Search

Background: Many individuals with systemic sclerosis (SSc) are at heightened risk for COVID-19 related morbidity and isolation due to interstitial lung disease, frailty, and immunosuppressant use. Minimal research has explored loneliness predictors in individuals with chronic illnesses during COVID-19. This study evaluated moderators of loneliness trajectories in individuals with SSc during COVID-19. Methods: Longitudinal data were analyzed across 30 timepoints from April 2020 to May 2022 from 775 adults in the Scleroderma Patient-centered Intervention Network (SPIN) COVID-19 Cohort. Hierarchical linear modeling evaluated cross-level moderators of loneliness trajectories, including marital status, baseline number of household members, number of virtual or telephone one-on-one or virtual group conversations, number of hours spent enjoying in-person household conversations or activities, and satisfaction with quality of in-person household conversations (all in the past week). Level-1 moderation analyses assessed effects of conversation, activity, and satisfaction means and slopes over time. Results: Baseline values were not statistically significant moderators of loneliness trajectories. Higher mean (averaged over time) virtual or telephone one-on-one and in-person household conversations, in-person household activity, and in-person household conversation satisfaction were associated with lower loneliness trajectories (ps <.05). The relationship between in-person household conversation satisfaction and loneliness trajectory was statistically significantly but minimally attenuated over time (p <.001). Conclusions: For people with SSc, higher mean conversation, activity, and satisfaction variables were associated with lower levels of loneliness during the pandemic, but changes in these social variables were generally not predictive of changes in loneliness. [ABSTRACT FROM AUTHOR]

Purpose: The Self-Efficacy to Manage Chronic Disease (SEMCD) scale is widely used, including in systemic sclerosis (SSc). The SEMCD has been validated in SSc, but the metric equivalence of the English and French versions has not been assessed (i.e., whether psychometric properties are equivalent across English and French). Methods: Participants were adults from the Scleroderma Patient-Centered Intervention Network (SPIN) Cohort (N = 2159) who completed baseline measures in English (n = 1473) or French (n = 686) between May 2014 to July 2020. Analyses assessed internal consistency reliability via Cronbach's alpha and McDonald's omega, convergent validity via Pearson's correlations, structural validity via confirmatory factor analysis (CFA), and differential item functioning via the Multiple-Indicator Multiple-Cause (MIMIC) model. Results: Internal consistency reliability was high in English (α =.93, ω =.93) and French (α =.92, ω =.93). All correlations between the SEMCD and measures of health outcomes were moderate to large, statistically significant, and in the hypothesized direction in both languages. The CFA demonstrated that the one-factor model of self-efficacy, overall, fit reasonably well (CFI =.96, TLI =.93, SRMR =.03, RMSEA =.14). Standardized factor loadings were large (.76 to.88). Three items displayed statistically significant uniform DIF and all six displayed nonuniform DIF; all DIF was of minimal magnitude. Comparison of unadjusted and DIF-adjusted models indicated that DIF did not meaningfully impact total score (ICC = 0.999, r = 0.999). Conclusion: Scores from English- and French-speaking adults with SSc can be combined for analysis or compared. [ABSTRACT FROM AUTHOR]

Black and Latino adult cancer patients are underrepresented in cancer clinical trials, which limits generalizability of findings and amplifies disparities in healthcare access and outcomes. Community-level education programs designed to address barriers to participation could improve representation in cancer clinical trials. Through a community–campus partner framework, this study evaluated the Women United: Clinical Trials and the Fight Against Breast Cancer Program in Spanish and English. Participants were 422 women (141 Black, 140 Latina Spanish preference, 141 Latina English preference) who were randomized to view either the intervention (n = 215) or a control (n = 207) program. Assessments of clinical trials knowledge and barriers to clinical trials participation were taken before and after viewing. Results suggested that clinical trials knowledge increased and perceived barriers to participation decreased for those who viewed the educational program. More specifically, those in the intervention condition perceived fewer barriers related to personal benefits, mistrust, and familiarity of clinical trials. As expected, there were no differences in perceived barriers related to community support for either condition. Participants in both conditions were equally likely to join a subsequent study or a clinical trials community ambassador program. There were no differences in any of the outcomes across ethnicity or language, suggesting the program works equivalently across groups. This program is easy to administer and can be recommended for use among Black and Latina women to address factors related to clinical trials participation. [ABSTRACT FROM AUTHOR]

Purpose: Sleep disturbance and cancer-related fatigue (CRF) are among the most commonly reported symptoms associated with breast cancer and its treatment. This study identified symptom cluster groups of breast cancer patients based on multidimensional assessment of sleep disturbance and CRF prior to and during chemotherapy.Methods: Participants were 152 women with stage I-IIIA breast cancer. Data were collected before chemotherapy (T1) and during the final week of the fourth chemotherapy cycle (T2). Latent profile analysis was used to derive groups of patients at each timepoint who scored similarly on percent of the day/night asleep per actigraphy, the Pittsburgh Sleep Quality Index global score, and the five subscales of the Multidimensional Fatigue Symptom Inventory-Short Form. Bivariate logistic regression evaluated if sociodemographic/medical characteristics at T1 were associated with group membership at each timepoint.Results: Three groups (Fatigued with sleep complaints, Average, Minimal symptoms) were identified at T1, and five groups (Severely fatigued with poor sleep, Emotionally fatigued with average sleep, Physically fatigued with average sleep, Average, Minimal symptoms) at T2. The majority of individuals in a group characterized by more severe symptoms at T1 were also in a more severe symptom group at T2. Sociodemographic/medical variables at T1 were significantly associated with group membership at T1 and T2.Conclusions: This study identified groups of breast cancer patients with differentially severe sleep disturbance and CRF symptom profiles prior to and during chemotherapy. Identifying groups with different symptom management needs and distinguishing groups by baseline sociodemographic/medical variables can identify patients at risk for greater symptom burden. [ABSTRACT FROM AUTHOR]

The interaction of body dissatisfaction and appearance investment (importance and effort ascribed to appearance) in relation to condomless anal sex has not previously been examined. Body dissatisfaction in the context of varying degrees of appearance investment may yield divergent sexual risk outcomes. Sexual minority men living with HIV (N = 105) completed a battery of self-report measures. A generalized linear model identified a significant interaction [b = 0.08 (95% CI 0.01, 0.16), p = 0.033] such that when appearance investment was low, body dissatisfaction was associated with fewer condomless anal sex acts; when appearance investment was high, body dissatisfaction was associated with increased condomless anal sex. [ABSTRACT FROM AUTHOR]

Purpose: We compared adoption consideration between female young adult cancer survivors and women of the same age in the general US population, hypothesizing that cancer survivors who desired children would report greater interest in adoption than an age-adjusted general population sample who desired children.Methods: After age-standardizing the cancer survivor cohort to match the age distribution of the 2006-2010 National Survey for Family Growth (NSFG), we estimated adoption consideration among women age 18-35 years who wanted a (another) child in the two cohorts overall and within age groups. We assessed characteristics and concerns related to adoption consideration among cancer survivors.Results: Among cancer survivors, 81.6 % (95 % CI 75.7-87.6) reported that they would consider adoption compared to 40.3 % (95 % CI 40.3-40.3) of women in the general population. While over 80 % of the cancer survivor sample reported that they would consider adoption, only 15 % of cancer survivors reported no concerns about adoption. The most common concerns were desire for a biological child (48 %), expense (45 %), adoption agency candidacy (41 %), and needing more information (39 %).Conclusion: We observed a twofold higher interest in adoption when comparing the cancer survivor with the general population, suggesting that adoption is a consideration for many young women who have survived cancer.Implications For Cancer Survivors: Adoption is an important family-building option for those who want to have a child but are unable to or choose not to have a biological child. However, young adult survivors may need more support to understand and navigate this process. [ABSTRACT FROM AUTHOR]

Purpose: Pain is a common but understudied quality of life concern in systemic sclerosis (SSc). This investigation sought to describe patient-reported pain during the early phase of the disease and to examine potential predictors of this over time.Methods: A prospective cohort (N = 316) of patients with early-disease SSc from the Genetics versus ENvironment In Scleroderma Outcome Study (GENISOS) were followed for 3 years. Multilevel modeling was used to describe longitudinal changes in pain and the extent to which pain variance was explained by disease type, emotional health, perceived physical health, health worry, and social support.Results: Patient-reported pain remained relatively stable, with slight improvement over time. More severe disease type was associated with worse initial pain, but the association was reduced to nonsignificance after accounting for the psychosocial variables. Better emotional health and perceived physical health were associated with lower initial pain. There were marginal interactive effects for perceived physical health and social support such that initial perceptions of poorer physical health, and higher social support, were predictive of greater improvements in pain over time.Conclusions: These data suggest that emotional health, perceived physical health, and social support are more relevant to longitudinal SSc pain than disease severity and that perceived physical health and social support may impact pain trajectories. Researchers and rheumatology health professionals should consider these factors in comprehensive pain models and pain management protocols. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study is to investigate factors associated with female young adult cancer survivors' (YCSs) use of fertility care (FC), including consultation or fertility treatment, after completing their cancer treatment.Methods: In this cross-sectional study, females between that ages of 18 and 35 years who had been diagnosed with childhood, adolescent, or young adult cancers completed a 20-min web-based survey that included demographics, reproductive history, use of FC, fertility-related informational needs, and reproductive concerns.Results: A total of 204 participants completed the survey. Participants' mean age was 28.3 ± 4.5 years. Thirty (15 %) participants reported using FC after cancer treatment. The majority of participants recalled not receiving enough information about fertility preservation options at the time of cancer diagnosis (73 %). In multivariable analysis, those with higher concerns about having children because of perceived risk to their personal health (P = 0.003) were less likely to report use of FC after cancer treatment. Those who had used FC before cancer treatment (P = 0.003) and who felt less fertile than age-matched women (P = 0.02) were more likely to use FC after their cancer treatment.Conclusions: While most YCSs in this cohort believed that they did not receive enough information about fertility and most wanted to have children, the vast majority did not seek FC. The findings of this study offer further evidence of the need for improved education and emotional support regarding reproductive options after cancer treatment is completed. Targeted discussions with YCSs about appropriate post-treatment FC options may improve providers' capacity to help YCSs meet their parenthood goals. [ABSTRACT FROM AUTHOR]

Purpose: Perceived discrimination has been associated with lower adherence to cancer screening guidelines. We examined whether perceived discrimination was associated with adherence to breast, cervical, colorectal, and prostate cancer screening guidelines in US Hispanic/Latino adults.Methods: Data were obtained from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study, including 5,313 Hispanic adults aged 18–74 from Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA, and those who were within appropriate age ranges for specific screening tests were included in the analysis. Cancer screening behaviors were assessed via self-report. Perceived discrimination was measured using the Perceived Ethnic Discrimination Questionnaire. Confounder-adjusted multivariable polytomous logistic regression models assessed the association between perceived discrimination and adherence to cancer screening guidelines.Results: Among women eligible for screening, 72.1 % were adherent to cervical cancer screening guidelines and 71.3 %were adherent to breast cancer screening guidelines. In participants aged 50–74, 24.6 % of women and 27.0 % of men were adherent to fecal occult blood test guidelines; 43.5 % of women and 34.8 % of men were adherent to colonoscopy/sigmoidoscopy guidelines; 41.0 % of men were adherent to prostate-specific antigen screening guidelines. Health insurance coverage, rather than perceived ethnic discrimination,was the variable most associated with receiving breast, cervical,colorectal, or prostate cancer screening.Conclusions: The influence of discrimination as a barrier to cancer screening may be modest among Hispanics/Latinos in urban US regions. Having health insurance facilitates cancer screening in this population. Efforts to increase cancer screening in Hispanics/Latinos should focus on increasing access to these services, especially among the uninsured. [ABSTRACT FROM AUTHOR]

Research has identified numerous correlates of sexual risk behaviors among adolescents. However, two potentially important cognitive constructs, perceived control and religious beliefs, have received considerably less attention. Research demonstrates that the most informative examination of the relationship of perceived control beliefs to sexual risk requires instruments that directly assess control beliefs specific to sexual risk behaviors. Further, beliefs about God as a source of control (e.g., the perception that God is [or is not] actively helping one to delay sexual contact, refuse engagement in high risk sexual behaviors, or limit the number of sexual partners) may influence adolescents’ decisions, yet there are no instruments available to examine such beliefs. This study describes the development of a measure of God control beliefs over sexual risk behavior and provides initial reliability and validity data. Results suggest that the Sexual Risk Behavior-related God Locus of Control measure for Adolescents (SexGLOC-A) is a reliable and valid measure having demonstrated high internal consistency and both convergent and discriminant validity. [ABSTRACT FROM AUTHOR]

Adolescent alcohol use is a significant problem. Recent evidence suggests that an individual’s belief that God directly controls his or her alcohol use (i.e., alcohol-related God/Higher Power control) may have particular importance as a protective factor against alcohol use and abuse. However, this relationship has not been investigated in adolescents as there are no appropriate measures to examine such beliefs. To address this need, the present study developed and evaluated a measure of alcohol-related God/Higher Power control beliefs for adolescents (AGLOC-A). African American adolescents ( N = 356) completed a questionnaire containing the AGLOC-A, alcohol-related internal control beliefs, and frequency of alcohol use and binge drinking in the past 30 days. Findings supported the AGLOC-A as a reliable and valid measure with AGLOC-A scores inversely related to alcohol involvement and distinct from religiosity and social desirability. Alcohol-related God/Higher Power control beliefs may be a useful protective factor against adolescent alcohol use and abuse. [ABSTRACT FROM AUTHOR]

Fatigue is a contributor to decreased quality of life and one of the most common symptoms reported by cancer survivors. Most assessment of fatigue has been retrospective and/or unidimensional. Single-item visual analogue scale ratings are commonly used, despite arguments that fatigue is better conceptualized as multidimensional. The relationships of daily to weekly ratings of fatigue, or of unidimensional to multidimensional assessments, have not been explored. Twenty-five breast cancer survivors provided daily ratings of fatigue and completed the Multidimensional Fatigue Symptom Inventory-Short Form weekly for one month. Using hierarchical linear modeling, stronger relationships of weekly ratings to average and peak rather than most recent daily ratings were found. Visual analogue scale ratings shared more variance with the General Fatigue subscale than with the other four fatigue dimensions measured. Findings suggest that different information is captured by daily versus weekly reports, and that although visual analogue scale ratings can provide a quick assessment of general fatigue, they do not capture other important dimensions. [ABSTRACT FROM AUTHOR]

Background: Minority groups are underrepresented in research, making it difficult to apply medical advances with confidence. In this study, we explored whether community-based cancer education sites and educators serving the African American community could be used to recruit minority participants to research.Methods: We invited Individuals at community education sites to provide buccal scrapings, saliva samples, psychometric data, and personal information anonymously.Results: Culturally aligned community sites (100%) collaborated in the research recruitment, as did 83% of the individuals at those sites.Conclusion: Community-based education sites offer exceptional promise for teaching about research benefits and recruiting members of minority groups to research studies. [ABSTRACT FROM AUTHOR]

Goals Of Work: Prostate cancer, the most common life-threatening cancer among American men, increases risk of psychosocial distress and negatively impacts quality of life for both patients and their spouses. To date, most studies have examined the relationship between patient coping and distress; however, it is also likely that what the spouse does to cope, and ultimately how the spouse adjusts, will affect the patient's adjustment and quality of life. The present study examined the relationships of spouse problem-solving coping, distress levels and patient distress in the context of prostate cancer. The following mediational model was tested: Spouses' problem-solving coping will be significantly inversely related to patients' levels of distress, but this relationship will be mediated by spouses' distress levels.Patients and Methods: One hundred seventy-one patients with prostate cancer and their spousal caregivers were assessed for mood; spouses were assessed for problem-solving coping skills. Structural equation modeling was used to test model fit.Main Results: The model tested was a good fit to the data. Dysfunctional spousal problem-solving was a significant predictor of spouse distress level but constructive problem-solving was not. Spouse distress was significantly related to patient distress. Spouse dysfunctional problem-solving predicted patient distress, but this relationship was mediated by spouse distress. The same mediational relationship did not hold true for constructive problem-solving.Conclusions: Spouse distress mediates the relationship between spouse dysfunctional coping and patient distress. Problem-solving interventions and supportive care for spouses of men with prostate cancer may impact not only spouses but the patients as well. [ABSTRACT FROM AUTHOR]

This study examined the role of two distinct factors of emotion, positive (PA) and negative affect (NA), in adjustment to a chronic rheumatic disease, systemic sclerosis (SSc). Ninety-two patients with a confirmed diagnosis of SSc completed self-report measures assessing PA and NA (Positive and Negative Affect Schedule), coping (Revised Ways of Coping Checklist), and functional outcomes (pain and disability measured with the Health Assessment Questionnaire). Confirmatory factor analysis indicated that PA and NA constituted separate, negatively correlated factors. PA and NA showed differential relationships to coping and functional outcomes. Affect mediated the association between coping and functional outcomes after controlling for disease severity. The results suggest the importance of both PA and NA as factors influencing adjustment to chronic illness. [ABSTRACT FROM AUTHOR]

Dyadic adjustment and coping styles have been shown to predict levels of psychological distress following cancer diagnoses. This study examined the relationship between coping and distress in couples faced with prostate cancer, considering dyadic functioning as a third variable that potentially moderated or mediated the relationship. To investigate its influence on the success of patients' and spouses' coping efforts, both moderational and mediational models were tested using couples' composite dyadic adjustment scores. Only the moderational model was supported for patients: dyadic strength moderated the effects of avoidant coping and intrusive thinking on mood disturbance. Despite maladaptive coping, patients that were members of stronger dyads reported less distress than those in more dysfunctional relationships. Findings suggest that the relationship between coping and distress depends on the quality of dyadic functioning. Being part of a strong dyad may serve as a buffering factor, implying the need for psychosocial intervention for couples in maladjusted relationships. [ABSTRACT FROM AUTHOR]

Although perceptions of internal control have been related to physical and psychosocial outcomes in chronic illness,less attention has been paid to perceptions of external sources of control and their implications for adaptation. One reason for this has been the dearth of adequate measures for assessing specific external control constructs. The God Locus of Health Control (GLHC) scale was developed to assess the extent of an individual's belief that God controls his or her health status. The GLHC was designed as an adjunct to the widely used Multidimensional Health Locus of Control (MHLC) scales. Initial studies of the psychometric properties of the GLHC scale in samples of persons with two rheumatic diseases, rheumatoid arthritis and systemic sclerosis, provide evidence of the scale's reliability and validity. [ABSTRACT FROM AUTHOR]

Although disease- and/or treatment-related changes in physical appearance accompany many illnesses, the relationship of these physical changes to appearance selfesteem and overall psychological adjustment has received little attention in the literature. In this study, subjects were 93 persons with diagnoses of systemic sclerosis, a chronic and progressive rheumatic disease characterized by physical changes, especially skin thickening. Subjects received clinical examinations of skin thickening and provided self-reports via questionnaires of their appearance-related self-esteem and overall psychological distress. Results showed that disease-related physical changes were related to appearance self-esteem. Stepwise multiple regression analysis found skin thickening of the righthand and fingers to be the strongest predictors of appearance self-esteem. Appearance self-esteem was examined as a possible moderator or mediator of the relationship between skin thickening and psychological distress. Results did not support a moderator role for appearance self-esteem; however, appearance self-esteem met statistical criteria as a mediator of the relationship between skin thickening and distress. Interestingly, results differed for the diffuse and limited subtypes ofsystemic sclerosis,suggesting that physical changes associated with disease may have stronger relationships with self-esteem and overall adjustment in the context of less serious illnesses. [ABSTRACT FROM AUTHOR]

Presents an assessment of self-statements in individuals varying in affective states, particularly negative affectivity (NA). Beck Depression Inventory; Beck Anxiety Inventory; Automatic thoughts Questionnaires; Positive and Negative Affect Scale; Positive and negative cognition; State-of-mind analysis.

Examines the attributions of behavioral and characterological self-blame and perceptions of control over disease progression and recurrence as predictors of symptoms of psychological distress in a sample of adults with cancer. Suggestion of a reciprocal relationship between characterological self-blame and distress; Control beliefs.

Introduces a series of articles on cognition and emotion.

Introduces articles published int April 1999 issue of the periodical "Cognitive Therapy and Research." Cognitive aspects of chronic illness; Relationship between cognitive errors and functional impairment in persons with coronary heart disease undergoing outpatient rehabilitation; Use of a learned helplessness conceptualization.