Psycho‐Oncology最新文献

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: 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.

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: 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.