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Clarke ST, Le Grande M, Murphy BM, Hester R, Jackson AC. Protocol for the development and validation of a clinical measurement tool for fear of disease progression and recurrence in cardiac patients. Chronic Dis Transl Med 2024; 10:195-204. [PMID: 39027197 PMCID: PMC11252435 DOI: 10.1002/cdt3.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/18/2023] [Accepted: 12/28/2023] [Indexed: 07/20/2024] Open
Abstract
Introduction One in two cardiac patients fear having another heart event or their heart condition getting worse. Research in other chronic illnesses demonstrates that screening for fear of progression and recurrence is vital for adequately addressing such concerns in clinical care. The current project aims to develop and validate a measure for fear of progression and recurrence in cardiac patients. Methods The Fear of Cardiac Recurrence and Progression Scale (FCRP) will be developed through a multistep process. An initial item pool will be generated through a review of the literature and existing measures and consultation with and feedback from key informants. The item pool will be tested in a sample of over 250 adults who have ever had an acute coronary event, undergone cardiac surgery, or a chronic cardiac condition. Exploratory factor analysis will be used to identify the underlying factors, and Rasch analysis will be used to reduce the number of items. A short form version of the FCRP will be developed for use as a brief screening tool, informed by clinical relevance and Rasch psychometric indices. Discussion While many cardiac patients experience fears related to the progression or recurrence of their illness, there remains the need for a validated tool with which these concerns can be identified and measured. It is expected that the design and validation of the FCRP will aid identification of cardiac patients suffering from clinically significant levels of fear of progression and recurrence and facilitate the design of tailored psychological interventions to target these fears.
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Affiliation(s)
- Sarah T. Clarke
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Australian Centre for Heart HealthMelbourneVictoriaAustralia
| | - Michael Le Grande
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Australian Centre for Heart HealthMelbourneVictoriaAustralia
| | - Barbara M. Murphy
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Australian Centre for Heart HealthMelbourneVictoriaAustralia
| | - Robert Hester
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | - Alun C. Jackson
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Australian Centre for Heart HealthMelbourneVictoriaAustralia
- Centre on Behavioral HealthUniversity of Hong KongPokfulamHong KongChina
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Schellekens MPJ, Zwanenburg LC, van der Lee ML. Resilience in the Face of Cancer: On the Importance of Defining and Studying Resilience as a Dynamic Process of Adaptation. Curr Oncol 2024; 31:4003-4014. [PMID: 39057169 PMCID: PMC11276221 DOI: 10.3390/curroncol31070297] [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: 05/24/2024] [Revised: 07/02/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Resilience is defined as the maintenance or relatively quick recovery of mental health during and after adversity. Rather than focusing on psychopathology and its causes, resilience research aims to understand what protective mechanisms shield individuals against developing such disorders and translate these insights to improve psychosocial care. This resilience approach seems especially promising for the field of oncology because patients face stressor after stressor from diagnosis to survivorship. Helping patients to learn how they can best use the resources and abilities available to them can empower patients to handle subsequent stressors. In the past few decades, resilience has increasingly been considered as a dynamic process of adaptation. While researchers use this definition, resilience has not yet been studied as a dynamic process in the field of oncology. As a result, the potential of resilience research to gain insight into what helps protect cancer patients from developing psychopathology is limited. We discuss conceptual and methodological proposals to advance resilience research in oncology. Most importantly, we propose applying prospective longitudinal designs to capture the dynamic resilience process. By gaining insight in how cancer patients engage in protective factors, resilience research can come to its full potential and help prevent psychopathology.
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Affiliation(s)
- Melanie P. J. Schellekens
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
| | - Laura C. Zwanenburg
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
| | - Marije L. van der Lee
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
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Huang J, Zhang L, Li B, Lian Y, Lin X, Li Z, Zhang B, Feng Z. Bibliometric and visual analysis in the field of two-dimensions nano black phosphorus in cancer from 2015 to 2023. Discov Oncol 2024; 15:260. [PMID: 38961044 PMCID: PMC11222346 DOI: 10.1007/s12672-024-01104-y] [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] [Received: 06/05/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024] Open
Abstract
This study aims to provide a comprehensive summary of the status and trends of Two-Dimensional Nano Black Phosphorus (2D nano BP) in cancer research from 2015 to 2023, offering insights for future studies. To achieve this, articles from the Web of Science database published between 2015 and 2023 were analyzed using R and VOSviewer software. The analysis included 446 articles, revealing a consistent increase in publication rates, especially between 2017 and 2019. China emerged as a leader in both publication volume and international collaborations. Prominent journals in this field included ACS Applied Materials & Interfaces and Advanced Materials, while key researchers were identified as Zhang Han, Tao Wei, and Yu Xuefeng. The analysis highlighted common keywords such as drug delivery, photothermal therapy, photodynamic therapy, and immunotherapy, indicating the major research focuses. The findings suggest that 2D nano BP holds significant promise in cancer treatment research, with a growing global interest. This study thus serves as a valuable reference for future investigations, providing a detailed analysis of the current state and emerging trends in this promising field.
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Affiliation(s)
- Jing'an Huang
- Scientific Research Center, Guilin Medical University, Guilin, China
| | - Ling Zhang
- Department of Pharmacy, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Boren Li
- Department of Pharmacy, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yuanchu Lian
- Scientific Research Center, Guilin Medical University, Guilin, China
| | - Xiaoxin Lin
- Scientific Research Center, Guilin Medical University, Guilin, China
| | - Zonghuai Li
- Scientific Research Center, Guilin Medical University, Guilin, China
| | - Bo Zhang
- Scientific Research Center, Guilin Medical University, Guilin, China.
| | - Zhongwen Feng
- Department of Pharmacy, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
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Zhou B, Gek Mui L, Li J, Hu J. The impact of mindfulness-based interventions on the experiences of cancer patients: A qualitative meta-synthesis. PATIENT EDUCATION AND COUNSELING 2024; 127:108353. [PMID: 38964172 DOI: 10.1016/j.pec.2024.108353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 06/03/2024] [Accepted: 06/14/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE This study analyzed qualitative research to explore cancer patients' perspectives on MBIs, including benefits, challenges, and recommendations. METHODS This systematic review focused on synthesizing qualitative data and was registered with PROSPERO under the protocol registration number xxx. Searched 7 databases for qualitative studies on MBIs & cancer patients (17 studies, 365 patients). Analyzed data using themes & assessed confidence in findings. RESULTS Thematic analysis using NVivo software revealed four significant themes: (1) benefits and positive outcomes (e.g., symptom improvement, team support, positive experiences), (2) challenges and difficulties (e.g., practice challenges, negative experiences), (3) the journey of change and acceptance (e.g., shifts in perception, personal growth, and acceptance), and (4) adaptations and recommendations (e.g., program modification and flexibility). CONCLUSION Mindfulness-based interventions have the potential to offer cancer patients positive emotional experiences, increased team support, and opportunities for personal growth, self-discovery, and acceptance. This, in turn, can help them manage the psychological distress associated with cancer. Customizing programs to align with individual patients' needs and preferences can enhance engagement and effectiveness. PRACTICE IMPLICATIONS Integrating MBIs into Patient Education and Counseling, tailored to individual needs and with ongoing support, can enhance cancer care. Group interventions foster peer support and effectiveness. Training providers and ensuring accessibility are crucial. Research and customization to patients' journeys optimize outcomes and satisfaction. A patient-centered approach is essential for positive experiences and improved clinical outcomes.
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Affiliation(s)
- Bo Zhou
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Malaysia; Huangshan Vocational College of Health, School of Nursing, China.
| | - Lim Gek Mui
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Malaysia
| | - Jinnan Li
- Huangshan Vocational College of Health, School of Nursing, China
| | - Jiahui Hu
- Huangshan Vocational College of Health, School of Nursing, China
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Wei F, Yang X, He R, Hu Z, Wang Y. Effectiveness of Cognitive Behavioral Therapy on Fear of Cancer Recurrence in Breast Cancer: A Systematic Review and Meta-analysis. Cancer Nurs 2024:00002820-990000000-00241. [PMID: 38625783 DOI: 10.1097/ncc.0000000000001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2024]
Abstract
BACKGROUND Fear of cancer recurrence is one of the psychological distresses that seriously affects the quality of life of breast cancer patients. However, the evidence for cognitive behavioral therapy on fear of cancer recurrence in breast cancer is limited. OBJECTIVE The aim of this study was to evaluate the effectiveness of cognitive behavioral therapy in reducing breast cancer patients' fear of cancer recurrence. METHODS Seven databases were searched for randomized controlled studies on cognitive behavioral therapy for fear of cancer recurrence in cancer patients from the inception of the database to April 30, 2023, with no language restrictions. Meta-analysis was performed using Stata MP 17. The Cochrane Risk of Bias Tool version 2 was used to assess the quality of the included studies. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation method. RESULTS This review includes a total of 13 randomized controlled trials with 1447 breast cancer patients and survivors. When compared with controls, meta-analysis revealed that cognitive behavioral therapy significantly reduced the fear of cancer recurrence (g = -0.44; 95% confidence interval, -0.75 to -0.13; P < .001), whereas subgroup analysis revealed that only mindfulness-based cognitive therapy was significant. The overall risk of bias was high. The Grading of Recommendations, Assessment, Development and Evaluation assessment showed a low overall quality of evidence. CONCLUSIONS Cognitive behavioral therapy may be effective in reducing fear of cancer recurrence in breast cancer patients, and mindfulness-based cognitive therapy is particularly worthy of implementation. IMPLICATIONS FOR PRACTICE Mindfulness-based cognitive therapy may be used as an additional strategy to help manage breast cancer patients' fears of cancer recurrence.
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Affiliation(s)
- Fangxin Wei
- Author Affiliations: School of Nursing, Jinan University (Mr Wei, and Mss Yang, He, and Hu); and The Community Service Center of Jinan University, The First Affiliated Hospital of Jinan University (Mrs Wang), Guangzhou, China
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Wilharm C, Pralong A, Weiss M, Hallek M, Voltz R, Tuchscherer A, Simon ST. Facing life-threat during youth: a qualitative study on challenges, coping, and needs among adolescents and young adults with cancer. Support Care Cancer 2024; 32:179. [PMID: 38383874 PMCID: PMC10881674 DOI: 10.1007/s00520-024-08370-0] [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: 09/25/2023] [Accepted: 02/11/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE While the unique situation of adolescents and young adults with cancer (AYAs) has become the focus of research and clinical practice, little is known about how they deal with the threat to life at a curative stage. The aim of this study was to obtain insight into the challenges, coping strategies, and needs of AYAs regarding the life-threatening nature of their diseases. METHODS Face-to-face in-depth interviews were conducted with patients who were 18-39 years old at diagnosis. The interviews took place 2-5 years after their diagnosis. Patients who were still undergoing treatment or who were suspected of recurrence were excluded. Interviews were transcribed verbatim and analyzed using qualitative content analysis. RESULTS Fifteen patients (mean age 27.33 years, nine females) were interviewed in a large comprehensive cancer center in Germany. Before diagnosis, AYAs had not faced their own mortality and had little experience with cancer. The sudden confrontation with a life-threatening disease and therapy, as well as experiencing the death of other AYAs, challenged them. Fear, particularly regarding recurrence and death, and the loss of trust in their own bodies were the major emotions that continued to limit them even after the end of treatment. For mothers, concern of leaving their young children alone was paramount. Coping strategies frequently mentioned were hope, avoidance, self-soothing, and valuing the experience as a chance. Health care professionals were expected to be reassuring, motivating, and open and to provide honest information based on individual and current needs. CONCLUSION AYAs appear to cope with life-threats similarly to older patients but have additional unique challenges, including inexperience with life-threatening diseases and responsibility for young children. More research is needed in this area, although it is already evident that AYAs need honest and reassuring communication regarding the life-threat during any curable phases of their disease. Trial registration number DRKS00030277; September 27, 2022 (German Clinical Trials Register).
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Affiliation(s)
- Carolin Wilharm
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Anne Pralong
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Mara Weiss
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital, Center for Integrated Oncology Cologne Aachen Bonn Cologne Duesseldorf (ABCD), University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
- Faculty of Medicine and University Hospital, Center for Integrated Oncology Cologne Aachen Bonn Cologne Duesseldorf (ABCD), University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
- Faculty of Medicine and University Hospital, Center for Health Services Research (ZVFK), University of Cologne, Cologne, Germany
| | - Armin Tuchscherer
- Department I of Internal Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital, Center for Integrated Oncology Cologne Aachen Bonn Cologne Duesseldorf (ABCD), University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Steffen T Simon
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany.
- Faculty of Medicine and University Hospital, Center for Integrated Oncology Cologne Aachen Bonn Cologne Duesseldorf (ABCD), University of Cologne, Kerpener Street 62, 50937, Cologne, Germany.
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Gumuchian ST, Boyle A, Hazel LH, Ellenbogen MA. Fear of depression recurrence among individuals with remitted depression: a qualitative interview study. BMC Psychiatry 2024; 24:152. [PMID: 38383311 PMCID: PMC10882790 DOI: 10.1186/s12888-024-05588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a prevalent psychiatric condition and the largest contributor to disability worldwide. MDD is highly recurrent, yet little is known about the mechanisms that occur following a Major Depressive Episode (MDE) and underlie recurrence. We explored the concept of fear of depression recurrence (FoDR) and its impact on daily functioning among individuals in remission from MDD. METHODS 30 participants (83% female; 37% White; Mage = 27.7, SD = 8.96) underwent semi-structured qualitative interviews. The interviews explored participants' experiences of FoDR including the frequency, severity, content, triggers, and impact of fears and associated coping strategies. We used content analysis to analyze the transcriptions. RESULTS Most participants (73%) reported having FoDR, with varying frequency, severity, and duration of fears. The triggers and content of participants' fears often mirrored the symptoms (e.g., low mood, anhedonia) and consequences (e.g., job loss, social withdrawal) endured during past MDEs. Some participants reported a minimal impact of FoDR on daily functioning, whereas others reported a positive (e.g., personal growth) or negative (e.g., increased anxiety) influence. LIMITATIONS Our sample size did not allow for explorations of differences in FoDR across unique MDD subtypes or sociocultural factors. CONCLUSIONS The concept of FoDR may present a window into understanding the unique cognitive and behavioural changes that occur following MDD remission and underlie depression recurrence. Future research should aim to identify underlying individual differences and characteristics of the disorder that may influence the presence and impact of FoDR. Finally, a FoDR measure should be developed so that associations between FoDR and recurrence risk, depressive symptoms, and other indices of functioning can be determined.
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Affiliation(s)
- Stephanie T Gumuchian
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, H4B 1R6, Montréal, Québec, Canada.
| | - Ariel Boyle
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, H4B 1R6, Montréal, Québec, Canada
| | - Lori H Hazel
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, H4B 1R6, Montréal, Québec, Canada
| | - Mark A Ellenbogen
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, H4B 1R6, Montréal, Québec, Canada
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Nic Giolla Chomhaill C, Ward J, Dowling M. Fear of recurrence in women with ovarian cancer: A qualitative evidence synthesis. Eur J Oncol Nurs 2024; 68:102487. [PMID: 38113769 DOI: 10.1016/j.ejon.2023.102487] [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: 09/08/2023] [Revised: 11/16/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Approximately 80% of ovarian cancers recur after first-line treatments. Women with ovarian cancer (OC) are therefore particularly vulnerable to experiencing fear of cancer recurrence (FCR). This study aimed to synthesise experiences of fear of cancer recurrence among women living with ovarian cancer. METHOD A qualitative evidence synthesis (QES) was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. A systematic search of seven databases was undertaken to identify all available qualitative research exploring fear of cancer recurrence in women with OC. Thematic synthesis of extracted data from included studies was undertaken and managed in NVivo. RESULTS Twenty-two papers reporting on eighteen studies were included in the synthesis. Three main themes were developed (triggers, responses, and coping) and included ten subthemes. FCR was triggered by factors relating to awareness of prognosis, treatment, and negative communication. Women responded to FCR by performing body checking and protecting their families. FCR led to adverse effects on women's wellbeing as it exacerbated uncertainty about their future. Women attempted to cope with FCR through seeking support, regaining control, and redirecting negative thoughts and actions. CONCLUSIONS Women use a variety of approaches to manage their fear of recurrence. Further research on the most appropriate interventions for FCR tailored specifically to the needs of women with OC is needed.
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Affiliation(s)
| | - Jana Ward
- Occupational Therapy Department, Galway University Hospital, Ireland.
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Ireland.
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Zhang H, Lin Z, Li T, Kong M, Li J, Wu W, He Z. The association between metacognition, coping style and fear of cancer recurrence among postmastectomy patients: A cross sectional study. Eur J Oncol Nurs 2023; 67:102460. [PMID: 37951072 DOI: 10.1016/j.ejon.2023.102460] [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: 05/12/2023] [Revised: 10/02/2023] [Accepted: 10/29/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE To investigate the incidence of fear of cancer recurrence (FCR) in Chinese postmastectomy patients and explore the relationships between metacognition, coping style, and FCR on the basis of the self-regulating executive function model. METHODS A total of 480 postmastectomy patients from two tertiary comprehensive hospitals in Xi'an were enrolled from March 2021 to November 2021. The participants completed demographic information, the Metacognitions Questionnaire-30 (MCQ-30), Positive Metacognitions and Positive Meta-Emotions Questionnaire (PMCEQ), Simplified Copying Style Questionnaire (SCSQ), and Fear of Cancer Recurrence Inventory Short Form (FCRI-SF). RESULTS 34.2% of the respondents had scores indicating a clinical level of FCR (FCRI-SF≥13). FCR had a positive correlation with maladaptive metacognition and negative coping style (P < 0.01), while adaptive metacognition and positive coping style were negatively correlated (P < 0.01). Besides, maladaptive metacognition had both direct and indirect effects on FCR, with the indirect effect primarily mediated by negative coping style (total effect, 0.430). Adaptive metacognition had both direct and indirect effects on FCR, with the indirect effect primarily mediated by positive coping style (total effect,﹣0.302). CONCLUSION FCR was a common phenomenon in postmastectomy patients and moderate in most patients. In addition, both metacognition and coping style had a direct and indirect association with the occurrence and development of FCR. Moreover, adaptive metacognition and maladaptive metacognition had different mechanisms on FCR in patients with breast cancer.
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Affiliation(s)
- Huifang Zhang
- Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, Shaan Xi, 710061, China
| | - Zihan Lin
- Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, Shaan Xi, 710061, China
| | - Tianzi Li
- Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, Shaan Xi, 710061, China
| | - Min Kong
- Xi'an Health School, No.463 Youyi East Road, Xi'an, Shaanxi, 710000, China
| | - Jin Li
- Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, Shaan Xi, 710061, China.
| | - Wenbin Wu
- Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, Shaan Xi, 710061, China
| | - Zhiqiang He
- Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, Shaan Xi, 710061, China
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Wang Z, Xiao M, Guo F, Yan Y, Tian H, Zhang Q, Ren S, Yang L. Biodegradable polyester-based nano drug delivery system in cancer chemotherapy: a review of recent progress (2021-2023). Front Bioeng Biotechnol 2023; 11:1295323. [PMID: 38026861 PMCID: PMC10647934 DOI: 10.3389/fbioe.2023.1295323] [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: 09/16/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Cancer presents a formidable threat to human health, with the majority of cases currently lacking a complete cure. Frequently, chemotherapy drugs are required to impede its progression. However, these drugs frequently suffer from drawbacks such as poor selectivity, limited water solubility, low bioavailability, and a propensity for causing organ toxicity. Consequently, a concerted effort has been made to seek improved drug delivery systems. Nano-drug delivery systems based on biodegradable polyesters have emerged as a subject of widespread interest in this pursuit. Extensive research has demonstrated their potential for offering high bioavailability, effective encapsulation, controlled release, and minimal toxicity. Notably, poly (ε-caprolactone) (PCL), poly (lactic-co-glycolic acid) (PLGA), and polylactic acid (PLA) have gained prominence as the most widely utilized options as carriers of the nano drug delivery system. This paper comprehensively reviews recent research on these materials as nano-carriers for delivering chemotherapeutic drugs, summarizing their latest advancements, acknowledging their limitations, and forecasting future research directions.
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Affiliation(s)
- Zongheng Wang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
- Liaoning Research Institute of Family Planning (The Reproductive Hospital of China Medical University), Shenyang, China
| | - Miaomiao Xiao
- Liaoning Research Institute of Family Planning (The Reproductive Hospital of China Medical University), Shenyang, China
- College of Kinesiology, Shenyang Sport University, Shenyang, China
| | - Fangliang Guo
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yue Yan
- Department of Emergency, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hong Tian
- Department of Oncology, The 4th People’s Hospital of Shenyang, China Medical University, Shenyang, China
| | - Qianshi Zhang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shuangyi Ren
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Liqun Yang
- Liaoning Research Institute of Family Planning (The Reproductive Hospital of China Medical University), Shenyang, China
- Research Center for Biomedical Materials, Shengjing Hospital of China Medical University, Shenyang, China
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Coutts-Bain D, Sharpe L, Techakesari P, Forrester MA, Hunt C. A mixed-methods review and meta-synthesis of fears of recurrence and progression in people with mental health conditions. Clin Psychol Rev 2023; 105:102342. [PMID: 37804564 DOI: 10.1016/j.cpr.2023.102342] [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: 02/15/2023] [Revised: 07/23/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023]
Abstract
A fear that one's physical illness will recur or worsen has received substantial research attention over the past decade, most notably as fear of cancer recurrence. Indeed, such fear is known to be associated with poorer quality of life, adjustment, and psychopathology. However, fear of a recurrence or progression (FORP) of mental health conditions has received comparatively little study. The present review aimed to, 1) systematically review quantitative research on FORP in mental health regarding its association with age, gender, quality of life, mental health outcomes, and health behaviours, and 2) meta-synthesize qualitative research related to FORP to construct a transdiagnostic model. A qualitative meta-synthesis of 19 studies identified four subthemes underlying FORP (fear of symptoms, loss of progress, fear of death, and traumatic experiences). The three themes related to FORP were: inability to trust oneself, hypervigilance, and a low-risk low-reward lifestyle which was comprised of three subthemes (limiting relationships, limiting life goals, and fear of changing treatment). A quantitative systematic review of 15 studies found that FORP was strongly associated with worse quality of life, and greater depression, anxiety, psychotic symptoms, and medication adherence, but was not associated with age or gender. Hence, FORP can be understood transdiagnostically, and is generally associated with poorer mental health outcomes but may also predict adaptive health behaviours, such as appropriate medication adherence.
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Affiliation(s)
- Daelin Coutts-Bain
- School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Australia.
| | - Pirathat Techakesari
- School of Psychology, Faculty of Science, The University of Sydney, Australia; Cancer Centre for Children, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Australia; Liverpool Cancer Therapy Centre, Liverpool Hospital, South Western Sydney Local Health District, Australia
| | | | - Caroline Hunt
- School of Psychology, Faculty of Science, The University of Sydney, Australia
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Bentley G, Zamir O, Dahabre R, Perry S, Karademas EC, Poikonen-Saksela P, Mazzocco K, Sousa B, Pat-Horenczyk R. Protective Factors against Fear of Cancer Recurrence in Breast Cancer Patients: A Latent Growth Model. Cancers (Basel) 2023; 15:4590. [PMID: 37760558 PMCID: PMC10526521 DOI: 10.3390/cancers15184590] [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: 08/08/2023] [Revised: 09/03/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
The current study aimed to examine the fear of cancer recurrence (FCR) trajectory and protective predictors in women coping with breast cancer (BC). The study's model investigated whether a higher coping self-efficacy and positive cognitive-emotion regulation at the time of the BC diagnosis would lead to reduced levels of FCR at six months and in later stages (12 and 18 months) post-diagnosis. The sample included 494 women with stages I to III BC from Finland, Italy, Portugal, and Israel. They completed self-report questionnaires, including the Fear of Cancer Recurrence Inventory (FCRI-SF), the Cancer Behavior Inventory-Brief Version (CBI-B), the Cognitive-Emotion Regulation Questionnaire (CERQ short), and medical-social-demographic data. Findings revealed that a higher coping self-efficacy at diagnosis predicted lower FCR levels after six months but did not impact the FCR trajectory over time. Surprisingly, positive cognitive-emotion regulation did not predict FCR levels or changes over 18 months. FCR levels remained stable from six to 18 months post-diagnosis. This study emphasizes the importance of developing specific cancer coping skills, such as coping self-efficacy. Enhancing coping self-efficacy in the first six months after BC diagnosis may lead to lower FCR levels later, as FCR tends to persist in the following year.
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Affiliation(s)
- Gabriella Bentley
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Osnat Zamir
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Rawan Dahabre
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Shlomit Perry
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Evangelos C. Karademas
- Department of Psychology, University of Crete and Foundation for Research and Technology, 70013 Heraklion, Greece
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center, University of Helsinki, 00100 Helsinki, Finland
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, 20139 Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20139 Milan, Italy
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, 1400-038 Lisboa, Portugal
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
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Yang L, Liu J, Liu Q, Wang Y, Yu J, Qin H. The relationships among symptom experience, family support, health literacy, and fear of progression in advanced lung cancer patients. J Adv Nurs 2023; 79:3549-3558. [PMID: 37139634 DOI: 10.1111/jan.15692] [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: 07/22/2022] [Revised: 04/07/2023] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
AIMS Fear of progression of cancer patients can affect their psychological well-being, while research on fear of progression of advanced lung cancer patients is limited. This study aimed to describe fear of progression among advanced lung cancer patients and explore the relationships among symptom experience, family support, health literacy, and fear of progression. DESIGN This study was a cross-sectional study. METHODS Convenience sampling was used to select advanced lung cancer patients from September 2021 to January 2022. The Chinese version of the Fear of Progression Questionnaire-Short Form, Lung Cancer Module of the MD Anderson Symptom Inventory, Family Support Questionnaire, and Health Literacy Scale for Patients with Chronic Disease were used to collect data. The structural equation modelling was used to analyse the relationships among symptom experience, family support, health literacy, and fear of progression. RESULTS Of 220 patients, 31.8% had dysfunctional fear of progression. Better symptom experience, higher family support, and higher health literacy were correlated directly with lower fear of progression. Higher health literacy was associated indirectly with lower fear of progression through the mediation of better symptom experience. CONCLUSION Fear of progression among advanced lung cancer patients needs attention. Strengthening symptom management, building a strong system of family support, and improving patients' health literacy may be effective strategies to reduce fear of progression. IMPACT The research aimed to increase our understanding of the relationships among symptom experience, family support, health literacy, and fear of progression. Fear of progression screening should be integrated into the healthcare trajectory of advanced lung cancer patients. The results emphasize that improving symptom management, family support, and health literacy is important to alleviate fear of progression. Further interventions are warranted to relieve fear of progression for advanced lung cancer patients. PATIENT OR PUBLIC CONTRIBUTION No public or patient involvement.
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Affiliation(s)
- Limin Yang
- School of Nursing, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Jiali Liu
- Department of Nursing, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
| | - Qi Liu
- School of Nursing, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Yalan Wang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
| | - Juan Yu
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
| | - Huiying Qin
- Department of Nursing, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
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Liu J, Griva K, Mahendran R. Latent Profiles of Fear of Cancer Recurrence and Associations with Physical and Mental Health Outcomes. Ann Behav Med 2023; 57:743-752. [PMID: 37203254 DOI: 10.1093/abm/kaad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a multidimensional construct; however, few studies have meaningfully integrated FCR severity (i.e., level of fear) with FCR-related concepts (e.g., triggers). PURPOSE The present study determined (a) latent profiles of FCR; (b) socio-demographic variations between identified profiles; (c) interactions between identified profiles and resilience and rumination on chronic physical disorders, depressive/anxiety symptoms, and quality of life. METHODS The present study is a secondary data analysis of which 404 cancer survivors were included in this study. All participants completed the Fear of Cancer Recurrence Inventory and measures of resilience, rumination, depressive/anxiety symptoms, and quality of life. RESULTS Latent profile analysis identified three distinct profiles based on varying levels of FCR and FCR-related concepts; Profile 1 "Low FCR" (n = 108; 26.4%), Profile 2 "Moderate FCR, High coping" (n = 197; 49.4%), and Profile 3 "High FCR, distress and impairment" (n = 99; 24.3%). Profile 3 was associated with younger age and history of radiotherapy. Latent profiles of FCR significantly interacted with resilience and rumination on depressive/anxiety symptoms. CONCLUSIONS Latent profile analysis integrates FCR severity and FCR-related concepts to support a nuanced understanding of FCR. Our results suggest specific points of intervention, which extend beyond addressing FCR severity.
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Affiliation(s)
- Jianlin Liu
- Research Division, Institute of Mental Health, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore
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Martinez-Calderon J, García-Muñoz C, Cano-García FJ, Heredia-Rizo AM. Psychological and spiritual interventions to enhance meaning in adults diagnosed with cancer: a systematic review with meta-analysis and meta-regression. Support Care Cancer 2023; 31:523. [PMID: 37584817 DOI: 10.1007/s00520-023-07986-y] [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: 05/16/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE To summarize the evidence on the effectiveness that psychological and/or spiritual interventions may have to change the levels of meaning, measured with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), in adults diagnosed with cancer. METHODS Systematic review with meta-analysis and meta-regression. CINAHL (via EBSCOhost), Embase, PubMed, PsycINFO (via ProQuest), and the Cochrane Library were searched from inception to 21st October 2022. Manual searches were conducted. Only randomized clinical trials (RCTs) were included. The risk of bias was assessed with the Cochrane Risk of Bias tool 2. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to judge the certainty of the evidence. RESULTS Eight RCTs were included (N = 1682). Although some individual studies showed positive effects to enhance meaning using mindfulness or dignity therapy, the overall and individual meta-analyses showed a lack of effect of psychological and spiritual interventions in comparison to comparator interventions (MD (95%CI) = -0.19 (-0.45 to 0.06), p = 0.11, Tau2 = 0.0015, I2 = 2%). Publication bias was undetected (Egger's test = 0.35). Furthermore, no RCTs were judged to have a low risk of bias and the overall certainty of the evidence was judged as low. Meta-regression and subgroups meta-analyses also found possible sources of heterogeneity such as some cancer characteristics, the educational stage, or the religious affiliation. CONCLUSIONS Despite some RCTs may show promising results following mindfulness or dignity therapy, no effects were observed in the meta-analysis. Moreover, important methodological and clinical concerns precluded us to make sound clinical recommendations with the available evidence. OPEN SCIENCE FRAMEWORK DOI REGISTRATION: https://doi.org/10.17605/OSF.IO/4YMTK .
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain.
- Universidad Loyola de Andalucía, Avda. de las Universidades s/n, 41704 Sevilla, Sevilla, Spain.
| | - Francisco Javier Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain
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Mardani A, Farahani MA, Khachian A, Vaismoradi M. Fear of Cancer Recurrence and Coping Strategies among Prostate Cancer Survivors: A Qualitative Study. Curr Oncol 2023; 30:6720-6733. [PMID: 37504353 PMCID: PMC10378434 DOI: 10.3390/curroncol30070493] [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: 05/08/2023] [Revised: 06/21/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR), as a commonly reported problem among prostate cancer survivors, has not been fully understood. This study aimed to explore the experience of FCR and relevant coping strategies among Iranian prostate cancer survivors. METHODS Qualitative research was conducted on 13 men who completed treatments for prostate cancer in the last 24 months. The participants were selected through purposeful sampling, and in-depth semi-structured interviews were used for data collection. Conventional content analysis was used for data analysis. RESULTS Data analysis led to the emergence of three themes. "Living with insecurity" describes the participants' experiences regarding what triggers FCR with two categories, including "fear of incomplete cure" and "fear of cancer return." In addition, "struggling to cope" with two categories, including "psychological strategies" and "spiritual coping," presents coping strategies used by the participants for reducing FCR. Furthermore, "trying to prevent cancer recurrence" with two categories, "seeking health" and "lifestyle modification," indicates coping strategies used by the participants to prevent cancer recurrence. CONCLUSIONS Healthcare providers need to consider the cultural characteristics of prostate cancer survivors when assessing their FCR, encourage them to disclose their concerns and fears, and provide tailored interventions in order to reduce FCR among them.
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Affiliation(s)
- Abbas Mardani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Mansoureh Ashghali Farahani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Alice Khachian
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW 2800, Australia
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Bai F, Huang Z, Luo J, Qiu Y, Huang S, Huang C, Liu T, Zhang H, Wang D. Bibliometric and visual analysis in the field of traditional Chinese medicine in cancer from 2002 to 2022. Front Pharmacol 2023; 14:1164425. [PMID: 37469862 PMCID: PMC10352617 DOI: 10.3389/fphar.2023.1164425] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/21/2023] [Indexed: 07/21/2023] Open
Abstract
Objective: Traditional Chinese medicine (TCM) has been used as a complementary treatment for cancer patients, but there has been no quantitative comprehensive analysis of TCM's efficacy. The purpose of this paper is to explore the current status and hotspots of TCM in cancer research from 2002 to 2022 and to provide a reference for future research. Methods: We retrieved articles published between 2002 and 2022 from the Web of Science database and analyzed them using R software, VOSviewer, and CiteSpace software. Results: A total of 7,129 articles were included in this study. The publication rate of TCM cancer research increased steadily from 2002 to 2022, with a rapid increase from 2010 to 2021. China was the country with the most published articles, followed by the United States, Republic of Korea, Germany, and Japan. China was also the country with the most international collaborations, and China Medical University and Shanghai University of Traditional Chinese Medicine were the most representative cooperation centers. The Journal of Ethnopharmacology was the most published and cited journal. Apoptosis, expression, in vitro, activation, and other related keywords were commonly used in these articles. Breast cancer, colorectal cancer, gastric cancer, liver cancer, and lung cancer were the most studied cancer types in TCM research. Pathway-related apoptosis, anti-inflammation, and oxidative stress were the hotspots and trends of TCM's anti-cancer mechanism. Metabolomics combined with network pharmacology was the main research method. Conclusion: Traditional Chinese medicine as an anti-cancer drug has received increasing attention from researchers worldwide, and it is expected to be a hotspot for developing new anti-cancer drugs in the future. Our study provides a comprehensive analysis of the current status and hotspots of TCM cancer research, which could serve as a valuable reference for future studies.
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Affiliation(s)
- Facheng Bai
- Pharmacy Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhenguang Huang
- Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jun Luo
- Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yue Qiu
- Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shuwen Huang
- Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chenglong Huang
- Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Taotao Liu
- Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hongliang Zhang
- Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Dandan Wang
- Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Modderkolk L, van Meurs J, de Klein V, Engels Y, Wichmann AB. Effectiveness of Meaning-Centered Coaching on the Job of Oncology Nurses on Spiritual Care Competences: A Participatory Action Research Approach. Cancer Nurs 2023:00002820-990000000-00152. [PMID: 37406216 DOI: 10.1097/ncc.0000000000001255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
BACKGROUND Nurses' competences in providing spiritual care can increase quality of care for and quality of life of patients with cancer and job satisfaction but are often suboptimal. Training to improve this mostly takes place off-site, although implementation in daily care practice is key. OBJECTIVES The aims of this study were to implement a meaning-centered coaching on the job intervention and to measure its effects on oncology nurses' spiritual care competences and job satisfaction, and factors influencing this. METHODS A participatory action research approach was adopted. Mixed methods were used to assess intervention effects in which nurses of an oncology ward in a Dutch academic hospital participated. Spiritual care competences and job satisfaction were quantitatively measured and complemented with content analysis of qualitative data. RESULTS Thirty nurses participated. A significant increase in spiritual care competences was found, particularly regarding communication, personal support, and professionalization. More self-reported awareness of personal experiences in caring for patients, and an increase in mutual communication and involvement around meaning-centered care provision as a team were found. Mediating factors were related to nurses' attitudes, support structures, and professional relations. No significant impact was found on job satisfaction. CONCLUSION Meaning-centered coaching on the job increased oncology nurses' spiritual care competences. Nurses developed a more exploratory attitude in their communication with patients-instead of acting based on their own assumptions about what is of meaning. IMPLICATIONS FOR PRACTICE Attention to and improving spiritual care competences should be integrated into existing work structures, and terminology used should match existing understandings and sentiments.
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Affiliation(s)
- Linda Modderkolk
- Author Affiliations: Department of Anaesthesiology, Pain and Palliative Medicine (Modderkolk, Engels and Wichmann), Department of Primary and Community Care (Modderkolk), Spiritual Care and Pastoral Service (van Meurs), Department of Medical Oncology (de Klein), Radboudumc, Nijmegen, the Netherlands
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Fang H, Zeng Y, Liu Y, Zhu C. The effect of the PERMA model-based positive psychological intervention on the quality of life of patients with breast cancer. Heliyon 2023; 9:e17251. [PMID: 37416631 PMCID: PMC10320023 DOI: 10.1016/j.heliyon.2023.e17251] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/04/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
Objective This research focused on exploring the impact of the PERMA model-based positive psychological intervention according to the negative emotions and quality of life of individuals with breast cancer. Methods A total of 82 individuals with breast cancer from our hospital were categorized into two groups randomly; the control group and the observation group (41 affected individuals each). The individuals in the control group underwent routine nursing intervention, while the ones in the observation group underwent PERMA nursing as per routine nursing intervention. Self-rating anxiety and depression scales along with Functional Assessment of Cancer Therapy-Breast were employed for the evaluation and analysis of patient status in both groups before and after the intervention. Results Following the intervention, the observation group's scores on self-rating anxiety and depression scales were considerably lower when compared with those in the control group (P < 0.001), and the physical, social, family, emotional, and functional statuses, along with additional attention and the total score of quality of Functional Assessment of Cancer Therapy-Breast in the observation group were considerably lower in comparison with those in the control group (P < 0.001). Conclusion The PERMA model-based positive psychological intervention program can ease the anxiety and depression of individuals with breast cancer, improve their quality of life, and has a good prospect of clinical application.
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Affiliation(s)
| | - Yonglei Zeng
- Corresponding author. Department of Oncology, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, 230061 No. 300 Shouchun Road, Luyang District, Hefei, Anhui, 230061, China.
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Banks H, Webb K, Sharpe L, Shaw J. A qualitative exploration of fear of cancer recurrence in caregivers. Psychooncology 2023. [PMID: 37157172 DOI: 10.1002/pon.6149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is one of the most common unmet needs for cancer patients and caregivers. Yet little is known about the potentially unique nature of caregiver FCR. Our research aimed to address this gap by qualitatively exploring the features and impact of caregiver FCR. METHODS Eighteen semi-structured telephone interviews with cancer caregivers were conducted to explore the content and impact of caregiver fears and worries about cancer recurrence or progression. Data analysis used a Framework Approach. RESULTS Qualitative analysis identified three themes (1) fear of the patient suffering, (2) the need to protect the patient from a recurrence and/or cancer-related distress, and (3) caregiver's sense of unpreparedness and uncertainty. Underpinning these themes was an overarching sense of personal responsibility for the life of the patient. This overarching theme was identified as a key driver of caregivers' personal and patient-centred fears. CONCLUSIONS Our findings confirm the conceptual differences between patient and caregiver FCR. Future research must therefore acknowledge the unique experiences of caregivers and prioritise the development of empirically driven theoretical models, instruments, and interventions for caregiver FCR.
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Affiliation(s)
- Hannah Banks
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Kyra Webb
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
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Sun D, Zhang X, Cui M. Association between self-esteem and fear of cancer recurrence in cancer survivors: A cross-sectional study. Eur J Oncol Nurs 2023; 64:102334. [PMID: 37148748 DOI: 10.1016/j.ejon.2023.102334] [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: 03/04/2023] [Revised: 04/24/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE There may be a correlation between self-esteem as an important psychological resource for individuals and Fear of cancer recurrence (FCR), but the relationship between the two is unclear. The aim of our investigation was to evaluate the association of FCR and self-esteem in cancer survivors. METHODS Cross-sectional sampling was used to select cancer survivors. The study instruments used included: General information questionnaire, Rosenberg Self-Esteem Scale, Perceived Social Support Scale, Fear of Cancer Recurrence Inventory- Shorter Form. We used logistic regression, where models were adjusted considering confounding variables to determine odds ratios (ORs) with 95% confidence intervals (CIs) for the association of FCR with self-esteem. RESULTS Between February 2022 to July 2022, we screened 380 participants for eligibility, of whom 348 were included in the study. The percentage of cancer survivors who experienced clinical level of FCR was 73.9% and the self-esteem score was 27.73 ± 3.67 at a moderate level. The Pearson' s correlation coefficient indicated a significant inverse relationship between FCR and self-esteem (p < 0.001; r = -0.375). In a multivariable logistic regression model, FCR still has a negative correlation with self-esteem (OR, 0.812; 95%CI, 0.734-0.898). Subgroup analysis indicated that the correlation between FCR and self-esteem in cancer survivors was nearly the same in various strata, demonstrating its soundness and stability. CONCLUSIONS This study confirms that elevated self-esteem in individuals surviving cancer may be a protective factor for FCR. Improving the level of self-esteem in cancer survivors can be one of the important directions of clinical interventions for FCR.
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Affiliation(s)
- Di Sun
- School of Nursing, Liaoning University of Traditional Chinese Medicine, No.79, Chongshan East Road, Shenyang, Liaoning, 110033, China
| | - Xu Zhang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Mengyao Cui
- Department of Breast Surgery, The First Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China.
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Taher R, Carr NJ, Vanderpuye N, Stanford S. Fear of Cancer Recurrence in peritoneal malignancy patients following treatment: a cross-sectional study. J Cancer Surviv 2023; 17:300-308. [PMID: 35900688 DOI: 10.1007/s11764-022-01238-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/19/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess Fear of Cancer Recurrence (FCR)-its prevalence, trajectory, and relationship to several demographic and clinical characteristics, and quality of life-in a sample of peritoneal malignancy survivors, up to 5 years post-surgery. METHODS The Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF) and 36-Item Short-Form Health Survey (SF-36) were used to collect cross-sectional data from peritoneal malignancy survivors to assess their Fear of Cancer Recurrence and quality of life respectively as well as other demographic and clinical data. RESULTS The results show that more than two-thirds of the participants (N = 301) experience severe/clinical FCR. FCR is relatively stable over time. Younger patients who are struggling with anxiety or depression or receiving professional mental health support at the time of the surgery are at a higher risk of FCR. FCR is associated with a worse quality of life. CONCLUSIONS Peritoneal malignancy survivors are at a high risk of FCR, and it compromises their psychological, mental, and social well-being (quality of life). IMPLICATIONS FOR CANCER SURVIVORS Raise awareness about the high risk of FCR in this population and the demographic and clinical factors that are associated with it. Encourage peritoneal malignancy services and health professionals to address FCR in this population by normalizing it and providing support for those struggling with it.
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Affiliation(s)
- Rayan Taher
- Peritoneal Malignancy Institute, Hampshire Hospitals NHS Foundation Trust, Ground Floor, The Ark, Dinwoodie Drive, Basingstoke, RG24 9NN, UK.
| | - Norman John Carr
- Peritoneal Malignancy Institute, Hampshire Hospitals NHS Foundation Trust, Ground Floor, The Ark, Dinwoodie Drive, Basingstoke, RG24 9NN, UK
| | - Nancy Vanderpuye
- Peritoneal Malignancy Institute, Hampshire Hospitals NHS Foundation Trust, Ground Floor, The Ark, Dinwoodie Drive, Basingstoke, RG24 9NN, UK
| | - Sophia Stanford
- Peritoneal Malignancy Institute, Hampshire Hospitals NHS Foundation Trust, Ground Floor, The Ark, Dinwoodie Drive, Basingstoke, RG24 9NN, UK
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23
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Almeida SN, Elliott R, Silva ER, Sales CMD. Developing an emotion‐focused therapy model for fear of cancer recurrence: A case‐level task analysis. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Susana N. Almeida
- Psychology Service Portuguese Institute of Oncology of Porto Francisco Gentil, E.P.E. Porto Portugal
- University of Maia – ISMAI Maia Portugal
| | - Robert Elliott
- Counselling Unit, School of Psychological Sciences and Health University of Strathclyde Glasgow UK
| | - Eunice R. Silva
- Psychology Service Portuguese Institute of Oncology of Porto Francisco Gentil, E.P.E. Porto Portugal
| | - Célia M. D. Sales
- Faculty of Psychology and Education Science at the University of Porto (FPCEUP), Center for Psychology at the University of Porto (CPUP) University of Porto Porto Portugal
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Deuning-Smit E, Custers JAE, Kwakkenbos L, Hermens RPMG, Prins JB. Evaluating the capacity of the distress thermometer to detect high fear of cancer recurrence. Psychooncology 2023; 32:266-274. [PMID: 36385563 PMCID: PMC10099705 DOI: 10.1002/pon.6066] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/31/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Fear of cancer recurrence (FCR) is common and burdensome to patients, but often remains undetected. Oncology professionals report need for tools to improve FCR detection in routine care. Oncology care guidelines recommend the Distress Thermometer (DT) for distress screening, but it has not been validated for FCR. This study evaluated the capacity of the DT and accompanying problem list to detect FCR. METHODS Amalgamated data of two studies with 149 breast cancer and 74 colorectal cancer survivors were used. We evaluated the Dutch DT including the DT score, problem list fears item and emotional domain score using Receiver Operating Characteristic analyses. The Dutch Cancer Worry Scale-6 (CWS-6) was used as reference measure, with validated cut-off scores ≥10 and ≥12 for high FCR. Sensitivity, specificity, negative and positive predictive values were calculated. RESULTS The DT score showed poor performance in discriminating between low and high FCR. The recommended cut-off ≥4 had low sensitivity (65% for CWS-6≥10; 72% for CWS-6 ≥12) and specificity (67% and 58%). No other cut-off had an acceptable combination of sensitivity and specificity. The fears item had low sensitivity (29% and 44.9%) and high specificity (95% and 94%). The emotional domain score had fair performance in discriminating between low and high FCR but there was no cut-off with acceptable sensitivity and specificity. CONCLUSION The DT as currently recommended in oncology care guidelines is not suitable to effectively detect FCR in routine care. To improve patients access to psychosocial care, it should be investigated how FCR-specific measures can be integrated in oncology practice.
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Affiliation(s)
- Esther Deuning-Smit
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Linda Kwakkenbos
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Clinical Psychology, Radboud University, Nijmegen, The Netherlands.,Department of Psychiatry, Radboudumc Center for Mindfulness, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Abstract
This article provides an overview of the fields of psychosocial and integrative oncology, highlighting common psychological reactions to being diagnosed with and treated for cancer, including distress, anxiety, depression, fear of cancer recurrence and caregiver burden, as well as symptoms of fatigue, pain, and sleep disturbance. Patterns of symptomatology across the disease continuum are also discussed. Interventions targeted at treating these symptoms are reviewed, including acceptance-based and mindfulness therapies, mind-body therapies, and meaning-based approaches designed for people with advanced stages of disease, including psychedelic therapy. Common methodological issues and shortcomings of the evidence base are summarized with design recommendations, and a discussion of trends in future research including pragmatic research design, digital health interventions, and implementation science completes the article.
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Affiliation(s)
- Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada;
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26
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Laranjeira C, Dourado M. "Dignity as a Small Candle Flame That Doesn't Go Out!": An Interpretative Phenomenological Study with Patients Living with Advanced Chronic Obstructive Pulmonary Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17029. [PMID: 36554911 PMCID: PMC9778832 DOI: 10.3390/ijerph192417029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/10/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Long-term illness, such as chronic obstructive pulmonary disease (COPD), can expose people to existential suffering that threatens their dignity. This qualitative study explored the lived experiences of patients with advanced COPD in relation to dignity. An interpretative phenomenological approach based on lifeworld existentials was conducted to explore and understand the world of the lived experience. Twenty individuals with advanced COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stages III and IV) were selected using a purposive sampling strategy. In-depth interviews were used to collect data, which were then analysed using Van Manen's phenomenology of practice. The existential experience of dignity was understood, in essence, as "a small candle flame that doesn't go out!". Four intertwined constituents illuminated the phenomenon: "Lived body-balancing between sick body and willingness to continue"; "Lived relations-balancing between self-control and belongingness"; "Lived Time-balancing between past, present and a limited future"; and "Lived space-balancing between safe places and non-compassionate places". This study explains how existential life phenomena are experienced during the final phases of the COPD trajectory and provides ethical awareness of how dignity is lived. More research is needed to investigate innovative approaches to manage complex care in advanced COPD, in order to assist patients in discovering their inner resources to develop and promote dignity.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena–Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Research in Education and Community Intervention (RECI I&D), Piaget Institute, 3515-776 Viseu, Portugal
- Center for Studies and Development of Continuous and Palliative Care (CEDCCP), Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
| | - Marília Dourado
- Center for Studies and Development of Continuous and Palliative Care (CEDCCP), Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, R. Larga, 3004-504 Coimbra, Portugal
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Triggers and Coping Strategies for Fear of Cancer Recurrence in Cancer Survivors: A Qualitative Study. Curr Oncol 2022; 29:9501-9510. [PMID: 36547160 PMCID: PMC9776860 DOI: 10.3390/curroncol29120746] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) has been demonstrated to be one of the most frequently reported unmet psychological needs among cancer survivors. The aim of this study was to explore and describe the potential triggers and coping strategies for FCR in Chinese cancer survivors. METHODS The study process was conducted using an interpretive phenomenological research method, and Chinese cancer survivors were interviewed face-to-face in a semi-structured interview, using purposive sampling combined with a maximum variance sampling strategy, and the interviews were transcribed, organized, and analyzed by applying Giorgi analysis with the help of NVivo11 software. RESULTS A total of 10 participants, 4 males and 6 females, were interviewed. Three themes emerged in terms of potential triggers for FCR: (1) intrusive thoughts; (2) disease symptoms; and (3) awaiting medical examination. Two themes regarding positive coping and avoidance coping emerged with regard to coping strategies adopted by cancer survivors when experiencing FCR. Under these 2 themes were 5 sub-themes: (1) seeking medical support; (2) self-health management; (3) spiritual coping; (4) unaccompanied toleration; and (5) attention shifting. CONCLUSION FCR as the most common psychological problem for cancer survivors, and it should be given more attention. Early identification and precise intervention for potential triggers of FCR may prevent the emergence and development of FCR. The guidance toward and cultivation of positive coping strategies when cancer survivors experience FCR could be an important direction in future nursing education.
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Rosmolen WD, Pouw RE, van Berge Henegouwen MI, Bergman JJ, Sprangers MA, Nieuwkerk PT. Long-term fear of cancer recurrence in patients treated endoscopically for early Barrett's neoplasia. Dis Esophagus 2022; 36:6862939. [PMID: 36461786 PMCID: PMC10150170 DOI: 10.1093/dote/doac083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/16/2022] [Indexed: 12/11/2022]
Abstract
Previous studies on fear of cancer recurrence after endoscopic treatment for early Barrett's neoplasia focused on fear during a relatively short period after the intervention. The aim of this study was to explore whether fear of cancer (recurrence) persists during long-term follow-up in patients treated endoscopically for Barrett's neoplasia compared to patients treated surgically for a more advanced stage of esophageal adenocarcinoma. Participants previously participated in a prospective longitudinal study investigating quality of life and fear of cancer recurrence and were treated endoscopically for early Barrett's neoplasia (high-grade dysplasia-T1sm1N0M0) or surgically for a more advanced esophageal adenocarcinoma (T1N0M0-T3N1M0). For the present study, participants were again invited to complete a set of questionnaires including the fear of cancer recurrence scale (FORS), worry for cancer scale (WOCS), and the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS Anxiety). Thirty-nine patients were eligible in the endoscopy group and 28 in the surgical group. The median time between the baseline measurement (original study) and the long-term follow-up assessment was 4 years (interquartile range 3-5 years). Fear and worry for cancer recurrence and general anxiety diminished over time in both treatment groups. However, at long-term follow-up, endoscopically treated patients had significantly higher levels of worry for cancer and general anxiety than surgically treated patients. Fear of cancer recurrence did not significantly differ between endoscopically and surgically treated patients. We found that worry and fear of cancer recurrence and general anxiety in endoscopically treated patients declined over time, but not as much as in surgically treated patients.
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Affiliation(s)
- Wilda D Rosmolen
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Roos E Pouw
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mark I van Berge Henegouwen
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jacques J Bergman
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam A Sprangers
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Pythia T Nieuwkerk
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Silva E, Gomes P, Matos PM, Silva ER, Silva J, Brandão C, Castro F, Neves MC, Sales CMD. “I have always lived with the disease in the family”: family adaptation to hereditary cancer-risk. BMC PRIMARY CARE 2022; 23:93. [PMID: 35461227 PMCID: PMC9034526 DOI: 10.1186/s12875-022-01704-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/21/2022] [Indexed: 11/24/2022]
Abstract
Background Hereditary cancer syndromes have been conceptualized as a family level process. The present study explores the complexity and challenges of family adaptation to the hereditary cancer syndrome, in the context of genetic counseling and long-term cancer risk management and follow-up surveillance. Methods We performed semi-structured interviews with 13 participants with one of the following hereditary cancer syndromes: Lynch Syndrome, Hereditary Diffuse Gastric Cancer Syndrome, Hereditary Breast and Ovarian Cancer Syndrome, or Familial Adenomatous Polyposis. The interview was developed through a participatory approach with the involvement of healthcare professionals and individuals with first-hand experience of living with the hereditary cancer syndromes. Results The family is the main source of information and emotional support to deal with hereditary cancer syndromes. Multiple individual adaptation processes and communal coping networks interact, influencing the emotional and health-related behavior of family members. This is affected and affects the family’s communication and its’ members reactions to disclosure, with consequent changes in relationships. Conclusions The systemic interdependent dynamics of family adaptation calls for family-centered care of genetic cancer syndromes.
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30
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Mind–body practices for cancer-related symptoms management: an overview of systematic reviews including one hundred twenty-nine meta-analyses. Support Care Cancer 2022; 30:10335-10357. [DOI: 10.1007/s00520-022-07426-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/20/2022] [Indexed: 12/04/2022]
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31
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Urbutienė E, Pukinskaitė R. Fear of Cancer Recurrence as Reminder About Death: Lived Experiences of Cancer Survivors' Spouses. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221123152. [PMID: 35995573 DOI: 10.1177/00302228221123152] [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: 11/15/2022]
Abstract
Fear of cancer recurrence is the most prevalent and burdensome emotional concern among cancer survivors' spouses after treatment. This qualitative study aimed to reveal death-related experiences of spouses of cancer survivors in remission, in the context of fear of cancer recurrence. Seven spouses (aged 35-56), four women and three men were explored. Data were obtained using an unstructured interview and analyzed by inductive thematic analysis. The spouses associate cancer relapse with death, risk of losing their spouse. The threat of death triggers not only the feelings of insecurity, uncertainty about the future and loss of control, but also appreciation of life, focus on positive aspects in relationships. Planning for the "worst" scenarios and avoidance helped spouses to reduce tension and enhance control. Interventions for spouses should focus on promotion of emotional expression of death related concerns underlying fear of relapse, also developing new coping strategies to accept and tolerate uncertainty.
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Affiliation(s)
- Eglė Urbutienė
- Institute of Psychology, Mykolas Romeris University, Vilnius, Lithuania
| | - Rūta Pukinskaitė
- Institute of Psychology, Mykolas Romeris University, Vilnius, Lithuania
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32
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Urbutienė E, Pukinskaitė R. Fear of Cancer Recurrence: Lived Experiences of Cancer Survivors’ Spouses. PSICHOLOGIJA 2022. [DOI: 10.15388/psichol.2022.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Fear of cancer recurrence is the most prevalent and burdensome emotional concern among cancer survivors’ spouses after treatment. This qualitative study aimed to disclose, what are cancer survivors’ spouses lived experiences of fear of cancer recurrence. Seven adult spouses were explored. Data were obtained using a semi-structured interview and analyzed by inductive thematic analysis. Analysis revealed that fear of cancer recurrence is interpersonal experience and fear transmits in a couple. The spouses associate cancer recurrence with death and risk of losing their spouse. The threat of cancer recurrence triggers not only the feelings of insecurity, uncertainty about the future and loss of control, but also appreciation of life. Planning and control, religiosity, avoidance and awareness of fear helped spouses to reduce concerns about relapse. Interventions for spouses should focus on promotion of emotional expression of cancer recurrence concerns, also learning to accept and tolerate uncertainty.
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Sakai M, Kondo M, Sugiura T, Akechi T. Acceptance and Commitment Therapy in the Transdiagnostic Treatment of a Breast Cancer Survivor: A Case Study. JAPANESE PSYCHOLOGICAL RESEARCH 2022. [DOI: 10.1111/jpr.12422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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34
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van Meurs J, Stommel W, Leget C, van de Geer J, Kuip E, Vissers K, Engels Y, Wichmann A. Oncologist responses to advanced cancer patients' lived illness experiences and effects: an applied conversation analysis study. BMC Palliat Care 2022; 21:37. [PMID: 35300674 PMCID: PMC8928655 DOI: 10.1186/s12904-022-00917-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background An advanced cancer patient’s life is often disturbed by fear of cancer recurrence, cancer progress, approaching suffering, and fear of dying. Consequently, the role of the medical oncologist is not only to provide best quality anti-cancer treatment, but also to address the impact of disease and treatment on a patient’s life, the lived illness experience. We aimed to gain insights into whether and how medical oncologists working at an outpatient clinic identify and explore lived illness experiences raised by patients with advanced cancer, and how this influences patients’ responses. Methods Conversation Analysis was applied to analyse 16 verbatim transcribed audio-recorded consultations. Results We identified 37 fragments in which patients expressed a lived experience from 11 of the 16 consultations. We found differing responses from different oncologists. Patients continued talking about their lived experiences if the listener produced a continuer such as humming or tried to capture the experience in their own words. In contrast, a response with optimistic talking or the presentation of medical evidence prevented patients from further unfolding the experience. In consultations in which the lived illness experience was most extensively unfolded, medical oncologists and patients could constantly see each other’s facial expressions. Conclusions When a patient with advanced cancer spontaneously introduces a lived illness experience, it helps to identify and explore it when the medical oncologist produces a continuer or tries to capture this experience in their own words. Our findings can be implemented in training sessions, followed by frequent reinforcement in daily care. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00917-4.
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Affiliation(s)
- Jacqueline van Meurs
- Department of Spiritual and Pastoral Care & Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, P.O. Box 9101 (714), Nijmegen, 6500 HB, Netherlands.
| | - Wyke Stommel
- Centre for Language Studies, Radboud University, Nijmegen, the Netherlands
| | - Carlo Leget
- Department of Care and Welfare, University of Humanistic Studies, Utrecht, The Netherlands
| | - Joep van de Geer
- Academic Hospice Demeter, Bilthoven & Agora, De Bilt, the Netherlands
| | - Evelien Kuip
- Department of Medical Oncology & Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Kris Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Anne Wichmann
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
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Sharpe L, Michalowski M, Richmond B, Menzies RE, Shaw J. Fear of Progression in chronic illnesses other than cancer: A systematic review and meta-analysis of a transdiagnostic construct. Health Psychol Rev 2022; 17:301-320. [PMID: 35132937 DOI: 10.1080/17437199.2022.2039744] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Fear of cancer recurrence (FCR) is the most common psychosocial issue amongst cancer survivors. However, fear of progression (FoP) has been studied outside of the cancer context. This review aimed to: (1) meta-synthesize qualitative studies of FoP in illnesses other than cancer; and (2) quantify the relationship between FoP and anxiety, depression, and quality of life (QoL) in non-cancer chronic illnesses. We identified 25 qualitative and 11 quantitative studies in a range of chronic illnesses. Participants described fears of progression and recurrence of their illness, including fears of dying, and fears of becoming a burden to family. Fears were often triggered by downward comparison (i.e. seeing people worse off than themselves). Participants coped in different ways, including by accepting the illness or seeking knowledge. Those for whom these fears caused distress reported hypervigilance to physical symptoms and avoidance. Distress, and seeking information, were associated with adherence. In quantitative analyses, FoP was moderately associated with QoL, and strongly associated with anxiety and depression. These results suggest that FoP in illnesses other than cancer is similar to FCR. FoP appears to be an important transdiagnostic construct associated with distress. Evidence-based FCR interventions could be adapted to better manage FoP in other illnesses.
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Affiliation(s)
- Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - M Michalowski
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - B Richmond
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - R E Menzies
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - J Shaw
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006.,Psycho-Oncology Co-operative Group (POCOG), The University of Sydney, NSW 2006
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36
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Luo X, Li W, Chen Y, Sun H, Humphris G, Liu T, Zhang J, Yang Y, Zhang B. Fear of Recurrence in Chinese Cancer Patients: Prevalence, Correlates, and Network Analysis. Front Psychiatry 2022; 13:803543. [PMID: 35197876 PMCID: PMC8859333 DOI: 10.3389/fpsyt.2022.803543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/11/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a significant issue for most cancer patients. Until now, a detailed investigation of the structure of FCR and the interaction among its constituent elements is lacking. This study aims to investigate the phenomenon of FCR by means of network analysis in Chinese cancer patients. METHODS This is a multi-center, cross-sectional study that included 996 cancer patients from southern China. All participants were assessed by the 7-item Chinese version Fear of Cancer Recurrence Scale (FCR-7). Multivariate logistic regression, and network analyses were conducted. Central symptoms (nodes) in the FCR network were identified. RESULTS Among the 996 patients, 543 (54.52%) reported moderate FCR, and 137 (13.76%) reported high FCR. Chemotherapy (OR = 2.954, P = 0.016), and childhood severe illness experience (OR = 2.331, P = 0.016) were positively associated with high FCR, while higher monthly income (OR = 0.403, P = 0.046) was negative associated with high FCR. The node #FCR2 (Worried/anxious about recurrence) was the most central node within the FCR network (Strength = 1.190), while node #FCR6 (Examining for physical signs) was the least central node (Strength = 0.373). The edge FCR1-FCR2 ("Afraid"-"Worried/anxious") was the thickest and most saturated edge in the network. After controlling for age and gender, an almost identical network was obtained with respect to edges magnitude and strength. CONCLUSION Fear of recurrence is a frequently reported issue among Chinese cancer patients. Patients with chemotherapy and childhood severe illness experience were more vulnerable and should be particularly monitored. Compared to behavioral component (i.e., body checking, overscreening and overtreatment) and cognitive component (i.e., intrusions), emotional component (i.e., worry/anxious) is more central to identify FCR and might be potential targets for further interventions.
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Affiliation(s)
- Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Wengao Li
- Department of Psychiatry, 999 Brain Hospital, Guangzhou, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China
| | - Gerry Humphris
- Department of Health Psychology, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Ting Liu
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Jingying Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
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37
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Assessing the fear of recurrence using the Cancer Worry Scale in a sample of Italian breast cancer survivors. Support Care Cancer 2021; 30:2829-2837. [PMID: 34845503 DOI: 10.1007/s00520-021-06718-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The fear of cancer recurrence (FCR) is one of the most reported problems by cancer survivors. A valid instrument to detect this issue could be useful to identify cancer survivors who are more vulnerable to developing FCR and related adverse outcomes (e.g., anxiety). The present study aimed to evaluate FCR in a sample of Italian breast cancer survivors using an Italian version of the 8-item Cancer Worry Scale (CWS) in order to establish a cut-off for the use in clinical settings. METHODS The participants were 119 breast cancer survivors (mean age 47.7 years) at least 1 year after their primary treatment. An exploratory factor analysis (EFA) of CWS, internal reliability of CWS, concurrent and divergent validity using a bivariate correlation between the key measures of the study (i.e., FCR, anxiety, depression, fatigue, and self-efficacy), and ROC analysis of CWS were performed. RESULTS Fit indices for the EFA were considered acceptable and showed a two-factor structure-labeled cancer worries and worries impact. The reliability of the two factors showed a Cronbach's alpha coefficient greater than 0.90. The CWS was positively related to anxiety, depression, fatigue, and negatively related to perceived self-efficacy. The best cut-off score was 24 versus 25, with a sensitivity of 74% and a specificity of 85%. CONCLUSIONS The CWS is a valid questionnaire to assess FCR among breast cancer survivors. The present study provides an overview of the relationship between CWS and the adverse outcomes related to FCR and coping strategies adopted to face it.
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Fear about Alzheimer's disease among Israeli and German laypersons, persons with Mild Neurocognitive Disorder and their relatives: a qualitative study. Int Psychogeriatr 2021; 33:1019-1034. [PMID: 33046144 DOI: 10.1017/s1041610220003397] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Alzheimer's disease (AD), the most common type of dementia, is one of the most feared diseases, obstructing help-seeking, and leading to discrimination. While research interest in fear of developing AD is increasing, little is known about its characterization, triggers, and consequences, especially among different cultures. In this study, we aimed at exploring and characterizing AD fear as experienced by laypersons (LP), persons with Mild Neurocognitive Disorder (MND), and their relatives, in Israel and Germany. DESIGN A qualitative study using focus groups (FGs) and semi-structured interviews was used. Thematic content analysis was conducted to extract key themes. SETTING Israeli and German not yet diagnosed people. PARTICIPANTS The study included a total of 130 participants (63 Israeli and 67 German participants) representing 3 groups: LP (n = 82), persons with MND (n = 28), and relatives of persons with MND (n = 20). RESULTS Two overarching themes were identified across groups and countries: fear of developing AD and fear of stigmatization. Other types of fear, such as fear of a person with AD, fear about the impact of a diagnosis of AD on family members, fear of becoming a caregiver, and fear of losing one's self-determination because of developing AD, were specific to a group type or country. Different types of fear were awakened by different triggers, and were dealt with different coping strategies.
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Abstract
BACKGROUND Fear of cancer recurrence (FCR) is one of the most common and aversive psychological phenomena among cancer survivors. Understanding the independent and potentially modifiable risk factors that contribute toward FCR seen in cancer survivors would inform future interventional trials aimed at reducing this risk. OBJECTIVE The aim of this study was to provide an evidence synthesis of factors correlated with FCR to inform the development of preventive interventions. METHODS A literature search was performed of the PsycINFO, EMBASE, and MEDLINE (PubMed) databases. Reports published from inception to 2020 focusing on the correlates of FCR with physical, psychological, and social factors were identified. Authors assessed the studies' risk of bias in accordance with the Standard Quality Assessment Criteria for Quantitative Studies (QualSyst criteria) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using RevMan 5.3 software. RESULTS Thirty-four articles were included in this study with a total sample of more than 13 000 cancer patients. Fear of cancer recurrence was positively correlated with anxiety, depression, avoidance, chemotherapy, distress, intrusive thoughts, fatigue, rumination, and neuroticism. It was negatively correlated with optimism, age, social support, quality of life, time since diagnosis, well-being, and self-efficacy. CONCLUSIONS We identified 16 factors that are correlated with FCR, 9 positively correlated with FCR and 7 negatively correlated with FCR. IMPLICATIONS FOR PRACTICE The findings of this study provide direction for the development of precise interventions for FCR in cancer survivors and lay the foundation for the further construction of an FCR-related nursing theoretical framework.
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Anderson K, Smith A'B, Diaz A, Shaw J, Butow P, Sharpe L, Girgis A, Lebel S, Dhillon H, Burhansstipanov L, Tighe B, Garvey G. A Systematic Review of Fear of Cancer Recurrence Among Indigenous and Minority Peoples. Front Psychol 2021; 12:621850. [PMID: 34012412 PMCID: PMC8126623 DOI: 10.3389/fpsyg.2021.621850] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/22/2021] [Indexed: 01/15/2023] Open
Abstract
While cancer survivors commonly experience fear and anxiety, a substantial minority experience an enduring and debilitating fear that their cancer will return; a condition commonly referred to as fear of cancer recurrence (FCR). Despite recent advances in this area, little is known about FCR among people from Indigenous or other ethnic and racial minority populations. Given the high prevalence and poor outcomes of cancer among people from these populations, a robust understanding of FCR among people from these groups is critical. The current review identified and aggregated existing literature on FCR amongst adult cancer survivors from Indigenous and minority populations. The protocol of this review was registered with PROSPERO in July 2020 (Registration number: CRD42020161655). A systematic search of bibliographic databases was conducted for relevant articles published from 1997 to November 2019. Data from eligible articles were extracted and appraised for quality by two independent reviewers. Nineteen articles from four countries (United States of America, Canada, Australia and the United Kingdom) met the inclusion criteria, including 14 quantitative, 4 qualitative and 1 mixed-methods study. Only one article reported on an Indigenous population. Few studies reported on FCR prevalence (n = 3) or severity (n = 9). While the variation in tools used to measure FCR hindered a robust estimate of severity, results suggested some differences in FCR severity between minority and dominant populations, although these may have been due to study metholodological differences. Few factors were reported as being associated with FCR in minorities across multiple studies. The qualitative synthesis found five themes associated with the lived experience of FCR: (i) variations in the lived experience of FCR; (ii) spirituality and worldview impacting on FCR; (iii) the importance of staying positive; (iv) complexities around support; and (v) increasing cancer knowledge. The findings of this review highlight differences in FCR across cultures and contexts, which reinforces the need for culturally-specific approaches to this condition. The dearth of research in this area is of concern given the significant burden of cancer in these populations. A deeper understanding of this condition among Indigenous and minority populations is critical to developing and delivering appropriate and effective psychosocial care for cancer survivors from these groups. Systematic Review Registration: identifier [CRD42020161655].
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Affiliation(s)
- Kate Anderson
- Menzies School of Health Research, Brisbane, QLD, Australia.,Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Allan 'Ben' Smith
- Centre for Oncology Education & Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Abbey Diaz
- Menzies School of Health Research, Brisbane, QLD, Australia.,Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Louise Sharpe
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Afaf Girgis
- Centre for Oncology Education & Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Haryana Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | | | - Boden Tighe
- Menzies School of Health Research, Brisbane, QLD, Australia.,Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Gail Garvey
- Menzies School of Health Research, Brisbane, QLD, Australia.,Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
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Uner FO, Korukcu O. A qualitative exploration of fear of cancer recurrence in Turkish cancer survivors who were referred for colposcopy. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:729-737. [PMID: 33662170 DOI: 10.1111/hsc.13326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/23/2021] [Accepted: 01/30/2021] [Indexed: 06/12/2023]
Abstract
We aimed to qualitatively explore factors related to fear of cancer recurrence in women who had a risk of cervical cancer relapse/metastasis and to identify the psychological effect of gynaecological examination and colposcopy in cancer survivors. We conducted the present descriptive study with a qualitative design based on the thematic analysis approach on ten women who under suspicion of new cancer and were admitted to the Gynaecological Oncology Polyclinic of Akdeniz University for colposcopy between July and October 2017 via in-depth interviews. As a result of the interviews, we identified three main themes: colposcopy-related fear, emotions associated with fear of cancer recurrence, and fear of being diagnosed with cancer. Moreover it was determined that women experienced a fear of death, fear of family being affected, fear of stigmatisation by society, and fear of not coping with the treatment process. We found that women with cancer history and undergoing colposcopy because of abnormal cervical cytology in routine oncology controls experienced a significant fear of cancer recurrence. We found that gynaecological examination and colposcopy caused anxiety in patients. Healthcare professions should be aware and help women to cope with the fear of cancer recurrence in the colposcopy process and should determine the social care needs of these patients.
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Affiliation(s)
- Fatma Ozlem Uner
- Department of Obstetrics and Gynecological Nursing, Faculty of Health, Alaaddin Keykubat University, Alanya, Turkey
| | - Oznur Korukcu
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Smit A, Coetzee B, Roomaney R, Swartz L. Understanding the subjective experiences of South African women with recurrent breast cancer: A qualitative study. J Health Psychol 2021; 27:1959-1970. [PMID: 33855880 DOI: 10.1177/13591053211002236] [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: 11/16/2022] Open
Abstract
This study explored the subjective experiences of 12 South African women diagnosed with recurrent breast cancer. Women were invited to take part in unstructured narrative interviews, and to complete a diary in which they could reflect on their breast cancer experiences. Most responded to their recurrence with an optimistic stance. Religious beliefs and support structures were important coping strategies. Women's perceptions of their changed bodies varied from being of least concern, to becoming the most distressing aspect. The findings highlight the complexity of illness experience and the different ways in which women make sense of a second episode of cancer.
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Affiliation(s)
- Anri Smit
- Stellenbosch University, South Africa
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van Helmondt SJ, van der Lee ML, Bisseling EM, Lodder P, de Vries J. Factor structure of the Fear of Cancer Recurrence Inventory (FCRI): Comparison of international FCRI factor structure data and factor analysis of the Dutch FCRI-NL using three predominantly breast cancer samples. Eur J Cancer Care (Engl) 2021; 30:e13431. [PMID: 33763943 PMCID: PMC8519082 DOI: 10.1111/ecc.13431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 12/03/2020] [Accepted: 02/25/2021] [Indexed: 11/27/2022]
Abstract
Objective Factor structure results of Fear of Cancer Recurrence Inventory (FCRI) translations are inconclusive. Through investigating the factor structure, this study aimed to improve the FCRI and its usability. Therefore, we did a comprehensive comparison of the factor structure results of all translations, by exploring and improving the structure of the Dutch FCRI‐NL and by testing this new factor structure in two patient samples. Methods To compare factor structure results of FCRI translations, we did a literature search using PubMed and Google Scholar. We performed exploratory factor analysis (EFA) in a mixed cancer sample. The confirmatory factor analyses (CFAs) were secondary analyses performed in two randomized controlled trial samples: consecutive breast cancer patients and distressed, mainly breast cancer patients. Results All translations showed comparable and reasonable factor structure results; however, the FCRI factor structure can be improved. The EFA resulted in a four‐factor solution: fear of cancer recurrence (FCR) severity, cognitive coping, impact of FCR on functioning and behavioural coping. However, the 4‐factor CFAs did not fit the sample 2 and 3 data well. Conclusion Further exploring the FCRI‐NL factor structure did not result in a psychometrically stronger FCRI‐NL. Therefore, we recommend retaining the 7‐factor FCRI‐NL.
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Affiliation(s)
- Sanne Jasperine van Helmondt
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands
| | - Marije Liesbeth van der Lee
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands
| | - Else Maria Bisseling
- Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands.,Department of Psychiatry, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Paul Lodder
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Jolanda de Vries
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Admiraal de Ruyter Hospital (Adrz), Goes, The Netherlands
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Zhang Y, Lou Y, Wang J, Yu C, Shen W. Research Status and Molecular Mechanism of the Traditional Chinese Medicine and Antitumor Therapy Combined Strategy Based on Tumor Microenvironment. Front Immunol 2021; 11:609705. [PMID: 33552068 PMCID: PMC7859437 DOI: 10.3389/fimmu.2020.609705] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/03/2020] [Indexed: 12/13/2022] Open
Abstract
Treatment of malignant tumors encompasses multidisciplinary comprehensive diagnosis and treatment and reasonable combination and arrangement of multidisciplinary treatment, which is not a simple superimposition of multiple treatment methods, but a comprehensive consideration of the characteristics and specific conditions of the patients and the tumor. The mechanism of tumor elimination by restoring the body's immune ability is consistent with the concept of "nourishing positive accumulation and eliminating cancer by itself" in traditional Chinese medicine (TCM). The formation and dynamic changes in the tumor microenvironment (TME) involve many different types of cells and multiple signaling pathways. Those changes are similar to the multitarget and bidirectional regulation of immunity by TCM. Discussing the relationship and mutual influence of TCM and antitumor therapy on the TME is a current research hotspot. TCM has been applied in the treatment of more than 70% of cancer patients in China. Data have shown that TCM can significantly enhance the sensitivity to chemotherapeutic drugs, enhance tumor-suppressing effects, and significantly improve cancer-related fatigue, bone marrow suppression, and other adverse reactions. TCM treatments include the application of Chinese medicine monomers, extracts, classic traditional compound prescriptions, listed compound drugs, self-made compound prescriptions, as well as acupuncture and moxibustion. Studies have shown that the TCM functional mechanism related to the positive regulation of cytotoxic T cells, natural killer cells, dendritic cells, and interleukin-12, while negatively regulating of regulatory T cells, tumor-associated macrophages, myeloid-derived suppressive cells, PD-1/PD-L1, and other immune regulatory factors. However, the application of TCM in cancer therapy needs further study and confirmation. This article summarizes the existing research on the molecular mechanism of TCM regulation of the TME and provides a theoretical basis for further screening of the predominant population. Moreover, it predicts the effects of the combination of TCM and antitumor therapy and proposes further developments in clinical practice to optimize the combined strategy.
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Affiliation(s)
- Yang Zhang
- Department of Internal Medicine, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yanni Lou
- Oncology Department of Integrated Traditional Chinese and Western Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Jingbin Wang
- Department of Spleen and Stomach Disease, Chinese Medicine Shenzhen Hospital, Guangzhou University, Shenzhen, China
| | - Cunguo Yu
- Department of Chinese Medicine, Qinhuangdao Haigang Hospital, Qinhuangdao, China
| | - Wenjuan Shen
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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Rogers K, McCabe C, Dowling S. What are the holistic experiences of adults living long-term with the consequences of cancer and its treatment? A qualitative evidence synthesis. Eur J Oncol Nurs 2020; 50:101864. [PMID: 33220598 DOI: 10.1016/j.ejon.2020.101864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The number of people living with and beyond cancer is increasing; a significant number of these people will experience the long-term and late effects of cancer and its treatment. Research into this group has been identified as a priority to better understand healthcare needs. This review identified and synthesised qualitative research data relating to the lived experience of the consequences of cancer and its treatment. METHODS A systematic search via electronic databases was conducted in July 2019. Literature was identified that explored the experience of adults living beyond cancer from their own perspective. Thematic synthesis was used to extract and analyse data. RESULTS Six articles were reviewed. Three main themes were identified with four subthemes:1. Living with an altered sense of self; 2. Things are never going to be quite the same again (2.1. The unexpected. 2.2 The uncertain.); 3. Ways of coping with the unexpected and the uncertain. (3.1. Drawing on internal resilience. 3.2. The influence and impact of external relationships.). The findings showed that the participants' world-view changed after cancer and this affected everyday lives both positively and negatively. CONCLUSIONS The experience of having had cancer remains significant long after diagnosis and treatment, yet effective preparation and ongoing support for living beyond cancer is lacking. The experience of living long-term after cancer is characterised by an altered sense of self and has implications for long-term wellbeing. Further research should explore healthcare needs and services required to adequately meet the needs of this growing group of people.
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Affiliation(s)
- Kathy Rogers
- University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK.
| | - Candy McCabe
- University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK; Florence Nightingale Foundation, Deans Mews, Cavendish Square, London, W1G 0AN, UK; Dorothy House Hospice Care, Winsley, Bradford-On-Avon, BA15 2LE, UK.
| | - Sally Dowling
- University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK.
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Alkan A, Yaşar A, Güç ZG, Gürbüz M, Başoğlu T, Sezgin Göksu S, Buğdaycı Başal F, Türk HM, Özdemir Ö, Yeşil Çınkır H, Güven DC, Kuş T, Türker S, Koral L, Karakaş Y, Ak N, Paydaş S, Karcı E, Demiray AG, Demir A, Alan Ö, Keskin Ö, Nayır E, Tanrıverdi Ö, Yavuzşen T, Yumuk PF, Ateş Ö, Coşkun HŞ, Turhal S, Çay Şenler F. Worse patient-physician relationship is associated with more fear of cancer recurrence (Deimos Study): A study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG). Eur J Cancer Care (Engl) 2020; 29:e13296. [PMID: 32864838 DOI: 10.1111/ecc.13296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/16/2020] [Accepted: 08/07/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is an important psychological trauma associated with reduction in the quality of life, disruptions in the level of adjustment, emotional distress and anxiety. The purpose of the study was to evaluate the impact of patient-physician relationship on FCR. METHODS The study was designed as a multicentre survey study. The cancer survivors, who were under remission, were evaluated with structured questionnaires. Patient-physician relationship (PPR) scale in which higher scores indicate better relationship and FCR inventory was used. RESULTS Between January and April 2019, 1,580 patients were evaluated. The median age was 57.0 (19-88), and 66% were female. There was high level of FCR scores in 51% of participants. There was a negative correlation between PPR and FCR scores (r = -.134, p < .001). In multivariate analysis, young age, female gender, history of metastasectomy and worse PPR were associated with high levels of FCR. CONCLUSION It is the first data showing the adverse impact of worse PPR on FCR. The strategies to improve the PPR should be practised. In addition, the cancer survivors, who are under the risk of FCR, should be evaluated and managed.
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Affiliation(s)
- Ali Alkan
- Medical Oncology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Arzu Yaşar
- Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Zeynep Gülsüm Güç
- Medical Oncology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Mustafa Gürbüz
- Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Tuğba Başoğlu
- Medical Oncology, Marmara University School of Medicine, İstanbul, Turkey
| | - Sema Sezgin Göksu
- Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Fatma Buğdaycı Başal
- Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey
| | - Hacı Mehmet Türk
- Medical Oncology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
| | - Özlem Özdemir
- Medical Oncology, İzmir Bozyaka Research and Training Hospital, İzmir, Turkey
| | - Havva Yeşil Çınkır
- Medical Oncology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Deniz Can Güven
- Medical Oncology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tülay Kuş
- Medical Oncology, Dr Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Sema Türker
- Medical Oncology, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Lokman Koral
- Medical Oncology, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Turkey
| | - Yusuf Karakaş
- Medical Oncology, Bodrum Acıbadem Hospital, Muğla, Turkey
| | - Naziye Ak
- Department of Medical Oncology, Institute of Oncology, Istanbul University, İstanbul, Turkey
| | - Semra Paydaş
- Medical Oncology, Çukurova University School of Medicine, Adana, Turkey
| | - Ebru Karcı
- Medical Oncology, Bağcılar Research and Training Hospital, İstanbul, Turkey
| | | | - Atakan Demir
- Medical Oncology, Acıbadem Maslak Hospital, İstanbul, Turkey
| | - Özkan Alan
- Medical Oncology, Tekirdağ Public Hospital, Tekirdağ, Turkey
| | - Özge Keskin
- Medical Oncology, Selçuk University School of Medicine, Konya, Turkey
| | - Erdinç Nayır
- Medical Oncology, VM Medical Park Mersin Hospital, Mersin, Turkey
| | - Özgür Tanrıverdi
- Medical Oncology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Tuğba Yavuzşen
- Medical Oncology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | | | - Öztürk Ateş
- Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey
| | - Hasan Şenol Coşkun
- Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Serdar Turhal
- Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey
| | - Filiz Çay Şenler
- Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
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Hall DL, Park ER, Cheung T, Davis RB, Yeh GY. A Pilot Mind-Body Resiliency Intervention Targeting Fear of Recurrence among Cancer Survivors. J Psychosom Res 2020; 137:110215. [PMID: 32818720 PMCID: PMC7873146 DOI: 10.1016/j.jpsychores.2020.110215] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/13/2020] [Accepted: 08/08/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Interventions for fear of recurrence (FOR) of cancer have nominal effects, perhaps due to limited integration of empirically supported skills. This pilot trial tested the acceptability and feasibility of a multimodal, mind-body resiliency intervention targeting FOR among survivors of various cancers. METHODS Early stage cancer survivors 3-30 months post-treatment were recruited to participate in an eight-session in-person mind-body resiliency group intervention that taught relaxation skills, cognitive-behavioral techniques, healthy lifestyle behaviors, mindfulness meditation, and positive psychology skills all targeted for FOR. Primary outcomes were feasibility (enrollment rate, session attendance, survey completion, skills practice) and acceptability (enjoyableness, convenience, helpfulness, relevance). Patient-reported outcomes (FOR, uncertainty intolerance, cancer-related uncertainty, perceived stress, resiliency, positive affect, and coping skills) were collected at baseline, post-intervention, +1 month, and +3 months. Exit interviews assessed survivors' reported benefits. RESULTS Participants (N = 4 groups, 23 survivors, enrollment response rate = 58%) included survivors of seven common cancer types who were on average 12 months post-treatment. Attendance was high (M = 6.1 sessions), and 96% of survivors completed all surveys. Sustained increases in relaxation skills practice 3+ days/week were reported (baseline = 16%, post-intervention = 76%, +3 months = 71%). Most sessions (87%) were rated as highly or very highly acceptable. Moderate-to-large (d = 0.87) improvements in FOR severity were observed post-intervention (p < .01) and across assessments (p < .01), with similar changes observed in other patient-reported outcomes. Exit interviews revealed behavioral, cognitive, emotional, and existential benefits. CONCLUSIONS The targeted mind-body resiliency intervention shows promising acceptability, feasibility, and favorable changes in FOR and coping skills practice. Further adaptation and testing in a randomized trial are warranted. ClinicalTrials.govRegistration Number: NCT03695406.
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Affiliation(s)
- Daniel L Hall
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States of America.
| | - Elyse R Park
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States of America
| | - Tina Cheung
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States of America
| | - Roger B Davis
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States of America; Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Gloria Y Yeh
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States of America
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Park S, Sato Y, Takita Y, Tamura N, Ninomiya A, Kosugi T, Sado M, Nakagawa A, Takahashi M, Hayashida T, Fujisawa D. Mindfulness-Based Cognitive Therapy for Psychological Distress, Fear of Cancer Recurrence, Fatigue, Spiritual Well-Being, and Quality of Life in Patients With Breast Cancer-A Randomized Controlled Trial. J Pain Symptom Manage 2020; 60:381-389. [PMID: 32105790 DOI: 10.1016/j.jpainsymman.2020.02.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 01/04/2023]
Abstract
CONTEXT Mindfulness-based interventions have been receiving growing attention in cancer care. OBJECTIVES The purpose of this randomized controlled trial is to examine the effectiveness of mindfulness-based cognitive therapy (MBCT) for psychological distress (anxiety and depression), fear of cancer recurrence (FCR), fatigue, spiritual well-being, and quality of life (QOL) in Japanese ambulatory patients with Stage I-III breast cancer. METHODS A total of 74 patients were randomly assigned to either an eight-week MBCT intervention group (n = 38) or a wait-list control group (n = 36). The primary outcome was psychological distress, measured on Hospital Anxiety and Depression Scale. The secondary outcomes were FCR (Concerns About Recurrence Scale-overall anxiety subscale), fatigue (Brief Fatigue Inventory), spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual), QOL (Functional Assessment of Cancer Therapy-General), and mindfulness skills (Five Facet Mindfulness Questionnaire). The participants were assessed at baseline (T0), Week 8 (T1), and Week 12 (T2). The results were analyzed using a intention-to-treat linear mixed model. RESULTS The participants in the MBCT group experienced significantly better outcomes in their psychological distress (Cohen's d = 1.17; P < 0.001), FCR (d = 0.43; P < 0.05), fatigue (d = 0.66; P < 0.01), spiritual well-being (d = 0.98; P < 0.001), and QOL (d = 0.79; P < 0.001) compared with the control group. The difference remained significant at T2 (four weeks after completion of the intervention). CONCLUSION MBCT was demonstrated to improve well-being that encompasses psychological, physical, and spiritual domains in Japanese patients with nonmetastatic breast cancer. The favorable effect was maintained up to four weeks after the completion of the intervention.
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Affiliation(s)
- Sunre Park
- Faculty of Nursing and Medical Care, Keio University, Shinjuku-ku, Tokyo, Japan.
| | - Yasuko Sato
- Department of Nursing, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Yuka Takita
- Faculty of Nursing and Medical Care, Keio University, Shinjuku-ku, Tokyo, Japan; Department of Nursing, Faculty of Health Sciences, Tokyo Kasei University, Itabashi-ku, Tokyo, Japan
| | - Noriko Tamura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Akira Ninomiya
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Teppei Kosugi
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Mitsuhiro Sado
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Clinical and Translational Research Center, Keio University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Maiko Takahashi
- Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Tetsu Hayashida
- Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Division of Patient Safety, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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The course of symptoms of anxiety and depression from time of diagnosis up to 2 years follow-up in head and neck cancer patients treated with primary (chemo)radiation. Oral Oncol 2020; 102:104576. [DOI: 10.1016/j.oraloncology.2020.104576] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/07/2020] [Accepted: 01/14/2020] [Indexed: 11/17/2022]
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Cherian R, Le G, Whall J, Gomez S, Sarkar U. Content shared on social media for national cancer survivors day 2018. PLoS One 2020; 15:e0226194. [PMID: 31940384 PMCID: PMC6961846 DOI: 10.1371/journal.pone.0226194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/18/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies estimate that the number of cancer survivors will double by 2050 due to improvements in diagnostic accuracy and treatment efficacy. Despite the growing population of cancer survivors, there is a paucity of research regarding how these individuals experience the transition from active treatment to long-term surveillance. While research has explored this transition from more organized venues, such as support groups for cancer survivors, this paper explores the discourses surrounding cancer survivorship on social media, paying particular attention to how individuals who identify as cancer survivors represent their experience. METHODS We identified social media posts relating to cancer survivorship on Twitter and Instagram in early June 2018, in order to coincide with National Cancer Survivorship Day on June 3, 2018. We used nine pre-selected hashtags to identify content. For each hashtag, we manually collected the 150 most recent posts from Twitter and the 100 most recent plus the top 9 posts from Instagram. Our preliminary sample included 1172 posts; after eliminating posts from one hashtag due to irrelevance, we were left with 1063 posts. We randomly sampled 200 of these to create a subset for analysis; after review for irrelevant posts, 193 posts remained for analysis (118 from Instagram and 75 from Twitter). We utilized a grounded theory approach to analyze the posts, first open-coding a subset to develop a codebook, then applying the codebook to the rest of the sample and finally memo writing to develop themes. RESULTS Overall, there is substantial difference in the tone and thematic content between Instagram and Twitter posts, Instagram takes on a more narrative form that represents journeys through cancer treatment and subsequent survivorship, whereas Twitter is more factual, leaning towards advocacy, awareness and fundraising. In terms of content type, 120 posts (62%) of the sample were images, of which 42 (35%) were images of the individual posting and 28 (23%) were images of patients posted by family or friends. Of the remaining images, 14 (12%) were of support groups and 7 (6%) were of family or friends. We identified four salient themes through analysis of the social media posts from Twitter and Instagram: social support, celebrating milestones and honoring survivors, expressing identity, and renewal vs. rebirth. DISCUSSION We observed a marked relationship between physical appearance, functional status and survivorship. Additionally, our findings suggest the importance of social support for cancer patients and survivors as well as the role social media can pay in identity formation. CONCLUSION Our findings suggest that individuals who identify as survivors on social media define their identity fluidly, incorporating elements of physical, emotional and psychological health as well as autonomy.
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Affiliation(s)
- Roy Cherian
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
| | - Gem Le
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
| | - James Whall
- California Northstate University College of Medicine, Elk Grove, California, United States of America
| | - Scarlett Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
| | - Urmimala Sarkar
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
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