Factors and Coping Styles Related to Breast Cancer Patients’ Preferences About Referrals to Psychotherapy as part of Treatment Factors and coping styles related to BC
Abstract
Background: The purpose of this mixed methods study was to examine what factors may influence emotional suppression and emotional expression in breast cancer patients and how coping styles relate to beliefs about physician-driven referrals to therapy.
Methods: A mixed method research design consisting of quantitative methods including a demographics survey, the Courtald Emotional Control Scale and treatment preference questionnaires followed by optional participation in a semi-structured interview.
Results: Demographic variables including age, marital status, income, and experience of psychotherapy prior to breast cancer diagnosis are statically significant factors that influence CECS scores and coping styles. Participants universally believed that there should be some level of psychotherapy referrals for supportive mental health care during and after the treatment process.
Conclusion: Participants who fell into either category of emotional suppressor or emotional expresser believed that there should be physician driven referrals to therapy during the breast cancer treatment process. Both those identified as suppressors and expressers indicated high rates of concealing one’s true emotional experience. This highlights the need for psychological therapy referrals to be integrated as a best practice, regardless of patient’s identified coping style or demographic identities. We suggest that all breast cancer patients be screened at multiple points and offered a referral by every member of their treatment team: regardless of how they seem to cope and that future research focus on the most efficient and holistic ways to decrease barriers to receiving psychological support during and after breast cancer treatment.
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References
Witt CM, Cardoso MJ. Complementary and integrative medicine for breast cancer patients - Evidence based practical recommendations. Breast. 2016;28:37-44. doi: 10.1016/j.breast.2016.04.012.
Carlson L, Waller A, Mitchell A. Screening for distress and unmet needs in patients with cancer: review and recommendations. Journal of Clinical Oncology. 2012;30:1160-77. doi: 10.1200/JCO.2011.39.5509.
Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160-74. doi: 10.1016/S1470-2045(11)70002-X.
Spiegel D, Riba MB. Managing anxiety and depression during treatment. Breast J. 2015;21(1):97-103. doi: 10.1111/tbj.12355.
Burgess C, Cornelius V, Love S, Graham. J, Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005;702. doi: 10.1136/bmj.38343.670868.D3.
Jamshidifar Z, Shemirani SM, Ahramian A, Ahmadi A, Lory SS, Moradi-Joo M. The effectiveness of positive psychotherapy on the psychological well-being of breast cancer patients. Cienc Nat. 2015;37. DOI:10.5902/2179460X20874
Blake-Mortimer J, Gore-Felton C, Kimerling R, Turner-Cobb JM, Spiegel D. Improving the quality and quantity of life among patients with cancer: a review of the effectiveness of group psychotherapy. Eur J Cancer. 1999;35(11):1581-6. doi: 10.1016/s0959-8049(99)00194-x.
Zolfa R, Moradi A, Mahdavi M, Parhoon H, Parhoon K, Jobson L. Feasibility and acceptability of written exposure therapy in addressing posttraumatic stress disorder in Iranian patients with breast cancer. Psychooncology. 2023;32(1):68-76. doi: 10.1002/pon.6037.
Ma X, Zhang J, Zhong W, Shu C, Wang F, Wen J. The diagnostic role of a short screening tool - the distress thermometer: a meta-analysis. Support Cancer Care. 2014;22:1741-55. doi: 10.1007/s00520-014-2143-1.
Meraner V, Giesinger J, Kemmler G, Taucher S, Hubalek M, Weber B, et al. Development of a screening tool for the identification of psychooncological treatment need in breast cancer patients. Psychooncology. 2009;18(9):974-83. doi: 10.1002/pon.1480.
Chida Y, Hamer M, Wardle J, Steptoe A. Do stress-related psychosocial factors contribute to cancer incidence and survival? Nat Clin Pract Oncol. 2008;5(8):466-75. doi: 10.1038/ncponc1134.
Temoshok L. Personality, coping style, emotion and cancer: towards an integrative model. Cancer Surv. 1987;6(3):545-67. doi: Not available
Iwamitsu Y, Shimoda K, Abe H, Tani T, Kodama M, Okawa M. Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression. Psychiatry Clin Neurosci. 2003;57(3):289-94. doi: 10.1046/j.1440-1819.2003.01119.x.
Iwamitsu Y, Shimoda K, Abe H, Tani T, Okawa M, Buck R. Anxiety, emotional suppression, and psychological distress before and after breast cancer diagnosis. Psychosomatics. 2005;46(1):19-24. doi: 10.1176/appi.psy.46.1.19.
Wasti SP, Simkhada P, van Teijlingen ER, Sathian B, Banerjee I. The Growing Importance of Mixed-Methods Research in Health. Nepal J Epidemiol. 2022;12(1):1175-8. doi: 10.3126/nje.v12i1.43633.
Morse J. Issues in qualitatively-driven mixed-methods designs: walking through a mixed-methods project. In: Hesse-Biber SN, Johnson RB, editors. The Oxford Handbook of Multimethod and Mixed Methods Research Inquiry. New York, NY: Oxford University Press; 2015. p. 206-23.
Hennick MM, Kaiser BN, Marconi VC. Code saturation versus meaning saturation: how many interviews are enough? Qualitative Health Research. 2016;27:591-608. doi: 10.1177/1049732316665344.
Teddlie C, Yu F. Mixed methods sampling: a typology with examples. Journal of Mixed Method Research. 2007;1.
Brandão T, Tavares R, Schulz MS, Matos PM. Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review. Clin Psychol Rev. 2016;43:114-27. doi: 10.1016/j.cpr.2015.10.002.
Watson M, Greer S. Development of a questionnaire measure of emotional control. J Psychosom Res. 1983;27(4):299-305. doi: 10.1016/0022-3999(83)90052-1.
Watson M, Greer S, Rowden L, Gorman C, Robertson B, Bliss JM, et al. Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients. Psychol Med. 1991;21(1):51-7. doi: 10.1017/s0033291700014641.
Ando N, Iwamitsu Y, Kuranami M, Okazaki S, Nakatani Y, Yamamoto K, et al. Predictors of psychological distress after diagnosis in breast cancer patients and patients with benign breast problems. Psychosomatics. 2011;52(1):56-64. doi: 10.1016/j.psym.2010.11.012.
Padgett DK. Qualitative methods in social work research, 3rd edition. Thousand Oaks, CA: SAGE Publications; 2016.
Reissman CK. Narrative analysis. Thousand Oaks, CA: SAGE Publications; 2022.
Admiraal JM, Hoekstra-Weebers JEHM, Schröder CP, Tuinier W, Hospers GAP, Reyners AKL. Distress, problems, referral wish, and supportive health care use in breast cancer survivors beyond the first year after chemotherapy completion. Support Care Cancer. 2020;28(7):3023-32. doi: 10.1007/s00520-019-05030-6.
Skaczkowski G, Sanderson P, Shand M, Byrne AF. Factors associated with referral offer and acceptance following supportive care problem identification in a comprehensive cancer service. European Journal of Cancer Care. 2018;27. doi: 10.1111/ecc.12869.
Scotte F, Taylor A, Davies A. Supportive care: the 'keystone' of modern oncology practice. Cancers (Basel). 2023;15. doi: 10.3390/cancers15153860.
Cordova MJ, Riba MB, Spiegel D. Post-traumatic stress disorder and cancer. Lancet Psychiatry. 2017;4(4):330-8. doi: 10.1016/S2215-0366(17)30014-7.
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