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 use of the political categories of Brexiter and Remainer in online comments about the EU referendum

In June 2016, the United Kingdom held a referendum on EU membership; 52% of those who voted, voted to leave, and 48% voted to remain. During the referendum campaign, two identities emerged: “Brexiter” and “Remainer,” which remained salient post‐referendum. This study explores how the categories of Brexiter and Remainer were deployed by posters online. Data comprise comment threads collected from four online newspapers both during the campaign and after the vote, which focus on the Brexit campaign promise: “We send £350m a week to the EU. Let's fund our NHS instead.” We draw on membership categorization analysis and discursive psychology to analyse when categories were made salient and what responses to the invocation of categories were. Analysis revealed that posters explicitly categorize the out‐group and in doing so implicitly define their group. Posters resisted other political identities when attributed to them in relation to the referendum. The analysis shows how Brexiter and Remainer are new, albeit contested, political categories and identities in their own right, with other political identities resisted when used. The paper highlights implications for the political system in the United Kingdom and for social divisions within U.K. society.     

Faith and Learning in Higher Education: Merging the Bible with Discipline-Specific Content

This article offers a brief history on the origin of universities, summarizes how faith shaped higher education from the European university’s advent to its Western reproduction, and presents recommendations from a contemporary faith integration method employed in many faith-based universities in the United States. Response to intervention was used to direct two examples of faith integration performed for 14 candidates enrolled in a teacher preparation program. The study advocates the instruction, modeling, and practicum elements of faith integration in curricula that provide postsecondary instructors with valuable insight to develop proficiency in the art of merging biblical content with discipline-specific content.     

Objectivity,diversity, democracy: locating social theory in <Emphasis Type="Italic">Objectivity and Diversity</Emphasis>

Reprising and revising a question from Longino regarding an earlier phase of standpoint theory, I raise some issues regarding the place of a substantive normative social theory in the strong objectivity project in Harding’s recent book, Objectivity and Diversity. I offer reasons to think the issue needs to be reframed in the co-constructionist and pluralist setting of the new book but that interesting issues continue to arise in thinking about the philosophical resources feminist philosophies of science can or might rely on.     

Feminist Therapy Pioneer: E. Kitch Childs

ABSTRACT

This article will focus on the life of the late Dr. E. Kitch Childs and her impact on Feminist Therapy. It seeks to celebrate and pay homage to her as one of the pioneers who helped pave the way for women in therapy. Dr. Childs was an African American lesbian woman who stood in the gap for social justice with her intellect, tenacity, and bravery and took the lead as a radical visionary.     

‘It was all intertwined’: Illness representations and self-management in patients with cancer and anxiety/depression

Objective: Cancer and anxiety/depression frequently co-occur, leading to poorer outcomes for these illnesses. However, the majority of existing research investigates how participants view single illnesses alone. This study aimed to explore the content of individuals’ multimorbid representations and how these relate to their coping behaviours and self-management strategies for cancer and anxiety/depression.

Design: A semi-structured qualitative research design with theoretical thematic analysis.

Main Outcome Measures: Multimorbid illness representations, coping behaviours, and self-management strategies.

Results: In interviews with 21 participants multimorbid representations varied, three participants viewed cancer and anxiety/depression as unrelated, five participants were uncertain about the relationship between cancer and anxiety/depression, and the majority of participants perceived cancer and anxiety/depression as related. This third group of participants often described relationships as causal, with representations having both positive and negative influences on coping behaviours and self-management strategies. Representations were shown to change over the course of the cancer experience, with fear of cancer recurrence and the influence of participants’ most challenging illness also discussed.

Conclusions: People hold multimorbid illness representations that can influence self-management. An awareness of these representations by researchers, health professionals, and patients is important for the creation of future interventions that aim to improve and maintain patient wellbeing.     

The Psychosocial Impact of Undergoing Prophylactic Total Gastrectomy (PTG) to Manage the Risk of Hereditary Diffuse Gastric Cancer (HDGC)

Individuals identified as at high risk of developing Hereditary Diffuse Gastric Cancer (HDGC) are advised to undergo prophylactic surgery - have their stomach removed - in their early twenties. Research with (older) cancer patients who undergo gastrectomy for curative reasons suggests that gastric resection has a number of physical and psychosocial sequelae. Because it is difficult to extrapolate the findings of studies of older cancer patients to younger healthy patients who are considering prophylactic total gastrectomy (PTG), the aim of this qualitative interview study was to determine the psychosocial implications of undergoing prophylactic surgery to manage genetic risk. Fourteen men and 13 women from the UK’s Familial Gastric Cancer study who had undergone PTG were invited to participate in qualitative interviews. Most reported that undergoing surgery and convalescence was easier than anticipated. There was evidence that age affected experiences of PTG, with younger patients tending to report faster recovery times and more transient aftereffects. All saw the benefits of risk reduction as outweighing the costs of surgery. Surgery was described as having a range of physical impacts (disrupted appetite, weight loss, fatigue, GI symptoms) that had related psychological, social and economic implications. Those considering PTG need to be aware that its impact on quality of life is difficult to predict and negative sequelae may be ongoing for some individuals.     

Association of Economic Internality With Saving Behavior and Motives,Financial Confidence,and Attitudes Toward State Intervention1

This study investigates economic locus of control (ELOC) in a Greek sample using Furnham's (1986) scale. In particular, it examines the association between ELOC and saving behavior and motives, attitudes toward state intervention in the economic field, and factors engendering confidence in economic matters. The main hypotheses predicted that internal ELOC should be associated with (a) desire for less state intervention; (b) confidence in factors under one's own control (knowing the other party in transactions, being well informed) more strongly than with other factors of economic trust, such as the state and the law; (c) more saving; and (d) that respondents with internal and external ELOC should be differentiated with respect to saving motives. Analysis was based on a sample of 135 participants from Athens. Principal components analysis of the Greek translation of Furnham's ELOC questionnaire gave results similar to those reported from England, yielding 4 factors interpretable as chance, internal, external/denial, and powerful others. The findings of the study include confirmation of all of the hypotheses.