Browsing by Author "Stout, Madison E."
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Item Abbreviated dignity therapy for adults with advanced-stage cancer and their family caregivers: Qualitative analysis of a pilot study(Cambridge University Press, 2019-06) Beck, Adrienne; Cottingham, Ann H.; Stutz, Patrick V.; Gruber, Rachel; Bernat, Jennifer K.; Helft, Paul R.; Wilhelm, Laura; Schmidt, Karen; Stout, Madison E.; Willard, Claire; Johns, Shelley A.; Medicine, School of MedicineObjective Dignity therapy (DT) is designed to address psychological and existential challenges that terminally ill individuals face. DT guides patients in developing a written legacy project in which they record and share important memories and messages with those they will leave behind. DT has been demonstrated to ease existential concerns for adults with advanced-stage cancer; however, lack of institutional resources limits wide implementation of DT in clinical practice. This study explores qualitative outcomes of an abbreviated, less resource-intensive version of DT among participants with advanced-stage cancer and their legacy project recipients. Method Qualitative methods were used to analyze postintervention interviews with 11 participants and their legacy recipients as well as the created legacy projects. Direct content analysis was used to assess feedback from the interviews about benefits, barriers, and recommendations regarding abbreviated DT. The legacy projects were coded for expression of core values. Result Findings suggest that abbreviated DT effectively promotes (1) self-expression, (2) connection with loved ones, (3) sense of purpose, and (4) continuity of self. Participants observed that leading the development of their legacy projects promoted independent reflection, autonomy, and opportunities for family interaction when reviewing and discussing the projects. Consistent with traditional DT, participants expressed “family” as the most common core value in their legacy projects. Expression of “autonomy” was also a notable finding. Significance of results Abbreviated DT reduces resource barriers to conducting traditional DT while promoting similar benefits for participants and recipients, making it a promising adaptation warranting further research. The importance that patients place on family and autonomy should be honored as much as possible by those caring for adults with advanced-stage cancer.Item Associations between Loneliness and Cancer Patients’ Pain and Fatigue(Office of the Vice Chancellor for Research, 2015-04-17) Stout, Madison E.; Adams, Rebecca N.; Mosher, Catherine E.Introduction: Pain and fatigue occur at higher rates in cancer patients than in the general population. One study found that loneliness predicted both pain and fatigue in cancer patients; however, the study only focused on patients with breast or colon cancer. The goal of the current study is to examine whether loneliness is associated with pain and fatigue in a sample of patients with various cancer types, including more rare diagnoses. We hypothesized that loneliness would be positively correlated with pain and fatigue, controlling for demographic and medical characteristics. Methods: Participants (N=44) were 60 years old (SD=12) on average, 68% Caucasian, and 59% female. All participants had received treatment for cancer at the Indiana University Simon Cancer Center or another Indiana University Hospital since 2013. Participants were recruited from the Indiana Tumor Registry, and after consenting, they were mailed a survey to complete at home that included measures of loneliness, pain, and fatigue. To test our hypothesis, we computed correlations between loneliness and each symptom (i.e., pain and fatigue), controlling for age, gender, and time since diagnosis. Results: As hypothesized, we found a large, positive correlation between loneliness and fatigue (r =0.51, p=0.001), controlling for demographic and medical characteristics. In addition, loneliness was positively correlated with pain, but this result fell just short of statistical significance (r=0.28, p=0.09). Conclusions: Results from this study suggest that greater loneliness is associated with greater fatigue in cancer patients, consistent with the results of one prior study. Although the association between loneliness and pain was more modest, it may reach statistical significance as the study sample size increases. If future longitudinal research shows that greater loneliness predicts cancer patients’ pain and fatigue, it would suggest that interventions to reduce loneliness may also reduce their physical symptoms.Item Attitudinal Correlates of HPV Vaccination in College Women(SAGE, 2022) Kasting, Monica L.; Christy, Shannon M.; Stout, Madison E.; Zimet, Gregory D.; Mosher, Catherine E.This study examined associations between general attitudes toward seeking medical care, attitudes about vaccines/fear of shots, and human papillomavirus (HPV) vaccine uptake and intentions in college women. Hypothesized associations were framed by the Theory of Planned Behavior (TPB). Participants (N = 330, mean age = 18.9 years, 75% White) completed a one-time survey. The majority (61%; n = 201) had received ≥1 HPV vaccine dose. Hierarchical logistic regression examined relationships between attitudes and vaccine uptake. Pearson correlation coefficients and Kruskal-Wallis tests examined associations between attitudes and vaccine intentions. Results were partially consistent with the TPB. In the final model, perceived benefits, but not fear of shots, were associated with vaccine uptake. Among the unvaccinated, perceived benefits, but not fear of shots, were associated with vaccine intentions. Provider recommendation was the strongest predictor of vaccine uptake. Findings suggest interventions incorporating discussion of perceived benefits and provider recommendation may improve HPV vaccine receipt among college women.Item Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women(Springer Nature, 2018-08) Stout, Madison E.; Meints, Samantha M.; Hirsh, Adam T.; Psychology, School of SciencePrevious research suggests that women who experience pain during intercourse also experience higher rates of depressive symptoms. Loneliness might be one factor that contributes to this relationship. We hypothesized that women who experience more severe and interfering pain during intercourse would report higher rates of loneliness and higher rates of depressive symptoms. Further, we hypothesized that loneliness would mediate the relationship between pain during intercourse and depressive symptoms. A total of 104 female participants (85.6% white, 74.03% partnered, 20.9 [3.01] years old) completed an online survey including demographic information, PROMIS Vaginal Discomfort Measure, PROMIS Depression Measure, and Revised UCLA Loneliness Scale. Pearson correlations and bootstrapped mediation analysis examined the relationships among pain during intercourse, loneliness, and depressive symptoms. Pain during intercourse, loneliness, and depressive symptoms were all significantly correlated (p < .05). Results of the mediation analysis indicated that loneliness was a significant mediator of the relationship between pain during intercourse and depressive symptoms (indirect effect = 0.077; 95% CI 0.05-0.19). After accounting for loneliness, pain during intercourse was not significantly related to depressive symptoms, suggesting that loneliness fully mediated the relationship between pain during intercourse and depressive symptoms. These findings are consistent with previous studies highlighting that pain during intercourse is related to depressive symptoms. The current study adds to that literature and suggests that more frequent and severe pain during intercourse leads to more loneliness, which then leads to increased depressive symptoms. This line of work has important implications for treating women who experience depressive symptoms and pain during intercourse.Item Mindfulness Training Supports Quality of Life and Advance Care Planning in Adults With Metastatic Cancer and Their Caregivers: Results of a Pilot Study(Sage, 2020-02) Johns, Shelley A.; Beck-Coon, Kathleen; Stutz, Patrick V.; Talib, Tasneem L.; Chinh, Kelly; Cottingham, Ann H.; Schmidt, Karen; Shields, Cleveland; Stout, Madison E.; Stump, Timothy E.; Monahan, Patrick O.; Torke, Alexia M.; Helft, Paul R.; Medicine, School of MedicineBackground: Emotional distress often causes patients with cancer and their family caregivers (FCGs) to avoid end-of-life discussions and advance care planning (ACP), which may undermine quality of life (QoL). Most ACP interventions fail to address emotional barriers that impede timely ACP. Aim: We assessed feasibility, acceptability, and preliminary effects of a mindfulness-based intervention to facilitate ACP for adults with advanced-stage cancer and their FCGs. Design: A single-arm pilot was conducted to assess the impact of a 6-week group mindfulness intervention on ACP behaviors (patients only), QoL, family communication, avoidant coping, distress, and other outcomes from baseline (T1) to post-intervention (T2) and 1 month later (T3). Participants: Eligible patients had advanced-stage solid malignancies, limited ACP engagement, and an FCG willing to participate. Thirteen dyads (N = 26 participants) enrolled at an academic cancer center in the United States. Results: Of eligible patients, 59.1% enrolled. Attendance (70.8% across 6 sessions) and retention (84.6% for patients; 92.3% for FCGs) through T3 were acceptable. Over 90% of completers reported high intervention satisfaction. From T1 to T3, patient engagement more than doubled in each of 3 ACP behaviors assessed. Patients reported large significant decreases in distress at T2 and T3. Family caregivers reported large significant improvements in QoL and family communication at T2 and T3. Both patients and FCGs reported notable reductions in sleep disturbance and avoidant coping at T3. Conclusions: The mindfulness intervention was feasible and acceptable and supported improvements in ACP and associated outcomes for patients and FCGs. A randomized trial of mindfulness training for ACP is warranted.Item Self-efficacy and HPV Vaccine Attitudes Mediate the Relationship Between Social Norms and Intentions to Receive the HPV Vaccine Among College Students(SpringerLink, 2020-12) Stout, Madison E.; Christy, Sharon M.; Winger, Joseph G.; Vadaparampil, Susan T.; Mosher, Catherine E.; Psychology, School of ScienceHuman papillomavirus (HPV) has been linked to genital warts and multiple cancers affecting both men and women. Despite college students’ high risk for HPV, their vaccination rates remain suboptimal. The current observational study examined the relationship between social norms and human papillomavirus (HPV) vaccine intentions and potential mechanisms underlying this relationship among undergraduates. Participants (N=190; 66.8% female) completed a survey assessing HPV vaccine social norms, attitudes, self-efficacy, and intentions. Three mediation analyses were conducted to examine whether self-efficacy and attitudes mediated the relationship between social norms (i.e., parents, friends, doctor) and intentions, controlling for demographic and health care covariates. Social norms were indirectly related to intentions through self-efficacy and attitudes in multiple models (ps<.05). Specifically, perceiving greater support for HPV vaccination from one’s friends, parents, and doctor was related to greater HPV vaccine self-efficacy, which, in turn, was related to increased vaccine intentions. In addition, perceiving greater parental and doctor support for HPV vaccination was related to more favorable attitudes towards the vaccine, which, in turn, were related to increased vaccine intentions. Findings suggest potential targets for future interventions to promote HPV vaccination among young adults.Item Self-efficacy mediates the relationship between social norms and HPV vaccine intentions in undergraduate students(Office of the Vice Chancellor for Research, 2016-04-08) Stout, Madison E.; Winger, Joseph G.; Christy, Shannon M.; Mosher, Catherine E.Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. The HPV vaccine reduces incidences of genital warts and certain cancers among both men and women. Unfortunately, many undergraduate students have not been vaccinated. Previous research suggests students are more likely to report greater intentions to get vaccinated when others (e.g., friends, physicians) believe they should receive the vaccine; that is, greater social norms are associated with greater vaccine intentions. However, few studies have examined potential mediators of this association. Drawing from the Theory of Planned Behavior and the Health Belief Model, we hypothesized that social norms would be related to vaccine intentions through self-efficacy. Undergraduate students (N=210) who had not received the HPV vaccine completed an online survey. Participants were predominately White (72%), female (67%), heterosexual (92%), and on average 19.9 years of age (SD=3.2). Forty-nine percent were in a romantic relationship, and 55% were sexually active within the past three months. Participants completed HPV vaccine specific measures, including social norms regarding vaccination, self-efficacy for vaccination, and vaccine intentions. Two mediation analyses (one per gender) were conducted to examine whether self-efficacy mediated the relationship between social norms and vaccine intentions. For women and men, greater social norms were related to greater self-efficacy, and greater selfefficacy was related to greater vaccine intentions (ps<0.05); additionally, social norms were indirectly related to vaccine intentions through self-efficacy (p<0.05). For women, after accounting for self-efficacy, social norms were still significantly related to intentions (p<0.05). For men, however, after accounting for self-efficacy, social norms were not significantly related to intentions (p=0.75). Consistent with previous findings, social norms were positively related to vaccine intentions; however, we found that this association was mediated by self-efficacy. Future intervention studies should consider targeting social norms and improving students’ confidence in their ability to obtain the vaccine.Item Time Perspective and Perceived Social Isolation: The Role of Social Interaction Anxiety(MDPI, 2024-08-31) Stout, Madison E.; Medlin, Austin R.; Gupta, Ritu; Tsotsoros, Cindy E.; Medicine, School of MedicineTime perspective is a theoretical construct that describes how humans perceive time, which can influence decision-making and subsequent behavior. Research has shown that an individual’s dominant time perspective can be linked to increased risk of poor health. This study aimed to investigate the relationships between time perspective and perceived social isolation. Specifically, we examined the role of social interaction anxiety in the relationship between time perspective and perceived social isolation in a normative sample of college-aged individuals. Undergraduates (n = 1780) at a large midwestern university completed an online survey. Results revealed that future-oriented, past-positive, and present-hedonistic time perspectives were significantly negatively associated with perceived social isolation. In contrast, past-negative was positively associated with perceived social isolation, and these relationships were partially explained by social interaction anxiety. Understanding dominant time perspectives can help us to better assess health risk factors and may help to develop interventions to promote healthy behaviors.