Cancer affects millions of people every year and survivorship has increased substantially recently. Two cancers that affect older adults is non-Hodgkin's lymphoma and breast cancer, yet very little research has focused on cancer and survivorship in late life. Emerging research has suggested that chemotherapy could have deleterious consequences on cognition, but few studies have considered the long-term neurocognitive sequelae of chemotherapy. Furthermore, social support and optimism have been independently examined as predictors of quality of life in cancer patients, but little research has considered the effects of these variables on other outcomes, such as cognition. The aim of this study was to gain a better understanding of the relationship between social support and optimism on cognition, specifically in non-Hodgkin's lymphoma (NHLS) and breast cancer survivors (BCS). It was hypothesized that social support and optimism would be positively related to cognition, and that social support would mediate the optimism-cognition relationship. Twenty-seven BCS (M age = 71.96), twenty-five female (M age = 69.76) and twenty-five male (M age = 65.28) NHLS groups were recruited. Each participant completed a three-hour standardized neuropsychological battery designed to evaluate a range of cognitive abilities involving attention, premorbid and current intellect, memory, language, visuospatial skills, and executive functioning, as well as self-report measures of mood, social support, and optimism. Performances on cognitive tests were within normal limits, but differences were found in aspects of executive functioning (p < .01) with the men outperforming women in the NHLS group. Women in the NHLS group performed better on a measure of executive functioning (p < .05) and visuospatial functioning (p < .01) than women in the BCS group. Women from both groups performed better than the male NHLS group on verbal learning and memory measures (all p's < .05). The groups did not differ on psychosocial variables. Correlations between psychosocial variables (i.e., social support and optimism) were variably related to cognitive measures in both groups. Social support did not mediate the optimism-cognition relationship. This is the first study to consider the relationship between social support, optimism, and cognition and early interventions to improve cognition in cancer survivors is discussed.

This study sought to provide a description of the psychosocial profile of persons with complex regional pain syndrome (CRPS). CRPS is an excruciatingly painful and debilitating condition that is poorly understood by medical professionals. Its profound impact on an individual's quality of life prompts a closer examination of the psychosocial profile of individuals suffering from CRPS. The extant literature examining psychological variables associated with CRPS is inconclusive with regard to the role that these factors play in the course of the syndrome. It has been shown, however, that CRPS patients suffer tremendous physical discomfort and this is often reflected in increased emotional distress. The present study assesses level of pain, anxiety, depression, disability, intrusive thoughts, quality of life, and demographic variables utilizing a national sample obtained from an online survey distributed to members of an organization that provides resources to CRPS patients. Descriptive data are presented for all data gathered and specific correlates of quality of life were examined. Results of the study demonstrated that this sample endorsed high levels of anxiety and depression and reported low levels of both physical and mental quality of life. When compared to normative data, this sample endorsed more pain and anxiety than other pain populations and also endorsed lower mental and physical quality of life than other pain conditions. The psychosocial profile of individuals with CRPS type I did not vary significantly from individuals with type II. Intrusive thoughts were uniquely predictive of disability, physical quality of life, and mental quality of life after controlling for age, gender, and pain level. The role of intrusive thoughts in predicting disability and quality of life suggests a potential mechanism by which clinicians can target psychotherapeutic treatment. Understanding the psychosocial profile and psychological sequelae of this disorder will help both physicians and psychologists understand the impact of CRPS on patients and provide a pathway for improved comprehensive interdisciplinary treatments.

Children account for approximately 34% of the burn-injured population in the United States and are particularly at risk for developing posttraumatic stress disorder (PTSD) or other significant psychopathology (i.e., behavioral and attentional difficulties, acute stress, depression, anxiety, phobias, dissociative symptoms, and enuresis). There is a significant risk that quality of life (QOL) can have a negative impact on children who have sustained a burn injury, particularly within the domain of social functioning. Specifically, children who meet the criteria for PTSD following a burn injury are at an increased risk of experiencing impairment in overall QOL. However, there remains significant evidence that a substantial portion of children exhibit satisfactory QOL outcomes following a burn injury at a level comparable to their noninjured peers. This positive outcome may be attributed to the child's level of resiliency--the protective factors that positively influence their ability to adjust and move forward following a traumatic event. Research on risk and resiliency of posttraumatic stress symptoms (PTSS) in pediatric burn survivors is limited. For psychological assessment and burn treatment to be successful, it is important to understand the resilient qualities that are present in children who experience positive post-burn-injury outcomes. By focusing on a child's mental health strengths and by building his or her resilience, a health professional may prevent or lessen the child's adjustment difficulty or psychopathological symptoms. Thus, the primary purpose of this study was to identify the relation between pediatric burn injury, demographic variables, resilience and QOL outcome with regard to PTSS. Demographic information (e.g, gender, age, household income, and diagnoses) and burn injury characteristics (e.g., age at time of burn, total body surface area injured, number or days spent in the hospital, and number of surgeries) were considered with regard to PTSS, resiliency, and QOL outcome. Further analysis efforts compared results from the Resiliency Scales for Children and Adolescents (RSCA) with scores obtained from the University of California at Los Angeles Posttraumatic Stress Reaction Index for Diagnostic and Statistical Manual--Fourth Edition (UCLA PTSD Reaction Index for DSM-IV; Reaction Index). Identical analyses were performed regarding the RSCA and the Pediatric Quality of Life Inventory, Version 4.0 (PedsQL 4.0). Analyses indicated a significant relation between PTSS severity and resilience, with positive resilience outcomes correlated to lower levels of PTSS severity. Further, a significant relation was found between QOL and PTSS, with positive QOL functioning related to lower levels of PTSS. Finally, a significant relation was found between resilience and QOL: Participants who endorse higher levels of resilience demonstrate better QOL outcomes. Overall, demographic information and burn injury characteristics did not significantly affect results regarding PTSS severity. Clinical implications and future areas of research are discussed.

While there has been extensive research on the quality of life for people with disabilities, very little research has been conducted on the way in which families impact the quality of life of these individuals. This study focused on how family dynamics impact the quality of life for people with disabilities who are clients of state vocational rehabilitation agencies. Specifically, family flexibility and cohesion, as well as family resilience, were the independent variables; quality of life was the dependent variable. It was found that family functioning and family resilience play an important role in the quality of life for people with disabilities. There was a strong relationship between family functioning and quality of life, in addition to family resilience and quality of life. Ten life domains were used to examine quality of life: physical health, mental health, work/education, leisure activities, relationship with significant other, family relationships, social relationships, financial situation, independence/autonomy, and religious/spiritual expression. For each domain, the participant was asked four questions on the importance, control, satisfaction, and impact of disability. Family functioning and family resilience significantly correlated with all of the 10 life domains on most of the four factors. Family dynamics account for 36% of the variance of quality of life. Family dynamics significantly impact the quality of life for people with disabilities and therefore should be taken into consideration in the rehabilitation process.

Breast cancer diagnosis and treatment has been suggested to effect sexual functioning. Little is known about how breast cancer patients compare to women without a history of cancer on measures of sexual functioning, as well as the psychological and physical factors may contribute to these difficulties. To address these issues, 71 breast cancer patients and 40 of their nominated friends were recruited and served as participants. All women received and returned via the mail measures on general background information, depression, fatigue, marital satisfaction, body image, vaginal symptoms, and sexual functioning. All the psychological and physical variables assessed correlated with a measure of overall sexual functioning in the expected directions. With the exception of the physical variable of vaginal problems (p =006), where the patient group reported more problems, the groups did not differ on any remaining physical or psychological variables. On the overall measure of sexual functioning, no significant differences were found between the two groups. Additional exploratory analyses in which only women treated with chemotherapy were compared to the non-cancer participants yield similar patterns of results. In addition, there was no evidence of interactive effects of age and breast cancer status on sexual functioning. These results suggest that sexual functioning in women treated for breast cancer is similar that of a non-cancer comparison with the exception of more menopausal symptoms. Continued research and interventions towards addressing menopausal symptoms may lead to even improved sexual functioning among breast cancer patients.

Magister Scientiae (Occupational Therapy) - MSc(OT) / Background: One of the most significant current discussions in public health and occupational therapy is the challenges facing adults with chronic diseases. Adults living with chronic diseases experience challenges of activity limitations and occupational disruptions which may influence their health, quality of life and well-being. Chronic diseases seem to have implications for adults’ areas of occupation, client factors and performance patterns as well as performance skills. Spirituality is considered as important in the lives of adults living with chronic diseases as a coping strategy assisting them to deal with the challenges of life in relation to physical, social, emotional and functional well-being. Despite the importance of spirituality in adults with chronic diseases, there is little known about the relationship between spirituality, health-related quality of life and occupational balance among adults with chronic diseases in the Western Cape, South Africa. Aim: The aim of the study was to examine the relationship between spirituality, healthrelated quality of life and occupational balance from the perspectives of adults living with chronic diseases. Methods: A sequential exploratory mixed methods two phase design approach was used for the purpose of the study. Thus, to examine the perspectives and determine the relationship on spirituality, health related quality of life and occupational balance of adults living with chronic diseases. Furthermore, to explore and describe the perceptions of adults with chronic diseases regarding the relationship between spirituality, health related quality of life and occupational balance.

Background Loneliness, or the perceived discrepancy between the quantity and quality of ones’ actual social relationships and desired level of connectedness, is a potentially important psychosocial factor in lung cancer patients. The purpose of the current study was to investigate the relationship of loneliness to depressive symptoms, quality of life, and social-cognitive variables and to explore the role of loneliness in mediating relationships between social-cognitive variables and depressive symptoms and quality of life. Finally, the study examined whether loneliness predicted change over time in depressive symptoms and quality of life. Methods Lung cancer patients were recruited from the Moffitt Cancer Center Thoracic Oncology Clinic to complete two study questionnaires via hard copy or online. Participants completed measures of loneliness (UCLA V3), depressive symptoms, (CES-D) and quality of life (FACT-L) at baseline and 30 days later. Participants also completed measures of demographic characteristics and social-cognitive variables, including cancer-related stigma (CLCSS), cancer-related negative social expectations (CNSES), social constraint (SCS), avoidant coping (CRI – avoidant coping), and beliefs about one’s ability to cope with cancer (CBI-B) at baseline. Clinical characteristics were assessed via medical record review. Results Participants (n = 109) reported a low to moderate level of loneliness (M = 33.8), and 38% reported clinically significant (CES-D > 16) depressive symptoms. Quality of life in the current study (M = 98.1) was consistent with normative FACT-L data collected from a sample of lung cancer patients. Loneliness was positively correlated with depressive symptoms (r = .44) and negatively correlated with quality of life (r = -.59). In addition, loneliness was positively correlated with social-cognitive variables in the expected directions and social-cognitive variables were related to depressive symptoms and quality of life in the expected directions (p’s < .001). Mediation analyses yielded evidence for partial mediation, with loneliness mediating the relationships of social-cognitive variables with depressive symptoms and quality of life for nine of the ten models tested. The exception was findings showing that loneliness did not mediate the relationship between beliefs about one’s ability to cope with cancer and depressive symptoms. Loneliness at Time 1 predicted additional variance in depressive symptoms at Time 2 (Β = .38, Adj R2 = .31) after accounting for depressive symptoms at Time 1, but loneliness at Time 1 did not account for additional variance in quality of life at Time 2 after accounting for quality of life at Time 1. Conclusions Results suggest that consideration of loneliness is important in order to understand differences in depressive symptoms and quality of life in lung cancer patients. Beyond its direct impact on clinically relevant outcomes, the experience of loneliness may be the mechanism by which social-cognitive factors influence depressive symptoms and quality of life. Investigation of the relationship between stigma and loneliness in the context of lung cancer is particularly novel and warrants further exploration.

A gengivite é um agravo frequente entre crianças e adolescentes e pode afetar a qualidade de vida destes.O objetivo desta investigação foi avaliar o impacto da gengivite na qualidade de vida relacionada á saúde bucal de escolares de 12 anos do Distrito Metropolitano da cidade de Quito- Ecuador. Foram avaliados 998 escolares através do índice CPI para a presença de sangramento gengival (SG) e cálculo (C). A qualidade de vida relacionada á saúde bucal foi verificada pelo questionário CPQ11-14. Um questionário estruturado para registro de dados demográficos e condições econômicas foi entregue aos pais dos escolares. Dos 998 escolares, 93% (IC 95% 91,4% a 94,6%) apresentaram sangramento gengival e 73% (IC 95%70,%7 a 76,2%) tinham cálculo dentário. A análise univariada mostrou que escolares que tinham mais de um sextante com sangramento gengival tinham média de CPQ11-14 18% maior (RT = 1,18; 95% IC= 1,11 a 1,27) que aquelesque tinham nenhum ou apenas um sextante afetado. Por sua vez, escolares do sexo masculino apresentaram média de CPQ 15% mais baixa (RT= 0,85; 95% IC= 0,76 a 0,96). A escolaridade do pai também apresentou associação significativa com qualidade de vida, pois crianças cujos pais tinham educação secundária incompleta ou superior tiveram média de CPQ 15% menor (RT= 0,85; 95% IC= 0,77 a 0,94).A presença de sangramento em mais de um sextante foisignificativamenteassociada com qualidade de vida, nos domínios bem-estar emocional (RT=1,40; 95%IC=1,03 a 1,90) e bem-estar social (RT=1,76; 95%IC=1,32 a 2,34). Podemos concluir que a presença de sangramento gengival teve impacto negativo na qualidade da vida dos escolares de 12 anos,principalmente nos domíniosbem-estar emocional e social. / Gingivitis are common among children and adolescents and may affect their quality of life. The objective of this study was to evaluate the impact of gingivitis on oral health-related quality of life among 12-yearold schoolchildren from the Metropolitan District of the city of Quito, Ecuador. We evaluated 998 schoolchildren using the CPI index for periodontal conditions: gingival bleeding (GB) and calculus (C). Quality of life was assessed with the CPQ11-14 questionnaire. A structured questionnaire was applied to record demographic data and socioeconomic conditions. Of the 998 schoolchildren, 93% (95% CI 91.4% to 94.6%) had gingival bleeding and 73% (95% CI, 70% to 76.2%) had dental calculus. The univariate analysis showed that schoolchildren who had more than one sextant with gingival bleeding had a 1.18 times higher mean CPQ11-14 (RR = 1.18, 95% CI = 1.11 to 1.27) than those who had none or just one affected sextant. On the other hand, male schoolchildren presented a mean CPQ of 15% lower (RT = 0.85; 95% CI = 0.76 to 0.96). Father\'s schooling also showed a significant association with quality of life, since children whose parents had incomplete secondary education or higher had a mean CPQ 15% lower (RT = 0.85; 95% CI = 0.77 to 0.94). The presence of bleeding in more than one sextant was significantly associated with worse quality of life for the emotional well-being domain (RT = 1.40, 95% CI = 1.03 to 1.90) and social well-being domain (RT = 1.76, 95% CI = 1.32 to 2.34). In conclusion, gingival bleeding had a negative impacton oral health-related quality of life of 12-years old schoolchildren, mainly in the emotional and social well-being domain.

Abstract not available

Health-Related Quality of Life (HRQOL) is an important outcomes measure in cancer and there are specific issues depending on the site, stage, treatment and patient age. Although numerous instruments are available for cancer HRQOL, most are designed for adults, some for children, but none for adolescents and young adults (AYA) who have special age-specific concerns and poor improvement in survival compared with other age groups. An existing HRQOL instrument was modified to ensure its suitability for AYA, its validity, reliability and sensitivity were tested in Australians aged 16 to 25 years old diagnosed with cancer or a blood disorder. Varni’s PedsQLTM Measurement Model (13-18 year olds) was selected, modified then administered to families recruited from haematology/oncology clinics and wards at three Sydney Metropolitan Hospitals in person or by telephone. The Memorial Symptom Assessment Scale was used to categorise participants into groups reflecting sensitivity of symptom severity (slight, moderate and severe). The instruments demonstrated excellent internal consistency reliability, making them suitable for both group and individual comparisons. Clinical validity, construct validity, and discriminant validity were demonstrated by “known-groups” analysis, exploratory factor analysis and correlations, respectively. These new versions of the PedsQL Generic Core and Cancer Module are reliable, valid and sensitive measures of HRQOL in patients aged 16-25 years diagnosed with cancer or a blood disorder. The measures will soon be available for use as outcome measures in clinical trials and clinical practice with this age cohort in Australasia and internationally.