Psycho‐Oncology最新文献

Background: Sexual dysfunction is a well-documented long-term side effect of pediatric cancer treatment, which significantly impacts the overall health of childhood cancer survivors (CCSs). There is a relative lack of qualitative research on sexual dysfunction among CCSs.

Aim: This study aimed to explore sexual experience, psychological factors, and typical response strategies among CCSs with sexual dysfunction in China.

Methods: A qualitative descriptive study employing semi-structured interviews was conducted. Based on purposive sampling and data saturation principles, CCSs with sexual dysfunction from the previous cross-sectional study were selected for semi-structured interviews. Data relevant to the research question was analyzed and coded using thematic analysis.

Results: 15 female and 15 male survivors provided written-informed consent and were interviewed in this study. Four core themes were identified, including: common sexual problems, psychological factors associated with sexual dysfunction and their related pathways, and coping strategies for sexual and psychological challenges. These themes were further categorized into 15 sub-themes.

Clinical implications: The findings of this study are expected for health professionals to develop a culturally specific intervention to improve the sexual function in childhood cancer survivors. Strengths & Limitations: To our knowledge, this qualitative study is the first to provide in-depth exploration on the sexual experience, how the identified psychological factors led to sexual dysfunction, and the coping strategies for sexual dysfunction in Chinese childhood cancer survivors. However, the findings may not be fully generalizable to older cancer survivors, and conducting interviews online may have influenced the richness of the data collected.

Conclusions: The present findings contribute to our understanding of sexual experience, psychological factors, and coping strategies to sexual problems among CCSs. The findings indicate that psychology is a significant factor for CCSs with sexual dysfunction and identify the mediating role of attention and self-compassion. Future research should develop an appropriate intervention based on the underlying psychological mechanisms of sexual dysfunction to improve the overall sexual function in CCSs.

Objective: To examine how dyadic patient- and partner-related risk and protective factors are interconnected with caregiver burden among partners of patients with advanced cancer using a network approach.

Methods: We conducted network and shortest-path analyses using cross-sectional baseline data from the eQuiPe study, including 564 patient-partner caregiver couples. The network included patient- and partner-reported physical, emotional, and sleep problems, social and partner support, continuity of care, and caregiver burden.

Results: Shortest-path analysis identified patient-perceived continuity of care as the only patient-related protective factor directly connected to lower caregiver burden. Patients' physical problems were indirectly linked to caregiver burden via emotional problems of both patients and partners.

Conclusions: Continuity of care and the interdependence between patient and partner emotional problems appeared to be important dyadic protective and risk factors of partners' caregiver burden. Improving continuity of palliative care and offering dyadic interventions targeting emotional functioning of both partners may help reduce caregiver burden. To further improve our understanding of caregiver burden and its dyadic factors, future studies should apply intensive longitudinal designs to explore how these components interact over time.

Objective: Rumination is a common cognitive response in cancer patients, influencing psychological adjustment. This study examined the associations between intrusive and deliberate rumination and self-compassion in individuals undergoing cancer treatment, using structural equation modeling (SEM).

Methods: A cross-sectional correlational study was conducted with 202 adult cancer patients undergoing active treatment at a public hospital. Participants completed validated self-report instruments: the Event-Related Rumination Inventory and the Brief Self-Compassion Inventory. Data were analyzed using descriptive statistics, Pearson correlation, and SEM.

Results: The SEM results indicated that intrusive rumination was significantly and negatively associated with self-compassion (β = -0.828, p < 0.001), whereas deliberate rumination showed a significant positive association with self-compassion (β = 0.753, p < 0.001). The model explained 60.3% of the variance in self-compassion. Subgroup analyses showed that self-compassion and deliberate rumination were higher among participants with higher education and those who were employed, while intrusive rumination was higher in patients with prior metastasis or relapse.

Conclusions: The findings underscore the need to distinguish between adaptive and maladaptive forms of rumination in cancer care. Targeting intrusive rumination and supporting deliberate reflection may represent important considerations for psychosocial care.

Objective: To test a moderated mediation model linking physical activity (PA) to health-related quality of life (HRQoL) via symptom burden, with hope as a moderator, in lung cancer patients.

Methods: A cross-sectional study of 203 adults with stage III-IV lung cancer (205 enrolled, 2 excluded due to incomplete data) from a Chinese hospital analyzed PA (IPAQ-LF), symptom burden (MDASI-C), hope (HHI), and HRQoL (SF-8). Covariates were identified via univariable screening (p < 0.05). Spearman correlations, hierarchical regression, and PROCESS (Model 7; 5000 bootstraps) tested the moderated mediation model, with simple-slope probing at hope ± 1 SD.

Results: PA correlated with higher HRQoL (ρ = 0.53) and lower symptom burden (ρ = -0.48), while symptom burden negatively predicted HRQoL (ρ = -0.71) and hope positively predicted HRQoL (ρ = 0.59) and lower symptom burden (ρ = -0.56). Hierarchical models explained 57.7% of HRQoL variance, with PA (0.132), symptom burden (0.231), and hope (0.046) as key predictors. The PA-by-hope interaction was significant (B = 0.018, p = 0.008), with stronger PA effects on reduced symptom burden at low hope (B = -0.270, p < 0.001). The moderated mediation index was -0.017 (95% CI -0.032 to -0.003).

Conclusions: PA improves HRQoL via reduced symptom burden, with this effect stronger at lower hope levels. Enhancing hope in interventions may maximize HRQoL benefits.

Background: Adult cancer survivors are likely to be hospitalised with chronic illnesses, although evidence for childhood and AYA survivors is limited.

Aim: This study quantified hospitalisations and the costs of health services used by survivors of childhood, adolescent, and young adult (AYA) cancers with and without chronic conditions.

Methods: We assessed long-term survivors (≥ 5 years past diagnosis) of childhood and AYA cancers diagnosed at ages 0-39 years between 1997 and 2011 in Queensland, Australia. Utilising a linked administrative dataset, we determined the prevalence of chronic conditions from hospital records using classification codes (ICD-10-AM) and quantified hospitalisations and associated costs in 2024 Australian dollars (AU$). Generalised linear regression modelling was used to examine how chronic conditions affected healthcare costs, controlling for clinical and socio-demographic factors.

Results: Of 14,422 participants, 16% (n = 2286) were hospitalised with at least one chronic disease, with hypertension (n = 675, 4.7%) and depression (n = 463, 3.2%) being the most common. Inpatient admissions were significantly higher for survivors with chronic conditions (mean 3, SD = 10) compared to those without chronic conditions (mean 1, SD = 4). The mean annual costs were highest for those with chronic kidney disease (AU$26,428, SD = AU$30,331), schizophrenia (AU$22,835, SD = AU$37,204), epilepsy (AU$22,361, SD = AU$37,224), paralysis (AU$22,051, SD = AU$32,165) and chronic heart failure (AU$21,912 SD = AU$38,763). Hypertension (AU$5.4 million) and depression (AU$4.3 million) incurred the highest total costs over the follow-up period.

Conclusion: Implementing targeted survivorship care and preventative measures for high-cost conditions such as schizophrenia and chronic kidney disease may optimise healthcare resource use and reduce the economic burden for this population.

Background: Young adult survivors of childhood brain tumors (YAS) are at risk for limited health-related quality of life (HRQOL) and extended dependence on their maternal caregivers during the transition to adulthood. A problem-solving intervention was adapted to address challenges to family management, self-management, and HRQOL.

Aims: To evaluate the acceptability, feasibility, and preliminary efficacy of a problem-solving intervention (TIPS; Training in Problem-solving) for condition-focused maternal caregivers of YAS.

Methods: Maternal caregivers who screened positive for condition-focused family management were randomized to TIPS (n = 26) or Enhanced Usual Care (EUC; n = 27) and completed measures of problem-solving, family management, YAS self-management, and caregiver and YAS HRQOL at baseline and post-intervention (T3)Acceptability and feasibility data were collected at T3 and described.

Results: Both TIPS and EUC had moderate to high acceptability ratings with higher ratings for TIPS utility in meeting family needs. Feasibility, as measured by retention (70% for TIPS) and limited, minor technical glitches, was supported. Session length was a notable exception for feasibility. The largest between-group differences were observed in condition management ability, favoring TIPS (d = -0.85), and condition management effort, favoring TIPS (d = 0.58). Smaller, yet notable, between group differences were identified for YAS self-management (d = 0.44), YAS HRQOL (d = -0.40), and Parent Mutuality (d = -0.32) in the hypothesized direction except for YAS self-management.

Conclusions: TIPS was highly acceptable and moderately feasible. EUC was also acceptable, but the TIPS group demonstrated improved family management and YAS HRQOL highlighting the role of active intervention for caregivers of YAS.

Clinical trials registration: NCI Clinical Trials Reporting Program (NCI-2019-05353).

Background: Global analyses of hematologic malignancies often lack subtype integration and advanced forecasting, limiting public health planning.

Methods: Using GBD 2021 data (1990-2021), we analyzed age-standardized incidence (ASIR), mortality (ASDR), and disability-adjusted life years (DALYs) for leukemia, lymphoma, and multiple myeloma. Spatiotemporal models quantified age-, sex-, and Socio-demographic Index (SDI)-stratified disparities. The Prophet model forecasted trends to 2031.

Results: In 2021, global ASIRs were 5.63, 7.93, and 1.74 per 100,000 for leukemia, lymphoma, and multiple myeloma, respectively. ASIR correlated positively with SDI for all subtypes (e.g., multiple myeloma: ρ = 0.81, p < 0.001). Mortality patterns were heterogeneous; Hodgkin lymphoma ASDR correlated negatively with SDI (ρ = -0.26, p < 0.001). Projections suggest stable or declining ASDRs by 2031 (e.g., leukemia: 3.86 to 3.40) but persistent male predominance. DALYs remain high in low-SDI regions.

Discussion: The disparity between high incidence in high-SDI areas and higher mortality fractions in low-SDI areas underscores diagnostic and therapeutic inequities. DALYs reflect associated long-term functional and psychosocial burden.

Conclusion: This study reveals profound global inequalities in hematologic malignancies. Mitigating this burden requires strengthening early diagnosis and treatment in low-SDI regions while integrating psychosocial support into global survivorship care.

Background: Major abdominal cancer surgery can significantly affect patients' psychosocial wellbeing, including anxiety, depression, sleep quality, and self-perceived health. Support from family caregivers during hospitalization may influence these outcomes.

Aim: This study evaluates the psychosocial outcomes of a Family Involvement Program (FIP) for patients undergoing major abdominal cancer surgery.

Methods: A secondary analysis was conducted using data from a patient-preferred prospective cohort study. Patients who participated in the FIP alongside a family caregiver were compared to those who received usual care. The following psychosocial outcomes were assessed and analyzed using linear mixed-effects models with stepwise backward selection: sleep quality, anxiety and depression (HADS), self-perceived health (EQ-VAS) and health related quality of life (EQ-5D-5L) index score. Satisfaction with care was analyzed using linear regression. Fidelity metrics included completion rates of fundamental and optional care activities and the number of caregivers staying overnight.

Results: Patients in the FIP group reported significant higher sleep quality and significantly higher satisfaction with healthcare than those receiving usual care. No significant differences were found in anxiety, depression, or self-perceived health between groups. Engagement in fundamental and optional care activities by family caregivers varied across activities and postoperative days, with 80%-90% of caregivers staying overnight.

Conclusion: Family caregiver involvement during hospital admission for major abdominal cancer surgery improved sleep quality and satisfaction with care. Participation in the FIP did not significantly affect patients' anxiety, depression, or self-perceived health. These findings suggest that family involvement programs may enhance the patients' psychosocial wellbeing during cancer recovery.