Journal of Psychosocial Oncology最新文献

Background: Talking about the cognitive side effects of cancer treatment is a complex challenge for care providers, as it is often influenced by emotional issues and social stereotypes.

Objective: This study explored oncology care providers' communication practices concerning treatment-related cognitive side effects, as well as the emotional implications of these exchanges both for them and for patients.

Method: We conducted 37 semi-structured interviews with oncologists and nurses specialized in oncology. Data were analyzed using a reflexive thematic approach.

Results: Communication about cognitive side effects was often downplayed or avoided. Care providers prioritized more visible side effects of treatment. Communication with patients varied according to patient profile, care providers being more likely to discuss cognitive side-effects with younger persons. A lack of time and training on how to manage (i) cognitive side effects and (ii) the emotional tension they felt trying to protect patients while maintaining their own professional identity, fostered a climate of concealment around this issue.

Conclusion: This study highlights the need to design training programs for healthcare professionals that focus on developing emotional skills and better communication of the cognitive side effects of cancer treatment. Encouraging multi-disciplinary dialogue on these side effects could contribute to care providers' well-being.

Background: Despite the known impact of social drivers of health (SDoH) on cancer related outcomes, the integration of SDoH screens into routine oncology clinical practice is scarce and suboptimal. This study describes a retrospective analysis of a quality initiative that integrated a SDoH screener and referral system into clinical workflow and patient outcomes.

Methods: In a quality improvement initiative, a 17-item Quality of Life and Support survey was developed and sent out via the patient portal 7 days prior to patients' second oncology appointment, with repeat measures every 90 days. Descriptive statistics were used to describe patients who completed versus didn't complete the survey and escalated surveys. A logistic regression estimated the odds of survey completion.

Results: 10,655 patients were assigned 25,353 surveys across 5 sites. 37% of the assigned surveys were completed with 6,179 individuals completing at least one survey, 43% before the appointment date. The most frequent reasons for survey escalation were distress, financial strain, and transportation. Completing at least one survey was associated with 33% (p < 0.000) and 19% (p < 0.05) lower odds for African American/Black and Asian individuals, respectively, compared to Whites. Completing at least one survey was associated with 27% and 46% lower odds (p < 0.00) when patients' preferred language is Spanish and 'Other', respectively, compared to English.

Conclusions: A SDoH screen was successfully integrated into ambulatory cancer care allowing for systematic referrals to relevant resources. Future research can incorporate clinician and patient perspectives and examine the impact of subsequent SDoH related interventions on patient outcomes.

Background: Adolescents and young adults (AYAs) with cancer have distinct psychosocial and information needs across the cancer care continuum. AYAs often experience developmental milestone disruptions, changes in social functioning, and an unmet need for social connection both during and after treatment. The multidimensional needs of AYAs with cancer necessitates tailored program development to provide patient-centered psychosocial support that is accessible and scalable. To address these critical gaps in AYA cancer care, this study describes an innovative cancer mobile application, iaya, an online platform uniquely for AYAs with cancer designed to promote coping and peer connection.

Methods: iaya data was collected from late 2021-December 2024. Descriptive statistics were used to examine iaya engagement, growth trends, and summarize user data, including user demographics, app feature engagement, and psychosocial coping toolbox utilization.

Results: Iaya has experienced steady growth over time and now has over 280 total members and 180 active members (66%). Members most frequently visited app spaces for discussion and socialization with other users. These spaces generated more engagement compared to informational or resource specific spaces.

Conclusions: Findings from this study indicate that there is a desire for social connection with AYA peers above and beyond the need for cancer-related information on iaya, suggesting that many AYAs with cancer are interested and willing to engage with online platforms that facilitate these social connections. Future AYA psychosocial oncology programs should be designed with a focus on strengthening social connectedness and community building among AYAs with cancer and consider implementing a mobile component as a valuable and scalable solution.

Background: This study explores how breast cancer patients use social media to seek medical information, emotional support, and peer connection, particularly during the early stages of diagnosis. Video content is preferred for general knowledge, while text-based platforms serve personalized inquiries.

Methods: This study employed a qualitative research design to explore how breast cancer patients engage with social media during the early stages of diagnosis.

Results: Social media enhances patients' autonomy and psychological resilience by facilitating self-care practices and fostering mutual support networks. However, many patients participate passively due to psychological stress, information overload, or anxiety triggered by negative content. Social media engagement often evolves from passive consumption to active support provision, reflecting psychosocial growth and changing roles throughout the cancer journey.

Conclusions: These findings highlight social media's dual role as both a valuable support resource and a potential source of emotional burden. These findings suggest that incorporating digital health literacy and emotional coping strategies into patient care could be beneficial. Future health policies may also consider supporting digital infrastructures that promote equitable and emotionally safe engagement in online cancer communities.

Background: A cancer diagnosis presents significant psychological challenges, often resulting in lasting distress and dis-ruption to daily life. Mindfulness-based interventions (MBIs) are increasingly recognized as vital components of supportive oncology care. Second-generation MBIs (SG-MBIs), such as Meditation Awareness Training (MAT), integrate Buddhist wisdom principles such as impermanence, compassion, emptiness, and non-self, offering potential for transformative therapeutic outcomes.

Objectives: This study explored the core subjective experiences, challenges, and benefits of cancer patients participating in an eight-week MAT programme, examining how integrated Buddhist wisdom teachings are engaged with and interpreted in real-world settings.

Methods: An inductive, realist thematic analysis was conducted on 102 anonymous online diary entries submitted by 20 participants undergoing the MAT intervention. The analysis followed Braun and Clarke's six-phase approach, with researcher reflexivity and consensus guiding theme development.

Results: Findings indicated a dynamic process of engagement. Individuals described a journey from uncertainty and ambivalence toward greater acceptance and emotional resilience, drawing on impermanence and other Buddhist principles to manage distress and reclaim identity beyond their illness. Participants shifted from relying solely on formal meditation practices to integrating mindfulness and wisdom flexibly into their daily lives, demonstrating a growing ability to adapt and embody the wisdom teachings introduced. Self-compassion and empathy developed, enhancing interpersonal relationships and connection both within the meditation group and with the natural world. The group setting provided vital validation and support, normalizing experiences and fostering community.

Conclusions: MAT's integration of Buddhist wisdom principles proved therapeutically meaningful, facilitating resilience, self-compassion, values-driven identity reconstruction. The diary analysis illuminated the temporal progression of change, informing SG-MBI refinement and underscoring the importance of context-sensitive, flexible delivery in oncology care.

Background: Effective patient-provider communication (PPC) is critical during the initiation of adjuvant endocrine therapy (AET) and is essential to health-related quality of life (HRQoL). Research highlighting factors linking PPC and HRQoL among women initiating AET is limited. This study sought to examine the relationship between PPC and HRQoL through the serial mediating effect of patient satisfaction (PS) and communication/attitudinal self-efficacy (CA-SE) among women initiating AET.

Methods: 572 hormone receptor-positive breast cancer survivors (BCSs) on AET completed questionnaires assessing demographic/clinical variables, HRQoL, PPC, PS and CA-SE. A serial mediation analysis was conducted.

Results: PPC was positively correlated with HRQoL (r = 0.219, p < 0.001). A serial mediation analysis demonstrated that PPC was a significant determinant of HRQoL which was primarily explained by the serial effect of PS and CA-SE (β = 0.04, BSCI [0.02, 0.07]).

Conclusions: Findings highlight the benefit of optimal PPC, PS, and CA-SE on HRQoL in BCSs initiating AET. Identifying such factors elucidate possible targets for future interventions.

Purpose: To evaluate the effects of positive psychological intervention (PPI) on sleep quality among cancer patients undergoing radiotherapy, and to investigate whether changes in psychological distress mediate the relationship between PPI and sleep quality specifically.

Methods: A total of 60 eligible patients were randomly assigned to two groups. The control group received usual care, and the intervention group received the PPI based on usual care. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and psychological distress with the Distress Thermometer at three time points: pre-intervention (T0), immediate post-intervention (T1), and 4 wk post-intervention (T2).

Results: Significant differences were observed between the two groups in terms of sleep quality and psychological distress (p < 0.001). Compared with the control group, the intervention group showed significant and lager effect in improving sleep quality (d = 1.28, p < 0.001) and psychological distress (d = 0.82, p = 0.002) from T0 to T1. At T2, the intervention group maintained a large effect on sleep quality (d = 1.10, p < 0.001), while the effect on psychological distress (d = 0.78, p = 0.004) was significant, with moderate effect. The total effect of PPI on sleep quality encompasses a full mediating effect, with 52.2% of the PPI effects on sleep quality mediated by the reduction in psychological distress at T1, and 45% at T2.

Conclusions: A 4-week PPI exerts a significant effect on psychological distress and sleep quality in cancer patients undergoing radiotherapy. Meanwhile, psychological distress acts as a mediating variable in the improvement of sleep quality by PPI.

Despite growing attention to the psychosocial aspects entangled within bodies affected by cancer, the needs and rights of a marginalized population continue to be overlooked. Psychiatrized people living with cancer are significantly less likely to benefit from screening, treatment, and end of life care. Paradoxically, they are also less likely to be referred for psychosocial support. There is a dearth of research on the needs of this population, particularly those with cognitive limitations, neurocognitive impairment and psychosis. This article presents a case study to shed light on the factors that shape the illness trajectory of psychiatrized people with cancer. We apply a critical humanistic lens to challenge systemic approaches that advance intervention at the expense of care and propose strategies for psychosocial oncology professionals working with this vulnerable population.

Background: Advances in cancer treatment have increased survival among childhood and adolescent patients, yet many survivors experience long-term psychosocial and health challenges. Structural factors such as health insurance and geographic location influence access to survivorship care, but little is known about their combined impact.

Methods: Secondary data were analyzed from 470 childhood and adolescent cancer survivors who completed the Impact of Cancer-Childhood Survivors (IOC-CS) questionnaire during visits to a survivorship clinic in the US Pacific Northwest. Hierarchical OLS regression examined predictors of positive and negative psychosocial impacts, including demographic, clinical, and environmental variables (geographic location and insurance type), and their interaction.

Results: The interaction between rural residence and public insurance significantly predicted higher negative impact scores (β = 0.13, p = .05) after controlling for covariates, indicating compounded risk for psychosocial distress. Public insurance independently predicted higher negative impact and lower positive impact scores. Rurality alone was not a significant predictor after accounting for interaction effects.

Conclusions: Survivors with both rural residence and public insurance face intersecting structural barriers that amplify psychosocial challenges. Future research should explore tailored interventions and policy strategies to reduce disparities in survivorship care access and outcomes.

Aims: A childhood cancer diagnosis can be one of the most distressing experiences for parents and poor social support is linked to higher distress levels. This study aimed to test the feasibility of a parent-to-parent mentoring program, pairing parents of newly diagnosed children with parents of survivors.

Methods: Parent mentors were trained using self-guided materials and a virtual workshop. Each mentoring relationship lasted three months and was conducted via phone, text, and/or videoconference.

Findings: In total, 10 parent mentors were trained, and 16 mentees enrolled (50% of those invited). Of the enrolled participants, nine (56%) mentor-mentee dyads completed the intervention. One hundred percent of mentors rated the training as acceptable. Of those mentees that completed the intervention, 89% found it beneficial overall, 100% reported increased feeling of support and reduced feeling of isolation, and 77% reported reduction in distress.

Conclusion: While the intervention was helpful to those that took part, the low participation rate suggests future implementation may be better suited to larger organizations with access to a larger patient population.