Journal of Psychosocial Oncology最新文献

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.

Psychosocial oncology and supportive care services are essential for addressing the multifaceted needs of patients with cancer and their families. This paper outlines the framework for a model program, Cedars-Sinai Cancer's Patient and Family Support Program, a service line that integrates psychosocial-spiritual care and supportive care services into standard ambulatory oncology practice throughout the geographic footprint of the institution. The program emphasizes a mission-driven, embedded, transdisciplinary, patient-centered approach, evidence-based interventions, and scholarly activity to improve quality of life, treatment tolerance, and overall outcomes. Key components include wellness offerings, palliative medicine, psychiatry, nutrition, social work, psychotherapeutic services, spiritual care, care coordination, oncology physical medicine and rehabilitation, and survivorship services. Approaches for implementation and strategies for overcoming barriers are also discussed, providing a roadmap for institutions aiming to establish or enhance their psychosocial oncology and supportive care services.

Objectives: While improved survival rates among pediatric cancer patients are a significant success, the intensive treatments required can lead to treatment-related late effects, psychosocial burden, and reduced health-related quality of life (HRQoL). Therefore, this paper examined the HRQoL of survivors with regard to gender-specific differences and explored the associations between health literacy (HL), self-efficacy (SE) and HRQoL using an exploratory approach.

Methods: Quantitative data of n = 58 childhood cancer survivors between 11 and 18 years were analyzed using a mediation model. All participants had completed cancer treatment and were in follow-up care. The mean age at diagnosis was 5 years. The majority of participants had been diagnosed with leukemia (55%), while the remaining participants had lymphomas, brain tumors, or other types of tumors. We assessed survivors HRQoL using the KINDL-R, a validated pediatric quality of life measure. To measure HL and SE, we used self-developed items, with SE defined as confidence in managing one's own health.

Results: No significant gender-specific differences were found between the survivors with regard to their HRQoL (t(55) = 1.65, p = 0.11). The mediation analysis revealed that SE fully mediated the relationship between HL and HRQoL. The direct effect of HL on HRQoL was not significant (β = -0.06, p = 0.715), while the indirect effect through SE was significant (β = -0.26, p = 0.024). According to the squares of multiple correlation coefficients, this model explained 31% of the variation in HRQoL and 18.2% of the variation in SE.

Conclusions: Our findings suggest that SE has a potentially important role, being positively associated with HRQoL and acting as a key mediator in the relationship between HL and HRQoL in childhood cancer survivors. Given the modest sample size and preliminary nature of this study, we recommend that future research further investigate SE's mediating role in larger cohorts. Screening for low SE and the development of SE-targeted interventions may be promising strategies to support survivors' abilities and promote autonomous health care, but these should be considered as exploratory suggestions pending further validation.

Background: There are nearly 500,000 childhood cancer survivors in the United States, and emerging evidence suggests at least 25% of these survivors have lost a peer to cancer. The current study investigated the nature of peer loss in a sample of young adult survivors of childhood cancer.

Methods: Survivors (n = 63) completed an online survey including measures of peer loss, survivor guilt (Interpersonal Guilt Questionnaire) and posttraumatic stress symptoms (PTSS; Posttraumatic Stress Disorder Checklist for DSM-5). Relations between peer loss, survivor guilt, and PTSS were assessed.

Results: Survivor guilt and PTSS were significantly correlated. Survivor guilt accounted for 6% of variance in PTSS beyond variance explained by other risk factors. Peer loss was not significantly correlated with survivor guilt or posttraumatic stress symptoms.

Discussion: Survivor guilt is a significant concern for childhood cancer survivors. Increased screening and intervention are warranted to reduce the impact of survivor guilt and related symptoms. Further research is needed to clarify the impact of peer loss on childhood cancer survivors given its lack of association with survivor guilt or PTSS.

Purpose: Breast cancer patients and caregivers experience anxiety, depression, fatigue, and pain symptoms during treatment. The present study sought to determine which times during the first year of breast cancer treatment have the greatest risk of interpersonal spillover on patient and caregiver symptoms.

Methods: Self-report survey data were collected from 55 estrogen-receptor positive (ER+) stage I-III breast cancer patients and their identified caregivers throughout the first year of primary treatment (e.g., surgery, radiation) to assess symptoms of biobehavioral reactivity (i.e., anxiety, depression, fatigue, and pain). Surveys from patients and caregivers were provided at baseline (before treatment), 6 weeks after surgery, 6 months after surgery, and 12 months after surgery. The present sample comprised primarily white, middle-income individuals with an average age of 63 years old. Data were analyzed using longitudinal Actor-Partner Interdependence Modeling in Mplus.

Results: Intrapersonally, preceding symptoms predicted poor future functioning for both patients and caregivers across the majority of time points. Interpersonally, patients' anxiety at 6 weeks (p = .04) and fatigue at baseline (p = .01) and 6 months (p = .04) predicted greater caregiver symptoms at the subsequent clinically relevant times. However, concurrent spillover occurs for all of the measures of biobehavioral reactivity at one or more times during treatment.

Conclusion: Anxiety and fatigue are vulnerable to longitudinal interpersonal "spillover" of symptoms, particularly for caregivers, starting early in treatment. We also find in this pilot study that concurrent biobehavioral reactivity symptom spillover occurs in some form throughout the first year of breast cancer treatment. It is common for interventions that target symptoms of biobehavioral reactivity to focus on the individual patient. However, given the degree of longitudinal and concurrent spillover observed between breast cancer patients and caregivers, we recommend future research test behavioral interventions that teach dyadic coping skills in addition to replicating findings with a fully powered prospective study.

Purpose: Cancer diagnosis can be distressing, leading to multidimensional care needs which are often not fully met. The experience of diagnosis and treatment may be traumatizing for some patients, leading to a greater demand for support during survivorship. Survivors exposed to trauma may also have a harder time addressing their own needs or require additional support for their needs which have been neglected by the available care.

Method: We examined the degree to which exposure to trauma and posttraumatic stress disorder (PTSD) symptoms influence cancer survivor unmet needs, and the role of unmet needs in survivor life satisfaction. Survivors diagnosed with cancer in the past year or prior (N = 1,138) from a nationally representative population (N = 11,708) reported Adverse Childhood Experiences (ACES-Q-10) and PTSD symptoms (PTSD-8). Unmet needs were reported on the Survivor Unmet Needs Survey (SF-SUNS). Life satisfaction was measured on a single item. Chronic pain, sociodemographic variables, and self-reported cancer stage were self-reported and included as covariates.

Results: In stepwise-hierarchical regression modeling, PTSD symptoms, advanced-stage cancer and younger age were significant predictors of unmet needs in the first year after diagnosis and in the years thereafter (ps < 0.001); but the influence of ACEs on unmet needs was overshadowed by the other variables in the regression model. Chronic pain was associated with unmet needs experienced after one year (p < 0.001) but not in the first year after diagnosis. Having more unmet needs predicted poor life satisfaction when controlling for income, education, and age (p < 0.001).

Conclusions: Findings suggest that cancer survivors with a trauma history and PTSD symptoms are more vulnerable to unmet needs, which contributes to poor life satisfaction. Trauma-informed care and PTSD treatment, especially in younger survivors and those with advanced-stage cancers, may mitigate the potential for unmet needs after cancer diagnosis and thereby improve health outcomes in survivorship.