Objective
The increasing numbers of breast cancer survivors highlight the importance of delineating factors that identify women who are at risk of poor psychological adjustment in the long term. In ...breast cancer survivors, higher attachment anxiety and attachment avoidance have been associated with poorer psychological adjustment. Moreover, there is evidence that self‐compassion, a kind manner of treating oneself during difficulties, is associated with psychological adjustment in this population. This study aimed to extend the association between attachment styles and psychological adjustment to the context of long‐term breast cancer survivors and to determine whether lower self‐compassion underlies this association.
Methods
Participants (N = 82) were recruited through emailed invitations to members of the Review and Survey Group of Breast Cancer Network Australia. Following online consent, participants completed measures assessing attachment styles, self‐compassion, psychological stress, and the perceived negative impact of cancer. Bootstrapping analyses using the PROCESS macro were used to test the significance of indirect effects.
Results
As hypothesised, correlational analyses revealed that higher attachment anxiety and attachment avoidance were significantly and positively associated with stress and perceived negative impact of cancer. Bootstrapping analyses revealed significant indirect effects of attachment anxiety and attachment avoidance (on both stress and perceived negative impact of cancer) through lower self‐compassion.
Conclusions
These findings suggest that self‐compassion training may be useful for enhancing the psychological adjustment of long‐term breast cancer survivors. Future longitudinal and experimental studies in more diverse samples are needed to confirm causal directionality of these relationships and to expand upon these findings.
As a critical component of medical practice, it is alarming that patient informed consent does not always reflect (1) adequate information provision, (2) comprehension of provided information, and ...(3) a voluntary decision. Consequences of poor informed consent include low patient satisfaction, compromised treatment adherence, and litigation against medical practitioners. To ensure a well-informed, well-comprehended, and voluntary consent process, the objective and replicable measurement of these domains via psychometrically sound self-report measures is critical. This systematic review aimed to evaluate the adequacy of existing measures in terms of the extent to which they assess the three domains of informed consent, are psychometrically sound and acceptable for use by patients. Extensive searching of multiple databases (PsychINFO, PubMed, Sociological s, CINAHL, AMED) yielded 10,000 potential studies, with 16 relevant scales identified. No existing scale was found to measure all three consent domains, with most only narrowly assessing aspects of any one domain. Information provision was the most frequently assessed domain, followed by comprehension, and then voluntariness. None of the identified scales were found to have adequate evidence for either high quality psychometric properties or patient user acceptability. No existing scale is fit for purpose in comprehensively assessing all domains of informed consent. In the absence of any existing measure meeting the necessary criteria relating to information, comprehension and voluntariness, there is an urgent need for a new measure of medical consent to be developed that is psychometrically sound, spans all three domains and is acceptable to patients and clinicians alike. These findings provide the impetus and justification for the redesign of the informed consent process, with the aim to provide a robust, reliable and replicable process that will in turn improve the quality of the patient experience and care provided.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Research has identified that living with the chronic inflammatory disease endometriosis adversely impacts social functioning and interpersonal relationships, specifically, feelings of ...loneliness and a lack of perceived social support. Commonly experienced body image disturbance (BID), combined with the anticipation of endometriosis-related stigma from others, may result in further social withdrawal. This study aimed to quantitatively investigate the association between BID and social functioning (loneliness and diminished perceived social support), and the potential moderating effect of anticipated stigma on these associations.
Method
Participants (
N
= 212) with a self-reported endometriosis diagnosis completed an online questionnaire measuring social and emotional loneliness, perceived social support, BID, anticipated stigma and demographic and medical characteristics.
Results
Mean scores indicated high levels of BID, emotional loneliness and diminished perceived social support. Bootstrapped multivariable regression analyses indicated that BID was significantly associated with greater emotional loneliness and lower perceived social support. BID was also associated bivariately with greater social loneliness. Anticipated stigma from healthcare workers moderated the association of BID with perceived social support, such that poorer perceived support was reported when anticipated stigma was high, despite the presence of minimal BID.
Conclusion
These findings highlight the psychological challenges of living with endometriosis in terms of highly prevalent BID, in the context of feeling lonely and poorly supported. The further negative impact of anticipated stigma suggests that psychosocial interventions may benefit from additionally targeting these perceptions of stigma.
Background
Endometriosis is a chronic reproductive disease manifesting in physical symptoms including pain, abdominal swelling, altered bowel and bladder function, and fatigue. These symptoms ...potentially threaten body image regarding subjective perceptions of functional, appearance, and sensory aspects of one’s body. The aim of this study was to qualitatively understand how endometriosis impacts on affective and perceptual aspects of body image.
Method
Participants (
N
= 40) were recruited through endometriosis consumer organizations. In an online survey, participants completed demographic and health history questions, then provided written narratives about body image–related impacts of their endometriosis in response to open-ended questions. These data were thematically analyzed using the template approach.
Findings
The majority of participants (M
age
= 28.3 years) were employed part-time, diagnosed on average for 4.2 years, and reported pelvic pain and bloating, fatigue, and nausea symptoms. Thematic analysis yielded three themes including My Body is a Barrier, Needing to Hide Myself, and Body as Healer and Teacher, all of which reflected affective and perceptual aspects of body image.
Conclusion
These findings highlight wide-ranging body image–related impacts of endometriosis, suggesting the need for targeted interventions to address these concerns.
This study examined the relationship between communication avoidance of cancer-related topics with psychological distress, and the mediating role of coping strategies, in women with breast cancer. ...Women diagnosed with breast cancer (N = 338) completed an online survey including measures of self- and perceived-partner communication avoidance, psychological distress (depression, anxiety and stress), and coping strategies. Linear regression analyses indicated that women’s and perceived-partner’s communication avoidance was associated with anxiety, depression, and stress in the cancer-affected women. Bootstrapping analyses showed significant mediation effects of self- and perceived-partner communication avoidance on all distress outcomes through greater disengagement coping, and on anxiety through lower engagement coping. Emotionally valenced topics (i.e., disease progression and sexuality) were most avoided and practical issues were least avoided. Enhancing couple communication about cancer and women’s adaptive coping skills (i.e., discourage use of disengagement coping strategies and promote use of engagement coping strategies) may be important targets for psychosocial intervention.
Purpose
Sexual dysfunction commonly arises for women following diagnosis and treatment of breast cancer. The aim of this study was to systematically evaluate the acceptability, reliability, and ...validity of the Female Sexual Functioning Index (FSFI) when used with these women.
Methods
Sexually active women previously diagnosed with breast cancer (
N
= 399) completed an online questionnaire including the FSFI and measures of acceptability (ease of use, relevance), sexual functioning, body image, fatigue, impact of cancer, physical and mental health, and relationship adjustment. Reliability and validity were evaluated using standard scale validation techniques.
Results
Participants indicated a high degree of acceptability. Excellent internal consistency (α = 0.83–0.96) and test–retest reliability (
r
= 0.74–0.86) of the FSFI were evident. According to the confirmatory factor analysis, the best fit was achieved with removal of item 14 (regarding the extent of emotional closeness with the partner) and six subscales (desire, arousal, lubrication, orgasm, satisfaction, pain), without a total score (TLI = 0.96, CFI = 0.97, RMSEA = 0.07). Correlations with measures of sexual functioning and related constructs provided evidence for convergent and divergent validities, respectively. All but one subscale (orgasm) discriminated between women who are, and are not, currently receiving treatment for breast cancer (discriminant validity).
Conclusions
These findings indicate that not only is the FSFI psychometrically sound when used with women with breast cancer, but it is perceived as being easy to use and relevant. It is recommended that the FSFI subscale scores can be used in both clinical and research settings as a screening tool to identify women experiencing sexual dysfunction following breast cancer.
Objective
Greater hope and self‐compassion have individually been associated with lower psychological distress in women with breast cancer. Self‐compassion is also associated with lower body image ...distress in this population, yet it is unknown whether hope also has this association. This study aimed to investigate the extent to which hope accounts for body image distress and psychological distress in breast cancer survivors alone, and in direct comparison to self‐compassion.
Method
A total of 195 women were recruited from the Breast Cancer Network Australia and completed a cross‐sectional online anonymous questionnaire containing self‐report measures of body image (Body Image Scale), self‐compassion (Self Compassion Scale‐SF), hope (State Hope Scale), psychological distress (depression, anxiety, stress; DASS), and demographic/medical questions.
Results
Self‐compassion and hope were inversely correlated with all outcomes. Hierarchical linear regression analyses indicated that self‐compassion and hope uniquely explained variance in all outcomes with different magnitudes of strength. Comparison of standardised betas indicated (a) Body image distress—self‐compassion (Bstd = −.355) vs hope (Bstd = −.161); (b) Stress—self‐compassion (Bstd = −.562) vs hope (Bstd = −.287); (c) Depression—hope (Bstd = −.447) vs self‐compassion (Bstd = −.374); (d) Anxiety—hope (Bstd = −.406) vs self‐compassion (Bstd = −.249).
Conclusion
The unique contribution of self‐compassion and hope in explaining body image distress and psychological distress suggests that combined, hope‐focused components of therapy may be suitable additions to the growing array of self‐compassion–based psychosocial interventions to address body image and psychological distress concerns of women with breast cancer.
Purpose Breast cancer treatment adverse effects result in one in three survivors experiencing body image-related distress (BID) that negatively impacts on a woman's ability to recover after cancer ...and into survivorship. My Changed Body (MyCB) is a Web-based psychological intervention to alleviate BID and improve body appreciation in survivors of breast cancer (BCSs) through a single-session, self-compassion focused writing activity. This randomized controlled trial evaluated the impact of MyCB on BID and body appreciation in BCSs. The moderating effect of lymphedema status (affected or unaffected) and appearance investment (self-importance placed on personal appearance) and the mediating effect of self-compassion were evaluated. Patients and Methods Women (disease-free stage I to III BCSs who had experienced at least one negative event related to bodily changes after breast cancer) were randomly assigned to MyCB (n = 149) or an expressive writing control arm (n = 155). Primary outcomes were reduction in BID and improvement in body appreciation 1 week after intervention. Secondary outcomes included psychological distress (depression and anxiety) and self-compassion. Follow-up assessments occurred 1 week, 1 month, and 3 months after writing. Results Compliance with the MyCB intervention was 88%, and attrition was 9.2%. Intent-to-treat linear mixed models indicated that participants who received MyCB reported significantly less BID ( P = .035) and greater body appreciation ( P = .004) and self-compassion ( P < .001) than expressive writing participants. Intervention effects on BID were moderated by lymphedema status ( P = .007) and appearance investment ( P = .042). Self-compassion mediated effects on both primary outcomes. Therapeutic effects were maintained at 1 month (BID and body appreciation) and 3 months (body appreciation) after intervention. Significant reductions in psychological distress (1-month depression, P = .001; 1-week and 1-month anxiety, P = .007) were evident for MyCB participants with lymphedema. Conclusion This study supports the efficacy of MyCB for reducing BID and enhancing body appreciation among BCSs.
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