Physiological linkage during interactions between doctors and cancer patients

Physiological synchrony in supportive discussions: An examination of co-rumination, relationship type, and heterogeneity

During times of stress, we look to close others for support. Social support conversations are critical for relationship maintenance and well-being. Yet, certain ways of talking about problems-such as co-ruminating-can exacerbate stress. Since social support and co-rumination are both dyadic processes, it is important to examine physiological responses during these conversations in a dyadic manner. Little research has examined physiological synchrony of the sympathetic nervous system (SNS) during social support conversations or co-ruminative conversations. The current research capitalizes on an experimental manipulation of co-rumination using a sample of close friends (147 dyads) and romantic partners (113 dyads) to examine physiological covariation in the context of support. Across both samples, dyads exhibited significant physiological covariation in pre-ejection period reactivity (PEP). Contrary to our hypothesis, dyads in the co-rumination condition did not show more covariation. Close friend dyads did, however, exhibit more covariation as compared to romantic dyads. We also found significant variability in physiological covariation across dyads, with a minority of dyads exhibiting negative covariation of PEP reactivity. The homogeneity of the samples limits the generalizability of the findings and highlights the need for more diverse samples in future work. These findings underline the need for further exploration into the mechanisms that contribute to distinct patterns of physiological synchrony, the conditions in which negative synchrony occurs, and what predicts especially strong positive synchrony. This work extends our understanding of physiological synchrony of the sympathetic nervous system during support conversations and emphasizes the importance of considering heterogeneity in physiological processes.

Neurophysiological markers of asymmetric emotional contagion: implications for organizational contexts

Emotions play a vital role within organizations, impacting various crucial aspects of work such as job satisfaction, performance, and employee well-being. Understanding how emotional states spread in organizational settings is therefore essential. Recent studies have highlighted that a leader's emotional state can influence their followers, with significant consequences on job performance. Leaders thus possess the ability to influence their employees' psychological state and, consequently, their well-being. However, the biological underpinnings of emotional contagion from leaders to followers remain unexplored. The field of interpersonal (neuro)physiology, which involves recording brain and peripheral activity of multiple individuals during interactions, holds great potential for investigating this phenomenon. Analyzing the time-lagged synchronization of neurophysiological activity during interactions may serve as a measure of the leader's influence on their followers in organizational contexts. In this "mini review," we examine empirical studies that have employed interpersonal (neuro)physiology to quantify the asymmetrical contagion of emotions in different contexts. Asymmetrical contagion was operationalized as the unidirectional influence exerted by one individual (i.e., the "sender") to another one (i.e., the "receiver"), whereby the receiver's state can be predicted by the sender's one. The reviewed literature reveals that delayed synchronization of physiological states is a widespread phenomenon that may underpin the transmission of emotions. These findings have significant implications for various aspects of organizational life, including leader-to-employee communication, and could drive the development of effective leadership training programs. We propose that Organizational Neuroscience may benefit from including interpersonal neurophysiology in its methodological toolkit for laboratory and field studies of leader-follower dynamics.

A new paradigm for investigating real-world social behavior and its neural underpinnings

Eye tracking and other behavioral measurements collected from patient-participants in their hospital rooms afford a unique opportunity to study natural behavior for basic and clinical translational research. We describe an immersive social and behavioral paradigm implemented in patients undergoing evaluation for surgical treatment of epilepsy, with electrodes implanted in the brain to determine the source of their seizures. Our studies entail collecting eye tracking with other behavioral and psychophysiological measurements from patient-participants during unscripted behavior, including social interactions with clinical staff, friends, and family in the hospital room. This approach affords a unique opportunity to study the neurobiology of natural social behavior, though it requires carefully addressing distinct logistical, technical, and ethical challenges. Collecting neurophysiological data synchronized to behavioral and psychophysiological measures helps us to study the relationship between behavior and physiology. Combining across these rich data sources while participants eat, read, converse with friends and family, etc., enables clinical-translational research aimed at understanding the participants' disorders and clinician-patient interactions, as well as basic research into natural, real-world behavior. We discuss data acquisition, quality control, annotation, and analysis pipelines that are required for our studies. We also discuss the clinical, logistical, and ethical and privacy considerations critical to working in the hospital setting.

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

BACKGROUND

Treatment nonadherence in cancer patients remains high with most interventions having had limited success. Most studies omit the multi-factorial aspects of treatment adherence and refer to medication adherence. The behaviour is rarely defined as intentional or unintentional.

AIM

The aim of this Scoping Review is to increase understanding of modifiable factors in treatment nonadherence through the relationships that physicians have with their patients. This knowledge can help define when treatment nonadherence is intentional or unintentional and can assist in predicting cancer patients at risk of nonadherence and in intervention design. The scoping review provides the basis for method triangulation in two subsequent qualitative studies: 1. Sentiment analysis of online cancer support groups in relation to treatment nonadherence; 2. A qualitative validation survey to refute / or validate claims from this scoping review. Thereafter, framework development for a future (cancer patient) online peer support intervention.

METHODS

A Scoping Review was performed to identify peer reviewed studies that concern treatment / medication nonadherence in cancer patients-published between 2000 to 2021 (and partial 2022). The review was registered in the Prospero database CRD42020210340 and follows the PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Searches. The principles of meta-ethnography are used in a synthesis of qualitative findings that preserve the context of primary data. An aim of meta-ethnography is to identify common and refuted themes across studies. This is not a mixed methods study, but due to a limited qualitativevidence base and to broaden findings, the qualitative elements (author interpretations) found within relevant quantitative studies have been included.

RESULTS

Of 7510 articles identified, 240 full texts were reviewed with 35 included. These comprise 15 qualitative and 20 quantitative studies. One major theme, that embraces 6 sub themes has emerged: 'Physician factors can influence patient factors in treatment nonadherence'. The six (6) subthemes are: 1. Suboptimal Communication; 2. The concept of Information differs between Patient and Physician; 3.Inadequate time. 4. The need for Treatment Concordance is vague or missing from concepts; 5. The importance of Trust in the physician / patient relationship is understated in papers; 6. Treatment concordance as a concept is rarely defined and largely missing from studies.

LINE OF ARGUMENT WAS DRAWN

Treatment (or medication) nonadherence that is intentional or unintentional is often attributed to patient factors-with far less attention to the potential influence of physician communication factors. The differentation between intentional or unintentional nonadherence is missing from most qualitative and quantitative studies. The holistic inter-dimensional / multi-factorial concept of 'treatment adherence' receives scant attention. The main focus is on medication adherence / nonadherence in the singular context. Nonadherence that is unintentional is not necessarily passive behaviour and may overlap with intentional nonadherence. The absence of treatment concordance is a barrier to treatment adherence and is rarely articulated or defined in studies.

CONCLUSION

This review demonstrates how cancer patient treatment nonadherence is often a shared outcome. An equal focus on physican and patient factors can increase understanding of the two main types of nonadherence (intentional or unintentional). This differentation should help improve the fundamentals of intervention design.

Cancer pain management program: Patients' experiences-A qualitative study

BACKGROUND

Cancer patients frequently experience unrelieved pain as a significant symptom. However, several studies have found that cancer-related pain is frequently undertreated.

PURPOSE

This study aimed to understand the pain experiences of cancer patients who were newly engaged in a multidisciplinary pain management program (PMP) at King Hussein Cancer Centre and still receiving cancer treatments and cancer pain management.

METHODS

A qualitative study design and semi-structured interviews were used to obtain data from 21 cancer patients who were purposefully selected. All patients had advanced cancer, including skeleton metastases. All female participants had breast cancer, and all male participants had prostate cancer.

RESULTS

It was found that the patient-healthcare professional relationship and satisfaction with services emerged as two themes in healthcare professionals' pain management.

CONCLUSION

The results from this study can offer a new understanding of the knowledge related to satisfaction of patients with cancer in terms of the quality of pain management. Additional qualitative studies are required to replicate the findings in populations from different backgrounds, ethnicities, and cultures experiencing cancer pain.