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Background: The timing of a breast cancer (BC) diagnosis has a significant psychological impact on patients. However, it reported that those eligible for treatment regimens based on neoadjuvant chemotherapy may experience high levels of depression, anxiety and distress. To cope with this situation, patients deploy psychological coping strategies. The aim of this study is to explore effective and ineffective psychological adjustment mobilized by Moroccan patients newly diagnosed with BC and before receiving neoadjuvant chemotherapy, as well as to identify their associations to socio-demographic and clinical determinants. Materials and methods: A total of 209 patients were recruited in outpatient in oncology department in the public oncology hospital of Fez city, between 2021 and 2023. Ethics approval was obtained for this study and patients has signed an informed consent form. The questionnaire interview included socio-economic and clinical variables and the Arabic version of Mini-Mental Adjustment to Cancer (Mini-MAC) scale, which measures the strategies of mental adjustment to disease, as fighting spirit (FS), hopelessness/helplessness (HH), anxious preoccupations (AP), cognitive avoidance (CA), fatalism (FA), "maladaptive coping" and "adaptive coping". Bivariate analysis of psychological adjustment strategies and sociodemographic and clinical variables was carried out using statistical tests according to the nature of the variables, to their normality and the homogeneity of their variances. Univariate and multivariate linear regression modelling was carried out using a forward "enter" regression procedure. Results: A mean age of 47.43 ± 9.45 was found among participants. Assessment of mental adjustment to cancer using Mini-MAC scores revealed that psychological adjustment strategies with a higher mean score were FA, FS and "adaptive coping" strategies. Based mainly on multiple linear Regression, monthly family income was negatively associated with HH, and FS and positively linked to FA and "adaptive coping" strategies. Moreover, the left side as BC laterality was negatively associated with AP and "maladaptive coping" strategies. Furthermore, positive ER status was negatively associated with HH and "maladaptive coping" strategies and high Ki-67 levels were positively linked to AP. Conclusion: Programs to strengthen psychological adjustment in patients with BC candidates for NACT, taking into consideration the determinants found associated in this study, are of great importance since the first oncology consultation. [ABSTRACT FROM AUTHOR]

Background: During neoadjuvant therapy (NAT), patients with locally advanced breast cancer (LABC) experience psychological distress (PD) and adopt appropriate coping strategies. Objective: This systematic review aimed to examine the prevalence and changes in PD and coping strategies in patients with LABC during NAT and to evaluate effective interventions to reduce their PD. Design: Quantitative (cross-sectional, longitudinal, and interventional) and qualitative studies reporting PD and coping strategies related to NAT during LABC were included. Data sources and methods: PubMed, Cochrane Library, Scopus, ScienceDirect, Wiley Online Library, and Web of Science databases were consulted to gather relevant literature from the first publications until July 25, 2023. Selection was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 41 articles were included, of which four were qualitative. The main results showed that the prevalence of depression before NAT ranged from 0% to 46% and that of anxiety from 5.5% to 54%. After NAT, the prevalence of depression ranged from 40% to 78.5% and anxiety accounted for 27%. Additionally, PD decreased during NAT. The main determinants of PD were perceived social support, living in joint families, being affected by COVID-19 infection, delays in diagnosis, and starting neoadjuvant treatment. For coping strategies, after NAT, "resigned coping" decreased, whereas "social support" increased, and active coping strategies were correlated with better PD. Some interventions found a reduction in PD, such as a mobile health application, fasting-mimicking diet, relaxation training, and guided imaging. Conclusion: These findings highlight the importance of considering PD and coping strategies in patients with LABC from diagnosis to the end of NAT. The results suggest that effective psychological interventions should be implemented. [ABSTRACT FROM AUTHOR]

Background: patients with locally advanced breast cancer (LABC) are often treated by neoadjuvant chemotherapy (NACT). This study aims to determine the prevalence of psychological distress and their sociodemographic and clinical factors in patients recently diagnosed with LABC and before NACT. Methods: A total of 209 LABC patients without metastatic localization were recruited between 2021 and 2022 in the oncology hospital at Fez. A structured questionnaire and the Hospital Anxiety and Depression Scale were used. A descriptive analysis and linear model were performed. Results: a mean age of participants was 47.43 ± 9.45 years. The prevalence of depression, anxiety and psychological distress among participants was 59.62% (95% CI: 52.61–33.34), 47.85% (95% CI: 40.91–54.85), and 65.07 (95% CI: 58.19–71.52) respectively. Depression was associated to age (< 50 years) (AOR = 2.19; 95% CI = 1.13–4.23) and health insurance (AOR = 3.64; 95% CI: 1.18–11.26). Anxiety was associated to age (< 50) (AOR = 2.21; 95% CI: 1.18–4.13) and right breast cancer (AOA = 2.01; 95% CI: 1.11–3.65). Psychological distress was associated to chronic illness (AOR = 2.78; 95% CI: 1.32–5.85) and lymph node status (AOR = 2.39; 95% CI: 1.26–4.57). Conclusions: Based on the high prevalence of depression and anxiety it appears opportune to treat psychological distress among LABC patient candidates for NACT. Each psychological intervention should take into account sociodemographic and clinical factors found associated in our study. Psychological therapeutic interventions are crucial for LABC patients as early as the time of diagnosis and through subsequent steps in NACT to improve their overall mental health. [ABSTRACT FROM AUTHOR]

Background: The Mini-Mental Adjustment to Cancer Scale (Mini-MAC) instrument is commonly used worldwide by professionals of oncology, but the scale has not, up to date, been validated in Arabic and Moroccan context, and there is an absence of data in the Moroccan population. This study aims to validate the Mini-MAC, translated and adapted to the Arabic language and Moroccan culture, in women with breast cancer.Methods: Data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 158). Then, this structure was confirmed in the validation sample (N = 203) using confirmatory factor analysis (CFA).Results: Confirmatory factor analysis confirmed Watson's original structure underlying the Mini-MAC items: Helpless/Hopeless, Anxious Preoccupation, Fighting Spirit, Cognitive Avoidance, and Fatalism. Absolute, incremental, and parsimonious fit indices showed a highly significant level of acceptance confirming a good performance of the measurement model. The instrument showed sufficient reliability and convergent validity demonstrated by acceptable values of composite reliability (CR =0.93-0.97), and average variance extracted (AVE = 0.66-0.93), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio of correlations values were lesser than 0.85, indicating acceptable discriminant validity.Conclusions: reliability; and both convergent and discriminant validity tests indicated that the Arabic version of the Mini-MAC had a good performance and may serve as a valid tool measuring psychological responses to cancer diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: The Coronavirus Disease 2019 (COVID-19) pandemic has triggered fear and distress among the public, thus potentiating the incidence rate of anxiety and depression. This study aims to investigate the psychological effect of quarantine on persons living in Morocco when the first COVID-19 cases were identified. The associations between anxiety, depression symptoms, and their predictors (sociodemographics, fatigue, and religious coping) were examined. Methods: A web-based cross-sectional survey, with a total of 1435 participants (≥18 years) recruited anonymously, was conducted during the COVID-19 pandemic (from 3 to 30 April 2020). A structured questionnaire was used to assess psychosocial factors, COVID-19 epidemic-related factors, and religious coping. Religious coping, fatigue, and depression, and anxiety were measured by Brief Religious Coping Scale (Brief RCOPE), Chalder Fatigue Scale (CFS), and Hospital Anxiety and Depression Scale (HADS), respectively. A generalized linear model (logistic regression) was used to determine the predictive factors of depression and anxiety. Results: The prevalence of anxiety and depression was 43.0% (n = 621) and 53.0% (n = 766), respectively. Both were associated with female gender, household income decline, tracking COVID-19 news, and fear to contract COVID-19 (aOR = 1.36 to 2.85). Additionally, 32.0% (n = 453) and 26.0% (n = 372) reported severe physical fatigue, and mental fatigue, respectively. Both latter factors were significantly and positively associated with depression as well as with anxiety. Depressive and anxious patients used more negative religious coping, while positive religious coping was slightly associated with depression. Conclusion: In this online survey of the general population in Morocco, anxiety and depressive symptoms are prevalent during the COVID-19 pandemic. Pandemic and psychosocial factors, such as female gender, income decline, infection fears, massive COVID-19 news exposure, negative religious coping, and fatigue were associated with increased risk of depression and anxiety symptoms. Psychosocial and financial support should be provided to the quarantined population. [ABSTRACT FROM AUTHOR]