Profiles of Posttraumatic Growth and Posttraumatic Stress Symptoms in Childhood Cancer Survivors.

The experience of childhood cancer (CC) could be a traumatic event that produces long-term emotional responses such as posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) in survivors. The relationship between both PTSS and PTG is not clear in CC survivors. Assessing challenges to core beliefs and rumination could give information regarding the different paths that lead to traumatic responses. Thus, this study aims to identify childhood cancer survivors' profiles from PTSS and PTG measures and to examine the pathways of relationships between PTSS and PTG, rumination, and challenge to core belief. Sixty-two CC survivors completed surveys on their childhood cancer experience, PTSS, PTG, challenge to core beliefs, and rumination. High PTG scores among childhood cancer survivors (Cluster 1), High PTSS scores among childhood cancer survivors (Cluster 2), and Childhood cancer survivors without changes (Cluster 3). Network analysis found that the challenge to core beliefs is the central point in the relationship between the variables, in a direct and positive relationship with PTG. We found an indirect path from challenge to core beliefs to PTSS, mediated by intrusive and deliberative ruminations. The combined findings suggested that there are different profiles related to trauma in CC survivors and the relationship between PTSS and PTG is mediated by the challenge to core beliefs and deliberative and intrusive rumination.

Assessing the Relationship between PTSS in Childhood Cancer Survivors and Their Caregivers and Their Quality of Life.

Childhood cancer is a traumatic experience for survivors and their families. The experience of this disease affects survivors' and families' quality of life, even years after it occurs. The purpose of the present study was to assess if the caregivers' posttraumatic stress symptoms mediated the associations between survivors' posttraumatic stress symptoms and caregivers' quality of life, in a sample of 46 dyads of caregivers and childhood cancer survivors. Survivors and caregivers completed the PCL-5, and caregivers completed the WHOQOL-bref. Results showed that survivors' and caregivers' posttraumatic stress symptoms scores and caregivers' quality of life were associated. The caregivers' posttraumatic stress symptoms mediated the relationship between survivors' posttraumatic stress symptoms and caregivers' quality of life. Knowing posttraumatic stress symptoms direct and indirect effects on caregivers' quality of life contributes to understand their experience and to develop intervention strategies with this population.

La revelación del diagnóstico en oncología: una investigación transcultural Brasil-España / Cancer disclosure: a cross-cultural research Brazil-Spain

Objetivo: examinar aspectos transculturales de la revelación del diagnóstico de cáncer en pacientes brasileños y españoles. Método: Se realizó una investigación cualitativa en la que fueron entrevistados 28 pacientes en quimioterapia (14 brasileños y 14 españoles). El análisis de contenido identificó tres ejes temáticos: 1) Cómo fue revelado el diagnóstico; 2) Contexto en que el diagnóstico fue revelado y 3) Quién reveló el diagnóstico. Resultados: existen particularidades en la manera de revelar el diagnostico entre los dos países. En Brasil aún ocurre que el enfermo puede ser derivado a un oncólogo sin una explicación satisfactoria previa sobre su estado de salud. Aunque en los dos países existan relatos de comunicación de diagnóstico en el contexto apropiado (consulta), también ha aparecido revelación de manera informal (por teléfono) sin un ambiente adecuado para que el paciente sea acogido y tenga posibilidad de expresar sus miedos y sus dudas. Conclusión: es necesario invertir en la formación profesional para mejorar la habilidad de comunicación y educación en salud para tratar pacientes con cáncer (AU)

Objective: The aim of this study was to examine cross-cultural aspects of the disclosure of cancer diagnosis in Brazilian and Spanish patients. Method: A qualitative research was carried out in which 28 chemotherapy patients (14 Brazilian and 14 Spanish) were interviewed. Content analysis identified three thematic categories: 1) How the diagnosis was disclosured; 2) Context in which the diagnosis was disclosured; 3) Who disclosured the diagnosis. Results: Particularities in the diagnosis disclosure between the two countries was found. In Brazil, it still happens that patient can be referred to an oncologist without a satisfactory explanation about his health status. Although there are reports of diagnosis disclosure in the appropriate context (consultation), also there are reports informal disclosure (by telephone), without an adequate environment for the patient to be welcomed and able to express their fears and doubts. Conclusion: It is necessary to improve the professional training to improve communication skills and health education to treat cancer patients (AU)

Personality traits and clinical/biochemical course in the first year after kidney transplant.

BACKGROUND: The relationship between personality and health is frequently studied in scientific research. This study investigated the clinical/biochemical course of kidney transplant patients based on personality traits. METHODS: A longitudinal study assessed 114 kidney transplant patients (men = 68 and women = 46) with an average age of 47.72 years (SD = 11.4). Personality was evaluated using the Brazilian Factorial Personality Inventory (BFP/Big Five Model). Clinical variables were analyzed based on patient charts (estimated glomerular filtration rate (eGFR), hypertension, acute rejection, infection, graft loss, and death). Personality types were assessed by hierarchical cluster analysis. RESULTS: Two groups with personality types were differentiated by psychological characteristics: Cluster 1 - average neuroticism, high surgency, agreeableness and conscientiousness, and low openness; Cluster 2 - high neuroticism, average surgency and agreeableness, average conscientiousness, and low openness. There was no statistically significant difference between the clusters in terms of hypertension, acute infection, graft loss, death, and Human Leukocyte Antigen (HLA) I and II panel reactive antibodies. eGFR was associated with the personality types. Cluster 2 was associated with a better renal function in the 9-month follow-up period after kidney transplantation. CONCLUSION: In this study, patients from Cluster 2 exhibited higher eGFR 9 months after the transplant procedure compared to those from Cluster 1. Monitoring these patients over a longer period may provide a better understanding of the relationship between personality traits and clinical course during the post-transplant period.

The influence of clinical variables on the psychological adaptation of adolescents after solid organ transplantation.

This study assessed the influence of clinical and socio-demographic variables on the psychological adaptation of transplanted adolescents. Twenty-six transplanted adolescents and 25 healthy adolescents, aged 13-17, and their parents participated in the study. The following domains were measured: social competence, emotional/behavioral problems, self-concept, self-esteem and subjective well-being. The findings revealed that transplanted boys presented significantly less social competence (U = 26,000, p < .05) and more externalizing problems (U = 25,000, p < .05), social problems (U = 25,000, p < .05) and attention problems (U = 17,500, p < .01) than healthy boys. In contrast, transplanted girls displayed significantly more internalizing problems (U = 47,000, p < .05) and lower physical self-concept (U = 49,500, p < .05) than healthy girls. Hierarchical regression analysis showed clinical variables, especially waiting-list time, significantly predicted attention problems (beta = .364, p < .05) and negative affect (beta = .632, p < .05) in transplanted adolescents. Also, male (beta = -0.554, p < .01) and younger (beta = -0.444, p < .01) transplanted adolescents were at risk for attention problems. Our data suggest the importance of the waiting-list time for transplanted adolescents. Efforts to reduce the pretransplant phase would help adolescents achieve better psychological adaptation at long-term posttransplant.

Psychological well-being in adults transplanted in childhood.

Few studies have explored the long-term psychological effects on young adults of childhood transplants. The aim of the present work was to examine psychological adaptation related to self-concept, self-esteem and subjective well-being in young adults who had undergone solid organ transplantation in childhood. Twenty-four adults transplanted in childhood participated in the study (13 of them received kidney transplants, five heart transplants and six liver transplants). Participants were of both sexes, aged 18-22, and were selected from three public hospitals in Madrid. The results reveal no differences in psychological adaptation according to the transplant type (kidney, heart, or liver), and a significant difference in negative affect between women and men (women present more negative affect than men). Hierarchical regression analysis, after controlling for possible confounding effects of demographic and clinical variables, showed the predictive power of self-esteem to explain positive affect (60% of the total variance). Furthermore, physical self-concept, health status and time on waiting list explain 71% of the negative affect variance. Our data suggest the importance of self-esteem for the positive affect, and the power of clinical variables for the negative affect in young adults transplanted in childhood.