Sónia Silva

Cancer patients may experience significant distress. The “Emotion Thermometers” (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental organization (NGO), and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of distress, age, gender, disease phase and 33 items of the problem list. Four items—sadness, depression, sleep and breathing—were found to be significantly related to a higher level of distress. Additionally, women and patients who were in the palliative phase also had significantly higher levels of distress. The results confirm the need for early emotional screening in cancer patients, as well as attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psychosocial services.

Cancer patients may experience significant distress. The “Emotion Thermometers” (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an NGO, and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of Distress and 33 items of the problem list. Four items - sadness, depression, sleep and breathing - were found to be significantly related to a higher level of Distress. Additionally, women and those who were in the palliative phase also had significantly higher levels of Distress. Conclusions: The results confirm the need for early emotional screening in cancer patients, as well as the relevance of attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psy-chosocial services.

Objective: Considering the lack of studies exploring the psychological impact of COVID-19 on patients living with and beyond cancer, this study aimed to explore the levels of emotional distress, anxiety, and depression in patients with cancer and survivors during the COVID-19 pandemic and to identify psychological risk factors. Methods: Data for this cross-sectional study were collected through an online questionnaire comprised a self-report questionnaire and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics and linear regression models were used to characterize the sample and identify the determinants of emotional distress, depression, and anxiety. Statistical analyses were performed using R, version 4.1.1. Results: The sample included 940 patients with cancer and survivors, mostly female (87.1%), with a mean age of 49.7 years. More than half of the patients were survivors (55.1%); 56.7% were diagnosed with breast cancer, and 35.0% had other chronic diseases. Most participants believed that they were more likely to be infected with COVID-19 (53.9%) and that they may have more complications if they were infected (76.7%). Approximately half of the participants revealed significant emotional distress (49.3%), 18.1% revealed significant depression, and 29.2% revealed significant anxiety. Female patients, participants with lower education levels, unemployed/lay-off, or in a medical leave with a chronic disease, taking care of someone with a chronic disease, or perceiving a higher risk of being infected with COVID-19 had higher levels of emotional distress, depression, and anxiety. Conclusions: This study provides useful information regarding the impact of the COVID-19 pandemic on the mental health of patients with cancer and survivors, showing that an increased number of patients experienced significant emotional distress during the pandemic.

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.

Stressful life events, such as breast cancer, offer possibilities for distress as well as for posttraumatic growth (PTG). This study examined PTG and psychosocial adjustment according to the occurrence of a highly stressful life event and the subjective perception of breast cancer as a traumatic experience. It also explored the possible moderation of these two variables in the relationship between PTG and adjustment. Participants were 71 breast cancer survivors and 89 healthy women who did not report the occurrence of a highly stressful life event. Findings suggest that PTG is not a result of the natural process of psychological maturity. For PTG to occur, a stressful event must be experienced, but it may not necessarily be perceived as traumatic. PTG has potential for adaptive consequences, especially for women who have survived breast cancer but who subjectively do not perceive it as a traumatic experience.

Objectives: Finding positive changes in the aftermath of breast cancer (BC) may protect women against impaired adjustment. This study examines posttraumatic growth (PTG) in a sample of women receiving treatment for BC and explores the buffering role of PTG on the links between perceived impact of BC and emotional distress and quality of life (QoL).Methods: Seventy‐eight women receiving chemotherapy (n = 57) or radiotherapy (n = 21) completed the Portuguese versions of the Posttraumatic Growth Inventory, the Hospital Anxiety and Depression Scale, the World Health Organization for QoL‐Bref and Consequences sub‐scale of the Brief Illness Perception Questionnaire (assessing perceived impact of BC).Results: PTG was frequently reported and co‐existed with distress and dysfunction. A more negative perception of the impact of BC was significantly associated with higher emotional distress and impaired Physical and Psychological QoL, but was unrelated to PTG. Hierarchical regression analyses showed that PTG moderated these relationships, acting as a stress‐buffering mechanism. Among women who perceived BC as having a more negative impact on their lives, higher levels of PTG buffered this negative perceived impact on Psychological and Social QoL (ppConclusions: Results provide support for the stress‐buffering role of PTG. Finding positive changes in cancer experience seems to protect women from the effects of a negative perception of the impact of BC on adjustment. Psychosocial intervention programs should facilitate PTG in order to promote women's adjustment. Copyright © 2011 John Wiley & Sons, Ltd.