Resilience is an important issue for adult cancer care. Researchers must carefully define a conceptual framework for developing nursing interventions aimed at furthering resilience in adult cancer care.

ObjectivePsychological distress remains a major challenge in cancer care. The complexity of psychological symptoms in cancer patients requires multifaceted symptom management tailored to individual patient characteristics and active patient involvement. We assessed the relationship between resilience, psychological distress and physical activity in cancer patients to elucidate potential moderators of the identified relationships.MethodA cross-sectional observational study to assess the prevalence of symptoms and supportive care needs of oncology patients undergoing chemotherapy, radiotherapy or chemo-radiation therapy in a tertiary oncology service. Resilience was assessed using the 10-item Connor-Davidson Resilience Scale (CD-RISC 10), social support was evaluated using the 12-item Multidimensional Scale of Perceived Social Support (MSPSS) and both psychological distress and activity level were measured using corresponding subscales of the Rotterdam Symptom Checklist (RSCL). Socio-demographic and medical data were extracted from patient medical records. Correlation analyses were performed and structural equation modeling was employed to assess the associations between resilience, psychological distress and activity level as well as selected socio-demographic variables.ResultsData from 343 patients were included in the analysis. Our revised model demonstrated an acceptable fit to the data (χ2(163) = 313.76, p = .000, comparative fit index (CFI) = .942, Tucker-Lewis index (TLI) = .923, root mean square error of approximation (RMSEA) = .053, 90% CI [.044.062]). Resilience was negatively associated with psychological distress (β = -.59), and positively associated with activity level (β = .20). The relationship between resilience and psychological distress was moderated by age (β = -0.33) but not social support (β = .10, p = .12).ConclusionCancer patients with higher resilience, particularly older patients, experience lower psychological distress. Patients with higher resilience are physically more active. Evaluating levels of resilience in cancer patients then tailoring targeted interventions to facilitate resilience may help improve the effectiveness of psychological symptom management interventions.

PurposeThere is increasing evidence that disease and therapy-related symptoms frequently co-occur in so-called symptom clusters (SCs), which may significantly impair quality of life in patients with cancer. Although psychosocial resources may play pivotal roles in maintaining or improving quality of life, they have been neglected in SC research. Therefore, we aim to identify SCs and their relative impact on quality of life when psychosocial resources are accounted for.MethodsPatients with cancer (n = 304) undergoing chemotherapy or chemo-radiation therapy participated in a cross-sectional survey consisting of measures assessing symptoms, quality of life, resilience, treatment-specific optimism (TSO), and social support. Exploratory factor analyses and multiple regression analyses were used to identify SCs and significant explanatory variables of overall quality of life.ResultsFatigue-pain, anxiety-depression, cancer therapy-related toxicity, and nausea-vomiting clusters were identified. In our final model, the fatigue-pain cluster (β = − 0.41, p < 0.001), nausea-vomiting cluster (β = − 0.28, p < 0.001), TSO (β = 0.21, p < 0.001), and receiving chemo-radiation treatment (β = − 0.11, p = 0.03) accounted for 44% of variance in overall quality of life. However, the identified SCs explained quality of life in patients with varying levels of TSO to a different extent.ConclusionsOur findings indicate that the TSO of patients may be a major factor to consider in managing SCs, because—depending on its level—different SCs and even clusters encompassing comparatively less distressing symptoms (i.e., cancer therapy-related toxicities) may strongly affect quality of life.

Caring for their chronically ill or disabled family members is a responsibility that may be assumed by children and adolescents ("young carers") and may affect young carers' lives in many ways. Some young carers may experience long-term adverse health effects related to their early caring responsibilities and others may demonstrate healthy adaptation. Little research applying nonretrospective designs, however, has been done from the perspective of young carers regarding the psychosocial resources that enable them to handle the responsibility of caring for chronically ill or disabled family members. The aim of the present study, therefore, was to identify psychosocial resources used by young carers in Austria. Ten children and adolescents (aged 9-17) took photographs to illustrate their everyday lives. The photographs were then used to guide subsequent interviews. Data were analyzed following the principles of directed qualitative content analysis and using the theoretical lens of resilience. We identified two sets of psychosocial resources: (1) Personal resources comprising (a) being able to spend leisure time and (b) finding distraction from sorrows and problems. (2) Interpersonal resources comprising (a) fostering meaningful friendships, (b) receiving support from the family, and (c) bonding with the ill or disabled family member. Young carers largely have the same repertoire of resources as other children and can use them specifically to respond to the care burden. Interventions to support young carers must focus on promoting peer contact and cohesion within the nuclear family as well as bonding with the ill or disabled relative. K E Y W O R D S photo novella, psychosocial adaptation, psychosocial resources, resilience, young caregivers, young carers 1 | INTRODUCTION AND BACKGROUND Worldwide, children and adolescents under the age of 18 years regularly look after chronically ill or disabled family members (Leu & Becker, 2017). These care providers are referred to as "young carers," "young caregivers," or "children who are next of kin." They provide care, assistance, or support to another family member, often on a regular basis. The person receiving care may be a parent, sibling, grandparent, or any relative with a disability, chronic illness, mental health problem, or condition requiring care,

Zusammenfassung:Hintergrund: Personalisierte Krebstherapien in Form einer Epidermal Growth Factor Receptor-Antikörpertherapie (EGFR-Antikörpertherapie) haben sich bei bestimmten soliden und metastasierten Tumoren als Therapieoption etabliert. Toxische Hautreaktionen zählen zum charakteristischen Nebenwirkungsspektrum dieser Therapien. Ziel: Erfassung des Ausmaßes, in welchem therapieinduzierte Hautreaktionen auf die Lebensqualität von onkologischen PatientInnen im Rahmen einer EGFR-Antikörpertherapie Einfluss nehmen, sowie die Erhebung des individuell wahrgenommenen Unterstützungsbedarfs der PatientInnen. Methode: Embedded Design mit quantitativem Schwerpunkt (Fragebogenerhebung, n = 32) und Auswertung ergänzender qualitativer Daten (Interviews, n = 5). Ergebnisse: Physische Manifestationen der Hautreaktionen (etwa Hautirritationen und Juckreiz) schränken die Lebensqualität der PatientInnen am stärksten ein, während damit verbundene emotionale und funktionelle Beeinträchtigungen deutlich seltener angegeben werden. Hautreaktionen werden von den PatientInnen nicht als prioritäre und stark belastende Problematik angesehen, sondern vielmehr als ein Teilaspekt der Gesamtsymptombelastung. Dennoch zeigen sich deutliche Zusammenhänge zwischen den Auswirkungen der Hautreaktionen auf die Lebensqualität und insbesondere dem allgemeinen physischen und psychologischen Unterstützungsbedarf. Schlussfolgerungen: Die Auswirkungen von toxischen Hautreaktionen auf die Lebensqualität der PatientInnen sind begrenzt, sie bedürfen dennoch gezielter, unterstützender, in das allgemeine Symptommanagement integrierter Interventionen. Schlüsselwörter: Hautreaktionen, Unterstützungsbedarf, EGFR-Antikörpertherapie, Krebs Skin toxicities and unmet supportive care needs of patients with cancer undergoing EGFR-inhibitor therapy Abstract:Background: Targeted therapies, such as the EGFR (epidermal growth factor receptor) inhibitor therapy, are being used to treat patients with various solid and metastatic tumours. Skin toxicities are a common side effect of this therapy. Aim: The aim of this study was to assess the effects of skin toxicities on quality of life of patients with cancer undergoing EGFR inhibitor therapy, as well as their unmet supportive care needs. Method: Embedded design. A standardised quantitative survey was administered and analysed. In addition, memos and audiotaped material of insightful conversations with the patients after survey administration were included in the analyses. Results: Among the three domains of the effects of skin toxicities on quality of life, physical symptoms (e. g. itching skin, rash) were most frequently reported to impair quality of life, while associated emotional and functional impairments were less frequently reported. Patients don't consider the management of skin toxicities to be a priority during their treatment, skin toxicities are rather perceived in context of the total symptom burden. Yet, we observed significant correlations between the assessed quality of life and unmet supportive care need...