br Corresponding author br E mail address agustinolivamd
E-mail address: email@example.com (A. Oliva).
Cancer is the second most common cause of mortality in the world, responsible for 8.8 million deaths in the year 2015. Around 14.1 million new cases were diagnosed in 2012, which is the last year with oﬃcial data from WHO’s GLOBOCAN project . By the year 2035 there are expected to be 24 million new cases worldwide. In Spain there were 215,535 new cases in 2012 and an estimated 228,482 new cases in 2017, and there are expected to be 315,413 in 2035 . Among Spanish women, the most frequently diagnosed cancers were breast, colon, uterus, lung, ovary, stomach, non-Hodgkin lymphoma, mela-noma and cervix. According to the Spanish Statistics National Institute, there were 8912 deaths caused by gynaecological cancer, including breast cancer .
Some authors have pointed out that resilience is an important issue for adult cancer care , as it Acetylcysteine can help patients to deal with the
adversity posed by diagnosis, treatment, symptoms and cancer-related stress. A few studies have suggested that menopausal symptoms in cancer survivors are worse than in non-cancer patients . Never-theless, there are no investigations of resilience, menopause and cancer combined.
The aims of the present investigation are to analyse the impact of cancer on the resilience of menopausal women and its eﬀect on quality of life. We also aim to investigate whether the severity of menopausal symptoms changes according to resilience scores in cancer survivors. All women completed the Wagnild and Young 14 item Resilience Scale (WYRS-14), the Cervantes 16-item short form (Cervantes-SF-16), which assesses quality of life during menopause, and a sociodemographic form.
2. Materials and methods
2.1. Study design and participants
A cross-sectional study was carried out from November 2016 to May 2018, with 293 menopausal women aged between 40 and 65, of whom 80 had a history of gynaecological cancer and 213 had no history of cancer. The cancer survivors were all in complete remission and had finished treatment between 3 months and 10 years prior to amino acid sequence study. The objectives of the investigation were explained and an informed consent form was signed. This investigation has been approved by the ethical committee of the Hospital Clínico San Carlos and has followed the Helsinki declaration. Quality of reporting was assessed using the ‘Strengthening the Reporting of Observational studies in Epidemiology’ (STROBE) checklist.
2.2. The 14-item Wagnild and Young resilience scale
The Spanish version of the WYRS-14 was used to assess resilience . This scale has been used in previous investigations of resilience and related factors. Each item is scored between 1 and 7, giving a total score between 14 and 98, with higher scores indicating greater resi-lience . Based on a study by Coronado et al. of peri- and post-menopausal women , a cut-oﬀ score was set at the 25th percentile (71 points) to distinguish low and high resilience.
2.3. Cervantes-SF-16 questionnaire
The Cervantes-SF-16 is specifically for menopausal Spanish women aged between 45 and 64 years that assesses the impact of menopausal symptoms on health-related quality of life. The original form, consisting of 31 items, was reduced to a 16-item short form. This self-administered questionnaire has 16 items in various domains (vasomotor symptoms, health and aging, psychological issues, sexuality, partner relations), scored on a Likert scale ranging from 0 to 5. For negative questions, 0 indicates the best scenario and 5 the worst. For positive questions, 0 means the worst state and 5 the best. Along with the shortening of the 31-item version, a rescaling method was established to convert the original scores into scores on a 0–100 scale [16,17], on which 0 in-dicates the best possible menopause-related quality of life and 100 the worst .