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Mansouri A, Javedani M, Rezazadeh Yazd SA, Nikandish M, Khataei A, Atrian A, Moradi F, Moghbeli N, Seifi Z. The Efficacy of Cognitive-Behavioral Group Therapy on Depression, Anxiety, and Pain-Coping Strategies in Women With Breast Cancer. J Nerv Ment Dis 2023; 211:835-840. [PMID: 37734162 DOI: 10.1097/nmd.0000000000001713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
ABSTRACT Cognitive-behavioral group therapy is one of the most effective forms of intervention in therapy for women with breast cancer. The present study aimed to investigate the efficacy of cognitive-behavioral group therapy on depression, anxiety, and pain-coping strategies in women with breast cancer. The present study is a semiexperimental research with a pretest-posttest with the control group. For this purpose, 50 people of women with breast cancer were admitted to the medical university hospitals of Tehran to method purposive sampling and were randomly selected as experimental ( n = 25) and control ( n = 25) groups. The results showed that cognitive-behavioral group therapy significantly reduces depression and anxiety and increases the use of pain-coping strategies in women with breast cancer. Also in the field of pain-coping strategies between the experimental and control groups, there is a significant difference.
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Affiliation(s)
- Aylar Mansouri
- Department of Psychology, Johannes Kepler University Linz, Social and Economic Science, Linz, Austria
| | - Mohammadreza Javedani
- Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | | | | | - Alireza Khataei
- Department of Psychology, Faculty of Humanities, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Alireza Atrian
- Department of Psychology, Isfahan University, Isfahan, Iran
| | - Fateme Moradi
- Department of General, School of Paramedical Sciences Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nina Moghbeli
- Department of Psychology, Payame Noor University, Tehran, Iran
| | - Zahra Seifi
- Department of Psychology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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2
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Paley CA, Boland JW, Santarelli M, Murtagh FEM, Ziegler L, Chapman EJ. Non-pharmacological interventions to manage psychological distress in patients living with cancer: a systematic review. BMC Palliat Care 2023; 22:88. [PMID: 37407974 DOI: 10.1186/s12904-023-01202-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Psychological distress is common in patients with cancer; interfering with physical and psychological wellbeing, and hindering management of physical symptoms. Our aim was to systematically review published evidence on non-pharmacological interventions for cancer-related psychological distress, at all stages of the disease. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered on PROSPERO (CRD42022311729). Searches were made using eight online databases to identify studies meeting our inclusion criteria. Data were collected on outcome measures, modes of delivery, resources and evidence of efficacy. A meta-analysis was planned if data allowed. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS Fifty-nine studies with 17,628 participants were included. One third of studies included mindfulness, talking or group therapies. Half of all studies reported statistically significant improvements in distress. Statistically significant intervention effects on distress were most prevalent for mindfulness techniques. Four of these mindfulness studies had moderate effect sizes (d = -0.71[95% CI: -1.04, -0.37] p < 0.001) (d = -0.60 [95% CI: -3.44, -0.89] p < 0.001) (d = -0.77 [CI: -0.146, -1.954] p < 0.01) (d = -0.69 [CI: -0.18, -1.19] p = 0.008) and one had a large effect size (d = -1.03 [95% CI: -1.51, -0.54] p < 0.001). Heterogeneity of studies precluded meta-analysis. Study quality was variable and some had a high risk of bias. CONCLUSIONS The majority of studies using a mindfulness intervention in this review are efficacious at alleviating distress. Mindfulness-including brief, self-administered interventions-merits further investigation, using adequately powered, high-quality studies. SYSTEMATIC REVIEW REGISTRATION This systematic review is registered on PROSPERO, number CRD42022311729.
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Affiliation(s)
- Carole A Paley
- University of Leeds, Academic Unit of Palliative Care, Leeds, UK.
| | - Jason W Boland
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Martina Santarelli
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Fliss E M Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Lucy Ziegler
- University of Leeds, Academic Unit of Palliative Care, Leeds, UK
| | - Emma J Chapman
- University of Leeds, Academic Unit of Palliative Care, Leeds, UK
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Jones MK, Davis SM, Gaskin-Cole G. An Integrative Review of Sistah Circles in Empirical Research. PSYCHOLOGY OF WOMEN QUARTERLY 2023. [DOI: 10.1177/03616843231154564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Sistah circles are spaces shared by Black women who share similar goals, exchange resources (e.g., support), and invest in developing strong relational bonds over time. Considering the significance of sistah circles for Black women's wellness and survival, in this study we examined how this phenomenon has been researched in the social sciences literature and, in turn, offered a more refined conceptual definition and framework that will direct future research on this topic. Specifically, we completed an integrative review of empirical studies on sistah circles using social science databases and search engines to identify relevant literature. Articles included for review met the following criteria: (a) published between 2000 and 2020, (b) analyzed empirical data, (c) were composed of Black women participants, and (d) mentioned Black women groups or friendships. Qualifying sources ( N = 45) were organized into a taxonomy of three types of sistah circles: health-focused, social, and professional. We also analyzed sample characteristics, research methods, and publication trends across all of the articles included in the review. Based upon our taxonomy and results of our review, we highlight the strengths and limitations of the current scholarship focused on Black women's sistah circles and offer suggestions regarding future research and practice. Additional online materials for this article are available on PWQ's website at http://journals.sagepub.com/doi/suppl/10.1177/03616843231154564
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Affiliation(s)
| | - Shardé M. Davis
- Department of Communication, University of Connecticut, Storrs, CT, USA
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Jassim GA, Doherty S, Whitford DL, Khashan AS. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev 2023; 1:CD008729. [PMID: 36628983 PMCID: PMC9832339 DOI: 10.1002/14651858.cd008729.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer affecting women worldwide. It is a distressing diagnosis and, as a result, considerable research has examined the psychological sequelae of being diagnosed and treated for breast cancer. Breast cancer is associated with increased rates of depression and anxiety and reduced quality of life. As a consequence, multiple studies have explored the impact of psychological interventions on the psychological distress experienced after a diagnosis of breast cancer. This review is an update of a Cochrane Review first published in 2015. OBJECTIVES To assess the effect of psychological interventions on psychological morbidities and quality of life among women with non-metastatic breast cancer. SEARCH METHODS: We searched the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov up to 16 March 2021. We also scanned the reference lists of relevant articles. SELECTION CRITERIA Randomised controlled trials that assessed the effectiveness of psychological interventions for women with non-metastatic breast cancer. DATA COLLECTION AND ANALYSIS Two review authors independently appraised, extracted data from eligible trials, and assessed risk of bias and certainty of the evidence using the GRADE approach. Any disagreement was resolved by discussion. Extracted data included information about participants, methods, the intervention and outcomes. MAIN RESULTS We included 60 randomised controlled trials comprising 7998 participants. The most frequent reasons for exclusion were non-randomised trials and the inclusion of women with metastatic disease. The updated review included 7998 randomised women; the original review included 3940 women. A wide range of interventions was evaluated. Most interventions were cognitive- or mindfulness-based, supportive-expressive, and educational. The interventions were mainly delivered face-to-face (56 studies) and in groups (50 studies) rather than individually (10 studies). Most intervention sessions were delivered on a weekly basis with an average duration of 14 hours. Follow-up time ranged from two weeks to 24 months. Pooled standardised mean differences (SMD) from baseline indicated that the intervention may reduce depression (SMD -0.27, 95% confidence interval (CI) -0.52 to -0.02; P = 0.04; 27 studies, 3321 participants, I2 = 91%, low-certainty evidence); anxiety (SMD -0.43, 95% CI -0.68 to -0.17; P = 0.0009; 22 studies, 2702 participants, I2 = 89%, low-certainty evidence); mood disturbance in the intervention group (SMD -0.18, 95% CI -0.31 to -0.04; P = 0.009; 13 studies, 2276 participants, I2 = 56%, low-certainty evidence); and stress (SMD -0.34, 95% (CI) -0.55 to -0.12; P = 0.002; 8 studies, 564 participants, I2 = 31%, low-certainty evidence). The intervention is likely to improve quality of life in the intervention group (SMD 0.78, 95% (CI) 0.32 to 1.24; P = 0.0008; 20 studies, 1747 participants, I2 = 95%, low-certainty evidence). Adverse events were not reported in any of the included studies. AUTHORS' CONCLUSIONS Based on the available evidence, psychological intervention may have produced favourable effects on psychological outcomes, in particular depression, anxiety, mood disturbance and stress. There was also an improvement in quality of life in the psychological intervention group compared to control group. Overall, there was substantial variation across the studies in the range of psychological interventions used, control conditions, measures of the same outcome and timing of follow-up.
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Affiliation(s)
- Ghufran A Jassim
- Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSI Bahrain), Busaiteen, Bahrain
| | - Sally Doherty
- Psychiatry, Royal College of Surgeons in Ireland- Medical University of Bahrain (RCSI Bahrain), Busaiteen, Bahrain
| | | | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
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Setyowibowo H, Yudiana W, Hunfeld JAM, Iskandarsyah A, Passchier J, Arzomand H, Sadarjoen SS, de Vries R, Sijbrandij M. Psychoeducation for breast cancer: A systematic review and meta-analysis. Breast 2022; 62:36-51. [PMID: 35121502 PMCID: PMC8819101 DOI: 10.1016/j.breast.2022.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Psychoeducation has emerged as an intervention for women with breast cancer (BC). This meta-analysis evaluated the effectiveness of psychoeducation on adherence to diagnostic procedures and medical treatment, anxiety, depression, quality of life (QoL), and BC knowledge among patients with BC symptoms or diagnosis and BC survivors. METHODS A systematic literature search (in PubMed, Embase, PsycINFO and Cochrane) for randomised controlled trials (RCTs) comparing the effects of psychoeducation to control among patients with BC symptoms or diagnosis and BC survivors. Effects were expressed as relative risks (RRs) and standardized mean differences (SMDs) with their 95% confidence intervals. RESULTS Twenty-seven RCTs (7742 participants; 3880 psychoeducation and 3862 controls) were included. Compared with controls, psychoeducation had no significant effect on adherence to diagnostic procedures and medical treatment (RR 1.553; 95% CI 0.733 to 3.290, p = .16), but it significantly decreased anxiety (SMD -0.710, 95% CI -1.395 to -0.027, p = .04) and improved QoL with (SMD 0.509; 95% CI 0.096 to 0.923, p < .01). No effects were found for psychoeducation on depression (SMD -0.243, 95% CI -0.580 to 0.091, p = .14), or BC knowledge (SMD 0.718, 95% CI -0.800 to 2.236, p = .23). CONCLUSION We demonstrated that psychoeducation did not improve adherence to diagnostic procedures and treatment, depression and BC knowledge but was valuable for reducing anxiety and improving QoL. Future studies may explore the effectiveness of psychoeducation in promoting adherence across various types of cancer.
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Affiliation(s)
- Hari Setyowibowo
- Department of Clinical, Neuro, and Developmental Psychology and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Educational Psychology, Universitas Padjadjaran, Jatinangor, Indonesia.
| | - Whisnu Yudiana
- Department of Experimental Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Joke A M Hunfeld
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Jan Passchier
- Department of Clinical, Neuro, and Developmental Psychology and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Homra Arzomand
- Department of Clinical, Neuro, and Developmental Psychology and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Sawitri S Sadarjoen
- Department of Clinical Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro, and Developmental Psychology and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, the Netherlands; World Health Organization Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, the Netherlands
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6
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Warmoth K, Yeung NCY, Xie J, Feng H, Loh A, Young L, Lu Q. Benefits of a Psychosocial Intervention on Positive Affect and Posttraumatic Growth for Chinese American Breast Cancer Survivors: A Pilot Study. Behav Med 2020; 46:34-42. [PMID: 30657442 PMCID: PMC6639149 DOI: 10.1080/08964289.2018.1541862] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 06/26/2018] [Accepted: 10/25/2018] [Indexed: 10/27/2022]
Abstract
Breast cancer survivors report persistent psychological and physical symptoms, which affect their quality of life and may challenge the recovery process. Due to social, cultural, and linguistic barriers, culturally sensitive care is largely unavailable for Chinese Americans, and their psychological needs are not often addressed. We aimed to investigate whether the Joy Luck Academy (JLA), a psychosocial intervention providing both information and peer support, was associated with positive adjustment among Chinese American breast cancer survivors. Thirty-nine Chinese American breast cancer survivors participated in a pilot psychosocial intervention. The educational materials and lectures were delivered in the participants' native language of Chinese. All of the educators and mentors shared the same linguistic and cultural background with the participants. The program utilized a community-based participatory research (CBPR) approach to further enhance the cultural sensitivity of the intervention. Participants' post-traumatic growth and positive affect were assessed before and after the intervention. The JLA showed an improvement in positive affect, and they had a greater appreciation for life. The intervention was found to be feasible, well-accepted, and beneficial for this population. Chinese American breast cancer survivors reported improved psychological health after attending the intervention. These findings encourage the development and implementation of psychosocial interventions for Chinese breast cancer survivors. Similar programs could be integrated into other ethnic or cultural communities.
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Affiliation(s)
- Krystal Warmoth
- University of Exeter Medical School, University of Exeter, Exeter, UK ()
| | - Nelson C. Y. Yeung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sino Building, Chung Chi Rd, Sha Tin, Hong Kong, China ()
| | - Jing Xie
- Culture & Health Research Center, University of Houston, Department of Psychology, Fred J. Heyne Building Rm 126, 3695 Cullen Boulevard, Houston, TX, USA 77204-5022 (; ; )
| | - Hannah Feng
- Culture & Health Research Center, University of Houston, Department of Psychology, Fred J. Heyne Building Rm 126, 3695 Cullen Boulevard, Houston, TX, USA 77204-5022 (; ; )
| | - Alice Loh
- Herald Cancer Association, Chinese Christian Herald Crusades, 715 E. Mission Road, San Gabriel, CA, USA 91776 (; )
| | - Lucy Young
- Herald Cancer Association, Chinese Christian Herald Crusades, 715 E. Mission Road, San Gabriel, CA, USA 91776 (; )
| | - Qian Lu
- Culture & Health Research Center, University of Houston, Department of Psychology, Fred J. Heyne Building Rm 126, 3695 Cullen Boulevard, Houston, TX, USA 77204-5022 (; ; )
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas ()
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7
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Ashing KT, George M. Exploring the efficacy of a paraprofessional delivered telephonic psychoeducational intervention on emotional well-being in African American breast cancer survivors. Support Care Cancer 2019; 28:1163-1171. [DOI: 10.1007/s00520-019-04899-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 05/29/2019] [Indexed: 12/20/2022]
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8
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Bellver-Pérez A, Peris-Juan C, Santaballa-Beltrán A. Effectiveness of therapy group in women with localized breast cancer. Int J Clin Health Psychol 2019; 19:107-114. [PMID: 31193149 PMCID: PMC6517697 DOI: 10.1016/j.ijchp.2019.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 02/05/2019] [Indexed: 11/12/2022] Open
Abstract
Background/Objective Breast cancer causes high levels of anxiety and depression, deteriorating quality of life of patients. Several studies have found that group therapy reduces depression and anxiety also improves the quality of life. The aim of this study is to analyze group therapy effectiveness in emotional state and quality of life in women with breast cancer after finalized medical treatments. Method Participants in this study were 100 adult women diagnosed of breast cancer non-mestastasic and were divided into two types of intervention groups (Self-esteem-Social Skills and Cognitive-Behavioral Therapy). Evaluation instruments were questionnaire Functional Assessment of Breast-cancer Therapy (FACT-B) and Hospital Anxiety and Depression Scale (HADS). Results A statistically significant effect of group therapy in reducing anxiety and depression were observed. Quality of life and emotional well-being significantly improved. These effects remain three months after intervention. Conclusions The results show that the psychological intervention group is efficient to improve emotional state and quality of life of women with breast cancer.
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Affiliation(s)
- Ascensión Bellver-Pérez
- Hospital Pare Jofre Valencia and Departament Personalitat, Avaluació i Tractaments Psicològics. Universitat de València, Spain
| | | | - Ana Santaballa-Beltrán
- Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe de Valencia, Spain
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9
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Ruiz-Pérez I, Rodríguez-Gómez M, Pastor-Moreno G, Escribá-Agüir V, Petrova D. Effectiveness of interventions to improve cancer treatment and follow-up care in socially disadvantaged groups. Psychooncology 2019; 28:665-674. [PMID: 30695816 DOI: 10.1002/pon.5011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/14/2019] [Accepted: 01/23/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To identify and characterize the interventions that aimed to improve cancer treatment and follow-up care in socially disadvantaged groups. To summarize the state of the art for clinicians and researchers. METHODS We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were randomized controlled trials and quasi-experimental studies with a control group (usual care or enhanced usual care) conducted in Organization for Economic Co-operation and Development (OECD) member countries and published until 2016. RESULTS Thirty-one interventions were identified, the majority of which were conducted in the United States in patients with breast cancer. Most interventions aimed to decrease social inequalities based on ethnicity/race and/or socioeconomic level, with fewer interventions targeting inequalities based on geographical area. The most frequently assessed outcomes were quality of life (n = 20) and psychosocial factors (n = 20), followed by treatment adherence or satisfaction (n = 12,), knowledge (n = 11), pain management (n = 10), and lifestyle habits (n = 3). CONCLUSIONS The impact of interventions designed to improve cancer treatment and follow-up care in socially disadvantages groups is multifactorial. Multicomponent-intervention approaches and cultural adaptations are common, and their effectiveness should be evaluated in the populations of interest. More interventions are needed from outside the Unite States and in patients with cancers other than breast cancer, targeting gender or geographical inequalities and addressing key outcomes such as treatment adherence or symptom management.
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Affiliation(s)
- Isabel Ruiz-Pérez
- Andalusian School of Public Health, Granada, Spain.,Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Madrid, Spain.,Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | | | - Guadalupe Pastor-Moreno
- Andalusian School of Public Health, Granada, Spain.,Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Madrid, Spain
| | - Vicenta Escribá-Agüir
- Department of Nursing, University of Valencia, Valencia, Spain.,Fundación para el fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), Valencia, Spain
| | - Dafina Petrova
- Andalusian School of Public Health, Granada, Spain.,Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Madrid, Spain.,Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
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10
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Kalter J, Verdonck-de Leeuw IM, Sweegers MG, Aaronson NK, Jacobsen PB, Newton RU, Courneya KS, Aitken JF, Armes J, Arving C, Boersma LJ, Braamse AMJ, Brandberg Y, Chambers SK, Dekker J, Ell K, Ferguson RJ, Gielissen MFM, Glimelius B, Goedendorp MM, Graves KD, Heiney SP, Horne R, Hunter MS, Johansson B, Kimman ML, Knoop H, Meneses K, Northouse LL, Oldenburg HS, Prins JB, Savard J, van Beurden M, van den Berg SW, Brug J, Buffart LM. Effects and moderators of psychosocial interventions on quality of life, and emotional and social function in patients with cancer: An individual patient data meta-analysis of 22 RCTs. Psychooncology 2018; 27:1150-1161. [PMID: 29361206 PMCID: PMC5947559 DOI: 10.1002/pon.4648] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 01/02/2018] [Accepted: 01/10/2018] [Indexed: 01/25/2023]
Abstract
Objective This individual patient data (IPD) meta‐analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention‐related characteristics. Methods Relevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed‐effect model analyses were used to study intervention effects on the post‐intervention values of QoL, EF, and SF (z‐scores), adjusting for baseline values, age, and cancer type. We studied moderator effects by testing interactions with the intervention for demographic, clinical, personal, and intervention‐related characteristics, and conducted subsequent stratified analyses for significant moderator variables.Results: PSI significantly improved QoL (β = 0.14,95%CI = 0.06;0.21), EF (β = 0.13,95%CI = 0.05;0.20), and SF (β = 0.10,95%CI = 0.03;0.18). Significant differences in effects of different types of PSI were found, with largest effects of psychotherapy. The effects of coping skills training were moderated by age, treatment type, and targeted interventions. Effects of psychotherapy on EF may be moderated by cancer type, but these analyses were based on 2 randomized controlled trials with small sample sizes of some cancer types. Conclusions PSI significantly improved QoL, EF, and SF, with small overall effects. However, the effects differed by several demographic, clinical, personal, and intervention‐related characteristics. Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients.
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Affiliation(s)
- J Kalter
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - I M Verdonck-de Leeuw
- Department of Clinical Psychology, VU University Amsterdam, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health research institute and Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M G Sweegers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - N K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - P B Jacobsen
- Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, Maryland, FL, USA
| | - R U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - K S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - J F Aitken
- Menzies Health Institute Queensland, Griffith University, Southport, Australia.,Cancer Council Queensland, Brisbane, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Australia
| | - J Armes
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - C Arving
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - L J Boersma
- Department of Radiation Oncology, Maastricht University Medical Center (MAASTRO clinic), Maastricht, The Netherlands.,GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A M J Braamse
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - Y Brandberg
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Southport, Australia.,Cancer Council Queensland, Brisbane, Australia.,Prostate Cancer Foundation of Australia, Sydney, NSW, Australia
| | - J Dekker
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - K Ell
- Department of Adults and Healthy Aging, University of Southern California, Los Angeles, CA, USA
| | - R J Ferguson
- Division of Hematology-Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - M F M Gielissen
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - B Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - M M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - K D Graves
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - S P Heiney
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - R Horne
- UCL School of Pharmacy, University College London, London, UK
| | - M S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - B Johansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - M L Kimman
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - H Knoop
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - K Meneses
- University of Alabama at Birmingham, School of Nursing, Birmingham, AL, USA
| | - L L Northouse
- University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - H S Oldenburg
- Department of Surgical Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - J B Prins
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Savard
- School of Psychology, Université Laval and Laval University Cancer Research Center, Québec, QC, Canada
| | - M van Beurden
- Department of Gynecology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - S W van den Berg
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Brug
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - L M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.,Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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11
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Fairchild AJ, Heiney SP, Baruth M, Tavakoli A, Parker Hayne PD, McDaniel HL. Mediators of Social Connection in a Group Teleconference Intervention. Res Theory Nurs Pract 2017; 31:121-136. [PMID: 28482993 DOI: 10.1891/1541-6577.31.2.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Social connection has a positive influence on cancer survivorship and has been targeted in intervention work. We examined whether the formation of social connection is influenced by fear, fatalism, and isolation. METHODS We conducted a mediation analysis on data from an intervention study with African American breast cancer survivors to investigate whether fear, fatalism, and isolation conveyed effects on social connection. RESULTS Although results indicated that there were no significant mediated effects of the intervention through these variables, we garnered information about action and conceptual theories underlying the program that inform future work. IMPLICATIONS FOR PRACTICE Our insights can be considered in future interventions conducted for African American women with breast cancer during and following treatment.
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12
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Jassim GA, Whitford DL, Hickey A, Carter B. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev 2015:CD008729. [PMID: 26017383 DOI: 10.1002/14651858.cd008729.pub2] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer affecting women worldwide. It is a distressing diagnosis and, as a result, considerable research has examined the psychological sequelae of being diagnosed and treated for breast cancer. Breast cancer is associated with increased rates of depression and anxiety and reduced quality of life. As a consequence, multiple studies have explored the impact of psychological interventions on the psychological distress experienced after a diagnosis of breast cancer. OBJECTIVES To assess the effects of psychological interventions on psychological morbidities, quality of life and survival among women with non-metastatic breast cancer. SEARCH METHODS We searched the following databases up to 16 May 2013: the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL and PsycINFO; and reference lists of articles. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) search portal and ClinicalTrials.gov for ongoing trials in addition to handsearching. SELECTION CRITERIA Randomised controlled trials that assessed the effectiveness of psychological interventions for non-metastatic breast cancer in women. DATA COLLECTION AND ANALYSIS Two review authors independently appraised and extracted data from eligible trials. Any disagreement was resolved by discussion. Extracted data included information about participants, methods, the intervention and outcome. MAIN RESULTS Twenty-eight randomised controlled trials comprising 3940 participants were included. The most frequent reasons for exclusion were non-randomised trials and the inclusion of women with metastatic disease. A wide range of interventions were evaluated, with 24 trials investigating a cognitive behavioural therapy and four trials investigating psychotherapy compared to control. Pooled standardised mean differences (SMD) from baseline indicated less depression (SMD -1.01, 95% confidence interval (CI) -1.83 to -0.18; P = 0.02; 7 studies, 637 participants, I(2) = 95%, low quality evidence), anxiety (SMD -0.48, 95% CI -0.76 to -0.21; P = 0.0006; 8 studies, 776 participants, I(2) = 64%, low quality evidence) and mood disturbance (SMD -0.28, 95% CI -0.43 to -0.13; P = 0.0003; 8 studies, 1536 participants, I(2) = 47%, moderate quality evidence) for the cognitive behavioural therapy group than the control group. For quality of life, only an individually-delivered cognitive behavioural intervention showed significantly better quality of life than the control with an SMD of 0.65 (95% CI 0.07 to 1.23; P = 0.03; 3 studies, 141 participants, I(2) = 41%, very low quality evidence). Pooled data from two group-delivered studies showed a non-significant overall survival benefit favouring cognitive behavioural therapy compared to control (pooled hazard ratio (HR) 0.76, 95% CI 0.25 to 2.32; P = 0.63; 530 participants, I(2) = 84%, low quality evidence). Four studies compared psychotherapy to control with one to two studies reporting on each outcome. The four studies were assessed as high risk of bias and provided limited evidence of the efficacy of psychotherapy. Adverse events were not reported in any of the included studies. AUTHORS' CONCLUSIONS A psychological intervention, namely cognitive behavioural therapy, produced favourable effects on some psychological outcomes, in particular anxiety, depression and mood disturbance. However, the evidence for survival improvement is still lacking. These findings are open to criticism because of the notable heterogeneity across the included studies and the shortcomings of the included studies.
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Affiliation(s)
- Ghufran A Jassim
- Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
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13
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Eficácia das intervenções psicológicas em grupo dirigidas a mulheres com cancro da mama: uma revisão sistemática. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rpsp.2015.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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14
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Green MA, Lucas J, Hanson LC, Armstrong T, Hayes M, Peacock S, Elliott-Bynum S, Goldmon M, Corbie-Smith G. Carrying the burden: perspectives of African American pastors on peer support for people with cancer. JOURNAL OF RELIGION AND HEALTH 2014; 53:1382-1397. [PMID: 23690130 PMCID: PMC3871986 DOI: 10.1007/s10943-013-9729-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
For African Americans facing advanced cancer, churches are trusted sources of support and ideal settings to improve access to supportive care. The Support Team model enhances community support for practical, emotional, and spiritual caregiving. We report on focus groups with pastors of 23 Black Churches and explore their perspective on the Support Team model for church members with cancer. Pastors describe the needs of church members facing cancer from a holistic perspective and recognize opportunities for synergistic faith-health collaboration. The results of this study indicate potential benefits of the Support Team model in Black Churches to reduce silent suffering among individuals facing cancer.
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Affiliation(s)
- Melissa A Green
- Cecil Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr Blvd, CB#7590, Chapel Hill, NC, 27599-7590, USA,
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15
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Whitehead NE, Hearn LE. Psychosocial interventions addressing the needs of Black women diagnosed with breast cancer: a review of the current landscape. Psychooncology 2014; 24:497-507. [PMID: 25045105 DOI: 10.1002/pon.3620] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 06/10/2014] [Accepted: 06/18/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND Poorer health outcomes and lower survival rates have been well documented among African American/Black (Black) women diagnosed with breast cancer. Black women are 41% more likely to die from breast cancer than White women despite a lower incidence rate. Apart from pharmacotherapy, psychosocial interventions are recommended by the Institute of Medicine as standard medical care for breast cancer patients at all phases of treatment. The current review is the first attempt to systematically evaluate the literature on the influence of psychosocial interventions for Black women diagnosed with breast cancer. METHODS This systematic review aimed to adhere to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A comprehensive computerized literature search of CINAHL, PsycINFO, PubMed, and Web of Science was conducted to obtain relevant studies. RESULTS Interventions demonstrated improved mood, decreased distress, increased ability to cope with intrusive thoughts and cancer-related stress, personal growth, and improved social well-being. However, aspects unique to this population require additional scientific inquiry. Over 80% of empirical interventions focused on Black women diagnosed with breast cancer have been concentrated on the posttreatment phase. There is a paucity of work at the time of diagnosis and during treatment. CONCLUSIONS To address gaps in the scientific literature, more work is needed to better understand how psychosocial interventions can improve the health trajectory for Black women diagnosed with breast cancer particularly in the areas of seeking help and support, identifying culturally acceptable methods for engaging support networks, and identifying best practices for enhancing coping skills.
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Affiliation(s)
- Nicole Ennis Whitehead
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
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16
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Stephen J, Collie K, McLeod D, Rojubally A, Fergus K, Speca M, Turner J, Taylor-Brown J, Sellick S, Burrus K, Elramly M. Talking with text: communication in therapist-led, live chat cancer support groups. Soc Sci Med 2013; 104:178-86. [PMID: 24581076 DOI: 10.1016/j.socscimed.2013.12.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 08/15/2013] [Accepted: 12/02/2013] [Indexed: 11/26/2022]
Abstract
CancerChatCanada is a pan-Canadian initiative with a mandate to make professionally led cancer support groups available to more people in Canada. Although online support groups are becoming increasingly popular, little is known about therapist-led, synchronous groups using live chat. The purpose of this study was to generate a rich descriptive account of communication experiences in CancerChatCanada groups and to gain an understanding of processes associated with previously-reported benefits. We used interpretive description to analyze interview segments from 102 patients, survivors and family caregivers who participated in CancerChatCanada groups between 2007 and 2011. The analysis yielded four inter-related process themes (Reaching Out From Home, Feeling Safe, Emotional Release, and Talking With Text) and one outcome theme (Resonance and Kinship). The findings extend previous research about text-only online support groups and provide novel insights into features of facilitated, live chat communication that are valued by group members.
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Affiliation(s)
- Joanne Stephen
- BC Cancer Agency, Patient and Family Counselling Services, 13750 96th Ave, Surrey, BC V3T 0C7, Canada.
| | - Kate Collie
- Cross Cancer Institute, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada.
| | - Deborah McLeod
- QE II Health Sciences Centre, School of Nursing, Dalhousie University, Victoria 11-006, 1278 Tower Rd., Halifax, NS B3H 2Y9, Canada.
| | - Adina Rojubally
- BC Cancer Agency, Patient and Family Counselling Services, 13750 96th Ave, Surrey, BC V3T 0C7, Canada.
| | - Karen Fergus
- Sunnybrook Odette Cancer Center, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.
| | - Michael Speca
- Tom Baker Cancer Centre, Department of Psychosocial Resources, Holy Cross Site, Phase I, 2202 - 2nd Street SW, Calgary, AB T2S 3C1, Canada.
| | - Jill Turner
- Cross Cancer Institute, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada.
| | - Jill Taylor-Brown
- Patient and Family Support Services, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, MB R3E 0V9, Canada.
| | - Scott Sellick
- Supportive Care, Thunderbay Regional Health Sciences Center, 980 Oliver Road, Thunder Bay, ON P7B 6V4, Canada.
| | - Kimberly Burrus
- BC Cancer Agency, Patient and Family Counselling Services, 13750 96th Ave, Surrey, BC V3T 0C7, Canada.
| | - Mai Elramly
- BC Cancer Agency, Patient and Family Counselling Services, 13750 96th Ave, Surrey, BC V3T 0C7, Canada.
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Gaston-Johansson F, Haisfield-Wolfe ME, Reddick B, Goldstein N, Lawal TA. The relationships among coping strategies, religious coping, and spirituality in African American women with breast cancer receiving chemotherapy. Oncol Nurs Forum 2013; 40:120-31. [PMID: 23448737 DOI: 10.1188/13.onf.120-131] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To (a) examine coping capacity, psychological distress, spiritual well-being, positive and negative religious coping, and coping strategies among African American (AA) women with breast cancer, and (b) explore relationships among these variables to enhance an already tested comprehensive coping strategy program (CCSP) intervention for AA women with breast cancer (CCSP-AA). DESIGN Descriptive-correlational. SETTING Comprehensive cancer center in Maryland. SAMPLE 17 AA women with breast cancer. METHODS Women completed the Hospital Anxiety and Depression Scale, Sense of Coherence scale, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, Brief Religious Coping Inventory, and Coping Strategies Questionnaire. MAIN RESEARCH VARIABLES Psychological distress, coping capacity, coping strategies, religious coping, and spiritual well-being. FINDINGS A higher coping capacity was beneficial, as it was related to less psychological distress, negative religious coping, and catastrophizing. Women using less negative religious coping had greater spiritual well-being and less distress. Using more coping self-statements was associated with higher spiritual well-being and less negative religious coping. Catastrophizing had a negative effect on psychological distress and spiritual well-being. CONCLUSIONS The development of a CCSP-AA that incorporates aspects of spirituality and components in a coping intervention needs to be tested in a clinical trial. The intervention will teach patients to recognize and restructure their thinking to avoid catastrophizing and negative religious coping. IMPLICATIONS FOR NURSING Nurses need to work collaboratively with AA women to reinforce beneficial coping patterns and approaches. A tailored CCSP-AA for women with breast cancer administered by a nurse can be taught to assist AA patients in coping more effectively. KNOWLEDGE TRANSLATION AA women with breast cancer use more positive religious coping and experience less distress and greater spiritual well-being, but catastrophizing has a negative effect on spiritual well-being. Nurses need to reinforce positive coping patterns for AA women with cancer.
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Ashing-Giwa K, Tapp C, Rosales M, McDowell K, Martin V, Santifer RH, Clark P, Steward J, Lewis L, Mitchell E. Peer-based models of supportive care: the impact of peer support groups in African American breast cancer survivors. Oncol Nurs Forum 2013; 39:585-91. [PMID: 23107852 DOI: 10.1188/12.onf.585-591] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the impact of support groups among African American breast cancer survivors (BCSs). RESEARCH APPROACH A qualitative research study. SETTING Community health and cancer centers and churches. PARTICIPANTS 62 African American BCSs. METHODOLOGIC APPROACH Focus groups were conducted with African American BCSs to share their experiences with peer-based support groups. A brief questionnaire was administered and assessed demographics, medical history, and support group impact. FINDINGS Survivors emphasized that a culturally embedded focus was essential for their participation in a cancer support group. The survivors underscored that cultural-based groups are rooted in the spiritual, linguistic, experiential, and historical contexts of the intended constituents. The peer-based support groups provided multilevel functions, including emotional, social, spiritual, informational, and financial support, as well as patient navigation. The groups' activities fostered personal development and a call to community advocacy that included prevention education and research engagement. CONCLUSIONS The unique strengths of grassroots community-based support groups are that they are culturally consonant, peer-based, and responsive to cancer-related and personal needs. The contribution and value of those multifaceted peer-based groups expand the paradigm of supportive care, extending the net of psychosocial care to underserved and underrepresented cancer survivors. INTERPRETATION Research provides the critical foundation to lead and articulate the studies necessary to bridge peer- and professional-based care to ensure the psychosocial needs of increasingly diverse survivors are met.
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Affiliation(s)
- Kimlin Ashing-Giwa
- City of Hope National Medical Center's Center of Community Alliance for Research and Education (CCARE), Duarte, CA, USA.
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Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R. Effects of Psycho-Oncologic Interventions on Emotional Distress and Quality of Life in Adult Patients With Cancer: Systematic Review and Meta-Analysis. J Clin Oncol 2013; 31:782-93. [PMID: 23319686 DOI: 10.1200/jco.2011.40.8922] [Citation(s) in RCA: 496] [Impact Index Per Article: 45.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose This study aimed to evaluate the effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer. Methods Literature databases were searched to identify randomized controlled trials that compared a psycho-oncologic intervention delivered face-to face with a control condition. The main outcome measures were emotional distress, anxiety, depression, and quality of life. Outcomes were evaluated for three time periods: post-treatment, ≤ 6 months, and more than 6 months. We applied standard meta-analytic techniques to analyze both published and unpublished data from the retrieved studies. Sensitivity analyses and meta-regression were used to explore reasons for heterogeneity. Results We retrieved 198 studies (covering 22,238 patients) that report 218 treatment-control comparisons. Significant small-to-medium effects were observed for individual and group psychotherapy and psychoeducation. These effects were sustained, in part, in the medium term (≤ 6 months) and long term (> 6 months). Short-term effects were evident for relaxation training. Studies that preselected participants according to increased distress produced large effects at post-treatment. A moderator effect was found for the moderator variable “duration of the intervention,” with longer interventions producing more sustained effects. Indicators of study quality were often not reported. Small-sample bias indicative of possible publication bias was found for some effects, particularly with individual psychotherapy and relaxation training. Conclusion Various types of psycho-oncologic interventions are associated with significant, small-to-medium effects on emotional distress and quality of life. These results should be interpreted with caution, however, because of the low quality of reporting in many of the trials.
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Affiliation(s)
- Hermann Faller
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Michael Schuler
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Matthias Richard
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Ulrike Heckl
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Joachim Weis
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Roland Küffner
- Hermann Faller, Michael Schuler, Matthias Richard, and Roland Küffner, University of Würzburg, Würzburg; and Ulrike Heckl and Joachim Weis, Tumor Biology Center, University of Freiburg, Freiburg, Germany
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Dastan NB, Buzlu S. Psychoeducation Intervention to Improve Adjustment to Cancer among Turkish Stage I-II Breast Cancer Patients: A Randomized Controlled Trial. Asian Pac J Cancer Prev 2012; 13:5313-8. [DOI: 10.7314/apjcp.2012.13.10.5313] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Taggart F, Donnelly P, Dunn J. Options for early breast cancer follow-up in primary and secondary care - a systematic review. BMC Cancer 2012; 12:238. [PMID: 22695275 PMCID: PMC3502561 DOI: 10.1186/1471-2407-12-238] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 06/13/2012] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Both incidence of breast cancer and survival have increased in recent years and there is a need to review follow up strategies. This study aims to assess the evidence for benefits of follow-up in different settings for women who have had treatment for early breast cancer. METHOD A systematic review to identify key criteria for follow up and then address research questions. Key criteria were: 1) Risk of second breast cancer over time - incidence compared to general population. 2) Incidence and method of detection of local recurrence and second ipsi and contra-lateral breast cancer. 3) Level 1-4 evidence of the benefits of hospital or alternative setting follow-up for survival and well-being. Data sources to identify criteria were MEDLINE, EMBASE, AMED, CINAHL, PSYCHINFO, ZETOC, Health Management Information Consortium, Science Direct. For the systematic review to address research questions searches were performed using MEDLINE (2011). Studies included were population studies using cancer registry data for incidence of new cancers, cohort studies with long term follow up for recurrence and detection of new primaries and RCTs not restricted to special populations for trials of alternative follow up and lifestyle interventions. RESULTS Women who have had breast cancer have an increased risk of a second primary breast cancer for at least 20 years compared to the general population. Mammographically detected local recurrences or those detected by women themselves gave better survival than those detected by clinical examination. Follow up in alternative settings to the specialist clinic is acceptable to women but trials are underpowered for survival. CONCLUSIONS Long term support, surveillance mammography and fast access to medical treatment at point of need may be better than hospital based surveillance limited to five years but further large, randomised controlled trials are needed.
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Affiliation(s)
- Frances Taggart
- Warwick Medical School Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK
| | - Peter Donnelly
- Breast Care Directorate, South Devon Healthcare NHS Foundation Trust, Lawes Bridge, Torquay, TQ2 7AA, UK
| | - Janet Dunn
- Warwick Medical School Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK
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22
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Gauchet A, Shankland R, Dantzer C, Pelissier S, Aguerre C. Applications cliniques en psychologie de la santé. PSYCHOLOGIE FRANCAISE 2012. [DOI: 10.1016/j.psfr.2012.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Participant evaluation of teleconference support for African American women with breast cancer. Cancer Nurs 2012; 35:E24-30. [PMID: 21760497 DOI: 10.1097/ncc.0b013e31821e9947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND African American women with breast cancer face obstacles such as transportation and family obligations when attending standard support groups. Teleconference support circumvents barriers such as transportation to participation, but few evaluations have been reported about teleconference support. OBJECTIVE The purpose of this article was to describe the format of a teleconference group and to provide a descriptive account of the participants' feedback about a teleconference group intervention. METHODS A descriptive design was used. Participants completed the Overall Support Group Evaluation tool at the end of the 10th group session. RESULTS Teleconference group participants' feedback indicated that they perceived they had gained knowledge about breast cancer and coping. The participants expressed that the group helped them to reach out and ask for support and improved family and work relationships. Also, participants rated the group highly for the presence of therapeutic factors. On a scale of 1 to 4, with 4 being the highest, mean scores ranged from 3.97 to 3.56. CONCLUSIONS The participants gave high ratings of satisfaction in terms of knowledge gained, leadership style, and benefits. The participants perceived that the group increased their knowledge about cancer, improved family connections, and increased their ability to deal with their cancer. IMPLICATIONS FOR PRACTICE Using teleconferencing technology to deliver a support group to African American breast cancer patients is a beneficial method to reach a disadvantaged population that may be unable to attend face-to-face groups.
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Heron-Speirs HA, Harvey ST, Baken DM. Moderators of psycho‐oncology therapy effectiveness: Addressing design variable confounds in meta‐analysis. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1468-2850.2012.01274.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Carmack CL, Basen-Engquist K, Gritz ER. Survivors at higher risk for adverse late outcomes due to psychosocial and behavioral risk factors. Cancer Epidemiol Biomarkers Prev 2012; 20:2068-77. [PMID: 21980014 DOI: 10.1158/1055-9965.epi-11-0627] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cancer survivors face significant morbidity and mortality associated with their disease and treatment regimens, some of which can be improved through modifying behavioral and psychosocial risk factors. This article examines risk factors for adverse late effects that contribute to morbidity and mortality in cancer survivors, provides a literature review on interventions to modify these risks factors, and summarizes the national recommendations and associated current practices for identifying and managing these risk factors. Finally, future directions for research and clinical practice are discussed.
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Affiliation(s)
- Cindy L Carmack
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77230, USA.
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Lechner SC, Ennis-Whitehead N, Robertson BR, Annane DW, Vargas S, Carver CS, Antoni MH. Adaptation of a Psycho-Oncology Intervention for Black Breast Cancer Survivors: Project CARE. COUNSELING PSYCHOLOGIST 2012; 41:286-312. [PMID: 25544778 PMCID: PMC4275843 DOI: 10.1177/0011000012459971] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Black women are traditionally underserved in all aspects of cancer care. This disparity is particularly evident in the area of psychosocial interventions where there are few programs designed to specifically meet the needs of Black breast cancer survivors. Cognitive-behavioral stress management intervention (CBSM) has been shown to facilitate adjustment to cancer. Recently, this intervention model has been adapted for Black women who have recently completed treatment for breast cancer. We outline the components of the CBSM intervention, the steps we took to adapt the intervention to meet the needs of Black women (Project CARE) and discuss the preliminary findings regarding acceptability and retention of participants in this novel study.
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Affiliation(s)
- Suzanne C. Lechner
- University of Miami, Miller School of Medicine and Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | | | - Belinda Ryan Robertson
- University of Miami, Miller School of Medicine and Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Debra W. Annane
- University of Miami, Miller School of Medicine and Sylvester Comprehensive Cancer Center, Miami, FL, USA
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Tamagawa R, Garland S, Vaska M, Carlson LE. Who benefits from psychosocial interventions in oncology? A systematic review of psychological moderators of treatment outcome. J Behav Med 2012; 35:658-73. [PMID: 22271329 DOI: 10.1007/s10865-012-9398-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 01/12/2012] [Indexed: 11/27/2022]
Abstract
Medical and demographic characteristics and psychological morbidity of individuals with cancer prior to a psychosocial intervention can influence the efficacy of interventions. However, little is known about the moderating role of patients' psychosocial characteristics on intervention effects. This review sought to identify and synthesize the impacts of psychosocial moderators of the effect of psychosocial interventions on the psychological well-being of cancer patients. A systematic review of the published literature was conducted. Databases searched included PsycINFO, PubMed, MEDLINE, Scopus, CINAHL, Web of Science, and Psychology and Behavioural Sciences Collection. Randomized controlled studies examining a moderator effect of patients' psychosocial characteristics other than baseline depression and anxiety levels were included. Of 199 potential papers, a total of 20 studies, involving 3,340 heterogeneous cancer patients are included. Of the 17 potential psychosocial moderators examined in this review, 14 significantly moderated the effects of interventions. Moderators were categorized into personality traits, mental and physical quality of life, social environment, and self-efficacy. Patients with poorer quality of life, interpersonal relationships and sense of control benefitted more from interventions than those who already had adequate resources. Patients with low levels of optimism and neuroticism, high levels of emotional expressiveness, interpersonal sensitivity, and dispositional hypnotizability also showed greater benefits from various interventions. This review adds to the growing literature aimed at personalizing psychosocial cancer treatment by identifying who benefits from which psychosocial interventions.
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Affiliation(s)
- Rie Tamagawa
- Department of Oncology, Faculty of Medicine, University of Calgary, Calgary, Canada,
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Heiney SP, Millon Underwood S, Tavakoli A, Arp Adams S, Wells LM, Bryant LH. Randomized trial of therapeutic group by teleconference: African American women with breast cancer. Cancer 2011; 118:3822-32. [PMID: 22180125 DOI: 10.1002/cncr.26676] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 10/11/2011] [Accepted: 10/13/2011] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effects of a therapeutic group by teleconference for African American women with breast cancer have not been documented, although the benefits of therapeutic groups for European women are well established. African American women with breast cancer may experience social disconnection, a sense of being cut off from partners, family, and friends because of side effects of treatment and fatalistic beliefs about cancer. A therapeutic group by teleconference may counteract these problems and improve social connection. METHODS A randomized trial design stratified by treatment type was used. Data were collected at baseline, at the end of the intervention, and 16 weeks from baseline. Repeated-measures, fixed-factor analyses of covariance were used for each outcome. The between-subject factors were group and replicate set, and the within-subject factor was time. Physical well being and educational level differed significantly between the 2 groups at baseline and were used as covariates. RESULTS The mixed-model analysis of the outcome variables revealed significant changes over time for knowledge (P ≤ .001), with higher scores on knowledge observed for the control group. Group-by-time interactions were observed for fatalism (P = .0276), fear (P = .0163), and social connection (P = .0174) as measured by the Social Well Being subscale from the Functional Assessment of Cancer Treatment-Breast Cancer Version. No group-by-time interaction was observed for social connection as measured by the Social Support Questionnaire. Social connection measured with the Social Well Being subscale improved significantly in the intervention group, whereas fatalism and fear significantly decreased. CONCLUSIONS In this study, the authors documented the benefits of a therapeutic group by teleconference, a novel way to provide support for African American women with breast cancer. Further research should include a behavioral outcome, such as treatment adherence.
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Affiliation(s)
- Sue P Heiney
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA.
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Lemieux J, Goodwin PJ, Bordeleau LJ, Lauzier S, Théberge V. Quality-of-life measurement in randomized clinical trials in breast cancer: an updated systematic review (2001-2009). J Natl Cancer Inst 2011; 103:178-231. [PMID: 21217081 DOI: 10.1093/jnci/djq508] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Quality-of-life (QOL) measurement is often incorporated into randomized clinical trials in breast cancer. The objectives of this systematic review were to assess the incremental effect of QOL measurement in addition to traditional endpoints (such as disease-free survival or toxic effects) on clinical decision making and to describe the extent of QOL reporting in randomized clinical trials of breast cancer. METHODS We conducted a search of MEDLINE for English-language articles published between May-June 2001 and October 2009 that reported: 1) a randomized clinical trial of breast cancer treatment (excluding prevention trials), including surgery, chemotherapy, hormone therapy, symptom control, follow-up, and psychosocial intervention; 2) the use of a patient self-report measure that examined general QOL, cancer-specific or breast cancer-specific QOL or psychosocial variables; and 3) documentation of QOL outcomes. All selected trials were evaluated by two reviewers, and data were extracted using a standardized form for each variable. Data are presented in descriptive table formats. RESULTS A total of 190 randomized clinical trials were included in this review. The two most commonly used questionnaires were the European Organization for Research and Treatment of Cancer QOL Questionnaire and the Functional Assessment of Cancer Therapy/Functional Assessment of Chronic Illness Therapy. More than 80% of the included trials reported the name(s) of the instrument(s), trial and QOL sample sizes, the timing of QOL assessment, and the statistical method. Statistical power for QOL was reported in 19.4% of the biomedical intervention trials and in 29.9% of the nonbiomedical intervention trials. The percentage of trials in which QOL findings influenced clinical decision making increased from 15.2% in the previous review to 30.1% in this updated review for trials of biomedical interventions but decreased from 95.0% to 63.2% for trials of nonbiomedical interventions. Discordance between reviewers ranged from 1.1% for description of the statistical method (yes vs no) to 19.9% for the sample size for QOL. CONCLUSION Reporting of QOL methodology could be improved.
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Affiliation(s)
- Julie Lemieux
- Santé des populations: Unité de recherche en santé des populations (URESP), Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec (CHA), Service d'hémato-oncologie du CHA and Centre des Maladies du Sein Deschênes-Fabia du CHA, Quebec City, QC, Canada.
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Manne SL, Kissane DW, Nelson CJ, Mulhall JP, Winkel G, Zaider T. Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: a pilot study. J Sex Med 2011; 8:1197-209. [PMID: 21210958 DOI: 10.1111/j.1743-6109.2010.02163.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Few couple-focused interventions have been developed to improve distress and relationship outcomes among men diagnosed with localized prostate cancer and their partners. AIMS We examined the effects of a five-session Intimacy-Enhancing Therapy (IET) vs. Usual Care (UC) on the psychological and relationship functioning of men diagnosed with localized prostate cancer and their partners. Pre-intervention levels of psychological and relationship functioning were evaluated as moderators of intervention effects. METHODS Seventy-one survivors and their partners completed a baseline survey and were subsequently randomly assigned to receive five sessions of IET or UC (no treatment). Eight weeks after the baseline assessment, a follow-up survey was administered to survivor and partner. MAIN OUTCOME MEASURES Distress, well-being, relationship satisfaction, relationship intimacy, and communication were investigated as the main outcomes. RESULTS IET effects were largely moderated by pre-intervention psychosocial and relationship factors. Those survivors who had higher levels of cancer concerns at pretreatment had significantly reduced concerns following IET. Similar moderating effects for pre-intervention levels were reported for the effects of IET on self-disclosure, perceived partner disclosure, and perceived partner responsiveness. Among partners beginning the intervention with higher cancer-specific distress, lower marital satisfaction, lower intimacy, and poorer communication, IET improved these outcomes. CONCLUSIONS IET had a marginally significant main effect upon survivor well-being but was effective among couples with fewer personal and relationship resources. Subsequent research is needed to replicate these findings with a larger sample and a longer follow-up.
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Affiliation(s)
- Sharon L Manne
- University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School-The Cancer Institute of New Jersey Section of Population Studies, New Brunswick, NJ, USA.
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An early structured psychoeducational intervention in patients with breast cancer: results from a feasibility study. Cancer Nurs 2010; 33:228-34. [PMID: 20357661 DOI: 10.1097/ncc.0b013e3181c1acd6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although the incidence of breast cancer in Italy is high, like in most Western countries, the role of psychosocial support in disease management and outcome is incompletely understood. A structured psychoeducational group intervention has been shown by Fawzy (J Psychosom Res. 1999, 45:191-200) to increase psychological well-being and natural killer immunological reactivity in patients with melanoma, with decreased relapse rate and prolonged survival time. OBJECTIVE The aims of the present study were to assess the feasibility of Fawzy's intervention by preliminary evaluation of its usefulness on a sample of women with early-stage breast cancer. METHODS Psychological reaction to the disease and its possible modification by the psychoeducational treatment were determined with the Mini-Mental Adjustment to Cancer scale at the time of study recruitment and at the end of the intervention. RESULTS A total of 29 patients participated in the study. Rate of participation and adherence to the intervention were 83% and 100%, respectively. A significant reduction in anxious preoccupation was observed in treated patients, whereas the other coping strategies identified by the Mini-Mental Adjustment to Cancer scale were not significantly modified. CONCLUSION The results support the feasibility of the intervention. In particular, the reduction in anxious preoccupation, characterizing the early phase of adaptation to breast cancer, may be the target for psychosocial intervention including specific nursing contributions. IMPLICATIONS FOR PRACTICE The results obtained encourage investigating in more depth and with adequate methodology the role of psychoeducational group support for patients with early-stage breast cancer. In particular, they suggest that more attention should be given to the early phase, which follows the communication of cancer diagnosis and precedes the beginning of chemotherapy, which seems to be characterized by anxious preoccupation. A further indication resulting from the study and development of psychoeducational groups for patients with cancer is the opportunity to include cancer nursing among the topics that are addressed during psychoeducational group meetings because it seems to have been neglected in the available studies despite its evident relevance in cancer care.
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Lessons to be learned from 25 years of research investigating psychosocial interventions for cancer patients. Cancer J 2010; 15:345-51. [PMID: 19826351 DOI: 10.1097/ppo.0b013e3181bf51fb] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Conducting rigorous psychosocial intervention research with cancer patients has many challenges including encouraging them to join studies, asking them to engage in interventions or be part of control conditions, and to provide data over follow-up assessments. Here, we highlight valuable insights regarding such challenges provided by investigators studying psychosocial interventions for cancer patients. Handling these skillfully has important implications for the internal and external validity of this research and the ethical treatment of participants. Challenges noted in research reports included in a systematic review of 25 years of research (comprising 488 unique projects) investigating interventions designed to enhance cancer patients' quality of life were compiled. Among the difficulties mentioned was the fact that patients may not feel the need for psychosocial interventions and thus may not be interested in joining an intervention study. Patients who do feel the need for such interventions may be deterred from joining trials by the prospect of being randomized to a nonpreferred group; if they do join a trial, participants may be disappointed, drop out, or seek compensatory additional assistance when they are assigned to a control group. Apart from randomization, other aspects of research may be off-putting to participants or potential participants, such as the language of consent forms or the intrusiveness of questions being asked. Potential remedies, such as research awareness interventions, monetary incentives, partnering with cancer support organizations, and using designs that take preferences into account merit consideration and further research inquiry.
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Schneider S, Moyer A, Knapp-Oliver S, Sohl S, Cannella D, Targhetta V. Pre-intervention distress moderates the efficacy of psychosocial treatment for cancer patients: a meta-analysis. J Behav Med 2010; 33:1-14. [PMID: 19784868 PMCID: PMC2813921 DOI: 10.1007/s10865-009-9227-2] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2009] [Accepted: 09/14/2009] [Indexed: 11/26/2022]
Abstract
This meta-analysis examined whether effects of psychosocial interventions on psychological distress in cancer patients are conditional upon pre-intervention distress levels. Published articles and unpublished dissertations between 1980 and 2005 were searched for interventions reporting the Hospital Anxiety and Depression Scale (HADS) or the Spielberger State-Trait Anxiety Inventory (STAI). Multilevel mixed-effects modeling was used to meta-analyze effect-sizes separately for the HADS (27 trials, 2,424 patients) and STAI (34 trials, 2,029 patients). Pre-intervention distress significantly moderated intervention effects, explaining up to 50% of the between-study effect-size variance: effects on anxiety and depression were generally negligible when pre-intervention distress was low and pronounced when it was high. These results could not be explained by differences in intervention type, setting, dose, and whether intervention was targeted at distressed patients. Psychosocial interventions may be most beneficial for cancer patients with elevated distress. Future research should identify which treatment components are most effective for these patients to facilitate optimal treatment tailoring and cost-effective health care.
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Affiliation(s)
- Stefan Schneider
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, USA.
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Sheppard VB, Williams KP, Harrison TM, Jennings Y, Lucas W, Stephen J, Robinson D, Mandelblatt JS, Taylor KL. Development of decision-support intervention for Black women with breast cancer. Psychooncology 2010; 19:62-70. [PMID: 19267384 PMCID: PMC3136087 DOI: 10.1002/pon.1530] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Adjuvant therapy improves breast cancer survival but is underutilized by Black women. Few interventions have addressed this problem. This preliminary report describes the process we used to develop a decision-support intervention for Black women eligible for adjuvant therapy. Aims were to use qualitative methods to describe factors that influence Black women's adjuvant therapy decisions, use these formative data to develop messages for a treatment decision-support intervention, and pilot test the acceptability and utility of the intervention with community members and newly diagnosed women. METHODS Thirty-four in-depth interviews were conducted with breast cancer patients in active treatment, survivors and cancer providers to gather qualitative data. Participant ages ranged from 38 to 69 years. A cultural framework was used to analyze the data and to inform intervention messages. Most women relied on their providers for treatment recommendations. Several women reported problems communicating with providers and felt unprepared to ask questions and discuss adjuvant treatment options. Other factors related to treatment experiences were: spiritual coping, collectivism and sharing breast cancer experiences with other Black survivors. RESULTS Using these formative data, we developed an intervention that is survivor-based and includes an in-person session which incorporates sharing personal stories, communication skills training and decision support. Intervention materials were reviewed by community members, researchers/clinicians and patients newly diagnosed with breast cancer. CONCLUSION Patients reported satisfaction with the intervention and felt better prepared to talk with providers. The intervention will be tested in a randomized trial to enhance decision support and increase use of indicated adjuvant treatment.
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Affiliation(s)
- Vanessa B. Sheppard
- Georgetown University, Cancer Control Program, 3300 Whitehaven St., NW, Suite 4100, Washington, DC 20007, 202-687-7036 (phone), 202-687-0305 (fax)
| | - Karen Patricia Williams
- Michigan State University, Obstetrics Gynecology & Reproductive Biology, 224D W Fee Hall, East Lansing, MI 48824-1315, 517-432-4790 (phone)
| | - Toni Michelle Harrison
- Georgetown University, Cancer Control Program, 3300 Whitehaven St., NW, Suite 4100, Washington, DC 20007, 202-687-7036 (phone), 202-687-0305 (fax)
| | - Yvonne Jennings
- Georgetown University, Cancer Control Program, 3300 Whitehaven St., NW, Suite 4100, Washington, DC 20007, 202-687-7036 (phone), 202-687-0305 (fax)
| | - Wanda Lucas
- Georgetown University, Cancer Control Program, 3300 Whitehaven St., NW, Suite 4100, Washington, DC 20007, 202-687-7036 (phone), 202-687-0305 (fax)
| | - Juleen Stephen
- Virginia Polytechnic Institute and State University, Department of Health Promotion, 206 War Memorial Hall, Blacksburg, VA 24061, 540-231-5029 (phone)
| | - Dana Robinson
- Sisters from the Heart, Washington, D.C., 5100 Auth Way, Suitland, MD 20747, 202-564-8018
| | - Jeanne S. Mandelblatt
- Georgetown University, Cancer Control Program, 3300 Whitehaven St., NW, Suite 4100, Washington, DC 20007, 202-687-7036 (phone), 202-687-0305 (fax)
| | - Kathryn L. Taylor
- Georgetown University, Cancer Control Program, 3300 Whitehaven St., NW, Suite 4100, Washington, DC 20007, 202-687-7036 (phone), 202-687-0305 (fax)
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Abstract
Taking CHARGE, a theory-based self-management program, was developed to assist women with survivorship concerns that arise after breast cancer treatment. Few such programs have been evaluated for cultural relevance with diverse groups. This study determined the utility and cultural relevance of the program for African American (AA) breast cancer survivors. Two focus groups were held with AA women (n = 13), aged 41 to 72 years, who had completed primary treatment. Focus group participants assessed the program content, format, materials, and the self-regulation process. Content analysis of audiotapes was conducted using an open, focused coding process to identify emergent themes regarding program relevance and topics requiring enhancement and/or further emphasis. Although findings indicated that the program's content was relevant to participants' experiences, AA women identified need for cultural enhancements in spirituality, self-preservation, and positive valuations of body image. Content areas requiring more emphasis included persistent fatigue, competing demands, disclosure, anticipatory guidance, and age-specific concerns about body image/sexuality. Suggested improvements to program materials included portable observation logs, additional resources, more photographs of younger AA women, vivid colors, and images depicting strength. These findings provide the basis for program enhancements to increase the utility and cultural relevance of Taking CHARGE for AA survivors and underscore the importance of evaluating interventions for racially/ethnically diverse groups.
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Weathers B, Kessler L, Collier A, Stopfer JE, Domchek S, Halbert CH. Utilization of religious coping strategies among African American women at increased risk for hereditary breast and ovarian cancer. FAMILY & COMMUNITY HEALTH 2009; 32:218-227. [PMID: 19525703 PMCID: PMC4155033 DOI: 10.1097/fch.0b013e3181ab3b53] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This observational study evaluated utilization of religious coping strategies among 95 African American women who were at increased risk for having a BRCA1/BRCA2 (BRCA1/2) mutation. Overall, women reported high levels of collaborative coping; however, women with fewer than 2 affected relatives (beta = -1.97, P = 0.04) and those who had a lower perceived risk of having a BRCA1/2 mutation (beta = -2.72, P = 0.01) reported significantly greater collaborative coping. These results suggest that African American women may be likely to use collaborative strategies to cope with cancer-related stressors. It may be important to discuss utilization of religious coping efforts during genetic counseling with African American women.
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Affiliation(s)
- Benita Weathers
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
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Shelby RA, Crespin TR, Wells-Di Gregorio SM, Lamdan RM, Siegel JE, Taylor KL. Optimism, social support, and adjustment in African American women with breast cancer. J Behav Med 2008; 31:433-44. [PMID: 18712591 PMCID: PMC3752850 DOI: 10.1007/s10865-008-9167-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Accepted: 07/31/2008] [Indexed: 11/25/2022]
Abstract
Past studies show that optimism and social support are associated with better adjustment following breast cancer treatment. Most studies have examined these relationships in predominantly non-Hispanic White samples. The present study included 77 African American women treated for nonmetastatic breast cancer. Women completed measures of optimism, social support, and adjustment within 10-months of surgical treatment. In contrast to past studies, social support did not mediate the relationship between optimism and adjustment in this sample. Instead, social support was a moderator of the optimism-adjustment relationship, as it buffered the negative impact of low optimism on psychological distress, well-being, and psychosocial functioning. Women with high levels of social support experienced better adjustment even when optimism was low. In contrast, among women with high levels of optimism, increasing social support did not provide an added benefit. These data suggest that perceived social support is an important resource for women with low optimism.
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Affiliation(s)
- Rebecca A Shelby
- Duke University Medical Center, 2200 W. Main St., Ste 340, Durham, NC 27705, USA.
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Ashing-Giwa KT. Enhancing physical well-being and overall quality of life among underserved Latina-American cervical cancer survivors: feasibility study. J Cancer Surviv 2008; 2:215-23. [DOI: 10.1007/s11764-008-0061-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Accepted: 07/04/2008] [Indexed: 10/21/2022]
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Shacham E, Reece M, Ong'or WO, Omollo O, Monahan PO, Ojwang C. Characteristics of psychosocial support seeking during HIV-related treatment in western Kenya. AIDS Patient Care STDS 2008; 22:595-601. [PMID: 18479225 PMCID: PMC2929147 DOI: 10.1089/apc.2007.0213] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
While the characteristics of those who seek psychosocial support following an HIV diagnosis have been well documented in western countries where linkages between HIV-related treatment and psychosocial support programs are well established, little is known about those who become engaged with such services in countries of the world where comprehensive HIV-related care and prevention systems are continuing to develop. Data were collected from 397 individuals who had enrolled in HIV-related psychosocial support groups in western Kenya in November 2005. Demographic and HIV-related characteristics, as well as assessments of psychological distress, were collected from each participant and analyzed by gender in order to document the characteristics of those seeking psychosocial care in conjunction with their participation in an HIV-related treatment and prevention program. Those seeking psychosocial support were primarily female (72%), living with HIV for an average of 2.5 years, and unemployed (70%). Women were younger and more likely to be either widowed or never married; while men were more likely to have advanced HIV disease, including lower CD4 counts and an AIDS diagnosis. Across all participants, HIV serostatus disclosure was rarely reported to sex partners, family members, and friends. Symptoms of psychological distress were more prevalent among women on multiple measures, including depression, anxiety, paranoid ideation, interpersonal sensitivity, and somatization. An increased understanding of the characteristics of those likely to seek psychosocial support groups will help HIV program managers to develop protocols necessary for facilitating linkages to psychosocial support for those enrolled in HIV-related treatment programs. Patient engagement in psychosocial support may facilitate improvements in psychological function and support an individual's maintenance of HIV treatment and prevention behaviors.
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Affiliation(s)
- Enbal Shacham
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, Missouri 63108, USA.
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Jones RA, Taylor AG, Bourguignon C, Steeves R, Fraser G, Lippert M, Theodorescu D, Mathews H, Kilbridge KL. Family interactions among African American prostate cancer survivors. FAMILY & COMMUNITY HEALTH 2008; 31:213-20. [PMID: 18552602 PMCID: PMC2810541 DOI: 10.1097/01.fch.0000324478.55706.fe] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Prostate cancer affects African Americans at a higher rate than any other ethnic group in the United States. Prostate cancer does not only affect the man with the disease but also affects those individuals who are closest to him, such as his family and friends. Open communication is valuable in coping with stressors that are affiliated with chronic illnesses. This article focuses on family and friend social support of men with prostate cancer. Data analysis revealed that support from family members and friends plays an important role in how men cope with their treatment and recovery from prostate cancer.
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Affiliation(s)
- Randy A Jones
- School of Nursing, University of Virginia, Charlottesville, VA 22908, USA.
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Pals SL, Murray DM, Alfano CM, Shadish WR, Hannan PJ, Baker WL. Individually randomized group treatment trials: a critical appraisal of frequently used design and analytic approaches. Am J Public Health 2008; 98:1418-24. [PMID: 18556603 DOI: 10.2105/ajph.2007.127027] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We reviewed published individually randomized group treatment (IRGT) trials to assess researchers' awareness of within-group correlation and determine whether appropriate design and analytic methods were used to test for treatment effectiveness. METHODS We assessed sample size and analytic methods in IRGT trials published in 6 public health and behavioral health journals between 2002 and 2006. RESULTS Our review included 34 articles; in 32 (94.1%) of these articles, inappropriate analytic methods were used. In only 1 article did the researchers claim that expected intraclass correlations (ICCs) were taken into account in sample size estimation; in most articles, sample size was not mentioned or ICCs were ignored in the reported calculations. CONCLUSIONS Trials in which individuals are randomly assigned to study conditions and treatments administered in groups may induce within-group correlation, violating the assumption of independence underlying commonly used statistical methods. Methods that take expected ICCs into account should be used in reexamining past studies and planning future studies to ensure that interventions are not judged effective solely on the basis of statistical artifacts. We strongly encourage investigators to report ICCs from IRGT trials and describe study characteristics clearly to aid these efforts.
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Affiliation(s)
- Sherri L Pals
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, MS E-45, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
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Maramaldi P, Dungan S, Poorvu NL. Cancer treatments. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2008; 50 Suppl 1:45-77. [PMID: 18924387 DOI: 10.1080/01634370802137793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Cancer is of particular importance to gerontology due to the changing nature of the disease. Survival rates are at all time highs as a result of technological advances in early detection and treatment of cancer. Some less aggressive or invasive forms of cancer are now seen as chronic illnesses rather than acute, terminal diseases. As a result, demand is increasing for evidence-based psychosocial interventions designed to improve the health and well-being of people living with cancer. This article reviews evidence-based psychosocial interventions designed to address the needs of persons with cancer and their family members. Traditional and technology enhance interventions are discussed as are complementary and alternative therapies designed to augment traditional interventions.
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Hughes Halbert C, Barg FK, Weathers B, Delmoor E, Coyne J, Wileyto EP, Arocho J, Mahler B, Malkowicz SB. Differences in cultural beliefs and values among African American and European American men with prostate cancer. Cancer Control 2007; 14:277-84. [PMID: 17615534 DOI: 10.1177/107327480701400311] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although cultural values are increasingly being recognized as important determinants of psychological and behavioral outcomes following cancer diagnosis and treatment, empirical data are not available on cultural values among men. This study evaluated differences in cultural values related to religiosity, temporal orientation, and collectivism among African American and European American men. METHODS Participants were 119 African American and European American men who were newly diagnosed with early-stage and locally advanced prostate cancer. Cultural values were evaluated by self-report using standardized instruments during a structured telephone interview. RESULTS After controlling for sociodemographic characteristics, African American men reported significantly greater levels of religiosity (Beta = 24.44, P < .001) compared with European American men. African American men (Beta = 6.30, P < .01) also reported significantly greater levels of future temporal orientation. In addition, men with more aggressive disease (eg, higher Gleason scores) (Beta = 5.11, P < .01) and those who were pending treatment (Beta = -6.42, P < .01) reported significantly greater levels of future temporal orientation. CONCLUSIONS These findings demonstrate that while ethnicity is associated with some cultural values, clinical experiences with prostate cancer may also be important. This underscores the importance of evaluating the effects of both ethnicity and clinical factors in research on the influence of cultural values on cancer prevention and control.
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Magai C, Consedine NS, Adjei BA, Hershman D, Neugut A. Psychosocial influences on suboptimal adjuvant breast cancer treatment adherence among African American women: implications for education and intervention. HEALTH EDUCATION & BEHAVIOR 2007; 35:835-54. [PMID: 17909222 DOI: 10.1177/1090198107303281] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite lower incidence, African American women are at increased risk of dying from breast cancer relative to their European American counterparts. Although there are key differences in both screening behavior and tumor characteristics, an additional part of this mortality difference may lie in the fact that African American women receive suboptimal adjuvant chemotherapy and may receive suboptimal hormonal therapy, therapies that are known to increase survival. The authors consider ethnic differences in the psychosocial factors that have been shown to relate to poor screening adherence and consider how they may influence adherence to breast cancer adjuvant treatment, thus the receipt of suboptimal adjuvant chemo or hormonal therapy. To this end, they review ethnic differences in cognitive, emotional, and social network variables. Psychosocial variables should be included in research designed to understand cancer disparities as well interventions that can be tailored to culturally diverse populations to improve treatment adherence.
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Affiliation(s)
- Carol Magai
- Department of Psychology, Long Island University, Brooklyn, New York 11201, USA.
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Gottlieb BH, Wachala ED. Cancer support groups: a critical review of empirical studies. Psychooncology 2007; 16:379-400. [PMID: 16986205 DOI: 10.1002/pon.1078] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Support groups for adults affected by cancer are widely offered by local community and national agencies in North America. This type of psychosocial intervention is defined in terms of its structure and functions, and its theoretical underpinnings and models of practice are described. Forty-four empirical studies of professionally led cancer support groups are summarized and critically reviewed. These studies include 32 outcome evaluations of randomized controlled trials, two process evaluations, and 10 consumer satisfaction studies. The findings reveal high levels of consumer satisfaction, and the outcome evaluations substantiate the morale and other quality of life benefits short of prolonging life. Discussion centers on priorities for future research and practice.
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Affiliation(s)
- Benjamin H Gottlieb
- Department of Psychology, University of Guelph, Guelph, Ont., Canada N1G 2W1.
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Carmack Taylor CL, Kulik J, Badr H, Smith M, Basen-Engquist K, Penedo F, Gritz ER. A social comparison theory analysis of group composition and efficacy of cancer support group programs. Soc Sci Med 2007; 65:262-73. [DOI: 10.1016/j.socscimed.2007.03.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2006] [Indexed: 10/23/2022]
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Cameron LD, Booth RJ, Schlatter M, Ziginskas D, Harman JE. Changes in emotion regulation and psychological adjustment following use of a group psychosocial support program for women recently diagnosed with breast cancer. Psychooncology 2007; 16:171-80. [PMID: 16858670 DOI: 10.1002/pon.1050] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study assesses the efficacy of a group intervention in altering emotion regulation processes and promoting adjustment in women with breast cancer. Using a design with 10 alternating phases of availability of the intervention versus standard care, we assessed women participating in one of three conditions: a 12-week group intervention (N = 54); a decliner group who refused the intervention (N = 56), and a standard care group who were not offered the intervention (N = 44). The intervention included training in relaxation, guided imagery, meditation, emotional expression, and exercises promoting control beliefs and benefit-finding. Emotion regulation processes and adjustment were assessed at baseline (following diagnosis), 4 months (corresponding with the end of the intervention), 6 months, and 12 months. At 4 months, intervention participants (compared to decliners and standard care participants) reported greater increases in use of relaxation-oriented techniques, perceived control, emotional well-being, and coping efficacy, and, greater decreases in perceived risk of recurrence, cancer worry, and anxiety. Intervention participants also reported relatively greater decreases in emotional suppression from baseline to 12 months, suggesting that the intervention had a delayed impact on these tendencies. The findings suggest an emotion regulation intervention can beneficially influence emotional experiences and regulation over the first year following diagnosis.
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Moadel AB, Morgan C, Dutcher J. Psychosocial needs assessment among an underserved, ethnically diverse cancer patient population. Cancer 2007; 109:446-54. [PMID: 17123273 DOI: 10.1002/cncr.22357] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Little attention has been directed towards identifying and addressing the psychosocial needs of ethnic minority and underserved cancer patients. This study describes the development of a psychosocial needs survey and patterns and predictors of need among an ethnically diverse underserved cancer patient population in Bronx, New York. A 34-item psychosocial needs assessment survey was developed to assess 4 categories of need: Informational, Practical, Supportive, and Spiritual. A total of 248 oncology outpatients (48% non-Hispanic whites, 25% African Americans; 19% Hispanic) completed the survey in oncology clinic waiting rooms. The survey demonstrated high internal consistency and face validity. Ethnicity was the sole predictor of needs (P < .02), even after controlling for education, time since diagnosis, treatment status, marital status, and age. The mean percentage of needs endorsed by African Americans, Hispanics, and non-Hispanic whites respectively was 81%, 85%, 70% for Informational; 63%, 68%, 36% for Practical; 69%, 73%, 48% for Supportive; and 49%, 60%, 31% for Spiritual needs. This needs assessment offers clear directions in which to focus QOL intervention efforts among underserved and ethnic minority cancer patients. Cancer 2007. (c) 2006 American Cancer Society.
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Affiliation(s)
- Alyson B Moadel
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
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