Dreams following trauma have been suggested to aid emotional adaptation, yet trauma‐related nightmares are a diagnostic symptom of Posttraumatic Stress Disorder (PTSD). There is little published data relating dreams to PTSD soon after trauma. We assessed dreams and PTSD in 60 injured patients after life‐threatening events and obtained follow‐up assessments in 39 of these participants 6 weeks later. Ten of 21 dream reports from morning diaries were rated and described as similar to the recent traumatic event. The participants reporting these distressing “trauma dreams” had more severe concurrent PTSD symptoms than those reporting other categories of dreams and had more severe initial and follow‐up PTSD than those without dream recall. These findings along with our preliminary longitudinal observations relating changes in dream patterns to outcome, suggest a relationship of dream characteristics and early adaptive versus maladaptive patterns of processing traumatic memory.
Background: Cognitive behavioral therapy (CBT) has been widely used in pediatric cancer patients to promote psychological adjustment (PA). Considering the diversity of region and culture in China, its effect in Chinese population is not well defined. Therefore, our study is to explore the effect of CBT on improving PA in Chinese pediatric cancer patients receiving chemotherapy. Methods: One hundred four Chinese pediatric cancer patients receiving chemotherapy were divided into CBT group and control group randomly and equally. The resilience and negative mood were applied to evaluate the ability of psychological adjustment (PA). The Conner-Davidson Resilience Scale (CD-RISC) and depression anxiety stress scale (DASS) were employed to measure resilience and negative mood before and after intervention. The SPSS 22.0 software was used to analyze data. Results: Prior to the intervention, the ability of psychological adjustment between 2 groups showed no significant difference ( P > .05 for all). After intervention, the total CD-RISC score was significantly higher (56.09 ± 7.29 vs 44.75 ± 5.40), whereas the scores of depression (4.57 ± 2.94 vs 7.25 ± 4.25), anxiety (5.83 ± 3.07 vs 8.66 ± 4.92), stress (7.51 ± 4.33 vs 11.17 ± 4.25) were obviously lower in CBT group than those in the control group ( P < .05 for all). Moreover, the decline of negative mood score in Yolk sac tumor children was the most evident in CBT group. While the resilience changes of cancer children in stage III was most obvious. Conclusions: CBT can effectively help Chinese pediatric cancer patients modify distorted cognition to have a positive attitude towards cancer and chemotherapy. This treatment enhances resilience and relieves negative mood, which results in good psychological adjustment ability, especially in Yolk sac tumor and stage III. It has a beneficial effect on better treatment cooperation and high long-term quality of life.
Using Gordon's Functional Health Pattern Model, the current cross-sectional study aimed to survey physical and psychosocial responses to the coronavirus disease 2019 (COVID-19) pandemic among Chinese frontline nurses and to identify the most vulnerable groups for future reference and interventions. A self-administered online questionnaire was used to collect demographic data and stress reactions of 115 Chinese frontline nurses. The 52-item version of Gordon's Functional Health Questionnaire was used to evaluate physical, psychological, and social effects of the COVID-19 pandemic among participants. The most prevalent problems were reported in the psychological aspect, where respondents referred to altered self-image due to constant use of masks (87.8%), excessive attention to clinical signs of COVID-19 (59.2%), depression (54%), forgetfulness (40.9%), and anxiety (39.1%). The most vulnerable nurses were those who were younger, had a chronic disease, and were divorced. [ Journal of Psychosocial Nursing and Mental Health Services, 59 (9), 30–37.]
Background: Obesity has been associated with worse pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) and overall outcome in breast cancer patients (pts). Our aim was to retrospectively evaluate body mass index (BMI) as a predictive factor of pCR to NACT in pts treated at our institution, taking into account tumor HER2 status and CT dose adjustment. Pts and methods: Pts with invasive breast cancer who received NACT followed by surgery at Vall d'Hebron University Hospital from January 2004 to December 2008 were analyzed. Pts were categorized as normal/underweight (BMI < 25 kg/m2), overweight (BMI of 25 to < 30 kg/m2), and obese (BMI ≥30 kg/m2). The overweight and obese groups were combined (BMI-high) and then compared with the normal/underweight group. Univariate and multivariate analyses were performed to assess the association between BMI and pCR (no invasive tumor in breast and nodes). Results: 256 consecutive pts were included. Median age was 52.5 years. According to BMI, 38.7% were normal/underweight and 59.4% were BMI-high. 23.4% of the pts had HER2 positive tumors (n=60), 84% received anthracyclines-and taxanes-based CT, and 46.6% of the HER2 positive pts were treated with trastuzumab. Drug dose was reduced in only five pts with a body surface area > 2m2. No statistically significant association was found between BMI and any tumor characteristics. In the univariate analysis, BMI-high was associated with worse pCR in the whole population (p=0.017), as well as in HER2 positive pts (p=0.013). In the multivariate analysis, BMI did not significantly predict pCR in the total population, although a trend was observed (p=0.098). In the HER2 positive subgroup, however, BMI was an independent predictive factor of pCR (p=0.001). Among luminal A [estrogen receptor positive and/or progesterone receptor positive and (Ki67 < 20% and histological grade 1 or 2)], luminal B [estrogen receptor positive and/or progesterone receptor positive and (Ki67 ≥20% or histological grade 3)], and triple negative tumors, BMI was not a predictive factor of pCR. Conclusions: Our results suggest that higher BMI is likely associated with worse pCR, particularly in HER2 positive pts. A better understanding of the molecular links between obesity and breast cancer is necessary to identify new predictive factors of pCR to NACT. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-03-04.
Fear of progression (FoP) is a prevalent psychological strain for cancer patients associated with poor quality of life and psychological morbidity. However, little evidence exists on FoP in children with cancer. Our study aimed to determine prevalence and correlates of FoP of cancer in children. From December 2018 to March 2019, cancer patients from Children’s Hospital in Chongqing, Southwest China, were recruited. A Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF) was adopted to assess children’ FoP. Descriptive statistics (percentages, median, and interquartile range), non-parametric tests, and multiple regression analyses were performed on these data. Prevalence of high-level FoP was 43.75% among these 102 children. Multiple regression analysis showed that reproductive system tumors (beta = 0.315, t = 3.235 95% CI [3.171, 13.334]), and level of psychological care needs (beta = −0.370, t = −3.793 95% CI [−5.396, −1.680]) were independent predictors of FoP. Regression model explained 27.10% of all included variables (adjusted R square = 27.10%). As with adults with cancer, children with cancer also have FoP. More attention should be paid to FoP in children with reproductive tumors and in children who need psychological support. More access to psychological support should be offered to reduce FoP and to improve their quality of life.
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