Journal of Cancer Survivorship最新文献

Purpose: Female breast cancer survivors (BCS) experience different paths to healing after the conclusion of primary treatment. This study sought to describe the experiences of female BCS in the months and years after primary treatment by determining how and when healing happens, as well as what healing means to BCS.

Methods: A qualitative approach was used through thematic analysis of data collected through questionnaires and semi-structured interviews from 17 female BCS.

Results: Data analysis identified four major themes: (i) the process of finishing treatment and continuity of care, (ii) support systems for BCS, (iii) self-efficacy and personal accountability, and (iv) the social transition after cancer.

Conclusions: Factors that affect the healing of BCS can be conceptualized as external or personal. Participants found that barriers to healing created by external factors were addressed by improved coordination of care and high-involvement transition programs as opposed to conversational support groups. Barriers created by personal factors were mitigated through organically formed support systems and promotion of self-efficacy and resilience. Participants expressed a desire for a shift in mainstream discourse to better reflect their experiences. Each BCS conceptualized survivorship differently, with some seeing a clear end to healing, and others who viewed it as a lifelong process.

Implications for cancer survivors: Understanding the many paths to healing taken by BCS after concluding primary treatment, as well as common barriers to and catalysts for healing, can aid providers in addressing patient needs based on their individual experiences.

Purpose: Explore the potential utility of a Cooperative Extension-specific program to support post-active treatment cancer survivors.

Methods: A user-centered study was conducted to identify barriers to and facilitators of the implementation of a program for adult cancer survivors living post primary cancer treatment ("cancer survivors") via Cooperative Extension ("Extension"), including interviews analyzed using the Consolidated Framework for Implementation Research. Participants included Cooperative Extension Educators and adult cancer survivors in Oklahoma who completed data collection from July 2023 to September 2023.

Results: N = 20 participants were enrolled. Cancer survivors indicated poor familiarity with Extension, or a primary association with agriculture. Some voiced surprise Extension was not already providing cancer-related programming. Many expressed poor support in their communities due to issues secondary to rurality, often relying on non-cancer programs. Educators voiced a strong capability to deliver cancer-related programming if intentionally designed, with many already providing education on relevant topics (e.g., finances, nutrition, physical activity). A salient barrier was poor connectivity with the healthcare system.

Conclusions: There is an immense need for improved survivorship care in underserved communities due to poor social connectedness, support structures, and poor mental health. Cooperative Extension is well-poised to deliver cancer survivorship-specific programming.

Implications for cancer survivors: Cooperative Extension provides an extensive network of professionals who can provide support to cancer survivors, particularly those post-active treatment.

Purpose: To (i) assess how and to what extent online communities are used among breast cancer survivors (BCS) as a source of social support, (ii) describe the kind of support BCS access through online communities, and (iii) explore how these communities foster social support for BCS that promotes well-being and reduces the challenges of survivorship.

Methods: We conducted a scoping review. A professional librarian performed a comprehensive search in multiple databases from January 2010 to May 2023. The review process adhered to the Johana Briggs Institute's method guidelines and the PRISMA-ScR reporting system.

Results: Fifteen studies were included. Participants used social media, cancer support communities, message boards, or websites for information and emotional support. Qualitative findings resulted in four themes: to reassure; to empower; to promote equity, diversity, and inclusion; and to demonstrate for BCS the drawbacks of online support.

Conclusions: We underscore that a variety of internet websites and social media platforms are valuable for and appreciated by BCS, especially as a source of social support and human connectedness. Our study raises the existing gap in cultural/ethnic representation in this field and shows that institutional and organizational efforts are needed to address gaps in information regarding access to social support for multiethnic BCS women.

Implications for cancer survivors: This data synthesis will empower the BCS community by sharing how they can strengthen and support their peers and community via their participation in online communities that connect and support cancer survivors in healthcare spaces.

Purpose: Lesbian, gay, bisexual, trans, queer, and intersex (LGBTQI) people face unique challenges in cancer care. This mixed methods study examined LGBTQI patients' satisfaction with cancer care and factors associated with satisfaction, including experiences of LGBTQI disclosure. The study also explored what helps to facilitate safe disclosure and improve satisfaction with care for this population.

Methods: We used a mixed methods approach, involving 430 surveys and 104 semi-structured interviews with LGBTQI people with cancer (16-92 years) with various cancer types, sexuality and gender identities, ages, and people with intersex variations.

Results: Most participants reported being satisfied with their cancer care (n = 300, 76.3%) and had disclosed their LGBTQI sexuality or gender identity or intersex variations to at least some of their cancer healthcare professionals (HCPs) (n = 357, 87.1%). Satisfaction with care was higher with more disclosure to HCPs, HCP acknowledgment of partner/s and support people, and the ability to find LGBTQI specific information about cancer; it was lower with reports of discrimination in cancer care. Qualitative analysis identified that some participants were always out to HCPs, but others felt burdened with the responsibility and emotion work of disclosure and feared negative responses. Same-gender intimate partners facilitated disclosure and need to be respected within cancer care.

Conclusions: HCPs need to take the lead in facilitating LGBTQI disclosure in cancer care. Targeted interventions and training for HCPs, including reception and administration staff, are crucial to ensure equitable, affirming cancer care for all LGBTQI patients, ultimately leading to improved satisfaction with cancer care.

Implications for cancer survivors: Creating safe and inclusive environments for LGBTQI cancer patients is essential to encourage disclosure and improve satisfaction with cancer care.

Purpose: Many cancer treatments can lead to a disrupted body image and identity. One intervention to address these outcomes is therapeutic tattooing. However, despite the wide dissemination of this practice for cancer survivors (CSs), current research on it is lacking. This study aimed to identify tattoo artists' (TAs') perspectives on the types, impacts, barriers, and facilitators of therapeutic tattooing for CSs and the impact of doing this work on themselves.

Methods: Twenty-two international TAs who tattoo CSs were interviewed and resultant transcripts were analyzed thematically.

Results: The following themes emerged: Emotional Management of Artists, Emotional Transformation of CSs, Stigma and its effects on CSs, Artist Barriers, CS Barriers, Artist Facilitators, and CS Facilitators. The findings also identify a typology of cancer survivorship therapeutic tattoos.

Conclusion: This is the first study to identify barriers/facilitators of therapeutic tattooing, a typology of cancer survivorship therapeutic tattoos, TAs' perspectives on therapeutic tattooing, and potential negative outcomes from this practice. The findings indicate that therapeutic tattooing can be both beneficial and harmful for CSs and TAs, that there is a need for better therapeutic tattooing training for TAs and healthcare providers (HPs), increased awareness of therapeutic tattoos, and a reduction in barriers to the practice and greater collaboration between HPs and TAs.

Implications for cancer survivors: Findings from this study have major policy implications for healthcare systems, non-profit organizations, and regulatory bodies, which could serve to empower cancer survivors to make more informed decisions about their bodies and support enhanced training and accreditation of this practice.

Purpose: Financial toxicity, the subjective distress caused by objective financial burden, significantly impacts cancer survivors. Yet, enduring effects on survivors remain unclear. Therefore, we investigated the experienced objective financial burden and subjective financial distress in long-term cancer survivors.

Methods: A cross-sectional nationwide online survey of adult cancer survivors ≥ 5y after diagnosis were analyzed. Objective financial burden was measured via extra expenses and income loss, while subjective financial distress covered psychological well-being, coping and support-seeking behavior, and financial concerns. Groups were compared (i.e., having cancer vs. former patients) by t-tests and chi-squared tests. Financial toxicity was visualized with Sankey plots and sunburst diagrams.

Results: 4,675 respondents completed the survey, of whom 2,391 (51%) were ≥ 5y after their cancer diagnosis. Among them, 75% experienced income loss and/or extra expenses after diagnosis. One-third of the previously employed respondents relied on work disability benefits. Further, 'being unable to make ends meet' increased from 2% before diagnosis to 13% ≥ 5y after diagnosis (p < .001). Additionally, 58% reported negative psychological impacts of financial toxicity, and 47% worried about their financial future.

Conclusions: Cancer survivors often face income loss and additional expenses, leading to ongoing financial difficulties that affect their psychological well-being. Despite this significant impact, there is a lack of guidance and support to help them manage these financial challenges. These findings highlight the need for healthcare professionals to recognize and address the financial challenges.

Implications for cancer survivors: This study underscores the widespread financial challenges cancer survivors encounter, emphasizing the need for ongoing financial support and comprehensive assessments of their physical and psychological well-being.

Purpose: Perceived cancer impact (PCI) is the degree to which one feels cancer has impacted one's life. It is unknown if PCI is associated with health behaviors. The aim of this study is to determine associations between PCI and health behaviors in childhood cancer survivors.

Methods: Participants were ≥ 5-year survivors enrolled in the St. Jude Lifetime (SJLIFE) cohort. The Brief Cancer Impact (BCIA) assessed PCI across four domains (caregiving/finances, diet/exercise, social/emotional functioning, religiosity). Responses were categorized as negative, neutral, or positive impact. Smoking, risky drinking, illicit drug use, and diet quality data were obtained via self-report. Physical activity (PA) was assessed via self-report and actigraphy. Cross-sectional and longitudinal associations between PCI and health behaviors were evaluated via multivariable logistic regression.

Results: A total of 3623 participants (mean age 30.4 ± 8.3 years, 49.6% female, 81.5% NH White) were included in baseline cross-sectional analysis; 1709 had a second visit 5.0 ± 1.4 years later and were included in longitudinal analysis. At baseline, the percentage of participants who endorsed cancer as having a negative impact on caregiving/finances was 37.5%, diet/exercise 30.5%, social/emotional functioning 40.6%, and religiosity 8.7%. Negative and neutral PCI across all four domains were cross-sectionally associated with all behaviors except illicit drug use. Negative and neutral PCI at the first time point across all four domains were associated with smoking, diet quality, and PA (ORs ranging from 1.35 to 2.41) in longitudinal analyses.

Conclusions: Endorsing negative or neutral PCI is associated with adverse health behaviors.

Implications for cancer survivors: Promoting optimal health behavior should include addressing PCI.

Background: The increasing population of cancer survivors poses a significant challenge for healthcare systems globally, necessitating comprehensive post-treatment care to address diverse physical, psychological, and social needs.

Objective: This systematic review aims to synthesize and critically evaluate the current evidence concerning the unmet needs for nursing services among cancer survivors, spanning various dimensions of survivorship care.

Methods: A systematic search was conducted across major databases, including PubMed, CINAHL, and PsycINFO, to identify relevant studies investigating the unmet needs and health-related quality-of-life (HRQOL) of nursing services led by nurses among cancer survivors. The final search update was conducted in June 2024. Unmet needs dimensions were categorized by the biopsychosocial-spiritual framework.

Results: Of the 9503 records searched, 18 studies were included. This review revealed mixed findings in the domains of unmet needs and interventions aimed at addressing them. While nurse-led interventions showed promise in addressing physical and daily living needs, outcomes related to psychological and emotional needs varied across studies. Additionally, nurse-led interventions were effective in addressing patient-clinician communication and health system/information needs, although statistical significance was not consistently observed. HRQOL assessments using general and cancer-specific measures yielded mixed findings.

Conclusions: Despite limitations of the risk of bias of included studies and weak study designs for evaluating nurse-led intervention effects for cancer survivors, the findings highlight the potential of nursing practice to significantly contribute to improving unmet needs of physical, psychological, and social perspectives and ultimately improving their HRQOL. However, the impact on the spiritual needs of nursing care services is limited by the low number of studies.

Implications for cancer survivors: By providing comprehensive support and management, nursing practice can enhance post-treatment outcomes and HRQOL for cancer survivors, contributing to more patient-centered and effective care delivery. More rigorous research considering a biopsychosocial-spiritual perspective to help cancer survivors improve HRQOL is needed.

Purpose: Anxiety is one of the most common psychological issues among colorectal cancer (CRC) survivors. It can interact with physical symptoms, impacting cancer progression, survival, and quality of life. This scoping review aims to explore the factors associated with anxiety in patients with CRC and the instruments used to measure anxiety.

Methods: Using Arksey and O'Malley's (2005) framework for the scoping review, studies investigating anxiety in CRC patients published in CINAHL, PubMed, PsycINFO, and Scopus between 2013 and 2024 were included.

Results: We analyzed fifty-one studies for this review. The review identified several risk factors and consequences of anxiety in CRC patients. The risk factors were classified into six domains using Niedzwiedz et al.'s (2019) framework: individual characteristics, social/ contextual factors, prior psychological factors, psychological responses to diagnosis and treatment, characteristics of cancer, and treatment. The consequences of anxiety were classified into three categories: global health status/quality of life, functions, and symptoms/problems. The most frequently used tool was the Hospital Anxiety and Depression Scale, with International Classification of Diseases codes being the second most used.

Conclusions: This scoping review highlighted the intricate interaction between biological and psychosocial aspects in the lives of CRC survivors. It also identified unique factors associated with anxiety among these individuals. However, the review found some inconsistencies in the results related to anxiety-related factors, potentially due to differences in study populations, designs, measurement tools, and analysis methods.

Implications for cancer survivors: This review underscores the potential for interventions targeting modifiable factors to prevent or reduce anxiety and enhance the quality of life for CRC survivors.

Background/objectives: Young adult (YA) cancer survivors, aged 18 to 39, face unique physical, emotional, and social challenges during critical developmental milestones. While nature-based engagement has potential as an intervention for these challenges, a research gap exists regarding the lived experiences of this population in nature-based engagement. The aim of this study was to describe YA cancer survivors' experiences engaging with nature before and after a cancer diagnosis.

Methods: A qualitative study was conducted with 15 YA cancer survivors recruited via social media and survivor groups. Data were collected through individual, one-on-one semi-structured interviews via Zoom, audio-recorded and transcribed. Data were analyzed iteratively using a general inductive approach and managed in NVivo to identify emergent themes.

Results: Participants were predominantly female, white, and diagnosed with breast cancer (mean age at diagnosis = 30.5 years). Identity, Reconstruction, and Healing emerged as the overarching central theme. Four main themes were as follows: (1) nature as a sanctuary for therapeutic and spiritual reflection, (2) transformation of the survivor's relationship with nature, (3) the role of nature in reclaiming agency, and (4) barriers to being in nature during illness.

Conclusions: Findings support nature's vital role as a restorative resource for emotional and physical recovery for YA cancer survivors. Results support further research into modalities of nature-based interventions that promote their social interaction and reduce barriers to engagement, including virtual reality-based nature interventions.

Implications for cancer survivors: Nature offers opportunity for YA cancer survivors to reconcile their pre- and post-diagnosis identities and help improve their well-being and quality of life.