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Görres C, Leuteritz K, Sender A, Geue K. [Young Adult Cancer Patients (AYA): Preferences for Outpatient Psychosocial Care and Gender-Specific Differences - Results from the AYA-LE study]. Psychother Psychosom Med Psychol 2024. [PMID: 39255802 DOI: 10.1055/a-2390-1690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
OBJECTIVE OF THE STUDY To investigate the importance of individual topics in outpatient care services and the preferences for their design from the perspective of young adults with cancer (AYA="adolescents and young adults") in Germany. METHODOLOGY A total of 514 AYAs aged 18-39 years were surveyed twice over a 12-month period (t1=immediately after acute treatment, t2=12 months post-treatment) regarding the importance and satisfaction with topics such as anxiety, the impact of the illness on partnerships/family and social environment, future perspectives, personal coping strategies, sexuality, and desire for children/fertility, as well as the types of care services. The subjective importance and satisfaction with the care topics and services were analyzed using variance and moderator analyses. RESULTS The most important topics for care services were future career prospects (M=3.22, SD=1.56), social impact (M=3.19, SD=1.54), and personal coping strategies (M=3.52, SD=1.46). The greatest dissatisfaction was noted in the areas of sexuality (M=2.01, SD=1.59) and desire for children/fertility (M=2.08, SD=1.72). At time t2, relaxation techniques (M=3.46, SD=1.36) and psychological counseling (M=3.43, SD=1.46) were the most desired care services. Female AYAs rated psychological counseling (F[1.199)=9.21, p=0.003), social counseling (F[1.221]=6.60, p=0.011), creative therapy options (F[1.219]=21.74, p<0.001), support groups (F[1.215]=4.29, p=0.040), patient education (F[1.210]=6.96, p=0.009), and relaxation techniques (F[1.194]=23.68, p<0.001) significantly more important than male AYAs. CONCLUSIONS The study highlighted several areas of dissatisfaction with the current outpatient care services for AYAs. The results demonstrate the need to incorporate cross-sex and gender-specific care preferences of AYAs to improve outpatient psychosocial care. A specific set of AYA-care services should be designed and implemented to address the aforementioned psychosocial topics, which include sexuality and the desire for children/fertility. It is also crucial for outpatient practice to raise awareness among the involved professional groups. Further research is required to gain a deeper understanding of sex differences.
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Affiliation(s)
- Charlyn Görres
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
| | - Katja Leuteritz
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum AöR, Mitteldeutsches Krebszentrum (CCCG), Universität Leipzig
| | - Annekathrin Sender
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum AöR, Mitteldeutsches Krebszentrum (CCCG), Universität Leipzig
| | - Kristina Geue
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum AöR, Mitteldeutsches Krebszentrum (CCCG), Universität Leipzig
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg
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Graybeal AJ, Compton AT, Swafford SH, Brandner CF, Thorsen T, Renna ME, Stavres J. Measurements of Abdominal Obesity are Associated with Metabolic Syndrome Severity Independent of Hypertensive Phenotype in White but not Black Young Adults. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02051-8. [PMID: 38902464 DOI: 10.1007/s40615-024-02051-8] [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: 01/29/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE This study sought to determine if metabolic syndrome severity (MetSindex) was differentially associated with abdominal obesity based on waist circumference (WC) site and the presentation of hypertensive phenotypes in a group of young White and Black adults. METHODS A total of 139 young adult (22.5 ± 3.3 years) non-Hispanic White (n = 73) and non-Hispanic Black (n = 66) males and females (M 53, 86 F) completed this cross-sectional evaluation. Participants had their WC measured at three distinct locations along the abdomen which were used to calculate waist-to-hip and waist-to-height ratios. Systolic (SBP) and diastolic blood pressure (DBP) were collected and used to calculate mean arterial pressure (MAP). In addition to traditional metabolic syndrome (MetS) risk factors, BP values were individually used to produce three separate MetSindex scores representing three specific hypertensive phenotypes (MetSSBP, MetSDBP, MetSMAP), and each of these were evaluated against each abdominal obesity estimate. RESULTS MetSDBP and MetSSBP were significantly higher than all other indices for females (all p ≤ 0.002) and males (all p < 0.001), respectively. MetSDBP was significantly higher than MetSMAP for White females (p = 0.039), and MetSSBP was significantly higher than MetSDBP and MetSMAP (both p < 0.001) for Black males. Standalone and joint estimates of abdominal obesity were uniquely associated with MetSindex across hypertensive phenotypes for White, but not Black males and females. CONCLUSIONS Specific hypertensive phenotypes may differentially determine MetSindex, but these estimates are not associated with abdominal obesity in young Black adults regardless of measurement location. Healthcare professionals should address this disparity by providing more comprehensive MetS screening procedures for young Black adults. CLINICAL TRIALS REGISTRATION NCT05885672.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA.
| | - Abby T Compton
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Sydney H Swafford
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Caleb F Brandner
- Department of Kinesiology and Health, Iowa State University, Ames, IA, 50011, USA
| | - Tanner Thorsen
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Megan E Renna
- School of Psychology, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Jon Stavres
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
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Gudenkauf LM, Fox RS, Gonzalez BD, Jim HSL, Salsman JM, Victorson DE, Sanford SD, Oswald LB. Need for Behavioral Interventions for Young Adults Living with Advanced Cancer in the U.S. Cancers (Basel) 2024; 16:1910. [PMID: 38791988 PMCID: PMC11120301 DOI: 10.3390/cancers16101910] [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: 03/28/2024] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
The population of young adults (YAs) aged 18-39 living with advanced cancer is growing and faces a compounded set of challenges at the intersection of age and disease. Despite these substantial challenges, behavioral interventions tailored to YAs living with advanced cancer remain scarce. This commentary aims to (1) discuss the unmet psychological, social, and behavioral needs of YAs living with advanced cancer; (2) highlight the paucity of behavioral interventions tailored to this growing population; (3) offer recommendations for the development of behavioral interventions targeting the unique needs of YAs living with advanced cancer; and (4) describe potential far-reaching public health benefits of these targeted behavioral interventions.
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Affiliation(s)
- Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33216, USA
| | - Rina S. Fox
- Division of Advanced Nursing Practice and Science, University of Arizona College of Nursing, Tucson, AZ 85721, USA
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33216, USA
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33216, USA
| | - John M. Salsman
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - David E. Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Cancer Control and Survivorship Program, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Stacy D. Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Cancer Control and Survivorship Program, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33216, USA
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Rosenberg AR, Salsman JM. Resilience in adolescent and young adult oncology: Problems and prospects. Cancer 2024; 130:1015-1018. [PMID: 38150308 DOI: 10.1002/cncr.35180] [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: 12/28/2023]
Abstract
Although resilience research in adolescent and young adult oncology is promising for improving patient‐centered outcomes, it does not adequately incorporate diverse perspectives of marginalized individuals. Including the unique aspects of minoritized adolescents and young adults and incorporating cultural, community, and system‐level considerations is essential to understanding and promoting resilience in an equitable fashion.
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Affiliation(s)
- Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
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Salsman JM, Rosenberg AR. Fostering resilience in adolescence and young adulthood: Considerations for evidence-based, patient-centered oncology care. Cancer 2024; 130:1031-1040. [PMID: 38163249 DOI: 10.1002/cncr.35182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
Adolescence and young adulthood are times of growth and change. For adolescents and young adults (AYAs) who are diagnosed with cancer, the demands of illness may compound normal developmental challenges and adversely affect physical, emotional, and social health. Nevertheless, AYAs have a tremendous capacity for psychosocial adaptation and resilience. Informed by the Transactional Model of Stress and Coping, observational studies in AYA oncology suggest consistent individual, social, and existential resources that may promote resilience. To date, few interventions have been designed to examine whether resilience can be taught and whether doing so affects patient-centered outcomes. Findings point to the potential value of multicomponent programs that include various skills-building strategies, such as stress management, mindfulness, gratitude, and positive reappraisal coping, among others. New research directions include the need to evaluate delivery strategies to enhance participant adherence and retention (e.g., eHealth modalities, optimization studies) and to examine program effectiveness in community-based oncology practices (e.g., less resource-rich settings in which most AYAs receive care). Ultimately, this scholarship may inform, refine, and strengthen intervention science in resilience more broadly.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
| | - Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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