Psycho‐Oncology最新文献

Background: Mindfulness-Based Interventions (MBIs) are recognized as beneficial in oncology supportive care. While qualitative analyses of mindfulness program experiences exist, this is the first mixed methods study to examine patients' experiences after participating in the online Mindfulness-Based Cancer Recovery (e-MBCR) program.

Methods: The SERENITY study was a pilot randomized controlled trial evaluating the early implementation, and effects of the e-MBCR program for women with breast or gynecological cancer in a French-speaking context. This article reports on secondary outcomes from a mixed methods analysis, exploring psychosocial aspects through questionnaires and participants' experiences through interviews. Sixty-two patients were randomized in a 2:1 ratio. Quantitative assessments were carried out at three timepoints; qualitative interviews only post-intervention. Both datasets were analyzed separately, then merged for interpretation.

Results: The intervention group showed a significant reduction in depression compared to the control group, with a medium effect size post-intervention. While other psychological measures did not show significant differences, this exploratory analysis revealed favorable trends, particularly in anxiety, spiritual well-being, and post-traumatic growth. At 3-month follow-up, most scales showed a diminished effect compared to post-intervention. Qualitative interviews revealed four themes: a safe and validating environment, acquiring skills and taking action, enhanced well-being, and exposure to memories of cancer. This last dimension was a source of beneficial inner work for most participants, although it was a deeply challenging experience for four women.

Conclusion: Participation in the e-MBCR program led to beneficial experiences, notably self-exploration, and enhanced self-efficacy. However, MBIs can also bring up challenging experiences, which are important to acknowledge.

Trial registration: NCT04564768.

Background: Parents of children newly diagnosed with acute leukemia (AL) experience significant traumatic stress that adversely affects their well-being, caregiving capacity, and family functioning. However, rigorous evidence of the feasibility and effectiveness of psychosocial interventions for this group remains limited.

Aims: To evaluate the study feasibility and acceptability of Emotion And Symptom-focused Engagement (EASE), a brief, manualized psychotherapeutic intervention designed to mitigate traumatic stress symptoms in individuals facing a life-threatening illness or in their close family member.

Methods: This single-arm, pre-post feasibility study recruited parents of children with AL who participated in EASE sessions delivered by trained clinicians. Measures of traumatic stress, depressive symptoms, and other psychosocial outcomes were obtained at baseline, 3- and 6-months. Feasibility was assessed based on enrollment, attrition, adherence to EASE, and questionnaire completion rates, with predefined criteria guiding trial progression. Acceptability was evaluated via thematic analysis of qualitative interviews. Descriptive statistics summarized outcome data.

Results: Of 59 parents approached, 40 (68%) enrolled. The study attrition rate was 15%. Participants attended six EASE sessions on average, with 88% receiving the minimum dose of three sessions. Outcome measures were completed by ≥ 78% of participants at each timepoint. Qualitative findings showed that EASE was well-received and provided emotional relief and enhanced coping to parents. Virtual intervention delivery and flexible scheduling facilitated engagement.

Conclusion: EASE is a feasible and acceptable intervention for parents of children with newly diagnosed AL, addressing critical caregiver support needs. Randomized controlled trials are warranted to evaluate its efficacy in reducing traumatic stress and improving caregiver well-being.

Trial registration: NCT05236296 ClinicalTrials.gov.

Background: The clinical trial landscape in oncology has evolved, with shifting endpoints and increased emphasis on early-phase clinical trials (EPCTs) across European centers.

Aims: This study aimed to update knowledge on the experiences of patients enrolling in EPCTs, focusing on the individual/contextual factors influencing decision-making, and how to improve ethical and psycho-oncological support.

Methods: This qualitative single-center study was part of a broader multicenter project. Twenty-five patients with locally advanced or metastatic solid cancer, for whom standard therapies had failed, were interviewed face-to-face, at a French EPCT center. A reflexive thematic analysis of the transcripts was conducted, following Braun and Clarke's six-step approach.

Results: Four overarching themes emerged: "Experiencing the EPCT proposal", "Accepting the EPCT", "Ambivalent feelings" and "Coping strategies", and several subthemes. Decisions were often made quickly in crisis situations and perceived as the only option. While patients reported receiving adequate information, their understanding of the trial's aims varied. Emotional distress and time pressure likely hindered full comprehension. Patients relied on trust in clinicians and reframed trial participation as a constructive goal, drawing on coping strategies to manage uncertainty and restore a sense of coherence.

Conclusions: Patients were neither delusional nor misinformed, but their decisions were shaped by complex emotional and relational dynamics. The perception of being well informed does not ensure true understanding, especially in high-stress contexts. Ambivalent emotions, tensions between expectations and hopes, and constrained choices should be considered when tailoring supportive care. Evidence-based strategies are needed to enhance communication and shared decision-making in EPCT settings.

Aims: To undertake a comprehensive systematic review of currently available instruments designed to assess health information-seeking behaviors among cancer patients, appraising their psychometric properties and methodological rigor to identify the most robust instrument for clinical application.

Design: A systematic review based on COSMIN methodology.

Date sources: Nine electronic databases CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Web of Science, CINAHL, and APA PsycINFO were systematically searched from inception until February 2025.

Review methods: Employing a rigorously validated search methodology developed by Terwee, we systematically interrogated nine multinational databases spanning Chinese and English publications from inception through February 20, 2025, and targeting cancer patient populations. Following independent dual screening by researchers, the psychometric characteristics of identified instruments were systematically assessed using COSMIN quality criteria for measurement tool evaluation.

Results: From the initial 6545 studies, 16 met the eligibility criteria, involving 11 instruments for evaluating health information-seeking behaviors in cancer populations. High-quality evidence revealed insufficient content validity for the BIAS and structural validity deficiencies in the HIOS, PSM, and MBSS, all assigned a class C recommendation, while the remaining seven instruments received class B ratings.

Conclusion: Compared to the other 10 instruments, the MHISBQ measurement attributes are relatively comprehensive and can be provisionally recommended for use. However, there is still a need for large-scale studies involving diverse cancer populations to directly or indirectly compare psychological attributes, such as the stability and responsiveness of the MHISBQ. Additionally, these studies should track changes in HISB and explore its impact on patients, so that they can help guide the delivery of accurate health information and support for cancer patients.

Registration: PROSPERO (CRD42024606469).

Background: Research confirmed that social support has an important impact on mental health, especially in traumatized individuals. Breast cancer patients who have experienced diagnosis, surgery and adjuvant treatment have distinct social support. They endured more posttraumatic stress symptoms in the course of their diseases. The aim of the present study was to investigate whether support was correlated with posttraumatic stress symptoms among breast cancer patients in China, explore the role of emotion status (including anxious and depressive symptoms) in this relationship, and further compare the magnitude of the two mediation effects.

Methods: A total of 612 breast cancer patients who had completed surgery and were on chemotherapy (radiotherapy) participated in this study by completing a set of questionnaires derived from a combination of the Chinese Version of Furman and Buhrmester's Network of Relationships Inventory, the Chinese version of General Anxiety Symptoms Scale, the Chinese version of Patient Health Questionnaire, and the Chinese version of Posttraumatic Stress SymptomsScale.

Results: The results revealed that social support was significantly negatively correlated with posttraumatic stress symptoms. Structural equation modeling showed that emotion status (including anxious and depressive symptoms) mediated the relationship between social support and posttraumatic stress symptoms. The two indirect effects do not differ significantly.

Conclusion: Negative emotion was one of the core responses of traumatized individuals. Improving emotion status (including anxious and depressive symptoms) in breast cancer patients may be one of the cruxes in the recovery of their posttraumatic stress symptoms. This prompts that providing more social support to breast cancer patients during treatment will relieve their anxious and depressive symptoms and thus alleviate their posttraumatic stress symptoms.

Introduction: High-grade gliomas, the most common and aggressive brain cancer, are associated with significant neurological disability and are almost uniformly fatal. Though the diagnosis of brain cancer is represented as one of the most stressful life events for patients as well as for their caregivers, the prevalence of depression as a longitudinal event during and after the initial diagnosis and sequential lines of treatment is under-researched.

Objectives: To inform clinical practice, we assembled published, time-specific estimates of the prevalence of depression in adult high-grade glioma patients to test the idea that depression prevalence varies across therapeutic trajectory milestones.

Methods: We a priori defined five time points in the clinical course of first-line therapy. After an exhaustive search of the current literature, we extracted time point-specific estimates of depression prevalence, pooled the data by time point across studies, and constructed 95% confidence intervals on depression prevalence at each time point. A total of 822 patients were identified and entered into our analyses.

Results: The prevalence of depression in adult high-grade glioma is about 16%-27% between surgery and the end of temozolomide maintenance therapy, which is higher than the 9% estimated for the general population. However, when assessed in the time interval between the initial diagnostic tumor imaging and the confirmatory surgery, at least 30% of these patients are depressed.

Conclusions: Because depression worsens the patient's quality of life and is treatable, the multidisciplinary treatment teams involved in the care of high-grade glioma patients should assess depression throughout the disease trajectory, and especially immediately after the first imaging study showing a suspicious intracranial mass.

Background: The patient-doctor relationship, including communication, is recognised as a critical aspect of the patient experience. Memorable messages are a part of communication between patient and doctor. However, little is known which memorable messages reduce patients' trust in doctors or lead to distrust.

Aims: To reconstruct memorable messages which breast cancer patients recalled while receiving care from their clinicians leads patients to distrust doctors.

Methods: In-depth interviews were conducted with 24 breast cancer patients, in Poland and Croatia. Participants ranged in age from 34 to 76 years. Reflexive thematic analysis was used.

Results: Breast cancer patients recalled many memorable messages that reduce trust in oncology care. The overarching theme of untrustworthy memorable messages was developed, and it embraces three themes: seemingly caring memorable messages, careless memorable messages, missing expected memorable messages. They come in verbal, nonverbal and absent forms. Patient's responses to them include drawing attention directly to inappropriate communication, changing the doctor, learning to be better prepared for medical encounters, or passive adaptation.

Conclusions: These results enrich the studies on memorable messages, enhancing the understanding of communication behaviors in triggering distrust toward doctors. Although patients are aware that doctors are overworked, they expect care, attention, individual approach, understanding, and empathy. However, doctors sometimes give untrustworthy memorable messages - especially messages perceived as dismissive, harmful, inadequate, or absent although expected - throughout the cancer trajectory. Thus, greater attention should be given to eliminating untrustworthy memorable messages, improving the understanding of trust dynamics in oncology, psycho-oncology and health education.

Introduction: Women with severe mental disorders (SMD) experience premature mortality, with disparities in healthcare access and quality contributing to this trend. This study aimed to analyze breast cancer screening rates in women with schizophrenia, major depressive disorder, and bipolar disorder, compared to women without SMD.

Methods: A systematic review and meta-analysis were conducted using PubMed, Embase, PsycINFO, Cochrane, and Web of Science databases. Studies were included if they examined women with SMD (schizophrenia, major depressive disorder, or bipolar disorder) who were within the age range eligible for participation in breast cancer screening programs, according to the guidelines in effect at the time and in the country where the study was conducted, and if they also reported screening rates. Odds ratios were calculated, and meta-analyses were performed using random-effects models.

Results: The review included 22 studies. Women with SMD showed significantly lower odds of mammography screening compared to women without SMD (pooled OR = 0.66, 95% CI: 0.65-0.80, p-val = < 0.0001). Subgroup meta-analyses revealed significantly reduced screening rates in women with schizophrenia (OR = 0.58, 95% CI: 0.38 - 0.88, p-val = 0.005) and major depressive disorder (OR = 0.41, 95% CI: 0.17 - 0.97, p-val = < 0.0001), but no significant difference for bipolar disorder.

Conclusion: Women with SMD, particularly schizophrenia and major depressive disorder, have lower mammography screening rates than women without a SMD diagnosis. Addressing this disparity requires targeted interventions and increased healthcare provider awareness to improve screening rates and ensure equitable access to preventive care.

Objective: Patient trust is fundamental to ensuring optimal cancer care, especially for vulnerable patients who may face additional challenges. However, there is a limited understanding of what it entails for nurses to establish and maintain trust among vulnerable patients. Grounded in the concept of Trust Work, this study explored nurses' efforts to nurture patient trust.

Methods: Drawing on qualitative insights from NAVIGATE, a multicenter randomized controlled trial, we explored the interaction between nurses and vulnerable patients with lung cancer in clinical encounters. We included 16 patients and eight nurses from five Danish hospital sites. Among other sources, data comprised 45 audio-recorded clinical encounters conducted over one year, 15 of which were also observed in clinic settings or patients' homes, as well as semi-structured interviews with all participating patients and nurses. Analyses were based on thematic analysis principles.

Results: We found that nurses were continuously engaged in nurturing trust. This trust work involved three interrelated aspects: (1) 'Recognition' - meticulous preparation to remember individual patients and recognize their lived experiences, (2) 'Witnessing' or 'Guarding' - sustained support, though with varying levels of engagement, and (3) 'Involvement' or 'Detachment'-engaging with affirming resources or disengaging from colleagues' or the broader healthcare system. These aspects were shaped by contextual factors, including nurses' available time and continuity of care, professional affiliations and roles, and collegial and institutional relationships.

Conclusion: This study highlights nurses' critical role in nurturing patient trust and identifies important contextual factors for improving care targeting vulnerable cancer patients.

Objectives: Parents of children with cancer are at increased risk for anxiety, depression, and post-traumatic stress, although wide variability among parents has been documented. This cross-sectional study was designed to examine the individual contributions and simultaneous interaction of three coping constructs-coping strategy, repertoire of coping techniques, and flexibility in applying these techniques-in parental distress related to childhood cancer.

Methods: A sample of 88 mothers and 57 fathers (N = 145) of children undergoing active cancer treatment were recruited from a pediatric hematology-oncology department. Parents' ages ranged from 22 to 58 years. Parents completed standardized measures including the Brief COPE, Coping Flexibility Scale-Revised, the Pediatric Parenting Stress Inventory, and the Profile of Mood States.

Results: Avoidance-focused coping strategy, repertoire of coping techniques, and coping flexibility were individually found to be significantly correlated with parental distress. Bootstrap mediation analysis revealed that the collective model explained 37%-43% of the variance in parental distress, with avoidance-focused coping strategy emerging as the most significant predictor, accounting for approximately 29% of the total variance.

Conclusions: These results suggest that clinical interventions should prioritize identifying and reducing parental reliance on avoidance-focused coping techniques as a primary target. Subsequently, expanding parents' repertoire of problem- and emotion-focused coping techniques and enhancing flexibility in their application could lead to better distress reduction. However, the cross-sectional design limits causal interpretation, and future longitudinal studies employing larger sample sizes are needed to establish the relationships between these constructs.