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Lahousse A, Reynebeau I, Nijs J, Beckwée D, van Wilgen P, Fernández-de-Las-Peñas C, Mostaqim K, Roose E, Leysen L. The effect of psychologically informed practice with behavioural graded activity in cancer survivors: systematic review and meta-analysis. J Cancer Surviv 2024; 18:854-899. [PMID: 36701101 PMCID: PMC9878499 DOI: 10.1007/s11764-022-01270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/01/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to determine the effectiveness of psychologically informed practice (PIP) with behavioural graded activity (BGA) compared to (1) waitlist controls (WLC), (2) other interventions (OI), (3) PIP alone or (4) BGA alone in cancer patients and survivors (CPaS). METHODS PubMed, Web of Science and Embase were screened for randomised controlled trials encompassing BGA + PIP in CPaS. Effect sizes were inventoried for outcomes regarding physical activity (PA), quality of life (QoL) and debilitating symptoms (DS), which were assessed at four time points: post-intervention (PI), follow-up F1 (1 to 3 months), F2 (4 to 6 months) and F3 (> 6 months). The quality of the evidence was classified by the GRADE approach. RESULTS Thirty-three studies were found eligible, comprising 4330 participants. Significant effects with low heterogeneity of PIP + BGA comparing to WLC were found for anxiety (SMD - 1.29 [-1.71; - 0.86]), depression (SMD - 0.79 [- 1.10; - 0.48]), functional impairment (SMD - 0.72 [- 0.95; - 0.50]), PA (self-reported: (SMD - 0.58 [- 0.84; - 0.32]) and objectively measured: (SMD - 0.51 [- 0.90; - 0.13])) and social impairment (SMD - 0.33 [- 0.58; - 0.08]). When comparing PIP + BGA to OI, fatigue (SMD - 0.35 [- 0.51; - 0.20]) and PA (SMD - 0.26 [- 0.41; - 0.11]) at PI, and fatigue (SMD - 0.34 [- 0.58; - 0.10]) at F1 were found significant with low heterogeneity. No significant effects were observed in the meta-analyses of studies comparing PIP + BGA to BGA or PIP alone. CONCLUSIONS PIP with BGA has a favourable effect on DS, PA and QoL in CPaS when compared to non-behavioural interventions such as WLC, usual care and education. However, further research is needed on 'how' and 'when' PIP + BGA should be provided in cancer rehabilitation. IMPLICATIONS FOR CANCER SURVIVORS PIP + BGA has the potential to facilitate CPaS to reach the recommended amount of PA and reduce DS.
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Affiliation(s)
- Astrid Lahousse
- Research Foundation - Flanders (FWO), Brussels, Belgium.
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Iris Reynebeau
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - David Beckwée
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Paul van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Transcare Transdisciplinary Pain Management Centre, Groningen, the Netherlands
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcon, Madrid, Spain
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Yang Y, Yi Y, Shi X, Yang X. Comparative efficacy of psychological interventions on anxiety and depression in patients with cancer: A systematic review and network meta-analysis. Medicine (Baltimore) 2024; 103:e38155. [PMID: 38787974 PMCID: PMC11124676 DOI: 10.1097/md.0000000000038155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 04/16/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Numerous studies have demonstrated that psychological interventions are effective in alleviating anxiety and depression in patients with cancer. However, the optimal psychological intervention to alleviate anxiety and depression in patients with cancer remains unknown. This study was carried out to compare and rank the comparative effectiveness of various psychological interventions on anxiety and depression in patients with cancer. METHODS Databases, namely PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CNKI, WanFang, VIP and CBM were systematically searched from their inception dates to December 2023 for randomized controlled trials of psychological interventions for anxiety and depression in patients with cancer. Utilizing the Cochrane Review Manager 5.4, we evaluated the risk of bias in the studies included in the current study based on the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The NMA was conducted using STATA 15.0. This study did not involve human participants and therefore did not require ethical approval. RESULTS Thirty-one randomized controlled trials involving 3471 participants were included. MT [SMD = 1.35, 95% CI (0.76, 1.93)] and cognitive behavioral therapy (CBT) [SMD = 0.97, 95% CI (0.53, 1.42)] were superior to usual care in alleviating anxiety. Besides, interpersonal psychotherapy (IPT) [SMD = 1.17, 95% CI (0.06, 2.28)], CBT [SMD = 0.97, 95 % CI (0.63, 1.30)], and MT [SMD = 0.93, 95% CI (0.35, 1.50)] were superior to usual care in alleviating depression. In addition, CBT was superior to family therapy in alleviating depression [SMD = 0.73, 95% CI (0.08, 1.38)]. The MT, CBT, and IPT ranked in the top three in alleviating anxiety, while IPT, CBT, and MT ranked in the top three in alleviating depression. CONCLUSION MT and IPT would be a more appropriate option in alleviating anxiety and depression in patients with cancer, respectively. This study also suggested that CBT had a significant effect in alleviating negative emotions in patients with cancer. However, the results need to be validated by high-quality and large-sample studies.
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Affiliation(s)
- Yinhao Yang
- School of Nursing, Hubei University of Medicine, Shiyan, China
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
| | - Yingying Yi
- School of Nursing, Hubei University of Medicine, Shiyan, China
| | - Xixi Shi
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
| | - Xueqin Yang
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
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Bickel EA, Schellekens MPJ, Smink JG, Mul VEM, Ranchor AV, Fleer J, Schroevers MJ. Looking at individual symptoms: the dynamic network structure of depressive symptoms in cancer survivors and their preferences for psychological care. J Cancer Surviv 2024; 18:479-488. [PMID: 35976556 PMCID: PMC9382609 DOI: 10.1007/s11764-022-01246-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE The majority of depressed cancer survivors do not receive psychological care, possibly because offered care does not align with their experiences and preferences. We examined (1) which depressive symptoms cancer survivors would like to receive psychological care for; (2) how distinct depressive symptoms are related to each other in the contemporaneous and temporal network of depressive symptoms; and (3) whether survivors' care needs correspond to the interconnectedness of these specific symptoms. METHOD Fifty-two cancer survivors suffering from at least mild depressive symptoms and were not receiving psychological care filled out a baseline questionnaire about their care needs for distinct depressive symptoms, followed by ecological momentary assessments (EMA) assessing depressive symptoms (14 days, five times a day). Multi-level vector autoregression analysis was used to estimate associations between distinct depressive symptoms as well as their centrality within the network. RESULTS Cancer survivors most strongly preferred to receive care for fatigue, feeling down, little enjoyment, and sleep problems. Fatigue, together with worry and lack of concentration, most strongly predicted the onset of other symptoms. Little enjoyment and feeling down were two of the most central symptoms (i.e., strongly connected to other symptoms) in the contemporaneous network and were most strongly influenced by other symptoms in the temporal network. CONCLUSIONS Clinicians can offer specific interventions that target fatigue, as these played an important role in the onset of symptoms and would align with survivors' needs. IMPLICATIONS FOR CANCER SURVIVORS Offering such symptom-specific care may increase the uptake of psychological interventions in cancer survivors.
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Affiliation(s)
- E A Bickel
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - M P J Schellekens
- Centre for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, De Bilt, The Netherlands
- Tilburg School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - J G Smink
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - V E M Mul
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - A V Ranchor
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J Fleer
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M J Schroevers
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Sato T, Seto M, Sangai T, Norihiko S, Nishimiya H, Kikuchi M, Shimizu A, Iwamitsu Y. The effectiveness of pretreatment video-based psychoeducation for patients with breast cancer. Palliat Support Care 2023:1-8. [PMID: 37937345 DOI: 10.1017/s1478951523001372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
OBJECTIVES This study confirms the effectiveness of pretreatment video-based psychoeducation on stress management and relaxation in reducing depression, anxiety, and uncertainty among patients with breast cancer. METHODS We conducted a nonrandomized trial with 86 pretreatment patients with breast cancer who were divided equally into intervention and control groups, and stratified according to cancer stages and patient ages. Omitting the excluded participants, 35 intervention group and 36 control group participants were asked to complete the Hospital Anxiety and Depression Scale and Universal Uncertainty in Illness Scale (UUIS) before the psychoeducational intervention (baseline, hereafter "BL ") as well as 1 and 3 months later. Then, a 2 group (intervention and control groups) × 3 time points (BL and 1 and 3 months post-intervention) mixed models repeated measures (MMRM) analysis was implemented. RESULTS Analysis confirmed interaction between 2 group × 3 time points for depression, anxiety, and UUIS. Multiple comparisons revealed that each score in the intervention group was significantly lower 1 and 3 months post-intervention compared to BL. Meanwhile, in the control group, the depression score was significantly higher at 3 months post-intervention compared to pre-intervention. The anxiety scores and UUIS of the same group were not significantly different between 1 and 3 months post-intervention. The effect size values 3 months post-intervention were -0.57 for depression, -0.25 for anxiety, and 0.05 for uncertainty. SIGNIFICANCE OF RESULTS Pretreatment psychoeducation reduced depression, anxiety, and uncertainty in the intervention group of patients with breast cancer compared to the control group. The effect sizes at 3 months post-intervention were moderate for depression and small for anxiety. These results suggest the effectiveness of psychoeducation for patients with breast cancer, using videos on stress management and relaxation, early at the pretreatment stage.
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Affiliation(s)
- Toshiko Sato
- Department of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Makiko Seto
- Department of Nursing, Kitasato University Hospital, Kanagawa, Japan
| | - Takafumi Sangai
- Department of Breast and Thyroid Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Sengoku Norihiko
- Department of Breast and Thyroid Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Hiroshi Nishimiya
- Department of Breast Surgery, Sagamihara Kyodo Hospital, Kanagawa, Japan
| | - Mariko Kikuchi
- Department of Breast and Thyroid Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Ayaka Shimizu
- Department of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Yumi Iwamitsu
- Department of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
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Zhang Y, Tang R, Bi L, Wang D, Li X, Gu F, Han J, Shi M. Effects of family-centered positive psychological intervention on psychological health and quality of life in patients with breast cancer and their caregivers. Support Care Cancer 2023; 31:592. [PMID: 37750931 DOI: 10.1007/s00520-023-08053-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/15/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Positive psychological intervention could improve individual's psychological health and quality of life. This study aimed to examine the effectiveness of family-centered positive psychological intervention on resilience, hope, perceived benefits, and quality of life in breast cancer patients and their caregivers. METHODS A two-group, randomized controlled study, including 98 dyads of breast cancer patients and caregivers, was conducted. Dyads were randomly assigned to intervention (n = 49) and control (n = 49) groups. Both the control and intervention groups received 4 weeks of health education, while the intervention group additionally received a 4-week family-centered positive psychological intervention. Outcome measures compared at baseline (T1), immediately after the intervention (T2), and at 1-month follow-up (T3), included validated measures of resilience (Connor-Davidson Resilience Scale), hope (Herth Hope Index), perceived benefits (Perceived Benefits of Diagnosis and Treatment of Breast Cancer, Positive Aspects of Caregiving), and quality of life (Functional Assessment of Cancer Therapy-Breast, Caregiver Quality of Life Scale). RESULTS Resilience, hope, perceived benefits, and quality of life of dyads were significantly higher in the intervention group than those in the control group at T2 and T3 (all p < 0.05). Linear mixed model analysis demonstrated a significant interaction effect of group × time × role (p = 0.007) on hope and a significant difference in the improvement of hope (p < 0.05) between patients and their caregivers. CONCLUSIONS Our family-centered positive psychological intervention was effective in improving psychological health and quality of life for breast cancer patients and caregivers. This study provides evidence for the effectiveness of positive clinical psychological interventions. TRIAL REGISTRATION ChiCTR2300072809.
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Affiliation(s)
- Yao Zhang
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Ruijin Tang
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Liuna Bi
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Dan Wang
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaoxu Li
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Feng Gu
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jing Han
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China.
| | - Ming Shi
- First Clinical College, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China.
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Cathcart-Rake EJ, Tevaarwerk AJ, Haddad TC, D'Andre SD, Ruddy KJ. Advances in the care of breast cancer survivors. BMJ 2023; 382:e071565. [PMID: 37722731 DOI: 10.1136/bmj-2022-071565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Breast cancer survivors may experience significant after effects from diagnoses of breast cancer and cancer directed therapies. This review synthesizes the evidence about optimal management of the sequelae of a diagnosis of breast cancer. It describes the side effects of chemotherapy and endocrine therapy and evidence based strategies for management of such effects, with particular attention to effects of therapies with curative intent. It includes strategies to promote health and wellness among breast cancer survivors, along with data to support the use of integrative oncology strategies. In addition, this review examines models of survivorship care and ways in which digital tools may facilitate communication between clinicians and patients. The strategies outlined in this review are paramount to supporting breast cancer survivors' quality of life.
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Gelse N, Bodschwinna D, Jarczok MN, Wanner M, Volz M, Mayer-Steinacker R, Huober J, Gündel H, Hönig K. Enhancing coping skills through brief interventions during cancer therapy - a quasi-experimental clinical pilot study. Front Psychol 2023; 14:1253423. [PMID: 37744600 PMCID: PMC10513768 DOI: 10.3389/fpsyg.2023.1253423] [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: 07/05/2023] [Accepted: 08/07/2023] [Indexed: 09/26/2023] Open
Abstract
IntroductionPsycho-oncological interventions can reduce distress by activating individual resources and enhancing coping skills. Since medical cancer treatment is performed increasingly in outpatient settings, there is a growing need for evidence-based and brief interventions to be integrated seamlessly into these treatment procedures. The aim of the present pilot study is to examine the feasibility of brief interventions to cope with illness in this area.MethodsA single center quasi-experimental design was developed in oncological outpatients at the University Medical Center Ulm, Germany, including N = 60 individuals with cancer undergoing chemotherapy or immunotherapy. The intervention group (IG) consisted of N = 40 participants. These were assigned to either cognitive behavioral interventions (CBI) or hypnotherapeutic interventions (HTI). The interventions each comprised three individual one-hour sessions. In addition, a waiting control group (WCG of N = 20) was set up, receiving care-as-usual. Primary outcomes were feasibility measures such as recruitment rates, participant retention rates, and complete data rates. Clinical results were discussed for the feasibility of a comprehensive efficacy study.ResultsThe recruitment and completion rates illustrate demand and acceptance of the offer. Of the 208 individuals with cancer offered to participate in the study, 77 were interested in enrolling. This rate of 37% roughly corresponds to the use of psycho-oncological services in general. 17 individuals (22%) withdraw from participation before the intervention began due to severe deterioration in their disease. Once started, all 40 individuals of the IG (100%) completed the intervention, and 17 individuals of the WCG (85%) completed the accompanying questionnaires. Tentative results on clinical outcomes indicate that brief interventions on resource activation could have lasting effects on well-being and stress management.DiscussionWith this feasibility study, we aimed to explore the potential of brief interventions such as hypnotherapeutic and cognitive-behavioral approaches in psycho-oncology as an integral part of oncology day care. Even with a small number of participants results seem to indicate that the study design and brief interventions such as those presented can offer a low-threshold service that can be seamlessly integrated into oncological therapy. Given the promising results of this pilot study, we propose a full RCT on the effectiveness of such a brief intervention program.Clinical trial registrationhttps://www.drks.de, German Trials Register (DRKS00019095).
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Affiliation(s)
- Norbert Gelse
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Daniela Bodschwinna
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
| | - Marc N. Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Magdalena Wanner
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Madeleine Volz
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Regine Mayer-Steinacker
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
- Department of Internal Medicine III, University Ulm Medical Center, Ulm, Germany
| | - Jens Huober
- Department of Gynecology and Obstetrics, University Ulm Medical Center, Ulm, Germany
- Cantonal Hospital, Breast Center St. Gallen, St. Gallen, Switzerland
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
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van Leeuwen M, Kieffer JM, Young TE, Annunziata MA, Arndt V, Arraras JI, Autran D, Hani HB, Chakrabarti M, Chinot O, Cho J, da Costa Vieira RA, Darlington AS, Debruyne PR, Dirven L, Doege D, Eller Y, Eichler M, Fridriksdottir N, Gioulbasanis I, Hammerlid E, van Hemelrijck M, Hermann S, Husson O, Jefford M, Johansen C, Kjaer TK, Kontogianni M, Lagergren P, Lidington E, Lisy K, Morag O, Nordin A, Al Omari ASH, Pace A, De Padova S, Petranovia D, Pinto M, Ramage J, Rammant E, Reijneveld J, Serpentini S, Sodergren S, Vassiliou V, Leeuw IVD, Vistad I, Young T, Aaronson NK, van de Poll-Franse LV. Phase III study of the European Organisation for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire. J Cancer Surviv 2023; 17:1111-1130. [PMID: 35088246 DOI: 10.1007/s11764-021-01160-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study is to develop a European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) questionnaire that captures the full range of physical, mental, and social health-related quality of life (HRQOL) issues relevant to disease-free cancer survivors. In this phase III study, we pretested the provisional core questionnaire (QLQ-SURV111) and aimed to identify essential and optional scales. METHODS We pretested the QLQ-SURV111 in 492 cancer survivors from 17 countries with one of 11 cancer diagnoses. We applied the EORTC QLG decision rules and employed factor analysis and item response theory (IRT) analysis to assess and, where necessary, modify the hypothesized questionnaire scales. We calculated correlations between the survivorship scales and the QLQ-C30 summary score and carried out a Delphi survey among healthcare professionals, patient representatives, and cancer researchers to distinguish between essential and optional scales. RESULTS Fifty-four percent of the sample was male, mean age was 60 years, and, on average, time since completion of treatment was 3.8 years. Eleven items were excluded, resulting in the QLQ-SURV100, with 12 functional and 9 symptom scales, a symptom checklist, 4 single items, and 10 conditional items. The essential survivorship scales consist of 73 items. CONCLUSIONS The QLQ-SURV100 has been developed to assess comprehensively the HRQOL of disease-free cancer survivors. It includes essential and optional scales and will be validated further in an international phase IV study. IMPLICATIONS FOR CANCER SURVIVORS The availability of this questionnaire will facilitate a standardized and robust assessment of the HRQOL of disease-free cancer survivors.
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Affiliation(s)
- Marieke van Leeuwen
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Jacobien M Kieffer
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Teresa E Young
- Lynda Jackson Macmillan Centre, North Hertfordshire NHS Trust Including Mount Vernon Cancer Centre, East &, Northwood, UK
| | | | - Volker Arndt
- Unit of Cancer Survivorship Research, Division of Clinical Epidemiology and Aging Research & Epidemiological Cancer Registry Baden-Wurttemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Didier Autran
- Pole Neurosciences Cliniques, Service de Neuro-Oncologie, Aix-Marseille Universite, Marseille, France
| | | | | | - Olivier Chinot
- Pole Neurosciences Cliniques, Service de Neuro-Oncologie, Aix-Marseille Universite, Marseille, France
| | - Juhee Cho
- Center for Clinical Epidemiology and Cancer Education Center, Samsung Medical Center, School of Medicine Sungkyunkwan University, Seoul, Korea
| | | | | | - Philip R Debruyne
- Kortrijk Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Daniela Doege
- Unit of Cancer Survivorship Research, Division of Clinical Epidemiology and Aging Research & Epidemiological Cancer Registry Baden-Wurttemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Yannick Eller
- Centre for Medical Education, University of Dundee, Dundee, UK
| | - Martin Eichler
- National Center for Tumor Diseases (NCT/UCC), University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Nanna Fridriksdottir
- National University Hospital of Iceland, Ugo De Giorgi, Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, 47014, Italy
| | | | - Eva Hammerlid
- Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Goteborg, Sweden
| | - Mieke van Hemelrijck
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Silke Hermann
- Epidemiological Cancer Registry Baden-Wurttemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Olga Husson
- Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Christoffer Johansen
- Oncology Clinic, Finsen Center, Copenhagen Colin Johnson, University Surgical Unit, University Hospitals Southampton, Southampton, UK
| | - Trille Kristina Kjaer
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Meropi Kontogianni
- Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Pernilla Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ofir Morag
- Oncology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Andy Nordin
- East Kent Gynaecological Oncology Centre, Margate, UK
| | | | - Andrea Pace
- Neuroncology Unit, National Cancer Institute Regina Elena, Rome, Italy
| | - Silvia De Padova
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, 47014, Italy
| | - Duska Petranovia
- Hematology Department, University Clinical Hospital Center Rijeka, Medical Faculty University of Rijeka, Rijeka, Croatia
| | - Monica Pinto
- Rehabilitation Medicine Unit, Department of Strategic Health Services, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - John Ramage
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | - Elke Rammant
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Jaap Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Samantha Serpentini
- Unit of Psychoncology-Breast Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Sam Sodergren
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Vassilios Vassiliou
- Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
| | - Irma Verdonck-de Leeuw
- Department of Otolaryngology / Head & Neck Surgery, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ingvild Vistad
- Department of Gynecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Teresa Young
- Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Northwood, UK
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
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9
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Xiong J, Chen Q, Li W, Zheng X. Effect of online interventions on reducing anxiety and depression for women with breast cancer: a systematic review and network meta-analysis protocol. BMJ Open 2023; 13:e073806. [PMID: 37474161 PMCID: PMC10357793 DOI: 10.1136/bmjopen-2023-073806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION Breast cancer has becoming the most common malignancy in women globally. Various online interventions have been conducted to help women with breast cancer to manage their psychological symptoms. However, there has been not yet a network meta-analysis that has synthesised scientific evidence about online intervention on reducing anxiety and depression for women with breast cancer. To fill the literature gap, this protocol aims to generate a systematic review and network meta-analysis to assess the effectiveness of online interventions on reducing anxiety and depression for these women with breast cancer. The study results may inform the recommendations for clinical guidelines and facilitate the decision-making process to improve psychological health of women with breast cancer. METHODS AND ANALYSIS The protocol is in compliance with the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and for Systematic Reviews and Network Meta-Analysis. The electronic databases of Pubmed, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Central Registry of Controlled Trials and OpenGrey will be used for searching of related randomised controlled trials from their inception. No restrictions on publication date and language will be applied. The primary outcomes are the symptoms of anxiety and depression, and the secondary outcome is the satisfaction with the received healthcare. Two reviewers independently evaluate the risk of bias using the Cochrane Collaboration's Risk of Bias tool. The assessment of heterogeneity, inconsistency, subgroup analysis, sensitivity analysis and publication bias will be conducted. The netmeta package of R software will be used to perform the network meta-analysis. ETHICS AND DISSEMINATION This study will be based on previous research findings, so that ethics approval is not required. Data searching commences in July 2023 and expects to complete in January, 2024. The findings will be disseminated through peer-reviewed journals and academic conferences. PROSPERO REGISTRATION NUMBER CRD42022318530.
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Affiliation(s)
- Juan Xiong
- Medical School, Shenzhen University, Shenzhen, Guangdong, China
| | - Qianqian Chen
- Medical School, Shenzhen University, Shenzhen, Guangdong, China
| | - Wenjie Li
- Medical School, Shenzhen University, Shenzhen, Guangdong, China
| | - Xujuan Zheng
- Medical School, Shenzhen University, Shenzhen, Guangdong, China
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10
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Aho T, Harno H, Lipsanen J, Kalso E, Sipilä R. Pain-related and psychological factors mediate the effect of personality on health-related quality of life. A study in breast cancer survivors with persistent pain. Front Psychol 2023; 14:1063920. [PMID: 37484101 PMCID: PMC10361063 DOI: 10.3389/fpsyg.2023.1063920] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Personality characteristics affect the long-term well-being and health-related quality of life (HrQoL) of breast cancer (BC) survivors. Persistent pain significantly affects psychosocial well-being and HrQoL in this patient group. We studied the effects of temperament and character via pain-related and psychological factors on dimensions of HrQoL in BC survivors. Methods We studied 273 patients who had been treated for BC and who reported persistent pain at any site of the body in Brief Pain Inventory. The patients were recruited from a longitudinal cohort of patients 4-9 years after surgery for BC. Short-Form-36 inventory was used to assess physical and mental dimensions of HrQoL and Temperament and Character Inventory to assess dimensions of temperament and character. We used parallel mediation modeling for studying effects of temperament and character on physical and mental HrQoL. Results A significant total effect was found for harm avoidance (HA) temperament (βtotal = -0.665, p < 0.001) and character dimensions self-directedness (SD) (βtotal = 0.609, p = 0.001) and cooperativeness (CO) (βtotal = 0.584, p = 0.028) on physical and mental HrQoL. Additionally, different combinations of pain-related and psychological variables fully mediated the indirect effects of HA, SD, and CO on physical and mental HrQoL. Discussion HA temperament is a potential emotional vulnerability factor for psychological burden and impaired HrQoL in BC survivors. Character dimensions SD and CO may protect from the negative effect of mood on HrQoL. The results provide new insights about the risk-and target-factors for clinical interventions and effective pain management to improve psychosocial well-being and HrQoL in BC survivors.
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Affiliation(s)
- Tommi Aho
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Harno
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Sleep Well Research Programme, University of Helsinki, Helsinki, Finland
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eija Kalso
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Sleep Well Research Programme, University of Helsinki, Helsinki, Finland
- Department of Pharmacology, University of Helsinki, Helsinki, Finland
| | - Reetta Sipilä
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Sleep Well Research Programme, University of Helsinki, Helsinki, Finland
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11
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Bae KR, Ahn Y, Park JW, Kim SJ. Exploring Fear of Cancer Recurrence (FCR) in cancer survivors from a medical social work perspective: A qualitative study of medical social workers in South Korea. PLoS One 2023; 18:e0288059. [PMID: 37410785 DOI: 10.1371/journal.pone.0288059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/18/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Fear of Cancer Recurrence (FCR) in cancer survivors has been insufficiently addressed despite its imperativeness in cancer journey. Although several studies have investigated healthcare professionals' experience with FCR in cancer survivors, a medical social work perspective has rarely been reflected. This study aimed to explore Korean medical social workers' experience with intervening FCR in cancer survivors. METHODS Snowball sampling recruited 12 experienced medical social workers intervening with cancer survivors at tertiary or university cancer hospitals in South Korea. Individual and focus-group interviews (FGI) were conducted with the medical social workers. The interviews were recorded, transcribed, and analyzed by using an inductive qualitative content analysis. RESULTS Content analysis of the interviews extracted the following major themes regarding FCR in cancer survivors. First, when and how FCR among cancer survivors emerged at the early stage of medical social work interventions was identified. Second, how medical social workers dealt with FCR in cancer survivors was illustrated. Third, the responses of cancer survivors to medical social work interventions for FCR were assessed. Finally, the internal and external issues underlying the medical social work interventions for FCR among cancer survivors were revealed and discussed. CONCLUSION Based on the results, this study suggested the implications on dealing with FCR in cancer survivors in the realm of medial social work profession. Furthermore, it expanded the discussion about FCR in cancer survivors from cancer hospitals to community.
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Affiliation(s)
- Ka Ryeong Bae
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Yeojin Ahn
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, South Korea
| | - Joung Won Park
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
- Division of Social Work, Samsung Medical Center, Seoul, South Korea
| | - Seok-Joo Kim
- Department of Social Welfare, College of Social Sciences, Daegu University, Gyeongbuk, South Korea
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12
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Husain N, Kiran T, Chaudhry IB, Sultan S, Dawood S, Lunat F, Nizami A, Shanahan L, Qureshi A, Un Nisa Z, Husain M, Shakoor S, Alvi MH, Zadeh Z, Memon R, Chaudhry N. Integrated Moving on After Breast Cancer and Culturally Adapted Cognitive Behavior Therapy intervention for depression and anxiety among Pakistani women with breast cancer: Protocol of a randomized controlled trial. SAGE Open Med 2023; 11:20503121231177549. [PMID: 37441193 PMCID: PMC10333993 DOI: 10.1177/20503121231177549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/05/2023] [Indexed: 07/15/2023] Open
Abstract
Objective The diagnosis and treatment of breast cancer is associated with significant distress that has huge impact on survivors' quality of life. The objective of this study is to assess the effectiveness of an integrated intervention "Moving on After Breast Cancer (ABC) Plus culturally adapted Cognitive Behavior Therapy" (Moving on ABC Plus). Method This is a randomized controlled trial that aims to recruit 354 breast cancer survivors from the inpatient and outpatient oncology departments in public and private hospitals in Karachi, Hyderabad, Lahore, Multan, and Rawalpindi in Pakistan. Patients scoring 10 or above on either the Patient Health Questionnaire-9 and/or the Generalized Anxiety Disorder scale (GAD-7) will be recruited. Baseline assessments will include Functional Assessment of Cancer Therapy-Breast; EuroQol-5D; Multidimensional Scale for Perceived Social Support; Intrusive Thoughts Scale; and Rosenberg Self-Esteem Scale. Participants randomized into intervention arm, Moving on ABC Plus, will receive 12 individual therapy sessions over 4 months. Follow-up will be completed at 4- and 6-month post-randomization, using all baseline instruments along with the Client Satisfaction Questionnaire (CSQ-8). We will also explore the participants', their family members', and the therapists' experiences of the trial and intervention. Results We will be assessing the effectiveness of intervention in reducing depression and anxiety in breast cancer survivors as a primary outcome of the trial. The secondary outcomes will include effectiveness of intervention in terms of reduction in intrusive thoughts and improvement in health-related quality of life, self-esteem, and perceived social support. Conclusion The results of the study will inform the design of a future larger randomized control trial with long-term follow-up.
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Affiliation(s)
- Nusrat Husain
- Division of Psychology and Mental
Health, University of Manchester, Manchester, UK
- Manchester Global foundation,
Manchester, UK
| | - Tayyeba Kiran
- Manchester Global foundation,
Manchester, UK
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | | | - Sarwat Sultan
- Department of Psychology, Bahauddin
Zakaria University, Multan, Pakistan
| | - Saima Dawood
- Center for Clinical Psychology,
University of Punjab, Lahore, Pakistan
| | - Farah Lunat
- Lancashire and South Cumbria NHS
Foundation Trust, Preston, UK
| | - Asad Nizami
- Institute of Psychiatry, Benazir Bhutto
Hospital, Rawalpindi, Pakistan
| | | | - Afshan Qureshi
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Zaib Un Nisa
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Mina Husain
- South London and Maudsley NHS
Foundation Trust, London, UK
| | - Suleman Shakoor
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Mohsin H Alvi
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Zainab Zadeh
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Rakhshi Memon
- Manchester Global foundation,
Manchester, UK
- Department of Science and Technology
Studies, University College London, London, UK
| | - Nasim Chaudhry
- Manchester Global foundation,
Manchester, UK
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
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13
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He LL, Xiao S, Jiang CH, Wu XW, Liu W, Fan CG, Ye X, Zhao Q, Wu WQ, Li YX, Wang H, Liu F. A randomized, controlled trial to investigate cognitive behavioral therapy in prevention and treatment of acute oral mucositis in patients with locoregional advanced nasopharyngeal carcinoma undergoing chemoradiotherapy. Front Oncol 2023; 13:1143401. [PMID: 37350940 PMCID: PMC10282775 DOI: 10.3389/fonc.2023.1143401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/15/2023] [Indexed: 06/24/2023] Open
Abstract
Purpose Oral mucositis is a common side effect of concurrent chemoradiotherapy (CCRT). This study aimed to determine whether cognitive behavioral therapy (CBT) could help prevent oral mucositis during chemoradiation therapy for locoregional advanced nasopharyngeal carcinoma (LA-NPC). Methods and materials Between July 15, 2020, and January 31, 2022, a randomized controlled phase II trial was conducted. Eligible patients (N=282, 18-70 years old) with pathologically diagnosed LA-NPC were randomly assigned to receive CBT or treatment as usual (TAU) during CCRT (computer-block randomization, 1:1). The primary endpoints were the incidence and latency of oral mucositis. Results The incidence of oral mucositis was significantly lower in the CBT group (84.8%; 95% confidence interval [CI], 78.7%-90.9%) than in the TAU group (98.6%; 95% CI, 96.6%-100%; P<0.001). The median latency period was 26 days and 15 days in the CBT and TAU groups, respectively (hazard ratio, 0.16; 95% CI, 0.12-0.22; P<0.001). CBT significantly reduced ≥ grade 3 oral mucositis (71.9% vs. 22.5%, P<0.001), dry mouth (10.8% vs. 3.7%, P=0.021), dysphagia (18% vs. 5.1%, P=0.001), and oral pain (10% vs. 3.6%, P=0.034) compared with TAU. Patients receiving CBT and TAU during CCRT had similar short-term response rates. Conclusions CBT reduced the occurrence, latency, and severity of oral mucositis in patients with LA-NPC during CCRT.
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Affiliation(s)
- Li-li He
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Shuai Xiao
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Cui-hong Jiang
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xiang-wei Wu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wen Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Chang-gen Fan
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xu Ye
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Qi Zhao
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wen-qiong Wu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yan-xian Li
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Wang
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Feng Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
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14
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Majidzadeh S, Mirghafourvand M, Farvareshi M, Yavarikia P. The effect of cognitive behavioral therapy on depression and anxiety of women with polycystic ovary syndrome: a randomized controlled trial. BMC Psychiatry 2023; 23:332. [PMID: 37170227 PMCID: PMC10174601 DOI: 10.1186/s12888-023-04814-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/24/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Women's mental health has a significant impact on the health of society. Due to the prevalence of mental health problems in women with PCOS, this study aimed to determine the effect of cognitive behavioral therapy on depression and anxiety (primary outcomes) and quality of life (secondary outcomes) in women with polycystic ovary syndrome. METHODS This randomized controlled trial was performed on 84 patients with PCOS referred to Al-Zahra Hospital in Tabriz-Iran, 2021. Participants were randomly assigned to intervention (n = 42) and control (n = 42) groups. Counseling with cognitive behavioral therapy was provided in 8 sessions of 60-90 min weekly in groups with 5 to 7 people in each group for the intervention group. Spielberger State-Trait Anxiety, Beck Depression, and Quality of Life Questionnaire for women with polycystic ovary syndrome (PCOSQ) were used to collect data. Independent t-test and ANCOVA were used to compare the outcomes between the two groups. RESULTS After the intervention, based on ANCOVA test with adjusting the baseline values, mean scores of depression (mean difference (MD): -18.6; 95% confidence interval (95% CI): -19.4 to -17.8: P < 0.001), trait anxiety (MD: -15.0; 95% CI: -16.0 to -13.9; P < 0.001), and state anxiety (MD: -15.3; 95% CI: -16.2 to -14.3; P < 0.001), were significantly lower in the intervention group compared to the control group. The mean score of quality of life (MD: 19.25; 95% CI: 17.66 to 20.84; P < 0.001) was significantly higher in the intervention group compared to the control group. CONCLUSION This study showed that CBT was effective in reducing depression and anxiety and improving the quality of life. Therefore it is recommended that health care providers use this approach to improve the mental health and quality of life of women with PCOS. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20110826007418N7. Date of registration: 25/10/2021. URL: https://en.irct.ir/trial/57348 ; Date of first registration: 25/10/2021.
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Affiliation(s)
- Sheida Majidzadeh
- Department of midwifery, Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Farvareshi
- Clinical Psychologist, Razi Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Yavarikia
- Department of midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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15
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Civilotti C, Lucchini D, Fogazzi G, Palmieri F, Benenati A, Buffoli A, Girardi V, Ruzzenenti N, Di Betta A, Donarelli E, Veglia F, Di Fini G, Gandino G. The role of integrated psychological support in breast cancer patients: a randomized monocentric prospective study evaluating the Fil-Rouge Integrated Psycho-Oncological Support (FRIPOS) program. Support Care Cancer 2023; 31:266. [PMID: 37058253 PMCID: PMC10104919 DOI: 10.1007/s00520-023-07732-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 04/04/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE This study examined the effects of Fil-Rouge Integrated Psycho-Oncological Support (FRIPOS) in a group of women with breast cancer compared with a group receiving treatment as usual (TAU). METHODS The research design was a randomized, monocentric, prospective study with three time points of data collection: after the preoperative phase (T0), in the initial phase of treatments (T1), and 3 months after the start of treatments (T2). The FRIPOS group (N = 103) and the TAU group (N = 79) completed a sociodemographic questionnaire, the Symptom Checklist-90-R (SCL-90-R) at T0; the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and EORTC QLQ-BR23 at T1; and SCL-90-R, EORTC QLQ-C30, and EORTC QLQ-BR23 at T2. RESULTS A series of independent and paired t tests showed that patients in the FRIPOS group performed better on all scales related to symptomatic manifestations and on some quality of life scales (fatigue, dyspnea, and sleep disturbances) at T2. In addition, a series of ten multiple regressions were performed to predict each SCL subscale at T2 from the SCL score at T0 and the EORTC QLQ-C30 scores at T2. In nine of ten regression models (all except somatization), both FRIPOS group membership and QoL subscale contributed significantly to prediction. CONCLUSIONS This study suggests that patients in the FRIPOS group have more benefits in emotional, psychological, and collateral symptoms than patients in the TAU group and that these improvements are due to integrated psycho-oncology care.
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Affiliation(s)
- Cristina Civilotti
- Department of Psychology, University of Turin, Turin, Italy
- Salesian University Institute (IUSTO), Turin, Italy
| | - Diana Lucchini
- Breast Psycho-Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
- Associazione Priamo, Via della Lama, 61, 25133, Brescia, Italy
| | - Gianluca Fogazzi
- Breast Medical Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Fabrizio Palmieri
- Breast Surgery, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Alice Benenati
- Breast Surgery, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
- Radiation Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Alberto Buffoli
- Radiation Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Veronica Girardi
- Breast Radiology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Nella Ruzzenenti
- Breast Pathology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | | | | | - Fabio Veglia
- Department of Psychology, University of Turin, Turin, Italy
| | - Giulia Di Fini
- Department of Psychology, University of Turin, Turin, Italy.
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16
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Miguel C, Karyotaki E, Ciharova M, Cristea IA, Penninx BW, Cuijpers P. Psychotherapy for comorbid depression and somatic disorders: a systematic review and meta-analysis. Psychol Med 2023; 53:2503-2513. [PMID: 34792017 PMCID: PMC10123840 DOI: 10.1017/s0033291721004414] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/01/2021] [Accepted: 10/11/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The treatment of depression in patients with somatic disorders is crucial, given its negative impact on quality of life (QoL), functioning, and even on the somatic disease prognosis. We aimed to examine the most updated evidence on the effects of psychotherapy in patients with depression and somatic disorders, including HIV, oncological, cardiometabolic, and neurological disorders. METHODS We conducted a meta-analysis of 75 randomized trials (8209 participants) of psychotherapy for adults with somatic disorders and a diagnosis or elevated symptoms of depression. Outcomes included depression, QoL, somatic health-related outcomes, and mortality. RESULTS Psychotherapy significantly reduced the severity of depression at post-treatment across all categories of somatic disorders (Hedges'g = 0.65; 95% CI 0.52-0.79), with sustained effects at 6-11 months (g = 0.38; 95% CI 0.22-0.53) and at 12 months follow-up or longer (g = 0.13; 95% CI 0.04-0.21). Psychotherapy also showed significant effects on QoL (g = 0.26; 95% CI 0.17-0.35), maintained up to 11 months follow-up (g = 0.25; 95% CI 0.16-0.34). No significant effects were observed on the most frequently reported somatic health-related outcomes (glycemic control, pain), and neither on mortality. Heterogeneity in most analyses was very high, and only 29 (38%) trials were rated at low risk of bias (RoB). CONCLUSIONS Psychotherapy may be an effective treatment option for patients with depression and somatic disorders, with long-term effects on depression severity and QoL. However, these results should be interpreted with caution due to heterogeneity and RoB.
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Affiliation(s)
- Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, The Netherlands
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Ioana A. Cristea
- Department of Brain and Behavioral Sciences, University of Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, The Netherlands
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Liou KT, McConnell KM, Currier MB, Baser RE, MacLeod J, Walker D, Casaw C, Wong G, Piulson L, Popkin K, Lopez AM, Panageas K, Bradt J, Mao JJ. Virtual Music Therapy versus Virtual Cognitive Behavioral Therapy for Anxiety in Cancer Survivors: Rationale and Protocol for a Comparative Effectiveness Trial (Preprint). JMIR Res Protoc 2023; 12:e46281. [PMID: 37103999 PMCID: PMC10176150 DOI: 10.2196/46281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/19/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Cancer survivors represent one of the fastest growing populations in the United States. Unfortunately, nearly 1 in 3 survivors experience anxiety symptoms as a long-term consequence of cancer and its treatment. Characterized by restlessness, muscle tension, and worry, anxiety worsens the quality of life; impairs daily functioning; and is associated with poor sleep, depressed mood, and fatigue. Although pharmacological treatment options are available, polypharmacy has become a growing concern for cancer survivors. Music therapy (MT) and cognitive behavioral therapy (CBT) are evidence-based, nonpharmacological treatments that have demonstrated effectiveness in treating anxiety symptoms in cancer populations and can be adapted for remote delivery to increase access to mental health treatments. However, the comparative effectiveness of these 2 interventions delivered via telehealth is unknown. OBJECTIVE The aims of the Music Therapy Versus Cognitive Behavioral Therapy for Cancer-related Anxiety (MELODY) study are to determine the comparative effectiveness of telehealth-based MT versus telehealth-based CBT for anxiety and comorbid symptoms in cancer survivors and to identify patient-level factors associated with greater anxiety symptom reduction for MT and CBT. METHODS The MELODY study is a 2-arm, parallel-group randomized clinical trial that aims to compare the effectiveness of MT versus CBT for anxiety and comorbid symptoms. The trial will enroll 300 English- or Spanish-speaking survivors of any cancer type or stage who have experienced anxiety symptoms for at least 1 month. Participants will receive 7 weekly sessions of MT or CBT delivered remotely via Zoom (Zoom Video Communications, Inc) over 7 weeks. Validated instruments to assess anxiety (primary outcome), comorbid symptoms (fatigue, depression, insomnia, pain, and cognitive dysfunction), and health-related quality of life will be administered at baseline and at weeks 4, 8 (end of treatment), 16, and 26. Semistructured interviews will be conducted at week 8 with a subsample of 60 participants (30 per treatment arm) to understand individual experiences with the treatment sessions and their impact. RESULTS The first study participant was enrolled in February 2022. As of January 2023, 151 participants have been enrolled. The trial is expected to be completed by September 2024. CONCLUSIONS This study is the first and largest randomized clinical trial to compare the short- and long-term effectiveness of remotely delivered MT and CBT for anxiety in cancer survivors. Limitations include the lack of usual care or placebo control groups and the lack of formal diagnostic assessments for psychiatric disorders among trial participants. The study findings will help guide treatment decisions for 2 evidence-based, scalable, and accessible interventions to promote mental well-being during cancer survivorship. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46281.
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Affiliation(s)
- Kevin T Liou
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | | | - Raymond E Baser
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jodi MacLeod
- Society for Integrative Oncology, Washington, DC, United States
| | | | - Camila Casaw
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Greta Wong
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Lauren Piulson
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Karen Popkin
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ana Maria Lopez
- Thomas Jefferson University, Philadelphia, PA, United States
| | | | - Joke Bradt
- Drexel University, Philadelphia, PA, United States
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Getu MA, Wang P, Addissie A, Seife E, Chen C, Kantelhardt EJ. The effect of cognitive behavioural therapy integrated with activity pacing on cancer-related fatigue, depression and quality of life among patients with breast cancer undergoing chemotherapy in Ethiopia: A randomised clinical trial. Int J Cancer 2023; 152:2541-2553. [PMID: 36744446 DOI: 10.1002/ijc.34452] [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: 11/26/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 02/07/2023]
Abstract
Fatigue is a common symptom experienced by 80% of individuals who receive chemotherapy and is one of the major factors that affect quality of life (QoL) of patients with breast cancer. Our study aimed to assess the effect of cognitive behavioural therapy integrated with activity pacing (CBT-AP) on cancer-related fatigue among patients with breast cancer undergoing chemotherapy. A parallel-group, randomised controlled trial was conducted. Severely fatigued patients were randomly assigned to the CBT-AP or usual care (UC) groups using a computer-generated random sequence. The new intervention was designed for seven sessions: three 2-hour face-to-face and four 30-minute telephone sessions. The primary outcome (fatigue severity) and the secondary outcomes (depression and QoL) were assessed at the end of the intervention and after 3 months. The data were analysed by repeated measures analyses of covariance (RM-ANCOVA). CBT-AP had a significant time effect (P < .001, ηp2 = 0.233) in reducing fatigue from baseline (adjusted mean = 7.48) to the end of the intervention (adjusted mean = 6.37) and the 3-month follow-up (adjusted mean = 6.54). Compared to the UC group, the CBT-AP group had lower fatigue and depression scores, and higher global health status scores. The group × time interaction revealed a significant reduction in fatigue and depression in the CBT-AP group compared to the UC group. Therefore, CBT-AP appears to be effective in reducing fatigue and depression and improving QoL in patients with breast cancer undergoing chemotherapy. It is highly recommended to integrate a CBT-AP intervention in routine cancer care.
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Affiliation(s)
- Mikiyas Amare Getu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,School of Nursing and Health, Zhengzhou University, Zhengzhou, China.,School of Nursing, Woldia University, Woldia, Ethiopia.,Global Health Working Group, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Adamu Addissie
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle (Saale), Germany.,School of Public Health, Department of Preventive Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Edom Seife
- Tikur Anbessa Specialized Hospital, Department of Oncology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle (Saale), Germany.,Department of Gynecology, Martin-Luther-University, Halle (Saale), Germany
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19
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Velasco L, Gutiérrez L, Alcocer N, Sánchez S, Catalá P, Peñacoba C. Exploring the moderated role of two psychological programs on sexual pleasure from physical symptoms, body image distortion and emotional problems of Hispanic women with breast cancer. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:643-658. [PMID: 36735842 DOI: 10.1080/0092623x.2023.2173111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Decreased sexual pleasure is a common problem in women with breast cancer. The aim of this study was to evaluate the effect of psychoeducation vs. acceptance and commitment therapy to improve sexual pleasure according to the predictive role of physical, cognitive and emotional factors. Results of 139 Hispanic women (Mexico and Spain) diagnosed with breast cancer reveal that only the emotional factor of depression predicts decreased sexual pleasure. Although women who participated in the psychoeducation program presented greater physical symptomatology, body image distortions and emotional distress, the results seem to indicate that psychoeducational guidelines are relevant to improve sexual pleasure in those women who manifest higher levels of previous depression. Future research is required to clarify these issues.
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Affiliation(s)
- Lilian Velasco
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Lorena Gutiérrez
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Natasha Alcocer
- Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de México, México
| | - Sofía Sánchez
- Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de México, México
| | - Patricia Catalá
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
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20
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ZHAO W, CHONG YY, CHIEN WT. Effectiveness of cognitive-based interventions for improving body image of breast cancer patients: A systematic review and meta-analysis. Asia Pac J Oncol Nurs 2023; 10:100213. [PMID: 37089782 PMCID: PMC10120298 DOI: 10.1016/j.apjon.2023.100213] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
Objective Breast cancer patients often suffer from body image disturbance due to impairment of their body/appearance resulting from surgeries, other cancer treatments, and/or their complications. Cognitive-based interventions (CBIs) have recently been adopted for patients having breast cancer but their effects on improving body image are uncertain. This systematic review aimed to examine the effects of CBIs on body image in these patients, identify the optimal dose, characteristics, and/or component(s) of an effective intervention for these patients to inform future research and practice. Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, ten online databases and five search engines were used to search for eligible studies. Quality appraisal of included studies and meta-analysis results were conducted using Rob 2 and Grading of Recommendations Assessment, Development and Evaluation profiler Guideline Development Tool, respectively. RevMan and comprehensive meta-analysis software were used to perform data analysis and synthesis. Results Eleven eligible randomized controlled trials (RCTs) examining the effects of cognitive behavioral, acceptance and commitment, mindfulness, and self-compassion therapies were reviewed. Results of the meta-analysis showed that CBIs significantly reduced negative body image perception (Standardised Mean Difference, SMD = -0.49, 95% confidence interval [CI], [-0.87, -0.11], I 2 = 81%, 6 RCTs, 758 participants), when compared to the control groups (mainly usual care) at immediately post-intervention; in which, CBT-based (SMD = -0.37, 95% CI (-0.60, -0.13), I 2 = 0%) and group-based (SMD = -0.38, 95% CI (-0.62, -0.13), I 2 = 0%) programs had more consistent and significant effects. Conclusions In view of the highly heterogeneous and limited RCTs identified, high-quality controlled trials of CBIs for improving the body image of patients having breast cancer are suggested. Systematic review registration PROSPERO, CRD42021259173.
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21
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Evidence-Based Guidance for Breast Cancer Survivorship. Hematol Oncol Clin North Am 2023; 37:225-243. [PMID: 36435612 DOI: 10.1016/j.hoc.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Breast cancer survivorship care includes management of lingering physical symptoms, supports to address the emotional toll exacted by a cancer diagnosis and cancer therapies, monitoring and optimization of cardiac and bone health, general wellness promotion, reproductive health care, surveillance for cancer recurrence, care coordination, and efforts to mitigate health disparities.
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22
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Zhang L, Liu X, Tong F, Zou R, Peng W, Yang H, Liu F, Yang D, Huang X, Yi L, Wen M, Jiang L. Cognitive behavioral therapy for anxiety and depression in cancer survivors: a meta-analysis. Sci Rep 2022; 12:21466. [PMID: 36509786 PMCID: PMC9744858 DOI: 10.1038/s41598-022-25068-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
This study aimed to investigate the effects of cognitive behavioral therapy (CBT) on anxiety and depression in cancer survivors. The PubMed, Embase, PsycINFO, and Cochrane Library databases were searched. Randomized controlled trials that evaluated the effects of CBT in cancer survivors were included. The standardized mean difference (SMD) was used as an effect size indicator. Fifteen studies were included. For the depression score, the pooled results of the random effects model were as follows: pre-treatment versus post-treatment, SMD (95% confidence interval [CI]) = 0.88 (0.46, 1.29), P < 0.001; pre-treatment versus 3-month follow-up, 0.83 (0.09, 1.76), P = 0.08; pre-treatment versus 6-month follow-up, 0.92 (0.27, 1.58), P = 0.006; and pre-treatment versus 12-month follow-up, 0.21 (- 0.28, 0.70), P = 0.40. For the anxiety score, the pooled results of the random effects model were as follows: pre-treatment versus post-treatment, 0.97 (0.58, 1.36), P < 0.001; pre-treatment versus 3-month follow-up, 1.45 (- 0.82, 3.72), P = 0.21; and pre-treatment versus 6-month follow-up, 1.00 (0.17, 1.83), P = 0.02). The pooled result of the fixed effects model for the comparison between pre-treatment and the 12-month follow-up was 0.10 (- 0.16, 0.35; P = 0.45). The subgroup analysis revealed that the geographical location, treatment time and treatment form were not sources of significant heterogeneity. CBT significantly improved the depression and anxiety scores of the cancer survivors; such improvement was maintained until the 6-month follow-up. These findings support recommendations for the use of CBT in survivors of cancer.
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Affiliation(s)
- Lemeng Zhang
- grid.216417.70000 0001 0379 7164Thoracic Medicine Department 1, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Changsha, 410013 People’s Republic of China
| | - Xiaohong Liu
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Fei Tong
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Ran Zou
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Wanglian Peng
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Hui Yang
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Feng Liu
- grid.216417.70000 0001 0379 7164Department of Radiation Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Changsha, 410013 People’s Republic of China
| | - Desong Yang
- grid.216417.70000 0001 0379 7164Department of Thoracic Surgery, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Changsha, 410013 People’s Republic of China
| | - Xufen Huang
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Lili Yi
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Minni Wen
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Ling Jiang
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
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23
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Long-Term Effects of Breast Cancer Therapy and Care: Calm after the Storm? J Clin Med 2022; 11:jcm11237239. [PMID: 36498813 PMCID: PMC9738151 DOI: 10.3390/jcm11237239] [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: 10/28/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
Breast cancer is still a lethal disease and the leading cause of death in women, undermining patients' survival and quality of life. Modern techniques of surgery and radiotherapy allow for the obtaining of good results in terms of survival, however they cause long-term side effects that persist over time, such as lymphedema and neuropathy. Similarly, the advent of new therapies such as endocrine therapy revolutionized breast cancer outcomes, but side effects are still present even in years of follow-up after cure. Besides the side effects of medical and surgical therapy, breast cancer is a real disruption in patients' lives considering quality of life-related aspects such as the distortion of body image, the psychological consequences of the diagnosis, and the impact on family dynamics. Therefore, the doctor-patient relationship is central to providing the best support both during treatment and afterwards. The aim of this review is to summarize the consequences of medical and surgical treatment on breast cancer patients and to emphasize the importance of early prevention of side effects to improve patients' quality of life.
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24
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Panjwani AA, Aguiar S, Gascon B, Brooks DG, Li M. Biomarker opportunities in the treatment of cancer-related depression. Trends Mol Med 2022; 28:1050-1069. [PMID: 36371336 DOI: 10.1016/j.molmed.2022.10.003] [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: 08/20/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/10/2022]
Abstract
Depression comorbid with cancer is common and associated with a host of negative health outcomes. The inflammatory basis of depression is a growing area of research in cancer, focused on how stressors transduce into inflammation and contribute to the emergence of depression. In this review, we synthesize inflammatory biomarker associations with both depression and the currently available pharmacotherapies and psychotherapies in cancer, underscoring the need for expanding research on anti-inflammatory agents with antidepressant effects. Modulation of inflammatory neuroimmune pathways can slow tumor progression and reduce metastases. Biomarkers associated with depression in cancer may help with diagnosis and treatment monitoring, as well as inform research on novel drug targets to potentially improve cancer survival.
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Affiliation(s)
- Aliza A Panjwani
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Stefan Aguiar
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Bryan Gascon
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - David G Brooks
- Princess Margaret Research Institute, Toronto, ON, Canada; Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Madeline Li
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Princess Margaret Research Institute, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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25
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Lin C, Tian H, Chen L, Yang Q, Wu J, Ji Z, Zheng D, Li Z, Xie Y. The efficacy of cognitive behavioral therapy for cancer: A scientometric analysis. Front Psychiatry 2022; 13:1030630. [PMID: 36419971 PMCID: PMC9676684 DOI: 10.3389/fpsyt.2022.1030630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
Cognitive behavioral therapy (CBT) is one of the most recognized psychological interventions to improve the overall quality of life of cancer survivors. To analyze current research trends in the field of the link between CBT and cancer and to provide potential future research directions, we conducted the scientometric analysis. The study was conducted on all documents in this field from 2012 to 2022 retrieved from Web of Science. Then Biblioshiny, VOSviewer software, and CiteSpace software were used for getting the information of article postings and citations, countries, institutions, journals, authors, and keywords. The number of documents about the link between CBT and cancer from 2012 to 19 July 2022, was 619, with 476 of articles and 143 of reviews. The number of annual publications has been fluctuating, with the highest number of publications in 2020. The country with the maximum number of publications and citations was the US. The University of Houston was the organization with the highest quantity of publications and total link strength (TLS). Psycho-Oncology was the most active journal in the field and has the highest h-index. Zvolensky MJ was the author with the highest quantity of publications. The most cited keywords were "Quality-of-life," "Cognitive-behavioral therapy," "Depression," "Cognitive therapy" and "Breast-cancer." And as evidenced by the keyword citations, the focus of this research area has gradually shifted to the mental health of patients and the underlying pathogenesis. The impact of CBT in cancer treatment is now well established and has gradually evolved toward symptom-specific treatment. However, the relationship between CBT and cancer has not been further developed. Future research is needed to be further developed in the identification of a generic formula for CBT in cancer and the exploration of mechanisms of CBT and cancer.
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Affiliation(s)
- Chuanghao Lin
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Huiting Tian
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Lingzhi Chen
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Qiuping Yang
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Jinyao Wu
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zeqi Ji
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Daitian Zheng
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zhiyang Li
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yanna Xie
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
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Zhang A, Wang K, Blumenstein K, Brose A, Kemp C, Meister D, Solomon P. For whom and what outcomes does cognitive-behavioral-therapy work among cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2022; 30:8625-8636. [PMID: 36040671 DOI: 10.1007/s00520-022-07337-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To perform a systematic review and meta-analysis of CBT for individuals diagnosed with cancer across a broad range of outcome domains, i.e., functional health, psychological health, health behaviors, social relational, and general wellness. METHODS A comprehensive search of 7 databases, 91 published reviews, and 4 professional websites was performed on August 30th, 2021. English-language clinical trials of CBT for cancer patients/survivors were included. Studies were independently screened, and data were extracted by 2 reviewers, and discrepancies were resolved by consensus among the investigative team. A total of 151 clinical trials (154 articles) published between 1986 and 2021 were included in the analysis. RESULTS CBT was overall effective for cancer patients/survivors in the domains of functional health, g = 0.931, p < 0.001, psychological health, g = 0.379, p < 0.001, and general wellness, g = 0.257, p < 0.001, but ineffective in domains of health behaviors, g = 0.792, p > 0.05, and social relational outcomes, g = 0.319, p > 0.05. Additional subgroup and moderator analyses further revealed CBT's differential treatment effect for different within domain outcomes, across different cancer disease stages, and CBT delivery format. CONCLUSIONS Findings of the study showed that CBT is an effective treatment for individuals diagnosed with cancer. However, treatment effects differ by important disease- and intervention-related factors, which should be considered when recommending CBT for cancer patients/survivors.
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Affiliation(s)
- Anao Zhang
- University of Michigan School of Social Work, 1080 South University Avenue, MI, 48109, Ann Arbor, USA.
- Michigan Medicine Adolescent and Young Adult Oncology Program, Ann Arbor, MI, USA.
| | - Kaipeng Wang
- University of Denver Graduate School of Social Work, CO, Denver, USA
| | - Kate Blumenstein
- Rosalind Franklin University Chicago Medical School, Chicago, IL, USA
| | - Anna Brose
- Wheaton College in Illinois, Chicago, IL, USA
| | - Chris Kemp
- University of Michigan School of Social Work, 1080 South University Avenue, MI, 48109, Ann Arbor, USA
| | - Dalton Meister
- University of Michigan School of Social Work, 1080 South University Avenue, MI, 48109, Ann Arbor, USA
| | - Phyllis Solomon
- University of Pennsylvania School of Social Policy & Practice, PA, Philadelphia, USA
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A randomized controlled trial of WeChat-based cognitive behavioral therapy intervention to improve cancer-related symptoms in gynecological cancer survivors: study protocol. BMC Health Serv Res 2022; 22:1052. [PMID: 35978353 PMCID: PMC9387008 DOI: 10.1186/s12913-022-08443-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022] Open
Abstract
Background Gynecological malignant patients often have significant psychological and physical problems. The feasibility and generalizability of traditional intervention method is low due to the high time and labor cost, large number of gynecological malignant tumor patients in China, as well as shortage of health professionals. Therefore, it is necessary to design an alternative, innovative, and easily accessible intervention method. This study aims to evaluate the effect of WeChat-based intervention on anxiety, depression and disease-related symptoms of patients with gynecological malignant tumors during rehabilitation. Methods A single-blinded, randomized, controlled, parallel-group pre-test and repeated post-test design will be conducted. A total of 76 participants will be randomly divided into the intervention group and control group. Anxiety and depression, disease-related symptoms, coping ability, benefit finding and quality of life will be measured at baseline and repeated immediately after the intervention (test 1), 3 months (test 2) and 6 months (test 3) after the intervention. Discussion As the first randomized controlled trial with rigorous research design for patients with gynecological malignant tumors in the rehabilitation stage in China, this study will provide evidences for the effectiveness of the WeChat platform during intervention of patients with gynecological malignant tumors in the rehabilitation stage. The results are helpful to further explore the effect of WeChat-based intervention on improving patients' anxiety and depression, disease-related symptoms, and quality of life. Trial registration Chinese Clinical Trial Registry: ChiCTR2100053450, Registered 21 November 2021,http://www.chictr.org.cn/searchproj.aspx
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Abstract
Background: Some levothyroxine (LT4)-treated hypothyroid patients report a constellation of persistent and distressing cognitive symptoms that has been termed brain fog. This narrative review focuses on attempts to define and measure hypothyroid-associated brain fog, summarize possible etiologies and contributing factors, present treatment options, and propose avenues for future research. Methods: Published literature was reviewed to summarize available information on patient-reported symptoms associated with brain fog in hypothyroidism, as well as objective evidence of impairment based on neurocognitive testing and functional imaging studies. Given the limited information specific for hypothyroid-associated brain fog, relevant data from other medical conditions associated with brain fog were also reviewed and incorporated into recommendations for clinical care and future research areas. Results: Hypothyroid-associated brain fog has not been well defined or quantitated, and the underlying pathophysiology is unclear. Symptoms vary among patients but commonly include fatigue, depressed mood, and cognitive difficulties in the areas of memory and executive function. Symptoms often predate the diagnosis of hypothyroidism, and the magnitude of cognitive impairment can range from mild to severe. Regardless of severity, these symptoms are associated with impaired quality of life and cause dissatisfaction with treatment, so often lead to requests for alternate therapies. Disease-specific and psychological factors impact the experience of brain fog in complex ways, including potential limitations in LT4 monotherapy, self-knowledge of a disease state, and expectations for therapeutic effects. Conclusions: Brain fog is a variable symptom complex in people with hypothyroidism, causing significant distress and diminished quality of life. In the absence of proven therapies, individualized treatment plans are recommended, which incorporate thyroid-specific, general medical, and psychosocial approaches. In particular, cognitive rehabilitation is an underutilized technique that is beneficial in other medical conditions associated with brain fog and could improve symptoms in hypothyroid people. The limitations in our current knowledge and questions presented throughout this review highlight a major need for clinical research in this understudied area. Future research should include attention to standardization of survey instruments to quantitate brain fog in hypothyroid people, as well as rigorously designed intervention studies.
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Affiliation(s)
- Mary H. Samuels
- Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland, Oregon, USA
- Address correspondence to: Mary H. Samuels, MD, Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, 3181 Sam Jackson Park Road, CR107, Portland, OR 97221, USA
| | - Lori J. Bernstein
- Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
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Antwi GO, Lohrmann DK, Jayawardene W, Chow A, Obeng CS, Sayegh AM. Associations between Cigarette Smoking and Health-Related Quality of Life in Adult Survivors of Adolescent and Young Adult Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:508-516. [PMID: 32728997 DOI: 10.1007/s13187-020-01837-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This cross-sectional, secondary data analysis examines the association between cigarette smoking and self-reported health-related quality of life (HRQoL) in adult survivors of Adolescent and Young Adult Cancer. Pooled data for survivors of Adolescent and Young Adult Cancer (N = 1495) were drawn from the 2016 and 2017 Behavioral Risk Factor Surveillance Survey. Binary logistic regression models were utilized to examine independent associations between each of the four HRQoL domains (i.e., self-related general health, activity limitation days, poor physical, and mental health days) and cigarette smoking. Of the 1495 Adolescent and Young Adult Onset Cancer Survivors (AYAO-CS) in this study, approximately 30% reported currently smoking cigarettes. Relative to never smokers, the odds of reporting fair/poor general health were significantly higher for current and former smokers: (OR = 3.95, 95% CI: 2.08-7.50) and (OR = 2.51, 95% CI: 1.46-4.32), respectively. Likewise, current smokers were significantly more likely to report frequent days of poor physical health (OR = 2.79, 95% CI: 1.38-5.65). The study findings suggest a significant cross-sectional association between cigarette smoking and poor health-related quality of life in adult survivors of adolescent and young adult cancer. These findings, although cross-sectional, underscore the need for prospective studies to examine the longitudinal association between HRQoL and cigarette smoking among cancer survivors. Findings also help establish both the need for smoking cessation programs and the importance of effective strategies for addressing HRQoL issues among cancer survivors.
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Affiliation(s)
- Godfred O Antwi
- Department of Public Health and Health Education, The College at Brockport, State University of New York, Brockport, NY, 14420, USA.
| | - David K Lohrmann
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Wasantha Jayawardene
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
- Institute for Research on Addictive Behavior, Indiana University School of Public Health Bloomington, Bloomington, IN, USA
| | - Angela Chow
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Cecilia S Obeng
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Aaron M Sayegh
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, 47405, USA
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Development and validation of a rapid psychosocial well-being screening tool in patients with metastatic breast cancer. Int J Nurs Sci 2022; 9:303-312. [PMID: 35891904 PMCID: PMC9305018 DOI: 10.1016/j.ijnss.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Methods Results Conclusion
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31
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Ansbaugh SM, Deng G, Handzo RGF, Syrjala KL, Bauman JR. Plenary Session—The Patient Journey: Cancer Survivor Care. J Natl Compr Canc Netw 2022. [DOI: 10.6004/jnccn.2022.5026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Quality survivorship care is critical for individuals dealing with the physical, mental, and emotional impacts of cancer and its treatment. Patients may not grasp the full traumatic impact of a cancer diagnosis until years later, but the mental health impacts of cancer can be significant. At the NCCN 2022 Annual Conference, a diverse panel discussed the cancer journey through the eyes of survivorship care, with voices representing both the patient and provider perspectives. Featured during the discussion were updates to the NCCN Distress Thermometer Problem List (to represent current psycho‐oncology best practices more accurately), NCCN recommendations for mental health screening, and the benefit of integrative medicine both to relieve symptoms and improve overall wellness. Empowering patients to become active participants in their own treatment and strong survivors afterward was the overriding theme throughout the panel discussion.
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Alimoradi Z, Jafari E, Broström A, Ohayon MM, Lin CY, Griffiths MD, Blom K, Jernelöv S, Kaldo V, Pakpour AH. Effects of Cognitive Behavioral Therapy for Insomnia (CBT-I) on Quality of Life: A Systematic Review and Meta-Analysis. Sleep Med Rev 2022; 64:101646. [DOI: 10.1016/j.smrv.2022.101646] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/01/2022] [Accepted: 04/29/2022] [Indexed: 12/15/2022]
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Emery J, Butow P, Lai-Kwon J, Nekhlyudov L, Rynderman M, Jefford M. Management of common clinical problems experienced by survivors of cancer. Lancet 2022; 399:1537-1550. [PMID: 35430021 DOI: 10.1016/s0140-6736(22)00242-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 01/23/2022] [Accepted: 02/03/2022] [Indexed: 12/16/2022]
Abstract
Improvements in early detection and treatment have led to a growing prevalence of survivors of cancer worldwide. Models of care fail to address adequately the breadth of physical, psychosocial, and supportive care needs of those who survive cancer. In this Series paper, we summarise the evidence around the management of common clinical problems experienced by survivors of adult cancers and how to cover these issues in a consultation. Reviewing the patient's history of cancer and treatments highlights potential long-term or late effects to consider, and recommended surveillance for recurrence. Physical consequences of specific treatments to identify include cardiac dysfunction, metabolic syndrome, lymphoedema, peripheral neuropathy, and osteoporosis. Immunotherapies can cause specific immune-related effects most commonly in the gastrointestinal tract, endocrine system, skin, and liver. Pain should be screened for and requires assessment of potential causes and non-pharmacological and pharmacological approaches to management. Common psychosocial issues, for which there are effective psychological therapies, include fear of recurrence, fatigue, altered sleep and cognition, and effects on sex and intimacy, finances, and employment. Review of lifestyle factors including smoking, obesity, and alcohol is necessary to reduce the risk of recurrence and second cancers. Exercise can improve quality of life and might improve cancer survival; it can also contribute to the management of fatigue, pain, metabolic syndrome, osteoporosis, and cognitive impairment. Using a supportive care screening tool, such as the Distress Thermometer, can identify specific areas of concern and help prioritise areas to cover in a consultation.
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Affiliation(s)
- Jon Emery
- Centre for Cancer Research and Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
| | - Phyllis Butow
- PoCoG and CeMPED, School of Psychology SoURCe, Institute of Surgery, University of Sydney, Sydney, NSW, Australia
| | | | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Meg Rynderman
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Michael Jefford
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia; Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Long Parma DA, Reynolds GL, Muñoz E, Ramirez AG. Effect of an anti-inflammatory dietary intervention on quality of life among breast cancer survivors. Support Care Cancer 2022; 30:5903-5910. [PMID: 35380268 PMCID: PMC10156067 DOI: 10.1007/s00520-022-07023-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Behavioral interventions have been used with breast cancer survivors (BCS) in cancer pain management and post-treatment quality of life (QOL) studies. We studied the effects of an anti-inflammatory dietary intervention on QOL in BCS. METHODS One hundred fifty-three overweight and obese (body mass index [BMI] ≥ 25 kg/m2), early stage (0-III), English-speaking BCS who had completed all cancer treatment 2 or more months prior to enrollment were recruited into a two-arm randomized controlled trial with a 2 (group) by 3 (time) repeated measures design. Intervention components included six monthly food-preparation workshops and twelve motivational interviewing telephone calls. Endpoints included the Perceived Stress Scale (PSS), the Functional Assessment of Cancer Therapy-General (FACT-G) and Breast Cancer (FACT-B), and the Center for Epidemiologic Studies Depression Scale (CES-D). Repeated measures analysis using PROC MIXED in SAS version 9.4 was used. RESULTS On repeated measures analysis (intent to treat), there were no differences between groups on any of the QOL outcomes except the PSS total scores. These were significantly different in the intervention group (IG; n = 76) compared to control group (CG; n = 77), showing a main effect of assignment but no effect of time and no interaction effects. CONCLUSION There was an impact on QOL as measured by the PSS between groups. The intervention reduced perceived stress at 6-month follow-up, but the effects dissipated by 12 months. Sources and stress and stress reduction should be a focus of future studies. Future research should also identify appropriate QOL measures that are sensitive to changes brought about by behavioral interventions.
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Affiliation(s)
- Dorothy A Long Parma
- Department of Population Health Sciences, Institute for Health Promotion Research, UT Health San Antonio, 7411 John Smith Dr. Suite 1000, San Antonio, TX, 78229, USA.
| | - Grace L Reynolds
- Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Edgar Muñoz
- Department of Population Health Sciences, Institute for Health Promotion Research, UT Health San Antonio, 7411 John Smith Dr. Suite 1000, San Antonio, TX, 78229, USA
| | - Amelie G Ramirez
- Department of Population Health Sciences, Institute for Health Promotion Research, UT Health San Antonio, 7411 John Smith Dr. Suite 1000, San Antonio, TX, 78229, USA
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White V, Linardon J, Stone JE, Holmes-Truscott E, Olive L, Mikocka-Walus A, Hendrieckx C, Evans S, Speight J. Online psychological interventions to reduce symptoms of depression, anxiety, and general distress in those with chronic health conditions: a systematic review and meta-analysis of randomized controlled trials. Psychol Med 2022; 52:548-573. [PMID: 32674747 DOI: 10.1017/s0033291720002251] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Over the past 15 years, there has been substantial growth in web-based psychological interventions. We summarize evidence regarding the efficacy of web-based self-directed psychological interventions on depressive, anxiety and distress symptoms in people living with a chronic health condition. METHOD We searched Medline, PsycINFO, CINAHL, EMBASE databases and Cochrane Database from 1990 to 1 May 2019. English language papers of randomized controlled trials (usual care or waitlist control) of web-based psychological interventions with a primary or secondary aim to reduce anxiety, depression or distress in adults with a chronic health condition were eligible. Results were assessed using narrative synthases and random-effects meta-analyses. RESULTS In total 70 eligible studies across 17 health conditions [most commonly: cancer (k = 20), chronic pain (k = 9), arthritis (k = 6) and multiple sclerosis (k = 5), diabetes (k = 4), fibromyalgia (k = 4)] were identified. Interventions were based on CBT principles in 46 (66%) studies and 42 (60%) included a facilitator. When combining all chronic health conditions, web-based interventions were more efficacious than control conditions in reducing symptoms of depression g = 0.30 (95% CI 0.22-0.39), anxiety g = 0.19 (95% CI 0.12-0.27), and distress g = 0.36 (95% CI 0.23-0.49). CONCLUSION Evidence regarding effectiveness for specific chronic health conditions was inconsistent. While self-guided online psychological interventions may help to reduce symptoms of anxiety, depression and distress in people with chronic health conditions in general, it is unclear if these interventions are effective for specific health conditions. More high-quality evidence is needed before definite conclusions can be made.
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Affiliation(s)
- V White
- School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
| | - J Linardon
- School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
| | - J E Stone
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria3168, Australia
| | - E Holmes-Truscott
- School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria3000, Australia
| | - L Olive
- School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
| | - A Mikocka-Walus
- School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
| | - C Hendrieckx
- School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria3000, Australia
| | - S Evans
- School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
| | - J Speight
- School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria3000, Australia
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36
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Moshina N, Falk RS, Botteri E, Larsen M, Akslen LA, Cairns JA, Hofvind S. Quality of life among women with symptomatic, screen-detected, and interval breast cancer, and for women without breast cancer: a retrospective cross-sectional study from Norway. Qual Life Res 2021; 31:1057-1068. [PMID: 34698976 PMCID: PMC8547129 DOI: 10.1007/s11136-021-03017-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 11/09/2022]
Abstract
Purpose Breast cancers detected at screening need less aggressive treatment compared to breast cancers detected due to symptoms. The evidence on the quality of life associated with screen-detected versus symptomatic breast cancer is sparse. This study aimed to compare quality of life among Norwegian women with symptomatic, screen-detected and interval breast cancer, and women without breast cancer and investigate quality adjusted life years (QALYs) for women with breast cancer from the third to 14th year since diagnosis. Methods This retrospective cross-sectional study was focused on women aged 50 and older. A self-reported questionnaire including EQ-5D-5L was sent to 11,500 women. Multivariable median regression was used to analyze the association between quality of life score (visual analogue scale 0–100) and detection mode. Health utility values representing women’s health status were extracted from EQ-5D-5L. QALYs were estimated by summing up the health utility values for women stratified by detection mode for each year between the third and the 14th year since breast cancer diagnosis, assuming that all women would survive. Results Adjusted regression analyses showed that women with screen-detected (n = 1206), interval cancer (n = 1005) and those without breast cancer (n = 1255) reported a higher median quality of life score using women with symptomatic cancer (n = 1021) as reference; 3.7 (95%CI 2.2–5.2), 2.3 (95%CI 0.7–3.8) and 4.8 (95%CI 3.3–6.4), respectively. Women with symptomatic, screen-detected and interval cancer would experience 9.5, 9.6 and 9.5 QALYs, respectively, between the third and the 14th year since diagnosis. Conclusion Women with screen-detected or interval breast cancer reported better quality of life compared to women with symptomatic cancer. The findings add benefits of organized mammographic screening. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-03017-7.
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Affiliation(s)
- Nataliia Moshina
- Cancer Registry of Norway, Majorstuen, P.O. 5313, 0304, Oslo, Norway.
| | - Ragnhild S Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | - Marthe Larsen
- Cancer Registry of Norway, Majorstuen, P.O. 5313, 0304, Oslo, Norway
| | - Lars A Akslen
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, Bergen, Norway.,Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - John A Cairns
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Solveig Hofvind
- Cancer Registry of Norway, Majorstuen, P.O. 5313, 0304, Oslo, Norway.,Department of Health and Care Sciences, UiT The Artic University of Norway, P.O. 6050, 9037, Tromsø, Norway
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Rentscher KE, Carroll JE, Juckett MB, Coe CL, Broman AT, Rathouz PJ, Hematti P, Costanzo ES. Sleep Disruption, Fatigue, and Depression as Predictors of 6-Year Clinical Outcomes Following Allogeneic Hematopoietic Cell Transplantation. J Natl Cancer Inst 2021; 113:1405-1414. [PMID: 33693799 PMCID: PMC8633423 DOI: 10.1093/jnci/djab032] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/04/2021] [Accepted: 03/04/2021] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Allogeneic hematopoietic cell transplantation (HCT) is a widely used treatment for hematologic cancers, with survival rates ranging from 25% to 78%. Known risk factors for chronic graft-versus-host disease (cGVHD), a serious and common long-term complication, disease relapse, and mortality following HCT have been identified, but much of the variability in HCT outcomes is unexplained. Biobehavioral symptoms including depression, sleep disruption, and fatigue are some of the most prevalent and distressing for patients; yet research on biobehavioral risk factors for HCT outcomes is limited. This study evaluated patient-reported depression, sleep disruption, and fatigue as risk factors for cGVHD, disease relapse, and mortality. METHODS Adults receiving allogeneic HCT for a hematologic malignancy (N = 241) completed self-report measures of depression symptoms, sleep quality, and fatigue (severity, interference) pre-HCT and 100 days post-HCT. Clinical outcomes were monitored for up to 6 years. RESULTS Cox proportional hazard models (2-tailed) adjusting for patient demographic and medical characteristics revealed that high pre-HCT sleep disruption (Pittsburgh Sleep Quality Index >9; hazard ratio [HR] = 2.74, 95% confidence interval [CI] = 1.27 to 5.92) and greater post-HCT fatigue interference (HR = 1.32, 95% CI = 1.05 to 1.66) uniquely predicted increased risk of mortality. Moderate pre-HCT sleep disruption (Pittsburgh Sleep Quality Index 6-9) predicted increased risk of relapse (HR = 1.99, 95% CI = 1.02 to 3.87). Biobehavioral symptoms did not predict cGVHD incidence. CONCLUSIONS Biobehavioral symptoms, particularly sleep disruption and fatigue interference, predicted an increased risk for 6-year relapse and mortality after HCT. Because these symptoms are amenable to treatment, they offer specific targets for intervention to improve HCT outcomes.
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Affiliation(s)
- Kelly E Rentscher
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Judith E Carroll
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Mark B Juckett
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Aimee T Broman
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - Paul J Rathouz
- Department of Population Health, University of Texas at Austin, Austin, TX, USA
| | - Peiman Hematti
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Erin S Costanzo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
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Abstract
PURPOSE OF REVIEW Depression is a prevalent comorbidity in cancer that significantly increases the risk for numerous negative health outcomes. This review updates the current evidence base for management of depression in cancer, highlighting new research directions based on the inflammatory hypothesis of depression. RECENT FINDINGS Research on pharmacotherapy and psychotherapy for depression in cancer has shown mixed efficacy partly because of methodological issues arising from the phenomenology of depression in cancer. After decades of stagnancy, more recent high-quality clinical trials are beginning to provide an evidence base to guide treatment. Inflammatory cytokine-associated depression is a subtype of depression that may have particular relevance in cancer, opening new avenues to explore therapeutic targets and biobehavioral impacts of interventions, which may improve cancer outcomes. SUMMARY The continuum of severity in cancer-related depression is important to consider in management approaches. Choice of treatment should be personalized to the patient and their symptom profile as there is currently insufficient evidence to recommend any particular medication or psychotherapy over another. Psychological interventions should be considered first line for mild-to-moderate depression, and pharmacological treatment added for more severe depression, which can be optimally delivered within a collaborative care model. VIDEO ABSTRACT http://links.lww.com/YCO/A62.
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Affiliation(s)
- Aliza A Panjwani
- Division of Psychosocial Oncology, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
| | - Madeline Li
- Division of Psychosocial Oncology, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
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Effects of tandem cognitive behavioral therapy and healthy lifestyle interventions on health-related outcomes in cancer survivors: a systematic review. J Cancer Surviv 2021; 16:1023-1046. [PMID: 34357555 PMCID: PMC8342979 DOI: 10.1007/s11764-021-01094-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/23/2021] [Indexed: 12/15/2022]
Abstract
Purpose Healthy lifestyle (HL) behaviors and cognitive behavioral therapy (CBT) have been individually shown to improve adverse effects of cancer treatment. Little is known about how such programs in tandem affect health-related outcomes. This review evaluates extant literature on tandem CBT/HL interventions on health-related outcomes in cancer survivors. Methods A comprehensive search of PubMed, PsychINFO, CINAHL, and Embase databases revealed numerous studies involving CBT and HL tandem interventions in cancer survivors in the last 20 years. Studies meeting the inclusion criteria were examined and assessed by the authors. Results The 36 studies included 5199 participants. Interventions involved the use of CBT in combination with a HL condition (stress reduction, increasing physical activity, etc.). These tandem conditions were compared against no intervention, usual care, and/or CBT alone or HL alone. Interventions were delivered by a variety of interventionists, and over different durations. The most common HL target outcomes were stress, and insomnia. Most studies (31 of 36) reported a reduction in adverse treatment and/or cancer-related effects. Conclusion Findings were biased with the overrepresentation of breast cancer survivors, and underrepresentation of minority groups, and those with advanced cancer. Thus, this review highlights the need for further research to test tandem interventions against CBT alone and HL alone, and toward identifying the most efficacious interventions for dissemination and implementation across diverse groups of cancer survivors. Implications for cancer survivors Tandem CBT/HL interventions can improve health-related outcomes for cancer survivors when compared to usual care, but there is a paucity of knowledge to suggest differential outcomes when compared to CBT or HL alone.
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40
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Szuhany KL, Malgaroli M, Riley G, Miron CD, Suzuki R, Park JH, Rosenthal J, Chachoua A, Meyers M, Simon NM. Barriers and engagement in breast cancer survivorship wellness activities. Breast Cancer Res Treat 2021; 188:317-325. [PMID: 34095986 PMCID: PMC8482782 DOI: 10.1007/s10549-021-06279-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Breast cancer survivors may be at risk for increased rates of emotional distress and poorer quality of life. Survivorship care plans (SCPs) promoting wellness activities may support well-being; however, survivors may not receive or engage in their SCPs. This study aimed to assess receipt and participation in SCP activities as well as barriers to engagement amongst breast cancer survivors. METHODS Breast cancer survivors (n = 187; 99% female, Mean age = 57.7) consented and completed self-reported assessments of SCP recommendations, engagement and interest in wellness activities, and potential barriers to engagement. RESULTS A minority of participants recalled receiving an SCP (21%). The most physician recommended (62%) and completed (53%) activity was exercise. Interest in adding other wellness activities to the SCP was high, with reported interest levels of approximately 50% for several activities (e.g., mind body, nutrition, psychotherapy interventions). Fully half reported that having a physician-designed plan would influence participation in activities. The most common reported barriers to SCP activity engagement were lack of time (82%), work/school (65%), and lack of information (65%). CONCLUSION Few survivors recalled receiving a formal SCP, and lack of information about wellness activities was a commonly reported barrier to participation. Interest in wellness activities was generally high and may indicate the need for more formal prescription or motivation enhancement techniques to promote SCP engagement. There may be a clinical need to emphasize SCP recommendations to enhance recall and increase engagement in wellness activities that may reduce psychological distress and improve quality of life.
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Affiliation(s)
- Kristin L Szuhany
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA.
| | - Matteo Malgaroli
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Gabriella Riley
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Carly D Miron
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | | | | | - Jane Rosenthal
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, NY, USA
| | - Abraham Chachoua
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, NY, USA
| | - Marleen Meyers
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, NY, USA
| | - Naomi M Simon
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
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Osma J, Martínez-García L, Quilez-Orden A, Peris-Baquero Ó. Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Medical Conditions: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5077. [PMID: 34064898 PMCID: PMC8151777 DOI: 10.3390/ijerph18105077] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 02/04/2023]
Abstract
Emotional disorders are those that most commonly present comorbidly with medical conditions. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral emotion-based intervention, has proven efficacy and versatility. The aim of this systematic review is to know the current (research studies) and future research interest (study protocols) in using the UP for the transdiagnostic treatment of emotional symptoms or disorders (EDs) in people with a medical condition. Using the PRISMA guidelines, a literature search was conducted in Web of Science, PubMed, Medline, and Dialnet. The nine research studies included in this review indicated that the UP is effective in treating emotional symptomatology in a population with a medical condition (effect sizes ranging from d = -3.34 to d = 2.16). The three included study protocols suggest interest in the future UP application to different medical conditions, and also in distinct application formats. Our review results are encouraging, and conducting more controlled studies is advised to recommend the UP to treat and/or prevent EDs in medical conditions, especially in children and youths.
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Affiliation(s)
- Jorge Osma
- Department of Psychology and Sociology, Universidad de Zaragoza, C/Atarazanas, 4, 44003 Teruel, Spain; (L.M.-G.); (A.Q.-O.); (Ó.P.-B.)
- Instituto de Investigación Sanitaria de Aragón, C/San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Laura Martínez-García
- Department of Psychology and Sociology, Universidad de Zaragoza, C/Atarazanas, 4, 44003 Teruel, Spain; (L.M.-G.); (A.Q.-O.); (Ó.P.-B.)
- Instituto de Investigación Sanitaria de Aragón, C/San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Alba Quilez-Orden
- Department of Psychology and Sociology, Universidad de Zaragoza, C/Atarazanas, 4, 44003 Teruel, Spain; (L.M.-G.); (A.Q.-O.); (Ó.P.-B.)
- Instituto de Investigación Sanitaria de Aragón, C/San Juan Bosco, 13, 50009 Zaragoza, Spain
- Mental Health Unit of Tarazona, C/Plaza Joaquín Zamora, 2, 50500 Tarazona, Spain
| | - Óscar Peris-Baquero
- Department of Psychology and Sociology, Universidad de Zaragoza, C/Atarazanas, 4, 44003 Teruel, Spain; (L.M.-G.); (A.Q.-O.); (Ó.P.-B.)
- Instituto de Investigación Sanitaria de Aragón, C/San Juan Bosco, 13, 50009 Zaragoza, Spain
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Liu F, Fu SN, Chen YZ, Yan OY, Tong F, Peng WL, Zou R, Wen MN, Jiang L, Ma HZ, He Q, Liu L, Yang H, Huang XF, Han YQ, Wang H, Liu XH. Effects of Cognitive Behavioral Therapy for Depression and Anxiety, Response Rates and Adverse Events in Patients with Locoregional Advanced Nasopharyngeal Carcinoma. Integr Cancer Ther 2021; 20:15347354211006179. [PMID: 33784875 PMCID: PMC8020041 DOI: 10.1177/15347354211006179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022] Open
Abstract
Purpose: This retrospective study investigated the effects of cognitive behavioral
therapy (CBT) on depression, anxiety, response rates, and adverse events in
patients with locoregional advanced nasopharyngeal carcinoma (NPC). Methods: A total of 269 patients with diagnosis of stage III-IVA NPC received either
CBT plus chemoradiotherapy (CBT group, n = 136) or treatment as usual (TAU)
plus chemoradiotherapy (TAU group, n = 133). Patients in the CBT group
received a series of 6 CBT sessions for 6 weeks during concurrent
chemoradiotherapy. Depression and anxiety were assessed using the Hospital
Anxiety and Depression Scale (HADS) score at baseline, the completion of
radiotherapy, and 6, 12, and 24 months after radiotherapy. Response rates
and adverse events were also evaluated. Results: Patients in the CBT group showed significantly less depression and anxiety
than patients in the TAU group after the completion of radiotherapy
(P < .05). Complete response rates were 99.3%
(135/136) and 92.5% (123/133) in the CBT group and TAU group with a small
effect size (Phi coefficient = .171), respectively
(P = .005). Compared with the TAU group, the CBT group
showed a significantly lower incidence of acute adverse events and late
toxic effects. Conclusions: The addition of CBT to chemoradiotherapy significantly reduced depressive and
anxiety symptoms. CBT combined with chemoradiotherapy is associated with
improved response rates, with reduced incidence of toxic effects in patients
with locoregional advanced NPC. Based on this study, we registered a
randomized controlled clinical trials to better define the role of CBT in
patients with locoregional advanced NPC (Registration number:
ChiCTR2000034701).
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Affiliation(s)
- Feng Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Sheng-Nan Fu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yan-Zhu Chen
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ou-Ying Yan
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Fei Tong
- Psychological Clinic, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wang-Lian Peng
- Department of Hospice Unit, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ran Zou
- Department of Hospice Unit, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Min-Ni Wen
- Department of Clinical Spiritual Care, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ling Jiang
- Department of Clinical Spiritual Care, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hong-Zhi Ma
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Qian He
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Lin Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Yang
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xu-Fen Huang
- Department of Hospice Unit, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ya-Qian Han
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Wang
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xiao-Hong Liu
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
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Guida JL, Agurs-Collins T, Ahles TA, Campisi J, Dale W, Demark-Wahnefried W, Dietrich J, Fuldner R, Gallicchio L, Green PA, Hurria A, Janelsins MC, Jhappan C, Kirkland JL, Kohanski R, Longo V, Meydani S, Mohile S, Niedernhofer LJ, Nelson C, Perna F, Schadler K, Scott JM, Schrack JA, Tracy RP, van Deursen J, Ness KK. Strategies to Prevent or Remediate Cancer and Treatment-Related Aging. J Natl Cancer Inst 2021; 113:112-122. [PMID: 32348501 PMCID: PMC7850536 DOI: 10.1093/jnci/djaa060] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/20/2020] [Accepted: 04/17/2020] [Indexed: 12/15/2022] Open
Abstract
Up to 85% of adult cancer survivors and 99% of adult survivors of childhood cancer live with an accumulation of chronic conditions, frailty, and/or cognitive impairments resulting from cancer and its treatment. Thus, survivors often show an accelerated development of multiple geriatric syndromes and need therapeutic interventions. To advance progress in this area, the National Cancer Institute convened the second of 2 think tanks under the auspices of the Cancer and Accelerated Aging: Advancing Research for Healthy Survivors initiative. Experts assembled to share evidence of promising strategies to prevent, slow, or reverse the aging consequences of cancer and its treatment. The meeting identified research and resource needs, including geroscience-guided clinical trials; comprehensive assessments of functional, cognitive, and psychosocial vulnerabilities to assess and predict age-related outcomes; preclinical and clinical research to determine the optimal dosing for behavioral (eg, diet, exercise) and pharmacologic (eg, senolytic) therapies; health-care delivery research to evaluate the efficacy of integrated cancer care delivery models; optimization of intervention implementation, delivery, and uptake; and patient and provider education on cancer and treatment-related late and long-term adverse effects. Addressing these needs will expand knowledge of aging-related consequences of cancer and cancer treatment and inform strategies to promote healthy aging of cancer survivors.
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Affiliation(s)
- Jennifer L Guida
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Tanya Agurs-Collins
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Judith Campisi
- Buck Institute for Research on Aging, Novato, CA, USA
- Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | | | | | - Jorg Dietrich
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Rebecca Fuldner
- Division of Aging Biology, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Lisa Gallicchio
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Paige A Green
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | | | - Michelle C Janelsins
- Department of Surgery and Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Chamelli Jhappan
- Division of Cancer Biology, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - James L Kirkland
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA
| | - Ronald Kohanski
- Division of Aging Biology, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Valter Longo
- University of Southern California, Los Angeles, California, USA
- IFOM Institute, Milan, Italy
| | - Simin Meydani
- Jean Mayer USDA Human Nutritional Research Center on Aging, Tufts University, Boston, MA, USA
| | - Supriya Mohile
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Laura J Niedernhofer
- Department of Biochemistry, Molecular Biology, and Biophysics, Institute on the Biology of Aging and Metabolism, University of Minnesota, Minneapolis, MN, USA
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Frank Perna
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Keri Schadler
- Department of Pediatrics, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Russell P Tracy
- Departments of Pathology & Laboratory Medicine, and Biochemistry, Larner College of Medicine, University of Vermont, Colchester, VT, USA
| | | | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA
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Fordham B, Sugavanam T, Edwards K, Hemming K, Howick J, Copsey B, Lee H, Kaidesoja M, Kirtley S, Hopewell S, das Nair R, Howard R, Stallard P, Hamer-Hunt J, Cooper Z, Lamb SE. Cognitive-behavioural therapy for a variety of conditions: an overview of systematic reviews and panoramic meta-analysis. Health Technol Assess 2021; 25:1-378. [PMID: 33629950 PMCID: PMC7957459 DOI: 10.3310/hta25090] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cognitive-behavioural therapy aims to increase quality of life by changing cognitive and behavioural factors that maintain problematic symptoms. A previous overview of cognitive-behavioural therapy systematic reviews suggested that cognitive-behavioural therapy was effective for many conditions. However, few of the included reviews synthesised randomised controlled trials. OBJECTIVES This project was undertaken to map the quality and gaps in the cognitive-behavioural therapy systematic review of randomised controlled trial evidence base. Panoramic meta-analyses were also conducted to identify any across-condition general effects of cognitive-behavioural therapy. DATA SOURCES The overview was designed with cognitive-behavioural therapy patients, clinicians and researchers. The Cochrane Library, MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Child Development & Adolescent Studies, Database of Abstracts of Reviews of Effects and OpenGrey databases were searched from 1992 to January 2019. REVIEW METHODS Study inclusion criteria were as follows: (1) fulfil the Centre for Reviews and Dissemination criteria; (2) intervention reported as cognitive-behavioural therapy or including one cognitive and one behavioural element; (3) include a synthesis of cognitive-behavioural therapy trials; (4) include either health-related quality of life, depression, anxiety or pain outcome; and (5) available in English. Review quality was assessed with A MeaSurement Tool to Assess systematic Reviews (AMSTAR)-2. Reviews were quality assessed and data were extracted in duplicate by two independent researchers, and then mapped according to condition, population, context and quality. The effects from high-quality reviews were pooled within condition groups, using a random-effect panoramic meta-analysis. If the across-condition heterogeneity was I2 < 75%, we pooled across conditions. Subgroup analyses were conducted for age, delivery format, comparator type and length of follow-up, and a sensitivity analysis was performed for quality. RESULTS A total of 494 reviews were mapped, representing 68% (27/40) of the categories of the International Classification of Diseases, Eleventh Revision, Mortality and Morbidity Statistics. Most reviews (71%, 351/494) were of lower quality. Research on older adults, using cognitive-behavioural therapy preventatively, ethnic minorities and people living outside Europe, North America or Australasia was limited. Out of 494 reviews, 71 were included in the primary panoramic meta-analyses. A modest effect was found in favour of cognitive-behavioural therapy for health-related quality of life (standardised mean difference 0.23, 95% confidence interval 0.05 to 0.41, prediction interval -0.05 to 0.50, I2 = 32%), anxiety (standardised mean difference 0.30, 95% confidence interval 0.18 to 0.43, prediction interval -0.28 to 0.88, I2 = 62%) and pain (standardised mean difference 0.23, 95% confidence interval 0.05 to 0.41, prediction interval -0.28 to 0.74, I2 = 64%) outcomes. All condition, subgroup and sensitivity effect estimates remained consistent with the general effect. A statistically significant interaction effect was evident between the active and non-active comparator groups for the health-related quality-of-life outcome. A general effect for depression outcomes was not produced as a result of considerable heterogeneity across reviews and conditions. LIMITATIONS Data extraction and analysis were conducted at the review level, rather than returning to the individual trial data. This meant that the risk of bias of the individual trials could not be accounted for, but only the quality of the systematic reviews that synthesised them. CONCLUSION Owing to the consistency and homogeneity of the highest-quality evidence, it is proposed that cognitive-behavioural therapy can produce a modest general, across-condition benefit in health-related quality-of-life, anxiety and pain outcomes. FUTURE WORK Future research should focus on how the modest effect sizes seen with cognitive-behavioural therapy can be increased, for example identifying alternative delivery formats to increase adherence and reduce dropout, and pursuing novel methods to assess intervention fidelity and quality. STUDY REGISTRATION This study is registered as PROSPERO CRD42017078690. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Beth Fordham
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Thavapriya Sugavanam
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Katherine Edwards
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Karla Hemming
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jeremy Howick
- Faculty of Philosophy, University of Oxford, Oxford, UK
| | - Bethan Copsey
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Hopin Lee
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Milla Kaidesoja
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Shona Kirtley
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sally Hopewell
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Roshan das Nair
- Department of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
| | | | | | - Zafra Cooper
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sarah E Lamb
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
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Akkol-Solakoglu S, Hevey D, Richards D. A randomised controlled trial comparing internet-delivered cognitive behavioural therapy (iCBT) with and without main carer access versus treatment-as-usual for depression and anxiety among breast cancer survivors: Study protocol. Internet Interv 2021; 24:100367. [PMID: 33552931 PMCID: PMC7851185 DOI: 10.1016/j.invent.2021.100367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/08/2021] [Accepted: 01/13/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Depression and anxiety are common problems among breast cancer survivors. Carer support is one of the most important determinants of women's psychological wellbeing. Survivors' distress can be alleviated by giving carers access to survivors' evidence-based treatment, which will help carers understand what survivors have been going through and help survivors feel more supported. Given the limited access to evidence-based treatments, an adapted internet-delivered cognitive behavioural therapy (iCBT) intervention for breast cancer survivors, but also open for carers' access, has the potential to decrease survivors' depression and anxiety symptoms and improve cancer-related communication and relationship quality between survivors and carers. OBJECTIVES This study evaluates (1) the effectiveness of a guided iCBT intervention for depression and/or anxiety symptoms among breast cancer survivors with and without main carer access, and (2) the acceptability and satisfaction with the iCBT programme. METHOD In this pilot study comparing the effectiveness of an adapted 7-week iCBT without main carer access against the iCBT with main carer access and treatment-as-usual control, 108 breast cancer survivors will be recruited and then randomised to either (1) treatment (n = 72) or (2) treatment-as-usual control group (n = 36) with a 2:1 ratio. The participants in the treatment group will be assigned to either iCBT alone or iCBT with the main carer also having access to the same content based on their preference. The primary outcome measure is the Hospital Anxiety and Depression Scale, and alongside secondary measures such as Cancer-Related Quality of Life, Breast Cancer Worry Scale, Brief COPE, and Medical Outcomes Study Social Support Survey will be completed by the survivors at baseline, post-treatment, and 2-month follow-up. Survivors who have carers will also complete Survivor-Carer Cancer Communication and Relationship Quality measures to provide insights into the effects of carer access. To assess the acceptability and satisfaction with the programme, survivors and their main carers will fill out the Helpful Aspects of Therapy Form (HAT) and Satisfaction with Online Treatment (SAT). Programme effectiveness and the effects of carer access on primary and secondary outcome measures will be evaluated on intention-to-treat and per-protocol basis using Linear-Mixed-Models. DISCUSSION This is the first trial comparing the effectiveness and acceptability of iCBT with and without carer access for depression and anxiety among breast cancer survivors. The findings of this study will provide novel data on the acceptability of iCBT programmes for breast cancer survivors and the impact of carer access on them and their carers.
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Affiliation(s)
- Selin Akkol-Solakoglu
- Aras an Phiarsaigh, School of Psychology, Trinity College Dublin, Dublin, Ireland
- Corresponding author.
| | - David Hevey
- Aras an Phiarsaigh, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Derek Richards
- Aras an Phiarsaigh, School of Psychology, Trinity College Dublin, Dublin, Ireland
- Clinical Research and Innovation, SilverCloud Health, Dublin, Ireland
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46
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Ye S, Williams CP, Gilbert AD, Huang CH, Salter TL, Rocque GB. The Impact of Depression on Health Care Utilization in Patients with Cancer. J Palliat Med 2021; 24:755-759. [PMID: 33481660 DOI: 10.1089/jpm.2020.0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Depression is common in the oncology patient population. Little data exist on the impact of depression on health care utilization. Objectives: We evaluated the prevalence of depression and the relationship between depression and health care utilization in patients with cancer. Design: This cross-sectional study utilized patient-reported outcome data from predominately Medicare beneficiaries with cancer. We examined the emergency department visits and inpatient admissions within 3 months from survey. The relationship between depression and hospital visits was assessed using generalized linear models. Results: Of 1038 patients included in the study, 13% had moderate to severe depression. In adjusted models, patients with moderate or severe depression trended toward increased risk of hospitalizations compared with patients without depression (risk ratio: 1.25, 95% confidence interval: 0.97-1.62). Conclusions: Clinically significant depression is not uncommon in cancer patients. Further research is needed evaluating the relationship between depression, health care utilization, and early psychiatric intervention in oncology.
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Affiliation(s)
- Star Ye
- Divisions of General Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Courtney P Williams
- Divisions of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Aidan D Gilbert
- College of Medicine, University of South Alabama, Mobile, Alabama, USA
| | - Chao-Hui Huang
- Division of Gerontology, Geriatrics, and Palliative Care, and University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Terri L Salter
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gabrielle B Rocque
- Divisions of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Gerontology, Geriatrics, and Palliative Care, and University of Alabama at Birmingham, Birmingham, Alabama, USA.,O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
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47
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Getu MA, Chen C, Panpan W, Mboineki JF, Dhakal K, Du R. The effect of cognitive behavioral therapy on the quality of life of breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Qual Life Res 2020; 30:367-384. [PMID: 33068239 DOI: 10.1007/s11136-020-02665-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Several lines of clinical research support the efficacy of Cognitive behavioral therapy (CBT) with a large number of population and various disease conditions, however, the true effects of CBT interventions on Quality of Life of breast cancer patients remain unknown. The aim of the study was to evaluate the effect of Cognitive Behavioral Therapy on the Quality of Life of breast cancer patients. METHODS A systematic review of articles published using Web of Science (1950-January 2020); Medline via EBSCO (1992-January 2020); Science direct via ELSEVIER (1996-January 2020); SCOPUS (2004-January 2020); and PubMed (1946-January 2020 excluding Medline from 1992-January 2020) were included. Additional studies were included after checking reference lists of all relevant studies; searching ongoing trials and research registers and manual search. Data extraction was conducted by two independent authors and a third independent author checked the data extraction. The PRISMA statement was adopted. RESULT Eleven Randomized controlled trials (RCT) with 1690 breast cancer patients were included in this review. The overall effect size of cognitive behavioral therapy on QoL of breast cancer patients was medium 0.39 (95% CI 0.12-0.66, P < 0.00001, I2 = 83%). Five studies had shown statistically significant improvement in functional and symptoms scales in the treatment group than the control group. CONCLUSION CBT is effective in improving the Quality of Life of breast cancer patients. In future research, further randomized controlled trials with adequate randomization, allocation concealment, and appropriate blinding may be needed.
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Affiliation(s)
- Mikiyas Amare Getu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.
| | - Changying Chen
- The First Affiliated Teaching Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wang Panpan
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | | | - Kamala Dhakal
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ruofei Du
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
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48
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Mokhatri-Hesari P, Montazeri A. Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018. Health Qual Life Outcomes 2020; 18:338. [PMID: 33046106 PMCID: PMC7552560 DOI: 10.1186/s12955-020-01591-x] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Breast cancer still is a topic. This overview of the literature aimed to update the current knowledge on quality of life in breast cancer patients. METHODS A review of literature in MEDLINE, Cochrane Database of Systematic Reviews and Google Scholar were carried out to identify review papers on health-related quality of life in breast cancer during the 2008 to 2018. All publications were screened using the PRISMA guideline. The methodological quality of reviews was assessed using the AMSTAR. The findings were summarized and tabulated accordingly. RESULTS Within over a decade, a total of 974 review papers were identified which according to the study selection criteria finally we have evaluated 82 reviews. Of these about 85% had a reasonable methodological quality. The findings were mainly summarized on several headings including instruments used to measure quality of life, treatment, supportive care, psychological distress, and symptoms. Questionnaires had a good performance to quantify quality of life in breast cancer patients. Most reviews were focused on the impact of treatment including endocrine therapy as well as integrating complementary and alternative medicine into the current practice. According to the reviews, yoga was the most recommended exercise to improve quality of life in breast cancer patients. CONCLUSION Overall, the findings from this overview indicated that quality of life in breast cancer patients enhanced during the last decade. Several simple but effective interventions such as physical activity and psychosocial interventions proved to be effective in improving quality of life in this population. However, management of symptoms such as pain, and lymphedema, issues related to worry, sexual function especially for young patients, and the future outlooks all are among topics that deserve further consideration. Also, this overview indicated that methodological issues in measuring quality of life in breast cancer patients improved greatly, but still there is a long way to go to understand what really matter to patients.
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Affiliation(s)
- Parisa Mokhatri-Hesari
- Integrative Oncology Research Group, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.,Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. .,Faculty of Humanity Sciences, University of Science and Culture, ACECR, Tehran, Iran.
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Cuervo NM, Silva PZ, Medina DAR, Flores JRL, Ramírez AML, Domínguez Trejo B. Terapia cognitivo-conductual grupal sobre la sintomatología depresiva-ansiosa y temperatura nasal en mujeres con cáncer de mama: Estudio piloto. PSICOONCOLOGIA 2020. [DOI: 10.5209/psic.70290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo. Evaluar el efecto de una intervención cognitivo-conductual grupal sobre la sintomatología ansiosa-depresiva y el funcionamiento autonómico afectivo en mujeres con cáncer de mama. Método. Estudio pre-experimental con una muestra de 17 mujeres mexicanas con un nivel de depresión de moderada-severa y diagnóstico de cáncer de mama. Los instrumentos de evaluación fueron el Inventario de Depresión de Beck y la Escala de ansiedad de Hamilton; además de una evaluación del funcionamiento autonómico mediante el registro intra-sesión de la temperatura periférica nasal. Resultados. Se observó una reducción de los síntomas de depresión (Z=-3.182, p=0.001), ansiedad (Z=-2.697, p=0.007) y un incremento de la temperatura al finalizar el tratamiento (Z=-2.669, p=008) que se mantuvo por seis meses (Z=-3.266, p=0.001). Conclusión. La terapia cognitivo conductual grupal fue eficaz para la reducción de la sintomatología ansiosa-depresiva y la regulación autonómica en el grupo de mujeres con cáncer de mama.
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Gabriel I, Creedy D, Coyne E. A systematic review of psychosocial interventions to improve quality of life of people with cancer and their family caregivers. Nurs Open 2020; 7:1299-1312. [PMID: 32802350 PMCID: PMC7424465 DOI: 10.1002/nop2.543] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/23/2020] [Accepted: 05/27/2020] [Indexed: 11/30/2022] Open
Abstract
Aims To review the characteristics and effectiveness of psychosocial interventions on quality of life of adult people with cancer and their family caregivers. Design A systematic review using PRISMA guidelines. Methods Seven databases were searched from 2009-2019 using key terms. Included studies were assessed using the Quality Assessment Tool for Quantitative Studies. Results 1909 studies were retrieved with 12 studies included, involving 3,390 patients/caregivers. Interventions aimed to improve communication, behaviour change and setting short-term goals. Duration of interventions varied from 4-17 weeks. Highest benefit was gained from telephone interventions. Interventions based on interpersonal counselling appeared more effective than other approaches. Studies predominantly focused on psychological, physical and social domains of quality of life. Spiritual well-being received relatively little attention. A paradigm shift is needed to develop psychosocial interventions that incorporate spiritual well-being. More research is needed in developing countries.
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Affiliation(s)
- Israel Gabriel
- School of Nursing and MidwiferyGriffith UniversityLogan CampusQueenslandAustralia
| | - Debra Creedy
- School of Nursing and MidwiferyGriffith UniversityLogan CampusQueenslandAustralia
| | - Elisabeth Coyne
- School of Nursing and MidwiferyGriffith UniversityLogan CampusQueenslandAustralia
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