Dalnim Cho

Cognitive and emotional aspects of fear of recurrence: predictors and relations with adjustment in young to middle‐aged cancer survivors

We investigated predictors of emotional (worry) and cognitive (perceived risk) dimensions of fear of recurrence (FOR) and their relationships with psychological well‐being in a sample of young and middle‐aged adult cancer survivors.

Emotional approach coping: Gender differences on psychological adjustment in young to middle-aged cancer survivors

Objective : The effect of emotional approach coping (EAC) varies by gender. However, this gender difference has not yet been investigated in cancer survivors. We investigated whether the effects of two kinds of EAC – emotional processing (EP) and emotional expression (EE) – vary by gender and whether EAC has effects above and beyond the effect of other coping strategies. Design : EAC and other coping strategies were assessed at baseline in a sample of 248 young to middle-aged adult (between the age of 22 and 55) cancer survivors. One hundred and sixty-six survivors responded to psychological adjustment one year later. Results : EAC had different relationships with Time 2 adjustment in men and women. Hierarchical regression analyses showed that for men, EE predicted lower intrusive thoughts and, for women, EP was associated with higher positive affect when other coping strategies and EE were controlled. Conclusion : Gender differences held true in cancer survivors, and EAC was effective when other coping strategies were controlled. Further, EE was effective in reducing negative adjustment in men while EP was helpful in promoting positive adjustment in women.

The impact of Yoga upon young adult cancer survivors

This study explored the use of Yoga by using a cross-sectional analysis of 286 young adult cancer survivors. The aim was to explore yoga practice, reasons for using this therapy; predictors of yoga use and any potential relationship between yoga use and well-being. Ninety one participants (32.82%) reported practicing yoga from their initial diagnosis. Practitioners reported a relatively high intensity (mean: 7.46 h/month) and length (25.88 months) of practice. The most common reasons given for undertaking yoga were to maintain flexibility and promote relaxation. Sociodemographic predictors of yoga use included gender, higher education with increased yoga use generally related to enhanced feelings of well-being. Results suggest that yoga use is more commonly used by cancer survivors with greater resources. Understanding more about the use of yoga by cancer survivors may facilitate the development and promotion of yoga-based interventions.

Assessing quality of life in young adult cancer survivors: development of the Survivorship-Related Quality of Life scale

AbstractPurposeScientific advances in treatments and outcomes for those diagnosed with cancer in late adolescence and early adulthood depend, in part, on the availability of adequate assessment tools to measure health-related quality of life (HRQOL) for survivors in this age group. Domains especially relevant to late adolescence and young adulthood (LAYA; e.g., education and career, committed romantic relationships, worldview formation) are typically overlooked in studies assessing the impact of cancer, usually more appropriate for middle-aged or older survivors. Current HRQOL measures also tend to assess issues that are salient during or shortly after treatment rather than reflecting life years after treatment.MethodsTo develop a new measure to better capture the experience of LAYA cancer survivors in longer-term survivorship (the LAYA Survivorship-Related Quality of Life measure, LAYA-SRQL), we completed an extensive measure development process. After a literature review and focus groups with LAYA cancer survivors, we generated items and ran confirmatory factor and reliability analyses using a sample of 292 LAYA cancer survivors. We then examined validity using existing measures of physical and mental health, quality of life, and impact of cancer.ResultsThe final model consisted of two domains (satisfaction and impact), each consisting of ten factors: existential/spirituality, coping, relationship, dependence, vitality, health care, education/career, fertility, intimacy/sexuality, and cognition/memory. Confirmatory factor analysis and validity analyses indicated that the LAYA-SRQL is a psychometrically sound instrument with good validity.ConclusionThe LAYA-SRQL fills an important need in survivorship research, providing a way to assess HRQOL in LAYAs in a developmentally informed way.

Cancer-related identities in people diagnosed during late adolescence and young adulthood

OBJECTIVES Identity labels with which people diagnosed with cancer identify may have important implications for post-cancer adjustment, yet little is known about these identities, and virtually nothing about them in people diagnosed during late adolescence and young adulthood (LAYA). We examined (1) the extent to which LAYA participants endorse different identities, (2) relations between identities and subsequent adjustment (positive/negative impact of cancer, quality of life, health behaviours), and (3) coping as mediating identity-adjustment links. DESIGN A longitudinal study in which 120 participants at Time 1 (T1) and 84 participants at Time 2 (T2; 1 year later) were assessed. METHODS Participants had been diagnosed between ages 15 and 39. Demographics, cancer-related variables, adjustment, and identities (victim/patient/someone who has had cancer/survivor/conqueror/member of the cancer community) were measured. RESULTS Late adolescence and young adulthoods with cancer identify with a variety of terms. At both time points, someone who has had cancer was the most highly endorsed identity. Survivor and member of the cancer community were also frequently chosen. Generally, T1 survivor, conqueror, and member of the cancer community identities were positively correlated with T2 adjustment, whereas victim and patient identities were negatively correlated with T2 adjustment. Both T1 member of the cancer community identity and T2 emotional expression coping independently and positively predicted T2 positive self-evaluation even when T1 positive self-evaluation was controlled. CONCLUSIONS Forming empowering identities (e.g., survivor) and emphasizing community identity (member of the cancer community) appear helpful to post-cancer adjustment. Future studies need to examine cancer-related identities and mechanisms explaining identity-adjustment links in this understudied group.

Moderating effects of perceived growth on the association between fear of cancer recurrence and health-related quality of life among adolescent and young adult cancer survivors

ABSTRACT We examined whether (1) fear of cancer recurrence was related to lower health-related quality of life and (2) perceived growth moderated the link between fear of recurrence and health-related quality of life. About 292 adolescent and young adult cancer survivors (diagnosed with cancer at ages 15–34) completed a cross-sectional survey. Fear of recurrence was related to poorer physical and mental health-related quality of life. The negative association between fear of recurrence and mental health-related quality of life was moderated by perceived growth. Fostering perceived growth may mitigate the adverse associations of fear of recurrence and health-related quality of life.

The association between fear of cancer recurrence and quality of life among Chinese cancer survivors: main effect hypothesis and buffering hypothesis

PurposeThe aim of the present study is to examine whether fear of cancer recurrence (FCR) is related to health-related quality of life (HRQOL) among Chinese cancer survivors, an understudied population (i.e., main effect hypothesis). Also, we investigated whether the FCR–HRQOL link is moderated by two coping strategies, avoidance and positive reappraisal (i.e., buffering hypothesis).MethodsThis is a cross-sectional study conducted among 238 Chinese cancer survivors in Beijing. Participants completed a set of questionnaires including FCR, coping, and HRQOL.ResultsFCR was related to lower physical, psychological, social, and spiritual well-beings, even when demographics, cancer-related factors, and coping were taken into account. There was only one moderation effect between FCR and avoidance coping. Surprisingly, the detrimental effect of FCR on spiritual well-being was lessened among those with high avoidance coping such that the negative association between FCR and spiritual well-being was only found in those with low avoidance coping and not among those with high avoidance coping.ConclusionsFindings largely supported the main effect hypothesis. FCR was associated with diverse domains of HRQOL among Chinese cancer survivors. The buffering hypothesis was largely not supported in this population. Rather, in some cases, the effects of FCR and coping strategies on HRQOL were independent. Thus, ways to attenuate the harmful effects of FCR on HRQOL among Chinese cancer survivors remain unresolved. It is urgent and timely that future studies focus on FCR and HRQOL in this population.

Assessing Disruptions in Meaning: Development of the Global Meaning Violation Scale

Models of meaning making following stressful events are based on the notion that individuals’ appraisals of events (i.e., their situational meaning) can violate their goals and beliefs (i.e., global meaning), and that resulting discrepancies between situational meaning and global meaning negatively affect their psychological adjustment. To date, research has relied primarily on indirect measures of meaning violation. We describe the development of a new instrument, the Global Meaning Violation Scale (GMVS), for directly assessing belief and goal violations. We establish the psychometric integrity of the GMVS across three studies. In Study 1, we identify and replicate a factor structure consisting of three subscales: belief violation, intrinsic goal violation, and extrinsic goal violation. In Study 2, we provide evidence for the reliability and validity of the GMVS. In Study 3, we test the predictive validity of the GMVS in a sample of undergraduates reporting on the most stressful experiences of their lives. Our findings indicate that the GMVS is a reliable and valid tool for directly examining global meaning violation. We anticipate that the GMVS will advance research on stress, trauma, and coping by giving researchers a tool to directly explore the role of violations in meaning making processes.

Interplay Between Self-Efficacy and Perceived Availability at Home and in the School Neighborhood on Adolescents’ Fruit and Vegetable Intake and Energy-Dense, Low-Nutrient Food and Sugary Drink Consumption

Objective: The current study aimed to examine the interplay between self‐efficacy and perceived availabilities of fruits and vegetables (F&V) and energy‐dense, low‐nutrient foods and sugary drinks (EDLNF&SD) at home and in the school neighborhoods on adolescents’ eating behaviors. Design: The Family Life, Activity, Sun, Health, and Eating study, a cross‐sectional, Internet‐based survey was analyzed. Participants: Adolescent–parent dyads (n = 1,657). Interventions: Self‐efficacy for F&V intake and limiting EDLNF&SD consumption, perceived F&V and EDLNF&SD availabilities at home and in the school neighborhood, and F&V intake and EDLNF&SD consumption. Analysis: Multiple regression analyses. Results: Adolescents’ self‐efficacy and perceived home and school neighborhood availability of F&V and EDLNF&SD had significant main effects on their F&V intake and EDLNF&SD consumption, respectively (all P < .01). The positive effect of self‐efficacy on F&V intake was greater when home F&V availability was high (+1 SD; b = .29; P < .001) than when it was low (–1 SD; b = .07; P = .040). The effect of home F&V availability on F&V intake was significant when F&V were not available in the school neighborhood (b = .09; P = .006). Conclusions and Implications: Given the central role of home availability, it may be considered a fundamental unit of nutrition intervention for adolescents. Multiple contexts (eg, individual, home, school neighborhood) need to be considered to promote adolescents’ eating behaviors.