Journal of Psychosocial Oncology最新文献

Background/purpose: Immunotherapies, such as CAR-T, have revolutionized cancer treatment for some cancers. However, these treatments often require active participation of a family member or friend to act as a caregiver at home for several weeks after infusion. Given the novelty of CAR-T, there is a need to better understand the experience of patients receiving these treatments and their caregivers.

Methods: As part of a larger study, patients receiving CAR-T and their caregivers were recruited to participate in semi-structured interviews about their experiences in treatment within a week of hospital discharge. Guided by the Dyadic Cancer Outcomes framework and using an inductive approach, trained coders qualitatively analyzed interview transcripts to identify key themes.

Results: Ten patients and nine of their caregivers participated in interviews in 2021. Three key themes surrounding CAR-T experiences were identified: individual, relational, and contextual. Firstly, the CAR-T experience impacted physical and psychosocial aspects of life for patients and caregivers. Secondly, the isolating and intensive nature of caregiving after discharge affected relationships between patients and caregivers. Thirdly, social contexts such as food, housing, and travel costs complicated the treatment experience.

Conclusions: Although CAR-T is a novel treatment, the experiences of patients and especially caregivers are often similar to those receiving other forms of cancer treatment. However, due to the requirement of a constantly-present caregiver in the weeks after therapy, these experiences may have been intensified. Future work is needed to develop inclusive, family-centered programs to help support patients and their caregivers through cancer treatments.

Objective: To explore the effects of live music to decrease psychological distress in adolescent and young adult (AYA) patients undergoing hematopoietic stem cell transplantation (HSCT).

Method: A quasi-experimental study was conducted. Sixty patients undergoing HSCT were divided into two groups, receiving either 4 week of live music (n = 31) or standard care (n = 29). Psychological distress, anxiety, the severity of symptom clusters and symptom interference were measured.

Results: When compared with the immediately and 1 month after intervention, patients in LM intervention group had significantly lower psychological distress and anxiety level than wait-list group. AYA undergoing HSCT reported significantly milder general symptom cluster and neurological symptom cluster at T3 than at baseline.

Conclusions: Live music intervention showed a positive effect on relieving psychological distress and anxiety in AYA patients undergoing HSCT. However, further researches are warranted to explore the effects of live music intervention on symptom cluster.

Objectives: Cancer survivors are at risk for suicidality. We aimed to expand the knowledge about protective factors and their interplay with risk factors by testing social support as a modifier of the association of Quality of Life (QoL) deficits with suicidal ideation.

Research approach: We surveyed N = 633 childhood cancer survivors (CCS) using validated questionnaires (EORTC Core Quality of Life questionnaire QLQ-C30, Patient Health Questionnaire PHQ-9). The interaction of QoL and social support was investigated using multiple linear regression analysis.

Findings: CCS reporting suicide attempts and current suicidal ideation (SI) had lower QoL. CCS with SI reported less social support. QoL and social support were independently associated with SI and interacted: among CCS with less social support, low QoL was more strongly associated with SI.

Conclusion: The results highlight the need for interdisciplinary survivorship care, and to focus on risk and protective factors to strengthen suicide prevention.

Purpose: To understand the scanxiety experience in pancreatic cancer (PC) survivors following curative surgical resection.

Design: A qualitative study with a hermeneutic phenomenological approach was used.

Methods: Eighteen PC survivors participated. Data from in-depth, semi-structured interviews were analyzed and themes emerged from systematic line-by-line coding of the interview transcripts.

Findings: Two key themes emerged: 'the recurring cycle of scanxiety' and 'hope for lifelong remission'. Participants experienced similar patterns of scanxiety that impacted everyday life. Hope was an essential stabilizing component of the cancer-scan experience, and enabled participants to conceptualize a cure, despite the high likelihood of recurrent, incurable disease. A conceptual framework was developed to provide further insight.

Implications: Everyday life is significantly affected during times of PC surveillance scans. This study enhances our understanding of the cancer-scan experience and provides a framework to guide care.

Objective: A preliminary examination of the psychosocial wellbeing of young people impacted by a family member's cancer, and changes after engaging with a community cancer support organization.

Methods: Five-hundred-and-sixty young people attending a community cancer support organization self-reported distress and unmet needs at baseline and 6-month follow-up. This included young people who: had a brother or sister living with cancer ("siblings"); had a parent living with cancer ("offspring"); had lost a brother or sister to cancer ("bereaved siblings"); or had lost a parent to cancer ("bereaved offspring").

Results: Between 36.1% (siblings) and 57.6% (bereaved offspring) reported high distress; 61.6% (siblings) to 88.1% (bereaved offspring) endorsed 10+ needs. Distress decreased significantly for offspring and bereaved offspring, and unmet needs decreased significantly for siblings, offspring and bereaved offspring. Between 50.0% (siblings) and 63.6% (bereaved siblings) showed significant improvement in distress, unmet needs, or both.

Conclusions: Many young people impacted by family cancer have elevated distress and unmet needs. Engagement with a community cancer support organization may improve their psychosocial wellbeing.

Problem identification: The purpose of this review was to identify and synthesize the published literature on Quality of Life (QoL) and unmet needs of late-stage (American Joint Committee on Cancer [AJCC] III) and metastatic (AJCC IV) CRC survivors.

Literature search: Databases searched included PubMed, CINAHL, and Embase from 2010 to 2023. Articles were included if they focused on self-reported CRC experiences of late-stage and metastatic survivors, identifying 512 articles, of which five met the inclusion criteria.

Data evaluation/synthesis: Five studies were identified that examined QoL and unmet needs of CRC survivors. Three studies assessed only stage III and IV cases. Core factors that may impact QoL included younger age, emotional support from social circles, and psychological support during post-therapy periods. Unmet needs reported by CRC survivors included help managing distress and psychological support for fear of cancer progression.

Conclusions: Limited research has explored unmet needs of late-stage and metastatic CRC survivors. Further research is needed to understand patient factors that impact QoL and unmet needs to support best care practices.

Objective: Long-term psychological impacts are well--documented among childhood cancer survivors. To our knowledge, however, no research has been conducted to investigate obsessive--compulsive and related disorders (OCRD) among childhood -cancer survivors (CCS).

Methods: Using a large electronic medical record database, relative risk were calculated to examine associations between demographic characteristics and childhood cancer type and OCRDs among childhood cancer survivors.

Results: Among 121 survivors of childhood cancer diagnosed with OCRD, 57% were female. The most common childhood cancer diagnoses were leukemia/lymphoma (41%) and central nervous system (CNS) malignancies (38%), and OCRD diagnoses most frequently observed were obsessive-compulsive disorder (OCD; 76%) and excoriation disorder (13%). Female sex (RR= 1.39, 95% confidence interval (CI) 1.17-1.61), White race (RR= 1.28, 95% CI 1.15-1.36) and history of CNS malignancies (RR= 1.36, 95% CI 1.18, 1.92) were associated with OCD.

Conclusions: Numerous factors, including sex, race, and cancer type, were seen as contributors to risk variance for OCRDs, particularly OCD, among CCS, compared to CCS with no OCRD diagnosis. This provides an enhanced understanding of risk factors for OCRD development and may help improve early identification and care for at-risk survivors.

Background: Skin cancer is the most common cancer worldwide and comprises various non-melanoma skin cancer (NMCS) diagnoses and malignant melanoma (MM). It places a psychological burden on patients and their spouses. The present study aims to investigate psychological distress, temporal changes of psychosocial resources (PR), as well as dyadic dynamics of psychological distress and PR in patients with NMSC or MM and their spouses.

Methods: Fifty-four heterosexual couples with different skin cancers, diagnosed within the previous 12 months, participated in this quantitative cross-sectional study. Patients and spouses provided information about depression and anxiety (Hospital Anxiety and Depression Scale), PR within the last four weeks and last three years (Essen Resource Inventory), and partnership quality (Partnership Questionnaire, short version). Dyadic dynamics were analyzed with multiple regression analyses.

Results: We found similar distress levels in patients and spouses, as well as in patients with different skin cancers. Spouses from patients with MM reported significant higher distress levels than spouses from patient with NMSC. Patients' depression predicted spouses' depression, and spouses' anxiety predicted patients' anxiety. In patients, we found associations between personal resources (within the last four weeks and three years) and depression, and an association between patients' social resources (within the last three years) and spouses' depression.

Conclusions: The psychological interdependencies between patients' and spouses' depression and anxiety highlight the importance of considering psychological distress in patients with different skin cancers from a dyadic perspective in clinical contexts. Further, personal resources were indicated as a "distress buffer" for patients' mental health. Our results underline the importance of couple interventions that activate PR in patients with cancer and their spouses.

Objective: Explore experiences of women and care partners living with metastatic breast cancer (MBC) in the new environment of extended MBC survival. Care partner results are presented.

Design: Qualitative descriptive interviews with conventional content analysis.

Sample: Twelve care partners nominated by 1-to-5-year MBC survivors participating in the overall study.

Methods: Semi-structured interviews conducted over phone, Zoom, and in-person.

Findings: "Becoming a Co-survivor" entailed 5 categories: Meeting New Challenges, Changing Supportive Roles, Navigating Decisions, Emotional Toll, and Coping. Sixteen subcategories provided depth and dimension. Qualitative differences depicted journeying from heighted emotions to increasing expertise and mutual communication between survivors and care partners over time.

Conclusions: MBC care partners possess varied characteristics, and experience challenges influenced by time since MBC diagnosis, necessitating further study.

Implications for psychosocial providers: Acknowledge the variety of persons who assume care partner roles, assess needs, and design programs to address psychosocial challenges presenting along the survivorship continuum.