Psycho‐Oncology最新文献

Objective: Rumination is a common cognitive response in cancer patients, influencing psychological adjustment. This study examined the associations between intrusive and deliberate rumination and self-compassion in individuals undergoing cancer treatment, using structural equation modeling (SEM).

Methods: A cross-sectional correlational study was conducted with 202 adult cancer patients undergoing active treatment at a public hospital. Participants completed validated self-report instruments: the Event-Related Rumination Inventory and the Brief Self-Compassion Inventory. Data were analyzed using descriptive statistics, Pearson correlation, and SEM.

Results: The SEM results indicated that intrusive rumination was significantly and negatively associated with self-compassion (β = -0.828, p < 0.001), whereas deliberate rumination showed a significant positive association with self-compassion (β = 0.753, p < 0.001). The model explained 60.3% of the variance in self-compassion. Subgroup analyses showed that self-compassion and deliberate rumination were higher among participants with higher education and those who were employed, while intrusive rumination was higher in patients with prior metastasis or relapse.

Conclusions: The findings underscore the need to distinguish between adaptive and maladaptive forms of rumination in cancer care. Targeting intrusive rumination and supporting deliberate reflection may represent important considerations for psychosocial care.

Background: Many patients with breast cancer report cognitive impairment for several years after treatment. The objective of this study was to describe associations between neurobehavioral symptoms experienced during chemotherapy for early-stage breast cancer and patient-reported cancer-related cognitive impairment (CRCI) ≥ 3 years post-chemotherapy.

Methods: This study is a secondary analysis of women with stage I-III breast cancer who had enrolled in clinical trials promoting self-directed walking during chemotherapy and were re-consented for a study focused on quality-of-life outcomes ≥ 3 years post-chemotherapy. Patient-reported CRCI was assessed using the FACT-Cog PCI (cut point for impairment < 54). Multivariable log-binomial regression models, adjusting for age, race, and education, examined associations between long-term CRCI and baseline demographic characteristics, cancer diagnosis and treatment, and patient-reported neurobehavioral symptoms during chemotherapy and at long-term follow-up.

Results: Among 104 participants, 39% reported CRCI at long-term follow-up, on average 6 years post-chemotherapy [range: 2.9-8.8]. CRCI was more common among those reporting moderate or worse depressive (RR 1.75, 95% CI 1.11-2.75, p = 0.02), anxiety (RR 1.95, 95% CI 1.22-3.11, p = 0.005), or fatigue (RR 1.92, 95% CI 1.09-3.36, p = 0.02) symptoms during chemotherapy. In sensitivity analyses limited to patients with none or mild symptoms prior to chemotherapy, depressive (RR 2.11, 95% CI 1.23-3.63, p = 0.007) and fatigue (RR 1.81, 95% CI 1.81, 95% CI 1.01-3.24, p = 0.05) symptoms emerging during chemotherapy were also associated with CRCI at follow-up.

Conclusions: Patient-reported neurobehavioral symptoms experienced during chemotherapy, including depression, anxiety, and fatigue, were associated with patient-reported CRCI years after primary treatment and should be monitored for timely intervention opportunities.

Background: The psychosocial needs of survivors of cancer in young adulthood in Switzerland remain poorly understood. With this study, we aimed to (1) describe psychosocial support needs of young adult cancer survivors (YACS) during treatment and survivorship, (2) determine whether these needs change from treatment to survivorship, and (3) identify characteristics associated with unmet needs.

Methods: We included survivors aged 21-39 years at diagnosis, diagnosed at least two years prior to our questionnaire survey. We used descriptive statistics to analyze distributions of psychosocial support needs during treatment and survivorship. McNemar's tests assessed changes in these needs over time, and logistic regressions identified determinants of unmet needs.

Results: A total of 131 YACS (mean age at study = 37.5 years; 61% female) participated in our study. Most YACS reported that their needs were met in all support domains, both during treatment and survivorship. During treatment, unmet needs were highest for insurance support (n = 30; 23%), support for friends (n = 20; 15%) and family (n = 17; 13%). During survivorship, unmet needs were most pronounced for insurance support (n = 15; 12%), information on cancer and late effects (n = 10; 8%), and work-related support (n = 9; 7%). Intrapersonal needs (e.g., information, psychological), remained stable, while unmet interpersonal (e.g., family, friends), and institutional/systemic (e.g., insurance, work) support needs declined during survivorship. Younger age and shorter time since diagnosis were associated with unmet intrapersonal needs during survivorship, while male sex predicted unmet interpersonal needs during treatment.

Conclusion: Although most support needs are met, targeted efforts are needed to address the remaining unmet needs of Swiss YACS in order to ensure they receive adequate survivorship care.

Background: As the most prevalent malignancy among women, breast cancer has a potentially shattering impact on quality of life (QoL). However, studies comparing QoL between breast cancer survivors and cancer-free peers have been inconsistent and little is known about possible moderators that contribute to inconsistent findings or specific QoL domains that affect breast cancer survivors most.

Objectives: This meta-analysis examined QoL differences between breast cancer survivors and controls without breast cancer ("controls" hereafter) across multiple QoL instruments and domains.

Methods: We searched major international and Chinese databases and identified 36 eligible case-control studies comprising 29,433 participants (12,261 survivors, 17,172 controls). Standardized mean differences were calculated using a random-effects model; subgroup analyses and meta-regression examined potential moderators.

Results: QoL impairments varied by assessment instrument. Medical Outcomes Study Short Form surveys showed lower physical component scores in breast cancer survivors (moderate effect size, SMD = -0.52) and small deficits in physical function, emotional role limitations, mental components, and general health domains. The European Organization for Research and Treatment of Cancer questionnaire revealed lower scores in insomnia (SMD = 0.80) and financial difficulties (SMD = 0.77). Regarding the Functional Assessment of Cancer Therapy-General, breast cancer survivors displayed comparatively large impairments across emotional, functional, and physical well-being domains. Short-term survivors (≤ 5 years post-diagnosis) experienced significantly greater deficits than long-term survivors did in physical role limitations and mental health domains.

Conclusions: Breast cancer survivors experience lower QoL than controls do, particularly in physical and emotional domains. This meta-analysis highlights the importance of developing effective interventions targeting specific QoL domains at different survivorship stages.

Cancer care, with its complex and variable protocols, frequent appointments, and high-stress, may present additional challenges for neurodivergent patients, and suitable care accommodations are necessary. Yet, a dearth of literature and an associated understanding on neuro-inclusive cancer care exists. The current case study aims to: (1) explore and identify barriers and challenges to neurodivergent cancer care; and (2) generate neuro-inclusive oncology-specific recommendations to guide healthcare providers in offering neuro-affirming care. To do this, we present the first author's lived experience navigating stage IV breast cancer as a neurodivergent individual and psychologist, exploring barriers and challenges encountered. Her personal and professional experience uniquely positions her to offer insights into this intersection. Based on her experience, and complemented by published data, we generate recommendations for neuro-inclusive care. Challenges and barriers identified include limited oncology provider knowledge, awareness, and tolerance of neurodivergence, and insufficient suitable accommodations to difficulties with standard care practices. Recommendations encompass six domains: patient communication, physical environments, physical pain, administrative approaches, technology usage, and systemic revisions. Clinical, training, and research recommendations and implications are reported. Clinical implications include raising awareness around the lack of neurodivergent-affirming cancer care. We highlight the need for neuro-inclusive training for all staff interacting with neurodivergent patients. Such training should be embedded into graduate programs and professional development. We call for co-designed training (development and delivery) and research, and highlight the lack of current available research. We note the need for empirically driven universal guidelines for neuro-inclusive oncology care, which we hope will be informed by the present study.

Objective: This scoping review aims to comprehensively evaluate psychological intervention strategies for patients undergoing surgical treatment for oral and maxillofacial tumors. By assessing the effectiveness of existing strategies and the theoretical models or behavior change techniques employed, the study seeks to provide evidence-based recommendations for designing targeted psychological intervention programs.

Methods: The review adheres to the methodological framework of Arksey and O'Malley and incorporates guidance from the Joanna Briggs Institute (JBI) for scoping reviews. A systematic search was conducted across PubMed, Embase, Web of Science Core Collection, CNKI, Wanfang, VIP, and SinoMed databases for studies published up to November 1, 2024. Two reviewers independently conducted literature screening and data extraction. Findings were integrated through descriptive analysis and social network analysis.

Results: A total of 88 studies published between 2004 and 2024 were included, covering 65 distinct intervention strategies and 37 outcome indicators. The interventions were founded on establishing trust between healthcare providers and patients, with health education as a cornerstone, Key strategies focused on individual psychological adjustment and behavioral change. Commonly reported outcomes included anxiety, depression, patient satisfaction, and quality of life. Social network analysis identified several behavior change strategies with high centrality, such as health education, psychological consolation, encouragement of self-expression and communication, relaxation training, mobilization of family and social support, cognitive-behavioral interventions, peer support, positive incentives, functional rehabilitation training, and meditation. These strategies demonstrated efficacy in alleviating psychological distress, facilitating cognitive restructuring, and improving quality of life and social functioning.

Conclusion: Patients undergoing surgery for oral and maxillofacial tumors face significant psychological and social challenges. The findings underscore the necessity of developing diverse, targeted, evidence-based psychological interventions tailored to the unique needs of this population, leveraging established behavior change techniques to improve postoperative psychological well-being and social recovery.

Objective: To test a moderated mediation model linking physical activity (PA) to health-related quality of life (HRQoL) via symptom burden, with hope as a moderator, in lung cancer patients.

Methods: A cross-sectional study of 203 adults with stage III-IV lung cancer (205 enrolled, 2 excluded due to incomplete data) from a Chinese hospital analyzed PA (IPAQ-LF), symptom burden (MDASI-C), hope (HHI), and HRQoL (SF-8). Covariates were identified via univariable screening (p < 0.05). Spearman correlations, hierarchical regression, and PROCESS (Model 7; 5000 bootstraps) tested the moderated mediation model, with simple-slope probing at hope ± 1 SD.

Results: PA correlated with higher HRQoL (ρ = 0.53) and lower symptom burden (ρ = -0.48), while symptom burden negatively predicted HRQoL (ρ = -0.71) and hope positively predicted HRQoL (ρ = 0.59) and lower symptom burden (ρ = -0.56). Hierarchical models explained 57.7% of HRQoL variance, with PA (0.132), symptom burden (0.231), and hope (0.046) as key predictors. The PA-by-hope interaction was significant (B = 0.018, p = 0.008), with stronger PA effects on reduced symptom burden at low hope (B = -0.270, p < 0.001). The moderated mediation index was -0.017 (95% CI -0.032 to -0.003).

Conclusions: PA improves HRQoL via reduced symptom burden, with this effect stronger at lower hope levels. Enhancing hope in interventions may maximize HRQoL benefits.

Background: Adult cancer survivors are likely to be hospitalised with chronic illnesses, although evidence for childhood and AYA survivors is limited.

Aim: This study quantified hospitalisations and the costs of health services used by survivors of childhood, adolescent, and young adult (AYA) cancers with and without chronic conditions.

Methods: We assessed long-term survivors (≥ 5 years past diagnosis) of childhood and AYA cancers diagnosed at ages 0-39 years between 1997 and 2011 in Queensland, Australia. Utilising a linked administrative dataset, we determined the prevalence of chronic conditions from hospital records using classification codes (ICD-10-AM) and quantified hospitalisations and associated costs in 2024 Australian dollars (AU$). Generalised linear regression modelling was used to examine how chronic conditions affected healthcare costs, controlling for clinical and socio-demographic factors.

Results: Of 14,422 participants, 16% (n = 2286) were hospitalised with at least one chronic disease, with hypertension (n = 675, 4.7%) and depression (n = 463, 3.2%) being the most common. Inpatient admissions were significantly higher for survivors with chronic conditions (mean 3, SD = 10) compared to those without chronic conditions (mean 1, SD = 4). The mean annual costs were highest for those with chronic kidney disease (AU$26,428, SD = AU$30,331), schizophrenia (AU$22,835, SD = AU$37,204), epilepsy (AU$22,361, SD = AU$37,224), paralysis (AU$22,051, SD = AU$32,165) and chronic heart failure (AU$21,912 SD = AU$38,763). Hypertension (AU$5.4 million) and depression (AU$4.3 million) incurred the highest total costs over the follow-up period.

Conclusion: Implementing targeted survivorship care and preventative measures for high-cost conditions such as schizophrenia and chronic kidney disease may optimise healthcare resource use and reduce the economic burden for this population.

Background: Pain, fatigue, psychological distress, and fear of progression often co-occur in postoperative pancreatic cancer patients. The coexistence and interaction of these symptoms can further exacerbate burden. Existing research has mainly focused on single symptom or broad symptom clusters, leaving the interaction structure and key symptoms insufficiently understood.

Aims: To characterize correlations among these symptoms in postoperative pancreatic cancer patients, and to identify the central and bridge symptoms most suitable as intervention targets through network analysis.

Methods: This multicenter cross-sectional study included 512 postoperative pancreatic cancer patients. Symptom data were collected using the Global Pain Scale, Cancer Fatigue Scale, Distress Management Screening Measure, and Fear of Progression Questionnaire. Network analysis was conducted to map symptom correlations, with central and bridge symptoms identified using the qgraph and networktools packages. The bootnet package was employed to assess model stability.

Results: The symptom network showed substantial overall connectivity. Two strongest positive edges were P1 (pain intensity) - D6 (distress thermometer) and F1 (physical fatigue) - FoP5 (peer-relationship strain). P1 (pain intensity) had the greatest expected influence value, followed by D6 (distress thermometer), indicating central symptoms. Moreover, D6 (distress thermometer), F1 (physical fatigue), P1 (pain intensity), and FoP5 (peer-relationship strain) were found as bridges linking different communities. The network demonstrated good stability in case-dropping bootstrap analyses.

Conclusion: Targeted interventions directed at the identified central and bridge symptoms may help reduce overall symptom burden and improve quality of life. These findings provide a foundation for developing more refined and individualized symptom management strategies.