Hispanic Cancer Survivors Exposed to Multiple Natural Disasters: Pre–Post-Disaster Changes in Anxiety, Depression, PTSD, Perceived Stress, and Physical Symptom Burden
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethical Statement
2.2. Participants’ Eligibility and Data Collection Process
2.3. Measures
2.4. Statistical Analysis
3. Results
3.1. Sociodemographic and Clinical Characteristics and Health Behaviors
3.2. Pre–Post-Disaster Changes among Cancer Patients
3.3. Comparison of Cancer Patients and Non-Cancer Controls
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Robinson, S.A.; Wren, C. Geographies of vulnerability: A research note on human system adaptations to climate change in the Caribbean. Geogr. Tidskr. Udgivet Bestyrelsen K. Dan. Geogr. Selsk. 2020, 120, 79–86. [Google Scholar] [CrossRef]
- Prohaska, T.R.; Peters, K.E. Impact of Natural Disasters on Health Outcomes and Cancer Among Older Adults. Gerontologist 2019, 59 (Suppl. 1), S50–S56. [Google Scholar] [CrossRef] [PubMed]
- Man, R.X.G.; Lack, D.A.; Wyatt, C.E.; Murray, V. The effect of natural disasters on cancer care: A systematic review. Lancet Oncol. 2018, 19, e482–e499. [Google Scholar] [CrossRef] [PubMed]
- Jafari, H. Cancer Patients During and after Natural and Man-Made Disasters: A Systematic Review. Asian Pac. J. Cancer Prev. 2018, 19, 2695–2700. [Google Scholar]
- Güner, P. Three Phases of Cancer in the Process of Mental Trauma: Diagnosis, Treatment, Survival. J. Psychiatr. Nurs. 2017, 9, 45–54. [Google Scholar] [CrossRef]
- Gieseler, F.; Gaertner, L.; Thaden, E.; Theobald, W. Cancer Diagnosis: A Trauma for Patients and Doctors Alike. Oncologist 2018, 23, 752–754. [Google Scholar] [CrossRef]
- Cordova, M.J.; Riba, M.B.; Spiegel, D. Post-traumatic stress disorder and cancer. Lancet Psychiatry 2017, 4, 330–338. [Google Scholar] [CrossRef]
- Pranjic, N.; Bajraktarevic, A.; Ramic, E. Distress and PTSD in Patients with Cancer: Cohort Study Case. Mater. Socio Medica 2016, 28, 12. [Google Scholar] [CrossRef]
- Fernandez, C.A.; Vicente, B.; Marshall, B.D.L.; Koenen, K.C.; Arheart, K.L.; Kohn, R.; Saldivia, S.; Buka, S.L. Longitudinal course of disaster-related PTSD among a prospective sample of adult Chilean natural disaster survivors. Int. J. Epidemiol. 2017, 46, 440–452. [Google Scholar] [CrossRef]
- Saeed, S.A.; Gargano, S.P. Natural disasters and mental health. Int. Rev. Psychiatry 2022, 34, 16–25. [Google Scholar] [CrossRef]
- Bambaren, C. Salud mental en desastres naturales. Rev. Psicol. Hered. 2014, 6, 20. [Google Scholar] [CrossRef]
- Siqveland, J.; Nygaard, E.; Hussain, A.; Tedeschi, R.G.; Heir, T. Posttraumatic growth, depression and posttraumatic stress in relation to quality of life in tsunami survivors: A longitudinal study. Health Qual. Life Outcomes 2015, 13, 18. [Google Scholar] [CrossRef] [PubMed]
- Ciążyńska, M.; Pabianek, M.; Szczepaniak, K.; Ułańska, M.; Skibińska, M.; Owczarek, W.; Narbutt, J.; Lesiak, A. Quality of life of cancer patients during coronavirus disease (COVID-19) pandemic. Psychooncology 2020, 29, 1377–1379. [Google Scholar] [CrossRef] [PubMed]
- Götze, H.; Ernst, J.; Brähler, E.; Romer, G.; von Klitzing, K. Predictors of quality of life of cancer patients, their children, and partners. Psychooncology 2015, 24, 787–795. [Google Scholar] [CrossRef]
- Morrison, E.J.; Novotny, P.J.; Sloan, J.A.; Yang, P.; Patten, C.A.; Ruddy, K.J.; Clark, M.M. Emotional Problems, Quality of Life, and Symptom Burden in Patients with Lung Cancer. Clin. Lung Cancer 2017, 18, 497–503. [Google Scholar] [CrossRef] [PubMed]
- Mazor, M.; Paul, S.M.; Chesney, M.A.; Chen, L.; Smoot, B.; Topp, K.; Conley, Y.P.; Levine, J.D.; Miaskowski, C. Perceived stress is associated with a higher symptom burden in cancer survivors. Cancer 2019, 125, 4509–4515. [Google Scholar] [CrossRef]
- Tsaras, K.; Papathanasiou, I.V.; Mitsi, D.; Veneti, A.; Kelesi, M.; Zyga, S.; Fradelos, E.C. Assessment of Depression and Anxiety in Breast Cancer Patients: Prevalence and Associated Factors. Asian Pac. J. Cancer Prev. 2018, 19, 1661–1669. [Google Scholar] [CrossRef]
- Fauzan; Nur, R.; Masni; Mallongi, A.; Sridani, N.W.; Devi, R. Factors related to quality of life of elderly victims of natural disasters in Palu City. Enferm. Clin. 2020, 30, 178–181. [Google Scholar] [CrossRef]
- Miles, J.N.V.; Marshall, G.N.; Schell, T.L. Spanish and English versions of the PTSD Checklist–Civilian version (PCL-C): Testing for differential item functioning. J. Trauma Stress 2008, 21, 369–376. [Google Scholar] [CrossRef]
- Torres, O.M.P.; Aníbal González-Rivera, J.; Rosario-Hernández, E.; Pagán-Torres, O.M.; González-Rivera, J.A. Reviewing the Psychometric Properties and Factor Structure of the Generalized Anxiety Disorder-7 (GAD-7) in a Sample of Puerto Rican Adults. Int. J. Recent. Sci. Res. 2020, 11, 36886–36888. [Google Scholar] [CrossRef]
- Gómez-Gómez, I.; Benítez, I.; Bellón, J.; Moreno-Peral, P.; Oliván-Blázquez, B.; Clavería, A.; Zabaleta-Del-Olmo, E.; Llobera, J.; Serrano-Ripoll, M.J.; Tamayo-Morales, O.; et al. Utility of PHQ-2, PHQ-8 and PHQ-9 for detecting major depression in primary health care: A validation study in Spain. Psychol. Med. 2022, 53, 5625–5635. [Google Scholar] [CrossRef]
- Baik, S.H.; Fox, R.S.; Mills, S.D.; Roesch, S.C.; Sadler, G.R.; Klonoff, E.A.; Malcarne, V.L. Reliability and validity of the Perceived Stress Scale-10 in Hispanic Americans with English or Spanish language preference. J. Health Psychol. 2017, 24, 628–639. [Google Scholar] [CrossRef] [PubMed]
- Golden-Kreutz, D.M.; Browne, M.W.; Frierson, G.M.; Andersen, B.L. Assessing Stress in Cancer Patients: A Second-Order Factor Analysis Model for the Perceived Stress Scale. Assessment 2004, 11, 216–223. [Google Scholar] [CrossRef] [PubMed]
- Cleeland, C.S.; Mendoza, T.R.; Wang, X.S.; Chou, C.; Harle, M.T.; Morrissey, M.; Engstrom, M.C. Assessing symptom distress in cancer patients. Cancer 2000, 89, 1634–1646. [Google Scholar] [CrossRef]
- Rodríguez-Rey, R.; Alonso-Tapia, J.; Hernansaiz-Garrido, H. Reliability and validity of the Brief Resilience Scale (BRS) Spanish Version. Psychol. Assess. 2016, 28, e101–e110. [Google Scholar] [CrossRef]
- Merz, E.L.; Roesch, S.C.; Malcarne, V.L.; Penedo, F.J.; Llabre, M.M.; Weitzman, O.B.; Navas-Nacher, E.L.; Perreira, K.M.; Gonzalez, F.; Ponguta, L.A.; et al. Validation of interpersonal support evaluation list-12 (ISEL-12) scores among English- and Spanish-speaking Hispanics/Latinos from the HCHS/SOL Sociocultural Ancillary Study. Psychol. Assess. 2014, 26, 384–394. [Google Scholar] [CrossRef]
- Weiss, T.; Berger, R. Reliability and validity of a Spanish version of the posttraumatic growth inventory. Res. Soc. Work Pract. 2006, 16, 191–199. [Google Scholar] [CrossRef]
- Lotfi-Jam, K.; Gough, K.; Schofield, P.; Aranda, S.; Jefford, M. A longitudinal study of four unique trajectories of psychological distress in cancer survivors after completing potentially curative treatment. Acta Oncol. 2019, 58, 782–789. [Google Scholar] [CrossRef] [PubMed]
- Edward, K.-L.; Chipman, M.; Giandinoto, J.-A.; Robinson, K. Quality of life and personal resilience in the first two years after breast cancer diagnosis: Systematic integrative review. Br. J. Nurs. 2019, 28, S4–S14. [Google Scholar] [CrossRef]
- Chen, S.; Bagrodia, R.; Pfeffer, C.C.; Meli, L.; Bonanno, G.A. Anxiety and resilience in the face of natural disasters associated with climate change: A review and methodological critique. J. Anxiety Disord. 2020, 76, 102297. [Google Scholar] [CrossRef]
- Aburn, G.; Gott, M.; Hoare, K. What is resilience? An Integrative Review of the empirical literature. J. Adv. Nurs. 2016, 72, 980–1000. [Google Scholar] [CrossRef] [PubMed]
- Herrman, H.; Stewart, D.E.; Diaz-Granados, N.; Berger, E.L.; Jackson, B.; Yuen, T. What is Resilience? Can. J. Psychiatry 2011, 56, 258–265. [Google Scholar] [CrossRef] [PubMed]
- Feldman, R. What is resilience: An affiliative neuroscience approach. World Psychiatry 2020, 19, 132–150. [Google Scholar] [CrossRef] [PubMed]
- Horn, S.R.; Feder, A. Understanding Resilience and Preventing and Treating PTSD. Harv. Rev. Psychiatry 2018, 26, 158–174. [Google Scholar] [CrossRef] [PubMed]
- Seiler, A.; Jenewein, J. Resilience in Cancer Patients. Front. Psychiatry 2019, 10, 208. [Google Scholar] [CrossRef]
- Eicher, M.; Matzka, M.; Dubey, C.; White, K. Resilience in Adult Cancer Care: An Integrative Literature Review. Oncol. Nurs. Forum 2015, 42, E3–E16. [Google Scholar] [CrossRef]
- Tamura, S.; Suzuki, K.; Ito, Y.; Fukawa, A. Factors related to the resilience and mental health of adult cancer patients: A systematic review. Support. Care Cancer 2021, 29, 3471–3486. [Google Scholar] [CrossRef]
- Groarke, A.; Curtis, R.; Skelton, J.; Groarke, J. Quality of life and adjustment in men with prostate cancer: Interplay of stress, threat and resilience. PLoS ONE 2020, 15, e0239469. [Google Scholar] [CrossRef]
- Lau, J.; Khoo, A.M.G.; Ho, A.H.Y.; Tan, K.K. Psychological resilience among palliative patients with advanced cancer: A systematic review of definitions and associated factors. Psychooncology 2021, 30, 1029–1040. [Google Scholar] [CrossRef]
- Wu, W.W.; Tsai, S.Y.; Liang, S.Y.; Liu, C.Y.; Jou, S.T.; Berry, D. The Mediating Role of Resilience on Quality of Life and Cancer Symptom Distress in Adolescent Patients With Cancer. J. Pediatr. Oncol. Nurs. 2015, 32, 304–313. [Google Scholar] [CrossRef]
- Sharpley, C.F.; Christie, D.R.H.; Bitsika, V. The association between fatigue and depression in prostate cancer patients is influenced by psychological resilience. J. Mens. Health 2021, 17, 1–6. [Google Scholar] [CrossRef]
Variables | Patients, n = 55 Mean (SD)/N (%) | Controls, n = 46 Mean (SD)/N (%) |
---|---|---|
Socio-Demographic Characteristics | ||
Age | 58.83 (11.44) | 58.55 (10.62) |
Sex (female) | 45 (81.8%) | 38 (82.6%) |
Civil Status (married) | 19 (34.5%) | 25 (54.3%) |
Employment status (employed) | 9 (16.3%) | 17 (36.9%) |
Income (≤12,001–19,000) | 42 (76.3%) | 30 (65.2%) |
Income enough (yes) | 11 (20%) | 20 (43.4%) * |
Education level (high school or higher) | 49 (89%) | 41 (89.1%) |
Clinical Characteristics | ||
Type of cancer | ||
Breast | 20 (36.3%) | |
Uterus | 8 (14.5%) | |
Thyroid | 5 (9%) | |
Prostate | 3 (5%) | |
Others | 17 (30%) | |
Metastasis (yes) | 10 (18.1%) | |
Cancer treatment | ||
Radiation therapy | 19 (34.4%) | |
Chemotherapy | 33 (53.1%) | |
Surgery | 44 (78.1%) | |
Hormone therapy | 6 (15.6%) | |
Time since cancer diagnosis (years) | 10.44 (10.60) | |
Self-reported body max index (BMI) | 31.72 (7.81) | |
Chronic conditions comorbidity | 4.37 (2.48) | 3 (2.41) |
Lifetime mental health diagnosis | 21 (38.1%) | 15 (32.6%) |
Health Behaviors | ||
Use of antidepressants | 14 (70%) | 6 (30%) |
Sleep hours per day (>8 h per day) | 38 (69%) | 33 (71.7%) |
Smoking behavior (yes) | 6 (10.9%) | 4 (8.6%) |
Alcohol consumption (yes) | 17 (30.9%) | 16 (34.7%) |
Physical activity (yes) | 31 (56.3%) | 28 (60.8%) |
Stress management strategies (yes) | 32 (58.1%) | 22 (47.8%) |
Variables | Pre (Mean/SD) | Post (Mean/SD) | t | Cohen’s d | Sig. |
---|---|---|---|---|---|
MDASI—Intensity | 39.09 (35.72) | 36.65 (31.19) | 0.633 | 0.085 | 0.529 |
MDASI—Interference | 20.07 (18.47) | 16.91 (18.06) | 1.555 | 0.212 | 0.126 |
MDASI—Total | 59.17 (51.99) | 52.76 (46.34) | 1.222 | 0.166 | 0.227 |
PHQ-8 | 8.76 (6.50) | 6.87 (6.44) | 2.492 | 0.336 | 0.016 |
GAD-7 | 7.95 (6.49) | 6.89 (6.19) | 1.329 | 0.179 | 0.190 |
PSS | 16.58 (9.09) | 15.87 (8.37) | 0.605 | 0.082 | 0.548 |
PCL-5 | 24.44 (18.71) | 20.15 (17.99) | 1.801 | 0.245 | 0.077 |
Depression (PHQ-8) | Anxiety GAD-7 | Perceived Stress (PSS) | PTSD (PCL-5) | SymptomBurden MDASI | Symptom Intensity MDASI | Symptom Interference MDASI | |
---|---|---|---|---|---|---|---|
Resilience (BRB) | −0.637 ** | −0.671 ** | −0.755 ** | −0.658 ** | −0.425 ** | −0.486 ** | −0.470 ** |
Social support (ISEL) | −0.315 * | −0.310 * | −0.425 ** | −0.355 ** | −0.336 * | −0.380 ** | −0.368 ** |
Post-traumatic growth (PTGI) | 0.205 | 0.273 * | 0.325 * | 0.325 * | 0.410 ** | 0.377 ** | 0.423 ** |
Stress management skills | −0.084 | 0.220 | 0.342 | 0.376 * | 0.106 | 0.104 | 0.062 |
PHQ-8 | Gad-7 | PSS | PCL-5 | MDA-SymptomBurden | MDA-Intensity | MDA-Interference | |
---|---|---|---|---|---|---|---|
Resilience (BRB) | −0.608 ** | −0.705 ** | −0.666 ** | −0.679 ** | −0.633 ** | −0.611 ** | −0.662 ** |
Social support (ISEL) | −0.412 ** | −0.374 * | −0.325 * | −0.329 * | −0.300 * | −0.400 * | −0.356 * |
Post-traumatic growth (PTGI) | 0.152 | 0.091 | 0.022 | 0.199 | 0.288* | 0.134 | 0.246 |
Number of stress management skills | 0.324 | 0.234 | 0.103 | 0.232 | 0.093 | 0.082 | 0.101 |
Variables | Code | Mean Rank | Sum of Ranks | Z | Sig. |
---|---|---|---|---|---|
PHQ-8 | Control | 48.74 | 2242.00 | −0.858 | 0.391 |
Patient | 53.77 | 3011.00 | |||
GAD-7 | Control | 48.26 | 2220.00 | −1.008 | 0.314 |
Patient | 54.16 | 3033.00 | |||
PSS | Control | 46.89 | 2157.00 | −1.428 | 0.153 |
Patient | 55.29 | 3096.00 | |||
PCL-5 | Control | 49.12 | 2259.50 | −0.738 | 0.461 |
Patient | 53.46 | 2993.50 |
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Castro-Figueroa, E.M.; Peña-Vargas, C.; Rodríguez-Santiago, M.; Figueroa, J.I.; Hernández, R.; Rodríguez, Z.; Jim, H.; Pereira, C.; Torres-Blasco, N.; Flores, I.; et al. Hispanic Cancer Survivors Exposed to Multiple Natural Disasters: Pre–Post-Disaster Changes in Anxiety, Depression, PTSD, Perceived Stress, and Physical Symptom Burden. Int. J. Environ. Res. Public Health 2024, 21, 1237. https://doi.org/10.3390/ijerph21091237
Castro-Figueroa EM, Peña-Vargas C, Rodríguez-Santiago M, Figueroa JI, Hernández R, Rodríguez Z, Jim H, Pereira C, Torres-Blasco N, Flores I, et al. Hispanic Cancer Survivors Exposed to Multiple Natural Disasters: Pre–Post-Disaster Changes in Anxiety, Depression, PTSD, Perceived Stress, and Physical Symptom Burden. International Journal of Environmental Research and Public Health. 2024; 21(9):1237. https://doi.org/10.3390/ijerph21091237
Chicago/Turabian StyleCastro-Figueroa, Eida M., Cristina Peña-Vargas, Mónica Rodríguez-Santiago, Juan I. Figueroa, Ruthmarie Hernández, Zindie Rodríguez, Heather Jim, Cristina Pereira, Normarie Torres-Blasco, Idhaliz Flores, and et al. 2024. "Hispanic Cancer Survivors Exposed to Multiple Natural Disasters: Pre–Post-Disaster Changes in Anxiety, Depression, PTSD, Perceived Stress, and Physical Symptom Burden" International Journal of Environmental Research and Public Health 21, no. 9: 1237. https://doi.org/10.3390/ijerph21091237