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van Dalen M, Snijders A, Dietvorst E, Bracké K, Nijhof SL, Keijsers L, Hillegers MHJ, Legerstee JS. Applications of the experience sampling method (ESM) in paediatric healthcare: a systematic review. Pediatr Res 2024; 95:887-900. [PMID: 38062256 PMCID: PMC10920184 DOI: 10.1038/s41390-023-02918-2] [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] [Received: 06/26/2023] [Revised: 10/19/2023] [Accepted: 11/03/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND With the Experience Sampling Method (ESM) participants are asked to provide self-reports of their symptoms, feelings, thoughts and behaviours in daily life. This preregistered systematic review assessed how ESM is being used to monitor emotional well-being, somatic health, fatigue and pain in children and adolescents with a chronic somatic illness. METHODS Databases were searched from inception. Studies were selected if they included children or adolescents aged 0-25 years with a chronic somatic illness and used ESM focussing on mental health or psychosocial wellbeing, biopsychosocial factors and/or somatic health. Two reviewers extracted data of the final 47 papers, describing 48 studies. RESULTS Most studies evaluated what factors influence medical or psychological symptoms and how symptoms influence each other. Another common purpose was to study the feasibility of ESM or ESM as part of an app or intervention. Study methods were heterogeneous and most studies lack adequate reporting of ESM applications and results. CONCLUSIONS While ESM holds great potential for providing results and feedback to patients and caregivers, little use is being made of this option. Future studies should consider what they report in their studies, conduct a priori power analyses and how ESM can be embedded in clinical practice. IMPACT While ESM has many clinical applications, it is currently mostly used for research purposes. Current studies using ESM are heterogeneous and lack consistent, high-quality reporting. There is great potential in ESM for providing patients and parents with personalised feedback.
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Affiliation(s)
- Marije van Dalen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
| | - Anne Snijders
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Evelien Dietvorst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Katrien Bracké
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Sanne L Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Loes Keijsers
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
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Kaphle M, Bajracharya D, Regmi N, Aryal D, Karki R. Depression and anxiety among cancer patients visiting a tertiary care cancer hospital. World J Psychiatry 2024; 14:287-295. [PMID: 38464775 PMCID: PMC10921282 DOI: 10.5498/wjp.v14.i2.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/25/2023] [Accepted: 01/19/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Cancer patients frequently experience psychological problems related to reactions to cancer diagnosis, cancer type and stage, treatment effects, recurrence, fear of end-of-life, survivorship, and financial burden. Depression and anxiety are both psychological and physiological disturbances among cancer patients. AIM To assess the prevalence of depression and anxiety among cancer patients attending a tertiary care cancer hospital. METHODS A cross-sectional study was conducted at Bhaktapur Cancer Hospital in Kathmandu Valley among 220 cancer patients aged from 18 years to 70 years. Ethical approval was taken from the Institutional Review Committee of CiST College. Convenient sampling was used to interview patients with the standardized Patient-Health Questionnaire (PHQ-9) for Depression and Hospital Anxiety and Depression sub-scale (HADS-A) for anxiety. Epi-Data was used for data entry and transferred to SPSS Version 25 for analysis. RESULTS The study revealed that of 220 patients, most of the respondents belonged to the age group 51-60 years. More than half 131 (59.6%) of the respondents were female, most of them had depression, and one-third had anxiety. Among the respondents, 124 (56.4%) had mild depression, 70 (31.8%) had moderate depression, and 3 (1.3%) had severe depression; 79 (35.9%) had mild anxiety, 64 (29.1%) had moderate anxiety, and 4 (1.8%) had severe anxiety. CONCLUSION Most respondents were depressed and one-third had anxiety. More than half and nearly one-third had mild and moderate depression, respectively, and nearly one-third had mild and moderate anxiety, which is higher than other studies.
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Affiliation(s)
- Maheshor Kaphle
- Department of Public Health, Peoples Dental College and Hospital, Tribhuvan University, Kathmandu 44600, Bagmati, Nepal
| | - Diya Bajracharya
- Department of Public Health, CiST College, Pokhara University, Kathmandu 44600, Bagmati, Nepal
| | - Nirmala Regmi
- Department of Oncology, Kanti Hospital, Maharajgunj, Kathmandu 44600, Nepal
| | - Dipsikha Aryal
- Department of Public Health, Peoples Dental College and Hospital, Tribhuvan University, Kathmandu 44600, Bagmati, Nepal
| | - Rajesh Karki
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu 44600, Bagmati, Nepal
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Kamphuis MJ, van der Kamp LT, van Eijk RPA, Rinkel GJE, Visser-Meily JMA, van der Schaaf IC, Vergouwen MDI. Scanxiety and quality of life around follow-up imaging in patients with unruptured intracranial aneurysms: a prospective cohort study. Eur Radiol 2024:10.1007/s00330-024-10602-0. [PMID: 38311702 DOI: 10.1007/s00330-024-10602-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVES Patients with an unruptured intracranial aneurysm (UIA) may experience scanxiety around follow-up imaging. We studied the prevalence and temporal pattern of scanxiety, and compared quality of life (QoL) outcomes in patients with and without scanxiety. METHODS We performed a prospective cohort study in a tertiary referral center in the Netherlands between October 2021 and November 2022. We sent questionnaires to patients ≥ 18 years old undergoing UIA follow-up imaging 4 weeks before (T1), immediately after (T2), and 6 weeks after the scan (T3) to assess health-related QoL (HRQoL) and emotional functioning. At T3, we also assessed scanxiety with a purpose-designed questionnaire. We compared differences in QoL outcomes between respondents with and without scanxiety using mixed models. RESULTS Of 158 eligible patients, 106 (67%) participated (mean age 61 years ± 11 [standard deviation], 84 women). Sixty of the 91 respondents (66%) who completed the purpose-designed questionnaire experienced scanxiety. Of the 49 respondents who experienced scanxiety after the scan, it resolved in 22 (45%) within a day after receiving the radiology report. HRQoL did not differ between respondents with or without scanxiety. Emotional functioning was worse for respondents with scanxiety (mean Hospital Anxiety and Depression Scale sum score difference at T1, 3.6 [95% CI, 0.9-6.3]; T2, 4.1 [95% CI, 1.5-6.8]; and T3, 4.0 [95% CI, 1.5-6.5]). CONCLUSIONS Two-thirds of the respondents experienced scanxiety around follow-up imaging, which often resolved within a day after receiving results. Patients with scanxiety had similar HRQoL but worse emotional functioning compared to patients without scanxiety. The time between the scan and receiving the results should be minimized to decrease the duration of scanxiety. CLINICAL RELEVANCE STATEMENT We showed that scanxiety is common in UIA patients, and negatively associated with emotional functioning. Since scanxiety often disappears immediately after receiving the radiology report, it should be communicated to the patient as early as possible to alleviate patients' distress. KEY POINTS • Many patients with an unruptured intracranial aneurysm experience emotional distress around follow-up imaging, termed "scanxiety." • Patients with scanxiety had worse emotional functioning compared to patients without scanxiety. • Scanxiety often resolved within a day after receiving the radiology report.
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Affiliation(s)
- Maarten J Kamphuis
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Laura T van der Kamp
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ruben P A van Eijk
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gabriel J E Rinkel
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Irene C van der Schaaf
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mervyn D I Vergouwen
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Smith SM, Steele N, Kim J, Yurkiewicz IR, Benedict C, Trivedi R, Heathcote LC, Simon PJ, Bugos K, Clayton A, Palesh O, Schapira L. Cancer Survivorship at Stanford Cancer Institute. J Cancer Surviv 2024; 18:53-58. [PMID: 38183579 DOI: 10.1007/s11764-023-01523-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/19/2023] [Indexed: 01/08/2024]
Abstract
The Stanford Cancer Survivorship Program is a key initiative of Stanford Cancer Institute. The program's mission is to improve the experience and outcomes of patients and family caregivers throughout all phases of the cancer trajectory by advancing survivorship research, clinical care, and education. The four pillars of the program include clinical care delivery with a focus on primary care-survivorship collaboration and expanding specialty services, education and training of healthcare professionals, transdisciplinary patient-oriented research, and community engagement. Cross-cutting areas of expertise include the following: (a) adolescents and young adults (AYAs), (b) mental health and patient self-management, (c) integration of primary care, and (d) postgraduate medical education. The clinical care model includes embedded survivorship clinics within disease groups in outpatient clinics, novel clinics designed to address unmet needs such as sexual health for women, and primary care-based faculty-led survivorship clinics for patients undergoing active cancer care requiring co-management, those who have completed active therapy and those at high risk for cancer due to genetic risk. Educational initiatives developed to date include an online course and medical textbook for primary care clinicians, a lecture series, monthly research team meetings, and rotations for medical trainees. Patient-facing activities include webinars and a podcast series designed to promote awareness, thus expanding the provision of expert-vetted information. Ongoing research focuses on oncofertility and family building after cancer, improving communication for AYAs, changing mindsets to improve quality of life through targeted digital interventions, increasing capacity to care for cancer survivors, and strengthening collaboration with community partners. IMPLICATIONS FOR CANCER SURVIVORS: Stanford's Cancer Survivorship Program includes a robust transdisciplinary and interdisciplinary research, training and clinical platform that is committed to advancing access and improving care for people living with and beyond cancer, through innovation in design and care delivery.
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Affiliation(s)
- Stephanie M Smith
- Department of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, USA
| | - Natasha Steele
- Department of Medicine, Stanford University School of Medicine, Stanford, USA
| | - Jennifer Kim
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, USA
| | - Ilana R Yurkiewicz
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, USA
| | - Catherine Benedict
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, USA
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, USA
| | - Ranak Trivedi
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
- Department of Psychiatry and Behavioral Sciences, Division of Public Mental Health and Population Sciences, Stanford University, Stanford, CA, USA
| | - Lauren C Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE1 9RT, UK
| | - Pamela J Simon
- Lucile Packard Children's Hospital at Stanford, Palo Alto, USA
- Stanford Adolescent & Young Adult Cancer Program, Palo Alto, USA
| | | | - Alison Clayton
- Stanford Health Care, Stanford, CA, USA
- Stanford Cancer Institute, 900 Welch Road, Suite 100, Palo Alto, CA, 94304, USA
| | - Oxana Palesh
- Department of Psychiatry, Massey Cancer Center, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Lidia Schapira
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, USA.
- Stanford Cancer Institute, 900 Welch Road, Suite 100, Palo Alto, CA, 94304, USA.
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Horwood M, Loades ME, Kosir U, Davis C. Illness Perceptions, Fear of Cancer Recurrence, and Mental Health in Teenage and Young Adult Cancer Survivors. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:44-55. [PMID: 37956647 DOI: 10.1177/27527530231190378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background: The Common-Sense Model of illness self-regulation underpins illness-specific cognitions (including both illness perceptions and a fear of cancer recurrence; FCR). There is evidence in adults of associations between FCR, illness perceptions, and mental health in adult cancer survivors. However, there is limited empirical research examining these constructs within the developmentally distinct population of adolescent and young adult (AYA) survivors of cancer. The current study aimed to bridge that gap to inform potentially modifiable treatment targets in this population. Method: A cross-sectional, correlational design was used to examine the associations between illness perceptions, FCR, and mental health. A web-based survey was completed by a convenience sample of AYA survivors. Regression and mediation analyses were performed. Results: Overall, more negative illness perceptions were associated with more severe FCR and greater depressive and anxiety symptomatology. Higher FCR was predictive of worse overall mental health. More negative overall illness perceptions predicted the relationship between FCR-depression, mediating 24.1% of the variance. Contrastingly, overall illness perceptions did not predict or mediate the relationship between FCR-anxiety. However, the specific illness perceptions regarding timeline, personal control, and emotional representation, were predictive of the FCR-anxiety relationship. Discussion: Illness perceptions and FCR were predictive of mental health outcomes. Identifying and therapeutically targeting negative illness perceptions in those young adults who have survived adolescent cancer could therefore be a means of reducing anxiety and depressive symptomatology. Limitations and future directions are discussed.
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Affiliation(s)
| | | | - Urska Kosir
- Orthopedic Oncology - Sarcoma Team, McGill University Health Centre (Sarcoma Team), Montreal, Canada
| | - Cara Davis
- Department of Psychology, University of Bath, Bath, UK
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Paterson C, Armitage L, Turner M. Current Landscape of Ecological Momentary Assessment (Real-Time Data) Methodology in Cancer Research: A Systematic Review. Semin Oncol Nurs 2023; 39:151514. [PMID: 37865555 DOI: 10.1016/j.soncn.2023.151514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To critically synthesize and describe the use and methods of ecological momentary assessment (EMA) in cancer research. DATA SOURCES A systematic review was conducted and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Guideline. Electronic databases (APA PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, MEDLINE, Scopus, and Web of Science Core Collection) were searched using a variety of keywords and subject headings by an expert systematic review librarian. All publications were double screened by two reviewers using predetermined exclusion and inclusion criteria throughout the full review process. The review used Covidence Systematic Review Software. Methodological quality assessment and data extraction were performed. A narrative synthesis was conducted to examine the aim for EMA, the characteristics of the study samples, the EMA sampling procedures, EMA completion rates, outcome measures, and any implications of findings for survivorship care. CONCLUSION A total of 42 EMA studies in cancer were included. Most studies used an electronic mobile device to capture EMA data apart from several that used paper diaries. Existing studies were found to have significant heterogeneity in methods and widely varying approaches to design and self-report measurements. While EMA in cancer research holds significant promise to advance cancer care research into the future by increasing ecological validity and reducing retrospective bias and can capture the unique idiographic within-person change over time, in real-time, further research is needed to develop standardized EMA self-report questionnaires. IMPLICATIONS FOR NURSING PRACTICE This is the first comprehensive systematic review to describe the use and methods of EMA in cancer research. There is significant heterogeneity in methods and widely varying approaches to design and self-report measurements in EMA cancer research. People affected by cancer found taking part in EMA studies reported benefit from the experience. However, researchers must engage with cancer survivors in the development and co-design of future EMA questionnaires to ensure relevant and acceptability of EMA data collection protocols.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Australia; Central Adelaide Local Health Network, Adelaide; Robert Gordon University, Aberdeen, Scotland, UK; Faculty of Health, University of Canberra, Bruce, ACT, Australia.
| | - L Armitage
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - M Turner
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
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Boerner KE, Desai U, Luu J, MacLean KE, Munzner T, Foladare H, Shen J, Gill J, Oberlander TF. "Making Data the Drug": A Pragmatic Pilot Feasibility Randomized Crossover Trial of Data Visualization as an Intervention for Pediatric Chronic Pain. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1355. [PMID: 37628354 PMCID: PMC10452969 DOI: 10.3390/children10081355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023]
Abstract
Data tracking is a common feature of pain e-health applications, however, viewing visualizations of this data has not been investigated for its potential as an intervention itself. We conducted a pilot feasibility parallel randomized cross-over trial, 1:1 allocation ratio. Participants were youth age 12-18 years recruited from a tertiary-level pediatric chronic pain clinic in Western Canada. Participants completed two weeks of Ecological Momentary Assessment (EMA) data collection, one of which also included access to a data visualization platform to view their results. Order of weeks was randomized, participants were not masked to group assignment. Objectives were to establish feasibility related to recruitment, retention, and participant experience. Of 146 youth approached, 48 were eligible and consented to participation, two actively withdrew prior to the EMA. Most participants reported satisfaction with the process and provided feedback on additional variables of interest. Technical issues with the data collection platform impacted participant experience and data analysis, and only 48% viewed the visualizations. Four youth reported adverse events not related to visualizations. Data visualization offers a promising clinical tool, and patient experience feedback is critical to modifying the platform and addressing technical issues to prepare for deployment in a larger trial.
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Affiliation(s)
- Katelynn E. Boerner
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC V6H 3V4, Canada; (K.E.B.)
| | - Unma Desai
- Department of Computer Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jessica Luu
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC V6H 3V4, Canada; (K.E.B.)
| | - Karon E. MacLean
- Department of Computer Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Tamara Munzner
- Department of Computer Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Haley Foladare
- Department of Computer Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jane Shen
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC V6H 3V4, Canada; (K.E.B.)
| | - Javed Gill
- BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada
| | - Tim F. Oberlander
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC V6H 3V4, Canada; (K.E.B.)
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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Seibel K, Sauer B, Wagner B, Becker G. "Scanxiety" and a sense of control: the perspective of lung cancer survivors and their caregivers on follow-up - a qualitative study. BMC Psychol 2023; 11:119. [PMID: 37069692 PMCID: PMC10111662 DOI: 10.1186/s40359-023-01151-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/29/2023] [Indexed: 04/19/2023] Open
Abstract
OBJECTIVES Lung cancer survivors often suffer from physical, emotional and social long-term effects of disease and treatment. Caregivers are also affected by the cancer diagnosis throughout the course of the disease and are frequently burdened by high levels of psychosocial stress. However, little is known about how follow-up care after the completed treatment phase can help to improve long-term quality of life. In the context of patient-centred cancer care, considering the survivors' and caregivers' perspectives is an important step toward improving care structures. We therefore explored how lung cancer survivors and their caregivers experience follow-up examinations and their possible psychosocial effects on everyday life in order to shed light on what support is helpful for improving their quality of life. MATERIAL AND METHODS 25 survivors after curative lung cancer treatment and 17 caregivers underwent a face-to-face semi-structured, audio-recorded interview that was analysed using qualitative content analysis. RESULTS Especially burdened cancer survivors and caregivers described recurring anxiety before a follow-up appointment influencing their everyday life. At the same time, follow-up care also provided reassurance of still being healthy and helped regain a sense of security and control until the following scan. Despite possible long-term consequences in everyday life, the interviewees reported that the survivors´ psychosocial needs were not explicitly assessed or discussed. Nevertheless, the interviewees indicated that conversations with the physician were important for the success of "good" follow-up care. CONCLUSION Anxiety surrounding follow-up scans, also known as "scanxiety", is a common problem. In this study, we expanded on previous findings and found a positive aspect of scans, namely regaining a sense of security and control, which can strengthen the psychological well-being of the survivors and their families. To optimize follow-up care and improve the quality of life of lung cancer survivors and caregivers, strategies to integrate psychosocial care, like the introduction of survivorship care plans or increased use of patient-reported outcomes, should be explored in the future.
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Affiliation(s)
- Katharina Seibel
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Robert-Koch-Str. 3, 79106, Freiburg, Germany.
| | - Barbara Sauer
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Robert-Koch-Str. 3, 79106, Freiburg, Germany
| | - Bernd Wagner
- Department of Palliative Care, Marienhaus Hospital, An der Goldgrube 11, 55131, Mainz, Germany
| | - Gerhild Becker
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Robert-Koch-Str. 3, 79106, Freiburg, Germany
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Derry-Vick HM, Heathcote LC, Glesby N, Stribling J, Luebke M, Epstein AS, Prigerson HG. Scanxiety among Adults with Cancer: A Scoping Review to Guide Research and Interventions. Cancers (Basel) 2023; 15:1381. [PMID: 36900174 PMCID: PMC10000102 DOI: 10.3390/cancers15051381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Background: Scan-related anxiety ("scanxiety") is distressing to people living with and beyond cancer. We conducted a scoping review to promote conceptual clarity, identify research practices and gaps, and guide intervention strategies for adults with a current or prior cancer diagnosis. Methods: Following a systematic search, we screened 6820 titles and abstracts, evaluated 152 full-text articles, and selected 36 articles. Definitions, study designs, measurement methods, correlates, and consequences of scanxiety were extracted and summarized. Results: The reviewed articles included individuals living with current cancer (n = 17) and those in the post-treatment phase (n = 19), across a breadth of cancer types and disease stages. In five articles, authors explicitly defined scanxiety. Multiple components of scanxiety were described, including those related to scan procedures (e.g., claustrophobia, physical discomfort) and scan results (e.g., implications for disease status and treatment), suggesting varied intervention approaches may be needed. Twenty-two articles used quantitative methods, nine used qualitative methods, and five used mixed methods. In 17 articles, symptom measures specifically referenced cancer scans; 24 included general measures without reference to scans. Scanxiety tended to be higher among those with lower education levels, less time since diagnosis, and greater baseline anxiety levels (three articles each). Although scanxiety often decreased immediately pre- to post-scan (six articles), participants reported the waiting period between scan and results to be particularly stressful (six articles). Consequences of scanxiety included poorer quality of life and somatic symptoms. Scanxiety promoted follow-up care for some patients yet hindered it for others. Conclusions: Scanxiety is multi-faceted, heightened during the pre-scan and scan-to-results waiting periods, and associated with clinically meaningful outcomes. We discuss how these findings can inform future research directions and intervention approaches.
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Affiliation(s)
- Heather M. Derry-Vick
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
- Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Lauren C. Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE1 9RT, UK
| | | | | | - Matthew Luebke
- Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
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