Journal of Psychosocial Oncology最新文献

Purpose: Compare demographic, care provision, and health-related characteristics of individuals fulfilling multiple illness-related caregiving roles (i.e. multicaregiving) versus singular (cancer only) caregiving and investigate factors associated with caregivers' mental and physical functioning.

Design: Cross-sectional national survey.

Participants: Family caregivers who self-reported illness-related caregiving for cancer survivors only (singular caregivers: n = 465) or for one or more family members with illnesses in addition to the cancer survivors (multicaregivers: n = 109).

Methods: Descriptive, logistic, and linear regression analysis.

Findings: Singular caregivers and multicaregivers were similar on demographic, care provision, and health characteristics. Caregiving group was not associated with caregivers' mental or physical functioning. Several caregiver and care recipient characteristics were associated with mental and physical functioning for singular caregivers; however, only age was associated with multicaregivers' mental functioning.

Conclusions: Uncovering correlates of multicaregiving can help describe who may serve in these roles and how concurrent care responsibilities may influence caregivers' well-being.

Purpose: The current study aimed to (1) examine the sociodemographic, clinical and psychological factors related to subjective cognitive functioning (SCF); (2) analyze the complex mutual interconnections between SCFs; and (3) address patients' perspectives on SCF and supportive care.

Method: A heterogeneous sample of oncological patients (N = 566) was recruited.Items inquiring about the senses, attention, memory, spatial functions, decision-making and speech were administered. A network of subjectively perceived changes in cognitive functions was estimated while three open-ended questions addressed patients' perspectives on SCF.

Results: Within the network, deficits in spatial perception, attention focus and problem-solving ability had the highest strength index while the deficits related to the senses were the least influential.

Conclusion: The findings indicate that psychological-based interventions focused on higher cognitive functions could improve patients' quality of life. The presence of supportive care and available information could strengthen SCF intervention and prevention for patients with cancer.

Objective: Cancer diagnosis represents a life crisis. It remains unclear whether/what psychosocial intervention may enhance cancer patients' quality of life (QoL) during existential plight. This study aimed to examine preliminary efficacy of a brief writing intervention for patients newly diagnosed with advanced cancer with a focus on affirming personally important values and beliefs.

Methods: This is a single-arm pilot study testing effect of a 4-week home-based self-affirmation writing intervention for patients newly diagnosed with advanced cancer using interrupted time series design (NCT05235750). Patients were eligible if they were newly diagnosed (within 8 weeks) with advanced stage (III or IV) or recurrent cancer. Longitudinal analyses were performed using generalized linear mixed model incorporating the correlation of repeated measures. All statistical analyses were performed at 5% significance level using SAS^® (version 9.4).

Results: Fifty-seven patients newly diagnosed with advanced stage cancer with a mean age of 63 years balanced in gender were enrolled. Intent-to-treat analysis revealed significant post-intervention change for Faith as measured by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 item scale (FACIT-Sp-12) (ES 0.23, p = .05) and Ge6 "I worry that my condition will get worse" as measured by the Functional Assessment of Cancer Therapy - General (FACT-G) (ES 0.26, p = .10). When comparing changes pre- and post-intervention, Ge6 remained clinically significant (ES_Δ 0.36, p = .27).

Conclusions: Self-affirmation via writing showed initial short-term efficacy in relieving cancer-specific existential concerns (Ge6 "I worry that my condition will get worse") and may be a promising innovative intervention approach that warrant randomized experiments to verify. Further research is also needed to find out who may most likely benefit from this intervention.

Background: The purpose of this study was to test dyadic interdependence in psychological distress (anxiety and depressive symptoms) and explore moderators of interdependence among cancer survivors in treatment and their informal caregivers.

Methods: Cancer survivors and their caregivers completed measures of anxiety and depressive symptoms, social support, social isolation, and burden of other symptoms, at three points in time over the course of 17 weeks.

Results: In 315 dyads, depressive symptoms and anxiety were transmitted from caregivers to survivors. Survivors with high symptom burden or low social support were especially influenced by caregivers' depressive symptoms. Caregivers who had high social isolation or low social support were most likely to be influenced by survivors' depressive symptoms.

Conclusion: Psychological distress is transmitted within dyads during cancer treatment. Dyadic interdependence was most pronounced from caregivers to survivors. Symptom burden, social isolation, and low social support enhanced this dyadic interdependence.

Background: To advance oncology treatment for adults, comprehensive understanding of how and why people decide to enroll in, remain in, and withdraw from cancer clinical trials is needed. While quantitative findings provide insights into these benefits and burdens, they provide limited understanding of how adults with cancer appraise their situation and approach decisions to undertake a clinical trial. The goal of this mixed methods analysis was to conceptualize participants' assessment of benefits and burdens related to cancer clinical trial participation.

Materials and methods: This sub-group analysis of 21 participants was part of a larger sequential, explanatory mixed methods study. We used Creamer's integrated approach to linking quantitative and qualitative data to assess convergence, with qualitative data explaining quantitative results. Participants were grouped into four categories based on quantitative benefit/burden scores and thematic analysis of their qualitative data was used to describe these categories.

Results: Across groups participants varied in descriptions of benefits and burdens of cancer clinical trial participation and reasons for participating. Those reporting high benefit/low burden described "seizing the opportunity to participate;" those reporting low benefit/low burden described "taking responsibility" through trial participation; those reporting low benefit/high burden described how they were "willing to endure," and those with high benefit/high burden emphasized "deciding to act."

Conclusions: Participants' qualitative descriptions of benefits and burdens were more nuanced and dynamic than reflected in their quantitative ratings. Thus, current measures may be missing important concepts, such as logistic challenges of trial participation. Our results have implications for consenting procedures and decisional support guidance offered to patients and their caregivers.

Background: Patterns in sedentary time (SED) and its impact on quality of life (QoL) in cancer survivors during the COVID-19 pandemic remains unknown. The purpose of this study was to 1) compare total and domain-specific SED before and during the pandemic; and 2) examine its association with QoL in a global sample of cancer survivors.

Methods: In an online survey, cancer survivors retrospectively self-reported domain-specific SED (e.g. transportation, television) before and during the pandemic via the Domain-Specific Sitting Time Questionnaire. QoL was assessed via the Functional Assessment of Cancer Therapy (FACT)-General and FACT-Fatigue. Paired t-tests compared daily SED before and during the pandemic. Analysis of covariance compared QoL among: those who remained high (>8 h/day), remained low (<8 h/day), increased (<8 h/day to >8 h/day), or decreased (>8 h/day to <8 h/day) daily SED.

Results: Among cancer survivors (N = 477, M_age=48.5 ± 15.4), 60.8% reported that their SED remained high, 19.7% remained low, 7.5% increased SED, and 11.9% decreased SED. Computer and television screen time significantly increased (p's<.001), while SED during transportation significantly decreased (p<.001). Sub-group analyses revealed that those who reduced SED who were normal or underweight (p=.042) or were meeting physical activity guidelines (p=.031) had significantly less fatigue than those who increased or remained high in SED, respectively. Those who remained high in SED with <3 comorbidities (p's =.005) had significantly better social well-being than those who increased SED.

Conclusions: As we transition to a post-pandemic era, behavioral strategies for cancer survivors should focus on reducing screen time to improve QoL and fatigue.

Objective: Insomnia and repetitive negative thinking (RNT) are both prevalent among cancer survivors, yet little work has investigated their interrelationship. To explore the hypothesis that RNT and insomnia are related, we conducted secondary analyses on data from a pilot clinical trial of cognitive behavioral therapy for insomnia (CBT-I) for cancer survivors.

Methods: This study analyzed survey data from 40 cancer survivors with insomnia who participated in a pilot randomized trial of CBT-I. Correlations and linear regression models were used to determine associations between aspects of RNT and related constructs (fear of cancer recurrence [FCR], cancer-specific rumination, worry, and intolerance of uncertainty) and sleep (insomnia and sleep quality), while accounting for psychiatric symptoms such as anxiety and depression. Treatment-related change in RNT was examined using a series of linear mixed models.

Results: Evidence for an association between RNT and insomnia among cancer survivors emerged. Higher levels of FCR and cancer-related rumination were correlated with more severe insomnia symptoms and worse sleep quality. Notably, FCR levels predicted insomnia, even after controlling for anxiety and depression. Results identified potential benefits and limitations of CBT-I in addressing RNT that should be examined more thoroughly in future research.

Conclusions: RNT is a potential target to consider in insomnia treatment for cancer survivors.

Objective: Long-term psychological impacts are well--documented among childhood cancer survivors. To our knowledge, however, no research has been conducted to investigate obsessive--compulsive and related disorders (OCRD) among childhood -cancer survivors (CCS).

Methods: Using a large electronic medical record database, relative risk were calculated to examine associations between demographic characteristics and childhood cancer type and OCRDs among childhood cancer survivors.

Results: Among 121 survivors of childhood cancer diagnosed with OCRD, 57% were female. The most common childhood cancer diagnoses were leukemia/lymphoma (41%) and central nervous system (CNS) malignancies (38%), and OCRD diagnoses most frequently observed were obsessive-compulsive disorder (OCD; 76%) and excoriation disorder (13%). Female sex (RR= 1.39, 95% confidence interval (CI) 1.17-1.61), White race (RR= 1.28, 95% CI 1.15-1.36) and history of CNS malignancies (RR= 1.36, 95% CI 1.18, 1.92) were associated with OCD.

Conclusions: Numerous factors, including sex, race, and cancer type, were seen as contributors to risk variance for OCRDs, particularly OCD, among CCS, compared to CCS with no OCRD diagnosis. This provides an enhanced understanding of risk factors for OCRD development and may help improve early identification and care for at-risk survivors.

Objectives: Recognizing the limitations of the current pain therapies, the study aimed to explore the unique needs and obstacles related to pain management in Breast Cancer Survivors (BCs) with Chronic Pain (CP).

Methods: 4 focus groups were conducted involving 17 BCs with CP (Mage = 51, SD = 7.99) with varying pain intensities. Thematic analysis was applied to transcribed discussions.

Findings: Three key themes emerged: (1) Challenges to pain management, including "Doctor-patients communications barriers" and "Contextual and societal barriers"; (2) Self-management needs, encompassing "Psycho-social support," "Care-related needs," and "Shared decision-making"; (3) Treatment preferences and perceptions of pain management, with subthemes like "Treatment preferences," "Institution preference," and "Decision role perception."

Conclusions: This study emphasizes tailored support systems targeting patient hesitancy, countering pain normalization, and addressing healthcare providers' attitudes. It underscores the importance of integrating caregiver and peer support. Findings advocate refining healthcare provider education, adopting a comprehensive multidisciplinary approach, and strategically incorporating eHealth tools into such care.

Introduction: Childhood cancer caregivers report psychological distress and unmet psychosocial needs, affecting outcomes for their children. An experimental study was carried out to measure the effectiveness of an intervention in addressing traumatic stress, depression and anxiety.

Methods: Caregivers (n = 59) of children with ALL were allocated to both groups (intervention, n = 29; TAU control, n = 30) via the SNOSE method. The intervention is a physical copy of a 2-week psychosocial self-help guidebook. Scores on the PCL-5, BDI and BAI were recorded at baseline, post-intervention and 1-month follow-up.

Results: There was a statistically significant difference in traumatic stress symptoms post intervention (F(1, 57) = 5.760, p = .020, n_p² = 0.093) in favor of the intervention group. No statistical significance was found for its effect at one-month follow-up, overall depression and anxiety.

Conclusion: A psychosocial module developed for caregivers of children with ALL was found to be effective in reducing symptoms of traumatic stress and potentially depression. However, the maintenance of its effectiveness and the effectiveness on anxiety requires further study.