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Browsing Department of Psychology Works by Author "Abonour, Rafat"
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Item The Cancer Loneliness Scale and Cancer-related Negative Social Expectations Scale: development and validation(SpringerLink, 2017-07) Adams, Rebecca N.; Mosher, Catherine E.; Rand, Kevin L.; Hirsh, Adam T.; Monahan, Patrick O.; Abonour, Rafat; Kroenke, Kurt; Psychology, School of SciencePURPOSE: Loneliness is a known risk factor for poor mental and physical health outcomes and quality of life in the general population, and preliminary research suggests that loneliness is linked to poorer health outcomes in cancer patients as well. Various aspects of the cancer experience contribute to patients feeling alone and misunderstood. Furthermore, loneliness theory suggests that negative social expectations, which may specifically relate to the cancer experience, precipitate and sustain loneliness. Cancer-specific tools are needed to assess key constructs of this theory. In the current study, we developed and tested measures of (1) loneliness attributed to cancer (i.e., cancer-related loneliness) and (2) negative social expectations related to cancer. METHODS: First, we developed the items for the measures based on theory, prior research, and expert feedback. Next, we assessed the measures' psychometric properties (i.e., internal consistency and construct validity) in a diverse sample of cancer patients. RESULTS: The final products included a 7-item unidimensional Cancer Loneliness Scale and a 5-item unidimensional Cancer-related Negative Social Expectations Scale. Evidence of excellent reliability and validity was found for both measures. CONCLUSIONS: The resulting measures have both clinical and research utility.Item Cancer-related loneliness mediates the relationships between social constraints and symptoms among cancer patients(Springer Nature, 2018-04) Adams, Rebecca N.; Mosher, Catherine E.; Winger, Joseph G.; Abonour, Rafat; Kroenke, Kurt; Psychology, School of ScienceCancer patients have high rates of persistent and disabling symptoms. Evidence suggests that social constraints (e.g., avoidance and criticism) negatively impact symptoms, but pathways linking these variables have yet to be identified. This study examined whether cancer-related loneliness (i.e., feeling socially disconnected related to having cancer) mediated the relationships between social constraints and symptoms (i.e., pain interference, fatigue, sleep disturbance, and cognitive complaints) in patients with various cancers (N = 182). Patients (51% female, mean age = 59) were recruited from the Indiana Cancer Registry and completed questionnaires assessing social constraints, cancer-related loneliness, and symptoms. Structural equation modeling was used to evaluate the hypothesized relationships among variables. The model demonstrated good fit. Consistent with our hypothesis, cancer-related loneliness mediated the relationships between social constraints and each symptom. Findings suggest that addressing cancer-related loneliness in symptom management interventions may mitigate the negative impact of social constraints on outcomes.Item Cognitive and Situational Precipitants of Loneliness Among Patients With Cancer: A Qualitative Analysis(Oncology Nursing Society, 2016-03) Adams, Rebecca N.; Mosher, Catherine E.; Abonour, Rafat; Robertson, Michael J.; Champion, Victoria L.; Kroenke, Kurt; Department of Psychology, School of SciencePURPOSE/OBJECTIVES: To identify situations and thoughts that may precipitate or protect against loneliness experienced by patients with cancer. RESEARCH APPROACH: Qualitative. SETTING: The hematology/oncology clinic at the Indiana University Melvin and Bren Simon Cancer Center, an outpatient oncology center in Indianapolis. PARTICIPANTS: Purposive sample of 15 patients undergoing treatment for multiple myeloma or non-Hodgkin lymphoma. METHODOLOGIC APPROACH: Individual, semistructured qualitative interviews were conducted. Theoretical thematic analysis was used to analyze interview data. FINDINGS: Factors that appeared to precipitate loneliness included several situations (e.g., physical isolation, social constraints such as criticism) and thoughts (e.g., unmet expectations for visits or questions about health, belief that others do not understand their cancer experience). Several situations (e.g., social support, normal routine) and thoughts (e.g., beliefs that time alone is desirable and that others' discomfort with cancer-related discussions is normative) appeared to protect against loneliness. Certain social situations were loneliness-inducing for some patients and not for others, suggesting that patients' thoughts about their situations, rather than the situations themselves, have the greatest impact on their loneliness. CONCLUSIONS: The current study fills gaps in loneliness theory by identifying cancer-related situations and thoughts that patients associate with their loneliness. Consistent with theory, patients reported feeling lonely when they had negative thoughts about their social situations. INTERPRETATION: Findings inform nursing assessment and intervention strategies to incorporate into care plans. For instance, when conducting assessments, nurses should be more attentive to patients' satisfaction with their social environment than actual characteristics of the environment. Normalizing patients' experiences and encouraging positive thoughts about others' behavior may reduce patients' loneliness.