Psycho‐Oncology最新文献

Objective: Synthesize qualitative research to explore post-treatment cancer survivors' social reintegration experience.

Methods: We conducted a meta-synthesis that included studies on all types of cancer. There were no restrictions on article age or location of the studies, provided they met the inclusion criteria. A search of the Cochrane Library, PubMed/MEDLINE, Web of Science, Embase (Ovid), and CINAHL (EBSCO) was conducted for studies published in English in February 2024. The PRISMA guidelines were followed. The Joanna Briggs Institute Reviewer's Manual was used to assess the quality of studies. Meta-aggregation was performed to synthesize the findings of the included studies.

Results: A total of 1031 articles were identified in the initial search. Sixteen articles met the inclusion criteria and were included in this review. The total number of cancer survivors included in this systematic review was 395. Five synthesized findings were identified: the impact of cancer and treatments on survivors' physical, psychological, and social interactions was the cause of social withdrawal; cancer survivors encountered internal and external obstacles in the process of social reintegration; cancer survivors took action to promote social reintegration; support from others encouraged cancer survivors' social reintegration, but they also had unmet needs; social reintegration promoted cancer survivors to view cancer positively and achieve self-transcendence.

Conclusion: This study synthesized qualitative evidence related to social reintegration among post-treatment cancer survivors. Cancer survivors took active measures for social reintegration. In turn, social reintegration also had a positive consequence on cancer survivors. Survivors had internal and external obstacles and needs in the process of social reintegration. Therefore, practitioners should identify obstacles and needs for social reintegration and develop targeted intervention programs to facilitate the social reintegration of survivors.

Objective: Cognitive-behavioral intervention (CBI) has shown positive effects in improving psychological and health-related outcomes in children with cancer. However, no evidence has been found in Ethiopia. This study aimed to evaluate the effects of CBI on anxiety, depression and quality of life (QoL) in Ethiopian children with hematological cancer receiving chemotherapy.

Methods: A parallel, two-armed, assessor-blinded, randomized controlled trial was conducted among 76 children randomized (1:1) to receive CBI or usual medical care. The intervention group received five weekly face-to-face CBI sessions of 30-40 min each, which included an introduction to CBI; identifying and challenging maladaptive thoughts, beliefs and behavior; behavior activation; deep breathing exercises; and treatment evaluation and relapse prevention. The outcomes were measured at baseline (T0), immediately post-intervention (T1) and 1 month post-intervention (T2).

Results: The intervention group showed a significant reduction in anxiety scores from T0 at T1 (β = -6.67, 95% CI [-9.16, -4.19], p < 0.001) and T2 (β = -8.14, 95% CI [-10.70, -5.57], p < 0.001), depression at T1 (β = -4.09, 95% CI [-6.94, -1.23], p = 0.005) and T2 (β = -6.12, 95% CI [-9.10, -3.13], p < 0.001) and improvement in QoL at T2 (β = 3.02, 95% CI [0.49, 5.56], p = 0.019) compared with the control group.

Conclusions: CBI has positive effects in reducing anxiety and depression and in improving QoL in children with hematological cancer receiving chemotherapy. The results suggest the need to incorporate CBI into pediatric hematology-oncology and studies on its long-term effects and cost-effectiveness are warranted.

Trial registration: ClinicalTrials.gov (NCT05270655). Registered on 08 March 2022.

Background: The post-treatment survivorship period marks the transition away from acute care and poses distinct challenges for individuals with head and neck cancer (HNC). This can be especially challenging for people in regional areas who travel long distances to access care and experience unique challenges in accessing health services.

Aim: To investigate unmet needs and healthcare utilisation of survivors of HNC in regional areas.

Methods: Invitations were sent to 619 survivors of HNC living in rural New South Wales, Australia, who were 1-15 years post-treatment. Participants self-reported unmet survivorship needs and the strength of these needs using the Cancer Survivors' Unmet Needs Measure. Health care utilisation over the preceding 12 months was collected using an investigator-designed questionnaire.

Results: One hundred and seventeen responses were received (19% response rate). Participants were predominantly male (65%), had oropharynx cancer (52%), with mean age of 70.2 years. Some 54% of participants reported at least one unmet need, and 40% rated these unmet needs as 'strong'. Top unmet needs included concern about recurrence (24%), access to local services (15%), and financial support (15%). 94% of participants reported seeing their GP, while 62% visited a dental clinic; only 10% sought professional psychosocial support despite prevalent unmet needs.

Conclusion: Rural survivors of HNC in Australia have substantial unmet psychosocial needs yet demonstrate low utilisation of professional psychosocial support. This may reflect the limited availability or accessibility of services for this population, which could be addressed with shared models of care utilising both GP-led and telehealth services.

Background: Parents with advanced cancer and their partners are more likely to experience psychological distress than their counterparts without minor children. Greater relationship functioning may support parents in distress.

Aims: The current study seeks to explore couples' cancer-related parenting communication behaviors, perception and their associations with psychological and relational wellbeing.

Methods: Women diagnosed with an advanced breast cancer (Stage III-IV) and their partners (n = 46 dyads) parenting a minor child reported psychological symptoms (CES-D, GAD-7), relational wellbeing (DAS-7) and cancer-related parenting concerns (PCQ, patient only). As part of an observational task, couples completed a Family Concern Inventory (FCI) to identify cancer-related family concerns. Then, each member selected one concern to discuss. Immediately after the discussion, participants rated their perception of the discussion and their state positive and negative affect.

Results: Parents (mean age = 43.4 years, 56% non-Hispanic White, two female couples) endorsed high psychological distress, with patients reporting greater family concerns than partners (t = 3.80, p < 0.001). Both members of the couple indicated high levels of self-disclosure and felt validated and accepted by their partners during the discussion. Yet, patients rated the discussion as more helpful than partners (t = 2.3, p = 0.03). There was a small reduction in positive affect following discussion for partners only. However, the more partners disclosed their emotions, the greater their post-discussion positive affect (r = 0.50, p < 0.001).

Conclusions: Couples' ability to openly communicate around cancer-related parenting concerns is associated with aspects of psychological adjustment. Findings identify targets and underscore importance of flexibility for future interventions.

Background: Postoperative patients with oral cancer are deeply distressed about their body image. However, their true inner feelings and the factors influencing body image remain unclear.

Aims: This study aims to investigate the experience of body image disturbance in patients 3 months after oral cancer surgery and analyze the influencing factors.

Methods: This study process was divided into three steps: (1) semi-structured interviews, based on the Society Ecosystems Theory, of patients with body image disorders 3 months after oral cancer surgery, followed by theme summaries; (2) appropriate selection of scales according to the qualitative results; and (3) a cross-sectional survey to explore the factors and pathways affecting the body image of the patients.

Results: Qualitative research summarized nine themes from the individual, family/employment, and societal/institutional levels, with the individual level being most commonly mentioned. Further investigation into the individual factors influencing the body image of the patients revealed that self-esteem and social alienation have a chain mediating effect on the relationship between speech handicap and body image.

Conclusions: The body image of postoperative patients with oral cancer is influenced by personal, family, and societal aspects. These study results lay the groundwork for formulating interventions to alleviate body image concerns.

Background: Pain is a prevalent, frequent, and often persistent symptom among children with acute lymphoblastic leukemia (ALL). Despite its high prevalence, pain has remained understudied, and no evidence-based recommendations exist for how best to assess and treat pain in this population. Without proper assessment, clinical efforts to improve pain management in pediatric ALL will be ineffective.

Aims: Therefore, the purpose of this systematic review is to describe and identify gaps in measurement approaches that have been used to assess pain in pediatric ALL, evaluate the psychometric properties of available pediatric pain measures, and provide recommendations for clinical research and practice.

Methods: Literature searches were performed following Cochrane and PRISMA guidelines for systematic reviews. Domains of pain assessed, measures used to assess pain, measure format, respondent, and timing of pain assessment were extracted from studies that met inclusion criteria. The psychometric properties of included measures were then evaluated. A total of 238 full-text articles were screened and 123 met inclusion criteria.

Results: Most studies assessed pain using generic health-related quality of life instruments rather than pain-specific measures. A total of 39 measures were used across the 123 included studies, and the psychometric properties of the measures varied considerably.

Conclusions: Recommendations include a selection of well-validated pain assessment measures that are currently available and can be used to facilitate best practices in ALL pain assessment. Clinicians and investigators are encouraged to utilize a multidimensional pain assessment approach to inform and enhance pain care in pediatric ALL.

Objective: Breast cancer patients often face a significant financial burden, leading to financial toxicity due to the necessity for long-term care, costly treatment, and follow-up measures. The purpose of this study is to systematically review the available qualitative evidence on how breast cancer patients cope with financial toxicity and their unmet need to promote the implementation of effective intervention strategies.

Methods: PubMed, Web of Science, PsycINFO, CINAHL, EMBASE, Scopus, CNKI, Wan Fang Data, and VIP databases were systematically searched for literature related to the study topic. This study was conducted according to the PRIMSA guidelines. Thematic synthesis methods were used to analyze the data and construct themes. The review was pre-registered on PROSPERO (CRD42024502030).

Results: The search yielded 1164 results; 23 articles met the inclusion criteria and reported on a total of 1098 breast cancer patients. The thematic analysis identified three themes and 15 sub-themes: coping emotions (shrouded in negative emotions and adopting a positive attitude); coping behaviors (increasing income sources, adjusting personal or family finances, seeking and accepting support, coping independently, avoidance, constrained decision, financial planning, and proactive negotiation); and coping needs (health insurance policy support, medical institutional support, non-medical institutional resources support, financial information needs, financial management needs).

Conclusion: Breast cancer patients exhibit a variety of emotional reactions and coping behaviors with financial toxicity alongside several unmet needs. This indicates the necessity of maintaining focus on financial toxicity in breast cancer patients and the implementation of appropriate management strategies to address their needs while optimizing the detection and mitigation of expenditures that jeopardize their health and quality of life.

Background: Nearly 20% of US cancer survivors develop cardiovascular disease (CVD) from cardiotoxic cancer treatments. Patients and providers may consider alternative treatments to lower cardiotoxicity risk, but these may be less effective at preventing relapse/recurrence, presenting a difficult tradeoff.

Aims: This study explored survivors' cancer treatment decision-making when weighing this tradeoff.

Methods: Using adjusted multivariable logistic regression, we examined 443 US survivors' risk perceptions (deliberative, affective, and intuitive) about cancer and CVD and associations of these with their selection between two hypothetical cancer treatments: Treatment A: 5% chance of cancer recurrence and 10% chance of CVD; Treatment B: 10% chance of recurrence and 5% chance of CVD. We explored the effects of delay discounting by randomizing to a condition describing cancer recurrence/CVD as either immediate or delayed.

Results: More survivors (Mage = 48, range = 18-93; M = 10.8 years post-diagnosis) selected Treatment A than Treatment B (72% v. 28%). Timing of onset was not associated with treatment selection. Greater affective risk perception (worry) about cancer was associated with increased odds of choosing Treatment A, whereas greater CVD worry was associated with decreased odds (OR-cancer = 1.33, p = 0.006; OR-CVD = 0.72, p = 0.007). Neither deliberative nor experiential risk perceptions were associated with treatment choice.

Conclusions: Survivors were more likely to select the treatment that minimized recurrence rather than CVD-regardless of the timing of onset. Treatment decision was linked to both cancer- and CVD-related worry but not deliberative or experiential risk perceptions. During treatment discussions, clinicians should open conversations about the risks of treatment-associated cardiotoxicity, the probabilities, and patients' relative worries about cancer and cardiotoxicity.

Objective: In recent years, many studies have investigated the triggers, perpetuating factors, and outcomes of Fear of Cancer Recurrence (FCR), highlighting its complexity with multiple dimensions that encompass both antecedents and consequences. In this sense, the cognitive approach to FCR has explored variables such as metacognition, maladaptive coping strategies, and intolerance of uncertainty (IU). On the other hand, the findings of a restricted number of studies investigating the relationship between FCR and stated variables appear to be inconsistent. The objective of this study was thus to examine the relationship that existed among these variables in breast cancer survivors by moderated mediation model.

Methods: In this cross-sectional study, 130 breast cancer survivors completed the Fear of Cancer Recurrence Inventory (FCRI), the Intolerance of Uncertainty Scale Short Form (IUS-12), Metacognitions Questionnaire-30 (MCQ-30), and Brief COPE Scale (BCS) Short Form. The mediated moderation analysis was conducted using Process Macro.

Results: There was a significant positive correlation found between FCR and IU (r = 0.87, p < 0.001), and between FCR and negative metacognitions (r = 0.72, p < 0.001). A weak to moderate positive correlation was identified between IU and maladaptive coping strategies (r = 0.19, p < 0.05), and between negative metacognitions and maladaptive coping strategies (r = 0.31, p < 0.001). The relationship between FCR and maladaptive coping strategies was nonsignificant (r = 0.16, p > 0.05). As a result of hierarchical regression analysis, controlling for demographic and clinical variables, IU, positive metacognitions, and negative metacognitions significantly explained 45%, 2%, and 1% of the variance in FCR, respectively.

Conclusion: The results of the current study contribute to the literature in terms of supporting the views that cognitive models of worrying could be used to understand the FCR mechanism and address the IU been which has limitedly studied in the FCR literature. The current study's findings have also contributed to the clinical field by highlighting the importance of incorporating breast cancer survivors' metacognitions and IU in FCR intervention programs.

Taste disturbances are prominent side effects of antineoplastic medications and contribute to morbidity and quality-of-life impairment. Few treatment options are available for antineoplastic-related taste disorders. Hypnosis has been found to be effective for a variety of symptoms in the cancer setting, including insomnia, pain, mood disorders and anxiety. Numerous somatosensory perceptual changes have been observed with hypnosis, including perception of tactile stimuli and color. Here, we report a case of a 74-year-old woman with recurrent metastatic breast cancer presenting with an 18-month history of antineoplastic-related hypogeusia. She was treated with hypnosis and reported resolution of taste symptoms after 10 days of daily practice. Her improvement seems to be related to hypnotic changes in somatosensory perception, which may be associated with functional alterations in salience, executive control and default mode networks during hypnosis. Further investigation of hypnosis for antineoplastic-related taste disturbances is indicated.