Psycho‐Oncology最新文献

Objective: Men from minority ethnic backgrounds experience a disproportionate burden of prostate cancer yet remain underrepresented in physical activity-related and psycho-oncology research. This study aimed to explore (1) how men from diverse ethnic backgrounds experience and interpret physical activity (PA) following prostate cancer, and (2) how psychological, cultural, and structural factors influence their engagement with PA and research.

Methods: Semi-structured interviews were conducted with ten men from African, Caribbean, Asian, and Middle Eastern backgrounds living with prostate cancer. Sampling continued until thematic saturation was achieved, consistent with qualitative methodological guidance. Data was analysed using Braun and Clarke's reflexive thematic analysis. A patient-informed topic guide and culturally reflexive approach were used to ensure contextual sensitivity and psychological safety.

Results: Six interconnected themes were identified: (1) PA as Mental Renewal, Identity, and Connection; (2) Cancer-Related Disruption and Fragmented PA Support; (3) Barriers to Participation in PA and Research; (4) Trust, Representation, and Inclusive Research Practices; (5) Cultural Stigma, Silence, and Shifting Perspectives; and (6) Altruism, Legacy, and Motivation to Engage. PA was described as psychologically meaningful, supporting coping, identity, and continuity, but was frequently disrupted by inconsistent guidance and structural barriers. Trust, representation, and relational communication were central to research engagement. Findings informed the development of a Culturally Sensitive Recruitment Framework.

Conclusions: PA engagement and research participation among minority ethnic men with prostate cancer are shaped by intersecting psychological, cultural, and structural factors. Culturally sensitive, relationship-centred approaches may strengthen integrated psycho-oncology care and promote more equitable research participation.

Background: Young adult survivors of childhood brain tumors (YAS) are at risk for limited health-related quality of life (HRQOL) and extended dependence on their maternal caregivers during the transition to adulthood. A problem-solving intervention was adapted to address challenges to family management, self-management, and HRQOL.

Aims: To evaluate the acceptability, feasibility, and preliminary efficacy of a problem-solving intervention (TIPS; Training in Problem-solving) for condition-focused maternal caregivers of YAS.

Methods: Maternal caregivers who screened positive for condition-focused family management were randomized to TIPS (n = 26) or Enhanced Usual Care (EUC; n = 27) and completed measures of problem-solving, family management, YAS self-management, and caregiver and YAS HRQOL at baseline and post-intervention (T3)Acceptability and feasibility data were collected at T3 and described.

Results: Both TIPS and EUC had moderate to high acceptability ratings with higher ratings for TIPS utility in meeting family needs. Feasibility, as measured by retention (70% for TIPS) and limited, minor technical glitches, was supported. Session length was a notable exception for feasibility. The largest between-group differences were observed in condition management ability, favoring TIPS (d = -0.85), and condition management effort, favoring TIPS (d = 0.58). Smaller, yet notable, between group differences were identified for YAS self-management (d = 0.44), YAS HRQOL (d = -0.40), and Parent Mutuality (d = -0.32) in the hypothesized direction except for YAS self-management.

Conclusions: TIPS was highly acceptable and moderately feasible. EUC was also acceptable, but the TIPS group demonstrated improved family management and YAS HRQOL highlighting the role of active intervention for caregivers of YAS.

Clinical trials registration: NCI Clinical Trials Reporting Program (NCI-2019-05353).

Purpose: This study aimed to examine health care use in a cross-sectional sample of Dutch cancer survivors > 2 years post-diagnosis.

Methods: The Dutch Federation of Cancer Patient Organizations (NFK), together with patient representatives and researchers, developed a cross-sectional online survey on life after cancer, which was distributed via email, websites, and social media.

Results: The study included 5710 respondents (> 2 years post-diagnosis). Among those who reported long-term cancer/treatment-related consequences (approximately 89% of participants), one-third (33%) had received professional care or support for these issues in the past 3 months. Those reporting more cancer- or treatment related consequences, those diagnosed 2-5 years ago, those (probably) not (getting) better, and those currently under treatment were more likely to receive professional care or support. Care was primarily provided by medical specialists (47%), physical therapists (37%), and/or general practitioners (32%). 15% expressed a desire for care or support that they did not receive, indicating reasons such as a long time since diagnosis or affordability. Overall, 68% knew where to turn for help; among those with consequences, 19% received peer/volunteer support and 10% wanted it but did not receive it.

Conclusion: A significant proportion of long-term cancer survivors in our sample reported unmet support needs (15% for professional care, 10% for peer support). Efforts should focus on improving access to affordable professional care, expanding peer support networks, providing personalized long-term follow-up care, and reducing stigma around seeking help, particularly within the context of the Dutch healthcare system.

Background: Despite the known benefits of smoking cessation for head and neck cancer (HNC) patients, a significant proportion continue to use tobacco after treatment. Although the causes of this phenomenon are multifactorial, the underlying psychological mechanisms are still poorly understood.

Aim: Investigate the influence of sociodemographic, clinicopathological, and psychological factors on smoking cessation after treatment of HNC.

Methods: This study included 71 smoking HNC patients who had completed cancer treatment for at least 12 months. Clinicopathological characteristics and anxiety and depression symptoms extracted the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were evaluated in the pre-treatment period. Data on smoking history was assessed through a semi-structured interview.

Results: A proportion of patients with HNC patients (39.4%) continued to smoke immediately after completing cancer treatment, with this proportion rising to 43.7% after 12 months of treatment. Logistic regression analyses showed that the occurrence of the primary tumor in the oral cavity (β = 6.891, P = 0.008) and the psychological symptom of sadness measured by the BDI (β = 5.279, P = 0.023) were predictive of smoking maintenance 12 months after the end of cancer treatment. Feeling like a failure before cancer treatment was the only predictor variable for smoking maintenance immediately after and 12 months after the end of treatment (β = 13.455, p < 0.001; β = 4.537, P = 0.043; respectively).

Conclusion: This study presents exploratory insights that identifies pre-treatment specific depressive symptoms and primary tumor location as promising predictive factors for continued tobacco use in patients treated for head and neck cancer.

Background: Young children with cancer (YCC; diagnosed ≤ 7 years) are at greatest risk for developmental late effects, yet research has mostly focused on school-aged youth.

Aim: To characterize psychosocial needs for YCC by comparing the perspectives of their women caregivers (WC), men caregivers (MC), and healthcare providers (HCP).

Methods: Thirty-four caregivers (22 women, 12 men) and 25 multidisciplinary HCP of YCC at a midwestern children's hospital completed surveys and interviews or focus groups to assess unmet needs and preferences for timing, format, and components of a caregiver intervention. Descriptive statistics compared unmet needs and intervention preferences across informants. Rapid analysis with three coders yielded qualitative themes, which were confirmed with member checking.

Results: Five major domains of unmet needs for caregivers of YCC related to: (1) anticipatory guidance about the developmental impact of treatment, (2) working with the school, (3) psychosocial needs of young survivors, (4) family impact, and (5) caregiver self-care. WC and HCP were aligned in their rank ordering of needs, while MC expressed different priorities. All participants reported that developmental activity ideas would help and were receptive to a virtual format for accessibility. HCP suggested intervention during transition off-treatment, while caregivers reported preference for more support during treatment.

Conclusions: Findings indicate better alignment between HCP and WC regarding unmet needs among caregivers of YCC, suggesting tailored approaches are needed to address the unique needs of MC. Future work should engage HCP and caregivers in co-designing tailored interventions to improve psychosocial outcomes for YCC and their families.

Background: Major abdominal cancer surgery can significantly affect patients' psychosocial wellbeing, including anxiety, depression, sleep quality, and self-perceived health. Support from family caregivers during hospitalization may influence these outcomes.

Aim: This study evaluates the psychosocial outcomes of a Family Involvement Program (FIP) for patients undergoing major abdominal cancer surgery.

Methods: A secondary analysis was conducted using data from a patient-preferred prospective cohort study. Patients who participated in the FIP alongside a family caregiver were compared to those who received usual care. The following psychosocial outcomes were assessed and analyzed using linear mixed-effects models with stepwise backward selection: sleep quality, anxiety and depression (HADS), self-perceived health (EQ-VAS) and health related quality of life (EQ-5D-5L) index score. Satisfaction with care was analyzed using linear regression. Fidelity metrics included completion rates of fundamental and optional care activities and the number of caregivers staying overnight.

Results: Patients in the FIP group reported significant higher sleep quality and significantly higher satisfaction with healthcare than those receiving usual care. No significant differences were found in anxiety, depression, or self-perceived health between groups. Engagement in fundamental and optional care activities by family caregivers varied across activities and postoperative days, with 80%-90% of caregivers staying overnight.

Conclusion: Family caregiver involvement during hospital admission for major abdominal cancer surgery improved sleep quality and satisfaction with care. Participation in the FIP did not significantly affect patients' anxiety, depression, or self-perceived health. These findings suggest that family involvement programs may enhance the patients' psychosocial wellbeing during cancer recovery.

Background: Global analyses of hematologic malignancies often lack subtype integration and advanced forecasting, limiting public health planning.

Methods: Using GBD 2021 data (1990-2021), we analyzed age-standardized incidence (ASIR), mortality (ASDR), and disability-adjusted life years (DALYs) for leukemia, lymphoma, and multiple myeloma. Spatiotemporal models quantified age-, sex-, and Socio-demographic Index (SDI)-stratified disparities. The Prophet model forecasted trends to 2031.

Results: In 2021, global ASIRs were 5.63, 7.93, and 1.74 per 100,000 for leukemia, lymphoma, and multiple myeloma, respectively. ASIR correlated positively with SDI for all subtypes (e.g., multiple myeloma: ρ = 0.81, p < 0.001). Mortality patterns were heterogeneous; Hodgkin lymphoma ASDR correlated negatively with SDI (ρ = -0.26, p < 0.001). Projections suggest stable or declining ASDRs by 2031 (e.g., leukemia: 3.86 to 3.40) but persistent male predominance. DALYs remain high in low-SDI regions.

Discussion: The disparity between high incidence in high-SDI areas and higher mortality fractions in low-SDI areas underscores diagnostic and therapeutic inequities. DALYs reflect associated long-term functional and psychosocial burden.

Conclusion: This study reveals profound global inequalities in hematologic malignancies. Mitigating this burden requires strengthening early diagnosis and treatment in low-SDI regions while integrating psychosocial support into global survivorship care.

Objective: Numerous psychosocial interventions have been developed to improve physical and psychological health-related outcomes among breast cancer survivors (BCS). Given the longstanding racial and ethnic disparities in breast cancer, culturally adapted psychosocial interventions aim to meet the unique needs of racial and ethnic minority BCS. This systematic review evaluates the efficacy of culturally adapted psychosocial interventions in improving psychological distress and quality of life for racial and ethnic minority BCS.

Methods: Search criteria included the following: studies reported psychosocial interventions with a control group, were conducted in the U.S., were culturally adapted for a racial or ethnic minority group, and included at least one of our target outcomes (distress, depression, anxiety, stress, mood disturbance, quality of life, coping, adjustment). Systematic searches were conducted using PubMed/MEDLINE, Scopus, CINAHL, and PsycINFO databases. The Effective Public Health Practice Project Quality Assessment Tool was used to evaluate risk of bias.

Results: Twenty-three studies met inclusion criteria. Interventions were adapted for Asian/Asian American, Latina, and African American/Black female patients, the vast majority of whom were diagnosed with non-metastatic breast cancer. Most studies used methodology classified as "weak" and did not report significant improvements in target outcomes compared to the control group.

Conclusions: Future culturally adapted psychosocial interventions should include more diverse patient populations (e.g., race and ethnicity, gender identity) and more rigorous study designs. Review findings have important implications for future research and practice, as survivorship needs for BCS increase and notable disparities for racial and ethnic minority patients persist.

Trial registration: PROSPERO CRD42022384472.

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.