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      Biopsychosocial needs of survivors of testicular cancer and evidence of validation of a brief scale Translated title: Necessidades biopsicossociais de sobreviventes de câncer de testículo e evidência de validação de escala breve

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          Abstract

          Abstract The favorable prognosis of testicular cancer does not minimize immediate and late biopsychosocial implications. This study sought to determine these needs, and to evaluate the evidence of validation of a brief and specific scale for this population. A sample of 29 survivors of testicular cancer (n = 29) was assessed for distress (Distress Thermometer), anxiety and depression (Hospital Anxiety and Depression Scale), quality of life and cognitive impairment (Functional Assessment of Chronic Illness Therapy-General and Cognitive Function), and specific needs (Cancer Assessment for Young Adults-Testicular). It was observed a high prevalence of distress (41.4%), a low prevalence of anxiety (6.9%) and depression (6.9%), and a moderate impact on quality of life and cognition. Self-image and sexual function were the most preponderant problems. The evidence of validation of Cancer Assessment for Young Adults-Testicular12 was verified in the psychometric analysis. Notably, biopsychosocial needs identified on global scales, and particularly in Cancer Assessment for Young Adults-Testicular12, assisted in understanding these specificities and in therapeutic planning.

          Translated abstract

          Resumo O prognóstico favorável do câncer de testículo não minimiza as implicações biopsicossociais imediatas e tardias. Este estudo objetiva determinar essas necessidades e avaliar a evidência de validação de escala breve e específica para essa população. Uma amostra de 29 pacientes sobreviventes de câncer de testículo foi avaliada quanto ao distress (Termômetro de Distress), ansiedade e depressão (Escala de Ansiedade e Depressão), qualidade de vida e prejuízo cognitivo (Functional Assessment of Chronic Illness Therapy-General e Cognitive Function) e demandas específicas (Cancer Assessment for Young Adults-Testicular12). Observou-se alta prevalência de distress (41,4%), baixa prevalência de ansiedade (6,9%) e depressão (6,9%) e moderado impacto na qualidade de vida e cognição. Autoimagem e função sexual foram os problemas mais preponderantes. A evidência de validação do Cancer Assessment for Young Adults-Testicular12 foi constatada na avaliação psicométrica. Notavelmente, as necessidades biopsicossociais identificadas nas escalas globais e, particularmente no Cancer Assessment for Young Adults-Testicular12, auxiliaram no entendimento dessas especificidades e no planejamento terapêutico.

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          Exploratory Factor Analysis With Small Sample Sizes.

          Exploratory factor analysis (EFA) is generally regarded as a technique for large sample sizes (N), with N = 50 as a reasonable absolute minimum. This study offers a comprehensive overview of the conditions in which EFA can yield good quality results for N below 50. Simulations were carried out to estimate the minimum required N for different levels of loadings (λ), number of factors (f), and number of variables (p) and to examine the extent to which a small N solution can sustain the presence of small distortions such as interfactor correlations, model error, secondary loadings, unequal loadings, and unequal p/f. Factor recovery was assessed in terms of pattern congruence coefficients, factor score correlations, Heywood cases, and the gap size between eigenvalues. A subsampling study was also conducted on a psychological dataset of individuals who filled in a Big Five Inventory via the Internet. Results showed that when data are well conditioned (i.e., high λ, low f, high p), EFA can yield reliable results for N well below 50, even in the presence of small distortions. Such conditions may be uncommon but should certainly not be ruled out in behavioral research data. ∗ These authors contributed equally to this work.
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            Sexuality and body image in long-term survivors of testicular cancer.

            This study explores sexual function and the influence of different treatment modalities on sexual function and body image among long-term survivors of testicular cancer (TCSs). A long-term follow-up assessment of all testicular cancer patients treated at Aarhus University Hospital, Denmark, from 1990 to 2000 was conducted. A total of 401 survivors (mean age: 46.6years; response rate: 66%) completed questionnaires concerning sexuality and changes in body image. Based on the treatment received, patients were categorised into one of four groups: surveillance, radiotherapy, chemotherapy, or chemotherapy supplemented with retroperitoneal lymph node dissection (RPLND). Sexual dysfunctions were reported: 24% reduced sexual interest, 43% reduced sexual activity, 14% reduced sexual enjoyment, 18% erectile dysfunction, 7% ejaculatory problems and 3% increased sexual discomfort. Seventeen percent of the long-term TCSs reported changes in body image, and this was significantly associated with all six parameters of sexual dysfunction. When comparing treatments, only the RPLND procedure was associated with sexual dysfunction in the form of ejaculatory dysfunction. Apart from RPLND, which was associated with ejaculatory dysfunction, treatment strategies for testicular cancer appeared not to influence sexual dysfunction. The level of erectile dysfunction seen in this sample of TCSs seemed to be higher than the level observed in the general male population and high levels of erectile dysfunction were associated with negative changes in body image. The results suggest that changes in body image are of importance when explaining the variation in sexual dysfunctions, but further prospective studies are needed to clarify this issue. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Sexual functioning among young adult cancer patients: A 2-year longitudinal study

              Cancer-related sexual dysfunction has been reported among adolescents and young adults (AYAs); however, its prevalence over time has not been examined. This longitudinal study investigated sexual dysfunction in AYAs over the course of 2 years after the initial diagnosis. Young adult patients (18–39 years old) completed the Medical Outcomes Study Sexual Functioning Scale within the first 4 months of their diagnosis (n = 123) and again 6 (n = 107) and 24 months later (n = 95). An ordered multinomial response model analyzed changes in the probability of reporting sexual dysfunction over time and the independent effects of demographic, clinical, and psychosocial variables. More than half of the participants reported sexual functioning to be problematic at each assessment. The probability of reporting sexual dysfunction increased over time ( P < .01) and was greater for cancer patients who were female ( P < .001), older ( P < .01), married or in a committed relationship ( P < .001), treated with chemotherapy ( P < .05), and reporting comorbid psychological distress ( P < .001) and lower social support ( P < .05). For women, being in a relationship increased the likelihood of reporting sexual problems over time; for men, the likelihood of reporting sexual problems increased regardless of their relationship status. A substantial proportion of young adults report ongoing problems with sexual functioning in the first 2 years after their cancer diagnosis. These findings justify the need to evaluate and monitor sexual functioning throughout a continuum of care.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                epc
                Estudos de Psicologia (Campinas)
                Estud. psicol. (Campinas)
                PUC-Campinas (Campinas, SP, Brazil )
                0103-166X
                March 2019
                : 36
                : 0
                : e180075
                Affiliations
                [1] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Hospital São Paulo orgdiv2Programa de Residência Multiprofissional em Oncologia Brazil
                [3] Duarte California orgnameCity of Hope Comprehensive Cancer Center orgdiv1Department of Medical Oncology & Experimental Therapeutics United States
                [2] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Escola Paulista de Enfermagem orgdiv2Departamento de Enfermagem Clínica e Cirúrgica Brazil
                Article
                S0103-166X2019000100904
                10.1590/1982-0275201936e180075
                0f593b93-d005-46ef-94e8-d81e5f5d8439

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 June 2018
                : 11 December 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 0
                Product

                SciELO Brazil

                Categories
                Health Psychology

                Depressão,Ansiedade,Anxiety,Depression,Testicular neoplasms,Distress,Neoplasias testiculares,Quality of life,Qualidade de vida

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