Psycho‐Oncology最新文献

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.

Objective: Numerous psychosocial interventions have been developed to improve physical and psychological health-related outcomes among breast cancer survivors (BCS). Given the longstanding racial and ethnic disparities in breast cancer, culturally adapted psychosocial interventions aim to meet the unique needs of racial and ethnic minority BCS. This systematic review evaluates the efficacy of culturally adapted psychosocial interventions in improving psychological distress and quality of life for racial and ethnic minority BCS.

Methods: Search criteria included the following: studies reported psychosocial interventions with a control group, were conducted in the U.S., were culturally adapted for a racial or ethnic minority group, and included at least one of our target outcomes (distress, depression, anxiety, stress, mood disturbance, quality of life, coping, adjustment). Systematic searches were conducted using PubMed/MEDLINE, Scopus, CINAHL, and PsycINFO databases. The Effective Public Health Practice Project Quality Assessment Tool was used to evaluate risk of bias.

Results: Twenty-three studies met inclusion criteria. Interventions were adapted for Asian/Asian American, Latina, and African American/Black female patients, the vast majority of whom were diagnosed with non-metastatic breast cancer. Most studies used methodology classified as "weak" and did not report significant improvements in target outcomes compared to the control group.

Conclusions: Future culturally adapted psychosocial interventions should include more diverse patient populations (e.g., race and ethnicity, gender identity) and more rigorous study designs. Review findings have important implications for future research and practice, as survivorship needs for BCS increase and notable disparities for racial and ethnic minority patients persist.

Trial registration: PROSPERO CRD42022384472.

Background: Fear of cancer recurrence (FCR) is a prevalent and distressing concern among cancer survivors. Although psychological interventions have demonstrated efficacy in reducing FCR, they often require significant resources and specialized personnel, limiting their accessibility. Remotely delivered exercise programs offer a scalable and cost-effective alternative, yet their impact on FCR remains underexplored.

Aims: To evaluate the effectiveness of a 12-week remote exercise intervention in reducing FCR among patients with cancer.

Methods: This study combines data from pilot studies assessing the feasibility of a remote exercise intervention. Patients were recruited from June 2022 to January 2024 from five Brazilian states, representing diverse geographic regions. Eligible participants were adults undergoing active cancer treatment with moderate-severe FCR (FCR-7 score ≥ 17). The intervention included a 12-week remote exercise program with weekly virtual consultations with an exercise physiologist and tailored exercise prescriptions. Primary and secondary outcomes included changes in FCR-7 and Functional Assessment of Cancer Therapy-General (FACT-G) scores. Statistical analyses included paired t-tests, Wilcoxon signed-rank tests, and mixed-effects modeling.

Results: A total of 149 patients with moderate-severe FCR were included; 86.5% adhered to the program. The mean FCR-7 score decreased significantly from 20.2 (SD = 4.6) at baseline to 12.8 (SD = 4.6) at 12 weeks (p = 0.001, Cohen's d = 1.6). FACT-G scores improved significantly from 84.4 (SD = 11.5) to 95.6 (SD = 9.2) (p = 0.001, Cohen's d = 1.0). Mixed-effects modeling confirmed a significant reduction in FCR-7 scores over time (F = 377.176, p < 0.001), with a significant overall effect across participants (F = 2210.733, p < 0.001).

Conclusion: This study suggests that a 12-week remote exercise program may reduce FCR among patients with cancer. Given its accessibility and scalability, remote exercise programs should be further explored as a feasible strategy for addressing FCR in diverse populations. However, these findings are preliminary and should be confirmed in larger, controlled trials.

Background: High-risk mothers undergoing BRCA testing must decide whether, when, and how to disclose hereditary cancer risk information to their adolescent and young adult (AYA) children.

Aims: This study explored maternal preferences/values and cognitive-affective factors influencing these decisions during genetic counseling.

Methods: Mothers (N = 282) reported on the perceived risks/benefits of AYA disclosure. Multivariable regression identified predictors of disclosure, and paired t-tests evaluated changes over time in maternal-AYA communication, distress, and decisional conflict following genetic counseling.

Results: Mothers reported valuing the benefits of disclosure more than risks (p < 0.001). Those who valued disclosure tended to have female (t = -1.74, p = 0.08) and older (r = 0.14, p = 0.03) children but were less knowledgeable about cancer risk (r = -0.17, p = 0.005). Conversely, mothers who perceived disclosure to AYAs as riskier tended to be non-white (t = 1.80, p = 0.072), Hispanic (t = 1.66, p = 0.098), lower-income (t = 2.56, p = 0.011), and with younger children (r = -0.28, p < 0.001) in poorer mental health (r = 0.12, p = 0.047). These findings were reaffirmed though a multivariable regression model controlling for benefits (adjusted R² = 0.11; age B = -1.09, p < 0.001; mental health B = 0.36, p = 0.04). Post-counseling, participants showed reduced decisional conflict (t = 2.4, p = 0.009) but increased depression/anxiety (t = -1.4, p = 0.08) and lower parent-child relationship quality (t = 2.7, p < 0.001).

Conclusions: Clinicians should be attuned to the factors shaping parental disclosure decisions and consider offering additional support to manage distress. Tailored educational tools for parents may aid family communication and improve psychosocial outcomes alongside genetic counseling.

Introduction: Depressive symptoms are common in cancer survivors. Recognizing depression can be complicated due to recall bias or oncological treatment-related symptoms including cognitive problems, which in turn may undermine the reliability of self-report questionnaires.

Aim: To explore the feasibility and patient satisfaction of smartphone-based Ecological Momentary Assessment (EMA) in primary care cancer survivors.

Methods: Patients > 18 years, curatively treated for cancer within the past two years, regardless whether they experienced depressive symptoms, were selected based on the GPs' health records. EMA questionnaires were sent three times daily for 6 weeks, covering positive and negative affect, along with related experiences. Patients received weekly EMA feedback reports. After the EMA period, they completed an evaluation questionnaire and participated in a follow-up phone call to discuss their EMA experiences.

Results: Patient recruitment achieved a reach of 17.0% who were invited for participation (158/931), of whom 33/158 agreed to participate yielding a response rate of 20.9%. Patients found the EMA questions clear and study participation easy with a completion rate of 67% among those who started. However, 64% felt the frequency of EMA prompts was excessive, with 52% considering the 6-week duration appropriate and 48% feeling it was too long. During phone call evaluations, patients reported becoming inattentive with filling out the EMA's. Weekly reports were viewed as relevant and provided valuable insights into levels and changes in their mood.

Conclusion: The relatively low reach and response rate do not entirely support the feasibility and acceptability of a 6-week EMA in cancer survivors in primary care without depressive symptoms. EMA was, however, completed by a majority among those who started and was regarded as a user-friendly tool that offered valuable insights to individuals. It could potentially benefit cancer survivors or other patients who do experience depressive symptoms in primary care.

Background: Youth feel uninformed in stem cell transplant and cellular therapy (SCTCT) decisions and those as young as 8 years of age want to be included in discussions. Decision support interventions for youth are few, and interventions targeting the youth-family interaction warrant attention.

Aims: The objective was to develop a family intervention to increase youth involvement in treatment decision-making (TDM) about SCTCT. A secondary objective was to obtain preliminary data on perceived usability (acceptability, feasibility, and appropriateness) of the intervention.

Methods: We used an iterative development process that included focus groups and individual interviews with an advisory panel and three groups: youth (8-17 years of age) and their parents; SCTCT providers; and experts in health communication and bioethics. Participants reviewed and discussed draft intervention materials, then completed a usability survey. Qualitative data were examined using content analysis and descriptive statistics summarized the quantitative data.

Results: Thirty-three participants provided feedback on content, design, delivery, perceived helpfulness, goals, and possible unintended harms. We made improvements to the final content, design, and delivery based on their suggestions. For example, we incorporated preferred terms and wording throughout, more color and illustrations, and multiple modes of delivery (e.g., paper and digital). The intervention was viewed as acceptable, feasible, and appropriate for the SCTCT decision context.

Conclusion: A family intervention called Let's Get REAL (Ready to Engage And Learn) about SCTCT was developed with experts and intended end-users. The intervention booklet is ready for real-time testing by youth and families referred for SCTCT.

Background: The benefits and harms of cancer screening must be balanced for all participant groups, including those who go on to have cancer diagnosed. The psychological impact of having cancer diagnosed through screening, rather than via another route, is currently unclear.

Aims: We conducted a systematic review to describe the psychological impact of detecting cancer through screening (screen-detected) compared to other routes (non-screen-detected).

Methods: Eligible studies investigated the psychological impact of screen-detected cancer. PubMed, Embase, and PsycINFO were searched. Two reviewers independently screened all titles, abstracts and full texts. We assessed quality using the Mixed Methods Appraisal Tool. Psychological outcome data were extracted for groups with screen-detected and non-screen-detected cancers, calculating Cohen's d where relevant. Results were narratively synthesized.

Results: We included 33 papers presenting quantitative results from 31 studies. All were considered medium to high quality. Studies measured psychological outcomes across six cancer screening programmes (breast, prostate, colorectal, lung, cervical and ovarian) using 31 different outcome measures. Receiving a screen-detected cancer diagnosis seemed to be associated with a small or moderate short-term increase in adverse psychological outcomes. In studies comparing outcomes by detection route, most found no difference (n = 16 studies), or that patients with screen-detected cancers fared better than those with non-screen-detected cancers (n = 11 studies), but effect sizes were small.

Conclusions: A screen-detected cancer diagnosis can lead to short-term adverse psychological outcomes; however, there is no strong evidence for a difference in psychological outcomes by detection route. Greater consistency of measures and timepoints would facilitate between-study comparisons.

Prospero registration: PROSPERO 2017 CRD42017075269.