Care burden and associated factors among caregivers of patients with bipolar type I disorder.

BACKGROUND: Family caregivers play a significant role in providing care for these people at home and need new evidence on the outcomes of their caregiving. Caregiving for people with chronic psychiatric disorders, especially Bipolar type I Disorder (BD-I), is a major challenge in the healthcare system. This study aimed to examine the relationship between caregiver burden, resilience and optimism in family caregivers of patients with BD-I. METHODS: This study used a cross-sectional design and involved 209 family caregivers of people with BD-I by convenience sampling method. Data were collected using the Zarit Burden Inventory (ZBI), Connor-Davidson Resilience Scale (CD-RISC), and Revised Life Orientation Test (LOT-R). The participants were selected from the list of family caregivers covered by the Ibn Sina Hospital's health clinic in Mashhad, Iran. The data were analyzed using descriptive statistics and multiple regression analysis with a significance level of 0.05. RESULTS: The average ages of the caregivers and their patients were 45.43 (13.34) and 36.7 (14.05), respectively. The average caregiver burden score was 41.92 (19.18), which was moderate (31 to 60). The predictors of caregiver burden in this study were caregiver-related factors such as optimism (p < 0.001, ß = 0.25) and employment status (housewife: p = 0.038, ß = 0.43; self-employed: p = 0.007, ß = 0.12; retired: p < 0.001, ß = 0.23), and patient-related factors such as the presence of psychotic symptoms (p < 0.001, ß = 0.33), daily caregiving hours (p < 0.001, ß = 0.16), history of suicide attempts (p = 0.035, ß = 0.43), and alcohol consumption (p < 0.001, ß = 0.85). These variables explained 58.3% of the variance in caregiver burden scores. CONCLUSION: The study concluded that family caregivers of people with BD-I had moderate levels of caregiver burden and low resilience, influenced by various factors related to themselves and their patients. Psychological education interventions within the framework of mental health support systems are recommended to reduce caregiver burden in these people.

Cruel optimism, affective governmentality and frontline poverty governance: 'You can promise the world'.

Cruel Optimism' (Berlant, 2011) sustains neoliberalism by promising freedom and autonomy through adherence to and performance of competitive behaviours. As Brown (2003) observes, neoliberalism is a discourse which operates, not through repression or restriction, but through promising self-fulfilment and happiness. The role of emotion-management in poverty governance has been widely acknowledged. However, this has focused on cultivation of population-level punitive, negative emotions (such as shame, stigma, or resentment). It is widely acknowledged that welfare provision has been specifically targeted by neoliberal discourse, justifying intensifying interventions aimed at reshaping the subjectivities and aspirations of poor and marginalised individuals and households to serve the needs of deregulated markets. However, little attention has been paid to the importance of positive, hopeful emotion management in legitimising and effecting co-operation. Drawing on interviews with 54 workers in the Welsh homelessness system, I argue that workers systematically create and sustain optimism in their clients as a mechanism to enable them to survive within an increasingly hostile housing system, as part of a deliberate, if reluctant, strategy to cultivate empowered, 'ethical' welfare selfhood against a backdrop of citizen abandonment. A three-stage approach deployed by workers includes (1) destabilisation of expectations of state help (2) re-orientation, through cultivation of belief in neoliberal promise (3) development of maintenance strategies. Improving applicant capacity to perform neoliberal welfare citizenship was perceived as an urgent, moral and pragmatic necessity, and justified by care logics. I demonstrate how this extends not only our understanding of welfare implementation, but also shows how positive emotion-management generally, and Berlant's Cruel Optimism specifically, can be used to understand the practicalities of welfare governance.

Association of stress and emotional well-being in non-medical college students: A systematic review and meta-analysis.

Stress among college students is a well-explored area with profound implications for their emotional well-being. Despite extensive research, the literature presents inconsistent and mixed findings regarding its relationship with emotional well-being, particularly focusing on medical students. Moreover, there is no meta-analytic study to address this inconsistency. To bridge these gaps, this study conducts a systematic review and meta-analysis to explore the nuanced association between stress among non-medical college students and their emotional well-being. The systematic review utilized databases: PubMed, Scopus, and Web of Science, search engine: Google Scholar, and gray literature sources: ProQuest and Research Gate. The dataset consisted of 46 eligible studies (k), comprising 26,214 participants across 20 countries. The mean age was 21.86 (k = 32), with females constituting 60 % (k = 45). The majority of studies employed a cross-sectional/correlational design. The estimated pooled correlation is found to be -0.27 (95 % CI: -0.33, -0.21, p < .01; I2 = 97.5 %, k = 46). Subgroup analysis revealed significant influences of the type of stress (p < .01), emotional well-being (p < .01), tools (p < .01) used, significance status of findings (p < .001), and demographic factors - country (p < .001) and income level (p < .05). The study found an inversely significant and moderate association between stress and emotional well-being in non-medical college students, consistent with existing literature. Significant moderation by study and demographic variables suggests substantial heterogeneity among studies, highlighting potential influences from demographics, methodologies, and populations.

A Longitudinal Study of the Impact of COVID-19 on Optimism Prediction.

The purpose of this longitudinal study was to investigate how optimistic predictions, hopelessness, and depressive symptoms changed as a result of the COVID-19 pandemic, and the causal relationships between these variables. To achieve this purpose, we used data from online surveys conducted in 2019 and 2021 among men and women aged 20-79. Based on item response theory, we developed a future prediction task for the assessment of optimistic predictions. Our comparison of online survey responses found a decline in optimistic predictions before and after the pandemic. More specifically, there were no change in predictions of negative future events, but there was the decrease in predictions of positive future events. Furthermore, we found that those who were more stressed by COVID-19 were less likely to have an optimistic view of the near future. We also found a relationship between optimistic predictions and hopelessness and depressive symptoms with lower optimism predicting more hopelessness and more depression predicting lower optimism. To prevent feelings of hopelessness, it is important to help people develop positive expectations about the future.

The relationship between psychological capital and self-directed learning ability among undergraduate nursing students-a cross-sectional study.

Background: Psychological capital has become a prominent focus in positive psychology, highlighting the positive influence of higher psychological capital on individuals. Self-directed learning ability is a fundamental skill for students, vital for enhancing academic performance and professional development, and is integral to the continuous learning process of nursing students. Recognizing the relationship between psychological capital and self-directed learning ability is crucial for the progress and development of undergraduate nursing students. Objective: This study aims to investigate the correlation between psychological capital and self-directed learning ability in undergraduate nursing students, as well as to explore the factors that influence these variables. Methods: A cross-sectional survey was conducted with 667 full-time undergraduate nursing students from a nursing school in Taizhou, China. Psychological capital and self-directed learning ability were assessed using the Psychological Capital Questionnaire and Self-Directed Learning Scale, respectively. Correlation and stepwise multiple regression analyses were then carried out to evaluate the relationship between psychological capital and self-directed learning ability among the participants. Results: The study revealed that the psychological capital score averaged at 103.24 ± 15.51, while the self-directed learning scale score averaged at 230.67 ± 27.66. Variations in psychological capital scores were noted based on factors including grade level, being an only child, growth environment, monthly living expenses, parental education level, voluntary selection of nursing major, and club experience. Similarly, differences in self-directed learning scores were associated with factors such as grade level, gender, parental education level, and voluntary selection of nursing major. Moreover, a positive correlation was identified between the overall psychological capital scores and the total self-directed learning ability scores among nursing students. Notably, the multiple regression analysis highlighted that optimism and resilience played significant roles as predictors of self-directed learning ability. Conclusion: Psychological capital is positively correlated with the self-directed learning ability of nursing students, with optimism and resilience identified as crucial predictors. Nursing educators can utilize strategies rooted in positive psychology and perseverance to improve the self-directed learning ability of nursing students.

Rational Optimism.

Optimistic beliefs have been criticized by philosophers as being irrational or epistemically deficient. This paper argues for the possibility of a rational optimism. We propose a novel four-fold taxonomy of optimistic beliefs and argue that people may hold optimistic beliefs rationally for at least two of the four types (resourced optimism and agentive optimism). These forms of rational optimism are grounded in facts about one's resources and agency and may be epistemically justified under certain conditions. We argue that the fourth type of optimism in our taxonomy (perspectival optimism) is not subject to epistemic scrutiny in the same way. It is better evaluated on practical and moral grounds. This paper advances the discussion of optimism within both the philosophical and psychological literatures by providing a compelling and philosophically rich taxonomy of optimism that clarifies the sometimes-competing forms of optimism identified by psychologists. This advances the field by putting forward cases of epistemically justified optimism, in contrast with unrealistic optimism, that is sometimes justified for its instrumental or adaptive characteristics, and also by highlighting a form of optimism, perspectival optimism, that is not being considered in the mainstream optimism literature in psychology. The paper concludes by suggesting several avenues for future empirical and philosophical research.

Mabrouk's Measure of Adolescent Optimism: Development and Validation of a New Scale of Adolescent Optimism.

Several measures of adolescent optimism exist. However, none of these measures have been developed in the African setting, and only a few of the available measures have been validated for use in this setting. We aimed to develop and validate a culturally appropriate measure for this context. We employed an exploratory sequential mixed methods design using a five-step approach to tool development, comprising literature reviews, construct clarification, item development, piloting, and scale evaluation. We constructed a six-item scale, the Mabrouk's Measure of Adolescent Optimism (MMAO). In a sample of 1616 adolescents from Kenya, the MMAO demonstrated adequate internal consistency (both Cronbach's alpha and McDonald's Omega > 0.80) and test-retest reliability (ICC = 0.46). Factor analysis supported a unidimensional scale with adequate criterion and divergent validity as well as measurement invariance across sex, age (younger vs. older adolescents), residence (rural vs. urban), schooling status (in-school vs. out-of-school adolescents), and language of administration (Swahili vs. English). We report on the development and validation of a new scale of adolescent optimism that can be used to assess optimism among adolescents in Kenya and similar contexts. Preliminary evidence shows support for this new measure's reliability and validity, although additional tests are needed.

Factors predicting depression among persons post-coronary artery bypass graft surgery: A cross-sectional study in Thailand.

Background: Coronary artery bypass graft (CABG) surgery is a highly effective coronary artery disease treatment, providing immediate relief and promising long-term benefits. However, it is a major procedure with significant risks, including the potential for depression. Many patients experience depression following CABG, which can negatively impact their overall recovery, affecting both physical and mental health. Objective: This study aimed to determine factors predicting depression in patients following CABG surgery. Methods: This cross-sectional study was conducted with data collected between January and April 2024. A total of 272 post-CABG patients from two super tertiary care hospitals in Bangkok, Thailand, were recruited through purposive sampling. All research instruments were validated and tested for reliability. Data were analyzed using multiple regression analysis. Results: The study found that hope, optimism, illness perception, social support, and anxiety were correlated with depression (adjusted R² = 0.381), but these variables explained only 38.1% of the variance (p <0.05). Among these factors, anxiety (ß = 0.311), optimism (ß = 0.203), social support (ß = -0.117), and illness perception (ß = -0.143) were significant predictors (p <0.05), while hope was not a significant predictor. Thus, anxiety emerged as the most crucial predictor of depression in patients who have undergone CABG. Conclusion: Nurses play a vital role in preventing and managing depression in post-CABG patients. Screening for anxiety and addressing it can prevent depression, enhance social support, and improve outcomes. To develop effective nursing strategies, it is essential for nurses to assess anxiety and implement interventions that promote social support, optimism, and illness perception. These measures can improve care quality, reduce readmission rates, and enhance patients' overall quality of life.

Italian university students' future time perspective and well-being during the COVID-19 pandemic.

Introduction: During the COVID-19 pandemic, young adults worldwide showed signs of distress as they were affected in their specific developmental tasks, including the construction of personal and professional futures. Methods: The present study aimed to assess the situational future time perspective of Italian university students during the second pandemic wave, as measured by an ad hoc constructed instrument, to explore its interaction with some dispositional traits relevant in future construction, such as optimism, sense of life, aggression, and dispositional future time perspective, and to test their effect on psychological well-being. The total sample consisted of 389 subjects (18-35 years, M = 23.5, SD = 4.4). Results and discussion: The results indicated that the pandemic experience, assessed by surveying specific indicators, negatively affected the future time perspective of students, particularly those dispositionally optimistic and convinced that life has meaning. However, awareness of the negative impact that the pandemic brought to the vision of the future seems to have dampened the levels of depression and stress, while anxiety was found to be related only to dispositional traits. The results also suggested the need for educational and economic policies that help young adults develop confidence in the future and in their ability to build it.

Bayesian analysis of psychological capital in peruvian university students: Differences by sex and age.

Psychological capital (PsyCap) constitutes a positive personal resource that enhances better well-being and academic performance in university students. Initially addressed in the organizational realm and recently in the academic one. This study aimed to establish the differences in PsyCap according to gender and age in Peruvian university students. A quantitative, comparative, non-experimental, and cross-sectional study was conducted with 708 students (77.4 % women and 22.6 % men), aged between 18 and 61 years (M = 22.1; SD = 5.95), selected in a non-probabilistic manner, who completed the Psychological Capital Questionnaire (PCQ-12). The results indicate very strong evidence supporting the existence of significant differences between different age groups, suggesting that the observed variations are not due to chance but reflect real differences between ages. Regarding gender, the data do not provide enough information to confidently assert whether there are significant differences between men and women in relation to psychological capital (PsyCap) and its dimensions. This implies that we cannot confirm whether gender influences these variables. These findings highlight the need to consider age when assessing and intervening in PsyCap in university students.

The Relationship between Big Five Personality Traits and Depression in the German-Speaking D-A-CH Region Including an Investigation of Potential Moderators and Mediators.

Considerable evidence links the "Big Five" personality traits (neuroticism, extroversion, conscientiousness, agreeableness, and openness) with depression. However, potential mediating and moderating factors are less well understood. We utilized data from a cross-sectional survey of 3065 German-speaking adults from the D-A-CH region to estimate multivariable-adjusted odds ratios and 95% confidence intervalsbetween personality traits and lifetime prevalence of depression (overall and stratified by sex and age). We further explored proportions mediated by psychosocial factors optimism, empathy, perspective-taking, work-life balance, and interpersonal trust. High levels of neuroticism were associated with more than two-fold higher odds of depression, whereas higher levels of conscientiousness were associated with approximately 30% lower odds of depression. The association with neuroticism persisted in all investigated subgroups; apparently, stronger associations for females and participants aged ≥60 years did not correspond to statistically significant interactions. Overall and across all strata, the association of neuroticism with depression appeared to be mediated in part by the considered psychosocial factors; optimism explained the largest proportion of the association. Our results provide empirical evidence for the dynamic predisposition model. Further investigations of these relationships are warranted in longitudinal data with more precise outcome assessments.

The prospective association between psychological strengths and incident musculoskeletal injury in active duty Army soldiers.

Extensive training, overuse, overexertion, and repetitive movements put Soldiers at increased risk for musculoskeletal injuries (MSIs). The present study investigated the prospective association between psychological strengths, physiological and social factors, and non-combat-related MSI in a sample of 24,746 active duty Army Soldiers. Over a mean follow-up period of 21.07 months (SD = 16.07), 65.42% of the Soldiers examined were treated for an MSI. Applying survival analysis techniques and adjusting for relevant physiological and social factors, we found greater baseline Optimism, Positive Affect, Coping, and Adaptability were each associated with a modest reduction in risk of MSI (4-8%). Additionally, being older, female, married, and having a higher BMI were each associated with an increased MSI risk, whereas being an officer (relative to enlisted) and obtaining post-secondary education were each associated with a decreased MSI risk. Future research should examine the mechanisms through which psychological-based interventions may impact Soldiers' risk of MSI.

Information as a resource: Can perceived information process quality in the workplace contribute to more optimism in times of crisis?

Against the background of Job Demands-Resources and Conservation of Resources theory and research on organizational communication, this prospective study among n = 312 employees explores the significant role of perceived information process quality (PIPQ) in enhancing employees' optimism during the COVID-19 pandemic. It thereby contributes to a deeper understanding of the factors influencing employee optimism in challenging contexts. In this study, PIPQ is defined by the availability of timely information, clarity, and consistency in the information provided. Results from latent change score modelling revealed that employees who experienced high PIPQ, particularly consistent information, reported feeling more optimistic about work-related aspects and also experienced spillover effects into their private lives. Notably, both consistency in information prior to the pandemic and increases in consistent information during the pandemic demonstrated this beneficial effect. Moreover, timely available information also positively influenced optimism, especially regarding work-related aspects. However, the study did not find evidence that clarity in information significantly affected optimism. In summary, the findings underscore the importance of accessible and consistent information as a vital resource for employees' ability to navigate crises.

Successful Aging in US Veterans with Mental Disorders: Results From the National Health and Resilience in Veterans Study.

OBJECTIVES: To determine the prevalence and correlates of successful aging in US veterans who screened positive for current major depressive disorder (MDD), generalized anxiety disorder (GAD), and/or posttraumatic stress disorder (PTSD). METHODS: In a nationally representative sample of 475 US military veterans (mean age=58.3, SD=14.7; range 24-92) who screened positive for MDD, GAD, and/or PTSD, multivariable logistic regression and relative importance analyses were conducted to identify independent correlates of successful aging. RESULTS: One-in-five (20.6%) veterans rated themselves as aging successfully. Resilience and gratitude were the strongest positive correlates of successful aging, accounting for 38.1% and 32.4% of the explained variance, respectively. Greater somatic symptoms were the strongest negative correlate, accounting for 11.2% of the explained variance. Higher gratitude moderated the negative association between somatic symptoms and successful aging. CONCLUSIONS: Positive psychiatry interventions targeting psychosocial factors such as resilience and gratitude may help promote successful aging among US veterans with mental disorders.

The role of psychological formulation in inpatient settings in supporting staff empathy and therapeutic optimism for adults diagnosed with borderline personality disorder: A pre- and post-vignette study.

WHAT IS KNOWN ON THE SUBJECT?: Psychological formulation brings together a service user story and expertise, with psychological knowledge, research, and practitioners clinical experience to make sense of a service users' presentation (thinking about their difficulties but also strengths). Evidence into the effectiveness of formulation is largely anecdotal, qualitative, or small scale. Although this is very valuable research, there is not a lot of research which quantitatively evidences the role of formulation for service users or services. Quantitative evidence that does exist is also conflicting. Considering how widely psychological formulation is used, and the governing guidelines that recognize this as a core competency for psychological practitioners, it is important to continue to add to the evidence base. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Psychological formulation can increase staff empathy and hope. This could help service users to feel more understood and hopeful. Formulation; however, did not impact feelings of personal distress in staff. This research may suggest a need for the two distinct processes (i.e. team formulation and reflective practice) to support all components of empathy within inpatient services. Psychological formulation could support the provision of psychologically informed care within inpatient services, of which promotes effective care delivery. ABSTRACT: OBJECTIVES: National Health Service (NHS) values, such as empathy and therapeutic optimism, are integral when supporting service users with complex mental health presentations. There is some evidence to suggest that psychological formulation can increase empathy and optimism in healthcare professionals. This study, therefore, aimed to investigate whether a psychological formulation of a hypothetical service user with a complex presentation, typically labelled with a diagnosis of borderline personality disorder (BPD), increased empathy and therapeutic optimism in professionals working in mental health inpatient services. METHOD: Sixty-six mental health professionals working in NHS inpatient services took part in a pre- and post-vignette study. Participants were asked to read a case vignette about a hypothetical service user, with a diagnostic label of BPD, and complete questionnaires capturing levels of empathy and therapeutic optimism. Participants were then randomized into two conditions and either asked to read the same information again (control condition) or read a psychological formulation based on the same hypothetical service user (intervention condition). The findings were analysed using a series of ANCOVAs/ANCOHETs. RESULTS: Two constructs of empathy (i.e. perspective taking and empathic concern), and therapeutic optimism significantly increased following exposure to the psychological formulation when compared to the control group condition. CONCLUSION: This study warrants further replication. These initial findings; however, indicate that psychological formulation can significantly increase the ability to perspective take, display empathic concern, and hold therapeutic optimism towards service users with a presentation associated with a diagnosis of BPD.

Testing a Mediation Model of Dispositional Optimism, Mindful Self-Care, and Subjective Well-Being.

Research consistently demonstrates a positive association between dispositional optimism (DO) and subjective well-being (SWB). This study takes a step forward by exploring potential mechanisms underlying this relationship, with a specific focus on the mediating role of mindful self-care (MSC). We conducted a cross-sectional online survey involving 312 Singaporean adults. Participants completed questionnaires assessing their DO, MSC practices, and overall SWB. Our findings confirmed a significant link between DO and SWB, with individuals exhibiting higher optimism reporting greater well-being. Importantly, the relationship was mediated by MSC, suggesting that optimism motivates individuals to engage in MSC practices, which in turn, enhances SWB. Moreover, DO was linked to all SWB subcomponents, even after controlling for MSC as a mediator. Among the six MSC facets, self-compassion and purpose, supportive relationships, and mindful awareness emerged as significant mediators. This study adds to the growing body of evidence recognizing the positive role of DO and MSC in improving well-being outcomes. It highlights the potential of interventions aimed at cultivating optimism as a promising approach for enhancing mindful self-care practices and ultimately promoting well-being in adults.

Investigation of Social Constraints, Psychosocial Adjustment and Optimism among Dialysis Patients.

BACKGROUND: Social constraints are perceived as unsupportive behaviors, leading to inadequate psychosocial adjustment, while optimism can help people recover from distress and reduce any negative effects of chronic disease. The aim of this study was to investigate social constraints, psychosocial adjustment and optimism among patients on dialysis. METHODS: In this study, 402 patients undergoing dialysis in Greece completed the following questionnaires: (i) the Social Constraints Scale (SCS) for the assessment of social constrains, (ii) the Psychosocial adjustment to illness scale (PAIS-SR) for the assessment of psychosocial adjustment, and (iii) the LOT-R scale for the assessment of optimism. A Mann-Whitney test was used for the comparison of continuous variables between two groups. Spearman correlation coefficients (rho) were used to explore the association of two continuous variables. Multiple linear regression analysis was used with the SCS scale. RESULTS: Greater difficulty in psychosocial adjustment in the domestic, vocational, extended family and social environments, sexual relationships, and health care as well as greater psychological distress were significantly associated with a greater occurrence of social constraints (p < 0.001). Additionally, greater optimism was significantly associated with fewer social constraints and lower difficulty in adjusting to their disease (p < 0.001). CONCLUSIONS: Greater difficulty in all dimensions of psychosocial adjustment is associated with more social constraints, while optimism is associated with fewer social constraints and better disease adjustment.

Optimism and mental health in college students: the mediating role of sleep quality and stress.

Objective: College students showed a high prevalence of stress, anxiety, and depression, with medical and nursing students experiencing particularly elevated levels of mental health challenges.Optimism significantly influences overall well-being by promoting a healthy lifestyle and cognitive responses. However, the association of optimism with sleep quality, stress, and mental health in college students remains unexplored. This study aimed to (1) explore the associations of optimism with sleep quality, stress, and mental health and (2) ascertain whether sleep quality and stress mediate the association between optimism and mental health among college students. Methods: A cross-sectional study was conducted using online surveys with students from health science majors at a public university in the northeast United States from September to December 2022. A total of 222 students participated in the study, providing data on sociodemographics, optimism, sleep quality, stress, anxiety, and depression. Parallel and serial mediation models were utilized to examine the potential mediating roles of sleep quality and stress in the association between optimism and mental health. Results: The study found that optimism influences anxiety and depression through both direct and indirect pathways. In line with predictions, the parallel mediation analysis revealed that the impact of optimism on anxiety (ßtotal = -0.598, 95% confident interval [CI]: -0.778 to -0.392) and depression (ßtotal = -0.724, 95% CI: -0.919 to -0.519) was mediated by stress and sleep quality. Furthermore, the serial mediation models revealed that stress and sleep quality co-mediated the relationship betweenoptimism and anxiety (indirect effect [IE] = -0.074, 95% CI: -0.135 to -0.029) or depression (IE = -0.084, 95% CI: -0.142 to -0.036) in a sequential manner. Conclusion: Optimism was negatively correlated with poor sleep quality, stress, anxiety, and depression. Enhanced optimism was linked to high sleep quality and less stress, anxiety, and depression. These insights emphasize the potential for school-based optimism interventions to improve sleep quality, ameliorate stress-related concerns, and alleviate mental health challenges in college students.

Setting the Stage for Cancer: Stay Soft and Optimistic.

In the Netherlands, one out of two people will be confronted with the diagnosis of cancer sometime in their life. Against this increased number of patients, a large proportion luckily can be cured. Today, a rather high proportion of people receive treatment to control cancer growth or stabilize the disease, sometimes, for the rest of their lives. If such long-standing treatment is administered for more than 10-20 years, the stage of cancer is presently often not referred to as "palliative" anymore, but much more often as "chronic." It could be argued that regardless of the cancer disease stage you are in and whether you are or can be cured, your cancer diagnosis nevertheless has become part of your life, including the experience of chronicity. Discussions surrounding the chronicity of cancer in the context of cancer are still ongoing. This is especially the case because "experiencing chronicity" is dependent on the type of cancer and is less applicable in cancers where the prognosis is often less than one year, such as is more frequently the case with lung or pancreatic cancer. In all situations, experiencing chronicity nevertheless brings along uncertainty, either with or without chronic stress. Combatting stress by choosing the right wording, maintaining an optimistic stance along with physical activity and/or psychosocial education seems important to optimize well-being and to stabilize tumor growth or remove the tumor. In conclusion, chronicity in the context of treating and caring for cancer seems a somewhat gray area. However, regardless in how we, as medical professionals, speak about cancer with long-standing disease trajectories (that sometimes even can be cured), it first of all seems important to approach, take care, and treat patients well. This can facilitate discussions with patients about their disease and disease experiences. Moreover, it can stimulate patients themselves to take responsibility for their own health, which can be of added value to the entire disease trajectory.

Relations of optimism and purpose in life to immune markers in aging.

OBJECTIVE: Optimism and purpose in life are associated with improved health outcomes. More information is needed on biological mechanisms, including immunosenescence. We investigated if psychological well-being is associated with healthier immunosenescence-related measures including naïve and terminally differentiated CD4+ and CD8+ T cell percentages, CD4+:CD8+, and cytomegalovirus (CMV) IgG response. METHODS: Participants were adults over age 50 from the Health and Retirement Study. Optimism was measured using the Life Orientation Test Revised. Purpose in life was assessed using the subscale from the Ryff psychological well-being measure. We examined the cross-sectional associations of optimism and purpose in life with measures of T cell subsets using linear regression and with CMV IgG using ordered logit regression, controlling for potential confounding factors. RESULTS: The final analytic sample ranged from 7250 to 7870. After adjusting for sociodemographic factors, a 1-SD increment in optimism was associated with the percentage of naïve CD4+ T cells increasing by 0.6 (95%CI 0.2%, 1.0%). A 1-SD increment in purpose in life was associated with the percentage of naïve CD4+ T cells increasing by 0.9 (95%CI 0.5%, 1.3%) after adjusting for sociodemographic factors and the association was maintained after further adjustments for health conditions, depression, and health behaviors. For naïve CD8+ T cell percentages, CD4:CD8 ratios, and CMV IgG antibodies, associations were seen only in models that adjusted for age. No significant associations were seen in any models for the terminally differentiated CD4+ and CD8+ T cells. CONCLUSIONS: We found associations of optimism and purpose in life with naïve CD4+ T cell percentages.