Psycho‐Oncology最新文献

Objective: The increasing number of young adult (YA) cancer survivors underscores the need for psychosocial interventions, which have been limited in scalability and their focus on mental health symptoms. We tested "Achieving Wellness After Reaching the End-of-treatment" (AWARE), an 8-week digital, coach-assisted intervention to promote hope and quality of life (QOL) in YA survivors.

Methods: A 2-arm RCT compared AWARE versus attention control (AC) among 155 YA survivors (ages 18-39; M_age = 32.89, 87.7% female, 8.4% Hispanic, 22.6% racial minority) within 3 years post-treatment, all recruited online. We assessed feasibility, acceptability, and preliminary efficacy on hope and QOL at baseline, end-of-treatment (EOT), and 16-week follow-up (FU).

Results: Both conditions showed high retention at EOT (94.2%; AWARE: 94.9% vs. AC: 93.5%) and FU (94.8%; AWARE: 96.2% vs. AC: 93.5%) and session completion (≥ 75%). AWARE (vs. AC) participants reported greater program recommendation (90.5% vs. 83.3%), satisfaction (M = 4.16 vs. M = 3.68), and helpfulness of the educational recordings/transcripts (M = 4.07 vs. M = 3.69), reflections (M = 4.18 vs. M = 3.39), and coaching (M = 4.15 vs. M = 3.46, p's < 0.05). AWARE participants provided positive comments about program concepts/components and suggested more application opportunities including on key issues (e.g., guilt, anger, communication). Multivariable regression showed no associations between condition and hope or QOL; however, AWARE (vs. AC) showed greater effects on those with lower baseline hope, and bivariates showed AWARE's unique effects on hope's pathways and certain QOL dimensions at FU.

Conclusions: Feedback on AWARE was positive; yet, intervention revisions or greater focus on those with lower hope may enhance AWARE's utility in promoting hope or QOL.

Trial registration: NCT05905250.

Objective: This study aimed to explore the complex dynamics of help-seeking behaviors among breast cancer patients in China through developing an explanatory theoretical model.

Methods: A Constructivist Grounded Theory (CGT) approach was employed to investigate breast cancer patients' help-seeking behaviors. Data collection occurred at a tertiary hospital in Zhejiang, China, from September 2024 to February 2025. We used a two-phase CGT design: Phase 1 inductively generated the preliminary model from patient interviews; Phase 2 employed theoretical sampling with nurses and non-participant observations to test negative cases, triangulate covert decision dynamics, and achieve category saturation. Sample size was based on theoretical saturation audit checks for coding consistency. Data analysis utilized NVivo 12.0 software following Strauss and Corbin's three-level coding paradigm.

Results: Analysis generated the Motivate-Response-Feedback Model (MRFM), outlining the dynamics of breast cancer help-seeking behavior. Intrinsic motivators included cognitive biases, perceived disease severity, and coping strategies, whereas extrinsic motivators encompassed cultural stigma, healthcare resource allocation, and family responsibilities. Patients' behavioral responses manifested as active (multi-source symptom verification, cross-regional care-seeking) or passive (delayed consultations, condition concealment). Feedback processes were categorized as positive (enhanced social support, reduced psychological stress) and negative (economic strain, negative emotional states), further influencing subsequent help-seeking behaviors.

Conclusions: This study provides a nuanced understanding of the complex interplay between intrinsic and extrinsic motivators, behavioral responses, and feedback loops shaping breast cancer help-seeking behaviors in China. We propose a culture-specific MRFM that explains intention-behavior gaps via dynamic feedback loops rather than static determinants. The developed MRFM highlights the need for culturally tailored interventions to reduce stigma, improve resource allocation, and enhance psychological and social support. Further quantitative validation and research exploring the role of digital health interventions in facilitating timely help-seeking behaviors are recommended.

Study objective: Patients with cancer living in regions of war face significant quality of life (QoL)-related concerns, both cancer- and war-related. This study examined the correlation between narratives of patients referred to an integrative oncology (IO) program in northern Israel and heart rate variability (HRV) measurements.

Methods: The study was nested within an ongoing prospective, randomized controlled trial, assessing IO interventions on QoL-related concerns among patients with cancer undergoing chemotherapy. Patients reporting cancer- and war-related concerns were eligible for study inclusion. Narratives from two open-ended questions addressing personal and health-related effects of the war were analyzed qualitatively using ATLAS.Ti software for systematic coding; and baseline electrocardiogram conducted for HRV measurement.

Results: Analysis of 125 patient narratives identified many war-related experiences and emotions, most significantly stress, fear, anxiety, distress, sadness, loneliness, and reduced daily functioning. In 36 patients (28.8%), a significant association was found between war and cancer-related concerns (e.g., pain, appetite, gastro-intestinal and emotional distress, insomnia). HRV analysis suggested a correlation between expressing both cancer- and war-related concerns with higher Power high-frequency (HF) [correlation: 0.24 (0.01, 0.44), p = 0.039]; Power lower frequency (LF) [correlation: 0.27 (0.06, 0.47), p = 0.015]; and autocorrelation slope [0.25 (0.05, 0.44); p = 0.015].

Conclusions: Patients with cancer- and war-related concerns reported a significant impact of the war on health, especially QoL cancer-related concerns. Baseline HRV analysis suggests that those expressing both groups of concerns showed increased sympathetic and para-sympathetic activity. Further research is needed to examine the impact of war on cancer care.

Objective: Decision self-efficacy reflects individuals' confidence in their ability to make effective health-related decisions. In oncology, it is essential to foster active engagement throughout the healthcare journey. Despite its relevance for quality of life, limited evidence exists on the factors influencing decision self-efficacy among cancer survivors. This exploratory study examined the role of personality traits, metacognition, coping strategies, and social support in predicting decision self-efficacy in breast cancer survivors.

Methods: 187 breast cancer survivors voluntarily completed online questionnaires assessing socio-demographic variables and standardized measures. Correlational analyses, multiple regressions, and mediation analyses were conducted.

Results: Findings evidenced that conscientiousness and cognitive self-consciousness positively predicted decision self-efficacy, whereas agreeableness showed a negative association. Problem-focused coping was positively related to decision self-efficacy; however, this effect was not significant when social support was included. Significant-other support and cognitive self-consciousness emerged as additional positive predictors. Mediation analysis indicated that agreeableness negatively influenced decision self-efficacy when mediated by problem-focused coping strategies.

Discussion: Knowing individual and social characteristics that foster decision self-efficacy can be crucial to promote well-being in breast cancer survivors, decreasing anxiety and distress about their health.

Objective: This study investigated the course of general well-being and health-related quality of life (HRQoL) in working-age melanoma patients during the first year following diagnosis. It also examines the use of psycho-oncological counseling and rehabilitation, and their impact on QoL.

Methods: Patients aged 18-65 years with stage 0 to IIIC melanoma were eligible for this single-center, prospective cohort study. Following informed consent, clinical data and data on general well-being (WHO-5), HRQoL (FACT-M) and need for psycho-oncological care (Hornheider Screening Instrument) were collected at baseline and every three months over one year.

Results: We included 221 melanoma patients (median age 51, range 19-65, 62% female). At baseline, 79% had melanoma stage IB or lower. After one year, 9% had progressed. 38% of patients showed a WHO-5 score below 52% following diagnosis, regardless of tumor stage. Women with stage 0 to IIA melanoma had significantly lower HRQoL in the first six months than men (p = 0.010), and a higher need for psychological support (p < 0.001). There was considerable variability in QoL trajectories both within individuals (median variation 11%) and across patients. In general, 52% needed psycho-oncological care at baseline, but neither counseling (24%) nor rehabilitation (18%) resulted in significant improvements in QoL over the year.

Conclusions: Melanoma diagnosis leads to a marked QoL reduction, particularly in lower stage women, with most patients improving over time. However, substantial intra-individual variation emphasizes the need for regular QoL assessments. Further research is needed to assess the long-term effectiveness of psycho-oncological support and rehabilitation.

Trial registration: German Clinical Trials Register No. DRKS00010005, 08. March 2016.

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.