pinecone/core-2020-05-10-deduplication huggingface dataset:
Level of physical activity and characteristics associated with change following breast cancer diagnosis and treatment

Objective: While the physical and psychosocial benefits of participating in physical activity\ud
(PA) during and following breast cancer treatment are well understood, less is known about\ud
rates and uptake of PA following diagnosis. This paper explores the levels and patterns of PA\ud
among women recently diagnosed with breast cancer and the factors associated with change in\ud
activity levels.\ud
Methods: Using a population-based recruitment approach, PA levels of 287 breast cancer\ud
patients were assessed at 6, 12 and 18 months post-diagnosis using the Behavioral Risk Factor\ud
Surveillance System, and then converted to MET (metabolic equivalent task)-hours/week.\ud
Regression analyses were used to explore the correlates associated with change between 6 and\ud
18 months post-diagnosis.\ud
Results: Although more than 80% of women participated in PA at each testing phases,\ud
more than 50% were considered insufficiently active or sedentary according to national\ud
recommendations and less than one-third reported engagement in vigorous or strength\ud
activities. Mean change in total MET-hours/week between 6 and 18 months post-diagnosis was\ud
minor (mean50.10, median50.0), however individual changes were substantial (ranging from\ud
100 to +174 MET-hours/week). Results are more encouraging for the lower threshold of 3+\ud
MET-hours/week, which may be most relevant specifically for breast cancer outcomes.\ud
Conclusions: Since the majority of women report insufficient levels of PA, there is a clear\ud
need for exercise interventions during and following breast cancer treatment. Few\ud
characteristics predict declines or improvements in PA levels, hence for optimal benefit,\ud
interventions should target the entire breast cancer population
Gynecological cancer survivors and community support services: Referral, awareness, utilization and satisfaction

Objectives\ud
\ud
To quantify gynaecological cancer survivors’ referral to, awareness of, utilisation of and satisfaction with community support services, as well as the factors associated with service use.\ud
\ud
Methods\ud
\ud
In 2004, 802 gynaecological cancer survivors, three months to five years post-diagnosis, completed a postal questionnaire (56% response rate). Descriptive statistics summarised outcome prevalences. Logistic regression models identified correlates of service utilisation.\ud
\ud
Results\ud
\ud
Substantial proportions of women were aware of the main cancer support organisation, Cancer Council Queensland (72%), and of information booklets (74%), helplines (66%), support groups (56%) and internet information (50%). Less than half were aware of other services. The most commonly used resources and services were information booklets (37%), the internet (23%), and helplines (20%). More broadly, 43% utilised information/internet support, 30% utilised psychosocial services and 27% utilised functional/practical services. Approximately one-fifth (19%) used more than one support types. Having a health care provider referral, being diagnosed with lymphoedema or living in northern Queensland were associated with higher odds of service use in all three of the support types. While most (86%) of those referred used a service, only a few women received referrals. Among users, satisfaction with services was high.\ud
\ud
Conclusions\ud
\ud
While gynaecological cancer survivors accessed a variety of support, there is a need to ensure women are aware of services. Given the low prevalence of referrals and that referral was a key influence on service use, clinician education may be necessary to improve service referral. Organisations should also consider strategies to keep services high on clinicians’ radars
Predictors of change in unmet supportive care needs in cancer

Objective: Patient Reported Outcome (PRO) assessments can assist health professionals to tailor their health practices to the individual needs of patients and improve patient care over time. The present study assessed prospective predictors of unmet supportive care needs in cancer patients over a six-month period.    Methods: Participants were recruited from a regional cancer treatment centre in Australia and completed the Supportive Care Needs Survey (SCNS) at recruitment (n=439; 61.4% response rate) and six months follow-up (n=396). Hierarchical logistic regression was used to identify predictors of change in unmet needs across each supportive care domain. Predictor variables were socio-demographic, treatment and psychosocial factors including depression, anxiety, social support, and patient satisfaction.    Results: Unmet needs were reported by approximately two-thirds of patients at baseline and half of patients at six months follow-up. Having unmet needs at baseline was the strongest predictor of unmet needs at six months. Longer time since diagnosis was a consistent predictor of greater unmet needs, associated with change in physical/daily living, psychological and health system and information unmet needs over time. By contrast, a complex relationship was found in that patient satisfaction, psychosocial and treatment characteristics predicted higher needs in some domains and lower needs in others.    Conclusions: Unmet supportive care needs persist over time and psychological needs may emerge later in the illness continuum. Interventions to meet the needs of longer term cancer survivors are needed and should closely articulate with reported supportive care needs. Copyright 頲009 John Wiley & Sons, Ltd.Griffith Health, School of Applied PsychologyFull Tex
Trajectories of psychological distress among Chinese women diagnosed with breast cancer

Background: The distinct trajectories of psychological distress over the first year of the diagnosis with breast cancer (BC) and its determinants have not been explored. Methods: 285 of 405 Chinese women receiving surgery for BC were assessed at 5-day, 1-month, 4-month, and 8-month post-surgery on measures of psychological distress, optimism, treatment decision-making (TDM) difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, and physical symptom distress. Latent growth mixture modelling identified trajectories of psychological response to BC. Multinominal logistic regression compared TDM difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, optimism, and physical symptom distress, by distress pattern adjusted for age, education, employment status, and stage of disease. Results: Four distinct trajectories of distress were identified, namely, resilience (66%), chronic distress (15%), recovered (12%), and delayed-recovery (7%). TDM difficulties, optimism, satisfaction with consultation, and physical symptom distress predicted distress trajectories. Psychologically resilient women had less physical symptom distress at early post-surgery compared with women with other distress patterns. Compared with the resilient group, women in the recovered or chronic distress groups experienced greater TDM difficulties, whereas women in the delayed-recovery group reported greater dissatisfaction with the initial medical consultation. Women in the chronic distress group reported greater pessimistic outlook. Conclusion: Optimism and better early post-operative treatment outcomes predicted resilience to distress. Pre-operative interventions helping women to establish a realistic expectation of treatment outcome may minimize disappointment with treatment outcome and resultant distress, whereas post-operative rehabilitation should focus on symptom management. © 2009 John Wiley & Sons, Ltd.postprin
Social support buffers the impact of functional  impairments on caregiver psychological well-being  in the context of brain tumor and other cancers

Abstract  Objective: This study investigated the association between functional impairments of individuals with cancer and caregiver psychological well-being, and examined the moderating effect of social support.    Methods: Sixty-three caregivers (71% female) of individuals with brain tumor (n=27) and other cancers (n=36) were recruited from community services. Caregivers rated their psychological well-being on the World Health Organisation Quality of Life measure Brief version, social support on a brief version of the Social Support Questionnaire, and the individuals' functional impairments on the Patient Competency Rating Scale.    Results: For caregivers of individuals with brain tumor, better psychological well-being was associated with lower functional impairment in all domains (rs=0.33-38, p<0.05), except for cognitive difficulties. For caregivers of individuals with other cancers, better psychological well-being was associated with lower functional impairment in all domains (rs=0.30-0.49, p<0.05), with the exception of activities of daily living. For the total caregiver sample, better psychological well-being was significantly correlated with overall functional impairment (r=0.34, p<0.005) and satisfaction with support (r=0.40, p<0.005). Caregivers supporting individuals with greater functional impairment had better psychological well-being if they were highly satisfied with their social support.    Conclusions: Effective social support is particularly important for caregivers who support individuals with poorer functional status, and this study highlights the need to evaluate caregiver social support interventions in the context of cancer.Griffith Health, School of Applied PsychologyFull Tex
Adopting a family approach to theory and practice: measuring distress in cancer patient-partner dyads with the distress thermometer

Objective: Significant others are central to patients' experience and management of their cancer illness. Building on our validation of the Distress Thermometer (DT) for family members, this investigation examines individual and collective distress in a sample of cancer patients and their matched partners, accounting for the aspects of gender and role.Method: Questionnaires including the DT were completed by a heterogeneous sample of 224 couples taking part in a multisite study.Results: Our investigation showed that male patients (34.2%), female patients (31.9%), and male partners (29.1%) exhibited very similar levels of distress, while female partners (50.5%) exhibited much higher levels of distress according to the DT. At the dyad level just over half the total sample contained at least one individual reporting significant levels of distress. Among dyads with at least one distressed person, the proportion of dyads where both individuals reported distress was greatest (23.6%). Gender and role analyses revealed that males and females were not equally distributed among the four categories of dyads (i.e. dyads with no distress; dyads where solely the patient or dyads where solely the partner is distressed; dyads where both are distressed).Conclusion: A remarkable number of dyads reported distress in one or both partners. Diverse patterns of distress within dyads suggest varying risks of psychosocial strain. Screening patients' partners in addition to patients themselves may enable earlier identification of risk settings. The support offered to either member of such dyads should account for their role- and gender-specific needs. Copyright © 2010 John Wiley & Sons, Ltd
Patterns, correlates, and prognostic significance of quality of life following breast cancer

Objective\ud
\ud
To describe quality of life (QOL) over a 12-month period among women with breast cancer, consider the association between QOL and overall survival (OS), and explore characteristics associated with QOL declines. \ud
\ud
\ud
Methods\ud
\ud
A population-based sample of Australian women (n=287) with invasive, unilateral breast cancer (Stage I+), was observed prospectively for a median of 6.6 years. QOL was assessed at six, 12 and 18 months post-diagnosis, using the Functional Assessment of Cancer Therapy, Breast (FACT-B+4) questionnaire. Raw scores for the FACT-B+4 and subscales were computed and individuals were categorized according to whether QOL declined, remained stable or improved between six and 18 months. Kaplan-Meier and Cox proportional hazards survival methods were used to estimate OS and its associations with QOL. Logistic regression models identified factors associated with QOL decline. \ud
\ud
Results\ud
\ud
Within FACT-B+4 sub-scales, between 10% and 23% of women showed declines in QOL. Following adjustment for established prognostic factors, emotional wellbeing and FACT-B+4 scores at six months post-diagnosis were associated with OS (p<0.05). Declines in physical (p<0.01) or functional (p=0.02) well-being between six and 18 months post-diagnosis were also associated significantly with OS. Receiving multiple forms of adjuvant treatment, a perception of not handling stress well and reporting one or more other major life events at six months post-diagnosis were factors associated with declines in QOL in multivariable analyses. \ud
\ud
Conclusions\ud
\ud
Interventions targeted at preventing QOL declines may ultimately improve quantity as well as quality of life following breast cancer
Rumination, post-traumatic growth, and distress : structural equation modelling with cancer survivors

Objective\ud
\ud
Theoretical models of post-traumatic growth (PTG) have been derived in the general trauma literature to describe the post-trauma experience that facilitates the perception of positive life changes. To develop a statistical model identifying factors that are associated with PTG, structural equation modelling (SEM) was used in the current study to assess the relationships between perception of diagnosis severity, rumination, social support, distress, and PTG.\ud
\ud
Method\ud
\ud
A statistical model of PTG was tested in a sample of participants diagnosed with a variety of cancers (N=313).\ud
\ud
Results\ud
\ud
An initial principal components analysis of the measure used to assess rumination revealed three components: intrusive rumination, deliberate rumination of benefits, and life purpose rumination. SEM results indicated that the model fit the data well and that 30% of the variance in PTG was explained by the variables. Trauma severity was directly related to distress, but not to PTG. Deliberately ruminating on benefits and social support were directly related to PTG. Life purpose rumination and intrusive rumination were associated with distress.\ud
\ud
Conclusions\ud
\ud
The model showed that in addition to having unique correlating factors, distress was not related to PTG, thereby providing support for the notion that these are discrete constructs in the post-diagnosis experience. The statistical model provides support that post-diagnosis experience is simultaneously shaped by positive and negative life changes and that one or the other outcome may be prevalent or may occur concurrently. As such, an implication for practice is the need for supportive care that is holistic in nature.\u
Ensuring Treatment Fidelity in a Multi-site Behavioral Intervention Study: Implementing NIH Behavior Change Consortium Recommendations in the SMART Trial

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children’s Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11–24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the NIH Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in 5 specific areas: 1) study design, 2) training providers, 3) delivery of treatment, 4) receipt of treatment, and 5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature illustrating the application of BCC recommendations in behavioral intervention studies
Perceived positive impact of cancer among long‐term survivors of childhood cancer: a report from the childhood cancer survivor study

Objective  Investigations examining psychosocial adjustment among childhood cancer survivors have focused primarily on negative effects and psychopathology. Emergent literature suggests the existence of positive impact or adjustment experienced after cancer, as well. The purpose of this study is to examine the distribution of Perceived Positive Impact (PPI) and its correlates in young adult survivors of childhood cancer.    Methods  6425 survivors and 360 siblings completed a comprehensive health survey, inclusive of a modified version of the Post‐traumatic Growth Inventory (PTGI) as a measure of PPI. Linear regression models were used to examine demographic, disease and treatment characteristics associated with PPI.    Results  Survivors were significantly more likely than siblings to report PPI. Endorsement of PPI was significantly greater among female and non‐white survivors, and among survivors exposed to at least one intense therapy, a second malignancy or cancer recurrence. Survivors diagnosed at older ages and fewer years since diagnosis were more likely to report PPI. Income, education and marital/relationship status appeared to have varied relationships to PPI depending upon the subscale being evaluated.    Conclusions  The existence and variability of PPI in survivors in this study suggest that individual characteristics, inclusive of race, gender, cancer type, intensity of treatment, age at diagnosis and time since diagnosis, have unique and specific associations with different aspects of perceived positive outcomes of childhood cancer.  Copyright © 2011 John Wiley & Sons, Ltd
Study of dyadic communication in couples managing prostate cancer: a longitudinal perspective

Objective : Cancer patients and partners often report inadequate communication about illness‐related issues, although it is essential for mutual support and informal caregiving. This study examined the patterns of change in dyadic communication between patients with prostate cancer and their partners, and also determined if certain factors affected their communication over time.   Method : Using multilevel modeling, this study analyzed longitudinal data obtained from a randomized clinical trial with prostate cancer patients and their partners, to examine their communication over time. Patients and partners ( N =134 pairs) from the usual‐care control group independently completed baseline demographic assessment and measures of social support, uncertainty, symptom distress, and dyadic communication at baseline, and 4‐, 8‐, and 12‐month follow‐ups.   Results : The results indicated that (1) patients and partners reported similar levels of open communication at the time of diagnosis. Communication reported by patients and partners decreased over time in a similar trend, regardless of phase of illness; (2) phase of illness affected couples' open communication at diagnosis but not patterns of change over time; and (3) couples' perceived communication increased as they reported more social support, less uncertainty, and fewer hormonal symptoms in patients. Couples' demographic factors and general symptoms, and patients' prostate cancer‐specific symptoms did not affect their levels of open communication.   Conclusions : Perceived open communication between prostate cancer patients and partners over time is affected by certain baseline and time‐varying psychosocial and cancer‐related factors. The results provide empirical evidence that may guide the development of strategies to facilitate couples' interaction and mutual support during survivorship. Copyright © 2010 John Wiley & Sons, Ltd
Adapting an in‐person patient–caregiver communication intervention to a tailored web‐based format

Background : Interventions that target cancer patients and their caregivers have been shown to improve patient‐caregiver communication, support, and emotional well‐being.   Objective : To adapt an in‐person communication intervention for cancer patients and caregivers to a web‐based format, and to examine the usability and acceptability of the web‐based program among representative users.   Methods : A tailored, interactive web‐based communication program for cancer patients and their family caregivers was developed based on an existing in‐person, nurse‐delivered intervention. The development process involved: (1) building a multidisciplinary team of content and web design experts, (2) combining key components of the in‐person intervention with the unique tailoring and interactive features of a web‐based platform, and (3) conducting focus groups and usability testing to obtain feedback from representative program users at multiple time points.   Results : Four focus groups with 2–3 patient–caregiver pairs per group ( n  = 22 total participants) and two iterations of usability testing with four patient–caregiver pairs per session ( n  = 16 total participants) were conducted. Response to the program's structure, design, and content was favorable, even among users who were older or had limited computer and Internet experience. The program received high ratings for ease of use and overall usability (mean System Usability Score of 89.5 out of 100).   Conclusions : Many elements of a nurse‐delivered patient–caregiver intervention can be successfully adapted to a web‐based format. A multidisciplinary design team and an iterative evaluation process with representative users were instrumental in the development of a usable and well‐received web‐based program. Copyright © 2011 John Wiley & Sons, Ltd
Internet interventions for improving psychological well‐being in psycho‐oncology: review and recommendations

Objective  Too few cancer patients and survivors receive evidence‐based interventions for mental health symptoms. This review examines the potential for Internet interventions to help fill treatment gaps in psychosocial oncology and presents evidence regarding the likely utility of Internet interventions for cancer patients.    Methods  The authors examined available literature regarding Internet interventions tailored to cancer patients' mental health needs and reviewed elements of Internet interventions for mental health relevant to advancing psycho‐oncology Internet intervention research.    Results  Few rigorous studies focusing on mental health of cancer patients have been conducted online. A growing body of evidence supports the efficacy, accessibility, and acceptability of mental health Internet interventions for a variety of general and medical patient populations. The authors present recommendations and guidelines to assist researchers in developing, testing, and disseminating Internet interventions for cancer patients and survivors, to manage and improve their mental health. Issues unique to Internet interventions—including intervention structure, customization, provider interaction, and privacy and confidentiality issues—are discussed. These guidelines are offered as a step toward establishing a set of “best practices” for Internet interventions in psycho‐oncology and to generate further discussion regarding the goals of such interventions and their place in cancer care.    Conclusions  Internet interventions have the potential to fill an important gap in quality cancer care by augmenting limited available mental health services. These interventions should be developed in a manner consistent with best practices and must be empirically tested and validated. Copyright © 2011 John Wiley & Sons, Ltd