Breast Cancer in Men: A Need for Psychological Intervention

Male breast cancer is a serious issue that needs to be addressed more fully by the medical and public community. However, due to a lack of awareness and limited research on the topic, there is a general absence of knowledge concerning the psychological implications of this disease in men as well as a need for greater understanding of the medical diagnosis and treatment of male breast carcinoma. Similarly, there still remains a considerable gender difference between the awareness of female breast cancer and male breast cancer Although breast cancer in men makes up only 1% of all breast cancers reported in the United States, it is increasing in incidence. There are approximately 2000 new cases and approximately 450 deaths due to male breast cancer each year. Breast cancer diagnosis and treatment in men is very similar to that described in women, however, it has been shown that men are being diagnosed at a later stage of the disease than women.     

乳腺癌手术患者术前心理危机的原因剖析与应对策略

乳腺癌手术患者术前严重的心理危机对其极为不利,笔者从多方面剖析了患者术前心理危机产生的原因,同时针对乳腺癌手术患者术前心理危机如何有效应对提出了诸多策略,最后就目前临床工作中存在的一些不足进行了必要的思考。     

A Classroom-Based Physical Activity Intervention for Elementary Student On-Task Behavior

Few youths engage in the recommended amount of physical activity (PA). Many educators have concerns about increasing PA in schools, including taking time from academics, though studies show that school-based PA can be beneficial to academics. This study extends previous research on the relationship between school-based PA and time on task (TOT) by engaging students in teacher-led PA breaks in the classroom and observing students' on-task behavior for a longer period than previous studies. A third-grade class of 23 students from a rural New England public school was observed as part of a single-subject withdrawal design study. The class, therefore, served as its own control. Student on-task behavior was observed for 45 min following both inactive and active conditions using systematic direct observation procedures. The intervention consisted of 10 min of whole-body movement: 1–2 min of warm-ups, 6–8 min of moderate PA, and 1–2 min of cool-downs. Multiple measures of effect indicate that simple, 10-min, breaks for PA can improve TOT rates among elementary students. This study supports the use of brief breaks for PA to improve student TOT while also indicating that the effects persist for at least 45 min. This is valuable to educators who wish to increase TOT with a simple classroom intervention and for those who wish to help students meet the recommended amount of daily PA.     

Knowledge of Breast Cancer Genetics Among Breast Cancer Patients and First-Degree Relatives of Affected Individuals

The cloning of BRCA1, a susceptibility gene for inherited breast cancer, has made genetic screening possible for individuals and families whose medical histories are suggestive of an inherited predisposition to breast cancer. To date, few systematic attempts have been made to determine the level of knowledge about breast cancer genetics among women who are likely to seek BRCA1 screening when it becomes widely available. The present study attempted to assess the general knowledge about BRCA1 mutations in two groups: (1) first-degree relatives (FDRs) of breast cancer patients; and (2) women with a previous diagnosis of breast cancer. A self-administered, thirty-item questionnaire was developed through a pilot study. Ten of the items were objective, factual questions about breast cancer genetics. Responses to these questions were used to generate an overall knowledge score for each respondent. The study population was moderately knowledgeable about breast cancer genetics, with an average score of 5.35 out of 10. Counselors should not underestimate the importance of evaluating each counselee's existing knowledge about breast cancer, which can affect the provision and reception of genetic information. In particular, specific areas of knowledge that may be confusing or misunderstood were identified and these topics are discussed in detail.     

乳腺癌患者二元调整的研究进展

通过检索相关文献,对乳腺癌患者二元调整的概念、国内外研究现状、评估工具、影响及干预措施等方面进行综述。探讨了二元调整对乳腺癌患者生理健康、心理健康及认知行为的影响,护理人员可以通过提高患者心理压力应对能力、提升疾病认知和鼓励伴侣参与等干预方式来提升乳腺癌患者的二元调整,并对未来的研究方向提出一些见解,旨在为我国开展乳腺癌患者二元调整的干预研究提供理论参考,以期改善乳腺癌患者的健康结局。

     

乳腺癌患者的心理状况及相关因素分析

乳腺癌患者常常被各种心理问题所困扰,特别是乳腺癌根治术对女性性特征所带来的严重影响,各种心理问题更为突出。这些心理问题不但影响患者的生活质量,而且影响疾病的发生、发展及转归。本文回顾了患者的个人因素、疾病本身和治疗因素及其他社会心理因素与心理状况的关系,对乳腺癌患者进行心理干预、临床的综合诊治和防治过程提供新思路。     

早期乳腺癌患者术后心理状况研究

早期乳腺癌的检出率越来越高,关注治愈率同时,人们越来越关心患者术后的心理状态及生活质量.本文对保乳术及根治术后5年患者进行心理调查.保乳组患者术后心理障碍发生率明显低于根治组.保乳组患者术后心理状况影响因素主要为术后美容效果,而根治组患者心理障碍发生率与年龄、职业、家庭收入相关.两种手术方式对患者5年生存率及无病生存率的影响无明显差异,所以对于早期乳腺癌患者,在符合保乳原则的前提下,保乳手术是一种既安全又能提高生活质量的手术方式.     

Coping and Emotional Distress in Primary and Recurrent Breast Cancer Patients

The purpose of this study was to explore the emotional distress and coping strategies among women with primary as against recurrent (local or metastatic) breast cancer. The study sample consisted of 80 women, all 1 year postdiagnosis of primary or recurrent breast cancer. All women completed a demographic questionnaire, the Emotional Symptoms Checklist (SCL-90R) and the Ways of Coping Questionnaire (WCQ). Patients with recurrence reported higher levels of depression and anxiety as well as a higher global severity index (GSI). This group used significantly fewer problem-solving and positive-focus strategies. Emotion-focused coping predicted depression and the GSI, but only positive attitude predicted the level of anxiety. The state of disease was a major predictor of emotional symptoms, and to a lesser extent of the coping strategies used. Although emotion-focused coping had a deleterious effect on emotional well-being, our study highlighted the importance and relevance of positive attitude for reducing emotional distress in general and level of anxiety in particular. Promotion of positive-focus coping strategies should thus be a key element in psychological interventions with cancer patients.     

Psychological Adjustment to Breast Cancer

Breast cancer remains a highly prevalent and extraordinarily stressful experience for hundreds of thousands of women each year in the United States and around the world. Psychological research has provided a picture of the emotional and social impact of breast cancer on patients' lives, and of factors associated with better versus worse adjustment. Psychosocial interventions have been beneficial in decreasing patients' distress and enhancing their quality of life. Recent research also suggests that psychological factors may be related to potentially important biological disease-related processes. In addition to providing an understanding of the psychological factors in breast cancer, research in this area has provided a framework for research on adaptation to health-related stress in general.     

Theological Strategies,Constructing Meaning,and Coping with Breast Cancer: A Qualitative Study

Examines ways in which the experience of breast cancer has impacted the theology and the ability to create meaning for 10 female breast cancer patients. Discusses three theological strategies emerging from participant interviews: 1) God causes cancer for a purpose, 2) God does not cause cancer, but there can still be meaning in illness, and 3) cancer is just part of life and has no inherent meaning, though meaning can be constructed through the experience.     

Predictors of Long-Term Exercise Engagement in Patients With Obsessive-Compulsive Disorder: The Role of Physical Activity Enjoyment

Most U.S. adults, even more so those with psychiatric conditions like obsessive-compulsive disorder (OCD), do not engage in the recommended amount of physical activity (PA), despite the wide array of physical and mental health benefits associated with exercise. Therefore, it is essential to identify mechanistic factors that drive long-term exercise engagement so they can be targeted. Using the science of behavior change (SOBC) framework, this study examined potential predictors of long-term exercise engagement as a first step towards identifying modifiable mechanisms, in individuals with OCD, such as PA enjoyment, positive or negative affect, and behavioral activation. Fifty-six low-active patients (mean age = 38.8 ± 13.0, 64% female) with a primary diagnosis of OCD were randomized to either aerobic exercise (AE; n = 28) or health education (HE; n = 28), and completed measures of exercise engagement, PA enjoyment, behavioral activation, and positive and negative affect at baseline, postintervention, and 3-, 6-, and 12-month follow-up. Significant predictors of long-term exercise engagement up to 6-months postintervention were baseline PA (Estimate = 0.29, 95%CI [0.09, 0.49], p = .005) and higher baseline PA enjoyment (Estimate = 1.09, 95%CI [0.30, 1.89], p = .008). Change in PA enjoyment from baseline to postintervention was greater in AE vs. HE, t(44) = −2.06, p = .046, d = −0.61, but endpoint PA enjoyment did not predict follow-up exercise engagement above and beyond baseline PA enjoyment. Other hypothesized potential mechanisms (baseline affect or behavioral activation) did not significantly predict exercise engagement. Results suggest that PA enjoyment may be an important modifiable target mechanism for intervention, even prior to a formal exercise intervention. Next steps aligned with the SOBC framework are discussed, including examining intervention strategies to target PA enjoyment, particularly among individuals with OCD or other psychiatric conditions, who may benefit most from long-term exercise engagement’s effects on physical and mental health.     

代谢综合征与乳腺癌

研究显示,代谢综合征可增加女性乳腺癌的患病风险,在绝经后妇女中表现更明显。这种作用可能通过胰岛素抵抗影响雌激素和性激素结合球蛋白水平、高胰岛素血症的直接或间接作用以及脂肪因子水平异常等机制实现。因此,对于我国乳腺癌发病率可能随代谢综合征人群不断扩大而上升的趋势应予以足够重视。     

QLQ-3O量表在乳腺癌化疗患者中的应用

应用EORTCQLQ-30核心量表调查初治乳腺癌化疗患者的生存质量。运用自身对比的队列研究方式,调查了42名乳腺癌化疗患者。结果显示化疗带来的生存质量的下降是显著但短暂的;某些因素对生存质量的影响较大,值得针对性地采取干预措施;对一些调查项目的修改,可以使EORTC QLQ-30量表更好地适应我国的国情和文化。     

晚期乳腺癌局部病灶的外科处理探讨

晚期乳腺癌局部病灶的外科治疗目前仍存在较多争议。本文对近年来晚期乳腺癌外科研究进展、常用的手术技术方法,治疗中应注意的几个问题进行探讨。对于晚期乳腺癌应遵循个体化治疗原则,权衡手术风险与生存获益,而不应该简单笼统选择或放弃局部外科治疗。     

Partners and Fellow Patients: Two Sources of Emotional Support for Women with Breast Cancer

This study examined the helping process that occurred when 26 breast cancer patients (the disclosers) talked about their illness-related concerns with their partner and, in a separate conversation, with a fellow patient (the volunteer helpers). The conversations were rated by trained observers and by the disclosers in terms of several process and outcome variables. From the observers' perspective, the volunteer helpers were more helpful, empathic, and supportive, less critical, and used more self-disclosure than the partners. Disclosers did not differentiate between the two types of helper, and gave generally high ratings to both conversations. Strengths and weaknesses of each type of helper were identified. Findings are discussed in relation to the literature on formal and informal helping, and implications for training nonprofessional helpers are suggested.     

节拍化疗——转移性乳腺癌治疗的新选择

肿瘤新生血管生成在肿瘤生长、转移等过程中起着重要作用,抗肿瘤血管治疗被认为是一种很有前途的肿瘤靶向治疗。化疗药物如环磷酰胺、甲氨蝶呤等在长期、低剂量非常规给药方式（节拍化疗）下具有显著的抗肿瘤血管生成能力。节拍化疗有望成为转移性乳腺癌一种全新的治疗模式。     

Reducing Psychological Distress in a Genetic Counseling Consultation for Breast Cancer

High levels of cancer specific distress have been found before and after genetic counseling for breast cancer. This study investigated the process of reducing distress during 111 genetic counseling consultations for familial breast cancer. Consultations were audiotaped, transcribed, and a detailed coding system developed to measure cues of emotional distress from the patient, and consultant (clinical geneticist or genetic counselor) behaviors before and after the cues. At least 1 emotional cue was given in 64 consultations, with a median of 1 cue per consultation. More emotional cues of distress occurred when the consultant responded empathetically to the first cue of distress. Satisfaction outcomes were largely positive regardless of the consultant's attentiveness to distress. Postconsultation depression scores were significantly reduced if more empathic responses were given, but anxiety remained the same. These results are discussed and recommendations are made for improving patient care.     

Feasibility,Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design

Bulimia nervosa (BN) is characterized by a pattern of binge eating and compensatory behaviors as well as an overemphasis on body weight and shape in self-evaluation. Although cognitive behavioral therapy (CBT) is efficacious, recent reviews suggest that only 30% of patients reach abstinence at posttreatment. One potential reason for these poor outcomes is that CBT fails to adequately reduce elevated negative affect (NA) and shape and weight concern, which have been shown to be correlated with poorer treatment outcomes in BN. Therefore, novel treatment components that focus on improving NA and shape and weight concern are needed in order to enhance outcomes. Promoting physical activity (PA) is a promising avenue through which to reduce NA and improve body image in healthy individuals, other clinical populations (e.g., individuals with depression or anxiety), and individuals with eating disorders. While prescribing PA for individuals with BN has been controversial (due to concerns that exercise maybe be used to compensate for binge episodes or become driven or compulsive), this approach may have many benefits, including promoting healthy lifetime exercise habits that reduce likelihood of relapse through the improvement of emotion regulation skills and weight regulation.Given the promise of PA for targeting key maintenance factors of BN, we developed a 12-session healthy PA promotion intervention for BN and tested initial feasibility, acceptability, and preliminary target engagement in an iterative case series design (n = 3). The treatment provided cognitive-behavioral skills designed to identify, practice, and achieve behavioral goals while asking patients to engage in up to 150 minutes of moderate-to-vigorous PA per week, which was preplanned during each session with the client’s therapist.Results suggested that the healthy PA promotion intervention was both feasible and acceptable to deliver. In addition, the intervention resulted in a clinically significant decrease in BN symptom frequency in each participant. Further, participants showed clinically significant decreases in NA and shape and weight concern.The current study demonstrates that healthy PA interventions can have beneficial effects on BN symptoms, NA, and shape and weight concern. However, due to the small sample size, conclusions must be treated with caution. Future research should investigate additional approaches for promoting healthy PA and include a larger sample in order to further test initial efficacy of this treatment approach.     

乳腺癌治疗的现代医学目的

乳腺癌的治疗方法的变化,恰好说明了传统医学目的与现代医学目的不是对立或相互排斥,而是辩证的统一.现代医学目的是以传统医学目的为基础和前提的,是继承和发展,是重新审视传统医学目的后提出来的.     

乳腺癌患者术后自我效能、应对方式及生活质量的相关性研究

调查乳腺癌患者术后自我效能、应对方式与生活质量,探讨三者间的相互关系.应用一般自我效能感量表、医学应对问卷和生活质量测定量表对116例乳腺癌术后患者的自我效能、应对方式和生活质量状况进行测评,并分析三者间的相互关系.乳腺癌术后患者自我效能处于较低水平,应对方式趋向于采取屈服方式,生活质量处于较高水平,自我效能、应对方式和生活质量三者之间存在一定程度的关联,可以通过提高患者的自我效能,指导患者采用积极的应对方式改善其生活质量.