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661.
662.
    
Purpose: Women undergoing surgery for breast cancer experience side effects, such as fatigue, reduced quality of life (QOL) and depression. Physical activity (PA) is associated with improved psychological adjustment during treatment and survivorship, yet little is known about how PA relates to fatigue, depression and QOL in the period following surgery for breast cancer. The purpose of the study was to examine the relationships between these constructs in women who recently underwent surgery for breast cancer.

Methods: At 2–10 weeks post-surgery, 240 women with non-metastatic breast cancer reported intensity and duration of moderate and vigorous PA (MVPA), fatigue (intensity and interference), depressed mood, clinician-rated depression and functional QOL.

Results: In the path analysis models tested, women that reported greater weekly MVPA reported less fatigue interference, greater functional QOL, less depressed mood, and lower clinician-rated depression. Tests of indirect effects suggested that fatigue interference may be an intermediate pathway by which MVPA relates to functional QOL, clinician-rated depression and depressed mood.

Conclusion: Women who are more physically active in the months after breast cancer surgery show greater psychological adaptation in the initial phases of their treatment.  相似文献   
663.
    
There is consistent evidence that health care professionals (hcps) are not addressing the sexual information and support needs of people with cancer. Thirty-eight Australian hcps across a range of professions working in cancer care were interviewed, to examine constructions of sexuality post-cancer, the subject positions adopted in relation to sexual communication, and the ways in which discourses and subject positions shape information provision and communication about sexuality. Participants constructed sexual changes post-cancer in physical, psychological and relational terms, and positioned such changes as having the potential to significantly impact on patient and partner well-being. This was associated with widespread adoption of a discourse of psychosocial support, which legitimated discussion of sexual changes within a clinical consultation, to alleviate distress, dispel myths and facilitate renegotiation of sexual practices. However, this did not necessarily translate into patient-centred practice outcomes, with the majority of participants positioning personal, patient-centred and situational factors as barriers to the discussion of sex within many clinical consultations. This included: absence of knowledge, confidence and comfort; positioning sex as irrelevant or inappropriate for some people; and limitations of the clinical context. In contrast, those who did routinely discuss sexuality adopted a subject position of agency, responsibility and confidence.  相似文献   
664.
    
Abstract

Cancer is recognized to have multifaceted stressful impact on all areas of a patient's life. Researchers commonly use self-report questionnaires, intended to measure stressors objectively. However, the item-content and response-format of such scales often tap physical and mental responses to stress, thereby contaminating prediction of adverse impact. This article reports the development and validation of English and French versions of the Inventory of Recent Life Experiences for Cancer Patients (IRLE-C) which is designed to minimize such “criterion-contamination”. This entailed (1) avoiding items reflecting physical or subjective distress; (2) rating stressors for degree of exposure only; and (3) use of an innocuous scale title. The initial item pool was administered serially to a sample of 100 Francophone breast-cancer and prostate-cancer patients. To guard against inflating reliability and validity estimates through capitalizing on chance, we administered the 30-item final scale to an independent sample of 96 Francophone breast-cancer and prostate-cancer patients undergoing radiation treatment. Following the item-selection step, factorial structure and validity analyses were performed using the combined French-speaking sample (n= 196). Second, we administered the English version of the scale to an English-speaking sample of 127 cancer patients (various cancer sites and stages). The measure showed good internal consistency (.94 and .89 for the Francophone and Anglophone samples respectively) and met criteria for a 2-week test-retest reliability (r= .70 for the item-selection subsample and .80 for the cross-replication sub-sample). Correlations between the IRLE-C and the POMS Total Mood Disturbance were around .60 for both the Francophone and Anglophone samples. Avoiding contamination (through content and format) without losing its relationship to subjective distress, the IRLE-C appears a useful instrument for applying the stress-process model in oncology to establish clear distinctions among stressors, mediators, reactions, and consequences.  相似文献   
665.
    
This study evaluates the contents of representations of skin cancer risk and their associations with risk appraisals, worry, and protection intentions and behaviors. The Assessment of Illness Risk Representations (AIRR) was used to measure conceptual and imagery contents of risk representations, as delineated by the Common-Sense Model. University students (N?=?120) completed the AIRR; measures of likelihood and severity appraisals, and worry; and measures of skin self-examination, clinical skin examination, and sun protection intentions and behaviors. Beliefs about identity, causal, and timeline risk were positively associated with likelihood appraisals, whereas consequences and timeline risk beliefs were positively associated with severity appraisals. Identity and timeline risk independently predicted worry. Representational attributes, including imagery vividness and valence, independently predicted intentions and behaviors, whereas likelihood and severity appraisals did not. Symptom imagery interacted with worry to predict detection and prevention intentions: worry predicted greater intentions for participants with symptom imagery but not for those without symptom imagery. The findings support the utility of the AIRR for assessing risk representations and identify ways in which risk representations may guide protective behavior.  相似文献   
666.
    
Abstract

The aims of the present study were to investigate socio-demographic and knowledge variables as predictors of re attendance for mammography screening and to examine the utility of the Health Belief Model (HBM) in predicting reattendance for mammography screening above and beyond socio-demographic and knowledge variables. A total of 88 reattenders and 44 non-reattenders of an Australian breast screening service completed a questionnaire assessing socio-demographics (age, marital status, education, physician recommendation and family history), knowledge and HBM variables. Results showed that reattenders were more likely to be older, married and report physician involvement than non-reattenders. Family history and knowledge did not significantly predict reattendance. Of the HBM variables, perceived benefits was related to reattendance above and beyond socio-demographics. Results support the utility of the HBM as a focus for improving regular attendance for breast screening. It is concluded that non-reattenders should be investigated as a seperate group to women who have never attended for mammography screening.  相似文献   
667.
    
Support from a partner can play a key role in a woman's emotional adjustment to breast cancer. However, little is known about the influence of partner behaviours on a woman's sexual adjustment. This study examined the prospective relationship between baseline levels of several types of perceived partner support (instrumental, informational, emotional and negative) and psychosexual adjustment (sexual functioning and relationship satisfaction) over the course of 12 months post-surgery in a sample of 130 women with breast cancer. Results indicated that perceptions of greater emotional and informational support from the partner at baseline were associated with less sexual difficulties among breast cancer patients concurrently and 6 months post-surgery. Baseline perceptions of greater emotional and instrumental support from a partner were associated with greater relationship satisfaction at all time points. Perceptions of informational support at baseline were related to greater concurrent relationship satisfaction. Baseline perceptions of negative partner support were related to less relationship satisfaction, but only concurrently. These findings suggest that the perception of a partner's provision of emotional, instrumental and informational support may each play a role in facilitating sexual adjustment and relationship satisfaction.  相似文献   
668.
    
Significant others play an important role in providing support in patients’ lives, but some types of support negatively affect the patients. This study was conducted in early-stage breast cancer patients to examine the structure of support, which was provided by their significant others and assessed negatively by the patients, and to identify negative support relating to the psychological adjustment of these patients. Thus, we first conducted interviews among 28 breast cancer patients to identify these support items assessed as negative; next, we conducted a questionnaire survey using the resulting items in 109 postoperative patients who had early-stage breast cancer. We performed exploratory and confirmatory factor analyses and obtained a valid second-order factor structure, including superordinate factors (excessive engagement, avoidance of problems and underestimation) and subordinate factors (overprotection, encouragement and management). Among these factors, the avoidance of problems was the only factor to be negatively associated with psychological adjustment of the patients, suggesting that these patients receive problem-avoiding support. The results of our study suggest that such problem-avoiding support from significant others can be counter-productive and potentially worsen the psychological adjustment of breast cancer patients.  相似文献   
669.
    
Objective: The purpose of the study is to describe from a relational perspective, partners’ psychological adjustment, coping and support needs for advanced prostate cancer.

Design: A mixed methods design was adopted, employing triangulation of qualitative and quantitative data, to produce dyadic profiles of adjustment for six couples recruited from the urology clinics of local hospitals in Tasmania, Australia.

Methods: Dyads completed a video-taped communication task, semi-structured interview and standardised self-report questionnaires.

Results: Themes identified were associated with the dyadic challenges of the disease experience (e.g. relationship intimacy, disease progression and carer burden). Couples with poor psychological adjustment profiles had both clinical and global locus of distress, treatment side-effects, carer burden and poor general health. Resilient couples demonstrated relationship closeness and adaptive cognitive and behavioural coping strategies. The themes informed the adaption of an effective program for couples coping with women’s cancers (CanCOPE, to create a program for couples facing advanced prostate cancer (ProCOPE-Adv).

Conclusion: Mixed method results inform the development of psychological therapy components for couples coping with advanced prostate cancer. The concomitance of co-morbid health problems may have implications for access and engagement for older adult populations in face-to-face intervention.  相似文献   
670.
    
Objective: This study assessed: (1) whether risk perceptions about skin cancer were related to parent's use of sunscreen on their children; (2) which combination of assessments susceptibility and severity best explain parental sunscreen protection behaviours and (3) whether risk perceptions influence behaviour directly through intentions or through attitudes, subjective norms and self-efficacy.

Design: Two longitudinal studies assessed sunscreen protection behaviours of parents for their toddlers (N?=?391) and young children (N?=?436).

Main outcome measure: Parent's use of sunscreen on their children.

Results: Risk perceptions correlated with future sunscreen protection behaviours of parents but were lower than those of attitude, social influence and self-efficacy. Treating susceptibility and severity as an additive function resulted in the best model fit. Risk perceptions were related with future intention and future sunscreen protection behaviour, but the effects were mediated through attitude, social influence and self-efficacy.

Conclusions: Our path analyses suggest treating susceptibility and severity as an additive function. A multiplicative model without main effects – although often used – had the poorest fit. Risk perceptions influence behaviour by influencing attitudinal and self-efficacy beliefs. Addressing risk perceptions in health communication programs is relevant when the purpose is to increase awareness and to influence attitudes and self-efficacy.  相似文献   
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