Impacto das preocupações reprodutivas sobre o ajustamento psicológico e social e o viés atencional em jovens sobreviventes de cancro da mama e cervical

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Publication . Bártolo, Ana; Santos, Isabel M.; Guimarães, Raquel; Reis, Salomé; Monteiro, Sara

Breast cancer diagnosis can threaten fertility and biological motherhood in women of reproductive age due to the gonadotoxic efects of treatments. Much evidence documents these women fertility-related concerns and distress, but no study has attempted to understand how implicit cognitive processes can contribute to this maladjustment. In this research, we explored whether reproduction-related stimuli interfere with cognition among cancer survivors with infertility risk using an emotional Stroop task. Furthermore, we investigated the relationship between reproduction-related cognitive processing and psychological morbidity. Young cancer survivors aged 18–40 years who received anticancer treatments and an age-matched noncancer control group without known fertility problems were compared. Color-naming times and error rates were assessed. Participants in both groups were slower naming the color of reproduction-related words in comparison to unrelated negative valence words. Although in the same direction, this diference did not reach statistical signifcance for positive and neutral unrelated word lists. Further analysis suggested that biased attention toward reproduction-related information was associated with higher depression levels in young women with personal breast cancer history, but not in healthy women. These fndings suggest that biased processing of reproduction-related cues might be a vulnerability factor after a breast cancer diagnosis. Additionally, this study puts in evidence the potential usefulness of using experimental tasks to investigate attentional bias in a context where fertility is at risk.

2021Journal article

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Attentional bias toward reproduction-related stimuli and fertility concerns among breast cancer survivors

Publication . Bártolo, Ana; Santos, Isabel M.; Guimarães, Raquel; Reis, Salomé; Monteiro, Sara

The current study examined whether an attentional bias exists for reproduction-related visual cues among breast cancer survivors and its relationship with fertility concerns and emotional distress. Breast cancer survivors (n ¼ 38) aged 18–40 were compared to 37 healthy women recruited from the general population. Attentional bias was investigated using a visual dot-probe task and response times (RT) were measured. Participants also completed several questionnaires, including the Reproductive Concerns After Cancer Scale (RCACS) and the Hospital Anxiety and Depression Scale (HADS). Biased cognitive processing toward reproduction-related stimuli was observed for all young women. However, attentional bias was a significant predictor of concerns about partner disclosure of fertility status, with higher bias scores associated with higher levels of concern only for breast cancer survivors. The desire to have a (or another) biological child was also a significant predictor of higher concerns related with fertility potential for all young women. Higher vigilance regarding reproduction-related cues seems to lead to higher concerns among women with breast cancer history whose fertility is threatened. This result may have important research and clinical implications. Interventions focused on goal-oriented attention self-regulation and problemsolving can help to manage fertility concerns and distress in the course of the disease.

2021Journal article

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Toward an understanding of the factors associated with reproductive concerns in younger female cancer patients: evidence from the literature

Publication . Bártolo, Ana; Santos, Isabel M.; Monteiro, Sara

Background: Cancer treatments may compromise fertility and family building in reproductive-age women. Previous research has shown that younger women with cancer experienced several reproductive health concerns. Objective: The aim of this study was to conduct a focused review of existing research about the subjective perceptions of reproductive concerns among young women with cancer (aged 15-49 years) and identify their potential predictors and outcomes. Methods: A systematic synthesis of mixed-methods research was conducted including peer-reviewed articles in English. Relevant studies were identified through the electronic databases Scopus, Web of Science, PubMed, ProQuest, and Psychology & Behavioral Sciences Collection (through EBSCOhost). Results: A total of 22 reports met the eligibility criteria (8 qualitative and 14 quantitative). Research showed that younger women reported concerns related to their fertility status and/or own health after conception, their children’s health, and their dyadic relationships. Redefinition of the motherhood role and the family future were also a source of concern. However, there is variance among women in concerns and experiences based on life stages and expectations. Conclusions: Reproductive concerns seem to be affected by personal circumstances and previous therapeutics. These concerns constitute a potential risk factor, simultaneously, for psychosocial maladjustment and adherence to endocrine therapy and fertility care. Implications for Practice: This article proposes a conceptual framework to understand the dimensions and potential predictors and outcomes of perceived concerns among reproductive-age cancer patients. Our data allow us to look at these concerns from a multifactorial perspective, identifying areas to be addressed in providing clinical care, namely, by nurses accompanying patients over an extended period.

2020Journal article

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Effectiveness of psycho-educational interventions with telecommunication technologies on emotional distress and quality of life of adult cancer patients: a systematic review

Publication . Bártolo, Ana; Pacheco, Emelda; Rodrigues, Fabiana; Pereira, Anabela; Monteiro, Sara; Santos, Isabel M.

Purpose: To provide a comprehensive review of psycho-educational interventions using telecommunication technologies developed for adult cancer patients, assessing their effectiveness in reducing emotional distress and improving quality of life (QoL). Materials and methods: A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified through the electronic databases PubMed, Scopus, Web of Science, ProQuest, Psychology & Behavioral Sciences Collection (through EBSCOhost), and CENTRAL. Results: Eight studies involving 1016 participants met inclusion criteria. The majority of the studies included (n¼6) used a randomized design and were published between 2007 and 2016. Interventions used a variety of delivery resources, such as telephone, e-mail and websites, but all were aiming to respond to information needs and develop stress control skills. A trend toward reducing distress and improving QoL was found, but estimated effect sizes were typically small (d<0.5). Telephonically delivered psycho-educational interventions presented the highest between-group effects on these outcomes during survival, but were limited by sample size. Conclusions: The efficacy of interventions using distance approaches in the cancer setting is still not wellestablished. Further research should be conducted through well-designed studies with more interactive features that minimize the lack of face-to-face interaction.

2017Journal article

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