Psycho‐Oncology最新文献

Background: Patients' coping styles, perceptions, and attitudes are important for healthy living and survivorship in breast cancer.

Aim: To assess factors associated with coping styles in patients with breast cancer surgery in an underserved population in Northern Nigeria.

Methods: This cross-sectional study included 72 patients with breast cancer post-surgery. Data was collected on clinico-demographic variables, patients' perceptions, the World Health Organization Quality of Life (WHOQOL-BREF), the General Health Questionnaire (GHQ-12), and the Coping Strategy Inventory (CSI-32).

Results: The mean age of participants was 45.9 (±9.1) years. Over 80% of participants underwent mastectomy, with 93.1% reporting complications. Notwithstanding, participants largely perceived that the procedure was life-saving, and most did not feel the need for a breast prosthesis. Notably, 70.8% reported an increased tendency to withdraw socially, but only 34.7% experienced functional difficulties with daily activities or chores. Patients practiced different engagement-disengagement coping strategies, albeit use of multiple dimensions of engagement coping was pronounced in a greater fraction (percentile) of patients. Multiple aspects of perception (including a lack of satisfaction with clothes fitting, feelings of incompleteness, greater time since surgery), and the experience of psychological distress were associated with disengagement coping. On the other hand, engagement coping was more likely in patients who were satisfied with clothing fit, experienced less impact on daily living, and had an improved quality of life.

Conclusion: Coping in patients with breast cancer post-surgery is multifaceted, varying by individual perception and psychosocial wellbeing. Future research is needed to guide interventions that bolster psychosocial well-being to promote healthy coping.

Background: Paediatric oncologists routinely face emotionally demanding situations, including prolonged exposure to child suffering, ethically complex decision-making, and high clinical workloads. These stressors contribute to burnout, moral distress, and psychological strain, yet their lived experiences remain underexplored.

Objective: To synthesise existing evidence on the psychological challenges experienced by paediatric oncologists, with a focus on burnout, emotional exhaustion, moral distress, and coping strategies.

Methods: A scoping review was conducted using the Joanna Briggs Institute methodology and reported in accordance with PRISMA-ScR guidelines. Five databases [PubMed, ProQuest, Scopus, Web of Science, and CINAHL] were searched for English-language studies published between 1992 and April 2025. Fourteen studies met the inclusion criteria [5 qualitative, 8 quantitative, 1 mixed-methods].

Results: Key psychological stressors included emotional exhaustion, depersonalisation, moral distress, and job dissatisfaction. Coping strategies ranged from peer support and physical activity to institutional interventions such as debriefing sessions and resilience training. Stigma surrounding help-seeking and systemic barriers to emotional support were recurrent themes.

Conclusion: Burnout in paediatric oncology is a multifaceted phenomenon shaped by personal, ethical, and organisational factors. Addressing these challenges requires both individual-level coping mechanisms and systemic reforms, including trauma-informed leadership, confidential mental health support, and the redistribution of workloads. Future research should explore longitudinal outcomes and culturally diverse experiences to inform targeted interventions.

Background: The recent developments in immunotherapy and targeted therapy drugs offer a new hope for prolonging overall survival and improving quality of life in individuals with advanced lung cancer. However, treatment response to these drugs is variable and unpredictable and early research indicates that these individuals are living with distressing uncertainty and unique supportive care needs.

Aims: Qualitatively characterize the psychological experience of receiving ICI and TT.

Methods: The study design and interview guide were developed with the charitable organization Lung Cancer Canada (LCC) and a patient advisory board. A diverse group of patients with advanced lung cancer receiving immunotherapy or targeted therapy were recruited from across Canada. Qualitative interviews (n = 24) explored their unmet needs using the Supportive Care Framework in Cancer Care. A thematic analysis was conducted.

Results: All participants described a similar treatment "cycle" associated with similar experiences and psychological concerns at each phase. Participants described shock and distressing uncertainty in illness at the beginning of treatment and during periods of disease and treatment change. Medically stable periods of treatment response were associated with difficulties with adjustment, coping, and finding new meaning in life. Participants described fear of progression and death anxiety in response to uncertainty in disease and treatment. Various psychological (e.g., acceptance, avoidance, meaning-making) and practical (e.g., social support, information seeking) coping strategies were described.

Conclusions: Advocates, clinicians, researchers, and policymakers should be aware of the unique psychological needs of this growing population. Psychological interventions must address illness uncertainty and corresponding fears and worries.

Purpose: With over 56,000 new cases of breast cancer a year in the UK and 76% of these expected to live beyond 10 years, managing long-term care and support is an urgent challenge. This scoping review aims to map the current literature on outcomes and lived experience of Self-Directed Aftercare (SDA) pathways following breast cancer surgery. We aim to assess what evidence exists to support the current delivery of this approach.

Methods: A scoping review in line with the PRISMA-ScR template was undertaken across 3 databases (Web of Science, PubMED and OVID Medline) using an iteratively developed search strategy based on concepts of "breast cancer", "self-directed" and "aftercare". Screening was undertaken by all authors and disagreements settled by team discussion. Key data were extracted from qualitative and quantitative studies, with descriptive statistical and thematic analysis conducted.

Conclusions: Available literature is sparse and of variable quality. While reductions in clinic attendance are reported, there is a wide range of patient lived experience. There are positive reports of the convenience of SDA, while negative aspects included unmet psychological and information needs, which also changed over time. Ease of access to speciality breast advice varied across studies.

Implications for cancer survivors: Globally more patients are being managed via SDA, but this review demonstrates the lack of research assessing the safety, acceptability, and cost-effectiveness of this approach. It is imperative that services address the evolving needs of breast cancer survivors and integrate feedback from patients with lived experience of breast cancer aftercare.

Trail registration: This project has been publicly registered with the Open Science Framework (July 2024). It can be found under the project "Exploring oncological outcomes and lived experiences of patients and their carers managed via self-directed aftercare pathways following breast cancer surgery" available at https://osf.io/b56vq/.

Background: Masculinity has been identified as a potential influence on psychological and physical health outcomes among male cancer survivors. This systematic review synthesized quantitative research examining associations between masculinity-related constructs and survivorship outcomes, including mental health, physical functioning, and health-related quality of life (HRQoL).

Methods: A systematic search of PsycINFO, CINAHL, and PubMed was conducted through March 2025, following PRISMA guidelines. Studies were included if they quantitatively assessed masculinity-related variables in male cancer survivors and reported associations with HRQoL, mental health, or physical health outcomes. Study quality was assessed and a narrative synthesis was conducted.

Results: Thirty-one studies met inclusion criteria. Traditional masculine norms (e.g., self-reliance, dominance, stoicism) and cancer-related masculine threat were consistently associated with poorer mental health, lower HRQoL, and greater symptom burden. In contrast, masculine self-esteem, a positive appraisal of one's masculinity post-cancer, was linked to better psychosocial outcomes and HRQoL across samples. Most studies were cross-sectional and focused on prostate cancer survivors, often lacking demographic diversity.

Conclusions: Masculinity-related constructs are meaningfully associated with cancer survivorship outcomes. Future work should prioritize longitudinal designs, cultural diversity, and clinical translation to develop gender-sensitive interventions targeting masculine identity disruption and promoting adaptive self-concepts.

Aims: Digital tools offer scalable support for cancer survivors' psychological well-being, however, direct efficacy comparisons between artificial intelligence (AI)-Enhanced and clinician-guided digital interventions are scarce. This study evaluated an AI-Enhanced expressive writing intervention against clinician-guided digital support and usual care for cancer survivors.

Methods: In this randomized controlled trial, 120 cancer survivors (111 completers) were randomized (1:1:1) to AI-Enhanced, clinician-guided, or usual care groups for a 4-week expressive writing intervention. Outcomes, including depression, anxiety, fear of progression (FoP), and resilience, were assessed at baseline, post-intervention, and 1-month follow-up between September 2024 and April 2025. Data were analyzed using repeated-measures ANOVAs and thematic analysis of semi-structured interviews.

Results: Both AI and clinician-guided interventions significantly reduced depression (AI: d = 0.92; Clinician: d = 0.98) and anxiety (AI: d = 0.59; Clinician: d = 0.66) versus usual care, with comparable efficacy. However, clinician-guided support demonstrated greater efficacy in reducing FoP (d = 0.62 vs. AI). Resilience improved over time across all groups, with no significant inter-group differences. Qualitatively, AI offered reduced stigma and accessibility, while the clinician-guided approach provided valued empathetic connection.

Conclusion: AI-Enhanced expressive writing is a viable, scalable tool for reducing depression and anxiety in cancer survivors. Yet, the greater efficacy of clinician-guided digital support for complex issues like FoP highlights the value of human-mediated empathy. This advocates for hybrid models in psychological care that integrate AI's scalability with the relational depth of clinical expertise to enhance survivor well-being.

Trial registration: Chinese Clinical Trial Registry (ChiCTR2400089455).

Background: Cancer pharmacotherapy imposes substantial physical and psychosocial burdens that affect patients' quality of life (QoL). While oncologic outcomes are well studied, the psychological dimensions-particularly future perspective, emotional resilience, and body image-remain underintegrated into routine care. The growing recognition of psycho-oncology highlights the need for synergistic collaboration between oncology and clinical psychology.

Aim: To evaluate changes in QoL before and after pharmacotherapy among women with breast cancer and identify domains most vulnerable to psychological distress, thereby informing the need for integrated psycho-oncologic care.

Methods: This prospective study included 106 women with breast cancer undergoing pharmacotherapy. Sociodemographic and clinical characteristics were collected, including cancer stage, treatment modalities, and baseline cardiometabolic parameters. QoL was assessed pre- and post-treatment using EORTC QLQ-C30 and BR23 instruments. Paired comparisons were performed using Wilcoxon signed-rank tests, and correlations with age were analyzed using Spearman or Pearson methods as appropriate.

Results: Global health status declined significantly after pharmacotherapy (83.3 to 66.7; p = 0.002). Functional domains-including physical, role, and social functioning-also worsened, while emotional functioning improved modestly. Symptom burden increased across fatigue, nausea, pain, appetite loss, and systemic side effects (all p < 0.001). Breast-cancer-specific domains such as body image and future perspective showed minimal change but remained highly variable, indicating psychosocial vulnerability. Distress related to hair loss demonstrated a modest inverse correlation with age (r = -0.296; p = 0.003).

Conclusion: Pharmacotherapy substantially reduces multiple QoL domains, highlighting symptom-function trade-offs and persistent psychological concerns. The patterns in emotional functioning and future perspective indicate unmet psychosocial needs. These findings underscore the imperative for integrated psycho-oncology models to enhance holistic survivorship care.

Background: Global illness-related stigma is increasingly recognized as a formidable barrier to health-seeking behavior, engagement in care, and adherence to treatments across a range of disease conditions. Stigma is experienced by many patients with lung cancer (PwLC) in the United States; however, less is known about how lung cancer stigma operates in Nigeria.

Aims: This qualitative study was conducted to describe lung cancer stigma and examine the cultural adaptability of the conceptual model of lung cancer stigma in Nigeria.

Methods: Individual and small group interviews were conducted with PwLC (N = 16) at University College Hospital (UCH), Ibadan and at Obafemi Awolowo University Teaching Hospitals Complex (OAU), Ile-Ife.

Results: Data analyses revealed that overall, the responses mapped onto the conceptual model of lung cancer stigma and participants described their perceptions of others' stigmatizing attitudes or behaviors, consistent with "perceived stigma" as well as feelings of self-blame, guilt, shame, and regret, consistent with "internalized stigma." Participants also characterized both adaptive and maladaptive consequences of stigma, including distress/depression and constrained disclosure. Further, participants described some specific cultural contexts (moderators) that are important in understanding the landscape of lung cancer stigma in Nigeria, namely causal attributions, cancer as a spiritual attack, financial constraints, systemic delays, and non-disclosure by clinicians.

Conclusions: PwLC experience stigma in Nigeria, which may get triggered during clinical interactions with oncology care clinicians. Communication skills trainings for clinicians in empathy and compassion may help mitigate lung cancer stigma and improve quality of care for PwLC in Nigeria.

Background: Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals in the US face significant health inequities driven by structural stigma. However, the health impacts of LGBTQ+ stigma and hypervigilance among LGBTQ+ individuals who are also a cancer caregiver are understudied.

Methods: LGBTQ+ adults in the US who provided unpaid care to a cancer patient ( $\le$  3 years prior) were recruited for an online survey. Survey domains/measures included sociodemographics, State Equality Index, Sexual Stigma Scale (adapted), Riggle Hypervigilance Measure, as well as health outcomes (PROMIS anxiety, depression, sleep disturbance, and fatigue). Latent class analysis (LCA) was used to group participants based on LGBTQ+ stigma and hypervigilance scores. Multivariable linear regression models tested the association between LCA classes and each PROMIS measure.

Results: Among 332 LGBTQ+ cancer caregivers, LCA identified four distinct classes: 1. Low stigma and hypervigilance (31.0%), 2. Moderate stigma and behavioral hypervigilance (21.7%), 3. Moderate contextual hypervigilance and scanning (19.3%), and 4. High stigma and hypervigilance (28.0%). In multivariable linear regression models, class 4 was associated with a 10.43-unit higher anxiety T-score (95% CI: 7.75-13.11), a 9.61 unit higher depression T-score (95% CI: 6.67-12.54), a 9.50-unit higher sleep disturbance T-score (95% CI: 7.02-11.98), and a 12.11-unit higher fatigue T-score (95% CI: 8.88-15.35) in comparison to class 1. Similar, but lower magnitude, trends were seen across the associations of classes 2 and 3.

Conclusions: The findings of this study algin with the LGBTQ+ literature and suggest that among LGBTQ+ cancer caregivers, increased levels of LGBTQ+ stigma and the resulting hypervigilance drive health inequities.

Objectives: This study evaluated the effectiveness of a social media-based life review intervention on happiness in advanced cancer patient-caregiver dyads and explored participants' subjective experiences.

Methods: A mixed-methods design was employed in oncology wards of a medical center in northern Taiwan between September 2024 and January 2025. Sixty patient-caregiver dyads were recruited through convenience sampling and randomly assigned to an experimental (social media-based life review) or control group (standard care). Final analysis included 28 dyads in the experimental group and 29 in the control group. Quantitative data were collected at baseline and post-intervention using the Subjective Happiness Scale and analyzed with descriptive statistics, t-tests, chi-square tests, and generalized estimating equations (GEE). Qualitative data were collected through two consecutive semi-structured interviews and were analyzed thematically to explore participants' experiences of happiness.

Results: Patients in the experimental group maintained stable happiness, whereas those in the control group decline significantly (p = 0.023). Between-group differences were non-significant. Caregivers in the experimental group demonstrated a significant improvement in happiness (p = 0.025), with no change in control group. Patient happiness was positively associated with family support and self-acceptance, whereas caregiver happiness was influenced by age, family support, and patient educational. Qualitative themes were "Always being there is happiness" and "Rediscovering us through memories."

Conclusion: Social media-based life review intervention enhanced caregiver happiness and prevented decline in patient happiness, highlighting the potential of digitally mediated, family-centered interventions in advanced cancer care.

Trial registration: ClinicalTrials.gov identifier: NCT06559917.