Journal of Psychosocial Oncology最新文献

Purpose/objectives: Hispanic and Latino (hereafter 'H/L') cancer survivors report higher rates of anxiety/depression and are less likely to receive psychosocial services than other survivors. We field-tested a culturally and linguistically adapted cognitive-behavioral therapy intervention with H/L post-treatment cancer survivors. Goals were to: (1) assess feasibility; (2) describe future efficacy outcomes; and (3) examine feedback for refinements.

Design/research approach: Single-arm feasibility study.

Sample/participants: H/L cancer survivors (N = 8).

Methods: Participants completed the 12-week CBT intervention, pre- and post-intervention measures, brief weekly feedback, and an in-depth interview. Recruitment, retention, and adherence, and changes in anxiety, depression, and fear of recurrence were summarized using descriptive statistics and 95% confidence intervals.

Findings: Of 44 H/L survivors approached, 18 agreed to screening, and 9 met criteria; 8 enrolled over 7.4 months. Although we did not perform formal hypothesis testing, we observed clinically meaningful decreases in anxiety and depression. All who completed the intervention (n = 7) recommended the intervention.

Conclusion: While recruitment was challenging, participants reported robust decreases in depression and/or anxiety and high intervention satisfaction.

Implications for psychosocial providers or policy: Future work should explore ways to decrease stigma and enhance recruitment to fully evaluate the adapted intervention among H/L survivors.

Purpose: To synthesize literature regarding the implementation and evaluation of psychosocial interventions designed to reduce distress in post-treatment haematological cancer survivors.

Methods: An integrative review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched were Medline, Cinahl, PsychInfo, WoS, and EMBASE, during November 2022.

Results: The total number of eligible studies was 14. The interventions comprised four main intervention categories: care planning, psychological therapy-based, supported self-care/self-management, and survivorship clinic visits. Overall psychosocial interventions were shown to improve outcomes for haematological cancer survivors.

Conclusions: Psychosocial interventions may play a role in reducing distress for post-treatment haematological cancer survivors and have shown improvements in both psychological and physical outcomes. However, the evidence base was limited and heterogeneous indicating the need for more research.

Implications for cancer survivors: Psychosocial interventions for haematological cancer survivors have the potential to reduce psychosocial distress during the post-treatment period.

Objective: This study utilized social risk data in the electronic heath record collected as part of routine clinical practice and examined relationships with supportive oncology care contacts and healthcare utilization.

Methods: A total of 2,807 cancer patients were screened for four social determinants of health (SDOH) domains (financial resource strain, housing instability, food insecurity, and transportation need) and categorized to low or high risk SDOH groups. The number of patient contacts with supportive oncology was compared amongst the groups. The data were analyzed for demographic and outcome differences including emergency department visits, inpatient admissions, and appointment adherence.

Results: Heightened social risk was associated with more total contacts with supportive oncology care. Patients with high SDOH risk had more contacts across all outcomes examined including emergency department visits (M = 13), inpatient admissions (M = 14), and missed appointments (M = 11).

Conclusions: Patients with both greater social risks and acute care utilization are associated with more psychosocial interventions in supportive oncology follow-up. These findings highlight the need for comprehensive action to respond to social risk factors identified in SDOH screening.

Objective: We assessed acceptability, feasibility, and preliminary efficacy of a culturally appropriate, cancer education program to improve cancer knowledge, attitudes, subjective norms, and screening intentions for oropharynx, colon, and prostate cancers among African American men. We detailed the community-engaged research process used for African American men to design, implement, and evaluate the program.

Materials and methods: We recruited 84 (61 in-person, 23 online) African American men over 2-months across 4 churches in Middle Tennessee in 2021. A single group, pre-post-test design was used to evaluate the 2.5-h hybrid program. Scales used were: General self-efficacy for cancer screening; attitudes toward cancer; general cancer knowledge; and subjective norms related to cancer. One-item measured cancer screening intention. Taba robust partial correlation measured the degree of association between changes in means of each explanatory variable with changes in means of each outcome variable. IBM SPSS version 28 and R/RStudio version 3.6.0 was used for data analysis. We conducted three focus groups (n = 17) to assess program acceptability. Microsoft Excel version 26 was used to conduct thematic analysis for this data.

Findings: Quantitative Significant differences were found in the pre/post comparisons of knowledge (mean difference: 0.22; p-value = 0.015), self-efficacy (mean difference: 0.23; p-value < 0.001), and prostate cancer screening intention (mean difference: 0.19; p-value = 0.049) scores. This indicates the mean score for knowledge, self-efficacy, and prostate cancer screening intention was significantly higher post-intervention. Qualitative Focus group themes were: (1) Impact of Program on Participants Psychosocial Health (2) Perspectives on Life after the program. (3) Views on Programmatic Components; (4) Recommendations for Program Improvement.

Conclusions: Results demonstrate our program is feasible, acceptable, and could increase cancer screening intentions and behavior. Psychosocial providers should demonstrate cultural awareness and humility when providing services to address the psychological and social needs for cancer screening among African American men.

Purpose: Patients with advanced cancer commonly bring a companion to medical appointments, often a family member. Despite increasing focus on family involvement, few studies are based on observations of real-life consultations. This study aimed to explore how companions contribute to the information exchange process during advanced cancer outpatient visits.

Methods: Data were ten videos of routine oncology visits. We identified when and how companions participated using microanalysis of clinical interaction.

Findings: Companion participation varied greatly. They tended to speak up spontaneously, contributing medical, personal, and contextual information that might otherwise have remained unsaid. They both brought information into the discussion and facilitated information exchanged between the physician and patient. Companions displayed few of their own concerns.

Conclusions: The findings suggest that companions may be an important resource during oncology visits, not only for the patient, but also for healthcare providers aiming for person-centered care to the individual patient.

Background: The purpose of this study was to test dyadic interdependence in psychological distress (anxiety and depressive symptoms) and explore moderators of interdependence among cancer survivors in treatment and their informal caregivers.

Methods: Cancer survivors and their caregivers completed measures of anxiety and depressive symptoms, social support, social isolation, and burden of other symptoms, at three points in time over the course of 17 weeks.

Results: In 315 dyads, depressive symptoms and anxiety were transmitted from caregivers to survivors. Survivors with high symptom burden or low social support were especially influenced by caregivers' depressive symptoms. Caregivers who had high social isolation or low social support were most likely to be influenced by survivors' depressive symptoms.

Conclusion: Psychological distress is transmitted within dyads during cancer treatment. Dyadic interdependence was most pronounced from caregivers to survivors. Symptom burden, social isolation, and low social support enhanced this dyadic interdependence.

Cancer is not only a physical illness but also a source of substantial emotional and psychological trauma and distress for patients. Oncology-related trauma stems from the uncertainty of diagnosis, invasive treatments, and the potential threat to life, leading to emotional distress, anxiety, and in some cases, Post-Traumatic Stress Disorder (PTSD). Addressing this trauma early is essential for patient well-being, as unresolved distress and trauma can exacerbate mental health challenges and hinder treatment adherence. Trauma-Informed Care (TIC) offers a framework to mitigate these issues by focusing on safety, trustworthiness, choice, collaboration, and empowerment in care settings. Organizational attention to trauma is critical, as healthcare environments that fail to address emotional distress can contribute to patient dissatisfaction, higher healthcare costs, and poorer outcomes. Oncology Social Workers (OSW) are professional that are positioned to lead the implementation of TIC due to their training in psychosocial care and trauma identification. OSWs role in healthcare encompasses not just individual patient support, but also educating healthcare teams, advocating for system-wide changes, and creating trauma-informed practices that benefit both patients, staff, and organizations. This manuscript discusses the implementation of TIC in oncology settings, recommending the use of a Trauma-Informed Assessment Protocol, such as the Distress Thermometer (DT), to facilitate early identification and intervention of distress, ultimately improving patient outcomes and organizational effectiveness.

Purpose: Young adults report challenges concerning cancer--related cognitive impairment (CRCI). This study aimed to: (1) describe cognition in young adults post-cancer treatment using self-report and performance-based measures, and (2) examine associations between cognition and relevant disease-related, psychological, and lifestyle (physical activity; PA) factors.

Methods: Forty-six young adults (M_age = 31.4 ± 5.4 years; 91.3% female) completed web-based questionnaires and neuropsychological tests; data were analyzed via descriptive statistics and bivariate correlations.

Results: Most (60.9%) self-reported clinically meaningful CRCI and displayed poorer executive functioning and processing speed (but not working memory) than normative data. Disease-related factors, psychological factors, and PA had null-to-moderate (rs = -0.32-0.28), small-to-large (rs = -0.74-0.77), and trivial-to-moderate (rs = -0.16 - 0.36) correlations with cognition (respectively), with differences in magnitude between self--reported and objective cognition.

Conclusion: The observed correlations warrant further exploration in larger prospective studies, and trials should investigate causative mechanisms and specific PA parameters.

Objectives: Recognizing the limitations of the current pain therapies, the study aimed to explore the unique needs and obstacles related to pain management in Breast Cancer Survivors (BCs) with Chronic Pain (CP).

Methods: 4 focus groups were conducted involving 17 BCs with CP (Mage = 51, SD = 7.99) with varying pain intensities. Thematic analysis was applied to transcribed discussions.

Findings: Three key themes emerged: (1) Challenges to pain management, including "Doctor-patients communications barriers" and "Contextual and societal barriers"; (2) Self-management needs, encompassing "Psycho-social support," "Care-related needs," and "Shared decision-making"; (3) Treatment preferences and perceptions of pain management, with subthemes like "Treatment preferences," "Institution preference," and "Decision role perception."

Conclusions: This study emphasizes tailored support systems targeting patient hesitancy, countering pain normalization, and addressing healthcare providers' attitudes. It underscores the importance of integrating caregiver and peer support. Findings advocate refining healthcare provider education, adopting a comprehensive multidisciplinary approach, and strategically incorporating eHealth tools into such care.

Purpose: Breast cancer is a prevalent and emotionally challenging condition that profoundly affects women worldwide. Effectively managing the mental and emotional dimensions of this disease is crucial for the holistic well-being of patients. Psychological capital (PsyCap) has emerged as a pivotal psychological construct with the potential to effectively address these challenges. This study aims to explore the influential role of PsyCap and its constructs on the subjective well-being (SWB) of Iranian breast cancer patients.

Methods: A total of 173 breast cancer patients participated in this study, selected through a random sampling approach. Face-to-face interview data on socio-demographics, PsyCap, and SWB were collected using a structured questionnaire. The analytical procedures encompassed independent sample t-tests, ANOVA tests, Pearson correlation tests, and stepwise multiple regression.

Results: The findings revealed that the majority of participants fell within the 41-50 age group (38.7%), with an average age of 46.50 ± 11.76 years, and 35.8% had tumor growth in the upper left lobe. The average PsyCap score was 107.93 ± 1.52 (out of a possible score of 144), whereas SWB scored 196.51 ± 1.90 (out of 291). Notably, PsyCap showed a positive correlation with SWB (r = 0.119), accounting for approximately 8% of the variance in SWB. The final regression model showed the substantial predictive roles of PsyCap (1.667), self-efficacy (-3.692), age (-2.977), and education (-3.939) in shaping SWB.

Conclusions: Focusing on understanding and addressing factors like PsyCap, self-efficacy, and educational support could improve SWB, offering a potential avenue for comprehensive and individualized psychosocial care for women with breast cancer.