Abstract
The purpose of the study is to explore changes in resilience and physical and psychological distress and their related factors over time in women with endometrial cancer. This study adopted a repeated measures design using purposive sampling and was conducted in a hospital in Taiwan. Data were collected before surgery, 2 weeks after surgery, and 3 months after surgery. The measured variables consisted of demographic and disease characteristics, social support, resilience, and physical and psychological distress. A total of 48 women participated in the study, of whom 42 (mean age = 54.2 years old) completed all of the questionnaires. The results showed that resilience and physical distress in women with endometrial cancer was not statistically significantly changed over time. Rather, their psychological distress was significantly alleviated 2 weeks and 3 months after surgery as compared to before surgery. Women with less social support showed a lower level of resilience. In addition, those with a lower level of resilience experienced greater psychological distress. Compared with those who received only surgical treatment, women who had undergone surgery combined with chemotherapy and radiotherapy had more physical distress. Clinical medical staff should conduct continuing assessments of the resilience, physical distress, and psychological distress of women with endometrial cancer. Interventions related to resilience-enhancing and self-care should be implemented to avoid worsening or to improve women’s resilience and distress.
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The data used in this study will be kept and managed by the first author and the corresponding author of this paper and can be provided to the journal for review when necessary.
References
Aburn G, Gott M, Hoare K (2016) What is resilience? An integrative review of the empirical literature. J Adv Nurs 72(5):980–1000. https://doi.org/10.1111/jan.12888
American Cancer Society (2020) Cancer facts & figures 2020. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2020.html. Accessed 29 Jan 2020
Campbell-Sills L, Forde DR, Stein MB (2009) Demographic and childhood environmental predictors of resilience in a community sample. J Psychiatr Res 43(12):1007–1012. https://doi.org/10.1016/j.jpsychires.2009.01.013
Canty-Mitchell J, Zimet GD (2000) Psychometric properties of the multidimensional scale of perceived social support in urban adolescents. Am J Community Psychol 28(3):391–400. https://doi.org/10.1023/A:1005109522457
Clough P, Earle K, Sewell D (2002) Mental toughness: the concept and its measurement. In: Cockerill I (ed) Solutions in sport psychology. Thomson, London, pp 32–43
Colombo N, Preti E, Landoni F, Carinelli S, Colombo A, Marini C, Sessa C (2013) Endometrial cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 24(suppl 6):vi33–vi38. https://doi.org/10.1093/annonc/mdt353
Connor KM, Davidson JR (2003) Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 18(2):76–82. https://doi.org/10.1002/da.10113
Cruz FOAM, Vilela RA, Ferreira EB, Melo NS, Reis P (2019) Evidence on the use of mobile apps during the treatment of breast cancer: systematic review. JMIR Mhealth Uhealth 7(8):e13245. https://doi.org/10.2196/13245
Davidson JRT (2018) Connor-Davidson Resilience Scale (CDRISC) Manual. http://connordavidson-resiliencescale.com. Accessed 1 May 2020
de Haes JC, van Knippenberg FC, Neijt JP (1990) Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom Checklist. Br J Cancer 62(6):1034–1038. https://doi.org/10.1038/bjc.1990.434
Dewhurst SA, Anderson RJ, Cotter G, Crust L, Clough PJ (2012) Identifying the cognitive basis of mental toughness: evidence from the directed forgetting paradigm. Pers Individ Diff 53:587–590. https://doi.org/10.1016/j.paid.2012.04.036
Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–191. https://doi.org/10.3758/bf03193146
Ferrandina G, Petrillo M, Mantegna G, Fuoco G, Terzano S, Venditti L, Marcellusi A, Vincenzo RD, Scambia G (2014) Evaluation of quality of life and emotional distress in endometrial cancer patients: a 2-year prospective, longitudinal study. J Gynecol Oncol 133(3):518–525. https://doi.org/10.1016/j.ygyno.2014.03.015
Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh-Navaei R, Allen C et al (2018) Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: a systematic analysis for the global burden of disease study. JAMA Oncol 4(11):1553–1568. https://doi.org/10.1001/jamaoncol.2018.2706
Fradelos EC, Latsou D, Mitsi D, Tsaras K, Lekka D, Lavdaniti M, Tzavella F, Papathanasiou IV (2018) Assessment of the relation between religiosity, mental health, and psychological resilience in breast cancer patients. Contemp Oncol (Pozn) 22(3):172–177. https://doi.org/10.5114/wo.2018.78947
Garcia-Dia MJ, DiNapoli JM, Garcia-Ona L, Jakubowski R, O’Flaherty D (2013) Concept analysis: resilience. Arch Psychiatr Nurs 27(6):264–270. https://doi.org/10.1016/j.apnu.2013.07.003
Harms CA, Cohen L, Pooley JA, Chambers SK, Galvão DA, Newton RU (2019) Quality of life and psychological distress in cancer survivors: the role of psycho-social resources for resilience. Psychooncology 28(2):271–277. https://doi.org/10.1002/pon.4934
Heo J, Chun M, Oh YT, Noh OK (2019) Psychiatric comorbidities among endometrial cancer survivors in South Korea: a nationwide population-based, longitudinal study. J Gynecol Oncol 30(2):e15. https://doi.org/10.3802/jgo.2019.30.e15
Jeppesen MM, Mogensen O, Dehn P, Jensen PT (2015) Needs and priorities of women with endometrial and cervical cancer. J Psychosom Obstet Gynaecol 36(3):122–132. https://doi.org/10.3109/0167482X.2015.1059417
Ku HC (2011) Symptoms disturbances, fatigue, anxiety and depression among women with gynecologic cancer during chemotherapy—a longitudinal approach. Master’s thesis, National Taipei University of Nursing and Health Sciences
Kwan YH, Ng A, Lim KK, Fong W, Phang JK, Chew EH, Lui NL, Tan CS, Thumboo J, Østbye T, Leung YY (2019) Validity and reliability of the ten-item Connor-Davidson Resilience Scale (CD-RISC10) instrument in patients with axial spondyloarthritis (axSpA) in Singapore. Rheumatol Int 39(1):105–110. https://doi.org/10.1007/s00296-018-4217-8
Loehr JE (1994) The new toughness training for sports: mental, emotional, and physical conditioning from one of the world’s premier sports psychologists. Plume, New York
Ludolph P, Kunzler AM, Stoffers-Winterling J, Helmreich I, Lieb K (2019) Interventions to promote resilience in cancer patients. Dtsch Arztebl Int 116:865–872. https://doi.org/10.3238/arztebl.2019.0865
Ma Y, Mazumdar M, Memtsoudis SG (2012) Beyond repeated-measures analysis of variance: advanced statistical methods for the analysis of longitudinal data in anesthesia research. Reg Anesth Pain Med 37(1):99–105. https://doi.org/10.1097/AAP.0b013e31823ebc74
Ministry of Health and Welfare Taiwan (2013) Cancer registry annual report 2010 Taiwan. https://www.hpa.gov.tw/Pages/TopicList.aspx?nodeid=269. Accessed 18 August 2020
Ministry of Health and Welfare Taiwan (2019) Cancer registry annual report 2017 Taiwan. https://www.hpa.gov.tw/Pages/TopicList.aspx?nodeid=269. Accessed 18 August 2020
Ristevska-Dimitrovska G, Stefanovski P, Smichkoska S, Raleva M, Dejanova B (2015) Depression and resilience in breast cancer patients. Open Access Maced J Med Sci 3(4):661–665. https://doi.org/10.3889/oamjms.2015.119
Sadeghi Bahmani D, Esmaeili L, Shaygannejad V, Gerber M, Kesselring J, Lang UE, Holsboer-Trachsler E, Brand S (2018) Stability of mental toughness, sleep disturbances, and physical activity in patients with multiple sclerosis (MS)-a longitudinal and pilot study. Front Psychiatry 9:1–8. https://doi.org/10.3389/fpsyt.2018.00182
Sadeghi Bahmani D, Gerber M, Kalak N, Lemola S, Clough PJ, Calabrese P, Shaygannejad V, Pühse U, Holsboer-Trachsler E, Brand S (2016) Mental toughness, sleep disturbances, and physical activity in patients with multiple sclerosis compared to healthy adolescents and young adults. Neuropsychiatr Dis Treat 12:1571–1579. https://doi.org/10.2147/ndt.S111208
Seiler A, Jenewein J (2019) Resilience in cancer patients. Front Psychiatry 10:208. https://doi.org/10.3389/fpsyt.2019.00208
Solano JP, da Silva AG, Soares IA, Ashmawi HA, Vieira JE (2016) Resilience and hope during advanced disease: a pilot study with metastatic colorectal cancer patients. BMC Palliat Care 15:70. https://doi.org/10.1186/s12904-016-0139-y
Suzuki N, Ninomiya M, Maruta S, Hosonuma S, Nishigaya Y, Kobayashi Y, Kiguchi K, Ishizuka B (2011) Psychological characteristics of Japanese gynecologic cancer patients after learning the diagnosis according to the hospital anxiety and depression scale. J Gynecol Oncol Res 37(7):800–808. https://doi.org/10.1111/j.1447-0756.2010.01437.x
Tu PC, Yeh DC, Hsieh HC (2019) Positive psychological changes after breast cancer diagnosis and treatment: the role of trait resilience and coping styles. J Psychosoc Oncol 38(2):156–170. https://doi.org/10.1080/07347332.2019.1649337
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349. https://doi.org/10.1016/j.jclinepi.2007.11.008
Wang HC (2008) Research of relationships among life stress, self-esteem, social support and suicidal ideation of high school students in Taipei county. Master’s thesis, National Taiwan Normal University
Wright SP (1992) Adjusted p-values for simultaneous inference. Biometrics 48(4):1005–1013. https://doi.org/10.2307/2532694
Wu Z, Liu Y, Li X, Li X (2016) Resilience and associated factors among mainland Chinese women newly diagnosed with breast cancer. PLoS One 11(12):e0167976–e0167976. https://doi.org/10.1371/journal.pone.0167976
Zhang H, Zhao Q, Cao P, Ren G (2017) Resilience and quality of life: exploring the mediator role of social support in patients with breast cancer. Med Sci Monit 23:5969–5979. https://doi.org/10.12659/MSM.907730
Zimet GD, Dahlem NW, Zimet SG, Farley GK (1988) The multidimensional scale of perceived social support. J Pers Assess 52(1):30–34. https://doi.org/10.1207/s15327752jpa5201_2
Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA (1990) Psychometric characteristics of the multidimensional scale of perceived social support. J Pers Assess 55(3-4):610–617. https://doi.org/10.14195/1647-8606_54_13
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Conceptualization: Ching-Hui Chien and Yi-Lin Chang; methodology: Ching-Hui Chien, Yi-Lin Chang, Chi-Mu Chuang, Xuan-Yi Huang, and Chieh-Yu Liu; formal analysis and investigation: Ching-Hui Chien, Yi-Lin Chang, Chi-Mu Chuang, and Shu-Yuan Liang; writing (original draft preparation): Ching-Hui Chien and Yi-Lin Chang; writing (review and editing): Ching-Hui Chien, Yi-Lin Chang, Chi-Mu Chuang, Xuan-Yi Huang, Shu-Yuan Liang, and Chieh-Yu Liu; resources: Yi-Lin Chang and Chi-Mu Chuang; supervision: Ching-Hui Chien
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The researchers strictly observed the regulations set by the Institutional Review Board. During the study, the researchers explained the content of the study to the participants that complied with the study criteria and gave them ample time to consider their willingness to participate. Questionnaire surveys were given to patients who agreed to participate to our study and consent forms were signed. Participants could withdraw from the study unconditionally without their treatment rights being affected. The researchers strictly assumed the responsibility of maintaining participants’ privacy and protected the data from being breached.
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The authors declare that they have no conflict of interest.
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The questionnaire and methodology for this study was approved by the Human Research Ethics committee of Taipei Veterans General Hospital, Taipei City, Taiwan (Ethics approval number: 2018-01-001CC#1).
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This study has obtained informed consent from all participants, who completed and signed consent forms.
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This study was conducted using self-raised funds. When obtaining informed consent and consent forms from participants, we clarified that all results would be used for academic purposes. The privacy of the participants will also be protected when publishing the article, and no data from any case will be identifiable.
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The IBM SPSS statistics 20.0 (IBM Corporation 2011, Armonk, New York) was utilized to analyze the data. Furthermore, the free software of G*Power was used to estimate the sample size.
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Chang, YL., Chuang, CM., Chien, CH. et al. Factors related to changes in resilience and distress in women with endometrial cancer. Arch Womens Ment Health 24, 413–421 (2021). https://doi.org/10.1007/s00737-020-01090-4
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DOI: https://doi.org/10.1007/s00737-020-01090-4