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Signorelli C, Høeg BL, Asuzu C, Centeno I, Estapé T, Fisher P, Lam W, Levkovich I, Manne S, Miles A, Mullen L, Nekhlyudov L, Sade C, Shaw J, Singleton A, Travado L, Tsuchiya M, Lemmen J, Li J, Jefford M. International Survey of Psychosocial Care for Cancer Survivors in Low-/Middle- and High-Income Countries: Current Practices, Barriers, and Facilitators to Care. JCO Glob Oncol 2024; 10:e2300418. [PMID: 38781550 DOI: 10.1200/go.23.00418] [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: 11/09/2023] [Revised: 01/24/2024] [Accepted: 03/26/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE The number of cancer survivors living with and beyond cancer treatment is rising globally. It is fundamental to understand the extent and type of psychosocial care services offered worldwide. We evaluated models of cancer survivorship care, psychosocial care practices in the post-treatment survivorship phase, and barriers/facilitators to delivery of psychosocial care services, including in low- and middle-income countries (LMICs). METHODS The International Psycho-Oncology Society (IPOS) Survivorship Special Interest Group led a cross-sectional online survey between March and November 2022. Health care professionals and researchers in psycho-oncology were invited through the IPOS global membership, social media, and snowballing. The survey was administered to individuals but included questions related to practices in their country at a national level. RESULTS Two hundred eighty-three respondents from 37 countries participated (40% from LMICs), with a median of 12 years of experience (IQR, 6-20) in the psycho-oncology field. Participants reported that the most common elements of routine survivorship care were related to the prevention/management of recurrences/new cancers (74%), physical late effects (59%), and chronic medical conditions (53%), whereas surveillance/management of psychosocial late effects (27%) and psychosocial/supportive care (25%) were least common. Service availability was more commonly reported in high-income countries (HICs) than LMICs related to reproductive health (29% v 17%), genetic counseling/support (40% v 20%), and identifying/managing distress (39% v 26%) and pain (66% v 48%). Key barriers included providers focusing on treatment not survivorship (57%), medical not psychosocial care (60%), and a lack of allied health providers to deliver psychosocial care (59%). CONCLUSION The psychosocial needs of people living with cancer are not adequately available and/or provided in post-treatment survivorship even in HICs, because of barriers at patient, provider, and system levels.
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Affiliation(s)
- Christina Signorelli
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | | | - Chioma Asuzu
- Unit of Psycho-Oncology, Department of Radiation Oncology, College of Medicine, Ibadan, Nigeria
| | - Isabel Centeno
- Breast Cancer Center, Hospital Zambrano Hellion, Monterrey, Mexico
| | - Tania Estapé
- Psychosocial Oncology Department, FEFOC Foundation, Barcelona, Spain
| | - Peter Fisher
- University of Liverpool; Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Wendy Lam
- School of Public Health, LSK Faculty of Medicine Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | - Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tiv'on, Israel
| | - Sharon Manne
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
| | - Anne Miles
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Louise Mullen
- National Cancer Control Programme, Health Services Executive, Kings Inns House, Dublin, Ireland
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Cristina Sade
- Psychosocial Oncology Department, Instituto Nacional del Cáncer, Santiago, Chile
| | - Joanne Shaw
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Anna Singleton
- Faculty of Medicine and Health, Engagement and Co-design Research Hub, University of Sydney, Sydney, Australia
| | - Luzia Travado
- Champalimaud Clinical and Research Center, Champalimaud Foundation, Lisbon, Portugal
| | - Miyako Tsuchiya
- Division of Healthcare Delivery, Survivorship and Policy Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
- Research Institute of Nursing, Musashino University, Tokyo, Japan
| | - Jesse Lemmen
- Pediatric Oncology, Emma's Children Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jie Li
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
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Grassi L, Watson M. Core-curriculum in psycho-oncology: Towards the certification of the psycho-oncologist profession. Psychooncology 2024; 33:e6285. [PMID: 38282216 DOI: 10.1002/pon.6285] [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: 01/30/2024]
Abstract
BACKGROUND Issues relating to certification of the Psycho-oncology profession require clarification in order to provide high quality comprehensive psychosocial care within oncology. We conducted a survey identifying existing training, professional registration requirements and accreditation programs, at national levels, for the specialty of psycho-oncology as well as the mandatory presence of this specialist in cancer teams. METHODS This survey was conducted within the International Psycho-Oncology Society Federation of psycho-oncology societies and included representatives of each national federated society and some countries not belonging to the Federation. Survey questions were emailed requesting specific details, from the registered contact person, for each country, about psycho-oncology training, professional registration and accreditation. RESULTS Of 43 countries contacted (34 Federated and 9 non-federated members), 39 replied and answered the questionnaire (90, 7%). Disparities were reported between countries, with details indicating differences from having no national program, to quite detailed and legally accredited requirements. The majority of countries had no formally recognized profession of "Psycho-oncologist," while some countries reported that it is mandatory (or recommended to have) a specialist in psycho-oncology in cancer centers and, thus, that an accredited, nationally recognized and certified training in this specialty exists. CONCLUSIONS The study underlines the need to create a curriculum for the specialty (certification and accreditation) for the profession of psycho-oncology. Given the lack of internationally recognized core standards, ideas and proposals for minimum standards of good care and the training required to deliver this, are explored to clarify who may use the designation "Clinical Psycho-oncologist."
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Affiliation(s)
- Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Section, Integrated Department of Mental Health, S. Anna and Local Health Trust, Ferrara, Italy
| | - Maggie Watson
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Onco-Genetics, Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Research and Innovation, University of Southern Queensland, Toowoomba, Queensland, Australia
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Baye AA, Bogale SK, Delie AT, Melak Fekadie M, Wondyifraw HG, Tigabu ME, Kebede M. Psychosocial distress and associated factors among adult cancer patients at oncology: a case of Ethiopia. Front Oncol 2023; 13:1238002. [PMID: 38192622 PMCID: PMC10772143 DOI: 10.3389/fonc.2023.1238002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024] Open
Abstract
Background Psychosocial distress is a chronic burden for cancer survivors, which impacts both their quality of life and their oncologic prognosis. Although the national cancer prevention and control program in Ethiopia has made efforts in cancer prevention, control, and management by implementing the national cancer control plan 2016-2020, there was no enough evidence about psychosocial distress among adult cancer patients. So, it is critical to understand the magnitude of psychosocial distress and the factors that contribute to it. Objective The purpose of this study was to assess the prevalence of psychosocial distress and associated factors among adult cancer patients at oncology units in the Amhara regional state, Ethiopia. 2022. Methods A multicenter institution-based cross-sectional study was conducted among a sample of 605 adult cancer patients from 30 April to 22 June 2022. A systematic random sampling technique was employed to select the study units. In addition, data were collected through interviewers administered questionnaires by using the validated and pretested tools. Distress was assessed using the Questionnaire on Stress in Cancer Patients Revised 10. Both bivariable and multivariable logistic regression was used to describe the association between dependent and independent variables. Independent variable with p < 0.25 in the bivariable logistic regression analyses were entered into multivariable logistic regression model. Variables with p < 0.05 in the multivariable logistic regression analyses were considered as statistically significant associated factors of psychosocial distress. Result A total of 593 adult cancer patients took part in this study with mean age of 46.86 ± 14.5 years. The overall prevalence of psychosocial distress was 63.74%. Variables such as being female [AOR = 1.98, 95% confidence interval (CI): 1.24-3.17], patients who lives in rural areas (AOR = 2.3, 95% CI: 1.49-3.54), community-based health insurance utilization (AOR = 0.34, 95% CI: 0.23-0.51), patients on chemotherapy treatment (AOR = 2.72, 95% CI: 1.38-5.39), patients with comorbidity (AOR = 3.2, 95% CI: 1.67-6.10), and symptom burdens such as severe fatigue (AOR = 1.65, 95% CI:1.09-2.39) and severe nausea (AOR = 2.07, 95% CI: 1.43-3.00) were statistically associated with psychosocial distress. Conclusion and recommendation In general, the findings of this study showed a relatively high magnitude in which around two-thirds of patients experienced psychosocial distress. It is better to establish and enforce the integration and coordination of psychosocial oncology service programs at national level with parallel guidelines and policies.
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Affiliation(s)
- Astewle Andargie Baye
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sitotaw Kerie Bogale
- Department of Adult Health Nursing, School of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebu Tegenaw Delie
- Department of Adult Health Nursing, School of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mengistu Melak Fekadie
- Department of Pediatric and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Mengistu Ewunetu Tigabu
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mulu Kebede
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Mullen L, Signorelli C, Nekhlyudov L, Jacobsen PB, Gitonga I, Estapé T, Lim Høeg B, Miles A, Sade C, Mazariego C, Degi CL, Howard F, Manne S, Travado L, Jefford M. Psychosocial care for cancer survivors: A global review of national cancer control plans. Psychooncology 2023; 32:1684-1693. [PMID: 37749754 DOI: 10.1002/pon.6218] [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: 06/27/2023] [Revised: 08/30/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE National Cancer Control Plans (NCCPs) are high-level policy documents that prioritise actions to be taken to improve cancer control activities. As the number of cancer survivors grows globally, there is an urgent need to assess whether and how psychosocial care across the cancer care continuum is included in NCCPs. This review aimed to ascertain the extent to which NCCPs referenced psycho-oncology care for cancer survivors in the post-treatment phase. METHODS NCCPs were obtained from the International Cancer Control Partnership (ICCP) portal (in November 2021) and reviewed in two phases. In Phase 1, all available NCCPs were screened to determine whether they mentioned psycho-oncology or survivorship. In Phase 2, reviewers extracted data from the NCCPs identified in Phase 1 on the degree that each plan articulated objectives/goals to improve psychosocial care in the post-treatment survivorship phase. RESULTS We screened 237 NCCPs. Of these, initial potential reference to psycho-oncology and survivorship content were identified in 97 plans (41%). In Phase 1, 57/97 (59%) had reference to psycho-oncology or survivorship content within defined criteria. In Phase 2, 27/97 (28%) had little mention of psycho-oncology specifically in survivorship, 47/97 (48%) had some (general or brief) mention, and the remaining 23/97 (24%) had substantial content/specific sections and clearly articulated goals and/or objectives. Common goals for improving psychosocial care in the post-treatment period included building capacity of healthcare professionals, implementing rehabilitation models, and increasing the utilisation of community services. CONCLUSIONS Most NCCPs did not reference psycho-oncology and only one-quarter contained clear objectives specifically in the post-treatment survivorship phase.
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Affiliation(s)
- Louise Mullen
- National Cancer Control Programme, Health Services Executive. Kings Inns House, Dublin, Ireland
| | - Christina Signorelli
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, UNSW Sydney, Randwick, New South Wales, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul B Jacobsen
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Isaiah Gitonga
- Department of Psychology, Maynooth University, Dublin, Ireland
- Ikuze Africa, Nairobi, Kenya
| | - Tania Estapé
- Psychosocial Oncology Department, FEFOC Foundation, Barcelona, Spain
| | - Beverley Lim Høeg
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Miles
- Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - Cristina Sade
- Psychosocial Oncology Department, Instituto Nacional del Cancer, Santiago, Chile
| | - Carolyn Mazariego
- Faculty of Medicine and Health, School of Population Health, UNSW Sydney, Randwick, New South Wales, Australia
| | - Csaba L Degi
- Faculty of Sociology and Social Work, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Fuchsia Howard
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sharon Manne
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Luzia Travado
- Champalimaud Clinical and Research Center, Champalimaud Foundation, Lisbon, Portugal
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
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Coppini V, Ferraris G, Monzani D, Grasso R, Pravettoni G. Disparities and barriers in the assessment of psychological distress, access to and use of psycho-oncological support in Europe: current perspectives. Front Psychol 2023; 14:1252843. [PMID: 37794912 PMCID: PMC10546339 DOI: 10.3389/fpsyg.2023.1252843] [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: 07/04/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023] Open
Abstract
The implementation of psycho-oncological support has shown important results in positively influencing treatment outcomes and quality of life in cancer patients and survivors. In the last few decades, the importance of mental health has been brought to attention to the general public and healthcare professionals on a national, institutional and organisational level. Official guidelines, policies, and training programs have been developed suggesting that psycho-oncological support should be considered as a non-negotiable requirement for quality cancer care in many hospitals and clinical centres across Europe. Health organisations, associations, institutions, and societies, such as the International Psycho-Oncology Society (IPOS) and the European Partnership for Action Against Cancer (EPAAC), are forming alliances, funding research projects and organising congresses in order to study, understand, and discuss the reasons for barriers and disparities in psycho-oncological support and, eventually, to overcome the existing cancer divide. Nevertheless, the World Health Organization's (WHO) estimations indicate that the cancer burden is still increasing, and relevant barriers and disparities in accessing psycho-oncological support continue to exist and influence the health conditions and quality of life of cancer patients and survivors. The present work will present the current disparities and barriers regarding assessment, access to and use of psycho-oncological support in the countries of the European Union, making suggestions for further research and possible solutions.
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Affiliation(s)
- Veronica Coppini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Ferraris
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Dario Monzani
- Department of Psychology, Educational Science and Human Movement (SPPEFF), University of Palermo, Palermo, Italy
| | - Roberto Grasso
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Bazilainsky S, Cohen M, Holtmaat K, Erlich B, Verdonck-de Leeuw IM. The impact of cancer on psychosocial function and quality of life: A cross-sectional study in 18 pan-European countries. Psychooncology 2023; 32:383-392. [PMID: 36604583 DOI: 10.1002/pon.6083] [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: 10/18/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND To improve psychosocial cancer care in Europe, more information is needed on psychosocial function and quality of life (QoL) among cancer patients in European countries. AIMS To investigate differences in psychosocial function between cancer survivors and the general population in Europe, in relation to national economic status and personal factors. METHOD Data were from the Survey of Health, Aging and Retirement in Europe (Wave 6). Main outcomes were psychosocial functioning: activity limitations, income adequacy, loneliness, depression, and QoL. Factors possibly associated with the main outcomes were ever having cancer, gross domestic product (GDP), and personal factors (age, gender, education, marriage status, employment status, number of children, number of chronic diseases). RESULTS The study sample featured 6238 cancer survivors and 60,961 individuals without cancer aged 50 or older in 17 European countries and Israel. Levels of depression were higher and QoL was lower among cancer survivors compared to individuals without cancer and worse in low GDP countries, whereas differences in income adequacy and loneliness were not statistically significant. The interaction of cancer groups and country groups indicated a significant interactional effect on activity limitations, loneliness, depression, and QoL. In a multivariate regression analysis, personal factors, GDP, and being a cancer survivor predicted the main outcome variables. CONCLUSIONS Cancer has a persistent negative effect on survivors that is related to a country's GDP. Cancer survivors in low-GDP countries are affected by the consequences of cancer intertwined with the hardships of living in a low-GDP country.
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Affiliation(s)
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
| | - Karen Holtmaat
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands.,Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
| | - Brach Erlich
- Braun School of Public Health, Hebrew University, Jerusalem, Israel
| | - Irma M Verdonck-de Leeuw
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands.,Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands.,Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Bergerot CD, Wang AWT, Csaba DL, Bahcivan O, Kim Y. Cancer Patients' Unmet Needs in Three Low- to Middle- Income Countries: Perspectives from Health Care Providers. Cancer Invest 2023; 41:1-8. [PMID: 36621937 PMCID: PMC10349901 DOI: 10.1080/07357907.2023.2167210] [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: 09/24/2022] [Revised: 12/14/2022] [Accepted: 01/08/2023] [Indexed: 01/10/2023]
Abstract
We sought to determine differences by low- and middle- income countries (Brazil, Romania, and Turkiye) on the degree to which health care providers (HCPs) note unmet needs among patients with cancer (N = 741). HCPs endorsed sexuality/intimacy and financial concerns as the most common. Investigating age differences in unmet needs between Brazil and Turkiye, were that should be targeted by. Results revealed that unmet needs to manage emotional distress were higher among older patients in Turkiye, whereas unmet needs to manage insomnia/fatigue were higher among pediatric patients in Brazil. Findings may guide the development of programs to address unmet needs among patients.
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Affiliation(s)
| | | | - Dégi L. Csaba
- Faculty of Sociology and Social Work, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Ozan Bahcivan
- Psiko-Onkologlar Dernegi (Turkish Psycho-Oncological Association), Izmir, Turkiye
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Costas-Muñiz R, Galindo-Vazquez O, Montana MF, Castro-Figueroa E, Torres-Blasco N, Ruda-Santolaria L, Sanchez-Ramirez JC, Esenarro-Valencia L, Bergerot CD, Castro J, Gany F, Breitbart W. FIPOL: An initiative to support research collaborations, resource development, scientific communication, and educational opportunities in psychosocial oncology for Latin America. Psychooncology 2023; 32:160-164. [PMID: 35301804 PMCID: PMC9482664 DOI: 10.1002/pon.5922] [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: 10/14/2021] [Revised: 01/21/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023]
Abstract
Key points
The goal of FIPOL (Training and Resources in Psychosocial Oncology for Latin America) is to support the development of psychosocial oncology (PO) in Latin American countries
FIPOL aims to increase global awareness of academic opportunities in PO and behavioral medicine and facilitates exchanges and collaborations between Spanish‐speaking clinicians and researchers from diverse backgrounds and Spanish‐speaking countries who work in cancer and psychosocial care
Professional organizations and networks such as FIPOL may contribute to the long‐term growth of PO in the region and implementation and sustainability of PO practice
FIPOL works towards its goals through efforts in training, resource development, collaborative research initiatives, and communication and dissemination with collaborations of Spanish‐speaking colleagues working on cancer and psychosocial care
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Affiliation(s)
- Rosario Costas-Muñiz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | | | | | - Eida Castro-Figueroa
- Department of Psychiatry and Human Behavior, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico, USA
| | - Normarie Torres-Blasco
- Department of Psychiatry and Human Behavior, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico, USA
| | | | | | | | | | | | - Francesca Gany
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - William Breitbart
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
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Dunn J, Rodin G. Global psycho-oncology in low middle-income countries: Challenges and opportunities. Psychooncology 2023; 32:3-5. [PMID: 36456764 PMCID: PMC10107342 DOI: 10.1002/pon.6078] [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: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES This Special Issue of Psycho-Oncology is focused on challenges and opportunities in the provision of psychosocial care to patients in low and middle-income countries (LMICs). The aim is to highlight global disparities and inequity in the provision of evidence-based, culturally-sensitive and timely psychosocial care and to showcase the work of researchers and practitioners to address this gap. We hope that this Issue will help to advance the psychological and social dimensions of cancer care in all parts of the world. METHODS The focus of the papers is on research and clinical innovations in LMICs that target the psychological, social and cultural dimensions of cancer and on interventions to improve or maintain the psychological well-being, social functioning and/or quality of life of those who are affected and their families. RESULTS These papers draw attention to guidelines, resource needs, clinical service evaluation, emerging research and knowledge translation within LMICs that advance knowledge and implementation in the field of psycho-oncology. CONCLUSIONS Innovations and advances in psycho-oncology are emerging from LMICs to enhance the care of patients with cancer and their families in these regions and in all parts of the world. A sustained global initiative is now needed to ensure that guidelines for such care are routinely included in global, national and local cancer control plans and that essential resources and attention are directed to implement them.
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Affiliation(s)
- Jeff Dunn
- University of Southern Queensland, Toowoomba, Queensland, Australia.,Australian Catholic University, Banyo, Queensland, Australia
| | - Gary Rodin
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada.,Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and University Health Network, Toronto, Ontario, Canada
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Kállay É, Medrea F, Müller-Fábián A, Dégi LC. Which type of fear of cancer progression contributes to the quality of life of Romanian cancer patients during the COVID-19 pandemic? Front Psychol 2023; 14:1122339. [PMID: 36935987 PMCID: PMC10019352 DOI: 10.3389/fpsyg.2023.1122339] [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: 12/12/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Fear of cancer progression (FoP) is one of the most frequently reported unmet needs invoked by the majority of cancer patients, which may significantly impair the quality of life (QoL) of patients. The major objective of the present cross-sectional study was to investigate the specificities of the relationship between different dimensions and intensity of FoP and different aspects of patients' QoL during the COVID-19 pandemic in Romania. Methods A nationwide sample of 330 participants completed a survey, including measures of demographic characteristics, medical variables, QoL, and FoP. Multivariate General Linear and Hierarchical Regression Models were conducted in order to assess the relationship between variables. Result Our results indicate that less than a quarter of the sample experienced low, between 63 and 70% moderate, and 15% high levels of FoP. Our results also indicate that anxiety/worry related to the possibility of progression of the disease, and loss of independence produced significant differences with large effect sizes in all the dimensions of QoL. Discussion Our results indicate that besides affective reactions, the fear of cancer survivors to lose independence, not being able to attend to their own lives, seems to be a considerable threat, especially in the context of Romanian health system which has difficulties in offering qualitative psychosocial care for cancer patients. The idea that patients will have to rely on others and may not function well independently, not being able to attend to their own lives, seems to be a considerable threat, next to the experienced affective reactions per se.
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Affiliation(s)
- Éva Kállay
- Faculty of Psychology and Educational Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Flavia Medrea
- Faculty of Psychology and Educational Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Andrea Müller-Fábián
- Faculty of Sociology and Social Work, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - László Csaba Dégi
- Faculty of Sociology and Social Work, Babeș-Bolyai University, Cluj-Napoca, Romania
- *Correspondence: László Csaba Dégi,
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Amonoo HL, Abdul-Rahim SA, Atobrah D, Addo-Mensah D, Longley RM, Jacobo MC, Pirl WF. Psychosocial oncology in Sub-Saharan Africa: Lessons from Ghana. Psychooncology 2023; 32:139-147. [PMID: 35584290 DOI: 10.1002/pon.5965] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Hermioni L Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Salisu A Abdul-Rahim
- National Radiotherapy, Oncology, and Nuclear Medicine Center, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Deborah Atobrah
- Institute of African Studies, University of Ghana, Accra, Ghana
| | - Dorothy Addo-Mensah
- Department of Adult Health, School of Nursing and Midwifery, University of Cape-Coast, Cape-Coast, Ghana
| | - Regina M Longley
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Michelle C Jacobo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - William F Pirl
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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12
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Kim Y, Ting A, Carver CS, Bahcivan O, Bergerot CD, Csaba D, Estape T, Fujisawa D, Goswami SS, Lam WWT, Parvu A, Shim EJ, Serpentini S, Takeuchi E, Wang A. International collaboration for assessing unmet needs of cancer survivors and family caregivers: Lens of healthcare professionals. Psychooncology 2023; 32:77-85. [PMID: 36251612 PMCID: PMC10741249 DOI: 10.1002/pon.6051] [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: 04/04/2022] [Revised: 08/07/2022] [Accepted: 09/28/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Cancer patients and their family caregivers have reported various needs that are not met. Recognition of the unmet needs by healthcare professionals may be a first step to adequately and systematically addressing them. Thus, the International Psycho-Oncology Society Survivorship Online Survey was developed to measure healthcare professionals' evaluation about the unmet needs of their patients and family caregivers around the globe. METHODS The survey was developed in English and translated to additional 14 different languages. The survey was distributed on the web-based REDCap application to over 50 psycho-oncology societies and their networking platforms as well as social media and to authors who have published in psycho-oncology journals globally. RESULTS A total of 1472 participants from 36 countries at least partially completed the survey. Healthcare professionals evaluated needs for managing one's emotional distress and patients' medical care and symptoms as the most common concerns for both patients and their family caregivers across all patient age groups. Less than two-thirds of the participating healthcare professionals reported that their institution had services or programs to address the needs of the patients or caregivers. CONCLUSIONS Findings suggest several directions for further analyses to provide more specific information that would be readily translated into clinical practices, research, and policy aimed to enhance the quality of life of cancer patients, survivors, and family caregivers around the globe. In addition, this collaborative effort also hints at the importance of establishing international networks to promote equity in care for people touched by cancer worldwide.
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Affiliation(s)
| | - Amanda Ting
- University of Miami, Coral Gables, Florida, USA
| | | | - Ozan Bahcivan
- Psycho-Oncological Association and Oz Psychology Family Counseling Centre, Izmir, Turkey
| | | | - Degi Csaba
- Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Tania Estape
- Fundación para La Educación y La Formación en Cáncer, Barcelona, Spain
| | | | | | | | | | | | | | - Emi Takeuchi
- National Cancer Center, Cancer Control Institute, Tokyo, Japan
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13
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Dirar A, Mekonnen W, Berhanu Z. The Experiences of Cervical Cancer Patients During Follow-Up Care in Ethiopia: A Qualitative Study. Cancer Manag Res 2022; 14:2507-2518. [PMID: 36035503 PMCID: PMC9416456 DOI: 10.2147/cmar.s373379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of the study was to explore the experiences among cervical cancer patients during follow-up care. Patients and Methods A qualitative study was conducted with purposively selected cervical cancer patients receiving follow-up treatment at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Data were collected using semi-structured interviews and analyzed via thematic analysis. Results The results obtained in this study indicated that women experienced a variety of physical and psychosocial difficulties in the context of cervical cancer care. The data analysis resulted in five themes. Women have undergone difficulties indicated as lack of satisfaction with the health care experience, dealing with treatment side effects, struggle in work and daily life, having stress, disruption in social relationships, and financial difficulties incurred because of their illness and treatment. Conclusion This study highlights that cervical cancer patient’s experience is the outcome of a complex interplay by personal, clinical, psychological, and social spheres. Thus, interdisciplinary approach between health and psychosocial professionals is needed during follow-up care in order to help women experience better psychosocial adjustment.
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Affiliation(s)
- Anteneh Dirar
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | | | - Zena Berhanu
- School of Social Work, Addis Ababa University, Addis Ababa, Ethiopia
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14
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Deatrick JA, Kazak AE, Scialla MA, Madden RE, McDonnell GA, Okonak K, Barakat LP. Advancing health equity in pediatric cancer through implementation of universal family psychosocial risk screening. Psychooncology 2022; 31:1483-1490. [PMID: 35726382 DOI: 10.1002/pon.5978] [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: 02/12/2022] [Revised: 04/29/2022] [Accepted: 06/08/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Unaddressed psychosocial risks may contribute to disparities in cancer care outcomes and may be addressed by early psychosocial risk screening. In a study implementing universal family psychosocial risk screening in 18 children's cancer programs in the United States, parents, clinicians, and organizational leaders described the importance of universal screening to health equity. PURPOSES The purposes of this study were to (1) describe the perspectives of parents, clinicians, and organizational leaders regarding the importance of universal family psychosocial risk screening in childhood cancer care and (2) identify barriers and facilitators to improving health equity and decreasing health disparities in childhood cancer through universal family psychosocial screening. METHODS Nineteen participants (parent advocates, clinicians, leaders in professional organizations and healthcare policy) were interviewed. Directed content analysis was used to identify thematic descriptions. RESULTS Theme 1: Personal (individual child and family) and systemic barriers to health care contribute to health disparities and can be identified by universal family psychosocial risk screening in pediatric cancer. Theme 2: Universal family psychosocial risk screening in pediatric cancer creates the opportunity for health equity through personalized psychosocial care. Theme 3: Recognition of health inequities and guidance from the Standards of Psychosocial Care for Children with Cancer and their Families suggest that clinicians and healthcare systems are ethically obligated to screen, provide resources, and advocate for services to meet identified needs. CONCLUSIONS Universal family psychosocial risk screening in pediatric oncology creates the opportunity to support efforts for health equity by guiding delivery of personalized psychosocial care. TRIAL REGISTRATION NCT04446728 23 June 2020.
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Affiliation(s)
- Janet A Deatrick
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science of Nemours Children's Health, Wilmington, Delaware, USA.,Department of Pediatrics, Sidney Kimmel Medical School of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Michele A Scialla
- Nemours Center for Healthcare Delivery Science of Nemours Children's Health, Wilmington, Delaware, USA
| | - Rebecca E Madden
- Divison of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Glynnis A McDonnell
- Nemours Center for Healthcare Delivery Science of Nemours Children's Health, Wilmington, Delaware, USA
| | - Katherine Okonak
- Nemours Center for Healthcare Delivery Science of Nemours Children's Health, Wilmington, Delaware, USA
| | - Lamia P Barakat
- Divison of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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15
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Frick J, Gebert P, Grittner U, Letsch A, Schindel D, Schenk L. Identifying and handling unbalanced baseline characteristics in a non-randomized, controlled, multicenter social care nurse intervention study for patients in advanced stages of cancer. BMC Cancer 2022; 22:560. [PMID: 35585571 PMCID: PMC9118792 DOI: 10.1186/s12885-022-09646-6] [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: 10/07/2021] [Accepted: 05/06/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose Given the psychosocial burdens patients in advanced stages of cancer face, innovative care concepts are needed. At the same time, such vulnerable patient groups are difficult to reach for participation in intervention studies and randomized patient inclusion may not be feasible. This article aims to identify systematic biases respectively selection effects occurring during the recruitment phase and to discuss their potential causes based on a non-randomized, multicenter intervention study with patients in advanced stages of cancer. Methods Patients diagnosed with at least one of 16 predefined cancers were recruited at four hospitals in three German cities. The effect of social care nurses’ continuous involvement in acute oncology wards was measured by health-related quality of life (EORTC QLQ-C30), information and participation preferences, decisional conflicts, doctor-patient communication, health literacy and symptom perception. Absolute standardized mean difference was calculated as a standardized effect size to test baseline characteristics balance between the intervention and control groups. Results The study enrolled 362 patients, 150 in the intervention and 212 in the control group. Except for gender, both groups differed in relevant socio-demographic characteristics, e.g. regarding age and educational background. With respect to the distribution of diagnoses, the intervention group showed a higher symptom burden than the control group. Moreover, the control group reported better quality of life at baseline compared to the intervention group (52.6 points (SD 21.7); 47.8 points (SD 22.0), ASMD = 0.218, p = 0.044). Conclusion Overall, the intervention group showed more social and health vulnerability than the control group. Among other factors, the wide range of diagnoses included and structural variation between the recruiting clinics increased the risk for bias. We recommend a close, continuous monitoring of relevant social and health-related characteristics during the recruitment phase as well as the use of appropriate statistical analysis strategies for adjustment, such as propensity score methods. Trial registration: German Clinical Trials Register (DRKS-ID: DRKS00013640); registered on 29th December 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09646-6.
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Affiliation(s)
- Johann Frick
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany
| | - Pimrapat Gebert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
| | - Ulrike Grittner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
| | - Anne Letsch
- Department of Medicine II, Hematology and Oncology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Charitéplatz 1, 10117, Berlin, Germany
| | - Daniel Schindel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany.
| | - Liane Schenk
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany
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16
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Kagee A. The need for psychosocial oncology research in sub-Saharan Africa: a review of the terrain. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2022. [DOI: 10.1177/00812463221093842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cancer is a major cause of morbidity and mortality in many sub-Saharan African countries, but the field of psycho-oncology is underdeveloped. This article reviews the literature on psychosocial oncology in sub-Saharan African with a view to developing a research and practice agenda in the field. The search engines used were Google Scholar, Psych Info, Web of Science, and PubMed and articles were focused on but not limited to the past 10 years. The search terms were ‘Africa, psycho-oncology, psychosocial oncology, mental health, and cancer’. The review is structured as follows: cancer surveillance in sub-Saharan African, behavioural risk factors, cancer screening, and psychosocial issues related to various types of cancers. Psychological reactions in the context of cancer including adjustment, depression, and anxiety disorders are also discussed. It is suggested that sub-Saharan African countries require appropriate funding to support improved systems of surveillance and implementation of cancer registries. Public health and behavioural interventions are needed to increase the awareness of cervical cancer and preventive health-seeking behaviour among high-risk women. Restrictive laws on opioids need to be reconsidered and behavioural health campaigns to control obesity, limit salt intake, and increase awareness of the risks of ultra-violet light are necessary to reduce the incidence of various cancers. Psychosocial support is necessary to ameliorate depressed mood, anxiety, and anticipation and fear of death among persons living with cancer and their families in sub-Saharan Africa. To this end, the training of practitioners to strengthen psychosocial aspects of care, especially palliative care, is a priority.
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Affiliation(s)
- Ashraf Kagee
- Department of Psychology, Stellenbosch University, South Africa
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17
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Zhang A, Zebrack B, Acquati C, Roth M, Levin NJ, Wang K, Schwartz S. Technology-Assisted Psychosocial Interventions for Childhood, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis. J Adolesc Young Adult Oncol 2022; 11:6-16. [PMID: 33960845 PMCID: PMC8864427 DOI: 10.1089/jayao.2021.0012] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose: Technology-assisted interventions are essential in supporting cancer survivors' psychosocial outcomes, especially for childhood, adolescent, and young adult (AYA) cancer survivors, a tech-savvy generation. This study aims to systematically evaluate review and meta-analyze technology-assisted interventions for childhood and AYA cancer survivors. Methods: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, the study team used a pre-set of key words and searched studies across 11 electronic databases and 4 professional websites, and conducted a manual search of reference lists from published reviews. Meta-analysis of small sample size corrected Hedges' g was conducted using meta-regression with robust variance estimation. Results: Final analysis included a total of 28 clinical trials, including 237 effect sizes reported an overall statistically significant treatment effect of technology-assisted psychosocial interventions for childhood and AYA cancer survivors, g = 0.382, 95% confidence interval (CI) 0.243 to 0.521, p < 0.0001. Subgroup analysis revealed that distraction-based interventions and interventions for psychosocial and emotional health were overall statistically significant, whereas interventions for childhood and AYA cancer survivors' cancer knowledge outcomes and physical and functional health outcomes were statistically nonsignificant. Moderator analysis found intervention target was a significant moderator. Conclusions: Technology-assisted interventions for childhood and AYA cancer survivors were overall effective across domains of survivorship outcomes. Favorable evidence was found primarily for childhood cancer survivors with limited support for AYA cancer survivors. Implications for Cancer Survivors: Although existing technology-assisted interventions are overall promising, research support for cancer survivors from different age groups and with different psychosocial challenges varies and should be considered individually.
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Affiliation(s)
- Anao Zhang
- University of Michigan School of Social Work, Ann Arbor, Michigan, USA.,Address correspondence to: Anao Zhang, PhD, MSW, University of Michigan School of Social Work, 1080 S. University Ave., Ann Arbor, MI 48109, USA
| | - Bradley Zebrack
- University of Michigan School of Social Work, Ann Arbor, Michigan, USA
| | - Chiara Acquati
- University of Houston Graduate College of Social Work; and The University of Texas MD Anderson Cancer Center Department of Health Disparities Research, Houston, Texas, USA
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Nina Jackson Levin
- University of Michigan School of Social Work, and Department of Anthropology, Ann Arbor, Michigan, USA
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Samantha Schwartz
- University of Michigan School of Social Work, Ann Arbor, Michigan, USA
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18
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Zomerdijk N, I Jongenelis M, Turner J, Huntley K, Smith A, Short CE. Telehealth access among hematology patients during the COVID-19 pandemic in Australia: a cross-sectional survey. Leuk Lymphoma 2022; 63:1488-1491. [PMID: 34989290 DOI: 10.1080/10428194.2021.2023743] [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: 10/19/2022]
Abstract
Hematology patients are more vulnerable to the effects of COVID-19 than patients with other cancers. We surveyed hematology patients to better understand their experiences of cancer care during the pandemic. A large reduction was observed in the number of healthcare services accessed by respondents. Telehealth assisted with access but requires improvement.
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Affiliation(s)
- Nienke Zomerdijk
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Victorian Comprehensive Cancer Centre Alliance, Melbourne, Australia
| | - Michelle I Jongenelis
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Melbourne Centre for Behaviour Change, University of Melbourne, Melbourne, Australia
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Australia
| | | | | | - Camille E Short
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Melbourne Centre for Behaviour Change, University of Melbourne, Melbourne, Australia.,School of Health Sciences, University of Melbourne, Melbourne, Australia
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19
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Madl M, Lieb M, Schieber K, Erim Y. The influence of patient-related factors on the frequency and duration of psycho-oncological sessions in a university cancer center. J Psychosoc Oncol 2021; 40:380-396. [PMID: 34860144 DOI: 10.1080/07347332.2021.1964013] [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: 10/19/2022]
Abstract
OBJECTIVE The present study aimed at identifying factors that are associated with the frequency and duration of psycho-oncological sessions. DESIGN In a retrospective single-center study, data of all patients who made use of the psycho-oncological service (POS) at the University Hospital Erlangen from April 2017 - March 2018 were registered. SAMPLE Over the course of one year, N = 1601 patients made use of the POS. METHODS In the hospital's digital documentation system, relevant data such as frequency of sessions, duration of sessions, gender, age, family status, preexisting mental disorder, prior psychotherapy, cancer entity (type of cancer) and treatment modality were recorded. Socio-demographic and clinical parameters were analyzed to predict frequency and duration of the psycho-oncology sessions. FINDINGS Regression analyses revealed that among POS users, women, younger patients, patients with a longer hospital stay and those with a preexisting mental disorder attended significantly more sessions than other patients (p < .001). Patients with skin cancer had significantly fewer POS sessions than those with a hematological diagnosis. Also, patients who had undergone surgery had significantly fewer sessions than patients with pharmacological treatment. Younger age and a longer hospital stay significantly predicted longer sessions (p < .001). In the regression model, patients with brain tumors and lung cancer had significantly longer sessions than patients with skin cancer. IMPLICATIONS With the identification of specific risk groups that require more and longer sessions, we can provide the basis for more patient-tailored intervention approaches and better scheduling according to the patients' needs. However, our results also suggest that the frequency and duration of POS sessions also depend on illness- and treatment-related criteria, e.g. the length of the hospital stay.
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Affiliation(s)
- Martina Madl
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Katharina Schieber
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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20
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Grassi L, Riba M. Psychiatric care in oncology and palliative medicine: new challenges and future perspectives. World Psychiatry 2021; 20:452-453. [PMID: 34505379 PMCID: PMC8429337 DOI: 10.1002/wps.20836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Michelle Riba
- Department of Psychiatry and Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
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21
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Caminiti C, Annunziata MA, Verusio C, Pinto C, Airoldi M, Aragona M, Caputo F, Cinieri S, Giordani P, Gori S, Mattioli R, Novello S, Pazzola A, Procopio G, Russo A, Sarobba G, Zerilli F, Diodati F, Iezzi E, Maglietta G, Passalacqua R. Effectiveness of a Psychosocial Care Quality Improvement Strategy to Address Quality of Life in Patients With Cancer: The HuCare2 Stepped-Wedge Cluster Randomized Trial. JAMA Netw Open 2021; 4:e2128667. [PMID: 34648011 PMCID: PMC8517739 DOI: 10.1001/jamanetworkopen.2021.28667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Many patients with cancer who would benefit from psychosocial care do not receive it. Implementation strategies may favor the integration of psychosocial care into practice and improve patient outcomes. OBJECTIVE To evaluate the effectiveness of the Humanization in Cancer Care (HuCare) Quality Improvement Strategy vs standard care as improvement of at least 1 of 2 domains (emotional or social function) of patient health-related quality of life at baseline and 3 months. A key secondary aim included investigation of the long-term effect. DESIGN, SETTING, AND PARTICIPANTS HuCare2 was a multicenter, incomplete, stepped-wedge cluster randomized clinical trial, conducted from May 30, 2016, to August 28, 2019, in three 5-center clusters of cancer centers representative of hospital size and geographic location in Italy. The study was divided into 5 equally spaced epochs. Implementation sequence was defined by a blinded statistician; the nature of the intervention precluded blinding for clinical staff. Participants included consecutive adult outpatients with newly diagnosed cancer of any type and stage starting medical cancer treatment. INTERVENTIONS The HuCare Quality Improvement Strategy comprised (1) clinician communication training, (2) on-site visits for context analysis and problem-solving, and (3) implementation of 6 evidence-based recommendations. MAIN OUTCOMES AND MEASURES The primary outcome was the difference between the means of changes of individual scores in emotional or social functions of health-related quality of life detected at baseline and 3-month follow-up (within each group) and during the postintervention epoch compared with control periods (between groups). Long-term effect of the intervention (at 12 months) was assessed as a secondary outcome. Intention-to-treat analysis was used. RESULTS A total of 762 patients (475 [62.3%] women) were enrolled (400 HuCare Quality Improvement Strategy and 362 usual care); mean (SD) age was 61.4 (13.1) years. The HuCare Quality Improvement Strategy significantly improved emotional function during treatment (odds ratio [OR], 1.13; 95% CI, 1.04-1.22; P = .008) but not social function (OR, 0.99; 95% CI, 0.89-1.09; P = .80). Effect on emotional function persisted at 12 months (OR, 1.05; 95% CI, 1.00-1.10; P = .04). CONCLUSIONS AND RELEVANCE In this trial, the HuCare Quality Improvement Strategy significantly improved the emotional function aspect of health-related quality of life during cancer treatment and at 12 months, indicating a change in clinician behavior and in ward organization. These findings support the need for strategies to introduce psychosocial care; however, more research is needed on factors that may maximize the effects. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03008993.
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Affiliation(s)
- Caterina Caminiti
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | | | - Claudio Verusio
- Department of Oncology, ASST Valle Olona, Busto Arsizio, Varese, Italy
| | - Carmine Pinto
- Medical Oncology Unit, Clinical Cancer Center, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Mario Airoldi
- Second Medical Oncology Division, AOU Città della Salute e della Scienza of Turin, Turin, Italy
| | - Marcello Aragona
- Medical Oncology Unit, Department of Human Pathology of Adult and Evolutive Age, University of Messina, Messina, Italy
| | | | - Saverio Cinieri
- Oncology Unit, San Antonio Perrino Hospital, Brindisi, Italy
| | - Paolo Giordani
- Medical Oncology Unit, Ospedali Riuniti Marche Nord, Pesaro and Fano, Italy
| | - Stefania Gori
- Medical Oncology Division, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Rodolfo Mattioli
- Medical Oncology Unit, Ospedali Riuniti Marche Nord, Pesaro and Fano, Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, AOU San Luigi Orbassano, Italy
| | - Antonio Pazzola
- Medical Oncology Unit, University-Hospital of Sassari, Sassari, Italy
| | - Giuseppe Procopio
- Department of Medical Oncology, National Cancer Institute of Milan, Milan, Italy
| | - Antonio Russo
- Medical Oncology Unit, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Giuseppina Sarobba
- Oncology Unit, San Francesco Hospital, ATS Sardegna ASSL Nuoro, Nuoro, Italy
| | | | - Francesca Diodati
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | - Elisa Iezzi
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | - Giuseppe Maglietta
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | - Rodolfo Passalacqua
- Medical Oncology Division, Department of Oncology, ASST of Cremona, Cremona, Italy
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22
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de Heus E, van der Zwan JM, Husson O, Frissen AR, van Herpen CML, Merkx MAW, Duijts SFA. Unmet supportive care needs of patients with rare cancer: A systematic review. Eur J Cancer Care (Engl) 2021; 30:e13502. [PMID: 34409667 DOI: 10.1111/ecc.13502] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/04/2021] [Accepted: 07/27/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Patients with rare cancers may experience different unmet needs than those with common cancer. The objective of this systematic review was to (1) investigate unmet supportive care needs of rare cancer patients throughout the disease trajectory and (2) identify predictive factors for these unmet needs. METHODS PubMed, PsycINFO and CINAHL were searched for publications (January 2011 to March 2021) focusing on unmet needs of patients with rare cancer. Two reviewers independently selected studies, extracted data and performed quality assessment. Findings were synthesised. RESULTS The search yielded 4,598 articles, of which 59 articles met eligibility criteria and 57 were of medium or high quality. Rare cancer patients most frequently reported unmet needs in the healthcare system and information domain (up to 95%), followed by the psychological domain (up to 93%) and the physical and daily living domain (up to 80%). Unmet needs were mainly reported in the posttreatment phase. The most frequently identified predictors were higher anxiety, younger age and higher neuroticism. CONCLUSION Patients with rare cancer have unmet needs throughout their disease trajectory. Supportive care needs of rare cancer patients should be addressed individually, depending on the rare cancer subdomain and phase of disease and from diagnosis onwards.
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Affiliation(s)
- Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Maarten van der Zwan
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Olga Husson
- Division of Psychosocial Research and Epidemiology and Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anne-Roos Frissen
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Carla M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Matthias A W Merkx
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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23
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Walker ZJ, Xue S, Jones MP, Ravindran AV. Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle-Income Countries: A Systematic Review and Meta-Analysis. JCO Glob Oncol 2021; 7:1233-1250. [PMID: 34343029 PMCID: PMC8457869 DOI: 10.1200/go.21.00056] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Cancer is a growing public health issue in low- and lower-middle–income countries (LLMICs), but the mental health consequences in this setting have not been well-characterized. We aimed to systematically evaluate the available literature on the prevalence, associates, and treatment of mental disorders in patients with cancer in LLMICs.
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Affiliation(s)
- Zoe J Walker
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Royal Hobart Hospital, Hobart, Australia
| | - Siqi Xue
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michael P Jones
- Royal Hobart Hospital, Hobart, Australia.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, Toronto, Toronto, Ontario, Canada
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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24
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Lingens SP, Schulz H, Bleich C. Evaluations of psychosocial cancer support services: A scoping review. PLoS One 2021; 16:e0251126. [PMID: 33945585 PMCID: PMC8096026 DOI: 10.1371/journal.pone.0251126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 04/20/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A diagnosis of cancer leaves most patients with cancer and their relatives with an increased psychological burden. Throughout the course of the illness, social, occupational or legal changes may lead to psychological distress. Psychosocial cancer support services offer psychological, social and legal support. However, little is known about the effectiveness of psychosocial support services implemented in health care. Therefore, this scoping review aims to provide an overview of current literature evaluating out-patient psychosocial support services. METHODS Databases searched were PubMed, PsycINFO, PSYNDEX, PsycArticle, Medline, Web of Science, Google Scholar, Cochrane, and Embase. Two independent researchers conducted the systematic search. We included studies that were published in English and assessed at least one patient reported outcome measure. Studies that assessed psychotherapy, online support or telephone counselling were excluded. The review was reported according to PRISMA-ScR guidelines. A search of the databases identified 2104 articles. After excluding duplicates, screening titles, abstracts and full-texts, 12 studies matching the criteria were identified. RESULTS One study was an RCT, six were prospective with no control group and five studies were cross-sectional with one measurement point. The most common outcome measures across studies were well-being, concerns and satisfaction with the support services. CONCLUSION While the included studies indicate some improvements to well-being for patients with cancer, the low number and lack of high quality of studies indicate these findings should be interpreted with caution. However, high-quality research on the effectiveness of psychosocial support services is needed to determine that the interventions are effective.
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Affiliation(s)
- Solveigh P. Lingens
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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25
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Antone N, Kizub D, Gralow J, Zujewski JA, Dvaladze A. Advancing Breast Cancer Advocacy in Eastern Europe and Central Asia: Findings From Women's Empowerment Cancer Advocacy Network (WE CAN) Summits. JCO Glob Oncol 2021; 7:585-592. [PMID: 33891477 PMCID: PMC8162962 DOI: 10.1200/go.20.00532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/03/2021] [Accepted: 03/09/2021] [Indexed: 12/09/2022] Open
Abstract
PURPOSE Breast cancer civil society organizations have emerged in Eastern Europe and Central Asia to raise awareness about cancer as a survivable disease and provide patient support. We explored the experiences and priorities of these organizations with the goal of making recommendations to advance cancer advocacy and improve cancer care. METHODS We conducted in-depth interviews and focus group discussions with representatives of civil society organizations attending the 7th Women's Empowerment Cancer Advocacy Network Summit in Romania in 2015. Interviews were audiorecorded, transcribed, coded, and analyzed for key themes. Findings were discussed at the 8th Women's Empowerment Cancer Advocacy Network Summit in Ukraine in 2017 to ensure accuracy. RESULTS We conducted nine in-depth interviews and three focus group discussions with a total of 36 participants. Survivor- and oncologist-led organizations played an important role in filling existing gaps in public health care systems through awareness raising, patient support, and advocacy to improve early detection and access to treatment. Barriers to these efforts included persistent stigma, mistrust of patients toward the public health care system, limited access to evidence-based guidelines, difficulty adapting existing best practices to their setting, and insufficient involvement of policymakers. Key facilitators of advocacy efforts included effective local and international partnerships with physicians, like-minded organizations, and policymakers to facilitate access to educational resources, improve breast cancer early detection and care, and catalyze meaningful policy change. CONCLUSION Our findings highlight the value of providing opportunities for advocates to connect and share experiences. To advance cancer advocacy and improve cancer care, the following needs were identified: dissemination of resource-adapted information for improving outcomes; needs assessments; improved program-monitoring practices; and fostering and promotion of collaboration between advocates, medical professionals, and local governments.
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Affiliation(s)
| | | | - Julie Gralow
- University of Washington, Seattle, WA
- Seattle Cancer Care Alliance, Seattle, WA
| | | | - Allison Dvaladze
- University of Washington, Seattle, WA
- Seattle Cancer Care Alliance, Seattle, WA
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26
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Newton JC, O'Connor M, Saunders C, Moorin R, Ali S, Nowak AK, Halkett GKB. The role of psychosocial support in the experiences of people living with advanced cancer: A qualitative exploration of patients' perspectives. Psychooncology 2020; 30:287-295. [PMID: 33037707 DOI: 10.1002/pon.5569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/21/2020] [Accepted: 10/06/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND People living with advanced cancer experience significant distress and reduced quality of life due to their symptom burden and life-limiting prognosis. Limited qualitative research has investigated their experiences accessing psychosocial supportive care, and how it meets their needs. AIM To explore patients' perspectives of the role of psychosocial support in their experiences of living with advanced cancer. METHODS This study used an exploratory qualitative research design and drew upon a social constructionist interpretive framework. Semi-structured interviews were conducted with 23 participants. Participants were asked about their experiences accessing and using psychosocial support following their diagnosis. Audio-recorded interviews were transcribed and analysed using deductive thematic analysis. RESULTS The following six themes can be used to describe participants' experiences with psychosocial support: (1) accessing different types of support, (2) appreciating support, (3) need, (4) difficulties accessing support, (5) knowing about support and (6) asking for support. Sources of psychosocial support included family and friends, health professionals, and psychosocial supportive care services. Not all participants were able to access care that met their needs; barriers included suitability of available support, accessibility and stigma surrounding support use. CONCLUSION Participants experienced broad variation in their awareness and access to psychosocial support services to meet their needs. Providers of psychosocial supportive care for advanced cancer patients need to consider service accessibility issues. Future psychosocial interventions targeting people living with advanced cancer should consider these issues during development and implementation.
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Affiliation(s)
- Jade C Newton
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Moira O'Connor
- WA Cancer Prevention Research Unit (WACPRU), School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Christobel Saunders
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Rachael Moorin
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Sayed Ali
- Medical Oncology Department, St John of God Midland Public Hospital, Midland, Western Australia, Australia
| | - Anna K Nowak
- Medical School, The University of Western Australia, Perth, Western Australia, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Georgia K B Halkett
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
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Abstract
Because of the increasing global cancer burden and the WHO epidemiological estimation in terms of number of new cases, deaths and long-survivors worldwide, an interdisciplinary approach, including psychiatric and psychoncology care is mandatory in oncology. About 50% of cancer patients have in fact been shown to have psychiatric disorders, including clinically significant emotional distress and/or unrecognised or untreated psychosocial conditions as a consequence of cancer at some point during the cancer trajectory. These problems are associated with the patient's reduction of quality of life, impairment in social relationships, longer rehabilitation time, poor adherence to treatment and abnormal illness behaviour. Because of these reasons, the internationally recognised IPOS Standards of Quality Cancer Care underline that psychosocial cancer care should be recognised as a universal human right; that quality cancer care must integrate the psychosocial domain into routine care and that distress should be measured as the sixth vital sign after temperature, blood pressure, pulse, respiratory rate and pain. In spite of social inequalities still existing between countries in the organisation and implementation of psychosocial oncology, recommendations and guidelines are available regarding screening, assessment and intervention to psychiatric and psychosocial disorders across the trajectory of cancer. The clinical and political agenda of psychoncology as a mandatory component of a whole comprehensive person-centred approach to cancer should therefore be acknowledged in psychiatry.
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28
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Almada AL, Casquinha P, Cotovio V, Santos MJHD, Caixeiro A. The Potential Role of Psychosocial Rehabilitation in Palliative Care. J R Coll Physicians Edinb 2018; 48:311-317. [DOI: 10.4997/jrcpe.2018.405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Palliative care is an approach to incurable and/or severe disease with limited prognosis, aiming to relieve the suffering and improve the quality of life of patients and their families. The existence of psychopathology is common in patients undergoing palliative care, and psychiatric comorbidities, such as depression and anxiety, are frequent and often underdiagnosed. This work constitutes a review of the literature and a reflection on the potential role of psychosocial rehabilitation in mental health in palliative care. Psychosocial rehabilitation may play a role in the mental health of patients undergoing palliative care, contributing to the minimisation of symptoms, support in daily life activities, the improvement of quality of life and the preparation for death.
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Affiliation(s)
- AL Almada
- Psychiatric resident (5th year), Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | - P Casquinha
- Psychiatrist, Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | - V Cotovio
- Psychiatrist and Psychotherapist, Clinical Director of the Psychiatric Hospital, Casa de Saúde do Telhal, Sintra, Portugal
| | - MJ Heitor dos Santos
- Psychiatrist, Instituto de Medicina Preventiva e Saúde Pública, Universidade de Lisboa, Portugal
- Psychiatrist, Instituto de Saúde Ambiental Faculdade de Medicina, Universidade de Lisboa, Portugal
- Head of the Psychiatry and Mental Health Department of Hospital Beatriz Ângelo, Loures, Portugal
| | - A Caixeiro
- Psychiatrist, Head of the Rehabilitation Unit in Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
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29
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Fernández-Rodríguez C, Villoria-Fernández E, Fernández-García P, González-Fernández S, Pérez-Álvarez M. Effects of Behavioral Activation on the Quality of Life and Emotional State of Lung Cancer and Breast Cancer Patients During Chemotherapy Treatment. Behav Modif 2017; 43:151-180. [PMID: 29276837 DOI: 10.1177/0145445517746915] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Research suggests that the progressive abandonment of activities in cancer patients are related to depression and worse quality of life. Behavioral activation (BA) encourages subjects to activate their sources of reinforcement and modify the avoidance responses. This study assesses the effectiveness of BA in improving quality of life and preventing emotional disorders during chemotherapy treatment. One sample of lung cancer patients and another of breast cancer patients were randomized into a BA experimental group (E.G.lung/4sess.n = 50; E.G.breast/6sess.n = 33) and a control group (C.G.lung/4sess.n = 40; C.G.breast/6sess.n = 35), respectively. In each session and in follow-ups (3/6/9 months), all participants completed different assessment scales. The results converge to show the effectiveness of BA, encouraging cancer patients to maintain rewarding activities which can activate their sources of day-to-day reinforcement and modify their experience avoidance patterns. BA appears to be a practical intervention which may improve social and role functioning and the emotional state of cancer patients during chemotherapy treatment.
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30
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Burnout among psychosocial oncologists in Israel: The direct and indirect effects of job demands and job resources. Palliat Support Care 2017; 16:677-684. [PMID: 29254511 DOI: 10.1017/s1478951517001006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Psychosocial oncologists may be particularly vulnerable to burnout. This study aimed to assess burnout among Israeli psychosocial oncologists in relation to the Job Demands-Resources model and the coping strategies model. METHOD Participants included 85 of 128 listed psychosocial oncologists currently working with cancer patients. They completed a questionnaire assessing emotional exhaustion, depersonalization, job demands, job resources, work engagement, overcommitment, and perceived value of work. RESULTS The mean level of burnout was low, whereas 16.3% experienced high levels of emotional exhaustion and only 2.4% experienced high levels of depersonalization. According to mediation analysis, overcommitment, partially mediated job demands-burnout associations, and work engagement mediated the perceived value-burnout association. Job resources and burnout were not related, either directly or indirectly.Significance of resultsThe study extended the Job Demands-Resources model to include perceived value as an additional resource, and work-engagement and overcommitment as coping strategies. Two distinct patterns of associations were found between work characteristics and burnout: the positive-protective pattern (perceived value and work engagement) and the negative pattern (job demands and overcommitment). These two patterns should be considered for further research and for implementing preventive interventions to reduce burnout in the workplace setting.
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Abstract
Cancer is a devastating disease causing significant psychological problems among patients and their families. In the past few decades, there have been growing implementation and dissemination of screening methods for the psychological consequences of cancer, including distress, depression, anxiety, post-traumatic stress, and demoralisation. Also, guidelines for the management of psychological distress have been developed and endorsed by a number of scientific cancer associations. This review examines some of the most significant related issues, also focusing on recent advances in psychosocial and psychopharmacological interventions as a part of a mandatory, integrated, and comprehensive approach to cancer care.
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Affiliation(s)
- Luigi Grassi
- University Hospital Psychiatric Unit, Integrated Department of Mental Health and Addictive Behavior, S. Anna University Hospital and Health Trust, Ferrara, Italy
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - David Spiegel
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Michelle Riba
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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32
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Caruso R, Nanni MG, Riba MB, Sabato S, Grassi L. The burden of psychosocial morbidity related to cancer: patient and family issues. Int Rev Psychiatry 2017; 29:389-402. [PMID: 28753076 DOI: 10.1080/09540261.2017.1288090] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
With cancer incidence increasing over time, attention to the burden of related psychiatric and psychosocial consequences of the disease and treatment is a major topic for both cancer patients and their caregivers. Among cancer patients, psychiatric (e.g. adjustment, anxiety, depressive disorders) and neuropsychiatric disorders (e.g. cognitive disorders secondary to treatment, delirium) have been shown to affect an average of 30-35% patients, with differences according to stage and type of cancer. Also other psychosocial syndromes (e.g. demoralization, health anxiety, irritable mood) not taken into account in usual nosological systems should be considered for their impact on the patient's quality-of-life. Also, it has been repeatedly reported that psychological distress reverberates substantially throughout the nuclear family, and that a family approach is necessary in cancer care, with the caregiver-patient dyad as a unit to be the focus and direction of assessment and intervention. In this review the most significant psychosocial disorders causing burden for cancer patients and their caregivers are examined, and the main methods of assessment for more proper referral and treatment are summarized.
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Affiliation(s)
- Rosangela Caruso
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
| | - Mara Giulia Nanni
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
| | - Michelle B Riba
- c Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA.,d University of Michigan Comprehensive Cancer Center , Ann Arbor , MI , USA.,e Psycho-oncology Program , University of Michigan Comprehensive Cancer Center , Ann Arbor , MI , USA
| | - Silvana Sabato
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy
| | - Luigi Grassi
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
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Travado L, Bultz BD, Ullrich A, Asuzu CC, Turner J, Grassi L, Jacobsen P. 2016 President's Plenary International Psycho-Oncology Society: challenges and opportunities for growing and developing psychosocial oncology programmes worldwide. Psychooncology 2017; 26:1231-1238. [PMID: 28599340 DOI: 10.1002/pon.4471] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 01/02/2023]
Abstract
Consistent with the International Psycho-Oncology Society's (IPOS) vision and goals, we are committed to improving quality cancer care and cancer policies through psychosocial care globally. As part of IPOS's mission, upon entering "Official Relations" for a second term with the World Health Organization (WHO), IPOS has dedicated much attention to reaching out to countries, which lack formalized psychosocial care programmes. One of IPOS's strategies to accomplish this goal has been to bring psycho-oncology training programmes to low- and middle-income countries and regions. To this end, the IPOS Board approved a new position on the Board of Directors for a member from a low- to middle-income country (LMIC). The IPOS 2016 President's Plenary focused on challenges and opportunities that exist in growing and developing psychosocial oncology programmes worldwide. The plenary presentations highlight how IPOS and WHO have aligned their goals to help LMICs support cancer patients as an essential element of cancer and palliative care. IPOS country representatives are strongly supported in liaising with national health authorities and with WHO Country Representatives in LMICs. The plenary speakers discussed the role IPOS Federation has taken in building a global network of psychosocial leaders and the impact this had in assisting LMICs in meeting IPOS's psychosocial care objectives. The plenary highlighted the challenges of expanding psychosocial reach into these countries. One significant question remains: Can psychosocial guidelines be adapted to LMICs and regions?
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Affiliation(s)
- Luzia Travado
- Psycho-oncology Service, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - Barry D Bultz
- Daniel Family Leadership Chair in Psychosocial Oncology, Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Andreas Ullrich
- World Health Organization, Noncommunicable Diseases and Mental Health Cluster, Switzerland
| | - Chioma C Asuzu
- Department of Counselling and Human Development Studies and Unit of Psycho-Oncology, Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jane Turner
- Faculty of Medicine, The University of Queensland, St Lucia, Australia
| | - Luigi Grassi
- Institute of Psychiatry, Section of Neurology, Psychiatry and Psychology, Department of Biomedical and Speciality Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Department of Mental Health and Addictive Behavior, S. Anna University Hospital and Health Authorities, Ferrara, Italy
| | - Paul Jacobsen
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
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34
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Caruso R, GiuliaNanni M, Riba MB, Sabato S, Grassi L. Depressive Spectrum Disorders in Cancer: Diagnostic Issues and Intervention. A Critical Review. Curr Psychiatry Rep 2017; 19:33. [PMID: 28488207 PMCID: PMC5423924 DOI: 10.1007/s11920-017-0785-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Depressive spectrum disorders, including major depression, persistent depression, minor and sub-syndromal depression, and other forms of depressive conditions, such as demoralization, are among the most common psychiatric consequences of cancer patients, affecting up to 60% of patients. In spite of the negative effects and the burden for cancer patients and their families, these disorders often remain under-recognized and undertreated. The present review aims at summarizing the relevant data concerning the diagnostic challenges within the depressive spectrum disorders among cancer patients. Also, the most relevant data relative to integrated intervention, including psychopharmacological and psychosocial treatment, for depression in cancer patients are critically evaluated. It is mandatory that health care professionals working in oncology (e.g., oncologists, surgeons, radiation oncologists, primary care physicians, nurses, social workers, psychologists) receive training in the diagnosis and integrated management of the different types of disorder within the spectrum of clinical depression.
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Affiliation(s)
- Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44121, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy
| | - Maria GiuliaNanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44121, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy
| | - Michelle B Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
- Psycho-oncology Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | - Silvana Sabato
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44121, Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44121, Ferrara, Italy.
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy.
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35
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Lee HJ, Lee KM, Jung D, Shim EJ, Hahm BJ, Kim JH. Psycho-oncology in Korea: past, present and future. Biopsychosoc Med 2017; 11:12. [PMID: 28469700 PMCID: PMC5410701 DOI: 10.1186/s13030-017-0097-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 04/11/2017] [Indexed: 11/10/2022] Open
Abstract
Background Psycho-oncology in Korea was introduced among the circle of consultation-liaison psychiatrists, in the 1990s. For almost 25 years, the field has been developing at a steady pace as the psychosocial needs of patients with cancer continue to increase. In this study, we review the history of psycho-oncology in Korea, in a chronological order, within the domains of clinical practice, research activity, training, and public policy. Main body Before the 1990s, patients with cancer with psychiatric comorbidities were usually taken care of by consultation-liaison psychiatrists in general hospitals. In 1993, psycho-oncology was first introduced by psychiatrists. Psychologists, nurses, and social workers have also been increasingly involved in providing psychosocial care for patients with cancer. Professionals from various disciplines began to communicate, and agreed to found the Korean Psycho-Oncology Study Group (KPOSG) in 2006, the first academic society in this field. In 2009, National Cancer Center published the “Recommendations for Distress Management in Patients with Cancer”, which are consensus-based guidelines for Korean patients. In 2014, the KPOSG was dissolved and absorbed into a new organization, the Korean Psycho-Oncology Society (KPOS). It functions as a center of development of psycho-oncology, publishing official journals, and hosting annual conferences. There are many challenges, including, low awareness of psycho-oncology, presence of undertreated psychiatric disorders in patients with cancer, shortage of well-trained psycho-oncologists, stigma, and suicide risk. It is important to improve the cancer care system to the extent that psycho-oncology is integrated with mainstream oncology. Considering the socio-cultural characteristics of Korean cancer care, a Korean model of distress management is being prepared by the KPOS. Conclusion This article provides an overview of the development, current issues, and future challenges of psycho-oncology in Korea. Through its long journey to overcome the many barriers and stigmas of cancer and mental illnesses, psycho-oncology is now acknowledged as an essential part of integrated supportive care in cancer. Active research and international cooperation can gradually shape the Korean model of distress management.
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Affiliation(s)
- Hyun Jeong Lee
- Mental Health Clinic, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408 Republic of Korea
| | - Kwang-Min Lee
- Public Health Medical Service, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 03080 Republic of Korea.,Department of Psychiatry, Gyeonggi Provincial Medical Center Uijeongbu Hospital, 142 Heungseon-ro, Uijeongbu-si, Gyeonggi-do 11671 Republic of Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-gil, Ulsan, 44919 Republic of Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University, 2 Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan, 46241 Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 03080 Republic of Korea.,Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, 103 Daehak-ro Jongno-gu, Seoul, 03080 Republic of Korea
| | - Jong-Heun Kim
- Mental Health Clinic, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408 Republic of Korea
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Ashley L, Lawrie I. Tackling inequalities in cancer care and outcomes: psychosocial mechanisms and targets for change. Psychooncology 2016; 25:1122-1126. [DOI: 10.1002/pon.4278] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/02/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Laura Ashley
- Faculty of Health and Social Sciences; Leeds Beckett University; Leeds UK
| | - Iain Lawrie
- The Pennine Acute Hospitals NHS Trust; Manchester UK
- Faculty of Biology, Medicine and Health; The University of Manchester; Manchester UK
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