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Sun Q, Duan YL, Li CY, Xie JF, Cheng AS. The effectiveness of live music intervention on psychological distress among adolescent and young adult patients undergoing hematopoietic stem cell transplantation. J Psychosoc Oncol 2024:1-17. [PMID: 38972065 DOI: 10.1080/07347332.2024.2373232] [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: 07/09/2024]
Abstract
OBJECTIVE To explore the effects of live music to decrease psychological distress in adolescent and young adult (AYA) patients undergoing hematopoietic stem cell transplantation (HSCT). METHOD A quasi-experimental study was conducted. Sixty patients undergoing HSCT were divided into two groups, receiving either 4 week of live music (n = 31) or standard care (n = 29). Psychological distress, anxiety, the severity of symptom clusters and symptom interference were measured. RESULTS When compared with the immediately and 1 month after intervention, patients in LM intervention group had significantly lower psychological distress and anxiety level than wait-list group. AYA undergoing HSCT reported significantly milder general symptom cluster and neurological symptom cluster at T3 than at baseline. CONCLUSIONS Live music intervention showed a positive effect on relieving psychological distress and anxiety in AYA patients undergoing HSCT. However, further researches are warranted to explore the effects of live music intervention on symptom cluster.
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Affiliation(s)
- Qian Sun
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ying-Long Duan
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Cheng-Yuan Li
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jian-Fei Xie
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Andy Sk Cheng
- Department of Re-habilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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2
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Thurston C, Deleemans JM, Gisser J, Piercell E, Ramasamy V, Tutelman PR. The Development and Impact of AYA Can-Canadian Cancer Advocacy: A Peer-Led Advocacy Organization for Adolescent and Young Adult Cancer in Canada. Curr Oncol 2024; 31:2582-2588. [PMID: 38785474 PMCID: PMC11119832 DOI: 10.3390/curroncol31050193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/24/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Adolescents and young adults (AYAs; 15-39 years) diagnosed with cancer face disparities in outcomes and survival. Patient advocacy organizations can play a pivotal role in advancing outcomes for underserved health conditions, such as AYA cancer. In 2018 a group of AYA patient advocates founded AYA Canada (later renamed to "AYA Can-Canadian Cancer Advocacy"), a peer-led national organization aimed at improving the experiences and outcomes of Canadian AYAs affected by cancer. The aim of this article is to describe the development and impact of AYA Can. AYA Can was incorporated as a not-for-profit organization in 2021 and became a registered charity in 2023. Since 2018, AYA Can has established a thriving community of practice comprising nearly 300 patients, healthcare providers, researchers, and charitable organizations with an interest in advocacy for AYA cancer. Other activities have included advocacy at academic conferences and on scientific committees, collaboration with scientists to advance AYA cancer research, training the next generation of AYA patient advocates through a "patient ambassador program," and developing a national resource hub to centralize knowledge and information on AYA cancer. Through its work to foster collaboration and amplify patient priorities on a national scale, AYA Can has become a leading voice for AYA cancer advocacy in Canada.
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Affiliation(s)
| | - Julie M. Deleemans
- AYA Can—Canadian Cancer Advocacy, Winnipeg, MB, Canada; (J.M.D.)
- Department of Oncology, University of Calgary, Calgary, AB T2S 3C3, Canada
| | - Jason Gisser
- AYA Can—Canadian Cancer Advocacy, Winnipeg, MB, Canada; (J.M.D.)
| | - Emily Piercell
- AYA Can—Canadian Cancer Advocacy, Winnipeg, MB, Canada; (J.M.D.)
| | - Vinesha Ramasamy
- AYA Can—Canadian Cancer Advocacy, Winnipeg, MB, Canada; (J.M.D.)
| | - Perri R. Tutelman
- Department of Oncology, University of Calgary, Calgary, AB T2S 3C3, Canada
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3
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Cho D, Roth M, Peterson SK, Jennings K, Kim S, Weathers SP, Ahmed S, Livingston JA, Barcenas C, You YN, Milbury K. Associations Between Stress, Health Behaviors, and Quality of Life in Young Couples During the Transition to Survivorship: Protocol for a Measurement Burst Study. JMIR Res Protoc 2024; 13:e53307. [PMID: 38652520 PMCID: PMC11077407 DOI: 10.2196/53307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Cancer is a life-threatening, stressful event, particularly for young adults due to delays and disruptions in their developmental transitions. Cancer treatment can also cause adverse long-term effects, chronic conditions, psychological issues, and decreased quality of life (QoL) among young adults. Despite numerous health benefits of health behaviors (eg, physical activity, healthy eating, no smoking, no alcohol use, and quality sleep), young adult cancer survivors report poor health behavior profiles. Determining the associations of stress (either cancer-specific or day-to-day stress), health behaviors, and QoL as young adult survivors transition to survivorship is key to understanding and enhancing these survivors' health. It is also crucial to note that the effects of stress on health behaviors and QoL may manifest on a shorter time scale (eg, daily within-person level). Moreover, given that stress spills over into romantic relationships, it is important to identify the role of spouses or partners (hereafter partners) in these survivors' health behaviors and QoL. OBJECTIVE This study aims to investigate associations between stress, health behaviors, and QoL at both within- and between-person levels during the transition to survivorship in young adult cancer survivors and their partners, to identify the extent to which young adult survivors' and their partners' stress facilitates or hinders their own and each other's health behaviors and QoL. METHODS We aim to enroll 150 young adults (aged 25-39 years at the time of cancer diagnosis) who have recently completed cancer treatment, along with their partners. We will conduct a prospective longitudinal study using a measurement burst design. Participants (ie, survivors and their partners) will complete a daily web-based survey for 7 consecutive days (a "burst") 9 times over 2 years, with the bursts spaced 3 months apart. Participants will self-report their stress, health behaviors, and QoL. Additionally, participants will be asked to wear an accelerometer to assess their physical activity and sleep during the burst period. Finally, dietary intake (24-hour diet recalls) will be assessed during each burst via telephone by research staff. RESULTS Participant enrollment began in January 2022. Recruitment and data collection are expected to conclude by December 2024 and December 2026, respectively. CONCLUSIONS To the best of our knowledge, this will be the first study that determines the interdependence of health behaviors and QoL of young adult cancer survivors and their partners at both within- and between-person levels. This study is unique in its focus on the transition to cancer survivorship and its use of a measurement burst design. Results will guide the creation of a developmentally appropriate dyadic psychosocial or behavioral intervention that improves both young adult survivors' and their partners' health behaviors and QoL and potentially their physical health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53307.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kristofer Jennings
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Seokhun Kim
- The Center for Clinical Research and Evidence-Based Medicine, The University of Texas McGovern Medical School, Houston, TX, United States
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sairah Ahmed
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - J Andrew Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Carlos Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Y Nancy You
- Department of Colon & Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kathrin Milbury
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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4
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Wolfson JA, Grimes AC, Nuno M, Bergheimer CL, Ramakrishnan S, Beauchemin M, Dickens D, Levine JM, Roth ME, Scialla M, Woods W, Vargas S, Boayue KB, Chang GJ, Stock W, Hershman D, Curran E, Advani A, O’Dwyer K, Luger S, Liu JJ, Freyer D, Sung L, Parsons SK. Characteristics of Health Care Settings Where Adolescents and Young Adults Receive Care for ALL. JCO Oncol Pract 2024; 20:491-502. [PMID: 38252911 PMCID: PMC11085951 DOI: 10.1200/op.23.00328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 10/04/2023] [Accepted: 11/06/2023] [Indexed: 01/24/2024] Open
Abstract
PURPOSE Individuals diagnosed with cancer between 15 and 39 years (adolescent and young adult [AYA]) face unique vulnerability. Detail is lacking about care delivery for these patients, especially those with ALL. We address these knowledge gaps by describing AYA ALL care delivery details at National Cancer Institute Community Oncology Research Program (NCORP) (sub)affiliates by model of care. METHODS Participating institutions treated at least one AYA with ALL from 2012 to 2016. Study-specific criteria were used to determine the number of unique clinical facilities (CFs) per NCORP and their model of care (adult/internal medicine [IM], pediatric, mixed [both]). Surveys completed by NCORPs for each CF by model of care captured size, resources, services, and communication. RESULTS Among 84 participating CFs (adult/IM, n=47; pediatric, n=15; mixed, n=24), 34% treated 5-10 AYAs with ALL annually; adult/IM CFs more often treated <5 (adult/IM, 60%; pediatric, 40%; mixed, 29%). Referral decisions were commonly driven by an age/diagnosis combination (58%), with frequent ALL-specific age minimums (87%) or maximums (80%). Medical, navigational, and social work services were similar across models while psychology was available at more pediatric CFs (pediatric, 80%; adult/IM, 40%; mixed, 46%-54%). More pediatric or mixed CFs reported oncologists interacting with pediatric/adult counterparts via tumor boards (pediatric, 93%; adult/IM, 26%; mixed, 96%) or initiating contact (pediatric, 100%; adult/IM, 77%; mixed 96%); more pediatric CFs reported an affiliated counterpart (pediatric, 53%; adult, 19%). Most CFs reported no AYA-specific resources (79%) or meetings (83%-98%). CONCLUSION System-level aspects of AYA ALL care delivery have not been examined previously. At NCORPs, these characteristics differ by models of care. Additional work is ongoing to investigate the impact of these facility-level factors on guideline-concordant care in this population. Together, these findings can inform a system-level intervention for diverse practice settings.
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Affiliation(s)
- Julie A. Wolfson
- Division of Pediatric Hematology-Oncology, University of Alabama at Birmingham
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham
| | - Allison C. Grimes
- Division of Pediatric Hematology-Oncology, University of Texas Health Science Center San Antonio
| | - Michelle Nuno
- Children’s Oncology Group
- Department of Population and Public Health Sciences, University of Southern California
| | | | | | | | - David Dickens
- Division of Pediatric Hematology-Oncology, University of Iowa
| | - Jennifer M. Levine
- Division of Pediatric Hematology-Oncology, Children’s National Medical Center
| | - Michael E. Roth
- Division of Pediatric Hematology-Oncology, MD Anderson Cancer Center
| | | | - Wendy Woods
- Division of Pediatric Hematology-Oncology, Blank Children’s Hospital
| | | | - Koh B. Boayue
- Division of Pediatric Hematology-Oncology, University of New Mexico Cancer Center
| | - George J. Chang
- Alliance Cancer Care Delivery Research; Department of Colon and Rectal Surgery and Department of Health Services Research, The University of Texas, MD Anderson Cancer Center
| | - Wendy Stock
- Alliance Leukemia; Division of Hematology-Oncology, University of Chicago Medicine
| | - Dawn Hershman
- SWOG Cancer Care Delivery Research; Division of Hematology-Oncology, Columbia University
| | - Emily Curran
- Alliance Leukemia; Division of Hematology-Oncology, University of Cincinnati
| | - Anjali Advani
- SWOG Leukemia; Division of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute
| | - Kristen O’Dwyer
- SWOG Leukemia; Division of Hematology-Oncology, University of Rochester, Wilmot Cancer Institute
| | - Selina Luger
- ECOG-ACRIN Leukemia, Division of Hematology-Oncology, University of Pennsylvania
| | - Jane Jijun Liu
- Alliance Community Oncology; Heartland NCORP, Division of Hematology-Oncology, Illinois CancerCare
| | - David Freyer
- Division of Pediatric Hematology-Oncology, Children’s Hospital Los Angeles
| | - Lillian Sung
- Division of Pediatric Hematology-Oncology, The Hospital for Sick Children
| | - Susan K. Parsons
- Division of Hematology/Oncology and Institute for Clinical Research and Health Policy Studies, Tufts Medical Center
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5
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Rosenberg AR, Salsman JM. Resilience in adolescent and young adult oncology: Problems and prospects. Cancer 2024; 130:1015-1018. [PMID: 38150308 DOI: 10.1002/cncr.35180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Although resilience research in adolescent and young adult oncology is promising for improving patient‐centered outcomes, it does not adequately incorporate diverse perspectives of marginalized individuals. Including the unique aspects of minoritized adolescents and young adults and incorporating cultural, community, and system‐level considerations is essential to understanding and promoting resilience in an equitable fashion.
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Affiliation(s)
- Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
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6
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Salsman JM, Rosenberg AR. Fostering resilience in adolescence and young adulthood: Considerations for evidence-based, patient-centered oncology care. Cancer 2024; 130:1031-1040. [PMID: 38163249 DOI: 10.1002/cncr.35182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
Adolescence and young adulthood are times of growth and change. For adolescents and young adults (AYAs) who are diagnosed with cancer, the demands of illness may compound normal developmental challenges and adversely affect physical, emotional, and social health. Nevertheless, AYAs have a tremendous capacity for psychosocial adaptation and resilience. Informed by the Transactional Model of Stress and Coping, observational studies in AYA oncology suggest consistent individual, social, and existential resources that may promote resilience. To date, few interventions have been designed to examine whether resilience can be taught and whether doing so affects patient-centered outcomes. Findings point to the potential value of multicomponent programs that include various skills-building strategies, such as stress management, mindfulness, gratitude, and positive reappraisal coping, among others. New research directions include the need to evaluate delivery strategies to enhance participant adherence and retention (e.g., eHealth modalities, optimization studies) and to examine program effectiveness in community-based oncology practices (e.g., less resource-rich settings in which most AYAs receive care). Ultimately, this scholarship may inform, refine, and strengthen intervention science in resilience more broadly.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
| | - Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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7
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Hughes L, Taylor RM, Beckett AE, Lindner OC, Martin A, McCulloch J, Morgan S, Soanes L, Uddin R, Stark DP. The Emotional Impact of a Cancer Diagnosis: A Qualitative Study of Adolescent and Young Adult Experience. Cancers (Basel) 2024; 16:1332. [PMID: 38611010 PMCID: PMC11010824 DOI: 10.3390/cancers16071332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
The biographical disruption that occurs in adolescents and young adults following a cancer diagnosis can affect various important psychosocial domains including relationships with family and friends, sexual development, vocational and educational trajectories, and physical and emotional wellbeing. While there is evidence of the physical impact of cancer during this period, less is known about the impact on emotional wellbeing and especially on the barriers for young people accessing help and support. We aimed to obtain a more in-depth understanding of young people's experiences of their diagnosis, treatment, psychological impact, and range of resources they could or wanted to access for their mental health. We conducted an in-depth qualitative study using semi-structured interviews with 43 young people who had developed cancer aged 16 to 39 years and were either within 6 months of diagnosis or 3-5 years after treatment had ended. Framework analysis identified three themes: the emotional impact of cancer (expressed through anxiety, anger, and fear of recurrence); personal barriers to support through avoidance; and support to improve mental health through mental health services or adolescent and young adult treatment teams. We showed the barriers young people have to access care, particularly participant avoidance of support. Interrupting this process to better support young people and provide them with flexible, adaptable, consistent, long-term psychological support has the potential to improve their quality of life and wellbeing.
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Affiliation(s)
- Luke Hughes
- Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK;
| | - Rachel M. Taylor
- Centre for Nurse, Midwife and AHP Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK;
- Department of Targeted Intervention, University College London, London WC1E 6BT, UK
| | - Angharad E. Beckett
- School of Sociology and Social Policy, University of Leeds, Leeds LS2 9JT, UK; (A.E.B.); (J.M.)
| | - Oana C. Lindner
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (R.U.); (D.P.S.)
| | - Adam Martin
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK;
| | - Joanne McCulloch
- School of Sociology and Social Policy, University of Leeds, Leeds LS2 9JT, UK; (A.E.B.); (J.M.)
| | - Sue Morgan
- Teenage and Young Adult Cancer Service, Leeds Teaching Hospitals NHS Foundation Trust, Leeds LS9 7TF, UK;
| | | | - Rizwana Uddin
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (R.U.); (D.P.S.)
| | - Dan P. Stark
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (R.U.); (D.P.S.)
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Capaldi JM, Shabanian J, Finster LB, Asher A, Wertheimer JC, Zebrack BJ, Shirazipour CH. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health Psychol Rev 2024; 18:41-74. [PMID: 36632776 DOI: 10.1080/17437199.2022.2162947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Abstract
The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.
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Affiliation(s)
- Jessica M Capaldi
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia Shabanian
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Laurel B Finster
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arash Asher
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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9
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Wolfe KR, Martinez A, Dains JE. The Psychosocial Impact of the COVID-19 Pandemic on Adolescent and Young Adult Cancer Survivors in the United States: An Integrative Review. J Adolesc Young Adult Oncol 2024; 13:80-96. [PMID: 37797223 DOI: 10.1089/jayao.2023.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Adolescent and young adult cancer survivors (AYAs) are uniquely challenged with navigating health care systems during an important developmental phase of life. During the Coronavirus disease 2019 (COVID-19) pandemic, many people experienced social isolation, mental health symptoms, and schooling and employment changes, which may have affected vulnerable AYA cancer survivors. The purpose of this integrative review is to explore the psychosocial impact of the COVID-19 pandemic on AYA cancer survivors in the United States. A literature search was conducted in November 2022 using PubMed, Web of Science, and SCOPUS databases with the following search terms: distress*, depress*, lonel*, anx*, insomnia*, cancer*, neoplasm, COVID-19, coronavirus, young adult, AYA, teen*, and adolescen*. The initial search yielded 468 articles. Inclusion criteria required that studies were conducted in the United States, published in English, with a sample of patients diagnosed with cancer between ages 15 and 39. After review and appraisal of each relevant article, eight were included. Through comparative analysis of eight articles, including qualitative and quantitative studies, three themes emerged: mental health impact, health care impact, and financial impact. Mental health impact included increased anxiety, worsening depression and social isolation, and sleep disturbances. Changes in health care included delays in care, medical cost-coping and benefits of virtual care. Financial difficulties included employment changes and benefits of remote work. The COVID-19 pandemic had an immense impact on the psychosocial health of AYA cancer survivors. It is essential that oncology providers and health care teams consider specific interventions to best serve the psychosocial needs of their AYA patients.
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Affiliation(s)
- Kelsey R Wolfe
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ashley Martinez
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Joyce E Dains
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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10
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Bonanno M, Desjardins L, Lugasi T, Carrier J, Labonté N, Sultan S, Coltin H, Perrault S, Provost C, Laverdière C, Cloutier N, Saragosti A, Régnier-Trudeau É, Koukoui B. Protocol for evaluation of the feasibility and preliminary efficacy of a targeted transition readiness workshop intervention for pediatric brain tumor survivors. Pilot Feasibility Stud 2024; 10:11. [PMID: 38243344 PMCID: PMC10797753 DOI: 10.1186/s40814-023-01437-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/21/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Pediatric brain tumor survivors (PBTS) are at risk of physical, cognitive, and psychosocial challenges related to their diagnosis and treatment. Routine follow-up care as adults is therefore essential to their long-term health and quality of life. In order to successfully navigate to adult healthcare, it is recommended that youth develop transition readiness skills. Existing transition readiness interventions often focus on disease management. However, PBTS are also at risk of social competence and cognitive functioning challenges. In this paper, we describe the protocol of this pilot study and the methodology that will be used for the evaluation of the feasibility, acceptability, and preliminary efficacy testing of the first targeted transition intervention workshops specifically designed to meet the needs of PBTS and their caregivers. METHODS This study will use a mixed method to evaluate three 1 ½-h workshops targeted for dyads (N = 40) of PBTS (14 years or older) and their parents. Dyads will be recruited via a community pediatric cancer organization and the long-term follow-up clinic of a large pediatric hospital. Participants will complete an online survey which includes the Transition Readiness Assessment Questionnaire (TRAQ) before and after the workshops. Each workshop will cover a specific topic related to PBTS transition readiness: disease management, social competence, and cognitive functioning. Workshops will follow the same structure: topic presentation, discussion by a post-transfer survivor or parent, teaching two strategies, and workshop evaluation. Workshops will be co-led by healthcare specialists and patient partners. Feasibility and acceptability will be assessed via recruitment, attendance, retention, and Likert scales, and they will be analyzed by describing and comparing rates. Satisfaction will be measured using satisfaction surveys and audio-recorded focus groups. Qualitative data will be described through thematic content analysis. In order to test the preliminary efficacy of this study, we will compare transition readiness skills pre- and post-workshops using paired samples T test and ANCOVA to examine the impact of workshop on TRAQ skills. DISCUSSION Results of the study will inform refinement and future broader implementation of targeted transition readiness workshops for the specific needs of pediatric brain tumor survivors.
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Affiliation(s)
- Marco Bonanno
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
- Sainte-Justine Research Health Center, Montreal, QC, Canada
| | | | - Tziona Lugasi
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Julie Carrier
- Department of Psychology, Université de Montréal, Montreal, Québec, Canada
| | - Nathalie Labonté
- École Des Petits-ExpCrateurs, Marie-Victorin School Board, Montreal, QC, Canada
| | - Serge Sultan
- Sainte-Justine Research Health Center, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, Québec, Canada
| | - Hallie Coltin
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Québec, Canada
| | - Sébastien Perrault
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Québec, Canada
| | - Carole Provost
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Caroline Laverdière
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Québec, Canada
| | - Nancy Cloutier
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Andrea Saragosti
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
| | | | - Benedicte Koukoui
- Hematology-Oncology Unit, Sainte-Justine University Health Center, Montreal, QC, Canada
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Neylon K, Condren C, Guerin S, Looney K. What Are the Psychosocial Needs of Adolescents and Young Adults with Cancer? A Systematic Review of the Literature. J Adolesc Young Adult Oncol 2023; 12:799-820. [PMID: 37130327 DOI: 10.1089/jayao.2022.0130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Adolescents and young adults with cancer (AYACs) have become recognized as a unique group in recent years. The unique developmental context and related challenges of being a young person with a cancer diagnosis can lead to a distinct and diverse set of psychosocial issues. Existing research has attempted to explore these psychosocial needs and challenges and to develop appropriate and individualized interventions. However, the needs of this group remain unmet, with ongoing calls for individualized support. This systematic review addressed the research question, "what are the psychosocial needs of AYACs aged 15-24 years?." PubMed, PsycINFO, and CINAHL databases were searched to identify relevant studies from January 2000 to December 2022 (inclusive). Qualitative, quantitative, and mixed methods designs were included and 29 studies met inclusion criteria. Findings provide an overview of needs from the existing literature and support the idea of a changing constellation of psychosocial needs for AYACs in areas such as identity, relationships, mental health, autonomy, and occupation. The main implications for theory and future research include the importance of the developmental context and consideration of discrepancies in the age range used within the literature to define this group.
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Affiliation(s)
- Karen Neylon
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Caoimhe Condren
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Kathy Looney
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
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Haines ER, Lux L, Stein J, Swift C, Matson M, Childers J, Kleissler D, Mayer DK, Steiner N, Steiner L, Rosenstein D, Gold S, Smitherman AB. Developing a Comprehensive Adolescent and Young Adult Cancer Program: Lessons Learned from 7 Years of Growth and Progress. J Adolesc Young Adult Oncol 2023; 12:868-878. [PMID: 37155196 PMCID: PMC10777816 DOI: 10.1089/jayao.2023.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Purpose: Every year, nearly 100,000 adolescents and young adults (15-39 years, AYAs) are diagnosed with cancer in the United States and many have unmet physical, psychosocial, and practical needs during and after cancer treatment. In response to demands for improved cancer care delivery for this population, specialized AYA cancer programs have emerged across the country. However, cancer centers face multilevel barriers to developing and implementing AYA cancer programs and would benefit from more robust guidance on how to approach AYA program development. Methods: To contribute to this guidance, we describe the development of an AYA cancer program at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center. Results: We summarize the evolution of UNC's AYA Cancer Program since it was established in 2015, offering pragmatic strategies for developing, implementing, and sustaining AYA cancer programs. Conclusion: The development of the UNC AYA Cancer Program since 2015 has generated many lessons learned that we hope may be informative to other cancer centers seeking to build specialized services for AYAs.
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Affiliation(s)
- Emily R. Haines
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Lauren Lux
- UNC Adolescent and Young Adult Cancer Program, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Jacob Stein
- Division of Oncology, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Catherine Swift
- UNC Adolescent and Young Adult Cancer Program, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Melissa Matson
- UNC Adolescent and Young Adult Cancer Program, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Julie Childers
- UNC Adolescent and Young Adult Cancer Program, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Daniel Kleissler
- Office of Clinical and Translational Research in Oncology, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Deborah K. Mayer
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Lucy Steiner
- Be Loud! Sophie Foundation, Chapel Hill, North Carolina, USA
| | - Donald Rosenstein
- Comprehensive Cancer Support Program, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Stuart Gold
- Pediatric Hematology-Oncology, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Andrew B. Smitherman
- Pediatric Hematology-Oncology, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
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Phan J, Laurence V, Marec-Berard P, Cordero C, Riberon C, Flahault C. The Place of Sick Peers in Adolescents and Young Adults with Cancer: Advantage, Disadvantage, and What Makes Barriers to the Encounter. J Adolesc Young Adult Oncol 2023; 12:879-889. [PMID: 36999900 DOI: 10.1089/jayao.2022.0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Purpose: The appreciation of peer support can vary from one country to another due to the cultural and relational differences. This study explores what perceptions French adolescents and young adults (AYAs) in post-treatment for cancer have of the place of sick peers during their treatment and what can make barriers to meet them. Methods: A semistructured interview has been proposed 6 months after the end of cancer treatments. A thematic analysis has been conducted to highlight the major themes and subthemes identified through the participants' discourses. Results: Twelve AYAs (mean age 23 y.o., standard deviation = 2.8; min = 19; max = 26) from two French cancer centers were interviewed. Five major themes were identified, but only two were presented in this article: the place of peers and the impact of coronavirus disease 2019 (COVID-19) epidemic on AYA facilities. AYA peers with cancer major theme demonstrated that meeting sick peers has benefits (e.g., identification, understanding, support, feeling of normalcy) but also has disadvantages (e.g., negative emotional influence). The benefits of peer-to-peer meetings seem to outweigh the disadvantages. Nevertheless, AYAs can face social barriers to this kind of relationship (e.g., fatigue, need to focus on oneself, confrontation to cancer and negative events, feeling of unnatural meeting). Finally, patients' encounters and the normal functioning of AYA facilities have been hampered by the COVID-19 pandemic. Conclusion: Even if AYA services systematically suggest a meeting with other sick peers, it is important to reiterate this proposal since the needs can evolve over time. It can also be interesting to propose places of life outside the hospital to make the encounters more comfortable and natural for AYAs. Clinical Trial Registration number: NCT03964116.
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Affiliation(s)
- Jeff Phan
- Psychopathology and Health Processes Laboratory, Paris Cité University, Boulogne Billancourt, France
- Adolescents and Young Adults Unit, Curie Institute, Paris, France
| | - Valérie Laurence
- Psychopathology and Health Processes Laboratory, Paris Cité University, Boulogne Billancourt, France
- Adolescents and Young Adults Unit, Medical Oncology and SIREDO (Care, Innovation and Research for Children, Adolescents, and Young Adults with Cancer) Departments, Curie Institute, Paris, France
| | - Perrine Marec-Berard
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Camille Cordero
- Adolescents and Young Adults Unit, Medical Oncology and SIREDO (Care, Innovation and Research for Children, Adolescents, and Young Adults with Cancer) Departments, Curie Institute, Paris, France
| | - Christèle Riberon
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Cécile Flahault
- Psychopathology and Health Processes Laboratory, Paris Cité University, Boulogne Billancourt, France
- Psycho-Oncology Unit, Gustave Roussy Hospital, Villejuif, France
- Functional Unit of Psychology and Liaison Psychiatry and Emergency, Adult and Elderly Psychiatry Service, George Pompidou European Hospital, Paris, France
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Baclig NV, Comulada WS, Ganz PA. Mental health and care utilization in survivors of adolescent and young adult cancer. JNCI Cancer Spectr 2023; 7:pkad098. [PMID: 37982744 PMCID: PMC10735415 DOI: 10.1093/jncics/pkad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/30/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Adolescent and young adult cancer survivors experience mental health challenges, yet little is known about the evolution of these difficulties. This study explored mental health symptoms and utilization among long-term adolescent and young adult cancer survivors. METHODS Using 30 432 respondents from the 2019 National Health Interview Survey, this study compared adults with a history of adolescent and young adult cancer (diagnosed when patients were between 15 and 39 years of age) to adults without adolescent and young adult cancer. Mental health symptom severity was measured using the Patient Health Questionnaire depression scale and 7-item Generalized Anxiety Disorder questionnaires. Care utilization constituted psychotherapy and mental health medication use. Inverse propensity score weights were used to balance demographics and combined with survey weights. Descriptive statistics, multivariable generalized linear models, and structural equation modeling with 2-sided tests were used for analysis. RESULTS We compared 639 adolescent and young adult survivors with 29 793 controls. Survivors were, on average, 20.5 years (SE = 0.74) past their cancer diagnosis dates. After adjusting for survey and propensity score weights, adolescent and young adult survivors reported more severe depression (incidence rate ratio = 1.42, 95% confidence interval [CI] = 1.09 to 1.84, P < .01) and anxiety (incidence rate ratio = 1.85, 95% CI = 1.55 to 2.21, P < .001). They were more likely to use psychotherapy (odds ratio = 1.91, 95% CI = 1.16 to 3.17, P < .05) and mental health medications (odds ratio = 1.89, 95% CI = 1.15 to 3.11, P < .05). Time since diagnosis was negatively associated with symptoms and utilization. Structural equation modeling demonstrated mediation of utilization effect by symptom severity. CONCLUSIONS Adolescent and young adult survivors experience worse mental health in late survivorship, despite small improvements over time. We highlight the importance of survivorship care that addresses the long-term mental health needs of these survivors.
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Affiliation(s)
- Nikita V Baclig
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Warren Scott Comulada
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Patricia A Ganz
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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15
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Son H, Haase JE, Docherty SL. The Concept of Double Protection in the Childhood Cancer Context. Cancer Nurs 2023; 46:335-343. [PMID: 37607369 DOI: 10.1097/ncc.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The concept of double protection is used to describe communication avoidance used by parents and their child or adolescents with cancer in attempts to protect the other against disease-related stress and emotions, resulting from communication about the cancer, its treatment, and thoughts. This concept has received limited attention in the research literature. OBJECTIVES The aims of this concept analysis are to (1) explore its defining characteristics, applicability, and utility, (2) spotlight the concept and increase awareness and interest among healthcare providers and researchers, and (3) provide a direction for future interventions to improve parent-child communication in the childhood cancer context. METHODS Rodgers' Evolutionary Concept Analysis was used, and the findings from a study that explored the communication experience of Korean adolescents with cancer and their parents were integrated. RESULTS This study explored the attributes, antecedents, consequences, and related terms. The following attributes were extracted: intention to protect, bidirectional, and absence of parent-child communication at a deeper level. CONCLUSION Clarification of the concept of double protection provides insight into the concept as a barrier to engagement in parent-child communication and supports the significance of double protection in the childhood cancer context. IMPLICATIONS FOR PRACTICE There is a need for increased awareness of the challenges and dangers inherent in family communication avoidance, double protection. In order to address the issue, developing developmentally appropriate and valid clinical assessment tool and interventions are required. More research on the evidence-based benefits of effective parent-child communication is also required.
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Affiliation(s)
- Heeyeon Son
- Author Affiliations: School of Nursing, Duke University, Durham, North Carolina (Mrs Heeyeon Son and Dr Docherty); and School of Nursing, Indiana University, Indianapolis, Indiana (Dr Haase)
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Salm S, Houwaart S, Cecon-Stabel N, Dresen A, Pfaff H, Scholten N, Krieger T. Integrating one-to-one peer support into psycho-oncological care in Germany: multi-perspective, mixed-methods evaluation of the isPO onco-guide service. J Cancer Res Clin Oncol 2023; 149:10399-10422. [PMID: 37273104 PMCID: PMC10240138 DOI: 10.1007/s00432-023-04951-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/27/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE One-to-one peer supporters called isPO onco-guides (isPO OGs) are an integral part of the new German psycho-oncological form of care 'integrated, cross-sectoral Psycho-Oncology' (isPO), additionally to professional care. The isPO OGs are cancer survivors with experiential knowledge, offering information on local support services and answering questions 'all around cancer' to newly diagnosed cancer patients. We aimed to evaluate the isPO OG service from three perspectives: patients, isPO OGs, and professional service providers. METHODS A mixed-methods approach was pursued. We conducted interviews and focus groups with the three person groups, and applied qualitative content analysis on the reported resources, processes and outcomes regarding the isPO OG service. Relations with patients' utilisation and isPO OGs' work satisfaction were identified with regression and correlation analyses of questionnaire and isPO care data. We compared isPO care networks (CN) with X2-tests or ANOVA. Qualitative and quantitative results were integrated during interpretation phase. RESULTS Qualitatively, the three person groups agreed on the benefits of the isPO OG service. The implementation's maturity differed between the CN concerning established processes and resource availability. Attitudes of professional service providers appeared to be crucial for patients' utilisation of the isPO OG service. Quantitative results emphasised the differences between the CN. CONCLUSION Beyond differences in the CN, the isPO OG service has two psychosocial benefits: providing relevant, reliable, and understandable information; and offering the encouraging example that surviving and living with cancer is possible. TRIAL REGISTRATION The study was registered in the German Clinical Trials Register (No. DRKS00015326) on 30.10.2018.
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Affiliation(s)
- Sandra Salm
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany.
- Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany.
| | - Stefanie Houwaart
- House of the Cancer Patient Support Associations of Germany (HKSH-BV), Bonn, Germany
| | - Natalia Cecon-Stabel
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany
- Unit of Health Services Research in Childhood and Adolescence, Clinic of General Pediatrics, Neonatology and Pediatric Cardiology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Antje Dresen
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Holger Pfaff
- Faculty of Medicine and University Hospital Cologne, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Quality Development and Evaluation in Rehabilitation, University of Cologne, Cologne, Germany
- Center for Health Services Research, University of Cologne, Cologne, Germany
| | - Nadine Scholten
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Theresia Krieger
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany
- Faculty of Medicine, Department of Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, University Hospital Cologne, Cologne, Germany
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Osmani V, Hörner L, Klug SJ, Tanaka LF. Prevalence and risk of psychological distress, anxiety and depression in adolescent and young adult (AYA) cancer survivors: A systematic review and meta-analysis. Cancer Med 2023; 12:18354-18367. [PMID: 37559504 PMCID: PMC10523984 DOI: 10.1002/cam4.6435] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer survivors (CS) face unique psychosocial challenges, which may affect their mental health. However, there are inconsistencies in AYA definitions and varying prevalence data on psychological distress, anxiety, and depression. We aimed to synthesize published literature on prevalence, risk, longitudinal changes, and predictors for these outcomes and estimate pooled prevalences. METHODS We searched for observational studies published in English before June 1 2022, in PubMed, PsycINFO, Scopus, and Web of Science. Two researchers extracted independently information on study characteristics, prevalence, and risk. The pooled prevalence (PP) of psychological distress, anxiety, and depression was estimated using random-effects models. Geographical region, treatment status, and assessment instruments were considered in stratified meta-analyses. RESULTS Sixty-eight studies were included in the systematic review and 57 in the meta-analyses. We estimated an overall prevalence of 32% (n = 30; 4226/15,213 AYAs; 95% CI, 23%-42%; I2 = 99%) for psychological distress, 29% for anxiety (n = 24; 2828/8751 AYAs; 95% CI, 23%-36%; I2 = 98%), and 24% (n = 35; 3428/16,638 AYAs; 95% CI, 18%-31%; I2 = 98%) for depression. The range of PP of psychological distress varied across geographical regions, treatment status, and assessment instruments. The PP of anxiety varied significantly across continents, while no variations were seen for depression. Studies found higher risks for psychological distress, anxiety, and depression in AYAs compared to older cancer survivors or cancer-free peers. CONCLUSIONS Our research found that one in three AYA-CS experience psychological distress or anxiety and one in four are affected by depression, highlighting the need for specialized psychological services for AYA-CS in oncology settings and AYA-focused interventions.
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Affiliation(s)
- Vanesa Osmani
- Chair of Epidemiology, TUM Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - Lucy Hörner
- Chair of Epidemiology, TUM Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - Stefanie J. Klug
- Chair of Epidemiology, TUM Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - Luana Fiengo Tanaka
- Chair of Epidemiology, TUM Department of Sport and Health SciencesTechnical University of MunichMunichGermany
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Elkefi S, Asan O. Perceived Patient Workload and Its Impact on Outcomes During New Cancer Patient Visits: Analysis of a Convenience Sample. JMIR Hum Factors 2023; 10:e49490. [PMID: 37594798 PMCID: PMC10474510 DOI: 10.2196/49490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/01/2023] [Accepted: 07/14/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Studies exploring the workload in health care focus on the doctors' perspectives. The ecology of the health care environment is critical and different for doctors and patients. OBJECTIVE In this study, we explore the patient workload among newly diagnosed patients with cancer during their first visit and its impact on the patient's perceptions of the quality of care (their trust in their doctors, their satisfaction with the care visits, their perception of technology use). METHODS We collected data from the Hackensack Meridian Health, John Theurer Cancer Center between February 2021 and May 2022. The technology use considered during the visit is related to doctors' use of electronic health records. A total of 135 participants were included in the study. Most participants were 50-64 years old (n=91, 67.41%). A majority (n=81, 60%) of them were White, and only (n=16, 11.85%) went to graduate schools. RESULTS The findings captured the significant effect of overall workload on trust in doctors and perception of health IT use within the visits. On the other hand, the overall workload did not impact patients' satisfaction during the visit. A total of 80% (n=108) of patients experienced an overall high level of workload. Despite almost 55% (n=75) of them experiencing a high mental load, 71.1% (n=96) reported low levels of effort, 89% (n=120) experienced low time pressure, 85.2% (n=115) experienced low frustration levels, and 69.6% (n=94) experienced low physical activity. The more overall workload patients felt, the less they trusted their doctors (odds ratio [OR] 0.059, 95% CI 0.001-2.34; P=.007). Low trust was also associated with the demanding mental tasks in the visits (OR 0.055, 95% CI 0.002-2.64; P<.001), the physical load (OR 0.194, 95% CI 0.004-4.23; P<.001), the time load (OR 0.183, 95% CI 0.02-2.35; P=.046) the effort needed to cope with the environment (OR 0.163, 95% CI 0.05-1.69; P<.001), and the frustration levels (OR 0.323, 95% CI 0.04-2.55; P=.03). The patients' perceptions of electronic health record use during the visit were negatively impacted by the overall workload experienced by the patients (OR 0.315, 95% CI 0.08-6.35; P=.01) and the high frustration level experienced (OR 0.111, 95% CI 0.015-3.75; P<.001). CONCLUSIONS The study's findings established pathways for future research and have implications for cancer patients' workload. Better technology design and use can minimize perceived workload, which might contribute to the trust relationship between doctors and patients in this critical environment. Future human factors work needs to explore the workload and driving factors in longitudinal studies and assess whether these workloads might contribute to unintended patient outcomes and medical errors.
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Affiliation(s)
- Safa Elkefi
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
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Wittwer A, Sponholz K, Frietsch JJ, Linke P, Kropp P, Hochhaus A, Hilgendorf I. Psychosocial distress in young adults surviving hematological malignancies: a pilot study. J Cancer Res Clin Oncol 2023; 149:5655-5663. [PMID: 36527483 PMCID: PMC10356626 DOI: 10.1007/s00432-022-04527-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Survivors of cancer during young adulthood face multiple psychosocial challenges following treatment. This study explores psychosocial distress and unmet needs among young adult survivors treated of hematological malignancies. METHODS A total of 85 young adults aged between 18 and 39 years at time of diagnosis, were invited to join the survey after the completion of treatment with curative intent. Sociodemographic data and the need for advice were gathered with a self-report questionnaire. A set of standardized questionnaires for quality of life (EORTC QLQ-C30), psychosocial stressors (PHQ-S), fear of progression (PA-F-KF), cancer-related fatigue (EORTC QLQ-FA12), and symptoms of anxiety (GAD-7) or depression (PHQ-9) was employed. Descriptive statistics and multivariate analysis were conducted. RESULTS Forty-seven young adult cancer survivors responded. A quarter of patients (26%) reported depressive symptoms, 15% suffered from anxiety, 36% from fear of progression, and 21% reported increased psychosocial stressors. They had a lower QoL than the general population and reported poorer outcomes on all single-item and multi-symptom scales. Employment was significantly associated with lower levels of psychosocial distress, anxiety, fatigue, and better QoL. CONCLUSION Young adult cancer survivors exhibited a high disposition for psychosocial distress. They reported excessive demands in everyday life and resumption of work. However, a longitudinal study of young adult cancer survivors is needed to confirm the results of this pilot study. In future, psycho-oncological and social support need to become an inherent part of the aftercare of survivors of young adult cancer survivors.
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Affiliation(s)
- Andreas Wittwer
- Abteilung für Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Kristin Sponholz
- Abteilung für Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
- Psychotherapie und Psychoonkologie, Institut für Psychosoziale Medizin, Universitätsklinikum Jena, Jena, Germany
| | - Jochen J Frietsch
- Abteilung für Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Paul Linke
- Abteilung für Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Peter Kropp
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Rostock, Germany
| | - Andreas Hochhaus
- Abteilung für Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Inken Hilgendorf
- Abteilung für Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
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Jäkel K, Richter D, Leuteritz K, Sender A, Hinz A. Sexuality, fertility, family planning, family life, and partnership in young breast cancer patients: a longitudinal study. Front Psychol 2023; 14:1127359. [PMID: 37251020 PMCID: PMC10213958 DOI: 10.3389/fpsyg.2023.1127359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Objectives Adolescent and young adult (AYA) breast cancer patients are often faced with sexuality-related problems. Since healthcare providers are often unfamiliar with problems specific to AYA cancer this topic is too little integrated into routine oncological care. The objective of this study was to analyze sexuality, fertility, family planning, family life, and partnership regarding satisfaction and supportive care needs in AYA breast cancer patients. Methods A total of 139 AYA breast cancer patients were examined twice, 1 year apart. The patients were asked to complete several questionnaires and to answer multiple questions about satisfaction with sexuality, fertility, family planning, family life, and corresponding supportive care needs in these domains. Results While the patients were largely satisfied with their family life and partnerships, they were less satisfied with their sexuality and family planning. Only small mean score changes were observed in these variables over the course of a year. Being a parent already and having the possibility of further completing family planning were strongly associated with higher satisfaction and lower supportive care needs in these domains. Satisfaction was generally negatively associated with supportive care needs. Older age was predictive of lower satisfaction with sexuality at follow-up. Conclusion AYA cancer patients deserve special consultations concerning the impact of cancer and treatment on their sexuality and fertility, and it is especially important that women who have yet to complete their family planning be actively offered information and support concerning sexuality and fertility protection before beginning treatment.
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Haines ER, Lux L, Swift C, Matson M, Kleissler D, Stein J, Childers J, Salsman JM, Smitherman AB. The Adolescent and Young Adult Needs Assessment & Service Bridge (NA-SB): A single-arm feasibility pilot study. J Psychosoc Oncol 2023; 42:16-31. [PMID: 36960673 PMCID: PMC10518024 DOI: 10.1080/07347332.2023.2192715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
PURPOSE In this pilot study, we evaluated the feasibility of implementing the Needs Assessment & Service Bridge (NA-SB)- an intervention to address the pervasive unmet needs of adolescents and young adults (AYAs) during cancer treatment. METHODS We conducted a mixed methods single-arm feasibility pilot study of NA-SB at the North Carolina Basnight Cancer Hospital. Eligible participants were AYAs ages 18-39 in active cancer treatment. After receiving NA-SB, participants completed a postintervention survey assessing their perceptions of NA-SB. We interviewed participating providers to assess their implementation experiences. RESULTS On average, AYA participants (n = 26) rated NA-SB's feasibility as 4.5/5, its acceptability as 4.5/5, and its appropriateness as 4.4/5. 77% of participants agreed or strongly agreed that their needs were met in the study period. CONCLUSION This pilot study generated preliminary evidence to establish NA-SB's feasibility as well as proof of concept for the intervention as a viable approach for identifying and addressing AYAs' unmet needs.
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Affiliation(s)
- Emily R Haines
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Lauren Lux
- Adolescent and Young Adult Cancer Program, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Catherine Swift
- Adolescent and Young Adult Cancer Program, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Melissa Matson
- Adolescent and Young Adult Cancer Program, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Daniel Kleissler
- Office of Clinical and Translational Research in Oncology, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Jacob Stein
- Division of Oncology, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Julie Childers
- Adolescent and Young Adult Cancer Program, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - John M Salsman
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Andrew B Smitherman
- Pediatric Hematology-Oncology, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
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22
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Zhang A, Froerer A. A Clinical Case Study of Solution-Focused Brief Therapy for Young Adult Cancer Patients’ Psychological Distress: Focusing on Positive Emotions. Clin Case Stud 2023. [DOI: 10.1177/15346501231161776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Psychological distress is highly prevalent among adolescent and young adult (AYA) cancer patients, an age-defined population (15–39) disproportionately impacted by their cancer diagnosis. Solution-focused brief therapy (SFBT) is a strength-based and evidence-supported approach for youth with medical conditions. The use of SFBT in young cancer patients, however, has been rarely described. Building on the broaden-and-build theory of positive emotions, this study describes how SFBT clinicians intentionally foster positive emotions, especially hope, in an AYA cancer patient to foster therapeutic change. We found improvements in the patient’s psychological distress as well as growth in levels of hope both in the immediate post-intervention assessment and in the 2-week follow-up. The findings of the study suggested that SFBT is a promising approach to the unique challenges confronting AYAs with cancer. It was not feasible for this case study to match the sex and racial identities for a therapist with the client’s preference, which is considered a main limitation of this study.
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Affiliation(s)
- Anao Zhang
- University of Michigan, Ann Arbor, MI, USA
- University of Michigan Health, Ann Arbor, MI, USA
| | - Adam Froerer
- The Solution Focused Universe, Arlington, TX, USA
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23
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Sharp J, Mulcare H, Schofield P. Trajectories of distress in women with gynaecological cancer treated with curative-intent radiotherapy. Psychol Health 2023:1-19. [PMID: 36628613 DOI: 10.1080/08870446.2022.2162555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/11/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aims of this study were to investigate trajectories of anxiety and depression symptoms among gynaecological cancer (GC) patients having curative-intent radiotherapy (RT) treatment and identify which patient characteristics predict anxiety and depression trajectories. METHODS AND MEASURES Latent profile analysis (LPA) was used to identify unique trajectories of anxiety and depression symptoms, spanning prior to the start of RT until 12-month post-RT, among 151 GC patients in the PeNTAGOn randomized control trial. Demographic and clinical characteristics were assessed at baseline, and anxiety and depression symptoms were assessed five times over 12 months. A bias-adjusted 3-step maximum likelihood approach was used to identify demographic and clinical predictors of trajectory profiles. RESULTS Four latent profiles each were identified for anxiety and depression trajectories. Most patients had minimal to mild levels of anxiety or depression that remained steady or declined over 12 months following treatment. A minority of patients were in profiles that exhibited clinically significant distress; either 'High fluctuating' anxiety or 'Mild-moderate fluctuating' depression. Anxiety and depression profiles were predicted by clinical and demographic factors, such as age, living arrangements, RT type, cancer stage, physical symptom distress and use of support services. CONCLUSIONS Psychological care of patients in the higher distress trajectories is paramount and, importantly, they could be identified prior to treatment based on the factors identified. Review for at least a month post-RT is warranted.
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Affiliation(s)
- Jessica Sharp
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Hunter Mulcare
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
- Psychology Department, Western Health, St Albans, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
- Behavioural Sciences Unit, Health Service Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
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24
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Deleemans JM, Samnani S, Lloyd C, Alimohamed N. Improving adherence and health outcomes in testicular cancer survivors using a mobile health-based intervention: A mixed-methods pilot study. Digit Health 2023; 9:20552076231167002. [PMID: 37113254 PMCID: PMC10126680 DOI: 10.1177/20552076231167002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/15/2023] [Indexed: 04/29/2023] Open
Abstract
Objective Testicular cancer (TC) is one of the most common cancers among young men, with survival rates exceeding 97% due to effective treatments. Post-treatment follow-up care is important for long-term survival and monitoring psychosocial symptoms, yet TC survivors (TCS) show poor adherence to post-treatment care. Mobile-health-based interventions show high acceptability in men with cancer. This study will examine the feasibility of using the Zamplo health app to improve adherence to post-treatment care and support psychosocial outcomes in TCS. Methods This mixed-methods, longitudinal, single-arm pilot study will recruit N = 30 patients with a diagnosis of TC who finished treatment within ≤ 6 months and are currently aged ≥18 years old. Adherence to follow-up appointments (e.g. blood work, scans) will be assessed (primary outcome), and measures for fatigue, depression, anxiety, sexual satisfaction and function, social roles satisfaction, general mental and physical health and body image (secondary outcomes) will be completed at four-time points: baseline, 3, 6 and 12 months. One-on-one semi-structured interviews will be conducted post-intervention (month 12). Results Improvements in post-treatment follow-up appointment adherence and psychosocial outcomes will be analyzed using descriptive statistics, paired samples t-tests to determine changes across time points 1 through 4, and correlation analysis. Qualitative data will be analyzed using thematic analysis. Conclusion Findings will inform future, larger trials that incorporate evaluation of sustainability and economic implications to improve adherence to TC follow-up guidelines. Findings will be disseminated via infographics, social media, publications and presentations conducted in partnership with TC support organizations and at conferences.
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Affiliation(s)
- Julie M Deleemans
- Department of Oncology, Cumming School
of Medicine, University of Calgary, Calgary, Canada
- Zamplo Research Inc., Calgary,
Canada
- Julie M Deleemans, Tom Baker Cancer Centre,
1331 29th Street NW, Calgary, AB, T2N 4N2, Canada.
| | - Sunil Samnani
- Department of Oncology, Cumming School
of Medicine, University of Calgary, Calgary, Canada
| | - Chris Lloyd
- OneBall Charitable Cancer Organization,
Calgary, Canada
| | - Nimira Alimohamed
- Department of Oncology, Cumming School
of Medicine, University of Calgary, Calgary, Canada
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25
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Halkett GKB, Lobb E, Spilsbury K, Dhillon H, Nowak AK. Brain cancer patients' levels of distress and supportive care needs over time. Psychooncology 2022; 31:2074-2085. [PMID: 36086830 PMCID: PMC10087040 DOI: 10.1002/pon.6028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/07/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE This study aimed to describe patient self-reported distress over time and how this was associated with wellbeing, and supportive care needs over a 6-month period from commencing chemoradiotherapy for high grade glioma (HGG). METHODS In this prospective cohort study, participants completed surveys at three time points: before chemoradiotherapy, at 3 and 6 months. These included Distress Thermometer, Functional Assessment of Cancer/Brain Cancer Treatment-general (Fact-G/FACT-BR), Supportive Care Needs Scale (SF-34) and Brain Tumour Specific subscale. Patient survival time was also collected. Group-based trajectory modelling was performed. Multinominal logistic regression assessed variables associated with different distress trajectory groups. RESULTS One hundred and sixteen participants completed assessments at baseline, 89 participants at 3 and 64 at 6 months. Four distress trajectory groups were identified; consistent low distress (18%), low to high distress (38%), high-to low distress (24%) and consistent high distress (19%). Younger participants tended to report decreased distress over time, whereas older participants reported consistently high distress. High distress trajectory participants had less education, lower physical wellbeing, more unmet needs, but higher functional wellbeing compared to the low to high distress trajectory. The number of unmet needs paralleled the patterns of distress over time. The highest unmet needs in people with HGG and high distress were disease specific changes in mental ability and physical side effects. CONCLUSION This study demonstrates people with HGG experience ongoing distress and highlights a need for continuous distress and unmet needs screening and referrals.
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Affiliation(s)
- Georgia K B Halkett
- Curtin School of Nursing, Faculty of Health Sciences, Perth, Western Australia, Australia.,Curtin Health Innovation Research Institute (CHIRI), Curtin University, Bentley, Western Australia, Australia
| | - Elizabeth Lobb
- Calvary Health Care Kogarah, Sydney, New South Wales, Australia.,School of Medicine, The University of Notre Dame, Sydney, New South Wales, Australia.,Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Katrina Spilsbury
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Haryana Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia.,Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
| | - Anna K Nowak
- Medical School, University of Western Australia, Nedlands, Western Australia, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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26
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Gu R, Chen H, Wang X, Jin X, Jiang F, Zhao W, Yun J, Zhou J, Wang H. The mediating role of appraisal on health-related quality of life in adolescent and young adult cancer survivors. Qual Life Res 2022; 32:1069-1084. [PMID: 36260164 DOI: 10.1007/s11136-022-03269-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer survivors (first diagnosed with cancer at age 15-39) are distinct within the cancer community due to their unique challenges and diverse psycho-behavioral characteristics. This study aimed to analyze psycho-behavioral pathways and further explore the mediating role of cognitive appraisals on AYA cancer survivors' quality of life (QoL). METHODS Three hundred and eighty-nine AYA cancer survivors were eligible for analyses and recruited to self-administer questionnaires on QoL (the Chinese version of EORTC Quality of Life Questionnaire-C30 v3.0), resilience, coping, and appraisal on site. This study performed structural equation modeling (SEM) to examine pathways on QoL based on the Rapkin & Schwartz QoL Appraisal Model. RESULTS The average age of participants (47.6% female) was 32.7 ± 4.1 years. The SEM results closely fit the measured data (RMSEA = 0.053, GFI = 0.955, CFI = 0.964, SRMR = 0.052). The final model showed direct negative effects of later clinical-stage, more comorbidities, and more Acceptance-Resignation coping on QoL; indirect positive effects of better resilience on QoL through less Acceptance-Resignation coping (β = 0.286, P = 0.002). Appraisal mediated the effects of treatment and resilience on QoL (β = -0.024, P = 0.038). Further, Calm, Peaceful, and Active appraisal patterns were associated with improved Cognitive Functioning (β = 0.119, P = 0.009). CONCLUSION Appraisal, coping, and resilience could significantly mediate the effects of cancer and its treatment on the QoL of AYA cancer survivors. Future interventions targeting cognitive appraisals and psycho-behaviors will be helpful. Figuring out what matters to such a unique population and how they appraise a cancer diagnosis through treatment trajectories could help nurses adjust support.
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Affiliation(s)
- Renjun Gu
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Hao Chen
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Xian Wang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Xiaoyuan Jin
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Fengyang Jiang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Wenhe Zhao
- Department of Tumor Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Jingyi Yun
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Jie Zhou
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Hongmei Wang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China.
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27
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Markwardt HS, Taghavi SE, Williams AP, Olivares MN, McDuffee PR, Al Achkar M, Hall BC. The AYA Care Plan: Initial Evaluation of a Web-Based Psychosocial Intervention. JCO Clin Cancer Inform 2022; 6:e2200086. [DOI: 10.1200/cci.22.00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Adolescents and young adults (AYA) with cancer do not fit neatly into pediatric or older adult oncology care settings. Recent efforts have led to the development of psychosocial interventions for AYAs, but studies show AYAs demonstrate low levels of engagement in psychosocial services. The AYA Care Plan is one of the only web-based tools providing a personalized, psychosocial resource that addresses unmet needs for AYAs in active treatment and post-treatment survivorship. The current study aims to assess the usability and utility of the AYA Care Plan and identify opportunities for improvement. METHODS Clinic staff administered an online distress and needs assessment to AYA patients with cancer at outpatient oncology clinics. Personalized care plans were sent to participants on the basis of their responses. A total of 11 AYAs between the ages 18 and 39 years, with a mean age of 31.64 years, then completed qualitative interviews about their experiences. Thematic analysis was used to identify themes on the AYA Care Plan. RESULTS A majority of participants reported positive usability features. Half of the participants reported using their care plan to make health care decisions. One person indicated not finding the resources helpful, and the other half of participants reported not engaging with the care plan. Participants also offered suggestions for improvement. CONCLUSION The AYA Care Plan appears to be a useful psychosocial intervention for some AYAs with cancer. Future research should continue to examine the AYA Care Plan's usability and utility, and specify when, how, and for whom the AYA Care Plan is useful.
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Affiliation(s)
- Haley S. Markwardt
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX
- UT Southwestern Moncrief Cancer Institute, Fort Worth, TX
| | - Sarah E. Taghavi
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX
- UT Southwestern Moncrief Cancer Institute, Fort Worth, TX
| | | | | | | | | | - Brittany C. Hall
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX
- UT Southwestern Moncrief Cancer Institute, Fort Worth, TX
- Fort Worth Adolescent Young Adult Oncology Coalition, Fort Worth, TX
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28
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Patient perspectives on testing for clonal hematopoiesis of indeterminate potential. Blood Adv 2022; 6:6151-6161. [PMID: 36129839 PMCID: PMC9791300 DOI: 10.1182/bloodadvances.2022008376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 12/30/2022] Open
Abstract
Clonal hematopoiesis of indeterminate potential (CHIP), an emerging biomarker for personalized risk-directed interventions, is increased in cancer survivors. However, little is known about patient preferences for CHIP testing. We surveyed participants in a prospective cohort study of young women with breast cancer (BC). The emailed survey included an introduction to CHIP and a vignette eliciting participants' preferences for CHIP testing, considering sequentially: population-based 10-year risk of BC recurrence, hematologic malignancy, and heart disease; increased CHIP-associated risks; current CHIP management; dedicated CHIP clinic; and hypothetical CHIP treatment. Preference changes were evaluated using the McNemar test. The survey response rate was 82.2% (528/642). Median age at time of survey was 46 years and median time from diagnosis was 108 months. Only 5.9% had prior knowledge of CHIP. After vignette presentation, most survivors (87.1%) recommended CHIP testing for the vignette patient. Presented next with CHIP-independent, population-based risks, 11.1% shifted their preference from testing to not testing. After receiving information about CHIP-associated risks, an additional 10.1% shifted their preference to testing. Preference for testing increased if vignette patient was offered a CHIP clinic or hypothetical CHIP treatment, with 7.2% and 14.1% switching preferences toward testing, respectively. Finally, 75.8% of participants desired CHIP testing for themselves. Among participants, 28.2% reported that learning about CHIP caused at least moderate anxiety. Most young survivors favored CHIP testing, with preferences influenced by risk presentation and potential management strategies. Our findings highlight the importance of risk communication and psychosocial support when considering biomarkers for future risk in cancer survivors. This trial has been registered at www.clinicaltrials.gov as #NCT01468246.
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29
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Masoudifar Z, Rassouli M, Ashrafizadeh H, Fathollah Zadeh E, Dadashi N, Khanali Mojen L. Unfulfilled psychosocial needs of the adolescent siblings of patients with cancer and the identification of the related factors. Front Psychol 2022; 13:983980. [PMID: 36211937 PMCID: PMC9534179 DOI: 10.3389/fpsyg.2022.983980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe diagnosis of cancer in a child is a stressful experience for the entire family, particularly for adolescent or young adult siblings and their psychosocial needs (PSNs) may remain unfulfilled. The aim of the study was to assess the unfulfilled PSNs of the adolescent siblings of patients with cancer in Iran and examine the relationships between demographic and medical variables and PSNs.MethodsThis descriptive analytical study was conducted in 2019 in seven teaching hospitals in Tehran, Iran. Participants were 188 adolescent siblings of patients with cancer. Sampling was performed consecutively. Data were collected using a demographic and clinical characteristics questionnaire and the Sibling Cancer Needs Instrument (SCNI). To investigate the relationship between demographic variables and the mean score of PSNs subscales, first, the correlation was determined, and afterward, the significant variables were analyzed using multiple linear regression.ResultsIn total, 180 adolescent siblings completed the study. Their mean age was 15.66 ± 2.55 years and the mean summary score of their PSNs was 121.15 ± 32.73. Around 80.60% of adolescents indicated at least one unmet need related to each question. The most common unfulfilled needs of participants were related to the information about sibling’s cancer dimension (INFO) (mean: 2.94 ± 0.79) and the less common unfulfilled needs were related to the practical assistance dimension (UFAM) (mean: 2.38 ± 0.93). Based on the regression coefficients, a significant relationship was observed between the mean summary score of PSNs with the duration of cancer (β = –2.199, p = 0.006) and mother’s age (β = –2.805, p = 0.029).ConclusionThe adolescent siblings of patients with cancer have different unfulfilled PSNs, particularly respecting information about their siblings’ cancer and support for emotional coping. Family members and healthcare providers should provide these adolescents with strong informational support and fulfill their needs in order to promote their health and their emotional coping.
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Affiliation(s)
- Zeynab Masoudifar
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadis Ashrafizadeh
- Student Research Committee, Faculty of Nursing, Dezful University of Medical Sciences, Dezful, Iran
| | - Ensieh Fathollah Zadeh
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Nasrin Dadashi
- Department of Nursing, Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Khanali Mojen
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Leila Khanali Mojen,
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30
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Phan J, Vander Haegen M, Karsenti L, Laurence V, Marec-Berard P, Cordero C, Thisse A, Riberon C, Flahault C. Psychological Adjustment, Adaptation, and Perception of Social Support in French Adolescents and Young Adults After the Diagnosis of Cancer. J Adolesc Young Adult Oncol 2022. [PMID: 36067271 DOI: 10.1089/jayao.2022.0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The third Cancer Plan (2014-2019) has helped with the recognition of adolescents and young adults (AYAs) with cancer's medical and psychosocial specificities and has enabled the creation of dedicated structures in France. Methods: The study involved 43 AYA patients (Nmen = 21; Nwomen = 22) between 15 and 27 years old (Mage = 19.9), diagnosed with all types of cancer, and were recruited in two French cancer centers. Online questionnaires were filled in 2 months after the beginning of treatment. AYAs completed measures of depressive and anxiety symptoms, perceived social support, and coping strategies. Results: Results demonstrated moderate depressive symptoms (M = 10.7, standard deviation [SD] = 7.0) and suggested a good satisfaction (M = 30, SD = 9.5) and a mild availability (M = 27, SD = 10.3) of the social support. Spearman's correlations demonstrated that coping strategies are related to depressive symptoms, for which acceptance (p < 0.01) of the disease played a key role in their psychological adjustment. Perceived social support subscales were positively correlated with the use of distraction as a coping strategy (p < 0.05). Kruskal-Wallis test demonstrated the preferential use of instrumental (p < 0.05) and emotional support (p < 0.01), denial (p < 0.01), and self-blame (p < 0.01) for women and the use of acceptance (p < 0.05) and humor (p < 0.05) for men; and there were no significant differences between patients hospitalized in the two cancer center facilities. Conclusion: Finally, a better understanding of the psychological adjustment and processes among French AYAs with cancer will help families and processionals to better adjust AYA-specific needs at the beginning of cancer treatment. ClinicalTrials.gov.: NCT03964116.
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Affiliation(s)
- Jeff Phan
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Adolescents and Young Adults Unit, Curie Institute, Paris, France
| | - Marie Vander Haegen
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Unit of Research: Health and Society Interfaculty, Liège University, Liège, Belgium.,Haute École Léonard de Vinci, Brussels, Belgium
| | - Lucille Karsenti
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Adolescents and Young Adults Unit, Curie Institute, Paris, France.,Psycho-Oncology Unit, Gustave Roussy Hospital, Villejuif, France
| | - Valérie Laurence
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Adolescents and Young Adults Unit, Medical Oncology and SIREDO (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer) Departments, Curie Institute, Paris, France
| | - Perrine Marec-Berard
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Camille Cordero
- Adolescents and Young Adults Unit, Medical Oncology and SIREDO (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer) Departments, Curie Institute, Paris, France
| | - Audrey Thisse
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Christèle Riberon
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Cécile Flahault
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Psycho-Oncology Unit, Gustave Roussy Hospital, Villejuif, France.,Functional Unit of Psychology and Liaison Psychiatry and Emergency, Adult and Elderly Psychiatry Service, George Pompidou European Hospital, Paris, France
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31
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Shrivastava SP, Elhence A, Jinwala P, Bansal S, Chitalkar P, Bhatnagar S, Patidar R, Asati V, Reddy PK. Assessment of Psychological Distress Among Indian Adolescents and Young Adults with Solid Cancer Using the National Comprehensive Cancer Network Distress Thermometer. South Asian J Cancer 2022. [DOI: 10.1055/s-0042-1756184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological distress among Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) distress thermometer.
Methods The demographic and clinical characteristics of AYAs patients (age 15–39 years) with cancer were recorded. Assessment of psychological distress of patients using the NCCN distress thermometer was performed at three time points over a period of 3 months. Distress thermometer scale and a self-administered questionnaire in English and Hindi languages was handed over to participants at three time points: at treatment commencement (T1), at 1 month, and 3 months (T2 and T3, respectively) into therapy.
Results Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤ 24 years old and 188 (73%) were>24 years old. Bone sarcoma (39%) was common cancer in AYA patients aged ≤ 24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were the highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. The distress score in the age ≤ 24 years was the highest (6.7) at T1, followed by those measured at T2 (2.6) and T3 (1.1) and among age>24 years was the highest (6.6) at T1, followed by those measured at T2 (2.6) and T3 (1.2). Among AYA patients>24 years old, worry, nervousness, sadness, transportation, and sleep were the top five identified problems and in ≤ 24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness.
Conclusion Adolescents and young adults experience some level of distress associated with the cancer diagnosis, effects of the disease, treatment regardless of the stage and various transitions throughout the trajectory of the disease. The distress thermometer is an easy and useful tool for the assessment of psychological distress in AYA cancers. Early identification of distress burden with the distress thermometer leads to effective interventions in patients with cancer which could improve outcomes including survival in AYAs with cancer in India.
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Affiliation(s)
- Shiv Prasad Shrivastava
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Aditya Elhence
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prutha Jinwala
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shashank Bansal
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prakash Chitalkar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shweta Bhatnagar
- Department of Radiology, CHL Hospital, Indore, Madhya Pradesh, India
| | - Rajesh Patidar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Vikas Asati
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Pradeep Kumar Reddy
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Pettit T, Proffit E, Reid J, Dobinson H, Waugh V, Sue L, Vincent T, McMillan S, Hemmaway C, Kilpatrick K, Wilding E, Watson H, Ballantine K. "I Don't Have to be Sick to Still Be Worthy": The Barriers Experienced by Adolescent and Young Adult Cancer Survivors in New Zealand. J Adolesc Young Adult Oncol 2022. [PMID: 35917507 DOI: 10.1089/jayao.2022.0051] [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: 11/12/2022] Open
Abstract
Purpose: To identify the spectrum and nature of survivorship barriers experienced by New Zealand's adolescent and young adult (AYA) cancer survivor population. In addition, we explore associations between survivorship barriers and sociodemographic characteristics, cancer type, and day-to-day happiness following the end of treatment. Methodology: Participants were recruited for the online survey from AYA cancer service patient databases. Eligibility criteria included: aged 12-24 years at diagnosis, diagnosed between 2010 and 2019, and completed treatment at least one year prior. The analysis focused on 11 barriers (domains, issues, or concerns) which respondents may have faced during survivorship. Results: Two hundred and eighteen AYA survivors participated in the study. The mean number of impactful survivorship barriers was 2.5 (standard deviation 1.7), with 13 respondents (6.0%) reporting no barriers of concern and 31 (14.2%) reporting 5 or more. A higher number of impactful barriers was associated with lower day-to-day happiness (r = -0.34, p ≤ 0.001). The most commonly identified impactful survivorship barriers were mental health (50.0% of respondents), physical health (43.1%), thinking and memory (33.0%), education and work (27.1%), social life (26.1%), and fertility (22.5%). Subgroup analysis identified significant differences according to gender, age at diagnosis, tumor group, ethnicity, and time since diagnosis. Poor access to health care and unmet needs were common themes. Positive impacts, particularly with regards to family relationships, were also identified. Conclusion: These results will inform initiatives to improve AYA survivorship care in New Zealand. Gaps in service delivery and funding will need to be overcome by utilizing innovative strategies and broad sector engagement.
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Affiliation(s)
- Tristan Pettit
- Children's Haematology Oncology Centre, Waipapa Hospital, Christchurch, New Zealand
| | - Ellyn Proffit
- Midland AYA Cancer Services, Waikato Hospital, Hamilton, New Zealand
| | - Julia Reid
- Department of Paediatrics and Child Health, Wellington Regional Hospital, Wellington, New Zealand
| | - Hazel Dobinson
- Department of Paediatrics and Child Health, Wellington Regional Hospital, Wellington, New Zealand
| | - Val Waugh
- Southern Blood & Cancer Service, Dunedin Hospital, Dunedin, New Zealand
| | - Louise Sue
- Canterbury AYA Cancer Services, Waipapa Hospital, Christchurch, New Zealand
| | - Tracey Vincent
- Auckland & Northland AYA Cancer Services, Auckland City Hospital, Auckland, New Zealand
| | - Simone McMillan
- Auckland & Northland AYA Cancer Services, Auckland City Hospital, Auckland, New Zealand
| | - Claire Hemmaway
- Department of Haematology, Auckland City Hospital, Auckland, New Zealand
| | - Kate Kilpatrick
- Department of Haematology, Auckland City Hospital, Auckland, New Zealand
| | - Eleanor Wilding
- Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Heidi Watson
- AYA Cancer Network Aotearoa, Auckland, New Zealand
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Park M, Kwon SY, Yun H, Lyu CJ, Han JW, Hahn SM, Jung M, Rha SY, Beom SH, Lee CK, Jang H. Care Needs of Adolescents and Young Adults with Cancer Undergoing Active Treatment in South Korea: A Mixed Methods Study. J Adolesc Young Adult Oncol 2022. [PMID: 35904961 DOI: 10.1089/jayao.2022.0030] [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: 11/12/2022] Open
Abstract
Purpose: Adolescents and young adults (AYAs) with cancer have special care needs that are different from those of children and older adults with cancer. This study assessed the perspective and experience of AYAs with cancer in South Korea to identify their care needs. Methods: This study used a convergent mixed-methods design. From July 2020 to November 2021, AYAs with cancer (N = 77; 15-39 years of age) participated in a quantitative cross-sectional study, using a tool developed by our study team. In May 2021, a qualitative focus group was conducted with 10 AYAs with cancer. Integrated analyses were conducted concurrently by reporting the quantitative and qualitative findings together. Results: Quantitative findings revealed that the highest care need domains were communication and information, whereas the highest care priority item was the management of pain and symptoms occurring during the treatment. Qualitative findings revealed 12 themes across 5 domains. Comparing and merging of the quantitative and qualitative data resulted in eight confirmed themes and four expanded findings, including knowing people who overcame similar illnesses, fear of death, dedicated space, and a program for AYAs with cancer. Conclusion: When developing and implementing programs and health care services, especially in countries with no established program or cancer specialty unit for AYAs with cancer, it is important to consider the special care needs and priorities of AYAs with cancer. This mixed methods study provided empirical evidence to help understand and prioritize the needs of AYAs with cancer undergoing active treatment in South Korea.
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Affiliation(s)
- Mina Park
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Seung Yeon Kwon
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Palliative Care Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - Hyeseon Yun
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Chuhl Joo Lyu
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Woo Han
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Min Hahn
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyu Jung
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea.,Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Sun Young Rha
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.,Department of Internal Medicine, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung-Hoon Beom
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Choong-Kun Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeju Jang
- Provider Partners Health Plan, Linthicum Heights, Maryland, USA
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Ann-Yi S, Wong A, Wu J, Charone M, Baumgartner K, Carmack CL, Castro D, Guzman D, Joy M, Kuriakose L, Madden K, Najera J, Pangemanan I, Rajani S, Raznahan M, Stewart H, Tallie K, Tanco K, Zhukovsky D, Bruera E. Physical and Psychosocial Symptoms of Young Adult Patients Referred to the Supportive Care Mobile Team. J Adolesc Young Adult Oncol 2022. [PMID: 35881858 DOI: 10.1089/jayao.2022.0032] [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: 11/12/2022] Open
Abstract
Young adult (YA) aged cancer patients have unique psychosocial needs with studies indicating more symptoms and emotional distress compared to older patients. Our study aimed to compare clinical characteristics and symptom distress between YAs and older adults. We retrospectively studied 896 randomly selected patients across 3 age groups: 18-39 YAs (n = 297), 40-64 (n = 300), and 65 and older (n = 299). We compared medical, psychosocial history, Morphine Equivalent Daily Dose (MEDD), Edmonton Symptom Assessment Scale (ESAS) scores, and Eastern Cooperative Oncology Group (ECOG) scores at the time of initial inpatient consultation with supportive care. YAs were more frequently female and white, with higher ECOG scores, had more self-reported psychiatric history and worse ESAS sleep scores compared to the other age cohort groups. YAs had higher pain expression than those of 65 years and older. YAs were more likely to have children younger than 18 years old, which was associated with worse pain, sleep, and financial distress. In general, YAs did not report higher symptoms distress, with the exception of insomnia and self-reported psychiatric history. Importantly, YAs with children was associated with higher ratings of pain, sleep difficulties, and financial distress. Overall, results suggest YAs may benefit from specialized services to address their unique psychosocial needs.
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Affiliation(s)
- Sujin Ann-Yi
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Angelique Wong
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA
| | - Jimin Wu
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Maira Charone
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Karen Baumgartner
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Cindy L Carmack
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Debra Castro
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diana Guzman
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Manju Joy
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Leela Kuriakose
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kevin Madden
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - John Najera
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Imelda Pangemanan
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sabeena Rajani
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Monica Raznahan
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Holly Stewart
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimmie Tallie
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimberson Tanco
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Donna Zhukovsky
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Olesen AMR, Boisen KA, Missel M. How Adolescents and Young Adults with Cancer Experience an Age-Appropriate Intervention When Undergoing Treatment in Adult Surgery Clinics: A Qualitative Study. J Adolesc Young Adult Oncol 2022; 12:177-184. [PMID: 35759421 DOI: 10.1089/jayao.2022.0012] [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: 11/12/2022] Open
Abstract
Purpose: Despite growing international attention, few interventions specifically target adolescents and young adults (AYAs) with cancer even though appropriate interventions may improve care delivery during cancer treatment. The study's purpose was to explore how AYAs with cancer experience an age-appropriate intervention when undergoing treatment in adult surgery clinics. Methods: Twenty AYAs with cancer, aged 18-29 years, from five surgery clinics at Copenhagen University Hospital Rigshospitalet participated in an intervention consisting of three main components: care provided by trained youth coordinator nurses (YCNs) to the greatest extent possible; a 1-hour one-on-one conversation with a YCN during hospitalization; and a postdischarge phone call. Semistructured interviews were used to collect data, which were analyzed in a stepwise process based on inductive content analysis. Results: Three themes were identified: a beacon in the dark; from patient to person; and the caring check-up. Participants felt safe and experienced a sense of presence and a caring environment in a significant and trusting relationship with YCNs, which encouraged them to share thoughts, feelings, and needs they previously had kept silent about. The one-on-one conversations helped them begin reflecting and in emotional processing and the postdischarge phone call was perceived as a caring check-up. Conclusions: The study shows how an age-appropriate intervention was experienced overall as meaningful for the participants hospitalized in adult surgery clinics, but more research is required to further examine the significance and effect of interventions that target AYAs with cancer.
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Affiliation(s)
- Anne Marie Roholm Olesen
- Department of Cardiothoracic Surgery, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kirsten A Boisen
- Department of Paediatrics and Adolescent Medicine, Centre of Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Malene Missel
- Department of Cardiothoracic Surgery, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Feasibility and Acceptability of Bright IDEAS-Young Adults: A Problem-Solving Skills Training Intervention. Cancers (Basel) 2022; 14:cancers14133124. [PMID: 35804896 PMCID: PMC9264826 DOI: 10.3390/cancers14133124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/09/2022] [Accepted: 06/17/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Young adults with cancer are a vulnerable group with unique emotional, social, and practical needs. There is a lack of evidence-based interventions to address their needs and to foster skills that could increase their capacity to cope. Bright IDEAS is a problem-solving skills training intervention that has demonstrated efficacy in improving people's problem-solving ability and reducing distress among caregivers of children with cancer. This study evaluated the feasibility and acceptability of Bright IDEAS adapted for young adults (Bright IDEAS-YA). METHODS Forty young adults recently diagnosed with cancer were enrolled in a single arm feasibility study. RESULTS Feasibility was demonstrated by the adequate enrollment (67.8%), retention (80.0%), and participants' adherence to the intervention (average of 5.2 out of 6 sessions completed). Participants reported satisfaction with the intervention. Qualitative feedback identified the systematic approach to problem-solving and interaction with the trainer as strengths of the intervention. Participants demonstrated improvements in problem-solving skills and symptoms of depression and anxiety. CONCLUSIONS In conclusion, the results support the feasibility of the intervention and an adequately powered randomized controlled trial is needed to determine the efficacy of the intervention on psychosocial outcomes.
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Tulk J, Garland SN, Howden K, Glidden C, Scott I, Chalifour K, Eaton G, Mahar A, Oberoi S. Prevalence and factors associated with insomnia symptoms in adolescents and young adults with cancer during the COVID-19 pandemic. Sleep Health 2022; 8:410-416. [PMID: 35729003 PMCID: PMC9212947 DOI: 10.1016/j.sleh.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has been particularly distressing for adolescents and young adults (AYAs) diagnosed with cancer. High levels of distress are associated with sleep disturbances. This study examined the prevalence of insomnia symptoms in AYAs during the COVID-19 pandemic and identified factors related to greater insomnia severity. DESIGN, SETTING, AND PARTICIPANTS An online survey was administered to Canadian AYAs (N = 805) diagnosed with cancer between 15 and 39 years from January to February 2021. MEASUREMENTS The primary measure was the Insomnia Severity Index (ISI). Univariable and multivariable binomial logistic regression examined demographic, clinical, and psychological factors associated with significant insomnia symptoms (ISI score ≥12). RESULTS Three hundred twelve (38.8%) participants reported insomnia symptoms. In the multivariable model, severe psychological distress (ie, depression and anxiety; adjusted odds ratio (AOR) = 28.75, p ≤.001), having a pre-existing mental health condition (AOR = 1.92, p = .03), worsened mental health during the pandemic (AOR = 1.73, p = .02), finished cancer treatment ≥1 year ago (AOR = 1.72, p = .03), and experiencing no changes to schooling during the COVID-19 pandemic (AOR = 2.18, p = .004) were associated with significant insomnia symptoms. Standardized coefficients also indicated that worrying about possible disruptions to cancer care and being a homemaker/caretaker contributed to insomnia symptoms. CONCLUSIONS Nearly 40% of AYAs with cancer reported insomnia symptoms during the COVID-19 pandemic. Insomnia was associated with potentially modifiable factors such as psychological distress, highlighting possible targets for intervention.
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Affiliation(s)
- Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Canada
| | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Canada; Discipline of Oncology, Faculty of Medicine, Memorial University, St. John's, Canada.
| | - Kaitlyn Howden
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Camille Glidden
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Ian Scott
- Department of Psychosocial Oncology, CancerCare Manitoba, Winnipeg, Canada
| | | | - Geoff Eaton
- Young Adult Cancer Canada, St. John's, NL, Canada
| | - Alyson Mahar
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Sapna Oberoi
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada; Section of Pediatric Hematology-Oncology, CancerCare Manitoba, Winnipeg, Canada
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Phan J, Laurence V, Marec-Berard P, Cordero C, Riberon C, Flahault C. La confrontation au deuil d’un pair chez une AJA atteinte de cancer. Une analyse phénoménologique interprétative. PSYCHO-ONCOLOGIE 2022. [DOI: 10.3166/pson-2022-0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectif : Les adolescents et jeunes adultes (AJA) atteints de cancer faisant face à la perte d’un autre AJA malade peuvent être confrontés à une « triple tâche » : le processus d’adolescence, l’ajustement psychologique au cancer et la mort d’un pair malade. L’objectif de l’étude a été d’explorer les processus sous-jacents à la perte d’un pair malade chez les AJA atteints de cancer.
Matériel et méthodes : Un entretien unique a été soumis à une Analyse phénoménologique interprétative (IPA), conçu pour comprendre le système de significations attaché à un phénomène subjectif et intime tel que le deuil.
Résultats : L’IPA a fait émerger six thèmes majeurs : le parcours de vie ; le parcours de soins ; les représentations du cancer, de soi et du monde ; l’ajustement psychologique au cancer ; les relations interpersonnelles ainsi que la perte d’un pair AJA malade. Le récit interprétatif montre la place centrale du processus d’identification aux pairs malades, notamment au défunt, dans la mise en sens du cancer et du deuil. Cette expérience du deuil d’un pair comporte des aspects négatifs (e.g., perspective de sa propre mort, perte de repère, peur de la rechute) et positifs (e.g., sentiment de continuité avec le défunt, changement de perception de soi et du monde).
Conclusion : L’étude montre l’importance de considérer ces processus dans l’accompagnement des AJA atteints de cancer confrontés à la mort d’un pair malade et de proposer des interventions adaptées à cette tranche d’âge.
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Ghazal LV, Cole S, Salsman JM, Wagner L, Duan F, Gareen I, Lux L, Parsons SK, Cheung C, Loeb DM, Prasad P, Dinner S, Zebrack B. Social Genomics as a Framework for Understanding Health Disparities Among Adolescent and Young Adult Cancer Survivors: A Commentary. JCO Precis Oncol 2022; 6:e2100462. [PMID: 35772048 PMCID: PMC9259142 DOI: 10.1200/po.21.00462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Lauren V Ghazal
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Steve Cole
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - John M Salsman
- Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University, Winston-Salem, NC
| | - Lynne Wagner
- Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University, Winston-Salem, NC
| | - Fenghai Duan
- Department of Biostatistics, Brown University, Providence, RI
| | - Ilana Gareen
- Department of Epidemiology and the Center for Statistical Sciences, Brown University School of Public Health, Providence, RI
| | - Lauren Lux
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Susan K Parsons
- Institute for Clinical Research and Health Policy Studies, Tufts Cancer Center, Tufts Medical Center, Boston, MA
| | | | | | - Pinki Prasad
- Louisiana State University Health, New Orleans, LA
| | - Shira Dinner
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Brad Zebrack
- Division of Cancer Control and Population Sciences, School of Social Work, Rogel Cancer Center, University of Michigan, Ann Arbor, MI
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40
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Surujballi J, Chan G, Strahlendorf C, Srikanthan A. Setting Priorities for a Provincial Adolescent and Young Adult Oncology Program. Curr Oncol 2022; 29:4034-4053. [PMID: 35735431 PMCID: PMC9222154 DOI: 10.3390/curroncol29060322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
Adolescent and young adult (AYA, ages 15–39 years) oncology patients are an underserved population with specialized needs. AYA programs are absent from most Canadian centers. We identified a priority list and sequence for new programs to address. Program goals, priorities, and activities were developed through literature review, national consensus documents, and expert opinion. Health care providers (HCPs) involved in AYA cancer care, administrators, and patient and family representatives were engaged to co-develop program goals and activities. A modified Delphi technique was used through two iterations followed by an in-person meeting to prioritize program implementation. Consensus was defined as a mean score of less than 2.0 (not important) or 4.0 or greater (important). Items without consensus (scored between 2.0 and 3.99) were discussed at the in-person meeting. Sixty provincial stakeholders completed the Delphi survey across multiple disciplines. Twenty-seven stakeholders attended the in-person meeting. All goals were deemed important, except development of a research program. Patient implementation tasks ranked highest. Priority sequence of implementation was: patient care first, followed by HCP education; patient and family education; program sustainability plan; evaluation; research; then a model for multidisciplinary tumor board review. These represent key goals for new AYA oncology programs and a priority sequence of implementation.
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Affiliation(s)
- Julian Surujballi
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada;
- The Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Grace Chan
- BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada; (G.C.); (C.S.)
| | | | - Amirrtha Srikanthan
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada;
- The Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Medicine, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- Correspondence: ; Tel.: +1-613-737-7700
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Patterson P, McDonald FEJ, Allison KR, Bibby H, Osborn M, Matthews K, Sansom-Daly UM, Thompson K, Plaster M, Anazodo A. The Clinical Utility of the Adolescent and Young Adult Psycho-Oncology Screening Tool (AYA-POST): Perspectives of AYA Cancer Patients and Healthcare Professionals. Front Psychol 2022; 13:872830. [PMID: 35602702 PMCID: PMC9120841 DOI: 10.3389/fpsyg.2022.872830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/21/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Routine psychosocial screening and assessment of people diagnosed with cancer are crucial to the timely detection of distress and provision of tailored supportive care; however, appropriate screening tools have been lacking for adolescents and young adults (AYAs), who have unique needs and experiences. One exception is the recently validated AYA Psycho-Oncology Screening Tool (AYA-POST) for use with young people aged 15–29 years, which comprises a distress thermometer and age-specific needs assessment. This study investigates the clinical utility of this measure, as well as the subsequent service responsiveness within the Australian Youth Cancer Services. Method In total, 118 AYAs and 29 healthcare professionals: (HCPs) completed surveys about the clinical utility of the AYA-POST; a subset of 30 AYAs completed a 3-month follow-up survey assessing service responsiveness. Descriptive statistics (frequencies/means) were computed for all items, with chi-square analyses used to explore whether perceived clinical utility varied with AYA age, AYA sex, HCP discipline or HCP length of time using the AYA-POST. Results Participants’ responses demonstrate high levels of satisfaction with the tool, evidencing its appropriateness, practicability and acceptability. Moreover, the AYA-POST was reported to facilitate communication about psychosocial needs and prompt referrals, indicating good service responsiveness. Ratings of clinical utility did not differ significantly between AYA and HCP groups. Conclusion This study demonstrates that the AYA-POST is an appropriate tool in the psychosocial screening of AYAs with cancer, facilitating the identification of distress and unique concerns in this population and valuable in triaging and tailoring care for young cancer patients.
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Affiliation(s)
- Pandora Patterson
- Canteen Australia, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- *Correspondence: Pandora Patterson,
| | - Fiona E. J. McDonald
- Canteen Australia, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | | | - Michael Osborn
- South Australia/Northern Territory Youth Cancer Service, Royal Adelaide Hospital, Adelaide, SA, Australia
- Department of Haematology and Oncology, Women’s and Children’s Hospital, Adelaide, SA, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Karen Matthews
- New South Wales/Australian Capital Territory Youth Cancer Service, Sydney, NSW, Australia
| | - Ursula M. Sansom-Daly
- New South Wales/Australian Capital Territory Youth Cancer Service, Sydney, NSW, Australia
- Behavioural Sciences Unit, School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, Discipline of Paediatrics and Child Health, University of New South Wales, Sydney, NSW, Australia
| | - Kate Thompson
- Victoria/Tasmania Youth Cancer Service, Melbourne, VIC, Australia
| | - Meg Plaster
- Western Australia Youth Cancer Service, Perth, WA, Australia
| | - Antoinette Anazodo
- New South Wales/Australian Capital Territory Youth Cancer Service, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Sydney, NSW, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
- School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
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Lichiello S, Rainwater L, Russell GB, Pulgar C, Clark J, Daniel S, McCall MH, Bentley P, Duckworth KE. Cancer during a pandemic: A psychosocial telehealth intervention for young adults. Curr Probl Cancer 2022; 46:100865. [PMID: 35687967 PMCID: PMC9106397 DOI: 10.1016/j.currproblcancer.2022.100865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/16/2022] [Accepted: 04/12/2022] [Indexed: 11/29/2022]
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Risk factors for psychological morbidity and the protective role of coping self-efficacy in young women with breast cancer early in diagnosis: a national multicentre cohort study. Breast Cancer Res Treat 2022; 194:91-102. [DOI: 10.1007/s10549-022-06576-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/17/2022] [Indexed: 11/02/2022]
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The Chemo-Gut Pilot Study: Associations between Gut Microbiota, Gastrointestinal Symptoms, and Psychosocial Health Outcomes in a Cross-Sectional Sample of Young Adult Cancer Survivors. Curr Oncol 2022; 29:2973-2994. [PMID: 35621633 PMCID: PMC9140183 DOI: 10.3390/curroncol29050243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/11/2022] [Accepted: 04/18/2022] [Indexed: 12/12/2022] Open
Abstract
Chemotherapy adversely affects the gut microbiota, inducing dysbiosis, and negatively impacts gastrointestinal (GI) and psychosocial health during treatment, but little is known about the long-term effects or how these factors are related. Methods: This cross-sectional pilot study investigated the effects of chemotherapy on the gut microbiota, GI symptoms, and psychosocial outcomes in cancer survivors aged 18−39 years old, compared to healthy controls. Gut microbial diversity and composition were assessed from stool samples using 16S rRNA gene sequencing. Results: Survivors (n = 17) and healthy controls (n = 18) participated. Mean age at diagnosis was 31 years (±5.3). Mean time off treatment was 16.9 months (±16.4). Survivors had more severe GI symptoms, poorer psychosocial health, and increased relative abundance of Selenomondales, Veilloneliaceae, and Intestinibacter. In survivors, Lachnospiraceae, Ruminococcaceae and Intestinibacter correlated with psychosocial symptoms, while diarrhea correlated positively with Lachnospiraceae. Results are statistically significant. Survivors ≤6 months post-treatment had lower alpha diversity than survivors >6 months post-treatment (p = 0.04) and controls (p = 0.19). Conclusion: This small exploratory study demonstrates potential long-term gut microbial dysbiosis in cancer survivors, which may be associated with psychosocial symptoms. Larger trials concurrently and longitudinally examining gut microbiota, GI symptoms, and psychosocial outcomes are needed.
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Inhestern L, Paul V, Winzig J, Rutkowski S, Escherich G, Bergelt C. Children with cancer and their families after active treatment: analyses of biopsychosocial needs and implications for healthcare - a study protocol. BMJ Open 2022; 12:e055633. [PMID: 35383068 PMCID: PMC8984037 DOI: 10.1136/bmjopen-2021-055633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Patients and families affected by paediatric cancer experience psychosocial burden not only during active treatment but also during follow-up care. Use of health services during follow-up treatment should be organised according to patients' and family members' needs with regard to their physical and mental situation. This study aims (1) at analysing healthcare use (medical and psychosocial) and associated factors in follow-up care of paediatric cancer patients and (2) at investigating the psychosocial situation and support needs of children and their families during follow-up care. Based on the results, recommendations for healthcare planning and for the development of new and the optimisation of existing support offers will be derived. METHODS AND ANALYSIS We will conduct a prospective observational study using a naturalistic explorative design with quantitative and qualitative methods. Paediatric cancer patients in follow-up care, their parents and siblings will be invited to fill out a questionnaire at three measurement points (baseline, 6 months follow-up, 12 months follow-up; target n=252 complete data sets over all measurement points). Additionally, parents will be interviewed using a semistructured interview guideline (target n=15-20) at baseline. Quantitative data will be analysed using descriptive statistics, linear mixed models and regression models. Moreover, explorative analyses will be conducted. Qualitative data will be analysed using qualitative content analyses. ETHICS AND DISSEMINATION The study was approved by the Local Psychological Ethics Committee (LPEK-0281). Our findings will be published in scientific, peer-reviewed journals and presented to clinicians and researchers on conferences. To assure that results will be available to affected patients and families, a lay summary will be written and disseminated using several ways (upload on the homepage of the research group, upload on the homepage of the psychosocial working group in the Society for Paediatric Oncology/Haematology in Germany, sending to relevant patient organisations). TRIAL REGISTRATION NUMBER DRKS00025289.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Verena Paul
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Winzig
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Rutkowski
- Clinic of Pediatric Hematology and Oncology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriele Escherich
- Clinic of Pediatric Hematology and Oncology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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46
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Heinrich M, Hofmann L, Baurecht H, Kreuzer PM, Knüttel H, Leitzmann MF, Seliger C. Suicide risk and mortality among patients with cancer. Nat Med 2022; 28:852-859. [PMID: 35347279 DOI: 10.1038/s41591-022-01745-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/14/2022] [Indexed: 11/09/2022]
Abstract
Despite substantial progress in cancer therapy in recent decades, patients with cancer remain at high suicide risk. Data from individual studies have not been comprehensively quantified and specific risk factors are ill-defined. We assessed suicide mortality risk according to cancer prognosis, stage, time since diagnosis, gender, ethnicity, marital status, year of recruitment and geographic region. We searched EMBASE, MEDLINE, PsycINFO, Web of Science, CINAHL and Google Scholar for relevant articles up to February 2021. We used a random effects model, performed meta-regression meta-analysis and assessed heterogeneity and publication bias using I², funnel plots and Egger's and Begg's tests. We performed a systematic review including 62 studies and 46,952,813 patients. To avoid patient sample overlap, the meta-analysis was performed on 28 studies, involving 22,407,690 patients with cancer. Suicide mortality was significantly increased compared with the general population (standardized mortality ratio = 1.85, 95% confidence interval = 1.55-2.20). Risk was strongly related to cancer prognosis, cancer stage, time since diagnosis and geographic region. Patients with cancer, particularly those with specific risk factors, should be closely monitored for suicidality and need specialized care to reduce short- and long-term risks of suicide.
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Affiliation(s)
- Michael Heinrich
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Luisa Hofmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Peter M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, Regensburg, Germany
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Corinna Seliger
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
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Bradford N, Cashion C, Holland L, Henney R, Walker R. Coping with cancer: A qualitative study of adolescent and young adult perspectives. PATIENT EDUCATION AND COUNSELING 2022; 105:974-981. [PMID: 34334263 DOI: 10.1016/j.pec.2021.07.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Cancer can have long-term biopsychological impacts for young people that persist for years. To promote adjustment, it is essential to understand how young people cope, yet this is relatively understudied. METHODS This study explored the coping strategies using semi-structured interviews with 16 young people with cancer aged 15-24 years. Eligible participants were diagnosed within the previous 24 months and recruited through Australian Youth Cancer Services. Transcribed interviews were analysed using content analysis. RESULTS Coping strategies included: seeking support; controlling the focus; avoiding negatives and staying positive; meaning making and; changes with time. During treatment, seeking support, focussing on the present, distraction and avoidance were commonly applied. Following treatment, planning for the future, avoidance of re-traumatising situations and meaning making were used. CONCLUSION Findings support the concept of coping as a dynamic process where different strategies are used depending on the stressor, available resources and previous experiences. PRACTICE IMPLICATIONS Comprehensive, developmentally appropriate psychosocial assessments, open communication, education and information provision, as well as appropriate referral for support are essential, particularly for young cancer survivors identified at risk.
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Affiliation(s)
- Natalie Bradford
- Queensland University of Technology, School of Nursing, Brisbane, Australia; Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Brisbane, Australia; Queensland Children's Hospital, Brisbane, Queensland, Australia.
| | | | - Lucy Holland
- Queensland University of Technology, School of Nursing, Brisbane, Australia; Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Rosyln Henney
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Rick Walker
- Queensland Children's Hospital, Brisbane, Queensland, Australia; Princess Alexandra Hospital, Brisbane, Queensland, Australia; The University of Queensland, School of Medicine, Queensland, Australia
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48
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Psychosocial Distress Due to Interference of Normal Developmental Milestones in AYAs with Cancer. CHILDREN 2022; 9:children9030309. [PMID: 35327680 PMCID: PMC8947616 DOI: 10.3390/children9030309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 01/19/2023]
Abstract
Cancer in the adolescent and young adult phase poses additional challenges to this period of development that is crucial to the transition to independence. This report provides a brief review of normal developmental milestones in this age range while highlighting the disruptive effects of cancer. We focus on the psychological burden of cancer in patients aged 15–39 years and explore the application of the total pain model to highlight the psychological/emotional, social, and spiritual aspects of non-physical pain. We also briefly review posttraumatic growth and resilience. Lastly, we provide a review of areas for possible development and future research.
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Ishiki H, Hirayama T, Horiguchi S, Iida I, Kurimoto T, Asanabe M, Nakajima M, Sugisawa A, Mori A, Kojima Y, Udagawa R, Tsuchiya H, Oki M, Shimizu M, Yanai Y, Touma S, Nozawa K, Kojima R, Inamura N, Maehara A, Suzuki T, Satomi E. A Support System for Adolescent and Young Adult Patients with Cancer at a Comprehensive Cancer Center. JMA J 2022; 5:44-54. [PMID: 35224259 PMCID: PMC8827278 DOI: 10.31662/jmaj.2021-0106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/05/2021] [Indexed: 01/08/2023] Open
Abstract
Cancer patients in adolescents and young adults (AYA) generation aged 15-39 years have various psychosocial needs during their treatment course such as school enrollment, finding employment, marriage, and fertility. It is difficult for medical professionals to gain experience related to providing medical care and consultation support to these kinds of AYA generation cancer patients. There is a need to provide information and establish both support and medical care systems that are able to meet the diverse needs unique to this generation. This review will explain how to launch an AYA support team (AST). We have worked and established the AST since 2016, which is medical care teams that provide support according to the life stage of each individual patient and build a multidisciplinary AYA generation patient support system. The team-building process consisted of two main projects: building and enlarging multidisciplinary team and establishing screening process of psychosocial needs of AYA generation patients. Multidisciplinary healthcare professionals got involved in the AST with already-existing patient support functions in our center: the patient support center, which is an outpatient department and the palliative care team, which is an inpatient interdepartmental team. The AST systematically finds patients in need of assistance and offers them support as a multidisciplinary team. The AST also established a procedure that systematically gathers information about the needs of patients by using a screening tool. In addition, the AST provides the following specialized services: reproductive medicine, supporting cancer patients with children, employment support, and peer support. The AST has been established and sophisticatedly worked. It can flexibly provide various psychosocial support services. This review will explain how to launch an AST.
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Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Saki Horiguchi
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Ikumi Iida
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Tamae Kurimoto
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Mihoko Asanabe
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Miho Nakajima
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akiko Sugisawa
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Ayako Mori
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoko Udagawa
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Hayato Tsuchiya
- Nutrition Management Office, National Cancer Center Hospital, Tokyo, Japan
| | - Mami Oki
- Department of Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Mariko Shimizu
- Center for Physician Referral and Medical Social Service, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Yanai
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shoko Touma
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Keiko Nozawa
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Rebekah Kojima
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Naoko Inamura
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Asami Maehara
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Center for Physician Referral and Medical Social Service, National Cancer Center Hospital, Tokyo, Japan
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Jacobson C, Miller N, Mulholland R, Baker L, Glazer D, Betts E, Brown L, Elders V, Carr R, Ogundiran O, Hudson LD. Psychological distress and resilience in a multicentre sample of adolescents and young adults with cancer during the COVID-19 pandemic. Clin Child Psychol Psychiatry 2022; 27:201-213. [PMID: 34865537 PMCID: PMC8829151 DOI: 10.1177/13591045211056923] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Understanding impact of the coronavirus pandemic (COVID-19) on Adolescents and Young Adults (AYA) with cancer is important to inform care. Online survey of 16-24 year olds receiving cancer treatment at eight cancer centres in the UK. We measured: self-perceived increased anxiety since COVID-19, impact of COVID-19 on treatment, life and relationships, PHQ-8, GAD and the two-item Connor-Davidson Resilience Scale (CD-RISC). 112 AYA participated. 59.8% had previous mental health difficulties. 78.6% reported COVID-19 having a significant impact on life. 79% reported experiencing increased anxiety since COVID-19.43.4% had moderate-severe PHQ-8 scores and 37.1% GADS-7 scores. Impact on life was associated with moderate-severe PHQ-8 scores (OR 5.23, 95% CI 1.65-16.56, p < 0.01), impact on relationships with moderate-severe GADS-7 and PHQ-8 score (OR 2.89, 95% CI 1.11-7.54, p = 0,03; OR 3.54, 95% CI 2.32-15.17, p < 0.01; OR 2.42, 95% CI 1.11-5.25, p =0.03). Greater resilience was associated with lower mod-severe GADS-7and PHQ-8 scores (OR 0.58, 95% CI 0.41-0.81, p < 0.01; OR 0.55 95% CI 0.4-0.72, p < 0.01; OR 0.52, 95% CI 0.38-0.69, p < 0.01). We found high levels of psychological distress. Perceived impact of COVID-19 on relationships and life was predictive of poorer mental health, with resilience a protective factor.
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Affiliation(s)
- Clare Jacobson
- 8945Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | | - Laura Baker
- 1984University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Daniel Glazer
- 8964University College London Hospitals NHS Foundation Trust, London, UK
| | - Emily Betts
- 6397Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | - Robert Carr
- 8945Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Lee D Hudson
- 11700GOS UCL Institute of Child Health, London, UK
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