Psycho‐Oncology最新文献

Background: In recent years, technology-based interventions have emerged as effective approaches to provide psychological support for the parents of children with cancer. Despite their increasing use, evidence on the effectiveness of technology-based empowerment interventions remains limited, largely due to the heterogeneity in intervention designs and measured outcomes.

Aim: This meta-analysis aims to evaluate the effectiveness of technology-based psychological empowerment interventions on the psychological well-being of parents of pediatric cancer patients.

Methods: A comprehensive literature search was conducted databases including Scopus, Medline, PubMed, Embase, Cochrane Library, Web of Science, APA PsycINFO, CINAHL Complete, and the Ovid Nursing Database Scopus, Medline, and PubMed identified 8020 studies, from which 9 RCTs involving 698 parents of children with cancer were included. The risk of bias was assessed using the revised Cochrane Risk of Bias (RoB 2) tool. Data analysis was assessed using a random effects model with standardized mean difference (SMD) using Review Manager Version 5.4. Heterogeneity was assessed using the chi-square test and I² statistic. Subgroup analyses and sensitivity analyses were performed.

Results: The meta-analysis revealed significant improvements in psychological outcomes, including decreases in distress (SMD: -0.42, 95% CI [-0.70, -0.13], p = 0.005), depression (SMD: -0.92, 95% CI [-1.56, -0.27], p = 0.005) and anxiety (SMD: -1.47, 95% CI [-2.50, -0.44], p = 0.005) immediately after the intervention. Follow-up analyses showed maintained decreases in depression (SMD: -0.39, 95% CI [-0.61, -0.17], p = 0.005) and anxiety (SMD:-0.32, 95% CI [-0.58, -0.07], p = 0.01). Additionally, significant increases were observed coping (SMD: 4.31, 95% CI [1.19, 7.44], p = 0.007) and resilience (SMD: 4.68, 95% CI [1.23, 8.13], p = 0.008) immediately after the intervention. However, no significant effect was found on health-related quality of life (SMD: 0.02, 95% CI [-0.25, 0.29], p = 0.88).

Conclusion: This meta-analysis provides evidence that technology-based psychological empowerment interventions dramatically improve the psychological well-being of parents of children with cancer. By effectively decreasing distress, depression, and anxiety while enhancing coping skills and resilience, these interventions are emerging as essential components of psychosocial support programs. These findings underscore the transformative potential of technology-driven approaches in addressing the unique and multifaceted needs of families, paving the way for more accessible and personalized support systems.

Background: Many childhood cancer survivors (CCS) experience cancer-related worries (CRW), for example about late effects and cancer recurrence. CRW are associated with lower quality of life (QoL) and maladaptive health care use. We examined the prevalence, severity, and factors associated with CRW in adult CCS.

Methods: We included quantitative studies of ≥ 100 participants reporting on prevalence, severity, mean scores and/or associated factors of CRW among CCS aged ≥ 18 years, diagnosed at ≤ 21 years, and ≥ 2 years post-diagnosis. We searched MEDLINE/PubMed and APA PsycINFO, hand-searched reference lists, and consulted experts. Risk of bias was assessed using the Cochrane Childhood Cancer Risk of Bias Criteria. Results were synthesized descriptively.

Results: The 17 included studies with a total of 26,306 CCS identified three main themes of CRW: health-related, financial, and interpersonal. Most prevalent were health-related worries regarding future health (88%-92%), late effects (83%), cancer recurrence (25%-88%), second cancers (50%-91%), and infertility (34%-68%). Factors associated with increased CRW varied depending on the specific CRW. These included female sex, more pain, anxiety, depression, chronic conditions (e.g., neurologic, being overweight), and treatment history (chemotherapy, radiotherapy).

Discussion and implications: Although most included studies used single items to assess CRW, this review underscores that health-related worries are particularly prevalent among CCS. Effectively identifying CCS at high risk, for example through using validated measures, and addressing severe CRW can facilitate adaptive healthcare use and improve QoL among CCS. Potential interventions can be providing information about late effects, psycho-education, discussions during follow-up care, and targeted psychosocial support for those with severe CRW.

Background: Prostate cancer (PCa) is a significant health burden within New Zealand (NZ). Survival gains from prostate cancer have created a shift in focus from survival towards quality of life (QoL) and supportive care during extended survivorship.

Method: We launched a nation-wide cross-sectional survey and recruited three cohorts of 1000 men with prostate cancer (men diagnosed with prostate cancer within 1 year, between 1 and 3 years, and between 3 and 5 years) as well as an additional Māori men group (N = 4000 in total). The survey instruments measured quality of life, supportive care needs, and care service utilization.

Results: Analysis of 1075 responses revealed that Māori men experienced lower quality of life and reported greater unmet supportive care needs. Information and psychology needs were mostly reported in both Māori and non- Māori groups. Key predictors of these needs included mental health conditions, hormonal imbalances, and employment status.

Conclusion: The study highlights significant ethnic disparities in the supportive care needs of New Zealand prostate cancer survivors (PCS), emphasizing the necessity for tailored, culturally sensitive healthcare interventions. Addressing the complex determinants of these needs is crucial for enhancing the well-being of all PCS.

Implications for cancer survivors: Actively seeking health information and mental health counselling would significantly benefit PCS by reducing unmet supportive care needs and improving overall quality of life. This approach encourages survivors to take an active role in their healthcare, potentially leading to better health outcomes and enhanced well-being.

Objective: This study aimed to elucidate the mechanisms by which symptom burden affects demoralization in Chinese lung cancer patients, with a focus on the roles of family functionality, resilience, and coping strategies. The study also explored differences in these pathways between two distinct demoralization categories.

Methods: A cross-sectional survey was conducted among 567 lung cancer patients who completed questionnaires assessing symptom burden, family functioning, resilience, coping strategies, and demoralization. Data were analyzed using partial least squares structural equation modeling (PLS-SEM), with multigroup structural equation modeling (MG-SEM) employed to compare pathways between the psychological distress-subjective incompetence group (PDSIG) and the low demoralization-emotional disturbance group (LDEDG).

Results: PLS-SEM analysis demonstrated a good model fit. Symptom burden (β = 0.26), confrontation coping (β = 0.11), and acceptance-resignation coping (β = 0.41) had positive direct effects on demoralization, whereas resilience (β = -0.19) and family function (β = -0.27) had negative direct effects. Additionally, family function, resilience, and acceptance-resignation coping mediated the relationship between symptom burden and demoralization. MG-SEM revealed that, in the PDSIG, symptom burden (β = 0.47) and family function (β = -0.46) had similarly strong impacts on demoralization, with stronger family function associated with lower demoralization. In contrast, resilience (β = -1.02) was the most significant factor in the LDEDG.

Conclusions: These findings highlight the importance of screening for demoralization, particularly among lung cancer patients with a high symptom burden, maladaptive resignation coping, family dysfunction, and low resilience. Effective strategies should focus on symptom management, family support, resilience building, and fostering positive coping mechanisms. Tailored interventions based on demoralization subtypes are essential to improve psychological well-being in this population.

Objective: There is an increasing amount of literature acknowledging the significance of addressing the psychosocial impact of prostate cancer (PCa) on couples' relationship functioning and well-being. However, research on developing and evaluating psychological interventions for individuals and couples coping with PCa remains limited. This systematic review aimed to critically evaluate and synthesise the effectiveness of psychological interventions in improving the relationship functioning of couples affected by PCa and to identify the moderating role of several methodological characteristics of intervention studies.

Methods: Five databases MEDLINE, PsycINFO, Embase, Global Health, and Cochrane Library were searched up to September 2024. Twenty-three studies with randomised trials and a total sample size of 3333 participants were included. Random effects meta-analyses for relationship functioning, sensitivity analysis for outliers, and publication bias analysis were conducted.

Results: The results showed that psychological interventions had a non-significant trivial effect (g = 0.06, p = 0.328) on improving relationship functioning among couples coping with PCa. Subgroup analyses identified two potential moderators: firstly, the intervention format (conjoint vs. individual; p = 0.005), and secondly, the intervention frequency (session number < 6 vs. session number ≥ 6; p = 0.004).

Conclusions: The findings suggest that more high-quality intervention studies are needed to improve the relationship functioning of those affected by PCa, with screening processes to select more representative samples at entry. The implications for clinical practice highlight the need to tailor interventions to the specific needs of couples coping with PCa.

Objective: Influenced by their life stage and socio-cultural background, young and middle-aged cancer patients in China may experience unique psychological distress. Therefore, this study investigated the severity, problems, and associated factors of psychological distress among young and middle-aged cancer patients.

Methods: We conducted a cross-sectional study on young and middle-aged cancer patients aged 18-59 who were treated at a radiotherapy center from February 2022 to September 2023. Participants' psychological distress severity and problems were measured using the Distress Thermometer and the Problem List. Binary logistic regression was used to identify sociodemographic and clinical factors, as well as PL items, associated with clinically significant psychological distress in young and middle-aged cancer patients.

Results: Among the 510 participants, 102 (20.0%) had DT scores ≥ 4, reported an average of 3.36 ± 3.78 problems, and 360 (70.6%) reported at least one problem. The five most frequently reported problems were worry, no time and energy to take care of children/elderly people, memory loss/lack of concentration, appearance/shape, and work/school. Annual household income, self-reported loneliness, nervousness, loss of interest in daily activities, eating, and nausea were associated with DT scores ≥ 4.

Conclusions: One-fifth of young and middle-aged cancer patients experienced clinically significant psychological distress. Greater attention should be paid to patients with lower household incomes and those who self-report loneliness, nervousness, loss of interest in daily activities, eating, and nausea, providing targeted support to alleviate psychological distress.

Background: Cognitive behavior therapy (CBT) has been shown to be effective in improving depression in patients with cancer. However, diversity exists in the CBT delivery formats, and the optimal delivery format remains unconfirmed.

Objectives: To compare the efficacy of different delivery formats of CBT interventions on depression in patients with cancer.

Design: Network meta-analysis of randomized controlled trials.

Data source: Six databases, including PubMed, Web of Science, Embase, CINAHL, the Cochrane Central Register of Controlled Trials and PsycINFO, were searched from inception to May 30, 2024.

Methods: Two reviewers independently conducted study inclusion, data extraction, and risk of bias assessment. A pairwise meta-analysis and a network meta-analysis were performed sequentially to determine the efficacy of CBT delivery formats for improving depression in patients with cancer.

Results: A total of 34 randomized controlled trials involving six delivery formats of CBT were included. Face-to-face group CBT (SMD = -0.88, 95% CI [-1.33, -0.44]), internet-based individual CBT (SMD = -0.49, 95% CI [-0.92, -0.06]), app-based individual CBT (SMD = -0.81, 95% CI [-1.45, -0.18]), and combined delivery formats of CBT for individual (SMD = -0.35, 95% CI [-0.62, -0.09]) were significantly more effective than the inactive control. The ranking probabilities revealed that face-to-face group CBT (P-score = 0.86), app-based individual CBT (P-score = 0.74) and internet-based individual CBT (P-score = 0.57) were the three most effective delivery formats of CBT.

Conclusions: This study revealed the efficacy ranking of different CBT delivery formats in improving depression in patients with cancer. These findings are expected to provide evidence-based support for future research and clinical decision making for improving depression in patients with cancer.

Trial registration: PROSPERO (CRD42024553977).

Background: Receiving a child's cancer diagnosis is a highly traumatic experience for parents, often leading to significant psychological distress, including symptoms of Post-Traumatic Stress Disorder (PTSD). The way healthcare professionals deliver this news can affect the severity of parents' reactions. While some research examines communication style's impact on patients, few studies focus on its effects on parents.

Aims: This study explores the relationship between the communication style used by oncologists when delivering a child's cancer diagnosis and the subsequent levels of PTSD symptoms, mental resilience, and self-efficacy in parents.

Methods: One hundred twenty eight parents of children diagnosed with cancer participated. Data were collected using the Styles of Communicating Questionnaire (SCQ), PTSD Checklist for DSM-V (PCL-5), the Connor-Davidson Resilience Scale (CD-RISK), and the General Self-Efficacy Scale. Correlations and hierarchical multiple regressions were performed to examine the relationship between communication style and psychological outcomes.

Results: Parents who perceived the oncologist's communication style as more activating (clear, structured, and action-oriented) reported significantly lower levels of PTSD symptoms and higher levels of resilience and self-efficacy. The perception of empathy played a crucial role, particularly when physicians balanced emotional and cognitive empathy. This balance was linked to better psychological outcomes in parents.

Conclusions: The study highlights the critical role of communication style in mitigating the psychological impact of a child's cancer diagnosis on parents. Training healthcare providers to balance cognitive and emotional empathy in communication may reduce PTSD symptoms and enhance resilience and self-efficacy in parents, ultimately improving their psychological well-being during such a challenging time.

Background: Although scanxiety is common and impactful for people with advanced lung cancer, few interventions address this psychosocial concern.

Aims: To create a stress management program for scanxiety.

Methods: We conducted a structured intervention adaptation process guided by the ADAPT-ITT framework. We tailored materials from an existing evidence-based program, drafted additional modules, and obtained feedback on initial content. Following content revisions and website prototype development, 21 participants (patients with metastatic lung cancer, n = 8; family members, n = 3; clinicians, n = 10) reviewed the program. Participants rated the program's acceptability (Acceptability of Intervention Measure; AIM), feasibility (Feasibility of Intervention Measure; FIM), appropriateness (Appropriateness of Intervention Measure; IAM), helpfulness (module Likert ratings), and usability (Post-Study System Usability Questionnaire; PSSUQ), and completed semi-structured interviews.

Results: Data revealed positive impressions of the program. Participants rated the program as acceptable (89%), feasible (89%), and appropriate (95%; proportion with average ratings ≥ 4 out of 5 on AIM, FIM, and IAM respectively). They rated 6 of the 7 modules as helpful, appropriate, and fitting with their experience (77%-100% with Likert ratings ≥ 4 out of 5); the below-threshold module (Introduction) was revised based on rapid qualitative analysis of interview data. Although 33% needed help to start using the website, its usability was rated highly after use (PSSUQ Mdn = 1.56, IQR = 1.11-1.82). The refined intervention is a largely self-guided program to enhance stress management skills using psychoeducation, recorded on-demand exercises, and 3 brief coaching calls.

Conclusions: This highly-rated intervention has the potential to alleviate scanxiety among people with advanced lung cancer.

Background: Adolescents and young adults (AYA) with cancer experience long-term consequences into survivorship that impact quality of life, including mental health symptoms, substance use, and persistent pain. Given the elevated rates of pain, AYA cancer survivors are at increased risk for opioid pain medication (OPM) exposure, increasing risk for opioid-related negative consequences, particularly for those with mental health symptoms. Minimal research has documented that a considerable proportion of AYAs with cancer receive OPM that continues into survivorship, yet the lack of consensus on the definition of problematic opioid use coupled with the high clinical need for OPM makes it particularly challenging to understand the impact of OPM use in this population.

Aims: Therefore, the current study examined differences in opioid pain medication use, use behaviors, and motives between AYA cancer survivors and non-cancer controls.

Methods: Using the National Survey on Drug Use and Health, we tested the impact of OPM use behaviors and motives on depressive symptoms and mental healthcare utilization variables.

Results: Results show that, compared to non-cancer controls, AYA cancer survivors evince higher rates of opioid use, behaviors, and pain relief motives. Within the cancer survivor group only, there were differential patterns of associations between OPM behaviors, motives, depressive symptoms, and mental healthcare utilization, with using opioid pain medication for emotion coping/to get high showed the largest effect sizes with outcome variables.

Conclusions: The results highlight the importance of moving beyond use itself and examining how and why AYAs with cancer are using opioids to understand potential negative consequences.