Psycho‐Oncology最新文献

Objective: Cancer patients who receive the information that they need may experience better quality of life and emotional wellbeing, and be more equipped to engage in shared decision-making. Our review explores the information needs of haematological malignancy patients specifically, and their experience of the information process.

Methods: Integrative review with data extraction and narrative synthesis (PROSPERO#: CRD42024543507). We searched PubMed, Web of Science, COCHRANE, CINAHL and APA PsycINFO for articles published before 21 May 2024. Two reviewers extracted the data; a third resolved disagreements. Quality was appraised using the Mixed Methods Appraisal Tool.

Results: Our search yielded 920 articles; 60 met the inclusion criteria. We identified three categories: Type of Information: Medical and Psychosocial Information Needs; Patient Information Experience; and Information Needs of Specific Populations. Information needs varied across patient groups and along the cancer pathway. The most common information needs were related to treatment (options and side effects) and disease (evolution and prognosis). Patients who receive clear, tailored information from healthcare professionals may be better able to engage in treatment decision-making. Information preferences varied, as did patient satisfaction and the emotional impact of the information they received.

Conclusion: Haematological malignancies are heterogeneous diseases, which further complicates the provision of information to patients. The information patients receive must be tailored to their specific disease and stage. Patient satisfaction with the information they receive varies, suggesting that the method and manner of communication is just as important as the content of the information itself.

Objective: Glioma patients often face a poor prognosis and frequently experience neurological impairments. This places caregivers under significant caregiving burden. This review aims to explore the role transition experiences in family caregivers of glioma patients and clarify their support needs.

Methods: We conducted a meta-synthesis that included studies on role transition experiences in family caregivers of glioma patients. PubMed, Embase, CINAHL, Scopus, Web of Science, Cochrane Library, PsycINFO, China Knowledge Resource Integrated Database, Wanfang Database, Weipu Database, and Chinese Biomedical were searched from the inception of the database to 25 February 2025. The JBI Qualitative Research Assessment Tool was used to assess the quality of the studies, and data synthesis was performed using the Thomas and Harden method of thematic and content analysis.

Results: A total of 14 qualitative studies were included. Four themes and 10 sub-themes were identified: (1) challenges at the diagnostic stage (sudden psychological shock and inadequate preparation for the caregiver role), (2) constant stress during the care process (dynamic management of disease, physical and mental burnout, and decision-making dilemma), (3) requirements for the supporting system (information requirement, emotional support requirement, and palliative care requirement), and (4) role growth (role adaptation and keep hope alive).

Conclusions: We explained the challenges caregivers face in initial stage of patients' glioma diagnosis, the ongoing stress and needs during the caregiving process, and how they eventually grow into their new role. Healthcare professionals should consider the role transition characteristics of caregivers and provide targeted skills training and psychological support to help them adapt successfully to their new role.

Background: Young and middle-aged cancer patients often face unique challenges, which may trigger their reflection and inquiry into the meaning in life. Patients from different cultural backgrounds and life stages may have varied experiences and perceptions of meaning in life, making it necessary to explore this further.

Aims: This study aimed to explore their experiences and perceptions of meaning in life among young and middle-aged cancer patients, providing a foundation for developing targeted interventions.

Methods: A descriptive phenomenological study was conducted through semi-structured interviews with young and middle-aged cancer patients aged 20 to 49 between June and September 2023. Data were analyzed using the Colaizzi method.

Results: Interviews were conducted with 23 young and middle-aged cancer patients, and four themes were identified: the foundation of meaning in life: shaped by era, education, and environment; the ebb and flow of meaning in life: revealed amid crisis, stress, and emotional fluctuations; the reconstruction of meaning in life: assimilation and accommodation triggered by emotional burden; and the growth of meaning in life: through active engagement with life.

Conclusions: Young and middle-aged cancer patients experience meaning in life as fluid and complex. Despite experiencing confusion and distress, patients can reconstruct their meaning system through assimilation and accommodation, and perceive the meaning in life in multiple ways through engagement with life. It is essential for healthcare providers and researchers to offer timely meaning-centered support.

Background: Little data exists on critical relationships for caregivers of patients with brain tumors, or how their social context impacts caregiver well-being.

Aims: Our goal was to describe and categorize the critical relationships reported by caregivers of patients with brain tumors, and to assess the association of categories of critical social relationships with caregiver reports of anxiety, depression, and burden.

Methods: We analyzed baseline self-report data collected from neuro-oncology caregivers enrolled in a supportive care trial. Data included demographics, presence of critical relationships-a confidante or person contributing stress, anxiety, depression, and burden. Critical relationships categories were operationalized as: positive (confidant, no stressful person), negative (no confidant, stressful person), neutral (no confidant nor stressful person), and ambivalent (confidant and stressful person). Descriptive statistics were calculated. One-way ANOVAs assessed differences between relationship category groups on caregiver reports of anxiety, depression, and burden.

Results: Data from 119 caregivers were analyzed. Caregivers had a mean age of 57 years (SD = 15), were mostly non-Hispanic White (92%), female (70%), spouses (52%) of patients with grade 4 tumors (69%). Most caregivers were categorized as having positive (53%) or ambivalent (30%) critical relationships. Significant differences between relationship categories were seen in anxiety, depression, and burden (ps < 0.01).

Conclusions: Although most caregivers of people with brain tumors have confidants, many also identify people who contribute stress. The presence of stressful individuals can negatively impact caregiver well-being in a way that is not counterbalanced by the co-presence of a confidant. Future work should focus on helping caregivers manage stressful relationships.

Study registration: The study was pre-registered at ClinicalTrials.gov: NCT04268979.

Analytic plan pre-registration: The analysis plan for this manuscript was not formally pre-registered.

Background: U.S. health surveillance data suggests that alcohol consumption is similar among cancer survivors and those without a cancer history. However, comparisons of the correlates of alcohol consumption between cancer survivors and those without a cancer history are lacking.

Aims: The purpose of this study was to examine correlates of alcohol use, particularly cancer-related beliefs, and if correlates differed by cancer history.

Methods: Merged data from the Health Information National Trends Survey (HINTS) 5, cycles 2-4 and HINTS 6 were analyzed to estimate patterns of current drinking among US adults with and without a cancer history. Multivariable logistic regression models examined associations among cancer history, cancer-related beliefs, and drinking. Stratified models by cancer history were also examined.

Results: Cancer history was not associated with current drinking in adjusted models (aOR: 0.97, 95% CI: 0.82-1.15, p = 0.742). After adjusting for demographic, behavioral, socio-economic, and health factors, cancer-related beliefs were not associated with current drinking. Correlates of drinking differed between adults with and without a cancer history. For example, among those without a cancer history, Black compared to White adults had lower odds of current drinking (OR: 0.80, 95% CI: 0.67-0.96, p = 0.017); among cancer survivors, no association was found.

Conclusions: Alcohol use is similar among adults regardless of cancer history; yet the correlates of alcohol use differed by cancer history. A better understanding of the determinants of alcohol use among cancer survivors is needed to inform tailored alcohol reduction interventions.

Objective: The increasing number of young adult (YA) cancer survivors underscores the need for psychosocial interventions, which have been limited in scalability and their focus on mental health symptoms. We tested "Achieving Wellness After Reaching the End-of-treatment" (AWARE), an 8-week digital, coach-assisted intervention to promote hope and quality of life (QOL) in YA survivors.

Methods: A 2-arm RCT compared AWARE versus attention control (AC) among 155 YA survivors (ages 18-39; M_age = 32.89, 87.7% female, 8.4% Hispanic, 22.6% racial minority) within 3 years post-treatment, all recruited online. We assessed feasibility, acceptability, and preliminary efficacy on hope and QOL at baseline, end-of-treatment (EOT), and 16-week follow-up (FU).

Results: Both conditions showed high retention at EOT (94.2%; AWARE: 94.9% vs. AC: 93.5%) and FU (94.8%; AWARE: 96.2% vs. AC: 93.5%) and session completion (≥ 75%). AWARE (vs. AC) participants reported greater program recommendation (90.5% vs. 83.3%), satisfaction (M = 4.16 vs. M = 3.68), and helpfulness of the educational recordings/transcripts (M = 4.07 vs. M = 3.69), reflections (M = 4.18 vs. M = 3.39), and coaching (M = 4.15 vs. M = 3.46, p's < 0.05). AWARE participants provided positive comments about program concepts/components and suggested more application opportunities including on key issues (e.g., guilt, anger, communication). Multivariable regression showed no associations between condition and hope or QOL; however, AWARE (vs. AC) showed greater effects on those with lower baseline hope, and bivariates showed AWARE's unique effects on hope's pathways and certain QOL dimensions at FU.

Conclusions: Feedback on AWARE was positive; yet, intervention revisions or greater focus on those with lower hope may enhance AWARE's utility in promoting hope or QOL.

Trial registration: NCT05905250.

Study objective: Patients with cancer living in regions of war face significant quality of life (QoL)-related concerns, both cancer- and war-related. This study examined the correlation between narratives of patients referred to an integrative oncology (IO) program in northern Israel and heart rate variability (HRV) measurements.

Methods: The study was nested within an ongoing prospective, randomized controlled trial, assessing IO interventions on QoL-related concerns among patients with cancer undergoing chemotherapy. Patients reporting cancer- and war-related concerns were eligible for study inclusion. Narratives from two open-ended questions addressing personal and health-related effects of the war were analyzed qualitatively using ATLAS.Ti software for systematic coding; and baseline electrocardiogram conducted for HRV measurement.

Results: Analysis of 125 patient narratives identified many war-related experiences and emotions, most significantly stress, fear, anxiety, distress, sadness, loneliness, and reduced daily functioning. In 36 patients (28.8%), a significant association was found between war and cancer-related concerns (e.g., pain, appetite, gastro-intestinal and emotional distress, insomnia). HRV analysis suggested a correlation between expressing both cancer- and war-related concerns with higher Power high-frequency (HF) [correlation: 0.24 (0.01, 0.44), p = 0.039]; Power lower frequency (LF) [correlation: 0.27 (0.06, 0.47), p = 0.015]; and autocorrelation slope [0.25 (0.05, 0.44); p = 0.015].

Conclusions: Patients with cancer- and war-related concerns reported a significant impact of the war on health, especially QoL cancer-related concerns. Baseline HRV analysis suggests that those expressing both groups of concerns showed increased sympathetic and para-sympathetic activity. Further research is needed to examine the impact of war on cancer care.

Objective: This study aimed to explore the complex dynamics of help-seeking behaviors among breast cancer patients in China through developing an explanatory theoretical model.

Methods: A Constructivist Grounded Theory (CGT) approach was employed to investigate breast cancer patients' help-seeking behaviors. Data collection occurred at a tertiary hospital in Zhejiang, China, from September 2024 to February 2025. We used a two-phase CGT design: Phase 1 inductively generated the preliminary model from patient interviews; Phase 2 employed theoretical sampling with nurses and non-participant observations to test negative cases, triangulate covert decision dynamics, and achieve category saturation. Sample size was based on theoretical saturation audit checks for coding consistency. Data analysis utilized NVivo 12.0 software following Strauss and Corbin's three-level coding paradigm.

Results: Analysis generated the Motivate-Response-Feedback Model (MRFM), outlining the dynamics of breast cancer help-seeking behavior. Intrinsic motivators included cognitive biases, perceived disease severity, and coping strategies, whereas extrinsic motivators encompassed cultural stigma, healthcare resource allocation, and family responsibilities. Patients' behavioral responses manifested as active (multi-source symptom verification, cross-regional care-seeking) or passive (delayed consultations, condition concealment). Feedback processes were categorized as positive (enhanced social support, reduced psychological stress) and negative (economic strain, negative emotional states), further influencing subsequent help-seeking behaviors.

Conclusions: This study provides a nuanced understanding of the complex interplay between intrinsic and extrinsic motivators, behavioral responses, and feedback loops shaping breast cancer help-seeking behaviors in China. We propose a culture-specific MRFM that explains intention-behavior gaps via dynamic feedback loops rather than static determinants. The developed MRFM highlights the need for culturally tailored interventions to reduce stigma, improve resource allocation, and enhance psychological and social support. Further quantitative validation and research exploring the role of digital health interventions in facilitating timely help-seeking behaviors are recommended.

Objective: Decision self-efficacy reflects individuals' confidence in their ability to make effective health-related decisions. In oncology, it is essential to foster active engagement throughout the healthcare journey. Despite its relevance for quality of life, limited evidence exists on the factors influencing decision self-efficacy among cancer survivors. This exploratory study examined the role of personality traits, metacognition, coping strategies, and social support in predicting decision self-efficacy in breast cancer survivors.

Methods: 187 breast cancer survivors voluntarily completed online questionnaires assessing socio-demographic variables and standardized measures. Correlational analyses, multiple regressions, and mediation analyses were conducted.

Results: Findings evidenced that conscientiousness and cognitive self-consciousness positively predicted decision self-efficacy, whereas agreeableness showed a negative association. Problem-focused coping was positively related to decision self-efficacy; however, this effect was not significant when social support was included. Significant-other support and cognitive self-consciousness emerged as additional positive predictors. Mediation analysis indicated that agreeableness negatively influenced decision self-efficacy when mediated by problem-focused coping strategies.

Discussion: Knowing individual and social characteristics that foster decision self-efficacy can be crucial to promote well-being in breast cancer survivors, decreasing anxiety and distress about their health.

Objective: This study investigated the course of general well-being and health-related quality of life (HRQoL) in working-age melanoma patients during the first year following diagnosis. It also examines the use of psycho-oncological counseling and rehabilitation, and their impact on QoL.

Methods: Patients aged 18-65 years with stage 0 to IIIC melanoma were eligible for this single-center, prospective cohort study. Following informed consent, clinical data and data on general well-being (WHO-5), HRQoL (FACT-M) and need for psycho-oncological care (Hornheider Screening Instrument) were collected at baseline and every three months over one year.

Results: We included 221 melanoma patients (median age 51, range 19-65, 62% female). At baseline, 79% had melanoma stage IB or lower. After one year, 9% had progressed. 38% of patients showed a WHO-5 score below 52% following diagnosis, regardless of tumor stage. Women with stage 0 to IIA melanoma had significantly lower HRQoL in the first six months than men (p = 0.010), and a higher need for psychological support (p < 0.001). There was considerable variability in QoL trajectories both within individuals (median variation 11%) and across patients. In general, 52% needed psycho-oncological care at baseline, but neither counseling (24%) nor rehabilitation (18%) resulted in significant improvements in QoL over the year.

Conclusions: Melanoma diagnosis leads to a marked QoL reduction, particularly in lower stage women, with most patients improving over time. However, substantial intra-individual variation emphasizes the need for regular QoL assessments. Further research is needed to assess the long-term effectiveness of psycho-oncological support and rehabilitation.

Trial registration: German Clinical Trials Register No. DRKS00010005, 08. March 2016.