Gender differences in patient-perceived changes to the system of values after a cancer diagnosis.

OBJECTIVE: The objective of the presented study was to investigate gender differences in the changes of value systems after a cancer diagnosis. METHODS: In the study, we used the Polish adaptation of the Rokeach Value Survey and compared within-subject differences in the obtained results from before (retrospective) and after patients' cancer diagnosis. In the analysis, we used the Aranowska ω Coefficient of Choice and Single-Sample t-test statistics. RESULTS: Generally, after cancer diagnosis communal values gained, and agentic - lost importance regardless of patients' gender. However, we found statistically significant effects of gender in value system changes, namely agency values ("independent" and "intellectual") become less important for men than women, while the communal value "Mature love" was placed higher by men than women. CONCLUSION: The results of the study confirm our initial hypothesis about significant gender differences in the changes of the value system. PRACTICE IMPLICATIONS: Obtained knowledge can be used to better predict patient motivation and behavior in the face of oncological treatment. It is important that gender differences are considered in the process of cancer patients treatment. It can be beneficial for communication between a doctor and a patient and for counseling regarding coping with the disease.

Patient-perceived changes in the system of values after cancer diagnosis.

A cross-sectional study investigated changes in patients' value systems following a diagnosis of cancer. Fifty patients at 1 to 6 months following cancer diagnosis, were asked to compare their current values with their recollection of past values. Using the Rokeach Value Survey we obtained statistically significant results showing that twenty-seven out of thirty-six values changed their importance from the patients' perspective: 16 values significantly increased, while 11 values significantly decreased in importance. Changes with respect to nine values were insignificant. We indentified clusters of values increasing in importance the most: Religious morality (Salvation, Forgiving, Helpful, Clean), Personal orientation (Self-Respect, True Friendship, Happiness), Self-constriction (Self-Controlled, Obedient, Honest), Family security (Family Security, Responsible), and Delayed gratification (Wisdom, Inner Harmony). We also observed that the following value clusters decreased in importance: Immediate gratification (An Exciting Life, Pleasure, A Comfortable Life); Self-expansion (Capable, Ambitious, Broadminded), Competence (A Sense of Accomplishment, Imaginative, Intellectual). The remaining values belonged to clusters that as a group changed slightly or not at all. Practical implications of the study are discussed.

[Relationship of preoperative anxiety-state and anxiety-trait in patients qualified for coronary artery bypass graft surgery to the perception of postoperative pain and other pain complaints]. / Poziom leku-stanu i leku-cechy u pacjentów zakwalifikowanych do leczenia operacyjnego pomostowaniem aortalno-wiencowym a percepcja bólu rany pooperacyjnej i innych dolegliwosci bólowych.

INTRODUCTION: The study investigated relationships of postoperative pain following coronary artery bypass graft (CABG) surgery with two variables: (1) level of preoperative anxiety (anxiety-state) and (2) level of anxiety-trait. MATERIAL AND METHODS: Eighty three randomly selected male patients (44-66 years old), qualified for CABG surgery, participated in the study. All of them were patients at the Cardiosurgery Medical Centre of Pomeranian Medical University. It was a prospective clinical study. Anxiety-state and anxiety-trait were measured in the preoperative period using a Polish version of STAI. During the postoperative period the following factors of postoperative pain were measured, using a modified version of McGill Pain Questionnaire: average level of perceived postoperative pain, level of extreme pain, pain frequency, degree of pain regression following analgesia and number of other pain complaints. RESULTS: A significant relationship of the level of preoperative anxiety-state and anxiety-trait with the degree of pain regression within the postoperative wound following the administration of medication (analgesia efficiency) was found (p < 0.01 and 0.001, respectively). Additionally, a significant relationship was found between the level of anxiety-trait with the level of perceived extreme postoperative pain (p < 0.01) and with the number of other pain complaints (p < 0.1). CONCLUSIONS: This investigation confirmed that relationships of anxiety and pain reported in other research are true also for CABG patients. It has been also observed that patients with a high level of preoperative anxiety-state and stronger anxiety-trait respond worse to analgesic medication than patients with a low level of anxiety-state and anxiety-trait. Therefore, actions undertaken to reduce patients' anxiety may reduce patients' need of analgesic medications.

[Family environment risk factors of depression in adolescence]. / Rodzinne czynniki ryzyka rozwoju depresji u dorastajacych.

General psychosocial theories of developmental psychopathology assert that family environment plays a significant role in forming both adaptive and maladaptive functioning of children. Also virtually all theories of depression assert that faulty parent-child relationships play a major role in the aetiology of this disorder. According these theoretical formulations familial risk factors have been the focus of most research on depression in adolescence. Several studies have shown that insecure attachment and parenting characterized by coldness, rejection, harsh discipline and unsupportive behaviour is positively related to adolescent depressive symptoms. Some research indicates that authoritative parenting, conceptualized as a composite of warmth, accept-involvement, firm control, and democratic discipline, is associated with the least depressive symptoms among adolescents. Pathogenetic factors within the family environment, such as parental depression, changes of family structure, violence or neglect, can also contribute to depression in adolescence. A causal relationship between anomalous parenting and depression is probably the interplay among genetic, cognitive, emotional, interpersonal and family environmental factors.

[Current concepts of depression during adolescence]. / Wspólczesne koncepcje depresji okresu dorastania.

Until the 1960-ties, there was considerable debate on whether or not depression exists before adulthood. Next, there were popular concepts, which emphasized that depression during adolescence is "normal" for that particular stage of development. From 1980-ties, adolescent depression is seen as the same problem as with adults. The diagnosis of depression in adolescents is based on adult diagnostic criteria. Today, there is a more generally accepted standard that adolescence depression is essentially the same phenomenon as adult depression but with some development specific modifications. As compared with adults, adolescents with depression demonstrate a more variable course. The adolescent with depression may exhibit somatic complaints, school difficulties and deconcentration rather than depressed mood. Three conceptualizations of depressive phenomena during adolescence have been presented in the literature: (1) depressed mood alone, (2) depressive syndrome, and (3) depressive disorders. Compas, Ey and Grant have compared and integrated different approaches to a synthesis that reflected a comprehensive model of depressive phenomena during adolescence. Depressed mood, syndromes, and disorders are integrated as 3 levels of depressive phenomena in a hierarchical and sequential model.

Construction of knowledge of the disease by patients after carotid endarterectomy.

The aim of this work was to characterize the knowledge that patients have of their disease. A special questionnaire was distributed (in 1998) to 33 patients with ischemic cerebrovascular disease who underwent carotid endarterectomy (CEA) in 1995-1996. The results show that the knowledge of patients is fragmentary, hermetic, and static, at the same time serving as their basic perceptive-cognitive filter.