An Investigation of Psychological Stress, Coping Styles/strategies and Psychological Adjustments in a Sample of Indian South African Women with Breast Cancer in Different Developmental Stages of the Life-cycle PDF Download

Author: Colette Anne Selmer
Publisher:
ISBN:
Category : Breast
Languages : en
Pages :

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Author: Aisha Kazi
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Breast cancer is a devastating disease that affects thousands of women every year influencing their psychological and physical well-being for many years after being diagnosed. The goal of the current study was to determine if there are distinct trajectories of functioning among breast cancer patients in the domains of negative psychological adjustment, positive psychological adjustment, and physical adjustment. This was accomplished using growth mixture modeling. Another goal of this study was to determine whether demographic, medical, and psychosocial variables were able to distinguish among the trajectories. The study combined women from two samples spanning 10 years providing a sample size of 376 women diagnosed and treated for breast cancer. These women were recruited to participate in a 10-week cognitive behavioral stress management intervention and were either randomized to the 10-week experimental condition or a one-day control group. It was hypothesized that distinct trajectories would emerge for each of the domains and that psychosocial variables (i.e., social support, benefit finding, and emotional approach coping) would distinguish among the trajectories. This study was able to statistically identify multiple classes or trajectories of adjustment, consistent with findings reported by Helgeson and colleagues (2004) and Donovan and colleagues (2007). It is difficult to say, however, whether these classes differ in clinically significant ways. The present study also provides a cautionary note to researchers who intend to use growth mixture modeling to identify different trajectories of functioning and the limitations associated with this statistical technique. First, it is important to start this process with strong empirical or theoretical support for the possibility of different classes or trajectories. Without this foundation it becomes difficult to justify why a certain number of classes were chosen. Another limitation of this statistical approach is that there is not a standard method for determining the best number of classes. There are conflicting opinions among researchers in the field about the best fit index to use when the multiple fit indices do not converge. A serious issue related to this is the fact that classes are used for interpreting results and drawing conclusions and inferences. Therefore, clinicians using GMM must be careful when deciding on the number of classes and the clinical inferences drawn from these analyses. Further research needs to be conducted validating these statistical techniques.

Author: Barbara L. Andersen
Publisher: Springer Science & Business Media
ISBN: 1461386713
Category : Psychology
Languages : en
Pages : 437

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A Woman With Cancer Deborah came to University Hospital when she was 25. She was the mainstay of a young farming family. Her husband, Merle, was now farming his family land, working hard to keep financially solvent during these difficult f;lrming days. They had four children: Carolyn, 4 months; Michael, 17 months; John, 4 years; and Susie, 5 years. There was nothing special about this woman or her circumstances; she was like every woman who had ordinary daily chores and responsibilities, people in her life about whom she cared and who cared for her, worries, goals, dreams, and her life before her. Deborah's 4-week postpartum checkup and Pap smear were normal; however, six weeks later she had heavy, irregular bleeding. To Deborah this symptom picture did not seem to fit the pattern of her other preg nancies, and so she returned to her doctor. A large lesion was found on the posterior cervix and biopsies of the tissue revealed moderately dif ferentiated adenocarcinoma of the cervix. Referral to the University Hospital 60 miles away confirmed the diagnosis. Further tumor workup, which included a pelvic ultrasound, bladder cystoscopy, sigmoidoscopy, and chest x-ray, was normal, although the IVP was notable for nonvi sualization of the right ureter, thought to be secondary to an enlarged lymph node.

Author: Sara E Vargas
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Breast cancer diagnosis and treatment constitute stressors that can lead to both temporary and long-lasting problems with psychosocial adaptation. The types of stressors and available coping resources may vary by point in cancer treatment (e.g., immediately after surgery versus months after the completion of adjuvant treatment). Cognitive-behavioral stress management (CBSM) is an intervention aimed to buffer against the negative effects of having breast cancer by enhancing protective factors that may facilitate psychosocial adaptation (i.e., use of relaxation, adaptive coping strategies, and social support). Two studies at the University of Miami have assessed the effects of a 10-week CBSM program among women with early-stage breast cancer: one study delivered CBSM in the weeks following surgical treatment (Coping and Recovery [C&R]; N=197) and the other study delivered CBSM in the months following completion of all surgical and adjuvant treatment (Coping After Treatment [CAT]; N=122). Both studies used randomized, controlled designs with a one-day psychoeducation seminar as the comparison group. For my doctoral dissertation, I have used these samples to examine whether point in treatment moderates intervention effects on coping resources (i.e., the proximal intervention outcomes) from pre- to post-intervention and in trajectories of change across four time points (pre-intervention, immediately post-intervention, and two follow-ups). Measures include selected subscales of the Measure of Current Status, Sources of Social Support Scale, Brief COPE, Emotional Approach Coping Scale, Benefit Finding scale, Affect Balance Scale, and Sickness Impact Profile (i.e., social disruption). Missing data was examined and estimated using multiple imputation. Specific aims were tested using repeated measures analysis of covariance in SPSS software as well as multiple group latent-growth modeling in MPLUS software. A moderation effect by sample was found for cancer-related interference in recreations and pastimes using RMANCOVA analysis of changes from Time 1 to Time 2 such that there was less interference over time in the CAT sample and slightly more interference over time in the C&R sample. Time by condition effects on relaxation were replicated in this sample, and time by condition effects were also found for bonding with other breast cancer patients and benefit finding.

Author: Diane Irvine
Publisher: Environment Canada
ISBN:
Category : Health & Fitness
Languages : en
Pages : 72

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Book Description
Synthesizes reports from the scientific literature on psycho-social adjustment to the consequences of breast cancer in women and summarizes an informal situational analysis involving key Health Canada contacts in the breast cancer and mental health fields. Main findings are highlighted in the following areas: the role of psycho-social factors in breast cancer aetiology and prognosis; breast cancer screening; the pre-diagnosis period; treatment; post-treatment and follow-up periods; breast cancer survivors; impact of breast cancer on the spouse or partner and family members; the role of coping strategies and social support in adjustment to breast cancer; and factors which impact on the quality of psycho-social care. Implications for future research are discussed. The appendix includes a glossary and an outline of various aspects of the Canadian Breast Cancer Initiative.

Author: Claudia Maggie Davis
Publisher:
ISBN:
Category :
Languages : en
Pages : 135

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California ranked within the top percentile among states that had the highest breast cancer mortality rates among African American women. To that end, the purpose of this dissertation was to gain an understanding of the breast cancer survivorship trajectory for African American women. The first arm utilized a qualitative approach to investigate the meaning of survivorship and utilization of resources among (n=155) African American breast cancer survivors (AABCS). Written responses were analyzed using Contemporary Narrative Inquiry (CNI). Results revealed that through their lived experiences, the participants self-identified with the meaning of survivor, exuded resilience and had a strong sense of spirituality. The Meaning of Survivorship model was developed for AABCS. The study findings revealed the important facets of their survivorship experience. The second arm of the study was comprehensive review of empirical studies of contributors to breast cancer disparities, including histopathological grade, hormone receptors, gene mutations, biological markers, age of diagnosis, parity, anthropometric factors, advanced stage at diagnosis, socioeconomic position, chronic stress burden, difference in breast cancer treatment, quality of care, and patient/physician factors. The review provided substantial evidence for development of the Biopsychosocial Model of Breast Cancer Survivorship (BBCS) for African American women. This conceptual explanatory model identified several key biological and psychosocial risk factors that may contribute to a severe disease trajectory. The final arm of the study examined the relationships between several biological predictors, specifically Estrogen (ER), progesterone (PR), triple negative breast cancer (TNBC), BReast CAncer gene (BRCA1/2), Tumor Protein 53 (p53) age less than or equal to 45 at diagnosis, Basal Metabolic Index (BMI), age less than or equal to 30 at first pregnancy, and psychosocial risk factors (socioeconomic position [SEP], chronic stress), that may affect the psychological functioning (anxiety, depression) of African American breast cancer survivors. Using general linear modeling (GLM), a modified model was tested with a sample (n = 155) of AABCS from Northern and Southern California. Results revealed that some biological and psychological risk factors were significant predictors for anxiety and depression among AABCS. Overall, the findings from this dissertation may serve as a benchmark for collaboration of various disciplines to develop interventions that address breast cancer disparities among these women.

Author: Michael H. Antoni
Publisher: Amer Psychological Assn
ISBN: 9781557989420
Category : Health & Fitness
Languages : en
Pages : 103

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Book Description
The Stress Management Intervention for Women With Breast Cancer: Participant's Workbook is tailored to meet the special needs of women dealing with the stress of breast cancer and its treatment. Designed specifically for group therapy participants, this workbook will be an invaluable tool for learning skills such as meditation and relaxation that have been proven to reduce stress during challenging times. While participating in the group therapy program, group members will turn to this book at home to deepen and personalize the learning that occurs in sessions. In these quiet "homework" moments, participants will learn how to create stress reduction strategies, better understand and manage their emotions, enhance their relationships with loved ones and caregivers, and examine their role in important health care decisions. As a vital component of this overall stress reduction program, this workbook will enable participants to discover, explore, and expand on the issues that matter most. (PsycINFO Database Record (c) 2004 APA, all rights reserved).

Author: Queenie K Leung
Publisher:
ISBN:
Category :
Languages : en
Pages : 195

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Book Description
Asian American is predicted to be the largest immigrant group by the year 2055. Breast cancer is the primary cancer diagnosis and the second-leading cause of death among Asian-American women. Despite the lengthy presence of Asian immigrants in the US and the recent predictions of increasing breast cancer incidence in this population, the unique cultural needs and psychological responses to cancer survivorship remain relatively unknown. In order to expand the understanding in Asian American breast cancer survivorship, this dissertation applied the Transactional Model of Stress and Coping to examine how stressors experienced by the Asian American breast cancer survivors and their coping use influenced their psychological well-being. Secondary data analysis was conducted on 233 participants (Chinese = 44%, Japanese = 37%, and Vietnamese = 19%) who completed qualitative questionnaires that assessed their physical, emotional, social, and financial stress. Participants also completed standardized measures on their coping strategies used and psychological well-being. The analysis on the relationship between stress and psychological well-being indicated that higher levels of stress (in all four types of stressors) were associated with poor psychological well-being. Moderation of ethnicity on the relationship between stress and psychological well-being was unable to be tested due to low sample size. The analysis of the relationship between coping and psychological well-being revealed ethnic differences in the following coping strategies: expressive suppression, active coping, denial, use of emotional support, use of instrumental support, positive reframing, acceptance, and self-blame. The increased use of all emotion-focused coping strategies of positive valence and problem-focused coping strategies was associated with good psychological well-being (except the relationship between cognitive reappraisal and self-stigma). Furthermore, the increased use of all emotion-focused coping strategies of negative valence was associated with poor psychological well-being. Moderation of ethnicity on the relationship between coping and psychological well-being could not be tested due to low sample size. Mediation of coping on the relationship between stress and psychological well-being could not be tested either, due to low sample size. The findings from this dissertation could advance public health theories and improve doctor-patient communication with Asian American breast cancer survivors.

Author: Cynthia Wan
Publisher:
ISBN:
Category :
Languages : en
Pages :

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The stress system comprises the hypothalamic-pituitary-adrenal (HPA) and the sympathetic-adrenal-medullary (SAM) axes. The two operate synergistically to regulate metabolic and biological processes, maintain homeostasis, and manage physiological responses towards various environmental challenges, known as stressors. Numerous studies have observed impaired HPA response among White breast cancer survivors followed by an eventual normalization of the HPA axis, but little is known about SAM functioning, the complementary relationship between physiological and psychological stress, and the influence of culturally related factors. This dissertation aims to address these gaps in the literature via three studies. In Study 1, we examined the diurnal and reactive patterns of salivary alpha-amylase, a SAM biomarker, in a sample of predominantly White women with and without a prior diagnosis of breast cancer. The purpose was to establish an initial understanding of SAM functioning in relation to the participants' HPA activity as measured by cortisol responses (complementary to a previously published study in the laboratory). Results of Study 1 revealed no abnormal response to stress. Virtually identical alpha-amylase slopes were observed between breast cancer survivors and control participants, except that breast cancer survivors had elevated basal levels of alpha-amylase, thus suggesting a "heightened sympathetic tone". In Study 2 acute and diurnal cortisol profiles and their accompanying psychological stress responses were examined in a sample of Chinese and White women with and without a prior diagnosis of breast cancer. In the same participants, we also examined chronic stress levels via hair cortisol concentrations which was the subject of Study 3. In both studies 2 and 3, we assessed the potential influences of cultural orientation and ethnocultural group membership on physiological and psychological stress patterns. For the most part, Study 2 supported previous findings from the literature and our laboratory: Breast cancer survivors displayed a blunted cortisol response and their diurnal profile was comparable to that of control participants. But contrary to our hypotheses, ethnocultural membership and cultural orientation did not influence physiological patterns of stress. However, an interaction between ethnocultural group, health status, and time (i.e., from baseline to one hour after stress induction) was observed in the subjective appraisal of an acute stressor. Specifically, White breast cancer survivors reported significantly lower levels of perceived stress than the other three groups. These results suggest that health-related stress may supersede the effects of culturally related stress and indicate the potential presence of posttraumatic growth among our sample of White breast cancer survivors only. Study 3 revealed no differences in hair cortisol concentrations between breast cancer survivors and control participants, nor between Chinese and White breast cancer survivors. However, it was observed that healthy Chinese women exhibited significantly higher levels of hair cortisol concentrations than their Western counterpart. Further analyses revealed that health status and cultural orientation did not significantly predict the observed patterns of physiological or psychological stress. Although non-significant, Study 3 results offered preliminary evidence that higher orientation towards both the dominant and non-dominant cultures is associated with higher levels of chronic physiological and psychological stress. Collectively, our studies may provide support for the long-term recovery of the HPA axis via the examination of acute, diurnal, and chronic patterns of cortisol, but further research will be required. The dissertation also highlights several important key points regarding culturally related factors, health, and stress: (1) The perception of stress is influenced by one's degree of cultural orientation and (2) effects of health-related stress may supersede those of culturally related stress, but (3) among healthy women, ethnocultural minorities may have more stressful encounters than their Western counterpart, thus having important clinical implications for ethnocultural minorities who are newly diagnosed with a chronic condition. Together, results of the studies highlight the importance of further investigating the enduring and acute implications of psychosocial variables - particularly the influence of cultural orientation - on the experience and perception of stress.

Author: Michael H. Antoni
Publisher:
ISBN:
Category :
Languages : en
Pages : 215

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This book and accompanying therapist's manual provide a complete clinical framework for health professionals who wish to offer group psychosocial support to breast cancer patients. This package focuses on training therapists to help group members cope with the diagnosis of breast cancer and its treatment while also providing empirical validation for the program's techniques and providing a session-by-session set of guidelines for each module of the program. The program includes 10 weekly cognitive-behavioral stress management sessions and their accompanying 10 weekly relaxation training sessions. A companion workbook available for group participants presents valuable psycho-educational and psychotherapeutic components that teach women coping with breast cancer how to use empirically supported skills such as meditation and relaxation exercises to overcome otherwise overwhelming stressors. Together, this stress management package presents a clearly articulated, empirically supported program for doctors, therapists, psychologists, nurses, and other health care providers. (PsycINFO Database Record (c) 2004 APA, all rights reserved).