Cette recherche exploratoire longitudinale a pour objectif principal d'évaluer l'impact psychologique de la découverte et du traitement de cancer chez la femme enceinte et chez la femme en post-partum. De manière plus précise nous évaluons l'influence de la maternité sur l'ajustement à la maladie cancéreuse et l'influence de la survenue du cancer sur le processus de parentalisation. Cette recherche permet d'appréhender le risque psychopathologique réel de cette situation comportant de nombreux éléments dépressiogènes et anxiogènes ainsi que le risque de pathologisation du lien mère-enfant. L'analyse quantitative et qualitative des données permettra in fine d'établir des recommandations concernant l'accompagnement psychologique des femmes rencontrant cette situation. Ce travail a pour particularité de faire le lien entre deux champs théoriques distincts: la psychologie périnatale et la psycho-oncologie. / This longitudinal exploratory study aims at assessing the psychological impact of the discovery and cancer treatment in pregnant women and in women postpartum. More specifically we evaluate the influence of motherhood on adjusting to cancer disease and the influence of the occurrence of cancer in the parentalisation process. This research allows us to understand the real psychopathological risk of this situation with many elements dépressiogènes and anxiety and the risk of pathologizing the mother-child bond. The quantitative and qualitative analysis of the data will ultimately establish recommendations for counseling of women encountering this situation. This work has the particularity to make the connection between two different theoretical fields: perinatal psychology and psycho-oncology.

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Hintergrund Subjektive Krankheitsannahmen beinhalten Annahmen über Symptome, emotionale Reaktionen, Verlauf, Konsequenzen und Kontrollierbarkeit einer Erkrankung. Aktuelle Studien zeigen, dass subjektive Krankheitsannahmen mit der Krankheitsverarbeitung und dem psychischen Wohlbefinden assoziiert sind. Bisher gibt es kein Erhebungsinstrument zur Befragung von Kindern, sodass hier oftmals nur der Bericht der Eltern verfügbar ist. Ziel der Arbeit Das Ziel ist die Entwicklung und psychometrische Überprüfung eines Puppeninterviews zur altersgerechten Erfassung subjektiver Krankheitsannahmen für Kinder ab 4 Jahren. Beschreibung von Durchführungsempfehlungen mit Indikation und Kontraindikation. Methode Das Puppeninterview zur Erfassung subjektiver Krankheitsannahmen wurde auf Grundlage des „Illness Perception Questionnaire“ (IPQ-R) und des „Berkeley Puppet Interviews“ entwickelt und an zwei Stichproben (n = 11 und n = 64) überprüft. Ergebnisse Die Anwendbarkeit, Verständlichkeit und Nützlichkeit des Puppeninterviews wurde für die Akut- und Nachsorgephase gezeigt, wobei sich die Krankheitsannahmen je nach Krankheitsphase unterscheiden können. Es zeigten sich erwartungskonforme Interskalenkorrelationen im Puppeninterview (z. B. Chronizität – Konsequenzen für die Lebensführung: r = 0,690, p ≤ 0,05), hypothesenkonforme Ergebnisse zur Konstruktvalidität (z. B. Chronizität – internale Kontrolle r = −0,711, p ≤ 0,05) und zufriedenstellende interne Konsistenzen. Mitunter besprachen die Kinder mit den Puppen mögliche Bewältigungsstrategien, was zu einer Entlastung beitrug. Schlussfolgerung Die Einschätzungen der Eltern können zukünftig durch eine zuverlässige Erhebung von subjektiven Krankheitsannahmen bei Kindern ab 4 Jahren ergänzt werden, um medikamentöse und psychosoziale Interventionen gezielt anzupassen. / Background Illness perceptions comprise assumptions about symptoms, timeline, consequences, controllability, and emotional responses of an illness. Recent evidence shows that illness perceptions are associated with coping and well-being. Until now, assessment is based on parental report only, since no instrument for the direct assessment of children is available. Objectives Development of a puppet interview for the age-appropriate assessment of illness perceptions in children up to the age of 4 years. Recommendations for the application (including indications and contraindications) and assessment of psychometric properties. Materials and methods The puppet interview was developed based on the Illness Perception Questionnaire (IPQ-R) and the Berkeley Puppet Interview and examined in two samples of patient–parent dyads (n = 11 und n = 64). Results The puppet interview is applicable (comprehensible, useful) in acute treatment and follow-up care. Illness perceptions may vary in different treatment phases. We saw confirming intercorrelation of scales (chronicity – consequences: r = 0.690, p ≤ 0.05) and adequate psychometric properties (construct validity: chronicity – internal control: r = −0.711, p ≤ 0.05, internal consistency). Some children even discussed potential coping strategies with the puppets. Conclusion Parental report can be complemented by a self-report measure of illness perceptions in affected children aged 4 years and older. This will allow for the further adaptation of medical and psychosocial treatment.

Background: Breast cancer (BC), the most common cancer affecting women, has consequences on physical and psychological health. Recent studies highlighted selfcompassions’-, and fear of receiving compassion's protective respectively detrimental effects on psychological health. This study explored the moderating role of fear of receiving compassion from others on the associations between self-compassion and psychological distress. Methods: Participants were 78 Portuguese women with non-metastatic BC. Participants completed self-report measures of self-compassion, fear of receiving compassion from others, and psychological distress. Moderation analyzes through PROCESS Macro in SPSS was conducted. Results: Fear of receiving compassion from others moderated the association between self-compassion and depressive symptoms. At moderate and high levels of the moderator, the association was significant, at low levels the association was nonsignificant. The associations of self-compassion with anxiety, and with stress were not moderated by fear of receiving compassion from others. Conclusions: To our knowledge this study is solitary in examining fear of receiving compassion from others as moderator of the associations between self-compassion and psychological distress. This study contributes to increased understanding of psychological distress among women with BC. The findings should direct future research towards longitudinal, intervention-based studies, targeting fear of receiving compassion, and self-compassion, through compassion-focused therapies. / Bakgrund: Bröstcancer (BC), den vanligaste cancerformen hos kvinnor, har konsekvenser för fysisk och psykologisk hälsa. Tidigare studier har belyst självmedkänsla och rädsla för att ta emot medkänslas skyddande, respektive skadliga effekter på psykologisk hälsa. Den här studien undersökte den modererande rollen av rädsla för att ta emot medkänsla från andra på sambandet mellan självmedkänsla och psykologiska besvär. Metod: Deltagarna var 78 portugisiska kvinnor med icke-metastaserad BC. Deltagarna genomförde självskattningar avseende självmedkänsla, rädsla för att ta emot medkänsla från andra och psykologiska besvär. Moderationsanalyser genomfördes i PROCESS Macro i SPSS. Resultat: Rädsla för att ta emot medkänsla från andra modererade sambandet mellan självmedkänsla och depressiva symtom. Vid moderata och höga nivåer av moderatorn var associationen signifikant, vid låga nivåer var associationen inte signifikant. Associationerna mellan självmedkänsla och ångest eller stress modererades inte av rädsla för att ta emot medkänsla från andra. Slutsatser: Såvitt vi vet är denna studie ensam att undersöka rädsla för att ta emot medkänsla från andra som moderator på sambandet mellan självmedkänsla och psykologiska besvär. Denna studie bidrar till ökad förståelse för psykologiska besvär hos kvinnor med BC. Resultaten bör rikta framtida forskning mot longitudinella, interventionsbaserade studier, inriktade på rädsla för att ta emot medkänsla och självmedkänsla genom compassionfokuserade terapier.

Advances in breast cancer detection and oncology treatment modalities have prolonged the survival time for the cancer population, which is officially the largest group of cancer survivors among women in the western world, including South Africa (Brem & Kumar, 2011; Fisher, Dolbeault, Sultan & Bredart, 2014; Herbst, 2011; Reyes-Gibby, et al., 2012). In the light of shocking statistics and ever rising numbers of cancer, especially breast cancer, the time is ripe for further research in the domain of psycho-oncology and has motivated the researcher, due to her interest and involvement in breast cancer, to make this her field of research. Despite the need for a bio-psycho-social approach when treating cancer patients there is little literature available on the psychological interventions in South Africa where the majority of research studies previously conducted in South Africa have generally focused on the bio-medical aspects of cancer (Albrecht, 2009; Venter, 2014). To comprehend the paradigm of psycho-oncology, which is the backbone of this study, a theoretical framework was attained from Engel’s humanistic or psychological model (caring) and Pasteur’s biomedical model (curing) (Borrel-Carrio, Suchman, & Epstein, 2004). The primary aim of this study was to explore the lived experiences of breast cancer patients concerning their diagnosis, treatment and survivorship and unique needs for psycho-oncological interventions through their own “voices”. The research was conducted within a qualitative framework with a case study method of inquiry employing open-ended style interviews and psychotherapeutic sessions with five purposely sampled breast cancer patients. Two qualitative questionnaires were also used for triangulation purposes. Transcripts of all the therapeutic sessions were analysed using interpretive analysis where categories and themes were developed and described in full. Findings indicated that in spite the extensive proof that breast cancer causes numerous sexual and psychological complications during active treatment and afterwards, patients still feel that they have no “platform” to express their emotions and sexual issues within the oncology framework, or that there is enough and sufficient assistance to attend to their needs. e The researcher hopes that this study will make a valuable contribution to research in the field of psycho-oncology in South Africa and to indicate new realities of the chronicity of breast cancer and treatment complications that demand psychotherapeutic interventions in cancer care and that the study will initiate new ways of understanding the role of psychology and the psychologist in the medical world of cancer. The researcher hopes that by offering an understanding of participants’ unique experiences of this process, practitioners will have insight when working therapeutically with this population and empower them to have a quality of life, even within the boundaries of their illness. / Psychology / D. Litt. et Phil. (Psychology)

Objective: Soft tissue sarcomas (STS) and gastrointestinal stromal tumours (GIST) are a group of rare malignant tumours with a high and heterogenous disease burden. As evidence is scarce, we analysed the prevalence of increased emotional distress and identified distress‐associated factors in these patients. - Methods: The PROSa‐study (Burden and medical care of sarcoma) was conducted between 2017 and 2020 in 39 study centres. Cross‐sectional data from adult STS and GIST patients were analysed. Distress was measured with the Patient Health Questionnaire (PHQ‐4). The relation of socioeconomic and clinical factors with distress was explored in adjusted logistic regression models. - Results: Among 897 patients, 17% reported elevated anxiety and 19% reported depression. Unemployed patients (odds ratio [OR] 6.6; 95% CI 2.9–15.0), and those with a disability pension (OR 3.1; 95% CI 1.9–5.0) were more likely to experience distress compared to employed patients. Also, patients with a disability pass had higher odds of increased distress than those without (OR 1.8; 95% CI 1.2–2.7). Lowest distress was observed in patients 2 to <5 years and ≥5 years after diagnosis (comparison: <6 months) (OR 0.4; 95% CI 0.2–0.6) and (0.3; 95% CI 0.2–0.6). Patients with thoracic STS (vs. lower limbs) had twice the odds to experience distress(OR2.0;95%CI 1.1–3.6). Distress was seen almost twice as often in patients with progressive disease (vs. complete remission) (OR 1.7; 95% CI 1.1–2.8). - Conclusion: The prevalence of elevated distress in STS and GIST patients is high. In unemployed patients, in those with a disability pension and in newly diagnosed patients a noticeable increase was observed. Clinicians should be aware of these factors and consider the social aspects of the disease.

La família és una peça clau en el suport del malalt durant el procés de la malaltia. No obstant això, les conseqüències psicològiques que comporta l'impacte de la malaltia i continus cures, sovint repercuteixen en la seva pròpia salut i per tant en la seva qualitat de vida. Objectiu: El present estudi analitza les principals necessitats del cuidador primari, així com les motivacions per a l'adquisició del rol i el manteniment de la cura. S'han identificat les principals estratègies d'afrontament que empren els cuidadors al llarg del procés de la malaltia per fer front a l'impacte de l'estrès, així com l'anàlisi del vincle afectiu que el cuidador manté amb el malalt. Metodologia: A través d'un estudi qualitatiu de tall transversal es van realitzar 35 entrevistes individuals i 10 grups focals. Es va comptar amb la participació de 26 dones i 9 homes amb una mitjana de 34 anys, tots ells cuidadors primaris de nens i nenes amb càncer albergats en un centre d'atenció que ofereix ajuda a malalts infantils de càncer de l'occident de Mèxic. Resultats: El perfil del cuidador primari correspon, principalment a dones, amb un nivell educatiu mitjà, casades i d'un estrat socioeconòmic baix, que exerceixen el seu rol de cuidadores i de mestresses de casa. La motivació de la cura està associada a sentiments amor, deure i altruisme. La majoria dels cuidadors empraven estratègies d'afrontament centrades en l'emoció i mantenien un vincle de tipus segur amb el malalt. / La familia es una pieza clave en el apoyo del enfermo durante el proceso de la enfermedad. Sin embargo, las consecuencias psicológicas que conlleva el impacto de la enfermedad y continuos cuidados, a menudo repercuten en su propia salud y por ende en su calidad de vida. Objetivo: El presente estudio analiza las principales necesidades del cuidador primario, así como las motivaciones para la adquisición del rol y el mantenimiento del cuidado. Se han identificado las principales estrategias de afrontamiento que emplean los cuidadores a lo largo del proceso de la enfermedad para hacer frente al impacto del estrés, así como el análisis del vínculo afectivo que el cuidador mantiene con el enfermo. Metodología: A través de un estudio cualitativo de corte transversal se realizaron 35 entrevistas individuales y 10 grupos focales. Se contó con la participación de 26 mujeres y 9 hombres con una media de 34 años, todos ellos cuidadores primarios de niños y niñas con cáncer albergados en un centro de atención que brinda ayuda a enfermos infantiles de cáncer del occidente de México. Resultados: El perfil del cuidador primario corresponde, principalmente a mujeres, con un nivel educativo medio, casadas y de un estrato socioeconómico bajo, que ejercen su rol de cuidadoras y de amas de casa. La motivación del cuidado está asociada a sentimientos amor, deber y altruismo. La mayoría de los cuidadores empleaban estrategias de afrontamiento centradas en la emoción y mantenían un vínculo de tipo seguro con el enfermo. / The family is essential in supporting the patient during the disease process. However, the psychological consequences that entails the impact of the disease and ongoing care, often affect their own health and quality of life. Objective: This study analyzes the main needs of primary caregiver, and the reasons for the acquisition and maintenance of the role of care. The study has identified the main coping strategies used by caregivers throughout the disease process to face the impact of stress and the attachment between the caregiver and the patient. Methodology: Through a cross-sectional qualitative study was conducted 35 individual interviews and 10 reflective groups. It was attended by 26 women and 9 men with an average of 34 years, all primary caregivers of children housed in a cancer care center that provides assistance to children of cancer patients in western Mexico. Results: The primary caregiver profile corresponds mainly to women, with an average educational level and a low socioeconomic status who carry out their role as caregivers and homemakers. The motivation of care is associated with feelings love, obligation and altruism. Most caregivers used coping strategies focused on emotion and had a positive and safe attachment with the patient.