Changes over time in self-efficacy to cope with cancer and well-being in women with breast cancer: a cross-cultural study.

OBJECTIVE: This study aimed to examine whether self-efficacy to cope with cancer changes over time in patients with breast cancer and whether these potential changes are similar across patients. It also aimed to examine whether these trajectories are related to patient psychological well-being and overall quality of life. METHODS: Participants (N = 404) from four countries (i.e. Finland, Israel, Italy, and Portugal) were enrolled in the study few weeks after breast surgery or biopsy. Self-efficacy to cope with cancer was assessed at baseline, six and 12 months later. Well-being indices were assessed at baseline, 12 and 18 months later. RESULTS: Using Latent Class Growth Analysis, two groups of patients were identified. The majority of patients reported high levels of self-efficacy to cope, which increased over time. For almost 15% of the patients, however, self-efficacy declined over time. Diminishing levels of self-efficacy to cope predicted worse levels of well-being. The pattern of self-efficacy changes and their relationships to well-being was consistent across countries. CONCLUSION: Monitoring self-efficacy to cope with cancer is probably important in order to detect alarming changes in its levels, as a declining self-efficacy to cope may serve as a signal of the need for intervention to prevent adaptation difficulties.

The Interplay Between Trait Resilience and Coping Self-efficacy in Patients with Breast Cancer: An International Study.

The role of self-efficacy to cope with breast cancer as a mediator and/or moderator in the relationship of trait resilience to quality of life and psychological symptoms was examined in this study. Data from the BOUNCE Project ( https://www.bounce-project.eu/ ) were used. Women diagnosed with and in treatment for breast cancer (N = 484), from four countries, participated in the study. Trait resilience and coping self-efficacy were assessed at baseline (soon after the beginning of systemic treatment), and outcomes (quality of life, psychological symptoms) 3 months later. Hierarchical regression, mediation, moderation, and conditional (moderated) mediation and moderation analyses were performed to examine the study hypotheses. Coping self-efficacy mediated the impact of trait resilience. In addition, higher levels of resilience in combination with higher levels of coping self-efficacy were associated with better outcomes. Country of origin had no impact on these results. Overall, it seems that coping self-efficacy is a key factor that should be taken into account for research and intervention efforts in cancer.

The mutual determination of self-efficacy to cope with cancer and cancer-related coping over time: a prospective study in women with breast cancer.

OBJECTIVE: The aim of this study was to examine the longitudinal impact of self-efficacy to cope with cancer on the cancer-related coping reactions of breast cancer patients and vice versa. DESIGN AND MAIN OUTCOMES MEASURES: Data from the BOUNCE Project (https://www.bounce-project.eu/) were used to address the hypotheses. Participants (N = 403) were enrolled in the study a few weeks after surgery or biopsy. Coping self-efficacy was assessed at baseline and six months later (M6). Cancer-related coping was assessed three (M3) and nine months (M9) after baseline. The analyses were performed using structural equation modeling with Mplus 8.6. RESULTS: Baseline coping self-efficacy predicted all M3 coping reactions, while M6 coping self-efficacy also predicted changes in all but one M9 coping reaction. Moreover, one of the M3 coping reactions, that is, hopelessness/helplessness, predicted the changes in M6 coping self-efficacy. The relation between coping self-efficacy and one coping reaction (i.e. cognitive avoidance) was rather weak. Stability paths from M3 to M9 coping reactions were moderate to high. CONCLUSION: The relationship between self-efficacy to cope with cancer and cancer-related coping is complex. New theoretical models are needed to more accurately describe the diverse aspects of this association.

Familiarity breeds discontent: senior hospital doctors' attitudes towards complementary/alternative medicine.

UNLABELLED: Studies have shown that many general medical practitioners refer their patients to complementary/alternative medicine (CAM) practitioners and believe in the therapeutic benefit of these modalities. However, there is less information concerning the beliefs and practices of senior hospital doctors. OBJECTIVES: In view of the increasing institutionalization of CAM and moves to incorporate CAM into secondary and tertiary healthcare settings, the objective of this study is to understand the attitudes and practices of senior hospital doctors, a sector whose members are often responsible for formulating and implementing institutional policy. DESIGN AND SETTING: A questionnaire was administered to 294 directors of hospital departments and their deputies on their attitudes and practices concerning CAM. Response rate was 70%. Almost all general hospitals in Israel participated in the study. RESULTS: The findings show, in general, that while senior hospital physicians in Israel hold positive attitudes towards CAM, they are not well disposed towards co-operation with CAM practitioners. Incorporating a CAM clinic into the hospital site does not seem to enhance clinical co-operation between conventional physicians and CAM practitioners. In hospitals that had functioning CAM clinics, doctors were consistently and significantly more opposed to co-operation with CAM than in hospitals without CAM clinics.

Self-efficacy and social support as mediators in the relation between disease severity and quality of life in patients with epilepsy.

PURPOSE: This study examined the influence of two psychosocial variables mediating between disease severity and quality of life (QoL) in epilepsy; social support and mastery (measured by locus of control and self-efficacy). A model placing these two variables as mediators between disease severity and QoL was tested with structural equation modeling. METHODS: Eighty-nine patients with epilepsy (58% men, age 36+/-12 years) were given the following instruments: Liverpool Seizure Severity Scale, Interpersonal Support Evaluation List, Epileptic Self-Efficacy Scale, Locus of Control scale, and the World Health Organization's Quality of Life Questionnaire, the WHOQOL. RESULTS: Structural equation modeling showed good fit between the research model and the data (Bentler-Bonett Normalized Index of fit, 0.96; LISREL GFI, 0.95). Ninety percent of the variance of the WHOQOL was explained by a combination of disease severity, self-efficacy in epilepsy, social support, and locus of control. Mastery was found to mediate the correlation between disease severity and QoL, and social support was found to act as a mediator between disease severity and mastery. CONCLUSIONS: The study findings emphasize the possibility of improving QoL among patients with epilepsy by counseling and treatment aimed at reinforcing their self-efficacy and locus of control, as well as by improving their SoS.

Willingness of staff to report to their hospital duties following an unconventional missile attack: a state-wide survey.

Adequate staffing of hospitals during a prolonged, potentially unconventional war is a key component in the disaster plan of institutions. In an attempt to determine policy regarding hospital staffing, a state-wide survey was conducted in Israel among hospital personnel during the recent Persian Gulf war. This survey aimed to explore the willingness of staff to report to their duties (WTR) following an unconventional missile attack described in a hypothetical scenario. Of the 2,650 questionnaires distributed among all categories of staff in 10 hospitals (42%) across the country, 51% were returned. Overall, 42% of the responding staff were WTR under the presented scenario. However, WTR would increase to 86% if safety measures were provided. Males, personnel with headquarter duty of hospital site managers, and parents of children older than 14 years of age, were the most WTR. The finding of extensive interhospital variation in WTR indicates the need for evaluating WTR on an institutional basis when establishing both the hospital and the regional disaster plan. Data are presented on the extent of WTR, the factors inhibiting WTR, and possible measures to improve WTR.