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Associations Between a Social Determinant of Health Summary Measure and Self-Reported Physical and Mental Health Among Cancer Survivors. 癌症幸存者中健康的社会决定因素摘要测量与自我描述的身心健康之间的关联。
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.1002/pon.9314
Meng-Han Tsai, Steven S Coughlin, Minjee Lee, Jorge Cortes, Yanbin Dong

Objective: We sought to examine the associations between a social needs measure and physical, and mental health among cancer survivors in the United States.

Methods: We conducted a cross-sectional analysis using the 2022 Behavioral Risk Factor Surveillance System survey involving 16,930 eligible cancer survivors. The primary outcomes of interest were self-reported physical and mental health in the past 30 days. A social needs measure was our primary exposure of interest. Multivariate logistic regression was used to examine the associations of interest.

Results: Overall, 56% and 73% survivors with several days of poor physical and mental health, respectively, reported having two or more social needs. In multivariate analysis, those having at least one social need were more likely to report several days of poor physical (one need: OR, 1.62; 95% CI, 1.31-2.00, two or more needs: OR, 3.52; 95% CI, 2.84-4.35) and mental health (one need: OR, 3.07; 95% CI, 2.07-4.57, two or more needs: OR, 9.69; 95% CI, 6.83-13.74). Among survivors with two or more social needs, having exercised in the past 30 days were 41% and 59% less likely to experience poor physical and mental health, respectively (p-value < 0.05). However, having at least one chronic disease was associated with several days of poor physical/mental health among those with two or more needs (p-value < 0.05).

Conclusion: Having social needs was associated with self-reporting of several days of poor physical and mental health among cancer survivors. Integrated care should include mental/physical health management addressing cancer survivors' various social needs.

目的我们试图研究美国癌症幸存者的社会需求衡量标准与身体和心理健康之间的关联:我们利用 2022 年行为风险因素监测系统调查进行了一项横断面分析,涉及 16930 名符合条件的癌症幸存者。我们关注的主要结果是过去 30 天内自我报告的身体和精神健康状况。社会需求测量是我们主要关注的暴露。我们使用多变量逻辑回归来检验相关的关联性:总体而言,分别有 56% 和 73% 的幸存者在数天内身体和精神健康状况较差,他们表示有两种或两种以上的社会需求。在多变量分析中,至少有一种社会需求的幸存者更有可能报告数天的身体状况欠佳(一种需求:OR, 1.62; 95%; 1.62%; 95%; 1.62OR,1.62;95% CI,1.31-2.00,两个或更多需求:OR,3.52;95% CI,2.84-4.35)和心理健康(一种需求:OR,3.07;95% CI,2.84-4.35):一项需求:OR,3.07;95% CI,2.07-4.57,两项或更多需求:OR,9.69;95% CI,2.84-4.35OR,9.69;95% CI,6.83-13.74)。在有两种或两种以上社交需求的幸存者中,过去 30 天内进行过锻炼的幸存者身体和心理健康状况不佳的几率分别降低了 41% 和 59%(P 值 结论:在有两种或两种以上社交需求的幸存者中,过去 30 天内进行过锻炼的幸存者身体和心理健康状况不佳的几率分别降低了 41% 和 59%:有社会需求与癌症幸存者自我报告的数天身体和心理健康状况不佳有关。综合护理应包括精神/身体健康管理,以满足癌症幸存者的各种社会需求。
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引用次数: 0
'I Live With Lynch. Cancer Worry Ebbs Into the Background, Then Something Brings It to the Fore.' A Qualitative Interview Study Exploring How Lynch Syndrome Carriers Make Sense of Their Cancer Risks and Implications to Support Decision Making. 我和林奇一起生活。对癌症的担忧逐渐淡出人们的视线,然后又被一些事情唤醒。一项定性访谈研究,探索林奇综合征携带者如何认识自己的癌症风险及其对决策的影响。
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.1002/pon.9312
Kelly Kohut, Kate Morton, Lesley Turner, Rebecca Foster, Elizabeth K Bancroft, Mary Jane Esplen, Helen Hanson, Karen Hurley, Katie Snape, Diana Eccles, Claire Foster

Background: Lynch syndrome carriers ('carriers') are presented with complex, emotionally laden choices regarding management of increased genetic cancer risks. Decision aids encourage active involvement in values-based health decisions. This paper aimed to address the research question: How do Lynch syndrome carriers make sense of their chances of developing cancer, and what are the implications for providing support with decision making about genetic cancer risk management?

Methods: Adult carriers were recruited through a genetics service or involvement with Lynch Syndrome UK. Semi-structured interviews explored lived experiences of carriers' access to care with a focus on decision support. Themes were constructed using framework analysis. These were developed into a conceptual model with recommendations for codevelopment of improved information and support including a tailored decision aid to complement integrated healthcare.

Results: Twenty participants included 12 women and eight men, half with a history of cancer. Six overarching themes were: (1) finding balance with Lynch; (2) living 'on higher alert'; (3) managing uncertainty: 'I've thought about it a lot'; (4) burden of responsibility: 'It's on me'; (5) access to joined-up care and support: 'There's something missing'; and (6) influence/pressure from others.

Conclusions: This qualitative interview study provided in-depth insights from Lynch syndrome carriers about their lived experiences, informed by their values. Recommendations to empower carriers to make sense of genetic cancer risks and support decisions included accessible, trusted information, educated healthcare professionals, shared decision making, and joined-up integrated care pathways complemented by tailored decision aids.

背景:林奇综合征带原者("带原者")在处理遗传性癌症风险增加的问题上面临着复杂、充满感情色彩的选择。决策辅助工具鼓励人们积极参与基于价值观的健康决策。本文旨在探讨以下研究问题林奇综合征携带者如何看待自己罹患癌症的几率,以及为遗传性癌症风险控制决策提供支持的意义何在?成年林奇综合征携带者是通过遗传学服务机构或英国林奇综合征协会招募的。半结构式访谈探讨了携带者获得治疗的生活经历,重点关注决策支持。采用框架分析法构建主题。这些主题被发展成一个概念模型,并提出了改进信息和支持的代码开发建议,包括量身定制的决策辅助工具,以补充综合医疗保健:20 名参与者包括 12 名女性和 8 名男性,其中一半有癌症病史。六个首要主题是(1) 与林奇找到平衡;(2) 生活在 "更高的警戒状态";(3) 处理不确定性:"我想了很多";(4) 责任负担:"这是我的责任";(5) 获得联合护理和支持:缺少一些东西";(6) 来自他人的影响/压力:这项定性访谈研究从林奇综合征携带者的价值观出发,深入了解了他们的生活经历。为增强林奇综合征携带者对遗传性癌症风险的认识并支持其做出决定而提出的建议包括:可获取的可信信息、受过教育的医疗保健专业人员、共同决策、联合综合护理路径以及量身定制的决策辅助工具。
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引用次数: 0
Reproductive Concerns Among Young Adult Women With Breast Cancer: A Systematic Review and Meta-Analysis. 患有乳腺癌的年轻成年女性对生殖问题的关注:系统回顾与元分析》。
IF 4.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1002/pon.9304
Li Hu, Binbin Xu, Pui Hing Chau, Kris Yuet Wan Lok, Jojo Yan Yan Kwok, Edmond Pui Hang Choi, Ying Lau

Objectives: Systemic cancer treatments pose threats to fertility, leading to concerns regarding fertility and parenthood in young adult women with breast cancer (YAWBC). This systematic review aimed to synthesize existing evidence on reproductive concerns (RCs) among YAWBC and identify areas where further research in needed.

Methods: A systematic review was conducted. Nine English and Chinese databases were searched for studies from inception to June 2023. A meta-analysis was employed to pool RC levels measured using the Reproductive Concerns After Cancer scale (RCAC scale; possible total scores: 18-90). Narrative synthesis was conducted in cases where a meta-analysis could not be performed.

Results: Twenty-four cross-sectional studies across seven countries were included in this review. The prevalence of RCs among YAWBC ranged from 21.75% to 80%. The pooled mean total score on the overall RCAC scale was 55.84 (95% confidence interval: 53.26-58.43). "Personal health," "child's health," and "fertility potential" were the top three types of RCs among YAWBC. Sociodemographic, clinical, and psychosocial factors were found to be associated with RCs among YAWBC. Additionally, significant correlations among RCs, nonadherence to treatment, depression, and quality of life were also identified among YAWBC.

Conclusion: RCs are a common issue among YAWBC, and age, parenthood status, fertility desire, and chemotherapy treatment are important factors associated with RCs among these women. Further research is needed to clarify RC-related factors to provide evidence aimed at tailoring interventions to mitigate RCs among YWBC.

目的:系统性癌症治疗会对生育能力造成威胁,因此年轻的成年女性乳腺癌患者(YAWBC)会对生育和为人父母产生担忧。本系统性综述旨在综合有关年轻女性乳腺癌患者生殖问题(RCs)的现有证据,并确定需要进一步研究的领域:方法:进行了一项系统性综述。检索了九个中英文数据库中从开始到 2023 年 6 月的研究。采用荟萃分析法对使用癌症后生殖关注量表(RCAC 量表;可能总分:18-90 分)测量的生殖关注水平进行汇总。如果无法进行荟萃分析,则进行叙述性综合:本综述纳入了 7 个国家的 24 项横断面研究。YAWBC 中的 RC 患病率从 21.75% 到 80% 不等。总体 RCAC 量表的汇总平均总分为 55.84(95% 置信区间:53.26-58.43)。"个人健康"、"子女健康 "和 "生育潜力 "是 YAWBC 的前三类 RC。研究发现,社会人口、临床和社会心理因素与 YAWBC 的生殖健康问题有关。此外,在 YAWBC 中还发现 RCs、不坚持治疗、抑郁和生活质量之间存在明显的相关性:RCs是YAWBC中的一个常见问题,年龄、生育状况、生育意愿和化疗治疗是这些妇女中RCs的重要相关因素。需要进一步开展研究,以明确与 RC 相关的因素,从而为定制干预措施以减轻 YAWBC 中的 RC 提供证据。
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引用次数: 0
If They'd Said You Should Only Drink Five Units I'd Have Listened: A Mixed Methods Study of Alcohol Consumption Following a Diagnosis of Breast Cancer. 如果他们说你只能喝五个单位,我一定会听:乳腺癌诊断后的酒精消费混合方法研究》。
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1002/pon.9305
Emma L Davies, Lucy McGeagh, Lauren Matheson, Julie Bennett, Sara Matthews, Jo Brett, Eila Watson

Objectives: As part of a wider study describing the impact of a breast cancer diagnosis on lifestyle behaviours, this paper describes the impact of a breast cancer diagnosis on alcohol consumption and factors influencing consumption.

Methods: Cross-sectional online survey of 140 people (138 women) and interviews with 21 women diagnosed with breast cancer in the last 10 years.

Results: Of the 100 survey participants who drank alcohol 25% were drinking at increasing or higher risk levels and 17% strongly wanted to change their drinking behaviour. The habitual aspects of alcohol consumption were the strongest predictor of current alcohol consumption behaviours. Social norms and perceptions about conflicting information were substantial barriers to change.

Conclusions: Breast cancer survivors need accurate information about the risks of alcohol consumption and guidelines in order to make informed decisions about making changes to their behaviour. Interventions to support breast cancer survivors to reduce alcohol consumption need to focus on the development of healthy habits and may benefit from a focus which includes partners and friends.

目的:作为一项更广泛研究的一部分,本文描述了乳腺癌诊断对生活方式行为的影响:作为描述乳腺癌诊断对生活方式行为影响的更广泛研究的一部分,本文描述了乳腺癌诊断对饮酒量的影响以及影响饮酒量的因素:方法:对 140 人(138 名女性)进行横断面在线调查,并对 21 名在过去 10 年中被诊断患有乳腺癌的女性进行访谈:结果:在 100 名参与调查的饮酒者中,25% 的人饮酒风险在增加或提高,17% 的人强烈希望改变其饮酒行为。饮酒习惯是当前饮酒行为的最强预测因素。社会规范和对冲突信息的看法是改变行为的主要障碍:结论:乳腺癌幸存者需要关于饮酒风险和指导原则的准确信息,以便在知情的情况下做出改变行为的决定。支持乳腺癌幸存者减少饮酒的干预措施需要侧重于培养健康的生活习惯,将伴侣和朋友纳入干预重点可能会使其受益。
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引用次数: 0
Sleep Composition of Patients With Colorectal Cancer and Their Sleep-Partner Caregivers: Physical Health Correlates of Sleep Diary and Actigraphy Measurements. 结直肠癌患者及其睡眠伴侣照顾者的睡眠构成:睡眠日记和活动记录仪测量的身体健康相关性
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1002/pon.9302
Amanda Ting, Thomas C Tsai, Jamie M Zeitzer, Armando Mendez, Youngmee Kim

Background: Disturbed sleep is frequently identified in adult patients with cancer and their caregivers, with detrimental impact on physical health. Less known is the extent to which self-reported and actigraph-measured sleep patterns are similar between patients and their sleep-partner caregivers, and how these different modes of sleep measurements are related to physical health.

Methods: Patients diagnosed with colorectal cancer and their sleep-partner caregivers (81 dyads) completed a questionnaire for physical functioning and collected saliva samples for seven consecutive days, from which cortisol slope was quantified. Additionally, participants completed a daily sleep diary and wore actigraph for 14 consecutive days, from which sleep duration, sleep onset latency (SOL), and duration of wake after sleep onset (WASO) were calculated.

Results: Participants reported sleep patterns that fell within or close to the optimal range, which were similar between patients and their caregivers. Self-reported and actigraph-measured sleep duration had moderate levels of agreement (ICC = 0.604), whereas SOL and WASO had poor agreement (ICC = 0.269). Among patients, longer self-reported WASO was associated with poorer physical health and flatter cortisol slope (p ≤ 0.013). Among caregivers, longer self-reported SOL was associated with poorer physical functioning, actigraph-measured WASO was associated with steeper cortisol slope, and longer self-reported sleep markers studied than actigraph-measured were associated with poorer physical functioning (p ≤ 0.042).

Conclusion: Findings suggest that employing multiple assessment modes for sleep and physical health is vital for comprehensive understanding of sleep health. Furthermore, when addressing patients' sleep health, it may be beneficial to include their sleep-partner caregivers who may experience similar disturbed sleep.

背景:成年癌症患者及其护理人员经常会出现睡眠紊乱的情况,对身体健康造成不利影响。人们较少了解患者及其睡眠伴侣照顾者自我报告的睡眠模式与动图测量的睡眠模式在多大程度上相似,以及这些不同的睡眠测量模式与身体健康的关系:方法:确诊为结肠直肠癌的患者及其睡眠伴侣照护者(81 对)填写了一份身体功能问卷,并收集了连续七天的唾液样本,从中量化了皮质醇斜率。此外,参与者还填写了每日睡眠日记,并连续 14 天佩戴行动计,从中计算睡眠持续时间、睡眠开始潜伏期(SOL)和睡眠开始后唤醒持续时间(WASO):结果:参与者报告的睡眠模式在最佳范围内或接近最佳范围,患者及其护理人员的睡眠模式相似。自我报告的睡眠时长与动图测量的睡眠时长具有中等程度的一致性(ICC = 0.604),而 SOL 和 WASO 的一致性较差(ICC = 0.269)。在患者中,自我报告的 WASO 时间越长,身体健康状况越差,皮质醇斜率越低(p ≤ 0.013)。在护理人员中,自我报告的SOL时间较长与身体机能较差有关,动图测量的WASO时间较长与皮质醇斜率较陡有关,而自我报告的睡眠标记时间长于动图测量的睡眠标记时间与身体机能较差有关(p≤0.042):研究结果表明,采用多种睡眠和身体健康评估模式对于全面了解睡眠健康状况至关重要。此外,在处理患者的睡眠健康问题时,将他们的睡眠伴侣照顾者包括在内可能会有好处,因为他们也可能经历类似的睡眠紊乱。
{"title":"Sleep Composition of Patients With Colorectal Cancer and Their Sleep-Partner Caregivers: Physical Health Correlates of Sleep Diary and Actigraphy Measurements.","authors":"Amanda Ting, Thomas C Tsai, Jamie M Zeitzer, Armando Mendez, Youngmee Kim","doi":"10.1002/pon.9302","DOIUrl":"10.1002/pon.9302","url":null,"abstract":"<p><strong>Background: </strong>Disturbed sleep is frequently identified in adult patients with cancer and their caregivers, with detrimental impact on physical health. Less known is the extent to which self-reported and actigraph-measured sleep patterns are similar between patients and their sleep-partner caregivers, and how these different modes of sleep measurements are related to physical health.</p><p><strong>Methods: </strong>Patients diagnosed with colorectal cancer and their sleep-partner caregivers (81 dyads) completed a questionnaire for physical functioning and collected saliva samples for seven consecutive days, from which cortisol slope was quantified. Additionally, participants completed a daily sleep diary and wore actigraph for 14 consecutive days, from which sleep duration, sleep onset latency (SOL), and duration of wake after sleep onset (WASO) were calculated.</p><p><strong>Results: </strong>Participants reported sleep patterns that fell within or close to the optimal range, which were similar between patients and their caregivers. Self-reported and actigraph-measured sleep duration had moderate levels of agreement (ICC = 0.604), whereas SOL and WASO had poor agreement (ICC = 0.269). Among patients, longer self-reported WASO was associated with poorer physical health and flatter cortisol slope (p ≤ 0.013). Among caregivers, longer self-reported SOL was associated with poorer physical functioning, actigraph-measured WASO was associated with steeper cortisol slope, and longer self-reported sleep markers studied than actigraph-measured were associated with poorer physical functioning (p ≤ 0.042).</p><p><strong>Conclusion: </strong>Findings suggest that employing multiple assessment modes for sleep and physical health is vital for comprehensive understanding of sleep health. Furthermore, when addressing patients' sleep health, it may be beneficial to include their sleep-partner caregivers who may experience similar disturbed sleep.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 8","pages":"e9302"},"PeriodicalIF":3.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prostate Cancer Related Sexual Dysfunction and Barriers to Help Seeking: A Scoping Review. 与前列腺癌相关的性功能障碍和求助障碍:范围界定综述》。
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1002/pon.9303
Megan Charlick, Tenaw Tiruye, Kerry Ettridge, Michael O'Callaghan, Sally Sara, Alexander Jay, Kerri Beckmann

Objective: Despite available support, sexuality needs are the most frequently reported unmet need among men with prostate cancer, which may be due to low help-seeking rates. Using the Ecological Systems Framework as a theoretical foundation, we conducted a scoping review of the available literature to understand what factors impact help-seeking behaviour for sexual issues after prostate cancer treatment among men who had received treatment.

Methods: Following PRISMA guidelines, a systematic search on Medline, PsychInfo, Embase, Emcare, and Scopus was conducted to identify studies of adult prostate cancer patients post-treatment, which reported barriers and/or facilitators to help-seeking for sexual health issues. Quality appraisals were conducted using Joanna Briggs Institute appraisal tools, and results were qualitatively synthesised.

Results: Of the 3870 unique results, only 30 studies met inclusion criteria. In general, studies were considered moderate to good quality, though only six used standardised measures to assess help-seeking behaviour. Barriers and facilitators for sexual help-seeking were identified across all five levels of the Ecological Systems Framework, including age, treatment type, and previous help seeking experience (individual level), healthcare professional communication and partner support (microsystem), financial cost and accessibility of support (meso/exosystem), and finally embarrassment, masculinity, cultural norms, and sexuality minority (macrosystem).

Conclusions: Addressing commonly reported barriers (and inversely, enhancing facilitators) to help-seeking for sexual issues is essential to ensure patients are appropriately supported. Based on our results, we recommend healthcare professionals include sexual wellbeing discussions as standard care for all prostate cancer patients, regardless of treatment received, age, sexual orientation, and partnership status/involvement.

目的:尽管有可用的支持,但在前列腺癌男性患者中,性需求是最常报告的未得到满足的需求,这可能是由于求助率低造成的。我们以生态系统框架为理论基础,对现有文献进行了范围界定,以了解哪些因素会影响接受过前列腺癌治疗的男性患者在治疗后就性问题寻求帮助的行为:按照 PRISMA 指南,我们在 Medline、PsychInfo、Embase、Emcare 和 Scopus 上进行了系统性检索,以确定有关成年前列腺癌患者治疗后的研究,这些研究报告了性健康问题求助的障碍和/或促进因素。采用乔安娜-布里格斯研究所的评估工具进行了质量评估,并对结果进行了定性综合:在 3870 项独特的结果中,只有 30 项研究符合纳入标准。总体而言,这些研究被认为质量中等至良好,但只有六项研究使用了标准化的方法来评估求助行为。研究发现,性求助的障碍和促进因素横跨生态系统框架的所有五个层面,包括年龄、治疗类型和以往的求助经历(个人层面)、医护人员沟通和伴侣支持(微观系统)、经济成本和支持的可及性(中观/生态系统),以及尴尬、男性气质、文化规范和性少数群体(宏观系统):要确保患者得到适当的支持,就必须解决常见的性问题求助障碍(反之,则要加强促进因素)。根据我们的研究结果,我们建议医护人员将性健康讨论作为所有前列腺癌患者的标准护理,无论患者接受了何种治疗、年龄、性取向以及伴侣状况/参与程度如何。
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引用次数: 0
Efficacy of Web-Based Interventions on Depression and Anxiety in Cancer Caregivers: A Systematic Review and Meta-Analysis. 基于网络的干预措施对癌症护理人员抑郁和焦虑的疗效:系统回顾与元分析》。
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-01 DOI: 10.1002/pon.9301
Myoungsuk Kim, Kelly R Tan, Lorinda A Coombs

Objective: This study aimed to evaluate the effectiveness of web-based interventions in depression and anxiety among informal caregivers of patients with cancer.

Methods: Databases such as PubMed, Cochrane, Web of Science, Embase, CINAHL, and PsycINFO were systematically searched from inception to April 15, 2024. Eligible studies encompassed randomized controlled trials (RCTs) focusing on web-based interventions tailored to informal caregivers of patients with cancer. The effect size was calculated as the standardized mean difference (SMD) with a 95% confidence interval (CI) utilizing a random effects model. The risk of bias was assessed independently utilizing Cochrane's Risk of Bias Tool (version 2.0) for RCTs.

Results: A total of 12 RCTs were incorporated into this meta-analysis. Web-based interventions demonstrated a significant effect in ameliorating depression among informal caregivers of patients with cancer compared to the control group (SMD = -0.21, 95% CI = -0.36 to -0.05, p < 0.01, I2 = 15%). Additionally, a significant effect was also observed in alleviating anxiety (SMD = -0.20, 95% CI = -0.36 to -0.05, p = 0.77, I2 = 0%).

Conclusions: Web-based interventions might be effective in reducing depression and anxiety among informal caregivers of patients with cancer. Nevertheless, several studies with an overall high risk of bias were included. As a result of the limited number and heterogeneity of the studies included in the subgroup analysis, deriving definitive conclusions on the most effective intervention components was challenging. Therefore, further studies incorporating high-quality research are warranted.

研究目的本研究旨在评估基于网络的干预措施对癌症患者非正式照顾者抑郁和焦虑的有效性:对 PubMed、Cochrane、Web of Science、Embase、CINAHL 和 PsycINFO 等数据库进行了系统检索,检索时间从开始到 2024 年 4 月 15 日。符合条件的研究包括随机对照试验(RCT),重点是针对癌症患者非正式护理人员的网络干预。采用随机效应模型计算效应大小,即标准化平均差 (SMD) 和 95% 置信区间 (CI)。利用针对 RCT 的 Cochrane 偏倚风险工具(2.0 版)对偏倚风险进行了独立评估:本次荟萃分析共纳入了 12 项研究性试验。与对照组相比,基于网络的干预对改善癌症患者非正式照顾者的抑郁状况有显著效果(SMD = -0.21,95% CI = -0.36至-0.05,P 2 =15%)。此外,在缓解焦虑方面也观察到了明显效果(SMD = -0.20,95% CI = -0.36 to -0.05,p = 0.77,I2 = 0%):结论:基于网络的干预措施可有效减轻癌症患者非正式照顾者的抑郁和焦虑。结论:基于网络的干预措施可能会有效减轻癌症患者非正式照顾者的抑郁和焦虑。由于纳入亚组分析的研究数量有限且存在异质性,因此很难就最有效的干预措施得出明确结论。因此,有必要进一步开展高质量的研究。
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引用次数: 0
Confirmatory validation of the Mesothelioma Psychological Distress Tool-Patients: A brief patient-reported outcome measure assessing psychological distress in malignant mesothelioma patients. 间皮瘤患者心理压力工具的确认验证:评估恶性间皮瘤患者心理压力的简短患者报告结果测量法。
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-01 DOI: 10.1002/pon.6371
Michela Bonafede, Isabella Giulia Franzoi, Maria Domenica Sauta, Alessandro Marinaccio, Carolina Mensi, Sabrina Rugarli, Enrica Migliore, Ilaria Cozzi, Domenica Cavone, Luigi Vimercati, Federica Grosso, Marinella Bertolotti, Giulia Raimondi, Marco Innamorati, Antonella Granieri

Objective: Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool-Patients (MPDT-P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-P.

Methods: The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT-P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach.

Results: The two-factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three-factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future.

Conclusions: Integrating the MPDT-P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts.

目的:恶性间皮瘤(MM)患者的心理痛苦不同于其他癌症患者,这是因为间皮瘤的病因是职业性或环境性的,而且症状和预后特殊(即预后差、治疗效果差、残余生活质量差、诊断时年龄大)。因此,我们开发了间皮瘤患者心理压力工具(MPDT-P),以评估这一人群心理痛苦的具体情况。本文介绍了修订版 MPDT-P 的项目选择、因素分析和心理测量评估:目前的分析工作旨在确认第一版 MPDT-P 中的因子结构。在非拟合情况下,旨在寻找模型中的替代结构和非拟合原因。研究采用贝叶斯方法寻找因子模型的拟合度:结果:第一版工具中报告的双因素模型与数据不符。贝叶斯确证分析表明,三因素解决方案充分拟合。根据项目的内容,我们将这些因子标记为功能失调的情绪、对正义的诉求和对未来的焦虑:将 MPDT-P 纳入临床实践有助于临床医生深入了解与 MM 相关的特定痛苦,并研究与不同职业和环境接触背景相关的潜在差异。
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引用次数: 0
Virtual Reality for advanced cancer patients assisted at home: A randomized controlled interventional study. 为在家接受治疗的晚期癌症患者提供虚拟现实技术:随机对照干预研究。
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-01 DOI: 10.1002/pon.6368
Andrea Giannelli, Serena Moscato, Rita Ostan, Raffaella Pannuti, Lorenzo Chiari, Guido Biasco, Silvia Varani

Objective: Virtual Reality (VR) has been demonstrated to be an effective option for integrating psychological interventions in different therapeutic settings. This randomized controlled interventional study aims to assess the effects of VR, compared to tablet controlled intervention, on anxiety, depression, pain, and short-term psychophysical symptoms in advanced cancer patients assisted at home.

Methods: Participants were provided with a VR headset or a tablet (TAB) for 4 days. On the first and last day, anxiety and depression were measured by Hospital Anxiety and Depression Scale and pain by Brief Pain Inventory. Before and after each VR and tablet session, symptoms were collected by the Edmonton Symptom Assessment Scale (ESAS).

Results: Fifty-three patients (27 VR vs. 26 TAB) completed the study. Anxiety significantly decreased in the VR group after the 4-day intervention. The analysis of ESAS showed a significant improvement in pain (p = 0.013), tiredness (p < 0.001), and anxiety (p = 0.013) for TAB group, and a significant reduction in tiredness (p < 0.001) in the VR group.

Conclusions: Technological and user-friendly tools, such as VR and tablets, might be integrated with traditional psychological interventions to improve anxiety and cancer-related short-term symptoms. Further studies are needed to better consolidate the possible beneficial effects of VR.

目的:虚拟现实(VR)已被证明是在不同治疗环境中整合心理干预的有效选择。这项随机对照干预研究旨在评估 VR 与平板电脑对照干预相比,对在家接受协助的晚期癌症患者的焦虑、抑郁、疼痛和短期心理物理症状的影响:为参与者提供为期 4 天的 VR 头显或平板电脑(TAB)。在第一天和最后一天,焦虑和抑郁通过医院焦虑抑郁量表进行测量,疼痛通过简易疼痛量表进行测量。在每次使用 VR 和平板电脑之前和之后,使用埃德蒙顿症状评估量表(ESAS)收集症状:53 名患者(27 名 VR 患者与 26 名 TAB 患者)完成了研究。在为期 4 天的干预后,VR 组的焦虑症明显减轻。对 ESAS 的分析表明,疼痛(p = 0.013)、疲倦(p 结论:VR 组的焦虑明显减轻,而 TAB 组的焦虑明显减轻:VR 和平板电脑等技术和用户友好型工具可与传统心理干预相结合,改善焦虑和与癌症相关的短期症状。要更好地巩固虚拟现实技术可能带来的益处,还需要进一步的研究。
{"title":"Virtual Reality for advanced cancer patients assisted at home: A randomized controlled interventional study.","authors":"Andrea Giannelli, Serena Moscato, Rita Ostan, Raffaella Pannuti, Lorenzo Chiari, Guido Biasco, Silvia Varani","doi":"10.1002/pon.6368","DOIUrl":"10.1002/pon.6368","url":null,"abstract":"<p><strong>Objective: </strong>Virtual Reality (VR) has been demonstrated to be an effective option for integrating psychological interventions in different therapeutic settings. This randomized controlled interventional study aims to assess the effects of VR, compared to tablet controlled intervention, on anxiety, depression, pain, and short-term psychophysical symptoms in advanced cancer patients assisted at home.</p><p><strong>Methods: </strong>Participants were provided with a VR headset or a tablet (TAB) for 4 days. On the first and last day, anxiety and depression were measured by Hospital Anxiety and Depression Scale and pain by Brief Pain Inventory. Before and after each VR and tablet session, symptoms were collected by the Edmonton Symptom Assessment Scale (ESAS).</p><p><strong>Results: </strong>Fifty-three patients (27 VR vs. 26 TAB) completed the study. Anxiety significantly decreased in the VR group after the 4-day intervention. The analysis of ESAS showed a significant improvement in pain (p = 0.013), tiredness (p < 0.001), and anxiety (p = 0.013) for TAB group, and a significant reduction in tiredness (p < 0.001) in the VR group.</p><p><strong>Conclusions: </strong>Technological and user-friendly tools, such as VR and tablets, might be integrated with traditional psychological interventions to improve anxiety and cancer-related short-term symptoms. Further studies are needed to better consolidate the possible beneficial effects of VR.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 7","pages":"e6368"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mixed-methods evaluation of a face-to-face educational intervention for health and social care professionals to deliver family-centred cancer supportive care when a parent with dependent children is at end of life. 对医疗和社会护理专业人员进行面对面教育干预的混合方法评估,以便在有受抚养子女的父母临终时提供以家庭为中心的癌症支持性护理。
IF 3.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-01 DOI: 10.1002/pon.6374
Jeffrey R Hanna, Cherith J Semple

Objective: To deliver and evaluate an educational intervention to equip health and social care professionals (professionals) on how best to support parents at end of life with cancer concerning their dependent children (<18).

Methods: An evidence-based and theory-driven face-to-face educational intervention was developed and evaluated using three levels of Kirkpatrick's Model of Evaluation. Pre-test, post-test surveys were completed immediately before-and-after the intervention using a validated self-efficacy scale and single-item questions evaluating perceived usefulness and relevance (levels one/two). Qualitative interviews ≥ 3-months post-intervention explored if, and how the intervention impacted professionals' practice (level three). Fourteen sessions were delivered at oncology settings to 347 professionals between 2021 and 2023. Two hundred seventy four professionals completed the pre-test survey, with 239 completing the post-test survey. Fourteen professionals were interviewed between three-and 19-months post-intervention.

Results: Quantitative findings demonstrated a statistically significant improvement in self-efficacy post-educational intervention (p < 0.001). Qualitative data highlighted professionals gained new approaches to progress end of life conversations with parents, despite some familial resistance to sharing the reality of the situation with children. Positive intervention content shaping clinical practice included the bereaved parent's lived experience, communication framework and roleplay videos. Some professionals considered a booster session and opportunities to practice conversations necessary to further consolidate learning into practice.

Conclusions: Evidence and theory-driven education can positively impact professionals' provision of family-centred cancer care. Future studies should explore the impact of this educational intervention on familial outcomes. Alongside a sustainable delivery of this intervention, advanced communication skills programmes should incorporate parent-child end of life conversations.

目的提供并评估一项教育干预措施,让医疗和社会护理专业人员(专业人员)了解如何为身患癌症、需要抚养子女的临终父母提供最佳支持(方法:采用柯克帕特里克评估模型的三个层次,开发了一项以证据为基础、理论为驱动的面对面教育干预措施:采用柯克帕特里克评估模型(Kirkpatrick's Model of Evaluation)的三个层次,制定并评估了一项以证据为基础、以理论为驱动的面对面教育干预措施。在干预前后立即完成了测试前和测试后调查,使用的是经过验证的自我效能量表和评估感知有用性和相关性的单项问题(第一/第二级)。干预后≥ 3 个月的定性访谈探讨了干预是否以及如何影响专业人员的实践(三级)。2021 年至 2023 年期间,在肿瘤学机构为 347 名专业人员提供了 14 次课程。274 名专业人员完成了测试前调查,239 人完成了测试后调查。在干预后的 3 至 19 个月期间,对 14 名专业人员进行了访谈:定量研究结果表明,教育干预后,专业人员的自我效能在统计学上有显著提高(p 结论:教育干预对专业人员的自我效能有显著提高:以证据和理论为导向的教育可对专业人员提供以家庭为中心的癌症护理产生积极影响。未来的研究应探讨这种教育干预对家庭结果的影响。在可持续地实施这一干预措施的同时,高级沟通技能计划应纳入亲子生命末期对话。
{"title":"Mixed-methods evaluation of a face-to-face educational intervention for health and social care professionals to deliver family-centred cancer supportive care when a parent with dependent children is at end of life.","authors":"Jeffrey R Hanna, Cherith J Semple","doi":"10.1002/pon.6374","DOIUrl":"https://doi.org/10.1002/pon.6374","url":null,"abstract":"<p><strong>Objective: </strong>To deliver and evaluate an educational intervention to equip health and social care professionals (professionals) on how best to support parents at end of life with cancer concerning their dependent children (<18).</p><p><strong>Methods: </strong>An evidence-based and theory-driven face-to-face educational intervention was developed and evaluated using three levels of Kirkpatrick's Model of Evaluation. Pre-test, post-test surveys were completed immediately before-and-after the intervention using a validated self-efficacy scale and single-item questions evaluating perceived usefulness and relevance (levels one/two). Qualitative interviews ≥ 3-months post-intervention explored if, and how the intervention impacted professionals' practice (level three). Fourteen sessions were delivered at oncology settings to 347 professionals between 2021 and 2023. Two hundred seventy four professionals completed the pre-test survey, with 239 completing the post-test survey. Fourteen professionals were interviewed between three-and 19-months post-intervention.</p><p><strong>Results: </strong>Quantitative findings demonstrated a statistically significant improvement in self-efficacy post-educational intervention (p < 0.001). Qualitative data highlighted professionals gained new approaches to progress end of life conversations with parents, despite some familial resistance to sharing the reality of the situation with children. Positive intervention content shaping clinical practice included the bereaved parent's lived experience, communication framework and roleplay videos. Some professionals considered a booster session and opportunities to practice conversations necessary to further consolidate learning into practice.</p><p><strong>Conclusions: </strong>Evidence and theory-driven education can positively impact professionals' provision of family-centred cancer care. Future studies should explore the impact of this educational intervention on familial outcomes. Alongside a sustainable delivery of this intervention, advanced communication skills programmes should incorporate parent-child end of life conversations.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 7","pages":"e6374"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Psycho‐Oncology
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