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Artificial intelligence (AI) is poised to transform breast cancer care. However, most scientists, engineers, and clinicians are not prepared to contribute to the AI revolution in healthcare. In this paper, we describe our experiences teaching a new undergraduate course for American students that aims to prepare the next generation for cross-cultural designthinking, which we believe is crucial for AI to achieve its full potential in breast cancer care. The key course activities are planning, conducting, and interpreting interviews of healthcare professionals from both Portugal and the United States. Since the course is offered as a short-term faculty-led study abroad program in Portugal, students are able to explore the impact of culture on healthcare delivery and the design of healthcare technologies. The learning assessments demonstrated student growth in several areas pertinent for future development of AI for breast cancer care. With respect to understanding breast cancer care, prior to taking this course, most students had underestimated the impact of cancer and its treatment on women's quality of life and most were unaware of the importance of multidisciplinary care teams. Regarding AI in medicine, students became more mindful of data privacy issues and the need to consider the effect of AI on healthcare professionals. This course illustrates the potential benefits for AI in medicine of introducing future scientists, engineers, and clinicians to cross cultural design-thinking early in their educational experiences. • Increased self-assessed global learning and intercultural knowledge and competence. • Increased knowledge of design-thinking methods. • Increased appreciation of quality of life concerns of breast cancer patients. • Increased awareness of multidisciplinary care teams in breast cancer care. • Increased recognition of the potential impact of artificial intelligence on personnel. [ABSTRACT FROM AUTHOR]

Background: Breast cancer survivors' (BCS) attitudes toward eMental Health (eMH) are largely unknown, and adoption predictors and their interrelationships remain unclear. This study aimed to explore BCS' attitudes toward eMH and investigate associated variables. Methods: A cross-sectional study involving 336 Portuguese BCS was conducted. Attitudes toward eMH, depression and anxiety symptoms, health-related quality of life, and sociodemographic, clinical, and internet-related variables were assessed using validated questionnaires. Spearman-ranked correlations, χ2, and multiple regression analyses were computed to explore associations between attitudes and collected variables. Results: BCS held a neutral stance toward eMH. In models adjusted for age and education, positive attitudes were statistically significantly associated with increased depressive symptoms and worse emotional, cognitive, and body image functioning. Social network use, online health information and mental healthcare seeking, higher self-reported knowledge of eMH, and previous use of remote healthcare were positively associated with better attitudes toward eMH. Conclusions: eMH programs targeting BCS seem to be a promising strategy for providing supportive psychosocial care to BCS. However, increasing awareness about eMH efficacy and security may be necessary to improve its acceptance and use among BCS. Additional research is necessary to understand how BCS' unmet care needs, and specifically their psychological distress severity, may impact BCS' acceptance and use of eMH. [ABSTRACT FROM AUTHOR]

Self-efficacy is a coping resource with a positive impact on well-being, quality of life, anxiety, and depression in cancer patients, even after treatment. This study focused on the validation of the Cancer Behavior Inventory-Brief Version (CBI-B) in Portuguese patients with breast cancer. The study included 115 patients with breast cancer receiving outpatient chemotherapy in four hospitals located in Portugal. Participants (N = 115) completed the translated version of the CBI-B in Portuguese and measures of quality of life (QLQ- C30), psychological distress (HADS), and illness perceptions (IPQ-B). Confirmatory factor analysis supported the four-factor original structure of the CBI-B. The Portuguese version of the CBI-B showed good psychometric properties as shown by measures of internal consistency (Cronbach's alpha =.88), test–retest reliability (intraclass correlation coefficient =.59), convergent validity with the QLQ-C30 (r =.43, p <.001), and divergent validity with the HADS (r = -.60, p <.001) and the IPQ-B (r = -.51, p <.001). The Portuguese version of the CBI-B is a valid and reliable instrument to evaluate the self-efficacy for coping in Portuguese breast cancer patients. Future studies should validate the CBI-B in patients with other types of cancer. [ABSTRACT FROM AUTHOR]

Objective: The main objective of this prospective multicenter study was to examine whether illness representations of control, affect, and coping behaviors mediate the effects of self‐efficacy to cope with cancer on psychological symptoms and overall quality of life, in breast cancer patients. Method: Data from 413 women (Mean age = 54.87; SD = 8.01), coming from four countries (i.e., Finland, Israel, Italy, Portugal), who received medical therapy for their early breast cancer, were analyzed. Coping self‐efficacy was assessed at baseline. Potential mediators were assessed three months later, and outcomes after six months. Results: Coping self‐efficacy was related to all mediators and outcomes. Illness representations of treatment control, positive and negative affect, and certain coping behaviors (mostly, anxiety preoccupation) mediated the effects of coping self‐efficacy. Coping self‐efficacy was related to each outcome through a different combination of mediators. Conclusions: Coping self‐efficacy is a major self‐regulation factor which is linked to well‐being through multiple cognitive, emotional, and behavioral pathways. Enhancement of coping self‐efficacy should be a central intervention goal for patients with breast cancer, towards promotion of their well‐being. [ABSTRACT FROM AUTHOR]

Breast cancer is linked to psychological distress and mood disorders that are in turn associated with higher psychological dysfunction and decreased breast cancer survival. It is considered that psychological health in breast cancer is considerably affected by body image impairment, which in turn seems to be highly associated with shame. However, the impact of these variables on mental health may not be direct. The current study aimed to explore a comprehensive model regarding the role of chronic illness‐related cognitive fusion in the relationship of body image dissatisfaction and chronic illness‐related shame with depression symptoms. The sample was composed of 75 women with nonmetastatic breast cancer, recruited in a Radiotherapy Service in central Portugal. The conducted path model presented an excellent fit and accounted for 59% of the variance of depressive symptomatology. Further, it demonstrated that body image dissatisfaction's impact on depressed mood is significantly explained by the mechanisms of chronic illness‐related shame and chronic illness‐related cognitive fusion. It was also revealed that chronic illness‐related cognitive fusion additionally mediated the impact of chronic illness‐related shame on depression. These findings are suggestive of the importance of body image and chronic illness shame in the determination of breast cancer patients' depression symptoms and also the central role of chronic illness‐related cognitive fusion in these relationships. Therefore, the implementation of acceptance and defusion‐based psychotherapeutic interventions to improve mental health in cancer patients seems to be of great importance. [ABSTRACT FROM AUTHOR]

This longitudinal study examined the role of coping strategies and posttraumatic growth (PTG) on the psychological adjustment to breast cancer trajectory. The participants were 50 women assessed at the time of surgery (T1), during adjuvant treatment (T2) and six months after the end of treatment (T3). Women completed questionnaires assessing coping strategies, PTG and psychological adjustment (psychological quality of life, anxiety and depression). Results showed that the greatest impact of breast cancer on women's adjustment occurred at T1, when patients were significantly more anxious than in the other phases of the disease. The type of surgery and adjuvant treatment did not account for the course of PTG and adjustment. Coping through seeking social support and using cognitive strategies at T1 were linked to psychological quality of life and depression at T3 via PTG dimension of personal resources and skills at T2. Findings emphasise the value of promoting adaptive coping strategies and PTG in order to improve psychological adjustment in breast cancer patients. [ABSTRACT FROM PUBLISHER]

Objective: This study explored the experiences and perceived changes of breast cancer (BC) patients after participating in 16‐weekly sessions of Supportive–Expressive Group Therapy (SEGT). Methods: A semi‐structured interview adapted from Elliott's Client Change Interview was carried out with 12 women (aged 33–60 years) with BC, about 6 months after completing the treatment. Results: Content analysis identified four main themes: expectations and motivations to participate in SEGT, group processes and experiences, perceived changes enhanced by SEGT and perceptions about the therapeutic relationship. The most helpful aspects of SEGT mentioned by participants were as follows: the expression/normalisation of feelings, thoughts and reactions; the improvement of social support; and the learning opportunities obtained through sharing of experiences among participants. Additionally, participants mentioned that SEGT contributed to improve personal and social skills, such as the capacity to express emotions and the ability to establish satisfactory interpersonal relationships. Conclusions: Based on the participants' experiences, SEGT seems to be an effective intervention to support women facing BC during the initial phase of cancer. The use of SEGT by health care professionals is encouraged, but the specific needs/problems of each group member should be carefully attended. [ABSTRACT FROM AUTHOR]