Psycho‐Oncology最新文献

Background: Compared with the general population, Black African and Black Caribbean women, living in the UK, are less likely to participate in breast cancer screening.

Aims: The aims of this review were to: (1) systematically describe the barriers to breast cancer screening, experienced by women of Black African and Black Caribbean descent, living in the UK and (2) identify which barriers interventions attempting to reduce inequalities have targeted, and whether they have been effective at increasing participation in breast cancer screening, among women of Black African and Black Caribbean descent.

Methods: We conducted a mixed-methods systematic review of primary research published in peer-reviewed journals. Seven databases were searched, yielding eight articles for inclusion in the review.

Results: Barriers to breast cancer screening participation were categorised into six analytical themes: 'Understanding of, and concerns about, breast screening, the procedure and the reliability of test results', 'Misconceptions about, and lack of understanding of, the causes of breast cancer and personal risk', 'Emotional responses to cancer and screening', 'General barriers to accessing healthcare services (including breast screening)', 'Beliefs about cancer as a treatable disease' and 'Religious beliefs, cultural taboos and stigma'. These findings derive largely from studies with women who were not eligible for screening. Four studies testing interventions to promote uptake among ethnic minority groups were identified. None of them targeted Black African or Black Caribbean women, specifically; however, it was possible to extract data, for these groups, from the studies.

Conclusion: Further research with women who are eligible for screening (but do not attend) is needed to verify the findings of this review. Studies targeting barriers experienced by Black women, particularly, are needed to reduce inequalities.

Background: Young adult survivors of childhood cancer exhibit rates of frailty similar to adults several decades older without a cancer history. Frailty has been associated with sleep disturbances in non-cancer populations, but the relationship has not been examined in childhood cancer survivors who are known to exhibit elevated rates of sleep problems.

Aims: Examine associations between frailty and poor sleep quality in long-term survivors of childhood cancer.

Methods: This study utilized data from 9044 participants (> 5 years from diagnosis, M_age = 40.8 years [SD = 9.5]) in the Childhood Cancer Survivor Study. Survivors' frailty status, chronic health conditions (CHC), health behaviors, mental health, and pain were collected in 2014-2016, and self-reported sleep quality in 2017-2019. Multivariable logistic regression models examined frailty status as a predictor of clinically significant poor sleep. All models were adjusted for age at diagnosis, age at survey, sex, race/ethnicity, smoking, risky/heavy alcohol use, and physical inactivity. Separate models included treatment-related variables, CHC burden (number/severity), and emotional health/pain as co-variates.

Results: Frail survivors had 6-fold (95% CI 4.48-7.96) increased odds of future poor sleep quality. Little attenuation of this association was observed when accounting for cancer diagnosis (Odds Ratio [OR] 5.80, 95% CI 4.47-7.52), treatment exposures (OR 5.80, 95% CI 4.43-7.71), or chronic health condition burden (OR 5.12, 95% CI 3.98-6.59), but adjustment for emotional health/pain (OR 2.88, 95% CI 2.18-3.82) attenuated the association appreciably.

Conclusions: Frail childhood cancer survivors have a higher prevalence of clinically significant poor sleep quality. Addressing poor physiologic reserve may impact sleep in frail childhood cancer survivors.

Objective: To describe trajectories of change in unmet supportive care needs over a two-year period among people diagnosed with cancer and assess whether these trajectories vary as a function of sociodemographic and clinical characteristics.

Methods: This analysis used data from a longitudinal study of people in Queensland, Australia who travelled largely from regional and remote areas to metropolitan centres to receive cancer care (N = 784). Supportive care needs were measured at baseline, then at 3-, 12-, and 24-month post-baseline across five domains ('psychological', 'physical and daily living', 'health systems and information', 'patient care and support', 'sexuality') using the Supportive Care Needs Survey-Short Form. Latent Curve Growth Analysis was performed to examine trajectories of change in unmet needs and assess whether these trajectories were influenced by participant characteristics.

Results: Significant linear slopes indicated a modest decrease in unmet supportive care needs for all domains, except sexuality. For most domains, significant variance in intercepts but not slopes indicated individual differences in needs at baseline but not in trajectories over time. At baseline, the proportion of unmet needs was highest for the 'physical and daily living' (M = 44.2%, SD = 39.1%) and 'psychological' domains (M = 37.8%, SD = 36.3%). Unmet needs at baseline were consistently higher among participants who were younger, had a higher education level, and who reported poorer QoL.

Conclusions: The proportion of unmet supportive care needs reported by people living with cancer may decrease over time, largely irrespective of sociodemographic and clinical characteristics. Despite this, unmet needs remain prevalent, particularly for physical and psychological support.

Objectives: Fear of cancer recurrence (FCR) is a prevalent unmet need for people affected by cancer, in the context of limited healthcare resources. Stratified-care models have potential to meet this need, while reducing resource demands. This study aimed to evaluate the feasibility and acceptability of screening procedures and interventions within the Fear-Less stratified-care model among those impacted by early-stage cancer.

Methods: People affected by breast, head and neck, or gynaecological cancer, who had completed curative treatment, were screened for FCR. Individuals experiencing moderate FCR (scored 13-21 on the Fear of Cancer Recurrence Inventory-Short Form; FCRI-SF) were offered a purpose-developed clinician-guided self-management intervention, while those experiencing severe FCR (FCRI-SF score ≥ 22) were offered individual therapy (ConquerFear). Re-screening and evaluation measures were completed post-intervention.

Results: Seventy-six (70%) of 109 eligible people completed screening, with 53/76 participating in the Fear-Less model evaluation. Thirty-nine of 53 participants reported FCR and were referred to an intervention; 30/39 (77%) accepted the referral. Fifteen (83%) of 18 participants completing the self-management intervention reported reading ≥ 75% of the resource at 5 weeks, with 10/18 (56%) reporting clinically meaningful (≥ 10%) reductions on the FCRI-SF post-intervention. Qualitative feedback indicated screening and the stratified-care received were acceptable.

Conclusions: Screening procedures and interventions forming the Fear-Less model appear feasible and acceptable for identifying and treating FCR among people affected by early-stage cancer. Although further research is required to evaluate its efficacy, this model has the potential to meet a major unmet need, where psychosocial services are limited amid increased demand.

Trial registration: This study was retrospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622000818730) on 10/6/2022.

Background: Cancer patients are at risk of post-traumatic stress disorder (PTSD) throughout their treatment journey due to serious challenges (e.g., complex surgical interventions, severe pain, and side effects from chemotherapy or radiation therapy). This may worsen patients' health and negatively impact their overall treatment journey and well-being. However, this area remains understudied in Algeria. Therefore, there is a need to understand the levels of PTSD symptoms and the associated factors among Algerian patients. To ensure accurate assessment and diagnosis, a validation study was conducted to confirm that the PTSD measurement instrument used was culturally appropriate for the Algerian context. The study's main objectives were to (i) determine the prevalence of PTSD among cancer patients in Algeria, (ii) validate the Arabic DSM-5 PTSD Checklist (PCL-5) among Algerian cancer patients, and (iii) explore the associations between demographic and clinical factors and PTSD among this population.

Methods: The present study was cross-sectional and comprised 370 cancer patients. All participants were patients receiving treatment in oncology wards across various hospitals. All participants completed the PCL-5. Confirmatory factor analysis (CFA) was used to examine the factor structure of the PCL-5.

Results: The PCL-5 was found to have a four-factor structure. Out of the 370 participants, 154 (41.6%) had PCL-5 scores below the cutoff of 31, indicating lower levels of PTSD symptoms; 216 participants (58.4%) had scores above this threshold, suggesting a likelihood of PTSD. Moreover, PTSD was significantly associated with patients' low educational attainment and more advanced stages of their disease.

Conclusions: The findings indicated moderate to high PTSD symptoms among cancer patients in Algeria. Moreover, the Arabic PCL-5 demonstrated good psychometric properties confirming that it is a reliable and valid tool for assessing PTSD symptoms among Algerian cancer patients.

Objective: Fear of cancer recurrence (FCR) is common, persistent, and associated with lower quality of life, impaired functioning, and psychological distress in family caregivers (FC) of individuals with a cancer diagnosis. Interventions are needed to specifically target FCR in FC. This study aimed to pilot test the adapted Family Caregiver-Fear Of Recurrence Therapy (FC-FORT) to establish its feasibility, acceptability, and clinical significance.

Methods: This pilot study used a mixed-method, parallel, two-group randomized control trial (FC-FORT vs. waitlist control group) design. Women FC were recruited through Canadian hospitals, community partners, and social media. FC in the intervention group completed 7 weekly sessions of virtual group therapy (FC-FORT) and an exit interview. All participants completed questionnaires at baseline, post-intervention, and 3-month follow-up. Feasibility (e.g., recruitment, allocation, fidelity), acceptability (e.g., dropout, completion, satisfaction) and clinical significance of secondary outcomes were evaluated. Descriptive statistics, mixed ANOVAs, and conventional content analyses were used.

Results: Regarding feasibility, 22 FC were recruited, 18 were randomized and therapist fidelity was 87%. As to acceptability, 67% of participants completed $\ge$ 5 sessions (33% dropout). Questionnaire completion rate was 92%. FC satisfaction was 80%. Analyses did not reveal any significant differences on the secondary outcomes between groups. Qualitative analyses revealed high importance, helpfulness, satisfaction, and group cohesion. Suggestions were made by FC for improvements.

Conclusions: This is one of the first interventions to address FCR in FC. While acceptability of FC-FORT was good, important feasibility issues need to be addressed before moving forward with a larger randomized control trial.

Trial registration: NCT, NCT05441384. Registered July 1st, 2022, https://classic.

Clinicaltrials: gov/ct2/show/NCT05441384.

Background: Cancer survivors who disclose their cancer diagnosis and cancer-related experiences derive a variety of benefits including enhanced quality of life. Given this, it would be helpful to better understand the factors that facilitate disclosure among survivors. Disclosure efficacy-confidence that one can successfully execute a self-disclosure-may play a key role.

Aims: In Study 1, survey data were analyzed to identify potential predictors of disclosure efficacy among cancer survivors and whether disclosure efficacy predicts intention to self-disclose in the future. In Study 2, a randomized, controlled design was used to evaluate whether psychoeducation about self-disclosure boosts disclosure efficacy.

Methods: Data were analyzed from 181 cancer survivors who participated in a cross-sectional, online survey study (Study 1) and randomized controlled test of disclosure-related psychoeducational material (Study 2).

Results: The results from Study 1 indicated that, as hypothesized, having engaged in more cancer-related disclosure in the past predicted higher levels of disclosure efficacy (though response to prior disclosures did not) and greater disclosure efficacy predicted greater intention to disclose again in the future. The results from Study 2 did not demonstrate that reading psychoeducational information on self-disclosure enhanced disclosure efficacy. However, exploratory analyses indicated that those receiving this information reported greater intention to engage in three of the four recommended, empirically based disclosure strategies.

Conclusions: Findings underscore the role of disclosure efficacy in facilitating cancer-related disclosure among cancer survivors. Likewise, findings suggest the utility of developing interventions that enhance disclosure efficacy and provide opportunities for behavioral rehearsal of cancer-related disclosures.

Objective: Patients with relapsed or refractory (r/r) indolent non-Hodgkin lymphoma (iNHL) live with incurable disease for a long-term, experiencing multiple relapses and treatments that impair their health-related quality of life (HRQOL). We aimed to better understand the unmet needs and HRQOL of patients with r/r iNHL.

Methods: This convergent mixed-methods study evaluated patients with r/r iNHL who received treatment. Unmet needs and HRQOL were assessed quantitatively using self-administered questionnaires and analyzed statistically. Qualitative data were collected through face-to-face semi-structured interviews for reflexive thematic analysis. Quantitative and qualitative findings were integrated through narrative discussion and joint display.

Results: Questionnaire respondents (50 participants, mean age: 72.42 years) reported unmet needs in the health system and information and psychological domains and a negative association between unmet needs and HRQOL. Interviews (20 participants, mean age: 72.75 years) identified four themes: "unremarkable symptoms," "anxiety of progression in the near future," "make the best of life," and "means to live with uncertainty." Integration revealed that participants accepted their low HRQOL and attempted to make the best of life, influencing their perception of unmet needs.

Conclusions: Throughout the long course of r/r and repeated treatment, patients with iNHL accepted their low HRQOL, valued their current situations, and endeavored to make the best of life. In this situation, support in the psychological and health system and information domains is crucial. Support for the unmet needs of patients with r/r iNHL is essential as they strive to live their best lives while maintaining a favorable HRQOL.

Objective: Peers play a crucial role in supporting wellbeing and psychosocial development for young people aged 12-25. However, a cancer experience often leads to challenges maintaining friendships. There have been no prior attempts to map or synthesise available research or resources on support specifically from friends for young people with cancer, limiting the capacity to draw conclusions or determine next steps for how to best support young people with cancer. This review aims to address this gap by mapping and synthesising the available literature and resources.

Methods: Included studies were required to obtain data from young people with a history of cancer or their friends, and have a main aim or outcome related to relationships between young people with cancer and their friends. Five databases (Medline, Web of Science, Embase, ProQuest and PsycInfo) were searched, and grey literature were sourced using three search engines (Brave Browser, DuckDuckGo, and Google).

Results: A total of 52 studies and 10 resources met inclusion criteria. Three main themes were identified within the literature (valued friendship dimensions and actions, cancer-related challenges to friendships, and changes to social needs, experiences, and outcomes). Resources for friends included education about what young people with cancer may experience, advice on supporting or talking to their friend, and encouragement for self-care.

Conclusions: Reviewed studies highlight the importance of friends support for young people with cancer, and the challenges faced. We present a future research agenda to address identified gaps, including the absence of studies exploring the perspectives and needs of friends.

Objective: As survival rates from breast cancer increase, the post-treatment period poses several challenges, including a high burden of cancer-related symptoms that interfere with quality of life. This study aims to provide a better understanding of the relationship between coping (approach and avoidance), emotional processing (emotional awareness and acceptance of emotions), and cancer-related symptoms.

Methods: This is a cross-sectional, secondary analysis of baseline data from a randomized controlled trial entitled "The Role of Emotional Processing in Art Therapy" (REPAT) study. Participants included 179 breast cancer survivors 6.1 months on average after completing primary treatment. Participants completed questionnaires measuring approach and avoidance coping, acceptance of emotions, cancer-related symptoms (depression, fatigue, and pain), and the Level of Emotional Awareness a performance scale. Hierarchical linear regressions were performed while adjusting for background variables.

Results: Participants experienced significant depressive symptoms (51.7%), fatigue (78.8%), pain interference (78%), and pain intensity (66%). There were strong correlations between depression, cancer-related fatigue, and pain. After adjusting for confounders, acceptance of emotions was negatively associated with depression, and avoidance coping was positively associated with depression, cancer-related fatigue, and pain interference. Emotional awareness and approach coping were not associated with cancer-related symptoms, but both were significantly associated with acceptance of emotions.

Conclusions: Breast cancer survivors' post-treatment period presents the challenge of dealing with elevated cancer-related symptoms. Regardless, breast cancer survivors with high acceptance of emotions and low avoidance coping experienced fewer cancer-related symptoms.