Journal of Psychosocial Oncology最新文献

Objective: One in three individuals will be diagnosed with cancer, often accompanied by psychological distress that worsens medical outcomes and raises healthcare costs. Mind Over Matter (MOM) is a five-week psychoeducational group program designed to support the emotional well-being of cancer patients and caregivers.

Methods: MOM integrates Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), and psychoeducation. Offered in-person or via telehealth, it helps participants manage the content of, and relationship to, thoughts and feelings.

Results: Since 2014, MOM has expanded to nine annual internal offerings. Externally, 60 facilitators have been trained, with the first cohort delivering 16 MOM programs within one year. Preliminary data indicate reductions in anxiety, depression, and physical symptom severity. MOM has been culturally adapted for Spanish-speaking participants, and feasibility among Black and African American women is under evaluation.

Conclusion: MOM is an innovative, evidence-based coping program for cancer care, scalable and adaptable across diverse healthcare settings.

Introduction: Sexual health is an important part of emotional and physical functioning. For patients undergoing cancer treatment, sexual health is an often-overlooked aspect of care for a variety of reasons. It is further overlooked for patients who are undergoing extended hospital admissions. There are no current standardized guidelines or recommendations around patients admitted to hospitals for extended periods of time, and as such, is left to the discretion of floor staff or individual hospital units. Often, there are no guidelines at all, which potentially puts patients in unsafe or emotionally taxing situations.

Case study: In this paper, we explore a case of a 21-year-old woman undergoing extended hospital admission due to complications secondary to a bone marrow transplant, and how the omission of sexual health from her care had significant implications for her emotional functioning. The patient and her family gave consent to participate in research.

Treatment implications: We discuss the ethical, legal, psychological, and medical implications of the case, and how certain guidelines and conversations would have potentially improved this patient's emotional state during her hospitalization.

Recommendations and conclusions: We conclude by providing recommendations for mental health providers on discussing healthy sexuality for chronically ill patients who might be subject to extended hospital stays. We strongly recommend that sexual health be an ongoing conversation between providers and their chronically ill patients who are undergoing extensive medical care or extended hospitalizations.

Purpose: Compare demographic, care provision, and health-related characteristics of individuals fulfilling multiple illness-related caregiving roles (i.e. multicaregiving) versus singular (cancer only) caregiving and investigate factors associated with caregivers' mental and physical functioning.

Design: Cross-sectional national survey.

Participants: Family caregivers who self-reported illness-related caregiving for cancer survivors only (singular caregivers: n = 465) or for one or more family members with illnesses in addition to the cancer survivors (multicaregivers: n = 109).

Methods: Descriptive, logistic, and linear regression analysis.

Findings: Singular caregivers and multicaregivers were similar on demographic, care provision, and health characteristics. Caregiving group was not associated with caregivers' mental or physical functioning. Several caregiver and care recipient characteristics were associated with mental and physical functioning for singular caregivers; however, only age was associated with multicaregivers' mental functioning.

Conclusions: Uncovering correlates of multicaregiving can help describe who may serve in these roles and how concurrent care responsibilities may influence caregivers' well-being.

Background: Traditional MBSR or MBTC programs do not delve deeply enough into emotional regulation, which is especially relevant in oncological patients. The aim of this study was to analyze the benefits of a mindfulness-based emotion regulation program in adult oncological patients.

Method: Psycho-oncologists from the AECC developed a mindfulness-based emotion regulation program. The Five Facet Mindfulness Questionnaire (FFMQ), Trait Meta-Mood Scale (TMMS), and Hospital Anxiety and Depression Scale (HADS) were administered before and after the program. A single-group pre-post test design with repeated measures was employed, utilizing the General Linear Model.

Results: Ninety-seven adult cancer patients completed the pre- and post-program assessments. Statistically significant improvements were observed in all FFMQ subscales, increased clarity of emotional discrimination, mood repair, and statistically significant reductions in anxiety and depressive symptoms.

Conclusions: Regardless of the phase of the disease, the results of this study suggest that emotional regulation may improve and anxiety and depressive symptomatology decrease after a mindfulness-based emotion regulation program in oncological patients.

Objectives: This project aimed to understand the experiences and preferences for social risk factor screening among racially, ethnically, and linguistically diverse cancer survivors in the Washington, DC, region.

Methods: Semi-structured interviews were conducted with English, Spanish, and Amharic-speaking breast and prostate cancer survivors. Data were inductively coded to identify themes, and differences by race and preferred language were evaluated.

Findings: Twenty-two interviews in English (n = 14), Spanish (n = 7), and Amharic (n = 1) among participants who identified as Black (n = 8), White (n = 5), Asian (n = 1), Other (n = 6), and multiracial (n = 2) were completed. Participants reported unresolved needs during treatment including transportation, healthful food, mental health care, financial help, and employment assistance. COVID-19 exacerbated many needs. Most participants did not recall discussing needs with oncology teams, but all participants were open to having these conversations.

Conclusion(s): This research reveals that cancer survivors might benefit from culturally appropriate strategies that address social needs.

Purpose: This study examines how patients with gastric cancer and their spouses communicate about the illness, assessing the impact of positive or negative communication on their psychological adaptation and the intimacy of their relationship as a couple.

Method: Employing The Relationship Intimacy Model of Couple Adaptation to Cancer, this study used purposive sampling with the principle of maximum variation to select participants. Sixteen pairs of patients with gastric cancer and their spouse caregivers, hospitalized in the oncology department of a tertiary hospital in Jingjiang City, Jiangsu Province, from March to July 2023, were chosen for semi-structured face-to-face interviews. The recorded data were transcribed within 24 h following each interview and supplemented with field notes. Directed content analysis was employed for the qualitative content analysis.

Results: The interview data revealed three themes and six subthemes. Theme 1: The impact of negative patient-spouse communication, with the subthemes being (i) a decline in couples' relationship intimacy and (ii) reduced psychological adaptation. Theme 2: The impact of positive patient-spouse communication, with the subthemes being (i) enhanced couples' relationship intimacy and (ii) increased psychological adaptation. Theme 3: The impact of protective concealment, with the subthemes being (i) declined couples' relationship intimacy and psychological adaptation, and (ii) increased couples' relationship intimacy and psychological adaptation. Throughout the chemotherapy period, patients with gastric cancer and their spouses experienced both positive and negative forms of patient-spouse communication. This underscores the significance of acknowledging protective concealment within couples. Moreover, the study highlights how the dynamics of couples' relationship intimacy and psychological adaptation are influenced by both positive and negative communication patterns surrounding the illness.

Conclusions: For patients with gastric cancer and their spouses, it is crucial for nurses to emphasize the importance of spousal disease communication during chemotherapy. Efforts should be made to mitigate one-sided, conflictual communication and avoidance behaviors, and to adopt appropriate communication strategies in terms of content and timing to deeply promote couple communication. Additionally, there is a need to focus on the physical and psychological stress of protective concealment in couples.

Background: To advance oncology treatment for adults, comprehensive understanding of how and why people decide to enroll in, remain in, and withdraw from cancer clinical trials is needed. While quantitative findings provide insights into these benefits and burdens, they provide limited understanding of how adults with cancer appraise their situation and approach decisions to undertake a clinical trial. The goal of this mixed methods analysis was to conceptualize participants' assessment of benefits and burdens related to cancer clinical trial participation.

Materials and methods: This sub-group analysis of 21 participants was part of a larger sequential, explanatory mixed methods study. We used Creamer's integrated approach to linking quantitative and qualitative data to assess convergence, with qualitative data explaining quantitative results. Participants were grouped into four categories based on quantitative benefit/burden scores and thematic analysis of their qualitative data was used to describe these categories.

Results: Across groups participants varied in descriptions of benefits and burdens of cancer clinical trial participation and reasons for participating. Those reporting high benefit/low burden described "seizing the opportunity to participate;" those reporting low benefit/low burden described "taking responsibility" through trial participation; those reporting low benefit/high burden described how they were "willing to endure," and those with high benefit/high burden emphasized "deciding to act."

Conclusions: Participants' qualitative descriptions of benefits and burdens were more nuanced and dynamic than reflected in their quantitative ratings. Thus, current measures may be missing important concepts, such as logistic challenges of trial participation. Our results have implications for consenting procedures and decisional support guidance offered to patients and their caregivers.

Background: Patterns in sedentary time (SED) and its impact on quality of life (QoL) in cancer survivors during the COVID-19 pandemic remains unknown. The purpose of this study was to 1) compare total and domain-specific SED before and during the pandemic; and 2) examine its association with QoL in a global sample of cancer survivors.

Methods: In an online survey, cancer survivors retrospectively self-reported domain-specific SED (e.g. transportation, television) before and during the pandemic via the Domain-Specific Sitting Time Questionnaire. QoL was assessed via the Functional Assessment of Cancer Therapy (FACT)-General and FACT-Fatigue. Paired t-tests compared daily SED before and during the pandemic. Analysis of covariance compared QoL among: those who remained high (>8 h/day), remained low (<8 h/day), increased (<8 h/day to >8 h/day), or decreased (>8 h/day to <8 h/day) daily SED.

Results: Among cancer survivors (N = 477, M_age=48.5 ± 15.4), 60.8% reported that their SED remained high, 19.7% remained low, 7.5% increased SED, and 11.9% decreased SED. Computer and television screen time significantly increased (p's<.001), while SED during transportation significantly decreased (p<.001). Sub-group analyses revealed that those who reduced SED who were normal or underweight (p=.042) or were meeting physical activity guidelines (p=.031) had significantly less fatigue than those who increased or remained high in SED, respectively. Those who remained high in SED with <3 comorbidities (p's =.005) had significantly better social well-being than those who increased SED.

Conclusions: As we transition to a post-pandemic era, behavioral strategies for cancer survivors should focus on reducing screen time to improve QoL and fatigue.

Objective: Insomnia and repetitive negative thinking (RNT) are both prevalent among cancer survivors, yet little work has investigated their interrelationship. To explore the hypothesis that RNT and insomnia are related, we conducted secondary analyses on data from a pilot clinical trial of cognitive behavioral therapy for insomnia (CBT-I) for cancer survivors.

Methods: This study analyzed survey data from 40 cancer survivors with insomnia who participated in a pilot randomized trial of CBT-I. Correlations and linear regression models were used to determine associations between aspects of RNT and related constructs (fear of cancer recurrence [FCR], cancer-specific rumination, worry, and intolerance of uncertainty) and sleep (insomnia and sleep quality), while accounting for psychiatric symptoms such as anxiety and depression. Treatment-related change in RNT was examined using a series of linear mixed models.

Results: Evidence for an association between RNT and insomnia among cancer survivors emerged. Higher levels of FCR and cancer-related rumination were correlated with more severe insomnia symptoms and worse sleep quality. Notably, FCR levels predicted insomnia, even after controlling for anxiety and depression. Results identified potential benefits and limitations of CBT-I in addressing RNT that should be examined more thoroughly in future research.

Conclusions: RNT is a potential target to consider in insomnia treatment for cancer survivors.

Objective: We examined the association of self-reported substance use with quality of life (QOL), and pain severity and interference among Veterans who are survivors of head and neck cancer (HNC).

Methods: We administered a cross-sectional survey to Veterans with chronic pain who were at least 2 years post-HNC diagnosis. We examined associations between self-reported nicotine, alcohol, and cannabis use with measures of HNC related QOL, pain interference, pain severity, and pain management self-efficacy. We hypothesized current substance use would be positively associated with pain interference and severity and inversely associated with QOL.

Results: The final sample included 191 Veterans, the majority were aged 66 years or older (58.7%), male (97.4%) and White identifying (82.7%). One-third of participants endorsed moderate (29.8%) or high (4.7%) current nicotine use, and one-quarter had moderate (21.5%) or high (2.7%) alcohol use. Compared to those who did not endorse alcohol use, high alcohol use was significantly associated with a 25-point lower score on eating quality of life (on a 0-100 scale) (p = 0.03). In interaction models, no/low nicotine use and low self-efficacy had significantly higher pain interference compared to those with high self-efficacy (5.8 (95% CI: 5.1, 6.6); 2.4 (95% CI: 1.6, 3.2).

Conclusion: Among HNC survivors, current alcohol and nicotine use is associated with lower quality of life and higher pain interference. Pain and substance use psychosocial services with focus on chronic pain, alcohol, and nicotine use, may improve QOL for patients post-HNC treatment.