Depression and anxiety are associated with a decline of health-related quality of life (QoL) in breast cancer patients, and the present study aims to investigate the longitudinal relationship of depression and anxiety with QoL in breast cancer patients. Depression and anxiety (HADS) as well as QoL (EORTC QLQ-C30) were assessed at baseline and six-month follow-up in 118 breast cancer patients and analysed using cross-lagged partial correlation analysis (CLPC). There were significant partial correlations between depression and anxiety at baseline and physical functioning, emotional functioning and "global health and QoL" at six-month follow-up (range of pr = -0.197 and -0.392; p < 0.05). "Global health and QoL" at baseline was significantly correlated with depression and anxiety at follow-up (pr = -0.207 and -0.327; p < 0.05). Cognitive functioning at baseline was significantly associated with anxiety at follow-up (pr = -0.248; p < 0.01). CLPC analysis of two models (depression and anxiety determining QoL vs. QoL determining depression and anxiety) did not show significant results. Hence, in breast cancer patients, depression and anxiety are closely related to QoL and the observed correlations suggest a complex interrelation in which depression and anxiety have to be regarded as indicators of QoL rather than determinants.
The rehabilitation of stroke survivors may be more successful if gender differences in caregivers' adaptation to their partners' mental changes are taken into consideration in intervention programs for families of stroke survivors. Men spousal caregivers may need counseling aimed at supporting their adjustment to stroke-related cognitive and emotional changes in their wives.
The aim of this study was to determine coping strategies which may represent important personal resources and have a buffering effect in preventing mental health problems in parents of children with Down syndrome. Forty-nine parents of children with Down syndrome completed self-administrated measures of psychological and physical health problems, and coping behaviour, using several established measuring instruments. According to the hierarchical regression analyses, parents who often used regenerative coping strategies, and who experienced positive personal changes in terms of posttraumatic growth suffered from less anxiety and somatisation symptoms, whereas dysfunctional coping was the best predictor for parental depression and physical symptoms. Regenerative coping mediated between parental tendency to recognize their emotional needs and somatisation symptoms. Intervention programs for families of children with Down syndrome may benefit if they address parents' reflection about their feelings, foster posttraumatic growth processes, and impart knowledge about long-term regenerative coping strategies.
Background: Breast cancer (BC) is generally assumed to have an impact on sexual function and activity. Although there are several studies addressing the issue, case control studies are currently limited. Methods: We performed a cross-sectional investigation of sexual function and activity utilizing the sexual activity questionnaire, the female sexual function index, and parts of the EORTC QLQ C30. Patients with breast cancer (BC) were compared with a control group (C) of non-cancer patients. Inclusion of BC was only allowed if treatment was completed ≥ 12 months previously and patients were disease-free. This study was approved by the ethical committee of the Landesärztekammer Hessen. All consecutive patients with breast cancer who were treated at our hospital were prospectively documented in a clinical tumor registry since 2001. All patients’ records are updated annually. The control sample without any oncologic disease of 392 age-matched females was recruited in the Department of Prosthodontics, University Hospital Mainz. Results: Between December 2009 and May 2010 the questionnaires were sent out to 790 women (398 x BC and 392 x C), 21.6% of which responded. Response rates in both groups were equivalent (84 patients with BC [21.2%] and 87 control subjects [22.2%]). Median age was 57 years (C) and 62 years (BC), respectively (p = 0.005). 51.5% (C) and 60% (BC) were not sexually active, mainly owing to lack of a partner (39%) or lack of interest (21%) in controls and lack of interest (48%, p<0.05), self-reported physical problems (34%, p<0.05), and physical problems of the partner (22%, p<0.05) in breast cancer patients. There were significant differences between both groups in the SAQ discomfort score (p<0.05). We did not observe significant differences in quality of life or other scores regarding sexuality. Conclusions: About half of the women in both groups were not sexually active. However, reasons for non-activity differ. Quality of sexuality tends to be impaired in BC patients, but this seems not to influence quality of life. A shift of priority caused by substantial anxiety regarding cancer specific survival might explain our findings. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-08-06.
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