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Tian X, Zhou X, Sun M, Yu NX, Peng Y, Zheng X, Xiao W. The effectiveness of positive psychological interventions for patients with cancer: A systematic review and meta-analysis. J Clin Nurs 2024; 33:3752-3774. [PMID: 38979929 DOI: 10.1111/jocn.17358] [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: 06/02/2023] [Revised: 06/04/2024] [Accepted: 06/27/2024] [Indexed: 07/10/2024]
Abstract
AIMS AND OBJECTIVES To evaluate the effectiveness of positive psychological interventions on quality of life, positive psychological outcomes and negative psychological outcomes in patients with cancer. BACKGROUND Patients with cancer often suffer from various psychological problems and have a poor quality of life. Positive psychological interventions have been increasingly applied to patients with cancer, but the results of these studies have not been synthesized. DESIGN A systematic review and meta-analysis of randomized controlled trials according to PRISMA. METHODS Six English databases and four Chinese databases were searched from the inception to December 2022. Two reviewers independently assessed the risk of bias using the Cochrane Risk of Bias tool. RevMan was used for meta-analysis. RESULTS Twenty-nine randomized controlled trials examined the effects of positive psychological interventions including meaning therapy, dignity therapy, positive psychotherapy, mindfulness- based intervention, life review, expressive writing intervention, acceptance and commitment psychotherapy, attention and interpretation therapy, compassion training and spiritual therapy on patients with cancer. Positive psychological interventions significantly improved the quality of life, enhanced positive psychological outcomes including well-being, meaning of life, self-esteem, optimism, resilience and self-efficacy and alleviated negative psychological outcomes including depression, anxiety and hopelessness. However, the heterogeneity of some outcomes was rather high, due to the wide diversity of the interventions included. CONCLUSION Positive psychological interventions have potentially positive effects on improving quality of life, enhancing positive psychological outcomes and alleviating negative psychological outcomes in patients with cancer. However, due to the heterogeneity and the lack of follow-up studies, more high-quality studies are needed to confirm the results of our review and to clarify the long-term effects of positive psychological interventions. RELEVANCE TO CLINICAL PRACTICE As feasible psychological interventions, healthcare professionals can consider applying appropriate positive psychological interventions according to the condition of cancer patients. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Xia Tian
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaojun Zhou
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Mimi Sun
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Yunyi Peng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaoting Zheng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wenli Xiao
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Chen J, Liu L, Wang Y, Qin H, Liu C. Effects of psychotherapy interventions on anxiety and depression in patients with gastrointestinal cancer: A systematic review and network meta-analysis. J Psychosom Res 2024; 179:111609. [PMID: 38394712 DOI: 10.1016/j.jpsychores.2024.111609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Various psychological interventions have been demonstrated to be effective at preventing anxiety and depression symptoms in patients with gastrointestinal (GI) cancer. However, it remains unclear which intervention is the best option. This study aimed to evaluate the impact of various psychological interventions on anxiety and depression in symptomatic patients with GI cancer. METHODS The PubMed, Cochrane Library, Embase, CNKI, WanFang Data, and VIP databases were systematically searched from inception to June 2023 to identify randomized controlled trials (RCTs). The primary outcomes were anxiety and depression levels. Two reviewers independently selected the studies, extracted the data based on prespecified criteria, and evaluated the risk of bias using the Cochrane Collaboration risk of bias tool. Stata 14.0 was used to conduct network meta-analysis. RESULTS Thirty-two RCTs (2453 patients) involving 9 psychological interventions were included. The results of the network meta-analysis showed that cognitive-behavioral therapy (CBT; mean difference [MD] = -4.98, 95% CI (-7.04, -2.93), relaxation therapy (MD = -4.39, 95% CI (-7.90, -0.88), reminiscence therapy (MD = -5.01, 95% CI (-8.20, -1.81)), and narrative nursing (MD = -4.89, 95% CI (-8.54, -1.23)) significantly reduced anxiety levels, and CBT (MD = -2.15, 95% CI (-4.28, -0.02), reminiscence therapy (MD = -7.20, 95% CI (-10.48, -3.91), and narrative nursing (MD = -7.20, 95% CI (-10.48, -3.91)) significantly reduced depression levels in patients with GI cancer compared with conventional nursing care. CONCLUSION The findings of this network meta-analysis revealed that CBT, reminiscence therapy and narrative nursing can be actively considered as part of sequential therapy to reduce anxiety and depression levels in patients with GI cancer.
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Affiliation(s)
- Jianwen Chen
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China.
| | - Li Liu
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China
| | - Yalan Wang
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China
| | - Huiying Qin
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China.
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, 246000 Anqing, Anhui Province, China.
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Sun M, Tian X, Peng Y, Wang Z, Lu Y, Xiao W. Effects of meaning therapy on spirituality, psychological health, and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled trials. Asia Pac J Oncol Nurs 2024; 11:100388. [PMID: 38586470 PMCID: PMC10997828 DOI: 10.1016/j.apjon.2024.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/26/2024] [Indexed: 04/09/2024] Open
Abstract
Objective This study aimed to systematically review studies of meaning therapy on patients with cancer and to evaluate its effectiveness on spiritual outcomes, psychological outcomes, and quality of life (QOL). Methods A comprehensive literature search were performed in five international databases (PubMed, Embase, Web of Science, The Cochrane Library, and CINAHL) and four Chinese databases (CNKI, Wanfang Data, VIP, and CBM) from the inception to August 2023. The methodological quality of each included studies was evaluated by using the revised Cochrane risk-of-bias tool for randomized trials. The random-effects model or fixed-effects model was utilized for effect size analysis, and the standardized mean difference (SMD) or mean difference (MD) along with its corresponding 95% confidence interval (CI) was computed. Meta-analysis was conducted by using the RevMan software 5.4.1. Results Eight randomized controlled trials with 1251 participants were included in this review. Meta-analyses revealed that meaning therapy can significantly improve the spiritual outcomes including meaning in life (SMD = -0.48; 95% CI = -0.89 to -0.07; P = 0.02), hopelessness (SMD = -0.30; 95% CI = -0.51 to -0.09; P = 0.005), self-esteem (MD = -2.74; 95% CI = -4.17 to -1.32; P = 0.0002) and spiritual well-being (MD = -3.32; 95% CI = -5.63 to -1.01; P = 0.005), psychological outcomes including anxiety (MD = -0.66; 95% CI = -1.30 to -0.01; P = 0.05), depression (SMD = -0.37; 95% CI = -0.55 to -0.20; P < 0.0001), psychological distress (SMD = -0.35; 95% CI = -0.70 to -0.01; P = 0.04) and desire for hastened death (MD = -0.76; 95% CI = -1.47 to -0.05; P = 0.04), and QOL (SMD = -0.29; 95% CI = -0.50 to -0.09; P = 0.006) in patients with cancer. Conclusions Meaning therapy has positive effects on improving spirituality, psychological health, and QOL of patients with cancer. More high-quality randomized controlled trials with larger sample sizes are warranted to confirm the results of our review and to clarify the long-term effects of meaning therapy in the future. Systematic review registration PROSPERO (No. CRD42021278286).
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Affiliation(s)
| | | | - Yunyi Peng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zheng Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yongmei Lu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wenli Xiao
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Shaygan M, Khaki S, Zarei D, Moshfeghinia R, Beheshtaeen F, Sadeghi Y. Effects of meaning-based psychotherapy on post-traumatic growth and death anxiety in patients with cancer: a systematic review and meta-analysis. Support Care Cancer 2024; 32:251. [PMID: 38532225 DOI: 10.1007/s00520-024-08448-9] [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: 11/26/2023] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION Cancer is one of the leading causes of mortality in the world which imposes numerous psychological burdens on the patients. Psycho-spiritual interventions such as meaning-based therapies may help decrease these challenges. This systematic review and meta-analysis aim to investigate the effects of meaning-based psychotherapy on post-traumatic growth and death anxiety of patients with cancer. METHODS PubMed, Scopus, Proquest, Web of Science, and Google Scholar were searched until 30 September 2023. The Cochrane Collaboration's tool was used to assess the quality of the included studies. A random-effect model was preferred, and statistical analysis was performed by STATA software version 17. RESULTS A total of 17 studies were included in the systematic review. Eleven articles examined the impact of meaning-based interventions on death anxiety and six articles examined post-traumatic growth in cancer patients. Ten studies with a total of 555 participants were included for analysis of the effect of logotherapy versus routine care on death anxiety. Analysis showed a significant decrease effect of logotherapy versus routine care on death anxiety (SMD, - 4.05 (- 6.20, - 1.90); I2, 98.38%). Three studies with a total of 364 participants were included for analysis of the effect of logotherapy versus routine care on post-traumatic growth in patients with cancer. Analysis showed a positive but non-significant effect of logotherapy versus routine care on post-traumatic growth (SMD, 2.05 (- 0.91, 5.01); I2, 99.08%). CONCLUSION The qualitative analysis showed the positive impact of meaning-based psychotherapy interventions on death anxiety and post-traumatic growth in cancer patients, but the results of the meta-analysis on post-traumatic growth were not statistically significant. The review shows the need for more clinical trial studies in larger and more diverse samples in terms of cancer types and cultural background.
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Affiliation(s)
- Maryam Shaygan
- Community Based Psychiatric Care Research Center, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sahar Khaki
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Davood Zarei
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Moshfeghinia
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Beheshtaeen
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Yasin Sadeghi
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Pilz MJ, Seyringer S, Hallsson LR, Bottomley A, Jansen F, King MT, Norman R, Rutten MJ, Verdonck-de Leeuw IM, Siersema PD, Gamper EM. The EORTC QLU-C10D is a valid cancer-specific preference-based measure for cost-utility and health technology assessment in the Netherlands. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-024-01670-6. [PMID: 38483665 DOI: 10.1007/s10198-024-01670-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/10/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Cost-utility analysis typically relies on preference-based measures (PBMs). While generic PBMs are widely used, disease-specific PBMs can capture aspects relevant for certain patient populations. Here the EORTC QLU-C10D, a cancer-specific PBM based on the QLQ-C30, is validated using Dutch trial data with the EQ-5D-3L as a generic comparator measure. METHODS We retrospectively analysed data from four Dutch randomised controlled trials (RCTs) comprising the EORTC QLQ-C30 and the EQ-5D-3L. Respective Dutch value sets were applied. Correlations between the instruments were calculated for domains and index scores. Bland-Altman plots and intra-class correlations (ICC) displayed agreement between the measures. Independent and paired t-tests, effect sizes and relative validity indices were used to determine the instruments' performance in detecting clinically known-group differences and health changes over time. RESULTS We analysed data from 602 cancer patients from four different trials. In overall, the EORTC QLU-C10D showed good relative validity with the EQ-5D-3L as a comparator (correlations of index scores r = 0.53-0.75, ICCs 0.686-0.808, conceptually similar domains showed higher correlations than dissimilar domains). Most importantly, it detected 63% of expected clinical group differences and 50% of changes over time in patients undergoing treatment. Both instruments showed poor performance in survivors. Detection rate and measurement efficiency were clearly higher for the QLU-C10D than for the EQ-5D-3L. CONCLUSIONS The Dutch EORTC QLU-C10D showed good comparative validity in patients undergoing treatment. Our results underline the benefit that can be achieved by using a cancer-specific PBM for generating health utilities for cancer patients from a measurement perspective.
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Affiliation(s)
- Micha J Pilz
- University Hospital of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall, I.T., Austria
| | - Simon Seyringer
- Department of Nuclear Medicine, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Lára R Hallsson
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall, I.T., Austria
| | - Andrew Bottomley
- Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Femke Jansen
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
- Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7-9, Amsterdam, The Netherlands
| | - Madeleine T King
- School of Psychology, University of Sydney, New South Wales, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Marianne J Rutten
- Center of Gynaecologic Oncology Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
- Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7-9, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Gastroenterology and Hepatology, Erasmus MC/University Medical Center, Rotterdam, The Netherlands
| | - Eva Maria Gamper
- University Hospital of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria.
- Department of Nuclear Medicine, Medical University of Innsbruck, 6020, Innsbruck, Austria.
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Capaldi JM, Shabanian J, Finster LB, Asher A, Wertheimer JC, Zebrack BJ, Shirazipour CH. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health Psychol Rev 2024; 18:41-74. [PMID: 36632776 DOI: 10.1080/17437199.2022.2162947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Abstract
The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.
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Affiliation(s)
- Jessica M Capaldi
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia Shabanian
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Laurel B Finster
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arash Asher
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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van Doornik SFW, Glashouwer KA, Ostafin BD, de Jong PJ. The Effects of a Meaning-Centered Intervention on Meaning in Life and Eating Disorder Symptoms in Undergraduate Women With High Weight and Shape Concerns: A Randomized Controlled Trial. Behav Ther 2024; 55:177-190. [PMID: 38216231 DOI: 10.1016/j.beth.2023.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/31/2023] [Accepted: 05/28/2023] [Indexed: 01/14/2024]
Abstract
Low meaning in life has been proposed as an important factor in the maintenance of eating disorders and previous findings suggest that targeting meaning might optimize treatment effectiveness. The current randomized controlled trial aimed to investigate the efficacy of meaning-centered psychotherapy adjusted for eating disorders (MCP-ED) to improve meaning in women with high weight and shape concerns. Female students with high weight and shape concerns (N = 134) were randomly assigned to the waiting-list control condition or the experimental condition, in which they followed six weekly individual sessions of MCP-ED. Self-report measures of meaning, eating disorder symptoms, general distress, psychological well-being, and satisfaction with meaningful life domains were completed at baseline, after the final session of MCP-ED or a 7-week waiting period, and at 4-week follow-up. Participants in the experimental condition showed a stronger increase in meaning than participants in the waiting-list condition after the intervention and at follow-up. The intervention also resulted in lower eating disorder symptoms and general distress, and higher psychological well-being and satisfaction with meaningful life domains. Findings support the efficacy of MCP-ED as an intervention to increase meaning and point to the relevance of examining whether adding MCP-ED to regular treatment might increase treatment effectiveness in individuals with eating disorders.
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Ang WR, Ang WHD, Cham SQG, de Mel S, Chew HSJ, Devi MK. Effectiveness of resilience interventions among cancer patients - A systematic review, meta-analysis, and meta-regression of randomised controlled trials. Eur J Oncol Nurs 2023; 67:102446. [PMID: 37879194 DOI: 10.1016/j.ejon.2023.102446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE This systematic review, meta-analysis and meta-regression aimed to (1) evaluate the effects of resilience interventions on cancer patients' resilience and posttraumatic growth and (2) identify essential contents and features of resilience interventions. METHODS A systematic review, meta-analysis, and meta-regression analyses were conducted. Published and unpublished randomised controlled trials evaluating the effects of resilience interventions among cancer patients were retrieved from nine databases, trial registries, and grey literature. The mean and standard deviation scores were used to compute the effect sizes. RESULTS 23 randomised controlled trials comprising 3287 cancer patients were included. The random effects model found that resilience interventions had beneficial impacts on patients' resilience, posttraumatic growth, quality of life, anxiety, and depressive symptoms with moderate to large effects. The subgroup analyses concluded that theoretically guided interventions that adopted synchronous communication delivered physically had greater effect sizes. Interventions comprising skills that promote patients' cognitive flexibility, self-efficacy, self-esteem, self-regulation, and coping had greater effect in comparison with interventions lacking these components. The meta-regression analyses revealed that sample size has a significant effect on posttraumatic growth scores. More well-designed trials are needed to confirm the effects of resilience interventions. CONCLUSIONS There is merit in utilizing resilience interventions to improve cancer patients' resilience and psychological well-being. Resilience interventions should be incorporated into the routine care for cancer patients and survivors.
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Affiliation(s)
- Wee Rong Ang
- Department of Nursing, Woodlands Health, National Healthcare Group, Singapore.
| | - Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Swss Qynn Grace Cham
- Division of Oncology Nursing, National University Cancer Institute, Singapore, National University Health System, Singapore.
| | - Sanjay de Mel
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, National University Health System, Singapore.
| | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - M Kamala Devi
- School of Medicine, Dentistry and Nursing, University of Glasgow.
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Sharpe L, Richmond B, Todd J, Dudeney J, Dear BF, Szabo M, Sesel AL, Forrester M, Menzies RE. A cross-sectional study of existential concerns and fear of progression in people with Rheumatoid Arthritis. J Psychosom Res 2023; 175:111514. [PMID: 37883892 DOI: 10.1016/j.jpsychores.2023.111514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/20/2023] [Accepted: 10/01/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVES People with rheumatoid arthritis (RA) have higher levels of fear of disease progression (FOP) than cancer survivors. In cancer, FOP is inextricably linked with existential concerns. However, this has not been investigated in people with RA. METHODS We recruited 165 people with RA (96%F) who volunteered for a treatment trial of psychological intervention. Participants completed the Existential Concerns Questionnaire (ECQ) and questionnaires measuring constructs associated with FOP in cancer. We created groups of people with RA, with and without clinically significant levels of FOP (clinical and control groups) and compared their existential concerns. We hypothesized that existential concerns would add to the variance in FOP over and above pain, psychopathology, and disability. RESULTS Nearly two-thirds of people with RA scored in the clinical range for FOP. The clinical group had higher levels of all existential concerns than the control group. When subscales of the ECQ were entered into a multiple regression with FOP as the dependent variable, death anxiety, meaninglessness and guilt domains accounted for significant variance in FOP. Moreover, when added to a regression equation controlling all other variables, existential concerns continued to account for unique variance in FOP (t = 2.712, p = 0.007). CONCLUSION Existential concerns were strongly associated with FOP. While this cross-sectional study cannot determine whether existential concerns underlie FOP in RA, these results show robust relationships that warrant future investigation.
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Affiliation(s)
- Louise Sharpe
- The School of Psychology, Faculty of Science, The University of Sydney, Australia.
| | - Bethany Richmond
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Jemma Todd
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Joanne Dudeney
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Australia
| | - Blake F Dear
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Australia
| | - Marianna Szabo
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Amy-Lee Sesel
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Madeline Forrester
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Rachel E Menzies
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
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Vrontaras N, Koulierakis G, Ntourou I, Karakatsoulis G, Sergentanis TΝ, Kyrou D, Kapetanakis A, Karademas E, Karamanidou C. Psychosocial interventions on the posttraumatic growth of adults with cancer: A systematic review and meta-analysis of clinical trials. Psychooncology 2023; 32:1798-1826. [PMID: 37964424 DOI: 10.1002/pon.6241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND It has been increasingly recognized that some people experience post-traumatic growth (PTG) as a result of struggling with cancer. OBJECTIVE This systematic review aims to identify psychosocial interventions that might facilitate PTG in adults with cancer. METHODS A search was conducted in PsycINFO, PubMed, Scopus, the Cochrane Library, and ProQuest up to 16 September 2022. The PRISMA guidelines were followed; all included interventional studies had to comprise 30 or more adults with cancer, using the Posttraumatic Growth Inventory, from 1994 forward. RESULTS A total of 2731 articles were retrieved, 1028 of those were screened and 37 unique trials were included (46 articles). A large number of studies were published since 2018 (52.4%), were randomized controlled trials (43.2%), and had group interventions (34.8%), including mainly female participants (83.8%) with a single cancer type (54.1%). Most interventions (75.7%) were moderately to highly effective in increasing PTG (d = 0.65, 95% CI 0.39-0.91) with the most effective interventions using Cognitive Behavioral Therapy (d = 1.24, 95% CI: 0.05-2.44), Mindfulness-based (d = 0.54, 95% CI = 0.14-0.94) and Education, Peer Support and Health Coaching interventions (d = 0.28, 95% CI: 0.1-0.46). Expression-based and Positive Psychology-based approaches also showed promising results. Notably, the majority of studies had a high risk of bias. CONCLUSIONS PTG facilitation is a promising field that should be pursued as it not only allows people with cancer to overcome their trauma but also results in them going over and above their pre-cancer state, enhancing resilience, health, and well-being.
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Affiliation(s)
- Nikolaos Vrontaras
- Department of Public Health Policy, University of West Attica, Athens, Greece
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | | | - Iliana Ntourou
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | - Georgios Karakatsoulis
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | | | - Dimitrios Kyrou
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | - Anargyros Kapetanakis
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | | | - Christina Karamanidou
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
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Wang J, Chen H, Yang L, Yu X, Zhang D, Zhao Q, Xiao M. Effectiveness of the Stress Process Model-Based Program in Dementia Caregiving (DeCare-SPM) for Family Caregivers: A Study Protocol for a Randomized Controlled Trial. J Multidiscip Healthc 2023; 16:3507-3519. [PMID: 38024118 PMCID: PMC10658953 DOI: 10.2147/jmdh.s438342] [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: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
This paper aims to describe a randomized controlled trial protocol evaluating the effectiveness, cost, and process of a stress process model-based program in dementia caregiving (DeCare-SPM) for family caregivers. Family caregivers of individuals with dementia will be recruited from memory clinics and community settings and randomly assigned to either DeCare-SPM or usual care. DeCare-SPM comprises three face-to-face sessions (ie, problem-based coping, emotion-based coping, meaning-based coping), and a fourth session (ie, social support) including weekly telephone-based consultation for four weeks and then monthly face-to-face boosters. Outcomes will be measured at baseline (T0), and at one (T1), three (T2), and six months (T3). The primary outcome is positive aspects of caregiving and secondary outcomes are caregiving (ie, sense of competence, caregiver burden, social support, anxiety, depression, and quality of life), dementia-related (ie, care dependency, neuropsychiatric symptoms, and quality of life), and stress-related biomarkers of blood and saliva. In addition, process and economic evaluations will be performed. Mixed-effects models will be used to assess intervention effects. Content analysis will be performed on the qualitative data. This paper described the protocol for comprehensive evaluation of the effectiveness, cost, and process of the theory-driven DeCare-SPM to inform how and why interventions work. It highlights the need to reduce challenges and enhance the positive aspects of dementia care. The DeCare-SPM will provide evidence-based insights into how to support and empower family caregivers in their important roles, thereby, leading to improved dementia care.
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Affiliation(s)
- Jun Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Hongmei Chen
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lin Yang
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiuli Yu
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dandan Zhang
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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Wang Q, Zhou M, Zhao D, Lv G, Zhang Y, Xie Z, Li P. Effects of Resilience-Promoting Interventions on Cancer Patients' Positive Adaptation and Quality of Life: A Meta-analysis. Cancer Nurs 2023; 46:E343-E354. [PMID: 35786671 DOI: 10.1097/ncc.0000000000001138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Resilience-promoting interventions (RPIs) are increasingly used for cancer patients. However, there are few comprehensive reports on the efficacy of RPIs in cancer patients. OBJECTIVE A meta-analysis of randomized controlled trials (RCTs) was conducted to systematically evaluate the effects of RPIs on resilience, posttraumatic growth (PTG), and quality of life in cancer patients. METHODS Two authors conducted independent literature searches in electronic databases (PubMed, Scopus, Web of Science, MEDLINE, EBSCO [ASC], Cochrane library, China National Knowledge Infrastructure, Wan Fang Data, and Chinese Scientific and Technological Journal Database) from the first available date to February 2021. Then, eligible studies were selected, data for meta-analysis were extracted, and the risk of bias was evaluated. RESULTS Sixteen independent randomized controlled trials with 1620 participants were included. Meta-analysis showed that RPIs significantly improved the level of resilience and PTG among cancer patients. Further analysis indicated that both group and individual interventions could enhance resilience and PTG levels. However, RPIs did not significantly enhance the quality of life in cancer patients. CONCLUSIONS Clinical evidence from current randomized controlled trials shows that RPIs can improve the positive adaptation in cancer patients through either group intervention or individual intervention methods. In the future, the impact of RPIs on the quality of life needs further validation. IMPLICATIONS FOR PRACTICE Interventions to enhance the positive adaptation for patients with cancer are needed. Considering that both group and individual forms of RPIs can improve resilience and PTG, future clinical intervention methods can be considered in combination with the specific situation of research implementation.
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Affiliation(s)
- Qing Wang
- Author Affiliation: School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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Wang S, Zheng M, Zhu Y, Zhang L, Li X, Wan H. Exploring the experience of meaning-centered group psychotherapy among Chinese cancer patients during active treatment: a descriptive qualitative study. Front Psychiatry 2023; 14:1264257. [PMID: 37867777 PMCID: PMC10590054 DOI: 10.3389/fpsyt.2023.1264257] [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: 07/25/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Meaninglessness poses a significant psychological challenge for cancer patients, negatively affecting their quality of life and increasing the risk of suicide. Meaning-Centered Group Therapy (MCGP) is an intervention designed specifically to enhance the meaning of life of cancer patients. Extensive research has documented its effectiveness across various cultures and populations. However, limited research has been conducted on the subjective experiences and perspectives of participants engaged in MCGP. Thus, the purpose of this study was to employ a qualitative design to explore the experiences and viewpoints of Chinese cancer patients who have undergone MCGP. Methods Within a two-week timeframe following the conclusion of MCGP, semi-structured interviews were administered to twenty-one participants who had engaged in the therapy. The interview data were transcribed and subjected to thematic analysis. Results Four main themes were identified: (a) Self-perceived personal change, (b) Overall experience of group therapy, (c) Barriers to participation of MCGP, and (d) Suggestions for future interventions. Conclusion Despite the barriers to participation in the MCGP process, the overall experience for Chinese cancer patients undergoing active treatment is valuable and positive, providing multiple benefits. Future studies could explore the adaptation of MCGP to a broader range of cancer populations and diverse study populations.
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Affiliation(s)
- Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Mimi Zheng
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Lijuan Zhang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Xiaoru Li
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
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Salsman JM, McLouth LE, Tooze JA, Little-Greene D, Cohn M, Kehoe MS, Moskowitz JT. An eHealth, Positive Emotion Skills Intervention for Enhancing Psychological Well-Being in Young Adult Cancer Survivors: Results from a Multi-Site, Pilot Feasibility Trial. Int J Behav Med 2023; 30:639-650. [PMID: 36890329 PMCID: PMC10485177 DOI: 10.1007/s12529-023-10162-5] [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] [Accepted: 02/01/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Young adult (YA) cancer survivors experience clinically significant distress and have limited access to psychosocial support. Given growing evidence for unique adaptive benefits of positive emotion in the context of health-related and other life stress, we developed an eHealth positive emotion skills intervention for post-treatment survivors called EMPOWER (Enhancing Management of Psychological Outcomes With Emotion Regulation) and evaluated feasibility and proof of concept for reducing distress and enhancing well-being. METHOD In this single-arm pilot feasibility trial, post-treatment YA cancer survivors (ages 18-39) participated in the EMPOWER intervention which included 8 skills (e.g., gratitude, mindfulness, acts of kindness). Participants completed surveys at baseline (pre-intervention), 8 weeks (post-intervention), and 12 weeks (1-month follow-up). Primary outcomes included feasibility (assessed by participation percentage) and acceptability (would recommend EMPOWER skills to a friend). Secondary outcomes included psychological well-being (mental health, positive affect, life satisfaction, meaning/purpose, general self-efficacy) and distress (depression, anxiety, anger). RESULTS We assessed 220 YAs for eligibility; 77% declined. Of those screened, 44 (88%) were eligible and consented, 33 began the intervention, and 26 (79%) completed the intervention. Overall retention was 61% at 12 weeks. Average acceptability ratings were high (8.8/10). Participants (M = 30.8 years, SD = 6.6) were 77% women, 18% racial/ethnic minorities, and 34% breast cancer survivors. At 12 weeks, EMPOWER was associated with improved mental health, positive affect, life satisfaction, meaning/purpose, and general self-efficacy (ps < .05, ds = .45 to .63) and decreased anger (p < .05, d = - 0.41). CONCLUSION EMPOWER demonstrated evidence of feasibility and acceptability as well as proof of concept for enhancing well-being and reducing distress. Self-guided, eHealth interventions show promise for addressing YA cancer survivors' needs and warrant additional research to optimize survivorship care. TRIAL REGISTRATION ClinicalTrials .gov NCT02832154, https://clinicaltrials.gov/ct2/show/NCT02832154.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine & Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Laurie E McLouth
- Department of Behavioral Science and Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine & Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Denisha Little-Greene
- Health Care Education, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Mia Sorkin Kehoe
- Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Wang S, Zhu Y, Wang Z, Zheng M, Li X, Zhang Y, Wan H. Efficacy of meaning-centered group psychotherapy in Chinese patients with cancer: A randomized controlled trial. Palliat Support Care 2023; 21:773-781. [PMID: 37558651 DOI: 10.1017/s1478951523000998] [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: 08/11/2023]
Abstract
OBJECTIVES Meaninglessness is one of the most common psychological problems in cancer patients, which can lead to anxiety, depression and psychological distress, and diminished quality of life. Recent evidence indicates that meaning-centered group psychotherapy (MCGP) effectively enhances the meaning in life among cancer patients. This study aimed to evaluate the impact of MCGP on the meaning in life, post-traumatic growth, psychological distress, and fear of recurrence among Chinese cancer patients with a favorable prognosis. METHODS Sixty-six cancer patients were randomly assigned to either the MCGP group (n = 33) or the control group (n = 33). Participants in the MCGP group underwent a 4-week, 8-session MCGP, while those in the control group received usual care. Meaning in life, post-traumatic growth, psychological distress, and fear of recurrence were assessed at both baseline and postintervention to evaluate the impact of the intervention. The intervention outcomes were analyzed using paired t-tests or analysis of covariance, as appropriate. RESULTS Patients in the MCGP group demonstrated significant improvements in meaning in life, post-traumatic growth, and fear of recurrence from baseline to postintervention. In comparison to the control group, the MCGP group displayed positive effects on meaning in life and post-traumatic growth following the intervention. However, no significant effects were observed in terms of psychological distress and fear of recurrence. SIGNIFICANCE OF RESULTS Our research offers evidence supporting the effectiveness of MCGP in enhancing meaning in life and post-traumatic growth among Chinese cancer patients with a favorable prognosis.
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Affiliation(s)
- Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Ziying Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Mimi Zheng
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Xiaoru Li
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Yu Zhang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
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Zhang Y, Tang R, Bi L, Wang D, Li X, Gu F, Han J, Shi M. Effects of family-centered positive psychological intervention on psychological health and quality of life in patients with breast cancer and their caregivers. Support Care Cancer 2023; 31:592. [PMID: 37750931 DOI: 10.1007/s00520-023-08053-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/15/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Positive psychological intervention could improve individual's psychological health and quality of life. This study aimed to examine the effectiveness of family-centered positive psychological intervention on resilience, hope, perceived benefits, and quality of life in breast cancer patients and their caregivers. METHODS A two-group, randomized controlled study, including 98 dyads of breast cancer patients and caregivers, was conducted. Dyads were randomly assigned to intervention (n = 49) and control (n = 49) groups. Both the control and intervention groups received 4 weeks of health education, while the intervention group additionally received a 4-week family-centered positive psychological intervention. Outcome measures compared at baseline (T1), immediately after the intervention (T2), and at 1-month follow-up (T3), included validated measures of resilience (Connor-Davidson Resilience Scale), hope (Herth Hope Index), perceived benefits (Perceived Benefits of Diagnosis and Treatment of Breast Cancer, Positive Aspects of Caregiving), and quality of life (Functional Assessment of Cancer Therapy-Breast, Caregiver Quality of Life Scale). RESULTS Resilience, hope, perceived benefits, and quality of life of dyads were significantly higher in the intervention group than those in the control group at T2 and T3 (all p < 0.05). Linear mixed model analysis demonstrated a significant interaction effect of group × time × role (p = 0.007) on hope and a significant difference in the improvement of hope (p < 0.05) between patients and their caregivers. CONCLUSIONS Our family-centered positive psychological intervention was effective in improving psychological health and quality of life for breast cancer patients and caregivers. This study provides evidence for the effectiveness of positive clinical psychological interventions. TRIAL REGISTRATION ChiCTR2300072809.
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Affiliation(s)
- Yao Zhang
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Ruijin Tang
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Liuna Bi
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Dan Wang
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaoxu Li
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Feng Gu
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jing Han
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China.
| | - Ming Shi
- First Clinical College, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China.
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Aydın R, Kabukcuoğlu K. The effect of logotherapy-based, nurse-guided meaning attribution conversations on women diagnosed with gynecologic cancer: A Turkish pilot study. Women Health 2023; 63:599-614. [PMID: 37642347 DOI: 10.1080/03630242.2023.2249123] [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: 10/06/2022] [Revised: 07/08/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
Although gynecological cancers are among the most common cancers worldwide, these diagnoses are among the most traumatic experiences in women's lives. This study aimed to examine the effects of logotherapy-based, nurse-guided meaning attribution conversations (MACs) on traumatic stress symptoms, post-traumatic growth, spiritual well-being, and life meaning attribution in gynecological cancer patients. This single-blind, randomized controlled trial consisted of face-to-face interviews with 68 women with gynecological cancer who received chemotherapy at Karadeniz Technical University Health Application And Research Center Farabi Hospital in 2019. Women in the intervention group underwent seven MAC sessions, whereas women in the control group only received routine nursing care. Data were collected using the Personal Information Form (PIF), the Traumatic Stress Symptom Scale (TSSS), the Post-Traumatic Growth Inventory (PTGI), the Meaning in Life Questionnaire (MLQ), and the Spiritual Well-Being Scale (SWBS). Descriptive statistics and parametric and nonparametric tests (Mann - Whitney U-test, Friedman test, Chi-squared test, and Fisher's exact test) were used to analyze the data. The study was registered at ClinicalTrials.gov (NCT05246462). We observed statistically significant differences in the post-intervention and follow-up mean TSSS, PTGI, and MLQ scores (p = .000) between groups. However, mean total SWBS scores were not significantly different between groups (p = .145). This study demonstrated that MACs decreased the traumatic stress symptoms of women with gynecological cancer and increased their post-traumatic growth and ability to attribute meaning to life, but did not affect their spiritual well-being.
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Affiliation(s)
- Ruveyde Aydın
- Health Sciences Faculty, Ondokuz Mayıs University, Samsun, Turkey
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18
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Asher A, Shirazipour CH, Capaldi JM, Kim S, Diniz M, Jones B, Wertheimer J. A 6-Week Program to Strengthen Resiliency Among Women With Metastatic Cancer: A Randomized Clinical Trial. Oncologist 2023:7146116. [PMID: 37104871 PMCID: PMC10400157 DOI: 10.1093/oncolo/oyad091] [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: 12/01/2022] [Accepted: 03/14/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE The objective of this study was to evaluate the effect of an intervention (Growing Resilience And CouragE; GRACE) on spiritual well-being, quality of life, and general well-being in women with metastatic cancers reporting existential or spiritual distress. PATIENTS AND METHODS Prospective, randomized, wait-list control clinical trial. Women with metastatic cancer experiencing existential or spiritual concerns were randomized to GRACE or waitlist control. Survey data were collected at baseline, end of program, and 1-month follow-up. Participants included English-speaking women, 18 or older, with metastatic cancer, existential or spiritual concerns, and reasonable medical stability. Eighty-one women were assessed for eligibility; 10 were excluded (not meeting exclusion criteria, refusal to participate, and death). The primary outcome was spiritual well-being measured pre- and post-program. Secondary measures assessed quality of life, anxiety, depression, hopelessness, and loneliness. RESULTS Seventy-one women (aged 47-72) were enrolled (GRACE n = 37, waitlist control n = 34). GRACE participants demonstrated significant improvements in spiritual well-being compared to control at end of program (parameter estimate (PE), 16.67, 95% CI, 13.17, 20.16) and 1-month follow-up (PE, 10.31, 95% CI, 6.73, 13.89). Additionally, significant improvements were demonstrated in quality of life at the end of program (PE, 8.51, 95% CI, 4.26, 12.76) and 1-month follow-up (PE, 6.17, 95% CI, 1.75, 10.58). GRACE participants also demonstrated improved depression and hopelessness at follow-up, as well as improved anxiety. CONCLUSIONS Findings suggest the value of evidence-based psychoeducational and experiential interventions for improving the well-being and quality of life of women with advanced cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02707510.
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Affiliation(s)
- Arash Asher
- Department of Medicine and Physical Medicine and Rehabilitation and Patient and Family Support Program at Cedars-Sinai Cancer, Los Angeles, CA, USA
| | - Celina H Shirazipour
- Division of Population Sciences, Cedars-Sinai Cancer, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jessica M Capaldi
- Division of Population Sciences, Cedars-Sinai Cancer, Los Angeles, CA, USA
| | - Sungjin Kim
- Biostatistics Research Center, Samuel Oschin Comprehensive Cancer Center and Departments of Medicine and Biomedical Sciences, Los Angeles, CA, USA
| | - Marcio Diniz
- Biostatistics Research Center, Samuel Oschin Comprehensive Cancer Center and Departments of Medicine and Biomedical Sciences, Los Angeles, CA, USA
| | - Bronwen Jones
- Department of Spiritual Care, Cedars-Sinai Cancer, Los Angeles, CA, USA
| | - Jeffrey Wertheimer
- Department of Physical Medicine and Rehabilitation at Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Yager J, Kay J. Purpose in Life: Addressing Transdiagnostic Psychopathologies Concerning Patients' Sense of Purpose. J Nerv Ment Dis 2023; 211:411-418. [PMID: 37094572 DOI: 10.1097/nmd.0000000000001657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
ABSTRACT Having a purpose in life is strongly associated with well-being and quality of life. Some individuals develop their sense of purpose early in life and can sustain lifelong ideals. In contrast, we identify four transdiagnostic syndromes where purpose in life is impaired: 1) deficiencies in generating purpose; 2) loss of purpose due to traumatic events such as catastrophic illnesses or bereavements; 3) conflicts due to crossed purposes; and 4) maladaptive purposes, such as life-limiting single-minded goals, dominating others, or exacting revenge. Several psychotherapies associated with positive and existential psychologies help patients construct, reconstruct, or retain a sense of purpose. However, given the strong links between a sense of purpose and beneficial health and mental health outcomes, the authors suggest that many patients in psychiatric treatment including psychotherapies will benefit from attention to these issues. This article reviews approaches for assessing and addressing purpose in life in psychiatric treatment, to enhance patients' healthy sense of purpose where this characteristic is impaired.
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Affiliation(s)
- Joel Yager
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
| | - Jerald Kay
- Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
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Kita S, Zonp Z, Saint Arnault D. Initial testing of components of the cultural determinants of trauma recovery (CDTR) theory amongst American Gender-Based violence survivors: Structural equation modelling. J Adv Nurs 2023; 79:1476-1492. [PMID: 35775114 DOI: 10.1111/jan.15331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/29/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022]
Abstract
AIM We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample. DESIGN A cross-sectional study using anonymous online surveys. METHODS This study was conducted with 225 American survivors of gender-based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL-5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help-seeking (shame, frozen and problem management subscales: BHS-TR Internal) and the GBV healing (GBV-Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses. RESULTS The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help-seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers; the relationship between internal help-seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers and SOC. CONCLUSIONS This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups. IMPACT This study can help us focus on psychological interventions that enhance meaning and mitigate internal help-seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities.
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Affiliation(s)
- Sachiko Kita
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Department of Health Quality and Outcome Research, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Zeynep Zonp
- Independent Researcher, Istanbul, Turkey
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Denise Saint Arnault
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
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Wierstra IR, Liefbroer AI, Post L, Tromp T, Körver J. Addressing spiritual needs in palliative care: proposal for a narrative and interfaith spiritual care intervention for chaplaincy. J Health Care Chaplain 2023; 29:64-77. [PMID: 34923933 DOI: 10.1080/08854726.2021.2015055] [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] [Indexed: 01/26/2023]
Abstract
Although many recognize the importance of addressing the spiritual domain in palliative care, empirically grounded interventions designed to alleviate spiritual needs for patients in palliative care are remarkably scarce. In this paper we argue that the development of such interventions for chaplains is important in order to improve spiritual care in a (post)secular and religiously plural context. We therefore propose an interfaith chaplain-led spiritual care intervention for home-based palliative care that addresses patients' spiritual needs. The intervention is based on elements of spiritual care interventions that have been investigated among other populations. Three important characteristics of the proposed intervention are (1) life review; (2) materiality, ritual and embodiment; and (3) imagination. The aim of this intervention is to improve palliative patients' spiritual wellbeing. It is anticipated that such a structured intervention could assist in improving spiritual care in palliative care.
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Affiliation(s)
- Iris R Wierstra
- Department of Practical Theology and Religious Studies, Tilburg School of Catholic Theology, Tilburg University, Utrecht, The Netherlands.,Chair group Humanist Chaplaincy Studies for a Plural Society, University of Humanistic Studies, Utrecht, The Netherlands
| | - Anke I Liefbroer
- Department of Practical Theology and Religious Studies, Tilburg School of Catholic Theology, Tilburg University, Utrecht, The Netherlands.,Faculty of Religion and Theology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lenneke Post
- Faculty of Religion and Theology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Spiritual Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thijs Tromp
- Department of Practical Theology, Protestant Theological University, Amsterdam, The Netherlands
| | - Jacques Körver
- Department of Practical Theology and Religious Studies, Tilburg School of Catholic Theology, Tilburg University, Utrecht, The Netherlands.,University Center for Chaplaincy Studies, Utrecht, The Netherlands
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22
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Khalid S, Abbas I, Javed S. Psychological Support for Cancer Patients. Cancer Treat Res 2023; 185:255-283. [PMID: 37306913 DOI: 10.1007/978-3-031-27156-4_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
From the time a person is diagnosed with cancer, a psychological sequalae of intense emotional challenges emerge for the patient as well as family members. Different stages require different types of psychosocial support including those for previvors, survivors, and people who need palliative care. Currently, there is an emphasis on not only providing psychological assistance to cope with emotional, interpersonal, and economic stresses, but training programs specially designed to activate personal and social resources to find happiness and meaning in adversity. Within this perspective, the chapter is divided into three sections, each considering the common mental health issues and positive changes and intervention and therapies for cancer patients, family members, caregivers, onco-staff, and professionals.
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Affiliation(s)
- Shazia Khalid
- Department of Psychology, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan.
| | - Imran Abbas
- Oncoplastic Breast Surgeon, Royal Cornwall Hospitals, NHS Trust, Cornwall, UK
| | - Saira Javed
- Department of Psychology, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
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23
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Carr AL, Roberts S, Bonnell LN, Kolva E. Existential distress and meaning making among female breast cancer patients with cancer-related fertility concerns. Palliat Support Care 2022; 21:1-9. [PMID: 36562084 DOI: 10.1017/s1478951522001675] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The current study explored the impact of cancer-related fertility concerns on existential distress and meaning making among female breast cancer (BC) patients of childbearing age and assessed support needs. METHODS The current study was embedded within a larger study. A seven-question online survey was administered to female BC participants to explore meaning and identity in their lives. Applied thematic analysis was used to analyze participants' written responses. RESULTS A total of 98 participants completed the survey, the majority of whom identified as white, married or partnered, and employed full time and with stage I or II BC. More than 50% of the participants expressed a need for support from a counselor or support group during their cancer experience. Three subthemes emerged related to existential distress and cancer-related fertility concerns: (1) loss of womanhood: treatment-related physical changes impact on gender identity; (2) existential distress due to treatment decisions impacting fertility; and (3) shattered vision: cancer-related infertility impact on meaning and purpose. Four subthemes emerged related to meaning making with fertility-related existential concerns: (1) coping with loss of meaning, (2) re-evaluating priorities in life; (3) resilience to loss, and (4) persistent loss of meaning. SIGNIFICANCE OF RESULTS Study results offer valuable insights into the experiences of female BC survivors' cancer-related fertility on existential distress and meaning making. Development of psychological interventions targeted to support this population to cope with existential distress due to cancer-related fertility concerns and meaning making are needed to improve the quality of life of this population.
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Affiliation(s)
- Alaina L Carr
- Division of Medical Oncology, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Sydneyjane Roberts
- Division of Medical Oncology, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
| | - Levi N Bonnell
- Population Health Research Core, University of Colorado Cancer Center - Anschutz Medical Campus, Aurora, CO, USA
| | - Elissa Kolva
- Division of Medical Oncology, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
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24
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ÜLBE S, DİRİK G. Kanser Tanısı almış Kişilere Uygulanan Anlam Temelli Müdahale Programları: Sistematik bir Derleme. KLINIK PSIKOLOJI DERGISI 2022. [DOI: 10.57127/kpd.26024438m0000104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Son yıllarda kanser tanısı almış kişilerin yalnızca yaşadıkları olumsuz psikolojik semptomları azaltmayı değil, aynı zamanda kişilerin yaşamdaki anlam kaynaklarını ve değerleri ile temasa geçerek yaşamlarını zenginleştirmeyi amaçlayan çeşitli anlam temelli müdahale geliştirilmiştir. Mevcut çalışmanın amacı kanser tanısı alan kişilerde doğrudan yaşamda anlam ve amaç duygularını geliştirmeye odaklanan müdahalelerin özelliklerini ve sonuçlarını sistematik olarak incelemektir. Bu kapsamda PsychINFO, MEDLINE, CINAHL Complete, PubMed, Scopus ve Web of Science olmak üzere toplamda altı elektronik veri tabanı kullanılarak sistematik bir literatür taraması yapılmıştır. 2000-2022 yılları arasında yapılan tarama sonucunda kanser tanısı almış kişiler için doğrudan anlam yaratmaya ve yaşamda anlam duygusuna odaklanan 14 farklı müdahale programını içeren 20 çalışmaya ulaşılmıştır. Derlemede yer alan araştırmaların örneklemini çoğunlukla kadın, orta yaş ve üzeri olan ve ileri evre kanser tanısı alan kişiler oluşturmuştur. Meme ve akciğer kanseri bu derlemedeki araştırmalarda en çok yer alan kanser türüdür. Derlemeye dâhil edilen çalışmaların çoğunluğunun kuramsal olarak Frankl’ın çalışmalarından etkilendiği ve psikoterapide varoluşsal yaklaşımı benimsedikleri görülmektedir. Anlam odaklı müdahale programlarının etkileri değerlendirildiğinde ise yapılan müdahalelerin anlam duygusunu, yaşam kalitesini ve spiritüel iyi oluş düzeylerini iyileştirmede büyük oranda etkili olduğu görülmektedir. Ayrıca anksiyete, depresyon, duygusal sıkıntı, iyimserlik ve umutsuzluk düzeyleri üzerinde görece olumlu etkileri olduğu düşünülmektedir. Bu kapsamda anlam odaklı müdahalelerinin kanser tanısı almış kişilerin hem anlam ve varoluşla ilgili sorularını hem de duygusal sıkıntılarını ele almada umut verici bir yaklaşım olduğu görülmektedir. Diğer taraftan anlam odaklı müdahalelere ilişkin daha kapsamlı çıkarımlar yapabilmek için daha titiz bir araştırma metodolojisi kullanan yeni çalışmalara ihtiyaç vardır.
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25
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Davari S, Boogar IR, Talepasand S, Evazi MR. The Effect of Religious-Spiritual Psychotherapy on Illness Perception and Inner Strength among Patients with Breast Cancer in Iran. JOURNAL OF RELIGION AND HEALTH 2022; 61:4302-4319. [PMID: 35690697 DOI: 10.1007/s10943-022-01594-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
Women diagnosed with breast cancer often suffer from illness-related issues, which negatively impact their illness perception and inner strength following diagnosis and/or during treatment. An investigation of the effectiveness of religious-spiritual psychotherapy based on the Twelver Shia Sects of Islam (RSP-TSS) was conducted among hospitalized cancer patients to determine whether it improved their disease perception and inner strength. Forty-five women (ages 31-58) diagnosed with breast cancer in Iran were randomly assigned to RSP-TSS (n = 15), attention control (n = 15) and untreated control groups (n = 15). To meet the needs of hospitalized participants, the manualized RSP-TSS protocol was adapted to consist of ten sessions, each lasting 90 min. Sessions were conducted once weekly for 10 weeks. Primary outcome measures were the Revised Illness Perception Questionnaire (IPQ-R) and the Inner Strength Questionnaire (ISQ). Data were collected in pre-intervention, post-intervention, and 4 months following the intervention. Repeated MANOVA measures showed that, as compared with the attention control and untreated control groups, the RSP-TSS group achieved significant improvements in illness perception and inner strengths, and those gains were maintained during the 4-month follow-up. By reframing illness perception and building inner strength, spiritual and religious-based interventions may improve patients coping with cancer and improve the quality of life for women hospitalized with breast cancer. These promising results warrant further investigation into the efficacy of spiritual and religious-based interventions to remediate illness perception and inner strength problems in women diagnosed with serious medical illnesses.
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Affiliation(s)
- Safoora Davari
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, 356411156, Mahdishahr, Semnan, Iran
| | - Isaac Rahimian Boogar
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, 356411156, Mahdishahr, Semnan, Iran.
| | - Siavash Talepasand
- Department of Educational Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran
| | - Mohamad Reza Evazi
- Department of Internal Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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26
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Marmarosh CL, Sandage S, Wade N, Captari LE, Crabtree S. New horizons in group psychotherapy research and practice from third wave positive psychology: a practice-friendly review. RESEARCH IN PSYCHOTHERAPY (MILANO) 2022; 25:643. [PMID: 36373391 PMCID: PMC9893048 DOI: 10.4081/ripppo.2022.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/19/2022] [Indexed: 11/09/2022]
Abstract
Group psychotherapy has been shown to be equivalent to individual therapy for many disorders, including anxiety, depression, grief, eating disorders, and schizophrenia (Burlingame & Strauss, 2021). In addition to effectiveness in reducing symptoms, group offers members a sense of belonging, purpose, hope, altruism, and meaning throughout treatment (Yalom & Leszcz, 2020). These additional outcomes are especially important considering the COVID-19 pandemic and national/international conflicts, given the trauma, disruptions, and losses people have experienced. Applying recent developments in positive psychology to group therapy can enhance treatment. A practice-friendly review examined recent advances in the positive psychology literature, demonstrating how group therapy offers members unique growth opportunities in addition to reducing symptoms. Key findings from studies applying positive psychological constructs to group therapy outcomes are synthesized. Our review sheds light on the relevance of third wave positive psychology to enrich group therapy (Lomas et al., 2021). Specifically, group therapy can facilitate the development of vitalizing psychological virtues, and these can be used to assess treatment outcome: humanity, wisdom, transcendence, courage, temperance, and justice. Interrelatedly, we present support for including attachment theory and mentalization within a positive psychological group framework. Implications are explored for group therapy research, clinical work, and training.
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Affiliation(s)
- Cheri L. Marmarosh
- Divine Mercy University, Sterling, VA, USA,Director of the Center for the International Study of Spirituality and Mental Health, Divine Mercy University, 4554 Underwood Lane, Sterling, VA 20166, USA. ;
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27
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Otto AK, Ketcher D, Reblin M, Terrill AL. Positive Psychology Approaches to Interventions for Cancer Dyads: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13561. [PMID: 36294142 PMCID: PMC9602591 DOI: 10.3390/ijerph192013561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Positive psychology approaches (PPAs) to interventions focus on developing positive cognitions, emotions, and behavior. Benefits of these interventions may be compounded when delivered to interdependent dyads. However, dyadic interventions involving PPAs are relatively new in the cancer context. This scoping review aimed to provide an overview of the available research evidence for use of dyadic PPA-based interventions in cancer and identify gaps in this literature. METHODS Following PRISMA guidelines, we conducted a scoping review of intervention studies that included PPAs delivered to both members of an adult dyad including a cancer patient and support person (e.g., family caregiver, intimate partner). RESULTS Forty-eight studies, including 39 primary analyses and 28 unique interventions, were included. Most often (53.8%), the support person in the dyad was broadly defined as a "caregiver"; the most frequent specifically-defined role was spouse (41.0%). PPAs (e.g., meaning making) were often paired with other intervention components (e.g., education). Outcomes were mostly individual well-being or dyadic coping/adjustment. CONCLUSIONS Wide variability exists in PPA type/function and their targeted outcomes. More work is needed to refine the definition/terminology and understand specific mechanisms of positive psychology approaches.
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Affiliation(s)
- Amy K. Otto
- University of Minnesota Medical School, Duluth Campus, Duluth, MN 55812, USA
| | - Dana Ketcher
- University of Minnesota Medical School, Duluth Campus, Duluth, MN 55812, USA
| | - Maija Reblin
- College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Alexandra L. Terrill
- Department of Occupational & Recreational Therapies, University of Utah, Salt Lake City, UT 84112, USA
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28
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Nicklas L, Albiston M, Dunbar M, Gillies A, Hislop J, Moffat H, Thomson J. A systematic review of economic analyses of psychological interventions and therapies in health-related settings. BMC Health Serv Res 2022; 22:1131. [PMID: 36071425 PMCID: PMC9450839 DOI: 10.1186/s12913-022-08158-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background This review aims to synthesise evidence on the economic impact of psychological interventions and therapies when applied to a broad range of physical health conditions. Methods The following bibliographic databases were searched for relevant articles: MEDLINE (Ovid), EMBASE (Ovid) and PsycINFO (Ebsco). As this review was intended to update an earlier review, the date range for the search was restricted to between January 2012 and September 2018. Reference lists from the review articles were also searched for relevant articles. Study quality was evaluated using the Scottish Intercollegiate Network Guidelines (SIGN) appraisal checklists for both economic studies and Randomised Controlled Trials (RCTs). When the economic analyses did not provide sufficient detail for quality evaluation, the original RCT papers were sought and these were also evaluated. Half of the papers were quality rated by a second author. Initial agreement was high and all disagreements were resolved by discussion. Results This yielded 1408 unique articles, reduced to 134 following screening of the title and abstract. The full texts of the remaining articles were reviewed by at least one team member and all exclusions were discussed and agreed by the team. This left 46 original research articles, alongside five systematic reviews. Fifty-seven per cent of the articles were deemed to be of high quality, with the remainder of acceptable quality. Fifteen different medical conditions were covered, with chronic pain (10 articles) and cancer (9 articles) being the two most investigated health conditions. Three quarters of the papers reviewed showed evidence for the cost-effectiveness of psychological interventions in physical health, with the clearest evidence being in the field of chronic pain and cancer. Conclusions This paper provides a comprehensive integration of the research on the cost-effectiveness of psychological therapies in physical health. Whilst the evidence for cost-effectiveness in chronic pain and cancer is encouraging, some health conditions require further study. Clearly, as the primary research is international, and was therefore conducted across varying health care systems, caution must be exercised when applying the results to counties outside of those covered. Despite this, the results are of potential relevance to service providers and funders. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08158-0.
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Affiliation(s)
- Leeanne Nicklas
- NHS Education for Scotland, 2 Central Quay, Glasgow, Scotland, UK.
| | - Mairi Albiston
- NHS Education for Scotland, 2 Central Quay, Glasgow, Scotland, UK
| | - Martin Dunbar
- Stobhill Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Alan Gillies
- NHS Education for Scotland, 2 Central Quay, Glasgow, Scotland, UK
| | | | - Helen Moffat
- NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK
| | - Judy Thomson
- NHS Education for Scotland, 2 Central Quay, Glasgow, Scotland, UK
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29
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Pashak TJ, Nelson OM, Tunstull MD, Vanderstelt BH, Nichols DP, Hitt JM. Embrace subjectivity: existentially-informed clinical psychological science, practice, and teaching. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2108695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Travis J. Pashak
- Department of Psychology, Saginaw Valley State University, University Center, MI, USA
| | - Olivia M. Nelson
- Department of Psychology, Saginaw Valley State University, University Center, MI, USA
| | - Makiya D. Tunstull
- Department of Psychology, Saginaw Valley State University, University Center, MI, USA
| | | | - David P. Nichols
- Department of Philosophy, Saginaw Valley State University, University Center, MI, USA
| | - James M. Hitt
- Department of Philosophy, Saginaw Valley State University, University Center, MI, USA
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30
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Li L, Wang L, Duan Y, Xiao P, Zhou Y, Luo X, Liu X, Xie J, Cheng ASK. Intelligent physical activity versus modified behavioral activation in adolescent and young adult cancer patients with psychological distress: A randomized, controlled pilot trial. Cancer Med 2022; 12:1935-1948. [PMID: 35848716 PMCID: PMC9883549 DOI: 10.1002/cam4.5030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND More than 80% of adolescent and young adult cancer patients (AYACPs) experienced psychological distress. Physical activity and behavioral activation are effective to relieve the psychological distress in AYACPs. METHODS Participants aged 15-39 years diagnosed with malignant tumors were included. A total of 143 eligible AYACPs were randomly assigned to three groups. The treatment-as-usual group (N = 48) received routine care, the physical activity group (N = 47) received 8 weeks of physical activity program based on intelligent wearable devices, and the behavioral activation group (N = 48) received an internet-based modified behavioral activation program for 8 weeks. Objective outcome measures included salivary cortisol and testosterone. RESULTS Linear mixed-model analyses showed significant differences between treatment-as-usual, physical activity and behavioral activation in salivary cortisol, as well as total scores on depression and anxiety, physical activity, self-efficacy, and social support. Significantly stronger effect sizes for physical activity group compared with behavioral activation group were found on physical activity (d = 0.53) (1 week after intervention), moderate activity (d = 0.61), and walking activity (d = 0.57) (3-month follow-up). CONCLUSIONS Intelligent, wearable, device-based physical activity program is more effective in alleviating anxiety and depression, reducing saliva cortisol, and improving physical activity in AYACPs than internet-based modified behavioral activation program. Intelligent, wearable, device-based physical activity program can reduce the time cost of AYACPs to ensure that the intervention is carried out.
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Affiliation(s)
- Lijun Li
- The Third Xiangya Hospital of Central South UniversityChangshaChina,Xiangya Nursing School of Central South UniversityChangshaChina
| | - Lu Wang
- Xiangya Nursing School of Central South UniversityChangshaChina
| | - Yinglong Duan
- The Third Xiangya Hospital of Central South UniversityChangshaChina
| | - Panpan Xiao
- Xiangya Nursing School of Central South UniversityChangshaChina
| | - Yi Zhou
- Xiangya Nursing School of Central South UniversityChangshaChina
| | - Xiaofei Luo
- Xiangya Nursing School of Central South UniversityChangshaChina
| | | | - Jianfei Xie
- The Third Xiangya Hospital of Central South UniversityChangshaChina
| | - Andy S. K. Cheng
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHong KongChina
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Ahmad T, Ornos EDB, Ahmad S, Al-Wassia RK, Mushtaque I, Shah SM, Al-Omari B, Baig M, Tang K. Global Research Mapping of Psycho-Oncology Between 1980 and 2021: A Bibliometric Analysis. Front Psychol 2022; 13:947669. [PMID: 35910981 PMCID: PMC9326365 DOI: 10.3389/fpsyg.2022.947669] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 01/15/2023] Open
Abstract
Background and Aim Psycho-oncology is a cross-disciplinary and collaborative sub-specialty of oncology that focuses on the psychological, behavioral, ethical, and social aspects of cancer in clinical settings. The aim of this bibliometric study was to analyze and characterize the research productivity and trends in psycho-oncology between 1980 and 2021. Methodology In May 2022, the Scopus® database was searched for psycho-oncology-related publications using predetermined search keywords with specific restrictions. Lotka’s law was applied to check the authors’ productivity, while Bradford’s law was used to assess the core journals in this field. The data was analyzed for different bibliometric indicators in the Biblioshiny package, an RStudio tool for bibliometric analysis. Results The initial search resulted in a total of 2,906 publications. Of which, 1,832 publications were included in the final analysis, published between 1980 and 2021. The analyzed publications were written by 7,363 authors from 74 countries and published in 490 journals. There has been a significant increase in psycho-oncology-related publications after 2010. The most productive year was 2021 (n = 365). The annual scientific growth rate was found to be 13.9%. The most relevant leading author in terms of publications was Luigi Grassi from the University of Ferrara, Italy (n = 42). Lotka’s law found that the number of authors declined as the number of papers written increased. The core journals were Psycho-Oncology, Supportive Care in Cancer, and Journal of Psychosocial Oncology. The most frequently used author’s keywords other than searching keywords were cancer, oncology, quality of life, depression, and anxiety. Recent psycho-oncology-related topics included mental health, COVID-19 infection in humans, people, pandemic, and tumor. The University of Sydney was the top-ranked institution. The leading country in terms of publications, citations, corresponding author country, and international collaboration was the United States of America (United States). The United States had the strongest collaboration with Australia and Canada. Conclusion The research hotspots include mental health conditions and interventions in cancer patients. We identified international collaboration and research expenditure to be strongly associated with psycho-oncology research productivity. Researchers’ collaboration, which is visible among developed countries, should be extended to low-income countries in order to expand psycho-oncology-related research and understanding.
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Affiliation(s)
- Tauseef Ahmad
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- *Correspondence: Tauseef Ahmad, ; ; orcid.org/0000-0001-8793-273X
| | - Eric David B. Ornos
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Shabir Ahmad
- Department of Agriculture, Bacha Khan University Charsadda, Charsadda, Pakistan
| | - Rolina Kamal Al-Wassia
- Department of Radiology, Radiation Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Iqra Mushtaque
- Department of Psychology, Bahauddin Zakariya University, Multan, Pakistan
| | - S. Mudasser Shah
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Basem Al-Omari
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- KU Research and Data Intelligence Support Center (RDISC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Basem Al-Omari,
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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32
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Yu Y, Chotipanvithayakul R, Wichaidit W, Cai W. Effects of Character Strength-Based Intervention vs Group Counseling on Post-Traumatic Growth, Well-Being, and Depression Among University Students During the COVID-19 Pandemic in Guangdong, China: A Non-Inferiority Trial. Psychol Res Behav Manag 2022; 15:1517-1529. [PMID: 35734195 PMCID: PMC9208671 DOI: 10.2147/prbm.s359073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study assessed the effects of character strengths-based invention (CSI) vs group counseling (GC) on mental health outcomes (ie, post-traumatic growth, well-being, and depression) among university students in Guangdong Province, China. Materials and Methods We conducted a randomized non-inferiority trial among 124 undergraduates at a medical university during the COVID-19 pandemic. We randomly allocated students to receive either CSI (n=62) or GC (n=62). A qualified psychologist delivered both activities on campus during two consecutive weekends with a total of 7.5 hours and also gave assignments to students during weekdays. We measured the outcomes at pre-intervention, post-intervention, and 1-month follow-up. We then analyzed data using descriptive statistics and a general linear mixed model. Results CSI and GC groups had similar baseline characteristics. Both CSI and GC experienced an increase in post-traumatic growth and well-being. The mean±SD scores for post-traumatic growth were significantly higher in CSI compared to GC groups (87.70±14.22 vs 78.15±20.72, respectively), whereas well-being scores were similar between CSI and GC (82.58±16.57 vs 83.68±15.59, respectively). Neither CSI nor GC experienced a reduction in depression scores. Conclusion CSI had non-inferior effects compared to GC with regards to improvement of post-traumatic growth and well-being during the COVID-19 pandemic. However, caveats regarding lack of blinding of investigator and limited generalizability should be considered in the interpretation of the study findings.
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Affiliation(s)
- Yulan Yu
- Department of Psychology/ Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, People's Republic of China.,Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Rassamee Chotipanvithayakul
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.,Research Center for Child and Youth Development, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Wit Wichaidit
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Wei Cai
- Department of Psychology/ Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, People's Republic of China
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Blessin M, Lehmann S, Kunzler AM, van Dick R, Lieb K. Resilience Interventions Conducted in Western and Eastern Countries-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6913. [PMID: 35682495 PMCID: PMC9180776 DOI: 10.3390/ijerph19116913] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/26/2022]
Abstract
Previous research has demonstrated the efficacy of psychological interventions to foster resilience. However, little is known about whether the cultural context in which resilience interventions are implemented affects their efficacy on mental health. Studies performed in Western (k = 175) and Eastern countries (k = 46) regarding different aspects of interventions (setting, mode of delivery, target population, underlying theoretical approach, duration, control group design) and their efficacy on resilience, anxiety, depressive symptoms, quality of life, perceived stress, and social support were compared. Interventions in Eastern countries were longer in duration and tended to be more often conducted in group settings with a focus on family caregivers. We found evidence for larger effect sizes of resilience interventions in Eastern countries for improving resilience (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI] 0.28 to 0.67; p < 0.0001; 43 studies; 6248 participants; I2 = 97.4%). Intercultural differences should receive more attention in resilience intervention research. Future studies could directly compare interventions in different cultural contexts to explain possible underlying causes for differences in their efficacy on mental health outcomes.
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Affiliation(s)
- Manpreet Blessin
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Sophie Lehmann
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Angela M. Kunzler
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
| | - Rolf van Dick
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, 55131 Mainz, Germany
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Carreno DF, Eisenbeck N. Existential Insights in Cancer: Meaning in Life Adaptability. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:461. [PMID: 35454300 PMCID: PMC9029503 DOI: 10.3390/medicina58040461] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022]
Abstract
Previous research demonstrated that the cancer diagnosis and treatment evoke existential concerns, especially ones related to meaning in life and meaning-making processes. The cancer experience is a vital challenge that often entails changes in what is personally important in life. Firstly, this paper collects evidence supporting that meaning adaptability, the way people adapt their meaning in life to the cancer experience, is a central element in the mental health of cancer patients. Various theories that could account for this meaning adaptability are introduced. Secondly, the paper provides a compilation of studies showing how people change what is significant in their lives within the course of cancer. Finally, the paper presents the available psychological therapies directed to facilitate meaning adaptability in this population. Meaning-centered interventions have been demonstrated to be effective in alleviating the suffering related to the cancer experience and promoting personal growth.
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Affiliation(s)
- David F. Carreno
- Department of Psychology, University of Almería, 04120 Almeria, Spain;
| | - Nikolett Eisenbeck
- Department of Personality, Evaluation and Psychological Treatment, University of Seville, 14004 Seville, Spain
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Jewett PI, Vogel RI, Galchutt P, Everson-Rose SA, Teoh D, Radomski M, Blaes AH. Associations between a sense of connection and existential and psychosocial outcomes in gynecologic and breast cancer survivors. Support Care Cancer 2022; 30:3329-3336. [PMID: 34985561 PMCID: PMC8727470 DOI: 10.1007/s00520-021-06784-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/22/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND A cancer diagnosis may lead to existential despair but potentially also to perceived inner growth. This growth may be fostered through meaningful connections with others. We sought to describe existential and related psychosocial outcomes and their association with a sense of connection with others in individuals with gynecological and breast cancers. METHODS We used cross-sectional data from two ongoing cohort studies of gynecologic (N = 236) and breast (N = 62) cancer survivors at the University of Minnesota. We summarized self-reported post-traumatic growth (PTG), sense of meaning, peace, spirituality, hopelessness, loneliness, and three exploratory measures of sense of connections with others, and used multivariate linear regression models to describe the associations between them. RESULTS Hope, sense of meaning, peace, and spirituality were generally high among participants, but PTG and loneliness scores varied more. Sense of connection with others was consistently associated with greater PTG and decreased loneliness with medium effect sizes: for example having positive interactions with most/all versus nobody on one's medical team, PTG (coefficient 10.49, 95% CI: 4.10, 16.87, Cohen's D 0.44); loneliness (coefficient - 0.85, 95% CI: - 1.36, - 0.34, Cohen's D 0.43). Those who knew someone in a similar life situation felt a strong sense of connection with such a person; however, 28% of participants had not met anyone in a similar situation. CONCLUSIONS There may be untapped opportunities to nurture beneficial existential outcomes in cancer survivors. Potential interventions include connecting survivors with one another and creating opportunities for more authentic patient-provider relationships, for example, within palliative care.
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Affiliation(s)
- Patricia I Jewett
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, 420 Delaware Street SE MMC 480, Minneapolis, MN, 55455, USA.
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Paul Galchutt
- Spiritual Health Services, M Health Fairview, Minneapolis, MN, USA
| | - Susan A Everson-Rose
- Department of Medicine, Division of General Internal Medicine, and Program in Health Disparities Research, University of Minnesota, Minneapolis, MN, USA
| | - Deanna Teoh
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Mary Radomski
- Courage Kenny Research, Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN, USA
| | - Anne H Blaes
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, 420 Delaware Street SE MMC 480, Minneapolis, MN, 55455, USA
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Marco JH, Llombart P, Guillén V, Baños RM, Romero R, Garcia-Conde A, Pérez Rodríguez S. Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial. Front Psychiatry 2022; 13:892573. [PMID: 35873227 PMCID: PMC9301386 DOI: 10.3389/fpsyt.2022.892573] [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: 03/09/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Meaning-Centered Psychotherapy (MCP) is effective in improving meaning in life, hope, optimism, self-efficacy, well-being, and quality of life, and in reducing stress in people with cancer. However, all the studies on the application of MCP in cancer patients have been carried out in Anglo-Saxon samples. Therefore, it is necessary to adapt and verify the efficacy of MCP in populations that speak languages other than English, such as Spanish. Moreover, to expand the data supporting the efficacy of MCP for cancer patients, it would be necessary to compare MCP to other active therapies such as Cognitive Behavioral Therapy (CBT). METHODS The aims of the proposed study are: the first objective is to verify the efficacy of the MCP intervention for Spanish participants with cancer in a randomized control trial (RCT) comparing it to CBT. The second objective is to analyze the feasibility and acceptance of MCP in Spanish participants with cancer. The third objective is to analyze whether the changes produced in the meaning in life dimensions (presence, search, comprehension, purpose, and mattering) will predict changes in anxiety, depression, quality of life, etc. Our research team adapted MCP for Spanish participants with cancer. This paper presents the study protocol. The study design consists of a two-arm RCT with two conditions: MCP and CBT, where participants will be randomized to one of the two groups. Eligible participants will be adults with stage I, II, and III cancer who were treated with curative intent and had completed their main medical treatment (surgery, radiotherapy, or chemotherapy). Participants will be assessed at pretreatment, post-treatment, and 6-month follow-up. The intention-to-treat principle will be used when analyzing data, using mixed-effects models with full information and maximum likelihood estimation. DISCUSSION This study will provide results that confirm the efficacy of the MCP in Spanish participants with cancer. TRIAL REGISTRATION ClinicalTrials.gov; https://register.clinicaltrials.gov/prs/app/template/Home.vm?uid=U0005WS9&ts=4&sid=S000BOTT&cx=bvr2ue, identifier NCT05197348.
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Affiliation(s)
- Jose Heliodoro Marco
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Pilar Llombart
- School of Doctorate, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.,Department of Psychology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Verónica Guillén
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Rosa M Baños
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Rocio Romero
- Department of Psychology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Ana Garcia-Conde
- Department of Psychology, Instituto Valenciano de Oncologia, Valencia, Spain.,Department of Personality, Assessment, and Therapeutic Interventions, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Sandra Pérez Rodríguez
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain
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The Psychological Adaptation Process in Chinese Parent Caregivers of Pediatric Leukemia Patients: A Qualitative Analysis. Cancer Nurs 2021; 45:E835-E842. [PMID: 34966062 DOI: 10.1097/ncc.0000000000001034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Psychological stresses caused by caring for pediatric leukemia patients can affect their parent caregivers' health. How these stressors are successfully managed determines how well these caregivers adapt to the illness situation over time. Previous studies suggest that caregivers will adapt gradually to the adverse consequences of caring for their child with a long-term illness. However, studies of the psychological adaptation process of family caregivers of children with leukemia are limited. OBJECTIVE The aim of this study was to study the psychological adaptation process of the parent caregivers of pediatric leukemia patients. METHODS In this qualitative study, we interviewed 32 caregivers of children with leukemia in China. Data were collected through semistructured interviews and analyzed using the content analysis method. RESULTS The psychological adaptation process in caregivers of pediatric leukemia patients seems to involve 5 stages: initial devastation, accumulation of hope, fluctuation in feelings, integration, and psychological adaptation. Significant emotional changes were observed at each stage. CONCLUSIONS This study identified commonalities in the psychological adaptation process experienced by caregivers of children with leukemia in the Chinese social and cultural context. It also characterized the different emotions that the caregivers had in the 5 stages of adaptation. In addition, our research identified the possible psychological interventions at different stages. IMPLICATIONS FOR PRACTICE The study described the adaptation process of Chinese parents of children with leukemia. The findings of this study will help nurses identify main coping resources, controllable intervention factors, and the timing of intervention for these caregivers of children with leukemia.
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Nilsen M, Stalsberg R, Sand K, Haugan G, Reidunsdatter RJ. Meaning Making for Psychological Adjustment and Quality of Life in Older Long-Term Breast Cancer Survivors. Front Psychol 2021; 12:734198. [PMID: 34650491 PMCID: PMC8510631 DOI: 10.3389/fpsyg.2021.734198] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/02/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives: This study aims to explore in depth the meaning and meaning discrepancies among older Norwegian breast cancer survivors in light of the meaning making model by Park (2013). Design: We utilized a qualitative design collecting data using semi-structured interviews of 23 elderly breast cancer survivors 7–8 years after treatment. The interviews followed an interview guide structured along three main themes: “everyday life activities,” “follow-up-care experiences” and “health status and QoL.” Results: Several health problems were reported by the women in the aftermaths of the disease, such as sleeping problems, pain, and fatigue—including cognitive and emotional impairments. Meaning discrepancies were concentrated on six main themes: shifting perspectives and priorities, growing sense of autonomy, widening the limits of normality, dissociating oneself from the disease, embracing alternative health services, and feeling lucky. The women engaged in a wide range of coping techniques as efforts to change global meaning, and to develop a more positive view on the cancer experience. Common coping efforts across the six main themes were social comparison, denial, positive reappraisal, problem-focused coping, and revaluing ordinary events. Conclusion: Many cancer patients report on unmet needs for help with their meaning making, and the facilitation of meaning making processes is rarely included in the follow-up care of cancer survivors. The findings of the present study may help health care professionals provide care for women who have experienced breast cancer. The concrete knowledge of common coping efforts in the meaning making process may contribute to the development of future interventions and for gaining a deeper understanding for older survivors of breast cancer.
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Affiliation(s)
- Marianne Nilsen
- Department of Social Work, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ragna Stalsberg
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kari Sand
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | - Gørill Haugan
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Randi Johansen Reidunsdatter
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Dietrich N, Estradé A, Antonio Cruzado J. Efficacy of Meaning-Centered Psychotherapy in adult patients with advanced cancer: A systematic review and meta-analysis. PSICOONCOLOGIA 2021. [DOI: 10.5209/psic.77752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: We conducted a PRISMA-compliant systematic review of clinical trials, and a meta-analysis of randomised clinical trials (RCTs) of manualised Meaning-Centered Psychotherapy (MCP) interventions for adult advanced cancer patients. We searched seven databases for trials published in English and Spanish, until March 27, 2021. Results: Seven trials were included in the systematic review, and four in the meta-analysis. The systematic review favoured the effectiveness of MCP for the improvement of spiritual well-being, quality of life (QoL), sense of meaning and psychological distress, although inconsistencies between the trials were found. In pre-post meta-analytic estimates, MCP had a superior therapeutic effect than control conditions for spiritual well-being (d=0.52, p<0.001), QoL (d=0.60, p<0.001), anxiety symptoms (d=-0.47, p<0.001), depressive symptoms (d=-0.50, p<0.001) and desire for hastened death (d=-0.28, p<0.001). No differences were observed in between-group comparisons. MCP was not associated with an increased risk of abandonment at post-treatment (OR=0.86, p=0.57). Conclusion: Manualised MCP interventions are a promising treatment for the improvement of spiritual well-being and quality of life and the reduction of psychological distress in adult patients with advanced cancer. The evidence base is still in an emerging state and should be expanded by higher methodological quality studies.
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Abstract
PURPOSE OF REVIEW Depression is a prevalent comorbidity in cancer that significantly increases the risk for numerous negative health outcomes. This review updates the current evidence base for management of depression in cancer, highlighting new research directions based on the inflammatory hypothesis of depression. RECENT FINDINGS Research on pharmacotherapy and psychotherapy for depression in cancer has shown mixed efficacy partly because of methodological issues arising from the phenomenology of depression in cancer. After decades of stagnancy, more recent high-quality clinical trials are beginning to provide an evidence base to guide treatment. Inflammatory cytokine-associated depression is a subtype of depression that may have particular relevance in cancer, opening new avenues to explore therapeutic targets and biobehavioral impacts of interventions, which may improve cancer outcomes. SUMMARY The continuum of severity in cancer-related depression is important to consider in management approaches. Choice of treatment should be personalized to the patient and their symptom profile as there is currently insufficient evidence to recommend any particular medication or psychotherapy over another. Psychological interventions should be considered first line for mild-to-moderate depression, and pharmacological treatment added for more severe depression, which can be optimally delivered within a collaborative care model. VIDEO ABSTRACT http://links.lww.com/YCO/A62.
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Affiliation(s)
- Aliza A Panjwani
- Division of Psychosocial Oncology, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
| | - Madeline Li
- Division of Psychosocial Oncology, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
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Abstract
OBJECTIVE To date, nearly 10,000 World Trade Center (WTC) responders have been diagnosed with at least one type of WTC-related cancer, and over 70 types of cancer have been related to WTC occupational exposure. Due to the observed latency period for malignancies, the WTC Health Program anticipates increases in rates of new cancer diagnoses. Given the growing number of cancer diagnoses in this population, there is an urgent need to develop a novel intervention to address the psychosocial needs of WTC responders with cancer. Meaning-centered psychotherapy (MCP) is a structured psychotherapeutic intervention originally developed to help patients with advanced cancer find and sustain meaning in life despite illness-related limitations. Existential distress and loss of meaning are critical and understudied elements of psychological health that have been widely overlooked among WTC responders with cancer. METHOD We have adapted MCP for WTC responders (MCP-WTC) for the treatment of WTC responders who have been diagnosed with WTC-certified cancers. MCP-WTC aims to target the complex crisis in meaning faced by those responders who responded to the 9/11 attacks and subsequently were diagnosed with cancer as a result of their service. RESULTS We describe the adaptation of MCP-WTC and the application of this intervention to meet the unique needs of those exposed to the terrorist attacks of September 11, 2001 (9/11), participated in the rescue, recovery, and clean-up effort at Ground Zero, and were diagnosed with WTC-related cancer. We highlight the novel aspects of this intervention which have been designed to facilitate meaning-making in the context of the patient's response to 9/11 and subsequent diagnosis of cancer. SIGNIFICANCE OF RESULTS This work provides a rationale for MCP-WTC and the potential for this intervention to improve the quality of life of WTC responders and help these patients navigate life after 9/11 and cancer.
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da Ponte G, Ouakinin S, Santo JE, Ohunakin A, Prata D, Amorim I, Gameiro Z, dos Santos ES, Breitbart W. Meaning-centered group psychotherapy in Portuguese cancer patients: A pilot exploratory trial. Palliat Support Care 2021; 19:464-473. [PMID: 34039464 PMCID: PMC8324537 DOI: 10.1017/s1478951521000602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe the feasibility of a meaning-centered group psychotherapy (MCGP) adaptation in a sample of Portuguese cancer patients. METHOD The study was carried out according to four steps: 1st - Transcultural adaptation and validation (focus groups); 2nd - Preliminary study with MCGP original version (to test its feasibility); 3rd - Adaptation of MCGP original version to a 4-session version (and internal pilot study); and 4th - Pilot exploratory trial (MCGP-4 session version), implemented between January 1, 2018 and December 31, 2019. Inclusion criteria were >18 years, psychological complaints, and difficulty to adapt to cancer. Allocation was according to participants' preference: MCGP vs. care as usual (CAU). Primary outcomes were: MCGP adapted version improved quality of life (QoL) and spiritual well-being; secondary outcomes were improvement of depression, anxiety, and distress. Assessments were done at baseline (T1) and 1 month after (T2), with self-report socio-demographic and clinical questionnaires, Distress Thermometer (DT), McGill Quality of Life Questionnaire (MQOL), Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), Hospital Anxiety and Depression Scale, and its subscales (HADS - HADS-D, HADS-A). RESULTS In the 1st step, and through focus groups, the manual was reformulated and tested. The preliminary study (2nd step) with MCGP original version showed a high number of dropouts which could jeopardize the study and, after reframing the sessions content, MCGP was adapted to a 4-session version, and its feasibility was tested by an internal pilot study (3rd step). The pilot exploratory trial (4th step) had 91 participants. Most socio-demographic and clinical characteristics between the groups (51: MCGP; 40: CAU) had no statistically significant differences. A comparison between the two groups at T2 showed that the MCGP group scored significantly higher in the general (U = 552.00, P < 0.001), and existential (U = 727.50, P = 0.018) domains and total score (U = 717.50, P = 0.015) of QoL, and CAU presented statistical higher levels in DT (U = 608.50, P = 0.001). Comparing the groups between T1 and T2, the MCGP group had a statistically significant improvement in the general (Z = -3.67, P < 0.001) and psychosocial (Z = -2.89, P = 0.004) domains and total score (Z = -2.71, P = 0.007) of QoL, and a statistically significant decrease in DT (Z = -2.40, P = 0.016). In terms of group effects, the MCGP group presented increased general (b = 1.42, P < 0.001, η2p = 0.179), and support (b = 0.80, P = 0.045, η2p = 0.048) domains and total score (b = 0.81, P = 0.013, η2p = 0.073) of QoL (small to elevated dimensions), and decreased levels of depression (b = -1.14, P = 0.044, η2p = 0.048), and distress (b = -1.38, P = 0.001, η2p = 0.127) (small to medium dimensions), compared with CAU. At T2, participants who attended ≥3 sessions (n = 38) had a statistically significant higher score in the general domain (U = 130.50, P = 0.009) of QoL, comparing with those who attended 1 or 2 sessions (n = 13). SIGNIFICANCE OF RESULTS This study supports the benefits of an MCGP adapted version in improving QoL and psychologic well-being. More studies are necessary to address the limitations of this pilot exploratory trial, as its small sample size.
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Affiliation(s)
- Guida da Ponte
- Department of Psychiatry and Mental Health, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal
- Medical School of Lisbon, University of Lisbon, Lisbon, Portugal
| | - Sílvia Ouakinin
- University Clinic of Medical Psychology and Psychiatry, Medical School of Lisbon, University of Lisbon, Lisbon, Portugal
| | | | - Afolabi Ohunakin
- Department of Family Medicine, Ekiti State University Teaching Hospital, Ado-ekiti, Nigeria
| | - Domingos Prata
- Faculty of Economics, University of Algarve, Faro, Portugal
| | | | - Zita Gameiro
- Department of Psychiatry and Mental Health, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal
| | | | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
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43
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Hamilton JB, Fluker WE. An Exploration of Suffering and Spirituality Among Older African American Cancer Patients as Guided by Howard Thurman's Theological Perspective on Spirituality. JOURNAL OF RELIGION AND HEALTH 2021; 60:2810-2829. [PMID: 33682079 DOI: 10.1007/s10943-021-01215-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
The use of the religious experience to mitigate suffering within the context of a cancer diagnosis and treatment is poorly understood. Specifically, in this article, we explore suffering and the religious experience using Howard Thurman's theological perspective. This perspective permits an exploration of the ways in which spirituality enables African American cancer patients to better manage suffering through: (1) a positive self-image as a child of God or the identification with the sufferings of Jesus; (2) seeking harmony in one's environment; (3) the use of spirituality as self-nourishment; and, (4) the perspective of suffering as sacrament. In this paper, we use the narratives of African American cancer patients to argue that these theological perspectives are indeed relevant to the relief of suffering among this population.
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Affiliation(s)
- Jill B Hamilton
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA.
- Candler School of Theology, Emory University, Atlanta, GA, 30322, USA.
| | - Walter E Fluker
- Candler School of Theology, Emory University, Atlanta, GA, 30322, USA
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Ferreira-Valente A, Fontes F, Pais-Ribeiro J, Jensen MP. The Meaning Making Model Applied to Community-Dwelling Adults with Chronic Pain. J Pain Res 2021; 14:2295-2311. [PMID: 34349554 PMCID: PMC8326769 DOI: 10.2147/jpr.s308607] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Chronic pain is a multidimensional experience that is influenced by biological, psychological, social, and spiritual factors. The Meaning Making Model is a recent cognitive behavioral model that has been developed to understand how psychosocial factors influence adjustment to stressful events, such as having a chronic illness. This qualitative study aims to understand the potential utility of this model for understanding the role of meaning making in adjustment to chronic pain. MATERIALS AND METHODS Eighteen community-dwelling adults with chronic low back pain or chronic pain due to osteoarthritis participated in four focus groups. Participants were asked open-ended questions about their pain experience, pain-related beliefs, meaning of pain, and the perceived association between pain and their meaning in life and sense of purpose. Data were submitted to thematic analysis and the identified themes were considered in light of the Meaning Making Model. RESULTS Three overarching themes emerged, each of which included two themes. The first overarching theme - "appraised meaning of pain" - included the themes "causal attributions" and "primary appraisals." The second - "meaning making processes" - included the themes "assimilation" and "accommodation." The third - "meanings made" - included the themes "pain as an opportunity" and "acceptance." CONCLUSION The key themes that emerged as individuals with chronic pain discussed pain and its impact are consistent with those that would be hypothesized as important from the Meaning Making Model, providing preliminary support for the utility of this model in the context of chronic pain. People with chronic pain appear to appraise pain in terms of its cause, controllability, threat, loss, or challenge. When a discrepancy between the appraised meaning of pain and one's global meaning emerged, participants engaged in meaning making processes (accommodation and assimilation), resulting in meanings made, such as a reappraised meaning of pain, perceptions of growth, and acceptance.
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Affiliation(s)
- Alexandra Ferreira-Valente
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Fernando Fontes
- Centre for Social Studies, University of Coimbra, Coimbra, Portugal
| | - José Pais-Ribeiro
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Van Beek FE, Wijnhoven LMA, Holtmaat K, Custers JAE, Prins JB, Verdonck-de Leeuw IM, Jansen F. Psychological problems among cancer patients in relation to healthcare and societal costs: A systematic review. Psychooncology 2021; 30:1801-1835. [PMID: 34228838 PMCID: PMC9291760 DOI: 10.1002/pon.5753] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/27/2021] [Accepted: 06/14/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study systematically reviewed the association of psychological problems among cancer patients with healthcare and societal resource use and costs. METHODS PubMed, PsycINFO, and Embase were searched (until 31 January 2021) for studies on psychological symptoms (anxiety, depression, distress, fear of recurrence) or psychiatric disorders (anxiety, depression, adjustment) and healthcare use (e.g., mental, inpatient healthcare), economic losses by patients and family, economic losses in other sectors (e.g., absence from work), and costs. The search, data extraction, and quality assessment were performed by two authors. RESULTS Of the 4157 identified records, 49 articles were included (psychological symptoms (n = 34), psychiatric disorders (n = 14), both (n = 1)) which focused on healthcare use (n = 36), economic losses by patients and family (n = 5), economic losses in other sectors (n = 8) and/or costs (n = 13). In total, for 12 of the 94 associations strong evidence was found. Psychological symptoms and psychiatric disorders were positively associated with increased healthcare use (mental, primary, inpatient, outpatient healthcare), losses in other sectors (absence from work), and costs (inpatient, outpatient, total healthcare costs). Moderate evidence was found for a positive association between (any) psychiatric disorder and depression disorder with inpatient healthcare and medication use, respectively. CONCLUSIONS Psychological problems in cancer patients are associated with increased healthcare use, healthcare costs and economic losses. Further research is needed on psychological problems in relation to understudied healthcare use or costs categories, productivity losses, and informal care costs.
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Affiliation(s)
- Florie E Van Beek
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lonneke M A Wijnhoven
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Karen Holtmaat
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, VUmc Cancer Center Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, VUmc Cancer Center Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands
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Verdam MGE, van Ballegooijen W, Holtmaat CJM, Knoop H, Lancee J, Oort FJ, Riper H, van Straten A, Verdonck-de Leeuw IM, de Wit M, van der Zweerde T, Sprangers MAG. Re-evaluating randomized clinical trials of psychological interventions: Impact of response shift on the interpretation of trial results. PLoS One 2021; 16:e0252035. [PMID: 34032803 PMCID: PMC8148324 DOI: 10.1371/journal.pone.0252035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/08/2021] [Indexed: 11/28/2022] Open
Abstract
Background Effectiveness of psychological treatment is often assessed using patient-reported health evaluations. However, comparison of such scores over time can be hampered due to a change in the meaning of self-evaluations, called ‘response shift’. Insight into the occurrence of response shift seems especially relevant in the context of psychological interventions, as they often purposefully intend to change patients’ frames of reference. Aims The overall aim is to gain insight into the general relevance of response shift for psychological health intervention research. Specifically, the aim is to re-analyse data of published randomized controlled trials (RCTs) investigating the effectiveness of psychological interventions targeting different health aspects, to assess (1) the occurrence of response shift, (2) the impact of response shift on interpretation of treatment effectiveness, and (3) the predictive role of clinical and background variables for detected response shift. Method We re-analysed data from RCTs on guided internet delivered cognitive behavioural treatment (CBT) for insomnia in the general population with and without elevated depressive symptoms, an RCT on meaning-centred group psychotherapy targeting personal meaning for cancer survivors, and an RCT on internet-based CBT treatment for persons with diabetes with elevated depressive symptoms. Structural equation modelling was used to test the three objectives. Results We found indications of response shift in the intervention groups of all analysed datasets. However, results were mixed, as response shift was also indicated in some of the control groups, albeit to a lesser extent or in opposite direction. Overall, the detected response shifts only marginally impacted trial results. Relations with selected clinical and background variables helped the interpretation of detected effects and their possible mechanisms. Conclusion This study showed that response shift effects can occur as a result of psychological health interventions. Response shift did not influence the overall interpretation of trial results, but provide insight into differential treatment effectiveness for specific symptoms and/or domains that can be clinically meaningful.
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Affiliation(s)
- M. G. E. Verdam
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
- Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, The Netherlands
- * E-mail:
| | - W. van Ballegooijen
- Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - C. J. M. Holtmaat
- Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H. Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Expert Center for Chronic Fatigue, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - J. Lancee
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - F. J. Oort
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - H. Riper
- Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - A. van Straten
- Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - I. M. Verdonck-de Leeuw
- Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M. de Wit
- Mental Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - T. van der Zweerde
- Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M. A. G. Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
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Process of therapeutic changes in Meaning-Centered Group Psychotherapy adapted to the Portuguese language: A narrative analysis. Palliat Support Care 2021; 18:254-262. [PMID: 31957635 DOI: 10.1017/s147895151900110x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim was to understand the processes of therapeutic changes in Meaning-Centered Group Psychotherapy (MCGP) in a Portuguese sample. METHOD Adult cancer patients with distress motivated to participate in MCGP were identified; descriptive and narrative analyses were performed on the session content. RESULTS The sample had 24 participants (mean age: 63.43 years); the majority were females (75%), with a median academic degree (54%). Breast cancer was most frequent (67%) at the localized stage (71%). The narrative analysis defined seven categories according to the MCGP themes. In "Moments with Meaning (MwM)," the most relevant dimensions were related to interpersonal relations, the moment of diagnosis, and personal achievements. This category established relations with almost all other categories, as did the category "historical sources of meaning (SoM)." The category "identity before and after cancer diagnosis" was only related to "attitudinal SoM" and "transitions." Historical SoM had two dimensions, "past" and "present and future" legacies, in which prominent topics related to family, childhood, achieved goals, and values to pass to others explored. Attitudinal SoM established relations only with the category "creative SoM," in which "courage" and "responsibility" were the main dimensions, which were also related to "MwM," "historical," and "attitudinal SoM." Experiential SoM, with the main dimension "love," was related to "MwM" and "historical SoM." Transitions only established relations with "historical SoM" and "identity before and after cancer." SIGNIFICANCE OF RESULTS The findings that "MwM" and "historical SoM" were the categories which established a solid pattern of relations suggest that these are the main psychotherapy topics that can have more influence for the participants; one explanation is that these categories imply a concrete way of thinking, which is easier to understand. This process of therapeutic changes must be integrated in a cultural context, as it is well known to have an impact upon the "meaning" of life.
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Abstract
OBJECTIVE Increasing meaning in life (MiL) among people experiencing disease or adversity may improve coping and resilience. The purpose of this review is to characterize the effects of MiL interventions. DATA SOURCE A systematic search of PubMed, PsycInfo, and Google Scholar was conducted encompassing the following parameters: meaning in life, purpose in life, or sense of purpose with randomized controlled trials. STUDY INCLUSION & EXCLUSION CRITERIA Randomized controlled trials (RCTs) of interventions with at least one outcome that measured improvement in MiL and were published in English between January 2000 and January 2020. DATA EXTRACTION & SYNTHESIS 33 randomized controlled trials (k = 35) were identified. Data were coded by authors and a research assistant for intervention type, control group type, and risk of bias. The random effects model of Review Manager 5.3 was used to produce SMD and evaluate heterogeneity. RESULTS The effect size for studies with a passive control group was SMD = 0.85 (95% CI 0.54 to 1.17) and for studies with an active control group was SMD = .032 (95% CI 0.09 to 0.55). Mindfulness programs produced the largest effect size (1.57) compared to passive controls, while narrative programs produced the largest effect relative to active controls (0.61). There was considerable heterogeneity in most estimates. CONCLUSION Several interventions increase MiL, including some that are relatively brief and do not require licensed professionals.
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Affiliation(s)
- Nicholas Manco
- 129532Yale Child Study Center, Yale University, New Haven, CT, USA
| | - Sherry Hamby
- Department of Psychology, 7303University of the South, Sewanee, TN, USA
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Nair D, Bonnet K, Wild MG, Umeukeje EM, Fissell RB, Faulkner ML, Bahri NS, Bruce MA, Schlundt DG, Wallston KA, Cavanaugh KL. Psychological Adaptation to Serious Illness: A Qualitative Study of Culturally Diverse Patients With Advanced Chronic Kidney Disease. J Pain Symptom Manage 2021; 61:32-41.e2. [PMID: 32711122 PMCID: PMC7770006 DOI: 10.1016/j.jpainsymman.2020.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 12/27/2022]
Abstract
CONTEXT Psychological distress is associated with adverse health outcomes in serious illness and magnified among patients of low socioeconomic status. Aspects of one's culture, such as religion and spirituality, can influence these patients' coping response to distress. Advanced chronic kidney disease (CKD) is a serious illness that disproportionately affects patients of low socioeconomic status, but a theory-based understanding of this group's lived experience of CKD is lacking. OBJECTIVES We explored the cognitions, emotions, and coping behaviors of patients with CKD with emphasis on those of low socioeconomic status. We further inquired into any influences of religion or spirituality. METHODS We interviewed 50 English-speaking or Spanish-speaking adults with advanced CKD from three medical centers in Nashville, Tennessee. Analyses occurred with isolation of themes; development of a coding system; and creation of a conceptual framework using an inductive-deductive approach. RESULTS Median age was 65 years; median annual income was $17,500 per year; and 48% of participants had not progressed beyond high school. Key beliefs (awareness of mortality and lack of control) influenced patients' emotions (existential distress in the form of death anxiety, prognostic uncertainty, and hopelessness) and coping behaviors (acceptance, avoidance, emotion regulation via spirituality, and seeking socialsupport via a religious community). CONCLUSION Individuals with advanced CKD and low socioeconomic status lack control over disease progression, experience death anxiety and existential distress, and emphasize spirituality to cope. Our study identifies novel components for a psychotherapeutic intervention for patients with advanced CKD at high risk for adverse health outcomes.
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Affiliation(s)
- Devika Nair
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA.
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Marcus G Wild
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Ebele M Umeukeje
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA
| | - Rachel B Fissell
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA
| | | | - Nader S Bahri
- Division of Nephrology, Meharry Medical College, Nashville, Tennessee, USA
| | - Marino A Bruce
- Program for Research on Faith, Justice, and Health, Department of Population Health, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA; Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David G Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Kenneth A Wallston
- Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kerri L Cavanaugh
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA; Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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