Journal of psychosocial oncology research and practice最新文献_第4页

A qualitative exploration of the lived experiences and perceived impact of a supportive-expressive group therapy on men living with gastrointestinal cancer 对生活经历的定性探索和支持表达团体治疗对男性胃肠道癌患者的感知影响

Journal of psychosocial oncology research and practice

Pub Date : 2023-01-01 DOI: 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.

文本中提供了补充数字内容。摘要背景：本研究试图通过探索（1）男性在群体过程中的生活经历和（2）与支持/表达目标相关的感知群体影响，来了解胃肠道（GI）男性专用支持性表达群体治疗（SEGT）计划的功能。方法：在入组后3个月和6个月，对参加正在进行的男性非胃肠道癌症SEGT的癌症胃肠道患者进行方便样本访谈。定性研究设计采用归纳和框架专题分析相结合的方法。开放式、半结构化的访谈指导了对团队经历的探索。SEGT的目标构成了探究小组感知影响的调查框架。结果：23名男性在干预3个月时接受了访谈，13名男性在介入6个月时进行了访谈。男性指出，全球对小组过程和讨论主题的总体满意度。SEGT模型为表达和规范参与者的感受和情绪提供了一个对性敏感、安全和相互支持的出口。出现了三个与群体体验相关的中心主题：（1）社会比较的作用，（2）支持性表达交流的作用，以及（3）群体形式、组成和促进的作用。感觉被倾听和验证加速了归属感，并促进了情感披露。SEGT有助于重新评估生活价值观/目标，缓解存在焦虑，改善情绪。结论：小组参与者认为SEGT在解决和减轻情绪和生存问题方面是有效的。感知到的收益与SEGT目标一致。这些发现为发展以男性为中心的癌症支持团体奠定了基础，这些团体通过验证和接受来促进情感探索和表达性披露。

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引用次数: 0

Characterizing unique supportive care needs among women living with metastatic breast cancer: A qualitative study. 描述癌症转移患者独特的支持性护理需求：一项定性研究。

Journal of psychosocial oncology research and practice

Pub Date : 2023-01-01 Epub Date: 2023-01-23 DOI: 10.1097/or9.0000000000000093

Patricia I Moreno, Blanca Noriega Esquives, Jessica L Thomas, Fiona S Horner, Joanna B Torzewski, William Gradishar, David Victorson, Frank J Penedo

Background: Women with metastatic breast cancer face unique challenges as they cope with life-limiting prognoses and arduous treatments. However, the vast majority of research has focused on optimizing quality of life in women with early-stage, non-metastatic breast cancer and little is known about supportive care needs among women living with metastatic cancer. As part of a larger project that sought to inform the development of a psychosocial intervention, the aim of this study was to characterize supportive care needs among women with metastatic breast cancer and elucidate challenges unique to living with a life-limiting prognosis.

Methods: Four, two-hour focus groups with 22 women were audio-recorded, transcribed verbatim, and analyzed in Dedoose using a general inductive approach to code categories and extract themes.

Results: A total of 16 codes emerged from 201 participant comments regarding supportive care needs. Codes were collapsed into four supportive care need domains: 1. psychosocial, 2. physical and functional, 3. health system and information, and 4. sexuality and fertility needs. The most prevalent needs were breast cancer-related symptom burden (17.4%), lack of social support (14.9%), uncertainty (10.0%), stress management (9.0%), patient-centered care (7.5%), and sexual functioning (7.5%). More than half of needs (56.2%) were in the psychosocial domain and more than two-thirds of needs (76.8%) were in the psychosocial and physical and functional domains. Supportive care needs unique to living with metastatic breast cancer included the cumulative effects of continuously undergoing cancer treatment on symptom burden, worry from scan-to-scan regarding response to cancer treatments, diagnosis-related stigma and social isolation, end-of-life concerns, and misconceptions regarding metastatic breast cancer.

Conclusions: Findings suggest that women with metastatic breast cancer have unique supportive care needs compared to women with early-stage breast cancer that are specific to living with a life-limiting prognosis and are not typically captured in existing self-report measures of supportive care needs. Results also highlight the importance of addressing psychosocial concerns and breast cancer-related symptoms. Women with metastatic breast cancer may benefit from early access to evidence-based interventions and resources that specifically address their supportive care needs and optimize quality of life and wellbeing.

背景：患有转移性乳腺癌症的女性在应对危及生命的预后和艰巨的治疗时面临着独特的挑战。然而，绝大多数研究都集中在优化早期非乳腺癌症患者的生活质量上，而对转移性癌症患者的支持性护理需求知之甚少。作为一个更大的项目的一部分，该项目旨在为心理社会干预的发展提供信息，本研究的目的是描述癌症转移性乳腺癌患者的支持性护理需求，并阐明生活在危及生命的预后中所特有的挑战。方法：对由22名女性组成的四个两小时的焦点小组进行录音、逐字转录，并使用通用归纳法对类别进行编码和提取主题。结果：201名参与者对支持性护理需求的评论共产生16个代码。代码被分解为四个支持性护理需求领域：1。心理社会，2。物理和功能，3。卫生系统和信息，以及4。性和生育需求。最普遍的需求是乳腺癌相关症状负担（17.4%）、缺乏社会支持（14.9%）、不确定性（10.0%）、压力管理（9.0%）、以患者为中心的护理（7.5%）和性功能（7.5%）。超过一半的需求（56.2%）在心理社会领域，超过三分之二的需求（76.8%）在心理、身体和功能领域。转移性癌症患者特有的支持性护理需求包括持续接受癌症治疗对症状负担的累积影响、从扫描到扫描对癌症治疗反应的担忧、诊断相关的耻辱和社会孤立、临终关怀以及对转移性癌症的误解。结论：研究结果表明，与早期癌症乳腺癌患者相比，转移性癌症乳腺癌患者具有独特的支持性护理需求，这些需求是预后缓慢的患者所特有的，并且在现有的支持性护理需求自我报告测量中通常没有反映出来。研究结果还强调了解决心理社会问题和乳腺癌相关症状的重要性。患有转移性癌症的妇女可能受益于早期获得循证干预和资源，这些干预和资源专门解决她们的支持性护理需求并优化生活质量和福祉。

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引用次数: 0

Psychosocial well-being and mental adjustment of patients with stage III melanoma in the re-entry phase: a scoping review III期黑色素瘤患者重返社会阶段的心理社会幸福感和心理调整：一项范围界定综述

Journal of psychosocial oncology research and practice

Pub Date : 2022-10-01 DOI: 10.1097/OR9.0000000000000089

Anna Visser, Lenneke Post, Joost Dekker, I. Konings

Supplemental Digital Content is Available in the Text. Abstract Background: The number of patients with stage III melanoma is rising because of increasing incidence and improved survival thanks to newly available adjuvant treatments. Patients may face specific challenges in the re-entry phase, the first 18 months after treatment, because of a high risk of recurrence and the intensity and long-term side effects of adjuvant treatment. The aims of this scoping review included summarizing the current state of evidence concerning patient psychosocial well-being and mental adjustment to the re-entry phase, as well as identifying knowledge gaps. Methods: A systematic literature search was conducted in PubMed and CINAHL using the PRISMA-ScR checklist. Results: Two qualitative and seven quantitative studies were included. Some studies found no evidence of diminished social and emotional functioning compared with the general population, while others reported emotional distress and impairment in psychological health. Regarding existential health, frequently expressed concerns encompassed fear of recurrence, hopelessness, and uncertainty about the future. Patients typically used behavioral coping, cognitive coping, and meaning-making to manage challenges in the re-entry phase. Only one study considered the effects of adjuvant therapy use on the re-entry phase. Conclusions: Limited evidence is available on the psychosocial status of patients with stage III melanoma in the re-entry phase, a phase in which patients face existential concerns. It may be beneficial to provide patients with support regarding existential concerns and meaning-making, for example by developing a practical tool to help set meaningful goals for the re-entry phase. A better understanding of the psychosocial well-being of these patients, the impact of adjuvant therapy, and the relationship between emotional distress, existential concerns, and meaning-making will require further research.

补充数字内容可在文本中获得。背景:III期黑色素瘤患者的数量正在上升，因为新的辅助治疗方法增加了发病率和生存率。由于复发的高风险以及辅助治疗的强度和长期副作用，患者在治疗后的前18个月的再入期可能面临特殊的挑战。这一范围审查的目的包括总结有关患者心理社会健康和重新进入阶段的精神调整的证据现状，以及确定知识差距。方法:采用PRISMA-ScR检查表在PubMed和CINAHL进行系统文献检索。结果:纳入2项定性研究和7项定量研究。一些研究发现，与一般人群相比，没有证据表明他们的社会和情感功能下降，而另一些研究则报告了情绪困扰和心理健康受损。关于存在性健康，经常表达的担忧包括害怕复发、绝望和对未来的不确定。患者通常使用行为应对、认知应对和意义创造来应对再入期的挑战。只有一项研究考虑了辅助治疗对再入期的影响。结论:关于III期黑色素瘤患者在再入期(患者面临生存问题的阶段)的社会心理状态的证据有限。为患者提供有关生存问题和意义创造方面的支持可能是有益的，例如，通过开发实用工具来帮助为重返社会阶段设定有意义的目标。为了更好地了解这些患者的社会心理健康、辅助治疗的影响以及情绪困扰、存在问题和意义创造之间的关系，还需要进一步的研究。

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引用次数: 0

Medication discharge teaching in pediatric hematopoietic stem cell transplantation: teaching characteristics, caregiver perceptions, and postdischarge adherence. 儿科造血干细胞移植的出院教学：教学特点、护理者认知和出院后依从性

IF 0.7

Journal of psychosocial oncology research and practice

Pub Date : 2022-10-01 DOI: 10.1097/or9.0000000000000088

Lauren Szulczewski, Julia K Carmody, Rachel Tillery, Adam S Nelson, Ahna L H Pai

Background: Hematopoietic stem cell transplantation (HCT) is an arduous but necessary treatment for many otherwise incurable diseases. It involves a complex medication regimen that is linked to significant clinical outcomes and must be learned by families before discharge. The purpose of this study was to qualitatively explore medication discharge teaching factors and to examine associations between those factors and caregiver self-perceived knowledge and efficacy.

Methods: Nineteen video-recorded medication discharge teachings, conducted by hematopoietic stem cell transplantation pharmacists, were coded to identify elements of discharge teaching, including information presented, communication, and environmental factors. Caregivers also completed a semistructured interview and a short measure to assess caregiver efficacy regarding their child's medication regimen.

Results: Pharmacists were consistent in their review of the names, dosages, and frequency of the medications being prescribed. However, there was variability regarding information provided about adherence, specific learnings (ie, how to read/fill syringe), and behavioral strategies to promote adherence (ie, adjust timing to fit family's schedule). Immediately and 1 week after the teaching, caregivers reported high levels of confidence regarding their ability to understand and manage their child's medication regimen.

Conclusion: Teaching families about the prescribed medication regimen is a critical component of the discharge process. The current findings suggest that increasing the consistency with which information is provided to families regarding the effective management of the medication regimen could potentially be a method to facilitate adherence.

背景:造血干细胞移植(HCT)是一项艰巨但必要的治疗许多其他无法治愈的疾病。它涉及一个复杂的药物治疗方案，与重要的临床结果有关，家庭必须在出院前了解。本研究旨在定性探讨出院教学因素，并探讨这些因素与护理人员自我认知知识和疗效之间的关系。方法:对19例由造血干细胞移植药师进行的出院教学录像进行编码，识别出院教学的要素，包括信息呈现、交流和环境因素。护理人员还完成了一项半结构化访谈和一项简短的措施，以评估护理人员对其孩子的药物治疗方案的疗效。结果:药剂师对处方药物的名称、剂量和频率的审查是一致的。然而，在依从性、具体学习(例如，如何阅读/填充注射器)和促进依从性的行为策略(例如，调整时间以适应家庭的时间表)方面提供的信息存在差异。教学后立即和1周，护理人员报告说，他们对自己理解和管理孩子药物治疗方案的能力有很高的信心。结论:在出院过程中，向家属传授处方药物治疗方案是一个重要组成部分。目前的研究结果表明，增加向家庭提供有关有效管理药物方案的信息的一致性可能是促进依从性的一种方法。

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引用次数: 0

Post-traumatic growth in family members of childhood cancer survivors—an updated systematic review 儿童癌症幸存者家庭成员的创伤后成长——一项最新的系统综述

Journal of psychosocial oncology research and practice

Pub Date : 2022-10-01 DOI: 10.1097/OR9.0000000000000087

Berglind Halldórsdóttir, G. Michel, Julia Baenziger

Abstract Background: Childhood cancer affects not only the patients, but their entire family. We systematically reviewed recent evidence of post-traumatic growth (PTG) among family members of childhood cancer survivors (CCS). Methods: We updated a systematic review of PTG among family members of CCS (including new evidence from March 2010 to December 2021). We screened 4 databases (PubMed, PsycINFO, CINAHL, and SCOPUS). Key study information and results were extracted for the quality appraisal. We narratively synthesized the evidence for reported levels and domains of PTG in caregivers (aim 1) and siblings (aim 2) and associated sociodemographic and psychosocial characteristics (aim 3) in families of CCS. Results: Of the 646 identified articles, 16 met eligibility criteria. Eleven studies used quantitative (all cross-sectional), 3 qualitative, and 2 mixed methods. Participants included parents and other primary caregivers (11 studies), grandparents (1 study), and siblings (5 studies). Most caregivers reported high levels of PTG, most often involving personal growth and stronger/closer family relationships. Siblings reported low-to-moderate PTG, with an emphasis on appreciating life and becoming more independent and mature. While sociodemographic and clinical characteristics were not associated with PTG, psychosocial factors such as personal resources, including social support and coping strategies, were associated with PTG outcomes. Conclusion: In the past decade, few studies have assessed PTG among families of CCS despite the call to focus on families in a previous review. We found that social support and proactive coping strategies may be the most helpful in promoting PTG.

背景:儿童癌症不仅影响患者，而且影响整个家庭。我们系统地回顾了儿童癌症幸存者(CCS)家庭成员创伤后生长(PTG)的最新证据。方法:我们更新了一项关于CCS家庭成员PTG的系统综述(包括2010年3月至2021年12月的新证据)。我们筛选了4个数据库(PubMed、PsycINFO、CINAHL和SCOPUS)。提取关键研究信息和结果进行质量评价。我们叙述性地综合了CCS家庭中照料者(目标1)和兄弟姐妹(目标2)中PTG水平和领域的报告证据，以及相关的社会人口统计学和心理社会特征(目标3)。结果:646篇文献中，16篇符合入选标准。11项研究采用定量方法(均为横断面)，3项采用定性方法，2项采用混合方法。参与者包括父母和其他主要照顾者(11项研究)、祖父母(1项研究)和兄弟姐妹(5项研究)。大多数照顾者报告高水平的PTG，最常涉及个人成长和更强/更紧密的家庭关系。兄弟姐妹报告的PTG处于低至中等水平，强调欣赏生活，变得更加独立和成熟。虽然社会人口学和临床特征与PTG无关，但心理社会因素，如个人资源，包括社会支持和应对策略，与PTG结果相关。结论:在过去的十年中，很少有研究评估CCS家庭中的PTG，尽管在之前的综述中呼吁关注家庭。我们发现社会支持和积极应对策略可能对促进PTG最有帮助。

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引用次数: 2

Need for a primary care–based intervention for fear of cancer recurrence: conclusions from the BLANKET trial 由于害怕癌症复发，需要以初级保健为基础的干预:来自BLANKET试验的结论

Journal of psychosocial oncology research and practice

Pub Date : 2022-10-01 DOI: 10.1097/OR9.0000000000000086

Yvonne L Luigjes-Huizer, C. Helsper, Marloes M. J. G. Gerrits, N. D. de Wit, M. L. van der Lee

Supplemental Digital Content is Available in the Text. Abstract Background: More than half of cancer survivors experience fear of cancer recurrence (FCR). There has been a call for easily accessible, inexpensive interventions for moderate FCR to complement existing specialized care. In the randomized BLANKET trial, we investigated the effectiveness of a short, primary care intervention for FCR. We report on the potential of the intervention and the suitability of primary care to offer this intervention. Methods: The BLANKET trial is a cluster randomized controlled trial with change in FCR severity (severity subscale of the Fear of Cancer Recurrence Inventory) as its main outcome. Participating general practitioners invited all patients who completed successful curative cancer treatment between 3 months and 10 years ago. We report effect measures, outcome of our recruitment strategy, intervention uptake, reasons not to participate, and experiences with the intervention. Results: Sixty-two of 1368 (4.5%) invited cancer survivors participated. Main reported reasons not to participate were not experiencing FCR and not wanting help. Owing to the low participation, we could not robustly evaluate the intervention's effectiveness. Indicatively, in the intention-to-treat analysis, FCR severity decreased from T0 to T1 by 2.7 points (standard deviation [SD] = 4.7) in the intervention group (n = 27) and 1.8 points (SD = 3.6) in the control group (n = 18). In the per-protocol analysis, the decreases were 3.5 points (SD = 4.5) and 0.7 points (SD = 2.7), respectively. Conclusion: Although the prevalence of FCR and the need for help for FCR are high according to the literature, the uptake of our primary care–based intervention was low. Although the intervention shows potential, alternative delivery routes need to be explored because of the low number of patients who need help for FCR per primary care practice. We recommend additional research on the impact of FCR, on which patients require and desire help, and on what kind of intervention and setting are fitting for what patients.

文本中提供了补充数字内容。摘要背景：超过一半的癌症幸存者经历了对癌症复发（FCR）的恐惧。有人呼吁为中度FCR提供方便、廉价的干预措施，以补充现有的专业护理。在随机BLANKET试验中，我们研究了FCR的短期初级保健干预的有效性。我们报告了干预的潜力以及初级保健提供这种干预的适宜性。方法：BLANKET试验是一项以FCR严重程度（癌症复发恐惧量表的严重程度分量表）的变化为主要结果的分组随机对照试验。参与的全科医生邀请了所有在3个月至10年前成功完成癌症治疗的患者。我们报告了效果测量、招募策略的结果、干预措施的接受、不参与的原因以及干预经验。结果：1368名受邀的癌症幸存者中有62人（4.5%）参与。据报道，不参加的主要原因是没有经历FCR和不需要帮助。由于参与度低，我们无法有力地评估干预措施的有效性。值得注意的是，在意向治疗分析中，干预组（n=27）的FCR严重程度从T0降至T1降低了2.7分（标准差[SD]=4.7），对照组（n=18）降低了1.8分（SD=3.6）。在按方案分析中，下降幅度分别为3.5分（SD=4.5）和0.7分（SD=2.7）。结论：尽管根据文献，FCR的患病率和对FCR的帮助需求很高，但我们基于初级保健的干预措施的接受率很低。尽管干预措施显示出了潜力，但由于每个初级保健机构需要FCR帮助的患者数量很少，因此需要探索替代的分娩途径。我们建议对FCR的影响进行更多的研究，研究哪些患者需要和渴望帮助，以及什么样的干预和环境适合哪些患者。

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引用次数: 1

The emotional impact of COVID-19 on Australian cancer patients, their caregivers, and oncology health professionals over time: a longitudinal qualitative study 随着时间的推移，新冠肺炎对澳大利亚癌症患者、其护理人员和肿瘤健康专业人员的情绪影响：一项纵向定性研究

Journal of psychosocial oncology research and practice

Pub Date : 2022-10-01 DOI: 10.1097/OR9.0000000000000090

J. Shaw, Polly E. Havard, H. Dhillon, B. Kelly, Lisa Beatty, I. Juraskova, L. Sharpe, M. Cigolini, R. Chan, L. Kirsten, M. Best, P. Butow

Supplemental Digital Content is Available in the Text. Abstract Background: Cross-sectional research has highlighted the emotional impacts of coronavirus disease 2019 (COVID-19) in cancer communities. The aim of this study was to extend findings and to provide a longitudinal perspective of emotional effects of COVID-19 on a range of participants, including patients with cancer, their family members, and oncology health professionals (HPs) in Australia. Methods: This mixed-methods, longitudinal study incorporated semistructured interviews and psychological well-being survey data collected at three time points between June 2020 and October 2021. Results: Seventy-seven participants volunteered at time point 1 (T1; 32 patients, 16 caregivers, 29 HPs), 52 at timepoint 2 (23 patients, 10 caregivers, 19 HPs), and 43 at timepoint 3 (19 patients, 8 caregivers, 16 HPs). Overall, participants were psychologically well; however, elevated depressive symptoms were detected in HPs by timepoint 3. Qualitative results highlighted the emotional toll of COVID-19 for all participant groups over time. Three shared themes emerged: (1) balancing fear and safety, (2) uncertainty in an ever-changing situation, and (3) fatigue due to lack of support and sense of isolation. An additional theme unique to HPs was also identified: (4) a sense of dread for what is to come in an already exhausted workforce. Conclusion: Despite Australia's relatively low COVID-19 case numbers, an emotional toll on the cancer community was apparent. Longitudinal results indicate consistency of themes over time with the burden for HPs adding a theme by the third interview. Participants were challenged to balance needs of personal safety against cancer priorities in an environment of uncertainty and isolation. Over time, a sense of fatigue emerged, and for HPs, increased workloads left many feeling overwhelmed and unsupported with a sense of dread around future outcomes.

补充数字内容可在文本中获得。背景:横断面研究强调了2019冠状病毒病(COVID-19)对癌症社区的情绪影响。本研究的目的是扩展研究结果，并提供COVID-19对一系列参与者的情绪影响的纵向视角，包括澳大利亚的癌症患者、他们的家庭成员和肿瘤卫生专业人员(hp)。方法:这项混合方法的纵向研究纳入了2020年6月至2021年10月三个时间点收集的半结构化访谈和心理健康调查数据。结果:77名参与者在时间点1 (T1;32名患者，16名护理人员，29名hp)， 52名患者在时间点2(23名患者，10名护理人员，19名hp)， 43名患者在时间点3(19名患者，8名护理人员，16名hp)。总体而言，参与者心理健康;然而，在时间点3时，hp患者发现抑郁症状升高。定性结果强调了COVID-19对所有参与者群体的情绪影响。出现了三个共同的主题:(1)平衡恐惧和安全;(2)在不断变化的情况下的不确定性;(3)由于缺乏支持和孤立感而产生的疲劳。我们还发现了惠普独有的另一个主题:(4)对已经疲惫不堪的员工队伍即将到来的恐惧。结论:尽管澳大利亚的COVID-19病例数相对较低，但癌症社区的情绪损失是显而易见的。纵向结果表明，随着时间的推移，主题的一致性与hp在第三次访谈时增加主题的负担。与会者面临的挑战是在不确定和孤立的环境中平衡个人安全需求与癌症优先事项。随着时间的推移，一种疲劳感出现了，对于惠普来说，工作量的增加让许多人感到不堪重负，对未来的结果感到恐惧。

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引用次数: 0

Prevalence and predictors of psychological distress in women diagnosed with breast cancer and women without breast cancer: a prospective study of psychological risk and resilience factors 诊断患有癌症和未患癌症的女性心理压力的患病率和预测因素：心理风险和恢复力因素的前瞻性研究

Journal of psychosocial oncology research and practice

Pub Date : 2022-10-01 DOI: 10.1097/OR9.0000000000000085

Lotte Van Noyen, Sabine E. Markovitz, N. Broers, M. Peters

Supplemental Digital Content is Available in the Text. Abstract Background: There is some controversy whether psychological distress after breast cancer diagnosis and treatment remains elevated at the long-term follow-up. This study compares the prevalence of psychological distress and anxiety and depressive disorders between patients with breast cancer and women without cancer in a prospective longitudinal design. Moreover, risk and protective factors for psychological distress and anxiety and depressive disorders were compared between the 2 groups. Methods: Two hundred fifty-three patients with breast cancer who underwent surgery completed a series of self-report questionnaires immediately after surgery and 18 months later. In addition, 211 female participants without being diagnosed with cancer were assessed at the same time points. Outcomes are psychological distress as measured with the Hospital Anxiety and Depression Scale and possible presence of anxiety and depressive disorders measured with the Patient Health Questionnaire. Trait resilience, optimism, and neuroticism were investigated as protective or risk factors for the development of psychological distress, anxiety, and depression. Results: We found that the levels of psychological distress and the prevalence of anxiety and depressive disorders are higher in the breast cancer group both at baseline and at 18 months of follow-up. Trait resilience and optimism were observed to be protective factors, and neuroticism was found to be a risk factor in both the breast cancer group and the comparison group. Conclusions: Psychological distress, depression, and anxiety remain elevated in patients with breast cancer over a period of one-and-a-half year. The identified protective and risk factors for these conditions are not unique for patients with breast cancer.

文本中提供了补充数字内容。摘要背景：在长期随访中，癌症诊断和治疗后的心理压力是否仍然升高存在争议。这项研究在前瞻性纵向设计中比较了癌症乳腺癌患者和非癌症女性之间的心理困扰、焦虑和抑郁障碍的患病率。此外，还比较了两组患者的心理困扰、焦虑和抑郁障碍的风险因素和保护因素。方法：253例接受手术的癌症患者在术后立即和术后18个月完成一系列自我报告问卷。此外，在同一时间点对211名未被诊断为癌症的女性参与者进行了评估。结果是用医院焦虑和抑郁量表测量的心理困扰，以及用患者健康问卷测量的可能存在的焦虑和抑郁障碍。特质恢复力、乐观主义和神经质被研究为心理困扰、焦虑和抑郁发展的保护或风险因素。结果：我们发现，在基线检查和随访18个月时，癌症组的心理压力水平以及焦虑和抑郁障碍的患病率较高。在癌症组和对照组中，观察到特质韧性和乐观是保护因素，而神经质是风险因素。结论：在一年半的时间里，癌症患者的心理压力、抑郁和焦虑持续升高。这些疾病的保护因素和风险因素对于癌症患者来说并不是唯一的。

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引用次数: 0

Implementation of the Distress Assessment and Response Tool at the Kuwait Cancer Control Centre 在科威特癌症控制中心实施痛苦评估和应对工具

Journal of psychosocial oncology research and practice

Pub Date : 2022-07-01 DOI: 10.1097/OR9.0000000000000083

Mariam Al-Awadhi, B. Gascon, Nawar Albarak, Ghazlan Aldeweesh, A. Hamadah, Hazim Abdulkarim, Yvonne W Leung, G. Rodin, Madeline Li

Supplemental Digital Content is Available in the Text. Abstract Background: This report describes the implementation of a comprehensive distress screening program at the Kuwait Cancer Control Center (KCCC), the first such initiative in the Middle East. A Kuwait-adapted version of the Distress Assessment and Response Tool (K-DART) was used in this screening program. Methods: Paper-based K-DART surveys were piloted in the lymphoma clinic at KCCC in July 2013, followed by gradual hospital-wide expansion. K-DART included patient-reported outcome measures to assess cancer-related physical and emotional symptoms and practical problems. English and Arabic translations of these measures were used. Trained nurses administered K-DART and followed up with the oncologist for patients with moderate-to-high levels of distress. Descriptive data are reported for prevalence of distress, psychosocial oncology program (PSOP) referral rates, and patient and staff satisfaction with K-DART. Results: A total of 1,153 K-DART surveys were completed by 618 patients in the pilot lymphoma clinic, with screening rates increasing from 33.5% to 75.3% over the first 12 months of implementation. Among all K-DART completers, 85/618 (13.8%) were referred to PSOP, whereas only 1/955 (0.1%) of K-DART noncompleters were referred to PSOP. After hospital-wide expansion of screening, a total of 2,017 patients completed K-DART in the first year of implementation. Both patients and physicians reported high satisfaction with K-DART, which was reported to enhance patient–physician communication and improve clinical care. Conclusion: Implementation of K-DART in a Middle Eastern country is feasible and facilitates a more comprehensive approach to cancer care, contributing to the successful establishment of a PSOP at the KCCC.

补充数字内容可在文本中获得。背景:本报告描述了科威特癌症控制中心(KCCC)实施的一项全面的窘迫筛查计划，这是中东地区第一个这样的倡议。在这个筛选项目中使用了科威特版的遇险评估和反应工具(K-DART)。方法:2013年7月在KCCC淋巴瘤诊所试点纸质K-DART调查，随后逐步在全院范围内推广。K-DART包括患者报告的结果测量，以评估癌症相关的身体和情绪症状和实际问题。使用了这些措施的英文和阿拉伯文译本。训练有素的护士使用K-DART，并与肿瘤学家一起对中度至重度痛苦的患者进行随访。描述性数据报告了痛苦的患病率，心理社会肿瘤学项目(PSOP)转诊率，以及患者和工作人员对K-DART的满意度。结果:在试点淋巴瘤诊所，618名患者共完成了1153项K-DART调查，在实施的前12个月，筛查率从33.5%上升到75.3%。在所有K-DART完井者中，有85/618(13.8%)被参考了PSOP，而只有1/955(0.1%)的K-DART未完井者被参考了PSOP。在医院范围内扩大筛查后，在实施的第一年，共有2,017名患者完成了K-DART。患者和医生都对K-DART表示高度满意，据报道，K-DART加强了医患沟通，改善了临床护理。结论:在中东国家实施K-DART是可行的，并促进了更全面的癌症治疗方法，有助于在KCCC成功建立PSOP。

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引用次数: 0

Mechanisms of change of a cognitive-existential group intervention for fear of cancer recurrence: mediation analyses of the FORT trial 认知-存在主义群体干预对癌症复发恐惧的改变机制:FORT试验的中介分析

Journal of psychosocial oncology research and practice

Pub Date : 2022-07-01 DOI: 10.1097/OR9.0000000000000077

S. Lebel, C. Maheu, C. Tomei, Brittany Mutsaers, L. Bernstein, C. Courbasson, S. Ferguson, Cheryl Harris, L. Jolicoeur, Monique Lefebvre, L. Muraca, A. Ramanakumar, Mina D. Singh, Julia Parrott

Abstract Background: Meta-analyses have demonstrated that brief interventions can address fear of cancer recurrence (FCR), but their mechanisms of action are largely unknown. Our goal was to identify the mediators of treatment efficacy of the Fear Of Recurrence Therapy (FORT) intervention using data from a multisite randomized controlled trial targeting FCR. That randomized controlled trial compared a 6-week cognitive-existential group intervention with an active control group. Methods: Participants (n = 135) were women diagnosed with stage I-III breast or gynecological cancer who were assessed at 4 time points (pretherapy, post-therapy, 3-month, and 6-month follow-up). The primary outcome, changes in FCR at 6 months, was measured with the Fear of Cancer Recurrence Inventory. We examined 6 mediators based on our theoretical model of FCR: perceived risk of recurrence, uncertainty in illness, intolerance of uncertainty, positive beliefs about worrying, reassurance-seeking, and cognitive avoidance. Changes in the possible mediator variables were simultaneously investigated to predict changes in FCR using Generalized Structural Equation Models with robust variance estimation. Results: FORT predicted FCR at 6 months in univariate analyses (β = −8.93, P = .0001). In the model including the 6 possible mediators, changes in uncertainty in illness (β = −8.72, P < .0001) and cognitive avoidance (β = −8.36, P < .0001) mediated the relationship between treatment and changes in FCR. However, FORT still predicted changes in FCR at 6 months (β = −6.35, P = .02), suggesting partial mediation. Conclusions: We identified 2 mechanisms of action that can be incorporated in future interventions. However, other processes that underlie the efficacy of these interventions need to be uncovered.

背景:荟萃分析表明，简短的干预可以解决癌症复发恐惧(FCR)，但其作用机制在很大程度上是未知的。我们的目的是利用一项针对FCR的多地点随机对照试验的数据，确定恐惧复发治疗(FORT)干预治疗效果的介质。这项随机对照试验将为期6周的认知存在干预组与积极对照组进行了比较。方法:参与者(n = 135)是诊断为I-III期乳腺癌或妇科癌症的妇女，在4个时间点(治疗前、治疗后、3个月和6个月的随访)进行评估。主要结局是6个月时FCR的变化，用癌症复发恐惧量表测量。基于我们的FCR理论模型，我们检查了6个中介:复发的感知风险、疾病的不确定性、对不确定性的不容忍、对担忧的积极信念、寻求安慰和认知回避。同时研究了可能中介变量的变化，使用具有稳健方差估计的广义结构方程模型来预测FCR的变化。结果:在单变量分析中，FORT预测6个月时的FCR (β = - 8.93, P = 0.0001)。在包含6种可能介质的模型中，疾病不确定性的变化(β = - 8.72, P < 0.0001)和认知回避(β = - 8.36, P < 0.0001)介导了治疗与FCR变化之间的关系。然而，FORT仍然预测6个月时FCR的变化(β = - 6.35, P = 0.02)，提示部分介导。结论:我们确定了两种可纳入未来干预措施的作用机制。然而，需要发现这些干预措施有效性背后的其他过程。

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引用次数: 1