Psycho-oncology
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The treatment of breast cancer tends to result in physical side effects (e.g., vaginal dryness, stomatitis, and atrophy) that can cause sexual problems. Although studies of early-stage breast cancer have demonstrated that sexual problems are associated with increased depressive symptoms for both patients and their partners, comparatively little is known about these associations in metastatic breast cancer (MBC) and how patients and partners cope together with sexual problems. We examined the links between sexual problems, depressive symptoms, and two types of spousal communication patterns (mutual constructive and demand-withdraw) in 191 couples in which the patient was initiating treatment for MBC. ⋯ Sexual problems were associated with depressive symptoms for both MBC patients and their partners. The way in which patients and partners talk with one another about cancer-related problems seems to influence this association for patients. MBC patients may benefit from programs that teach couples how to minimize demand-withdraw communication and instead openly and constructively discuss sexual issues and concerns.
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This study examined whether cognitive impairment in advanced cancer patients is associated with a heightened frequency of psychiatric disorders in their primary caregivers. ⋯ Caregivers of cognitively impaired advanced cancer patients appear at heightened risk of major depression that resolves after the patient's death. Further study with a larger sample and more sensitive longitudinal cognitive measures is indicated.
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The present study examined the long-term cognitive implications of cancer treatment among breast cancer survivors aged 65 years and older to better understand the long term implications of cancer treatment. ⋯ Our findings suggest that cognitive outcomes may involve greater age-related deficits among older cancer survivors compared with matched healthy subjects.
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Randomized Controlled Trial Multicenter Study
Randomized clinical trial of a brief and extensive dyadic intervention for advanced cancer patients and their family caregivers.
Few intervention programs assist patients and their family caregivers to manage advanced cancer and maintain their quality of life (QOL). This study examined (i) whether patient-caregiver dyads (i.e., pairs) randomly assigned to a brief or extensive dyadic intervention (the FOCUS Program) had better outcomes than dyads randomly assigned to usual care and (ii) whether patients' risk for distress and other factors moderated the effect of the brief or extensive program on outcomes. ⋯ Both brief and extensive programs had positive outcomes for patient-caregiver dyads, but few sustained effects. Patient-caregiver dyads benefit when viewed as the 'unit of care'.
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Religious/spiritual resources may serve multiple functions in adjustment to cancer. However, there is very little evidence of the importance of religious/spiritual variables outside the USA. This paper reports the cross-sectional data of a longitudinal study examining the beneficial and harmful effects of religious/spiritual coping resources on adjustment in the first year after a breast cancer diagnosis. ⋯ Using religious/spiritual resources in the coping process during the early stages of breast cancer may play an important role in the adjustment process in patients with breast cancer. Patients may benefit from having their spiritual needs addressed as experiencing some form of religious/spiritual struggle may serve as a barrier to illness adjustment. Implications for research and clinical practices are discussed.