Pub Date : 2023-07-01DOI: 10.1097/OR9.0000000000000107
Sharon H. J. Hou, C. Forbes, Sara Cho, Andrew Tran, Victoria Forster, C. Wakefield, L. Heathcote, L. Wiener, G. Michel, P. Patterson, M. Stokoe, Kathleen Reynolds, F. Schulte
Abstract Introduction: Parents of survivors of childhood cancer may be particularly vulnerable to the experience of poor mental health amid the COVID-19 pandemic. This study aimed to (1) describe the mental health of parents of childhood cancer survivors; (2) explore the role of intolerance of uncertainty (IU) in mental health; and (3) explore the associations of parent mental health and health behaviors with IU. Methods: A cross-sectional, quantitative assessment of parents of survivors of childhood cancer (younger than 18 years) was conducted between May and June 2020. Participants completed an online questionnaire regarding their mental health (PROMIS anxiety, depression), IU (Intolerance of Uncertainty Scale), and health behaviors. Recruitment was conducted through social media and community organizations using convenience and snowball sampling. Results: Seventy-two participants from 6 countries completed the study (99% mothers, mean age of survivors = 11.4 years). Fifty percent of participants reported that their mental health had declined since the start of the COVID-19 pandemic, whereas 46% reported their mental health did not change. More than half of the participants (56%) reported decreased physical activity and 38% reported increased alcohol use. Exploring associations of parent mental health and health behaviors with IU, parent depression, and hours of exercise emerged as significant predictors (B = 3.62, P < .01; B = –1.58, P < .01, respectively), whereby higher depression and less exercise was associated with higher IU. Conclusions: At the height of the COVID-19 global pandemic, some parents of survivors of childhood cancer experienced poor mental health. IU plays a significant role in mental health outcomes, but this does not translate to health behaviors.
{"title":"Mental health and health behaviors of parents of survivors of childhood cancer in the early COVID-19 pandemic: Exploring the role of intolerance of uncertainty","authors":"Sharon H. J. Hou, C. Forbes, Sara Cho, Andrew Tran, Victoria Forster, C. Wakefield, L. Heathcote, L. Wiener, G. Michel, P. Patterson, M. Stokoe, Kathleen Reynolds, F. Schulte","doi":"10.1097/OR9.0000000000000107","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000107","url":null,"abstract":"Abstract Introduction: Parents of survivors of childhood cancer may be particularly vulnerable to the experience of poor mental health amid the COVID-19 pandemic. This study aimed to (1) describe the mental health of parents of childhood cancer survivors; (2) explore the role of intolerance of uncertainty (IU) in mental health; and (3) explore the associations of parent mental health and health behaviors with IU. Methods: A cross-sectional, quantitative assessment of parents of survivors of childhood cancer (younger than 18 years) was conducted between May and June 2020. Participants completed an online questionnaire regarding their mental health (PROMIS anxiety, depression), IU (Intolerance of Uncertainty Scale), and health behaviors. Recruitment was conducted through social media and community organizations using convenience and snowball sampling. Results: Seventy-two participants from 6 countries completed the study (99% mothers, mean age of survivors = 11.4 years). Fifty percent of participants reported that their mental health had declined since the start of the COVID-19 pandemic, whereas 46% reported their mental health did not change. More than half of the participants (56%) reported decreased physical activity and 38% reported increased alcohol use. Exploring associations of parent mental health and health behaviors with IU, parent depression, and hours of exercise emerged as significant predictors (B = 3.62, P < .01; B = –1.58, P < .01, respectively), whereby higher depression and less exercise was associated with higher IU. Conclusions: At the height of the COVID-19 global pandemic, some parents of survivors of childhood cancer experienced poor mental health. IU plays a significant role in mental health outcomes, but this does not translate to health behaviors.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43555045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/OR9.0000000000000105
L. M. Wijnhoven, L. Kwakkenbos, I. V. Verdonck‐de Leeuw, J. Prins, J. Custers
Abstract Background: Patients with colorectal cancer (CRC) may experience symptoms of adjustment disorder (AD) after cancer diagnosis and treatment. Time-limited symptoms of AD may become persistent if the stressor or its consequences have not disappeared after 6 months, but evidence on the course of AD symptoms is scarce. This longitudinal observational study investigates the proportion of patients with CRC with time-limited and persistent AD symptoms within the first year after diagnosis, in relation to demographic, clinical, and psychological factors and health-related quality of life (HRQoL). Methods: Informed consent was retrieved from 232 participants, and 194 participants completed questionnaires at baseline, 3, 6, and 12 months postdiagnosis. Hospital Anxiety and Depression Scale total scores (HADS-T) were categorized as indication for no symptoms of a mental disorder (MD) (HADS-T ≤10), AD symptoms (HADS-T 11–14), and other MD symptoms (HADS-T ≥15). Symptom subgroups over time were a priori defined: no MD, time-limited AD, persistent AD, other MD, and fluctuating symptoms. Results: Complete data were available for 81 participants (41.4%). Over time, 38.3% had no MD symptoms, 8.6% had time-limited AD symptoms, 1.2% had persistent AD symptoms, 4.9% had other MD symptoms, and 46.9% had fluctuating symptoms. Participants with AD and fluctuating symptoms reported higher fear of cancer recurrence, lower HRQoL, and higher cancer-specific distress than participants without MD symptoms (P < .5). Conclusions: During the first year after CRC diagnosis, only a small proportion of the patients showed time-limited and persistent AD symptoms and most showed fluctuating symptoms. More prospective research is needed to determine how repeated assessments for elevated AD symptoms relate to an AD diagnosis established with a diagnostic interview.
{"title":"Evaluating time-limited and persistent symptoms of adjustment disorder in cancer patients after a colorectal cancer diagnosis: a longitudinal observational study","authors":"L. M. Wijnhoven, L. Kwakkenbos, I. V. Verdonck‐de Leeuw, J. Prins, J. Custers","doi":"10.1097/OR9.0000000000000105","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000105","url":null,"abstract":"Abstract Background: Patients with colorectal cancer (CRC) may experience symptoms of adjustment disorder (AD) after cancer diagnosis and treatment. Time-limited symptoms of AD may become persistent if the stressor or its consequences have not disappeared after 6 months, but evidence on the course of AD symptoms is scarce. This longitudinal observational study investigates the proportion of patients with CRC with time-limited and persistent AD symptoms within the first year after diagnosis, in relation to demographic, clinical, and psychological factors and health-related quality of life (HRQoL). Methods: Informed consent was retrieved from 232 participants, and 194 participants completed questionnaires at baseline, 3, 6, and 12 months postdiagnosis. Hospital Anxiety and Depression Scale total scores (HADS-T) were categorized as indication for no symptoms of a mental disorder (MD) (HADS-T ≤10), AD symptoms (HADS-T 11–14), and other MD symptoms (HADS-T ≥15). Symptom subgroups over time were a priori defined: no MD, time-limited AD, persistent AD, other MD, and fluctuating symptoms. Results: Complete data were available for 81 participants (41.4%). Over time, 38.3% had no MD symptoms, 8.6% had time-limited AD symptoms, 1.2% had persistent AD symptoms, 4.9% had other MD symptoms, and 46.9% had fluctuating symptoms. Participants with AD and fluctuating symptoms reported higher fear of cancer recurrence, lower HRQoL, and higher cancer-specific distress than participants without MD symptoms (P < .5). Conclusions: During the first year after CRC diagnosis, only a small proportion of the patients showed time-limited and persistent AD symptoms and most showed fluctuating symptoms. More prospective research is needed to determine how repeated assessments for elevated AD symptoms relate to an AD diagnosis established with a diagnostic interview.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49443189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1097/OR9.0000000000000099
Matilda Ong'ondi, Irene N Njuguna, Ronniey Obulumire, E. Munyoro, V. Okech, Njoroge Ann, B. Bultz
Supplemental Digital Content is Available in the Text. Abstract Background: Psychosocial care for oncology patients is now recognized as a critical aspect of care because it has a positive impact on patient outcomes. Various screening tools have been validated to objectively measure the levels of distress, such as the National Comprehensive Cancer Network distress thermometer. However, there is little evidence of its use in sub-Saharan Africa, where the cancer burden continues to increase. This study sought to evaluate the levels of psychological distress in patients with cancer and the impact of the COVID-19 pandemic. Methods: This was a single-center cross-sectional study among patients with a histological diagnosis of cancer attending the hemato-oncology and radio-oncology units at the Kenyatta National Hospital, a referral tertiary center. We used the National Comprehensive Cancer Network Distress Thermometer and Problem Checklist to define psychological distress, fear of COVID-19 scale, and Corona Anxiety Score to determine the level of fear and anxiety caused by COVID-19 given the study happened during the pandemic, and the Eastern Cooperative Oncology Group (ECOG) to assess the performance status. Results: Of the 361 patients, the median age was 54 years (interquartile range, 43–63), and most were female (70%). The leading cancer diagnosis was breast cancer (26%), followed by cervical cancer (24%), with most of the patients having advanced disease and 28% having ECOG 3. Most (80%) patients were able to continue with their treatment despite the COVID-19 pandemic; however, 71% had a high level of fear of COVID-19 but minimal anxiety symptoms based on Corona Anxiety Score. The mean distress thermometer score was 2.7 (SD, 2.6), with 30% having a high level of distress (4 or above). ECOG status was the only variable significantly associated with high levels of distress, with the strongest association observed in the highest ECOG status (ECOG 4: OR, 6.8 [95% CI, 2.8–16.6] P < .001). Transportation was the main problem in the practical domain (62%) while fears and worries in the emotional domain (46% and 49%, respectively), and pain (65%) were the main physical problems. Conclusions: One-third of patients experienced high levels of distress. These patients reported significant concerns, such as transportation, fears, worry, and pain, in the problem checklist. There is a need to incorporate screening for distress into our patient population to help identify these patients and institute appropriate interventions.
{"title":"Psychological distress in patients with cancer at the Kenyatta National Hospital in Nairobi, Kenya, during the COVID-19 pandemic","authors":"Matilda Ong'ondi, Irene N Njuguna, Ronniey Obulumire, E. Munyoro, V. Okech, Njoroge Ann, B. Bultz","doi":"10.1097/OR9.0000000000000099","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000099","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Abstract Background: Psychosocial care for oncology patients is now recognized as a critical aspect of care because it has a positive impact on patient outcomes. Various screening tools have been validated to objectively measure the levels of distress, such as the National Comprehensive Cancer Network distress thermometer. However, there is little evidence of its use in sub-Saharan Africa, where the cancer burden continues to increase. This study sought to evaluate the levels of psychological distress in patients with cancer and the impact of the COVID-19 pandemic. Methods: This was a single-center cross-sectional study among patients with a histological diagnosis of cancer attending the hemato-oncology and radio-oncology units at the Kenyatta National Hospital, a referral tertiary center. We used the National Comprehensive Cancer Network Distress Thermometer and Problem Checklist to define psychological distress, fear of COVID-19 scale, and Corona Anxiety Score to determine the level of fear and anxiety caused by COVID-19 given the study happened during the pandemic, and the Eastern Cooperative Oncology Group (ECOG) to assess the performance status. Results: Of the 361 patients, the median age was 54 years (interquartile range, 43–63), and most were female (70%). The leading cancer diagnosis was breast cancer (26%), followed by cervical cancer (24%), with most of the patients having advanced disease and 28% having ECOG 3. Most (80%) patients were able to continue with their treatment despite the COVID-19 pandemic; however, 71% had a high level of fear of COVID-19 but minimal anxiety symptoms based on Corona Anxiety Score. The mean distress thermometer score was 2.7 (SD, 2.6), with 30% having a high level of distress (4 or above). ECOG status was the only variable significantly associated with high levels of distress, with the strongest association observed in the highest ECOG status (ECOG 4: OR, 6.8 [95% CI, 2.8–16.6] P < .001). Transportation was the main problem in the practical domain (62%) while fears and worries in the emotional domain (46% and 49%, respectively), and pain (65%) were the main physical problems. Conclusions: One-third of patients experienced high levels of distress. These patients reported significant concerns, such as transportation, fears, worry, and pain, in the problem checklist. There is a need to incorporate screening for distress into our patient population to help identify these patients and institute appropriate interventions.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45947697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1097/OR9.0000000000000102
T. Paredes, S. Silva, A. F. Pacheco, Bruno de Sousa, Carlos Pires, Albina S. Dias, Ana L. Costa, A. R. Mesquita, Eloisa E. Fernandes, Graciete F. Marques, Marla S. Vieira, Monick Leal, Natalia J. Amaral, Vitor J. Rodrigues
Abstract Objective: Considering the lack of studies exploring the psychological impact of COVID-19 on patients living with and beyond cancer, this study aimed to explore the levels of emotional distress, anxiety, and depression in patients with cancer and survivors during the COVID-19 pandemic and to identify psychological risk factors. Methods: Data for this cross-sectional study were collected through an online questionnaire comprised a self-report questionnaire and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics and linear regression models were used to characterize the sample and identify the determinants of emotional distress, depression, and anxiety. Statistical analyses were performed using R, version 4.1.1. Results: The sample included 940 patients with cancer and survivors, mostly female (87.1%), with a mean age of 49.7 years. More than half of the patients were survivors (55.1%); 56.7% were diagnosed with breast cancer, and 35.0% had other chronic diseases. Most participants believed that they were more likely to be infected with COVID-19 (53.9%) and that they may have more complications if they were infected (76.7%). Approximately half of the participants revealed significant emotional distress (49.3%), 18.1% revealed significant depression, and 29.2% revealed significant anxiety. Female patients, participants with lower education levels, unemployed/lay-off, or in a medical leave with a chronic disease, taking care of someone with a chronic disease, or perceiving a higher risk of being infected with COVID-19 had higher levels of emotional distress, depression, and anxiety. Conclusions: This study provides useful information regarding the impact of the COVID-19 pandemic on the mental health of patients with cancer and survivors, showing that an increased number of patients experienced significant emotional distress during the pandemic.
{"title":"Psychological distress in a Portuguese sample of cancer patients during the COVID-19 pandemic: a cross-sectional study","authors":"T. Paredes, S. Silva, A. F. Pacheco, Bruno de Sousa, Carlos Pires, Albina S. Dias, Ana L. Costa, A. R. Mesquita, Eloisa E. Fernandes, Graciete F. Marques, Marla S. Vieira, Monick Leal, Natalia J. Amaral, Vitor J. Rodrigues","doi":"10.1097/OR9.0000000000000102","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000102","url":null,"abstract":"Abstract Objective: Considering the lack of studies exploring the psychological impact of COVID-19 on patients living with and beyond cancer, this study aimed to explore the levels of emotional distress, anxiety, and depression in patients with cancer and survivors during the COVID-19 pandemic and to identify psychological risk factors. Methods: Data for this cross-sectional study were collected through an online questionnaire comprised a self-report questionnaire and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics and linear regression models were used to characterize the sample and identify the determinants of emotional distress, depression, and anxiety. Statistical analyses were performed using R, version 4.1.1. Results: The sample included 940 patients with cancer and survivors, mostly female (87.1%), with a mean age of 49.7 years. More than half of the patients were survivors (55.1%); 56.7% were diagnosed with breast cancer, and 35.0% had other chronic diseases. Most participants believed that they were more likely to be infected with COVID-19 (53.9%) and that they may have more complications if they were infected (76.7%). Approximately half of the participants revealed significant emotional distress (49.3%), 18.1% revealed significant depression, and 29.2% revealed significant anxiety. Female patients, participants with lower education levels, unemployed/lay-off, or in a medical leave with a chronic disease, taking care of someone with a chronic disease, or perceiving a higher risk of being infected with COVID-19 had higher levels of emotional distress, depression, and anxiety. Conclusions: This study provides useful information regarding the impact of the COVID-19 pandemic on the mental health of patients with cancer and survivors, showing that an increased number of patients experienced significant emotional distress during the pandemic.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42128676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1097/OR9.0000000000000100
S. Savas, Mercy Winsor, E. Tenkorang, C. Simmonds, T. Stuckless
Supplemental Digital Content is available in the text. Abstract Background: Among all Canadians, residents of the province of Newfoundland and Labrador (NL) have the highest risk of developing and dying of cancer. Effects of cancer-associated stigma and discrimination can contribute to the negative consequences of cancer and unnecessarily burden individuals diagnosed with cancer. In this study, we aimed to examine stigma and discrimination-related experiences of individuals diagnosed with cancer and predictors of experiencing stigma in NL. Methods: This was a cross-sectional and self-administered online survey study. The survey instrument included both open-ended and closed-ended items, and data were collected between June 2019 and February 2020. Descriptive statistics, thematic analyses, and regression techniques were used for data analysis. Results: A total of 325 respondents participated in this study. Self-perceived stigmatization and discrimination were reported by 24% and 14% of the participants, respectively. The most common sources contributing to these experiences were friends, insurance and financial companies, and workplace relations. Issues related to insurance, social relations, and workplace opportunities were among the most common reported impacts of cancer. A large portion of the participants had not experienced stigma and discrimination or experienced anything but positive support from others. Several factors associated with experiencing stigma were also identified, such as age, disease stage, ethnicity, and socioeconomic status. Misconceptions related to cancer, issues with insurance companies, and change of life after cancer were the top themes identified by thematic analysis. Conclusions: This study identified a rich overview of cancer-associated lived experiences in the NL population. Educational campaigns on cancer, integration of stigma-related support in cancer care, and stronger antidiscriminatory legislations and practices should be encouraged in NL.
{"title":"Social stigma associated with cancer in the Newfoundland and Labrador population: an exploratory study","authors":"S. Savas, Mercy Winsor, E. Tenkorang, C. Simmonds, T. Stuckless","doi":"10.1097/OR9.0000000000000100","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000100","url":null,"abstract":"Supplemental Digital Content is available in the text. Abstract Background: Among all Canadians, residents of the province of Newfoundland and Labrador (NL) have the highest risk of developing and dying of cancer. Effects of cancer-associated stigma and discrimination can contribute to the negative consequences of cancer and unnecessarily burden individuals diagnosed with cancer. In this study, we aimed to examine stigma and discrimination-related experiences of individuals diagnosed with cancer and predictors of experiencing stigma in NL. Methods: This was a cross-sectional and self-administered online survey study. The survey instrument included both open-ended and closed-ended items, and data were collected between June 2019 and February 2020. Descriptive statistics, thematic analyses, and regression techniques were used for data analysis. Results: A total of 325 respondents participated in this study. Self-perceived stigmatization and discrimination were reported by 24% and 14% of the participants, respectively. The most common sources contributing to these experiences were friends, insurance and financial companies, and workplace relations. Issues related to insurance, social relations, and workplace opportunities were among the most common reported impacts of cancer. A large portion of the participants had not experienced stigma and discrimination or experienced anything but positive support from others. Several factors associated with experiencing stigma were also identified, such as age, disease stage, ethnicity, and socioeconomic status. Misconceptions related to cancer, issues with insurance companies, and change of life after cancer were the top themes identified by thematic analysis. Conclusions: This study identified a rich overview of cancer-associated lived experiences in the NL population. Educational campaigns on cancer, integration of stigma-related support in cancer care, and stronger antidiscriminatory legislations and practices should be encouraged in NL.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47966734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1097/OR9.0000000000000101
K. Hata, Emi Tajima, Shin-ichi Suzuki
Abstract Background: Activity restriction is known as a predictor of depressive mood in cancer survivors. However, there is inconsistent evidence about precisely how this takes place. Environmental reward is a state where a person senses mastery or pleasure because of their activity, and this is known to be a possible mediator of the activity restriction effect on depressive mood. We sought to investigate that the mediating effect environmental reward could have on the relationship between activity restriction and depressive mood when moderated by cancer-related fatigue. Methods: Cancer survivors (n = 94; mean age, 60.07 years) recruited through cancer support groups in Japan participated in this study. They completed a battery of questionnaires, including demographic and clinical information about the respondents, the Activity Restriction Scale for Cancer Patients—Revised, the Environmental Reward Observation Scale, the Cancer Fatigue Scale, and the Hospital Anxiety and Depression Scale. Results: Moderated mediation analysis revealed that high levels of activity restriction predict a decrease in environmental reward, and a decrease in environmental reward exacerbates depressive mood. The full mediating effect (when the indirect effect is statistically significant and there is no direct effect from the antecedent to outcome) of environmental reward was observed when cancer-related fatigue was moderated by ±1 SD of the mean score. This implies that, regardless of the level of fatigue cancer survivors experience, it is not the activity restriction per se that predicts depressive mood but rather the inability to experience pleasurable emotions because of the activity restriction that leads to the exacerbation of depressive mood. Conclusion: From these results, environmental reward was found to be a possible mediator of activity restriction on depressive mood, consistent with behavioral models of depression. These results could explain the inconsistent findings about the direct effect of activity restriction on depressive mood and provide theoretical evidence for the effectiveness of psychological treatments for cancer survivors that focus on positive affect, such as behavioral activation interventions.
{"title":"The mediating effect of environmental reward on activity restriction and depressive mood in cancer survivors: a cross-sectional study","authors":"K. Hata, Emi Tajima, Shin-ichi Suzuki","doi":"10.1097/OR9.0000000000000101","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000101","url":null,"abstract":"Abstract Background: Activity restriction is known as a predictor of depressive mood in cancer survivors. However, there is inconsistent evidence about precisely how this takes place. Environmental reward is a state where a person senses mastery or pleasure because of their activity, and this is known to be a possible mediator of the activity restriction effect on depressive mood. We sought to investigate that the mediating effect environmental reward could have on the relationship between activity restriction and depressive mood when moderated by cancer-related fatigue. Methods: Cancer survivors (n = 94; mean age, 60.07 years) recruited through cancer support groups in Japan participated in this study. They completed a battery of questionnaires, including demographic and clinical information about the respondents, the Activity Restriction Scale for Cancer Patients—Revised, the Environmental Reward Observation Scale, the Cancer Fatigue Scale, and the Hospital Anxiety and Depression Scale. Results: Moderated mediation analysis revealed that high levels of activity restriction predict a decrease in environmental reward, and a decrease in environmental reward exacerbates depressive mood. The full mediating effect (when the indirect effect is statistically significant and there is no direct effect from the antecedent to outcome) of environmental reward was observed when cancer-related fatigue was moderated by ±1 SD of the mean score. This implies that, regardless of the level of fatigue cancer survivors experience, it is not the activity restriction per se that predicts depressive mood but rather the inability to experience pleasurable emotions because of the activity restriction that leads to the exacerbation of depressive mood. Conclusion: From these results, environmental reward was found to be a possible mediator of activity restriction on depressive mood, consistent with behavioral models of depression. These results could explain the inconsistent findings about the direct effect of activity restriction on depressive mood and provide theoretical evidence for the effectiveness of psychological treatments for cancer survivors that focus on positive affect, such as behavioral activation interventions.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47447291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.1097/OR9.0000000000000097
E. Harju, Katharina Roser, B. Eisenreich, K. Scheinemann, Gisela Michel
Supplemental Digital Content is Available in the Text. Abstract Background: Childhood cancer affects patients and their parents. Childhood cancer survivors are at risk of mental health problems. Regular psychological screening is recommended. The emotion thermometer (ET) is a short, validated tool to detect psychological distress in adult patients with cancer. However, its suitability and acceptability in young cancer populations have not yet been reported. We (1) describe mental health in survivors and their parents before and after a follow-up appointment and (2) investigate the ET's usefulness for screening in young childhood cancer survivors. Methods: Survivors (15 years or older at study, ≥1 year after treatment ended) and their parents completed two electronic surveys to assess mental health (including somatization, depression, anxiety, a Global Severity Index [GSI], fear of cancer recurrence/relapse and post-traumatic stress). The first questionnaire was completed in the weeks leading up to the follow-up appointment and the second one after. We assessed survivors' opinion on acceptability of the ET. Results: Forty-five survivors (age at study: 22 years, 54% female) and 46 parents (age: 54 years, 63% female) participated. Scores for somatization, depression, and the GSI were lower after the appointment (p<.05 for all). For parents, there was no change. A subset of survivors reported clinically relevant post-traumatic stress (Nbefore = 3 [8%], Nafter = 4 [10%]). Fear of cancer recurrence/relapse remained stable. The ET identified moderate-to-severe distress in 13 survivors (29%), showing good specificity (0.91) and sensitivity (0.91) in relation to the gold standard Symptom Checklist-90-R. Survivors found the ET to be easy to use and understand. Conclusions: Psychological distress in survivors attending follow-up care is common, and screening is imperative. The ET may be helpful for initial psychological screening.
{"title":"Psychological distress in survivors of childhood cancer and their parents before and after a follow-up appointment: the need for screening and validation of the emotion thermometer","authors":"E. Harju, Katharina Roser, B. Eisenreich, K. Scheinemann, Gisela Michel","doi":"10.1097/OR9.0000000000000097","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000097","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Abstract Background: Childhood cancer affects patients and their parents. Childhood cancer survivors are at risk of mental health problems. Regular psychological screening is recommended. The emotion thermometer (ET) is a short, validated tool to detect psychological distress in adult patients with cancer. However, its suitability and acceptability in young cancer populations have not yet been reported. We (1) describe mental health in survivors and their parents before and after a follow-up appointment and (2) investigate the ET's usefulness for screening in young childhood cancer survivors. Methods: Survivors (15 years or older at study, ≥1 year after treatment ended) and their parents completed two electronic surveys to assess mental health (including somatization, depression, anxiety, a Global Severity Index [GSI], fear of cancer recurrence/relapse and post-traumatic stress). The first questionnaire was completed in the weeks leading up to the follow-up appointment and the second one after. We assessed survivors' opinion on acceptability of the ET. Results: Forty-five survivors (age at study: 22 years, 54% female) and 46 parents (age: 54 years, 63% female) participated. Scores for somatization, depression, and the GSI were lower after the appointment (p<.05 for all). For parents, there was no change. A subset of survivors reported clinically relevant post-traumatic stress (Nbefore = 3 [8%], Nafter = 4 [10%]). Fear of cancer recurrence/relapse remained stable. The ET identified moderate-to-severe distress in 13 survivors (29%), showing good specificity (0.91) and sensitivity (0.91) in relation to the gold standard Symptom Checklist-90-R. Survivors found the ET to be easy to use and understand. Conclusions: Psychological distress in survivors attending follow-up care is common, and screening is imperative. The ET may be helpful for initial psychological screening.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45394150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1097/OR9.0000000000000094
M. Flynn, Shokouh Abolhosseini, Jessame Gamboa, T. Campbell, L. Carlson
Abstract Background: Deterioration in cognitive function is common among cancer survivors undergoing treatment. These problems may persist for several years after completion of treatment and can adversely affect cancer survivors' treatment adherence and quality of life. The cause of cognitive changes in cancer survivors is unclear, although it is likely a complex interaction of disease-related, treatment-related, and psychological factors. Mindfulness-based interventions (MBIs) are one promising intervention for cancer survivors to alleviate unwanted and burdensome side effects, including disruptions in cognitive function. The aim of the current review was to synthesize the literature on MBIs and cognitive function in cancer survivors. Methods: We searched five databases from inception on May 27, 2021 (original search), and May 4, 2022 (updated search): PubMed, MEDLINE Ovid, EMBASE Ovid, PsycInfo Ovid, CINAHL EBSCO, and Web of Science. Articles were screened at the abstract and full-text level by two reviewers. Results: A total of 1916 records were retrieved, and 24 unique studies met the inclusion criteria. There was significant variability across studies regarding type of MBIs investigated, types of cognitive outcome measures used, and study assessment timelines. Eleven studies were included in a meta-analysis of self-reported cognitive function, significantly favoring MBIs over inactive controls (ie, usual care) (standardized mean difference = 0.86; 95% confidence interval = 0.32–1.41). A similar model, including four studies, compared MBIs with active controls (ie, music listening, metacognition treatment, fatigue education and support, walking program); this model also demonstrated a statistically significant pooled effect (standardized mean difference = 0.61; 95% confidence interval = 0.23–0.99). Owing to a small number of studies, meta-analysis could not be completed for objectively assessed cognitive function; a narrative summary for this outcome revealed mixed results. Conclusions: MBIs demonstrated evidence for improving cognitive function among cancer survivors and particularly self-reported cognitive function. However, most studies demonstrated a high risk of bias and significant concerns regarding study quality. Further research is needed to determine the effects of MBIs on both self-reported and objectively assessed cognitive function for cancer survivors, as well as optimal intervention structure and timing.
摘要背景：在接受治疗的癌症幸存者中，认知功能的恶化是常见的。这些问题可能在治疗结束后持续数年，并可能对癌症幸存者的治疗依从性和生活质量产生不利影响。癌症幸存者认知变化的原因尚不清楚，尽管这可能是疾病相关、治疗相关和心理因素的复杂相互作用。基于心理的干预（MBI）是癌症幸存者的一种很有前途的干预措施，可以减轻不必要和沉重的副作用，包括认知功能的破坏。本综述的目的是综合有关癌症幸存者MBI和认知功能的文献。方法：我们从2021年5月27日（原始搜索）和2022年5月4日（更新搜索）开始搜索了五个数据库：PubMed、MEDLINE Ovid、EMBASE Ovid，PsycInfo Ovid和CINAHL EBSCO，以及Web of Science。两名评审员对文章的摘要和全文进行了筛选。结果：共检索到1916份记录，24项独特的研究符合纳入标准。在所调查的MBI类型、使用的认知结果测量类型和研究评估时间表方面，各研究存在显著差异。11项研究被纳入自我报告认知功能的荟萃分析中，显著支持MBI而非非活动对照（即常规护理）（标准化平均差=0.86；95%置信区间=0.32-1.41）。一个类似的模型，包括4项研究，将MBI与主动对照（即，听音乐、元认知治疗、疲劳教育和支持、步行计划）进行比较；该模型还证明了具有统计学意义的合并效应（标准化平均差=0.61；95%置信区间=0.23–0.99）。由于研究数量较少，无法完成客观评估认知功能的荟萃分析；对这一结果的叙述性总结显示出好坏参半的结果。结论：MBI证明了改善癌症幸存者认知功能的证据，尤其是自我报告的认知功能。然而，大多数研究表明，存在偏见的风险很高，并且对研究质量存在重大担忧。需要进一步的研究来确定MBI对癌症幸存者自我报告和客观评估的认知功能的影响，以及最佳干预结构和时机。
{"title":"Mindfulness-based interventions and cognitive function in cancer survivors: a systematic review and meta-analysis","authors":"M. Flynn, Shokouh Abolhosseini, Jessame Gamboa, T. Campbell, L. Carlson","doi":"10.1097/OR9.0000000000000094","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000094","url":null,"abstract":"Abstract Background: Deterioration in cognitive function is common among cancer survivors undergoing treatment. These problems may persist for several years after completion of treatment and can adversely affect cancer survivors' treatment adherence and quality of life. The cause of cognitive changes in cancer survivors is unclear, although it is likely a complex interaction of disease-related, treatment-related, and psychological factors. Mindfulness-based interventions (MBIs) are one promising intervention for cancer survivors to alleviate unwanted and burdensome side effects, including disruptions in cognitive function. The aim of the current review was to synthesize the literature on MBIs and cognitive function in cancer survivors. Methods: We searched five databases from inception on May 27, 2021 (original search), and May 4, 2022 (updated search): PubMed, MEDLINE Ovid, EMBASE Ovid, PsycInfo Ovid, CINAHL EBSCO, and Web of Science. Articles were screened at the abstract and full-text level by two reviewers. Results: A total of 1916 records were retrieved, and 24 unique studies met the inclusion criteria. There was significant variability across studies regarding type of MBIs investigated, types of cognitive outcome measures used, and study assessment timelines. Eleven studies were included in a meta-analysis of self-reported cognitive function, significantly favoring MBIs over inactive controls (ie, usual care) (standardized mean difference = 0.86; 95% confidence interval = 0.32–1.41). A similar model, including four studies, compared MBIs with active controls (ie, music listening, metacognition treatment, fatigue education and support, walking program); this model also demonstrated a statistically significant pooled effect (standardized mean difference = 0.61; 95% confidence interval = 0.23–0.99). Owing to a small number of studies, meta-analysis could not be completed for objectively assessed cognitive function; a narrative summary for this outcome revealed mixed results. Conclusions: MBIs demonstrated evidence for improving cognitive function among cancer survivors and particularly self-reported cognitive function. However, most studies demonstrated a high risk of bias and significant concerns regarding study quality. Further research is needed to determine the effects of MBIs on both self-reported and objectively assessed cognitive function for cancer survivors, as well as optimal intervention structure and timing.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46230191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1097/OR9.0000000000000095
Nienke Zomerdijk, J. Turner, D. Gottlieb, Annette Barnes, J. Butler, K. Markey, Geoffrey R. Hill
Supplemental Digital Content is Available in the Text. Abstract Background: In light of the increased demand for related donors in allogeneic stem cell transplantation, recognition of the psychosocial issues has also emerged. While resources supporting unrelated volunteer donors exist, none address the emotional issues specific to being a related donor. Providing related donors with preparatory information could help improve the overall donation experience and donor's outcomes. Objective: The objectives of this study were to develop and pilot test a print-based psycho-educational resource to support donors in coping with the physical and emotional aspects of donating to a relative. This article describes the development and pilot testing of the resource. Methods: Seventeen related donors and eight transplant nurses and physicians (transplant professionals) completed a survey and provided quantitative and qualitative feedback on the acceptability of the resource and preferences regarding the ideal distribution time. Results: Respondents endorsed the resource and found it useful and appropriate for the information needs at different stages of the donation and transplant process. The most useful reported components of the resource were testimonials from previous donors and explanations of blood cancers and the stem cell donation process. Most donor respondents indicated that the resource should be distributed as soon as possible while transplant professionals felt this should be after tissue typing, once the donor is confirmed as suitable. Respondents requested additional information on the side effects of donating and the possibility of being asked to repeat donation if the recipient relapses. More donor testimonials were also desired. Conclusion: The resource appears to be acceptable to donors and transplant professionals and helpful for developing confidence about coping with the physical and emotional aspects of donation. Findings from this study are currently being used to further refine and deliver the resource in additional formats.
{"title":"Supporting family members requested to donate hematopoietic stem cells to a relative: development and pilot testing of a psycho-educational resource","authors":"Nienke Zomerdijk, J. Turner, D. Gottlieb, Annette Barnes, J. Butler, K. Markey, Geoffrey R. Hill","doi":"10.1097/OR9.0000000000000095","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000095","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Abstract Background: In light of the increased demand for related donors in allogeneic stem cell transplantation, recognition of the psychosocial issues has also emerged. While resources supporting unrelated volunteer donors exist, none address the emotional issues specific to being a related donor. Providing related donors with preparatory information could help improve the overall donation experience and donor's outcomes. Objective: The objectives of this study were to develop and pilot test a print-based psycho-educational resource to support donors in coping with the physical and emotional aspects of donating to a relative. This article describes the development and pilot testing of the resource. Methods: Seventeen related donors and eight transplant nurses and physicians (transplant professionals) completed a survey and provided quantitative and qualitative feedback on the acceptability of the resource and preferences regarding the ideal distribution time. Results: Respondents endorsed the resource and found it useful and appropriate for the information needs at different stages of the donation and transplant process. The most useful reported components of the resource were testimonials from previous donors and explanations of blood cancers and the stem cell donation process. Most donor respondents indicated that the resource should be distributed as soon as possible while transplant professionals felt this should be after tissue typing, once the donor is confirmed as suitable. Respondents requested additional information on the side effects of donating and the possibility of being asked to repeat donation if the recipient relapses. More donor testimonials were also desired. Conclusion: The resource appears to be acceptable to donors and transplant professionals and helpful for developing confidence about coping with the physical and emotional aspects of donation. Findings from this study are currently being used to further refine and deliver the resource in additional formats.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46733605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1097/OR9.0000000000000091
Celestina Martopullo, D. Oberoi, L. Carlson, B. Bultz
Supplemental Digital Content is Available in the Text. Abstract Background: This study seeks to understand the functioning of a gastrointestinal (GI) men-only Supportive-Expressive Group Therapy (SEGT) program over time by exploring (1) men's lived experiences with group process and (2) perceived group impact relevant to supportive/expressive goals. Methods: A convenience sample of patients with GI cancer attending an ongoing, men-only GI cancer SEGT was interviewed at 3 and 6 months from enrollment. A qualitative study design with mixed inductive and framework thematic analysis was used. Open-ended, semistructured interviews directed the exploration of group experiences over time. SEGT goals framed the inquiry toward exploring the perceived impact of the group. Results: Twenty-three men were interviewed at 3 months and 13 men at 6 months of intervention. Men pointed to an overall global satisfaction with group process and subjects discussed. The SEGT model provided a sex sensitive, safe, and mutually supportive outlet for expressing and normalizing participants' feelings and emotions. Three central themes emerged relevant to group experiences: (1) the role of social comparison, (2) the role of supportive-expressive exchanges, and (3) the role of the group format, composition, and facilitation. Feeling heard and validated accelerated a sense of belonging and facilitated emotional disclosure. SEGT contributed to re-evaluation of life values/goals, mitigation of existential anxiety, and mood improvement. Conclusions: Group participants perceived the SEGT as effective in addressing and mitigating emotional and existential concerns. Perceived benefits were consistent with SEGT goals. The findings offer groundwork for developing men-centered cancer support groups that foster emotional exploration and expressive disclosure through validation and acceptance.
{"title":"A qualitative exploration of the lived experiences and perceived impact of a supportive-expressive group therapy on men living with gastrointestinal cancer","authors":"Celestina Martopullo, D. Oberoi, L. Carlson, B. Bultz","doi":"10.1097/OR9.0000000000000091","DOIUrl":"https://doi.org/10.1097/OR9.0000000000000091","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Abstract Background: This study seeks to understand the functioning of a gastrointestinal (GI) men-only Supportive-Expressive Group Therapy (SEGT) program over time by exploring (1) men's lived experiences with group process and (2) perceived group impact relevant to supportive/expressive goals. Methods: A convenience sample of patients with GI cancer attending an ongoing, men-only GI cancer SEGT was interviewed at 3 and 6 months from enrollment. A qualitative study design with mixed inductive and framework thematic analysis was used. Open-ended, semistructured interviews directed the exploration of group experiences over time. SEGT goals framed the inquiry toward exploring the perceived impact of the group. Results: Twenty-three men were interviewed at 3 months and 13 men at 6 months of intervention. Men pointed to an overall global satisfaction with group process and subjects discussed. The SEGT model provided a sex sensitive, safe, and mutually supportive outlet for expressing and normalizing participants' feelings and emotions. Three central themes emerged relevant to group experiences: (1) the role of social comparison, (2) the role of supportive-expressive exchanges, and (3) the role of the group format, composition, and facilitation. Feeling heard and validated accelerated a sense of belonging and facilitated emotional disclosure. SEGT contributed to re-evaluation of life values/goals, mitigation of existential anxiety, and mood improvement. Conclusions: Group participants perceived the SEGT as effective in addressing and mitigating emotional and existential concerns. Perceived benefits were consistent with SEGT goals. The findings offer groundwork for developing men-centered cancer support groups that foster emotional exploration and expressive disclosure through validation and acceptance.","PeriodicalId":73915,"journal":{"name":"Journal of psychosocial oncology research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47192368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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