Psycho‐Oncology最新文献

Objective: In the context of cancer, pain demands interpretation. Our research has found that fear of cancer recurrence (FCR) is associated with the tendency to interpret ambiguous information as health-related. We aimed to determine whether we could modify these interpretation biases to improve FCR, and pain outcomes.

Methods: We conducted a double-blind randomized controlled trial comparing two fully automated Cognitive Bias Modification for Interpretation (CBM-I) programs to a matched sham. We randomized 174 people with breast or ovarian cancer to one of three groups (pain-related CBM, cancer-specific CBM or sham). Participants completed four training sessions, and outcomes were assessed before and after intervention and 2 weeks later. We nominated co-primary outcomes as FCR and fear of progression (FoP) so that measures were suited to those with and without active disease and measured pain outcomes and other secondary psychosocial outcomes.

Results: We analyzed data using mixed-model linear regression and intention-to-treat. Results indicated that both the cancer-specific and pain-related training groups showed significant improvements in FCR (F_(2,440) = 17.19, p < 0.0005) and FoP (F_(2,440) = 15.03, p < 0.0005) over time compared to sham. Both versions of CBM were associated with benefits in pain intensity (F_(2,440) = 6.14, p < 0.0005) and pain interference (F_(2,440) = 5.223, p = 0.001) compared to sham. No other secondary outcomes improved.

Conclusion: CBM for interpretation is an efficacious treatment for FCR, FoP and pain outcomes in ovarian and breast cancer. This intervention was delivered wholly online, had high completion rates (80%) and therefore is highly scalable. CBM-I could be part of a stepped care model to meet the large unmet need for people who are living with and beyond cancer.

Background: Depression is a common psychological disorder in patients with cancer. Exercise intervention has been demonstrated as an effective non-pharmacological intervention for improving depression. However, the relative efficacy of different types of exercise interventions remains uncertain.

Objective: To compare the effectiveness of different types of exercise interventions in patients with cancer.

Methods: Seven databases were systematically searched. Two reviewers independently conducted the data extraction and quality assessment. The random effects model was used for the meta-analysis. Traditional pairwise meta-analysis and network meta-analysis were performed via STATA software.

Results: Forty-nine studies with 4738 participants were included. The interventions were categorized as mind-body exercise, aerobic exercise, anaerobic exercise, resistance exercise, combined exercise, and progressive muscle relaxation. Network meta-analysis consistently revealed the greatest therapeutic benefits of aerobic exercise (SUCRA: 68.4%), followed by combined exercise (SUCRA: 66.4%) and resistance exercise (SUCRA: 55.7%).

Conclusions: Exercise has potential benefits for relieving depression in patients with cancer, and it is poised to serve as a valuable complementary or alternative therapy. Large-scale and more rigorous RCTs are needed to evaluate the long-term effects of exercise interventions and examine intervention characteristics related to better intervention outcomes.

Objective: Despite strong evidence supporting universal psychosocial risk screening in pediatric cancer implementation remains inconsistent. Factors at organizational, provider, and patient/family levels impact implementation. Potential differing perspectives regarding risk screening among multidisciplinary providers may influence uptake. This study describes perceived barriers and facilitators in implementing the Psychosocial Assessment Tool (PAT), a psychosocial risk screener and examines differences by discipline.

Methods: One hundred seventeen healthcare providers (HCPs) representing medical, social work, and psychology from 18 pediatric cancer programs completed two scales from PAT Implementation Questionnaire (PIQ). Item scores (1-4 scale) were ranked and differences tested by discipline.

Results: Barriers were perceived as "minor" and facilitators as "significant" and overall PIQ scale scores did not differ by discipline. PIQ-B had a significantly lower mean score (M = 2.03) than PIQ-F (M = 3.08), p < 0.001). Barriers and facilitators rated most impactful (highest mean scores) were: Barriers: "Language barriers/cultural considerations" (M = 2.37) and "Integrating results in EHR" (M = 2.26); and Facilitators: "Promotes psychosocial care for all families" (M = 3.31) and "Promotes positive psychosocial outcomes" (M = 3.25). Significant differences were found in the rank ordering of barriers and facilitators by discipline, between social workers and psychologists, with the former noting time constraints associated with screening.

Conclusions: Multidisciplinary HCPs generally agree on the benefits and challenges in implementation of screening with the PAT. Subtle variations in perceived impact of barriers and facilitators between social workers and psychologists highlight the importance of interdisciplinary collaboration and communication to facilitate implementation.

Background: Self-advocacy is essential for cancer patients to obtain high-quality care. However, existing self-advocacy assessment tools-developed by Western scholars-are poorly aligned with the cultural and healthcare context of China.

Aim: The study aimed to develop and validate a new self-advocacy scale tailored to Chinese cancer patients.

Methods: In phase I, an item pool was formulated through a literature review, qualitative interviews with 14 cancer patients, and focus group discussions. In phase II, the scale's domains and items were revised based on feedback from two rounds of Delphi consultation involving 16 experts. In phase III, a cross-sectional survey was administered to a convenient sample of 257 cancer patients, and item analysis and exploratory factor analysis were used to explore the scale's structure. In Phase IV, the scale's validity and reliability were comprehensively evaluated using data from a convenience sample of 311 cancer patients. Finally, the Cancer Patient Self-Advocacy Scale (CPSAS) was developed.

Results: The newly developed scale comprised 21 items across four dimensions: information seeking, autonomous decision-making, active communication, and informational support. The scale demonstrated adequate convergent and discriminant validity supported by average variance extracted and composite reliability, good criterion validity through significant correlations with quality of life and treatment adherence, and excellent internal consistency and split-half reliability.

Conclusions: The CPSAS is a valid, reliable, and efficient tool for assessing self-advocacy in Chinese cancer patients, suitable for both outpatient and inpatient settings. Additional research is necessary to evaluate the psychometric properties of the scale.

Background: Sarcopenic obesity (SO)-excess adiposity with low muscle strength and mass-is a concern in oncology as it may exacerbate functional decline and cancer-related fatigue (CRF). The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recently proposed diagnostic criteria for SO, but these remain untested in breast cancer (BC). We examined associations between SO, CRF, quality of life (QoL), and physical function in women with early BC.

Methods: Sixty-six patients (48.0 ± 9.9 years; stages I-III) underwent assessments of body mass index (BMI) and composition (DXA), waist circumference (WC), and handgrip strength. Physical function was evaluated using the timed up-and-go (TUG) and the 6-m walk test (6-MWT), while QoL and CRF were assessed using the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQ-C30) and the Cancer Fatigue Scale (B-CFS). The ESPEN-EASO consensus was applied to classify participants as Eutrophic (normal BMI and WC), Obesity (high BMI and/or WC with preserved muscle strength and mass), or SO (high BMI and/or WC with reduced muscle strength and mass).

Results: Global health/QoL (p = 0.03) was lower in SO (61.6 ± 7.2) and Obesity (60.4 ± 3.7) than Eutrophic (81.1 ± 6.9). Physical functioning scale/QoL was lower in Obesity (84.6 ± 2.2) than Eutrophic (97.0 ± 4.1). Mean physical and overall fatigue in both Obesity (5.3 ± 5.5 and 19.6 ± 9.9) and SO (5.0 ± 4.1 and 18.8 ± 8.6) were not statistically different from Eutrophic (2.0 ± 2.9 and 14.3 ± 7.8). TUG was worse in SO (7.5 ± 0.2 s) than both Eutrophic (6.6 ± 0.2 s) and Obesity (6.8 ± 0.1 s-p < 0.01). Comparisons were adjusted for age, menopausal status, and physical activity. SO-related traits were correlated to physical function and to domains of QoL and CRF.

Conclusions: Obesity and SO are associated with poorer QoL, while SO is also linked with worse physical function in early BC. Assessing SO traits in clinical settings will improve the management of BC, though confirmation across disease stages is needed.

Objective: Cancer patients who receive the information that they need may experience better quality of life and emotional wellbeing, and be more equipped to engage in shared decision-making. Our review explores the information needs of haematological malignancy patients specifically, and their experience of the information process.

Methods: Integrative review with data extraction and narrative synthesis (PROSPERO#: CRD42024543507). We searched PubMed, Web of Science, COCHRANE, CINAHL and APA PsycINFO for articles published before 21 May 2024. Two reviewers extracted the data; a third resolved disagreements. Quality was appraised using the Mixed Methods Appraisal Tool.

Results: Our search yielded 920 articles; 60 met the inclusion criteria. We identified three categories: Type of Information: Medical and Psychosocial Information Needs; Patient Information Experience; and Information Needs of Specific Populations. Information needs varied across patient groups and along the cancer pathway. The most common information needs were related to treatment (options and side effects) and disease (evolution and prognosis). Patients who receive clear, tailored information from healthcare professionals may be better able to engage in treatment decision-making. Information preferences varied, as did patient satisfaction and the emotional impact of the information they received.

Conclusion: Haematological malignancies are heterogeneous diseases, which further complicates the provision of information to patients. The information patients receive must be tailored to their specific disease and stage. Patient satisfaction with the information they receive varies, suggesting that the method and manner of communication is just as important as the content of the information itself.

Background: Young and middle-aged cancer patients often face unique challenges, which may trigger their reflection and inquiry into the meaning in life. Patients from different cultural backgrounds and life stages may have varied experiences and perceptions of meaning in life, making it necessary to explore this further.

Aims: This study aimed to explore their experiences and perceptions of meaning in life among young and middle-aged cancer patients, providing a foundation for developing targeted interventions.

Methods: A descriptive phenomenological study was conducted through semi-structured interviews with young and middle-aged cancer patients aged 20 to 49 between June and September 2023. Data were analyzed using the Colaizzi method.

Results: Interviews were conducted with 23 young and middle-aged cancer patients, and four themes were identified: the foundation of meaning in life: shaped by era, education, and environment; the ebb and flow of meaning in life: revealed amid crisis, stress, and emotional fluctuations; the reconstruction of meaning in life: assimilation and accommodation triggered by emotional burden; and the growth of meaning in life: through active engagement with life.

Conclusions: Young and middle-aged cancer patients experience meaning in life as fluid and complex. Despite experiencing confusion and distress, patients can reconstruct their meaning system through assimilation and accommodation, and perceive the meaning in life in multiple ways through engagement with life. It is essential for healthcare providers and researchers to offer timely meaning-centered support.

Background: Little data exists on critical relationships for caregivers of patients with brain tumors, or how their social context impacts caregiver well-being.

Aims: Our goal was to describe and categorize the critical relationships reported by caregivers of patients with brain tumors, and to assess the association of categories of critical social relationships with caregiver reports of anxiety, depression, and burden.

Methods: We analyzed baseline self-report data collected from neuro-oncology caregivers enrolled in a supportive care trial. Data included demographics, presence of critical relationships-a confidante or person contributing stress, anxiety, depression, and burden. Critical relationships categories were operationalized as: positive (confidant, no stressful person), negative (no confidant, stressful person), neutral (no confidant nor stressful person), and ambivalent (confidant and stressful person). Descriptive statistics were calculated. One-way ANOVAs assessed differences between relationship category groups on caregiver reports of anxiety, depression, and burden.

Results: Data from 119 caregivers were analyzed. Caregivers had a mean age of 57 years (SD = 15), were mostly non-Hispanic White (92%), female (70%), spouses (52%) of patients with grade 4 tumors (69%). Most caregivers were categorized as having positive (53%) or ambivalent (30%) critical relationships. Significant differences between relationship categories were seen in anxiety, depression, and burden (ps < 0.01).

Conclusions: Although most caregivers of people with brain tumors have confidants, many also identify people who contribute stress. The presence of stressful individuals can negatively impact caregiver well-being in a way that is not counterbalanced by the co-presence of a confidant. Future work should focus on helping caregivers manage stressful relationships.

Study registration: The study was pre-registered at ClinicalTrials.gov: NCT04268979.

Analytic plan pre-registration: The analysis plan for this manuscript was not formally pre-registered.

Objective: Glioma patients often face a poor prognosis and frequently experience neurological impairments. This places caregivers under significant caregiving burden. This review aims to explore the role transition experiences in family caregivers of glioma patients and clarify their support needs.

Methods: We conducted a meta-synthesis that included studies on role transition experiences in family caregivers of glioma patients. PubMed, Embase, CINAHL, Scopus, Web of Science, Cochrane Library, PsycINFO, China Knowledge Resource Integrated Database, Wanfang Database, Weipu Database, and Chinese Biomedical were searched from the inception of the database to 25 February 2025. The JBI Qualitative Research Assessment Tool was used to assess the quality of the studies, and data synthesis was performed using the Thomas and Harden method of thematic and content analysis.

Results: A total of 14 qualitative studies were included. Four themes and 10 sub-themes were identified: (1) challenges at the diagnostic stage (sudden psychological shock and inadequate preparation for the caregiver role), (2) constant stress during the care process (dynamic management of disease, physical and mental burnout, and decision-making dilemma), (3) requirements for the supporting system (information requirement, emotional support requirement, and palliative care requirement), and (4) role growth (role adaptation and keep hope alive).

Conclusions: We explained the challenges caregivers face in initial stage of patients' glioma diagnosis, the ongoing stress and needs during the caregiving process, and how they eventually grow into their new role. Healthcare professionals should consider the role transition characteristics of caregivers and provide targeted skills training and psychological support to help them adapt successfully to their new role.

Background: U.S. health surveillance data suggests that alcohol consumption is similar among cancer survivors and those without a cancer history. However, comparisons of the correlates of alcohol consumption between cancer survivors and those without a cancer history are lacking.

Aims: The purpose of this study was to examine correlates of alcohol use, particularly cancer-related beliefs, and if correlates differed by cancer history.

Methods: Merged data from the Health Information National Trends Survey (HINTS) 5, cycles 2-4 and HINTS 6 were analyzed to estimate patterns of current drinking among US adults with and without a cancer history. Multivariable logistic regression models examined associations among cancer history, cancer-related beliefs, and drinking. Stratified models by cancer history were also examined.

Results: Cancer history was not associated with current drinking in adjusted models (aOR: 0.97, 95% CI: 0.82-1.15, p = 0.742). After adjusting for demographic, behavioral, socio-economic, and health factors, cancer-related beliefs were not associated with current drinking. Correlates of drinking differed between adults with and without a cancer history. For example, among those without a cancer history, Black compared to White adults had lower odds of current drinking (OR: 0.80, 95% CI: 0.67-0.96, p = 0.017); among cancer survivors, no association was found.

Conclusions: Alcohol use is similar among adults regardless of cancer history; yet the correlates of alcohol use differed by cancer history. A better understanding of the determinants of alcohol use among cancer survivors is needed to inform tailored alcohol reduction interventions.