Chemotherapy-induced cognitive impairment in breast cancer survivors: A systematic review of studies from 2000 to 2021.

BACKGROUND: Studies have indicated that apart from enhancing patient survival, chemotherapy has adverse side effects on the psychological, social, and cognitive functions of breast cancer survivors. AIMS: This study was conducted to understand chemotherapy's impact on breast cancer survivors' cognitive functions. METHODS AND RESULTS: Our study is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched English databases, including PubMed/MEDLINE, PsycINFO, and Web of Science, and Persian databases, such as Irandoc and Elmnet, using Persian keywords of cancer, breast cancer, chemotherapy, cognitive functions, executive functions, and neuropsychological functions. Two reviewers independently evaluated the full text of the articles according to predefined criteria. Among the 937 available studies, 26 were selected based on the inclusion and exclusion criteria, of which 17 (65%) were longitudinal and 9 (35%) were cross-sectional. The findings indicated a significant relationship between the use of chemotherapy and cognitive impairments, most notably attention, working and short-term memory, and executive functions. However, the studies differed in their findings regarding the long-term persistence of cancer-related cognitive impairment (CRCI), which could be due to the wide range of tools used, different methods to measure cognitive functions, and the difference in the sample size of the studies. CONCLUSION: Chemotherapy, affecting cortical and subcortical brain structures, causes a set of cognitive impairments that can lead to impairments in social responsibility acceptance, daily functioning, and quality of life of women. Therefore, rigorous and extensive research design is required to understand the causes and consequences of CRCI using standardized and sensitive measures of cognitive functions. Specifically, studies comparing the effects of different chemotherapy regimens on cognition and potential mechanisms and/or moderators of CRCI would be instrumental in designing more effective therapy regimens and evaluating the efficacy and cost-effectiveness of cognitive rehabilitation and supportive care programs.

Conceptualization of Breast Cancer and Attitudes toward Breast Cancer Screening: A Qualitative Study on Iranian and Australian Women.

OBJECTIVE: Regular screening can lead to early diagnosis of breast cancer. Australia is one of the countries with a high rate of participation in breast cancer screening, while in Iran, most patients are diagnosed in advanced stages. This qualitative study used a thematic analysis method to examine the attitudes and beliefs of Iranian and Australian women toward breast cancer and breast cancer screening. METHOD: In-depth interviews were conducted with eight Iranian and seven Australian women. Data were collected through semi-structured interviews and analyzed using thematic analysis with an inferential approach. RESULTS: According to the results, four main themes were extracted for the perceptions of breast cancer, including "the meaning of breast cancer", "causes of breast cancer", "prevention of breast cancer" and "effects of significant people in life". Considering the perceptions of breast cancer screening, three themes were identified, including "beliefs about breast cancer screening," "sources of information about breast cancer screening," and "barriers to breast cancer screening." CONCLUSION: Cultural and social factors influence women's perceptions of breast cancer and screening. Therefore, investigating the cultural meaning of breast cancer and breast cancer screening for women can be useful for screening and prevention purposes.

A Qualitative Exploration of Body Image from the Perspective of Adolescents with a Focus on Psychological Aspects: Findings from Iran.

The current study employs a qualitative approach to uncover the perceptions of Iranian adolescents regarding their bodies, with a focus on the psychological components that contribute to their body image perceptions. Data collection conducted using 13 semi-structured focus group discussions with 42 girls and 42 boys (15-18 years). All focus group discussions were audio recorded and transcribed verbatim. Data analysis was done manually using constant comparative analysis according to the Strauss and Corbin analysis method. Based on the participants' statements, four main themes and related categories emerged from data: (1) Beliefs including uncontrollable body, biased opinion of those around, priority of health, spiritual/religious beliefs and affecting future success, (2) Body-evaluation including direct body evaluation and indirect body evaluation, (3) Feelings and emotions including disgust and hatred, frustration, sadness, shame, envy, fear, approval and satisfaction and (4) Behaviors including lifestyle modifications, beautifying and using make up, extreme dieting, physical inactivity, avoidance behaviors, passive behaviors, aggressive behaviors and social isolation. Findings of the current study provide further information regarding cognitive, emotional and behavioral aspects of body image from the perspectives of adolescents in a West-Asian region.

I didn't want to remember memories of caring, but I can't help it": A qualitative study of the experiences of bereaved Iranian carers with elevated levels of prolonged grief symptoms.

The lived experience of caring for people with cancer and the influence of culture on Iranian carers who have elevated levels of prolonged grief symptoms after the death has received little in-depth attention. Bereaved carers (N = 17) were interviewed. All showed high levels of prolonged grief symptoms. Thematic analysis resulted in four overarching themes: unfamiliarity with cancer, high involvement in carer's role, lack of processing events, and emptiness. The way that carers of cancer patients understand and cope with their caring role and their dominant cultural context can make their grieving process complex.

Development and validation of the body image scale for youth (BISY).

BACKGROUND: Body dissatisfaction has been known as an important public health concern that can influence the physical and psycho-social health of adolescents. Hence, health professionals need a valid and reliable tool to assess this problem and its related factors in youth. This study aims to develop and assess the psychometric properties of an indigenous scale for the evaluation of body image and to investigate its association with body weight status among Iranian adolescents. METHODS: This study was conducted on 857 adolescents who completed the body image scale for Youth (BISY) and self-reported their body weight and height. Face, content, and construct validity methods were used to assess the validity of the BISY. Exploratory factor analysis (EFA) was used to assess construct validity. Moreover, the internal consistency of the scale was assessed by calculating Cronbach's alpha coefficient (α), and test-retest reliability was examined using the intra-class correlation coefficient (ICC). To compare the BISY scores across sex and body weight status groups, the Independent samples t-test and the analysis of variance (ANOVA) or Welch tests were used, respectively. RESULTS: Mean age and body mass index (BMI) of participants were 16.5 ± 1.1 years and 22.4 ± 4.5 kg/m2, respectively. The EFA showed a 10-factor construct which explained 57% of the variance. The Cronbach's alpha coefficient for overall items of the scale was 0.896 and ranged from 0.42 to 0.92 for subscales. The test-retest reliability result was acceptable for the BISY (ICC = 0.805). The ICC values ranged from 0.753 to 0.990 for BISY subscales. The BISY total score was significantly higher in girls compared to boys (34.8 ± 12.7 vs. 31.3 ± 10.2; p < 0.001). In girls, the BISY total score was significantly lower in normal-weight girls compared to their overweight (p = 0.009), and obese (p = 0.012) counterparts. This difference was not observed in boys. CONCLUSION: These findings support the reliability and validity of the BISY for the assessment of body image in Iranian adolescents; this scale can be applied as an appropriate tool for the assessment of body image in adolescents in related future studies. Current findings highlight considering body image as an important aspect of intervention programs targeting overweight and obesity in adolescents, specifically girls. Negative body image has been known as an important public health concern that can adversely influence different aspects of adolescents' health. Hence, a valid and reliable tool is necessary to identify adolescents at risk of developing negative body image and its related disorders. There is a lack of an indigenous scale that can comprehensively assess body image and its related factors in Iranian adolescents; hence, the current study aimed to develop and assess the psychometric properties of an indigenous scale for evaluation of body image and further investigate the association between body image and body weight status among Iranian adolescents. The current findings support the reliability and validity of the BISY. In addition, more negative body images were observed in girls compared to boys and in overweight/obese girls compared to their normal-weight counterparts. Therefore, promoting a healthy body image should be incorporated as an important component of future health promotion programs to address obesity, eating disorders, and other health-related concerns among adolescents, specifically girls.

Network Associations Among Body Image, Lifestyle, Body Mass Index, and Quality of Life in Adolescents.

Background: Body image is known as an important factor affecting different aspects of adolescents' health; however, its relationship with lifestyle, body mass index (BMI), and health-related quality of life (HRQoL) in Iranian adolescents has not been addressed in a conceptual model. Objectives: This study aimed to investigate the network associations among body image, lifestyle, BMI, and HRQoL in adolescent boys and girls. Methods: The present study examined 760 adolescents (15 - 18 years) from Tehran. Adolescents reported their weight and height, according to which the participants' BMIs were calculated. The adolescents' body image, lifestyle, and HRQoL were assessed using a set of questionnaires, including the Body Image Scale for Youth (BISY), Modifiable Activity Questionnaire (MAQ), Eating Habits Checklist, Eating Attitudes Test (EAT-26), and Pediatric Quality of Life Inventory (PedsQLTM). Results: The participants' mean age and BMI were 16.5 ± 1.0 years and 22.4 ± 4.6 kg/m2, respectively. More than one-third of boys (39.9%) and less than a quarter of girls (22.6%) were overweight/obese. In the final model, body image was significantly and directly associated with physical activity, disordered eating, eating habits, and HRQoL in both genders (P < 0.05). Moreover, body image was directly correlated with screen time in boys (P = 0.012) and BMI in girls (P = 0.001). Body image was indirectly correlated with BMI by the mediating role of disordered eating in girls. Moreover, body image was indirectly associated with HRQoL by the mediating role of physical activity and eating habits in both genders and screen time only in boys. Conclusions: The network associations among body image, lifestyle, BMI, and HRQoL revealed a gender-specific pattern among the study population. Body image was a significant determinant of lifestyle and HRQoL in both genders and excessive weight in girls. The present findings would contribute to designing and implementing relevant health promotion interventions.

Purposes of internet use among Iranian university students: exploring its relationship with social networking site (SNS) addiction.

BACKGROUND: Higher education students are heavy users of the internet for a wide variety of reasons, including Social Networking Sites (SNSs). This study investigated various purposes of internet use among undergraduate university students, and how different categories of such activities are related to SNS addiction. METHODS: The sample set from 420 SNS users (280 females), a survey questionnaire was used to collect the information, including demographic information, purposes for internet usage (social, entertainment, academic, and economic purposes), and SNS addiction. Descriptive statistics, correlation, and a path diagram to estimate the regression coefficients were used to examine the data. RESULTS: Findings revealed that the most common purposes for using the internet were online social networking and information seeking, followed by listening to music or watching movies, learning, relaxing, using email for educational needs, and reading socio-political news. In the comparison between categories of purposes for internet usage, the most prevalent group of purposes were academic and informative, recreational, social, and economic categories respectively. Moreover, the most significant influences belonged to the social group [positively], the academic and informative group (negatively), and the recreational group (positively) on SNS addiction respectively. The economic group of purposes did not have a significant influence on SNS addiction. CONCLUSION: This study has important implications for education and health providers, particularly in universities; we recommend that they try to improve students' mental health and academic performance by providing opportunities for them to improve their IT literacy and skills.

Psychometric Properties of the Persian Internet Addiction Test-Social Networking Sites Version: Dimensionality Assessment of Social Networking Site Addiction.

BACKGROUND: By evaluating the psychometric properties of the Persian version of the Internet Addiction Test-Social Networking Sites version (IAT-SNS) in a sample of Iranian university students, this study investigated the dimensionality of SNS addiction for the first time. METHODS: A total of 620 SNS users (414 women) participated in the study. The study questionnaire comprised demographic information, SNS usage patterns, the IAT-SNS, and the Bergen Social Media Addiction Scale (BSMAS). FINDINGS: Exploratory factor analysis (EFA) identified the 3-factor structure of the IAT-SNS, namely 'Lack of Control', 'Emotional and Relational Conflict', and 'Preference for online relationships' that explained 54% of the total variance. Confirmatory factor analysis (CFA) verified the current model. Problematic users on average exhibited higher scores on the whole IAT-SNS and each of the 3 factors as compared to non-problematic users. The IAT-SNS and its factors showed good internal consistency, and strong convergent and concurrent validity. CONCLUSION: The Persian version of the IAT-SNS is valid and reliable, and is applicable for measuring the 3 dimensions of SNS addiction among students.

Symbols of Hope on Pediatric Oncology Ward: Children's Perspective Using Photovoice.

Background Hope nurtures confidence and enhances positivity. It is known to be a critical factor in illness, recovery and healing. This study aimed to identify the views of hospitalized children with cancer about the circumstances and factors that create hope for them in the oncology ward. Methods: This qualitative study explored children's experiences using Photovoice, which is an arts-based approach. Twenty children aged 6-12 years diagnosed with various cancers at a Pediatric Hospital in Tehran, Iran, participated in this study. Participants were requested to take photographs of objects, circumstances, or anything that gave them hope or represented a sign of hope in the oncology ward. The photographs were then used to facilitate face-to-face interviews with these children. Data were analyzed using thematic analysis. Results: Data analysis revealed six main themes: emotional connectedness with nursing staff; the playroom as a means to soften the hospital space; the presence of a parent; symbols of recovery; a touch of nature in the hospital setting; and escaping the hospital cage. Discussion: Hopefulness among children can emanate from diverse events and circumstances within the hospital environment. Nurses and physicians need an understanding of children's perspectives to design interventions to improve hopefulness among hospitalized children with cancer.

The main physical components of body image from the perspectives of Iranian adolescents: a qualitative study.

BACKGROUND: Although different aspects of body image have been extensively studied in Western societies, there is little evidence regarding the main physical components that contribute to perceptions of body image from the perspective of adolescents, especially in Eastern-Mediterranean regions. This study aims to investigate main physical components of body image from the perspectives of Iranian boys and girls. METHODS: This qualitative study has been conducted using a grounded theory approach. The focus of the current study was on identifying the main physical characteristics of body image as perceived by participants. A total of 13 semi-structured focus group discussions were conducted with 84 adolescents (42 girls and 42 boys), aged 15-18 years. All focus group discussions were audio recorded and transcribed verbatim. Data collection continued until saturation was reached. RESULTS: The mean age and BMI of participants were 16.2±0.9 years and 24.3±8.0 kg/m2 respectively. Regarding main physical components of body image, three main themes emerged from the data: 1) perceived face/hair, which included three subthemes-facial features, facial shape/form and hair, 2) perceived body, which included three subthemes-body size, body shape and bone structure and 3) perceived physical functioning which included three subthemes-physical ability, physical health and voice tone. Among mentioned themes, perceived body was the concept which was most frequently addressed by both adolescent boys and girls. Additionally, in terms of the other remaining two themes, when adolescents were talking about their bodies, girls more frequently mentioned their faces and its features, while boys tended to talk more about their physical functioning. CONCLUSION: This qualitative study provide further insight into the physical components of body image as perceived by Iranian boys and girls. Current findings indicated that besides those features that focused on body appearance and its aesthetic aspects, physical functioning was another main component of perceived body image by participants. These findings can contribute to the design and implementation of effective interventions aiming at improving body image and its related disorders in Iranian adolescents.

The mediating role of social skills and sensation seeking in the relationship between trait emotional intelligence and school adjustment in adolescents.

Drawing upon a sample of 400 female high school students in Tehran, Iran, the present study examines the mediating role of social skills and sensation seeking in the relationship between trait emotional intelligence and school adjustment in adolescent girls. Statistical analysis revealed positive correlations between trait emotional intelligence and school adjustment; trait emotional intelligence and social skills; and social skills and school adjustment. The study also revealed a negative correlation between trait emotional intelligence and sensation seeking, as well as sensation seeking and school adjustment. In addition, the data provided a good fit to the hypothesized model of the mediating role of social skills and sensation seeking in the relationship between trait emotional intelligence and school adjustment.

Application of the Information-Motivation and Behavioral Skills (IMB) model in risky sexual behaviors amongst male students.

As AIDS is not merely a hygienic problem but a disease that creates a great deal of economic, cultural, and social problems, it is necessary for most of the state and nongovernmental organizations and individuals to participate in both controlling AIDS and preventing it. As no effective vaccine or therapy for this disease exists currently, the only method for avoiding being afflicted by this disease is prevention. The present study aims to examine the Information-Motivation and Behavioral Skills (IMB) model in risky sexual behaviors. For this purpose, a group of 151 male students was sampled using a multistage random sampling method to complete the quality of HIV information questionnaire, national AIDS questionnaire, international AIDS questionnaire and global positive attitude to AIDS questionnaire. The results show that there is a significant relationship between the perception of HIV infection risk and sexual behavior. Thus, the perception of risk is considered the first step toward modifying sexual behaviors from risk-taking behaviors to safer behaviors.

An information-motivation-behavioral skills (IMB) model-based intervention for CABG patients.

BACKGROUND: In order to benefit from a coronary artery bypass graft (CABG) surgery, patients must adhere to medical recommendations and health advices. Despite the importance of adherence in CABG patients, adherence rates are disappointingly low. Despite the low adherence rates, very few articles regarding adherence-enhancing intervention among heart patients have been published. PURPOSE: The goal of this study was to assess the effects of the Information-Motivation-Behavioral Skills (IMB) model-based intervention on the IMB model constructs among patients undergoing CABG and to evaluate the relationship of information, motivation, and behavioral skills with adherence. METHOD: A total of 152 CABG patients were randomly assigned to either an intervention group or to a standard care control group. Participants completed pretest measures and were reassessed 1 month later. RESULTS: Findings showed mixed support for the effectiveness of the intervention. There was a significant effect of IMB intervention on information and motivation of patients, but no significant effect on behavioral skills. Furthermore, the results revealed that intervention constructs (information, motivation, and behavioral skills) were significantly related to patients' adherence. CONCLUSIONS: Findings provided initial evidence for the effectiveness of IMB-based interventions on the IMB constructs and supported the importance of these constructs to improve adherence; however, there are additional factors that need to be identified in order to improve behavioral skills more effectively.

Personality and chronic fatigue syndrome: The role of the five-factor model.

The aim of this study was to examine the relationships between personality factors and the symptomatology of fatigue among people with chronic fatigue syndrome (CFS), and compare them to people from the general population. Seventy-seven CFS patients (47 women, 30 men) were compared with 72 healthy individuals (44 women, 28 men) to investigate whether personality factors are related to the symptomatology of fatigue. All participants were asked to complete the NEO Five Factor Inventory (NEO-FFI), the Modified Fatigue Impact Scale (MFIS), the Fatigue Severity Scale (FSC), and the Mental Health Inventory (MHI). The results revealed that the CFS group reported higher levels of neuroticism and conscientiousness than the control group. These two personality factors were significantly related to fatigue symptoms, impact, and severity in both groups. These findings suggest that personality factors of neuroticism and conscientiousness may play an important role in the development and perpetuation of fatigue symptoms.

The effectiveness of the information-motivation-behavioral skills model in promoting adherence in CABG patients.

This study tested the efficacy of the Information-Motivation-Behavioral (IMB) skills model-based intervention to promote adherence among patients undergoing Coronary Artery Bypass Grafting (CABG) surgery, and evaluated the relationship of psychological variables with adherence. A total of 152 CABG patients were randomly assigned to either an intervention group or to a standard care control group. Participants completed pretest measures and were reassessed one and three months later. Findings revealed that the intervention group was significantly more adherent, which showed support for the effectiveness of the IMB-based intervention. Furthermore, psychological factors played an important role in patient adherence.