Does change in positive affect mediate and/or moderate the impact of symptom distress on psychological adjustment after cancer diagnosis? A prospective analysis

Abstract

Physical symptom distress is one of the commonest correlates of psychological adjustment in cancer patients. Positive affect (PA) can be a dynamic resource for patients to cope with the cancer-related physical demands. The present study examined whether differential patterns of change in PA were associated with anxiety and depressed mood, and whether PA modified the association between change in symptom distress and psychological distress in 215 Chinese people newly diagnosed with colorectal cancer (CRC). Participants completed measures of physical symptoms, PA, and anxiety and depression at diagnosis and again at 3-month follow-up. Multivariate analyses of covariance revealed that at follow-up, people reporting higher anxiety and depressed mood demonstrated loss in PA, whereas those reporting lower depressed mood demonstrated a gain in PA. Structural equation modelling revealed that change in PA significantly mediated and moderated the associations between increased symptom distress and anxiety and depressed mood. We conclude that in line with Hobfoll's conservation of resources theory, continuous physical symptom distress depletes PA of newly diagnosed cancer patients, resulting in higher levels of anxiety and depressed mood. Effectiveness of symptom management intervention could be enhanced by preserving or enhancing PA in patients.

Perceived Control Mediates the Prospective Impact of Relationship Quality in the Year After Colorectal Cancer Diagnosis

“…One of our previous studies developed a psychometric instrument for assessing multiple dimensions of relationship quality that are significantly associated with psychosocial functioning of Chinese CRC patients, namely Family Intimacy-empathy and closeness through day-to-day emotions and activities, and secure attachment to family at critical times; Family Commitment-determination to maintain satisfying and enjoyable family relationships; and Friendships-positive relationships and interactions with friends [27]. We have also reported the adaptation process in these people [28][29][30][31]. Apart from perceiving a sense of personal control over cancer-related problems, Chinese CRC patients also reported a separate sense of control, i.e., collective control in collaboration with close social partners.…”

“…A study of Chinese women with gynecologic cancers has demonstrated a link between social relationships and satisfaction with life; however, a small sample size (n=62) and the use of non-validated measure to assess satisfaction with life (i.e., a single item) limit generalizability and conclusiveness of the findings [68]. Our previous study has reported that change in positive affect mediates the negative impact of physical symptom distress on Chinese CRC patients [30]. This study extends previous studies by using an adequate sample of Chinese patients (n=234), one of the largest samples in psycho-oncology research with Chinese.…”

“…Both personal and collective control were associated with psychological distress and well-being, but only the later was associated with social support and relationships, suggesting a socially oriented adjustment pathway in these people [28]. In addition, the positive impact of perceived control is likely to be significant during remission or treatment [28,30,31], as our qualitative findings have shown a shift toward reliance on personal effort and collaborations with close social partners to field cancer-related demands concurrent with a gradual distancing from medical care among these people [29]. Based on the Social-Cognitive Processing Model, the transactional model of coping, and our previous works, we predicted that perceived personal and collective control over cancer-related problems reported at 3-month follow-up would demonstrate a significant mediational effect on the association between social relationship quality reported shortly after diagnosis and psychological distress and well-being reported at 12-month follow-up among Chinese CRC patients.…”

Sentidos do cuidado: a perspectiva de cuidadores de homens com câncer

“…Estudos apontam que o diagnóstico de câncer provoca uma ruptura na vida da pessoa adoecida (Hou, Law & Fu, 2010 …”

Psycho-oncological intervention in haematopoietic progenitor cell transplant (HPT): Effects of emotional impact

“…The main purpose of any psychological intervention in patients diagnosed with cancer is to aid toleration of the diagnosis and treatment, decreasing the feelings of defencelessness and abandonment, reducing the anxiety related to the treatments, and clarifying any erroneous information and perceptions (Dempster, McCorry, Brennan, Donnelly, Murray & Johnston, 2011;Dobkin & Costa, 2000;Hou, Law & Fu, 2010;Novoa, Vargas, Obispo, Petrus & Rivera, 2010;Pinquart & Fröhlich, 2009) 32, 33, 34, 35, 36) . According to Bárez, et al (2003) 37) , the strategies that are carried out in this type of situation are related to emotional support, in terms of the patient feeling that they are being listened to, understood, encouraged and well cared for, to educational-informational support, which favours the necessary level of information to be able to handle the whole process, and to instrumental support, where the patients are provided with different economic and material resources or with home assistance.…”