Psycho‐Oncology最新文献

Background: Psychosocial risk factors (PSRFs) have emerged as important nontraditional risk factors for poor medical outcomes but have not been well-studied in the field of hematopoietic stem cell transplantation (HSCT).

Objectives: In this study, we retrospectively examined in-hospital and short-term outcomes in patients with PSRFs who underwent HSCT.

Methods: We used the National Readmission Database (NRD) to identify patients who underwent HSCT between 2011 and 2020. Patients were stratified based on the presence of either 0 or ≥ 1 PSRFs, which included factors such as mental illness, substance abuse, cognitive problems, a low income level, and an uninsured status. Patients were also classified into allogeneic-HSCT (allo-HSCT) and autologous-HSCT (auto-HSCT) groups. Our primary endpoints were in-hospital and short-term outcomes.

Results: In this nationally representative cohort, 90,747 patients underwent auto-HSCT, while 26,600 patients underwent allo-HSCT. In the auto-HSCT group, individuals with PSRFs exhibited notably higher in-hospital mortality (2.4% vs. 2.8%; p < 0.001) and 30-day all-cause readmission rates (14.4% vs. 17.8%; p < 0.001) compared to those without PSRFs. Similarly, within the allo-HSCT group, patients with PSRFs had significantly higher in-hospital mortality (5.4% vs. 6.4%; p < 0.001) and 30-day all-cause readmission rates (27.3% vs. 31.2%; p < 0.001) compared to those without PSRFs. After adjusting for risk factors, the presence of PSRFs emerged as a substantial predictor for heightened 30-day readmission in allo-HSCT and auto-HSCT.

Conclusion: The presence of PSRFs is correlated with poorer in-hospital and short-term outcomes after both allo-HSCT and auto-HSCT, with a more pronounced effect observed in allo-HSCT. This research underscores the significance of pinpointing high-risk patients and implies support for merging PSRFs after HSCT is beneficial.

Objective: Psychosocial oncology specialists in academic medical centers are at risk for burnout as they deliver a wide range of clinical, research, educational, and administrative services in high demand work environments. No national productivity benchmarks exist for this specialty. This study examines factors contributing to burnout among academic psychosocial oncology psychologists (PSOP), presents viable productivity standards, and a sustainable care model to mitigate burnout.

Methods: Psychosocial oncology specialists recruited from the American Psychosocial Oncology Society membership were surveyed to determine frequency of burnout as measured by the Mini Z, professional fulfillment via the Stanford Professional Fulfillment Index, as well as demographic, clinical practice, and systems predictors of burnout. We examine salary discrepancies by gender and race. We focus on psychologists providing services in academic medical centers.

Results: Burnout was reported by 37%-44% of psychologists and was associated with high clinical volumes, mid-career status, and less than 10% administrative time. There were no differences in burnout by gender or race. However, females earned significantly less than men at each academic rank.

Conclusions: PSOP report high levels of burnout consistent with other oncology professionals. Critical predictors include patient volume and lack of administrative time. Mid-career providers are more vulnerable to burnout, suggesting an inflection point at which individuals may be more likely to leave the field. We recommend a benchmark for clinical volume and sufficient administrative time to support the tripartite mission (education, research, patient care) and quadruple aim (patient experience, population health, cost, worker well-being) of academic medical centers.

Objective: Many cancer patients are raising young children while suffering from the seriousness of the illness, and it is challenging for parents to talk to their children about their parents' advanced cancer. The purpose of this systematic review was to synthesize the existing evidence on parents' and children's experiences of communicating about parental advanced cancer.

Methods: Seven databases including Pubmed, Web of Science, Embase (OVID), PROQUEST health and medical, CINAL Complete (EMBSO), Medline (OVID), Cochrane Library were systematically searched. A total of 3480 articles were retrieved. Finally, 21 articles were appraised and synthesized.

Results: Three synthesized findings were identified, including open communication with children, concerns about communication, and factors influencing ongoing communication. Most parents appreciated open communication, but struggled with the words, timing and amount of information, and were concerned about causing additional worry to their children. Talking openly about a parent's advanced cancer provided an opportunity for both parents and their children to support each other emotionally, although some parents reported distress in their children.

Conclusions: This systematic review showed the current evidence on parent-child communication when a parent was diagnosed with advanced cancer. Future studies should be conducted to explore how parent-child communication about a parent's advanced cancer affects children's physical and psychological health, and explore children's experiences more directly. Interventions should be developed to help parents with advanced cancer and their children of different ages.

Background: Several screening models have recently been applied to study awareness and help people make informed decisions regarding cancer screening.

Aims: This study aimed to explore the knowledge, attitudes, and lung cancer screening health beliefs (LCSHBs) among Jordanians. Moreover, we intended to translate the LCSHBs scale into the Arabic language and test its validity and reliability.

Methods: An online survey (Google Forms) was completed by 916 participants in Jordan via snowball sampling technique from February 10, 2024, to March 2, 2024, assessing lung cancer screening knowledge, lung cancer preventive attitudes, screening-related health beliefs, and stages of screening adoption. Linear regression analysis, correlations, and non-parametric statistics were utilized for statistical inference.

Results: Participants had high mean percentage scores of 86.56% and 85.75% for knowledge and preventive attitudes towards lung cancer screening, respectively. The Arabic version of the LCSHBs model was found to be a valid and reliable tool, as indicated by principal component analysis extraction and Cronbach's alpha values. Lung cancer screening knowledge was positively associated with perceived benefits and negatively associated with perceived barriers to screening. Knowledge, perceived barriers, perceived risk of lung cancer, self-efficacy (SE) to screen, and lung cancer preventive attitudes were significantly associated with the perceived benefits of lung cancer screening (p < 0.05). We also found that the higher the SE, the higher the physical activity and the lower the perceived barriers.

Conclusion: The Arabic version of the LCSHBs model is valid and reliable for assessing health beliefs toward lung cancer screening. We recommend enhancing targeted interventions, educational outreach, and improving health insurance access to reduce lung cancer incidence in Jordan and promote screening behaviors.

Objective: Children in families with parental cancer may experience emotional, social or physical problems. The aims are to analyze child, parent and family-based determinants of children's health-related quality of life (HRQoL) and their experiences of parental cancer.

Methods: As part of a mixed-methods, multicenter, prospective, interventional non-randomized study "Family-SCOUT," a family-centered intervention in the form of care and case management was developed. Children's HRQoL (KIDSCREEN-10) was assessed at baseline (study inclusion). Descriptive analyses and family cluster-adjusted linear mixed models were performed. Qualitative coding of children's experiences reported in an open-ended text field of the questionnaire was performed.

Results: Four hundred and seventy-two families with 472 parents with cancer and 649 children were included in the study of which N = 346 were analyzed. The average age of the children was 12.8 years. 48% of the children were female. Family cluster-adjusted mixed linear model showed significant associations between children's HRQoL (dependent variable) and children's age (-0.44, p = 0.023, 95%-CI = -0.82 to -0.06) and between families (ICC^{null model} = 0.377, Pseudo-R² = 0.443). Children experienced changes in the family situation, such as daily routines and communication among all family members, death of a parent, COVID-19-related difficulties, and supportive social relationships.

Conclusions: Child, parent and family-based factors appear to be related to children's HRQoL. Research on children's HRQoL and experiences in the context of parental cancer underscores the need for a multidimensional and family-based approach to support these children.

Background: Mesothelioma is a cancer of growing global incidence, especially in developing countries, with unique complex psychosocial impacts on patients and their carers.

Aims: To provide a comprehensive understanding of the psychosocial needs of people living with pleural mesothelioma and family carers.

Methods: A mixed methods design with 61 semi-structured interviews and psychometrically validated questionnaires to assess pleural mesothelioma patients' (n = 36) quality of life and frailty and carers' (n = 25) caregiving experiences, quality of life, and pre-loss prolonged grief symptoms.

Results: People with mesothelioma (29 men, 7 women, aged 46-89 years) indicated moderate quality of life; 18 (50%) met criteria for frailty. Current carers (21 women, 4 men; aged 41-79 years) generally reported positive caregiving experiences and high quality of life; 5 (20%) scored in the range indicative of risk for prolonged grief disorder. Four themes were generated: a desire for tailored information with bespoke detail, assistance to coordinate tasks of treatment, improved social and peer support, and effective psychological services. Needs varied, with main concerns being about breaking the news to spouses/children, the impact of the disease and death on family, loss of personal future, managing psychological symptoms, and avoiding burden.

Conclusions: These specific and unmet psychosocial needs provide a strong basis for individualised care pathways to address these needs via the integration of psychology into the multidisciplinary care team and the development and evaluation of mental health and wellbeing interventions for mesothelioma patients and carers. Doing so will reduce psychosocial distress and improve residual vitality.

Objective: Lung cancer is associated with the highest incidence and mortality of all cancers. New treatments, called targeted therapies (TT) and immunotherapies (IO), offer higher treatment efficacy and fewer side effects compared to traditional treatments but are accompanied by uncertainty and an unpredictable treatment course. There is a paucity of research on the experiences of individuals living with advanced or metastatic lung cancer receiving TT/IO, and even less is known about the supportive care needs of this population.

Methods: Twenty four participants from across Canada participated in semi-structured interviews regarding their supportive care needs. Thematic analysis was utilized to identify their supportive care needs.

Results: Qualitative coding identified unmet needs and challenges. All participants indicated difficulties with unmet supportive care needs, including psychological, informational, and practical needs.

Conclusions: The exploration of supportive care experiences of patients receiving TT/IO exposes high distress and unmet needs. Results indicate the need for timely and accessible supportive cancer care. Results can inform patient advocacy efforts and the development of new services.

Objective: Existential distress is a common phenomenon in palliative care cancer patients. Developing a reliable and easy-to-use assessment scale for existential distress of palliative care cancer patients is crucial. The aim of this study was to develop a measurement of existential distress for palliative care cancer patients and test its properties.

Methods: The guidelines for developing a scale proposed by DeVellis were followed. Palliative care cancer patients were invited to test the draft scale. Two-hundred and nineteen valid questionnaires were included for the item analysis and exploratory factor analysis. Three-hundred and two valid questionnaires were included for confirmatory factor, convergent validity, discriminant validity, and internal consistency reliability analyses. Twenty repeated data were measured for test-retest reliability analysis.

Results: The Existential Distress Scale for Palliative Care Cancer Patients was developed with nine items and three dimensions, including meaninglessness, alienation, and death anxiety. The confirmatory factor analysis showed that the developed scale had a stable factor structure. The Cronbach's α for the whole scale was 0.81, and that for each dimension was 0.76, 0.67, and 0.70, respectively. The test-retest reliability of the scale was 0.79, and that of each dimension was 0.58-0.64.

Conclusions: The Existential Distress Scale for Palliative Care Cancer Patients is a simple but reliable and valid tool.

Objective: Access to work accommodations, such as time off to attend medical appointments, is a key predictor of cancer-related job loss. We aimed to develop and validate a measure of self-efficacy to request and obtain work accommodations related to diagnosis of breast cancer and need for treatment.

Methods: The 5-item Self-efficacy to Ask for Work Accommodations (SAWA) tool was adapted from a scale that measures self-efficacy in patient-physician interactions. English-speaking, employed women, aged 18-64, who were undergoing treatment for stage I-III breast cancer completed surveys during treatment (chemotherapy, radiation, and/or < 60 days since surgery) and 4 months after its completion. Post-treatment surveys were the primary validation dataset; analyses were repeated using baseline data to further evaluate validity/reliability. Psychometric analyses included internal consistency, principal component factor analysis, convergent and divergent validity, and test-retest reliability (in a subset of patients, 2 weeks after post-treatment surveys).

Results: Among 362 participants, the SAWA measure had a Cronbach's alpha of 0.93, indicating high scale reliability. Factor analysis revealed one summary measure which could be divided into two subscales. Overall, the SAWA demonstrated convergent and divergent validity based on the hypothesized variables. Similar patterns were observed when analyses were repeated using baseline survey data. In the test-retest subset, the Pearson correlation between SAWA assessed 4 months post-treatment versus retest 2 weeks later was 0.79.

Conclusions: The SAWA is a validated survey instrument that can be used to measure self-efficacy in employed cancer patients to ask for and obtain employment accommodations.

Introduction: Social support, social strain and stressful life events could induce chronic stress, which affects prognosis and survival after breast cancer diagnosis. However, few studies have examined the impact of psychosocial factors on different competing mortality events.

Methods: We included 9154 postmenopausal women who were newly diagnosed with invasive breast cancer after enrollment in the Women's Health Initiative, as of March 6th, 2021. Psychosocial factors were collected and stratified into quartiles. Cause of death was verified through adjudicated medical record reviews. Associations between psychosocial factors and all-cause mortality, breast cancer mortality, and cardiovascular disease mortality were examined by competing risk models. Subsequent stratified analyses were performed by race.

Results: With a median follow-up time of 8.6 years, 3218 deaths were identified. Compared to participants with less social support, those who had higher social support had significantly lower all-cause mortality (Q4 vs. Q1, HR = 0.89, 95% CI: 0.81, 0.9). The highest quartile of social strain was associated with lower CVD mortality (Q4 vs. Q1: HR = 0.80, 95% CI: 0.65, 0.99). After stratification, a similar relationship was found in White women but not in Black women.

Conclusion: Our findings suggest that there was an association between high social support and reduced all-cause mortality regardless of cancer stages at diagnosis. Social support interventions after breast cancer diagnosis could have the potential to reduce overall mortality.