Journal of Psychosocial Oncology最新文献

Objectives: The study aims to evaluate distress levels and concerns, assess the effectiveness of the Distress Thermometer in screening for psychological distress in patients undergoing mastectomy or conservative surgery, and propose an appropriate cutoff point for this population.

Methods: Cross-sectional study evaluating 236 women who had surgery within the last 36 months. An interview protocol gathered sociodemographic and clinical data, the Distress Thermometer (DT, version 2.2022), and the Hospital Anxiety and Depression Scale (HADS).

Results: Distress levels had a mean of 5.4 (SD 2.7). Anchored by HADS-T, this study proposes "6" as the cutoff point for the Distress Thermometer (sensitivity: 0.80, specificity: 0.72, Youden coefficient: 0.52) when evaluating Brazilian women with breast cancer. 45.76% (n = 108) of participants scored above the new cutoff point (≥6). The main concerns were emotional (worry and anxiety, 89%) and practical (caring for others, 73.3%).

Conclusions: DT effectively screens for psychological distress in Brazil, aiding in the diagnosis and referral of patients for appropriate follow-up.

Background: Ovarian cancer survivors report elevated levels of psychological distress due to the high rates of recurrence and mortality, but little is currently known about the coping skills and strengths that survivors draw upon during their cancer survivorship. One such possible strength is psychological flexibility, defined as the ability to stay in the present moment regardless of unpleasant experiences and make behavioral choices based on values.

Objective: The study aimed to explore psychological flexibility and coping among ovarian cancer survivors prior to their participation in a web-based psychosocial intervention and to examine potential mediators of distress.

Methods: Ovarian cancer survivors were recruited to participate in an 11-week group-based, web-delivered psychosocial intervention. Participants completed assessments of mood, psychological flexibility and coping before the intervention. 165 ovarian cancer survivors provided survey data on psychosocial and clinical characteristics prior to randomization. Multiple mediation models were used to examine potential mediators in the relation of psychological flexibility with depression and anxiety.

Results: Survivors reported mild levels of depression and anxiety. Multiple mediation models revealed significant indirect effects of psychological flexibility on both anxiety and depression. The negative association between psychological flexibility and anxiety was partially mediated by avoidant coping (p = .030). Moreover, the association between psychological flexibility and depression was mediated by cancer-related worry (p = .004).

Conclusions: Psychological flexibility is associated with less distress in ovarian cancer survivors who present for psychological intervention, and this pathway is partially mediated by avoidant coping and cancer-related worry. Mindfulness techniques and coping skills training may ameliorate these effects and improve psychological functioning.

Objective: This study characterizes utilization of, and attitudes toward, a two-part intervention of (1) mailed materials, including educational laminated cards for patients and healthcare providers, and (2) telephone counseling, that aimed to increase screening mammography uptake among adult female survivors of childhood cancer compared to attention controls.

Methods: Participants (n = 136, median age 35 years, range 25-49 years) were diagnosed with cancer between 1976 and 1999 before age 21 years and had been treated with chest radiation. At study end, participants completed a questionnaire asking about their use of and attitudes toward the intervention components. Fisher's exact tests assessed associations.

Results: Among 130 survivors who completed the survey, 45 (35%) received a mammogram. Eighty-five (65%) survivors recalled receiving both intervention components; about half (n = 73, 56%) found the laminated cards helpful and/or described the telephone counseling as positive or activating (n = 81, 62%). Of the 96 women who provided responses, approximately two-thirds (n = 64, 67%) reported little to no fear/anxiety regarding the intervention. Women were more likely to obtain a mammogram if they remembered receiving both intervention components compared to women who reported receiving one or no components (45% vs. 24%, p = 0.050), reported using the laminated card to discuss screening with a healthcare provider (72% vs. 51%, p = 0.086), or found the telephone counseling motivational (61% vs. 30%, p = 0.003).

Conclusions: In summary, the two-part intervention was well-received and elicited minimal fear/anxiety. Receiving intervention messaging in multiple forms and sharing it with a healthcare provider was associated with intervention efficacy.

Purpose: Information is lacking regarding how patients interpret the term spiritual. Consequently, for questions containing the word spiritual, such as in the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 item Scale (FACIT-Sp-12), it is unclear whether patients are responding to religious or non-religious spirituality. To address this question, we replaced the word "spiritual" with "fundamental values and beliefs" on three items of the FACIT-Sp-12 Faith subscale and tested its psychometric properties in a sample of patients recently diagnosed with advanced cancer.

Methods: Internal consistency, item-total correlations, and construct validity were evaluated for the original and modified scales. Bivariate and multivariable associations of the FACIT-Sp-12 with self-esteem, overall and global quality of life (QoL), anxiety, and depressive symptoms were assessed at the scale and factor levels.

Results: The original and modified Faith factor demonstrated excellent internal consistency. Construct validity of the modified scale was supported in the positive association with self-esteem and QoL and negative association with distress symptoms to the same degree as the original scale. Of note, the modified Faith factor tended to be less associated with a religious affiliation.

Conclusions: The psychometric characteristics in the original and modified FACIT-Sp-12 were comparable, suggesting that either version can be considered for future use. Further research on its psychometric properties is warranted.

Objective: The growing incidence of cancer in adults under 50 years old means that more patients are caring for minor children while undergoing oncology treatment. Psychosocial and palliative care clinicians must be prepared to address parenting concerns in their patients. This survey aimed to describe the concerns that patients raised with clinicians, how equipped clinicians feel to address them, and their interest in further training in addressing parenting concerns.

Methods: Multidisciplinary adult clinicians in a single urban NCCN-designated cancer center participated in a live interactive poll about these issues.

Results: Clinicians (N = 78) reported that their patients raised the following concerns: end-of-life (79-100%), communicating with children about the illness (89-96%), and addressing the children's emotional issues (86-92%). Many clinicians (57% of social workers, 33% of psychologists and psychiatrists, and 80% of palliative care providers) felt only somewhat equipped to help parents with their concerns. Most respondents (96% of social workers, 56% of psychologists/psychiatrists, and 85% of palliative care providers) wanted additional training in how to address parenting in their patients. The majority of providers (70% of social workers, 88% of psychologists/psychiatrists, and 100% of palliative care clinicians) wanted to be able to refer for specialized parenting consultations when needed.

Conclusions: Adult psychosocial and palliative care clinicians are asked by patients about complex parenting issues, and do not feel fully equipped to address these concerns. They are interested in further training and access to expert consultation to help them support the growing population of parents with cancer and their families.

Introduction: Self-compassion, directing kindness toward oneself during difficult experiences, has been linked to lower anxiety, depression, and stress throughout the cancer trajectory. This meta-analysis aimed to systematically review existing findings, calculate aggregated effect sizes, and examine cancer phase (acute vs. survivorship) as a potential moderator.

Methods: A systematic review and meta-analysis of 24 studies (3,626 participants across 13 countries) was conducted, assessing associations between self-compassion and anxiety (14 studies), depression (20), and stress (14) in cancer populations. PsycInfo, PubMed, and Google Scholar were searched on June 6, 2025.

Results: Medium-to-large negative associations were found between self-compassion and both anxiety and stress, and a large negative association with depression. Cancer phase moderated the relationship with stress, showing a stronger effect in survivorship than in the acute phase.

Conclusion: Self-compassion appears protective against psychological distress in cancer patients, especially during survivorship. Tailoring self-compassion-based interventions to cancer phase may enhance their effectiveness.

Background: Little is known about the cancer symptom experiences of Indigenous populations, particularly concerning fatigue and hair loss. Hair loss can have many detrimental effects given the significant cultural importance of hair in Indigenous communities. Gaining a better understanding of the unique perspectives of American Indian male cancer survivors as they manage these two distinct symptoms is essential for improving symptom management and quality of life measures in this underserved population. Methods: A multi-pronged study explored the barriers, facilitators, and cultural constructs associated with cancer symptoms. Focus group sessions with American Indian cancer survivors and caregivers in the Southwest gathered data on survivor experiences, with male responses isolated for analysis. The subsequent randomized control trial intervention (N = 231) tested an educational toolkit and "Talking Circles" designed to help survivors and their families better manage cancer symptoms. Results: Study findings report on the unique fatigue and hair loss experiences of American Indian male cancer survivors. Conclusion: The insights gained prove valuable for educational and intervention programs targeting the mangagement of cancer symptoms among Indigenous populations.

Purpose: Studies describing breast cancer care experiences of sexual minority women (SMW) and partners of survivors are lacking. Using a community-engaged approach, we characterized barriers to quality, person-centered care and quality of life outcomes in sexual minority breast cancer survivors.

Methods: Sexual minority breast cancer survivors and partners participated in a brief survey and 60-minute qualitative interview. Data were analyzed using applied thematic analysis using NVivo software.

Findings: Participants were survivors (n = 14), partners (n = 5), and individuals who were both survivors and partners (n = 4). Three themes describe the influence of sexual orientation on the cancer experience; influence of cancer treatment on sexuality, gender experience, and relationships; and advice for other SMW survivors and breast cancer clinicians.

Conclusions: Significant gaps in breast cancer care delivery were identified, warranting clinical education, resources, and interventions to improve SMW breast cancer care.

Purpose: To identify patterns of co-occurring symptoms in a sample of head and neck cancer (HNC) survivors; compare symptom burden among latent classes; and examine associations between symptom classes and social wellbeing outcomes.

Methods: This cross-sectional survey of HNC survivors ≥1 year post-diagnosis was conducted in 2020 using a tumor registry at an academic medical center. Primary outcomes were loneliness and activities impairment. Participants reported 19 HNC-specific symptoms using the European Organization for Research and Treatment of Cancer HNC module (EORTC HN-43), and general cancer symptoms (sleep, pain, anxiety, depression, fatigue). Latent class analysis was used to identify subgroups with different symptom patterns. Multivariable regression models were estimated to examine associations between class membership and social wellbeing outcomes.

Findings: Three hundred forty-seven survivors (mean age 65.5 ± 11.3 years; 3.72 ± 2.3 years post-diagnosis) completed the survey. Participants were predominantly male (72.6%), White (81.6%), and under age 65 years at diagnosis (59.4%). Three symptom classes were identified: (1) complex symptom burden (45%), (2) oral/sensory symptom dominant (38.9%), and (3) limited symptom impact (15.8%). Membership in the complex symptom burden class was associated with increased activity impairment (β = 28.6, SE = 3.7, p<.001) and increased loneliness (β = 1.1, SE = 0.2, p<.001) compared to the oral/sensory class (most similar to overall sample).

Conclusion: Elevated and complex HNC symptom burden is associated with higher levels of general cancer symptoms and risk for loneliness and reduced engagement in daily activities. Tailored survivorship care models addressing symptom profiles of HNC survivors, particularly those with complex symptom burden, are needed to improve quality of life.