101
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Close AG, Ghuman A, Friehling E, Hamm M, Frederick NN, Miller E, Kazmerski TM. Experiences with Menses and Menstrual Suppression of Young Women with a History of Cancer. J Adolesc Young Adult Oncol 2019; 9:23-29. [PMID: 31592736 DOI: 10.1089/jayao.2019.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Adolescent and young adult (AYA) women undergoing multiagent chemotherapy are at risk for heavy menstrual bleeding (HMB). There is a paucity of data on the experiences with menses of AYA women with cancer, their risk for HMB, and how they perceive menstrual suppression. Objective: This study aimed to (1) describe the attitudes and experiences of AYA women with a history of cancer regarding their menses and menstrual suppression and to (2) investigate facilitators and barriers to improve this aspect of oncologic care. Design/Methods: AYA women with a history of cancer completed individual semistructured interviews regarding their experiences, attitudes, and preferences around menstrual health. Two independent reviewers conducted a thematic analysis of transcribed interviews to elicit major themes. Results: We interviewed 20 young women with a history of cancer (mean age 19.9 years) who were treated with chemotherapy within the past 5 years. Themes included the following: (1) negative feelings and worry about menstrual bleeding; (2) positive attitudes toward menstrual suppression; (3) misconceptions about menstrual health; and (4) desire for tailored discussions about menstrual suppression. Conclusions: AYA women with a cancer history elucidate clear opinions regarding menstruation during chemotherapy, and many hold misconceptions regarding menses and menstrual suppression. Enhanced patient-provider communication and patient educational resources around menstrual health and menstrual suppression are needed to improve comprehensive oncologic care during chemotherapy.
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Affiliation(s)
- Allison G Close
- Division of Hematology/Oncology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amita Ghuman
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erika Friehling
- Division of Hematology/Oncology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Megan Hamm
- Director of Qualitative, Evaluation, and Stakeholder Engagement Research Services, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Natasha N Frederick
- Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Traci M Kazmerski
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh, Pittsburgh, Pennsylvania
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102
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Pettit T, Sue L, Waugh V, Ballantine K, Gardner K, Bremer L, Pemberton L, Allison L, Adams S, Chou E, Spearing R. An Age Stratified Analysis of the Access to Care Continuum Across Three Tumor Groups: Are There Delays for AYA? J Adolesc Young Adult Oncol 2019; 8:402-409. [DOI: 10.1089/jayao.2018.0126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tristan Pettit
- Children's Hematology Oncology Centre, Christchurch Hospital, Christchurch, New Zealand
| | - Louise Sue
- South Island Adolescent and Young Adult Cancer Service, Canterbury District Health Board, Christchurch, New Zealand
| | - Val Waugh
- South Island Adolescent and Young Adult Cancer Service, Southern District Health Board, Dunedin, New Zealand
| | - Kirsten Ballantine
- Children's Hematology Oncology Centre, Christchurch Hospital, Christchurch, New Zealand
- Children's Haematology Oncology Centre, Christchurch Hospital, Christchurch, New Zealand
| | - Kate Gardner
- Department of Medical Oncology, Christchurch Hospital, Christchurch, New Zealand
| | - Louise Bremer
- Department of Medical Oncology and Dunedin Hospital, Dunedin, New Zealand
| | - Lucy Pemberton
- Department of Haematology, Dunedin Hospital, Dunedin, New Zealand
| | - Lucy Allison
- Division of Health Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Savannah Adams
- Division of Health Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Eunice Chou
- Division of Health Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Ruth Spearing
- Department of Haematology, Christchurch Hospital, Christchurch, New Zealand
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103
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Sender A, Friedrich M, Leuteritz K, Nowe E, Stöbel-Richter Y, Mehnert A, Geue K. Unmet supportive care needs in young adult cancer patients: associations and changes over time. Results from the AYA-Leipzig study. J Cancer Surviv 2019; 13:611-619. [PMID: 31273638 DOI: 10.1007/s11764-019-00780-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/21/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Coping with cancer at a young adult age (AYA) is a challenge for many patients and raises support needs. We aim to examine unmet supportive care needs and to investigate predictors of and changes in unmet needs over time. METHODS We surveyed AYAs (18-39 years at time of diagnosis, diagnosis < 4 years) at two time points (t2 = 12 months after t1) using the Supportive Care Needs Survey (SCNS-SF34) among other validated measures. We conducted multiple hierarchical regressions to identify sociodemographic, medical and psychosocial predictors of unmet needs. RESULTS A total of 514 AYAs (386 women) with a mean age of 29.6 years participated at both times. Psychological needs (Mt1 = 35.7; Mt2 = 32.09; p = 0.001) and informational needs (Mt1 = 32.18; Mt2 = 29.04; p = 0.021) were the most often reported unmet needs at both measurements and decreased slightly at t2. All other SCNS domains, except for patient care, remained stable over time. Higher supportive needs were associated with greater levels of effort to cope with the disease at both times in all domains. Older age and female gender were significantly associated with two and one of six domains, respectively, at t1 and t2. CONCLUSIONS AYAs reported primarily unmet psychological and informational needs, which were stable over time and indicated that AYAs do not have sufficient access to the support they need. The degree of effort to cope with cancer plays a key role in terms of unmet support needs. IMPLICATIONS FOR CANCER SURVIVORS Regular screening for this variable in acute and especially follow-up care settings could pave the way for clinicians to offer more targeted support.
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Affiliation(s)
- Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Katja Leuteritz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Erik Nowe
- Medical Clinic II, Hospital St. Elisabeth and St. Barbara, Mauerstr. 5, 06110, Halle (Saale), Germany
| | - Yve Stöbel-Richter
- Faculty of Managerial and Cultural Studies, University of Zittau/Goerlitz, 30 06 48, Goerlitz, Germany
- Integrated Research and Treatment Center (IFB), University Medical Center, Leipzig, Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
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104
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Aubin S, Rosberger Z, Hafez N, Noory MR, Perez S, Lehmann S, Batist G, Kavan P. Cancer!? I Don't Have Time for That: Impact of a Psychosocial Intervention for Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:172-189. [DOI: 10.1089/jayao.2017.0101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
| | | | - Nada Hafez
- Jewish General Hospital, Montreal, Canada
| | | | | | | | | | - Petr Kavan
- Jewish General Hospital, Montreal, Canada
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105
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Sinnott SM, Park CL. Social Well-Being in Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2019; 8:32-39. [DOI: 10.1089/jayao.2018.0043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sinead M. Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut
| | - Crystal L. Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut
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106
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Michel G, François C, Harju E, Dehler S, Roser K. The long-term impact of cancer: Evaluating psychological distress in adolescent and young adult cancer survivors in Switzerland. Psychooncology 2019; 28:577-585. [DOI: 10.1002/pon.4981] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/18/2018] [Accepted: 01/01/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Gisela Michel
- Department Health Sciences and Health Policy; University of Lucerne; Switzerland
- Institute of Social and Preventive Medicine; University of Bern; Switzerland
| | - Constanza François
- Department Health Sciences and Health Policy; University of Lucerne; Switzerland
| | - Erika Harju
- Department Health Sciences and Health Policy; University of Lucerne; Switzerland
| | - Silvia Dehler
- Cancer Registry Zurich and Zug, Institute of Surgical Pathology, University Hospital Zurich and Epidemiology, Biostatistics and Prevention Institute; University Zurich; Switzerland
- Departement Gesundheit und Soziales, Abteilung Gesundheit; Aarau Switzerland
| | - Katharina Roser
- Department Health Sciences and Health Policy; University of Lucerne; Switzerland
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107
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Elsbernd A, Crenner C, Rosell T, Panicker J. Individual Experiences and Utilization of Supportive Resources in Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:329-334. [PMID: 30653388 DOI: 10.1089/jayao.2018.0107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Adolescents and young adults (AYAs) with cancer are often impacted by distress due to disease and treatment. Despite these concerns, prior research has found that AYAs do not utilize support resources, do not find these resources adequate, and or do not have adequate access to services. Objective: The objective of this project was to understand and identify AYA patient concerns and experiences throughout cancer treatment, what resources were utilized, how they were identified, and how supportive care resources for AYA cancer patients can be improved. Methods: Twenty-eight AYA cancer patients and survivors were interviewed on their experiences and utilization of supportive resources throughout cancer treatment. Qualitative data were analyzed using thematic analysis and organized through a priori framework examining specific domains of experience and resources utilized. Results: The most frequently discussed topic in qualitative interviews was the benefit of the health care team. Other frequently identified resources were generalized internet searches and webpages. Suggested unmet resource needs included supportive resources for family members and caregivers throughout the time of treatment. Conclusions: AYAs experience stress throughout treatment for cancer attributed to physical, practical, and psychosocial causes. Health care workers play a vital role in serving as an informative and supportive resource for their AYA patients. As such, health care workers and other supportive resources may alleviate these concerns, but these resources are still underexplored.
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Affiliation(s)
- Abbey Elsbernd
- 1 University of Kansas School of Medicine, Kansas City, Kansas
| | - Christopher Crenner
- 2 Department of History and Philosophy of Medicine, University of Kansas School of Medicine, Kansas City, Kansas
| | - Tarris Rosell
- 2 Department of History and Philosophy of Medicine, University of Kansas School of Medicine, Kansas City, Kansas
| | - Jyoti Panicker
- 3 Division of Hematology and Oncology, Department of Pediatrics, University of Kansas School of Medicine, Kansas City, Kansas
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108
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Masoudifar Z, Khanali Mojen L, Rassouli M, Nasiri M, Patterson P, Mc Donald F, Eshghi P. Psychometric Properties of the Persian Version of the Sibling Cancer Needs Instrument (SCNI). ASIAN PACIFIC JOURNAL OF CANCER PREVENTION : APJCP 2018; 19:3457-3462. [PMID: 30583669 PMCID: PMC6428549 DOI: 10.31557/apjcp.2018.19.12.3457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The sibling cancer needs instrument (SCNI) is the first developed specifically for assessing psychosocial unmet needs of adolescents having a sibling with cancer. The aim of this study is to evaluate the psychometric properties of its Persian version.
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Affiliation(s)
- Zeynab Masoudifar
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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109
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Cable M, Kelly D. An analysis of the development of adolescent and young adult cancer care in the United Kingdom: A Foucauldian perspective. Nurs Inq 2018; 26:e12272. [DOI: 10.1111/nin.12272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 10/13/2018] [Accepted: 10/13/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Maria Cable
- School of Health; Coventry University; Coventry UK
| | - Daniel Kelly
- Royal College of Nursing Chair of Nursing Research; School of Healthcare Sciences; Cardiff University; Cardiff UK
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110
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Tsai W, Lu Q. Ambivalence over emotional expression and intrusive thoughts as moderators of the link between self-stigma and depressive symptoms among Chinese American breast cancer survivors. J Behav Med 2018; 42:452-460. [PMID: 30474805 DOI: 10.1007/s10865-018-9996-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Abstract
Due to successful public health campaigns, breast cancer has successfully transformed from a highly stigmatized illness to a philanthropically supported disease in the United States. However, Chinese American breast cancer survivors continue to experience high levels of self-stigma and associated negative mental health outcomes. In the present study, we examined the relations between self-stigma and depressive symptoms, and further tested individual difference variables such as ambivalence over emotional expression and intrusive thoughts that may exacerbate the harmful effects of self-stigma among this population. One hundred and twelve foreign-born Chinese breast cancer survivors living in the United States completed questionnaires measuring self-stigma, depressive symptoms, AEE, and intrusive thoughts. We found significant AEE × self-stigma and intrusive-thought × self-stigma interaction effects in predicting depressive symptoms. Specifically, the relationships between self-stigma and depressive symptoms were exacerbated among individuals with high levels of AEE and intrusive thoughts. Self-stigma represents a significant predictor of depressive symptoms among Chinese breast cancer survivors, and particularly so for individuals with higher levels of AEE and intrusive thoughts. The findings suggest that for interventions designed to reduce the negative mental health outcomes associated with self-stigma, targeting risk factors such as AEE and intrusive thoughts might be promising.
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Affiliation(s)
- William Tsai
- Department of Applied Psychology, New York University, New York, USA.
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, USA. .,Department of Psychology, University of Houston, Houston, USA.
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111
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Burnos A, Bargiel-Matusiewicz KM. Quality of Life and PTSD Symptoms, and Temperament and Coping With Stress. Front Psychol 2018; 9:2072. [PMID: 30443229 PMCID: PMC6221927 DOI: 10.3389/fpsyg.2018.02072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 10/08/2018] [Indexed: 11/23/2022] Open
Abstract
Due to advances in medicine, a malignant neoplasm is a chronic disease that can be treated for a lot of patients for many years. It may lead to profound changes in everyday life and may induce fear of life. The ability to adjust to a new situation may depend on temperamental traits and stress coping strategies. The research presented in this paper explores the relationships between quality of life, PTSD symptoms, temperamental traits, and stress coping in a sample of patients diagnosed with cancer. One hundred and twenty nine participants aged 24-81 years, 69 females diagnosed with breast cancer and 60 males diagnosed with lung cancer completed Formal Characteristics of Behavior - Temperament Inventory, Coping Inventory for Stressful Situations, PTSD Inventory, and Quality of life SF-36 questionnaire. Higher level of emotional reactivity and higher level of perseveration was associated with lower emotional quality of life. Higher level of emotion oriented-coping and higher level of avoidant-distracted coping was associated with higher level of PTSD symptoms. Emotion-oriented coping and avoidant-distracted coping are ineffective in dealing with stress in the case of patients diagnosed with cancer, because they are associated with a higher level of PTSD symptoms. The significance of temperamental traits for quality of life in the situation of the patients is marginal. Control of specific factors concerned with current health and treatment status is needed the future research.
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112
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113
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Lathren C, Bluth K, Campo R, Tan W, Futch W. Young adult cancer survivors' experiences with a mindful self-compassion (MSC) video-chat intervention: A qualitative analysis. SELF AND IDENTITY 2018; 17:646-665. [PMID: 30774563 DOI: 10.1080/15298868.2018.1451363] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Young adult cancer survivors (YACS) are a vulnerable population that reports high anxiety, social isolation, and feelings of inadequacy after cancer treatment completion. Mindful self-compassion (MSC) provides strategies for coping with suffering. We explored how MSC practices addressed the psychosocial needs of a nationally recruited YACS sample (N=20, all female, age M=27.00, various cancer types) that participated in an 8-week MSC video-chat intervention. Descriptive qualitative analysis of the intervention recordings revealed three YACS' psychosocial needs: peer isolation, body concerns, and health-related anxiety. MSC practices addressed these in a number of ways including: self-reliance for emotional support, common humanity within the YACS community, gratitude, self-kindness, and acceptance. Meanwhile, the body scan practice initially triggered distress for some; implications are discussed.
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Affiliation(s)
- Christine Lathren
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Karen Bluth
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Rebecca Campo
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Winfield Tan
- Department of Psychiatry University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514
| | - Will Futch
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
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114
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Laskowska A. Quality of life in cancer as a function of temperament, coping and posttraumatic stress disorder. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-0008-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AbstractThe research presented in this paper explores the relationship between three blocks of explaining variables, ie. temperamental traits, stress coping PTSD and the explained variable which is quality of life in a sample of patients diagnosed with cancer. One hundred and twenty nine participants aged 24–81 years, 69 females diagnosed with breast cancer and 60 males diagnosed with lung cancer completed Formal Characteristics of Behaviour – Temperament Inventory (FCB-TI), Coping Inventory for Stressful Situations (CISS), PTSD Inventory (PTSD-C) and Quality of life SF-36 questionnaire. Higher level of emotional reactivity was associated with lower emotional quality of life. Higher level of emotion oriented-coping and higher level of avoidant-distracted coping was associated with higher level of intrusion/arousal and avoidance/numbing, ie. dimensions of PTSD symptoms. There were no statistically significant associations between temperamental traits and stress coping strategies nor between PTSD symptoms level and quality of life. Emotion-oriented coping and avoidant-distracted coping are ineffective in dealing with stress in the situation of patients diagnosed with cancer, because it leads to higher level of PTSD symptoms. The significance of temperamental traits for quality of life in the situation of the patients is marginal. Control of specific factors concerned with current health and treatment status is needed the future research.
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115
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Taking a “Snapshot”: Evaluation of a Conversation Aid for Identifying Psychosocial Needs in Young Adults with Cancer. J Adolesc Young Adult Oncol 2018; 7:565-571. [DOI: 10.1089/jayao.2018.0027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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116
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McCann L, McMillan KA, Hewitt C. An e-Prehabilitation System of Care for Teenagers and Young Adults Diagnosed With Cancer: Protocol for a Qualitative Co-Design Study. JMIR Res Protoc 2018; 7:e10287. [PMID: 30209030 PMCID: PMC6231758 DOI: 10.2196/10287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/29/2018] [Accepted: 06/19/2018] [Indexed: 11/24/2022] Open
Abstract
Background A diagnosis of cancer in young adulthood can pose many different and unique challenges for individuals. The provision of adequate and appropriate information as well as care and support for teenagers and young adults at the time of diagnosis is central to their health care experience going forward. Moreover, appropriate and accessible information provision is critical to ensure that young individuals with cancer feel equipped and empowered to make decisions about, and be involved in, their treatment and recovery throughout their experience; this is a concept known as prehabilitation. As digital interventions and resources that support teenagers and young adults with cancer are an increasingly desirable part of health care provision, this study will focus on the development of an age- and population-appropriate electronic prehabilitation (e-Prehabilitation) system of care. Objective We will conduct an exploratory, co-design research project that will inform the development of an e-Prehabilitation system of care to support teenagers and young adults diagnosed with cancer. A collaborative approach to data collection and prototype design will ensure that a patient-centered approach is embedded throughout. Methods A qualitative, co-design study utilizing surveys, interviews, and focus group discussions is being conducted with teenagers and young adults, health care professionals, and technologists. Results This research study is in progress; recruitment and data collection activities have commenced and findings are expected in early 2019. Conclusions The findings of this study will have important implications for informing the future development and evaluation of an e-Prehabilitation system of care to support teenagers and young adults diagnosed with cancer. Registered Report Identifier RR1-10.2196/10287
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Affiliation(s)
- Lisa McCann
- Digital Health & Wellness Group, Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Kathryn A McMillan
- Digital Health & Wellness Group, Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Christopher Hewitt
- Beatson West of Scotland Cancer Centre, NHS Greater Glasgow & Clyde, Glasgow, United Kingdom
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117
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Sawyer SM, McNeil R, Thompson K, Orme LM, McCarthy M. Developmentally appropriate care for adolescents and young adults with cancer: how well is Australia doing? Support Care Cancer 2018; 27:1783-1792. [PMID: 30155569 DOI: 10.1007/s00520-018-4420-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 08/12/2018] [Indexed: 01/23/2023]
Abstract
PURPOSE Developmentally appropriate care underpins quality cancer treatment. This study aimed to describe how well Australian cancer services deliver patient-focussed, developmentally appropriate care to adolescents and young adults (AYAs) with cancer. METHODS In a national, cross sectional study, 196 AYAs with cancer aged between 15 and 25 years at diagnosis reported their general experiences of the cancer care team (Cancer Needs Questionnaire), access to age-appropriate treatment environments (Cancer Needs Questionnaire) and frequency of psychosocial assessment (Adolescent Friendly Hospital Survey). RESULTS Very positive responses were reported around engagement and communication with staff who were reported as approachable, friendly and trustworthy; 11 of the 14 items were positively rated by over 90% of respondents. In contrast, over 70% of AYAs expressed unmet need around their physical and social environments, whether in relation to the opportunity to be nursed in wards designed for AYAs, spend time with other young people with cancer, or talk to young people their own age; less than a third reported their needs had been met on the majority of these items. The frequency that specific psychosocial assessment domains were discussed was highly variable; responses suggested that AYAs were less commonly questioned about overtly sensitive topics. AYAs who experienced private consultations with health care providers (41%) were significantly more likely to experience thorough psychosocial assessment. CONCLUSION Australian cancer services are generally communicating well with AYAs. There is room for improvement around more developmentally specific aspects of healthcare quality, such as psychosocial assessment, and around treatment environments that promote greater social interaction between AYAs.
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Affiliation(s)
- S M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, Australia.
- Murdoch Children's Research Institute, Parkville, VIC, Australia.
- Department of Paediatrics, The University of Melbourne, Parkville, Australia.
| | - R McNeil
- Centre for Adolescent Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - K Thompson
- Victorian Youth Cancer Service, Peter MacCallum Hospital, Parkville, VIC, Australia
| | - L M Orme
- Victorian Youth Cancer Service, Peter MacCallum Hospital, Parkville, VIC, Australia
- Children's Cancer Centre, Royal Children's Hospital, Parkville, VIC, Australia
| | - M McCarthy
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Children's Cancer Centre, Royal Children's Hospital, Parkville, VIC, Australia
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118
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Chalmers JA, Sansom-Daly UM, Patterson P, McCowage G, Anazodo A. Psychosocial Assessment Using Telehealth in Adolescents and Young Adults With Cancer: A Partially Randomized Patient Preference Pilot Study. JMIR Res Protoc 2018; 7:e168. [PMID: 30158103 PMCID: PMC6135966 DOI: 10.2196/resprot.8886] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 03/05/2018] [Accepted: 04/26/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescent and young adults with cancer are at increased risk of psychosocial difficulties relative to their healthy peers. Current models of inpatient face-to-face psychosocial care might limit the capacity for clinicians to provide timely and personalized assessment and intervention for this group. Telehealth offers a promising alternative toward increasing access to the provision of evidence-based psychosocial assessment and treatment for adolescent and young adults with cancer. OBJECTIVE This pilot study aimed to assess the feasibility and acceptability for both patients and clinicians of providing a psychosocial assessment via telehealth to adolescents and young adults currently receiving treatment for cancer, relative to face-to-face delivery. METHODS We included patients who were aged 15-25 years, currently receiving treatment, could speak English well, and medically stable. Patients were recruited from oncology clinics or wards from 5 hospitals located across Sydney and Canberra, Australia, and allocated them to receive psychosocial assessment (Adolescent and Young Adult Oncology Psychosocial Assessment Measure) with a clinical psychologist or social worker through face-to-face or telehealth modalities using a partially randomized patient preference model. Patients completed a pre- and postassessment questionnaire comprising validated and purposely designed feasibility and acceptability indices, including the impact of technical difficulties, if patients had their own devices; number of patients who were content with their group allocation; self-reported preference of modality; Treatment Credibility and Expectations Questionnaire; and Working Alliance Inventory. Clinicians also completed a postassessment questionnaire rating their impressions of the acceptability and feasibility of intervention delivery by each modality. RESULTS Of 29 patients approached, 23 consented to participate (response rate: 79%). Participants were partially randomized to either telehealth (8/23, 35%; mean age 16.50 years, range 15-23 years; females: 4/8, 50%) or face-to-face (11/23, 62%; mean age 17 years, range 15-22 years; females: 8/11, 72%) conditions. Four participants withdrew consent because of logistical or medical complications (attrition rate: 17.4%). Most participants (6/8, 75%) in the telehealth group used their computer or iPad (2 were provided with an iPad), with minor technical difficulties occurring in 3 of 8 (37.5%) assessments. Participants in both groups rated high working alliance (Working Alliance Inventory; median patient response in the telehealth group, 74, range 59-84 and face-to-face group, 63, range 51-84) and reported positive beliefs regarding the credibility and expectations of their treatment group. Postassessment preferences between face-to-face or telehealth modalities varied. Most patients in the telehealth group (5/8, 63%) reported no preference, whereas 6 of 11 (55%) in the face-to-face group reported a preference for the face-to-face modality. CONCLUSIONS Telehealth is acceptable as patient comfort was comparable across modalities, with no significant technological barriers experienced. However, patients varied in their preferred interview modality, highlighting the need to tailor the treatment to patient preference and circumstances. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12614001142628; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366609 (Archived by WebCite at http://www.webcitation.org/721889HpE).
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Affiliation(s)
| | - Ursula Margaret Sansom-Daly
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,Sydney Youth Cancer Service, Prince of Wales Hospitals, Randwick, Australia
| | - Pandora Patterson
- Department of Research, Evaluation & Social Policy, CanTeen Australia, Newtown, Australia.,Cancer Nursing Research Unit, University of Sydney, Sydney, Australia
| | - Geoffrey McCowage
- Cancer Centre for Children, Children's Hospital at Westmead, Westmead, Australia
| | - Antoinette Anazodo
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospitals, Randwick, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
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119
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Psychosocial challenges and health-related quality of life of adolescents and young adults with hematologic malignancies. Blood 2018; 132:385-392. [DOI: 10.1182/blood-2017-11-778555] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/05/2018] [Indexed: 12/28/2022] Open
Abstract
Abstract
Adolescents and young adults (AYAs) occupy a unique place within the hematologic malignancy community due to the challenges they face related to their disease biology and physical, psychosocial, and economic circumstances, as well as issues related to access to care and long-term follow-up. Efforts to define age-specific (supportive) care needs and targets for intervention in these areas are evolving. This review discusses the psychosocial issues AYAs with hematologic malignancies are dealing with, how these might affect their health-related quality of life, and the challenges in delivering high-quality supportive care to this underserved population.
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120
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Treatment strategies for adolescent and young adult patients with acute myeloid leukemia. Blood 2018; 132:362-368. [PMID: 29895667 DOI: 10.1182/blood-2017-12-778472] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/05/2018] [Indexed: 11/20/2022] Open
Abstract
Adolescents and young adults (AYAs) form a unique group of patients with newly diagnosed acute myeloid leukemia (AML). They differ in terms of disease biology, psychosocial challenges, survival, and in other important respects from children as well as from middle-aged and older adults. AYAs may be treated using pediatric protocols developed in trials composed primarily of younger patients, or using adult protocols developed in trials composed primarily of older patients. After reviewing the distinguishing characteristics of AYAs with AML, we compare and contrast the chemotherapy approaches and argue that neither the pediatric nor adult approaches may be ideally suited for AYAs and the development of AYA-specific approaches merits further consideration. We finish by putting forth ideas for future research to optimize chemotherapy treatment of AYAs with AML.
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121
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Dawson EW, Clark K, Obenchain R, Loscalzo MJ, Folbrecht J. Biopsychosocial Distress in Young Adult Oncology Patients: Examining Sex Differences in Sources of High Distress and Requests for Assistance. J Adolesc Young Adult Oncol 2018; 7:367-373. [DOI: 10.1089/jayao.2017.0081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Elaine Wheat Dawson
- Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, California
| | - Karen Clark
- Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, California
| | - Richard Obenchain
- Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, California
| | - Matthew J. Loscalzo
- Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, California
| | - Jeanelle Folbrecht
- Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, California
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122
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Soanes L, Gibson F. Protecting an adult identity: A grounded theory of supportive care for young adults recently diagnosed with cancer. Int J Nurs Stud 2018; 81:40-48. [DOI: 10.1016/j.ijnurstu.2018.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 12/15/2022]
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123
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Viola A, Taggi-Pinto A, Sahler OJZ, Alderfer MA, Devine KA. Problem-solving skills, parent-adolescent communication, dyadic functioning, and distress among adolescents with cancer. Pediatr Blood Cancer 2018; 65:e26951. [PMID: 29316232 PMCID: PMC5867217 DOI: 10.1002/pbc.26951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/17/2017] [Accepted: 12/05/2017] [Indexed: 12/20/2022]
Abstract
Some adolescents with cancer report distress and unmet needs. Guided by the disability-stress-coping model, we evaluated associations among problem-solving skills, parent-adolescent cancer-related communication, parent-adolescent dyadic functioning, and distress in adolescents with cancer. Thirty-nine adolescent-parent dyads completed measures of these constructs. Adolescents were 14-20 years old on treatment or within 1 year of completing treatment. Better problem-solving skills were correlated with lower adolescent distress (r = -0.70, P < 0.001). Adolescent-reported cancer-related communication problems and dyadic functioning were not significantly related to adolescent distress (rs < 0.18). Future work should examine use of problem-solving interventions to decrease distress for adolescents with cancer.
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Affiliation(s)
- Adrienne Viola
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | | | - Melissa A. Alderfer
- Nemours Children’s Health System, Wilmington, Delaware,Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
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124
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Geue K, Brähler E, Faller H, Härter M, Schulz H, Weis J, Koch U, Wittchen HU, Mehnert A. Prevalence of mental disorders and psychosocial distress in German adolescent and young adult cancer patients (AYA). Psychooncology 2018; 27:1802-1809. [DOI: 10.1002/pon.4730] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 03/29/2018] [Accepted: 03/30/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Kristina Geue
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Psychosomatic Medicine and Psychotherapy; Universal Medical Center Mainz; Mainz Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken; University of Würzburg; Würzburg Germany
| | - Martin Härter
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Holger Schulz
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Joachim Weis
- Department of Psychooncology, Tumor Biology Center; University Medical Center Freiburg; Freiburg Germany
| | - Uwe Koch
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
- Deanery, University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy; Technical University Dresden; Dresden Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
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125
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Niepage M, Georgievski G, Shama W, Lucchetta S. Exploring Adolescents' Cancer Journey Through Photovoice: A Narrative Synthesis. J Adolesc Young Adult Oncol 2018; 7:15-21. [DOI: 10.1089/jayao.2017.0073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mark Niepage
- Department of Social Work, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Georgi Georgievski
- Department of Social Work, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Wendy Shama
- Department of Social Work, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Sonia Lucchetta
- Department of Social Work, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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126
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Park JL, Brandelli Y, Russell KB, Reynolds K, Li Y, Ruether D, Giese-Davis J. Unmet Needs of Adult Survivors of Childhood Cancers: Associations with Developmental Stage at Diagnosis, Cognitive Impairment, and Time from Diagnosis. J Adolesc Young Adult Oncol 2018; 7:61-71. [DOI: 10.1089/jayao.2017.0023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Joanne L. Park
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Yvonne Brandelli
- Division of Psychosocial Oncology, Department of Oncology, University of Calgary, Calgary, Canada
- Alberta Health Services, Tom Baker Cancer Centre, Psychosocial Resources, Calgary, Canada
| | - K. Brooke Russell
- Division of Psychosocial Oncology, Department of Oncology, University of Calgary, Calgary, Canada
- Alberta Health Services, Tom Baker Cancer Centre, Psychosocial Resources, Calgary, Canada
| | - Kathleen Reynolds
- Long Term Survivor's Clinic, Alberta Children's Hospital, Calgary, Canada
| | - Yong Li
- Division of Psychosocial Oncology, Department of Oncology, University of Calgary, Calgary, Canada
- Alberta Health Services, Tom Baker Cancer Centre, Psychosocial Resources, Calgary, Canada
| | - Dean Ruether
- Alberta Health Services, Community Oncology, Calgary, Canada
| | - Janine Giese-Davis
- Division of Psychosocial Oncology, Department of Oncology, University of Calgary, Calgary, Canada
- Alberta Health Services, Tom Baker Cancer Centre, Psychosocial Resources, Calgary, Canada
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127
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Gorman JR, Standridge DC, Lyons KS, Elliot DL, Winters-Stone K, Julian AK, Weprin J, Storksdieck M, Hayes-Lattin B. Patient-centered communication between adolescent and young adult cancer survivors and their healthcare providers: Identifying research gaps with a scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:185-194. [PMID: 28882546 DOI: 10.1016/j.pec.2017.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/23/2017] [Accepted: 08/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To conduct a scoping literature review to identify practices or programs that promote AYA patient-centered communication. METHODS Between January and May of 2016, we applied standard scoping review methodology to systematically review articles. We considered peer-reviewed, English language articles written at any phase of intervention research. Both qualitative and quantitative studies were eligible, and no additional search restrictions were applied. We retained articles that included explicit or implicit outcomes for one of the six functions of patient-centered communication in cancer care. At least two independent reviewers assessed the articles. RESULTS We screened a total of 4072 titles and abstracts, retaining 27 for full-text review. Ultimately, eight titles met the review's inclusion criteria. We categorized each publication by the action or setting used to improve patient-centered communication, resulting in five categories. Most studies were not included because they did not include a patient-centered communication outcome. CONCLUSION This area of research is still emerging, as indicated by the small number of eligible studies and predominance of qualitative, descriptive, pilot, and feasibility studies with small sample sizes. PRACTICE IMPLICATIONS Our results suggest a clear need to develop and evaluate interventions focused on improving patient-centered communication between AYA survivors and their healthcare providers.
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Affiliation(s)
- Jessica R Gorman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.
| | - Danielle C Standridge
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
| | - Karen S Lyons
- School of Nursing, Oregon Health & Science University, Portland, USA.
| | - Diane L Elliot
- Department of Medicine, Oregon Health & Science University, Portland, USA.
| | | | - Anne K Julian
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.
| | - Jennifer Weprin
- School of Nursing, Oregon Health & Science University, Portland, USA.
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128
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Park EM, Gelber S, Rosenberg SM, Seah DSE, Schapira L, Come SE, Partridge AH. Anxiety and Depression in Young Women With Metastatic Breast Cancer: A Cross-Sectional Study. PSYCHOSOMATICS 2018. [PMID: 29525523 DOI: 10.1016/j.psym.2018.01.007] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Young adults with cancer experience disruptions in their normal developmental trajectories and commonly experience psychologic distress related to their diagnoses. Young women with metastatic breast cancer (MBC) are at particular risk of adverse mental health outcomes. OBJECTIVE We sought to determine the prevalence of and factors associated with anxiety and depression symptoms in young women with newly diagnosed de novo MBC. METHODS A total of 54 women with newly diagnosed de novo MBC were identified from an ongoing, prospective, multicenter cohort of women diagnosed with breast cancer at age <40. Depression and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Items assessing socio-demographics, physical symptom burden, social support, and disease and treatment history, with complementary medical record review, were used to assess variables potentially associated with anxiety and depression symptoms. RESULTS Mean HADS Depression score was 4.4 (standard deviation = 3.7) and mean HADS Anxiety score was 7.9 (standard deviation = 5.0). Eleven (20%) women scored ≥8 on the HADS Depression subscale, the suggested threshold for depression/anxiety screening, and 24 (44%) women scored ≥8 on the HADS Anxiety subscale. In a multivariable model of anxiety, higher physical symptom scores (odds ratio = 4.41, p = 0.005) was significantly associated with higher anxiety scores. None of the other variables improved the model fit. CONCLUSION In this study, a considerable proportion of young women with newly diagnosed MBC experienced anxiety symptoms, although depression was less common. Future strategies focused on distress reduction in young MBC patients should focus on physical symptom management as well as anxiety identification and management.
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Affiliation(s)
- Eliza M Park
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Shari Gelber
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Davinia S E Seah
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Sacred Heart Supportive and Palliative Care, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Lidia Schapira
- Department of Medicine, Stanford University Medical Center, Palo Alto, CA
| | - Steven E Come
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Department of Medicine, Brigham and Women's Hospital, Boston, MA
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129
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Richter D, Mehnert A, Schepper F, Leuteritz K, Park C, Ernst J. Validation of the German version of the late adolescence and young adulthood survivorship-related quality of life measure (LAYA-SRQL). Health Qual Life Outcomes 2018; 16:4. [PMID: 29301526 PMCID: PMC5755338 DOI: 10.1186/s12955-017-0827-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 12/14/2017] [Indexed: 11/23/2022] Open
Abstract
Background Cancer has adverse effects on patient’s quality of life. As such, measuring quality of life (QoL) has become an integral part of psycho-oncological health care. Because adolescent and young adult patients have different needs in contrast to children and older cancer patients, instruments for adequately measuring QoL of cancer survivors in this age range are essential. As there is not a corresponding instrument in Germany, we aimed to validate the German version of the Late Adolescence and Young Adulthood Survivorship-Related Quality of Life Measure (LAYA-SRQL), a 30-item questionnaire covering 10 dimensions related to QoL. Methods The LAYA-SRQL was translated into German following state-of-the-art criteria. We enrolled 234 adolescent and young adult (AYA) cancer patients with different tumour entities aged between 16 and 39 years old. Factorial structure was tested using confirmatory factor analysis. Internal consistency was determined by Cronbach’s α. The Short Form Survey quality of life questionnaire (SF-12v2) was used to examine convergent validity. Results The 10-factor structure of the LAYA-SRQL was confirmed in the German sample, and the model shows high values of fit indicators: χ2 = 723.32 (df = 360, p < 0.001), CFI = 0.92, TLI = 0.90, SRMR = 0.074, RMSEA = 0.066). Subscales showed acceptable to excellent internal consistencies with Cronbach’s α > 0.70 and total Cronbach’s α of 0.93. Convergent validity was demonstrated by high positive correlations between the LAYA-SRQL and the physical (r = 0.45) and mental component (r = 0.65) of the SF-12v2. Conclusions The German version of the LAYA-SRQL showed good psychometric properties. The instrument proved to be a highly reliable and valid instrument that can be recommended for use in the follow-up care of AYAs and for clinical research.
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Affiliation(s)
- Diana Richter
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Florian Schepper
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Medical Center Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Katja Leuteritz
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Crystal Park
- Department of Psychology, University of Connecticut, Psychological Sciences Department, Bousfield Psychology Building, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | - Jochen Ernst
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
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130
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Khoshnood Z, Iranmanesh S, Rayyani M, Dehghan M. Getting Out or Remaining in the Cage of Inauthentic Self: The Meaning of Existential Challenges in Patients' with Cancer. Indian J Palliat Care 2018; 24:131-138. [PMID: 29736113 PMCID: PMC5915877 DOI: 10.4103/ijpc.ijpc_179_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Context: Cancer as a life-threatening disease develops a range of existential challenges in persons. These challenges cause the patients to encounter some existential questions and tensions. This study method focuses on a person's experience about them. Aims: The aim of this study is to illuminate the meaning of existential challenges in patients with cancer in Iran. Subjects and Methods: A hermeneutic phenomenological approach, influenced by the philosophy of Ricoeur, was used to analyze the experiences of 10 Iranian patients with cancer. Data analysis was based on three stages of simple and fast understanding, structural analysis, and comprehensive understanding. Results: The present study showed that existential challenges in patients with cancer can be considered as getting out or remaining in the cage of inauthentic self. This theme consists of two subthemes “Being exposed to the light of awareness that revealed the cage of inauthentic self” and “The tension between getting out of the cage or remaining.” First, being exposed to the light of awareness revealed the cage of inauthentic self which subjectively refers to the emergence of existential questions, the past, the fear of future, and the collapse of physical body identity. Second, the tension between getting out of the cage or still staying which is characterized by anger, denial, sense of loneliness, and depression. Conclusions: According to the results of this qualitative study, it is possible to form discussion groups with peers or have self-reflective practice teaching groups to reflect patients' questions and existential challenges. In this way, participants can express themselves, share their experiences, challenges, learn, and find the answers.
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Affiliation(s)
- Zohreh Khoshnood
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Sedigheh Iranmanesh
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Rayyani
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahlegha Dehghan
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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131
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Barriers to Addressing Social Determinants of Health in Pediatric Nursing Practice: An Integrative Review. J Pediatr Nurs 2017; 37:51-56. [PMID: 28676190 DOI: 10.1016/j.pedn.2017.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/17/2017] [Indexed: 12/26/2022]
Abstract
PROBLEM Despite a substantial body of knowledge regarding the importance of the social determinants of health, recognizing and responding to the psychosocial circumstances of seriously and chronically ill children and their families is not well established in routine pediatric nursing care. ELIGIBILITY CRITERIA The search process focused on psychological and social determinants and care in the healthcare setting. Searches were limited to research and review publications written in the English language. The quality of evidence was graded using the National Health and Medical Research Council evidence hierarchy. RESULTS Thirteen publications were identified for inclusion. Healthcare providers do recognize emotional distress experienced by patients, but feel unable to address psychosocial issues due to the lack of time, a lack of confidence in their own communication skills, and the perception that patients and their families prioritize physical care over psychosocial care. For patients and their families the main issue was that the healthcare system was focused on physical care with little opportunity to talk about psychosocial concerns. CONCLUSIONS The greatest barrier to addressing the social determinants of health in the pediatric context is the dominance of the 'medical model' of care. Also, many healthcare providers believe that they lack the communication skills necessary to talk about psychosocial issues. IMPLICATIONS The way forward will be to empower nurses through the sharing of knowledge of the social determinants of health, the development of skills in relationship building and therapeutic communication, and the mentorship of compassionate family-centered care.
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Rotz SJ, Nagarajan R, Sorger JI, Pressey JG. Challenges in the Treatment of Sarcomas of Adolescents and Young Adults. J Adolesc Young Adult Oncol 2017; 6:406-413. [DOI: 10.1089/jayao.2017.0007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Seth J. Rotz
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rajaram Nagarajan
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Joel I. Sorger
- Division of Orthopedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Joseph G. Pressey
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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133
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Barr RD, Bleyer WA. New horizons on the landscape of AYA oncology. Pediatr Blood Cancer 2017; 64. [PMID: 28741306 DOI: 10.1002/pbc.26291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Ronald D Barr
- Departments of Pediatrics, Pathology and Medicine, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - W Archie Bleyer
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
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134
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Morrison CF, Pai ALH, Martsolf D. Facilitators and Barriers to Self-Management for Adolescents and Young Adults Following a Hematopoietic Stem Cell Transplant [Formula: see text]. J Pediatr Oncol Nurs 2017; 35:36-42. [PMID: 28786302 DOI: 10.1177/1043454217723864] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Adolescents and young adults who experience hematopoietic stem cell transplant are at risk for self-management difficulties based on development, psychological comorbidities, and the complexity of the care regimen. Recommendations for practice change were designed to address facilitators and barriers to self-management for adolescents and young adults following hematopoietic stem cell transplant. As part of a grounded theory research study, 30 participants (17 adolescents and young adults and 13 of their caregivers) were individually interviewed and asked about facilitators and barriers to managing care and advice for health care providers. Participant responses were coded into categories, which were named with terms used by the participants. The number of participants who provided data per category was recorded. Self-management is generally characterized only in the ability to follow a prescribed care regimen. Participants indicated mental and emotional experiences as a result of treatment were indistinguishable from self-management activities. Facilitators included having a positive attitude, social support, organization, motivation, and information. Barriers included physical and psychological symptoms, isolation, difficulties with the medication regimen, single parenting, and having a bad attitude. Advice for health care providers included communicating effectively, treating patients holistically, and providing social support.
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Affiliation(s)
- Caroline F Morrison
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,2 University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Ahna L H Pai
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,3 University of Cincinnati, College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Donna Martsolf
- 2 University of Cincinnati, College of Nursing, Cincinnati, OH, USA
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135
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Baudry AS, Lelorain S, Mahieuxe M, Christophe V. Impact of emotional competence on supportive care needs, anxiety and depression symptoms of cancer patients: a multiple mediation model. Support Care Cancer 2017; 26:223-230. [DOI: 10.1007/s00520-017-3838-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/24/2017] [Indexed: 10/19/2022]
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136
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137
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Sohn IJ, Han JW, Hahn SM, Song DH, Lyu CJ, Cheon KA. Factors Associated with Emotional Distress in Children and Adolescents during Early Treatment for Cancer. Yonsei Med J 2017; 58:816-822. [PMID: 28540996 PMCID: PMC5447114 DOI: 10.3349/ymj.2017.58.4.816] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/22/2017] [Accepted: 03/24/2017] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Children and adolescents diagnosed with cancer experience emotional distress, such as sadness, worrying, and irritability. However, there is little information about the psychological well-being of parents at the time of their child's diagnosis. We sought to identify factors that were associated with emotional distress in cancer patients as a basis for developing innovative psychological interventions. MATERIALS AND METHODS A retrospective chart review was performed on patients newly diagnosed with cancer at a single center in Korea from 2014 to 2016. Eighty-five patients and their mothers completed psychological inventories. To determine factors associated with emotional distress in patients, we assessed the psychological inventory results using multiple linear regression after performing correlation analysis. RESULTS The maternal Beck Depression Inventory-II (BDI-II) score was positively correlated with total problem scores and externalizing scores in patients aged less than 7 years. In patients aged 7-12 years, there was no significant association between the patient's emotional distress and other variables. In contrast, the maternal BDI-II score was the strongest factor associated with patient depression in adolescents. CONCLUSION We suggest that the most important factor affecting emotional distress in children and adolescents with cancer is maternal depression, especially in patients aged 1-6 years and aged 13-17 years. Understanding the factors associated with emotional distress of cancer patients allows us to develop early psychiatric interventions for patients and their parents at the initial psychological crisis.
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Affiliation(s)
- In Jung Sohn
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Woo Han
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Min Hahn
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ho Song
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chuhl Joo Lyu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
| | - Keun Ah Cheon
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.
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138
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LaRosa KN, Stern M, Bleck J, Lynn C, Hudson J, Reed DR, Quinn GP, Donovan KA. Adolescent and Young Adult Patients with Cancer: Perceptions of Care. J Adolesc Young Adult Oncol 2017; 6:512-518. [PMID: 28537818 DOI: 10.1089/jayao.2017.0012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescent and young adults with cancer (AYACs) face unique medical, psychosocial, and supportive care needs. The purpose of this study was to identify AYACs perceptions and expectations of cancer care services on and off treatment. METHODS Semistructured interviews were conducted with 23 AYACs aged 19-38 years (13 on and 10 off treatment), who were receiving care at a comprehensive cancer center. Verbatim transcripts were created from audiotaped interviews and hand coded using inductive content analysis methodology. RESULTS Perceptions of optimal care were reported by AYACs through two main themes as follows: perceived barriers and facilitators during treatment. Within each main theme were three subthemes, including perceived facilitators reported as the provision of social support, the website and patient portal, and the educational information provided by the cancer center. Younger female AYACs (age 19-31) on active treatment reported perceived barriers to optimal care related to the management of physical and mental health symptoms, while older patients (age 32 and up) on active treatment endorsed a fear of cancer returning. The third perceived barrier equally endorsed by patients both on and off treatment and across age ranges included limited assistance with financial issues. CONCLUSIONS AYACs reported perceived barriers and facilitators to optimal care. Implications for these findings are discussed in the context of the importance of adding a patient navigator to the AYACs care team.
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Affiliation(s)
- Kayla N LaRosa
- 1 Department of Educational and Psychology Studies, University of South Florida , Tampa, Florida
| | - Marilyn Stern
- 2 Department of Child and Family Studies, University of South Florida , Tampa, Florida.,3 Health Outcomes and Behavior Program, Moffitt Cancer Center , Tampa, Florida.,4 Adolescent and Young Adult Program, Moffitt Cancer Center , Tampa, Florida
| | - Jennifer Bleck
- 2 Department of Child and Family Studies, University of South Florida , Tampa, Florida
| | - Courtney Lynn
- 1 Department of Educational and Psychology Studies, University of South Florida , Tampa, Florida
| | - Janella Hudson
- 3 Health Outcomes and Behavior Program, Moffitt Cancer Center , Tampa, Florida
| | - Damon R Reed
- 4 Adolescent and Young Adult Program, Moffitt Cancer Center , Tampa, Florida.,5 Sarcoma Program, Moffitt Cancer Center , Tampa, Florida
| | - Gwendolyn P Quinn
- 3 Health Outcomes and Behavior Program, Moffitt Cancer Center , Tampa, Florida.,4 Adolescent and Young Adult Program, Moffitt Cancer Center , Tampa, Florida.,6 Morsani College of Medicine, University of South Florida , Tampa, Florida
| | - Kristine A Donovan
- 3 Health Outcomes and Behavior Program, Moffitt Cancer Center , Tampa, Florida.,4 Adolescent and Young Adult Program, Moffitt Cancer Center , Tampa, Florida.,6 Morsani College of Medicine, University of South Florida , Tampa, Florida
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139
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Crook B, Love B. Examining the Light and Dark of an Online Young Adult Cancer Support Community. QUALITATIVE HEALTH RESEARCH 2017; 27:938-948. [PMID: 27742764 DOI: 10.1177/1049732316672638] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The young adult (YA) cancer community represents an understudied population in interpersonal and health communication scholarship. Through qualitative analysis, this study sought to advance a dark side perspective by exploring the content of messages shared in an online support forum for YAs with cancer. Our findings highlight a variety of complexities YAs face in an online cancer support community, including the light and dark of soliciting support, disclosing to a community, advocacy online, negative sentiment evaluating health care services, and asynchronous communication. Understanding the light and dark nuances involved with participating in an online YA support forum advances a dark side perspective on the scholarly research in health communication that can ultimately help care providers recommend resources and coach YAs to optimally and effectively use and navigate online support groups.
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Affiliation(s)
| | - Brad Love
- 1 The University of Texas at Austin, Austin, Texas, USA
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140
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Isenalumhe LL, Fridgen O, Beaupin LK, Quinn GP, Reed DR. Disparities in Adolescents and Young Adults With Cancer. Cancer Control 2017; 23:424-433. [PMID: 27842332 DOI: 10.1177/107327481602300414] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cancer care for adolescents and young adults (AYAs) focuses on the care of patients aged 15 to 39 years. Historically, this group has favorable outcomes based on a preponderance of diagnoses such as thyroid cancers and Hodgkin lymphoma. Improvements in outcomes among the AYA population have lagged behind compared with younger and older populations. METHODS We discuss and review recent progress in AYA patient care and highlight remaining disparities that exist, including financial disadvantages, need for fertility care, limited clinical trial availability, and other areas of evolving AYA-focused research. RESULTS Survival rates have not improved for this age group as they have for children and older adults. Disparities are present in the AYA population and have contributed to this lack of progress. CONCLUSIONS Recognizing disparities in the care of AYAs with cancer has led many medical specialty disciplines to improve the lives of these patients through advocacy, education, and resource development. Research addressing barriers to clinical trial enrollment in this population, quality-of-life issues, and the improvement of survivorship care is also under way.
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141
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Sawyer SM, McNeil R, McCarthy M, Orme L, Thompson K, Drew S, Dunt D. Unmet need for healthcare services in adolescents and young adults with cancer and their parent carers. Support Care Cancer 2017; 25:2229-2239. [DOI: 10.1007/s00520-017-3630-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 02/06/2017] [Indexed: 02/01/2023]
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142
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Thabrew H, McDowell H, Given K, Murrell K. Systematic Review of Screening Instruments for Psychosocial Problems in Children and Adolescents With Long-Term Physical Conditions. Glob Pediatr Health 2017; 4:2333794X17690314. [PMID: 28255576 PMCID: PMC5315369 DOI: 10.1177/2333794x17690314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 12/27/2016] [Indexed: 01/03/2023] Open
Abstract
Children and adolescents with long-term physical conditions (LTPCs) are at greater risk of developing psychosocial problems. Screening for such problems may be undertaken using validated psychometric instruments to facilitate early intervention. A systematic review was undertaken to identify clinically utilized and psychometrically validated instruments for identifying depression, anxiety, behavior problems, substance use problems, family problems, and multiple problems in children and adolescents with LTPCs. Comprehensive searches of articles published in English between 1994 and 2014 were completed via Medline, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases, and by examining reference lists of identified articles and previous related reviews. Forty-four potential screening instruments were identified, described, and evaluated against predetermined clinical and psychometric criteria. Despite limitations in the evidence regarding their clinical and psychometric validity in this population, a handful of instruments, available at varying cost, in multiple languages and formats, were identified to support targeted, but not universal, screening for psychosocial problems in children and adolescents with LTPCs.
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143
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Korsvold L, Mellblom AV, Finset A, Ruud E, Lie HC. A content analysis of emotional concerns expressed at the time of receiving a cancer diagnosis: An observational study of consultations with adolescent and young adult patients and their family members. Eur J Oncol Nurs 2017; 26:1-8. [DOI: 10.1016/j.ejon.2016.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 10/05/2016] [Accepted: 10/31/2016] [Indexed: 11/29/2022]
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144
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Leuteritz K, Friedrich M, Nowe E, Sender A, Stöbel-Richter Y, Geue K. Life situation and psychosocial care of adolescent and young adult (AYA) cancer patients - study protocol of a 12-month prospective longitudinal study. BMC Cancer 2017; 17:82. [PMID: 28129743 PMCID: PMC5273846 DOI: 10.1186/s12885-017-3077-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 01/19/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In recent years, there has been an increased research focus on adolescent and young adult (AYA) cancer patients. Few longitudinal studies have taken into consideration the specifics of their life situation and the status of psychosocial care services for this population. Our ongoing study aims to determine the psychosocial life and supportive care situation of AYA cancer patients, to describe risk groups, and to develop recommendations for their psycho-oncological care and support. METHODS The AYA-Leipzig study (AYA-LE) is a German prospective, longitudinal, study examining AYAs´ life situation (e.g. psychological distress, quality of life) and psychosocial care (e.g. evaluation and preferences, support needs) using two measurement points, namely, upon acute treatment completion (baseline) and 12 months later. N = 577 AYA cancer patients aged between 18 and 39 years at diagnosis, and representing all major tumor entities fill out a standardized questionnaire (online or by post), mainly based on validated instruments. AYA-specific concerns (e.g. family planning, sexual and reproductive health, social support, health behavior) will explicitly be considered. Participants are recruited in 16 German acute care hospitals, four rehabilitation clinics, and from two German state tumor registries. DISCUSSION In summary, our longitudinal study will create a large database encompassing all malignant tumor entities and including detailed information about the distress and quality of life, specific problems, and specific support needs of AYA cancer patients at two different points in time post-diagnosis. The information we gather about existing psychosocial care and patient preferences and desires concerning psycho-oncological care will be used to develop recommendations for psycho-oncological care providers.
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Affiliation(s)
- Katja Leuteritz
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, 04103 Germany
| | - Michael Friedrich
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, 04103 Germany
| | - Erik Nowe
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, 04103 Germany
| | - Annekathrin Sender
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, 04103 Germany
| | - Yve Stöbel-Richter
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, 04103 Germany
- University of Zittau / Goerlitz, Faculty of Management and Cultural Sciences, P. O. Box 30 06 48, Goerlitz, 02811 Germany
| | - Kristina Geue
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, 04103 Germany
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145
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Campo RA, Bluth K, Santacroce SJ, Knapik S, Tan J, Gold S, Philips K, Gaylord S, Asher GN. A mindful self-compassion videoconference intervention for nationally recruited posttreatment young adult cancer survivors: feasibility, acceptability, and psychosocial outcomes. Support Care Cancer 2017; 25:1759-1768. [PMID: 28105523 DOI: 10.1007/s00520-017-3586-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/10/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE Young adult (YA) cancer survivors report substantial distress, social isolation, and body image concerns that can impede successful reintegration into life years after treatment completion. Mindful Self-Compassion (MSC) interventions focus on developing mindfulness and self-compassion for managing distress, hardships, and perceived personal inadequacies. An MSC intervention would be beneficial in supporting YA survivors' management of psychosocial challenges that arise in survivorship; however, a telehealth intervention modality is essential for reaching this geographically dispersed population. We conducted a single-arm feasibility study of an MSC 8-week videoconference intervention for nationally recruited YA survivors (ages 18-29). METHODS The MSC intervention was group-based, 90-minute videoconference sessions, held weekly over 8 weeks, with audio-supplemented home practice. Feasibility and acceptability were assessed via attendance rate and an intervention satisfaction scale. Baseline to post-intervention changes in psychosocial outcomes (body image, anxiety, depression, social isolation, posttraumatic growth, resilience, self-compassion, mindfulness) were assessed using paired t tests and Cohen's d effect sizes. RESULTS Thirty-four participants were consented and 25 attended a videoconference group. Feasibility was established with 84% attending at least six of the eight sessions, and intervention acceptability was high (M = 4.36, SD = 0.40, score range = 1-5). All psychosocial outcomes, except for resilience, demonstrated significant changes (p < 0.002), with medium to large effect sizes (Cohen's d > 0.5). CONCLUSION YA survivors are interested in receiving an MSC videoconference intervention. Feasibility, acceptance, and potential psychosocial benefits of the intervention were demonstrated. Findings can be applied toward the design of an efficacy randomized controlled trial to improve quality of life for YA survivors in transition after cancer treatment.
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Affiliation(s)
- Rebecca A Campo
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
| | - Karen Bluth
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sheila J Santacroce
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sarah Knapik
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Julia Tan
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Stuart Gold
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Pediatrics and Division of Pediatric Hematology-Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Kamaira Philips
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Susan Gaylord
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Gary N Asher
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
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146
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Penn A, Kuperberg A, Zebrack BJ. Psychosocial Issues in Adolescent and Young Adult Patients and Survivors. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_23] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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147
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Van der Gucht K, Takano K, Labarque V, Vandenabeele K, Nolf N, Kuylen S, Cosyns V, Van Broeck N, Kuppens P, Raes F. A Mindfulness-Based Intervention for Adolescents and Young Adults After Cancer Treatment: Effects on Quality of Life, Emotional Distress, and Cognitive Vulnerability. J Adolesc Young Adult Oncol 2016; 6:307-317. [PMID: 28002681 DOI: 10.1089/jayao.2016.0070] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Adolescent and young adult cancer (AYAC) survivors show an elevated risk of distress. Targeted psychosocial interventions for this distinct population are needed. This study examined the potential efficacy of a mindfulness-based intervention (MBI) to alleviate emotional distress and improve quality of life (QoL) in AYAC survivors. METHODS Participants were 16 AYAC survivors, aged 14-24, who had completed acute medical treatment. A two-baseline (8 and 1 week before the intervention), post- (1 week after the intervention) and 3 months follow-up within-subjects design was used. Each participant completed two baseline assessments, followed by an 8-week MBI. The primary outcome variables were emotional distress and QoL. Secondary outcomes were cognitive vulnerability factors and mindfulness skills. RESULTS Multilevel modeling showed (1) a significant reduction in emotional distress and improvement in QoL at 3 months of follow-up, (2) a significant reduction in negative attitudes toward self (i.e., a cognitive vulnerability factor), and (3) a significant improvement in mindfulness skills. CONCLUSION MBI is a promising approach that is used to treat emotional distress and to improve QoL in AYAC survivors. Further research using randomized controlled trials is needed to generalize these findings. Trial registration information: www.trialregister.nl ; NTR4358.
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Affiliation(s)
- Katleen Van der Gucht
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Keisuke Takano
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Veerle Labarque
- 2 Department of Pediatric Hemato-Oncology, University Hospitals Leuven , Leuven, Belgium
| | - Karen Vandenabeele
- 2 Department of Pediatric Hemato-Oncology, University Hospitals Leuven , Leuven, Belgium
| | - Nathalie Nolf
- 3 Department of Paediatric Haematology-Oncology and Stem Cell Transplantation, Ghent University Hospital , Ghent, Belgium
| | - Sanne Kuylen
- 4 Paediatric Haematology, Oncology and HIV, Antwerp University Hospital , Edegem, Belgium
| | - Veerle Cosyns
- 5 Medical Oncology & Haematology KZ, Brussel University Hospital , Jette, Belgium
| | - Nady Van Broeck
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Peter Kuppens
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Filip Raes
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
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148
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McCarthy MC, McNeil R, Drew S, Dunt D, Kosola S, Orme L, Sawyer SM. Psychological Distress and Posttraumatic Stress Symptoms in Adolescents and Young Adults with Cancer and Their Parents. J Adolesc Young Adult Oncol 2016; 5:322-329. [DOI: 10.1089/jayao.2016.0015] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maria C. McCarthy
- Murdoch Childrens Research Institute, Parkville, Australia
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Australia
| | - Robyn McNeil
- Murdoch Childrens Research Institute, Parkville, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia
| | - Sarah Drew
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - David Dunt
- School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Silja Kosola
- Murdoch Childrens Research Institute, Parkville, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia
| | - Lisa Orme
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Australia
- ONTrac at Peter Mac Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - Susan M. Sawyer
- Murdoch Childrens Research Institute, Parkville, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
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Wu WW, Liang SY, Hung GY, Tsai SY, Lee TY. The experiences of adolescents with osteosarcoma during the one-year of treatment in Taiwan. J Child Health Care 2016; 20:473-482. [PMID: 26647022 DOI: 10.1177/1367493515616203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Osteosarcoma (OS) typically occurs during puberty. The one-year treatment for OS can be very challenging. However, little empirical research has explored the experiences of adolescents with OS. This research explored the experiences of Taiwanese adolescents with OS, utilizing a qualitative inductive content analysis with in-depth interviews and field notes that captured interviewer observations. In total, 20 participants-aged between 10 and 19 years and being treated for OS-were recruited. Ten categories were extracted: disbelief, hope for recovery and maintaining body integrity, experience with physical symptoms, inappropriate sleep hygiene, experience of psychosocial distress, use of spirituality to recover from misfortune, information acquisition, preparation to return to school, interdependence, and dedication to hope of recovery. This is the first empirical qualitative study to explore the experiences of Taiwanese adolescents with OS during treatment since being diagnosed. Close surveillance of the compliance in rehabilitation and physical function is needed. Providing age-appropriate and culture-oriented support systems would be helpful for addressing their psychosocial difficulties. Social networking sites closely moderated by health professionals may be a feasible way enhancing psychosocial well-being. Conducting a descriptive exploratory qualitative study for further development of psychosocial supportive care interventions is recommended.
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Affiliation(s)
- Wei-Wen Wu
- 1 School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Yuan Liang
- 1 School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Gung-Yi Hung
- 2 Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shao-Yu Tsai
- 3 School of Nursing, National Taiwan University, Taipei, Taiwan
| | - Tzu-Ying Lee
- 1 School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Wilson JZ, Marin D, Maxwell K, Cumming J, Berger R, Saini S, Ferguson W, Chibnall JT. Association of Posttraumatic Growth and Illness-Related Burden With Psychosocial Factors of Patient, Family, and Provider in Pediatric Cancer Survivors. J Trauma Stress 2016; 29:448-456. [PMID: 27580167 DOI: 10.1002/jts.22123] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/04/2016] [Accepted: 06/19/2016] [Indexed: 11/12/2022]
Abstract
Research has indicated that childhood cancer may lead to posttraumatic growth (PTG), given cancer's association with posttraumatic stress. PTG may be associated with family/home and health care dynamics, as well as parental resilience, distress, and coping. This cross-sectional study investigated the associations of psychosocial factors of the patient, family, and health care team with PTG and illness-related burden (IRB) in childhood cancer survivors. The sample comprised 61 children and adolescents (7-18 years of age), their parents, and their nurses. Respondents completed their assessment an average of 1.73 years after the end of treatment for the child's disease, which was either leukemia, a solid tumor, or lymphoma. Regression analyses showed that PTG was positively associated with the patients' posttraumatic stress symptoms. It was also positively associated with the parents' religious coping, and with measures of stronger family and oncologist relationships (R2 = .32). IRB was positively associated with patient-reported posttraumatic stress symptoms, negatively associated with the nurse's trust in the family, and positively associated with parent-reported mental distress, lower family socioeconomic status, and female gender (R2 = .53). There was no significant association with parenting style or parent-reported posttraumatic stress symptoms in the child. The findings suggested that the young cancer patient's psychosocial and resource milieu (e.g., financial) may be instrumental in PTG and IRB. Psychosocial interventions with high-risk families and their health care teams could increase growth and reduce burden.
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Affiliation(s)
- J Zachary Wilson
- Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Donna Marin
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Katherine Maxwell
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Joseph Cumming
- Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Ryan Berger
- Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Shermini Saini
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - William Ferguson
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - John T Chibnall
- Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
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