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Wurz A, Petrella A, Tulk J, Sabiston CM, Schulte F, Bender J, D’Agostino N, Hou SHJ, Eaton G, Chalifour K, Garland SN. Describing and Exploring Coping Strategies among Those Diagnosed with Cancer as an Adolescent or Young Adult: A YACPRIME Study. Curr Oncol 2024; 31:685-692. [PMID: 38392044 PMCID: PMC10888435 DOI: 10.3390/curroncol31020050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
A greater understanding of how young people cope with a cancer diagnosis is needed in order to inform age-appropriate supportive care. This paper describes the coping strategies used and explores relationships between coping strategies and personal, medical, and psychological variables among young adults (YAs) diagnosed with cancer. YAs (n = 547, mean age = 34.05 ± 6.00 years) completed an online survey, including the Brief COPE and measures of psychological functioning. Descriptive statistics and bivariate correlations were computed. Acceptance, self-distraction, positive reframing, and planning were the most used coping strategies by this sample. There were small (r = -0.09) to large (r = 0.51) significant relationships between personal, medical, and psychological variables and selected coping strategies. Coping with a cancer diagnosis early in life remains poorly understood. Identifying additional correlates and exploring inter- and intrapersonal variation in coping strategy use is required.
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Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC V2S 7M7, Canada;
| | - Anika Petrella
- Cancer Clinical Trials Unit, University College Hospital, London NW1 2BU, UK;
| | - Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St. John’s, NL A1C 5S7, Canada
| | - Catherine M. Sabiston
- Department of Exercise Sciences, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON M5R 0A3, Canada;
| | - Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (F.S.); (S.H.J.H.)
| | - Jackie Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada; (J.B.)
| | - Norma D’Agostino
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada; (J.B.)
| | - Sharon H. J. Hou
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (F.S.); (S.H.J.H.)
- Department of Psychology, BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada
| | - Geoff Eaton
- Young Adult Cancer Canada, St. John’s, NL A1B 3K3, Canada
| | | | - Sheila N. Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John’s, NL A1C 5S7, Canada
- Discipline of Oncology, Faculty of Medicine, Memorial University, St. John’s, NL A1C 5S7, Canada
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Tulk J, Wurz A, Hou SHJ, Bender J, Schulte FSM, Eaton G, Chalifour K, Garland SN. Rural-urban differences in distress, quality of life, and social support among Canadian young adult cancer survivors: A Young Adults with Cancer in Their Prime (YACPRIME) study. J Rural Health 2024; 40:121-127. [PMID: 37355833 DOI: 10.1111/jrh.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/11/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE Geographic location plays a significant role in the health and wellbeing of those with cancer. This project explored the impact of rurality and social support on distress and quality of life in young adults (YAs) with cancer in Canada. METHODS The current research analyzed data from the Young Adults with Cancer in Their Prime (YACPRIME) study. Participants completed measures of emotional distress (10-item Kessler Psychological Distress Scale), quality of life (12-item Short-form Health Survey), and social support (Medical Outcomes Study-Social Support Survey). Rural and urban-dwelling survivors were compared using MANOVAs. Bivariate analyses were conducted to explore associations between distress and social support. FINDINGS Of the sample (N = 379), 26% identified their location as rural. Rural YA cancer survivors reported higher distress and worse physical health-related quality of life (HRQOL) than survivors from urban areas but similar levels of mental-health-related quality of life. Social support appeared to have a marginally greater effect on psychosocial outcomes for urban participants. All types of social support were associated with lower levels of distress. However, different types of social support were associated more strongly with distress depending on a participant's geography. CONCLUSIONS Rural-dwelling YA cancer survivors experience significantly more distress and poorer physical HRQOL than urban-dwelling survivors. Different needs and preferences for social support may influence the psychological health of rural cancer survivors. Additional research is needed to determine how best to understand and address distress in rural YAs with cancer.
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Affiliation(s)
- Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, British Columbia, Canada
| | - Sharon H J Hou
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Psychology, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Jacqueline Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Fiona S M Schulte
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Geoff Eaton
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, Canada
| | - Karine Chalifour
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, Canada
| | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Discipline of Oncology, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
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Lazard AJ, Meernik C, Collins MKR, Vereen RN, Benedict C, Valle CG, Love B. Social Media Use for Cancer Support Among Young Adults with Cancer. J Adolesc Young Adult Oncol 2023; 12:674-684. [PMID: 37257189 DOI: 10.1089/jayao.2023.0025] [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: 06/02/2023] Open
Abstract
Purpose: Social media can facilitate peer support among young adults with cancer; however, information is needed about what social media are used, by whom, and how to inform resource and intervention recommendations. Methods: In December 2021, we conducted an online survey with 396 young adults with cancer, ages 18-39, with any diagnosis ages 15-39. Participants reported their social media use to connect with other young adults with cancer, including frequency of use, type of support, and affect (positive to negative) when using to connect with cancer peers. Results: Participants were on average 31 years old (SD = 5.2), with an average age of 27 at diagnosis (63.4% male, 62.1% non-Hispanic White). Almost all (97.5%) reported using social media to connect with other young adults with cancer. Many (48.0%) used three or more social media platforms for cancer support, including Facebook (44.4%), YouTube (43.6%), Instagram (43.4%), Snapchat (36.9%), and Twitter (36.9%). Daily use for cancer support was common (32.9%-60.9%) among those who used social media, particularly among those who were younger; are not transgender; live in urban areas; or had brain, gynecologic, or testicular cancers. Across social media platforms, young adults with cancer reported seeking and sharing emotional support (88.9%), informational support (84.1%), and making connections (81.3%). Conclusion: Young adults with cancer use social media to connect with cancer peers for support. Commonly used existing social media (e.g., Facebook, YouTube, Instagram) should be prioritized in interventions to reach young adults who desire more age-appropriate resources to improve their psychosocial health.
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Affiliation(s)
- Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Clare Meernik
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Meredith K Reffner Collins
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Catherine Benedict
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Carmina G Valle
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brad Love
- Center for Health Communication, The University of Texas, Austin, Texas, USA
- GRYT Health, Rochester, New York, USA
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Garland SN, Tulk J, Cotter R, Zhou ES, Daniel LC, Schulte FSM, Bender JL, Chalifour K, Eaton G. Understanding sleep quality in a national cohort of young adult cancer survivors: Results from the YACPRIME study. Sleep Med 2023; 109:293-299. [PMID: 37499465 DOI: 10.1016/j.sleep.2023.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE A cancer diagnosis in young adulthood can negatively impact sleep quality. The present study describes sleep issues in young adults (YAs) and analyzes potential demographic and clinical characteristics related to sleep quality. METHODS Canadian YAs (n = 359) diagnosed with cancer between ages 15-39 participated in the study. Pittsburgh Sleep Quality Index (PSQI) items were examined to identify specific sleep issues that occurred 3+ times per week. Logistic regression was used to examine demographic, clinical, and symptom-related variables associated with poor sleep quality (defined as a PSQI global score >8) and sleep medication use. RESULTS Participants were predominantly female (87.5%) with an average age of 32 years. Of the sample, 52% had poor sleep quality, 55.5% took >30 min to fall asleep, 32.9% slept <7 h, and 54.6% reported a habitual sleep efficiency of <85%. YAs with poor sleep quality were 5.7 times more likely to report severe distress (p=<.001), as well as 1.8 times more likely to report poorer mental (p = .03) and physical functioning (p = .05). Nearly half (44%) of YAs used sleep medication to help them sleep. YAs who reported severe psychological distress were 2.4 times more likely to use sleeping medication (p = .01), whereas those with a household income ≥$100,000/year were half as likely to use medication to help with sleep (p = .04). CONCLUSION Psychological distress is associated with worse sleep quality and sleep medication use in YA cancer survivors. Sleep quality may be a possible target for future research and intervention to promote long-term function and recovery.
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Affiliation(s)
- Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada; Discipline of Oncology, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada.
| | - Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Riley Cotter
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Eric S Zhou
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lauren C Daniel
- Department of Psychology and Health Sciences, Rutgers University, Camden, NJ, USA
| | - Fiona S M Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jacqueline L Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 585 University Avenue, Toronto, Ontario, Canada
| | - Karine Chalifour
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, Canada
| | - Geoff Eaton
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, Canada
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Barnes E, Hillier-Moses G, Murray H, Stevinson C, Franks HA, Gossage L. Evaluation of the MOVE online exercise programme for young people aged 13-30. Support Care Cancer 2023; 31:377. [PMID: 37273014 DOI: 10.1007/s00520-023-07758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/14/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE To evaluate the MOVE exercise programme in supporting the recovery of young people affected by cancer. METHODS Participants in an 8-week exercise rehabilitation programme delivered online by cancer rehabilitation specialists completed self-reported questionnaires at baseline and after programme completion. Assessments included cancer-related fatigue (FACIT fatigue scale) and health-related quality of life (EORTC-QLC-30). Qualitative data were provided through written accounts of participant experiences and underwent content analysis. RESULTS Seventy-one participants commenced the exercise rehabilitation programme and 57 completed the programme and provided data for analysis (63% female; median age 22 years). Statistically significant improvements were observed in post-programme scores for all measured outcomes (cancer-related fatigue, quality of life, physical functioning, role functioning, emotional functioning). Content analysis of written experiences generated ten unique codes. The highest frequency codes were enjoyment (n = 34), motivation (n = 14) and fitness (n = 13). CONCLUSIONS These findings indicate feasibility of delivery, acceptability to patients and physical and psychological benefits of a personalised online exercise rehabilitation programme for young people living with and beyond cancer. Further research involving a control arm and long-term follow-up would be beneficial. IMPLICATIONS FOR CANCER SURVIVORS These results support the inclusion of a personalised exercise programme as part of cancer rehabilitation for young people living with and beyond cancer.
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Affiliation(s)
- Ellie Barnes
- Queens Medical Centre, University of Nottingham School of Medicine, Nottingham, NG7 2UH, UK
| | - Gemma Hillier-Moses
- MOVE Charity, 21 Cleeve Mount, Registered Charity Number 1165675, Loughborough, LE11 4SD, UK
| | - Helen Murray
- MOVE Charity, 21 Cleeve Mount, Registered Charity Number 1165675, Loughborough, LE11 4SD, UK
| | - Clare Stevinson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Hester A Franks
- Centre for Cancer Sciences, Translational Medical Sciences, Biodiscovery Institute, University of Nottingham, Nottingham, NG7 2RD, UK.
- Department of Oncology, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK.
| | - Lucy Gossage
- MOVE Charity, 21 Cleeve Mount, Registered Charity Number 1165675, Loughborough, LE11 4SD, UK
- Department of Oncology, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK
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Reported Mental Health, Diet, and Physical Activity in Young Adult Cancer Survivors. Nutrients 2023; 15:nu15041005. [PMID: 36839363 PMCID: PMC9961696 DOI: 10.3390/nu15041005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
Young adult (YA) cancer survivors are at increased risk for chronic diseases and face age-dependent stressors that may hinder their ability to maintain healthy lifestyle behaviors. This study examined associations between reported mental health, eating beliefs, and health behaviors in YA cancer survivors. YA cancer survivors aged 18-39 years (n = 225) completed a self-administered REDCap® survey, including the Perceived Stress Scale 10, PROMIS® Anxiety and Depression, Eating Beliefs Questionnaire, National Health and Nutrition Examination Survey Dietary Screener Questionnaire, Godin-Shephard Leisure-Time Physical Activity Questionnaire, and demographic and diagnosis-related questions. Descriptive statistics, bivariate analyses, and multiple linear regression were performed. Participants were mean 31.3 years old and 3.7 years post-treatment; 77.3% were women. Most participants reported White (78%) or Black or African American (11.2%) race and non-Hispanic ethnicity (84%). Adjusting for covariates, perceived stress, anxiety, and depression were associated with increased added sugar intake (p < 0.001) and eating beliefs (p < 0.001). Perceived stress and depression were associated with reduced vegetable intake (p < 0.05). There were no associations with fruit intake or physical activity in the adjusted models. Health behavior interventions for this population may address psychosocial needs by including a stress management or mind-body component. Further research including direct measures of health behaviors is warranted.
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Bender JL, Akinnibosun R, Puri N, D’Agostino N, Drake EK, Tsimicalis A, Howard AF, Garland SN, Chalifour K, Gupta AA. A comparison of the sociodemographic, medical, and psychosocial characteristics of adolescents and young adults diagnosed with cancer recruited in-person and online: A Canadian cross-sectional survey. Digit Health 2023; 9:20552076231205278. [PMID: 37900258 PMCID: PMC10605661 DOI: 10.1177/20552076231205278] [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] [Accepted: 09/15/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Adolescents and young adults diagnosed with cancer (AYAs) are under-represented in research. The Internet and social media could increase the reach of recruitment efforts but may impact sample characteristics. This study evaluated the characteristics of AYAs recruited in-person at an urban hospital versus the Internet in terms of their sociodemographic and medical characteristics, and psychosocial wellbeing, and offers recommendation for increasing the inclusivity and representativeness of research samples. Methods Participant data from a cross-sectional survey of AYAs in Canada were evaluated. In-person hospital recruitment used a registry to identify patients attending ambulatory clinics. Internet recruitment included notices on hospital, team members', and community partners' social media channels, and email newsletters. Independent sample t-tests and Chi-squared tests were used to identify differences in participant sociodemographic, medical, and psychosocial characteristics based on recruitment source. Results Of 436 participants, 217 (49.8%) were recruited in-person and 219 (50.2%) online. Online participants were more likely: to be white (p < .001), women (p < .001), and Canadian-born (p < .001); to speak English at home (p < .001), live alone (p = .001) and live in rural settings (p = .014); and to be farther from diagnosis (p = .023), diagnosed with breast cancer (p < .001), and cancer free (p < .001) compared to the hospital sample. Online participants also reported higher anxiety, depression, and loneliness (p < .001), and lower social support (p < .001), self-efficacy for coping with cancer (p < .001), and life satisfaction (p = .006). Conclusions Online recruitment yielded a more geographically diverse but less sociodemographically diverse sample of AYAs who were farther from diagnosis and had poorer psychosocial wellbeing than in-person recruitment at an urban hospital. Future research efforts should consider partnering with under-represented communities and using targeted and stratified online and in-person recruitment strategies to achieve an inclusive and representative sample of AYAs.
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Affiliation(s)
- Jacqueline L Bender
- Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Rukayyah Akinnibosun
- Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Natasha Puri
- Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Norma D’Agostino
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Emily K Drake
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - A Fuchsia Howard
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - Sheila N Garland
- Department of Psychology, Memorial University, St John's, NL,
Canada
| | | | - Abha A Gupta
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Emotional Distress and Financial Toxicity in Younger Adult Patients Undergoing Oncologic Surgery. Ann Surg 2022; 276:694-700. [PMID: 35838403 DOI: 10.1097/sla.0000000000005593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There has been an alarming increase in the number of young adults diagnosed with cancer. The emotional, psychosocial, and financial distress experienced by newly diagnosed young adults undergoing cancer surgery remains largely unknown. METHODS A validated biopsychosocial distress screening tool (SupportScreen®) was administered to patients diagnosed with cancer prior to surgery between 2009 and 2017 in a National Cancer Institute Comprehensive Cancer Center. Patients were stratified into younger adults ≤45 years (YA) and older adults >45 years (OA). Descriptive statistics and logistic regression were used to analyze distress outcomes. RESULTS In total, 4,297 patients were identified, with YA comprising 13.3% (n=573) of the cohort. YA reported higher emotional distress, including increased anxiety (33.8% vs. 27.4%, P=0.002), greater fear of procedures (26.7% vs. 22%, P=0.018), and difficulty managing emotions (26% vs. 20.7%, P=0.006). YA struggled more frequently to manage work/school (29.5% vs. 19.3%, P<0.001), finding resources (17.8% vs. 11.8%, P<0.001), changes in physical appearance (22.2% vs. 13.4%, P<0.001), fatigue (36% vs. 27.3%, P<0.001), and ability to have children (18.4% vs. 3%, P<0.001). Financial toxicity was significantly higher in the YA group (40.5% vs. 28%, P<0.001). While income level was strongly protective against emotional distress and financial toxicity in OAs, it was less protective against the risk of financial toxicity in YA. Younger age was an independent predictor of financial toxicity in a model adjusted to income (OR-1.52, P=0.020). CONCLUSION Younger adults in the prime of their personal and professional years of productivity require special attention when undergoing surgical evaluation for cancer. Resource allocation and counseling interventions should be integrated as part of their routine care to expedite their return to optimal physical and holistic health and mitigate psychosocial distress and financial toxicity.
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Munsie C, Ebert J, Joske D, Ackland T. A randomised controlled trial investigating the ability for supervised exercise to reduce treatment-related decline in adolescent and young adult cancer patients. Support Care Cancer 2022; 30:8159-8171. [PMID: 35792926 PMCID: PMC9257117 DOI: 10.1007/s00520-022-07217-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 06/09/2022] [Indexed: 11/23/2022]
Abstract
Introduction Exercise is recognised as integral in mitigating a myriad negative consequences of cancer treatment. However, its benefit within adolescent and young adult (AYA) cancer cohorts remains relatively under researched, and caution should be taken in extrapolating outcomes from adult and paediatric populations given AYA distinctly different physiological and psychosocial contexts. This study sought to evaluate the impact of an exercise intervention on mitigating the expected decline in fitness, strength, physical functioning, and quality of life (QOL) in AYA undergoing cancer treatment. Methods This prospective, randomised controlled trial (FiGHTINGF!T) allocated 43 participants (63% male, mean age 21.1 years) to a 10-week, multimodal, bi-weekly exercise intervention (EG) or control group (CG) undergoing usual care. Pre- and post-intervention assessments included cardiopulmonary exercise tests, one-repetition maximum (1RM) strength, functional tests, and QOL patient-reported outcome measures. Data were analysed via linear mixed models and regression. Results While no significant group differences (p > 0.05) were observed, neither group significantly declined (p > 0.05) in any outcome measure over the 10-week period. No significant (p˃0.05) strength or functional improvements were observed in the CG, though the EG demonstrated significant improvements in their 1RM leg press (p = 0.004) and chest press (p = 0.032), maximal push ups (p = 0.032), and global QOL (p = 0.011). The EG reported a significant increase in fatigue (p = 0.014), while the CG reported significant positive changes in anxiety measures (p = 0.005). Conclusion The exercise intervention produced superior improvements in strength and global QOL, compared with the CG. Regardless of group allocation, enrolment in the exercise study appeared to mitigate the treatment-related decline expected in AYA undergoing cancer treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-07217-w.
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Affiliation(s)
- Claire Munsie
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia. .,WA Youth Cancer Service, Locked Bag 2012, Nedlands, WA, 6009, Australia. .,Sir Charles Gairdner Hospital, Perth, WA, Australia.
| | - Jay Ebert
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - David Joske
- Sir Charles Gairdner Hospital, Perth, WA, Australia.,School of Medicine, The University of Western Australia, Perth, WA, Australia
| | - Timothy Ackland
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
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Tulk J, Garland SN, Howden K, Glidden C, Scott I, Chalifour K, Eaton G, Mahar A, Oberoi S. Prevalence and factors associated with insomnia symptoms in adolescents and young adults with cancer during the COVID-19 pandemic. Sleep Health 2022; 8:410-416. [PMID: 35729003 PMCID: PMC9212947 DOI: 10.1016/j.sleh.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has been particularly distressing for adolescents and young adults (AYAs) diagnosed with cancer. High levels of distress are associated with sleep disturbances. This study examined the prevalence of insomnia symptoms in AYAs during the COVID-19 pandemic and identified factors related to greater insomnia severity. DESIGN, SETTING, AND PARTICIPANTS An online survey was administered to Canadian AYAs (N = 805) diagnosed with cancer between 15 and 39 years from January to February 2021. MEASUREMENTS The primary measure was the Insomnia Severity Index (ISI). Univariable and multivariable binomial logistic regression examined demographic, clinical, and psychological factors associated with significant insomnia symptoms (ISI score ≥12). RESULTS Three hundred twelve (38.8%) participants reported insomnia symptoms. In the multivariable model, severe psychological distress (ie, depression and anxiety; adjusted odds ratio (AOR) = 28.75, p ≤.001), having a pre-existing mental health condition (AOR = 1.92, p = .03), worsened mental health during the pandemic (AOR = 1.73, p = .02), finished cancer treatment ≥1 year ago (AOR = 1.72, p = .03), and experiencing no changes to schooling during the COVID-19 pandemic (AOR = 2.18, p = .004) were associated with significant insomnia symptoms. Standardized coefficients also indicated that worrying about possible disruptions to cancer care and being a homemaker/caretaker contributed to insomnia symptoms. CONCLUSIONS Nearly 40% of AYAs with cancer reported insomnia symptoms during the COVID-19 pandemic. Insomnia was associated with potentially modifiable factors such as psychological distress, highlighting possible targets for intervention.
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Affiliation(s)
- Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Canada
| | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Canada; Discipline of Oncology, Faculty of Medicine, Memorial University, St. John's, Canada.
| | - Kaitlyn Howden
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Camille Glidden
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Ian Scott
- Department of Psychosocial Oncology, CancerCare Manitoba, Winnipeg, Canada
| | | | - Geoff Eaton
- Young Adult Cancer Canada, St. John's, NL, Canada
| | - Alyson Mahar
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Sapna Oberoi
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada; Section of Pediatric Hematology-Oncology, CancerCare Manitoba, Winnipeg, Canada
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Bender JL, Puri N, Salih S, D’Agostino NM, Tsimicalis A, Howard AF, Garland SN, Chalifour K, Drake EK, Marrato A, McKean NL, Gupta AA. Peer Support Needs and Preferences for Digital Peer Navigation among Adolescent and Young Adults with Cancer: A Canadian Cross-Sectional Survey. Curr Oncol 2022; 29:1163-1175. [PMID: 35200598 PMCID: PMC8870696 DOI: 10.3390/curroncol29020099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
Abstract
Adolescents and young adults (AYA) with cancer desire peer support and require support programs that address their unique needs. This study investigated the need for, and barriers to, peer support and preferences for digital peer navigation among AYA. A cross-sectional survey was administered to AYA, diagnosed with cancer between the ages of 15–39, at a cancer center and through social media. Descriptive summary statistics were calculated. Participants (n = 436) were on average 31.2 years (SD = 6.3), 3.3 years since-diagnosis (SD = 3.8), and 65% (n = 218) were women. Over three-quaters (n = 291, 76.6%) desired peer support from cancer peers, but 41.4% (n = 157) had not accessed peer support. Main access barriers were: Inconvenience of in-person support groups (n = 284, 76.1%), finding AYA with whom they could relate (n = 268, 72.4%), and finding AYA-specific support programs (n = 261, 70.4%). Eighty-two percent (n = 310) desired support from a peer navigator through a digital app, and 63% (n = 231) were interested in being a peer navigator. Participants indicated a greater need for emotional (n = 329, 90.1%) and informational support (n = 326, 89.1%) than companionship (n = 284, 78.0%) or practical support (n = 269, 73.6%) from a peer navigator. Foremost peer matching characteristics were cancer-type (n = 329, 88.4%), specific concerns (n = 317, 86.1%), and age-at-diagnosis (n = 316, 86.1%). A digital peer navigation program was desired by over 80% of a large Canadian sample of AYA and could potentially overcome the barriers AYA experience in accessing peer support. The design of a peer navigation program for AYA should consider the matching characteristics and multidimensional support needs of AYA.
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Affiliation(s)
- Jacqueline L. Bender
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (N.M.D.); (A.A.G.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M7, Canada
- Correspondence: ; Tel.: +1-416-581-8606
| | - Natasha Puri
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
| | - Sarah Salih
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
| | - Norma M. D’Agostino
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (N.M.D.); (A.A.G.)
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC H3A 2M7, Canada;
| | - A. Fuchsia Howard
- School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada;
| | - Sheila N. Garland
- Department of Psychology, Memorial University, St. John’s, NL A1C 3X9, Canada;
| | | | - Emily K. Drake
- Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Anthony Marrato
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
| | - Nikki L. McKean
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
| | - Abha A. Gupta
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (N.M.D.); (A.A.G.)
- Adolescent and Young Adult Cancer Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada
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Glidden C, Howden K, Romanescu RG, Hatala A, Scott I, Deleemans JM, Chalifour K, Eaton G, Gupta AA, Bolton JM, Garland SN, Mahar AL, Oberoi S. Psychological distress and experiences of Adolescents and Young Adults with cancer during the COVID-19 pandemic: A cross-sectional survey. Psychooncology 2022; 31:631-640. [PMID: 34989053 DOI: 10.1002/pon.5849] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/16/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND This study investigated prevalence of psychological distress, factors associated with distress, and experiences of Adolescents and Young Adults (AYAs) with cancer during the COVID-19 pandemic. It also compared distress in this group to previously surveyed Canadian AYAs with cancer in 2018 by the Young Adults with Cancer in their Prime (YACPRIME) study. METHODS A cross-sectional, online, self-administered survey of AYAs diagnosed with cancer between 15 and 39 years of age was conducted. Psychological distress was measured by the Kessler Psychological Distress Scale (K10). Associations between variables and high psychological distress (K10 ≥ 25), and comparison of prevalence of psychological distress with the YACPRIME study were done using multivariable logistic regression. Summative qualitative content analysis analyzed participant experiences during this pandemic. RESULTS We included 805 participants. High psychological distress was present in over two-thirds of the group (68.0%; 95% CI, 64.7%-71.2%). Employment impact during pandemic (AOR (adjusted odds ratio), 2.16; 95% CI, 1.41-3.31) and hematologic malignancy (AOR, 1.76; 95% CI 1.08-2.97) were associated with higher psychological distress, while older age [AOR, 0.95; 95% CI, 0.92-0.99] and personal income < $40,000 (AOR, 0.38; 95% CI, 0.24-0.58) were associated with lower distress. Adjusted odds of experiencing psychological distress among AYAs with cancer during pandemic compared to pre-pandemic years was 1.85 (95% CI: 1.36-2.53). Overarching themes of pandemic experiences included: inferior quality of life, impairment of cancer care, COVID-19 related concerns and extreme social isolation. CONCLUSION AYAs diagnosed with cancer are experiencing high psychological distress during this pandemic. Distress screening and evidence-based interventions to alleviate distress are essential.
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Affiliation(s)
- Camille Glidden
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kaitlyn Howden
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Razvan G Romanescu
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Andrew Hatala
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ian Scott
- Department of Psychosocial Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Julie M Deleemans
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | | | - Geoff Eaton
- Young Adult Cancer Canada, St.John's, Newfoundland, Canada
| | - Abha A Gupta
- Princess Margaret Cancer Care Research Institute, Toronto, Ontario, Canada.,Department of Pediatric Hematology-Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sheila N Garland
- Department of Psychology, Memorial University of Newfoundland, St.John's, Newfoundland, Canada
| | - Alyson L Mahar
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Sapna Oberoi
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Pediatric Hematology-Oncology/BMT, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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