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.

The role of acculturation attitudes and social support in anxiety and depression of Indian immigrants in Greece.

In the present study, we examined factors that may impact immigrants' anxiety and depressive symptoms, focusing on the role of acculturation attitudes and social support. The participants of the present study were first generation Indian immigrants residing in Crete, Greece (N=114). Our first hypothesis was that Indian immigrants will choose two acculturation attitudes, namely integration and separation, as these may enable them maintain certain aspects of their culture of origin given their distinct differences from Greeks in religion, cultural values, and physical appearance. It was also hypothesized that integration and separation will be positively related to social support. Social support was also expected to mediate the negative relationship of separation and integration to anxiety and depression. Furthermore, social support was expected to act protectively for Indian immigrants who chose integration and separation, minimizing the levels of anxiety and depression (i.e., a moderation effect). Using specific measures for anxiety, depression, social support, and acculturation attitudes, the results showed that Indian immigrants report a greater preference for integration and separation. Separation was the only acculturation attitude positively related to social support and negatively to depression through social support from friends and family. Moreover, higher levels of social support seemed to protected immigrants who choose integration from depression and medium and high levels of social support protected immigrants who choose assimilation from anxiety. These findings indicate that both integration and separation are preferred by Indian immigrants in Greece. Moreover, it seems that in the case of Indian immigrants in Greece, separation could be related to more immigrants' social support than other acculturation attitudes, ending in turn to less depression symptoms. These findings demonstrate that different acculturation attitudes (i.e. assimilation, integration, separation) may have different effects on distinct psychological indices. Moreover, immigrants' social support is a protecting factor in the relationship between acculturation attitudes to anxiety and depression. The present study suggests that the increase of the immigrants' social networks could prove helpful for their adaptation to the Greek society.