A survey of smoking status and cancer risk perceptions among participants attending a hospital-based head and neck screening program

Abstract

Screening for head and neck cancer is underutilized. Given that lack of knowledge of the risk factors may partially account for screening underutilization. we surveyed subjective risk and knowledge of risk factors for head and neck cancer among 124 individuals who attended a free. hospital-based head and neck cancer screening. Few participants were current smokers. Most attendees perceived their risk as similar to others of their age and sex. Personal health habits comprised almost all of the risk-decreasing factors, yet less than half of the risk-increasing factors. generated. Personal habits were less frequently endorsed than factors such as pollution and heredity. Those who mentioned a risk behavior, or a family cancer history, reported higher subjective risk. Those who mentioned a personal health habit reported lower subjective risk. Results highlight needed efforts to increase screening among high-risk individuals through targeted education messages.     

Manifestations of anxiety and coping strategies in patients with metastatic lung cancer and their family caregivers: a qualitative study

Objective: Advanced non-small cell lung cancer (NSCLC) is common, deadly, and associated with impairing anxiety for patients and caregivers who often co-experience similar symptoms that can vary together over time. We aimed to discover themes as to how NSCLC patients and caregivers express and cope with anxiety.

Design: Semi-structured interviews of patient-caregiver dyads (N?=?21), coded using NVivo Software.

Main Outcome Measures: Open-ended questions on anxiety mutuality, giving or receiving care, communication, and the most difficult aspects of having or caring for someone with Stage IV NSCLC.

Results: Analyses revealed that patients and caregivers were linked psychologically, co-experiencing symptoms of distress or coping, rising and falling together. Shared patient and caregiver themes emerged of cognitive, behavioural and physiological manifestations of anxiety and coping mechanisms.

Conclusions: Patient and caregiver expressions of anxiety and coping methods mapped onto the cognitive-behavioural model, implying potential use of cognitive behavioural therapy (CBT) to address these issues. This expands understanding of symptoms and coping strategies in NSCLC, explores patient-caregiver interaction, and confirms the need for future clinical intervention. Future research should focus on development and dissemination of CBT-based dyadic interventions addressing anxiety in NSCLC patients and caregivers.     

Changes over time in head and neck cancer patients’ and caregivers’ illness perceptions and relationships with quality of life

Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.

Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.

Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).

Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.

Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL.     

The burden of filial piety: A qualitative study on caregiving motivations amongst family caregivers of patients with cancer in Singapore

Objective. This study explores (1) the motivations and challenges facing family caregiving for cancer in Singapore and (2) suggests a possible framework to guide culturally sensitive future work on caregivers.

Design. Twenty caregivers of patients being treated for cancer at a public hospital in Singapore were interviewed. A semi-structured interview format and inductive thematic analysis were used to analyse the data. Caregivers were asked about their motivations for caregiving and the challenges they faced.

Results. Caregivers’ motivations grouped into three categories: personal value and fulfilment, giving care because of societal expectations such as filial piety, and practical need. Challenges were grouped into interpersonal challenges, disclosure and finding balance. Caregivers with different primary motivations varied in their responses to these challenges. More autonomous caregivers cited learning points and reprioritised more effectively than less autonomous caregivers, who reported more internal conflict and less control over their situation.

Conclusions. In Singapore and Asia, sociocultural values of family caregiving are not uniformly experienced as positive, and may be burdensome for caregivers who give care primarily for extrinsic motivations. As family caregiving needs increase, targeted psychosocial support for caregivers with less autonomous behavioural orientations may pre-empt caregiver burnout and burden.     

Psychological support for people with dementia: A preliminary study

Aim/Purpose

Evidence suggests nonpharmacological therapies could improve quality of life in people with Alzheimer's disease (Olazaran et al., 2010). This study aimed to explore attitudes to, and acceptability of, psychological support for people with mild dementia, from their perspective.

Design/Methodology

Semi‐structured interviews were conducted with five people identified from secondary care services. Questions concerned the experience of being diagnosed, experience of support services and their opinion of alternative support options. Interviews were audio‐recorded, transcribed and analysed using thematic analysis.

Results/Findings

Three main themes were identified: loss, coping mechanisms and support. Loss of physical abilities was associated with loss of identity and place in the community. Coping mechanisms included asserting control, and growth and development, including engaging in new activities or using humour. Individual needs and preferences were key to effective support. Social aspects of support and opportunities to talk about their feelings were valued by participants. Counselling, mindfulness and group‐based activities, including walking and gardening, were viewed positively. Support from admiral nurses or specialist nurses tended to be viewed in terms of physical health needs, and most needed in later stages of dementia.

Research Limitations

Limitations include the small sample size, potential inaccuracies acknowledged by participants regarding recollections of events and researcher bias in hoping that psychological support would be well received.

Conclusions/Implications

Talking therapies and psychosocial interventions are acceptable sources of support. Person‐centred support which considers personal preferences and abilities can support people to live well with dementia.     

Psychological intervention with couples coping with breast cancer: A systematic review

Objective: Information about psychological intervention with couples coping with breast cancer is not well-disseminated. This can be explained, at least in part, by the absence of knowledge about the efficacy of this kind of intervention. The aim of the present systematic review is to identify and describe psychological interventions for couples coping with breast cancer and evaluate their efficacy.

Design: Studies identified by a searching multiple literature databases related to health and psychology between 1975 and 2013. Rigorous inclusion and exclusion criteria were utilised.

Results: Of 129 abstracts, 13 were extracted for further analysis and a final ten studies were deemed eligible for inclusion. Data were extracted from each study regarding study sample characteristics, design, results and methodological limitations. The results obtained were mixed in regard to efficacy, although the overwhelming majority of studies (eight studies) found benefits for both women and their partners in some dimensions, such as quality of life, psychological distress, relationship functioning and physical symptoms associated with cancer.

Conclusion: Psychological interventions for couples coping with breast cancer appear to be effective for both women and their partners. However, further studies are needed to evaluate the efficacy of couple-based interventions and, to identify for whom and how they are more effective.     

People who help people: A needs assessment of those who provide interpersonal support to individuals with chronic illnesses

Social support during an ongoing illness has been shown to be beneficial for both the provider and the receiver, but people often struggle with offering effective, appropriate support. There is a lack of communication-focused training not specifically tied to caregiving or training that is designed for all social network members of a person experiencing a chronic illness, which we call interpersonal support providers (ISPs). We conducted a concurrent mixed-methods needs assessment, surveying both ISPs and support receivers, to understand communicative challenges and inform an evidence-based intervention. Analysis of results from an online survey (N_providers = 91, N_receivers = 97), consisting of five open-ended and 15 quantitative items, suggests that ISPs have difficulty managing their worries and emotions while providing comfort to others, which may impact support quality. In addition, ISPs and receivers both identify “listening” as a key skill for ISPs to hone, though ISPs feel they are more skilled at listening than receivers say they are. Lastly, ISPs feel they are good at sharing information and advice, but receivers often perceive it as patronizing or unhelpful. These results will inform the creation of an intervention for everyone offering emotional, esteem, and informational support to individuals with chronic illnesses.     

Helpful processes in psychological therapy for patients with primary cancers: A qualitative interview study

Aims: The purpose of this study was to identify what patients with primary cancers found helpful in therapy. Method: In‐depth qualitative interviews were conducted with eight patients who had completed a course of psychological therapy within an NHS psychology service for cancer patients. Data were analysed using thematic analysis. Results: The participants identified a range of helpful processes in therapy: talking and expressing their feelings to someone outside of the family; forming a relationship with their therapist; normalisation through the therapists' expert knowledge; problem‐solving and CBT. Limitations: As with all qualitative studies, the small sample and size and dependence on participant recall limits generalisability of the findings. Implications: The findings of this study are consistent with a pluralistic perspective: that multiple therapeutic processes ‐ aligned to a range of different orientations ‐ can be of value to patients with primary cancers. This supports the provision of a range of therapeutic interventions and strategies for this patient group.     

Psychological impact of breast cancer on the patient and the family: A clinical perspective

Breast cancer is the most frequently occurring cancer in women, with 182,000 new cases diagnosed in 1993. Breast cancer will strike a sizable percentage of women during the child-rearing years impacting, therefore, not only on the woman, but on the significant others in her life. This article explores the impact of breast cancer for the patient's life partner, parents, and children. A model intervention program for cancer patients with young children, piloted at the Derner Institute and developed in conjunction with the American Cancer Society, is also discussed.     

The impact of social support on the acceptance process among RA patients: A qualitative study

Acceptance is an important component of pain management, being associated with improved quality of life and lower levels of pain and depression. In enabling patients with chronic diseases to accept unpleasant consequences and to establish a new way of living, the support they receive from their social environment may play a decisive role. In this article, we identify the key sources and types of social support that are relevant for rheumatoid arthritis (RA) patients, and explore when and how those sources are important across the different stages of the acceptance process. We conducted a qualitative study involving 20 semi-structured interviews with RA patients in Switzerland. Analysis of the data followed the precepts of grounded theory. We found that, amid the complexity and variety of patients’ struggles for acceptance, there were some common experiences or ‘key moments’ in which social support played an important role. While three sources of support – family, physicians and the external social context – are fundamental for RA patients, all three may inhibit as well as encourage acceptance, due to the invisible and unpredictable character of the disease. There is a pervasive risk either of underestimating patients’ suffering or of over-supporting, both of which prevent patients accepting the disease and developing a new ‘normal’ life. We conclude that sources of social support need to find a middle way between scepticism and solicitousness.     

Cumulative mild head injury (CMHI) among college rugby players: A replication and extension study

We investigated the prevalence of cumulative mild head injury (CMHI) symptoms among college student rugby players pre- and post-season. The players completed a number of neuropsychological tests known to be sensitive to CMHI effects: vocabulary, working memory, motor coordination, and a self-report Post Concussive Symptomology (PCS) checklist. A total of 18 rugby players registered at a South African university were participants (age range 18 to 24 years, SD?=?2.02 years). Data were analysed utilising Fishers Exact Test comparisons of pre- and post-season mean scores. There was significant variability on mean scores between the rugby forwards and backline players in terms of verbal memory and concept formation, cognitive flexibility, working memory, and visual motor-processing speed. Poorer overall scores from the rugby forwards may also be indicative of depression as they reported more insomnia and anger on the PCS than the backline players.     

Career support needs of learners with historical disadvantage: an exploratory study

This study explored the career support needs of learners from a historically disadvantaged rural South African school setting. Participants were a convenience sample of 20 high school learners (females=60%; males=40%; age range 15–17 years; schools grades 9–10). They completed focus group interviews relating to their career awareness and needs. The data were thematically analysed. The results suggested learners have significant in-school career awareness and support needs. The learners accessed career related information informally from social networks they were using out of school rather than in the educational setting.     

Factors that enhance academic learning and study behaviours: A qualitative study

This exploratory study examined students’ conceptions of factors that enhance the use and application of academic learning and study strategies (LSS). A qualitative approach was used to explore the conceptions of 23 first-year university students (female = 14; age range = 18–24 years). Data were collected using unstructured interviews and narrative sketches. Thematic analysis revealed three themes; namely clarity, emotional intelligence, and life circumstances. LSS clarity showed that knowledge of the self as a learner and well-defined educational goals can enhance engagement in the academic study process. Emotional intelligence as LSS referred to the importance of self-management and emotional regulation; while life circumstances in LSS emphasised the impact of real world challenges that affect the learning process. Student development counselling for LSS should consider the extent to which students have a sense of clarity, emotional intelligence, and life orientation important for their education success.     

Efficacy of stress management program for depressive patients with advanced head and neck cancer: A single-center pilot study

Background/ObjectivePatients with head and neck cancer (HNC) have some problems such as dysfunction of breathing, eating, and/or speaking. The aim of this study was to examine efficacy of the stress management program for HNC patients (SMAP-HNC) compared with usual care (UC).MethodWe conducted a pilot study of SMAP-HNC for depressive HNC patients between January 2016 and March 2018. The program contains psychoeducation, stress coping training, and operant reinforcement. The outcome measure was the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy (FACT), and Brief Coping Inventory (COPE).ResultsTwenty patients were randomly assigned to SMAP-HNC and UC group. Although a small sample sizes, there was no significant difference of depression score change between SMAP-HNC and UC group (Hedges’d g -0.83; 95% CI -1.80 to 0.13).ConclusionsIt was the first study to conduct stress management program for HNC patients. Unfortunately, our trial designed as a randomized controlled trial is underpowered to make conclusion as to the efficacy of SMAP-HNC. However, there are some valuable suggestions to modify the stress management program in future.     

Embodying sexual subjectivity after cancer: A qualitative study of people with cancer and intimate partners

Research has increasingly recognised the profound impact that cancer can have upon embodied subjectivity. However, there has been little acknowledgement of the centrality of sexuality to subjectivity, and marginalisation of the experiences of intimate partners of people with cancer. This Australian qualitative study explores the post-cancer experiences of embodied sexual subjectivity for 44 people with cancer (23 women and 21 men) and 35 partners of people with cancer (18 women and 17 men) across a range of cancer types and stages. Semi-structured interviews were analysed with theoretical thematic analysis, guided by a post-structuralist approach to sexual subjectivity as a dynamic process of becoming that can change over time, and by Williams’ [(1996). The vicissitudes of embodiment across the chronic illness trajectory. Body and Society, 2, 23–47] framework on post-illness embodiment. Participants took up the following post-cancer subject positions: ‘dys-embodied sexual subjectivity’ – characterised by bodily betrayal, sexual loss, lack of acceptance, depression, and anxiety; ‘re-embodied sexual subjectivity’ – characterised by greater sexual confidence, acceptance, the exploration of non-coital sexual practices and increased relational closeness; and ‘oscillating sexual subjectivity’ – involving a shift between states of sexual dys-embodiment and sexual re-embodiment. The findings point to the importance of focusing on the sexual health of people with cancer and partners across the cancer trajectory.     

Peer support critical elements and experiences in supporting the homeless: A qualitative study

Peer supporters are individuals with lived experience and are an integral part of health care systems, providing support to those affected by various phenomena such as homelessness and addictions. However, little is known about the critical elements that underpin peer support interventions. This qualitative study sought to understand the critical elements of intentional peer support with a homeless population, voiced by those who provide and/or receive this support. Twenty‐nine participants from 4 different homeless charities in England were interviewed about their experiences of providing/receiving peer support and what they felt were critical factors to its success. Participants defined peer support as an experience‐based relationship, built upon mutual understanding, empathy, and support. Thematic analysis was utilised to in developing 6 themes. Results identified peers' persistence in developing unique experience‐based relationships, providing social support, role modelling recovery, and peers' motivations were perceived as important factors involved in peer support. It was also found that peers described benefitting from helping, such as, undergoing transformative identity developments that helped them to escape homelessness. Through the retelling of their stories, they create meaning and restructure their autobiography, attributing experiences of homelessness as a catalyst for positive changes in their lives. Limitations and future research are discussed.     

Exploring the role,needs and challenges of relatives of mothers with HIV or HIV and psychosis: A qualitative study

This study explored types and nature of supports by relatives of mothers living with HIV and psychosis in comparison to mothers with HIV only. Interview data on their experiences of their roles, needs and challenges were collected from 33 relatives on mothers with HIV and psychosis (n=12, females=10, blacks =12, age ranges 21 to 62) and those with HIV only (n=21, females=16, blacks =21, age ranges 18 to 63). The data were thematically analysed utilizing Atlas.ti. The results showed that relatives in both groups provided a variety of supporting roles. Important challenges were experiencing the negative consequences of especially HIV in combination with psychosis in their lives and dealing with the caregiving responsibilities without having enough information. Important strengths included utilizing support networks and remaining hopeful. Support needs for carers of mothers living with HIV related psychosis or HIV only, can be enhanced with increasing social and material resources at the community level. Supporting needs can be addressed by empowering communities through psycho-education.