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Krakowczyk JB, Truijens F, Teufel M, Lalgi T, Heinen J, Schug C, Erim Y, Pantförder M, Graf J, Bäuerle A. Evaluation of the e-Mental Health Intervention Make It Training From Patients' Perspectives: Qualitative Analysis Within the Reduct Trial. JMIR Cancer 2024; 10:e53117. [PMID: 38592764 DOI: 10.2196/53117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/23/2023] [Accepted: 01/10/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Make It Training is an e-mental health intervention designed for individuals with cancer that aims to reduce psychological distress and improve disease-related coping and quality of life. OBJECTIVE This study evaluated the experienced usefulness and usability of the web-based Make It Training intervention using a qualitative approach. METHODS In this study, semistructured interviews were conducted with participants at different cancer stages and with different cancer entities. All participants had previously taken part in the Reduct trial, a randomized controlled trial that assessed the efficacy of the Make It Training intervention. The data were coded deductively by 2 independent researchers and analyzed iteratively using thematic codebook analysis. RESULTS Analysis of experienced usefulness resulted in 4 themes (developing coping strategies to reduce psychological distress, improvement in quality of life, Make It Training vs traditional psychotherapy, and integration into daily life) with 11 subthemes. Analysis of experienced usability resulted in 3 themes (efficiency and accessibility, user-friendliness, and recommendations to design the Make It Training intervention to be more appealing) with 6 subthemes. Make It Training was evaluated as a user-friendly intervention helpful for developing functional coping strategies to reduce psychological distress and improve quality of life. The consensus regarding Make It Training was that it was described as a daily companion that integrates well into daily life and that it has the potential to be routinely implemented within oncological health care either as a stand-alone intervention or in addition to psychotherapy. CONCLUSIONS e-Mental health interventions such as Make It Training can target both the prevention of mental health issues and health promotion. Moreover, they offer a cost-efficient and low-threshold option to receive psycho-oncological support.
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Affiliation(s)
- Julia Barbara Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Femke Truijens
- Department of Psychology, Educational and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Tania Lalgi
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Jana Heinen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center, University Hospital Erlangen, Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center, University Hospital Erlangen, Erlangen, Germany
| | - Michael Pantförder
- Fraunhofer Institute for Software and Systems Engineering, Dortmund, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
- Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
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Colina-Matiz S, Hernández Leal J, Ariza-Vargas JC, Beltrán Higuera OR, Ovalle-Chaparro C, González Suárez NL, Medellin-Olaya J, Reina-Gamba NC, Correa-Mazuera C, De Los Reyes Valencia I, Lozano-Mosos JS. Social robotics as an adjuvant during the hospitalization process in pediatric oncology patients. J Psychosoc Oncol 2024:1-11. [PMID: 38563200 DOI: 10.1080/07347332.2024.2335170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To describe the experience of implementing social robotics as an adjuvant during the hospitalization process in pediatric oncology patients. METHODS Before and after cohort study, applying an intervention with the Lego Mindstorms EV3 kit in patients between 8 and 17 years old that are hospitalized with a cancer diagnosis. We excluded patients from the intensive care unit or when their treating physician recommended so. The intervention consisted of a three-phase workshop: an open architecture story, building a car robot using the Lego Mindstorm EV3 kit, and cooperative playing activities such as races and passing obstacles. RESULTS Thirteen patients received the intervention with robotic lego. The median age was 15 years (IQR = 3), and 84.6% of the population (n = 11) were male. We found significant improvement in the language (topic management p = .011 and communicative intention p = .034). Other characteristics improved, but not significantly (self-care activities index, catching). No adverse events occurred during the intervention. CONCLUSIONS The results of this pilot study suggest that implementing social robotics during hospitalization in children with cancer is a therapeutic adjuvant and safe intervention that promotes better communication, self-care, and a physical activity improvement. For future studies, the impact of this intervention could be measured in hospitalized pediatric cancer patients.
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Affiliation(s)
| | | | | | | | | | | | | | - Nadia Carolina Reina-Gamba
- Nursing School, Universidad Nacional de Colombia and Nursing School, Universidad Antonio Nariño, Bogota, Colombia
| | | | - Iliana De Los Reyes Valencia
- Rehabilitation Unit, Hospital Militar Central for pediatric oncology, Hospital Militar Central, Bogota, Colombia
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Rosenberg AR, Salsman JM. Resilience in adolescent and young adult oncology: Problems and prospects. Cancer 2024; 130:1015-1018. [PMID: 38150308 DOI: 10.1002/cncr.35180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Although resilience research in adolescent and young adult oncology is promising for improving patient‐centered outcomes, it does not adequately incorporate diverse perspectives of marginalized individuals. Including the unique aspects of minoritized adolescents and young adults and incorporating cultural, community, and system‐level considerations is essential to understanding and promoting resilience in an equitable fashion.
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Affiliation(s)
- Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
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Salsman JM, Rosenberg AR. Fostering resilience in adolescence and young adulthood: Considerations for evidence-based, patient-centered oncology care. Cancer 2024; 130:1031-1040. [PMID: 38163249 DOI: 10.1002/cncr.35182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
Adolescence and young adulthood are times of growth and change. For adolescents and young adults (AYAs) who are diagnosed with cancer, the demands of illness may compound normal developmental challenges and adversely affect physical, emotional, and social health. Nevertheless, AYAs have a tremendous capacity for psychosocial adaptation and resilience. Informed by the Transactional Model of Stress and Coping, observational studies in AYA oncology suggest consistent individual, social, and existential resources that may promote resilience. To date, few interventions have been designed to examine whether resilience can be taught and whether doing so affects patient-centered outcomes. Findings point to the potential value of multicomponent programs that include various skills-building strategies, such as stress management, mindfulness, gratitude, and positive reappraisal coping, among others. New research directions include the need to evaluate delivery strategies to enhance participant adherence and retention (e.g., eHealth modalities, optimization studies) and to examine program effectiveness in community-based oncology practices (e.g., less resource-rich settings in which most AYAs receive care). Ultimately, this scholarship may inform, refine, and strengthen intervention science in resilience more broadly.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
| | - Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Smith A'B, Bamgboje-Ayodele A, Jegathees S, Butow P, Klein B, Salter M, Turner J, Fardell J, Thewes B, Sharpe L, Beatty L, Pearce A, Beith J, Costa D, Rincones O, Wu VS, Garden FL, Kiely BE, Lim K, Morstyn L, Hanley B, Hodgkin R, Beattie A, Girgis A. Feasibility and preliminary efficacy of iConquerFear: a self-guided digital intervention for fear of cancer recurrence. J Cancer Surviv 2024; 18:425-438. [PMID: 35876964 PMCID: PMC9309991 DOI: 10.1007/s11764-022-01233-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/07/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Approximately 50% of cancer survivors experience moderate-severe fear of cancer recurrence (FCR). Self-guided digital interventions have potential to address the high level of FCR-related unmet needs at scale, but existing digital interventions have demonstrated variable engagement and efficacy. This study aimed to evaluate the feasibility and preliminary efficacy of iConquerFear, a five-module self-guided digital FCR intervention. METHODS Eligible curatively treated breast cancer survivors were recruited. Participants reporting clinically significant FCR (≥ 13 on the Fear of Cancer Recurrence Inventory-Short Form; FCRI-SF) were given access to iConquerFear. Feasibility was indicated by > 50% of eligible participants enrolling in iConquerFear and recording moderate (≥ 120 min) or greater usage. Preliminary efficacy was evaluated via changes in self-reported FCR severity, anxiety, depression, intrusions and metacognitions from baseline to immediately and 3 months post-intervention. RESULTS Fifty-four (83%) of 65 eligible participants enrolled in iConquerFear; six subsequently withdrew. Thirty-nine (83%) participants recorded moderate (n = 24; 120-599 min) or high (n = 15; ≥ 600 min) usage. Engagement levels increased with participant age (p = 0.043), but were lower in participants with higher baseline FCR (p = 0.028). Qualitative feedback indicated engagement was sometimes limited by difficulties with navigation and relating to featured survivors. Participants reported significantly improved FCR (mean reduction (95%CI): baseline to post-intervention - 3.44 (- 5.18, - 1.71), baseline to 3-month follow-up - 4.52 (- 6.25, - 2.78), p = < 0.001). CONCLUSION iConquerFear is a feasible and potentially efficacious intervention for reducing FCR in breast cancer survivors. Easier navigation and more relatable examples may enhance engagement. IMPLICATIONS FOR CANCER SURVIVORS iConquerFear may help address moderate but burdensome FCR levels in cancer survivors.
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Affiliation(s)
- Allan 'Ben' Smith
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, Australia.
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW, 1871, Australia.
| | - Adeola Bamgboje-Ayodele
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, Australia
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sharuja Jegathees
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Britt Klein
- Health Innovation & Transformation Centre (HITC) & Biopsychosocial and eHealth Research & Innovation (BeRI), DVC-R&I Portfolio, Federation University Australia, Churchill, Australia
| | - Marj Salter
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Jane Turner
- Department of Psychiatry, University of Queensland, Brisbane, Australia
| | - Joanna Fardell
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Western Sydney Youth Cancer Service, Westmead Hospital, Westmead, Australia
| | - Belinda Thewes
- School of Psychology, University of Sydney NSW, Sydney, Australia
| | - Louise Sharpe
- School of Psychology, University of Sydney NSW, Sydney, Australia
| | - Lisa Beatty
- College of Education, Psychology & Social Work, Flinders University, Adelaide, Australia
| | - Alison Pearce
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Jane Beith
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Daniel Costa
- School of Psychology, University of Sydney NSW, Sydney, Australia
| | - Orlando Rincones
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Verena S Wu
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Frances L Garden
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Belinda E Kiely
- South Western Sydney Local Health District, Campbelltown Hospital, Campbelltown, NSW, Australia
| | - Karen Lim
- South Western Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | - Lisa Morstyn
- Breast Cancer Network Australia (BCNA), Camberwell, Australia
| | - Brigid Hanley
- Cancer Council Queensland, Fortitude Valley, Australia
| | | | | | - Afaf Girgis
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
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6
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You J, Luo F, Dong Y, Xu T, Jing J, Zuo J. Association of explicit and implicit social support with psychological adjustment in Chinese women with breast cancer: An interpersonal explanation. J Health Psychol 2024; 29:396-409. [PMID: 38102739 DOI: 10.1177/13591053231215994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
This study aimed to examine the linear and non-linear relationship between explicit and implicit social support and psychological adjustment as well as the underlying interpersonal mechanisms in a sample of Chinese women with breast cancer (n = 202). The results showed that explicit social support was associated with poorer psychological adjustment, while implicit social support exhibited the opposite trend. Moreover, the association between implicit social support and psychological adjustment was stronger at lower levels of implicit social support, but it weakened or disappeared at moderate or higher levels. Furthermore, we found that all the associations between social support and psychological adjustment could be explained by relationship concerns and perceived burdensomeness. These findings emphasize the importance of providing social support and supportive care to patients who have unmet supportive care needs, in line with cultural norms and expectations.
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Affiliation(s)
| | | | - Yue Dong
- Queensland University of Technology, Australia
| | | | - Jing Jing
- Department of breast surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
- Hubei Provincial Clinical Research Center for Breast Cancer, China
- Wuhan Clinical Research Center for Breast Cancer, China
| | - Jie Zuo
- Department of breast surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
- Hubei Provincial Clinical Research Center for Breast Cancer, China
- Wuhan Clinical Research Center for Breast Cancer, China
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7
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Azman N, Leong Bin Abdullah MFI, Musa KI, Hassan N, Mohd Shariff N. Prospective cohort study of unmet supportive care needs, post-traumatic growth, coping strategy and social supports among patients with breast cancer: The PenBCNeeds study. J Psychosoc Oncol 2024:1-21. [PMID: 38449103 DOI: 10.1080/07347332.2024.2325498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE While the unmet healthcare needs are still being improved upon, the wellbeing of cancer patients has increasingly become a prime concern in Malaysia. The objective of this study is to ascertain the trend of unmet supportive care needs, post-traumatic growth (P T G), coping strategies, and social supports among patients with breast cancer over the three time points of treatment: T1 at early diagnosis, T2 for three months after diagnosis, and T3 for six months after diagnosis. METHODS A total of 240 cancer patients participated in this prospective cohort study, with follow-up visits from October 2019 until July 2021. Data were collected using several instruments: Brief COP E, the Source of Social Support Scale (SSSS), the Post-Traumatic Growth Inventory - Short Form (P T GI-SF), and a Malay version of the 34-Item Shortform Supportive Care Need Survey (SCNS-SF34). RESULTS The results indicated a significant change from T1 to T3 for all domains of the unmet needs (p-value < 0.001), except for the sexual domain. A lower SCNS-SF34 score resulted from more unfavorable social support. The P T GI-SF results indicated a trend toward meeting the unmet needs, and a higher SCNS-SF-34 score predicted a considerably higher P T GI-SF score. CONCLUSIONS Our study findings suggest that majority of the factors evaluated in terms of unmet needs among cancer patients have undergone considerable changes.
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Affiliation(s)
- Nizuwan Azman
- Unit of Biostatistics and Bioinformatics, Division of Research and Networking, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Malaysia
| | | | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Norsuraya Hassan
- Faculty of Health Sciences, Universiti Teknologi MARA, Cawangan Pulau Pinang, Kepala Batas, Malaysia
| | - Noorsuzana Mohd Shariff
- Department of Community Health, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Malaysia
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Pilehvari A, Recklitis CJ, Zhou ES, You W. A retrospective cost-effectiveness analysis of different cognitive-behavioral therapy for insomnia intervention delivery approaches in adult cancer survivors. Psychooncology 2024; 33:e6327. [PMID: 38497829 DOI: 10.1002/pon.6327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 02/03/2024] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Cognitive-behavioral therapy for insomnia (CBT-I) is considered the gold standard treatment for insomnia. Prior trials have delivered CBT-I across a range of treatment sessions. Understanding the economics of varying treatment approaches is essential for future implementation considerations. METHODS We conducted a retrospective cost-effectiveness analysis from the provider's perspective, comparing the implementation of a three-session CBT-I program for cancer survivors (CBT-I-CS) versus a stepped care treatment approach consisting of an initial single sleep education session followed by CBT-I-CS if elevated insomnia symptoms persisted. The effectiveness measure used was the percentage of participants whose insomnia had remitted by the end of each program. RESULTS Stepped care delivery was more effective than CBT-I-CS alone, resulting in 35.4% more remitted patients by the end of the overall program. For a $480 willingness to pay threshold per percentage of remitted patients, stepped care CBT-I-CS reached a 98% probability of being cost-effective, while CBT-I-CS alone had only a 2% probability. Larger group sessions in the first step of a stepped care delivery model resulted in more favorable cost-effectiveness. CONCLUSIONS A stepped care delivery model may be a more cost-effective approach if it can be implemented efficiently. These findings inform policies aimed at improving cancer survivors' access to much-needed insomnia treatment in settings where financial resources for CBT-I may be limited, and be an important barrier to treatment dissemination. CLINICAL TRIAL REGISTRATION These analyses were not registered.
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Affiliation(s)
- Asal Pilehvari
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
- Comprehensive Cancer Center, University of Virginia, Charlottesville, Virginia, USA
| | | | - Eric S Zhou
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Wen You
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
- Comprehensive Cancer Center, University of Virginia, Charlottesville, Virginia, USA
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Seib C, Harbeck E, Anderson D, Porter-Steele J, Nehill C, Sanmugarajah J, Perrin L, Shannon C, Cabraal N, Jennings B, Otton G, Adams C, Mellon A, Chambers S. Establishing the sensitivity and specificity of the gynaecological cancer distress screen. Psychooncology 2024; 33:e6328. [PMID: 38504431 DOI: 10.1002/pon.6328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/08/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE Nuanced distress screening tools can help cancer care services manage specific cancer groups' concerns more efficiently. This study examines the sensitivity and specificity of a tool specifically for women with gynaecological cancers (called the Gynaecological Cancer Distress Screen or DT-Gyn). METHODS This paper presents cross-sectional data from individuals recently treated for gynaecological cancer recruited through Australian cancer care services, partner organisations, and support/advocacy services. Receiver operating characteristics analyses were used to evaluate the diagnostic accuracy of the DT-Gyn against criterion measures for anxiety (GAD-7), depression (patient health questionnaire), and distress (IES-R and K10). RESULTS Overall, 373 individuals aged 19-91 provided complete data for the study. Using the recognised distress thermometer (DT) cut-off of 4, 47% of participants were classified as distressed, while a cut-off of 5 suggested that 40% had clinically relevant distress. The DT-Gyn showed good discriminant ability across all measures (IES-R: area under the curve (AUC) = 0.86, 95% CI = 0.82-0.90; GAD-7: AUC = 0.89, 95% CI = 0.85-0.93; K10: AUC = 0.88, 95% CI = 0.85-0.92; PHQ-9: AUC = 0.85, 95% CI = 0.81-0.89) and the Youden Index suggested an optimum DT cut-point of 5. CONCLUSIONS This study established the psychometric properties of the DT-Gyn, a tool designed to identify and manage the common sources of distress in women with gynaecological cancers. We suggest a DT cut point ≥5 is optimal in detecting 'clinically relevant' distress, anxiety, and depression in this population.
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Affiliation(s)
- Charrlotte Seib
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
| | - Emma Harbeck
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Debra Anderson
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Janine Porter-Steele
- The Wesley Hospital Choices Cancer Support Centre (Choices), Wesley Hospital, Auchenflower, Queensland, Australia
- School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia
| | - Caroline Nehill
- Cancer Australia, Strawberry Hills, New South Wales, Australia
| | - Jasotha Sanmugarajah
- Gold Coast University Hospital, Southport, Queensland, Australia
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Lewis Perrin
- Mater Hospital and Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Catherine Shannon
- Mater Hospital and Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Nimithri Cabraal
- Mater Hospital and Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Bronwyn Jennings
- Mater Hospital and Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Geoffrey Otton
- Lambton Women's Health, Lambton, New South Wales, Australia
| | | | - Anne Mellon
- Hunter New England Centre for Gynaecological Cancer, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
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10
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Broadbridge E, Venetis MK, Devine KA, Lee LE, Banerjee SC, Greene K. Supporting the support person: Oncologists' roles in reducing support people's uncertainty and facilitating psychological adjustment. Psychooncology 2024; 33:e6313. [PMID: 38446532 PMCID: PMC11046424 DOI: 10.1002/pon.6313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/29/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Support people of cancer patients are at significant risk for psychological distress. Additionally, cancer patients' well-being is reciprocally associated with support peoples' psychological well-being. Informed by Uncertainty in Illness Theory, this study tests whether support person psychological well-being is influenced by provider communication and uncertainty reduction. METHODS We tested a multiple mediation model to investigate how empathic communication facilitates psychological adjustment in support people of cancer patients and how this process is mediated by support peoples' illness uncertainty and caregiver burden. Support people of cancer patients (N = 121; including spouses, adult children, etc.) completed an online questionnaire about their perceptions of oncologists' empathy, uncertainty about the cancer patients' illness, perceived caregiving burden, and their psychological adjustment to diagnoses. RESULTS Path analysis revealed that (1) more perceived oncologist empathy was associated with less illness uncertainty, (2) more illness uncertainty was associated with worse psychological adjustment and more perceived caregiver burden, and (3) more burden was associated with worse adjustment (χ2 (2) = 1.19, p = 0.55; RMSEA < 0.01; CFI = 1.00; SRMR = 0.02). CONCLUSIONS Given the reciprocal nature of well-being between cancer patients and their support people, it is critical to understand and bolster support people's psychological well-being. Results demonstrated how empathic provider communication can support psychological well-being for support people of cancer patients. Additionally, this study offers theoretical contributions to understandings of illness uncertainty in caregiver populations.
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Affiliation(s)
| | - Maria K. Venetis
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| | - Katie A. Devine
- Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Lauren E. Lee
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| | - Smita C. Banerjee
- Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kathryn Greene
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
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11
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Yu Y, Li Y, Zhao J, Yao J, Duan Y, Shao Y, Xie J, Zhu L. The longitudinal relationship between self-compassion and cancer patients' unmet supportive care needs. Psychooncology 2024; 33:e6319. [PMID: 38497821 DOI: 10.1002/pon.6319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/20/2023] [Accepted: 02/25/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES Unmet supportive care needs are associated with psychological symptoms such as depression and anxiety. However, so far, few studies have explored the protective psychological factors of unmet needs. Therefore, this study intends to explore the protective effect of self-compassion on unmet needs of Chinese cancer patients and to examine the predictive role of self-compassion on these needs during treatment. METHODS A longitudinal study was performed at Shaanxi Provincial Cancer Hospital in Xi'an, China. A total of 153 heterogeneous cancer patients were assessed after the first diagnosis (T1), at the beginning (T2) and end (T3) of medical treatment. Hierarchical linear regression analyses were used to examine the research questions. RESULTS Cross-sectional regression analyses showed that self-compassion at T1 was significantly related to psychological needs at T1. Negative self-compassion at T1 was significantly related to total unmet needs, psychological needs, health system, and information and sexual needs. Longitudinal regression analyses showed that self-compassion at T1 significantly predicted total unmet needs; health system and information (HSI) needs at T2, psychological needs at T3, and negative self-compassion at T1 significantly predicted total unmet needs, HSI needs, physical needs, and patient care needs at T2 when controlling for unmet needs at T1. Positive self-compassion was not a predictor of unmet needs. CONCLUSIONS Self-compassion can be a protective factor of unmet needs in cancer patients. Future intervention studies should focus on improving the overall level of self-compassion and reducing the level of negative self-compassion in cancer patients to reduce patients' unmet needs.
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Affiliation(s)
- Yunlei Yu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Yanze Li
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Jiang Zhao
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Juntao Yao
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Yaokun Duan
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Yufei Shao
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Juan Xie
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Lei Zhu
- School of Psychology, Shaanxi Normal University, Xi'an, China
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12
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Myers L, Johnston EA, Zajdlewicz L, Viljoen B, Kelly S, Perry N, Stiller A, Crawford-Williams F, Chan RJ, Emery JD, Bergin RJ, Aitken JF, Goodwin BC. What are the mechanisms underlying the delivery of survivorship care information in Australia? A realist review. Psychooncology 2024; 33:e6321. [PMID: 38488825 DOI: 10.1002/pon.6321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/15/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Quality survivorship information is an essential component of cancer care. However, survivors often report not receiving this information and healthcare professionals report limited practical guidance on how to effectively deliver survivorship information. Therefore, this study used realist review methods to identify mechanisms reported within the published literature for communicating survivorship information and to understand the contextual factors that make these mechanisms effective. METHODS Full-text papers published in CINAHL, PubMed, Web of Science, Scopus, Cochrane Library, and Academic Search Ultimate were included. Studies included in this review were conducted in Australia between January 2006 and December 2023, and reported on how information regarding survivorship care was communicated to adult cancer survivors living in the community. This review utilized realist methodologies: text extracts were converted to if-then statements used to generate context-mechanism-outcome theories. RESULTS Fifty-one studies were included and six theories for mechanisms that underpin the effective delivery of survivorship information were formed. These include: (1) tailoring information based on the survivors' background, (2) enhancing communication among providers, (3) employing dedicated survivorship staff, (4) providing survivorship training, (5) reducing the burden on survivors to navigate their care, and (6) using multiple modalities to provide information. CONCLUSIONS Findings can inform practical guidance for how survivorship care information is best delivered in practice. Clinicians can apply this guidance to improve their individual interactions with cancer survivors, as can policymakers to develop healthcare systems and procedures that support effective communication of cancer survivorship information.
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Affiliation(s)
- Larry Myers
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Elizabeth A Johnston
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Leah Zajdlewicz
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Bianca Viljoen
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
| | - Sarah Kelly
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Nicole Perry
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Anna Stiller
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Jon D Emery
- Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Cancer Research, University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca J Bergin
- Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Belinda C Goodwin
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
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13
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Tometich DB, Welniak T, Gudenkauf L, Maconi ML, Fulton HJ, Martinez Tyson D, Zambrano K, Hasan S, Rodriguez Y, Bryant C, Li X, Reed DR, Oswald LB, Galligan A, Small BJ, Jim HSL. "I couldn't connect the wires in my brain." Young adult cancer survivors' experience with cognitive functioning. Psychooncology 2024; 33:e6309. [PMID: 38420860 DOI: 10.1002/pon.6309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/20/2024] [Accepted: 02/11/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE There is a dearth of literature describing young adult (YA) cancer survivors' experiences with cancer-related cognitive impairment (CRCI). We aimed to elucidate CRCI among YA cancer survivors and identify potentially modifiable risk factors. METHODS We conducted individual qualitative interviews with YA cancer survivors aged 18-30 years at study enrollment and used applied thematic analysis to identify themes across three topics (i.e., affected cognitive abilities, risk and protective factors influencing the impact of CRCI, and strategies for coping with CRCI). RESULTS YA cancer survivors (N = 20) were, on average, 23 years old at diagnosis and 26 years old when interviewed. Diverse cancer types and treatments were represented; most participants (85%) had completed cancer treatment. Participants described experiences across three qualitative topics: (1) affected cognitive abilities (i.e., concentration and attention, prospective memory, and long-term memory), (2) Risk factors (i.e., fatigue, sleep problems, mood, stress/distractions, and social isolation) and protective factors (i.e., social support), and (3) coping strategies, including practical strategies that helped build self-efficacy (e.g., writing things down, reducing distractions), beneficial emotion-focused coping strategies (e.g., focus on health, faith/religion), strategies with mixed effects (i.e., apps/games, medications/supplements, and yoga), and "powering through" strategies that exacerbated stress. CONCLUSIONS YA cancer survivors experience enduring cognitive difficulties after treatment. Specific concerns highlight the importance of attention and executive functioning impairments, long-term memory recall, and sensitivity to distractions. Future work is needed to improve assessment and treatment of CRCI among YA cancer survivors.
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Affiliation(s)
- Danielle B Tometich
- Moffitt Cancer Center, Tampa, Florida, USA
- University of South Florida, Tampa, Florida, USA
| | | | | | | | | | | | | | - Syed Hasan
- Moffitt Cancer Center, Tampa, Florida, USA
| | | | | | - Xiaoyin Li
- Moffitt Cancer Center, Tampa, Florida, USA
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14
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Wang Z, Chen X, Zhou J, Lin C, Zhao J, Li Q. The effect of a couple-based posttraumatic growth intervention in supporting couples coping with colorectal cancer: A randomized controlled study. Psychooncology 2024; 33:e6326. [PMID: 38498049 DOI: 10.1002/pon.6326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/23/2024] [Accepted: 03/05/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To promote posttraumatic growth (PTG) in colorectal cancer (CRC) couples, a couple-based PTG intervention was conducted, and the intervention had previously proved be feasible in CRC couples. The current study was conducted to validate the effects of intervention in CRC couples. METHOD This is a randomized controlled study that included 174 CRC couples. All participants were randomized to either the intervention (usual care plus 5-week PTG intervention, n = 87) or the control group (usual care, n = 87). Data were collected from CRC couple dyads at baseline and immediately post-intervention periods. Primary outcome refers to positive changes, and secondary outcomes include marital satisfaction, quality of life (QOL), and anxiety and depression. Multilevel modeling was applied to analyze the intervention effects. RESULTS Participants in the program showed increased PTG, marital satisfaction, and QOL both physically and mentally, and decreased levels of anxiety and depression over time. And spousal caregivers showed greater improvement in marital satisfaction and physical QOL compared with patients. In addition, significant intervention effects were shown in the participants' benefit finding, physical health and depressive symptoms. CONCLUSION The study confirmed the effect of the PTG intervention on CRC couples' benefit finding, physical health and depressive symptoms. However, this study only measured outcome variables at two time-points. Future studies should add follow-up assessments to evaluate long-term effects of the intervention in CRC couples. REGISTRATION NUMBER ChiCTR2300067809.
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Affiliation(s)
- Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Chunyan Lin
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jie Zhao
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
- Affiliated Hospital of Jiangnan University, Wuxi, China
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15
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Hong YT, Ye BQ, Lin JL, Chen QH, Zhang J, Chen WT, Huang FF. Characteristics and influencing factors of demoralization in patients with lung cancer: A latent class analysis. Psychooncology 2024; 33:e6312. [PMID: 38429989 DOI: 10.1002/pon.6312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/10/2024] [Accepted: 02/16/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Demoralization has garnered increasing attention in recent years as a significant psychological distress. This study aims to identify latent classes of demoralization in lung cancer patients using Latent Class Analysis (LCA) from a person-centered perspective and to explore the factors influencing the latent classes of demoralization. METHODS A cross-sectional study using convenience sampling was conducted among 567 lung cancer patients in three tertiary hospitals in China. LCA was employed to classify heterogeneous classes of demoralization. Multinomial logistic regression analyses were performed to explore the associations between demographic and clinical characteristics, as well as physical symptoms, resilience, family function, and coping strategies, with class membership in the identified heterogeneous subgroups of lung cancer patients. RESULTS Three latent classes of demoralization were identified: the high demoralization group (Class 1, 14.8%), the moderate demoralization-distress and helplessness group (Class 2, 37.2%), and the low demoralization group (Class 3, 48.0%). In comparison to Class 3, lung cancer patients with hypertension, higher core symptom burden, poorer resilience, dysfunctional family dynamics, and resignation coping were more likely to belong to Class 1 and Class 2. CONCLUSIONS The demoralization patterns in lung cancer patients were varied. Targeted intervention should be developed based on the characteristics of each class, and timely attention should be paid to high-risk patients.
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Affiliation(s)
- Yu Ting Hong
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Bi Qin Ye
- Department of Oncology, Affiliated Hospital of Putian University, Putian, Fujian, China
| | - Jia Ling Lin
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Qiu Hong Chen
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Juan Zhang
- The 900th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, Fuzhou, Fujian, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Fei Fei Huang
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
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16
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Badaghi N, van Kruijsbergen M, Speckens A, Vilé J, Prins J, Kelders S, Kwakkenbos L. Group, Blended and Individual, Unguided Online Delivery of Mindfulness-Based Cognitive Therapy for People With Cancer: Feasibility Uncontrolled Trial. JMIR Form Res 2024; 8:e52338. [PMID: 38381493 PMCID: PMC10918539 DOI: 10.2196/52338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/29/2023] [Accepted: 01/14/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Online mindfulness based cognitive therapy (eMBCT) has been shown to reduce psychological distress in people with cancer. However, this population has reported lack of support and asynchronous communication as barriers to eMBCT, resulting in higher nonadherence rates than with face-to-face MBCT. Using a co-creation process, we developed 2 formats of eMBCT: group, blended (combination of therapist-guided group and individual online sessions) and individual, unguided (individual, unguided online sessions only). Group, blended eMBCT offers peer support and guidance, whereas individual, unguided eMBCT offers flexibility and the possibility of large-scale implementation. OBJECTIVE The objective of this nonrandomized feasibility study was to assess aspects of feasibility of the group, blended and individual, unguided eMBCT interventions. METHODS Participants were people with cancer who chose between group, blended and individual, unguided eMBCT. Both intervention conditions followed the same 8-week eMBCT program, including an introductory session and a silent day (10 sessions total). All sessions for individual, unguided eMBCT occurred via the platform Minddistrict, whereas group, blended eMBCT consisted of 3 online videoconference sessions guided by a mindfulness teacher and 5 sessions via Minddistrict. We assessed the feasibility of the intervention quantitatively and qualitatively by evaluating its acceptability among participants. Additionally, we assessed limited efficacy by looking at the number of questionnaires participants completed pre- and postintervention. RESULTS We included 12 participants for each eMBCT condition. Participants in group, blended eMBCT completed, on average, 9.7 of 10 sessions, compared with an average 8.3 sessions for individual, unguided eMBCT (excluding dropouts). Of the 24 participants, 13 (54%) agreed to be interviewed (5 unguided and 8 blended). Participants in both conditions reported positive experiences, including the convenience of not having to travel and the flexibility to choose when and where to participate. However, among the barriers for participation, participants in the group, blended condition reported a preference for more group sessions, and participants in the individual, unguided condition reported a lack of guidance. Additionally, for the group, blended condition, the effect sizes were small for all outcome measures (Hedges g range=0.01-0.36), except for fatigue, which had a moderate effect size (Hedges g=0.57). For the individual, unguided condition, the effect sizes were small for all outcome measures (Hedges g range=0.24-0.46), except for mindfulness skills (Hedges g=0.52) and engagement with the intervention (Hedges g=1.53). CONCLUSIONS Participants in this study had a positive experience with group, blended and individual, unguided eMBCT. Based on the results from this study, we will adjust the intervention prior to conducting a full-scale randomized controlled trial to evaluate effectiveness; we will add 1 group session to the group, blended eMBCT using Zoom as the platform for the group sessions; and we will send reminders to participants to complete questionnaires. TRIAL REGISTRATION ClinicalTrials.gov NCT05336916; https://clinicaltrials.gov/ct2/show/NCT05336916.
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Affiliation(s)
- Nasim Badaghi
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Anne Speckens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Joëlle Vilé
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Judith Prins
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Saskia Kelders
- Department of Psychology, Health, and Technology, University of Twente, Enschede, Netherlands
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
| | - Linda Kwakkenbos
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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Hinz A, Schulte T, Mehnert-Theuerkauf A, Richter D, Sender A, Brock H, Friedrich M, Briest S. Fear of Cancer Progression: A Comparison between the Fear of Progression Questionnaire (FoP-Q-12) and the Concerns about Recurrence Questionnaire (CARQ-4). Healthcare (Basel) 2024; 12:435. [PMID: 38391810 PMCID: PMC10888487 DOI: 10.3390/healthcare12040435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
As cancer patients often suffer from fear of cancer progression (FoP), valid screening for FoP is of high relevance. The aims of this study were to test psychometric properties of two FoP questionnaires, to determine their relationship to other anxiety-related constructs, and to analyze the impact of sociodemographic and clinical factors on the FoP. Our sample consisted of n = 1733 patients with mixed cancer diagnoses. For measuring FoP, the Fear of Progression questionnaire (FoP-Q-12) and the Concerns About Cancer Recurrence Questionnaire (CARQ-4) were used. The mean scores of the FoP-Q-12 and the CARQ-4 were 30.0 ± 10.4 and 16.1 ± 10.8, respectively, indicating relatively high levels of FoP. Both questionnaires showed excellent internal consistency coefficients, α = 0.895 and α = 0.915, respectively. The correlation between the two FoP questionnaires was r = 0.72. Female patients reported more FoP than male patients (d = 0.84 and d = 0.54, respectively). There was a nonlinear age dependency of FoP, with an increase found in the age range from 18 to 50 years and a decrease in the older age range. Radiation, chemotherapy, and antibody therapy, but not surgery, lead to an increase in FoP. Both questionnaires show good psychometric properties and can be recommended for use in an oncological routine. Female patients and patients in the middle-age range deserve special attention from healthcare providers.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, 32549 Bad Oeynhausen, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Hannah Brock
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Susanne Briest
- Department of Gynecology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
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18
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Bybee SG, Waters AR, Smith K, Warner EL. Misalignment of social support in the social media posts of young adult cancer caregivers. Cancer Rep (Hoboken) 2024; 7:e1998. [PMID: 38389399 PMCID: PMC10884617 DOI: 10.1002/cnr2.1998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/05/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Compared with older cancer caregivers, young adult cancer caregivers (YACC) experience greater stress and depression during the first 6 months of caregiving. Social support can buffer the negative psychological effects associated with cancer caregiving. However, the misalignment of social support is associated with increased distress and worse emotional well-being. As YACC are more likely to utilize social media (SM) to seek social support compared with older cancer caregivers, they may be at greater risk of experiencing the misalignment of social support and related negative outcomes. OBJECTIVE The purpose of this study was to identify ways that SM posts containing support for YACC's were potentially misaligned with the social support desired by YACC. METHODS In this secondary analysis, cancer-related SM posts (N = 760) from 34 YACC's SM accounts were extracted for 6 months following the day of cancer diagnosis and imported into NVivo qualitative analysis software. Open coding of posts from four YACC identified a pattern of SM posts containing responses that may misalign with social support requests, and could be perceived as dismissive of YACC's emotions. Similar posts were grouped together, forming categories which were used to create a codebook and applied in coding all posts from the remaining 30 YACC. RESULTS Content analysis identified three categories of social support misalignment originating from YACC's SM posts: supplications (n = 251, 33%), prevailing (n = 7, 10.1%), and consolations (n = 16, 2.1%). Supplications involved prayer or trust in god, prevailing posts compared dealing with cancer to a fight and suggested that the person would overcome cancer, and consolations used quotes, song lyrics, and or general reassurances in SM posts. CONCLUSIONS Findings suggest that when YACC use SM during cancer experiences, they may interpret SM posts as social support or as misalignment of social support requests, which in turn can lead to either improved quality of life or additional distress (respectively). This study adds to the body of knowledge regarding how YACC use social media for social support and may inform future interventions designed to match YACC's desired support with support offered.
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Affiliation(s)
- Sara G. Bybee
- College of Nursing, University of UtahSalt Lake CityUtahUSA
| | - Austin R. Waters
- Huntsman Cancer Institute at the University of UtahSalt Lake CityUtahUSA
| | - Keely Smith
- The University of Arizona, College of NursingTucsonArizonaUSA
| | - Echo L. Warner
- College of Nursing, University of UtahSalt Lake CityUtahUSA
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19
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Kubo A, Kurtovich E, McGinnis M, Aghaee S, Altschuler A, Quesenberry C, Kolevska T, Liu R, Greyz-Yusupov N, Avins A. Pilot pragmatic randomized trial of mHealth mindfulness-based intervention for advanced cancer patients and their informal caregivers. Psychooncology 2024; 33:e5557. [PMID: 32979294 DOI: 10.1002/pon.5557] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/03/2020] [Accepted: 09/21/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Assess the feasibility of conducting a cluster randomized controlled trial (RCT) comparing technology-delivered mindfulness-based intervention (MBI) programs against a waitlist control arm targeting advanced cancer patients and their informal caregivers. METHODS Two-arm cluster RCT within Kaiser Permanente Northern California. We recruited patients with metastatic solid malignancies or hematological cancers and their informal caregivers. Intervention-group participants chose to use either a commercially available mindfulness app (10-20 min/day) or a webinar-based mindfulness course for 6 weeks. The waitlist control group received usual care. We assessed feasibility measures and obtained participant-reported data on quality of life (QoL; primary outcome) and distress outcomes (secondary) pre- and postintervention. RESULTS A hundred and three patients (median age 67 years; 70% female; 81% White) and 39 caregivers (median age 66 years; 79% female; 69% White) were enrolled. Nearly all participants chose the mindfulness app over the webinar-based program. Among the participants in the intervention arm who chose the mobile-app program and completed the postintervention (6-week) survey, 21 (68%) patients and 7 (47%) caregivers practiced mindfulness at least 50% of the days during the 6-week study period. Seventy-four percent of intervention participants were "very" or "extremely" satisfied with the mindfulness program. We observed improvements in anxiety, QoL, and mindfulness among patients in the intervention arm compared to those in the control group. CONCLUSIONS We demonstrated the feasibility of conducting a cluster RCT of mHealth MBI for advanced cancer patients and their caregivers. Such remote interventions can be helpful particularly during the COVID-19 pandemic.
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Affiliation(s)
- Ai Kubo
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Elaine Kurtovich
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - MegAnn McGinnis
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Sara Aghaee
- Kaiser Permanente Division of Research, Oakland, California, USA
| | | | | | - Tatjana Kolevska
- Kaiser Permanente Napa/Solano Medical Center, Vallejo, California, USA
| | - Raymond Liu
- Kaiser Permanente Division of Research, Oakland, California, USA
- Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA
| | | | - Andrew Avins
- Kaiser Permanente Division of Research, Oakland, California, USA
- School of Medicine, University of California, San Francisco, California, USA
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20
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Pichler T, Mumm F, Dehar N, Dickman E, Díez de Los Ríos de la Serna C, Dinkel A, Heinrich K, Hennink M, Parviainen AD, Raske V, Wicki N, Moore AC. Understanding communication between patients and healthcare professionals regarding comprehensive biomarker testing in precision oncology: A scoping review. Cancer Med 2024; 13:e6913. [PMID: 38298115 PMCID: PMC10905543 DOI: 10.1002/cam4.6913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/15/2023] [Accepted: 12/23/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Precision oncology, using comprehensive biomarker testing (cBT) to inform individual cancer diagnosis, prognosis and treatment, includes increasingly complex technology and clinical data sets. People impacted by cancer (patients and caregivers) and healthcare professionals (HCPs) face distinct challenges in navigating the cBT and personalized treatment landscape. This review summarizes evidence regarding cBT-related communication between people impacted by cancer and HCPs and identifies important avenues for future research in precision oncology. METHODS A scoping review was conducted using records published in PubMed during January 2017-August 2022, focusing on the breadth of topics on patient-HCP communication and knowledge resources used by HCPs as guidance in cBT-related communication. Data were extracted from records meeting inclusion criteria, and findings were summarized according to main topics. RESULTS The search identified 287 unique records and data were extracted from 42 records, including nine from expert input. Most records originated from the United States included patients with different types of cancer, and oncologists were the main HCPs. Patients' motivation for undergoing cBT and receiving results was generally high in different settings. However, patients' understanding of cBT-related concepts was limited, and their knowledge and information preferences changed based on cBT implications and significance to family members. HCPs were valued by patients as a trusted source of information. Limited evidence was available on HCPs' information-seeking behavior and factors influencing cBT-related knowledge and confidence, often self-reported as insufficient. CONCLUSIONS Patient education by knowledgeable and confident HCPs, information management and a caring patient-HCP relationship communicating continuity of care regardless of cBT results are crucial to empower patients and shared decision-making in precision oncology. More data on the process and structure of cBT-related communication, distinction between and characterization of different timepoints of patient-HCP interactions are needed.
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Affiliation(s)
- Theresia Pichler
- Department of Internal Medicine III, University HospitalLMU MunichMunichGermany
- Comprehensive Cancer Center Munich LMU (CCC Munich)MunichGermany
| | - Friederike Mumm
- Department of Internal Medicine III, University HospitalLMU MunichMunichGermany
- Comprehensive Cancer Center Munich LMU (CCC Munich)MunichGermany
| | - Navdeep Dehar
- Department of Medical OncologyQueen's UniversityKingstonOntarioCanada
| | - Erin Dickman
- Oncology Nursing SocietyPittsburghPennsylvaniaUSA
| | - Celia Díez de Los Ríos de la Serna
- European Oncology Nursing SocietyBrusselsBelgium
- Faculty of Medicine and Health Sciences, School of NursingBarcelona UniversityBarcelonaCataloniaSpain
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine and HealthTechnical University of MunichMunichGermany
- Comprehensive Cancer Center Munich TUM (CCC Munich)MunichGermany
| | - Kathrin Heinrich
- Comprehensive Cancer Center Munich LMU (CCC Munich)MunichGermany
| | | | - Anndra D. Parviainen
- Department of Nursing Science, Faculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
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Antoniadis D, Giakoustidis A, Paramythiotis D, Michalopoulos A, Mandanas ZN, Papadopoulos VN. Mental health well-being and functional adjustment in colorectal cancer patients: a prospective cohort study. Acta Chir Belg 2024; 124:20-27. [PMID: 36369863 DOI: 10.1080/00015458.2022.2145725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/05/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Colorectal cancer significantly affects the quality of life of patients, while at the same time contributing to the development of symptoms of psychopathology. The aim of this prospective study, is to investigate the role of the disease in the quality of life of patients with colon cancer and in the appearance of symptoms of anxiety and depression, as well as the connection of the above characteristics during the recovery process, given the distress symptoms experienced by the patients. METHODS In the present study, HADS, FACT - C, well as the DT are use, in a sample of 118 patients of an average age of 70.5 ± 8.5 years, which were submitted to partial or total colectomy surgery. RESULTS Moderate levels of anxiety (M = 8.25, SD = 3.87) and low levels of depression (M = 6.90, SD = 2.97) and distress (M = 5.84, SD = 2.60) emerged preoperatively, while the improvement was significant of patients' quality of life level 6 months after surgery. At the same time, a significant negative effect of the patients' distress level preoperatively on their quality of life, during the recovery process was observed. CONCLUSION Preoperative anxiety is not considered to be an element that affects the functionality and the psychological and physical adaptation to the disease of patients with colon cancer. On the contrary, the feelings of distress they experience can be a predictive factor of their quality of life after the partial or total colectomy surgery.
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Affiliation(s)
- Diomidis Antoniadis
- Post-doctoral researcher, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexander Giakoustidis
- 1st Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Daniel Paramythiotis
- 1st Propaedeutic Surgery Department, School of Medicine, Aristotle University of Thessaloniki, General Hospital AHEPA, Thessaloniki, Greece
| | - Antonios Michalopoulos
- 1st Propaedeutic Surgery Department, School of Medicine, Aristotle University of Thessaloniki, General Hospital AHEPA, Thessaloniki, Greece
| | | | - Vasileios N Papadopoulos
- 1st Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
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DeForge SM, Smith K, Anderson KA, Baltazar AR, Beck M, Enzinger AC, Tulsky JA, Allsop M, Edwards RR, Schreiber KL, Azizoddin DR. Pain coping, multidisciplinary care, and mHealth: Patients' views on managing advanced cancer pain. Psychooncology 2024; 33:e6308. [PMID: 38366975 DOI: 10.1002/pon.6308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Pain is common among people with advanced cancer. While opioids provide significant relief, incorporating psycho-behavioral treatments may improve pain outcomes. We examined patients' experiences with pain self-management and how their self-management of chronic, cancer-related pain may be complemented by behavioral mobile health (mHealth) interventions. METHODS We conducted semi-structured qualitative interviews with patients with advanced cancer and pain. Each participant reviewed content from our behavioral mHealth application for cancer pain management and early images of its interface. Participants reflected on their experiences self-managing cancer pain and on app content. Interviews were transcribed verbatim and analyzed using a combination of inductive and deductive thematic analysis. RESULTS Patients (n = 28; 54% female; mean age = 53) across two geographic regions reported using psychological strategies (e.g., reframing negative thoughts, distraction, pain acceptance, social support) to manage chronic cancer-related pain. Patients shared their perspectives on the integration of psycho-behavioral pain treatments into their existing medical care and their experiences with opioid hesitancy. Patient recommendations for how mHealth interventions could best support them coalesced around two topics: 1.) convenience in accessing integrated pharmacological and psycho-behavioral pain education and communication tools and 2.) relevance of the specific content to their clinical situation. CONCLUSIONS Integrated pharmacological and psycho-behavioral pain treatments were important to participants. This underscores a need to coordinate complimentary approaches when developing cancer pain management interventions. Participant feedback suggests that an mHealth intervention that integrates pain treatments may have the capacity to increase advanced cancer patients' access to destigmatizing, accessible care while improving pain self-management.
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Affiliation(s)
- Sara M DeForge
- Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, Oklahoma, USA
| | - Kyla Smith
- Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, Oklahoma, USA
| | - Kris-Ann Anderson
- Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, Oklahoma, USA
| | - Ashton R Baltazar
- Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, Oklahoma, USA
| | - Meghan Beck
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Andrea C Enzinger
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Matthew Allsop
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kristin L Schreiber
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Desiree R Azizoddin
- Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, Oklahoma, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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23
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Applebaum AJ, Schofield E, Kastrinos A, Gebert R, Behrens M, Loschiavo M, Shaffer KM, Levine M, Dannaoui A, Bellantoni C, Miller MF, Zaleta AK. A randomized controlled trial of a distress screening, consultation, and targeted referral system for family caregivers in oncologic care. Psychooncology 2024; 33:e6301. [PMID: 38363002 DOI: 10.1002/pon.6301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/16/2024] [Accepted: 01/27/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Distress screening is standard practice among oncology patients, yet few routine distress screening programs exist for cancer caregivers. The objective of this study was to demonstrate the feasibility, acceptability, and preliminary efficacy of Cancer Support Source-CaregiverTM (CSS-CG, 33-item), an electronic distress screening and automated referral program with a consultation (S + C) to improve caregiver unmet needs, quality of life, anxiety, depression, and distress relative to Enhanced Usual Care (EUC; access to educational materials). METHOD 150 caregivers of patients with varying sites/stages of cancer were randomized to S + C or EUC and completed assessments at baseline, 3-months post-baseline, and 6-months post-baseline. A subset of participants (n = 10) completed in-depth qualitative interviews. RESULTS S + C was feasible: among 75 caregivers randomized to S + C, 66 (88%) completed CSS-CG and consultation. Top concerns reported were: (1) patient's pain and/or physical discomfort; (2) patient's cancer progressing/recurring; and (3) feeling nervous or afraid. Differences between groups in improvements on outcomes by T2 and T3 were modest (ds < 0.53) in favor of S + C. Qualitative data underscored the helpfulness of S + C in connecting caregivers to support and helping them feel cared for and integrated into cancer care. CONCLUSIONS S + C is feasible, acceptable, and yields more positive impact on emotional well-being than usual care. Future studies will examine programmatic impact among caregivers experiencing higher acuity of needs, and benefits of earlier integration of S + C on caregiver, patient, and healthcare system outcomes.
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Affiliation(s)
- Allison J Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Amanda Kastrinos
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Rebecca Gebert
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mia Behrens
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Morgan Loschiavo
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kelly M Shaffer
- Center for Behavioral Health and Technology, University of Virginia, Charlottesville, Virginia, USA
| | - Marcia Levine
- Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Aimee Dannaoui
- Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Courtney Bellantoni
- Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Melissa F Miller
- Research and Training Institute, Cancer Support Community, Philadelphia, Pennsylvania, USA
| | - Alexandra K Zaleta
- Research and Training Institute, Cancer Support Community, Philadelphia, Pennsylvania, USA
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Raque TL, Bashakevitz K, Wright O, Scout N. Applying the Multicultural Orientation in Cancer Care for Sexual and Gender Minority Cancer Survivors: A Cross-Sectional Correlational Study. LGBT Health 2024. [PMID: 38215231 DOI: 10.1089/lgbt.2023.0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024] Open
Abstract
Purpose: Sexual and gender minority (SGM) cancer survivors report unique needs that are not met by some providers. The multicultural orientation (MCO) holds promise for creating a paradigm shift in providing affirmative cancer care, yet has not been tested empirically. This study examines the predictive strength of MCO's tenets of cultural humility and cultural opportunities for SGM cancer patient-provider relationships. Methods: In this cross-sectional study, 108 SGM cancer survivors completed surveys on perceptions of their oncology providers' cultural humility and actualization of cultural opportunities as predictors of survivors' treatment adherence and the patient-provider alliance. Hierarchical regression analyses were conducted. Results: Average participant age was 50 years (standard deviation = 15 years). Over 10 cancer types were represented and 69% of participants were in active treatment, with the remaining 31% receiving follow-up care. Age at diagnosis and not being in active treatment positively correlated with perceptions of providers' cultural humility, patient-provider alliance, and treatment adherence. Regression models explained 38% and 61%, respectively, of the variance in treatment adherence and patient-provider alliance, with cultural humility remaining a significant predictor in both models after accounting for all other variables. Conclusion: Providers' cultural humility and navigation of cultural opportunities in incorporating their patients' salient cultural identities into cancer care are strongly associated with how supported SGM cancer survivors feel by their oncology providers. The MCO is a useful framework for identifying important dimensions in SGM affirmative cancer care.
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Affiliation(s)
- Trisha L Raque
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Kat Bashakevitz
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Orphea Wright
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Nfn Scout
- National LGBT Cancer Network, Providence, Rhode Island, USA
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25
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Hebi M, Czamanski-Cohen J, Azaiza F, Weihs KL. Values and their relationship with emotion processing and physical and psychological symptoms among Jewish and Arab breast cancer survivors. Front Psychol 2024; 14:1297377. [PMID: 38239457 PMCID: PMC10794551 DOI: 10.3389/fpsyg.2023.1297377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Individuals from different cultures differ in their values, which encompass belief systems that individuals develop based on their culture, and play a pivotal role in shaping their perspectives. These values may affect emotion processing (EP): the recognition, interpretation, expression and response to bodily sensations, translated as emotions. These varying values may contribute to distinct emotional experiences, impacting physical and psychological symptoms in breast cancer (BC) survivors. Methods This cross-sectional study investigated how EP including acceptance, expression (avoidance and approach coping), and awareness, may mediate the relationship between conservation values and symptoms of pain, fatigue, and depression among Arab (n = 62) and Jewish (n = 179) women BC survivors in Israel. Conservation values include tradition, conformity, and security. Results Depression and fatigue were negatively correlated with acceptance of emotions, and positively correlated with avoidance and conservation levels. Emotion processing mediated the relationship between conservation and fatigue and depression. Arab women reported higher levels of various values, emotional acceptance, pain, fatigue, and depression symptoms compared to Jewish women. Conservation was higher in Arab women and correlated with both approach and avoidance coping which was not the case in Jewish women. Avoidance coping had a positive relationship with fatigue in the Jewish, but not the Arab women. Similarly, approach coping was negatively related to depression in Jewish, but not in Arab women. Discussion Cultural differences are important for understanding the experience of cancer in individuals from different cultures. Future interventions for more conservative BC survivors should take culture into account.
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Affiliation(s)
- Maimounah Hebi
- The School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Johanna Czamanski-Cohen
- The School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Faisal Azaiza
- The College of Sakhnin for Teacher Education, Sakhnin, Israel
| | - Karen L. Weihs
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
- Cancer Prevention and Control Program, University of Arizona Comprehensive Cancer Center, Tucson, AZ, United States
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Gordon LG, Jones S, Parker G, Chambers S, Aitken JF, Foote M, Shum DHK, Robertson J, Conlon E, Pinkham MB, Ownsworth T. Cost-utility analysis of a telehealth psychological support intervention for people with primary brain tumor: Telehealth Making Sense of brain tumor. Psychooncology 2024; 33:e6243. [PMID: 37946565 DOI: 10.1002/pon.6243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To undertake an economic evaluation of a telehealth psychological support intervention for patients with primary brain tumor (PBT). METHODS A within-trial cost-utility analysis over 6 months was performed comparing a tailored telehealth-psychological support intervention with standard care (SC) in a randomized control trial. Data were sourced from the Telehealth Making Sense of Brain Tumor (Tele-MAST) trial survey data, project records, and administrative healthcare claims. Quality-adjusted life years (QALYs) were calculated based on the EuroQol-5D-5L. Non-parametric bootstrapping with 2000 iterations was used to determine sampling uncertainty. Multiple imputation was used for handling missing data. RESULTS The Tele-MAST trial included 82 participants and was conducted in Queensland, Australia during 2018-2021. When all healthcare claims were included, the incremental cost savings from Tele-MAST were -AU$4,327 (95% CI: -$8637, -$18) while incremental QALY gains were small at 0.03 (95% CI: -0.02, 0.08). The likelihood of Tele-MAST being cost-effective versus SC was 87% at a willingness-to-pay threshold of AU$50,000 per QALY gain. When psychological-related healthcare costs were included only, the incremental cost per QALY gain was AU$10,685 (95% CI: dominant, $24,566) and net monetary benefits were AU$534 (95% CI: $466, $602) with a 65% likelihood of the intervention being cost-effective. CONCLUSIONS Based on this small randomized controlled trial, the Tele-MAST intervention is a cost-effective intervention for improving the quality of life of people with PBT in Australia. Patients receiving the intervention incurred significantly lower overall healthcare costs than patients in SC. There was no significant difference in costs incurred for psychological health services.
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Affiliation(s)
- Louisa G Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Stephanie Jones
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Giverny Parker
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| | | | - Matthew Foote
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Elizabeth Conlon
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Mark B Pinkham
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Brisbane, Queensland, Australia
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McFadden K, Rankin NM, Nickel B, Li T, Jennett CJ, Sharman AR, Quaife SL, Dodd RH, Houssami N. Lung cancer screening program factors that influence psychosocial outcomes: A systematic review. Psychooncology 2024; 33:e6252. [PMID: 37971147 DOI: 10.1002/pon.6252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Lung cancer screening (LCS) programs are being designed and implemented globally. Early data suggests that the psychosocial impacts of LCS are influenced by program factors, but evidence synthesis is needed. This systematic review aimed to elucidate the impact of service-level factors on psychosocial outcomes to inform optimal LCS program design and future implementation. METHODS Four databases were searched from inception to July 2023. Inclusion criteria were full-text articles published in English that reported an association between any program factors and psychosocial outcomes experienced during LCS. Study quality was appraised, and findings were synthesised narratively. RESULTS Thirty-two articles were included; 29 studies were assessed at high or moderate risk of bias. Study designs were RCT (n = 3), pre-post (n = 6), cross-sectional (n = 12), mixed-methods (n = 1), and qualitative (n = 10) studies, and conducted primarily in the USA (n = 25). Findings suggested that targeted interventions can improve smoking-related or decisional psychosocial outcomes (e.g., smoking cessation interventions increase readiness/motivation to quit) but impacts of interventions on other psychological outcomes were varied. There was limited evidence reporting association between service delivery components and psychological outcomes, and results suggested moderation by individual aspects (e.g., expectation of results, baseline anxiety). Opportunities for discussion were key in reducing psychological harm. CONCLUSIONS Certain program factors are reportedly associated with psychosocial impacts of LCS, but study heterogeneity and quality necessitate more real-world studies. Future work should examine (a) implementation of targeted interventions and high-value discussion during LCS, and (b) optimal methods and timing of risk and result communication, to improve psychosocial outcomes while reducing time burden for clinicians.
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Affiliation(s)
- Kathleen McFadden
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Nicole M Rankin
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Brooke Nickel
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tong Li
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Chloe J Jennett
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ashleigh R Sharman
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Samantha L Quaife
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Rachael H Dodd
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Nehmat Houssami
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
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28
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Yeoh SA, Webb S, Phillips A, Li LSK, Kumar S. Psychosocial interventions for ovarian cancer survivors: A systematic review. Psychooncology 2024; 33:e6280. [PMID: 38282217 DOI: 10.1002/pon.6280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVES Ovarian cancer survivorship is complex and is associated with greater symptom burden, fear of reoccurrence, sexual dysfunction, lower quality of life and heightened existential distress in contrast to other cancers. This systematic review aimed to investigate the effectiveness for, and perspective of, psychosocial interventions encompassing psychological, social, and emotional support, tailored to, or involving ovarian cancer survivors at all stages of disease. METHODS Adhering to the PRISMA-SR statement guidelines, a systematic search was conducted across PsycINFO, MEDLINE, Embase, Emcare, CINAHL, Scopus, Cochrane Library databases, Google, and Google Scholar. Two reviewers independently undertook a two-stage screening process. The Mixed Methods Appraisal Tool was utilised to assess the methodological quality of included studies. Data were extracted using customised data extraction tools and narratively synthesised. RESULTS Thirteen studies were included in this review. Generally positive effects of psychosocial interventions were observed across a range of outcome domains (meaning enhancing, cognitive, social, emotional, and cancer-specific). However, the characteristics of interventions and outcome measures varied across studies. Psychoeducational interventions were identified as the most common psychosocial approach, while Acceptance and Commitment Therapy showed promise in addressing the disease's high symptom burden. Women's perspectives of psychosocial interventions were described as "useful" and promoted positive self-regard. CONCLUSION While the evidence base largely support positive effects of psychosocial interventions for ovarian cancer survivors, this finding is constrained by heterogeneity of interventions and modest gains. Future research may explore the standardisation of psychosocial interventions for this demographic, investigating its effects on less explored but prevalent concerns among ovarian cancer survivors such as fear of cancer recurrence and sexual dysfunction.
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Affiliation(s)
- Su Ann Yeoh
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Stephanie Webb
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Anna Phillips
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Lok Sze Katrina Li
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Saravana Kumar
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Merz S, Friedrich M, Brock H, Leuteritz K, Geue K, Richter D, Mehnert-Theuerkauf A, Sender A. Changes and predictors of social support in adolescent and young adult cancer survivors-Results of a 7-year longitudinal study. Psychooncology 2024; 33:e6282. [PMID: 38282213 DOI: 10.1002/pon.6282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/28/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE As social support has been shown to have beneficial effects on coping with cancer, our study aims to close the research gap on perceived social support in adolescent and young adult (AYA) cancer survivors. METHODS AYAs evaluated their perceived positive social support (PS) and detrimental interactions (DI) by completing the Illness-Specific Social Support Scale (ISSS-8) upon completion of acute treatment (t1) as well as 1 year (t2) and 7 years (t6) later. Temporal changes of social support were examined. Sociodemographic, psychological and medical factors were investigated as predictors for PS and DI by using mixed effects models. RESULTS We analyzed data from 319 cancer survivors (74.9% women). At baseline, survivors reported an average score of 13.73 (SD = 2.52) for PS and 3.92 (SD = 2.85) for DI. Average perceived PS changed over time, while DI remained stable. Males, AYAs without a partner and AYAs with clinically meaningful anxiety or depression levels reported fewer PS. Higher effort to cope with the disease and clinically significant anxiety and depression levels were associated with more perceived DI. CONCLUSIONS Existing social networks and perceived social support should be evaluated regularly in AYA-cancer survivorship. The identification and discussion of mental health of AYAs should also be a standard component in survivor consultations both during treatment and follow-up care, as elevated depression and anxiety levels were associated with fewer PS and more perceived DI.
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Affiliation(s)
- Sabrina Merz
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Hannah Brock
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Katja Leuteritz
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
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Matsuzaka S, Ohba A, Masukawa K, Aoyama M, Morita T, Kizawa Y, Tsuneto S, Shima Y, Miyashita M. Factors associated with the preparedness for bereavement in families of patients with cancer: A secondary analysis of a nationwide bereaved family survey. Psychooncology 2024; 33:e6276. [PMID: 38282233 DOI: 10.1002/pon.6276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVES Insufficient preparedness for bereavement can affect a family's psychological health status after bereavement. However, factors associated with preparedness remain unclear. This study aimed to identify factors associated with preparedness for bereavement in families of patients with cancer. METHODS We conducted a secondary analysis of a nationwide bereaved family survey in Japan, analyzing data from 9123 family members of patients with cancer. Logistic regression analysis was conducted to explore how sociodemographic factors, health status, and perceived care for patients and families were associated with preparedness for bereavement. RESULTS Of the 9123 families, 1338 (15.1%) were not prepared for bereavement. Factors associated with insufficient preparedness for bereavement (all p < 0.001) were found as follows: patients' spouses (OR = 2.54), receiving care in acute hospitals (OR = 1.83), worse psychological health status during caregiving (OR = 2.13), lower social support for family members (OR = 1.90), wrong patients' awareness of medical condition from family's perspective (OR = 1.75-2.12), family preference of more aggressive treatment rather than palliative care (OR = 1.71) or not sure (OR = 2.31), not wanting to know information about the patient's prognosis (OR = 1.64-1.77), end-of-life discussion with physician 1 month before patient's death (OR = 1.45), and late or early end-of-life discussions with physician and family (OR = 1.78-1.95). CONCLUSIONS This study's results might assist clinicians in assessing and identifying families who are not prepared for bereavement; however, preparedness for bereavement may have been associated with other factors.
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Affiliation(s)
- Sakiko Matsuzaka
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Akiho Ohba
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kento Masukawa
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Maho Aoyama
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara General Hospital, Hamamtsu, Shizuoka, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative and Supportive Care, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Winzig J, Inhestern L, Sigmund D, Paul V, Hail LA, Rutkowski S, Escherich G, Bergelt C. And what about today? Burden and support needs of adolescent childhood cancer survivors in long-term follow-up care-A qualitative content analysis. Child Care Health Dev 2024; 50:e13207. [PMID: 38083813 DOI: 10.1111/cch.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/21/2023] [Accepted: 11/18/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE Childhood cancer affects approximately 2000 children annually in Germany, and there is an increasing number of long-term childhood cancer survivors. Due to developmental tasks, adolescent survivors in long-term follow-up (LTFU) care may face specific challenges and perceive different burden due to their disease. The current study explored (a) the impact of cancer and burden regarding survivorship and (b) supportive needs of adolescent childhood cancer survivors in LTFU care. METHODS Semistructured qualitative interviews were conducted with 18 adolescent childhood cancer survivors in LTFU care aged 14-18 years (average age 16.4 years). Interviews were transcribed verbatim and analysed using content analysis. RESULTS Based on the exploratory research questions, two key categories were generated: (1) The impact and burden on survivors' lives during LTFU care and (2) support needs of adolescent childhood cancer survivors in LTFU care. The four subcategories that emerged regarding the impact and burden on survivors' lives during LTFU care were (1) physical consequences, (2) cognitive impairments, (3) difficulties in social interactions, and (4) psychosocial burden. Additionally, two subcategories, (1) practical and (2) emotional support needs of adolescent childhood cancer survivors were identified. CONCLUSIONS Our results indicate that childhood cancer influences adolescent survivors' life in a negative way even many years after the end of treatment. Furthermore, parents seem to play a crucial role in the survivorship experience of childhood cancer survivors, as they remain keep responsible for most cancer-related concerns even during LTFU care, causing adolescents to persist in the child role. A family systemic approach to care is suggested to facilitate development-specific tasks and to enable adolescents to become autonomous adults. Still, the question remains as to who in the health care system could take over the family systemic tasks.
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Affiliation(s)
- Jana Winzig
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Désirée Sigmund
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Verena Paul
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lesley-Ann Hail
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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Snyder S, Milbury K, Wagner R, Cohen L. Words matter: The use of generic "you" in expressive writing in an oncology setting. J Health Psychol 2024; 29:42-51. [PMID: 37358056 DOI: 10.1177/13591053231182218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
The use of generic "you" (GY) in writing samples fosters psychological distancing and functions as a linguistic mechanism to facilitate emotion regulation. This method of creating psychological distance from the traumatic experience of cancer may be used by patients processing emotions. We used behavioral coding to analyze expressive writing samples collected from 138 cancer patients to examine the association between the use of "you" and cancer-related symptoms and psychological outcomes. Occurrences of GY were low, but our qualitative results showed how the use of GY could create a universal experience of cancer. The use of GY was not associated with cancer-related symptoms and depressive symptoms, but longitudinal analyses revealed that those using GY had fewer intrusive thoughts and avoidance behaviors across the follow-up period of 1, 4, and 10 months after the intervention. The development of psychological self-distancing prompts to use in writing interventions or as a clinical tool for cancer patients should be explored.
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Affiliation(s)
- Stella Snyder
- Indiana University-Purdue University Indianapolis, USA
- The University of Texas MD Anderson Cancer Center, USA
| | | | | | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, USA
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Gore C, Lisy K, O'Callaghan C, Wood C, Emery J, Martin A, De Abreu Lourenco R, Schofield P, Jefford M. Colorectal cancer survivors' experiences and views of shared and telehealth models of survivorship care: A qualitative study. Psychooncology 2024; 33:e6265. [PMID: 38072641 DOI: 10.1002/pon.6265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/13/2023] [Accepted: 11/26/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVES The number of colorectal cancer (CRC) survivors is increasing and current models of survivorship care are unsustainable. There is a drive to implement alternative models of care including shared care between general practitioners (GPs) and hospital-based providers. The primary objective of this study was to explore perspectives on facilitators and barriers to shared care. The secondary objective was to explore experiences of telehealth-delivered care. METHOD Qualitative data were collected via semi-structured interviews with participants in the Shared Care for Colorectal Cancer Survivors (SCORE) randomised controlled trial. Interviews explored patient experiences of usual and shared survivorship care during the SCORE trial. In response to the COVID pandemic, participant experiences of telehealth appointments were also explored. Interviews were recorded and transcribed for thematic analysis. RESULTS Twenty survivors of CRC were interviewed with an even number in the shared and usual care arms; 14 (70%) were male. Facilitators to shared care included: good relationships with GPs; convenience of GPs; good communication between providers; desire to reduce public health system pressures. Barriers included: poor communication between clinicians; inaccessibility of GPs; beliefs about GP capacity; and a preference for follow-up care with the hospital after positive treatment experiences. Participants also commonly expressed a preference for telehealth-based follow-up when there was no need for a clinical examination. CONCLUSIONS This is one of few studies that have explored patient experiences with shared and telehealth-based survivorship care. Findings can guide the implementation of these models, particularly around care coordination, communication, preparation, and personalised pathways of care.
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Affiliation(s)
- Claire Gore
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Psychosocial Oncology Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Clare O'Callaghan
- Departments of Psychosocial Cancer Care and Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Colin Wood
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jon Emery
- Centre for Cancer Research and Department of General Practice and Primary Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Martin
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
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Van Hoyweghen S, Bm Claes K, de Putter R, Wakefield C, Van Schoors M, Hellemans S, Verhofstadt L. The psychological impact of genetic testing in childhood cancer: A systematic review. Psychooncology 2024; 33:e6279. [PMID: 38282231 DOI: 10.1002/pon.6279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Cancer predisposition syndromes are being more frequently recognized in the etiology of pediatric oncology and genetic-related technologies are evolving rapidly, leading to an increasing availability of genetic testing for families. This systematic review assessed the psychological impact of genetic testing on children and parents in the context of childhood cancer. METHODS Searches were performed using three databases (Web of Science, Pubmed and Embase) to identify relevant empirical studies. Following Cochrane guidelines, we screened 3838 articles and identified 18 eligible studies, representing the perspectives of children and/or parents. RESULTS The included studies described the impact of genetic testing in different contexts (e.g. predictive testing and diagnostic testing) and in different subgroups, (e.g. carriers and non-carriers). Overall, the studies did not identify clinically-relevant long-term increases in negative emotions (depression, anxiety, distress, uncertainty, guilt) as a result of genetic testing. Negative emotions were typically time-limited and generally occurred in families with particular characteristics (e.g. those with a history of multiple cancer diagnoses, families receiving an unfavorable result for one child and a favorable result in siblings, and those with pre-existing mental health difficulties). Positive emotions (hopefulness, relief and peace of mind) were also reported. Knowing their genetic risk status appeared to help to foster empowerment among families, regardless of the result and any associated emotions. CONCLUSIONS Genetic testing in pediatric oncology does not appear to cause significant additional harm and can lead to positive outcomes. Clinicians need to be especially attentive when counseling families at increased risk of distress.
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Affiliation(s)
- Sophie Van Hoyweghen
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, University of Ghent, Ghent, Belgium
- Cancer Research Institute Ghent CRIG, Ghent, Belgium
| | - Kathleen Bm Claes
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
- Cancer Research Institute Ghent CRIG, Ghent, Belgium
- Center of Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Robin de Putter
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
- Cancer Research Institute Ghent CRIG, Ghent, Belgium
- Center of Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Claire Wakefield
- School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | | | - Sabine Hellemans
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
- Center of Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Lesley Verhofstadt
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, University of Ghent, Ghent, Belgium
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Grassi L, Watson M. Core-curriculum in psycho-oncology: Towards the certification of the psycho-oncologist profession. Psychooncology 2024; 33:e6285. [PMID: 38282216 DOI: 10.1002/pon.6285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
BACKGROUND Issues relating to certification of the Psycho-oncology profession require clarification in order to provide high quality comprehensive psychosocial care within oncology. We conducted a survey identifying existing training, professional registration requirements and accreditation programs, at national levels, for the specialty of psycho-oncology as well as the mandatory presence of this specialist in cancer teams. METHODS This survey was conducted within the International Psycho-Oncology Society Federation of psycho-oncology societies and included representatives of each national federated society and some countries not belonging to the Federation. Survey questions were emailed requesting specific details, from the registered contact person, for each country, about psycho-oncology training, professional registration and accreditation. RESULTS Of 43 countries contacted (34 Federated and 9 non-federated members), 39 replied and answered the questionnaire (90, 7%). Disparities were reported between countries, with details indicating differences from having no national program, to quite detailed and legally accredited requirements. The majority of countries had no formally recognized profession of "Psycho-oncologist," while some countries reported that it is mandatory (or recommended to have) a specialist in psycho-oncology in cancer centers and, thus, that an accredited, nationally recognized and certified training in this specialty exists. CONCLUSIONS The study underlines the need to create a curriculum for the specialty (certification and accreditation) for the profession of psycho-oncology. Given the lack of internationally recognized core standards, ideas and proposals for minimum standards of good care and the training required to deliver this, are explored to clarify who may use the designation "Clinical Psycho-oncologist."
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Affiliation(s)
- Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Section, Integrated Department of Mental Health, S. Anna and Local Health Trust, Ferrara, Italy
| | - Maggie Watson
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Onco-Genetics, Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Research and Innovation, University of Southern Queensland, Toowoomba, Queensland, Australia
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Schuster L, Führes H, Wandke S, Thomas M, Scholl I. Psycho-oncologists' experiences with video consultations during the Covid-19 pandemic and implications for the future-a multi-methods study. Psychooncology 2024; 33:e6257. [PMID: 38078678 DOI: 10.1002/pon.6257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE During the Covid-19 pandemic, there has been a substantial uptake of telemental health interventions. Consequently, the objective of this study was to assess psycho-oncologists' attitudes toward and experiences with video consultations (VC) since the beginning of the Covid-19 pandemic. Additionally, we sought to investigate psycho-oncologists' perspectives on the benefits and drawbacks of VC and its' potential implementation beyond the pandemic. METHODS We used a multi-methods study design. First, semi-structured interviews with psycho-oncologists (N = 6) were conducted to inform the development of a cross-sectional online survey, which represented the quantitative part of our study. We invited psycho-oncologists, working in different settings, from all over Germany to participate. RESULTS Data of N = 217 participants (88% female, 49% over 10 years work experience) of the online survey was analyzed. Psycho-oncologists' acceptance toward VC was average to high. In their daily practice, they preferred in-person consultations. Improved access to care and enhanced flexibility were seen as main advantages. The most significant disadvantages included technical issues, privacy concerns at home, loss of non-verbal cues and absence of physical presence for emotional support. Nevertheless, on average, psycho-oncologists wanted to continue seeing approximately 25% of their patients via VC in the future. CONCLUSIONS Given the average to high acceptance of VC among psycho-oncologists and their desire to continue using VC flexibly even after the pandemic, it may be beneficial to implement VC into future psycho-oncology services. Still, future research should focus on the patients' perspective and the effectiveness of VC in psycho-oncology services.
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Affiliation(s)
- Lara Schuster
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah Führes
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Svenja Wandke
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- II. Department of Medicine (Hematology/Oncology), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mareike Thomas
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Isabelle Scholl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Zeng C, Matias-Gomez L, Kelly M, Hershman DL, Rosenberg S, Pinheiro LC. Psychosocial support among adults living with metastatic breast cancer: Perspectives from providers across four New York-Presbyterian hospitals. Psychooncology 2024; 33:e6296. [PMID: 38282222 DOI: 10.1002/pon.6296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/30/2024]
Abstract
Key Points
We conducted semi‐structured interviews with providers at four New York‐Presbyterian (NYP) hospitals: Weill Cornell Medicine (WCM), NYP‐Queens, NYP‐Brooklyn Methodist Hospital, and Columbia University Medical Center.
Emergent themes identified factors that influenced healthcare delivery at the institutional, provider, and patient levels.
Most frequently reported barriers included a lack of formal protocols for communicating and offering psychosocial resources to patients (institutional), lack of vital staff such as, social workers and patient navigators (institutional), time constraints (provider), and stigma regarding mental health care (patient).
Most frequently cited facilitators to delivering psychosocial care included having a trained social worker on staff (institutional), awareness of psychosocial needs (provider), and engagement (patient).
Our findings highlight opportunities to improve the provision of psychosocial care for adults with metastatic breast cancer (mBC) at multiple levels.
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Affiliation(s)
- Caroline Zeng
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | | | - Mia Kelly
- Cornell University, Ithaca, New York, USA
| | - Dawn L Hershman
- Division of Medical Oncology, Columbia University Medical Center, New York, New York, USA
| | - Shoshana Rosenberg
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Laura C Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
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Chen F, Ou M, Xiao Z, Xu X. Trajectories of fear of cancer recurrence and its influence factors: A longitudinal study on Chinese newly diagnosed cancer patients. Psychooncology 2024; 33:e6271. [PMID: 38282228 DOI: 10.1002/pon.6271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/21/2023] [Accepted: 12/07/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE The fear of cancer recurrence (FCR) is an ongoing and common psychological problem faced by cancer patients. The objective of this study was to explore the variation trend of FCR and its influencing factors in Chinese newly diagnosed cancer patients from admission to 2 months after discharge. Demographic and tumor characteristics, as well as experiential avoidance (EA), were used as predictors. METHOD A longitudinal design and a consecutive sampling method were used to select 266 newly diagnosed cancer patients admitted to a tertiary cancer hospital in China from July to December 2022. Measurements of FCR and EA were obtained at admission (T1), 1 month after discharge (T2), and 2 months post-discharge (T3). Generalized estimating equations were used to identify factors associated with FCR for longitudinal data analysis. RESULTS A total of 266 participants completed the follow-up. Both FCR and EA scores of patients with newly diagnosed cancer showed a significant trend of first increasing and then decreasing at baseline and follow-up (p < 0.001). The junior secondary and less education level, rural residence, advanced tumor and high EA level were risk factors for higher FCR. CONCLUSIONS Our findings suggest that the FCR levels of most newly diagnosed cancer patients in China are different at the three time points and affected by different factors, with the highest level at 1 month after discharge. These results have significant implications for future identifying populations in need of targeted intervention based on their FCR trajectories.
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Affiliation(s)
- Furong Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
- School of Nursing, University of South China, Hengyang, China
| | - Meijun Ou
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
| | - Zhirui Xiao
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
- School of Nursing, University of South China, Hengyang, China
| | - Xianghua Xu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
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Dax V, Ftanou M, Tran B, Lewin J, Wiley JF. Malignancy, masculinities, and psychological distress: Comparisons made between men with testicular cancer and healthy controls. Psychooncology 2024; 33:e6262. [PMID: 38102869 DOI: 10.1002/pon.6262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Psychological distress is common in men with testicular cancer (TC), and masculinities may work to explain this. This study aimed to compare masculinities and distress in TC and healthy control (HC) populations and explore relationships between correlates of distress (psychological flexibility and coping style) and masculinities in TC. METHODS A cross-sectional, online survey was completed by 92 men with TC (Mage = 34.8) and 90 HC (Mage = 30.7). Measures included psychological distress (Patient-Reported Outcomes Measurement Information System Depression/Anxiety, fear of cancer recurrence inventory-short form), masculinities (gender role conflict-short form, inventory of subjective masculinity experiences/subjective masculinity stress scale, masculinity in chronic disease inventory), coping style (mini-mental adjustment to cancer ) and psychological flexibility (comprehensive assessment of acceptance commitment therapy). Linear regressions were conducted to compare groups and analyse associations. RESULTS There were no differences in masculinities or psychological distress between populations (all p > 0.05 and all Cohen's d < 0.20), except for subjective masculine stress and restrictive affectionate behaviour between men. For men with TC, restrictive affection/emotion, conflicts between family/work and subjective masculine stress were associated with psychological distress (rs 0.21-0.58). Optimistic action was negatively associated with depression/anxiety, helplessness/hopelessness coping (rs -0.27 to -0.42) and positively associated with psychological flexibility (r = 0.35). CONCLUSIONS Masculinities are implicated in psychological distress in men with TC. Psychological flexibility as well as leveraging masculine beliefs (e.g., optimistic action) may be modifiable targets to reduce distress in men with TC.
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Affiliation(s)
- Victoria Dax
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Maria Ftanou
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ben Tran
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Division of Personalized Medicine, Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
| | - Jeremy Lewin
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Ontrac at Peter MacCallum Cancer Centre, Victorian Adolescent and Young Adult Cancer Centre, Melbourne, Victoria, Australia
| | - Joshua F Wiley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Howren MB, Seaman A, Super GL, Christensen AJ, Pagedar NA. Examination of Predictors of Pain at 12 Months Postdiagnosis in Head and Neck Cancer Survivors. Otolaryngol Head Neck Surg 2023; 169:1506-1512. [PMID: 37403789 PMCID: PMC10766866 DOI: 10.1002/ohn.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/02/2023] [Accepted: 06/17/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVE Pain following the completion of treatment is important but has received less attention in the head and neck cancer (HNC) literature. The present study sought to examine the prevalence and predictors of pain measured 12 months postdiagnosis and its impact on HNC-specific health-related quality of life (HRQOL) in 1038 HNC survivors. STUDY DESIGN Prospective observational study. SETTING Single-institution tertiary care center. METHODS Pain was measured using a single item ranging from 0 to 10 with 0 representing no pain and 10 representing the worst pain possible. Self-reported depressive symptomatology was measured using the Beck Depression Inventory and self-reported problem alcohol use was measured by the Short Michigan Alcoholism Screening Test. HNC-specific HRQOL was measured using the Head and Neck Cancer Inventory (HNCI). RESULTS Hierarchical multivariable linear regression analyses indicated that in addition to pain at 3 months postdiagnosis (β = .145, t = 3.18, sr2 = .019, p = .002), both depressive symptomatology (β = .110, t = 2.49, sr2 = .011, p = .015) and problem alcohol use (β = .092, t = 2.07, sr2 = .008, p = .039) were significant predictors of pain at 12 months postdiagnosis. Subgroup analyses suggest that across all 4 HNCI domains, those in the moderate and severe pain groups at 12 months postdiagnosis failed to reach 70 which is indicative of high functioning. CONCLUSION Pain in patients with HNC is a considerable issue at 12 months postdiagnosis, deserving further attention. Behavioral factors such as depression and problem alcohol use may be associated with pain and require systematic screening over time to identify and treat issues that impact optimal long-term recovery from HNC, including disease-specific HRQOL.
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Affiliation(s)
- M. Bryant Howren
- Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University; Tallahassee, FL
- Florida Blue Center for Rural Health Research & Policy, College of Medicine, Florida State University; Tallahassee, FL
| | - Aaron Seaman
- Center for Access Delivery Research & Evaluation (CADRE), VA Iowa City Healthcare System; Iowa City, IA
- Department of Internal Medicine, The University of Iowa; Iowa City, IA
| | - Grace L. Super
- College of Medicine, Florida State University; Tallahassee, FL
| | | | - Nitin A. Pagedar
- Department of Otolaryngology—Head and Neck Surgery, Carver College of Medicine, The University of Iowa; Iowa City, IA
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Neylon K, Condren C, Guerin S, Looney K. What Are the Psychosocial Needs of Adolescents and Young Adults with Cancer? A Systematic Review of the Literature. J Adolesc Young Adult Oncol 2023; 12:799-820. [PMID: 37130327 DOI: 10.1089/jayao.2022.0130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Adolescents and young adults with cancer (AYACs) have become recognized as a unique group in recent years. The unique developmental context and related challenges of being a young person with a cancer diagnosis can lead to a distinct and diverse set of psychosocial issues. Existing research has attempted to explore these psychosocial needs and challenges and to develop appropriate and individualized interventions. However, the needs of this group remain unmet, with ongoing calls for individualized support. This systematic review addressed the research question, "what are the psychosocial needs of AYACs aged 15-24 years?." PubMed, PsycINFO, and CINAHL databases were searched to identify relevant studies from January 2000 to December 2022 (inclusive). Qualitative, quantitative, and mixed methods designs were included and 29 studies met inclusion criteria. Findings provide an overview of needs from the existing literature and support the idea of a changing constellation of psychosocial needs for AYACs in areas such as identity, relationships, mental health, autonomy, and occupation. The main implications for theory and future research include the importance of the developmental context and consideration of discrepancies in the age range used within the literature to define this group.
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Affiliation(s)
- Karen Neylon
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Caoimhe Condren
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Kathy Looney
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
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Grassi L, Zachariae R, Caruso R, Palagini L, Campos-Ródenas R, Riba MB, Lloyd-Williams M, Kissane D, Rodin G, McFarland D, Ripamonti CI, Santini D. Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline. ESMO Open 2023; 8:102047. [PMID: 38158225 PMCID: PMC10774975 DOI: 10.1016/j.esmoop.2023.102047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 01/03/2024] Open
Abstract
•Insomnia is common in patients with cancer, with a higher prevalence than observed in the general population. •Insomnia is often under-recognised and inadequately treated in patients with cancer. •Brief validated screening tools are available for the evaluation of insomnia in clinical practice. •First-line therapy should be based on international guidelines recommending cognitive behavioural therapy for insomnia.
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Affiliation(s)
- L Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - R Zachariae
- Unit for Psychooncology and Health Psychology (EPoS), Department of Oncology, Aarhus University Hospital, Aarhus; Danish Center for Breast Cancer Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark
| | - R Caruso
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - L Palagini
- Sleep Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - R Campos-Ródenas
- Department of Psychiatry, Hospital Clínico Universitario Lozano Blesa, University of Zaragoza, Zaragoza, Spain
| | - M B Riba
- Department of Psychiatry, University of Michigan, Ann Arbor; University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, USA
| | - M Lloyd-Williams
- Academic Palliative and Supportive Care Studies Group (APSCSG), Primary Care and Mental Health, University of Liverpool, Liverpool; Department of Supportive and Palliative Care, Liverpool John Moores University, Liverpool, UK
| | - D Kissane
- Department of Psychiatry, Monash University and Monash Medical Centre, Monash Health, Clayton, Australia
| | - G Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - D McFarland
- Department of Psychiatry, University of Rochester, Rochester; Wilmont Cancer Institute, University of Rochester Medical Center, Rochester, USA
| | - C I Ripamonti
- School of Speciality in Palliative Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - D Santini
- Medical Oncology A, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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Liu J, He S, Butow P, Shaw J, McHardy CJ, Harris G, Serafimovska A, Butt Z, Beith J. A novel clinician-delivered intervention to reduce fear of recurrence in breast cancer survivors: Results from a Phase I/II implementation study (CIFeR_2). Psychooncology 2023; 32:1930-1938. [PMID: 37955600 DOI: 10.1002/pon.6249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is highly prevalent, however there is no formal training for clinicians to address FCR. A novel brief clinician intervention to help patients manage FCR (Clinician Intervention to Reduce Fear of Recurrence (CIFeR)) was shown to be feasible, acceptable, and reduced FCR in breast cancer patients in a pilot study. We now aim to explore the barriers and facilitators of implementing CIFeR within routine oncology practice in Australia. METHODS This multicentre, single-arm Phase I/II implementation study recruited surgical, medical and radiation oncologists who treat women with early breast cancer. Participating clinicians completed online CIFeR training and were asked to use CIFeR for the next 6 months. Questionnaires were administered before (T0), immediately after (T1), then 3 (T2) and 6 months (T3) after training to assess confidence in addressing FCR and Proctor Implementation outcomes. The primary outcome was adoption at T2. Secondary outcomes were self-efficacy in FCR management, acceptability, feasibility, costs, barriers and facilitators of implementation. RESULTS Fifty-two clinicians consented of whom 37 completed the CIFeR intervention training. Median age of participants was 41.5 (range 29-61), 73% were female and 51% were medical oncologists. The primary endpoint was met, with CIFeR adopted by 82%. Clinician intervention delivery took 7.4 min on average and was deemed acceptable, appropriate and feasible. Self-efficacy in managing FCR improved significantly across all domains (p < 0.001). Lack of time was the greatest barrier to routine CIFeR_2 implementation. CONCLUSIONS A structured brief, low-cost clinician intervention to reduce FCR is useful, acceptable and improved self-efficacy with FCR management. Fear of cancer recurrence training should be incorporated into communication skills training of oncologists and surgeons. TRIAL REGISTRATION Prospectively registered with the Australian New Zealand Clinical Trials Registry, ACTRN12621001697875. TRIAL SPONSOR Chris O'Brien Lifehouse.
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Affiliation(s)
- Jia Liu
- The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, New South Wales, Australia
- The University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, New South Wales, Australia
- St Vincent's Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - Sharon He
- The University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, New South Wales, Australia
- The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Phyllis Butow
- The University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, New South Wales, Australia
| | - Joanne Shaw
- The University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, New South Wales, Australia
| | | | - Georgia Harris
- The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | | | - Zoe Butt
- The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Jane Beith
- The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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Luigjes-Huizer YL, Helsper CW, de Wit NJ, van der Lee ML. Effectiveness of a guided online primary care intervention for fear of cancer recurrence: A randomised controlled trial. Psychooncology 2023; 32:1839-1847. [PMID: 37850876 DOI: 10.1002/pon.6231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/05/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Fear of Cancer Recurrence (FCR) is highly prevalent among cancer survivors and leads to decreased quality of life and increased healthcare costs. We assessed the effectiveness of a guided online primary care intervention for FCR, compared to waiting list. METHODS In this RCT, participants were recruited online and randomised 1:1. All adults who finished successful curative cancer treatment between 3 months and 10 years ago, wanted support for FCR, and had sufficient Dutch skills were eligible. The intervention consisted of a 10-week online programme and three to five video calling sessions with a trained mental health worker. After 6 months, the control group received the same intervention. The primary outcome was the difference between the groups in the change in FCR severity from baseline (T0) to 6 months (T2), measured online with the short form of the Fear of Cancer Recurrence Inventory. RESULTS One hundred and seventy-three participants were enroled and randomised to the intervention (n = 86) or control group (n = 87). FCR severity dropped 2.1 points more in the intervention group than in the control group (2.7 points (SD = 3.9) versus 0.6 points (SD = 3.6), t(154) = 3.4, p = 0.0007). General mental well-being also improved significantly in the intervention group and remained stable in the control group. These improvements remained at 10 months follow up. CONCLUSIONS This easily accessible and relatively inexpensive intervention effectively reduces FCR and has potential to replace or precede existing more intensive psychological treatments, improving patients' access to care. TRIAL REGISTRATION The trial was prospectively registered in the Netherlands Trial Register on 25-02-2019 with number NL7573.
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Affiliation(s)
- Yvonne L Luigjes-Huizer
- Helen Dowling Institute, Bilthoven, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Charles W Helsper
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Niek J de Wit
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marije L van der Lee
- Helen Dowling Institute, Bilthoven, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Franzoi IG, Granieri A, Sauta MD, Agnesone M, Gonella M, Grimaldi C, Vallauri I, Boglione A, Vana F, Bergnolo P, Comandone A. The psychological impact of sarcoma on affected patients. Psychooncology 2023; 32:1787-1797. [PMID: 37930090 DOI: 10.1002/pon.6240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Sarcoma diagnosis and its treatment trajectory may deeply affect the somatopsychic balance of patients and their caregivers. This systematic review aimed at deepening the understanding of sarcoma's impact on the entire family unit involved in the illness experience on a physical (e.g. fatigue), psychological (e.g. mental health, affective regulation, defense mechanisms), and interpersonal (e.g. social isolation, loneliness) level. METHODS The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification and subsequent inclusion of 44 articles focused on sarcoma patients. Results were classified into seven categories: Quality of Life, worries and distress, anxiety and depression, suicide ideation, financial and occupational consequences, unmet needs, and coping strategies. Our search identified only one study focusing on informal caregivers, thus we could not perform a systematic review on these results. RESULTS Our findings underlined the traumatic impact of the sarcoma diagnosis. Patients can experience an impoverished emotional life, somatization, social withdrawal, difficulty in decision-making, increased feelings of discouragement and demoralization, and profound experiences of helplessness and vulnerability. Moreover, they seemed to display anxiety and depression and might present a higher suicide incidence than the general population. CONCLUSION Our review highlighted that the psychosocial aftermath of sarcoma patients should guide institutions and healthcare professionals toward the design of assessment and intervention models that could contemplate the different dimensions of their suffering. Furthermore, it points out that there is still a lack of evidence regarding the psychosocial impact affecting sarcoma patients' caregivers.
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Affiliation(s)
| | | | | | - Monica Agnesone
- S.S Psychology, Local Health Authority "Città di Torino", Turin, Italy
| | - Marco Gonella
- Department of Psychology, University of Turin, Turin, Italy
- S.S Psychology, Local Health Authority "Città di Torino", Turin, Italy
| | | | - Irene Vallauri
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Federica Vana
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
| | - Paola Bergnolo
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
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Bach Y, Panov E, Espin‐Garcia O, Chen E, Krzyzanowska M, O'Kane G, Moore M, Prince RM, Knox J, Grant R, Ma LX, Allen MJ, Eng L, Kosyachkova E, Megid TBC, Barron C, Wang X, Saltiel M, Farooq ARR, Jang RW, Elimova E. First impressions: A prospective evaluation of patient-physician concordance and satisfaction following the initial medical oncology consultation. Cancer Med 2023; 12:22293-22303. [PMID: 38063318 PMCID: PMC10757128 DOI: 10.1002/cam4.6758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/14/2023] [Accepted: 09/30/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND An especially significant event in the patient-oncologist relationship is the initial consultation, where many complex topics-diagnosis, treatment intent, and often, prognosis-are discussed in a relatively short period of time. This study aimed to measure patients' understanding of the information discussed during their first medical oncology visit and their satisfaction with the communication from medical oncologists. METHODS Between January and August 2021, patients without prior systemic treatment of their gastrointestinal malignancy (GI) attending the Princess Margaret Cancer Centre (PMCC) were approached within 24 h of their initial consultation to complete a paper-based questionnaire assessing understanding of their disease (diagnosis, treatment plan/intent, and prognosis) and satisfaction with the consultation. Medical oncology physicians simultaneously completed a similar questionnaire about the information discussed at the initial visit. Matched patient-physician responses were compared to assess the degree of concordance. RESULTS A total of 184 matched patient-physician surveys were completed. The concordance rates for understanding of diagnosis, treatment plan, treatment intent, and prognosis were 92.9%, 59.2%, 66.8%, and 59.8%, respectively. After adjusting for patient and physician variables, patients who reported treatment intent to be unclear at the time of the consultation were independently associated with lower satisfaction scores (global p = 0.014). There was no statistically significant association between patient satisfaction and whether prognosis was disclosed (p = 0.08). CONCLUSION An in-depth conversation as to what treatment intent and prognosis means is reasonable during the initial medical oncology consultation to ensure patients and caregivers have a better understanding about their cancer.
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Affiliation(s)
- Yvonne Bach
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | - Elan Panov
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | - Eric Chen
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | | | | | | | | | - Robert Grant
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | - Lucy X. Ma
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | - Lawson Eng
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | | | - Carly Barron
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | - Xin Wang
- Princess Margaret Cancer CentreTorontoOntarioCanada
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Ham L, Fransen HP, Raijmakers NJH, van den Beuken-van Everdingen MHJ, van den Borne B, Creemers GJ, de Graeff A, Hendriks MP, de Jong WK, van Laarhoven H, van Leeuwen L, van der Padt-Pruijsten A, Smilde TJ, Stellingwerf M, van Zuylen L, van de Poll-Franse LV. Trajectories of emotional functioning and experienced care of relatives in the last year of life of patients with advanced cancer: A longitudinal analysis of the eQuiPe study. Psychooncology 2023; 32:1858-1866. [PMID: 37882097 DOI: 10.1002/pon.6233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/30/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE Advanced cancer has a major impact on both patients and their relatives. To allow for personalized support, it is important to recognize which relatives will experience a decline in emotional functioning during the patient's last year of life, when this decline will occur, and what factors are associated with it. This study aimed to examine the trajectory of emotional functioning of relatives during that time and the characteristics associated with changes in this trajectory. METHODS A prospective, longitudinal, multicenter, observational study in patients with advanced cancer and their relatives was conducted (eQuiPe). We analyzed relatives' changes in emotional functioning in the patient's last year using the EORTC QLQ-C30 and assessed associations with sociodemographic and care characteristics using multivariable mixed-effects analysis. RESULTS 409 relatives completed ≥1 questionnaires during the patient's last year of life. Mean age was 64 years, 61% were female and 75% were the patient's partner. During this year, mean emotional functioning declined significantly over time from 73.9 to 64.6 (p = 0.023, effect size = 0.43). The type of relationship between relatives and patients (p = 0.002), patient' sleep problems (p = 0.033), and continuity of care (p = 0.002) were significantly associated with changes in emotional functioning. CONCLUSIONS Relatives' emotional functioning declined during the patient's last year of life. Support for them, especially partners and relatives of patients with sleep problems, is important. Relatives who experienced more continuity of care had a less steep decline in emotional functioning.
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Affiliation(s)
- Laurien Ham
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Heidi P Fransen
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Natasja J H Raijmakers
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Marieke H J van den Beuken-van Everdingen
- Centre of Expertise for Palliative Care, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
- Department of Anesthesiology and Pain Management, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
| | - Ben van den Borne
- Department of Pulmonology, Catharina Hospital, Eindhoven, The Netherlands
| | - Geert Jan Creemers
- Department of Medical Oncology, Catharina Hospital, Eindhoven, The Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, The Netherlands
| | - Wouter K de Jong
- Department of Pulmonology, Hospital Gelderse Vallei, Ede, The Netherlands
| | - Hanneke van Laarhoven
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Lobke van Leeuwen
- Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands
| | | | - Tineke J Smilde
- Department of Internal Medicine, Jeroen Bosch Hospital, Den Bosch, The Netherlands
| | - Margriet Stellingwerf
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lia van Zuylen
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Medical Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Center for Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Zomerdijk N, Jongenelis MI, Collins B, Short CE, Huntley K, Smith A, Turner J. The lived experiences of hematology healthcare providers during and beyond the COVID-19 crisis: A qualitative study. Psychooncology 2023; 32:1939-1947. [PMID: 37950341 DOI: 10.1002/pon.6250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/16/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Amid the COVID-19 pandemic, healthcare providers (HCPs) of hematology patients face unique challenges due to the vulnerability of their patients. This study explores the lived experiences of these providers during and beyond the crisis. METHODS Twenty-one Australian HCPs caring for hematology patients completed semi-structured interviews exploring their experiences and needs during the COVID-19 pandemic, adequacy of support and information provided by healthcare organizations, impact on hematology patients, and the benefits and challenges of telehealth care. Data were analyzed using reflexive thematic analysis. RESULTS Four themes were identified: (1) Managing an initial state of flux (unsettling uncertainty and fear, unique needs of hematology patients, getting on with the job together); (2) Concerns about care provision (questioning care efficacy, burden of compassion); (3) Disconnect between HCP needs and system-level responses (burnout, isolation, and poor work-life balance, broadcast fatigue, protecting mental health), and; (4) Reflecting on the future (ongoing challenges for hematology patients, higher staff turnover and heavier workloads, innovation in the healthcare field). CONCLUSION This study sheds light on the challenges that hematology HCPs face during and beyond the COVID-19 crisis, impacting their wellbeing. Addressing these challenges is paramount for the healthcare system at large. Provider-led peer support programs may be beneficial for addressing moral distress and building resilience. Additionally, specific consideration for the ongoing vulnerability of hematology patients could have positive impacts on providers' professional satisfaction.
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Affiliation(s)
- Nienke Zomerdijk
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle I Jongenelis
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Melbourne Centre for Behaviour Change, University of Melbourne, Melbourne, Victoria, Australia
| | - Ben Collins
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Camille E Short
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Melbourne Centre for Behaviour Change, University of Melbourne, Melbourne, Victoria, Australia
- School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Andrew Smith
- Leukaemia Foundation, Brisbane, Queensland, Australia
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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Taylor J, Fradgley EA, Clinton‐McHarg T, Hall A, Paul CL. Perceived importance of emotional support provided by health care professionals and social networks: Should we broaden our focus for the delivery of supportive care? Asia Pac J Clin Oncol 2023; 19:681-689. [PMID: 36698247 PMCID: PMC10947305 DOI: 10.1111/ajco.13922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 12/08/2022] [Accepted: 12/26/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Emotional support provided by health care professionals (HCPs) for people diagnosed with cancer is associated with improved outcomes. Support via social networks may also be important. AIMS To report among a sample of distressed patients and caregivers, (1) the importance attributed to different sources of emotional support (HCPs and social networks) by distressed cancer patients and caregivers; (2) the proportion who indicate they did not receive sufficient levels of emotional support; and (3) potential associations between respondents' demographic and clinical characteristics and reported lack of emotional support. METHODS This study utilised cross-sectional data from telephone interviews collected during the usual-care phase of the Structured Triage and Referral by Telephone (START) trial. Participants completed a telephone interview 6 months after their initial call to the Cancer Council Information and Support service and included recall of importance and sufficiency of emotional support. RESULTS More than two-thirds of patients (n = 234) and caregivers (n = 152) reported that family and friends were very important sources of emotional support. Nurses (69% and 42%) and doctors (68% and 47%) were reported very important, while a lower proportion reported that psychologists and psychiatrists were very important (39%, and 43%). Insufficient levels of support were reported by 36% of participants. Perceptions of insufficient support were significantly associated with distress levels (p < .0001) and not having a partner (p = .0115). CONCLUSION Social networks, particularly family, are an important source of emotional support. Higher levels of distress, those without partners, and caregivers may require targeted interventions to increase their access to emotional support.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
| | - Elizabeth A. Fradgley
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
- Cancer Institute New South WalesCancer Institute New South Wales, EveleighSydneyAustralia
| | - Tara Clinton‐McHarg
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- School of PsychologyUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Alix Hall
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
- Hunter New England Population HealthHunter New England Area Health ServiceNewcastleNew South WalesAustralia
| | - Christine L. Paul
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
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Tsiouris A, Mayer A, Wiltink J, Ruckes C, Beutel ME, Zwerenz R. Recruitment of Patients With Cancer for a Clinical Trial Evaluating a Web-Based Psycho-Oncological Intervention: Secondary Analysis of a Diversified Recruitment Strategy in a Randomized Controlled Trial. JMIR Cancer 2023; 9:e42123. [PMID: 38010774 DOI: 10.2196/42123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/17/2022] [Accepted: 08/29/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Participant recruitment poses challenges in psycho-oncological intervention research, such as psycho-oncological web-based intervention studies. Strict consecutive recruitment in clinical settings provides important methodological benefits but is often associated with low response rates and reduced practicability and ecological validity. In addition to preexisting recruitment barriers, the protective measures owing to the COVID-19 pandemic restricted recruitment activities in the clinical setting since March 2020. OBJECTIVE This study aims to outline the recruitment strategy for a randomized controlled trial evaluating the unguided emotion-based psycho-oncological online self-help (epos), which combined traditional and web-based recruitment. METHODS We developed a combined recruitment strategy including traditional (eg, recruitment in clinics, medical practices, cancer counseling centers, and newspapers) and web-based recruitment (Instagram, Facebook, and web pages). Recruitment was conducted between May 2020 and September 2021. Eligible participants for this study were adult patients with any type of cancer who were currently receiving treatment or in posttreatment care. They were also required to have a good command of the German language and access to a device suitable for web-based interventions, such as a laptop or computer. RESULTS We analyzed data from 304 participants who were enrolled in a 17-month recruitment period using various recruitment strategies. Web-based and traditional recruitment strategies led to comparable numbers of participants (151/304, 49.7% vs 153/304, 50.3%). However, web-based recruitment required much less effort. Regardless of the recruitment strategy, the total sample did not accurately represent patients with cancer currently undergoing treatment for major types of cancer in terms of various sociodemographic characteristics, including but not limited to sex and age. However, among the web-recruited study participants, the proportion of female participants was even higher (P<.001), the mean age was lower (P=.005), private internet use was higher (on weekdays: P=.007; on weekends: P=.02), and the number of those who were currently under treatment was higher (P=.048). Other demographic and medical characteristics revealed no significant differences between the groups. The majority of participants registered as self-referred (236/296, 79.7%) instead of having followed the recommendation of or study invitation from a health care professional. CONCLUSIONS The combined recruitment strategy helped overcome general and COVID-19-specific recruitment barriers and provided the targeted participant number. Social media recruitment was the most efficient individual recruitment strategy for participant enrollment. Differences in some demographic and medical characteristics emerged, which should be considered in future analyses. Implications and recommendations for social media recruitment based on personal experiences are presented. TRIAL REGISTRATION German Clinical Trials Register DRKS00021144; https://drks.de/search/en/trial/DRKS00021144. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.invent.2021.100410.
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Affiliation(s)
- Angeliki Tsiouris
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Anna Mayer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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