Social barriers to emotional expression and their relations to distress in male and female cancer patients

Zakowski, Sandra G.; Harris, Casey A.; Krueger, Nancy; Laubmeier, Kimberly K.; Garrett, Susan; Flanigan, Robert C.; Johnson, Peter C.

doi:10.1348/135910703322370851

Cited by 101 publications

(92 citation statements)

References 20 publications

(30 reference statements)

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“…This has been studied before among women with cancer (Collins et al, 2004;Serin et al, 2005). concluded that fatigue and anxiety were the most frequent problems for breast and gynaecological cancer patients, and those problems made housework more difficult (Zakowski et al, 2003). There were no reports of emotional distress being a work-related difficulty among workers and only two reports of it being the reason for current unemployment among nonworkers.…”

Section: Discussionmentioning

confidence: 99%

Employment status and work-related difficulties in stomach cancer survivors compared with the general population

Lee

Bae

et al. 2008

Br J Cancer

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Little was known about work situation and work-related difficulties, including housework after stomach cancer diagnosis. We aimed to compare employment status and work-related difficulties between stomach cancer survivors and the general population. We enrolled 408 stomach cancer survivors from two hospitals 28 months after diagnosis and 994 representative volunteers from the general population from 15 geographic districts. Working was defined as being employed (including self-employed) and nonworking as being retired or a homemaker. Nonworking was significantly higher among stomach cancer survivors (46.6%) than in the general population (36.5%). Compared with the general population, the survivors had more fatigue in performing both housework (adjusted odds ratio (aOR) ¼ 2.08; 95% confidence interval (95% CI) ¼ 1.01 -4.29) and gainful work (aOR ¼ 4.02; 2.55 -6.33). More cancer survivors had reduced working hours (aOR ¼ 1.42; 95% CI ¼ 4.60 -28.35) and reduced work-related ability (aOR ¼ 6.11; 95% CI ¼ 3.64 -10.27) than did the general population. The association of nonworking with older age and being female was significantly more positive for survivors than for the general population. Among survivors, poorer Eastern Cooperation Oncology Group Performance Status and receiving total gastrectomy were positively associated with nonworking. Stomach cancer survivors experienced more difficulties in both housework and gainful employment than did the general population. Our findings on stomach cancer survivors' work-related difficulties and the predictors of nonworking will help physicians guide patients towards more realistic postsurgical employment plans.

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Section: Discussionmentioning

confidence: 99%

Employment status and work-related difficulties in stomach cancer survivors compared with the general population

Lee

Bae

et al. 2008

Br J Cancer

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“…These speculations are supported by recent data suggesting that individuals with poorer interpersonal relationships tend to react to PCa diagnosis and treatment with more self-blame 40 and greater distress when seeking support from others. 41 In terms of the impact of interpersonal sensitivity on the efficacy of the CBSM intervention, one recent study demonstrated that certain negative baseline indicators traditionally associated with interpersonal problems (i.e., low self-esteem and depression) were predictive of larger treatment gains in a psychoeducational intervention for men recovering from localized PCa. 42 Further, we have previously demonstrated that interpersonal sensitivity is related to poorer sexual function (r = −.28), deficits in perceived partner support (r = −.37) and poorer doctorpatient communication (r = −.27).…”

Section: Present Studymentioning

confidence: 99%

Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: The role of interpersonal sensitivity

Molton

Siegel²,

Penedo

et al. 2008

Journal of Psychosomatic Research

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Objective-Treatment for localized carcinoma of the prostate (PCa) is frequently associated with decrements in sexual functioning and satisfaction. Given the highly interpersonal nature of these decrements, interpersonal problems (such as interpersonal sensitivity) may affect recovery of sexual functioning after PCa treatment by interfering with physician and partner communication and through distorted cognitions surrounding sexual dysfunction. The objective of the present study was to determine the effect of interpersonal sensitivity on several treatment indicators, including response to a group based psychosocial intervention.Methods-Participants were 101 older men recovering from radical prostatectomy and were enrolled in a randomized controlled trial of a 10-wk group-based cognitive behavioral stress management (CBSM) intervention. Measures included the Inventory of Interpersonal Problems (IIP) and the Sexual Functioning subscale of the UCLA quality of life measure.Results-At baseline, interpersonal sensitivity was related to a belief linking sexual dysfunction to core male identity (r = .29, p < .05). Using hierarchical regression, we found that (a) the CBSM intervention was effective in promoting sexual recovery in all participants and that (b) this effect was moderated by interpersonal sensitivity, such that individuals with higher levels of interpersonal sensitivity made larger improvements in sexual functioning in response to CBSM.Conclusions-CBSM was effective for improving sexual function after radical prostatectomy. Individuals with higher levels of interpersonal sensitivity were more likely to perceive sexual dysfunction as a threat to masculine identity and made larger gains in the CBSM intervention. Results and relevance to the older male cancer patient are discussed from the perspective of interpersonal theory.

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“…It is possible that patients hold this belief because they think that their significant others might not be able to cope with their concerns (Zhang & Siminoff, 2003), for example, because in some cases spouses or family members have had avoidant reactions when cancer patients have tried to express their concerns about their disease at home (Manne et al, 1999;Zakowski et al, 2003;Zhang & Siminoff, 2003). Other studies (e.g., Clayton, Butow, & Tattersall, 2005) suggest that spouses and family members do prefer openness about patients' concerns during medical consultations so that the patient can receive adequate information to address his or her concerns.…”

Section: Discussionmentioning

confidence: 99%

“…However, research shows that patients' intention to express concerns might not be optimal (Street, 2001). Therefore, the focus of this study is on explaining intention.Past studies have indicated that, in line with the IMBP, attitudes (e.g., Okuyama et al, 2008), perceived social norm (e.g., Zakowski et al, 2003), and self-efficacy (e.g., Street, 2001) play a role in patients' concern expression; thus, it can be expected that these determinants are also related to patients' intention to express concerns. Therefore, the objective of this study is to examine whether cancer patients' attitudes, perceived social norm, and self-efficacy to express concerns are positively related to their intention to express concerns during a consultation.…”

mentioning

confidence: 98%

“…A few studies on concern expression have examined the determinants of intention from the IMBP individually (e.g., Manne, Alfieri, Taylor, & Dougherty, 1999; Okuyama et al, 2008;Zakowski et al, 2003). However, to our knowledge, no studies have assessed attitude, perceived social norm, and self-efficacy together to examine which of these are most strongly related to patients' intention to express concerns and are therefore potential candidates for intervention targets.…”

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confidence: 99%

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Unraveling the Determinants of Cancer Patients’ Intention to Express Concerns

Brandes

Linn

Smit

et al. 2016

Journal of Health Communication

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Little is known about the behavioral determinants that underlie cancer patients' intention to express concerns during a consultation. This information can be relevant to developing effective interventions for cancer patients. In this study, the integrative model of behavioral prediction (IMBP) is used as a framework to unravel the determinants of patients' intention to express concerns. The objectives of this study are to examine which of the IMBP determinants (attitude, perceived social norm, and=or self-efficacy) are significantly related to intention and what content of these determinants can be targeted to effect a change in patients' intention. An online survey based on the IMBP determinants was distributed. A total of 236 cancer patients and cancer survivors participated. The results of the survey showed that patients' attitudes and perceived social norm were the most important determinants of their intention to express concerns. The largest change in patients' intention might be achieved by targeting the affective attitude, referring to the extent to which patients believe that expressing concerns is (un)pleasant, and the social norm, referring to the extent to which patients feel (un)supported by significant others in expressing concerns.A life-threatening disease such as cancer can evoke many concerns in patients (Farrell, Heaven, Beaver, & Maguire, 2005). A concern is defined as ''a clear and an unambiguous expression of an unpleasant current or recent emotion where the emotion is explicitly verbalized ('I am worried', 'I am upset')'' (Zimmermann et al., 2011, p. 144). Concerns that are experienced by patients include medical concerns (e.g., patients are worried about the possible side effects of their treatment), psychosocial concerns (e.g., patients are anxious that they might not survive cancer), and practical concerns (e.g., patients are concerned about whether they can keep their jobs; Chaturvedi, Shenoy, Prasad, Senthilnathan, & Premlatha, 1996;Hill, Amir, Muers, Connolly, & Round, 2003).Studies have indicated that many cancer patients do not express these concerns sufficiently. For example, patients often express their concerns indirectly with cues (i.e., unclear verbal or nonverbal hints of experienced concerns) rather than directly (Grimsbø, Ruland, & Finset, 2012;Heyn, Ruland, & Finset, 2012). Health care providers often do not notice those cues and indicate that they better detect concerns when these concerns are expressed explicitly (Butow et al., 2008). When concerns are explicitly verbalized by patients, it is easier for health care providers to respond adequately. Receiving adequate information to address concerns has been associated with positive outcomes for patients, such as better psychological well-being (de Haes & Bensing, 2009;Street, Makoul, Arora, & Epstein, 2009). In contrast, when patients do not explicitly express concerns, and these concerns remain undetected, they can worsen and possibly lead to depression (Chochinov, 2001;Ryan et al., 2005). Thus, it is important to suppor...

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Social barriers to emotional expression and their relations to distress in male and female cancer patients

Abstract: Men may be more vulnerable to social barriers to expression than previously assumed. Gender differences in emotional expressivity may be less important than the social context in which expression takes place.

Cited by 101 publications

References 20 publications

Employment status and work-related difficulties in stomach cancer survivors compared with the general population

Employment status and work-related difficulties in stomach cancer survivors compared with the general population

Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: The role of interpersonal sensitivity

Unraveling the Determinants of Cancer Patients’ Intention to Express Concerns

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