Skin cancer: Assessing perceived risk and behavioural attitudes

Abstract

Measures of attitude concerning exposure to the sun, and judgements of risk and other beliefs concerning skin cancer and four other problems (stomach cancer, deafness, AIDS and sunstroke) were obtained from a questionnaire completed by 176 university students. Subjects also estimated the incidence of each problem using one of three response formats. The highest incidence estimates were obtained when subjects were asked to guess at an absolute number, and the lowest when they used a scale which differentiated between lower frequencies, while grouping higher frequencies into a single response category. The effect of the response scale format, however, did not generalize to other ratings of personal risk. Subjects' ratings of their personal risk, compared with their peers, showed an optimistic bias over the five problems as a whole, particularly for AIDS, but not reliably so in the case of skin cancer. Optimism was inversely related to the amount of thought given to each problem. Men and women did not differ overall in their optimism regarding their own risk of skin cancer. However, differences as a function of gender and optimism were found on various behavioural attitudes. The results are discussed in relation to a tendency of disregard base-rates in subjective risk judgements, unrealistic optimism, and implications for health education.     

Health psychology and uptake of preventive health services: A review of 30 years' research on cervical screening

Abstract

A review of thirty years' research in cervical screening was conducted to assess the role of social and psychological factors in screening utilisation. The role of age, social class, attitudes towards and beliefs about screening as well as social influence and personality variables are considered. A reanalysis of reasons for non-attendance following an invitation for screening from ten previous studies is presented and the importance of theoretical accounts of service utilisation in this area are assessed. Research findings show significant associations for both demographic and psychological factors though poor operationalisations and statistical analyses in previous research make difficult the assessment of their importance as additive, interactive or mediational variables. The significance of service provision issues in terms of both providers' behaviour and the flexibility of delivery is highlighted. The need for further research using a theoretical framework which can unify demographic, psychological and service provision variables is identified.     

Men’s strategies for preserving emotional well-being in advanced prostate cancer: An interpretative phenomenological analysis

Objective: This study explores men with advanced prostate cancers’ own practices for promoting and maintaining emotional well-being using Interpretative Phenomenological Analysis.

Design: Five men with advanced prostate cancer participated in face-to-face, semi-structured, in-depth interviews.

Results: Within rich narratives of lost and regained well-being, two super-ordinate themes emerged – ‘living with an imminent and uncertain death’ and ‘holding on to life.’ Well-being was threatened by reduced sense of the future, isolation and uncertainty. Yet, the men pursued well-being by managing their emotions, striving for the future whilst enjoying life in the present, taking care of their families and renegotiating purpose. Running through participant’s accounts was a preference for taking action and problem-solving. Sense of purpose, social connectedness, and life engagement were revealed as concepts central to improving well-being, indicating areas which practitioners could explore with men to help them re-establish personal goals and life purpose.

Conclusions: The findings also add weight to the evidence base for the potential value of psychological interventions such as cognitive behaviour therapy and mindfulness in men with prostate cancer.     

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.     

Quality-of-life after penile prosthesis placed at radical prostatectomy

Abstract

The clinical and psychosocial effects of immediate penile prosthesis implantation at the time of radical prostatectomy (RP) were investigated in 97 consecutive patients and 68 partners. Prosthesis recipients reported more frequent sexual contact, fewer marital problems and slightly fewer sexual functioning problems than the RP-alone patients. There were no group differences on any sociodemographic characteristics, on disease recurrence, on physical and psychosocial functioning, or on reported depression. Patients who chose the prosthesis did, however, evidence less of a link between depression and functional limitations and between depression and marital problems. They also had lower levels of agreement with their partners in reporting their own depression, as compared to the patients who opted for RP surgery alone. We conclude that the penile prosthesis was associated with an increased frequency of sexual contact, a reduction in reported marital problems, and stylistic differences between the two patient groups in dealing with affect.     

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.     

‘Them’ and ‘us’: The experiences of women with metastatic disease in mixed-stage versus stage-specific breast cancer support groups

The objective of this study was to explore the experiences of women with metastatic breast cancer (MBC) in mixed-stage and stage-specific groups. Interpretative phenomenological analysis (IPA) was used to examine 15 interviews from eight women with MBC. The interviewees felt that their experiences were very much different from those of women with primary breast cancer (BC), because of their different prognoses. In mixed-stage groups, the interviewees described feeling silenced, marginalised and helpless. They did not receive support in these groups because survivors of primary BC are often afraid to face the idea of metastasis. In stage-specific MBC groups, on the other hand, women were able to talk openly and were understood by others with whom they identified. They became more informed about issues related to their illness. Seeing others living well despite MBC made them feel more hopeful. Although there are some disadvantages of participating in stage-specific groups, the findings suggest that, overall, stage-specific groups are more helpful to women with MBC than mixed-stage groups. These findings have implications for the provision of group support for this population.     

Can the effectiveness of health promotion campaigns be improved using self-efficacy and self-affirmation interventions? An analysis of sun protection messages

Health-risk communications frequently target self-efficacy in order to encourage adaptive responses. Research has also indicated that self-affirmation may be a useful supplementary or alternative intervention technique. This study compared the effects of self-efficacy, self-affirmation and a combination of these techniques for two risk messages. Young British females (N?=?677) read about ultraviolet light and skin cancer or skin ageing (‘photoageing’) and were randomly assigned to a single intervention (self-affirmation/self-efficacy), the combined intervention or no intervention. The efficacy intervention led to greater message acceptance and perceived risk in both the cancer and photoageing conditions, while the only main effect of self-affirmation was on acceptance of the photoageing message. However, self-affirmation moderated the effect of efficacy information. For photoageing messages, efficacy information was associated with greater message acceptance only amongst self-affirmed participants, but the opposite occurred for skin cancer messages. Although these findings should be interpreted cautiously, they imply that health promoters should select efficacy information if only one intervention is used but that self-affirmation can influence responsiveness to efficacy interventions for particular messages.     

Risk factors for psychological morbidity in women attending a one-stop diagnostic clinic with suspected breast disease

Abstract

The present study was designed to identify risk factors for psychological morbidity in women attending a one-stop diagnostic clinic with suspected breast disease. A cohort of 158 women were recruited and were asked to complete scales measuring psychological morbidity and psychosocial factors in the period immediately before their appointment and to repeat the assessments of psychological morbidity on the day of the appointment. Relevant clinical and demographic data were also collated. Within the cohort 1.4% of respondents received a diagnosis of malignant disease. Psychological morbidity, both prior to and during the diagnostic appointment was strongly predicted by psychosocial factors (i.e., acceptance-resignation coping, personal self esteem and discrepancies in social support), accounting for 54% and 63% of the variance at pre-appointment and appointment day phases respectively. Other measured variables were found not to be correlated with and/or to account for a significant proportion of the variance in the measures of morbidity. These results suggest that these psychosocial variables should be targeted in interventions designed to reduce psychological morbidity in this patient group.     

A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.