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Cho D, Roth M, Peterson SK, Jennings K, Kim S, Weathers SP, Ahmed S, Livingston JA, Barcenas C, You YN, Milbury K. Associations Between Stress, Health Behaviors, and Quality of Life in Young Couples During the Transition to Survivorship: Protocol for a Measurement Burst Study. JMIR Res Protoc 2024; 13:e53307. [PMID: 38652520 PMCID: PMC11077407 DOI: 10.2196/53307] [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: 10/09/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Cancer is a life-threatening, stressful event, particularly for young adults due to delays and disruptions in their developmental transitions. Cancer treatment can also cause adverse long-term effects, chronic conditions, psychological issues, and decreased quality of life (QoL) among young adults. Despite numerous health benefits of health behaviors (eg, physical activity, healthy eating, no smoking, no alcohol use, and quality sleep), young adult cancer survivors report poor health behavior profiles. Determining the associations of stress (either cancer-specific or day-to-day stress), health behaviors, and QoL as young adult survivors transition to survivorship is key to understanding and enhancing these survivors' health. It is also crucial to note that the effects of stress on health behaviors and QoL may manifest on a shorter time scale (eg, daily within-person level). Moreover, given that stress spills over into romantic relationships, it is important to identify the role of spouses or partners (hereafter partners) in these survivors' health behaviors and QoL. OBJECTIVE This study aims to investigate associations between stress, health behaviors, and QoL at both within- and between-person levels during the transition to survivorship in young adult cancer survivors and their partners, to identify the extent to which young adult survivors' and their partners' stress facilitates or hinders their own and each other's health behaviors and QoL. METHODS We aim to enroll 150 young adults (aged 25-39 years at the time of cancer diagnosis) who have recently completed cancer treatment, along with their partners. We will conduct a prospective longitudinal study using a measurement burst design. Participants (ie, survivors and their partners) will complete a daily web-based survey for 7 consecutive days (a "burst") 9 times over 2 years, with the bursts spaced 3 months apart. Participants will self-report their stress, health behaviors, and QoL. Additionally, participants will be asked to wear an accelerometer to assess their physical activity and sleep during the burst period. Finally, dietary intake (24-hour diet recalls) will be assessed during each burst via telephone by research staff. RESULTS Participant enrollment began in January 2022. Recruitment and data collection are expected to conclude by December 2024 and December 2026, respectively. CONCLUSIONS To the best of our knowledge, this will be the first study that determines the interdependence of health behaviors and QoL of young adult cancer survivors and their partners at both within- and between-person levels. This study is unique in its focus on the transition to cancer survivorship and its use of a measurement burst design. Results will guide the creation of a developmentally appropriate dyadic psychosocial or behavioral intervention that improves both young adult survivors' and their partners' health behaviors and QoL and potentially their physical health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53307.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kristofer Jennings
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Seokhun Kim
- The Center for Clinical Research and Evidence-Based Medicine, The University of Texas McGovern Medical School, Houston, TX, United States
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sairah Ahmed
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - J Andrew Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Carlos Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Y Nancy You
- Department of Colon & Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kathrin Milbury
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Capaldi JM, Shabanian J, Finster LB, Asher A, Wertheimer JC, Zebrack BJ, Shirazipour CH. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health Psychol Rev 2024; 18:41-74. [PMID: 36632776 DOI: 10.1080/17437199.2022.2162947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Abstract
The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.
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Affiliation(s)
- Jessica M Capaldi
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia Shabanian
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Laurel B Finster
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arash Asher
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Lin CC, Her YN. Demoralization in cancer survivors: an updated systematic review and meta-analysis for quantitative studies. Psychogeriatrics 2024; 24:35-45. [PMID: 37877340 DOI: 10.1111/psyg.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 09/18/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Demoralization can cause impairments across all life aspects of cancer patients. Cancer patients are also vulnerable during their survivorship. The purpose of this review is to examine the risk of demoralization and associated risk factors among cancer survivors who have completed their primary anti-cancer treatment or time since diagnosis ≥5 years without recurrence. METHODS We searched databases of PubMed, Cochrane, Embase, PsycINFO and ClinicalTrial.gov to identify eligible studies which reported the demoralization level among cancer survivors. A random-effect meta-analysis model was used for calculating mean demoralization level. Heterogeneity was evaluated by I2 statistics. Funnel plots and Egger's regression tests were performed for checking publication bias. We used one-study-removed method for sensitivity analysis. Subgroup analysis was also done to examine the difference of demoralization level between cancer types. Meta-regression was performed to reveal risk factors of demoralization. RESULTS A meta-analysis of 12 articles involving 2902 cancer survivors was conducted. The mean demoralization score among cancer survivors was 25.98 (95% CI: 23.53-28.43). Higher demoralization level was seen in participants with older age, higher female ratio, higher married/living together status ratio and higher patient health questionnaire-9 score. The literature review revealed correlations between demoralization and suicide risk, anxiety and quality of life. No consistent correlation between demoralization and post-traumatic stress symptoms could be seen. CONCLUSIONS High demoralization level is noticed among cancer survivors. Risks for females, elder patients or breast cancer survivors are identified. More longitudinal or interventional studies for cancer survivors' demoralization are expected in the future.
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Affiliation(s)
- Cian-Cian Lin
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ning Her
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Baclig NV, Comulada WS, Ganz PA. Mental health and care utilization in survivors of adolescent and young adult cancer. JNCI Cancer Spectr 2023; 7:pkad098. [PMID: 37982744 PMCID: PMC10735415 DOI: 10.1093/jncics/pkad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/30/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Adolescent and young adult cancer survivors experience mental health challenges, yet little is known about the evolution of these difficulties. This study explored mental health symptoms and utilization among long-term adolescent and young adult cancer survivors. METHODS Using 30 432 respondents from the 2019 National Health Interview Survey, this study compared adults with a history of adolescent and young adult cancer (diagnosed when patients were between 15 and 39 years of age) to adults without adolescent and young adult cancer. Mental health symptom severity was measured using the Patient Health Questionnaire depression scale and 7-item Generalized Anxiety Disorder questionnaires. Care utilization constituted psychotherapy and mental health medication use. Inverse propensity score weights were used to balance demographics and combined with survey weights. Descriptive statistics, multivariable generalized linear models, and structural equation modeling with 2-sided tests were used for analysis. RESULTS We compared 639 adolescent and young adult survivors with 29 793 controls. Survivors were, on average, 20.5 years (SE = 0.74) past their cancer diagnosis dates. After adjusting for survey and propensity score weights, adolescent and young adult survivors reported more severe depression (incidence rate ratio = 1.42, 95% confidence interval [CI] = 1.09 to 1.84, P < .01) and anxiety (incidence rate ratio = 1.85, 95% CI = 1.55 to 2.21, P < .001). They were more likely to use psychotherapy (odds ratio = 1.91, 95% CI = 1.16 to 3.17, P < .05) and mental health medications (odds ratio = 1.89, 95% CI = 1.15 to 3.11, P < .05). Time since diagnosis was negatively associated with symptoms and utilization. Structural equation modeling demonstrated mediation of utilization effect by symptom severity. CONCLUSIONS Adolescent and young adult survivors experience worse mental health in late survivorship, despite small improvements over time. We highlight the importance of survivorship care that addresses the long-term mental health needs of these survivors.
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Affiliation(s)
- Nikita V Baclig
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Warren Scott Comulada
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Patricia A Ganz
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Benedict C, Stal J, Davis A, Zeidman A, Pons D, Schapira L, Diefenbach M, Ford JS. Greater fertility distress and avoidance relate to poorer decision making about family building after cancer among adolescent and young adult female survivors. Psychooncology 2023; 32:1606-1615. [PMID: 37695291 PMCID: PMC10591918 DOI: 10.1002/pon.6212] [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: 02/24/2023] [Revised: 07/28/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Many adolescent and young adult female (AYA-F) cancer survivors face decisions about family building using reproductive medicine or adoption to achieve parenthood. This study evaluated associations among reproductive distress, avoidance, and family-building decision making and identified sociodemographic and clinical characteristics related to high distress and avoidance. METHODS A cross-sectional survey assessed AYA-F survivors' oncofertility experiences. Measures included an investigator-designed Unmet Information Needs scale, Reproductive Concerns After Cancer Scale, Impact of Events Scale-Avoidance subscale, Decision Self-Efficacy scale, and Decision Conflict Scale. Two linear regression models evaluated correlates of decision self-efficacy and decisional conflict about family building after cancer. Bivariate analyses evaluated correlates of avoidance using Pearson's correlation, t-test, and ANOVA. RESULTS AYA-Fs (N = 111) averaged 31-years-old (SD = 5.49) and 3 years post-treatment (range: 1-23 years); 90% were nulliparous. Most common diagnoses were leukemia (24%) and breast cancer (22%). Average decisional conflict was 52.12 (SD = 23.87, range: 0-100); 74% of the sample reported DCS scores within the clinically significant range. Higher levels of reproductive distress (B = -0.23, p = 0.04) and avoidance (B = -0.24, p = 0.02) related to lower decision self-efficacy. Younger age (B = -0.18, p = 0.03), greater unmet information needs (B = 0.33, p < 0.001), and higher levels of reproductive distress (B = 0.34, p = 0.001) related to worse decisional conflict. Predictors of distress and avoidance were identified. CONCLUSIONS After cancer treatment, high fertility distress and avoidant coping were associated with poorer quality decision making about family building after cancer. Fertility counseling post-treatment should support self-efficacy and constructive coping skills to counteract high distress, maladaptive coping, and facilitate values-based decision making.
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Affiliation(s)
- Catherine Benedict
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA
- Stanford Cancer Institute, Stanford, CA
| | - Julia Stal
- Department off Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA
| | - Ali Davis
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA
- Department of Clinical Psychology, Palo Alto University, Palo Alto, CA
| | - Anna Zeidman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA
| | - Devon Pons
- University of San Francisco, San Francisco, CA
| | | | - Michael Diefenbach
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY
| | - Jennifer S. Ford
- Hunter College and The Graduate Center, City University of New York (CUNY), New York, NY
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Siembida EJ, Fladeboe KM, Ip E, Zebrack B, Snyder MA, Salsman JM. A Developmental Science Approach to Informing Age Subgroups in Adolescent and Young Adult Cancer Research. J Adolesc Health 2023; 73:543-552. [PMID: 37294255 PMCID: PMC10524106 DOI: 10.1016/j.jadohealth.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Adolescent and young adult (AYA; diagnosed ages 15-39) cancer survivors are developmentally heterogenous, and this population consists of at least three distinct theoretically informed subgroups, as follows: adolescents, emerging adults, and young adults. However, there are limited evidence-based recommendations for delineating the validity of these subgroups in cancer-specific research. We sought to inform recommended chronological age ranges for each subgroup based on developmental processes. METHODS The data were collected using a 2x3 stratified sampling design (on-vs. off-treatment; ages 15-17, 18-25, 26-39) and a cross-sectional survey. AYAs (N = 572) completed three subscales of the Inventory of Dimensions of Emerging Adulthood (identity exploration, experimentation/possibilities, and other-focused), and we used regression tree analyses to identify distinct shifts in mean subscale scores that would indicate unique subgroups. Models included (a) chronological age, (b) chronological age + cancer-related variables, and (c) chronological age + sociodemographic/psychosocial variables as predictors of each developmental measure. RESULTS The recommended age ranges for AYA survivors receiving active treatment were consistent with prior research as follows: adolescents ages 15-17, emerging adults ages 18-24, and young adults ages 25-39. Models for off-treatment survivors suggested four distinct subgroups: adolescents ages 15-17, emerging adults ages 18-23, and 'younger' (ages 24-32) and 'older' young adults (ages 33-39). No sociodemographic or psychosocial variables meaningfully shifted these recommendations. DISCUSSION Our results suggest that three developmental subgroups remain appropriate for on-treatment survivors, but a second young adult subgroup (ages 33-39) emerged for off-treatment survivors. Therefore, development disruptions may be more likely to occur or manifest in post-treatment survivorship.
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Affiliation(s)
- Elizabeth J Siembida
- Institute of Health System Science, Northwell Health, Manhasset, New York; Northwell Health Cancer Institute, Northwell Health, Manhasset, New York.
| | - Kaitlyn M Fladeboe
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Edward Ip
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina; Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - Brad Zebrack
- University of Michigan School of Social Work, Ann Arbor, Michigan; University of Michigan Rogel Cancer Center, Ann Arbor, Michigan
| | - Mallory A Snyder
- Office of Research, The University of Chicago, Chicago, Illinois
| | - John M Salsman
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina; Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Koizumi T, Sugishita Y, Suzuki-Takahashi Y, Nara K, Miyagawa T, Nakajima M, Sugimoto K, Futamura M, Furui T, Takai Y, Matsumoto H, Yamauchi H, Ohno S, Kataoka A, Kawai K, Fukuma E, Nogi H, Tsugawa K, Suzuki N. Oncofertility-related psycho-educational therapy for young adult patients with breast cancer and their partners: Randomized controlled trial. Cancer 2023; 129:2568-2580. [PMID: 37082910 DOI: 10.1002/cncr.34796] [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: 10/05/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND A couples' psycho-educational program called Oncofertility! Psycho-Education and Couple Enrichment (O!PEACE) therapy was created and its effect when provided before cancer treatment was examined. METHODS This multicenter randomized controlled trial with nonmasking, parallel two-group comparison enrolled women aged 20 to 39 years with early-stage breast cancer and their partners. They were randomly assigned to receive O!PEACE (37 couples) or usual care (37 couples). Primary end points were cancer-related posttraumatic stress symptoms, symptoms of depression, and anxiety. Secondary end points were stress-coping strategies, resilience, and marital relationship. RESULTS Women receiving psycho-educational therapy had significantly reduced Impact of Event Scale-revised version for Japanese scores (p = .011, ηp 2 = = .089). For patients with Impact of Event Scale-revised version for Japanese scores at baseline ≥18.27, O!PEACE therapy improved these scores when compared with usual care (U = 172.80, p = .027, r = 0.258). A >5-point reduction was present in 59.3% and 30% of women in the O!PEACE therapy and usual-care groups, respectively. For partners, O!PEACE therapy significantly improved stress-coping strategies (95% CI, -0.60 to -0.05; p = .018, ηp 2 = = .074) and escape-avoidance marital communication (95% CI, -0.33 to -0.08; p = .001, ηp 2 = .136). O!PEACE therapy significantly improved the partners' support (95% CI, 0.10-0.50; p = .001, ηp 2 = .127), the rate of receiving fertility preservation consultations, and knowledge levels. CONCLUSIONS O!PEACE therapy before cancer treatment can improve posttraumatic stress symptoms, stress-coping behavior, and marital relationships. Larger sample sizes and longer term follow-up are required. PLAIN LANGUAGE SUMMARY A psycho-educational program, the Oncofertility! Psycho-Education and Couple Enrichment (O!PEACE) therapy program was developed and evaluated for women diagnosed with breast cancer and their partners. A multicenter randomized controlled trial showed that the O!PEACE psycho-educational therapy, with only two precancer treatment sessions, can reduce cancer-related posttraumatic stress symptoms and improve oncofertility knowledge and marital relationships in young adult patients with breast cancer. The therapy could also improve stress-coping strategies in marital communications with their partners. Couples may use O!PEACE psycho-educational therapy to consider fertility preservation and improve their psychosocial aspects.
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Affiliation(s)
- Tomoe Koizumi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Yodo Sugishita
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kazuko Nara
- Department of Clinical Psychology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tomoko Miyagawa
- Department of Clinical Psychology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | | | - Kouhei Sugimoto
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Manabu Futamura
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Gifu, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, Gifu, Gifu, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical University Saitama Medical Center, Kawagoe, Saitama, Japan
| | - Hiroshi Matsumoto
- Lacteal Gland Surgery Department, Saitama Cancer Center, Kitaadachi, Saitama, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Chuo, Tokyo, Japan
| | - Shinji Ohno
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto, Tokyo, Japan
| | - Akemi Kataoka
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto, Tokyo, Japan
| | - Kiyotaka Kawai
- Kameda IVF Clinic, Chiba, Chiba, Japan
- Assisted Reproductive Technology Center, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Eisuke Fukuma
- Breast Center, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Hiroko Nogi
- Department of Surgery, Jikei University School of Medicine, Minato, Tokyo, Japan
| | - Koichiro Tsugawa
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Matsui M, Taku K, Tsutsumi R, Ueno M, Seto M, Makimoto A, Yuza Y. Role of Peer Support in Posttraumatic Growth Among Adolescent and Young Adult Cancer Patients and Survivors. J Adolesc Young Adult Oncol 2023; 12:503-511. [PMID: 36579948 DOI: 10.1089/jayao.2022.0064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose: Adolescents and young adults (AYA) who undergo cancer treatment sometimes report posttraumatic growth (PTG). Although the importance of peer support has been suggested, its association with PTG, especially its five distinct domains, needs to be investigated further in AYA cancer survivors. The present study examined the role of demographics and peer support in PTG among AYA cancer patients and survivors. Methods: The present, multicenter, cross-sectional, web-based study enrolled AYA cancer patients and survivors (median age: 28 years). Of 549 AYA patients recruited, 212 from 11 cancer centers and 12 cancer patient communities agreed to participate by completing a self-reported measure of PTG (Extended Version of the Posttraumatic Growth Inventory-Japanese) and providing information about their diagnosis, treatment, peer support (affiliation with an AYA patient community or friendship with other AYA patients), and social status. Multiple regression analysis was used to identify significant correlations overall and in the five PTG domains. Results: PTG was positively associated with male sex, having a confidant, and friendship with other AYA patients, and negatively associated with cranial radiation. Friendship with other AYA patients was positively associated with four of the five PTG subscales. For the five subscale scores, "cranial radiation" was negatively associated with "relating to others"; "belonging to a religion" was positively associated with "spiritual change"; and "having a confidant" was positively associated with "relating to others" and "new possibility." Conclusion: "Having a confidant" and "friendship with other AYA patients" were positively associated with PTG. Psychosocial interventions mobilizing peer support may contribute to promoting PTG in AYA patients. UMIN000035439.
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Affiliation(s)
- Motohiro Matsui
- Department of Pediatric Hematology Oncology, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
- Department of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
| | - Kanako Taku
- Department of Psychology, Oakland University, Oakland, Michigan, USA
| | - Rina Tsutsumi
- Department of Nursing, Kyorin University, Mitaka, Tokyo, Japan
| | - Midori Ueno
- Department of Nursing, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Mayuri Seto
- Department of Nursing, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Atsushi Makimoto
- Department of Pediatric Hematology Oncology, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Yuki Yuza
- Department of Pediatric Hematology Oncology, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
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Dorfman CS, Shelby RA, Stalls JM, Somers TJ, Keefe FJ, Vilardaga JP, Winger JG, Mitchell K, Ehren C, Oeffinger KC. Improving Symptom Management for Survivors of Young Adult Cancer: Development of a Novel Intervention. J Adolesc Young Adult Oncol 2023; 12:472-487. [PMID: 36178972 PMCID: PMC10457621 DOI: 10.1089/jayao.2022.0100] [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: 11/13/2022] Open
Abstract
Purpose: Improved symptom management is a critical although unmet post-treatment need for young adult (YA) cancer survivors (aged 18-39 at diagnosis). This study aimed to develop and refine a behavioral symptom management intervention for YA survivors. Methods: Phase I: YA survivors (N = 21) and oncology providers (N = 11) completed individual interviews and an online, self-report assessment to examine symptom experiences, the need for a behavioral symptom management intervention for YAs, and perceptions about potential intervention components, structure, and format. Phase II: YA survivors (N = 10) completed user testing sessions, providing feedback on the prototype intervention materials (paper manual and mobile application), and completed an online assessment. Quantitative data were examined using descriptive statistics. Rapid qualitative analysis, a methodologically rigorous standardized approach, was used. Results: Pain, fatigue, and distress were ranked as top concerns by most YAs and providers. Phase I interviews underscored the need for a symptom management intervention for YAs. YAs and providers highlighted potential coping strategies and program format/structure suggestions (e.g., small group format) to best meet YAs' needs. A prototype intervention was developed combining the following: traditional behavioral symptom coping skills; home-based physical activity; strategies from Acceptance and Commitment Therapy and Meaning-Centered Psychotherapy; and strategies to foster self-compassion. Phase II user testing sessions highlighted strengths and suggestions for refining the prototype materials. Conclusion: Post-treatment symptoms are common for YAs. A tailored behavioral symptom management program was developed and refined with input from YAs and providers and will be examined for feasibility and acceptability in a pilot randomized controlled trial. Clinical Trial: Clinicaltrials.gov identifier NCT04035447.
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Affiliation(s)
- Caroline S. Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Rebecca A. Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann M. Stalls
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Francis J. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Jennifer Plumb Vilardaga
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Joseph G. Winger
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kara Mitchell
- Duke Health and Fitness Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Christopher Ehren
- Duke Health and Fitness Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Kevin C. Oeffinger
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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10
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Son H, Hong S, Hong M, Silva SG. Measure of perceived social support from family, friends, and healthcare providers for Korean adolescents and young adults with cancer. Asia Pac J Oncol Nurs 2023; 10:100244. [PMID: 37448534 PMCID: PMC10336414 DOI: 10.1016/j.apjon.2023.100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/11/2023] [Indexed: 07/15/2023] Open
Abstract
Objective Assessing the perceived social support (PSS) that adolescents and young adults (AYAs) with cancer receive from family, friends, and healthcare providers is critical to promoting their adjustment. This study developed a reliable and comprehensive self-report PSS assessment tool that measures various aspects of social support by translating existing measurements into Korean. Methods The translation was completed in accordance with international guidelines. To focus on cultural adaptation, the main ideas associated with items were translated to reflect the differences between Western and Eastern culture. In total, 144 Korean AYAs with cancer (mean age: 17 years; 46% female) completed the translated version. A separate principal component analysis (PCA) with an orthogonal quartimax rotation, a minimum eigenvalue of 1.0, and minimum factor loadings of 0.50 was used for each subscale. Cronbach's alpha coefficients were calculated for each PCA-derived subscale. Results Four subscales with 46 items were identified. Two subscales represented perceived emotional support within the family (PSS-ESF, 14 items) and the AYA's perceived helpfulness within the family (PSS-HWF, 3 items). The third scale represented the perceived support of friends (PSS-Friends, 14 items). The final scale represented the perceived support of healthcare providers (PSS-HCPs, 15 items). Excellent reliability per subscale was demonstrated (Cronbach's alpha: 0.93 for PSS-ESF, 0.73 for PSS-HWF, and 0.92 each for PSS-Friends and PSS-HCPs). Conclusions A culturally adapted and reliable Korean version questionnaire with four independent subscales was developed. Further assessment of the Korean PSS is required and will contribute to the development of culturally adapted and tailored interventions.
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Affiliation(s)
- Heeyeon Son
- College of Nursing, University of Tennessee, Knoxville, TN, USA
| | - Sungsil Hong
- Department of Nursing, Kangwon National University, Samcheok, South Korea
| | - Michin Hong
- School of Social Work, Indiana University, Indianapolis, IN, USA
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11
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Werk RS, Koyama T, Sun L, Wolden S, Kelly KM, Constine LS, Schwartz CL, Friedman DL. Post-Traumatic Stress Symptoms in Adolescent Hodgkin Lymphoma Survivors: A Report from Children's Oncology Group AHOD0031. J Adolesc Young Adult Oncol 2023; 12:359-365. [PMID: 36094417 PMCID: PMC10282797 DOI: 10.1089/jayao.2022.0053] [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: 11/12/2022] Open
Abstract
Purpose: The intrusive thoughts of cancer diagnosis, treatments, re-experiencing, and avoidance associated with post-traumatic stress symptoms (PTSS) can negatively affect Hodgkin lymphoma (HL) survivors. This study investigates the associations between experiences and beliefs and PTSS among adolescent survivors of intermediate-risk HL treated on the Children's Oncology Group (COG) AHOD0031 study. Methods: COG AHOD0031 participants completed self-report surveys at end of therapy concerning post-treatment medical conditions, activity limitations, fatigue, future concerns, exercise, and PTSS. Results: One thousand one hundred ten of 1721 participants in AHOD0031 completed the first survey at a median of 6.7 months post-diagnosis (interquartile range: 5.3-11.5 months), and of these, 736 (66.3%) completed a second survey at a median of 12.4 (10.1-17.6) months following the first. The mean PTSS score (ranging from 0 to 20) was 5.5 (standard deviation [SD] = 5.1) on survey 1 and 4.4 (SD = 4.8) on survey 2. Increased fatigue (odds ratio [OR] = 1.14, p < 0.01), concerns for the future (OR = 1.13, p < 0.01), activity limitations (OR = 1.05, p < 0.01), and relapse history (OR = 2.18, p < 0.05) were associated with higher PTSS scores in the initial survey. Increased fatigue (OR = 1.16, p < 0.01), concerns for the future (OR = 1.14, p < 0.01), activity limitations (OR = 1.05, p < 0.05), and higher PTSS scores on the first survey (OR = 1.19, p < 0.01) were associated with higher PTSS scores in the subsequent survey. Longer time since diagnosis (OR = 0.85, p < 0.05; OR = 0.84, p < 0.05) was associated with lower PTSS scores on both surveys. Conclusions: Based on our findings, future research should examine the onset and trajectory of PTSS among HL survivors, focusing on early recognition and intervention to improve quality of life.
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Affiliation(s)
- Rachel S. Werk
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Tatsuki Koyama
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lili Sun
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Suzanne Wolden
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kara M. Kelly
- Department of Pediatric Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Louis S. Constine
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA
| | - Cindy L. Schwartz
- Department of Pediatrics, Children's Hospital of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Debra L. Friedman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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12
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Severity and Longitudinal Course of Depression, Anxiety and Post-Traumatic Stress in Paediatric and Young Adult Cancer Patients: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12051784. [PMID: 36902569 PMCID: PMC10003651 DOI: 10.3390/jcm12051784] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND A diagnosis of cancer and treatment may constitute a highly traumatic period for paediatric cancer patients (PYACPs). However, no review has comprehensively analysed how the mental health of PYACPs is acutely affected and the longitudinal course. METHODS This systematic review followed PRISMA guidelines. Comprehensive searches of databases were conducted to identify studies of depression, anxiety and post-traumatic stress symptoms in PYACPs. Random effects meta-analyses were used for the primary analysis. RESULTS From 4898 records, 13 studies were included. Acutely after diagnosis, depressive and anxiety symptoms were significantly elevated in PYACPs. Depressive symptoms only significantly decreased after 12 months (standardised mean difference, SMD = -0.88; 95% CI: -0.92, -0.84). This downward trajectory persisted to 18 months (SMD = -1.862; 95% CI: -1.29, -1.09). Anxiety symptoms similarly only decreased after 12 (SMD = -0.34; 95% CI: -0.42, -0.27) up to 18 months (SMD = -0.49; 95% CI: -0.60, -0.39) after the cancer diagnosis. Post-traumatic stress symptoms showed protracted elevations throughout follow-up. Overall, significant predictors of poorer psychological outcomes included unhealthy family functioning, concomitant depression or anxiety, poor cancer prognosis or experiencing cancer and treatment-related side effects. CONCLUSIONS While depression and anxiety may improve over time with a favourable environment, post-traumatic stress may have a protracted course. Timely identification and psycho-oncological intervention are critical.
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13
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Prevalence and associated factors of psychological distress among young adult cancer patients in Japan. Palliat Support Care 2023; 21:93-99. [PMID: 35225198 DOI: 10.1017/s1478951521002054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Adolescent and young adult (AYA) cancer patients may be at high risk of experiencing psychological distress because their diagnosis came during a key time of consolidation of identity and social growth. This study aimed (1) to examine the prevalence of psychological distress among AYA cancer patients within a year of diagnosis to long-term survivors and (2) to describe socio-demographic and cancer-related characteristics associated with psychological distress. METHODS In a cross-sectional web-based survey, patients who scored 5 or more on the Kessler Psychological Distress Scale were assessed for significant psychological distress. Logistic regression examined whether demographics, clinical variables, and social support were associated with psychological distress. RESULTS A total of 206 young adult cancer patients participated. The median age at the survey was 34.5 years (range: 22-39 years), and 87.4% were female. The prevalence of psychological distress was 55.3%. Psychological distress among patients diagnosed within a year and long-term survivors (≥10 years since diagnosis) was significantly higher than patients 1-4 years since diagnosis. Pain, decrease in income after a cancer diagnosis, experience of negative change in work/school after a cancer diagnosis and poor social support were significantly associated with psychological distress. SIGNIFICANCE OF RESULTS Over half of young adult patients had significant psychological distress in Japan. Our findings potentially contribute to the intervention components for distress management among AYA cancer survivors.
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14
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Dorfman CS, Stalls J, Lachman S, Shelby RA, Somers TJ, Oeffinger KC. Symptom Communication Preferences and Communication Barriers for Young Adult Cancer Survivors and Their Health Care Providers. J Adolesc Young Adult Oncol 2022; 11:506-517. [PMID: 35049386 PMCID: PMC9595618 DOI: 10.1089/jayao.2021.0172] [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: 11/13/2022] Open
Abstract
Purpose: Effective communication between young adult (YA; aged 18-39 years) cancer survivors and their health care providers is critical for managing post-treatment symptoms. Yet, little is known about YAs' and providers' preferences for and barriers to symptom communication, variables important for developing interventions to improve and optimize YA-provider communication. Methods: YA survivors (N = 21) and oncology providers (N = 11) rank ordered their preferred methods for symptom communication and top communication barriers. Interviews were conducted to obtain qualitative data (i.e., preferred methods for, barriers, and suggestions to improve symptom communication). Interviews were transcribed, and thematic qualitative analysis was used. Results: Sixty-two percent of YAs preferred communicating using the electronic messaging system affiliated with the medical record (MyChart), whereas providers (100%) preferred communicating during in-person clinic visits. Qualitative data from YAs pointed to benefits of MyChart, including ease of use and rapid responses. Providers acknowledged that, although efficient, high message volumes and expectations for rapid responses were barriers to MyChart. Providers described benefits of in-person visits, including visually assessing patients' concerns, providing immediate support, and more safely managing symptoms. Lack of time (48%) was YAs' top communication barrier, whereas providers endorsed patients not bringing up symptoms (64%). Qualitative data reflected patient-level (e.g., embarrassment/discomfort, lack of skills) and provider-level (e.g., forgetting to ask about a symptom) barriers. YAs and providers offered strategies to improve communication. Conclusion: Survivor- and provider-level communication interventions that account for YAs' and providers' differing communication preferences and directly address communication barriers unique to survivors' developmental stage may be necessary to improve symptom communication.
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Affiliation(s)
- Caroline S. Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann Stalls
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Sage Lachman
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Rebecca A. Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Kevin C. Oeffinger
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
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15
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Psychosocial Distress Due to Interference of Normal Developmental Milestones in AYAs with Cancer. CHILDREN 2022; 9:children9030309. [PMID: 35327680 PMCID: PMC8947616 DOI: 10.3390/children9030309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 01/19/2023]
Abstract
Cancer in the adolescent and young adult phase poses additional challenges to this period of development that is crucial to the transition to independence. This report provides a brief review of normal developmental milestones in this age range while highlighting the disruptive effects of cancer. We focus on the psychological burden of cancer in patients aged 15–39 years and explore the application of the total pain model to highlight the psychological/emotional, social, and spiritual aspects of non-physical pain. We also briefly review posttraumatic growth and resilience. Lastly, we provide a review of areas for possible development and future research.
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16
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Akechi T, Mishiro I, Fujimoto S. Risk of Major Depressive Disorder in Adolescent and Young Adult Cancer Patients in Japan. Psychooncology 2022; 31:929-937. [PMID: 35001472 PMCID: PMC9305902 DOI: 10.1002/pon.5881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To estimate the risk of major depressive disorder (MDD) in adolescent and young adult (AYA) patients with cancer in Japan and identify risk factors for MDD among these patients. METHODS This was a matched cohort study using a large claims database in Japan. Included patients were aged 15-39 years, newly diagnosed with cancer during 2012-2017 and assessable for a follow-up period of 12 months. Kaplan-Meier estimates and Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for MDD in the AYA patients with cancer versus age-, sex- and working status-matched cancer-free controls. A subgroups analysis of the AYA patients with cancer was performed to explore MDD risk factors. RESULTS A total of 3,559 AYA patients with cancer and 35,590 matched controls were included in the analysis. AYA patients with cancer had a 3-fold higher risk for MDD compared with cancer-free controls (HR, 3.12; 95% CI, 2.64-3.70). Among cancer categories with >100 patients, patients with multiple cancer categories, including those with metastatic cancer (HR, 6.73, 95% CI, 3.65-12.40) and leukemia (HR, 6.30; 95% CI, 3.75-10.58), had the greatest MDD risk versus matched controls. Patients who received inpatient chemotherapy as initial treatment had a higher risk for MDD than patients without chemotherapy (HR, 0.43; 95% CI, 0.30-0.62). CONCLUSIONS AYA patients in Japan with cancer are at high risk for MDD. Particularly, those with multiple cancer categories, leukemia, and those who receive aggressive anticancer treatments should be monitored closely for symptoms of MDD. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Shinji Fujimoto
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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17
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Sansom-Daly UM, Wakefield CE, Ellis SJ, McGill BC, Donoghoe MW, Butow P, Bryant RA, Sawyer SM, Patterson P, Anazodo A, Plaster M, Thompson K, Holland L, Osborn M, Maguire F, O’Dwyer C, De Abreu Lourenco R, Cohn RJ. Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial. Cancers (Basel) 2021; 13:2460. [PMID: 34070134 PMCID: PMC8158368 DOI: 10.3390/cancers13102460] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 12/20/2022] Open
Abstract
Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors' mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention ('Recapture Life') in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (Mage = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00-15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times.
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Affiliation(s)
- Ursula M. Sansom-Daly
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Sarah J. Ellis
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Brittany C. McGill
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Mark W. Donoghoe
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW 2033, Australia
| | - Phyllis Butow
- Centre for Medical Psychology & Evidence-Based Decision-Making (CeMPED), School of Psychology, University of Sydney, Sydney, NSW 2050, Australia;
| | | | - Susan M. Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia;
- Royal Children’s Hospital Centre for Adolescent Health, Melbourne, VIC 3052, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
| | - Pandora Patterson
- Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia;
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Antoinette Anazodo
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Megan Plaster
- Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, WA 6009, Australia;
| | - Kate Thompson
- Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia;
- Department of Social Work, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Lucy Holland
- Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Herston, QLD 4006, Australia;
- School of Nursing, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Michael Osborn
- Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, SA 5000, Australia;
| | - Fiona Maguire
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Catherine O’Dwyer
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW 2000, Australia;
| | - Richard J. Cohn
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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Shin YJ, Oh EG. Factors Influencing Resilience among Korean adolescents and young adult survivors of childhood cancer. Eur J Oncol Nurs 2021; 53:101977. [PMID: 34144358 DOI: 10.1016/j.ejon.2021.101977] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/21/2021] [Accepted: 05/03/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE The number of childhood cancer survivors has been steadily increasing because of improved cancer treatment outcomes. We aimed to examine the level of cancer stigma, coping, spirituality, hope, family communication, social support and resilience in adolescent and adult childhood cancer survivors and identify factors associated with resilience. METHOD This study is a descriptive survey conducted on 139 childhood cancer survivors aged 15-29 years who had been diagnosed with cancer prior to the age of 19 years at a general hospital in Seoul. The questionnaire consisted of the Cancer Stigma Scale, Jalowiec Coping Scale, Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp), Hearth Hope Index (HHI), Parent-Adolescent Communication Inventory (PACI), Multidimensional Scale of Perceived Social Support (MSPSS), and Haase Resilience in Illness Scale (HARS). Collected data were analyzed using multiple linear regression analysis with SPSS 23.0. RESULTS Resilience positively correlated with courageous coping, spirituality, hope, family communication and social support, and negatively correlated with cancer stigma and defensive coping. Regression analyses revealed that courageous coping (β = 0.303, p < .001), hope (β = 0.317, p = .001), and solid tumor diagnosis (β = -0.144, p = .012) were significantly predictive of resilience among childhood cancer survivors, and these factors explained 65.2% of the variance. CONCLUSIONS Resilience among childhood cancer survivors was higher with increasing courageous coping and hope and lower with solid tumors. These results suggest that coping and hope management should be included in the strategies to enhance the resilience of AYA cancer survivors.
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Affiliation(s)
- Yoon Jung Shin
- College of Nursing, Yonsei University, Seoul, South Korea; Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | - Eui Geum Oh
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
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19
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Lu AD, Zheng Z, Han X, Qi R, Zhao J, Yabroff KR, Nathan PC. Medical Financial Hardship in Survivors of Adolescent and Young Adult Cancer in the United States. J Natl Cancer Inst 2021; 113:997-1004. [PMID: 33839786 DOI: 10.1093/jnci/djab013] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/27/2020] [Accepted: 01/11/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cancer and its treatment can result in lifelong medical financial hardship, which we aimed to describe among adult survivors of adolescent and young adult (AYA) cancers in the United States. METHODS We identified adult (aged ≥18 years) survivors of AYA cancers (diagnosed ages 15-39 years) and adults without a cancer history from the 2010-2018 National Health Interview Surveys. Proportions of respondents reporting measures in different hardship domains (material [eg, problems paying bills], psychological [eg, distress], and behavioral [eg, forgoing care due to cost]) were compared between groups using multivariable logistic regression models and hardship intensity (cooccurrence of hardship domains) using ordinal logistic regression. Cost-related changes in prescription medication use were assessed separately. RESULTS A total of 2588 AYA cancer survivors (median = 31 [interquartile range = 26-35] years at diagnosis; 75.0% more than 6 years and 50.0% more than 16 years since diagnosis) and 256 964 adults without a cancer history were identified. Survivors were more likely to report at least 1 hardship measure in material (36.7% vs 27.7%, P < .001) and behavioral (28.4% vs 21.2%, P < .001) domains, hardship in all 3 domains (13.1% vs 8.7%, P < .001), and at least 1 cost-related prescription medication nonadherence (13.7% vs 10.3%, P = .001) behavior. CONCLUSIONS Adult survivors of AYA cancers are more likely to experience medical financial hardship across multiple domains compared with adults without a cancer history. Health-care providers must recognize this inequity and its impact on survivors' health, and multifaceted interventions are necessary to address underlying causes.
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Affiliation(s)
- Amy D Lu
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Zhiyuan Zheng
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Xuesong Han
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Ruowen Qi
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jingxuan Zhao
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - K Robin Yabroff
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Paul C Nathan
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada.,Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
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20
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Rajaei A, Jensen JF, Brimhall AS, Torres ET, Schwartz AJ. Dyadic Function of Couples with Cancer: A Review. JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2020. [DOI: 10.1080/15332691.2020.1841055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Afarin Rajaei
- Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Jakob F. Jensen
- Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Andrew S. Brimhall
- Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Essie T. Torres
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Abby J. Schwartz
- School of Social Work, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
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21
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Vandraas KF, Reinertsen KV, Kiserud CE, Lie HC. Fear of cancer recurrence among young adult cancer survivors-exploring long-term contributing factors in a large, population-based cohort. J Cancer Surviv 2020; 15:497-508. [PMID: 32989672 PMCID: PMC8272704 DOI: 10.1007/s11764-020-00943-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Fear of cancer recurrence (FCR) may be debilitating, yet knowledge of FCR among the growing population of long-term young adult cancer survivors (YACS) is scarce. We explored risk of FCR and associated factors in a nation-wide, population-based cohort of YACS. METHODS All 5-year survivors diagnosed at the ages of 19-39 years with breast cancer (BC), malignant melanoma (MM), colorectal cancer (CRC), leukemia (LEU), or non-Hodgkin lymphoma (NHL) between 1985 and 2009 in Norway were identified by the Cancer Registry of Norway and completed the cross-sectional comprehensive NOR-CAYACS health survey. Univariate and multivariate linear regression modeling was performed. RESULTS In total, 936 survivors were included, with an average of 16 years since diagnoses. BC was the most prevalent cancer form (38.4%), followed by MM (24.7%), NHL (15.6%), CRC (11.8%), and LEU (9.6%). Survivors worried most about getting another cancer (74%), and (20%) reported quite a bit or a lot of FCR. BC and MM survivors had the highest FCR scores. Post-traumatic stress symptoms (PTSS) had the strongest association with FCR (Std B 0.21, p < 0.01), above demographic and clinical variables. CONCLUSIONS FCR is prevalent even among long-term YACS, including survivors of MM with favorable prognoses. IMPLICATIONS FOR CANCER SURVIVORS Attention to ongoing risks of PTSS and FCR in this growing survivor population is warranted to optimize future survivorship care.
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Affiliation(s)
- Kathrine F Vandraas
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
| | - Kristin V Reinertsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Hanne C Lie
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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22
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Nilsson S, Hård Af Segerstad Y, Olsson M. Worrying About Death: An Initial Analysis of Young Adult Cancer Patients' Needs. J Adolesc Young Adult Oncol 2020; 10:105-108. [PMID: 32552246 DOI: 10.1089/jayao.2020.0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Young adults (YAs) with cancer may have a need to develop strategies to cope with their worries about death. This brief report presents findings from a pilot study on YAs' needs with regard to such issues. An anonymous, web-based questionnaire was posted with a total of 83 cancer patients taking the questionnaire (71 females and 12 males). Almost half of the participants thought about death every day. Since most of the participants had ended their treatment, this would appear to show that matters related to death remain an important issue after the YAs' cancer treatment has ended. The results show a need for YAs to talk about death, either with professionals or with peers.
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Affiliation(s)
- Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg Center for Person-Centered Care, University of Gothenburg, Gothenburg, Sweden
| | - Ylva Hård Af Segerstad
- Department of Applied IT, University of Gothenburg Center for Person-Centered Care, University of Gothenburg, Gothenburg, Sweden
| | - Maria Olsson
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Center for Person-Centered Care, University of Gothenburg, Gothenburg, Sweden
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23
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Sharkey CM, Schepers SA, Drake S, Pai ALH, Mullins LL, Grootenhuis MA. Psychosocial Risk Profiles Among American and Dutch Families Affected by Pediatric Cancer. J Pediatr Psychol 2020; 45:463-473. [PMID: 32196095 DOI: 10.1093/jpepsy/jsaa012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/09/2020] [Accepted: 02/17/2020] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Little is known about relations between domains of psychosocial risk among pediatric cancer populations. The Psychosocial Assessment Tool 2.0 (PAT2.0) is one internationally validated screening measure that can examine these relations. This study aimed to examine risk profiles and predictors of these patterns exhibited by American and Dutch families. METHODS Caregivers of children newly diagnosed with cancer (N = 262; nUSA=145, nNL=117) completed the PAT2.0 as part of larger studies conducted in the United States and the Netherlands. Latent profile analysis and multinomial logistic regression examined differences in demographic and medical variables across risk profiles. Domains assessed included Family Structure/Resources, Child Problems, Sibling Problems, Family Problems, Caregiver Stress Reactions, and Family Beliefs. RESULTS Four groups were identified: "Low-Risk" (n = 162) defined by generally low risk across domains; "Moderate-Caregiver" (n = 55) defined by elevated Caregiver Stress Reactions domain; "Moderate-Children" (n = 25) defined by elevated Child Problems and/or Sibling Problems, and "Elevated-Risk" (n = 20) marked by generally high overall risk. Dutch families had higher odds of being in the Elevated-Risk group, compared to the Low-Risk group. Caregiver age, gender, and educational attainment predicted group membership. Families classified as Targeted or Clinical had higher odds of being in the Moderate or Elevated risk groups. CONCLUSION The PAT2.0 appears to identify largely similar patterns of risk, suggesting that families experience common psychosocial difficulties in both American and Dutch societies. The two Moderate groups demonstrated specific risk sources, suggesting that evaluation of domain patterns, rather than reliance on PAT2.0 risk level, could be of clinical benefit.
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24
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Pailler ME, Beaupin LK, Brewer-Spritzer E, Grant PC, Depner RM, Levy K, Tenzek KE. Reaching Adolescent and Young Adult Cancer Patients Through Social Media: Impact of the Photographs of Meaning Program. J Adolesc Young Adult Oncol 2020; 9:508-513. [PMID: 32255697 DOI: 10.1089/jayao.2019.0140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study assessed the feasibility and preliminary efficacy of the Photographs of Meaning Program for Adolescent and Young Adult cancer patients and survivors (POM-AYA). Methods: POM-AYA is a structured 10-week meaning-based intervention in which participants post photographs and accompanying narratives through a social media platform. Measures of depression, overall quality of life (QoL), and spiritual well-being were assessed on consent (T1), after completing the 10-week intervention (T2) and 2 months' postintervention (T3). Participants also completed a satisfaction questionnaire and follow-up semi-structured interviews. Results: Thirty AYA cancer patients and survivors (ages 17-36) were enrolled in the study. At T2, depressive symptoms were significantly lower and QoL was significantly higher compared with T1. These gains were maintained at T3. There were no significant differences in reported spiritual well-being across the study period. Overall, participants reported high rates of study satisfaction in both the survey and qualitative feedback. Conclusion: POM-AYA appears to be a potentially beneficial, widely accessible intervention in reducing depressive symptoms and increasing QoL in AYA cancer patients and survivors.
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Affiliation(s)
- Megan E Pailler
- Department of Psychology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Lynda K Beaupin
- Pediatrics, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA
| | - Erin Brewer-Spritzer
- Department of Psychology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Pei C Grant
- Palliative Care Institute, The Center for Hospice and Palliative Care, Cheektowaga, New York, USA
| | - Rachel M Depner
- Palliative Care Institute, The Center for Hospice and Palliative Care, Cheektowaga, New York, USA.,University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Kathryn Levy
- Palliative Care Institute, The Center for Hospice and Palliative Care, Cheektowaga, New York, USA
| | - Kelly E Tenzek
- University at Buffalo, The State University of New York, Buffalo, New York, USA
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25
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Worldwide benefits of improving cancer care for adolescents and young adults in LMICs. Lancet Oncol 2020; 21:487-489. [DOI: 10.1016/s1470-2045(20)30101-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 11/23/2022]
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26
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Victorson D, Murphy K, Benedict C, Horowitz B, Maletich C, Cordero E, Salsman JM, Smith K, Sanford S. A randomized pilot study of mindfulness-based stress reduction in a young adult cancer sample: Feasibility, acceptability, and changes in patient reported outcomes. Psychooncology 2020; 29:841-850. [PMID: 32040222 DOI: 10.1002/pon.5355] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/20/2020] [Accepted: 02/05/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND The primary purpose of this study was to examine the feasibility and acceptability of participation in a randomized waitlist-controlled intervention of mindfulness-based stress reduction (MBSR) in a young adult cancer sample. A secondary aim was to examine patterns of change in patient reported outcomes (PROs) of physical, social, and emotional functioning. METHODS Participants were enrolled at a large Midwestern comprehensive cancer center and randomized to MBSR or a waitlist control. Feasibility and acceptability were examined through enrollment metrics and a survey. PROs were gathered at baseline, 8-weeks, and 16-weeks. Descriptive statistics and mixed models were used in analyses. RESULTS Of 597 eligible participants, 151 (26.5%) consented from which 126 (83.4%) completed baseline measures. Sixty-seven participants were randomized to MBSR, and 59 to the waitlist. Immediately following MBSR, the majority of respondents (72%-78%) reported their experience with mindfulness was very logical and useful to increasing their wellbeing. Compared to waitlist members, MBSR participant's scores on PROs improved in expected directions. CONCLUSIONS Our findings suggest that recruitment for an intensive, in-person, multi-week supportive intervention can be challenging with young adults with cancer, similar to other cancer survivor populations; however once enrolled, feasibility and acceptability of MBSR was supported. Further, initial evidence on the role of MBSR on short-term changes in select PROs with this population was also demonstrated.
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Affiliation(s)
- David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karly Murphy
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Catherine Benedict
- Psychiatry and Behavioral Services, Stanford University, Palo Alto, California
| | - Bruriah Horowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Carly Maletich
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristin Smith
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Stacy Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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27
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Prevalence of posttraumatic stress disorder (PTSD) in patients with an incisional hernia. Am J Surg 2019; 218:934-939. [DOI: 10.1016/j.amjsurg.2019.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 02/25/2019] [Accepted: 03/02/2019] [Indexed: 12/19/2022]
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28
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Naik H, Leung B, Laskin J, McDonald M, Srikanthan A, Wu J, Bates A, Ho C. Emotional distress and psychosocial needs in patients with breast cancer in British Columbia: younger versus older adults. Breast Cancer Res Treat 2019; 179:471-477. [PMID: 31630293 DOI: 10.1007/s10549-019-05468-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/08/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE This study evaluates the prevalence of emotional distress and psychosocial needs in young adult (YA, age 18-39) patients at the time of their breast cancer diagnosis compared to older patients. METHODS Through a province-wide program, BC Cancer patients complete the PsychoSocial Scan for CANcer-Revised (PSSCAN-R) questionnaire, which screens for the presence of symptoms of anxiety and depression and assesses psychosocial needs using the Canadian Problem Checklist (CPC). The study population comprised all breast cancer patients who completed the questionnaire within 6 months of their cancer diagnosis between 2011 and 2016. Clinical information was retrospectively collected from electronic health records. Univariate and multivariate analyses using the X2, Fisher's exact test, and logistical regression were used to compare patient age groups. RESULTS The cohort included 10,734 breast cancer patients: median age 62, 4% YA, 99% female, and 96% presented with non-metastatic disease. After adjusting for clinical and demographic variables, YA patients were more likely to report depression (33.6% vs. 25.5%, OR 1.47, p = 0.001) and anxiety symptoms (58.6% vs. 35.7%, OR 2.49, p < 0.001) than older patients. Psychosocial needs regarding work/school (OR 3.79, p < 0.001), intimacy/sexuality (OR 2.82, p < 0.001), and finances (OR 2.78, p < 0.001) were more common among YA than older adults. CONCLUSIONS After a breast cancer diagnosis, YAs have higher levels of emotional distress compared to older patients. Differences in specific psychosocial needs likely reflect differences in life stage between these age groups. The data suggest that YAs warrant specific attention with respect to early psychosocial assessment and tailored intervention.
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Affiliation(s)
- Hiten Naik
- University of British Columbia, Vancouver, Canada
| | - Bonnie Leung
- Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada
| | - Janessa Laskin
- University of British Columbia, Vancouver, Canada.,Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada
| | - Melanie McDonald
- Department of Psychosocial Oncology, BC Cancer, Vancouver, Canada
| | - Amirrtha Srikanthan
- Department of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada
| | - Jonn Wu
- University of British Columbia, Vancouver, Canada.,Department of Radiation Oncology, BC Cancer, Vancouver, Canada
| | - Alan Bates
- University of British Columbia, Vancouver, Canada.,Department of Psychosocial Oncology, BC Cancer, Vancouver, Canada
| | - Cheryl Ho
- University of British Columbia, Vancouver, Canada. .,Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada.
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29
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Mütsch J, Friedrich M, Leuteritz K, Sender A, Geue K, Hilbert A, Stöbel-Richter Y. Sexuality and cancer in adolescents and young adults - a comparison between reproductive cancer patients and patients with non-reproductive cancer. BMC Cancer 2019; 19:828. [PMID: 31438895 PMCID: PMC6704507 DOI: 10.1186/s12885-019-6009-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 08/02/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Sexuality is an important aspect of quality of life for adolescent and young adults that remains understudied in cancer patients. Most current knowledge about how cancer and cancer treatments can affect patients' sexuality pertains to reproductive cancer patients (breast, gynecological, male reproductive organs), whereas only little is known about how the disease affects the sex lives of patients with other types of cancer. This study examined sexual satisfaction and sexual supportive care needs among adolescent and young adult cancer patients, with a particular focus on how the type of cancer a person has is associated with these issues differently. METHODS Five hundred seventy-seven (n = 424 females, 73.5%) patients between 18 and 39 years of age at diagnosis and representing all major tumor entities completed the standardized questionnaire. The analysis addressed the following topics: sexual satisfaction (Life Satisfaction Questionnaire), sexual supportive care needs (Supportive Care Needs Survey), and changes in sexuality (Questions on Life Satisfaction Modules). These topics were tested by mean differences between reproductive and non-reproductive cancer, equivalence testing and regression analyses. RESULTS About one third of the patients reported being dissatisfied with their sexuality and having supportive care needs in this area. Changes in sexuality were significantly more common in women with reproductive cancers than in those who had other types of cancer (t = - 2.693, p = .007), while both groups had equivalence in scores for sexual satisfaction and sexual supportive care needs. Reproductive cancers are not more associated with deterioration of sexual satisfaction (R2 = .002, p = .243), changes in sexuality (R2 = .006, p = .070) or increased sexual supportive care needs than non-reproductive cancers (R2 = .004, p = .131). CONCLUSIONS The results indicate that about a third of adolescents and young adults with both reproductive but also with non-reproductive cancer experience sexual dissatisfaction in similar measure. An equal percentage of these patients also express a desire to receive supportive care in this area. Consequently, health care professionals should address issues of sexuality and cancer as a matter of routine when caring for young adults even when patients have a non-reproductive cancer.
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Affiliation(s)
- Julian Mütsch
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Michael Friedrich
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Katja Leuteritz
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Annekathrin Sender
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Kristina Geue
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Anja Hilbert
- Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Yve Stöbel-Richter
- Faculty of Managerial and Cultural Studies, University of Applied Sciences Zittau / Goerlitz, P. O. Box 30 06 48, 02811 Goerlitz, Germany
- Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
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30
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Tsangaris E, D'Agostino N, Rae C, Breakey V, Klassen AF. Development and Psychometric Evaluation of the Cancer Distress Scales for Adolescent and Young Adults. J Adolesc Young Adult Oncol 2019; 8:566-580. [PMID: 31274372 DOI: 10.1089/jayao.2019.0005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose: The use of valid and reliable screening tools to measure distress may help to identify adolescent and young adults (AYA) with cancer who need additional support. Our study describes a two-phase approach to adapt the Australian AYA oncology and survivorship distress screening tools for use in Canada. Methods: Phase 1 involved refining the Australian AYA oncology and survivorship screening tools using cognitive interviews with AYA with cancer and feedback from experts. In phase 2, a field-test study was performed, and Rasch Measurement Theory (RMT) analysis was used for item reduction and to examine reliability and validity. Results: Cognitive interviews with 45 AYA with cancer and feedback from 25 experts resulted in a field-test version of the Cancer Distress Scales for AYA (CDS-AYA) consisting of 91 items that measure 9 constructs. The field-test sample included 515 participants. RMT analysis identified five scales (impact of cancer, physical, emotional, cancer worry, and cognitive) with ordered thresholds, good item fit (-3.70 to 2.82), and acceptable reliability (0.85-0.94). Reliability for the remaining four scales (employment, education, practical, and social) was low, and the scales were retained as checklists, with the exception of the social scale that was dropped. Conclusion: The final item-reduced CDS-AYA consist of 48 items in 5 scales, with 2 stand-alone items in the physical and emotional scales and 23 items in 3 checklists. The CDS-AYA can be used in research and in clinical practice to measure distress in AYA with cancer.
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Affiliation(s)
- Elena Tsangaris
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Norma D'Agostino
- Department of Supportive Care, Princess Margaret Cancer Center, Toronto, Canada
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Vicky Breakey
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Canada
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31
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Baird H, Patterson P, Medlow S, Allison KR. Understanding and Improving Survivorship Care for Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:581-586. [PMID: 31268400 DOI: 10.1089/jayao.2019.0031] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose: To explore and highlight the opportunities and challenges that underlie the development of survivorship care for adolescent and young adult cancer. Methods: A multimethod approach was used, with perspectives of survivors, relatives, and health care professionals elicited through an online survey, focus group, and semistructured interviews. Results: Four themes were identified using thematic analysis: adjusting to life after cancer, transition to community-based care, ongoing change and reform of health care, and supporting survivorship services. Adolescents and young adults (AYAs) and their families struggled with the transition from active treatment, which was complicated by ongoing disease/treatment impacts and a collective dearth of knowledge and resources on how to support AYAs during this time. Limited confidence and communication in patient-general practitioner relationships complicated the transition to community-based care, with treatment summaries and survivorship care plans an underused resource. A growing movement toward integrated, holistic, and equitable survivorship care was identified, but progress has been fragmented and under-resourced. Further research, funding, and advocacy are needed to support ongoing survivorship initiatives. Conclusions: Although some survivorship concerns are common across age groups, others are specific to AYAs' developmental stage, emphasizing the need for integrated, age-appropriate, and targeted survivorship services for AYAs. The transition from active treatment to longer term survivorship presents challenges for ongoing clinical care and support; change is needed at individual, service, and system levels to provide quality, sustainable, and integrated care to AYA cancer survivors.
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Affiliation(s)
- Hannah Baird
- Research, Evaluation and Social Policy, CanTeen Australia, Sydney, Australia
| | - Pandora Patterson
- Research, Evaluation and Social Policy, CanTeen Australia, Sydney, Australia.,Cancer Nursing Research Unit, The University of Sydney, Sydney, Australia
| | - Sharon Medlow
- Wellbeing Health & Youth, Centre of Research Excellence in Adolescent Health, The University of Sydney, Sydney, Australia.,Discipline of Child & Adolescent Health, The Children's Hospital at Westmead, Sydney, Australia
| | - Kimberley R Allison
- Research, Evaluation and Social Policy, CanTeen Australia, Sydney, Australia
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32
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Fidler MM, Frobisher C, Hawkins MM, Nathan PC. Challenges and opportunities in the care of survivors of adolescent and young adult cancers. Pediatr Blood Cancer 2019; 66:e27668. [PMID: 30815985 DOI: 10.1002/pbc.27668] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 02/06/2023]
Abstract
Adolescents and young adults (AYA) with cancer are an understudied group. Much of what is known about long-term outcomes after AYA cancer has been derived from cohorts of childhood cancer survivors, which seldom include patients at the older end of the AYA age spectrum. In general, AYA cancer survivors have a lower risk for premature mortality, subsequent primary neoplasms and chronic health conditions than childhood cancer survivors. However, AYA cancer survivors are vulnerable to psychosocial challenges, concerns about fertility and relationships and financial toxicity. No single model is optimal for the care of these survivors, but it is generally agreed that all survivors require a survivor care plan that promotes their adherence to evidence-based surveillance guidelines. There is a need to create survivor cohorts that include the full range of AYA ages and diagnoses to be able to address the many pressing questions that remain unanswered in this vulnerable population.
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Affiliation(s)
- Miranda M Fidler
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Canada
| | - Clare Frobisher
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Michael M Hawkins
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Paul C Nathan
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.,Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
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33
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Aubin S, Rosberger Z, Hafez N, Noory MR, Perez S, Lehmann S, Batist G, Kavan P. Cancer!? I Don't Have Time for That: Impact of a Psychosocial Intervention for Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:172-189. [DOI: 10.1089/jayao.2017.0101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
| | | | - Nada Hafez
- Jewish General Hospital, Montreal, Canada
| | | | | | | | | | - Petr Kavan
- Jewish General Hospital, Montreal, Canada
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34
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The Effect of Optimism and Connectedness on Psychological Adjustment of Children with Cancer and Comparison Peers. J Dev Behav Pediatr 2019; 40:208-216. [PMID: 30633067 PMCID: PMC7192235 DOI: 10.1097/dbp.0000000000000641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present study aimed to examine the relationship of optimism and connectedness with psychological adjustment outcomes in children with cancer and determine whether these relations differ for children with cancer and comparison peers. METHODS Participants were 155 children with cancer and 143 comparison youth without a history of cancer, aged 8 to 17 years at study entry, who were followed longitudinally over a 3-year period. Participants completed self-report measures at 3 time points: baseline optimism at study entry (T1), connectedness at 1 year after baseline (T2), and emotional symptoms at 3 years after baseline (T3). A series of regression analyses were conducted using conditional process analysis to examine whether connectedness mediated the relationship between optimism and psychological adjustment and whether this was moderated by health status (i.e., history of childhood cancer vs no history of cancer or other serious or chronic illness). RESULTS Connectedness to parents, peers, and friends significantly mediated the relationship between optimism and psychological adjustment (b parents = -0.1387, 95% confidence interval [CI] [-0.2341 to -0.0515]; b peers = -0.2021, 95% CI [-0.3575 to -0.0818]; b friends = -0.0703, 95% CI [-0.1640 to -0.0050]). However, this mediation was not significantly moderated by having a history of cancer. Cancer history did moderate the direct relationship between optimism and psychological adjustment and between connectedness to parents and psychological adjustment. CONCLUSION Findings suggest that patients with cancer are doing remarkably well with regard to adjustment. Connectedness with parents and peers mediates the relationship between optimism and psychological adjustment. As such, children with cancer who are identified as experiencing poor adjustment may benefit from interventions to foster connectedness.
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Burkart M, Sanford S, Dinner S, Sharp L, Kinahan K. Future health of AYA survivors. Pediatr Blood Cancer 2019; 66:e27516. [PMID: 30362237 DOI: 10.1002/pbc.27516] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/22/2018] [Accepted: 09/28/2018] [Indexed: 12/25/2022]
Abstract
Adolescent and young adult (AYA) oncology patients (ages 15-39) have been identified as a group with healthcare disparities including gaps and challenges in diagnosis, access to care, research, clinical trial participation, and cure rates. Like other patient groups with cancer or other chronic illnesses, disparities can lead to poor future health and outcomes, which is a well-recognized concern within the AYA population. Cancer is the leading disease-related cause of death in this age range. Numerous interested groups including the National Cancer Institute have met to address the research and cancer care needs of AYAs. This review highlights how these gaps in care during and after treatment can affect future health of this population of patients. Access to care, models of survivorship care, and lack of provider education are discussed. Survivorship care and use of guidelines, and promotion of psychosocial support and health behaviors during treatment and beyond are essential to optimizing future health of AYA patients.
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Affiliation(s)
- Madelyn Burkart
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Stacy Sanford
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Shira Dinner
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Lisa Sharp
- Department of Medicine, Section of Health Promotion, University of Illinois at Chicago, Chicago, Illinois
| | - Karen Kinahan
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
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36
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Michel G, François C, Harju E, Dehler S, Roser K. The long-term impact of cancer: Evaluating psychological distress in adolescent and young adult cancer survivors in Switzerland. Psychooncology 2019; 28:577-585. [DOI: 10.1002/pon.4981] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/18/2018] [Accepted: 01/01/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Gisela Michel
- Department Health Sciences and Health Policy; University of Lucerne; Switzerland
- Institute of Social and Preventive Medicine; University of Bern; Switzerland
| | - Constanza François
- Department Health Sciences and Health Policy; University of Lucerne; Switzerland
| | - Erika Harju
- Department Health Sciences and Health Policy; University of Lucerne; Switzerland
| | - Silvia Dehler
- Cancer Registry Zurich and Zug, Institute of Surgical Pathology, University Hospital Zurich and Epidemiology, Biostatistics and Prevention Institute; University Zurich; Switzerland
- Departement Gesundheit und Soziales, Abteilung Gesundheit; Aarau Switzerland
| | - Katharina Roser
- Department Health Sciences and Health Policy; University of Lucerne; Switzerland
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37
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Baker KS, Syrjala KL. Long-term complications in adolescent and young adult leukemia survivors. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2018; 2018:146-153. [PMID: 30504303 PMCID: PMC6245964 DOI: 10.1182/asheducation-2018.1.146] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Adolescents and young adults (AYAs) with cancer, defined by the National Cancer Institute as having been diagnosed between the ages of 15 and 39 years old, have not benefited from the same improvements in quality of outcomes and survival that have been seen for individuals diagnosed in childhood or as older adults. Although is leukemia composed of a diverse group of diagnoses, leukemia AYA survivors share unique vulnerabilities with other AYA diagnostic groups. They will spend the majority of their lives as survivors, with clear evidence of adverse medical conditions, health care requirements, and social and psychological needs that differ not only from their peers but also, from the needs of other cancer survivor populations. Furthermore, they share a developmental stage of life in which careers, finances, and family concerns are uniquely impacted by the cancer diagnosis and treatment. Leukemia in AYAs typically presents with higher-risk biologic features, and treatment requires multiagent chemotherapy, including alkylating agents, anthracyclines, high-dose steroids, frequently intrathecal chemotherapy, and sometimes, cranial radiation. Thus, AYAs have significant risks for long-term complications, subsequent malignancies, and accelerated development of usual age-related comorbid conditions, such as cardiovascular disease and dyslipidemias. AYAs require specialized health care monitoring, surveillance for late effects, and periodic evaluation of psychosocial, health behavior, and life goal outcomes.
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Affiliation(s)
- K Scott Baker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Karen L Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
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38
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Sansom‐Daly UM, Wakefield CE, Bryant RA, Patterson P, Anazodo A, Butow P, Sawyer SM, McGill BC, Evans HE, Cohn RJ. Feasibility, acceptability, and safety of the Recapture Life videoconferencing intervention for adolescent and young adult cancer survivors. Psychooncology 2018; 28:284-292. [DOI: 10.1002/pon.4938] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/05/2018] [Accepted: 11/04/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Ursula M. Sansom‐Daly
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
- Nelune Comprehensive Cancer CentrePrince of Wales Hospital Sydney Australia
| | - Claire E. Wakefield
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | | | - Pandora Patterson
- Research, Evaluation and Social Policy UnitCanTeen Newtown Australia
- Cancer Nursing Research Unit, Sydney Nursing SchoolThe University of Sydney Sydney Australia
| | - Antoinette Anazodo
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
- Nelune Comprehensive Cancer CentrePrince of Wales Hospital Sydney Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence‐based Decision‐making (CeMPED), School of PsychologyUniversity of Sydney Sydney Australia
| | - Susan M. Sawyer
- Department of PaediatricsUniversity of Melbourne Melbourne Australia
- Murdoch Children's Research Institute Melbourne Australia
- Royal Children's Hospital Centre for Adolescent Health Melbourne Australia
| | - Brittany C. McGill
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | - Holly E. Evans
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | - Richard J. Cohn
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
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40
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Taylor MF, Pooley JA. Life is precious: Sarcoma/giant-cell tumors survivors' perspectives on their psychological journey. J Psychosoc Oncol 2018; 36:681-699. [PMID: 30372404 DOI: 10.1080/07347332.2018.1498425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Although surviving bone resection/limb salvage surgery treatment is the beginning of the journey towards recovery, the importance of providing patients with post-operative psychological support is often overlooked by health professionals. Hence, patients typically are left to their own devices in terms of ensuring their mental health and well-being. Methodological Approach and Participants: This qualitative analysis of seven long-term sarcoma survivors' reflective journal entries provides insights into the different phases of distress, resilience building, resilient growth and advice-giving that they moved through during their survivorship journey. INTERPRETATION Our findings identify the fragility of patient resilience and highlight areas for future research.
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Affiliation(s)
- Myra Frances Taylor
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia
| | - Julie Ann Pooley
- b School of Arts and Humanities , Edith Cowan University , Joondalup , Australia
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41
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Beaupin LK, Pailler ME, Brewer-Spritzer E, Kishel E, Grant PC, Depner RM, Tenzek KE, Breier JM. Photographs of meaning: A novel social media intervention for adolescent and young adult cancer patients. Psychooncology 2018; 28:198-200. [PMID: 30242937 PMCID: PMC10367124 DOI: 10.1002/pon.4896] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Lynda K Beaupin
- Pediatric Hematology Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.,Cancer and Blood Disorder Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Megan E Pailler
- Department of Psychology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Erin Brewer-Spritzer
- Department of Psychology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Eric Kishel
- Department of Psychology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Pei C Grant
- Palliative Care Institute, Center for Hospice and Palliative Care, Cheektowaga, New York, USA
| | - Rachel M Depner
- Palliative Care Institute, Center for Hospice and Palliative Care, Cheektowaga, New York, USA.,Department of Counseling, School and Educational Psychology, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Kelly E Tenzek
- Department of Communication, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Jennifer M Breier
- Palliative Care Institute, Center for Hospice and Palliative Care, Cheektowaga, New York, USA
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42
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Lathren C, Bluth K, Campo R, Tan W, Futch W. Young adult cancer survivors' experiences with a mindful self-compassion (MSC) video-chat intervention: A qualitative analysis. SELF AND IDENTITY 2018; 17:646-665. [PMID: 30774563 DOI: 10.1080/15298868.2018.1451363] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Young adult cancer survivors (YACS) are a vulnerable population that reports high anxiety, social isolation, and feelings of inadequacy after cancer treatment completion. Mindful self-compassion (MSC) provides strategies for coping with suffering. We explored how MSC practices addressed the psychosocial needs of a nationally recruited YACS sample (N=20, all female, age M=27.00, various cancer types) that participated in an 8-week MSC video-chat intervention. Descriptive qualitative analysis of the intervention recordings revealed three YACS' psychosocial needs: peer isolation, body concerns, and health-related anxiety. MSC practices addressed these in a number of ways including: self-reliance for emotional support, common humanity within the YACS community, gratitude, self-kindness, and acceptance. Meanwhile, the body scan practice initially triggered distress for some; implications are discussed.
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Affiliation(s)
- Christine Lathren
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Karen Bluth
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Rebecca Campo
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Winfield Tan
- Department of Psychiatry University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514
| | - Will Futch
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
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43
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Katzman B, John R. Adolescent Cancer Survivors: A Literature Review of Psychological Effects Following Remission. Clin J Oncol Nurs 2018; 22:507-515. [DOI: 10.1188/18.cjon.507-515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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44
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Effects of an Empowerment Program on Resilience and Posttraumatic Growth Levels of Cancer Survivors. Cancer Nurs 2018; 42:E1-E13. [DOI: 10.1097/ncc.0000000000000644] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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45
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Huss E, Samson T. Drawing on the Arts to Enhance Salutogenic Coping With Health-Related Stress and Loss. Front Psychol 2018; 9:1612. [PMID: 30319472 PMCID: PMC6167555 DOI: 10.3389/fpsyg.2018.01612] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/13/2018] [Indexed: 11/23/2022] Open
Abstract
The connection between art therapy and specific theories of positive psychology such as Antonovsky’s theory of salutogenic sense of coherence (SOC) has been less articulated in the literature. This paper draws a methodological connection between art therapy and SOC, that is, meaning, manageability and comprehensibility, as the components of coping. This theoretical and methodological connection is then explored with a group of participants dealing with the health-stress of cancer. Method: We conducted a large-scale, qualitative study that included fifty transcribed hours of thematically analyzed arts processes and one hundred art works, used to explore salutogenic theory within a support group for recovering oncological patients. Results: The results point to the arts as including mechanisms that enhance meaning, manageability, and comprehensibility in an embodied and synergetic way. The art makes it possible both to separate and to ‘fill’ these three components, while on the other hand, integrating them into a cyclical element. We outline theoretical and methodological implications of understanding art therapy as a methodology to enact and concretize positive psychology theories, as well as presenting a protocol for using arts to enhance salutogenic coping in the context of health-related stress.
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Affiliation(s)
- Ephrat Huss
- The Charlotte B. and Jack J. Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Tali Samson
- The Charlotte B. and Jack J. Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beersheba, Israel
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46
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The Resilience in Illness Model Part 2: Confirmatory Evaluation in Adolescents and Young Adults With Cancer. Cancer Nurs 2017; 40:454-463. [PMID: 27984241 DOI: 10.1097/ncc.0000000000000450] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Empirically derived and tested models are necessary to develop effective, holistic interventions to improve positive health outcomes in adolescents and young adults (AYA) with cancer, yet few exist. This article is the second of 2 articles reporting on evaluation of the Resilience in Illness Model (RIM) as a predictive model to guide positive health research and practice. OBJECTIVE The aim of this study was to report the confirmatory model evaluation of the RIM. METHODS A confirmatory evaluation of RIM was done using baseline data from a sample of 113 AYA aged 11 to 24 years who were undergoing hematopoietic stem cell transplant and enrolled in a randomized controlled trial of a behavioral intervention to enhance resilience. Data were analyzed using latent variable structural equation modeling. RESULTS Goodness-of-fit indices supported RIM as a confirmed model that accounted for large amounts of variance in the outcomes of self-transcendence (62%) and resilience (72%), and in 3 of 5 mediators, specifically social integration (74%), courageous coping (80%), and hope-derived meaning (87%), as well as small to moderate amounts of variance in the remaining mediators of defensive coping (1%) and family environment (35%). CONCLUSIONS Findings establish the RIM as a plausible predictive framework for explaining ways AYA with cancer transcend their illness and achieve resilience resolution and for guiding intervention studies in this population. Additional research is needed to explore RIM's transferability based on stage of illness, other chronic diseases, and cultural diversity. IMPLICATIONS FOR PRACTICE Results support the RIM as an appropriate guide for developing and evaluating interventions to foster positive adjustment in AYA with cancer.
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47
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Rosenberg AR, Bradford MC, Bona K, Shaffer ML, Wolfe J, Baker KS, Lau N, Yi-Frazier J. Hope, distress, and later quality of life among adolescent and young adults with cancer. J Psychosoc Oncol 2017; 36:137-144. [PMID: 28934026 DOI: 10.1080/07347332.2017.1382646] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We aimed to explore the predictive value of screening for distress alone, hope alone, or a combination of both. In a multicenter prospective study, 37 English-speaking adolescents and young adults with cancer and 40 parents completed validated instruments at diagnosis ("baseline") and 3-6 months later ("follow-up"). Correlated regression models described associations. Within each instrument, baseline and follow-up scores were associated. However, only a composite hope/distress score predicted all three patient-centered outcomes. Multidimensional screens incorporating positive and negative psychosocial constructs may predict patient-centered outcomes better than isolated, single-construct instruments.
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Affiliation(s)
- Abby R Rosenberg
- a Seattle Children's Hospital, Center for Clinical and Translational Research , Seattle , Washington , USA.,b Fred Hutchinson Cancer Research Center, Clinical Research Division , Seattle , Washington , USA.,c Seattle Children's Hospital, Treuman Katz Center for Pediatric Bioethics , Seattle , Washington , USA.,d Department of Pediatrics , University of Washington , Seattle , Washington , USA
| | - Miranda C Bradford
- a Seattle Children's Hospital, Center for Clinical and Translational Research , Seattle , Washington , USA
| | - Kira Bona
- e Department of Medicine , Boston Children's Hospital , Boston , Massachusetts , USA.,f Department of Pediatric Oncology , Dana-Farber Cancer Institute , Boston , Massachusetts , USA.,g Department of Pediatric Oncology , Harvard Medical School , Boston , Massachusetts , USA
| | - Michele L Shaffer
- a Seattle Children's Hospital, Center for Clinical and Translational Research , Seattle , Washington , USA.,d Department of Pediatrics , University of Washington , Seattle , Washington , USA
| | - Joanne Wolfe
- e Department of Medicine , Boston Children's Hospital , Boston , Massachusetts , USA.,g Department of Pediatric Oncology , Harvard Medical School , Boston , Massachusetts , USA.,h Department of Psychosocial Oncology and Palliative Care , Dana-Farber Cancer Institute , Boston , Massachusetts , USA
| | - K Scott Baker
- a Seattle Children's Hospital, Center for Clinical and Translational Research , Seattle , Washington , USA.,b Fred Hutchinson Cancer Research Center, Clinical Research Division , Seattle , Washington , USA.,d Department of Pediatrics , University of Washington , Seattle , Washington , USA
| | - Nancy Lau
- a Seattle Children's Hospital, Center for Clinical and Translational Research , Seattle , Washington , USA.,d Department of Pediatrics , University of Washington , Seattle , Washington , USA
| | - Joyce Yi-Frazier
- a Seattle Children's Hospital, Center for Clinical and Translational Research , Seattle , Washington , USA.,d Department of Pediatrics , University of Washington , Seattle , Washington , USA
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48
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Allen J, Willard VW, Klosky JL, Li C, Srivastava DK, Robison LL, Hudson MM, Phipps S. Posttraumatic stress-related psychological functioning in adult survivors of childhood cancer. J Cancer Surviv 2017; 12:216-223. [PMID: 29101712 DOI: 10.1007/s11764-017-0660-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/21/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The majority of research examining posttraumatic stress symptoms/disorder (PTSS/PTSD) among adult survivors of childhood cancer has been oriented to cancer, assuming that cancer has been the most traumatic experience in their lives. Whether that assumption is valid, and how it might impact assessment of PTSS, is unknown. METHODS Survivors in the St. Jude Lifetime Cohort study completed an assessment of PTSS without cancer orientation, global psychological functioning, perceived stress, and cancer-related anxiety. RESULTS Participants (n = 2969; Mage = 32.5 ± 8.5 years, 24.1 years since diagnosis, 49.1% female) obtained a mean score on the PTSD Checklist of 27.7, which is comparable to a normative population. Using established cutoffs, 11.8% obtained scores in the at-risk range. Multivariable modeling indicated that psychological factors [global distress (p < 0.0001), perceived stress (p = 0.001), cancer-related anxiety (p < 0.0001)] and demographic variables [female gender (p < 0.0001), survivors with less than a college education (p = 0.002)] were risk factors for increased PTSS. Only 14.5% identified a cancer-related traumatic event, and there was no difference in PTSS scores between those who identified cancer vs. non-cancer events as most stressful (28.4 ± 12.6 vs. 28.5 ± 12.7, p = 0.93). CONCLUSION One in eight adult long-term survivors of childhood cancer had PTSS above the cutoff, though subgroups (e.g., females and those with lower education) report more distress symptoms. Most adult survivors do not identify cancer as their most stressful event. IMPLICATIONS FOR CANCER SURVIVORS Screening for distress in survivorship clinics should not assume that distress is directly related to the survivor's cancer experience.
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Affiliation(s)
- Jennifer Allen
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 740, Memphis, TN, 38105, USA
| | - Victoria W Willard
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 740, Memphis, TN, 38105, USA.
| | - James L Klosky
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 740, Memphis, TN, 38105, USA
| | - Chenghong Li
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - D Kumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Leslie L Robison
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melissa M Hudson
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 740, Memphis, TN, 38105, USA
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Abstract
Adolescent and young adult (AYA) individuals with a history of cancer make up a fraction of the total number of cancer survivors in the United States, but they represent a population with needs distinct from either the childhood or the older adult cancer populations. Fertility concerns, psychosocial factors, and health care access are just a few of the distinguishing characteristics. Caring for AYA cancer survivors presents unique opportunities for primary care providers to collaborate with oncology colleagues to minimize the long-term cancer burden.
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Affiliation(s)
- Linda Overholser
- Division of General Internal Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop B180, Aurora, CO 80045, USA.
| | - Kristin Kilbourn
- Department of Psychology, College of Liberal Arts and Sciences, University of Colorado Denver, 1200 Larimer Street, NC 5002-M, PO Box 173364, Denver, CO 80017, USA
| | - Arthur Liu
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Ct, MS F706 Aurora, CO 80045, USA
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50
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Vetsch J, Wakefield CE, McGill BC, Cohn RJ, Ellis SJ, Stefanic N, Sawyer SM, Zebrack B, Sansom-Daly UM. Educational and vocational goal disruption in adolescent and young adult cancer survivors. Psychooncology 2017; 27:532-538. [DOI: 10.1002/pon.4525] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Janine Vetsch
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
- School of Women's and Children's Health, UNSW Sydney; NSW Australia
- Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
| | - Claire E. Wakefield
- School of Women's and Children's Health, UNSW Sydney; NSW Australia
- Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
| | - Brittany C. McGill
- School of Women's and Children's Health, UNSW Sydney; NSW Australia
- Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
| | - Richard J. Cohn
- School of Women's and Children's Health, UNSW Sydney; NSW Australia
- Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
| | - Sarah J. Ellis
- School of Women's and Children's Health, UNSW Sydney; NSW Australia
- Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
| | - Natalie Stefanic
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology; The University of Sydney; Camperdown NSW Australia
| | - Susan M. Sawyer
- Department of Paediatrics; The University of Melbourne; Parkville VIC Australia
- Centre for Adolescent Health; Royal Children's Hospital; Parkville VIC Australia
- Murdoch Children's Research Institute; Parkville VIC Australia
| | - Brad Zebrack
- School of Social Work; University of Michigan; Ann Arbor MI USA
| | - Ursula M. Sansom-Daly
- School of Women's and Children's Health, UNSW Sydney; NSW Australia
- Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
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