Phyllis H. Y. Lo

The Influence of Culture on Couples Coping with Breast Cancer: A Comparative Analysis of Couples from China, India, and the United States

This study examines the process of dyadic coping among couples who are managing stress related to a partners breast cancer diagnosis and identifies cultural factors that affect how couples cope together. Utilizing a qualitative method based on relational psychologies, the “Listening Guide,” the authors analyzed the narratives of 28 couples who where coping with early-stage breast cancer and lived in Hong Kong-China, India, and the United States. Analysis revealed four cultural factors influencing the process of coping with breast cancer. These factors included (1) family boundaries, (2) gender roles, (3) personal control, and (4) interdependence. Some couples were able to transcend prevailing cultural norms to re-establish balance in their lives and adapt to the cancer. Implications for using couple-based interventions with cancer patients in differing cultural contexts are discussed.

Tai-Chi for Residential Patients with Schizophrenia on Movement Coordination, Negative Symptoms, and Functioning: A Pilot Randomized Controlled Trial

Objective. Patients with schizophrenia residing at institutions often suffer from negative symptoms, motor, and functional impairments more severe than their noninstitutionalized counterparts. Tai-chi emphasizes body relaxation, alertness, and movement coordination with benefits to balance, focus, and stress relief. This pilot study explored the efficacy of Tai-chi on movement coordination, negative symptoms, and functioning disabilities towards schizophrenia. Methods. A randomized waitlist control design was adopted, where participants were randomized to receive either the 6-week Tai-chi program and standard residential care or only the latter. 30 Chinese patients with schizophrenia were recruited from a rehabilitation residency. All were assessed on movement coordination, negative symptoms, and functional disabilities at baseline, following intervention and 6 weeks after intervention. Results. Tai-chi buffered from deteriorations in movement coordination and interpersonal functioning, the latter with sustained effectiveness 6 weeks after the class was ended. Controls showed marked deteriorations in those areas. The Tai-chi group also experienced fewer disruptions to life activities at the 6-week maintenance. There was no significant improvement in negative symptoms after Tai-chi. Conclusions. This study demonstrated encouraging benefits of Tai-chi in preventing deteriorations in movement coordination and interpersonal functioning for residential patients with schizophrenia. The ease of implementation facilitates promotion at institutional psychiatric services.

Association of Fatigue with Perceived Stress in Chinese Women with Early Stage Breast Cancer Awaiting Adjuvant Radiotherapy

Cancer-related fatigue (CRF) is common in women with breast cancer, but little is known of its relationship with perceived stress. We conducted a cross-sectional study to explore the associations of CRF with perceived stress, anxiety, depression, pain and sleep quality in 133 Chinese women (aged 25-68 years) with early stage breast cancer. The majority of women had completed surgery and chemotherapy and were awaiting radiotherapy. Self-administered questionnaires consisting of the Brief Fatigue Inventory, Perceived Stress Scale-10, Hospital Anxiety and Depression Scale, Brief Pain Inventory, and Pittsburgh Sleep Quality Index were used to collect data. Forty-five per cent of the women were severely fatigued. Compared with local healthy women and US breast cancer patients, the groups mean perceived stress score was significantly higher (both p < 0.01). Higher perceived stress (β = 0.18, p = 0.032), higher anxiety (β = 0.30, p < 0.001) and higher pain severity (β = 0.38, p < 0.001) were associated with increased severity of CRF. The association of CRF with perceived stress was partially mediated by anxiety, suggesting a possible pathway from cancer and cancer treatment to CRF via stress appraisals and emotional distress. The findings indicate the importance of monitoring the psychological status of patients during treatment.

A Good Time to Dance? A Mixed-Methods Approach of the Effects of Dance Movement Therapy for Breast Cancer Patients During and After Radiotherapy.

Background: Dance movement therapy (DMT) is premised on an interconnected body and mind. It has known benefits for cancer patients’ physical and psychological health and quality of life. Objective: To offer greater insight into a previous randomized controlled trial, the present study qualitatively explored the beneficial elements of DMT over the course of radiotherapy. To better understand the uniqueness of DMT intervention for patients receiving radiotherapy, the study statistically compared them with patients who received DMT after treatment completion. Methods: Participants were randomized into radiotherapy and postradiotherapy control groups. The radiotherapy group received DMT (6 sessions at 90 minutes each) as they were undergoing radiotherapy. The postradiotherapy group was provided with the same DMT intervention at 1 to 2 months after completing radiotherapy. Results: One hundred and four participants identified 5 main benefit categories. Dance movement therapy helped them (1) cope with cancer, treatment, and physical symptoms; (2) improve mental well-being, attention, and appreciation for the self and body; (3) improve total functioning; (4) bridge back to a normal and better life; and (5) participate in shared positive experiences. The radiotherapy group reported categories 1 and 2 more prominently than did the postradiotherapy group. Conclusions: The findings reinforced the benefits of DMT while adding the new perspective that delivering DMT intervention throughout cancer treatment can have different and even additional benefits for patients. Implications for Practice: The pleasure of dancing and the psychological and physical relief from DMT help patients cope with daily radiation treatments. This could decrease treatment dropout rates when administered in clinical settings.

A Strength-Based Arts and Play Support Program for Young Survivors in Post-Quake China: Effects on Self-Efficacy, Peer Support, and Anxiety:

A year after the earthquake in Sichuan, China, a strength-based arts and play support program was launched to promote the well-being of young survivors, and this study was designed to examine its effectiveness. It was hypothesized that participation in the program would have direct positive effects on general self-efficacy and peer support, and that these would mediate the effect of the program on anxiety. One hundred twelve Grade 4 students joined the study, the measures of which included the General Self-Efficacy Scale, the Classmate Support Scale, and the Generalized Anxiety subscale in the Spence Children’s Anxiety Scale. The results showed that participation in the program was associated with increased general self-efficacy and peer support, which lowered anxiety, although the relationship was not statistically significant. This study has provided insights for the development of a culturally sound arts and play program for young disaster victims in China.

Holistic interventions to trauma management for teachers following disaster: expressive arts and integrated body-mind-spirit approaches

Schools are often an entry point for offering psychosocial interventions to communities following disasters. However, teachers often lack skills to facilitate classroom activities that can address post-traumatic symptoms. Further, they are not trained in mental health and they themselves have been traumatised. A solution is to provide teachers with an intervention protocol to be used in the typical classroom. As an alternative to traditional counselling, holistic interventions can alleviate traumatic symptoms, while promoting personal wellness and community development. A method for offering both expressive arts and integrated body-mind-spirit approaches is offered with reference to the 2008 Wenchuan earthquake in China.