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  • Breast Cancer
  • MEDLINE/PubMed (NLM)  (7)
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  • 1
    Language: English
    In: Applied Nursing Research, 2008, Vol.21(3), pp.165-168
    Description: This article describes a team-based approach to the development of a comprehensive codebook for multiple researchers to use during content analysis of the transcripts of the expressive writings of women (in this study, = 89) with metastatic breast cancer. The codebook structure was developed iteratively by reaching a consensus on the analysis of shared transcripts to create an all-encompassing set of codes, with definitions, inclusion and exclusion criteria, and exemplar text from the transcripts. The Qualitative Solutions and Research International NVivo software program was used to maintain an electronic database of the consensus analysis of transcripts, information about each code, and a detailed log about the process of developing the codebook. The team ultimately created a comprehensive codebook that contained 27 codes with definitions, inclusion and exclusion criteria, and example text. The codes were verified by each team member through reanalysis of a set of shared transcripts that had been previously coded using an earlier version of the codebook. The team met to discuss individual coding and reached a consensus on the final version of the codebook. No new code was identified during the reanalysis, and there was fairly uniform agreement on the coding. The final version of the codebook will be used to guide each team member's individual analysis of the remaining (74) transcripts, which will be divided among the team. Periodic meetings are planned to discuss the individual analysis and to resolve any issue associated with using the codebook. As new codes are identified and agreed upon by the team, they will be added to the codebook. A team-based approach can facilitate the development of a practical and accurate codebook to guide the analysis of a large amount of qualitative data.
    Keywords: Medicine ; Nursing
    ISSN: 0897-1897
    E-ISSN: 1532-8201
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  • 2
    Language: English
    In: Health Psychology, 2016, Vol.35(6), pp.584-593
    Description: Objective: Coping processes directed toward avoiding and approaching stressor-related thoughts and emotions predict psychological adjustment. However, few studies have examined how the relationship between dispositional emotional tendencies and stressor-specific coping affects outcomes. The aim of the current study was to examine the association of dispositional emotional expressivity (i.e., the propensity to experience and express emotions strongly) with cancer-specific coping through avoidance and emotional approach to predict intrusive thoughts and depressive symptoms in Latinas with breast cancer. Method: Recently diagnosed Latina breast cancer patients receiving treatment completed standardized assessments via interview at 2 time points: within 18 months of diagnosis (Time 1; N = 95) and 3 months later (Time 2; N = 79). Results: Most women were immigrants (93%), reported a combined household income of $20,000 or less (75%), did not graduate from high school (59%), and primarily spoke Spanish (88%). In path analyses, more recent immigration was associated with greater dispositional expressivity, which in turn was associated with coping with the cancer experience using both greater avoidance and emotional approach strategies. Only avoidance-oriented strategies predicted an increase in intrusive thoughts at 3 months. No significant effects on depressive symptoms were observed. Conclusions: Findings suggest that Latina breast cancer patients who have a propensity to experience and express emotions strongly may be initially overwhelmed by their cancer-related emotions and consequently turn to avoidance-oriented and emotional approach strategies to cope with their diagnosis. Avoidance-oriented coping in turn may uniquely predict an increase in cancer-related intrusive thoughts 3 months later.
    Keywords: Avoidance ; Approach ; Breast Cancer ; Coping ; Latina
    ISSN: 0278-6133
    E-ISSN: 1930-7810
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  • 3
    Language: English
    In: Journal of Behavioral Medicine, 2017, Vol.40(6), pp.875-885
    Description: Breast cancer patients often experience adverse physical side effects of medical treatments. According to the biobehavioral model of cancer stress and disease, life stress during diagnosis and treatment may negatively influence the trajectory of women’s physical health-related adjustment to breast cancer. This longitudinal study examined chronic and episodic stress as predictors of bothersome physical symptoms during the year after breast cancer diagnosis. Women diagnosed with breast cancer in the previous 4 months ( N  = 460) completed a life stress interview for contextual assessment of chronic and episodic stress severity at study entry and 9 months later. Physical symptom bother (e.g., pain, fatigue) was measured at study entry, every 6 weeks through 6 months, and at nine and 12 months. In multilevel structural equation modeling (MSEM) analyses, both chronic stress and episodic stress occurring shortly after diagnosis predicted greater physical symptom bother over the study period. Episodic stress reported to have occurred prior to diagnosis did not predict symptom bother in MSEM analyses, and the interaction between chronic and episodic stress on symptom bother was not significant. Results suggest that ongoing chronic stress and episodic stress occurring shortly after breast cancer diagnosis are important predictors of bothersome symptoms during and after cancer treatment. Screening for chronic stress and recent stressful life events in the months following diagnosis may help to identify breast cancer patients at risk for persistent and bothersome physical symptoms. Interventions to prevent or ameliorate treatment-related physical symptoms may confer added benefit by addressing ongoing non-cancer-related stress in women’s lives.
    Keywords: Stress ; Life events ; Breast cancer ; Physical symptoms ; Survivorship
    ISSN: 0160-7715
    E-ISSN: 1573-3521
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  • 4
    Language: English
    In: Annals of Behavioral Medicine, 2016, Vol.50(3), pp.370-384
    Description: BACKGROUND: Few studies examine whether dispositional approach and avoidance coping and stressor-specific coping strategies differentially predict physical adjustment to cancer-related stress.PURPOSE: This study examines dispositional and situational avoidance and approach coping as unique predictors of the bother women experience from physical symptoms after breast cancer treatment, as well as whether situational coping mediates the prediction of bother from physical symptoms by dispositional coping.METHOD: Breast cancer patients (N = 460) diagnosed within the past 3months completed self-report measures of dispositional coping at study entry and of situational coping and bother from physical symptoms every 6weeks through 6months.RESULTS: In multilevel structural equation modeling analyses, both dispositional and situational avoidance predict greater symptom bother. Dispositional, but not situational, approach predicts less symptom bother. Supporting mediation models, dispositional avoidance predicts more symptom bother indirectly through greater situational avoidance. Dispositional approach predicts less symptom bother through less situational avoidance.CONCLUSION: Psychosocial interventions to reduce cancer-related avoidance coping are warranted for cancer survivors who are high in dispositional avoidance and/or low in dispositional approach.
    Keywords: Avoidance ; Approach ; Coping ; Breast cancer ; Physical symptoms
    ISSN: 0883-6612
    E-ISSN: 1532-4796
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  • 5
    In: British Journal of Health Psychology, September 2017, Vol.22(3), pp.609-626
    Description: Byline: Margaret R. Bauer, Joshua F. Wiley, Karen L. Weihs, Annette L. Stanton Keywords: avoidance; intrusive thoughts; coping; cognitive processing; cancer Objectives Theories and research regarding cognitive and emotional processing during the experience of profound stressors suggest that the presence of intrusive thoughts and feelings predicts greater use of avoidance and that the use of avoidance paradoxically predicts more intrusions. However, empirical investigations of their purported bidirectional relationship are limited. Design This study presents a longitudinal investigation of the reciprocal relationship between intrusions and avoidance coping over a 6-month period in the year following breast cancer diagnosis. Methods Breast cancer patients (N = 460) completed measures of cancer-related intrusions and avoidance at study entry, 3 months, and 6 months later (i.e., an average of 2, 5, and 8 months after diagnosis, respectively). Results Cross-lagged panel analyses revealed that intrusive thoughts, feelings, and images at study entry predicted greater avoidance 3 months later, and avoidance coping at study entry predicted intrusions 3 months later, controlling for the stability of intrusions and avoidance as well as time since diagnosis. Findings were not statistically significant for avoidance predicting intrusions, or vice versa, between the 3-month and the 6-month assessment period, during which they declined. Conclusions These findings provide empirical support for the theoretical contention that avoidance and intrusive thoughts and emotions reciprocally influence one another following stressful events. Additionally, in the months shortly after breast cancer diagnosis, intrusions and avoidance are positively related. However, the relationships attenuate over time, which could indicate resolved cognitive and emotional processing of the cancer experience. Statement of contribution What is already known on this subject? Following stressful life events, individuals often experience intrusive thoughts and feelings related to the event and they report avoidance of such reminders. Many studies demonstrate that greater intrusions predict more subsequent use of avoidance coping, and other studies show that greater use of avoidance predicts more intrusions. Their reciprocal relation has not been examined, however. What does this study add? This is the first examination of the concurrent, reciprocal influence of intrusions and avoidance. Findings suggest that accounting for the bidirectional influence of avoidance and intrusions best estimates hypothesized models. Higher intrusions and avoidance predicted each other for the first 3 months after study entry, but the relationship diminished 6 months after study entry, perhaps due to productive mental processing of the stress of breast cancer diagnosis and treatment.
    Keywords: Avoidance ; Intrusive Thoughts ; Coping ; Cognitive Processing ; Cancer
    ISSN: 1359-107X
    E-ISSN: 2044-8287
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  • 6
    Language: English
    In: PLoS ONE, 2009, Vol.4(4), p.e5342
    Description: HER2-targeted therapy with the monoclonal antibody trastuzumab (Herceptin®) has improved disease-free survival for women diagnosed with HER2-positive breast cancers; however, treatment resistance and disease progression are not uncommon. Current data suggest that resistance to treatment in HER2 cancers may be a consequence of NF-κB overexpression and increased COX2-derived prostaglandin E2 (PGE 2 ). Conjugated linoleic acid (CLA) has been shown to have anti-tumor properties and to inhibit NF-κB activity and COX2. ; In this study, HER2-overexpressing SKBr3 breast cancer cells were treated with CLA. Protein expression of the HER2 receptor, nuclear NF-κB p65, and total and phosphorylated IκB were examined by western blot and immunofluorescence. PGE levels were determined by ELISA. Proliferation was measured by metabolism of 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT), and apoptosis was measured by FITC-conjugated Annexin V staining and flow cytometry. ; We observed a significant decrease in HER2 protein expression on western blot following treatment with 40 and 80 µM CLA (p〈0.01 and 0.001, respectively) and loss of HER2 protein in cells using immunoflourescence that was most pronounced at 80 µM. Protein levels of nuclear NF-κB p65 were also significantly reduced at the 80 µM dose. This was accompanied by a significant decrease in PGE levels (p = 0.05). Pretreatment with CLA significantly enhanced TNFα-induced apoptosis and the anti-proliferative action of trastuzumab (p = 0.05 and 0.001, respectively). These data add to previous reports of an anti-tumor effect of CLA and suggest an effect on the HER2 oncogene that may be through CLA mediated downregulation of COX2-derived PGE.
    Keywords: Research Article ; Nutrition ; Cell Biology -- Cell Signaling ; Oncology -- Breast Cancer ; Women's Health -- Breast Cancer
    E-ISSN: 1932-6203
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  • 7
    Language: English
    In: PLoS ONE, 2009, Vol.4(5), p.e5578
    Description: Avicins, a class of electrophilic triterpenoids with pro-apoptotic, anti-inflammatory and antioxidant properties, have been shown to induce redox-dependant post-translational modification of cysteine residues to regulate protein function. Based on (a) the cross-talk that occurs between redox and phosphorylation processes, and (b) the role of Stat3 in the process of apoptosis and carcinogenesis, we chose to study the effects of avicins on the processes of phosphorylation/dephosphorylation in Stat3. Avicins dephosphorylate Stat3 in a variety of human tumor cell lines, leading to a decrease in the transcriptional activity of Stat3. The expression of Stat3-regulated proteins such as c-myc, cyclin D1, Bcl2, survivin and VEGF were reduced in response to avicin treatment. Underlying avicin-induced dephosphorylation of Stat3 was dephosphorylation of JAKs, as well as activation of protein phosphatase-1. Downregulation of both Stat3 activity and expression of Stat 3-controlled pro-survival proteins, contributes to the induction of apoptosis in avicin treated tumor cells. Based on the role of Stat3 in inflammation and wounding, and the in vivo inhibition of VEGF by avicins in a mouse skin carcinogenesis model, it is likely that avicin-induced inhibition of Stat3 activity results in the suppression of the pro-inflammatory and pro-oxidant stromal environment of tumors. Activation of PP-1, which also acts as a cellular economizer, combined with the redox regulation by avicins, can aid in redirecting metabolism from growth promoting anabolic to energy sparing pathways.
    Keywords: Research Article ; Cell Biology ; Oncology ; Cell Biology -- Cell Signaling
    E-ISSN: 1932-6203
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