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Daniels S, Franqui-Rios ND, Mothi SS, Gaitskill E, Cantrell K, Kaye EC. Access to legacy-oriented interventions at end of life for pediatric oncology patients: A decedent cohort review. Pediatr Blood Cancer 2024; 71:e31066. [PMID: 38757484 DOI: 10.1002/pbc.31066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/13/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Legacy-oriented interventions have the potential to offer pediatric oncology patients and families comfort at end of life and during bereavement. Certified child life specialists often provide these services, and presently little is known about whether disparities exist in the provision of legacy-oriented interventions. METHODS In this retrospective decedent cohort study, we examined demographic and clinical characteristics from a sample of 678 pediatric oncology patients who died between 2015 and 2019. Bivariate analysis assessed differences between patients who received any versus no legacy-oriented intervention. Uni- and multivariable logistic regression models assessed associations of baseline characteristics and likelihood of receiving legacy-oriented intervention. Further multivariable analysis explored joint effects of significant variables identified in the univariable analysis. RESULTS Fifty-two percent of patients received a legacy-oriented intervention. Older adolescents (≥13 years) were less likely (odds ratio [OR]: 1.73, p = .007) to receive legacy-oriented interventions than younger ones. Patients with home/hospice deaths were also less likely (OR: 19.98, p < .001) to receive interventions compared to patients who passed away at SJCRH locations. Hispanic patients (OR: 1.53, p = .038) and those in palliative care (OR: 10.51, p < .001) were more likely to receive interventions. No significant race association was noted. CONCLUSION All children and adolescents with cancer deserve quality care at end of life, including access to legacy-oriented interventions, yet nearly half of patients in this cohort did not receive these services. By identifying demographic and clinical characteristics associated with decreased odds of receiving legacy-oriented interventions, healthcare professionals can modify end-of-life care processes to improve access. Introducing legacy-oriented interventions early and increasing exposure in community spaces may enhance access to legacy-oriented interventions for pediatric oncology patients.
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Affiliation(s)
- Sarah Daniels
- Child Life Program, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Nelson D Franqui-Rios
- School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico, Puerto Rico
| | - Suraj S Mothi
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Elizabeth Gaitskill
- Child Life Program, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Kathryn Cantrell
- Department of Human Development, Family Studies, and Counseling, Texas Woman's University, Denton, Texas, USA
| | - Erica C Kaye
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Hinton T, Burns-Nader S. "They Did Not Understand": Exploring Adult Survivors of Childhood Cancer's Memories of Their Experiences With Peers. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:276-282. [PMID: 39169722 DOI: 10.1177/27527530241245657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Background: Peer relationships are impacted by the diagnosis of childhood cancer. Children with cancer can feel isolation, such as bullying and lack of engagement, from their peers. As the rates of survival increase, one way to further learn about the experiences of childhood cancer is to reflect on the memories of adult survivors. This study examines adult survivors of childhood cancer's memories of their experiences with peers during their cancer. Method: Twenty-seven adult survivors (15 male, 12 female) of childhood cancer were recruited from Amazon Mechanical Turk, a crowdsourcing marketplace for survey distribution, and surveyed about their experiences with peers during childhood cancer. Using inductive thematic analysis, open-ended survey questions were analyzed. Results: Five main themes emerged, including age, perceptions of cancer, acts of kindness, peer responses, and limited peer engagement. Participants' memories included peers' lack of understanding about their diagnosis, prognosis, and treatment, positive and negative responses to their cancer diagnosis, acts of services and gifts from peers, and feelings of isolation during the cancer experience. Discussion: In the current study, adult survivors of childhood cancer had specific memories about how cancer impacted peer relationships. Such findings contribute to the evidence that children with cancer could benefit from psychosocial interventions, including education to peers about the diagnosis and the impact of diagnosis on peer relationships, peer engagement activities, and peer support groups.
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Neylon K, Condren C, Guerin S, Looney K. What Are the Psychosocial Needs of Adolescents and Young Adults with Cancer? A Systematic Review of the Literature. J Adolesc Young Adult Oncol 2023; 12:799-820. [PMID: 37130327 DOI: 10.1089/jayao.2022.0130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Adolescents and young adults with cancer (AYACs) have become recognized as a unique group in recent years. The unique developmental context and related challenges of being a young person with a cancer diagnosis can lead to a distinct and diverse set of psychosocial issues. Existing research has attempted to explore these psychosocial needs and challenges and to develop appropriate and individualized interventions. However, the needs of this group remain unmet, with ongoing calls for individualized support. This systematic review addressed the research question, "what are the psychosocial needs of AYACs aged 15-24 years?." PubMed, PsycINFO, and CINAHL databases were searched to identify relevant studies from January 2000 to December 2022 (inclusive). Qualitative, quantitative, and mixed methods designs were included and 29 studies met inclusion criteria. Findings provide an overview of needs from the existing literature and support the idea of a changing constellation of psychosocial needs for AYACs in areas such as identity, relationships, mental health, autonomy, and occupation. The main implications for theory and future research include the importance of the developmental context and consideration of discrepancies in the age range used within the literature to define this group.
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Affiliation(s)
- Karen Neylon
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Caoimhe Condren
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Kathy Looney
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
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Lazard AJ, Meernik C, Collins MKR, Vereen RN, Benedict C, Valle CG, Love B. Social Media Use for Cancer Support Among Young Adults with Cancer. J Adolesc Young Adult Oncol 2023; 12:674-684. [PMID: 37257189 DOI: 10.1089/jayao.2023.0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Purpose: Social media can facilitate peer support among young adults with cancer; however, information is needed about what social media are used, by whom, and how to inform resource and intervention recommendations. Methods: In December 2021, we conducted an online survey with 396 young adults with cancer, ages 18-39, with any diagnosis ages 15-39. Participants reported their social media use to connect with other young adults with cancer, including frequency of use, type of support, and affect (positive to negative) when using to connect with cancer peers. Results: Participants were on average 31 years old (SD = 5.2), with an average age of 27 at diagnosis (63.4% male, 62.1% non-Hispanic White). Almost all (97.5%) reported using social media to connect with other young adults with cancer. Many (48.0%) used three or more social media platforms for cancer support, including Facebook (44.4%), YouTube (43.6%), Instagram (43.4%), Snapchat (36.9%), and Twitter (36.9%). Daily use for cancer support was common (32.9%-60.9%) among those who used social media, particularly among those who were younger; are not transgender; live in urban areas; or had brain, gynecologic, or testicular cancers. Across social media platforms, young adults with cancer reported seeking and sharing emotional support (88.9%), informational support (84.1%), and making connections (81.3%). Conclusion: Young adults with cancer use social media to connect with cancer peers for support. Commonly used existing social media (e.g., Facebook, YouTube, Instagram) should be prioritized in interventions to reach young adults who desire more age-appropriate resources to improve their psychosocial health.
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Affiliation(s)
- Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Clare Meernik
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Meredith K Reffner Collins
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Catherine Benedict
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Carmina G Valle
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brad Love
- Center for Health Communication, The University of Texas, Austin, Texas, USA
- GRYT Health, Rochester, New York, USA
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5
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Daniels S, Willard VW. Social media interactions after diagnosis: Social experiences of adolescents and young adults (AYA) with cancer. J Psychosoc Oncol 2023; 42:351-364. [PMID: 37651311 DOI: 10.1080/07347332.2023.2249876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
PURPOSE Cancer disrupts the social lives of adolescents and young adults (AYA). Social media may be a resource to engage with social networks, seek entertainment, and receive social support. However, some aspects of social media engagement may be emotionally burdensome and sensitive for AYA to navigate. The aim of this qualitative study was to contextualize the impact of cancer on AYA social media interaction. METHODS Eight AYA ages 15-21 years and recently diagnosed with cancer participated in a semi-structured interview. AYA were asked about their social media interactions, engagement habits, and online cancer-related disclosure. Interviews averaged 36 min in length and were de-identified and transcribed verbatim and analyzed using thematic analysis. RESULTS Four salient themes emerged from the data: (1) AYA engage in active and passive social media use depending on the platform, (2) AYA social media habits change due to treatment experiences, (3) AYA evaluate and protect their self-image, privacy, and time, and (4) AYA access social support online and interpret its meaning in different ways. AYA reported using social media, but many altered their frequency and type of interaction after diagnosis. Some were comfortable sharing about cancer and continued to interact actively online; others felt protective and vulnerable, transitioning to media consumption, or withdrawing from use. While social media provided space to receive direct and indirect social support, AYA interpreted the meaning of support in complex ways. CONCLUSIONS Social media may serve a variety of socio-emotional needs, but not all AYA will benefit from the same types of social media interaction. This study highlights the importance of talking to AYA with cancer about their social media interactions during treatment to better support their coping and adjustment.
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Affiliation(s)
- Sarah Daniels
- St. Jude Children's Research Hospital, Memphis, TN, USA
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Zenone M, Snyder J, Bélisle-Pipon JC, Caulfield T, van Schalkwyk M, Maani N. Advertising Alternative Cancer Treatments and Approaches on Meta Social Media Platforms: Content Analysis. JMIR INFODEMIOLOGY 2023; 3:e43548. [PMID: 37256649 DOI: 10.2196/43548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/13/2023] [Accepted: 03/27/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Alternative cancer treatment is associated with a greater risk of death than cancer patients undergoing conventional treatments. Anecdotal evidence suggests cancer patients view paid advertisements promoting alternative cancer treatment on social media, but the extent and nature of this advertising remain unknown. This context suggests an urgent need to investigate alternative cancer treatment advertising on social media. OBJECTIVE This study aimed to systematically analyze the advertising activities of prominent alternative cancer treatment practitioners on Meta platforms, including Facebook, Instagram, Messenger, and Audience Network. We specifically sought to determine (1) whether paid advertising for alternative cancer treatment occurs on Meta social media platforms, (2) the strategies and messages of alternative cancer providers to reach and appeal to prospective patients, and (3) how the efficacy of alternative treatments is portrayed. METHODS Between December 6, 2021, and December 12, 2021, we collected active advertisements from alternative cancer clinics using the Meta Ad Library. The information collected included identification number, URL, active/inactive status, dates launched/ran, advertiser page name, and a screenshot (image) or recording (video) of the advertisement. We then conducted a content analysis to determine how alternative cancer providers communicate the claimed benefits of their services and evaluated how they portrayed alternative cancer treatment efficacy. RESULTS We identified 310 paid advertisements from 11 alternative cancer clinics on Meta (Facebook, Instagram, or Messenger) marketing alternative treatment approaches, care, and interventions. Alternative cancer providers appealed to prospective patients through eight strategies: (1) advertiser representation as a legitimate medical provider (n=289, 93.2%); (2) appealing to persons with limited treatments options (n=203, 65.5%); (3) client testimonials (n=168, 54.2%); (4) promoting holistic approaches (n=121, 39%); (5) promoting messages of care (n=81, 26.1%); (6) rhetoric related to science and research (n=72, 23.2%); (7) rhetoric pertaining to the latest technology (n=63, 20.3%); and (8) focusing treatment on cancer origins and cause (n=43, 13.9%). Overall, 25.8% (n=80) of advertisements included a direct statement claiming provider treatment can cure cancer or prolong life. CONCLUSIONS Our results provide evidence alternative cancer providers are using Meta advertising products to market scientifically unsupported cancer treatments. Advertisements regularly referenced "alternative" and "natural" treatment approaches to cancer. Imagery and text content that emulated evidence-based medical providers created the impression that the offered treatments were effective medical options for cancer. Advertisements exploited the hope of patients with terminal and poor prognoses by sharing testimonials of past patients who allegedly were cured or had their lives prolonged. We recommend that Meta introduce a mandatory, human-led authorization process that is not reliant upon artificial intelligence for medical-related advertisers before giving advertising permissions. Further research should focus on the conflict of interest between social media platforms advertising products and public health.
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Affiliation(s)
- Marco Zenone
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | | | - May van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nason Maani
- Global Health Policy Unit, University of Edinburgh, Edinburgh, United Kingdom
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Steineck A, Lau N, Fladeboe KM, Walsh CA, Rosenberg AR, Yi-Frazier JP, Barton KS. Seeking virtual support: Digital technology use in adolescent and young adults with advanced cancer. Pediatr Blood Cancer 2022; 69:e29938. [PMID: 36069542 PMCID: PMC10324622 DOI: 10.1002/pbc.29938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND A cancer diagnosis, especially advanced cancer, interferes with adolescent/young adult (AYA) peer relationships. AYAs increasingly use digital technologies (i.e., social media, video games) as a social instrument; little is known about the role of digital technologies in the AYA cancer experience. The objective of this analysis was to describe the use and impact of digital technologies among AYAs with advanced cancer. PROCEDURE As part of the "Exploring the Concept of a 'Good Death'" study, semi-structured interviews were conducted with 32 English-speaking AYAs (14-25 years) with advanced cancer (relapsed/refractory disease, estimated survival <50%). Interviews were audio recorded, deidentified, and transcribed verbatim. Questions focused on communication and sources of psychosocial support. Directed content analysis was used for codebook creation. Three reviewers completed transcript coding and reconciled discrepancies. Thematic analysis identified hierarchical themes. The present analysis focused on the specific theme of "digital technologies as a support mechanism." RESULTS When asked about sources of support, social media and multiplayer online games were most often recognized by AYAs. Three themes emerged regarding the role of digital technologies: distraction, maintaining existing peer support, and connecting with peers with cancer. Two AYAs acknowledged negative consequences of social media. CONCLUSIONS AYAs with advanced cancer cite digital technologies as a mechanism for maintaining and seeking peer support. Digital technologies may be leveraged to provide psychosocial support for AYAs with advanced cancer.
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Affiliation(s)
- Angela Steineck
- Seattle Children’s Hospital, Cancer and Blood Disorders Center; Seattle, WA
- Seattle Children’s Research Institute, Center for Clinical and Translational Research, Palliative Care and Resilience Lab; Seattle, WA
- University of Washington School of Medicine, Department of Pediatrics; Seattle, WA
- MACC Fund Center for Cancer and Blood Disorders, Department of Pediatrics, Medical College of Wisconsin; Milwaukee, WI, USA
| | - Nancy Lau
- Seattle Children’s Research Institute, Center for Clinical and Translational Research, Palliative Care and Resilience Lab; Seattle, WA
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA
| | - Kaitlyn M. Fladeboe
- Seattle Children’s Research Institute, Center for Clinical and Translational Research, Palliative Care and Resilience Lab; Seattle, WA
- University of Washington School of Medicine, Department of Pediatrics; Seattle, WA
| | - Casey A. Walsh
- Seattle Children’s Research Institute, Center for Clinical and Translational Research, Palliative Care and Resilience Lab; Seattle, WA
- University of Washington, Department of Health Services, Seattle, WA
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA
| | - Abby R. Rosenberg
- Seattle Children’s Hospital, Cancer and Blood Disorders Center; Seattle, WA
- Seattle Children’s Research Institute, Center for Clinical and Translational Research, Palliative Care and Resilience Lab; Seattle, WA
- University of Washington School of Medicine, Department of Pediatrics; Seattle, WA
| | - Joyce P. Yi-Frazier
- Seattle Children’s Research Institute, Center for Clinical and Translational Research, Palliative Care and Resilience Lab; Seattle, WA
| | - Krysta S. Barton
- Seattle Children’s Research Institute, Center for Clinical and Translational Research, Palliative Care and Resilience Lab; Seattle, WA
- Biostatistics Epidemiology and Analytics for Research (BEAR) Core, Seattle Children’s Research Institute, Seattle, WA
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Cheung CK, Norlander MG, Vest AN, Thomas BN, Zebrack BJ. A Thin Line Between Helpful and Harmful Internet Usage: Embodied Research on Internet Experiences Among Adolescent and Young Adult Cancer Patients. J Adolesc Young Adult Oncol 2022; 11:478-485. [PMID: 34882036 PMCID: PMC11071103 DOI: 10.1089/jayao.2021.0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The purpose of this study was to expand upon findings from a prior Delphi study of adolescent and young adults' (AYAs') preferences for cancer resources. Utilizing an embodied approach, this study intended to elucidate a deeper and nuanced understanding of the expressed benefits and risks of engaging in cancer-related online interactions. Methods: Using Gale et al.'s framework method for qualitative, multidisciplinary health research and Thanem and Knights's embodied research methods for the social sciences, an investigative team of embodied researchers (AYA cancer patients turned researchers) conducted semistructured in-depth interviews with AYA cancer patients (n = 10) diagnosed between ages 15 and 39 years. To generate themes, researchers identified commonalities and differences within the qualitative data, and indexed codes according to the agreed analytic framework. Furthermore, by fully engaging with personal reflexivity, bracketing, and analytic memos across data collection and analysis, the investigative team elucidated benefits and risks of embodied research. Results: Findings impart evidence on AYAs' needs for internet-based content at the time of cancer diagnosis, use of the internet to fulfill cancer-related needs, perception of gaps in online cancer resources, and advice to other AYA cancer patients accessing internet-based information and support. Content analysis of interview data on participants' descriptions of personal engagement with the internet revealed beneficial themes of empowerment and harmful themes of fear-inducing consequences. Conclusions: In our rapidly evolving context of postpandemic internet reliance, developers of online cancer content should prioritize and respond to the nuanced vulnerabilities of AYAs. Future research must include socioeconomically disadvantaged participants to better understand practical challenges and promote health equity.
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Affiliation(s)
| | | | - Adriana N. Vest
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Bria N. Thomas
- Loyola University Maryland, Department of Biology and Department of Psychology, Baltimore, Maryland, USA
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Rost M, Espeli V, Ansari M, von der Weid N, Elger BS, De Clercq E. Covid-19 and beyond: broadening horizons about social media use in oncology. A survey study with healthcare professionals caring for youth with cancer. HEALTH POLICY AND TECHNOLOGY 2022; 11:100610. [PMID: 35265457 PMCID: PMC8895679 DOI: 10.1016/j.hlpt.2022.100610] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objectives Methods Results Conclusion
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Affiliation(s)
- Michael Rost
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, CH, Basel 4056, Switzerland
| | - Vittoria Espeli
- Istituto Oncologico della Svizzera Italiana, Oncologia Medica Bellinzona, TI, CH, Switzerland
| | - Marc Ansari
- Hôpitaux Universitaires de Genève Département de l'Enfant et de l'Adolescent, Onco-Hématologie Pédiatrique, CH, Genève, Switzerland
| | | | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, CH, Basel 4056, Switzerland
| | - Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, CH, Basel 4056, Switzerland
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Psychosocial Distress Due to Interference of Normal Developmental Milestones in AYAs with Cancer. CHILDREN 2022; 9:children9030309. [PMID: 35327680 PMCID: PMC8947616 DOI: 10.3390/children9030309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 01/19/2023]
Abstract
Cancer in the adolescent and young adult phase poses additional challenges to this period of development that is crucial to the transition to independence. This report provides a brief review of normal developmental milestones in this age range while highlighting the disruptive effects of cancer. We focus on the psychological burden of cancer in patients aged 15–39 years and explore the application of the total pain model to highlight the psychological/emotional, social, and spiritual aspects of non-physical pain. We also briefly review posttraumatic growth and resilience. Lastly, we provide a review of areas for possible development and future research.
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Sisk BA, Harvey K, Friedrich AB, Antes AL, Yaeger LH, Mack JW, DuBois J. Multilevel barriers and facilitators of communication in pediatric oncology: A systematic review. Pediatr Blood Cancer 2022; 69:e29405. [PMID: 34662485 PMCID: PMC8875310 DOI: 10.1002/pbc.29405] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/03/2023]
Abstract
Multiple factors can facilitate or impede the fulfillment of communication functions in pediatric cancer. In this systematic review, we evaluated 109 studies from the preceding 20 years that presented qualitative or quantitative evidence of barriers or facilitators to communication in pediatric cancer. Using a multilevel framework developed in our prior study, we then analyzed and categorized the levels of barriers and facilitators identified in included studies. The vast majority of studies focused on individual-level barriers, rather than team, organization/system, collaborating hospital, community, or policy-level barriers. Future studies should explore the full range of factors that affect communication.
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Affiliation(s)
- Bryan A. Sisk
- Department of Pediatrics, Division of Hematology/Oncology, Washington University School of Medicine, St. Louis, Missouri.,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Kieandra Harvey
- Brown School of Social Work, Washington University School of Medicine, St. Louis, Missouri
| | - Annie B. Friedrich
- Albert Gnaegi Center for Health Care Ethics, Saint Louis University, St. Louis, Missouri
| | - Alison L. Antes
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Lauren H Yaeger
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer W. Mack
- Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts; and Division of Pediatric Hematology/Oncology, Boston Children’s Hospital, Boston, Massachusetts
| | - James DuBois
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Eysenbach G, Angyan P, Le N, Buchanan TA. Using Patient-Generated Health Data From Twitter to Identify, Engage, and Recruit Cancer Survivors in Clinical Trials in Los Angeles County: Evaluation of a Feasibility Study. JMIR Form Res 2021; 5:e29958. [PMID: 34842538 PMCID: PMC8665395 DOI: 10.2196/29958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/07/2021] [Accepted: 09/20/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Failure to find and attract clinical trial participants remains a persistent barrier to clinical research. Researchers increasingly complement recruitment methods with social media-based methods. We hypothesized that user-generated data from cancer survivors and their family members and friends on the social network Twitter could be used to identify, engage, and recruit cancer survivors for cancer trials. OBJECTIVE This pilot study aims to examine the feasibility of using user-reported health data from cancer survivors and family members and friends on Twitter in Los Angeles (LA) County to enhance clinical trial recruitment. We focus on 6 cancer conditions (breast cancer, colon cancer, kidney cancer, lymphoma, lung cancer, and prostate cancer). METHODS The social media intervention involved monitoring cancer-specific posts about the 6 cancer conditions by Twitter users in LA County to identify cancer survivors and their family members and friends and contacting eligible Twitter users with information about open cancer trials at the University of Southern California (USC) Norris Comprehensive Cancer Center. We reviewed both retrospective and prospective data published by Twitter users in LA County between July 28, 2017, and November 29, 2018. The study enrolled 124 open clinical trials at USC Norris. We used descriptive statistics to report the proportion of Twitter users who were identified, engaged, and enrolled. RESULTS We analyzed 107,424 Twitter posts in English by 25,032 unique Twitter users in LA County for the 6 cancer conditions. We identified and contacted 1.73% (434/25,032) of eligible Twitter users (127/434, 29.3% cancer survivors; 305/434, 70.3% family members and friends; and 2/434, 0.5% Twitter users were excluded). Of them, 51.4% (223/434) were female and approximately one-third were male. About one-fifth were people of color, whereas most of them were White. Approximately one-fifth (85/434, 19.6%) engaged with the outreach messages (cancer survivors: 33/85, 38% and family members and friends: 52/85, 61%). Of those who engaged with the messages, one-fourth were male, the majority were female, and approximately one-fifth were people of color, whereas the majority were White. Approximately 12% (10/85) of the contacted users requested more information and 40% (4/10) set up a prescreening. Two eligible candidates were transferred to USC Norris for further screening, but neither was enrolled. CONCLUSIONS Our findings demonstrate the potential of identifying and engaging cancer survivors and their family members and friends on Twitter. Optimization of downstream recruitment efforts such as screening for digital populations on social media may be required. Future research could test the feasibility of the approach for other diseases, locations, languages, social media platforms, and types of research involvement (eg, survey research). Computer science methods could help to scale up the analysis of larger data sets to support more rigorous testing of the intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT03408561; https://clinicaltrials.gov/ct2/show/NCT03408561.
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Affiliation(s)
| | - Praveen Angyan
- Southern California Clinical and Translational Science Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - NamQuyen Le
- USC Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
| | - Thomas A Buchanan
- Southern California Clinical and Translational Science Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States.,Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Yang CC, Holden SM, Ariati J. Social Media and Psychological Well-Being Among Youth: The Multidimensional Model of Social Media Use. Clin Child Fam Psychol Rev 2021; 24:631-650. [PMID: 34169391 DOI: 10.1007/s10567-021-00359-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 12/13/2022]
Abstract
Social media use is almost ubiquitous among adolescents and emerging adults. Although much has been studied about the psychological implications of social media use, there is currently no integrative model in which multiple dimensions of social media are considered. The goal of this theoretical article is to introduce the Multidimensional Model of Social Media Use (MMSMU), which aims to provide a useful framework for researchers and practitioners to study and understand young people's social media use in relation to their psychological well-being. The model attends to three major dimensions: activities performed on social media, motives for social media use, and communication partners connected through social media. We present empirical evidence showing whether each dimension is associated with better or poorer well-being and identify or propose mechanisms explaining the associations. Before concluding the article, we discuss clinical implications and possible ways to further expand the proposed model.
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Affiliation(s)
- Chia-Chen Yang
- School of Educational Foundations, Leadership and Aviation, Oklahoma State University, Stillwater, USA.
| | - Sean M Holden
- Office of Institutional Research, University of Memphis, Memphis, USA
| | - Jati Ariati
- School of Educational Foundations, Leadership and Aviation, Oklahoma State University, Stillwater, USA
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