latinos living in New York City after receiving a recommendation for colonoscopy screening and navigation services. The sample included 702 Latinos recruited for two cancer screening projects targeting Latinos eligible for colonoscopy who seek healthcare in New York City. Participants completed a survey that included sociodemographic, health-related questions, psychosocial assessments and cancer screening practices, in Spanish or English. Migration, acculturation, and language factors were found to predict colonoscopy completion. The results indicated that Latinos born in the Dominican Republic and Central America were more likely to complete a screening colonoscopy than their counterparts born in the US. Further, those who emigrated at an older age, who have resided in the US for less than 20 years, preferred Spanish and those with lower US acculturation levels were also more likely to complete a screening colonoscopy. The findings suggest that Latinos who are less acculturated to the US are more likely to complete a screening colonoscopy after receiving a physician recommendation for colonoscopy screening. The results provide important information that can inform clinical practice and public health interventions. Continued attention to cultural and migration influences are important areas for cancer screening intervention development.
Assuntos
Aculturação , Colonoscopia/estatística & dados numéricos , Emigrantes e Imigrantes , Hispânico ou Latino , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Idoso , América Central/etnologia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/etnologia , República Dominicana/etnologia , Feminino , Humanos , Pessoa de Meia-Idade , Cidade de Nova Iorque , Porto Rico/etnologia , América do Sul/etnologia , Inquéritos e QuestionáriosRESUMO
AIM: The aim of this study was to identify the coping strategies Hispanic adolescents employed to deal with parental cancer, looking specifically at how gender and psychological symptoms such as depression and anxiety relate to such strategies. METHODS: Participants were 51 Puerto Rican adolescents who have a parent living with cancer. Adolescents completed a structured questionnaire with scales measuring depression (CES-D), anxiety (STAI), and coping strategies (COPE). RESULTS: The strategies used with the highest frequency were those generally viewed as positive and emotion-focused: emotional support, acceptance, and religion. The means for these coping strategies indicated that they occurred with high frequency. The findings revealed no differences in coping strategies between girls and boys. Depression was related to two maladaptive coping strategies: denial and behavioral disengagement; and one emotion-focused strategy: acceptance. Anxiety had significant correlations with one emotion-focused strategy: acceptance; and two dysfunctional strategies: substance use and behavioral disengagement. The best predictors of adolescents' depression and anxiety were dysfunctional coping and problem-focused strategies. CONCLUSIONS: The study contributes to the knowledge about the coping strategies of Hispanic adolescents experiencing parental cancer and the importance of taking individual coping strategies into account when evaluating the impact of parental cancer on psychological well-being. This is especially true for adolescents who are likely to use dysfunctional strategies such as denial, substance use, and behavioral disengagement. Through psychosocial interventions, professionals need to assist these adolescents to improve and learn better coping strategies.