Psycho‐Oncology最新文献

Objective: Advanced cancer affects both patients and their spousal caregivers. Understanding dyadic coping experiences in cancer care provides insights into the psychological and emotional dynamics between patients and their partners. This study aimed to explore the dyadic coping experiences of cancer patients and their spouses during treatment in China.

Methods: Utilizing a longitudinal, qualitative study, we conducted semi-structured interviews with cancer patients and their spouses during the first 6 months following cancer diagnosis. A total of 18 patient-spouse dyads were recruited, and 16 dyads completed all follow-ups at baseline and after three and six months. Audio-recorded interviews were transcribed and analyzed thematically to identify dyadic coping experiences and develop a generalized typology emotional journey map.

Findings: The identified themes across the four phases in the context of Chinese culture are as follows: (1) Crisis impact and reactive coping during the early diagnosis; (2) Coping differentiation and role restructuring in the initial treatment phase; (3) Collaborative adaptation and emotional adjustment throughout the regular treatment period; (4) Sustained care and anticipatory preparation during home care. Additionally, twelve sub-themes for dyadic coping experiences emerged during cancer care. Based on these results, a journey framework was provided, revealing dyadic coping experiences in a dynamic process.

Conclusion: The dyadic coping experiences of patient-spouse dyads in cancer care evolve dynamically, undergoing evident shifts across the illness trajectory. The findings suggest that healthcare providers should view cancer issues as a dyadic challenge rather than an individual condition, and develop tailored, culturally congruent, couple-centred interventions.

Objective: To evaluate the feasibility of an online expressive writing (EW) intervention for survivors of adolescent and young adult (AYA) cancer and determine whether iterative, theory-driven modifications can enhance response, adherence, and completion rates.

Methods: In this randomized pilot trial, survivors of AYA cancer were recruited through a hospital-based AYA oncology clinic and an online community. Forty participants were randomly assigned to the EW intervention or control group. To improve on lower-than-expected adherence and completion rates in a previous cohort, the protocol was iteratively revised using the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS). Modifications included extending the intervention from 3 to approximately 6 weeks, allowing more flexibility; two prompt choices per session; and proactive, personalized reminders. Response, adherence, and follow-up survey completion rates at 1, 3, and 6 months were collected via REDCap surveys, and participant feedback was obtained through post-study interviews.

Results: We achieved a 46% response rate, compared to 40% in the previous cohort. Adherence improved significantly, with 83.3% of participants completing all 3 writing tasks versus 25.0% in the previous cohort (p < 0.001). The 6-month follow-up completion rate also increased to 72% from 50% in the previous cohort. Qualitative feedback indicated that the flexible timeline, tailored prompts, and personalized reminders were well received.

Conclusions: Iterative, FRAME-IS-guided modifications markedly improved the feasibility of the online EW intervention for AYA cancer survivors. These findings support further research to assess the clinical efficacy of EW in enhancing health outcomes and quality of life.

Background: Depression and anxiety are prevalent among patients with esophagogastric cancers and may adversely affect survival, yet their prognostic significance in this population remains unclear. We conducted the first systematic review and meta-analysis to quantify the impact of baseline depressive and anxiety symptoms on survival outcomes in patients with esophageal and gastric cancers.

Methods: Following PRISMA guidelines, we searched PubMed, Scopus, Embase, and Web of Science through July 2, 2025. Eligible studies reported hazard ratios (HRs) for overall survival (OS), disease-free survival (DFS), or progression-free survival (PFS) in adults with histologically confirmed esophagogastric cancer and assessed depression and/or anxiety using validated instruments. Two reviewers independently screened records, extracted data, and appraised study quality. We pooled multivariate-adjusted HRs using random-effects models, assessed heterogeneity with I², and examined publication bias via Egger's and Begg's tests. Sensitivity analyses used a leave-one-out approach.

Results: Ten studies (n = 10,442) met the inclusion criteria, of which six provided sufficient data for meta-analysis. When depression and/or anxiety were analyzed collectively among patients with gastric or esophageal cancer, the pooled hazard ratio (HR) indicated a significant association with poorer survival (HR = 1.64; 95% CI: 1.31-2.06; p < 0.05; I² = 51.22%). Depression alone was also significantly associated with worse overall survival (HR = 1.77; 95% CI: 1.29-2.44; p < 0.05; I² = 60.05%). A subgroup analysis limited to gastric cancer patients revealed a similarly significant association for combined depression and anxiety (HR = 1.68; 95% CI: 1.28-2.21; p < 0.05; I² = 39.43%). Sensitivity analyses demonstrated that no single study significantly altered the results. Evidence of potential publication bias was observed in Egger's test for both the full sample and depression-only models (p = 0.001). For Begg's test, a significant result was found in the full sample (p = 0.024), whereas no significant bias was detected in the depression-only model (p = 0.221). No publication bias was detected in the gastric cancer subgroup (Egger's p = 0.08; Begg's p = 0.29).

Discussion: Depression and anxiety appear to predict poorer survival in esophagogastric cancer patients, underscoring the prognostic importance of psychological distress. Future prospective studies with standardized, longitudinal assessments of mental health and interventional trials are needed to clarify causal pathways and test whether psychological support can improve survival and quality of life in this vulnerable population.

Objective: To understand the role of social support in the caregiving experience of cancer patients through a narrative synthesis of systematic reviews and meta-analyses, providing a comprehensive overview in the field.

Methods: A systematic search of systematic reviews and meta-analyses published between 2013 and 2024 was conducted in PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Scopus using PCC-based search terms related to informal caregivers, social support, and cancer.

Results: The search resulted in a total of 1377 articles, of which 32 met the inclusion criteria and quality assessment. Through a high-level narrative synthesis, we identified three main thematic areas: (i) the role of social support in shaping caregivers' outcomes, including their psychological well-being, adaptation to the caregiving role and difficulties in receiving and seeking help; (ii) changes in interpersonal relationships, including the relationship with the patient; and (iii) support needs and psychosocial interventions designed to address them.

Conclusions: Our narrative synthesis confirms social support as a critical factor shaping psychological well-being, role adaptation, and quality of life among informal caregivers. Evidence consistently shows that emotional and instrumental support reduce caregiver burden and distress, despite frequently reported barriers to seeking and receiving help. Caregiving reshapes interpersonal relationships, requiring ongoing role renegotiation within the caregiver-patient dyad. Dyadic interventions focusing on relational communication are more effective than information-only approaches and adaptable across settings. Future research and policies should prioritize person-centered support throughout the cancer trajectory.

Objective: Haitian migrant women experience disproportionate rates of cervical cancer. Cultural worldviews have been implicated as a factor influencing cervical cancer behaviors. However, no validated or reliable scale has been developed to measure the influence of cultural worldviews on cervical cancer risk and behaviors in this community.

Methods: We detail the original development and psychometric testing of the Traditional Health Practices for Cervical Cancer Prevention Scale (THP-CCP). A total of N = 151 Haitian women who recently migrated to the U.S. participated in the study. Scale items were newly developed based on qualitative interviews conducted by our team. Items were administered to participants, and the scale's construct validity, reliability, and concurrent validity were evaluated. We hypothesized that the scale would be associated with women's education levels and superstitious beliefs toward cancer, which we tested with an ANOVA and Pearson's correlation.

Results: A total of 30 items were developed in Haitian Creole and were evaluated by an expert panel of reviewers. Factor analysis yielded a one-factor solution consisting of 11-items interpreted as traditional health practices and cultural beliefs influencing cervical cancer risk and behaviors. The total scale Cronbach's alpha reliability coefficient was 0.79. The THP-CCP scores demonstrated concurrent validity with women's education level (F = 3.56, p = 0.031) and superstitious beliefs toward cancer (r = 0.26, p value = 0.001).

Conclusion: The THP-CCP scale demonstrated strong psychometric properties and can assist researchers in better understanding cultural influences toward engagement in cervical cancer prevention behaviors among Haitian women.

Background: Cancer is a significant psychological burden for patients. Previous evidence syntheses suggest creative arts therapies (CATs) may improve psychological outcomes, but are limited by heterogeneity in intervention types, study designs, and outcomes, and the lack of a certainty of evidence assessment.

Aims: We conducted a robust systematic review and meta-analysis of current randomized trial literature to explore the efficacy of CATs in improving anxiety, depression, and quality of life in cancer patients.

Methods: We searched PubMed, Embase, and PsycInfo databases for peer-reviewed randomized trials evaluating the effectiveness of CATs against a control in patients with current cancer diagnoses. We performed pairwise random-effects meta-analyses of standardized mean differences (SMD) for anxiety, depression, and quality of life, stratified by time-interval. We conducted subgroup analyses by session frequency, intervention type, treatment setting, and region. For studies not pooled quantitatively, results were qualitatively summarized.

Results: 67 randomized trials with 6259 patients were included. The majority of interventions were music-based (80.6%), multi-session (59.7%), inpatient-based (73.1%), and conducted in North America (29.9%). Meta-analyses demonstrated positive effects of CATs on anxiety at < 7 days (SMD = -0.62 [95% CI -1.01, -0.24]), 4-6 weeks (-1.21 [-2.08, -0.34]), and 2-3 months (-1.19 [-2.14, -0.24]); depression at 1-3 weeks (-0.44 [-0.87, -0.00]) and 4-6 weeks (-1.14 [-1.76, -0.52]); and quality of life at 1-3 weeks (0.65 [0.05, 1.25]), 4-6 weeks (1.17 [0.02, 2.32]), 2-3 months (1.42 [0.55, 2.29]), and 4-6 months (0.42 [0.04, 0.80]. Qualitative results corroborate these findings. GRADE assessment revealed low-to-very-low certainty of evidence.

Conclusion: Creative arts therapies may improve anxiety, depression, and quality of life among cancer patients.

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.

Background: Depression is common among older adults with cancer. The USA-developed CARE (Cancer and Ageing: Reflection for Elders) psychotherapy intervention, specifically addresses the unique needs of older people (≥ 70 years) navigating the challenges of ageing, depression, and cancer.

Aims: To review and tailor the CARE resources to ensure they are culturally appropriate and acceptable for older Australians.

Methods: Semi-structured cognitive 'think aloud' interviews were conducted with older Australians (≥ 70 years) diagnosed with cancer. Participants reviewed the intervention resources for each session providing feedback on content relevance and understandability. Content analysis was used to analyse the interviews.

Results: We completed 20 cognitive interviews. Participants had a mean age of 74 years (range 70-79) and most with a diagnosis of blood (55% n = 11) or breast cancer (45%, n = 9) within 10 years. Resource content resonated with participants and a telephone-delivered intervention was acceptable. Participants emphasised the need to simplify wording and modify language to reflect Australian culture. In Australia 'elders' is a cultural term used by First Nations peoples to identify a custodian of knowledge; most participants suggested changing this. For some participants, the analogy of ageism to racism used felt unfamiliar.

Conclusions: This study highlights that cultural adaptation of psycho-oncology interventions is required, even between English-speaking countries, to ensure cultural appropriateness and enhance feasibility, acceptability and to maximise uptake for older adults facing cancer and depression.

Background & aims: Cancer treatments and survival rates have significantly improved, yet distress in patients and their relatives remains overlooked, leaving them with needs unmet. One contributing factor is inadequate screening, which could be improved by digitalisation. This study examined differences in distress among outpatients, inpatients, and their relatives, along with acceptance and usability of digital screening tools.

Methods: 149 participants including relatives, outpatients, and inpatients were randomised using established analogue screening versus digital screening with text-based instructions or digital screening with video-based instructions for the Distress Thermometer and rated their distress. Participants then provided ratings for usability and acceptance of digital screening measures.

Results: Overall distress levels on average were high for all, inpatients, outpatients and relatives. There were no significant differences between groups in overall distress levels. Inpatients without wish for counseling reported greater physical distress and lower psychological and psychosocial distress than inpatients with wish for counseling, who were similar to relatives and outpatients. Participants expressed high overall satisfaction with digital screening measurements. Digital screening with text-based instructions seems to be superior to analogue screening or video-based screening, regardless of age and gender, when people have hands-on experience. Patients and relatives using analogue screening are more skeptical of digital screening, especially elderly and female users.

Conclusion: Our study offered valuable insights into the varying distress levels of inpatients, outpatients, and relatives, which leads to the implication that outpatients and relatives should also be screened closely. The decisive variable was wish for counseling. There is a need for more counseling options for both cancer patients and their relatives. Our findings support the use of digital screening methods for patients and relatives. The hands-on experience seems to be crucial for a higher acceptance.