Medics as a Positive Deviant in Influenza Vaccination: The Role of Vaccine Beliefs, Self-Efficacy and Contextual Variables.

The influenza vaccination rate remains unsatisfactorily low, especially in the healthy adult population. The positive deviant approach was used to identify key psychosocial factors explaining the intention of influenza vaccination in medics and compare them with those in non-medics. METHODS: There were 709 participants, as follows: 301 medics and 408 non-medics. We conducted a cross-sectional study in which a multi-module self-administered questionnaire examining vaccination beliefs, risk perception, outcome expectations (gains or losses), facilitators' relevance, vaccination self-efficacy and vaccination intention was adopted. We also gathered information on access to vaccination, the strength of the vaccination habit and sociodemographic variables. RESULTS: We used SEM and were able to explain 78% of the variance in intention in medics and 56% in non-medics. We identified both direct and indirect effects between the studied variables. In both groups, the intention was related to vaccination self-efficacy, stronger habits and previous season vaccination, but access to vaccines was significant only in non-medics. CONCLUSIONS: Applying the positive deviance approach and considering medics as positive deviants in vaccination performance extended the perspective on what factors to focus on in the non-medical population. Vaccination promotion shortly before the flu season should target non- or low-intenders and also intenders by the delivery of balanced information affecting key vaccination cognitions. General pro-vaccine beliefs, which may act as implicit attitudes, should be created in advance to build proper grounds for specific outcome expectations and facilitators' recognition. It should not be limited only to risk perception. Some level of evidence-based critical beliefs about vaccination can be beneficial.

How gender-specific are predictors of post-MI HRQoL? A longitudinal study.

PURPOSE: Extant research shows that health-related quality of life (HRQoL) differs between female and male survivors of myocardial infarction (MI), but the reasons for this are not fully understood. We aimed to examine the predictors of HRQoL in female and male survivors during the first year after MI. METHODS: At timepoints 1 and 2, the sample comprised 222 MI survivors (59 women and 163 men; mean age 53.84 years, range 24-65) referred for in-patient cardiac rehabilitation. This number dropped to 140 participants (42 women and 98 men) at the third timepoint, approximately one year after the MI. We examined the gender differences in various predictors of physical and mental HRQoL: demographic factors (e.g., age, education, marital status), disease-related factors (pre- and post-MI), personality and coping with stress. RESULTS: Initially, both physical and mental HRQoL were lower in women than men, but the differences disappeared at timepoint 3. Stepwise regressions performed separately for men and women revealed that the factors shaping HRQoL were different in both genders; they also changed over time. Substantially fewer factors predicted physical HRQoL in women than in men. Trait anxiety seems to play a similarly negative role in both genders. CONCLUSIONS: The psychosocial resources that influence HRQoL were different for women and men. There were also differences concerning predictors of HRQoL dimensions. Further studies with a different or broader range of predictors are needed, especially among women.

Assessment of quality of life in patients surgically treated for penile cancer: Impact of aggressiveness in surgery.

PURPOSE: Health-related quality of life (HRQoL) evaluations are being increasingly used for clinical assessment of cancer treatment outcomes. For a patient, not only is life expectancy important, but also a general sense of sustained global health. Intuitively, the more disfiguring the treatment, the more pronounced could be the deterioration in the QoL. We aimed to compare various aspects of QoL in three groups of patients surgically treated for penile cancer by local excision, partial penectomy, or total penectomy. METHODS: HRQoL was assessed in 51 patients surgically treated for penile cancer. Total penectomy, partial penectomy, or wide local excision was performed in 11, 27, and 13 patients, respectively. The EORTC QLQ-C30 questionnaire was used for HRQoL assessment. Relations between the patients and their partners were also assessed. RESULTS: Statistically significant negative correlation was found between aggressiveness of the surgical procedure and both, assessment of global health status (p = 0.04) and physical functioning (p = 0.047). The more aggressive the surgery, the lower was the patients' assessment of their QoL. Among the patients who maintained their partner relations postsurgery, 58.9% declared that their relations postoperatively were not inferior compared to those preoperatively. There was no statistically significant effect of the surgery type on relations with female partners (p = 0.619). CONCLUSION: The magnitude of disfigurement caused by surgical treatment of penile cancer had a significant impact on the selected QoL domains assessed by the EORTC QLQ C-30 questionnaire. There was no correlation between the scope of surgical intervention and partner relations.

Basic issues concerning health-related quality of life.

INTRODUCTION: Chronic diseases such as cancer have a strong influence on both physical health and quality of life, which together comprise the concept of health-related quality of life (HRQoL) - in other words, the complete state of physical, social, and psychological functioning. Herein, we review the literature on the theory of HRQoL in relation to oncological diseases. MATERIAL AND METHODS: A literature search of English-language publications that included an analysis of the conceptual models of HRQoL was performed using PubMed. The data were screened and synthesized by all authors and relevant papers were selected. RESULTS: We outline the theoretical models most often used to conceptualize HRQoL, including the Centre for Health Promotion model from the University of Toronto, the conceptual model of Wilson and Cleary and the contextual model of Ashing-Giwa formulated specifically for cancer patients. CONCLUSIONS: Understanding the theoretical basis of HRQoL is indispensable for valid research in this area.

[Cognitive emotion regulation of patients qualified for implantation of heart rhythm control device]. / Poznawcza regulacja emocji u pacjentów zakwalifikowanych do zabiegu wszczepienia urzadzenia sterujacego rytmem serca.

The aim of the artificial heart stimulation is not only saving lives, but also improvement of the quality of life of patients with cardiac arrhythmias. One of the key dimensions of quality of life is psychological functioning. Until now, little research assess this dimension in patients before the implantation of the heart rhythm control device. AIM: The aim of the study was to assess the severity of depression and anxiety and the frequency of the used cognitive emotion regulation strategies and to examine the relationship between them. MATERIALS AND METHODS: The study group consisted of 60 people qualified for pacemaker implantation (42 PM patients and 18 ICD): 15 women and 45 men ranging in age from 43 to 85. To assess cognitive emotion regulation strategies Cognitive Emotion Regulation Questionnaire was used, and to assess the severity of depression and anxiety - Mood Assessment Questionnaire. RESULTS: Patients with PM more often than patients with ICD use the strategy of Positive Reappraisal (U = 231.50, p = 0.045). There were no statistically significant differences in the frequency of use of other strategies and severity of depression and anxiety. In PM patients there are negative correlations between the severity of depression and anxiety and the use of Acceptance ( τ = -0.380), a Positive Reappraisal ( τ = -0.278), Positive Refocusing ( τ = -0.366) and between the level of anxiety and Putting into Perspective ( τ = -0.402). In ICD patients there was a positive relationship between anxiety and Cathastrophizing ( τ = 0.324). CONCLUSIONS: The severity of depression and anxiety, and emotion regulation strategies in patients qualified for PM implantation in comparison with patients qualified for ICD implantation are similar. Both groups of patients show a good adaptation of the psychological.

Anxiety and depression and cognitive coping strategies and health locus of control in patients with ovary and uterus cancer during anticancer therapy.

AIM OF THE STUDY: The crisis associated with cancer may contribute to the development of anxiety and depressive disorders. Contemporary psycho-oncology focuses on the psychological determinants of the cancer patients functioning to find which disease-coping strategies help the healing process, facilitate the establishment of a good therapeutic relationship and the process of adapting to difficult situations. Aim of the study was assess the psychological functioning of patients with cancer of reproductive organs in the cancer-treating process. The practical aim was to develop guidelines for psychological care dedicated to this group of patients. MATERIAL AND METHODS: The study was conducted in the Reproductive Organs Cancer Clinic in Institute of Oncology in Warsaw using a questionnaire consisting of: Demographic, Hospital Anxiety and Depression Scale (HADS), Multidimentional Health Locus of Control (MHLC), Cognitive Emotions Regulations Questionaire (CERQ). RESULTS: Seventy-eight patients aged 22 to 82 (average 54) were examined. Investigation of relationships between anxiety and depression and coping strategies showed: positive correlation of anxiety with self blame and rumination, positive correlation of anxiety and depression with catastrophizing, positive correlation of depression with blaming others, negative correlation of anxiety and depression with acceptance and positive refocusing, negative correlation of depression with refocus of planning and putting into perspective. CONCLUSIONS: The results of this study indicate that there may be an indirect method of diagnosing anxiety and depression disorders in cancer patients by observing the coping strategies to cope with the difficult situation.