Evidence suggests that more depressed breast cancer patients will less likely adhere to treatment plans. This study presents evidence that the theory of planned behaviour mediates the relation between depression and intentions to adhere to treatment plans and between depression and lack of adherence to medication regime. Two hundred and thirteen women undergoing breast cancer treatment participated in this study. Measures of depressive symptoms and planned behaviour variables were collected at the first time point; measures of medication adherence were collected at the second time point. Structural equation models were utilised to fit the data to the proposed models. Depressive symptoms were significantly correlated to both intentions and medication adherence. In support of hypotheses, the relation between depressive symptoms and treatment intention was mediated by attitudes towards health maintenance plans. The relation between depressive symptoms and medication adherence was fully mediated by the planned behaviour process. Conditions under which treatment intentions and perceptions of control in adhering to treatment were most related to medication adherence were elucidated. The results point to avenues for interventions to increase medication adherence among breast cancer patients. Manipulating attitudes and perceptions of control towards treatment plans will potentially serve to increase medication adherence. 相似文献
Women with metastatic breast cancer and significant psychological distress (N?=?87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p?<?0.05). Findings suggest that expressive writing may improve the uptake of mental health services among distressed cancer patients, but is not broadly effective as a psychotherapeutic intervention. 相似文献
Background: Hysterectomy and mastectomy surgery for gender affirmation have traditionally been performed as separate surgeries. Our institution offers these surgeries as a single combined procedure, typically with same-day discharge. Decreasing the number of times patients need to have surgery may reduce barriers to care by limiting surgical and hospital stay events. Our primary objective was to describe the perioperative experience of transgender patients who underwent combined hysterectomy and mastectomy surgery.
Methods: This retrospective case series assessed patients who underwent combined hysterectomy and mastectomy surgery between 2013 and 2015 in an integrated health care setting in the United States. Chart reviews were performed for outcomes of interest, which included operative and postoperative complications.
Results: We identified 25 patients who underwent a combined hysterectomy and mastectomy for the indication of gender transition. Preoperative patient characteristics included a median age of 31, with a median BMI of 25. Ninety-two percent of the patients were on testosterone therapy at the time of surgery. A total of 76% and 24% of patients had laparoscopic and vaginal hysterectomies, respectively. Intraoperatively, the average blood loss was 104 mL, and there were no complications. Eighty percent of patients were discharged on the same day. Postoperatively, 92% of patients experienced no major complications. One patient received a uterine artery embolization and blood transfusion for postoperative intraabdominal bleeding, and one patient presented 9 weeks after surgery with partial vaginal cuff dehiscence requiring a cuff revision. There were no re-admissions within six months of surgery. There were no major mastectomy-related complications.
Conclusions: Combined surgeries are feasible and reduce the number of surgical events and hospital stays. There were no complications that could be attributed to undergoing two procedures as a single incident. 相似文献
Objective: Understanding the concerns of cancer survivors is essential for effective interventions. This study was designed to identify the primary concerns of dyads coping with cancer, how concerns differed by role and sex, and whether concerns expressed during counselling were associated with survivors’ psychosocial well-being and adjustment.
Design: Forty-three dyads with breast and prostate cancer (N = 86 participants) were enrolled in an interpersonal telephone counselling intervention. Audio recordings of 228 counselling sessions were transcribed and content analysed qualitatively to identify major themes and key concerns. A total of three 30-min sessions were coded for each study participant. Quantitative data and statistical analyses were used to predict changes in survivors’ quality of life.
Main Outcome Measures: Participants completed psychosocial well-being measures (depression, positive/negative affect, and relationship satisfaction), pre- and post-counselling.
Results: Survivors’ concerns focused on cancer- and treatment-related issues, whereas partners’ concerns centred on the well-being of their spouse/partner with cancer, and what they were doing to help their loved one cope with his/her illness. Key concerns for all consisted of relationship maintenance and communication issues. Further, discussion of these concerns was predictive of significant improvements in adjustment post-counselling for women with breast cancer.
Conclusion: Discussion of interpersonal concerns may play a more important role in the well-being of women, than men, coping with cancer. 相似文献
Engagement in online interventions, defined as the extent to which participants are involved in and attentive to the contents of the intervention, has been shown to predict treatment outcome. However, participant engagement and program completion are often quite low. Aiming to provide insights that could help improve engagement, this study explores engagement in an online intervention for young couples with breast cancer, Couplelinks, by describing the development of a method to assess engagement, presenting a framework for understanding varying engagement levels, and discussing strategies used by Couplelinks facilitators to work with participants of differing engagement levels. The measure of engagement developed for this study was a composite consisting of indices of average completion time, accountability, and attitude. Utilizing this composite measure, the following distinct “couple types,” with varying levels of engagement, were discerned: (a) “keen” couples, (b) “compliant” couples, (c) “apologetic” couples, and (d) “straggling” couples. Facilitators’ approaches to working with each type of couple and suggestions for potential therapeutic applications are discussed. The finding that couples vary in terms of engagement level, and not solely based on facilitator skill and/or involvement, supports the need to better understand the concept of engagement in order to make online interventions more effective. 相似文献