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Dunsmore VJ, Neupert SD. Social isolation, coping efficacy, and social well-being over time in patients with lung cancer. J Behav Med 2024; 47:927-934. [PMID: 39078571 PMCID: PMC11364695 DOI: 10.1007/s10865-024-00508-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 07/09/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Little work has examined how coping efficacy and lung cancer-related social isolation relate to social well-being in the context of a patient's computed tomography (CT) scan. Researchers tested the cross-sectional relationship of social isolation and social well-being, and the longitudinal relationship between coping efficacy and social well-being before CT scans. METHOD 25 patients with lung cancer, within 6 months of their upcoming CT scan, participated. Baseline surveys collected clinical information, demographics, and social isolation; repeated monthly surveys collected coping efficacy and social well-being every 30 days until one's scan. RESULTS [Cross-sectional] High levels of social isolation were associated with low levels of social well-being. [Longitudinal] On months patients reported high coping efficacy, they also reported increases in social well-being. CONCLUSIONS Social interventions may improve well-being among those with lung cancer as our work shows that getting and receiving support are strongly related to well-being in the time surrounding a scan.
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Affiliation(s)
- Victoria J Dunsmore
- Department of Psychology, North Carolina State University, Raleigh, USA.
- UNC Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, USA.
| | - Shevaun D Neupert
- Department of Psychology, North Carolina State University, Raleigh, USA
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Kamphuis MJ, van der Kamp LT, van Eijk RPA, Rinkel GJE, Visser-Meily JMA, van der Schaaf IC, Vergouwen MDI. Scanxiety and quality of life around follow-up imaging in patients with unruptured intracranial aneurysms: a prospective cohort study. Eur Radiol 2024; 34:6018-6025. [PMID: 38311702 PMCID: PMC11364567 DOI: 10.1007/s00330-024-10602-0] [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: 09/18/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVES Patients with an unruptured intracranial aneurysm (UIA) may experience scanxiety around follow-up imaging. We studied the prevalence and temporal pattern of scanxiety, and compared quality of life (QoL) outcomes in patients with and without scanxiety. METHODS We performed a prospective cohort study in a tertiary referral center in the Netherlands between October 2021 and November 2022. We sent questionnaires to patients ≥ 18 years old undergoing UIA follow-up imaging 4 weeks before (T1), immediately after (T2), and 6 weeks after the scan (T3) to assess health-related QoL (HRQoL) and emotional functioning. At T3, we also assessed scanxiety with a purpose-designed questionnaire. We compared differences in QoL outcomes between respondents with and without scanxiety using mixed models. RESULTS Of 158 eligible patients, 106 (67%) participated (mean age 61 years ± 11 [standard deviation], 84 women). Sixty of the 91 respondents (66%) who completed the purpose-designed questionnaire experienced scanxiety. Of the 49 respondents who experienced scanxiety after the scan, it resolved in 22 (45%) within a day after receiving the radiology report. HRQoL did not differ between respondents with or without scanxiety. Emotional functioning was worse for respondents with scanxiety (mean Hospital Anxiety and Depression Scale sum score difference at T1, 3.6 [95% CI, 0.9-6.3]; T2, 4.1 [95% CI, 1.5-6.8]; and T3, 4.0 [95% CI, 1.5-6.5]). CONCLUSIONS Two-thirds of the respondents experienced scanxiety around follow-up imaging, which often resolved within a day after receiving results. Patients with scanxiety had similar HRQoL but worse emotional functioning compared to patients without scanxiety. The time between the scan and receiving the results should be minimized to decrease the duration of scanxiety. CLINICAL RELEVANCE STATEMENT We showed that scanxiety is common in UIA patients, and negatively associated with emotional functioning. Since scanxiety often disappears immediately after receiving the radiology report, it should be communicated to the patient as early as possible to alleviate patients' distress. KEY POINTS • Many patients with an unruptured intracranial aneurysm experience emotional distress around follow-up imaging, termed "scanxiety." • Patients with scanxiety had worse emotional functioning compared to patients without scanxiety. • Scanxiety often resolved within a day after receiving the radiology report.
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Affiliation(s)
- Maarten J Kamphuis
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Laura T van der Kamp
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ruben P A van Eijk
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gabriel J E Rinkel
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Irene C van der Schaaf
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mervyn D I Vergouwen
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Morimoto Y, Lian CPL, Lai C, Kyogoku S, Daida H. Health literacy in medical imaging: a scoping review of current evidence and future directions. Public Health 2024; 234:84-90. [PMID: 38968928 DOI: 10.1016/j.puhe.2024.05.032] [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: 01/22/2024] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE The importance of health literacy in medical imaging is well recognized, yet the current landscape remains inadequately understood. This study aims to explore the extent of health literacy studies contextualized to medical imaging. STUDY DESIGN Scoping review. METHODS A scoping review was conducted using three online bibliographic databases namely, PubMed, ScienceDirect, and CINAHL. We have adopted the concept of health literacy, as a clinical risk and personal asset, to guide this review. RESULTS Of 311 unique articles, 39 met our selection criteria. Five themes (categories) were identified by the authors: appropriate communication with patients who receive medical imaging test results, appropriate usage of medical imaging, classes and characteristics of eHealth literacy, disease/deterioration prevention, and patient education. Additionally, 17 health literacy assessment tools were identified, including 11 original creations. Finally, 11 recommendations have emerged from this scoping review, offering valuable insights into methods, considerations, and strategies for promoting health literacy. CONCLUSIONS Health literacy studies in medical imaging cover both clinical and public health perspectives, benefiting diverse populations, regardless of underlying medical conditions. Notably, the majority of assessment tools used in these studies were author-generated, hindering cross-study comparisons. Given the innate capacity of medical images to convey intuitive information, those images do not solely benefit the patients who are given medical imaging examinations, but they also hold significant potential to enhance public health literacy. Health literacy and medical imaging are closely associated and mutually reinforce each other.
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Affiliation(s)
- Yuh Morimoto
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Cheryl Pei Ling Lian
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore.
| | - Christopher Lai
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Shinsuke Kyogoku
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, Tokyo, Japan
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Dukhanin V, Gamper MJ, Gleason KT, McDonald KM. Patient-reported outcome and experience domains for diagnostic excellence: a scoping review to inform future measure development. Qual Life Res 2024:10.1007/s11136-024-03709-w. [PMID: 38850395 DOI: 10.1007/s11136-024-03709-w] [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] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Abstract
PURPOSE "Diagnostic excellence," as a relatively new construct centered on the diagnostic process and its health-related outcomes, can be refined by patient reporting and its measurement. We aimed to explore the scope of patient-reported outcome (PRO) and patient-reported experience (PRE) domains that are diagnostically relevant, regardless of the future diagnosed condition, and to review the state of measurement of these patient-reported domains. METHODS We conducted an exploratory analysis to identify these domains by employing a scoping review supplemented with internal expert consultations, 24-member international expert convening, additional environmental scans, and the validation of the domains' diagnostic relevance via mapping these onto patient diagnostic journeys. We created a narrative bibliography of the domains illustrating them with existing measurement examples. RESULTS We identified 41 diagnostically relevant PRO and PRE domains. We classified 10 domains as PRO, 28 as PRE, and three as mixed PRO/PRE. Among these domains, 19 were captured in existing instruments, and 20 were captured only in qualitative studies. Two domains were conceptualized during this exploratory analysis with no examples identified of capturing these domains. For 27 domains, patients and care partners report on a specific encounter; for 14 domains, reporting relates to an entire diagnostic journey over time, which presents particular measurement opportunities and challenges. CONCLUSION The multitude of PRO and PRE domains, if measured rigorously, would allow the diagnostic excellence construct to evolve further and in a manner that is patient-centered, prospectively focused, and concentrates on effectiveness and efficiency of diagnostic care on patients' well-being.
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Affiliation(s)
- Vadim Dukhanin
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Suite 643, Baltimore, MD 21205, USA.
| | - Mary Jo Gamper
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Kelly T Gleason
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Kathryn M McDonald
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Derry-Vick HM, Heathcote LC, Glesby N, Stribling J, Luebke M, Epstein AS, Prigerson HG. Scanxiety among Adults with Cancer: A Scoping Review to Guide Research and Interventions. Cancers (Basel) 2023; 15:1381. [PMID: 36900174 PMCID: PMC10000102 DOI: 10.3390/cancers15051381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Background: Scan-related anxiety ("scanxiety") is distressing to people living with and beyond cancer. We conducted a scoping review to promote conceptual clarity, identify research practices and gaps, and guide intervention strategies for adults with a current or prior cancer diagnosis. Methods: Following a systematic search, we screened 6820 titles and abstracts, evaluated 152 full-text articles, and selected 36 articles. Definitions, study designs, measurement methods, correlates, and consequences of scanxiety were extracted and summarized. Results: The reviewed articles included individuals living with current cancer (n = 17) and those in the post-treatment phase (n = 19), across a breadth of cancer types and disease stages. In five articles, authors explicitly defined scanxiety. Multiple components of scanxiety were described, including those related to scan procedures (e.g., claustrophobia, physical discomfort) and scan results (e.g., implications for disease status and treatment), suggesting varied intervention approaches may be needed. Twenty-two articles used quantitative methods, nine used qualitative methods, and five used mixed methods. In 17 articles, symptom measures specifically referenced cancer scans; 24 included general measures without reference to scans. Scanxiety tended to be higher among those with lower education levels, less time since diagnosis, and greater baseline anxiety levels (three articles each). Although scanxiety often decreased immediately pre- to post-scan (six articles), participants reported the waiting period between scan and results to be particularly stressful (six articles). Consequences of scanxiety included poorer quality of life and somatic symptoms. Scanxiety promoted follow-up care for some patients yet hindered it for others. Conclusions: Scanxiety is multi-faceted, heightened during the pre-scan and scan-to-results waiting periods, and associated with clinically meaningful outcomes. We discuss how these findings can inform future research directions and intervention approaches.
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Affiliation(s)
- Heather M. Derry-Vick
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
- Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Lauren C. Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE1 9RT, UK
| | | | | | - Matthew Luebke
- Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
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Liang Y, Hao G, Wu M, Hou L. Social isolation in adults with cancer: An evolutionary concept analysis. Front Psychol 2022; 13:973640. [PMID: 36262430 PMCID: PMC9574202 DOI: 10.3389/fpsyg.2022.973640] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/31/2022] [Indexed: 12/24/2022] Open
Abstract
Background In extant literature, the concept of social isolation has been explored primarily in the context of older adults. However, people with cancer may also experience social isolation, and there is a need for increased clarity regarding this phenomenon in this population. Objective To conceptualize social isolation in adult cancer care. Methods PubMed, Web of Science, PsycINFO, CINAHL, China National Knowledge Infrastructure, Wanfang Data, and the Chinese Biomedical Literature Database were systematically searched using the key terms “cancer,” “social isolation,” “social alienation,” and “social exclusion” for studies (from the earliest date available to June 2022). The main disciplines involved were psychology, nursing, medicine, and public health. Rodgers’ evolutionary concept analysis was employed to clarify the antecedents, attributes, and consequences of social isolation in adults with cancer. Results A total of 60 eligible articles were reviewed entirely and the main findings were categorized into antecedents, attributes, and consequences. The antecedents of social isolation were classified into six categories: cancer-related physiological changes, cognitive beliefs, psychological wellbeing, unsatisfactory social supports or relationships, restrictions associated with receiving treatments, and social-level barriers. Attributes were characterized according to behavior or social avoidance and negative affective experiences, while consequences were attributed to low therapeutic compliance, poor health conditions and mental health problems, and low quality of life. White’s heuristic model is a potential theoretical context applicable to social isolation in adults with cancer. Conclusion This concept analysis provides a basis for developing multidimensional assessment tools and measures to alleviate social isolation in adults with cancer, a complex and varied phenomenon. However, while this review contributes to the current knowledge on social isolation in people with cancer, studies should further investigate the relationships among attributes associated with social isolation.
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Affiliation(s)
- Yanjing Liang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
- Nursing Department, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guihua Hao
- Nursing Department, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mei Wu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Lili Hou
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
- Nursing Department, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Lili Hou,
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Bui KT, Kiely BE, Dhillon HM, Brown C, Xu K, Shafiei M, Blinman P. Prevalence and severity of scanxiety in people with advanced cancers: a multicentre survey. Support Care Cancer 2021; 30:511-519. [PMID: 34333717 DOI: 10.1007/s00520-021-06454-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Scan-associated anxiety ('scanxiety') is a problem for people with advanced cancer. We aimed to determine the prevalence, severity and associations of scanxiety in this population. METHODS People with advanced cancer and a computed tomography scan within the last 4 months completed a multicentre survey including self-rated presence (yes/no) and severity (distress thermometer, 0-10) of scanxiety, state anxiety (STAI-6), clinical anxiety and depression (HADS), and fear of progression (FOP-Q-SF). Associations with scanxiety were evaluated. RESULTS There were 222 participants: mean age 64 years (range 26 to 91), female (61%), most common cancer types (breast 37%, lung 19%, colorectal 16%) and > 1 year since cancer diagnosis (82%). Sixty-two percent had a scan within the last month, and 70% reported waiting > 2 days for the result. Over half (55%) of participants experienced scanxiety. On multivariable analysis, scanxiety was more prevalent in participants who were younger (mean age 62 years with v 66 years without scanxiety, p = 0.02) and more remote (v major city, OR 2.6, p = 0.04). Among participants with scanxiety, the mean severity score was 6 (range 1-10) with peak severity occurring when waiting for scan results. On multivariable analysis, scanxiety was 1.2 points higher in participants who had been diagnosed within the past year (v > 1 year, p = 0.04) and was higher in participants who had higher STAI-6 scores (β = 0.06, p = 0.004). CONCLUSION Scanxiety is common and can be severe. Strategies to reduce scanxiety are needed.
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Affiliation(s)
- Kim Tam Bui
- Medical Oncology, Concord Cancer Centre, 1A Hospital Road, Concord, NSW, 2139, Australia. .,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
| | - Belinda E Kiely
- Medical Oncology, Concord Cancer Centre, 1A Hospital Road, Concord, NSW, 2139, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.,Medical Oncology, Macarthur Cancer Therapy Centre, Campbelltown, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
| | - Chris Brown
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Kay Xu
- Medical Oncology, Macarthur Cancer Therapy Centre, Campbelltown, NSW, Australia
| | - Mohsen Shafiei
- Medical Oncology, Alan Coates Cancer Centre, Dubbo, NSW, Australia
| | - Prunella Blinman
- Medical Oncology, Concord Cancer Centre, 1A Hospital Road, Concord, NSW, 2139, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Abstract
OBJECTIVES To identify available literature on prevalence, severity and contributing factors of scan-associated anxiety ('scanxiety') and interventions to reduce it. DESIGN Systematic scoping review. DATA SOURCES Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Scopus, EBSCO CINAHL and PubMed up to July 2020. STUDY SELECTION Eligible studies recruited people having cancer-related non-invasive scans (including screening) and contained a quantitative assessment of scanxiety. DATA EXTRACTION Demographics and scanxiety outcomes were recorded, and data were summarised by descriptive statistics. RESULTS Of 26 693 citations, 57 studies were included across a range of scan types (mammogram: 26/57, 46%; positron-emission tomography: 14/57, 25%; CT: 14/57, 25%) and designs (observation: 47/57, 82%; intervention: 10/57, 18%). Eighty-one measurement tools were used to quantify prevalence and/or severity of scanxiety, including purpose-designed Likert scales (17/81, 21%); the State Trait Anxiety Inventory (14/81, 17%) and the Hospital Anxiety and Depression Scale (9/81, 11%). Scanxiety prevalence ranged from 0% to 64% (above prespecified thresholds) or from 13% to 83% ('any' anxiety, if no threshold). Mean severity scores appeared low in almost all measures that quantitatively measured scanxiety (54/62, 87%), regardless of whether anxiety thresholds were prespecified. Moderate to severe scanxiety occurred in 4%-28% of people in studies using descriptive measures. Nine of 20 studies assessing scanxiety prescan and postscan reported significant postscan reduction in scanxiety. Lower education, smoking, higher levels of pain, higher perceived risk of cancer and diagnostic scans (vs screening scans) consistently correlated with higher scanxiety severity but not age, gender, ethnicity or marital status. Interventions included relaxation, distraction, education and psychological support. Six of 10 interventions showed a reduction in scanxiety. CONCLUSIONS Prevalence and severity of scanxiety varied widely likely due to heterogeneous methods of measurement. A uniform approach to evaluating scanxiety will improve understanding of the phenomenon and help guide interventions.
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Affiliation(s)
- Kim Tam Bui
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Roger Liang
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Belinda E Kiely
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Chris Brown
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, The University of Sydney, Camperdown, New South Wales, Australia
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Camperdown, New South Wales, Australia
| | - Prunella Blinman
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
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