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Dekker J, Doppenberg-Smit E, Braamse A, Lamers F, van Linde M, Verheul HMW, Sprangers M, Beekman ATF. Toward an improved conceptualization of emotions in patients with cancer. Front Psychiatry 2024; 15:1352026. [PMID: 38600981 PMCID: PMC11004313 DOI: 10.3389/fpsyt.2024.1352026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Cancer and its associated treatment is a major stressor, leading to emotions such as anxiety or depressive mood. Human emotions have developed through the course of evolution because they facilitate adaptation to important events, such as cancer and its associated treatment. On the other hand, emotions can be maladaptive and interfere with adaptation to cancer. Emotions are maladaptive if they are disproportionally severe or persistent, and if they interfere with functioning. We aim to expand the conceptualization of adaptive and maladaptive emotions in patients with cancer. We draw on major theories in the field of mental disorder and mental health, and apply these theories to conceptualize adaptive and maladaptive emotions in patients with cancer. (i) Maladaptive emotions have two essential features: mental dysfunction and patient harm. Maladaptive emotions are characterized by a network of strongly associated emotional symptoms, which may include cancer-related somatic symptoms. The dysfunctional symptom network is hypothesized to be the result of disturbance of life goal pursuit caused by cancer. (ii) Adaptive emotions have two essential features: ability to deal with cancer and functioning well. The ability to use emotions in an adaptive way depends on skills to recognize, express, and regulate emotions in a flexible manner. A secure attachment style facilitates adaptive emotional responses to cancer. The present conceptualization of adaptive and maladaptive emotions is expected to contribute to better understanding and management of emotions in patients with cancer.
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Affiliation(s)
- Joost Dekker
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Elise Doppenberg-Smit
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Annemarie Braamse
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
| | - Myra van Linde
- Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Henk M. W. Verheul
- Department of Medical Oncology, Erasmus University Rotterdam, Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands
| | - Mirjam Sprangers
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Aartjan T. F. Beekman
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
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Martin M, Rice K, Murray CV, Rock AJ, Usher KJ. Distress and psychosocial support seeking: A comparison of rural and metropolitan oncology patient experiences. Aust J Rural Health 2024; 32:29-41. [PMID: 37926968 DOI: 10.1111/ajr.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/12/2023] [Accepted: 10/15/2023] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION Prevalence of distress in cancer patients is established at approximately 50%, yet uptake of psychosocial support is minimal. OBJECTIVE This study aimed to understand why clinically distressed oncology patients choose not to access psychosocial support, including whether this differs by geographic location. It also aimed to determine the proportion of rural and metropolitan patients experiencing clinical levels of distress, and of these, the proportion who do not wish to access support. DESIGN The study used a cross-sectional design. Two hundred and ninety-eight Australian cancer patients completed an online survey, including the Distress Thermometer and open-ended questions about reasons for declining support. Descriptive statistics and content analysis were used to analyse the data. FINDINGS More than half (56%) of participants reported experiencing clinically significant levels of distress. Of these, almost half (47%) declined psychosocial support. Content analysis of reasons for declining psychosocial support resulted in six main concepts: I don't need support; I'm using personal resources to cope; negative perceptions and attitudes; life doesn't stop for cancer; I'm focussed on fighting cancer; and systemic barriers. Rural cancer patients most often indicated using personal resources to cope, while metropolitan participants most commonly indicated not needing support. A range of subconcepts were also identified. Perceiving distress as manageable or transient was almost exclusively reported by metropolitan participants, while stigma was almost exclusively reported by rural participants. DISCUSSION The findings provided greater depth of insight into reasons cancer patients decline psychosocial support and identified several qualitative differences in the reasons provided by metropolitan and rural patients. Recommendations are provided for clinicians, in particular for clinicians who work with rural cancer patients and their supporters. CONCLUSION These findings can inform equitable resourcing of psychosocial support in rural areas and the adaptation of psychosocial interventions to be more flexible and responsive to individual needs. This may help increase patient uptake of support, particularly in rural areas.
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Affiliation(s)
- Mahala Martin
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Kylie Rice
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Clara V Murray
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Adam J Rock
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Kim J Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
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Hecht K, Günther MP, Kirchebner J, Götz A, von Känel R, Schulze JB, Euler S. Predictive Factors Associated with Declining Psycho-Oncological Support in Patients with Cancer. Curr Oncol 2023; 30:9746-9759. [PMID: 37999127 PMCID: PMC10670809 DOI: 10.3390/curroncol30110707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
(1) Background: International cancer treatment guidelines recommend low-threshold psycho-oncological support based on nurses' routine distress screening (e.g., via the distress thermometer and problem list). This study aims to explore factors which are associated with declining psycho-oncological support in order to increase nurses' efficiency in screening patients for psycho-oncological support needs. (2) Methods: Using machine learning, routinely recorded clinical data from 4064 patients was analyzed for predictors of patients declining psycho-oncological support. Cross validation and nested resampling were used to guard against model overfitting. (3) Results: The developed model detects patients who decline psycho-oncological support with a sensitivity of 89% (area under the cure of 79%, accuracy of 68.5%). Overall, older patients, patients with a lower score on the distress thermometer, fewer comorbidities, few physical problems, and those who do not feel sad, afraid, or worried refused psycho-oncological support. (4) Conclusions: Thus, current screening procedures seem worthy to be part of daily nursing routines in oncology, but nurses may need more time and training to rule out misconceptions of patients on psycho-oncological support.
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Affiliation(s)
- Karoline Hecht
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, 8091 Zürich, Switzerland; (M.P.G.); (J.B.S.); (S.E.)
| | - Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, 8091 Zürich, Switzerland; (M.P.G.); (J.B.S.); (S.E.)
| | - Johannes Kirchebner
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Lenggstrasse 31, 8032 Zürich, Switzerland;
| | - Anna Götz
- Department of Hemato-Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland;
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, 8091 Zürich, Switzerland; (M.P.G.); (J.B.S.); (S.E.)
| | - Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, 8091 Zürich, Switzerland; (M.P.G.); (J.B.S.); (S.E.)
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, 8091 Zürich, Switzerland; (M.P.G.); (J.B.S.); (S.E.)
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Parmet T, Yusufov M, Braun IM, Pirl WF, Matlock DD, Sannes TS. Willingness toward psychosocial support during cancer treatment: a critical yet challenging construct in psychosocial care. Transl Behav Med 2023; 13:511-517. [PMID: 36940406 PMCID: PMC10465092 DOI: 10.1093/tbm/ibac121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
Psychosocial distress screening, mandated by the American College Surgeons' Commission on Cancer, continues to be implemented across cancer centers nationwide. Although measuring distress is critical to identifying patients who may benefit from additional support, several studies suggest that distress screening may not actually increase patients' utilization of psychosocial services. While various investigators have identified barriers that may impede effective implementation of distress screening, we posit that patients' intrinsic motivation, which we term patients' willingness, may be the biggest predictor for whether cancer patients choose to engage with psychosocial services. In this commentary, we define patient willingness towards psychosocial services as a novel construct, distinct from the intention toward a certain behavior described across pre-existing models of health behavior change. Further, we offer a critical perspective of models of intervention design that focus on acceptability and feasibility as preliminary outcomes thought to encompass the willingness construct described herein. Finally, we summarize several health service models that successfully integrate psychosocial services alongside routine oncology care. Overall, we present an innovative model that acknowledges barriers and facilitators and underscores the critical role of willingness in health behavior change. Consideration of patients' willingness toward psychosocial care will move the field of psychosocial oncology forward in clinical practice, policy initiatives, and study design.
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Affiliation(s)
- Tamar Parmet
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
- Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, CO, USA
| | - Miryam Yusufov
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - Ilana M Braun
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - William F Pirl
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - Daniel D Matlock
- Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, CO, USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Veteran Affairs (VA) Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA
| | - Timothy S Sannes
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
- University of Massachusetts Medical School/UMass Memorial Hospital, Worcester, MA, USA
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5
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Jung W, Park J, Jeong A, Cho JH, Jeon YJ, Shin DW. Fear of cancer recurrence and its predictors among patients with non-small cell lung cancer (NSCLC). J Cancer Surviv 2023:10.1007/s11764-023-01419-9. [PMID: 37351732 DOI: 10.1007/s11764-023-01419-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is a multidimensional phenomenon among cancer survivors. This cross-sectional study aimed to identify the prevalence of FCR and its predictors among survivors of non-small cell lung cancer (NSCLC) in Korea. METHODS Participants who finished NSCLC treatment one or more months prior completed the Korean version of Fear of Cancer Recurrence Inventory-Short Form (K-FCRI-SF) and the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) at single tertiary hospital in Korea. Multivariate-adjusted logistic regression and stepwise backward selection were used to determine the potential predictors of FCR. RESULTS Of the total 949 participants (mean age 63.4 ± 8.8 years, 44.3% women), 55.8% had high FCR. Female (adjusted odds ratio [aOR] 1.44, 95% confidence interval [CI] 1.06-1.95), pathologic stage III (aOR 1.97, 95% CI 1.18-3.30), poor overall quality of life (aOR 1.42, 95% CI 1.03-1.95), poor emotional functioning (aOR 3.91, 95% CI 2.64-5.81), poor social functioning (aOR 1.87, 95% CI 1.31-2.68), and severe dyspnea (aOR 2.91, 95% CI 1.03-8.21) were independent predictors of high FCR. Old age (≥ 70 years) was included in the final model (aOR 0.74, 95% CI 0.51-1.06) but did not show clinical significance. CONCLUSIONS Our study demonstrated that high FCR was prevalent in NSCLC patients in Korea. To prevent this, we suggest screening and early detection of FCR based on sex, pathologic stage, quality of life, emotional and social functioning, and dyspnea. IMPLICATIONS FOR CANCER SURVIVORS Screening and early detection of FCR based on sex, pathologic stage, quality of life, emotional and social functioning, and dyspnea is suggested.
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Affiliation(s)
- Wonyoung Jung
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Medicine, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Junhee Park
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Ansuk Jeong
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Jong Ho Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Yeong Jeong Jeon
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea.
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
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Blasco T, Jovell E, Mirapeix R, Leon C. Patients' Desire for Psychological Support When Receiving a Cancer Diagnostic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14474. [PMID: 36361350 PMCID: PMC9654838 DOI: 10.3390/ijerph192114474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Factors related to the desire of receiving psychological help in cancer patients are not well known. The aim of this study is to assess the prevalence of patients who would ask for psychological assistance in the first weeks following diagnosis, and to identify their psychosocial and disease-related profile. METHOD This cross-sectional study assessed 229 consecutive cancer outpatients at a visit with their oncologist to be informed about the treatment they will receive. Disease-related and medical characteristics were assessed, and patients were asked about their mood states, levels of self-efficacy, and difficulties coping with the disease. Finally, patients were asked about their desire to receive psychological assistance. RESULTS Only 20% of patients expressed a desire for psychological help. These patients were lower in age and had previous history of mood disorders and reported higher discouragement and coping difficulties. These variables explained 30.6% of variance. CONCLUSIONS Although psycho-oncologists can provide helpful interventions, the percentage of patients interested in receiving psychological assistance in this study is low. Although further studies are needed, results from this study suggest methods that could easily be used by oncologists and nurses to identify patients who would like to receive psychological support.
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Affiliation(s)
- Tomás Blasco
- GIES, Grup d’Investigació en Estrès i Salut, Departament de Psicologia Bàsica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Esther Jovell
- Hospital de Terrassa, Unidad de Epidemiología y Evaluación Asistencial, 08227 Terrassa, Spain
| | - Rosanna Mirapeix
- GIES, Grup d’Investigació en Estrès i Salut, Departament de Psicologia Bàsica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Concha Leon
- GIES, Grup d’Investigació en Estrès i Salut, Departament de Psicologia Bàsica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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7
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Karchoud JF, de Kruif AJTCM, Lamers F, van Linde ME, van Dodewaard-de Jong JM, Braamse AMJ, Sprangers MAG, Beekman ATF, Verheul HMW, Dekker J. Clinical judgment of the need for professional mental health care in patients with cancer: a qualitative study among oncologists and nurses. J Cancer Surviv 2021; 17:884-893. [PMID: 34855132 DOI: 10.1007/s11764-021-01151-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE In daily practice, oncologists and nurses frequently need to decide whether or not to refer a patient for professional mental health care. We explored the indicators oncologists and nurses use to judge the need for professional mental health care in patients with cancer. METHODS In a qualitative study, oncologists (n = 8) and nurses (n = 6) were each asked to select patients who were or were not referred for professional mental health care (total n = 75). During a semi-structured interview, they reflected on their decision concerning the possible referral of the patient. Thematic analysis was used to analyze the data. RESULTS Respondents reported using a strategy when judging whether professional mental health care was needed. They allowed patients time to adjust, while monitoring patients' psychological well-being, especially if patients exhibited specific risk factors. Risk and protective factors for emotional problems included personal, social, and disease- and treatment-related factors. Respondents considered referral for professional mental health care when they noted specific indicators of emotional problems. These indicators included lingering or increasing emotions, a disproportionate intensity of emotions, and emotions with a negative impact on a patient's daily life or treatment. CONCLUSIONS This study identified the strategy, risk and protective factors, and the indicators of emotional problems used by oncologists and nurses when judging the need for professional mental health care in patients with cancer. IMPLICATIONS FOR CANCER SURVIVORS Oncologists and nurses can play an important role in the identification of patients in need of professional mental health care.
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Affiliation(s)
- Jeanet F Karchoud
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Anja J Th C M de Kruif
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Myra E van Linde
- Department of Medical Oncology, Amsterdam University Medical Centers, Vrije Universiteit, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | | | - Annemarie M J Braamse
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Joost Dekker
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
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Seib C, Lazenby M, Dunn J, Chambers S. Considerations about risk of ongoing distress: what can we learn from repeat screening? Support Care Cancer 2021; 30:1011-1014. [PMID: 34697675 DOI: 10.1007/s00520-021-06621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
The importance of routine distress screening in cancer patients is widely acknowledged, though non-compliance with screening protocols is common. Cited reasons for non-adherence include lack of time and expertise and concerns about the resources associated with the identification and management of clinically relevant distress. This commentary examines changes in distress among people with cancer who participated in a tele-based psychosocial intervention, from the point of initial distress screening to 12 months after commencing the intervention. The goal is to contribute to the discussion about the potential infrastructure requirements of implementing screening programs among screening 'hesitant' cancer care services. Secondary analysis showed a general downward distress trajectory though the greatest reduction occurred between recruitment and baseline and before receiving a low-intensity psychosocial intervention (β = - 1.84, 95% CI - 2.12, - 1.56). While acknowledging transience of distress in some patients, our results support the possible therapeutic benefit of assessing and validating individuals' distress in the hope of preventing the development of more overt health problems associated with undiagnosed and untreated symptoms.
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Affiliation(s)
- Charrlotte Seib
- Menzies Health Institute Queensland, Griffith University, Clinical Sciences 2 Building, Parklands Drive, Southport, Queensland, 4215, Australia.
| | - Mark Lazenby
- School of Nursing, University of Connecticut, Mansfield, CT, USA
| | - Jeffrey Dunn
- Centre for Health Research, University of Southern Queensland, Darling Heights, Australia.,Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.,Australian Catholic University, Brisbane, Australia
| | - Suzanne Chambers
- Menzies Health Institute Queensland, Griffith University, Clinical Sciences 2 Building, Parklands Drive, Southport, Queensland, 4215, Australia.,Centre for Health Research, University of Southern Queensland, Darling Heights, Australia.,Australian Catholic University, Brisbane, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
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White VM, Pejoski N, Vella E, Skaczkowski G, Ugalde A, Yuen EYN, Livingston P, Wilson C. Improving access to cancer information and supportive care services: A systematic review of mechanisms applied to link people with cancer to psychosocial supportive care services. Psychooncology 2021; 30:1603-1625. [PMID: 34133053 DOI: 10.1002/pon.5744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Previous research has described the low uptake of psychosocial support services in people living with cancer. While characteristics of individuals using services have been examined, mechanisms applied to link individuals to support services are less frequently considered. This review aims to identify the mechanisms used to link people with cancer to support services and assess their impact. METHODS Systematic searches of Pubmed, CINAHL, EMBASE and PsycINFO were conducted up to May 2020. Studies reporting service use associated with mechanisms to link adults with cancer to support services targeting emotional, informational, practical or social support needs were eligible. Eligible study designs included controlled trials, pre-post designs and observational studies. Study quality was assessed and a narrative synthesis of findings undertaken. RESULTS A total of 10 papers (from 8,037 unique titles) were eligible. Testing the feasibility of the linkage mechanism was the primary aim in five (50%) studies. Three linkage mechanisms were identified: (a) outreach from the support service; (b) clinician recommendation/referral; (c) mailed invitation. Outreach was the most successful in connecting people with cancer to services (52%-90% use); clinician recommendation/referral was least successful (3%-28%). The impact of different linkage mechanisms for different demographic groups was not assessed. CONCLUSIONS Outreach from services shows the most potential for increasing access to support services. However, the limited number of studies and limitations in the types of support services people with cancer were linked to, demonstrated the need for further work in this area. Identifying mechanisms that are effective for underserved, high-needs patient groups is also needed.
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Affiliation(s)
- Victoria M White
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Natalie Pejoski
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, VIC, Australia
| | - Elizabeth Vella
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Gemma Skaczkowski
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, VIC, Australia
| | - Anna Ugalde
- School of Nursing & Midwifery and Institute of Health Transformation, Deakin University, Burwood, VIC, Australia
| | - Eva Y N Yuen
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, VIC, Australia.,School of Nursing & Midwifery and Institute of Health Transformation, Deakin University, Burwood, VIC, Australia.,Monash Health, Clayton, VIC, Australia.,School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Patricia Livingston
- School of Nursing & Midwifery and Institute of Health Transformation, Deakin University, Burwood, VIC, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, VIC, Australia.,School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
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10
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Dekker J, Karchoud J, Braamse AMJ, Buiting H, Konings IRHM, van Linde ME, Schuurhuizen CSEW, Sprangers MAG, Beekman ATF, Verheul HMW. Clinical management of emotions in patients with cancer: introducing the approach "emotional support and case finding". Transl Behav Med 2020; 10:1399-1405. [PMID: 33200793 PMCID: PMC7796719 DOI: 10.1093/tbm/ibaa115] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The current approach to the management of emotions in patients with cancer is “distress screening and referral for the provision of psychosocial care.” Although this approach may have certain beneficial effects, screening and referral programs have shown a limited effect on patient psychological well-being. We argue that this limited effect is due to a mismatch between patient needs and the provision of care, and that a fundamental reconceptualization of the clinical management of emotions in patients with cancer is needed. We describe the rationale and characteristics of “emotional support and case finding” as the approach to the management of emotions in patients with cancer. The two main principles of the approach are: (1) Emotional support: (a) The treating team, consisting of doctors, nurses, and allied health staff, is responsive to the emotional needs of patients with cancer and provides emotional support. (b) The treating team provides information on external sources of emotional support. (2) Case finding: The treating team identifies patients in need of mental health care by means of case finding, and provides a referral to mental health care as indicated. We present a novel perspective on how to organize the clinical management of emotions in patients with cancer. This is intended to contribute to a fruitful discussion and to inform an innovative research agenda on how to manage emotions in patients with cancer.
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Affiliation(s)
- Joost Dekker
- Department of Psychiatry, Amsterdam University Medical Centers (location VUmc), Amsterdam, the Netherlands
| | - Jeanet Karchoud
- Department of Psychiatry, Amsterdam University Medical Centers (location VUmc), Amsterdam, the Netherlands
| | - Annemarie M J Braamse
- Department of Medical Psychology, Amsterdam University Medical Centers (location AMC), Amsterdam, the Netherlands
| | - Hilde Buiting
- Department of Psychiatry, Amsterdam University Medical Centers (location VUmc), Amsterdam, the Netherlands
| | - Inge R H M Konings
- Department of Medical Oncology, Amsterdam University Medical Centers (location VUmc), Amsterdam, the Netherlands
| | - Myra E van Linde
- Department of Medical Oncology, Amsterdam University Medical Centers (location VUmc), Amsterdam, the Netherlands
| | | | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers (location AMC), Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam University Medical Centers (location VUmc), Amsterdam, the Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Radboud UMC, Nijmegen, the Netherlands
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11
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Dekker J, Graves KD, Badger TA, Diefenbach MA. Management of Distress in Patients with Cancer-Are We Doing the Right Thing? Ann Behav Med 2020; 54:978-984. [PMID: 33416842 PMCID: PMC7791612 DOI: 10.1093/abm/kaaa091] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Screening for distress and referral for the provision of psychosocial care is currently the preferred approach to the management of distress in patients with cancer. To date, this approach has shown a limited effect on the reduction of distress. Recent commentaries have argued that the implementation of distress screening should be improved. On the other hand, the underlying assumption that a referral for psychosocial care is required for distressed patients can be questioned. This has led to the development of an alternative approach, called emotional support and case finding. PURPOSE In the context of finding innovative solutions to tomorrow's health challenges, we explore ways to optimize distress management in patients with cancer. METHODS AND RESULTS We discuss three different approaches: (i) optimization of screening and referral, (ii) provision of emotional support and case finding, and (iii) a hybrid approach with multiple assessments, using mobile technology. CONCLUSIONS We suggest continued research on the screening and referral approach, to broaden the evidence-base on improving emotional support and case finding, and to evaluate the utility of multiple assessments of distress with new interactive mobile tools. Lessons learned from these efforts can be applied to other disease areas, such as cardiovascular disease or diabetes.
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Affiliation(s)
- Joost Dekker
- Department of Psychiatry and Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Kristi D Graves
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Terry A Badger
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Michael A Diefenbach
- Institute for Clinical Outcomes Research (iCOR), Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
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12
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van Linde ME, Braamse AMJ, Collette EH, Hoogendoorn AW, Snoek FJ, Verheul HMW, Dekker J. Clinical assessment of emotions in patients with cancer: Diagnostic accuracy compared with two reference standards. Psychooncology 2020; 29:775-780. [PMID: 32011016 PMCID: PMC7216973 DOI: 10.1002/pon.5347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Previous research has suggested that clinical assessment of emotions in patients with cancer is suboptimal. However, it is a possibility that well-trained and experienced doctors and nurses do recognize emotions but that they do not evaluate all emotions as necessitating professional mental health care. This implies that the sensitivity of clinical assessment should be tested against the need for professional mental health care as reference standard, instead of emotional distress. We hypothesized that the observed sensitivity of clinical assessment of emotions would be higher when tested against need for professional mental health care as reference standard, compared with emotional distress as reference standard. PATIENTS AND METHODS A consecutive series of patients starting with chemotherapy were recruited during their routine clinical care, at a department of medical oncology. Clinical assessment of emotions by medical oncologists and nurses was derived from the patient file. Emotional distress and need for professional mental health care were assessed using the Distress Thermometer and Problem List. RESULTS Clinical assessment resulted in notes on emotions in 42.2% of the patient files with 36.2% of patients experiencing emotional distress and 10.8% expressing a need for professional mental health care (N = 185). As expected, the sensitivity of clinical assessment of emotions was higher with the reference standard "need for professional mental health care" compared with "emotional distress" (P < .001). For specificity, equivalent results were obtained with the two reference standards (P = .63). CONCLUSIONS Clinical assessment of emotions in patients with cancer may be more accurate than previously concluded.
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Affiliation(s)
- Myra E van Linde
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Annemarie M J Braamse
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Emma H Collette
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Adriaan W Hoogendoorn
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joost Dekker
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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13
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Leppin N, Nagelschmidt K, Koch M, Riera-Knorrenschild J, Seifart C, Rief W, Barke A, von Blanckenburg P. Cancer patient utilisation of psychological care in Germany: The role of attitudes towards seeking help. Eur J Cancer Care (Engl) 2019; 28:e13165. [PMID: 31571288 DOI: 10.1111/ecc.13165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Even if significantly distressed, many patients with cancer do not seek psychological help. There is growing evidence that attitudes are central barriers for help-seeking, and instruments to assess cancer patients' attitudes towards help-seeking are urgently needed. This study aimed to evaluate the German Attitudes towards Seeking Help after Cancer Scale (ASHCa-G) and investigated the relationship between patients' attitudes and psychological care utilisation. METHODS The ASHCa-G was presented to 270 patients with cancer (age 63.0 ± 12.7 years, 44.8% women). Item analyses, principal component analysis and associations with age, social support, help-seeking intention and psychological care utilisation were calculated. A hierarchical logistic regression was performed to ascertain the leading role of attitudes in explaining psychological care utilisation. RESULTS Principal component analysis supported a two-component solution, which showed good internal consistency for the positive attitudes (α = 0.80) and negative attitudes (α = 0.75) subscales. The associations with age, distress and help-seeking intention confirmed the validity of the ASHCa-G. Positive attitudes explained most variance of cancer patients' current psychological care utilisation. CONCLUSION The ASHCa-G seems to be a reliable and valid questionnaire for assessing attitudes towards seeking psychological help among patients with cancer. Clinical practice might profit from identifying attitudinal barriers that hinder patients with cancer from seeking psychological help.
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Affiliation(s)
- Nico Leppin
- Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | | | - Martin Koch
- Institutional Review Board, Clinical Ethics, Philipps-University Marburg, Marburg, Germany
| | - Jorge Riera-Knorrenschild
- Department of Internal Medicine, Division Hematology and Oncology, University Hospital Giessen and Marburg, Marburg, Germany
| | - Carola Seifart
- Institutional Review Board, Clinical Ethics, Philipps-University Marburg, Marburg, Germany
| | - Winfried Rief
- Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Antonia Barke
- Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Pia von Blanckenburg
- Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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14
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Meiss F, Loquai C, Weis J, Giesler JM, Reuter K, Nashan D. Psycho-oncological care of melanoma patients in certified skin cancer centers. J Dtsch Dermatol Ges 2019; 16:576-582. [PMID: 29750461 DOI: 10.1111/ddg.13521] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 11/02/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The establishment und certification of skin cancer centers (SCCs) in compliance with requirements issued by the German Cancer Society play a key role for quality-assured treatment of skin cancer patients. These requirements also call for the implementation of a qualified psycho-oncology program. When planning the present study, we assumed site-specific differences in the way such programs were implemented at various SCCs. METHODS In 2014, we conducted a cross-sectional survey of all SCCs certified at the time (n = 43), in which these institutions were asked to provide information on the structural and process quality of their psycho-oncology programs. RESULTS Overall, 81.4 % of certified SCCs (n = 35) participated in the survey. Thirty-seven percent of SCCs directly employed personnel trained in psycho-oncology. Nearly all facilities offered information/counseling, crisis intervention, one-on-one discussions, and palliative/end-of-life care as part of their psycho-oncology program. Standardized screening tools were commonly used to evaluate patients' need for psycho-oncological support. Eighty-three percent of psycho-oncology programs primarily focused on inpatients. On average, 25.2 % of melanoma patients received psycho-oncological support. Ninety-seven percent of SCCs stated that the certification requirements had actually improved the psycho-oncological care of their patients. Seventy-one percent of SCCs reported to be satisfied with the implementation of the requirements. CONCLUSIONS The certification of institutions as SCCs has led to the implementation of personnel, structural, and content requirements relating to psycho-oncological care. The majority of SCCs surveyed reported to be satisfied with the quality of care thus achieved.
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Affiliation(s)
- Frank Meiss
- Department of Dermatology and Venereology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carmen Loquai
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - Joachim Weis
- Chair of Selfhelp Research, Comprehensive Cancer Center, University Medical Center Freiburg, Medical Faculty, University Freiburg, Freiburg, Germany
| | - Jürgen M Giesler
- Institute of Medical Biometry and Statistics, Section for Health Care Research and Rehabilitation Research, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Katrin Reuter
- Group Practice for Psychotherapy and Psychooncology (PPPO), Stadtstraße 11, Freiburg, Germany
| | - Dorothée Nashan
- Medical Center Dortmund, Department of Dermatology, Dortmund, Germany
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15
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Towards a framework for reporting self-guided interventions for people with cancer. Curr Opin Support Palliat Care 2019; 12:293-298. [PMID: 29916843 DOI: 10.1097/spc.0000000000000353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The purpose of this article is to provide an updated review exploring the recent developments in the field of self-guided interventions and describe the state of knowledge. This article builds on a previous systematic review on self-guided interventions, finding that the recent literature demonstrates that evidence for these interventions is mixed. The field is limited by descriptions of these interventions, and it is not possible to ascertain what aspects of interventions are more successful. RECENT FINDINGS Development of a reporting framework whereby self-guided interventions could be clearly presented, would be a substantial contribution to understanding the evidence for these studies. Recent findings also support the need to understand patient adherence and engagement, which could be achieved within a reporting framework. Additionally, ensuring patient safety is paramount and all studies should develop strategies to ensure patients can engage with these studies in a way that allows them to access more help and support if required. SUMMARY Self-guided interventions have potential for implementation and further translation because of being cost-effective and requiring few resources; and a reporting framework has the capacity to lead to clearer definitions and descriptions; and significantly improve the quality of evidence for these studies.
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16
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Körner A, Roberts N, Steele RJ, Brosseau DC, Rosberger Z. A randomized controlled trial assessing the efficacy of a self-administered psycho-educational intervention for patients with cancer. PATIENT EDUCATION AND COUNSELING 2019; 102:735-741. [PMID: 30545649 DOI: 10.1016/j.pec.2018.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 10/25/2018] [Accepted: 12/02/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Bibliotherapy refers to psychological self-help interventions that utilize treatment books to improve psychological well-being. Research supports bibliotherapy as an efficacious intervention for a variety of mental health problems. Yet, few studies have investigated bibliotherapy in psychosocial oncology. The objective of this randomized controlled trial was to examine the efficacy of the NuCare intervention, delivered as a self-directed workbook, for enhancing empowerment, coping, and quality of life and reducing distress in patients with cancer. METHODS Eighty-nine adult patients with cancer were randomized to receive the workbook for 6 weeks or the control condition, usual care. Participants completed questionnaires at baseline, 6 weeks post-baseline, and 10 weeks post-baseline. RESULTS The increase of empowerment (main outcome) and quality of life and the decrease of distress in the NuCare group from pre-intervention to follow-up assessment differed significantly from the respective difference scores in the control group. CONCLUSIONS The self-administered NuCare workbook is a potentially cost-effective, minimal intervention addressing psychosocial needs of patients with cancer. PRACTICE IMPLICATIONS Evidence-based bibliotherapy can empower patients and has the promise of reducing the burden on the healthcare system while enhancing the immediacy of psychosocial support.
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Affiliation(s)
- Annett Körner
- Departments of Educational and Counselling Psychology and of Oncology, McGill University, Montreal, Canada; Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center, Jewish General Hospital, Montreal, Canada; Psychosocial Oncology Program, McGill University Health Centre, Montreal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.
| | - Nicole Roberts
- Counselling Services, McGill University, Montreal, Canada
| | - Russell J Steele
- Department of Mathematics and Statistics, McGill University, Montreal, Canada
| | | | - Zeev Rosberger
- Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center, Jewish General Hospital, Montreal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Departments of Psychology, Oncology and Psychiatry, McGill University, Montreal, Canada
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17
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Meiss F, Loquai C, Weis J, Giesler JM, Reuter K, Nashan D. Psychoonkologische Versorgung von Melanompatienten in zertifizierten Hautkrebszentren. J Dtsch Dermatol Ges 2018; 16:577-584. [PMID: 29750470 DOI: 10.1111/ddg.13521_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 11/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Frank Meiss
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Carmen Loquai
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Mainz
| | - Joachim Weis
- Professur Selbsthilfeforschung, Comprehensive Cancer Center, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert Ludwigs Universität Freiburg im Breisgau
| | - Jürgen M Giesler
- Institut für Medizinische Biometrie und Statistik, Sektion Versorgungsforschung und Rehabilitationsforschung, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Katrin Reuter
- Praxengemeinschaft für Psychotherapie und Psychoonkologie (PPPO), Stadtstraße 11, Freiburg im Breisgau
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18
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Coolbrandt A, Wildiers H, Laenen A, Aertgeerts B, Dierckx de Casterlé B, van Achterberg T, Milisen K. A Nursing Intervention for Reducing Symptom Burden During Chemotherapy. Oncol Nurs Forum 2018; 45:115-128. [DOI: 10.1188/18.onf.115-128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Dekker J, Braamse A, Schuurhuizen C, Beekman ATF, van Linde M, Sprangers MAG, Verheul HM. Distress in patients with cancer - on the need to distinguish between adaptive and maladaptive emotional responses. Acta Oncol 2017; 56:1026-1029. [PMID: 28145789 DOI: 10.1080/0284186x.2017.1280848] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Joost Dekker
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Annemarie Braamse
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Claudia Schuurhuizen
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Medical Oncology, VUmc Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Aartjan T. F. Beekman
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Myra van Linde
- Department of Medical Oncology, VUmc Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Mirjam A. G. Sprangers
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk M. Verheul
- Department of Medical Oncology, VUmc Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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20
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Carolan C, Smith A, Davies G, Forbat L. Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence. Eur J Cancer Care (Engl) 2017; 27:e12720. [DOI: 10.1111/ecc.12720] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2017] [Indexed: 11/27/2022]
Affiliation(s)
- C.M. Carolan
- Faculty of Health Sciences and Sport; University of Stirling (Western Isles Campus); Stornoway UK
- NHS Western Isles; Stornoway UK
| | - A. Smith
- Faculty of Health Sciences and Sport; University of Stirling (Western Isles Campus); Stornoway UK
| | - G.R. Davies
- PGT Tertiary & Higher Education; Faculty of Arts, Humanities and Business; Lews Castle College UHI; Stornoway UK
| | - L. Forbat
- Palliative Care; Australian Catholic University and Calvary Health Care; Australian Catholic University; Canberra ACT Australia
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21
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Ugalde A, Haynes K, Boltong A, White V, Krishnasamy M, Schofield P, Aranda S, Livingston P. Self-guided interventions for managing psychological distress in people with cancer - A systematic review. PATIENT EDUCATION AND COUNSELING 2017; 100:846-857. [PMID: 28081937 DOI: 10.1016/j.pec.2016.12.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 12/01/2016] [Accepted: 12/13/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE People with cancer can experience psychological distress but do not always desire, or engage with, professional support to assist with managing distress. Interventions that are self-directed or guided by patients may hold promise as they allow patients to engage with interventions as they need. The objective of this review is to describe and appraise the evidence for effectiveness of self-guided interventions that aim to manage psychological distress in people with cancer. METHODS A systematic search of Medline, PsychInfo and CINAHL identified 15 relevant papers, reporting on 14 studies. RESULTS Of the interventions, three studies comprised hard-copy workbooks, six studies used resource packs, four were online resources and one was a brief multimedia resource. One study was adequately powered and demonstrated a positive effect. Almost all interventions required some level of facilitation. Distressed participants may benefit more from interventions. CONCLUSION Self-guided interventions represent a potentially efficient way of delivering support for people affected by cancer, however evidence supporting them is lacking. PRACTICE IMPLICATIONS There is a need to generate evidence to understand the impact of self-guided interventions for: i) the ideal delivery point in the disease trajectory, ii) patient groups, iii) intervention content and iv) type and mode of delivery.
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Affiliation(s)
- Anna Ugalde
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia; Cancer Information and Support Service, Cancer Council Victoria, Melbourne, Victoria, Australia.
| | - Kerry Haynes
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Anna Boltong
- Cancer Information and Support Service, Cancer Council Victoria, Melbourne, Victoria, Australia; Department of Nursing, University of Melbourne, Parkville, Victoria, Australia
| | - Victoria White
- Department of Nursing, University of Melbourne, Parkville, Victoria, Australia; Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Meinir Krishnasamy
- Department of Nursing, University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Parkville, Victoria, Australia; Centre for Cancer Research, University of Melbourne, Parkville, Victoria, Australia
| | - Penelope Schofield
- Department of Nursing, University of Melbourne, Parkville, Victoria, Australia; Peter MacCallum Cancer Centre, Parkville, Victoria, Australia; Swinburne University, Hawthorn, Victoria, Australia
| | - Sanchia Aranda
- Department of Nursing, University of Melbourne, Parkville, Victoria, Australia; Cancer Council Australia, Sydney, New South Wales, Australia
| | - Patricia Livingston
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
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Prevalence, risk factors, and the desire for help of distressed newly diagnosed cancer patients: A large-sample study. Palliat Support Care 2016; 15:295-304. [DOI: 10.1017/s1478951516000717] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTObjective:Beginning in 2007, all newly diagnosed cancer patients at the Koo Foundation Sun Yat-Sen Cancer Center (KF–SYSCC) were screened for psychosocial distress. Our social workers, as part of the psychosocial care team (PCT), have engaged in proactive outreach with patients identified as distressed. The goal of the present study was to assess the prevalence of psychosocial distress and the extent of contact between the PCT and distressed patients.Method:Newly diagnosed patients who were treated at KF–SYSCC between 2007 and 2010 for cancer were eligible if there were at least 100 patients with the same type of cancer. Before treatment began, they were screened with the Pain Scale and the Distress Thermometer (DT) and had the option to specify a desire for help. The rates of distress were analyzed by cancer type and by probable related factors. Information regarding contact with the PCT was retrieved from computerized databases.Results:Overall, some 5,335 cancer patients representing 12 major cancer types were included in our study. Of these, 1,771 (33.20%) were significantly distressed. By multivariate logistic regression, younger age, female gender, higher pain score, and disease stage, but not cancer type, were found to be associated with higher rates of distress. Among these distressed patients, 628 (36%) had some contact with the PCT.Significance of results:This Taiwanese study with a large sample size revealed a prevalence rate of psychosocial distress similar to rates found in Western countries. Contact with the PCT was established in only 36% of significantly distressed patients, despite a proactive outreach program. It is very important to have screening results made available in a timely fashion to the psycho-oncology team so that appropriate care can be offered promptly.
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Lo-Fo-Wong DNN, de Haes HCJM, Aaronson NK, van Abbema DL, den Boer MD, van Hezewijk M, Immink M, Kaptein AA, Menke-Pluijmers MBE, Reyners AKL, Russell NS, Schriek M, Sijtsema S, van Tienhoven G, Sprangers MAG. Predictors of enduring clinical distress in women with breast cancer. Breast Cancer Res Treat 2016; 158:563-72. [PMID: 27417105 PMCID: PMC4963436 DOI: 10.1007/s10549-016-3896-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/02/2016] [Indexed: 10/25/2022]
Abstract
To date, little is known about enduring clinical distress as measured with the commonly used distress thermometer. We therefore used the distress thermometer to examine: (a) the prevalence of enduring clinical distress, distress-related problems, and subsequent wish for referral of women with breast cancer, and (b) sociodemographic, clinical, and psychosocial predictors of enduring clinical distress. The study had a multicenter, prospective, observational design. Patients with primary breast cancer completed a questionnaire at 6 and 15 months postdiagnosis. Medical data were retrieved from chart reviews. Enduring clinical distress was defined as heightened distress levels over time. The prevalence of enduring clinical distress, problems, and wish for referral was examined with descriptive analyses. Associations between predictors and enduring clinical distress were examined with multivariate analyses. One hundred sixty-four of 746 patients (22 %) reported having enduring clinical distress at 6 and 15 months postdiagnosis. Of these, 10 % wanted to be referred for care. Fatigue was the most frequently reported problem by patients with and without clinical distress, at both time points. Lack of muscle strength (OR = 1.82, 95 % CI 1.12-2.98), experience of a low level of life satisfaction (OR = 0.77, 95 % CI 0.67-0.89), more frequent cancer worry (OR = 1.40, 95 % CI 1.05-1.89), and neuroticism (OR = 1.09, 95 % CI 1.00-1.18) were predictors of enduring clinical distress. In conclusion, one in five women with breast cancer develops enduring clinical distress. Oncologists, nurse practitioners, and cancer nurses are advised to use single-item questions about distress and distress-related problems to ensure timely detection of high-risk patients. Providers should also routinely assess fatigue and its causes, as fatigue is the most frequently reported distress-related problem over time.
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Affiliation(s)
- Deborah N N Lo-Fo-Wong
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands.
| | - Hanneke C J M de Haes
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
| | - Neil K Aaronson
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Doris L van Abbema
- GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Mathilda D den Boer
- Erasmus MC - Cancer Institute, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands
| | - Marjan van Hezewijk
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Marcelle Immink
- Reinier de Graaf Hospital, Reinier de Graafweg 3-11, 2625 AD, Delft, The Netherlands
| | - Ad A Kaptein
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | | | - Anna K L Reyners
- University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Nicola S Russell
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Manon Schriek
- St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands
| | - Sieta Sijtsema
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Geertjan van Tienhoven
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
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Brebach R, Sharpe L, Costa DSJ, Rhodes P, Butow P. Psychological intervention targeting distress for cancer patients: a meta-analytic study investigating uptake and adherence. Psychooncology 2016; 25:882-90. [PMID: 26893285 DOI: 10.1002/pon.4099] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 01/18/2016] [Accepted: 01/18/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Although cancer care guidelines recommend screening for distress among cancer patients and offering psychological support when indicated, many patients decline offers of such support. This study aimed to quantify uptake and adherence to psychological support and to identify predictors of each. METHODS Searches were conducted in Embase, Medline, PsychInfo and Scopus to identify studies reporting uptake or adherence rates for individual psychological interventions targeting distress, anxiety or depression for cancer patients or survivors. RESULTS Across the 53 included studies reporting uptake and/or adherence rates for 12 323 cancer patients, the uptake and adherence rates were 60.1% and 90.4%, respectively. Patients screened and identified as distressed were less likely to accept intervention than unselected patients (50.3% compared with 66.3%, Q(1) = 4.66, P = 0.031). Uptake of therapy was higher for interventions delivered by telephone rather than face-to-face (71.2% compared with 53.8%, Q(1) = 4.91, P = 0.027) and when therapy was offered prior to medical treatment compared with later (72.9% compared with 56.8%, Q(1) = 5.60, P = 0.018). Patients were more likely to accept intervention from nurses than other allied health professionals (68.3% compared with 50.5%, Q(1) = 5.76, P = 0.016). CONCLUSIONS Patients appeared more receptive to interventions offered near diagnosis, over the telephone and by nurses. Although this suggests higher acceptability of such interventions, evidence of their greater efficacy is lacking, and this merits further investigation. Research is needed to understand barriers to acceptance of psychological support, particularly because uptake rates were lower for distressed patients. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Rachel Brebach
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniel S J Costa
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul Rhodes
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Phyllis Butow
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.,PoCoG & CeMPED, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.,SoURCe, Institute of Surgery, Sydney, New South Wales, Australia
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Rankin NM, Butow PN, Thein T, Robinson T, Shaw JM, Price MA, Clover K, Shaw T, Grimison P. Everybody wants it done but nobody wants to do it: an exploration of the barrier and enablers of critical components towards creating a clinical pathway for anxiety and depression in cancer. BMC Health Serv Res 2015; 15:28. [PMID: 25608947 PMCID: PMC4307637 DOI: 10.1186/s12913-015-0691-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 01/09/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This study aimed to explore barriers to and enablers for future implementation of a draft clinical pathway for anxiety and depression in cancer patients in the Australian context. METHODS Health professionals reviewed a draft clinical pathway and participated in qualitative interviews about the delivery of psychosocial care in their setting, individual components of the draft pathway, and barriers and enablers for its future implementation. RESULTS Five interrelated themes were identified: ownership; resources and responsibility; education and training; patient reluctance; and integration with health services beyond oncology. CONCLUSIONS The five themes were perceived as both barriers and enablers and provide a basis for an implementation plan that includes strategies to overcome barriers. The next steps are to design and deliver the clinical pathway with specific implementation strategies that address team ownership, endorsement by leaders, education and training modules designed for health professionals and patients and identify ways to integrate the pathway into existing cancer services.
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Affiliation(s)
- Nicole M Rankin
- Translational Research Fellow, Sydney Catalyst, The University of Sydney, Chris O'Brien Lifehouse, Level 6, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Phyllis N Butow
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.
| | - Thida Thein
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.
| | - Tracy Robinson
- Workforce Education and Development Group, Sydney Medical School, The University of Sydney, Sydney, Australia.
| | - Joanne M Shaw
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.
| | - Melanie A Price
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.
| | - Kerrie Clover
- Calvary Mater Newcastle Hospital, Newcastle, Australia.
| | - Tim Shaw
- Workforce Education and Development Group, Sydney Medical School, The University of Sydney, Sydney, Australia.
| | - Peter Grimison
- Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW, Australia.
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Clover KA, Mitchell AJ, Britton B, Carter G. Why do oncology outpatients who report emotional distress decline help? Psychooncology 2014; 24:812-8. [DOI: 10.1002/pon.3729] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/14/2014] [Accepted: 11/03/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Kerrie Ann Clover
- Psycho-Oncology; Calvary Mater Newcastle; Newcastle New South Wales Australia
- Priority Research Centre for Translational Neuroscience and Mental Health; University of Newcastle; Newcastle New South Wales Australia
- School of Psychology; University of Newcastle; Newcastle New South Wales Australia
| | - Alex J. Mitchell
- Department of Psycho-oncology; University of Leicester and Leicestershire Partnership Trust; Leicestershire UK
| | - Ben Britton
- Psycho-Oncology; Calvary Mater Newcastle; Newcastle New South Wales Australia
- Priority Research Centre for Translational Neuroscience and Mental Health; University of Newcastle; Newcastle New South Wales Australia
| | - Gregory Carter
- Priority Research Centre for Translational Neuroscience and Mental Health; University of Newcastle; Newcastle New South Wales Australia
- Consultation-Liaison Psychiatry; Calvary Mater Newcastle; Newcastle New South Wales Australia
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