Psycho‐Oncology最新文献

Background: Cancer and its treatments often result in visible bodily changes and emotional distress, affecting self-perception, mood, and overall well-being. Body image, particularly in women with breast cancer, plays a key role in shaping psychological adjustment and quality of life. However, its potential mediating role between depression and quality of life in cancer populations remains underexplored.

Aims: This cross-sectional study investigated whether body image statistically mediates the relationship between depression and quality of life in female patients with cancer and whether this differs between patients with breast cancer compared to other cancer diagnoses.

Methods: Overall, 160 women with cancer aged 18-65 were recruited from a single clinical site. Participants completed the Body Image Scale (BIS), the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D), and the EORTC QLQ-C30 to assess quality life. U-Mann Whitney tests were used for group comparisons. Mediation analyses testing two separate models for breast cancer and non-breast cancer groups were conducted.

Results: In breast cancer group, body image statistically mediated the relationship between depression and quality of life. Depression was associated with greater body image distress, which in turn, predicted lower quality of life. In contrast, among patient with other cancer diagnosis, depression directly impacted quality of life without a significant mediating effect from body image.

Conclusions: These findings underscore the unique psychological burden of breast cancer and highlight the importance of addressing body image in psychological interventions to improve the quality of life in this population.

Background: The Cancer Behavior Inventory Brief Form (CBI-B) allows assessing self-efficacy for coping with cancer as a personal resource of patients facing a diagnosis of cancer and its treatment. While psychometric analyses of CBI-B versions in other languages than English exist, the German version has not been analyzed more thoroughly in this respect yet.

Aims: Against this background, we analyzed the factor structure, internal consistency, and criterion validity of the German 12-item version of the Cancer Behavior Inventory Brief Form, the CBI-B-D-12.

Methods: Based on a pooled sample of N = 1034 cancer patients from various settings, we performed confirmative factor analyses, computed Cronbach's α and McDonald's ω for the 12-item summary scale, and determined criterion correlations with measures of patients' health-related quality of life, anxiety, depression, fear of progression, and fatigue.

Results: With few adjustments, confirmative factor analysis revealed good fit of a 4-factor model identifying the same dimensions of coping self-efficacy as the original instrument (Maintaining Independence and Positive Attitude, Participating in Medical Care, Coping and Stress Management, and Managing Affect). With values of Cronbach's α and McDonald's ω being 0.89 and 0.88 respectively, estimates of the scale's internal consistency were good, and criterion correlations further supported its validity.

Conclusions: The German 12-item version of the CBI-B represents a reliable measure of cancer patients' self-efficacy for coping with cancer that is valid in terms of factorial structure and correlations with major distress and quality of life criteria. It may thus be used in clinical practice and psycho-oncological research.

Objective: The aim of this study was to determine which cognitive patient reported outcome measure (PROM) best represents self-reported cognitive functioning in real-world environments among breast cancer survivors (BCS) as measured by ecological momentary assessments (EMA), and to compare their ability to predict future everyday functioning.

Methods: One-hundred twenty-four BCS (ages 24-88) completed self-report measures of cognitive functioning (FACT-Cog PCI, PROMIS Cog, CFQ, EORTC-CF) and everyday functioning (SDI, FACT-G Functional Well-being subscale) at baseline (Time 1) and at 9 weeks follow up (Time 2). Between assessments, EMA protocols (including one item to assess cancer-related cognitive symptoms) were administered every other day for 8 weeks. Person-specific means and standard deviations were calculated for EMA data. Hierarchical linear regression models were used to model cognitive PROM predictors of person-specific averages and variability in EMAs, SDI, and FACT-G functional well-being, and model parameters (R², AIC, BIC, semi-partial R) were compared.

Results: Follow-up FACT-Cog PCI most accurately predicted both the average (ΔR² = 0.213, p < 0.001) and variability (ΔR² = 0.071, p < 0.001) in EMA CRCI symptoms. For future functional outcomes, the PROMIS Cog and FACT-Cog PCI at baseline demonstrated similar predictive power for Time 2 Functional Well-being (ΔR² = 0.210, p < 0.001). Additionally, baseline FACT-Cog PCI was the strongest predictor of social dysfunction (SDI; ΔR² = 0.205, p < 0.001).

Conclusions: These findings support the ecological validity of cognitive PROMs in BCS and indicate that both FACT-Cog PCI and PROMIS Cog effectively capture real-world cognitive symptoms and predict future everyday functioning, including social function and well-being.

Background: Breast cancer, the most common cancer among women, has a high survival rate due to advances in medical treatment. Mobile health (mHealth) interventions offer promising avenues for psychosocial support, yet limited evidence exists regarding their feasibility and acceptability among Asian breast cancer populations.

Aims: This study developed and pilot-tested a mobile app designed to enhance self-efficacy and resilience among breast cancer patients undergoing chemotherapy.

Methods: This study was conducted in two phases. Phase One involved qualitative research and expert panel discussions to develop the "i KMU Breast Cancer Care Hub" prototype based on patient needs. Phase Two conducted a randomized controlled trial (RCT) using a two-group pretest-posttest design in a medical center in southern Taiwan. Seventy-three patients were randomized to receive either standard care plus app access (n = 37) or standard care alone (n = 36). Feasibility outcomes included recruitment rate, retention rate, adherence, and usability scores. In addition, data on self-efficacy and resilience were collected at baseline and 4 weeks post-intervention using validated scales.

Results: High task completion rates and good app usability were observed, along with generally positive user satisfaction (75.88 ± 15.87). Eighty-three patients were approached, with a refusal rate of 12%. No attrition was observed during the study. The experimental group showed significant improvements in self-efficacy (p = 0.01), especially in decision-making (p = 0.03) and positive attitude (p = 0.01), compared to the control group (p = 0.01 and p = 0.02, respectively). No significant change was observed in stress reduction (p = 0.13). Although resilience declined in both groups, the experimental group experienced a smaller decrease, suggesting a protective effect of the intervention.

Conclusions: The mobile application demonstrated good feasibility, high acceptability, and significant psychosocial benefits by enhancing self-efficacy and mitigating declines in resilience. These findings contribute to the growing evidence supporting the use of mHealth interventions within psycho-oncology to empower breast cancer patients during active treatment.

Trial registration: https://clinicaltrials.gov/: NCT05576545.

Objective: This meta-analysis systematically evaluated the efficacy of web-based interventions in reducing psychological distress in patients with cancer.

Methods: We conducted a comprehensive literature search of five major databases-PubMed, Web of Science, Embase, CINAHL, and the Cochrane Library-through April 05, 2025. Following the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions, we identified randomized controlled trials comparing web-based interventions to control conditions. We extracted standardized mean differences (SMDs) and 95% confidence intervals (CIs) to quantify the effect sizes. Between-study heterogeneity was assessed using the I² statistic, and predefined subgroup analyses were used to explore potential moderators. Two independent reviewers appraised the methodological quality using the Cochrane Risk of Bias 2.0 tool, and the overall certainty of evidence was graded using the GRADE framework.

Results: Twenty RCTs, including 2470 participants, met the inclusion criteria. Pooled analysis showed that web-based interventions significantly reduced psychological distress compared to controls (SMD = -0.37, 95% CI: -0.55, -0.18), with substantial heterogeneity (I² = 73.2%; p < 0.001). Studies assessing psychosocial distress as a primary outcome showed larger effects, contributing to heterogeneity. Subgroup analyses indicated that therapist-guided interventions produced greater reductions in psychosocial distress than self-guided approaches.

Conclusions: Web-based interventions provide a modest but significant benefit in alleviating psychological distress among patients with cancer, with greater efficacy when therapist support is included. Despite the substantial heterogeneity across trials, these findings underscore the scalability and accessibility of online mental health tools for oncology care. Future research should address optimal intervention components and delivery strategies to maximize clinical impact.

Background: IBP therapies (immunotherapies, biologics and precision therapies) have had a significant impact on cancer survival. They differ from conventional cancer treatments in that they may be used long term and have less predictable adverse effects. We aimed to explore the psychological impact of IBP therapies from the perspectives of those living with advanced cancer.

Methods: Semi-structured interviews with 20 women and 11 men with advanced cancer - (lung, colorectal, ovary, (female) breast, renal and malignant melanoma) - about their experiences of IBP therapies. Data were analysed thematically.

Results: We elicited two overarching themes from the data: (1) the psychological impact of a stage IV diagnosis and living with advanced cancer, and (2) uncertainty and dependency associated with IBP therapies. Although some were relieved to have a diagnosis, others responded with shock and disbelief. Day to day, cancer was foremost in the minds of many, and the remainder chose to push these thoughts aside and focus on making the most of life. Living with cancer led to a shift in their sense of self. Uncertainty and dependency throughout the care pathway were centred around treatment effectiveness, heightened by the belief that the therapy was keeping them alive. Participants were uncertain and anxious about any interruption of, or changes to, their current treatment regimen, stopping their current treatment and next steps.

Conclusion: Interventions are needed to support the psychological needs of people using IBP therapies. These should go beyond monitoring and managing IBP treatment-related adverse effects and address uncertainty and psychological dependency.

Objective: To evaluate the effectiveness of an integrative intervention combining psychological and physical therapies with pharmacologic treatment for postmastectomy pain syndrome (PMPS), and to assess its impact on pain, anxiety, and quality of life in breast cancer patients.

Methods: In this prospective randomized controlled study, 302 breast cancer patients with chronic postoperative pain were assigned to a control group (standard pharmacologic treatment) or an experimental group (combined drug, psychological, and physical therapies). Key outcomes included NRS scores during movement and rest, pain interference, Hospital Anxiety and Depression Scale (HADS), and Breast-Q scores, assessed at T0 (baseline), T1 (end of intervention), and T2 (3 months after intervention).

Results: At T2, the experimental group showed significantly lower movement NRS scores (p = 0.0143), pain interference scores (p = 0.0488), and anxiety scores (p = 0.0001) compared to the control group. Two-way ANOVA revealed significant time × group interactions for multiple pain-related outcomes (p < 0.05). Quality of life improved over time (p = 0.0026), but no significant between-group difference was found.

Conclusion: A multimodal integrative intervention combining psychological and physical therapies can enhance pain relief and emotional well-being in patients with PMPS. This approach supports the application of integrative medicine in oncology rehabilitation.

Background: Distress affects about one-third of people with cancer, yet many never want, seek, or receive mental health care. Identifying the barriers that distinguish those who obtain help from those who do not can guide service design in psychosocial oncology.

Aims: To examine how attitudinal, stigma, instrumental, financial, and accessibility barriers predict mental-health care need status (met need, unmet need, or low perceived need or reluctance).

Methods: Survey data from 300 distressed adults in the Cancer Support Community's Cancer Experience Registry (August 2022) were analyzed. Need status reflected desire for, attempts to access, and receipt of mental health care. Multinomial logistic regression tested barrier-domain associations with need status, adjusting for sociodemographic and clinical variables.

Results: Thirty-eight percent reported met need, 25% unmet need, and 37% low perceived need or reluctance. Each one-point increase in attitudinal barrier scores was associated with a higher likelihood of reporting unmet need (relative risk ratio [RRR] = 4.21, 95% CI 1.56-11.37) and low perceived need or reluctance (RRR = 2.85, 95% CI 1.17-6.91) compared to met need. Greater accessibility barriers were also linked to a higher likelihood of unmet need (RRR = 1.73, 95% CI 1.11-2.67). Stigma, instrumental, and financial barriers were not independent predictors in multivariate analyses.

Conclusion: In oncology, help-seeking and access to mental health care appear negatively associated with patient attitudinal beliefs and system-level constraints. Interventions that normalize mental health care, provide education on its benefits, and embed providers within oncology services may reduce the distress burden more effectively than strategies focusing solely on cost or logistics.

Objective: Informal caregivers of patients with terminal cancer can experience an emotionally difficult time in the final stages of their caregiving journey with implications on their bereavement experience. The current study examined anxiety and depression among caregivers of terminal cancer patients and subsequent bereavement adjustment.

Method: Caregivers from the Singapore COMPASS cohort study (N = 192) were prospectively followed from 6-month pre- to 6-month post-patient death. Multinomial and logistic regression models were performed to examine factors associated with anxiety, depression and complicated grief that may be targets for intervention.

Results: Rates of anxiety and depression significantly increased closer to patient death (Anxiety: 47%-61%; Depression: 31%-42%) before decreasing 6-month post-patient death (Anxiety: 21%, Depression: 24%). 16% of caregivers reported persistent anxiety and 15% reported persistent depression from 6-month pre- to 6-month post-patient death, which were associated with the following pre-death caregiver factors: poorer physical health and high caregiving burden impacting their schedule and health. 33% of caregivers reported sub-threshold/likely complicated grief, which was associated with close caregiver-patient relationship, caregiver anxiety or depression at pre-patient death and greater perceived patient suffering.

Conclusions: Efforts to identify and support caregivers pre- and post-patient death are important to mitigate psychological sequalae.

Background: Breast cancer can negatively impact survivors' physical activity (PA). Social cognitive theory (SCT) constructs may be correlated with PA, but it is unclear if cancer-related factors affect these relationships.

Aims: To examine associations between PA, self-efficacy, social support, and exercise barriers interference in breast cancer survivors and whether cancer-related factors moderate these relationships.

Methods: Baseline data from 341 post-primary treatment breast cancer survivors in a web-based diet/exercise intervention trial were analyzed. SCT constructs, accelerometry-measured and self-reported moderate-to-vigorous physical activity (MVPA), and cancer-related factors (stage, time since diagnosis, history of chemotherapy, history of radiation, and hormone therapy status) were examined using Pearson correlation analysis and multivariable linear regression analyses.

Results: Exercise barriers interference was inversely associated with self-reported (r = -0.272, p < 0.001); and accelerometry-measured MVPA (r = -0.128, p = 0.020). No other statistically significant associations were found. Stage and history of chemotherapy moderated the association between social support and self-reported MVPA. The association was stronger among survivors diagnosed with DCIS/stage I versus stage II/III (β = 4.14, p = 0.043, CI = -2.20-10.49) and weaker among individuals who previously received chemotherapy versus no chemotherapy history (β = -5.02, p = 0.026, CI = -11.51-1.47); effects were independent of one another.

Conclusions: Cancer stage and previous chemotherapy moderate the association between social support and MVPA. Targeting social support in early-stage breast cancer survivors or survivors that did not receive chemotherapy may improve intervention effectiveness.