Journal of Psychosocial Oncology最新文献

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.

Objective: To examine the longitudinal relationship between the use of religious and existential coping strategies on future psychological growth and distress among youth with a history of cancer and matched peers without cancer.

Method: Participants (n = 294; cancer history = 179; no cancer history = 115) were aged 8-17 years at time of study enrollment. Participants completed assessments of religious and existential coping 3 years from baseline assessment, and assessments of psychological stress and growth 5 years from baseline assessment. Regression analyses examined medical, sociodemographic, and religious and existential coping factors associated with assessments of psychological stress and growth. The moderating roles of religious and existential coping on the relationship between group membership (i.e. those with/without cancer history) and psychological distress and growth were explored.

Results: A significant interaction effect was observed for psychological distress which indicated non-cancer comparisons, but not youth with cancer, reported greater psychological distress at year 5 when low levels of existential coping were reported at year 3. Additionally, a significant interaction effect was observed for psychological growth which indicated youth with cancer, but not non-cancer comparisons, reported greater psychological growth at year 5 when high levels of religious coping were reported at year 3.

Conclusion: Results highlight religious coping was associated with greater psychological growth but not distress among youth with cancer, and suggest clinicians should aim to treat patient's spirituality with cultural humility and find ways to incorporate aspects of patient's spirituality into evidence-based behavioral health treatments.

Purpose: African American women experience significant disparities in cancer outcomes, shaped not only by social determinants of health but also by persistent communication barriers within oncology care. This manuscript presents a trauma-informed, culturally grounded intervention - story circles - a narrative-based program designed to improve relational trust and mutual understanding between African American women with cancer and their oncology providers.

Approach: This article outlines the conceptual foundations, implementation strategy, and evaluation framework for story circles in oncology. The model integrates trauma-informed care, narrative medicine, and critical race theory, and is adapted from UNESCO and the Free Southern Theater's Story Circle Process. It is designed to support cross-cultural dialogue in a structured, inclusive setting.

Program description: Oncology social workers facilitate sessions of four to six participants using structured storytelling prompts and reflective dialogue. Participants include African American women with cancer and oncology providers. Each session emphasizes cultural humility, listening without judgment, and honoring lived experience. Story circles promote trust, and provider empathy, relational insight, and communication equity.

Implications: Story circles are a low-cost, scalable strategy that aligns with institutional health equity priorities and national quality standards and can be integrated into ongoing professional development and psychosocial oncology services. Oncology social workers are well-positioned to lead implementation. This model supports cultural responsiveness, strengthens communication, and can inform future quality improvement and policy initiatives.

Purpose: Young Latino survivors of Acute Lymphoblastic Leukemia (ALL) and Lymphoblastic lymphoma (LL) are at higher risk for adverse psychosocial health-related quality of life (HRQOL). However, past research investigating within-group variation is limited. The current study compared HRQOL among sub-groups of Latino pediatric ALL/LL survivors based on dominant language spoken at home.

Participants: Young Latino ALL/LL survivors and their parent (Spanish-speaking n = 50; English-Speaking n = 56).

Methods: Language groups were compared on child self-reports and parent proxies from the Pediatric Quality of Life Inventory (PedsQL).

Findings: Children from predominantly Spanish-speaking families reported higher social functioning F(1, 105) = [15.21], p < 0.001); however, this difference was not present for older children (ages ≥ 9 years).

Conclusion: Younger Latino survivors from predominantly Spanish-speaking families may experience better social functioning, warranting further investigation on protective factors of traditional Latino culture for social functioning in Latino CCS.

Background: Refractory anemia is a hallmark of myelodysplastic syndromes (MDSs), a heterogeneous group of clonal hematopoietic stem cell disorders. Approximately 12% of MDS patients are under 50 years old, and nearly 50% exhibit poor response to standard treatments. Psychodynamic psychotherapy has been shown to be particularly effective in treating somatic disorders and medically unexplained symptoms.

Objective: This study reports a clinical case in which group psychotherapy, in combination with standard treatment, led to improvements in hematological parameters and treatment response in a patient with MDS.

Methods: A 48-year-old male patient diagnosed with idiopathic refractory myelodysplasia was undergoing treatment with epoetin (40,000 IU/ml, twice weekly) and vitamin B12 (1 g/day). The patient, experiencing depressive and obsessive symptoms, voluntarily initiated a group psychotherapy, based on the Human Birth Theory, a framework that fosters a clinician's focus on curability and vitality.

Results: The patient experienced gradual improvements in both psychological and medical conditions. Hematological para-meters began to improve after two years of therapy, reaching a stable normal range after four years. Psychological assessments (Beck Depression Inventory and Beck Anxiety Inventory) showed significant improvement post-treatment. After six years and five months, the patient completed psychotherapy. Four months later, pharmacological treatment was discontinued, with sustained clinical stability.

Conclusion: This case suggests that clinicians' attitude and an idea of curability can be crucial for the patient's psychological response to the treatment. Given the potential negative impact of psychiatric comorbidities on treatment efficacy and disease progression, psychological interventions can be considered as part of an integrated therapeutic approach. Psychotherapy based on the Human Birth Theory may offer specific benefits by fostering a more vital psychological response in the patient, in line with its foundational principles.

Mindfulness-based interventions are gaining recognition as effective therapeutic tools for psychological distress in oncology. However, the widespread adoption of mindfulness in Western clinical contexts has raised ethical and philosophical concerns, particularly regarding the Westernisation and cultural appropriation of Buddhist wisdom. This paper examines the ethical implications of employing Buddhist-informed mindfulness in cancer care, focusing on issues affecting patients, practitioners, and researchers. We propose modifications to Westernised MBIs to ensure practitioners are knowledgeable about Buddhist philosophy and equipped to communicate the tradition's origins transparently to oncology patients. Recommendations include ethically and compassionately introducing Buddhist principles into oncology treatment, emphasising clinician education on the philosophical foundations of mindfulness, especially "Right Mindfulness." By fostering understanding that mindfulness is a long-standing ethically informed practice, practitioners can better support patients in addressing existential questions. We advocate for shared decision-making and trauma-informed adaptations, while respecting the cultural origins and philosophical depth of this ancient practice.

Background: Over the past 25 years, a growing body of literature has shown oncology family caregivers experience as much, if not more, stress than the oncology patient. This research has demonstrated the need to establish programs to support these family caregivers.

Aim: To establish a proactive oncology family caregiver support process to assist family caregivers during the cancer patient's treatment regimen.

Methods: Based on the Iowa Model of Evidence-Based Practice, an evidence-based practice process was established in a large, downtown hospital's oncology infusion center designed to assess the distress and burden level of the family caregivers. Using the Caregiver Quality of Life Index - Cancer questionnaire, family caregivers were assessed for their overall sense of well-being. In the initial pilot process, family caregivers of patients with GI or lung cancer were asked if they wished to participate as they represented two of the largest disease group populations for this oncology clinic. Eighty-three family caregivers (44%) agreed. The sixty-six family caregivers who reported an increased level of distress were referred to the oncology medical social worker to assist with interventions as indicated by their responses.

Results: The efficacy of this proactive approach of assessing family caregiver distress resulted in the implementation of 95 baseline interventions for the 66 participants. The follow-up assessments resulted in 25 interventions, a 26% decrease. Family caregivers reported a 13% increase in their reported quality of life at the time of their third evaluation with the lowest scores improving by 50%.

Conclusion: The need for ongoing support services for oncology family caregivers to help them thrive through the cancer journey was validated. In response to this need, as of September 2024, this process became a permanent feature of the hospital's oncology infusion center services which now supports family caregivers of patients in all oncology disease groups.

Objective: Coping trajectories are important predictors of depressive symptoms among individuals with cancer. However, less is understood about the relationship between coping and depression within the context of psychosocial interventions, especially among minoritized (i.e. "underserved") populations. The current study addresses this gap by investigating the relationship between coping strategies and changes in depression severity among underserved cancer patients participating in the Collaborative Oncology Project to Enhance Depression Care (COPE-D), a 12-week collaborative care depression management intervention for patients with cancer.

Methods: The sample comprised 137 participants who completed both baseline and 12-week follow-up measures. Coping strategies were measured using a shortened version of the adapted Coping Orientation to Problems Experienced (COPE) Inventory, and depression severity was assessed using the Patient Health Questionnaire-9 (PHQ-9). Pre-intervention coping strategies were investigated as predictors of change in depression severity over the intervention, and changes in coping were investigated as moderators of the association between pre- and post-intervention depression severity.

Results: Participants reported significant increases in approach-oriented coping over the course of the intervention (t = 6.57, df = 140, p < 0.001). Conversely, participants exhibited a statistically significant decrease in avoidance-oriented coping (t = -2.76, df = 192, p = 0.006). Neither the degree of approach nor avoidant baseline coping strategies significantly predicted changes in depression severity over the course of the intervention. Changes in avoidance-oriented coping were associated with changes in depression severity (β = 0.2662, p = 0.0304) such that those who maintained or increased avoidant coping over time were less likely to report decreases in depressive symptoms.

Conclusions: Baseline coping did not predict changes in depression severity during the intervention. However, increases in avoidance-oriented coping were associated with greater increases in depression severity over time. These findings underscore the importance of considering coping strategies in depression management interventions for cancer patients.

Background: Breast cancer is the most prevalent and fatal cancer among women. This study aimed to investigate the effectiveness of group compassion-focused therapy (CFT) on difficulty in emotion regulation, pain, and quality of life in women with breast cancer.

Method: The participants were 44 women with breast cancer who had been referred to Yaserbi and Beheshti Hospital in Kashan (Isfahan). After obtaining informed consent, these women were randomly divided into two intervention (n = 22) and control (n = 22) groups, and they were asked to complete the Difficulty in Emotion Regulation Scale (DERS), the Revised McGill Pain Questionnaire (SF-MPQ-2) and Quality of Life questionnaire for cancer patients (QLQ-C30) before treatment, after treatment, and at two-month follow-up.

Results: Data analysis using repeated measure ANOVA showed that CFT significantly improves difficulty in emotion regulation, pain intensity, and quality of life of women with breast cancer.

Discussion: The findings suggest that CFT can be an effective approach to reducing psychological symptoms in women with breast cancer.

Purpose: To explore subjective meanings and lived experiences of spirituality among adults with cancer.

Methods: Participants (age ≥ 18, any type/stage of cancer, English-speaking) were recruited from one cancer center. Semi-structured interviews elicited what "spirituality" means and how it was experienced when facing cancer. Data were analyzed using interpretive thematic analysis.

Results: 25 participants from diverse religious/spiritual backgrounds, primarily white (92%) and female (64%), with an average age of 59 years (range: 43-90), most often described spirituality as connection with something greater. Spirituality in daily life was described as participation in spiritual practices, engagement in service and nurturing others, finding and/or creating sacredness everyday, holding a supportive worldview, and relating with mortality.

Conclusions: Meanings and experiences of spirituality vary widely among people with cancer. Findings underscore the need to tailor spirituality screening. Future research should focus on better understanding spirituality across diverse populations and developing interventions to support spiritual care.