Aim To investigate the mediation/moderation effect between Coping Behaviors (CBs) and Sense of Coherence (SOC) in the prediction of health‐related quality of life (HRQoL) in breast cancer patients. Design Cross‐sectional. Methods A total of 221 patients were included in this study. The 13‐item Orientation to Life Questionnaire, Brief COPE and Functional Assessment of Cancer Therapy—Breast were investigated. Pearson's correlation coefficient and mediation/moderation analysis were performed. Results Significant correlations were observed for SOC, active coping, acceptance, positive reframing (PR), planning, use of emotional support (UES), use of instrumental support, behaviour disengagement and self‐blame with HRQoL. Except for planning and acceptance, SOC partially mediated the CBs' effect on HRQoL. The UES and PR's effects on HRQoL were significant at lower SOC levels and diminished at higher SOC levels. Conclusion Practitioners can incorporate SOC and adaptive CBs, including PR and UES, into the rehabilitation programmes to improve HRQoL in patients.
Background COVID-19 related stigma has been identified as a critical issue since the beginning of the pandemic. We developed a valid and reliable questionnaire to measure COVID-19 related enacted stigma, inflicted by the non-infected general population. We applied the questionnaire to measure COVID-19 related enacted stigma among Tehran citizens from 27 to 30 September 2020. Methods A preliminary questionnaire with 18 items was developed. The total score ranged from 18 to 54; a higher score indicated a higher level of COVID-19 related stigma. An expert panel assessed the face and content validity. Of 1637 randomly recruited Tehran citizens without a history of COVID-19 infection, 1064 participants consented and were interviewed by trained interviewers by phone. Results Item content validity index (I-CVI), Item content validity ratio (I-CVR), and Item face validity index (I-FVI) were higher than 0.78 for all 18 items. The content and face validity were established with a scale content validity index (S-CVI) of 0.90 and a scale face validity index (S-CVI) of 93.9%, respectively. Internal consistency of the questionnaire with 18 items was confirmed with Cronbach’s alpha of 0.625. Exploratory factor analysis revealed five latent variables, including “blaming”, “social discrimination”, “dishonor label”, “interpersonal contact”, and “retribution and requital attitude”. The median of the stigma score was 24 [25th percentile: 22, 75the percentile: 28]. A large majority (86.8%) of participants reported a low level of stigma with a score below 31. None of the participants showed a high level of stigma with a score above 43. We found that the higher the educational level the lower the participant’s stigma score. Conclusion We found a low level of stigmatizing thoughts and behavior among the non-infected general population in Tehran, which may be due to the social desirability effect, to the widespread nature of COVID-19, or to the adaptation to sociocultural diversity of the large city.
Objective: New coronavirus (COVID-19) pandemic socioeconomically affected the world. In this study, we measured the perceived stress in response to the COVID-19 pandemic among Iranians to determine the groups at both extremes of the spectrum followed by identifying the stressors and coping mechanisms. Methods: This study was a mixed-methods study. We distributed a web-based 10-item perceived stress scale (PSS-10), to measure perceived stress score (PSS), through social networks from March 12 to 23, 2020. Then, we interviewed 42 students, 31 homemakers, 27 healthcare providers, and 21 male participants to identify the sources of stress and coping mechanisms. Results: Finally, 13,454 participants completed the questionnaires. The median and interquartile range (IQR) of the participants’ PSS was 21 (15-25). Students, homemakers, and healthcare workers (HCWs) showed a higher median (IQR) of PSS compared to other groups (23 [18 to 27], 22 [16 to 26], and 19 [14 to 24], respectively). Male participants showed a lower median (IQR) PSS (17 [12 to 23]). Content analysis of 121 participants’ answers showed that the most common stressors were school-related issues mentioned by students, family-related issues mentioned by homemakers, and COVID-19-related issues mentioned by healthcare providers. Male participants’ coping mechanisms were mostly related to the perception of their abilities to cope with the current crisis. Conclusion: Our participants clinically showed a moderate level of PSS. The main stressors among students, homemakers, and HCWs were related to their principal role in this period, and male participants’ coping mechanisms were inspired by the self-image retrieved from the social perspectives.
Hemangioma is one of the most common benign congenital complications of the human body which can arise in interior organs and external limbs. The main aim of this work is to present a new method for automatic detection of liver hemangioma and its boundaries in ultrasound images, using image processing techniques. Overall there are two phases, the preprocessing procedure and the boundary delineation phase. The preprocessing phase includes three main stages: 1. Image contrast enhancement using Difference of Offset Gaussian (DoOG) method, 2. Applying Canny edge filtering, 3. Applying an adaptive threshold in order to detect the ROI (hemangioma). Following, the snake algorithm is used to segment the hemangioma region in the second phase. For the quantitative assessment of the proposed method for the segmentation stage, the results derived via the proposed algorithms have been compared with the corresponding segmented regions determined by an expert using three similarity criteria. The results showed 73 percent similarity without pre-processing and 90 percent similarity with pre-processing.
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