Journal of Psychosocial Oncology最新文献

A diagnosis of pediatric cancer generates emotional distress for patients and parents, particularly during prognostic discussions in the context of upsetting information and uncertainty. Emotional support from pediatric oncologists is cited as a key factor in psychological well-being during these conversations; however, gaps persist in addressing emotional needs. This qualitative study explored perspectives from 25 patients with cancer aged 12-25 years with an estimated survival of ≤50%, 40 parents, and 20 pediatric oncologists on best practices for providing emotional support during prognostic discussions. Using a structured rapid qualitative analysis approach that employed standardized templates and summary matrices, we generated four key approaches for optimizing emotional support: 1) deliver high-quality information with consistent reliability; 2) dedicate time, space, and attention to families; 3) validate emotions; and 4) preserve hope and positivity. These themes offer actionable insights to inform the design of future communication skills training as well as clinical interventions to encourage individualized emotional support for patients and families facing advanced cancer.

Objective: Breast cancer is the most common malignancy among Arab women in the Middle East.

Objectives: This study examined the relationships between marital support, partner participation, body image, and mental distress among Bedouin women diagnosed with breast cancer.

Design: A total of 100 Muslim Bedouin women who were at least a year from their initial breast cancer diagnoses participate in the study.

Results: The findings indicated negative and significant relationships between partner support and mental distress and between body image and mental distress. In addition, a clear positive relationship was found between partner support and partner participation in the home and between education, income, and spousal support. Women who underwent breast reconstruction following mastectomy reported a higher level of support and improved psychological outcomes. Finally, several distinct relationships were found between demographic variables and the research variables.

Conclusion: The provision of culturally appropriate, patient-centered cancer treatments has not been explored for Muslim Arab women in the Middle East in general and in the Bedouin community more specifically, despite their unique cultural characteristics and increases in the rate of breast cancer among these populations. This study highlights the need for further studies in this area.

Background: Breast cancer survivors (BCS) are at risk of developing psychological distress associated with their cancer and are also more likely to experience comorbid diabetes mellitus (DM), which may worsen distress. Effective patient-physician communication is associated with increased psychological well-being, higher quality of life, and may prolong survival. We aimed to examine the association between race/ethnicity, patient-provider communication, and cancer-related distress in BCS with comorbid DM.

Methods: BCS with DM were surveyed using the Impact of Events Scale-Revised (IES-R) to assess for cancer-related post-traumatic stress (PTS) and the Patient Reactions Assessment (PRA) to assess their views of provider communications with their cancer (PRA-C) and DM providers (PRA-D). Bivariate analyses were conducted to examine the relationships between race/ethnicity, cancer-related PTS, and PRA scores. Pearson's correlation coefficients were used to examine the relationship between PRA and IES-R scores by race/ethnicity.

Results: A total of 181 female BCS with DM [mean (SD) age: 66.7 (7.0) years] who self-identified as White (39.8%), Black (32.0%), or Hispanic/Other (28.2%) were included. Non-White groups reported worse communication with their cancer (p = 0.01) but not with their DM providers (p = 0.09). BCS with cancer-related PTS had lower PRA-C scores (p = 0.04) but no difference in PRA-D scores (p = 0.22), versus those without cancer-related PTS. PRA-C and IES-R scores were significantly correlated, such that better communications with cancer (r = -0.23, p = 0.01) but not DM providers (r = -0.13, p = 0.08), were associated with lower IES-R scores. In subgroup analyses, the correlation between cancer-related PTS and PRA-C scores was significant in Hispanic/Other BCS (r = -0.39, p = 0.01), in contrast to Black (r = -0.12, p = 0.42) and White BCS (r = -0.09, p = 0.49); no significant correlation was observed between cancer-related PTS and PRA-D scores by race/ethnicity.

Conclusions: Compared to White BCS, minoritized BCS with comorbid DM report less satisfaction in communications with their cancer providers, which is associated with higher levels of cancer-related distress.

Purpose: This study explored the types of support necessary for building romantic relationships and marriages after a cancer diagnosis among adolescent and young adult (AYA) cancer survivors.

Method: Semi-structured interviews were conducted with 24 AYA cancer survivors who were unmarried at the time of diagnosis, including any form of cancer. Participants were diagnosed between ages 15 and 39 and were aged 20 to 45 at the time of the interviews.

Results: Five core themes were identified: Providing Information, Emotional Support, Engaging with Others' Experiences, Structural Support, and Negative or Unintended Consequences of Support. Peer cancer survivors and healthcare professionals were the primary sources of both utilized and desired support, though the type of support differed across these areas.

Conclusion: The findings highlight the need for integrated support systems that address the interconnected concerns related to relationships through peer and professional guidance tailored to the age-specific needs of AYA cancer survivors.

Objective: A cancer experience may complicate how young survivors relate to their bodies. To enhance our understanding, it is necessary to move beyond a narrow focus on bodily appearance. The current study examines how the multidimensional construct of embodiment is related to the developmental trajectories of identity formation and psychological late effects in young survivors.

Methods: Survivors completed self-report questionnaires on embodiment at Timepoint 4 and on identity synthesis and confusion, posttraumatic stress symptoms (PTSS), cancer-related worries, and benefit finding at Timepoints 1-3. Using structural equation modeling, embodiment 3 years later was predicted by developmental trajectories of identity and psychological late effects of cancer.

Results: Higher initial levels of identity synthesis and lower initial levels of identity confusion, PTSS, and cancer-related worries were associated with higher levels of embodiment 3 years later. Increases in identity synthesis and decreases in identity confusion were associated with higher levels of embodiment 3 years later.

Conclusions: This longitudinal study highlights the significant value of embodiment in understanding the bodily experiences of young survivors, and reveals how embodiment is related to identity development and psychological late effects of cancer.

Purpose: This study examined cancer-related disruptions to family, friend, and intimate relationships, as well as fertility/reproduction, and related implications regarding hope among young adults.

Methods: We analyzed data from young adult survivors (ages 18-39) who participated in: 1) qualitative interviews (April-July, 2023; n = 23) regarding cancer's social/reproductive impacts; and 2) surveys (February-September, 2024; n = 155) assessing quality of life (FACT-G and PROMIS) and hope.

Results: Interview themes included cancer's impacts on: relationships with friends/family (increased prioritization of family/relationships, unanticipated reconnections, role disruption, others not relating or providing support); intimate relationships (importance of spouses/partners, disclosure to potential partners); and reproduction (family planning disruptions). Multivariable linear regression models indicated that higher scores on FACT-G social well-being and PROMIS participating in social roles/activities were associated with higher hope, adjusting for covariates and other quality of life measures.

Conclusions: Interventions for this population targeting hope and navigating social relationships/roles may enhance quality of life.

Background: Sexual concerns are a key unmet need among patients with cancer. Women are less likely than men to be assessed for sexual concerns, due in part to a lack of appropriate screening tools. The Self-Efficacy to Communicate about Sex and Intimacy (SECSI) scale measures perceived ability to communicate about sex and intimacy during cancer yet has not been evaluated among patients undergoing active treatment.

Objectives: This study describes sexual, emotional, and interpersonal well-being of partnered women undergoing chemotherapy and evaluates the psychometrics of the SECSI in this sample.

Methods: Participants (N = 149) completed measures of mental health, sexual health, and relationship satisfaction.

Results: Almost 60% of participants reported engaging in sexual activity in the last month. Participants reported feeling most bothered by low sexual interest. Confirmatory factor analysis indicated a single-factor structure was insufficient for the SECSI while exploratory factor analysis extracted one factor. Convergent and discriminant validity of the SECSI were also supported by this study's findings.

Conclusions: This study indicates women undergoing chemotherapy are both engaged in sexual activity, yet bothered by decreased interest, and provides further support for the use of the SECSI in a group of women currently in chemotherapy.

Objectives: Many patients with breast cancer (BC) experience reproductive concerns that contribute to psychosocial distress. Although many patients experience elevated levels of distress, few pursue psychosocial support (PSS) to manage their distress. We characterized the associations between BC patients' PSS utilization and demoralization, hopelessness, anxiety, depression, health-related quality of life (HRQOL), and previous experiences with psychosocial providers.

Methods: One hundred and four BC patients with reproductive concerns were recruited. Bivariate correlations assessed the relationships between measures of psychosocial distress and health care utilization. Independent logistic regressions were run to evaluate the unique associations between predictors of interest and PSS utilization.

Results: Most participants (57.7%) reported utilizing PSS during treatment. Higher levels of demoralization (OR = 1.109, p = 0.004) and HRQOL (OR = 0.964, p = 0.010) were significantly associated with increased odds of PSS utilization. Prior satisfaction with mental healthcare practitioners was also significantly associated with psychosocial utilization (OR = 0.561, p = 0.018). Anxiety, depression, and hopelessness were not significantly associated with PSS utilization.

Conclusions: These data underscore the role of demoralization, HRQOL, and prior mental health care experiences in BC patient's PSS utilization. Many distress screening tools assess patients for the presence of depression and anxiety, but do not assess for demoralization. Thus, incorporating demoralization into screening tools may better identify and engage BC patients with reproductive concerns in PSS services.

Purpose: Work ability is critical for maintaining financial stability, particularly for cancer survivors with limited socioeconomic resources. This study examined the association between neighborhood socioeconomic status (SES) and work ability using UNC Cancer Survivorship Cohort.

Methods: Neighborhood SES was assessed using the Yost index linked to enrollment residential address. Work ability was measured via self-reported general and composite physical/mental work ability scores, and annual missed workdays. We estimated mean differences and 95% confidence intervals between Yost index quintiles using multivariable linear regression.

Results: Among 1,326 currently working participants, those in the highest SES quintile (Q5) had higher general and composite physical/mental work ability scores than those in the lowest (Q1). Fewer annual missed workdays in Q5 vs. Q1 were found among subgroups without chemotherapy, with prostate cancer, ≤ 1 year diagnoses, and urban residence.

Conclusion: Higher neighborhood SES may contribute to better work ability among cancer survivors, highlighting vulnerable groups diagnosed at working age.