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Elledge D, Leavitt A, Hoeft A, Albritton K. Utilization of the Adolescent and Young Adult Psycho-Oncology Screening Tool in a Pediatric Hospital Adolescent/Young Adult Program. J Adolesc Young Adult Oncol 2024. [PMID: 38959175 DOI: 10.1089/jayao.2023.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024] Open
Abstract
Purpose: The AYA Psycho-Oncology Screening Tool was developed to assess adolescent and young adult (AYA) patients' distress during cancer treatment. The on-treatment distress screening tool has been validated with AYAs and includes a 10-point distress thermometer (DT) and a 53-item problem checklist (PCL). However, previous studies have not solely examined AYA cancer distress within a children's hospital. Therefore, our project aimed to explore AYA distress in a pediatric cancer setting. Methods: AYA-aged participants (aged ≥15) were given the distress screener initially within 1 month of diagnosis and every 2, 4, or 6 months, depending on their previous distress score. Chi-square, independent t-tests, and binary logistic regressions were conducted for data analysis. Results: Between January 2021 and July 2022, we completed 123 screenings in 68 AYAs (age 15-30) on treatment. Average DT score was 2.96 with 30% of participants endorsing distress levels of 5 and above. There were statistically significant differences by sex as females endorsed higher levels of distress compared with males. Adolescents (<18) endorsed statistically significant higher frequency of emotional PCL items in comparison with young adults (≥18). There were no differences by race or diagnosis. Conclusions: Our team gained awareness of specific areas of concerns for AYAs, allowing for more targeted interventions for distressed participants. Certain demographic variables may put participants at risk for increased distress. As a result of the project, a protocol has been developed to follow up with participants if they report a certain distress score (5 or above) and/or endorse critical items.
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Affiliation(s)
- Daniel Elledge
- Department of Psychology, Cook Children's Medical Center, Fort Worth, Texas, USA
| | | | - Alice Hoeft
- Research Data Science and Analytics, Cook Children's Medical Center, Fort Worth, Texas, USA
| | - Karen Albritton
- Department of Hematology/Oncology, Cook Children's Medical Center, Fort Worth, Texas, USA
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Dorfman CS, Shelby RA, Stalls JM, Thomas SM, Arrato NA, Herold B, Somers TJ, Keefe FJ, Winger JG, Vilardaga JP, Oeffinger K. Improving symptom management for survivors of young adult cancer: rationale and study protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2024; 10:87. [PMID: 38851732 PMCID: PMC11161971 DOI: 10.1186/s40814-024-01510-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 05/14/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Young adult (YA) cancer survivors are a growing, yet underserved population who often face significant and long-lasting cancer-related physical (e.g., pain, fatigue) and emotional (e.g., psychological distress) symptoms. Post-treatment symptoms can persist, disrupting YA's abilities to complete goals consistent with their developmental stage (e.g., completing their education, achieving autonomy and independence, building their careers, establishing peer and romantic relationships, building their families). While symptom management has been identified as a significant issue in YA's transitions to survivorship, the symptom management needs of this population largely go unmet. METHODS We developed an eight-session, group-based behavioral intervention that is delivered using videoconferencing to address the unique symptom management needs of YA cancer survivors. The intervention was developed in conjunction with YA survivors, leading to the novel combination of traditional behavioral symptom coping strategies, home-based physical activity, strategies from contemporary cognitive-behavioral approaches (e.g., those derived from acceptance and commitment therapy, strategies to foster self-compassion), concepts from meaning centered psychotherapy, and behavioral strategies to improve communication and health care engagement. Participants receive printed intervention materials and access to a study-specific mobile application, both of which are used throughout the program. Herein, we report on a pilot study that is in progress. Recruitment has been completed. YA cancer survivors were recruited in cohorts of n = 10 or n = 11 (n = 61) and randomized to the intervention or waitlist control arms. All participants completed a baseline assessment and four additional assessments over 1 year, with each involving a battery of self-report measures. DISCUSSION The primary objective is to evaluate intervention feasibility and acceptability. As a secondary objective, we will examine patterns of change in intervention targets (i.e., pain, fatigue, emotional distress, symptom interference). Changes from baseline among intervention targets will be estimated for each patient and compared between arms using unadjusted statistical testing. Unadjusted and adjusted multilevel modeling will be used to estimate the effect of the intervention on changes in intervention targets. Interaction models will be used to compare the trajectory of change over time between arms. We expect that this pilot trial will inform our future approach to identify, recruit, and retain participants and provide preliminary data to support a larger, fully powered randomized controlled trial evaluating the intervention. TRIAL REGISTRATION NCT04035447 at clinicaltrials.gov; registered July 29, 2019.
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Affiliation(s)
- Caroline S Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, NC, USA.
- Duke Cancer Institute, Durham, NC, USA.
| | - Rebecca A Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
| | - Juliann M Stalls
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
| | - Samantha M Thomas
- Duke Cancer Institute, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Nicole A Arrato
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Brianna Herold
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Tamara J Somers
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
| | - Francis J Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
| | - Joseph G Winger
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
| | - Jennifer Plumb Vilardaga
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
| | - Kevin Oeffinger
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, NC, USA
- Department of Medicine, Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA
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Wilharm C, Pralong A, Weiß M, Blütgen S, Hallek M, Voltz R, Simon ST, Tuchscherer A. "The Most Important Thing is That You Are Not Left Alone"-A Qualitative Study of Challenges and Needs of Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2024. [PMID: 38770689 DOI: 10.1089/jayao.2023.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
Purpose: We aimed to gain in-depth insights into the challenges and needs of adolescents and young adults with cancer (AYA) throughout their disease to detect increased needs for support. Methods: We conducted face-to-face interviews with 15 patients 18-39 years old at the time of diagnosis of malignancies who had completed treatment at the time of the interview. The interviews were analyzed using content analysis. Results: The unexpected diagnosis of a serious illness shocked the participants, especially since many were in a life phase of transition at that time and had little knowledge about cancer and its therapy. They reported feelings of helplessness, unfairness, and insecurity triggered by side effects, divergent information from health care professionals (HCPs), or lack of information. After the end of the therapy, many AYAs were challenged by prolonged changes in their lives since they gained strength from the hope of returning to "the life before." The primary needs were social and psychological support, connecting with peers, orientation, and guidance. Conclusion: AYAs face special challenges requiring support and guidance from HCPs that should extend beyond the end of the therapy. There is a need for exchange opportunities with other AYAs. Trial Registration Number: DRKS00030277 (German Clinical Trials Register); September 27, 2022.
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Affiliation(s)
- Carolin Wilharm
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Koln, Germany
| | - Anne Pralong
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Koln, Germany
| | - Mara Weiß
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Koln, Germany
| | - Saskia Blütgen
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Koln, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Faculty of Medicine and University Hospital, University of Cologne, Koln, Germany
- Faculty of Medicine and University Hospital, University of Cologne, Center for Integrated Oncology Cologne Aachen Bonn Cologne Duesseldorf (ABCD), Koln, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Koln, Germany
- Faculty of Medicine and University Hospital, University of Cologne, Center for Integrated Oncology Cologne Aachen Bonn Cologne Duesseldorf (ABCD), Koln, Germany
- Faculty of Medicine and University Hospital, University of Cologne, Center for Health Services Research (ZVFK), Koln, Germany
| | - Steffen T Simon
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Koln, Germany
- Faculty of Medicine and University Hospital, University of Cologne, Center for Integrated Oncology Cologne Aachen Bonn Cologne Duesseldorf (ABCD), Koln, Germany
| | - Armin Tuchscherer
- Department I of Internal Medicine, Faculty of Medicine and University Hospital, University of Cologne, Koln, Germany
- Faculty of Medicine and University Hospital, University of Cologne, Center for Integrated Oncology Cologne Aachen Bonn Cologne Duesseldorf (ABCD), Koln, Germany
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Gudenkauf LM, Fox RS, Gonzalez BD, Jim HSL, Salsman JM, Victorson DE, Sanford SD, Oswald LB. Need for Behavioral Interventions for Young Adults Living with Advanced Cancer in the U.S. Cancers (Basel) 2024; 16:1910. [PMID: 38791988 PMCID: PMC11120301 DOI: 10.3390/cancers16101910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
The population of young adults (YAs) aged 18-39 living with advanced cancer is growing and faces a compounded set of challenges at the intersection of age and disease. Despite these substantial challenges, behavioral interventions tailored to YAs living with advanced cancer remain scarce. This commentary aims to (1) discuss the unmet psychological, social, and behavioral needs of YAs living with advanced cancer; (2) highlight the paucity of behavioral interventions tailored to this growing population; (3) offer recommendations for the development of behavioral interventions targeting the unique needs of YAs living with advanced cancer; and (4) describe potential far-reaching public health benefits of these targeted behavioral interventions.
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Affiliation(s)
- Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33216, USA
| | - Rina S. Fox
- Division of Advanced Nursing Practice and Science, University of Arizona College of Nursing, Tucson, AZ 85721, USA
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33216, USA
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33216, USA
| | - John M. Salsman
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - David E. Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Cancer Control and Survivorship Program, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Stacy D. Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Cancer Control and Survivorship Program, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33216, USA
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Sebastian T, Close A, DeVeau C, Fessenden C, Braunreiter C. Implementing Mental Health Screening for Adolescent Hematology and Oncology Patients: A Quality Improvement Initiative. J Adolesc Young Adult Oncol 2024. [PMID: 38708692 DOI: 10.1089/jayao.2023.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
Purpose: Adolescents and young adults (AYA) with chronic illnesses experience an increase in mental health concerns. A mental health screening (MHS) process for hematology and oncology patients was implemented in a single institution. The quality improvement project was conducted to integrate a MHS process, educate providers about the importance of mental health in this patient population, and evaluate the process. Methods: The COM-B (capability, opportunity, motivation-behavior) model for behavior change was used to inform strategic planning and Plan-Do-Study-Act (PDSA) methodologies for process improvement. Retrospective chart reviews and surveys were conducted to determine missed screening rates and providers' perceptions, knowledge, attitudes, and skills of the MHS process. Results: Of 334 eligible patient encounters, the missed screening rate was 15.0%, the overall error rate of completing the screening was 3.8%, the error rate of completing the suicide or self-harm indicator was 2.6%, and the missed medical social worker touch point was 4.8%. Conclusion: The rising rates of mental health concerns in AYA hematology and oncology patients call for streamlined MHS processes to improve the identification of patients who may need intervention and services. Processes should be tailored to workflows and available resources. Future PDSA cycles will include providing dedicated nursing education and determining the cost needed to meet the rising mental health needs of the AYA hematology and oncology population.
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Affiliation(s)
- Tara Sebastian
- Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Allison Close
- Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
- Division of Pediatric Hematology and Oncology, Helen DeVos Children's Hospital at Corewell Health, Grand Rapids, Michigan, USA
| | - Clare DeVeau
- Division of Pediatric Hematology and Oncology, Helen DeVos Children's Hospital at Corewell Health, Grand Rapids, Michigan, USA
| | - Chad Fessenden
- Division of Pediatric Hematology and Oncology, Helen DeVos Children's Hospital at Corewell Health, Grand Rapids, Michigan, USA
| | - Chi Braunreiter
- Division of Pediatric Hematology and Oncology, Helen DeVos Children's Hospital at Corewell Health, Grand Rapids, Michigan, USA
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6
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Oberoi S, Garland A, Yan AP, Lambert P, Xue L, Decker K, Israels SJ, Banerji S, Bolton JM, Deleemans JM, Garand-Sheridan B, Louis D, Lix LM, Mahar AL. Mental Disorders Among Adolescents and Young Adults With Cancer: A Canadian Population-Based and Sibling Cohort Study. J Clin Oncol 2024; 42:1509-1519. [PMID: 38335465 DOI: 10.1200/jco.23.01615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/01/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024] Open
Abstract
PURPOSE To compare the cumulative incidence of mental disorders among adolescents and young adults (AYAs) diagnosed with cancer with the general population and their unaffected siblings. METHODS A retrospective, population-based, matched cohort design was used to investigate the impact of cancer diagnosis on mental disorders among individuals age 15-39 diagnosed between 1989 and 2019. Two cancer-free cohorts were identified: matched population-based and sibling cohorts. Outcomes included incidence of mood and anxiety disorders, substance use disorders, suicide outcomes, psychotic disorders, and any of the preceding four categories within 5 years of cancer diagnosis. Competing risk regression was used to estimate adjusted subhazard ratios (aSHR) and 95% CIs. RESULTS Among 3,818 AYAs with cancer matched to the population-based cancer-free cohort, individuals with cancer were more likely to be diagnosed with incident mental disorders than those without cancer; the risk was highest immediately after a cancer diagnosis and decreased over time with aSHR [95% CI] for mood and anxiety disorders at 0-6 months (11.27 [95% CI, 6.69 to 18.97]), 6-12 months (2.35 [95% CI, 1.54 to 3.58]), and 12-24 months (2.06 [95% CI, 1.55 to 2.75]); for substance use disorders at 0-6 months (2.73 [95% CI, 1.90 to 3.92]); for psychotic disorders at 0-6 months (4.69 [95% CI, 2.07 to 10.65]); and for any mental disorder at 0-6 months (4.46 [95% CI, 3.41 to 5.85]), 6-12 months (1.56 [95% CI, 1.14 to 2.14]), and 12-24 months (1.7 [95% CI, 1.36 to 2.13]) postcancer diagnosis. In sibling comparison, cancer diagnosis was associated with a higher incidence of mood and anxiety and any mental disorder during first 6 months of cancer diagnosis. CONCLUSION AYAs with cancer experience a greater incidence of mental disorders after cancer diagnosis relative to population-based and sibling cohorts without cancer, primarily within first 2 years, underscoring the need to address mental health concerns during this period.
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Affiliation(s)
- Sapna Oberoi
- Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Pediatric Hematology/Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Allan Garland
- Department of Internal Medicine, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Adam P Yan
- Division of Pediatric Hematology Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Pascal Lambert
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Lin Xue
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Kathleen Decker
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Sara J Israels
- Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Pediatric Hematology/Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Shantanu Banerji
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - James M Bolton
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Julie M Deleemans
- Department of Oncology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | | | - Deepak Louis
- Section of Neonatology, Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Alyson L Mahar
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
- School of Nursing, Queen's University, Kingston, Ontario, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
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Cho D, Roth M, Peterson SK, Jennings K, Kim S, Weathers SP, Ahmed S, Livingston JA, Barcenas C, You YN, Milbury K. Associations Between Stress, Health Behaviors, and Quality of Life in Young Couples During the Transition to Survivorship: Protocol for a Measurement Burst Study. JMIR Res Protoc 2024; 13:e53307. [PMID: 38652520 PMCID: PMC11077407 DOI: 10.2196/53307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Cancer is a life-threatening, stressful event, particularly for young adults due to delays and disruptions in their developmental transitions. Cancer treatment can also cause adverse long-term effects, chronic conditions, psychological issues, and decreased quality of life (QoL) among young adults. Despite numerous health benefits of health behaviors (eg, physical activity, healthy eating, no smoking, no alcohol use, and quality sleep), young adult cancer survivors report poor health behavior profiles. Determining the associations of stress (either cancer-specific or day-to-day stress), health behaviors, and QoL as young adult survivors transition to survivorship is key to understanding and enhancing these survivors' health. It is also crucial to note that the effects of stress on health behaviors and QoL may manifest on a shorter time scale (eg, daily within-person level). Moreover, given that stress spills over into romantic relationships, it is important to identify the role of spouses or partners (hereafter partners) in these survivors' health behaviors and QoL. OBJECTIVE This study aims to investigate associations between stress, health behaviors, and QoL at both within- and between-person levels during the transition to survivorship in young adult cancer survivors and their partners, to identify the extent to which young adult survivors' and their partners' stress facilitates or hinders their own and each other's health behaviors and QoL. METHODS We aim to enroll 150 young adults (aged 25-39 years at the time of cancer diagnosis) who have recently completed cancer treatment, along with their partners. We will conduct a prospective longitudinal study using a measurement burst design. Participants (ie, survivors and their partners) will complete a daily web-based survey for 7 consecutive days (a "burst") 9 times over 2 years, with the bursts spaced 3 months apart. Participants will self-report their stress, health behaviors, and QoL. Additionally, participants will be asked to wear an accelerometer to assess their physical activity and sleep during the burst period. Finally, dietary intake (24-hour diet recalls) will be assessed during each burst via telephone by research staff. RESULTS Participant enrollment began in January 2022. Recruitment and data collection are expected to conclude by December 2024 and December 2026, respectively. CONCLUSIONS To the best of our knowledge, this will be the first study that determines the interdependence of health behaviors and QoL of young adult cancer survivors and their partners at both within- and between-person levels. This study is unique in its focus on the transition to cancer survivorship and its use of a measurement burst design. Results will guide the creation of a developmentally appropriate dyadic psychosocial or behavioral intervention that improves both young adult survivors' and their partners' health behaviors and QoL and potentially their physical health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53307.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kristofer Jennings
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Seokhun Kim
- The Center for Clinical Research and Evidence-Based Medicine, The University of Texas McGovern Medical School, Houston, TX, United States
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sairah Ahmed
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - J Andrew Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Carlos Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Y Nancy You
- Department of Colon & Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kathrin Milbury
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Hendriks RTJ, van Eenbergen MCHJ, de Boer ML, Sleeman SHE, Boll D, Husson O, Bootsma TI. 'There is still a part of me that would love to be the old me again', how do adolescents and young adults (AYA) experience cancer-related bodily changes: a phenomenological interview study. J Cancer Surviv 2024:10.1007/s11764-024-01578-3. [PMID: 38573458 DOI: 10.1007/s11764-024-01578-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE Due to the increase in both cancer incidence and overall survival rates, more adolescents and young adults (AYAs) have to live with the effects that their cancer diagnosis and following treatments have on their bodies. This qualitative phenomenological study aimed to gain more insight into the way AYAs experience these effects and how they respond to these effects. METHODS Semi-structured interviews with a sample of 11 AYAs with an age range of 25-41 years at the time of the interview, who were diagnosed with different types of cancer, were conducted. Participants were recruited via social media and patient associations until data saturation was reached. A topic guide with open-ended questions about lived experiences was used. Interpretative phenomenological analysis (IPA) was performed to analyse the transcripts. RESULTS We identified six Group Experiential Themes based on different ways AYAs experience their bodies: (1) self-conscious body, (2) vulnerable body, (3) adapting to the body, (4) uncontrollable body, (5) remembering the body and (6) shared bodies. CONCLUSION This study offers in-depth insight into the bodily experiences of AYAs after cancer and how they respond to these changes from a phenomenological point of view. IMPLICATIONS FOR CANCER SURVIVORS This knowledge could be beneficial to provide more guidance for AYAs during and after their illness, by focussing on personalised psychological (after)care.
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Affiliation(s)
- Robin T J Hendriks
- Department of Culture Studies, School of Humanities and Digital Sciences, Tilburg University, 5000 LE, Tilburg, the Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, the Netherlands
| | - Mies C H J van Eenbergen
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, 3511 DT, Utrecht, the Netherlands
- Department of Communication and Cognition, Tilburg University, 5000 LE, Tilburg, the Netherlands
| | - Marjolein L de Boer
- Department of Culture Studies, School of Humanities and Digital Sciences, Tilburg University, 5000 LE, Tilburg, the Netherlands
| | - Sophia H E Sleeman
- Dutch AYA 'Young & Cancer' Care Network, 3511 DT, Utrecht, the Netherlands
| | - Dorry Boll
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, 3511 DT, Utrecht, the Netherlands
- Department of Communication and Cognition, Tilburg University, 5000 LE, Tilburg, the Netherlands
- Department of Gynaecology, Catharina Hospital, Eindhoven, the Netherlands
| | - Olga Husson
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, the Netherlands.
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD, Rotterdam, the Netherlands.
| | - Tom I Bootsma
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, the Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD, Rotterdam, the Netherlands
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Hughes K, Jacobson CEH, Lavelle G, Carr E, Henley SMD. The Association of Resilience with Psychosocial Outcomes in Teenagers and Young Adults with Cancer. J Adolesc Young Adult Oncol 2024; 13:331-337. [PMID: 37643298 DOI: 10.1089/jayao.2022.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Purpose: There is limited research on the psychological impact of cancer for teenagers and young adults (TYAs) and the role of protective factors such as resilience. This study investigated associations between resilience and psychosocial outcomes in this group. Methods: Data were collected from TYAs (aged 16-24) who attended the TYA cancer clinic at Guy's Hospital between 2013 and 2021. Participants (N = 63) completed psychosocial questionnaires within 4 weeks of their treatment start date (T1) and again between 9 and 15 months later (T2). We used separate multivariable linear regression models to analyze associations of resilience (Brief Resilience Questionnaire) with outcomes measured at T2, including symptoms of depression (Patient Health Questionnaire [PHQ]-9), anxiety (Generalized Anxiety Disorder [GAD]-7), and subjective quality of life. Models were adjusted for age, gender, ethnicity, and T1 outcome assessments. Results: Higher resilience at T1 was associated with increased anxiety (β = 1.68; bootstrapped confidence interval [95% CI -0.28 to 3.19]), depression (β = 1.24; [-0.85 to 2.90]), and quality of life (5.76; [-0.88 to 15.60]). In contrast, an increase in resilience over time was associated with decreases in the same period in anxiety (β = -3.16; [-5.22 to -1.47]) and depression (β = -2.36, [-4.41 to -0.58]), and an increase in quality of life (β = 9.82, [-0.24 to 21.13]). Conclusion: Increases in resilience during cancer treatment were associated with reduced symptoms of depression and anxiety in TYAs. We discuss factors likely to influence these outcomes, the implications for psychosocial interventions in this population, and identify further research to explore the impact of other factors such as diagnosis and treatment type.
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Affiliation(s)
- Kathryn Hughes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | | | - Grace Lavelle
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, King's College London, London, United Kingdom
| | - Susie M D Henley
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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10
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Salsman JM, Rosenberg AR. Fostering resilience in adolescence and young adulthood: Considerations for evidence-based, patient-centered oncology care. Cancer 2024; 130:1031-1040. [PMID: 38163249 DOI: 10.1002/cncr.35182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
Adolescence and young adulthood are times of growth and change. For adolescents and young adults (AYAs) who are diagnosed with cancer, the demands of illness may compound normal developmental challenges and adversely affect physical, emotional, and social health. Nevertheless, AYAs have a tremendous capacity for psychosocial adaptation and resilience. Informed by the Transactional Model of Stress and Coping, observational studies in AYA oncology suggest consistent individual, social, and existential resources that may promote resilience. To date, few interventions have been designed to examine whether resilience can be taught and whether doing so affects patient-centered outcomes. Findings point to the potential value of multicomponent programs that include various skills-building strategies, such as stress management, mindfulness, gratitude, and positive reappraisal coping, among others. New research directions include the need to evaluate delivery strategies to enhance participant adherence and retention (e.g., eHealth modalities, optimization studies) and to examine program effectiveness in community-based oncology practices (e.g., less resource-rich settings in which most AYAs receive care). Ultimately, this scholarship may inform, refine, and strengthen intervention science in resilience more broadly.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
| | - Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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11
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Schilstra CE, Ellis SJ, Cohen J, Gall A, Diaz A, Clarke K, Dumlao G, Chard J, Cumming TM, Davis E, Dhillon H, Burns MA, Docking K, Koh ES, O'Reilly J, Sansom-Daly UM, Shaw J, Speers N, Taylor N, Warne A, Fardell JE. Exploring Web-Based Information and Resources That Support Adolescents and Young Adults With Cancer to Resume Study and Work: Environmental Scan Study. JMIR Cancer 2024; 10:e47944. [PMID: 38526527 PMCID: PMC11002739 DOI: 10.2196/47944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 11/14/2023] [Accepted: 02/06/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) diagnosed with cancer experience physical, cognitive, and psychosocial effects from cancer treatment that can negatively affect their ability to remain engaged in education or work through cancer treatment and in the long term. Disengagement from education or work can have lasting implications for AYAs' financial independence, psychosocial well-being, and quality of life. Australian AYAs with cancer lack access to adequate specialist support for their education and work needs and report a preference for web-based support that they can access from anywhere, in their own time. However, it remains unclear what web-based resources exist that are tailored to support AYAs with cancer in reaching their educational or work goals. OBJECTIVE This study aimed to determine what web-based resources exist for Australian AYAs with cancer to (1) support return to education or work and (2) identify the degree to which existing resources are age-specific, cancer-specific, culturally inclusive, and evidence-based; are co-designed with AYAs; use age-appropriate language; and are easy to find. METHODS We conducted an environmental scan by searching Google with English search terms in August 2022 to identify information resources about employment and education for AYAs ever diagnosed with cancer. Data extraction was conducted in Microsoft Excel, and the following were assessed: understandability and actionability (using the Patient Education and Materials Tool), readability (using the Sydney Health Literacy Laboratory Health Literacy Editor), and whether the resource was easy to locate, evidence-based, co-designed with AYAs, and culturally inclusive of Aboriginal and Torres Strait Islander peoples. The latter was assessed using 7 criteria previously developed by members of the research team. RESULTS We identified 24 web-based resources, comprising 22 written text resources and 12 video resources. Most resources (21/24, 88%) were published by nongovernmental organizations in Australia, Canada, the United States, and the United Kingdom. A total of 7 resources focused on education, 8 focused on work, and 9 focused on both education and work. The evaluation of resources demonstrated poor understandability and actionability. Resources were rarely evidence-based or co-designed by AYAs, difficult to locate on the internet, and largely not inclusive of Aboriginal and Torres Strait Islander populations. CONCLUSIONS Although web-based resources for AYAs with cancer are often available through the websites of hospitals or nongovernmental organizations, this environmental scan suggests they would benefit from more evidence-based and actionable resources that are available in multiple formats (eg, text and audio-visual) and tailored to be age-appropriate and culturally inclusive.
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Affiliation(s)
- Clarissa E Schilstra
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Faculty of Medicine and Health, Randwick Clinical Campus, University of New South Wales Sydney, Randwick, Australia
| | - Sarah J Ellis
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Faculty of Medicine and Health, Randwick Clinical Campus, University of New South Wales Sydney, Randwick, Australia
| | - Jennifer Cohen
- Faculty of Medicine and Health, Randwick Clinical Campus, University of New South Wales Sydney, Kensington, Australia
- Canteen Australia, Newtown, Australia
| | - Alana Gall
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia
| | - Abbey Diaz
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | | | - Gadiel Dumlao
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Faculty of Medicine and Health, Randwick Clinical Campus, University of New South Wales Sydney, Randwick, Australia
| | - Jennifer Chard
- Western Sydney Youth Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
| | - Therese M Cumming
- Faculty of Arts, Design and Architecture, University of New South Wales Sydney, Kensington, Australia
- Disability Innovation Institute, University of New South Wales Sydney, Kensington, Australia
| | | | - Haryana Dhillon
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, Australia
| | - Mary Anne Burns
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, Australia
| | - Kimberley Docking
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Eng-Siew Koh
- South West Sydney Clinical School, Faculty of Medicine and Health, University of New South Wales Sydney, Liverpool, Australia
- Liverpool and Macarthur Cancer Therapy Centres, Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | | | - Ursula M Sansom-Daly
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Faculty of Medicine and Health, Randwick Clinical Campus, University of New South Wales Sydney, Randwick, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia
| | - Joanne Shaw
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, Australia
| | - Nicole Speers
- Cancer survivor representative, New South Wales, Australia
| | - Natalie Taylor
- Faculty of Medicine and Health, Randwick Clinical Campus, University of New South Wales Sydney, Kensington, Australia
| | - Anthea Warne
- Faculty of Medicine and Health, Randwick Clinical Campus, University of New South Wales Sydney, Kensington, Australia
| | - Joanna E Fardell
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Faculty of Medicine and Health, Randwick Clinical Campus, University of New South Wales Sydney, Randwick, Australia
- Western Sydney Youth Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
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12
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Tutelman PR, Moran C, Beattie SM, Khu M, Howlett M, Scheidl J, Boychuk A, Silveira K, Henning JW, Schulte FSM. Acceptability, feasibility and preliminary effects of an online group psychotherapy intervention for adolescents and young adults with cancer. Psychooncology 2024; 33:e6335. [PMID: 38526517 DOI: 10.1002/pon.6335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/23/2024] [Accepted: 03/14/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Adolescents and young adults (AYAs; ages 15-29 years) diagnosed with cancer are increasingly recognized as an oncology population with distinct psychosocial needs. However, few specialized psychosocial interventions for AYAs currently exist. This study reports on the development of a novel group-based psychotherapy intervention to address the psychosocial needs of AYAs. The objective was to evaluate the acceptability, feasibility, and preliminary effects of the intervention. METHODS The manualized group psychotherapy program is delivered virtually over an 8-week period by registered psychologists. Four groups (n = 5-11 AYAs per group) with a total of N = 33 participants (Mage = 20.97 years, SD = 3.68, range = 15-29 years, 76% women) were conducted. Recruitment and retention data assessed intervention feasibility. Patient-reported psychosocial outcomes were measured at baseline and immediately following the intervention to assess preliminary effects. Acceptability was assessed following the intervention using a self-report measure of participant satisfaction. RESULTS Overall, the completion rate of the intervention was 85% (n = 28). All participants "strongly agreed" (88%) or "agreed" (13%) that they were satisfied with the group. Meeting, sharing experiences, and expressing feelings with other AYAs were identified as the most helpful aspects. Participants reported significant improvements in emotional (p < 0.05) and functional (p < 0.01) quality of life from baseline to immediately post-intervention with medium effect sizes (d = 0.58-0.70). CONCLUSIONS Findings suggest that the intervention is feasible, acceptable, and shows promise for improving psychosocial outcomes for AYAs. Further research will refine the intervention and establish efficacy in a randomized trial.
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Affiliation(s)
- Perri R Tutelman
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Chelsea Moran
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
| | - Sara M Beattie
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Khu
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Melissa Howlett
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jessica Scheidl
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - April Boychuk
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Kristen Silveira
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Jan-Willem Henning
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Fiona S M Schulte
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada
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13
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Lee-Miller C, Montgomery KE, Evered J, Phelps K, Norslien K, Parkes A, Kwekkeboom K. A Midwest Stakeholder Evaluation of an Adolescent and Young Adult Cancer Survivor Needs Assessment Survey. J Adolesc Young Adult Oncol 2024; 13:123-131. [PMID: 37581596 DOI: 10.1089/jayao.2023.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Purpose: Over 87,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States each year. Improvement in outcomes in the AYA population has lagged that of both younger and older patients. This decrement may be attributable to several factors, including insufficient supportive care services. Our team modified the Needs Assessment & Service Bridge (NA-SB) tool, utilizing an iterative approach with patient and clinician stakeholders to meet the needs of the AYA population at a large Midwestern Cancer Center. Methods: We recruited a 10-member AYA Advisory Board (AB) from our Cancer Center patients, and met five times over 9 months to discuss supportive care and the NA-SB. We recruited a multidisciplinary group of oncology clinicians to assess content validity and conducted interviews with nine clinician stakeholders to discuss implementation. Results: The AB generated a 59-item-modified NA-SB, retaining most of the original NA-SB items and adding several more. Five items with concerns for relevance and/or clarity were revised to create the final 58-item-modified NA-SB. Priorities for implementation were identified by AB and clinician stakeholders. Conclusions: The modified NA-SB thoroughly reflects supportive care needs of our Midwestern AYA cancer survivors. When implemented, the tool may facilitate patient-care team communication and provide data to prioritize development of new supportive care resources. AYA cancer survivors have unique supportive care needs that are insufficiently addressed by current care models; using the modified NA-SB may help address those needs, leading to improved AYA outcomes.
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Affiliation(s)
- Cathy Lee-Miller
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | | | - Jane Evered
- Department of Family Medicine and Community Health, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kat Phelps
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin, USA
| | | | - Amanda Parkes
- Division of Hematology, Medical Oncology, and Palliative Care, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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14
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Marino JL, Peate M, McNeil R, Orme LM, McCarthy MC, Glackin A, Sawyer SM. Experiences of Family and Partner Support in Fertility Decision-Making Among Adolescents and Young Adults with Cancer: A National Australian Study. J Adolesc Young Adult Oncol 2024; 13:180-188. [PMID: 37339458 DOI: 10.1089/jayao.2023.0037] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
Purpose: To understand how adolescents and young adults (AYAs) with cancer experience family and partner involvement in fertility preservation (FP) decision-making. Methods: As part of a nationally representative Australian cross-sectional study of 15-25-year olds with cancer, 196 participants (mean age 19.9 [standard deviation 3.2] years at diagnosis; 51% male) were surveyed regarding FP decision-making. Results: One hundred sixty-one (83%) participants reported discussion of potential effects of cancer and its treatment on fertility, of whom 57 (35%) did not undertake FP (51% of females; 19% of males). Parental involvement (mothers 62%, fathers 45%) in decision-making was considered helpful, including for 73% of 20-25-year olds with partners. Sisters and brothers were involved less often, yet rated helpful in 48% and 41% of cases, respectively. Older participants were more likely than younger ones to have involved partners (47% vs. 22%, p = 0.001) and less likely to have involved mothers (56% vs. 71%, p = 0.04) or fathers (39% vs. 55%, p = 0.04). Conclusion: This is the first quantitative study to explore family and partner involvement in AYA FP decision-making in both females and males in a nationally representative sample. Parents are important resources who commonly assist AYAs with these complex decisions. Although many AYAs will be the main decision-makers when it comes to FP, particularly as AYAs mature, these data suggest that resources and support should be available for and inclusive of parents, partners, and siblings.
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Affiliation(s)
- Jennifer L Marino
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Specialty of Child and Adolescent Health, The University of Sydney, Westmead, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Australia
| | - Robyn McNeil
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Lisa M Orme
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- ONTrac at Peter Mac, Victorian Youth Cancer Service, Peter MacCallum Hospital, Parkville, Australia
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Australia
| | - Maria C McCarthy
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Australia
| | - Aoife Glackin
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia
- Murdoch Children's Research Institute, Parkville, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
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15
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Subih HS, Al-Shwaiyat EA, Al-Bayyari N, Obeidat BS, Abu-Farsakh F, Bawadi H. Dietary Intake Is Not Associated with Body Composition nor with Biochemical Tests but with Psychological Status of Cancer Patients Receiving Chemotherapy. Nutrients 2023; 15:5087. [PMID: 38140346 PMCID: PMC10746082 DOI: 10.3390/nu15245087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/21/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
Chemotherapy can negatively affect cancer patients' eating patterns, psychological status, body composition, and quality of life. In this study, we aimed to investigate the correlations between dietary intake/care and the psychological status of cancer patients treated with chemotherapy. An observational study was conducted on 75 participants during their first cycle of chemotherapy treatment, and they were followed up for three cycles. Each participant completed a reliable validated questionnaire, psychological questionnaire, quality of life questionnaire, and three-day food records. Dietary intake was considered adequate if there was an adherence of participants to dietary recommendations offered by the dietitian and was confirmed by ESHA analysis software (version 10.6.3). Seventy-five percent of participants had inadequate nutrition intake. All anthropometric measurements decreased after 2 months of chemotherapy regardless of patients' dietary intake. Approximately half of the participants reported depression and anxiety. There were significant differences between all nutrient intake levels when compared to the recommended dietary allowance except for fat, unsaturated fatty acids, and iron. Also, there were associations between nutritional intake and life quality and depression. In conclusion, poor dietary intake was associated with depression and insufficient macro- and micronutrient intake. Emotional and nutritional support from healthcare providers and family are highly necessary.
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Affiliation(s)
- Hadil S. Subih
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan;
| | - Esraa A. Al-Shwaiyat
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan;
| | - Nahla Al-Bayyari
- Department of Nutrition and Food Processing, Faculty of Al-Huson University College, Al-Balqa Applied University, Al-Salt 19117, Jordan
| | - Belal S. Obeidat
- Department of Animal Production, Faculty of Agriculture, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan;
| | - Fadi Abu-Farsakh
- Department of Oncology, King Hussein Cancer Center, Amman 11941, Jordan;
| | - Hiba Bawadi
- College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
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16
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Gupta S, Li Q, Kassam A, Rapoport A, Widger K, Chalifour K, Baxter NN, Nathan PC, Coburn NG, Sutradhar R. Specialty Palliative Care and Symptom Severity and Control in Adolescents and Young Adults With Cancer. JAMA Netw Open 2023; 6:e2338699. [PMID: 37862015 PMCID: PMC10589816 DOI: 10.1001/jamanetworkopen.2023.38699] [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] [Received: 06/15/2023] [Accepted: 09/02/2023] [Indexed: 10/21/2023] Open
Abstract
Importance Adolescents and young adults (AYAs) with cancer experience substantial symptom burden. Specialty palliative care (SPC) is recommended but often not involved or involved late. Objectives To determine whether patient-reported symptom severity was associated with subsequent SPC involvement and whether SPC was associated with symptom improvement in AYAs with cancer. Design, Setting, and Participants This cohort study comprised AYAs (aged 15-29 years) with primary cancer diagnosed between January 1, 2010, and June 30, 2018, in Ontario, Canada. Data, including self-reported Edmonton Symptom Assessment System (ESAS) scores, were obtained from health care databases. Specialty palliative care was identified through billing codes and validated algorithms. Final data analysis was performed on April 4, 2023. Main Outcomes and Measures Associations of ESAS scores with subsequent SPC involvement were determined. A difference-in-differences approach was used for patients who died within 5 years of their cancer diagnosis. Case patients (SPC predeath, index date equals first SPC service) were matched 1:1 to control patients (no SPC at equivalent time before death). The study examined whether the difference between 90-day postindex and preindex mean ESAS scores was itself different between case and control patients. Results This study included 5435 AYAs with cancer, with a median follow-up of 5.1 (IQR, 2.5-7.9) years for analyses of general palliative care. Their median age at cancer diagnosis was 25 (IQR, 22-27) years, and more than half were male (2809 [51.7%]). For all symptoms, moderate and severe ESAS scores were associated with an increased likelihood of SPC involvement compared with mild scores. The greatest magnitude of association was seen for pain scores (hazard ratio for severe vs mild, 7.7 [95% CI, 5.8-10.2]; P < .001). A total of 721 AYAs (13.3%) died within 5 years of diagnosis, and 612 of these patients (84.9%) had received SPC before death. Among 202 case-control pairs, SPC involvement was associated with improved pain trajectories (mean scores improved from 3.41 to 3.07 in case patients and worsened from 1.86 to 2.16 in control patients; P = .003). Other symptom trajectories were not affected. Conclusions and Relevance In this cohort study of AYAs with cancer, those reporting moderate or severe symptoms through a screening program were more likely to subsequently receive SPC. These findings suggest that SPC was associated with a subsequent decrease in pain severity but did not affect other symptoms. New interventions targeting other symptoms during treatment and particularly at the end of life are needed.
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Affiliation(s)
- Sumit Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Cancer Research Program, ICES (Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, Ontario, Canada
| | - Qing Li
- Cancer Research Program, ICES (Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
| | - Alisha Kassam
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Southlake Regional Health Centre, Newmarket, Ontario, Canada
| | - Adam Rapoport
- Division of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Emily’s House Children’s Hospice, Toronto, Ontario, Canada
| | - Kimberley Widger
- Paediatric Advanced Care Team, The Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Karine Chalifour
- Young Adult Cancer Canada, St John’s, Newfoundland and Labrador, Canada
| | - Nancy N. Baxter
- Cancer Research Program, ICES (Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul C. Nathan
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Cancer Research Program, ICES (Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, Ontario, Canada
| | - Natalie G. Coburn
- Cancer Research Program, ICES (Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- Cancer Research Program, ICES (Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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17
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Fox RS, Armstrong GE, Gaumond JS, Vigoureux TF, Miller CH, Sanford SD, Salsman JM, Katsanis E, Badger TA, Reed DR, Gonzalez BD, Jim HS, Warner EL, Victorson DE, Oswald LB. Social isolation and social connectedness among young adult cancer survivors: A systematic review. Cancer 2023; 129:2946-2965. [PMID: 37489837 PMCID: PMC10584376 DOI: 10.1002/cncr.34934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Social isolation and connectedness are social determinants of health that have demonstrated effects on cancer-related outcomes. These constructs have been systematically evaluated among pediatric and older adult cancer populations. In this review, the authors evaluated the prevalence, correlates, and psychosocial implications of social isolation and connectedness among young adult (YA) cancer survivors aged 18-39 years. METHODS Peer-reviewed articles published in English before June 2021 were identified from database searches and included articles' reference lists according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included articles described studies that assessed social isolation and/or connectedness among YA cancer survivors. RESULTS In total, 5094 unique records were identified; 4143 were excluded after title/abstract screening, and 907 were excluded after full-text review. Forty-four articles were included. Few studies used validated measures or directly assessed social isolation or connectedness. Social isolation was similarly prevalent among YAs and older cancer survivors and noncancer populations. Demographic, clinical, and behavioral risk and protective factors for social isolation were identified. Social isolation was related to worse psychological well-being, whereas social connectedness was often, but not always, related to better psychological well-being. CONCLUSIONS This growing literature underscores the relevance of social isolation and connectedness as important health determinants among YA cancer survivors. The identified risk and protective factors can identify YAs who especially may benefit from screening for social isolation. Future studies are needed that directly, reliably, and validly evaluate social isolation and connectedness to inform the development of interventions to decrease isolation and increase connectedness.
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Affiliation(s)
- Rina S. Fox
- University of Arizona College of Nursing, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Grace E. Armstrong
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Chicago School of Professional Psychology, Chicago, IL, USA
| | - Julia S. Gaumond
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Corinne H. Miller
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stacy D. Sanford
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - John M. Salsman
- Wake Forest School of Medicine, Winston-Salem, NC, USA
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Emmanuel Katsanis
- University of Arizona Cancer Center, Tucson, AZ, USA
- University of Arizona College of Medicine, Tucson, AZ, USA
| | - Terry A. Badger
- University of Arizona College of Nursing, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | | | | | | | - Echo L. Warner
- University of Utah College of Nursing, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - David E. Victorson
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
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18
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Black LL, Peugh JL, Pai ALH. Health Competence Beliefs and Health-Related Quality of Life Among Adolescent and Young Adult Survivors of Childhood Cancer and Healthy Peers. J Adolesc Young Adult Oncol 2023; 12:653-661. [PMID: 36862533 DOI: 10.1089/jayao.2022.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Purpose: Adolescent and young adult (AYA) survivors of childhood cancer are at risk for late-effects that can impact how one perceives their health and well-being. Understanding beliefs about health competence and well-being among survivors can help identify support needs and increase adherence to long-term follow-up guidelines. This study examined differences in health competence beliefs and health-related quality of life (HRQOL) between AYA survivors of childhood cancer and matched healthy peers. In addition, the relationship between health competence beliefs and HRQOL, as well as the moderating effect of cancer survivorship, was investigated. Methods: Survivors (n = 49) and healthy peers (n = 54) completed measures about health competence beliefs (i.e., Health Perception, Cognitive Competence, Autonomy, and School/Work Functioning) and HRQOL. Multiple group analysis was used to investigate differences in health competence beliefs and HRQOL between survivors and peers. Multivariate multiple regression analyses were used to investigate the relationships between health competence beliefs and HRQOL. Finally, a history of cancer was examined as a possible moderator using additional multivariate multiple regression analyses. Results: Survivors reported significantly lower Health Perception, Cognitive Competence, Autonomy, and School/Work Functioning scores compared to healthy peers. Among both groups, Health Perception and Cognitive Competence scores were associated with multiple domains of HRQOL. These relationships were not moderated by having a history of cancer. Conclusions: Perceptions about one's health and cognitive abilities may impact HRQOL among AYA survivors of childhood cancer and health peers. Identifying those at risk for poor well-being may help to guide interventions aimed at increasing adherence to medical recommendations.
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Affiliation(s)
- Lora L Black
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - James L Peugh
- Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati Medical School, Cincinnati, Ohio, USA
| | - Ahna L H Pai
- Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati Medical School, Cincinnati, Ohio, USA
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19
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Tanner S, Engstrom T, Lee WR, Forbes C, Walker R, Bradford N, Pole JD. Mental health patient-reported outcomes among adolescents and young adult cancer survivors: A systematic review. Cancer Med 2023; 12:18381-18393. [PMID: 37596768 PMCID: PMC10524059 DOI: 10.1002/cam4.6444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer patients and survivors face significant mental health challenges throughout their cancer journey that are different to those faced by children and older adults. Patient-reported outcome measures (PROMs) can be used to explore the experiences of AYAs, and to identify important issues and areas for potential improvement in quality of life. OBJECTIVE We aimed to compare patient reported mental health outcomes between AYAs diagnosed with cancer and non-cancer controls. METHOD We built on a larger systematic review of AYA cancer PROMs which searched PubMed, EMBASE, CINAHL and PsychINFO. This review identified 175 articles, which were filtered to those reporting on mental health and including a non-cancer control group. RESULTS We identified 12 eligible studies. Seven studies (58%) found those diagnosed with cancer reported poorer mental health than the non-cancer controls. The remaining five (42%) studies found no significant difference in severity or prevalence of mental health between the AYA cancer cohort and the healthy control group. Most (83%) were cross-sectional studies, highlighting the need for further longitudinal assessment of this group throughout their journey. CONCLUSIONS The mental health outcomes feature conflicting results and illustrate the need for larger studies to characterise discrepancies.
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Affiliation(s)
- Sarah Tanner
- Centre for Health Services ResearchThe University of QueenslandHerstonQueenslandAustralia
| | - Teyl Engstrom
- Centre for Health Services ResearchThe University of QueenslandHerstonQueenslandAustralia
| | - Wen Ray Lee
- Centre for Health Services ResearchThe University of QueenslandHerstonQueenslandAustralia
| | - Cheryl Forbes
- Centre for Health Services ResearchThe University of QueenslandHerstonQueenslandAustralia
| | - Rick Walker
- School of MedicineThe University of QueenslandHerstonQueenslandAustralia
- Queensland Children's HospitalBrisbaneQueenslandAustralia
- Princess Alexandra HospitalBrisbaneQueenslandAustralia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health ResearchQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Jason D. Pole
- Centre for Health Services ResearchThe University of QueenslandHerstonQueenslandAustralia
- Dalla Lana School of Public HealthThe University of TorontoTorontoOntarioCanada
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20
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Siembida EJ, Fladeboe KM, Ip E, Zebrack B, Snyder MA, Salsman JM. A Developmental Science Approach to Informing Age Subgroups in Adolescent and Young Adult Cancer Research. J Adolesc Health 2023; 73:543-552. [PMID: 37294255 PMCID: PMC10524106 DOI: 10.1016/j.jadohealth.2023.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Adolescent and young adult (AYA; diagnosed ages 15-39) cancer survivors are developmentally heterogenous, and this population consists of at least three distinct theoretically informed subgroups, as follows: adolescents, emerging adults, and young adults. However, there are limited evidence-based recommendations for delineating the validity of these subgroups in cancer-specific research. We sought to inform recommended chronological age ranges for each subgroup based on developmental processes. METHODS The data were collected using a 2x3 stratified sampling design (on-vs. off-treatment; ages 15-17, 18-25, 26-39) and a cross-sectional survey. AYAs (N = 572) completed three subscales of the Inventory of Dimensions of Emerging Adulthood (identity exploration, experimentation/possibilities, and other-focused), and we used regression tree analyses to identify distinct shifts in mean subscale scores that would indicate unique subgroups. Models included (a) chronological age, (b) chronological age + cancer-related variables, and (c) chronological age + sociodemographic/psychosocial variables as predictors of each developmental measure. RESULTS The recommended age ranges for AYA survivors receiving active treatment were consistent with prior research as follows: adolescents ages 15-17, emerging adults ages 18-24, and young adults ages 25-39. Models for off-treatment survivors suggested four distinct subgroups: adolescents ages 15-17, emerging adults ages 18-23, and 'younger' (ages 24-32) and 'older' young adults (ages 33-39). No sociodemographic or psychosocial variables meaningfully shifted these recommendations. DISCUSSION Our results suggest that three developmental subgroups remain appropriate for on-treatment survivors, but a second young adult subgroup (ages 33-39) emerged for off-treatment survivors. Therefore, development disruptions may be more likely to occur or manifest in post-treatment survivorship.
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Affiliation(s)
- Elizabeth J Siembida
- Institute of Health System Science, Northwell Health, Manhasset, New York; Northwell Health Cancer Institute, Northwell Health, Manhasset, New York.
| | - Kaitlyn M Fladeboe
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Edward Ip
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina; Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - Brad Zebrack
- University of Michigan School of Social Work, Ann Arbor, Michigan; University of Michigan Rogel Cancer Center, Ann Arbor, Michigan
| | - Mallory A Snyder
- Office of Research, The University of Chicago, Chicago, Illinois
| | - John M Salsman
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina; Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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21
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Osmani V, Hörner L, Klug SJ, Tanaka LF. Prevalence and risk of psychological distress, anxiety and depression in adolescent and young adult (AYA) cancer survivors: A systematic review and meta-analysis. Cancer Med 2023; 12:18354-18367. [PMID: 37559504 PMCID: PMC10523984 DOI: 10.1002/cam4.6435] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer survivors (CS) face unique psychosocial challenges, which may affect their mental health. However, there are inconsistencies in AYA definitions and varying prevalence data on psychological distress, anxiety, and depression. We aimed to synthesize published literature on prevalence, risk, longitudinal changes, and predictors for these outcomes and estimate pooled prevalences. METHODS We searched for observational studies published in English before June 1 2022, in PubMed, PsycINFO, Scopus, and Web of Science. Two researchers extracted independently information on study characteristics, prevalence, and risk. The pooled prevalence (PP) of psychological distress, anxiety, and depression was estimated using random-effects models. Geographical region, treatment status, and assessment instruments were considered in stratified meta-analyses. RESULTS Sixty-eight studies were included in the systematic review and 57 in the meta-analyses. We estimated an overall prevalence of 32% (n = 30; 4226/15,213 AYAs; 95% CI, 23%-42%; I2 = 99%) for psychological distress, 29% for anxiety (n = 24; 2828/8751 AYAs; 95% CI, 23%-36%; I2 = 98%), and 24% (n = 35; 3428/16,638 AYAs; 95% CI, 18%-31%; I2 = 98%) for depression. The range of PP of psychological distress varied across geographical regions, treatment status, and assessment instruments. The PP of anxiety varied significantly across continents, while no variations were seen for depression. Studies found higher risks for psychological distress, anxiety, and depression in AYAs compared to older cancer survivors or cancer-free peers. CONCLUSIONS Our research found that one in three AYA-CS experience psychological distress or anxiety and one in four are affected by depression, highlighting the need for specialized psychological services for AYA-CS in oncology settings and AYA-focused interventions.
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Affiliation(s)
- Vanesa Osmani
- Chair of Epidemiology, TUM Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - Lucy Hörner
- Chair of Epidemiology, TUM Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - Stefanie J. Klug
- Chair of Epidemiology, TUM Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - Luana Fiengo Tanaka
- Chair of Epidemiology, TUM Department of Sport and Health SciencesTechnical University of MunichMunichGermany
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22
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Dorfman CS, Shelby RA, Stalls JM, Somers TJ, Keefe FJ, Vilardaga JP, Winger JG, Mitchell K, Ehren C, Oeffinger KC. Improving Symptom Management for Survivors of Young Adult Cancer: Development of a Novel Intervention. J Adolesc Young Adult Oncol 2023; 12:472-487. [PMID: 36178972 PMCID: PMC10457621 DOI: 10.1089/jayao.2022.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Improved symptom management is a critical although unmet post-treatment need for young adult (YA) cancer survivors (aged 18-39 at diagnosis). This study aimed to develop and refine a behavioral symptom management intervention for YA survivors. Methods: Phase I: YA survivors (N = 21) and oncology providers (N = 11) completed individual interviews and an online, self-report assessment to examine symptom experiences, the need for a behavioral symptom management intervention for YAs, and perceptions about potential intervention components, structure, and format. Phase II: YA survivors (N = 10) completed user testing sessions, providing feedback on the prototype intervention materials (paper manual and mobile application), and completed an online assessment. Quantitative data were examined using descriptive statistics. Rapid qualitative analysis, a methodologically rigorous standardized approach, was used. Results: Pain, fatigue, and distress were ranked as top concerns by most YAs and providers. Phase I interviews underscored the need for a symptom management intervention for YAs. YAs and providers highlighted potential coping strategies and program format/structure suggestions (e.g., small group format) to best meet YAs' needs. A prototype intervention was developed combining the following: traditional behavioral symptom coping skills; home-based physical activity; strategies from Acceptance and Commitment Therapy and Meaning-Centered Psychotherapy; and strategies to foster self-compassion. Phase II user testing sessions highlighted strengths and suggestions for refining the prototype materials. Conclusion: Post-treatment symptoms are common for YAs. A tailored behavioral symptom management program was developed and refined with input from YAs and providers and will be examined for feasibility and acceptability in a pilot randomized controlled trial. Clinical Trial: Clinicaltrials.gov identifier NCT04035447.
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Affiliation(s)
- Caroline S. Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Rebecca A. Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann M. Stalls
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Francis J. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Jennifer Plumb Vilardaga
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Joseph G. Winger
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kara Mitchell
- Duke Health and Fitness Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Christopher Ehren
- Duke Health and Fitness Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Kevin C. Oeffinger
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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23
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Corrigan KL, Reeve BB, Salsman JM, Siembida EJ, Smith GL, Swartz MC, Lee KL, Afridi F, Andring LM, Bishop AJ, Gunther JR, Livingston JA, Peterson SK, Parsons SK, Roth M. Association of Patient-Reported Health-Related Quality of Life With Physician-Reported Toxicities in Adolescents and Young Adults Receiving Radiation Therapy for Cancer. JCO Oncol Pract 2023; 19:610-619. [PMID: 37311165 PMCID: PMC10424910 DOI: 10.1200/op.22.00852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/09/2023] [Accepted: 05/02/2023] [Indexed: 06/15/2023] Open
Abstract
PURPOSE Radiation therapy (RT) may cause toxicities in adolescents and young adults (AYAs, age 15-39 years) with cancer. However, the range of RT-related toxicities in AYAs and the affect on health-related quality of life (HRQOL) has not been well studied. We performed a cross-sectional study in AYAs with cancer who received RT to identify RT-related toxicities and examine their impact on HRQOL. MATERIALS AND METHODS A total of 178 AYAs received RT and completed PROMIS HRQOL instruments from 2018 to 2022. Acute and late physician-graded Common Terminology Criteria for Adverse Events RT-related toxicities were extracted and described. Multivariable linear regression was used to evaluate the association of RT-related toxicity with HRQOL scores during and post-RT. Minimally important differences were used to evaluate the clinical relevance of relationships. RESULTS Eighty-four AYAs completed HRQOL surveys during RT and 94 post-RT. In the during-RT cohort, 75 AYAs (89%) had acute RT-related toxicities, a majority of which were grade 1 (n = 49, 65%). AYAs who experienced acute grade 2 or greater toxicities reported worse global mental health (B = -7.35, P < .01) and worse pain (B = 5.25, P = .01) than those with acute grade 1 or no toxicities. In the post-RT cohort, the median (IQR) time from RT to survey completion was 24 (14-27) months. Forty-eight AYAs (51%) had late RT-related toxicities, a majority of which were grade 1 (n = 37, 77%). AYAs who experienced late grade 2 or greater toxicities reported worse global mental health (B = -8.07, P = .01), worse social roles (B = -9.96, P < .01), and greater sleep disturbance (B = 10.75, P < .01) than those with late grade 1 or no RT toxicities. CONCLUSION The presence of acute and late grade 2 or greater RT-related toxicities may contribute to worse HRQOL, especially global mental health, in AYAs. Screening and early interventions to mitigate RT-related toxicities are needed to improve AYA HRQOL.
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Affiliation(s)
- Kelsey L. Corrigan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Bryce B. Reeve
- Center for Health Measurement, Department of Population Health Sciences, Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - John M. Salsman
- Department of Social Sciences and Health Policy, Wake Forest University, Winston-Salem, NC
| | | | - Grace L. Smith
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Maria C. Swartz
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kamaria L. Lee
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Faraz Afridi
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lauren M. Andring
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Andrew J. Bishop
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jillian R. Gunther
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J. Andrew Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Susan K. Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Susan K. Parsons
- Department of Medicine, Tufts University School of Medicine, ICRHPS, Tufts Medical Center, Boston, MA
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX
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24
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Crowder SL, Sauls R, Gudenkauf LM, James C, Skinner A, Reed DR, Stern M. The Lived Experience of Young Adult Cancer Survivors after Treatment: A Qualitative Study. Nutrients 2023; 15:3145. [PMID: 37513563 PMCID: PMC10385438 DOI: 10.3390/nu15143145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE The purpose of this qualitative study was to compare the lived experiences among extended (one year or less post-treatment) and long-term (three years or more post-treatment) young adult (YA) cancer survivors (ages 18-39 years old). METHODS Two trained researchers conducted semi-structured interviews inquiring about the overall lived experience of N = 24 YA cancer survivors (n = 12 extended and n = 12 long-term). The same two researchers independently completed line-by-line coding and thematic content analysis. RESULTS Interviews lasted an average of 41 min and revealed common themes of symptoms, psychosocial concerns, coping, and changes in health behaviors (e.g., nutrition and physical activity). All participants discussed symptoms impairing their quality of life and affecting their fear of recurrence. Specific psychosocial concerns among extended survivors were appearance-related (e.g., hair loss, weight gain) whereas concerns among long-term survivors included job loss, fertility, and financial stress. Coping strategies described by extended survivors were often distraction-based (e.g., watching television to "escape"), while long-term survivors described more active coping strategies (e.g., yoga, meditation, and seeking support from family and friends). Most survivors reflected on limited physical activity or unhealthy eating during treatment; however, nearly all declared healthy eating and physical activity post-treatment to improve well-being. CONCLUSIONS YA cancer survivors report differing symptoms, psychosocial concerns, and coping strategies across time since treatment. While survivors reported challenges with physical activity and nutrition during treatment, nearly all emphasized the importance of these health behaviors post-treatment. Thus, health behavior interventions could represent a preferred approach to address post-treatment challenges and improve quality of life for YA survivors.
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Affiliation(s)
- Sylvia L Crowder
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Rachel Sauls
- College of Public Health, University of South Florida, Tampa, FL 33620, USA
- Non-Therapeutic Research Operations, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Christy James
- Non-Therapeutic Research Operations, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Amber Skinner
- Adolescent and Young Adult Program, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Damon R Reed
- Adolescent and Young Adult Program, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
- Department of Individualized Cancer Management, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33620, USA
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25
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Hirayama T, Ikezawa S, Okubo R, Mizuta T, Iwata S, Suzuki T. Mental health care use and related factors in adolescents and young adults with cancer. Support Care Cancer 2023; 31:247. [PMID: 37000309 PMCID: PMC10066100 DOI: 10.1007/s00520-023-07708-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/26/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE The actual state of mental health care use and related factors in adolescent and young adult (AYA) patients with cancer is not well understood in Japan. This study aimed to (1) examine the actual state of mental health care use among AYA patients with cancer and (2) describe socio-demographic and related factors associated with mental health care use. METHODS We retrospectively reviewed the medical records of AYA patients with cancer aged 15-39 who first visited the National Cancer Center Hospital in Japan (NCCH) between January 2018 and December 2020. Logistic regression was used to analyze the association between social background characteristics and mental health care use. The association between the patient's course of cancer treatment and mental health care use was analyzed to help identify which patients might benefit from early mental health intervention. RESULTS Among 1,556 patients, 945 AYA patients with cancer were registered. The median age at the time of the study was 33 years (range, 15-39 years). The prevalence of mental health care use was 18.0% (170/945). Age 15-19 years, female gender, urogenital cancer, gynecological cancer, bone or soft tissue cancer, head and neck cancer, and stage II-IV disease were associated with mental health care use. Regarding treatment, palliative treatment, chemotherapy, and hematopoietic stem cell transplantation were associated with mental health care use. CONCLUSION Factors associated with mental health care use were identified. Our findings potentially contribute to psychological support interventions for AYA patients with cancer.
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Affiliation(s)
- Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
| | - Satoru Ikezawa
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Endowed Institute for Empowering Gifted Minds, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Ryo Okubo
- Department of psychiatry and neurology, National hospital organization Obihiro hospital, Hokkaido, Japan
| | - Tomoko Mizuta
- Department of Psycho-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan
| | - Shintaro Iwata
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
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26
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Gupta S, Li Q, Nathan PC, D'Agostino N, Baxter NN, Fox C, Chalifour K, Coburn N, Sutradhar R. Prevalence, severity, and predictors of symptom burden among adolescents and young adults with cancer. Cancer Med 2023. [DOI: 10.1002/cam4.5837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/23/2023] [Accepted: 03/12/2023] [Indexed: 03/29/2023] Open
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Knoerl R, Mazzola E, Woods H, Buchbinder E, Frazier L, LaCasce A, Luskin MR, Phillips CS, Thornton K, Berry DL, Ligibel J. Exploring Influencing Factors of Anxiety Improvement Following Mindfulness-Based Music Therapy in Young Adults with Cancer. J Music Ther 2023:7036622. [PMID: 36787235 DOI: 10.1093/jmt/thac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The purpose of this secondary analysis was to explore physiological, psychological, and situational influencing factors that may affect the impact of a mindfulness-music therapy intervention on anxiety severity in young adults receiving cancer treatment. Young adults receiving cancer treatment for ≥ eight weeks were recruited from adult and pediatric oncology outpatient centers at Dana-Farber Cancer Institute. Participants were asked to attend up to four, in-person (offered virtually via Zoom video conference after the onset of the COVID-19 pandemic) 45-min mindfulness-based music therapy sessions over twelve weeks with a board-certified music therapist. Participants completed questionnaires about anxiety, stress, and other cancer treatment-related outcomes before and after participating in the intervention. Changes in anxiety (i.e., PROMIS Anxiety 4a) over time were compared among baseline physiological (e.g., age or sex), psychological (e.g., stress), and situational influencing (i.e., intervention delivery format) factors using Wilcoxon-rank sum tests. Thirty-one of the 37 enrolled participants completed the baseline and post-intervention measures and were eligible for inclusion in the secondary analysis. Results revealed that higher baseline physical functioning (median change = -6.65), anxiety (median change=-5.65), fatigue (median change = -5.6), sleep disturbance (median change = -5.6), female sex (median change = -5.15), or virtual intervention delivery (median change = -4.65) were potential physiological, psychological, or situational influencing factors associated with anxiety improvement following mindfulness-based music therapy. Additional investigation into physiological, psychological, or situational influencing factors associated with anxiety response will help to tailor the design of future mindfulness-music therapy interventions to decrease psychological distress and address the unique psychosocial concerns among young adults receiving cancer treatment. Trial Registration: ClinicalTrials.gov Identifier: NCT03709225.
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Affiliation(s)
- Robert Knoerl
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Emanuele Mazzola
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Heather Woods
- The Leonard P. Zakim Center for Integrative Therapies and Healthy Living, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ann LaCasce
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Marlise R Luskin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Carolyn S Phillips
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Katherine Thornton
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Donna L Berry
- Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - Jennifer Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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Prevalence and associated factors of psychological distress among young adult cancer patients in Japan. Palliat Support Care 2023; 21:93-99. [PMID: 35225198 DOI: 10.1017/s1478951521002054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Adolescent and young adult (AYA) cancer patients may be at high risk of experiencing psychological distress because their diagnosis came during a key time of consolidation of identity and social growth. This study aimed (1) to examine the prevalence of psychological distress among AYA cancer patients within a year of diagnosis to long-term survivors and (2) to describe socio-demographic and cancer-related characteristics associated with psychological distress. METHODS In a cross-sectional web-based survey, patients who scored 5 or more on the Kessler Psychological Distress Scale were assessed for significant psychological distress. Logistic regression examined whether demographics, clinical variables, and social support were associated with psychological distress. RESULTS A total of 206 young adult cancer patients participated. The median age at the survey was 34.5 years (range: 22-39 years), and 87.4% were female. The prevalence of psychological distress was 55.3%. Psychological distress among patients diagnosed within a year and long-term survivors (≥10 years since diagnosis) was significantly higher than patients 1-4 years since diagnosis. Pain, decrease in income after a cancer diagnosis, experience of negative change in work/school after a cancer diagnosis and poor social support were significantly associated with psychological distress. SIGNIFICANCE OF RESULTS Over half of young adult patients had significant psychological distress in Japan. Our findings potentially contribute to the intervention components for distress management among AYA cancer survivors.
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Friend BD, Broglie L, Logan BR, Chhabra S, Bupp C, Schiller G, Beitinjaneh A, Perez MAD, Guilcher GMT, Hashem H, Hildebrandt GC, Krem MM, Lazarus HM, Nishihori T, Nusrat R, Rotz SJ, Wirk B, Wieduwilt M, Pasquini M, Savani BN, Stadtmauer EA, Sorror ML, Thakar MS. Adapting the HCT-CI Definitions for Children, Adolescents, and Young Adults with Hematologic Malignancies Undergoing Allogeneic Hematopoietic Cell Transplantation. Transplant Cell Ther 2023; 29:123.e1-123.e10. [PMID: 36442769 PMCID: PMC9911376 DOI: 10.1016/j.jtct.2022.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/08/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
Allogeneic hematopoietic cell transplantation is a curative procedure for hematologic malignancies but is associated with a significant risk of non-relapse mortality (NRM). The Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) is a prognostic tool that discriminates this risk in all age groups. A recent survey of transplant physicians demonstrated that 79% of pediatric providers used the HCT-CI infrequently, and most reported concerns about its applicability in the younger population. We conducted a retrospective study using the Center for International Blood and Marrow Transplant Research database to examine the impact of expanded HCT-CI definitions on NRM in pediatric and young adult patients with hematologic malignancies. We included 5790 patients <40 years old receiving allogeneic transplants between 2008 and 2017 to examine broader definitions of comorbidities in the HCT-CI, including history of mechanical ventilation and fungal infection, estimated glomerular filtration rate, and body mass index (BMI) percentiles. Multivariable Fine-Gray models were created to determine the effect of each HCT-CI defining comorbidity and its modification on NRM and were used to develop 2 novel risk scores. We next developed the expanded HCT-CI for children and young adults (youth with malignancies; expanded ymHCT-CI), where 23% patients had an increased comorbidity score, compared to the HCT-CI. Comorbidities with hazard ratio < 1.2 were then removed to create the simplified HCT-CI for children and young adults (youth with malignancies; simplified ymHCT-CI), which demonstrated higher scores corresponded to a greater risk of NRM (P < .001). These novel comorbidity indexes with broader definitions are more relevant to pediatric and young adult patients, and prospective studies are needed to validate these in the younger patient population. It remains to be seen whether the development of these pediatric-specific and practical risk indexes increases their use by the pediatric transplant community.
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Affiliation(s)
- Brian D Friend
- Baylor College of Medicine Center for Cell and Gene Therapy, Houston, Texas
| | - Larisa Broglie
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Brent R Logan
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Saurabh Chhabra
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Hematology/Oncology, Department of Medicine, Mayo Clinic Arizona, Phoenix, Arizona.
| | - Caitrin Bupp
- CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Gary Schiller
- Hematological Malignancy/Stem Cell Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Gregory M T Guilcher
- Section of Pediatric Oncology/Cellular Therapy, Alberta Children's Hospital, Departments of Oncology and Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Hasan Hashem
- Division of Pediatric Hematology/Oncology and Bone Marrow Transplantation, King Hussein Cancer Center, Amman, Jordan
| | | | | | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, Florida
| | | | - Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Matthew Wieduwilt
- Department of Medicine, University of Oklahoma, Stephenson Cancer Center, Oklahoma City, Oklahoma
| | - Marcelo Pasquini
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Edward A Stadtmauer
- University of Pennsylvania Abramson Cancer Center, Philadelphia, Pennsylvania
| | - Mohamed L Sorror
- Clinical Research Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington; Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Monica S Thakar
- Clinical Research Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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Gruen LJ, Lee-Miller CA, Osman F, Parkes A. Benefit of Interdisciplinary Care in Resource Identification in an Adolescent and Young Adult Oncology Care Model. J Adolesc Young Adult Oncol 2023; 12:752-757. [PMID: 36595361 DOI: 10.1089/jayao.2021.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Purpose: There are limited data to identify the best care model to support the vulnerable adolescent and young adult (AYA) oncology population. We sought to compare the impact of AYA physician visits versus interdisciplinary team (IDT) care on AYA-specific resource identification and utilization, as well as to provide a model of AYA oncology care implementation. Methods: We identified AYA-aged patients 15-39 years with a current or prior history of cancer seen by the University of Wisconsin Carbone Cancer Center (UWCCC) AYA Oncology Program between January 21, 2021 and May 27, 2021. Patients in this program have a one-on-one clinic visit with an AYA oncologist followed 4 days later by presentation at an AYA IDT meeting. We conducted retrospective chart review to quantify AYA-specific resource utilization before the AYA program visit, as well as novel resources identified by the AYA physician visit and the IDT meeting, and conducted a descriptive statistical analysis of the data. Results: We identified 35 patients seen by the UWCCC AYA Oncology Program. Before their AYA clinic visit, patients used an average of 2.51 AYA-specific services. An average of 4.45 novel resources was identified by the AYA Oncology Program per patient. This included an average of 2.54 and 1.91 additional resources identified per patient through the AYA physician visit and IDT meeting, respectively. The most common resource needs identified overall fell into the "other" category, consisting of a wide variety of resource domains (26/35) and peer support (27/35). Conclusions: Our data support increased resource identification through an AYA-specific care model. These objective data support the critical importance of AYA interdisciplinary care, as well as the use of an AYA IDT meeting model as a method to include interdisciplinary care in AYA programs despite possible resource constraints.
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Affiliation(s)
- Leah J Gruen
- Division of Hematology, Medical Oncology and Palliative Care, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Cathy A Lee-Miller
- Division of Hematology, Oncology and Bone Marrow Transplant, Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Fauzia Osman
- Division of Hematology, Medical Oncology and Palliative Care, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Amanda Parkes
- Division of Hematology, Medical Oncology and Palliative Care, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Abu-Odah H, Molassiotis A, Zhao IY, Su JJ, Allsop MJ. Psychological distress and associated factors among Palestinian advanced cancer patients: A cross-sectional study. Front Psychol 2022; 13:1061327. [PMID: 36533049 PMCID: PMC9755485 DOI: 10.3389/fpsyg.2022.1061327] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/11/2022] [Indexed: 11/05/2023] Open
Abstract
OBJECTIVE There is limited research exploring the experiences of people living with advanced cancer in the Gaza Strip (GS), Palestine. Thus, this study aimed to determine the level of psychological distress, anxiety, and depression among advanced cancer patients in the GS and identify factors associated with a high level of distress. MATERIALS AND METHODS A secondary analysis was performed using primary data from a larger study focusing on supportive care needs in advanced cancer patients in GS. Three hundred sixty-one patients agreed to participate and filled out the Distress Thermometer (DT) and the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression was conducted to identify factors associated with high distress levels. RESULTS Over two-thirds of advanced cancer patients (70.6%) reported a high level of distress. They also reported a significantly higher distress level than patients with early cancer (96.5 vs. 3.5%; p = 0.001). About 92.8% of participants reported depression and anxiety symptoms. Physical, emotional, and practical problems were the primary sources of distress. Breast cancer patients were more likely to have psychological distress than colon and stomach cancer patients. Newly diagnosed patients had a higher level of anxiety, depression, and distress than those who had a cancer diagnosis for an extended period. CONCLUSION Patients with advanced cancer in the GS exhibited a significantly higher level of psychological distress, depression and anxiety than patients with advanced cancer elsewhere. Efforts should be made to identify psychological distress as a routine part of oncology practice. Future research should further explore the causes of psychological distress in cancer patients in conflict zones and feasible mitigation strategies.
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Affiliation(s)
- Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza, Palestine
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Ivy Y. Zhao
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Matthew J. Allsop
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
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Oswald LB, Lyleroehr M, Gudenkauf LM, Armstrong GE, Tometich DB, Sanford SD, Loecher N, Geiss C, Rodriguez Y, Scheel KL, Nieves-Lopez A, Jim HSL, Gonzalez BD, Antoni MH, Penedo FJ, Reed D, Katsanis E, Salsman JM, Victorson D, Fox RS. Development and initial testing of TOGETHER-YA: an eHealth-delivered and group-based psychosocial intervention for young adult cancer survivors. Support Care Cancer 2022; 30:10067-10076. [PMID: 36229547 PMCID: PMC9722531 DOI: 10.1007/s00520-022-07382-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/01/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE This study aimed to (1) develop TOGETHER-YA, an e-Health-delivered and group-based health-related quality of life (HRQOL) intervention for young adult (YA) cancer survivors aged 18-39 (Part 1), and (2) determine its initial feasibility and acceptability in a single-arm pilot trial (Part 2). METHODS TOGETHER-YA is a manualized, 10-week intervention for YA survivors that includes elements of relaxation training, cognitive-behavioral therapy, and health education. In Part 1, content was adapted from existing evidence-based interventions with feedback from YAs (N = 22) in four iterative focus groups. In Part 2, YA survivors (N = 11) participated in a single-arm pilot trial of TOGETHER-YA. Intervention groups were led by a trained facilitator over videoconference. Primary outcomes were feasibility (i.e., recruitment, session attendance, retention) and acceptability (i.e., participant satisfaction). RESULTS Focus groups reacted positively to TOGETHER-YA and provided actionable recommendations for enhancing its relevance and acceptability, which were implemented. In initial testing, all feasibility and acceptability benchmarks were met; 58% of eligible YAs were recruited, participants attended M = 6 intervention sessions (SD = 3), and 82% of participants were retained post-intervention. On average, participants "agreed" to "strongly agreed" with positive statements about the weekly sessions and the overall program. CONCLUSION TOGETHER-YA was developed in collaboration with YA cancer survivors and found to be feasible and acceptable in initial testing. TOGETHER-YA is the first HRQOL intervention for a broad range of YA survivors that is eHealth-delivered for convenience and group-based for peer support. Future large-scale trials should test its efficacy for improving HRQOL. TRIAL REGISTRATION NCT05048316, September 17, 2021; NCT05054569, September 23, 2021.
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Affiliation(s)
- Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA.
| | - Madison Lyleroehr
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Grace E Armstrong
- Department of Counseling, The Family Institute of Northwestern University, Evanston, IL, USA
| | - Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Stacy D Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Nele Loecher
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA
| | - Carley Geiss
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Kelsey L Scheel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Amarilis Nieves-Lopez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Damon Reed
- Department of Individualized Cancer Management, Moffitt Cancer Center, Tampa, FL, USA
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
- University of Arizona College of Nursing, Tucson, AZ, USA
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White GW, Rhind SG, Nathan PC, Caterini JE, Jones HN, Wells GD. Physiological stress reactivity in pediatric cancer survivors treated with chemotherapy. Pediatr Blood Cancer 2022; 69:e29881. [PMID: 35881000 DOI: 10.1002/pbc.29881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/27/2022] [Accepted: 06/22/2022] [Indexed: 11/06/2022]
Abstract
Children who experience early life stress demonstrate changes to their stress responses, which may modulate long-term health. Childhood cancer presents significant stress during diagnosis, treatment, and survivorship. We hypothesized that children who have completed chemotherapy treatment for ALL will demonstrate altered hormone patterns in response to a stressor compared with healthy controls. Twelve pediatric ALL survivors and 12 healthy controls completed the Trier Social Stress Test. Salivary samples, heart rate, and self-report ratings of stress were collected at baseline, pretest, and posttest. Between group comparison showed baseline (interleukin [IL]-8) was significantly higher in the survivor group versus controls (survivors: 89.9, 40.1-544.9 pg ml-1 ; controls: 30.7, 5.6-241.9 pg ml-1 , p = .001) as was peak (IL-8) (survivors: 147.1, 71.6-1177.6 pg ml-1 ; controls: 75.5, 28.6-698.6 pg ml-1 ). Peak salivary alpha-amylase (sAA) concentration was significantly lower in the survivor group (survivors: 69.3, 19.4-195.5 U ml-1 ; controls: 91.2, 27.7-213.7 U ml-1 ; p = .04). Repeated measures ANOVA revealed significant main effects for time on cortisol (F(2.35, 50.81) = 5.9, p < .01), sAA (F(1.56, 33.17) = 6.6, p < .01), stress ratings (F(3.42, 88.14) = 53.4, p < .001), and heart rate (F(8, 83) = 16.8, p < .05). Significant main effects for group were observed for IL-8 (F(1, 23) = 8.2, p < .01) and tumor necrosis factor-α (F(1, 23) = 6.8, p < .05). Significant interaction effects for group × time were found for sAA (F(5, 106) = 2.8, p < .05). Our results indicate that childhood ALL survivors have similar responses to stress as healthy controls, but lower sympatho-adrenal-medullary reactivity. Therefore, altered stress regulation may present a pathway modulating long-term health in this population.
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Affiliation(s)
- Gillian W White
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada.,Graduate Department of Exercise Science, University of Toronto, Toronto, Canada
| | - Shawn G Rhind
- Defense Research and Development Canada, Toronto Research Centre, Toronto, Ontario, Canada
| | - Paul C Nathan
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Jessica E Caterini
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada.,Queen's Medical School, Kingston, Ontario, Canada
| | - Heather Np Jones
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Greg D Wells
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada
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Oswald LB, Fox RS, Murphy KM, Salsman JM, Sanford SD, McDade TW, Victorson DE. Preliminary Effects of Mindfulness Training on Inflammatory Markers and Blood Pressure in Young Adult Survivors of Cancer: Secondary Analysis of a Pilot Randomized Controlled Trial. Int J Behav Med 2022; 29:676-684. [PMID: 35048316 PMCID: PMC9296689 DOI: 10.1007/s12529-021-10050-w] [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] [Accepted: 12/13/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND This was a secondary analysis of a pilot randomized controlled trial (RCT) of mindfulness-based stress reduction (MBSR) among young adult (YA) survivors of cancer, which showed preliminary evidence for improving psychosocial outcomes. Secondary outcomes assessed were the feasibility of collecting biological data from YAs and preliminary effects of MBSR on markers of inflammation and cardiovascular function. METHOD Participants were randomized to 8-week MBSR or a waitlist control condition. Participants provided whole blood spot samples for analysis of C-reactive protein (CRP) and interleukin (IL)-6 as well as blood pressure data in-person at baseline and 16-week follow-up. Feasibility was assessed with rates of providing biological data. Linear mixed effects modeling was used to evaluate preliminary effects of MBSR on inflammatory markers and blood pressure over time. RESULTS Of 126 total participants enrolled, 77% provided biological data at baseline (n = 48/67 MBSR, n = 49/59 control). At 16 weeks, 97% of the 76 retained participants provided follow-up biological data (n = 34/35 MBSR, n = 40/41 control). Relative to the control group, MBSR was associated with decreased systolic blood pressure (p = 0.042, effect sizes (ES) = 0.45) and decreased diastolic blood pressure (p = 0.017, ES = 0.64). There were no changes in CRP or IL-6. CONCLUSION This was the first study to explore the feasibility of collecting biological data from YA survivors of cancer and assess preliminary effects of MBSR on inflammatory and cardiovascular markers in an RCT. Minimally invasive biological data collection methods were feasible. Results provide preliminary evidence for the role of MBSR in improving cardiovascular outcomes in this population, and results should be replicated.
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Affiliation(s)
- Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA
| | - Karly M Murphy
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stacy D Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA
| | - Thomas W McDade
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA
- Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - David E Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 2205 Tech Drive, Suite 2-120, Evanston, Chicago, IL, USA.
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Dorfman CS, Stalls J, Lachman S, Shelby RA, Somers TJ, Oeffinger KC. Symptom Communication Preferences and Communication Barriers for Young Adult Cancer Survivors and Their Health Care Providers. J Adolesc Young Adult Oncol 2022; 11:506-517. [PMID: 35049386 PMCID: PMC9595618 DOI: 10.1089/jayao.2021.0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Effective communication between young adult (YA; aged 18-39 years) cancer survivors and their health care providers is critical for managing post-treatment symptoms. Yet, little is known about YAs' and providers' preferences for and barriers to symptom communication, variables important for developing interventions to improve and optimize YA-provider communication. Methods: YA survivors (N = 21) and oncology providers (N = 11) rank ordered their preferred methods for symptom communication and top communication barriers. Interviews were conducted to obtain qualitative data (i.e., preferred methods for, barriers, and suggestions to improve symptom communication). Interviews were transcribed, and thematic qualitative analysis was used. Results: Sixty-two percent of YAs preferred communicating using the electronic messaging system affiliated with the medical record (MyChart), whereas providers (100%) preferred communicating during in-person clinic visits. Qualitative data from YAs pointed to benefits of MyChart, including ease of use and rapid responses. Providers acknowledged that, although efficient, high message volumes and expectations for rapid responses were barriers to MyChart. Providers described benefits of in-person visits, including visually assessing patients' concerns, providing immediate support, and more safely managing symptoms. Lack of time (48%) was YAs' top communication barrier, whereas providers endorsed patients not bringing up symptoms (64%). Qualitative data reflected patient-level (e.g., embarrassment/discomfort, lack of skills) and provider-level (e.g., forgetting to ask about a symptom) barriers. YAs and providers offered strategies to improve communication. Conclusion: Survivor- and provider-level communication interventions that account for YAs' and providers' differing communication preferences and directly address communication barriers unique to survivors' developmental stage may be necessary to improve symptom communication.
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Affiliation(s)
- Caroline S. Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann Stalls
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Sage Lachman
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Rebecca A. Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Kevin C. Oeffinger
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
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Shrivastava SP, Elhence A, Jinwala P, Bansal S, Chitalkar P, Bhatnagar S, Patidar R, Asati V, Reddy PK. Assessment of Psychological Distress Among Indian Adolescents and Young Adults with Solid Cancer Using the National Comprehensive Cancer Network Distress Thermometer. South Asian J Cancer 2022. [DOI: 10.1055/s-0042-1756184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological distress among Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) distress thermometer.
Methods The demographic and clinical characteristics of AYAs patients (age 15–39 years) with cancer were recorded. Assessment of psychological distress of patients using the NCCN distress thermometer was performed at three time points over a period of 3 months. Distress thermometer scale and a self-administered questionnaire in English and Hindi languages was handed over to participants at three time points: at treatment commencement (T1), at 1 month, and 3 months (T2 and T3, respectively) into therapy.
Results Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤ 24 years old and 188 (73%) were>24 years old. Bone sarcoma (39%) was common cancer in AYA patients aged ≤ 24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were the highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. The distress score in the age ≤ 24 years was the highest (6.7) at T1, followed by those measured at T2 (2.6) and T3 (1.1) and among age>24 years was the highest (6.6) at T1, followed by those measured at T2 (2.6) and T3 (1.2). Among AYA patients>24 years old, worry, nervousness, sadness, transportation, and sleep were the top five identified problems and in ≤ 24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness.
Conclusion Adolescents and young adults experience some level of distress associated with the cancer diagnosis, effects of the disease, treatment regardless of the stage and various transitions throughout the trajectory of the disease. The distress thermometer is an easy and useful tool for the assessment of psychological distress in AYA cancers. Early identification of distress burden with the distress thermometer leads to effective interventions in patients with cancer which could improve outcomes including survival in AYAs with cancer in India.
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Affiliation(s)
- Shiv Prasad Shrivastava
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Aditya Elhence
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prutha Jinwala
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shashank Bansal
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prakash Chitalkar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shweta Bhatnagar
- Department of Radiology, CHL Hospital, Indore, Madhya Pradesh, India
| | - Rajesh Patidar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Vikas Asati
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Pradeep Kumar Reddy
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Park M, Kwon SY, Yun H, Lyu CJ, Han JW, Hahn SM, Jung M, Rha SY, Beom SH, Lee CK, Jang H. Care Needs of Adolescents and Young Adults with Cancer Undergoing Active Treatment in South Korea: A Mixed Methods Study. J Adolesc Young Adult Oncol 2022. [PMID: 35904961 DOI: 10.1089/jayao.2022.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Adolescents and young adults (AYAs) with cancer have special care needs that are different from those of children and older adults with cancer. This study assessed the perspective and experience of AYAs with cancer in South Korea to identify their care needs. Methods: This study used a convergent mixed-methods design. From July 2020 to November 2021, AYAs with cancer (N = 77; 15-39 years of age) participated in a quantitative cross-sectional study, using a tool developed by our study team. In May 2021, a qualitative focus group was conducted with 10 AYAs with cancer. Integrated analyses were conducted concurrently by reporting the quantitative and qualitative findings together. Results: Quantitative findings revealed that the highest care need domains were communication and information, whereas the highest care priority item was the management of pain and symptoms occurring during the treatment. Qualitative findings revealed 12 themes across 5 domains. Comparing and merging of the quantitative and qualitative data resulted in eight confirmed themes and four expanded findings, including knowing people who overcame similar illnesses, fear of death, dedicated space, and a program for AYAs with cancer. Conclusion: When developing and implementing programs and health care services, especially in countries with no established program or cancer specialty unit for AYAs with cancer, it is important to consider the special care needs and priorities of AYAs with cancer. This mixed methods study provided empirical evidence to help understand and prioritize the needs of AYAs with cancer undergoing active treatment in South Korea.
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Affiliation(s)
- Mina Park
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Seung Yeon Kwon
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Palliative Care Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - Hyeseon Yun
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Chuhl Joo Lyu
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Woo Han
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Min Hahn
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyu Jung
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea.,Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Sun Young Rha
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.,Department of Internal Medicine, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung-Hoon Beom
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Choong-Kun Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeju Jang
- Provider Partners Health Plan, Linthicum Heights, Maryland, USA
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38
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Bradford NK, McDonald FEJ, Bibby H, Kok C, Patterson P. Psychological, functional and social outcomes in adolescent and young adult cancer survivors over time: A systematic review of longitudinal studies. Psychooncology 2022; 31:1448-1458. [PMID: 35734846 PMCID: PMC9544373 DOI: 10.1002/pon.5987] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/15/2022] [Accepted: 06/19/2022] [Indexed: 11/12/2022]
Abstract
Objective Most adolescents and young adults (AYA) can expect to survive a cancer diagnosis and treatment, but all will be left with the potential of long‐term negative effects that can impact their ability to reach their full potential in life. Understanding aspects of psychological, functional, and social health and well‐being outcomes, is pivotal for optimising long‐term well‐being. Methods We completed a systematic review of longitudinal studies reporting outcomes after anti‐cancer treatment for Adolescents and Young Adults diagnosed between the age of 12–29 years according to established systematic review processes. The protocol was registered with PROSPERO (ID: CRD 42020203116). Results Thirteen reports from 10 studies met eligibility criteria representing 17,645 individuals (50.3% female, mean age at diagnosis 22 years, and 26 years at last, follow up). Eleven reports were from eight quantitative studies that relied on self‐report surveys and two were qualitative studies. Psychological outcomes were reported to improve over time, as were functional health outcomes, although reported health behaviours were inconsistent between studies. Neurocognitive deficits were reported to affect the ability to return to work and impacts on fertility and sexuality were sustained over time. Conclusions While some outcomes for AYA are reported to improve over time, particularly for physical functioning, and anxiety and depression, the long‐term impact of cancer on many important domains remains largely unknown. Specifically, the evidence to understand what changes occur over time, and when, remains underdeveloped. Adolescents and young adults have a long time to live as survivors of cancer, and the negative effects of disease and treatment can compromise long‐term well‐being Longitudinal research is important for understanding changes in outcomes over time While a wide range of outcomes have been studied, the evidence to understand what changes occur and when remains underdeveloped
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Affiliation(s)
- Natalie K Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Fiona E J McDonald
- Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Helen Bibby
- Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia
| | - Cindy Kok
- Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Pandora Patterson
- Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Ghazal LV, Cole S, Salsman JM, Wagner L, Duan F, Gareen I, Lux L, Parsons SK, Cheung C, Loeb DM, Prasad P, Dinner S, Zebrack B. Social Genomics as a Framework for Understanding Health Disparities Among Adolescent and Young Adult Cancer Survivors: A Commentary. JCO Precis Oncol 2022; 6:e2100462. [PMID: 35772048 PMCID: PMC9259142 DOI: 10.1200/po.21.00462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Lauren V Ghazal
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Steve Cole
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - John M Salsman
- Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University, Winston-Salem, NC
| | - Lynne Wagner
- Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University, Winston-Salem, NC
| | - Fenghai Duan
- Department of Biostatistics, Brown University, Providence, RI
| | - Ilana Gareen
- Department of Epidemiology and the Center for Statistical Sciences, Brown University School of Public Health, Providence, RI
| | - Lauren Lux
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Susan K Parsons
- Institute for Clinical Research and Health Policy Studies, Tufts Cancer Center, Tufts Medical Center, Boston, MA
| | | | | | - Pinki Prasad
- Louisiana State University Health, New Orleans, LA
| | - Shira Dinner
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Brad Zebrack
- Division of Cancer Control and Population Sciences, School of Social Work, Rogel Cancer Center, University of Michigan, Ann Arbor, MI
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40
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Antwi GO, Lohrmann DK, Jayawardene W, Chow A, Obeng CS, Sayegh AM. Associations between Cigarette Smoking and Health-Related Quality of Life in Adult Survivors of Adolescent and Young Adult Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:508-516. [PMID: 32728997 DOI: 10.1007/s13187-020-01837-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This cross-sectional, secondary data analysis examines the association between cigarette smoking and self-reported health-related quality of life (HRQoL) in adult survivors of Adolescent and Young Adult Cancer. Pooled data for survivors of Adolescent and Young Adult Cancer (N = 1495) were drawn from the 2016 and 2017 Behavioral Risk Factor Surveillance Survey. Binary logistic regression models were utilized to examine independent associations between each of the four HRQoL domains (i.e., self-related general health, activity limitation days, poor physical, and mental health days) and cigarette smoking. Of the 1495 Adolescent and Young Adult Onset Cancer Survivors (AYAO-CS) in this study, approximately 30% reported currently smoking cigarettes. Relative to never smokers, the odds of reporting fair/poor general health were significantly higher for current and former smokers: (OR = 3.95, 95% CI: 2.08-7.50) and (OR = 2.51, 95% CI: 1.46-4.32), respectively. Likewise, current smokers were significantly more likely to report frequent days of poor physical health (OR = 2.79, 95% CI: 1.38-5.65). The study findings suggest a significant cross-sectional association between cigarette smoking and poor health-related quality of life in adult survivors of adolescent and young adult cancer. These findings, although cross-sectional, underscore the need for prospective studies to examine the longitudinal association between HRQoL and cigarette smoking among cancer survivors. Findings also help establish both the need for smoking cessation programs and the importance of effective strategies for addressing HRQoL issues among cancer survivors.
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Affiliation(s)
- Godfred O Antwi
- Department of Public Health and Health Education, The College at Brockport, State University of New York, Brockport, NY, 14420, USA.
| | - David K Lohrmann
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Wasantha Jayawardene
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
- Institute for Research on Addictive Behavior, Indiana University School of Public Health Bloomington, Bloomington, IN, USA
| | - Angela Chow
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Cecilia S Obeng
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Aaron M Sayegh
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, 47405, USA
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Rossi AA, Marconi M, Taccini F, Verusio C, Mannarini S. Screening for Distress in Oncological Patients: The Revised Version of the Psychological Distress Inventory (PDI-R). Front Psychol 2022; 13:859478. [PMID: 35602698 PMCID: PMC9121122 DOI: 10.3389/fpsyg.2022.859478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/17/2022] [Indexed: 12/17/2022] Open
Abstract
Background Psychological research in oncological settings is steadily increasing and the construct of psychological distress has rapidly gained popularity-leading to the development of questionnaires aimed at its measurement. The Psychological Distress Inventory (PDI) is one of the most used instruments, but its psychometric properties were not yet deeply evaluated. The present studies aimed at investigating the psychometric properties of the PDI (Study 1) and providing a revised version of the tool (Study 2). Methods Oncological outpatients were enrolled at the Department of Medical Oncology of the Presidio Ospedaliero of Saronno, ASST Valle Olona, Italy. For the first study (N = 251), an Exploratory Graph Analysis was used to explore the item structure of the PDI. In the second study (N = 902), the psychometric properties of the revised PDI (PDI-R) were deeply assessed. Results Study 1 showed that the PDI has a not clear structure and it should be reconsidered. On the opposite, Study 2 showed that the revised version (PDI-R) has a solid factorial structure, it is invariant across gender and age, and it has good psychometric properties. Conclusion Results suggest that the PDI-R is a reliable measure of psychological distress in different samples of oncological patients, with stronger psychometric properties than the original version. Its use in the clinical and research field is therefore recommended to improve the quality of both assessment and treatment of psychological distress in patients with oncological problems.
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Affiliation(s)
- Alessandro Alberto Rossi
- Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padua, Italy
- Interdepartmental Center for Family Research, University of Padova, Padua, Italy
| | - Maria Marconi
- Department of Medical Oncology, Presidio Ospedaliero di Saronno, ASST Valle Olona, Saronno, Italy
| | - Federica Taccini
- Interdepartmental Center for Family Research, University of Padova, Padua, Italy
| | - Claudio Verusio
- Department of Medical Oncology, Presidio Ospedaliero di Saronno, ASST Valle Olona, Saronno, Italy
| | - Stefania Mannarini
- Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padua, Italy
- Interdepartmental Center for Family Research, University of Padova, Padua, Italy
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Evaluating the Feasibility and Acceptability of an Artificial-Intelligence-Enabled and Speech-Based Distress Screening Mobile App for Adolescents and Young Adults Diagnosed with Cancer: A Study Protocol. Cancers (Basel) 2022; 14:cancers14040914. [PMID: 35205663 PMCID: PMC8870320 DOI: 10.3390/cancers14040914] [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] [Received: 12/11/2021] [Revised: 01/21/2022] [Accepted: 02/03/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Adolescent and young adult (AYA) patients diagnosed with cancer are at a higher risk of psychological distress, which requires regular monitoring throughout their cancer journeys. Paper-and-pencil or digital surveys for psychological stress are often cumbersome to complete during a patient’s visit, and many patients find completing the same survey multiple times repetitive and boring. Recent advances in mobile technology and speech science have enabled flexible and engaging ways of monitoring psychological distress. This paper describes the scientific process we will use to evaluate an artificial intelligence (AI)-enabled mobile app to monitor depression and anxiety among AYAs diagnosed with cancer. Abstract Adolescents and young adults (AYAs) diagnosed with cancer are an age-defined population, with studies reporting up to 45% of the population experiencing psychological distress. Although it is essential to screen and monitor for psychological distress throughout AYAs’ cancer journeys, many cancer centers fail to effectively implement distress screening protocols largely due to busy clinical workflow and survey fatigue. Recent advances in mobile technology and speech science have enabled flexible and engaging methods to monitor psychological distress. However, patient-centered research focusing on these methods’ feasibility and acceptability remains lacking. Therefore, in this project, we aim to evaluate the feasibility and acceptability of an artificial intelligence (AI)-enabled and speech-based mobile application to monitor psychological distress among AYAs diagnosed with cancer. We use a single-arm prospective cohort design with a stratified sampling strategy. We aim to recruit 60 AYAs diagnosed with cancer and to monitor their psychological distress using an AI-enabled speech-based distress monitoring tool over a 6 month period. The primary feasibility endpoint of this study is defined by the number of participants completing four out of six monthly distress assessments, and the acceptability endpoint is defined both quantitatively using the acceptability of intervention measure and qualitatively using semi-structured interviews.
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Abdelhadi OA, Pollock BH, Joseph JG, Keegan THM. Psychological distress and associated additional medical expenditures in adolescent and young adult cancer survivors. Cancer 2022; 128:1523-1531. [PMID: 35001391 DOI: 10.1002/cncr.34064] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/19/2021] [Accepted: 11/13/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer survivors experience psychological distress often because of cancer and its treatment. However, no prior studies have evaluated the additional medical expenditures and health care utilization associated with psychological distress in AYA cancer survivors. METHODS AYA cancer survivors and a comparison matched group of adults with no history of cancer were identified from 2011-2016 Medical Expenditure Panel Survey data. Medical expenditures and health care utilization were evaluated with multivariable regression models. RESULTS AYA cancer survivors were more likely to have psychological distress (11.5% of 1757) than adults with no history of cancer (5.8% of 5227). The prevalence of psychological distress was found to be high many years after the diagnosis, with 11.2% reporting distress ≥20 years after their cancer diagnosis. AYA cancer survivors with psychological distress were more likely to smoke and have chronic conditions and were less likely to exercise regularly in comparison with AYAs with no history of psychological distress. AYA cancer survivors with psychological distress had additional annual medical expenses ($4415; 95% CI, $993-$9690), office visits (2.80; 95% CI, 0.23-6.15), and use of prescription medications/medication renewals (11.58; 95% CI, 5.70-19.47) in comparison with AYA cancer survivors without psychological distress. Additional annual medical expenses of psychological distress were $2600 higher in AYA cancer survivors than adults without a history of cancer ($1802; 95% CI, $440-$3791). CONCLUSIONS These results highlight the substantial economic burden associated with psychological distress in AYA cancer survivors. This research could inform survivorship care plans and interventions addressing the psychological needs of AYA cancer survivors.
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Affiliation(s)
- Ola A Abdelhadi
- Graduate Group of Epidemiology, University of California Davis, Davis, California
| | - Brad H Pollock
- Graduate Group of Epidemiology, University of California Davis, Davis, California.,Department of Public Health Sciences, University of California Davis, Sacramento, California
| | - Jill G Joseph
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California
| | - Theresa H M Keegan
- Graduate Group of Epidemiology, University of California Davis, Davis, California.,Department of Public Health Sciences, University of California Davis, Sacramento, California.,Center for Oncology Hematology Outcomes Research and Training and Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California
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Akechi T, Mishiro I, Fujimoto S. Risk of Major Depressive Disorder in Adolescent and Young Adult Cancer Patients in Japan. Psychooncology 2022; 31:929-937. [PMID: 35001472 PMCID: PMC9305902 DOI: 10.1002/pon.5881] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To estimate the risk of major depressive disorder (MDD) in adolescent and young adult (AYA) patients with cancer in Japan and identify risk factors for MDD among these patients. METHODS This was a matched cohort study using a large claims database in Japan. Included patients were aged 15-39 years, newly diagnosed with cancer during 2012-2017 and assessable for a follow-up period of 12 months. Kaplan-Meier estimates and Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for MDD in the AYA patients with cancer versus age-, sex- and working status-matched cancer-free controls. A subgroups analysis of the AYA patients with cancer was performed to explore MDD risk factors. RESULTS A total of 3,559 AYA patients with cancer and 35,590 matched controls were included in the analysis. AYA patients with cancer had a 3-fold higher risk for MDD compared with cancer-free controls (HR, 3.12; 95% CI, 2.64-3.70). Among cancer categories with >100 patients, patients with multiple cancer categories, including those with metastatic cancer (HR, 6.73, 95% CI, 3.65-12.40) and leukemia (HR, 6.30; 95% CI, 3.75-10.58), had the greatest MDD risk versus matched controls. Patients who received inpatient chemotherapy as initial treatment had a higher risk for MDD than patients without chemotherapy (HR, 0.43; 95% CI, 0.30-0.62). CONCLUSIONS AYA patients in Japan with cancer are at high risk for MDD. Particularly, those with multiple cancer categories, leukemia, and those who receive aggressive anticancer treatments should be monitored closely for symptoms of MDD. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Shinji Fujimoto
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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45
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Guleria B, Viswanath S, Soneji D, Kapoor R, Guleria P, Suresh P, Kumar M, Patel A, Swamy S. Cancer in the Adolescent and Young Adults (AYA) and Children: A Comprehensive Analysis of the Epidemiology and Psychosocial Morbidity in the Indian Population. South Asian J Cancer 2021; 11:73-81. [PMID: 35833048 PMCID: PMC9273329 DOI: 10.1055/s-0041-1735482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aims
Adolescent and young adults (AYAs), children with cancer, and their guardians have unique psychosocial morbidities adversely effecting quality of life (QOL). This is measurable using patented tools. We analyzed epidemiological and clinicopathological patterns of solid organ cancers in this subgroup. We also assessed psychosocial morbidity and changes in QOL faced by them.
Methods
All patients aged 2 to 39 years, newly diagnosed with cancer from April 2017 to March 2019 were included. Clinical history, diagnosis, staging, treatment, outcomes, and follow-up were recorded. The National Comprehensive Cancer Network (NCCN) distress thermometer and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C-30) were used to assess psychosocial morbidity of AYAs, children ≥ 12 years, and parents of children < 12 years. Pediatric Quality of Life Inventory (Peds QL) version 3.0 was used for children < 12 years. Data was analyzed using descriptive statistics.
Results
A total of 571 patients (512 AYAs, 59 children) were enrolled. Median age was 30 years with male predominance (58.1%). Most cases (98.6%) were absent from school or work. Carcinoma breast was the most common in females (29.3%) and non-Hodgkin lymphoma in males (12.6%). 91.06% had overall NCCN distress score ≥ 4. Also, 73.81 and 79.49% had “quite a bit” or “very much” responses on functional and symptom scales, respectively, in EORTC QLQ C-30 questionnaire. Peds QL version 3.0 revealed total score ranging from 276 to 523 for each patient.
Conclusion
AYAs and children with cancer are extremely vulnerable to psychological stress and morbidity. Use of well-established tools help in assessing their mental status and timely psychiatric referral can be initiated.
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Affiliation(s)
- Bhupesh Guleria
- Department of Medical Oncology, Malignant Diseases Treatment Center, Command Hospital (Southern Command), Pune, Maharashtra, India
| | - S. Viswanath
- Department of Medical Oncology, Malignant Diseases Treatment Center, Command Hospital (Central Command), Lucknow, Uttar Pradesh, India
| | - Dharmesh Soneji
- Department of Medical Oncology, Malignant Diseases Treatment Center, Army Hospital Research and Referral, New Delhi, India
| | - Rajan Kapoor
- Department of Hematology, Command Hospital (Eastern Command), Kolkata, West Bengal, India
| | - Prerna Guleria
- Department of Pathology, Command Hospital (Southern Command), Pune, Maharashtra, India
| | - P. Suresh
- Department of Medical Oncology, Malignant Diseases Treatment Center, Army Hospital Research and Referral, New Delhi, India
| | - Manish Kumar
- Department of Medical Oncology, Malignant Diseases Treatment Center, Army Hospital Research and Referral, New Delhi, India
| | - Amol Patel
- Department of Medical Oncology, INHS ASVINI, Mumbai, Maharashtra, India
| | - Shivshankar Swamy
- Department of Medical Oncology, Malignant Diseases Treatment Center, Army Hospital Research and Referral, New Delhi, India
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Rosenberg AR, Zhou C, Bradford MC, Salsman JM, Sexton K, O’Daffer A, Yi-Frazier JP. Assessment of the Promoting Resilience in Stress Management Intervention for Adolescent and Young Adult Survivors of Cancer at 2 Years: Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2136039. [PMID: 34817581 PMCID: PMC8613597 DOI: 10.1001/jamanetworkopen.2021.36039] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Adolescents and young adults (AYAs) with cancer have a high risk of poor psychosocial outcomes. The Promoting Resilience in Stress Management (PRISM) intervention is one of few psychosocial interventions targeting younger people with cancer that has demonstrated efficacy in a randomized clinical trial. OBJECTIVE To explore 2-year trajectories of patient-reported well-being among AYA cancer survivors. The hypothesis was that AYAs who initially responded to PRISM would report sustained positive changes. DESIGN, SETTING, AND PARTICIPANTS This secondary analysis of data from a single-center, parallel, phase 2 randomized clinical trial was conducted from January 2015 to October 2016. Eligible participants were English-speaking AYAs between ages 13 and 25 years with cancer treated at a single, quaternary children's hospital in the US. Participants were randomly assigned (1:1) to PRISM or usual care. Data were analyzed between March 2021 and June 2021. INTERVENTION PRISM is a brief, skills-based coaching program targeting 4 resilience resources (stress management, goal setting, cognitive reframing, and meaning making). MAIN OUTCOMES AND MEASURES Patient-reported cancer-related quality of life (QoL) (PedsQL scale), hope (Hope scale), resilience (Connor-Davidson Resilience scale), and psychological distress (Kessler-6 scale) were collected at baseline, 6, 12, and 24 months. Data from AYAs who remained alive at 24 months were analyzed. Improvement was defined as a positive change in instrument scores between baseline and 6 months (ie, the end of the PRISM program) and used linear mixed effects regression to assess changes over time. RESULTS A total of 57 AYAs were included in analysis at 24 months (62% of 92 randomized). Twenty-six participants (46%) were female; 36 (63%) were between ages 13 and 17 years; and 20 (35%) identified as part of a racial or ethnic minority group (4 [7%] Asian, 11 [19%] Hispanic or Latino, 16 [28%] mixed race or other). PRISM was associated with improved QoL, hope, resilience, and distress between baseline and 6 months, and these associations were sustained for QoL over 12 months (β = 7.4; 95% CI, 0.8 to 14; P = .03) and hope throughout the study period (12 months: β = 6.2; 95% CI, 2.7 to 9.6; P < .001; 24 months: β = 4.6; 95% CI, 1 to 8.3; P = .01). Of those whose scores improved between baseline and 6 months, PRISM participants more commonly reported sustained improvements in QoL (16 of 21 participants [76%] vs 8 of 17 [47%]), hope (14 of 24 participants [58%] vs 6 of 14 [43%]), resilience (9 of 18 participants [50%] vs 4 of 14 [29%]), and distress (14 of 19 participants [74%] vs 6 of 19 [32%]) at 24 months compared with usual care. CONCLUSIONS AND RELEVANCE These results suggest that PRISM was associated with sustained improvements in psychosocial outcomes as reported by adolescents and young adults. Those who responded to PRISM in the first 6 months reported continued well-being 2 years later. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02340884.
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Affiliation(s)
- Abby R. Rosenberg
- Palliative Care and Resilience Lab, Seattle Children’s Research Institute, Seattle, Washington
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington
- Division of General Pediatrics, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Miranda C. Bradford
- Palliative Care and Resilience Lab, Seattle Children’s Research Institute, Seattle, Washington
- Biostatistics, Epidemiology, and Analytics in Research Program, Seattle Children’s Research Institute, Seattle, Washington
| | - John M. Salsman
- Wake Forest School of Medicine and Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, North Carolina
| | - Katie Sexton
- Department of Medical Education, University of Washington School of Medicine, Seattle
| | - Alison O’Daffer
- Palliative Care and Resilience Lab, Seattle Children’s Research Institute, Seattle, Washington
| | - Joyce P. Yi-Frazier
- Palliative Care and Resilience Lab, Seattle Children’s Research Institute, Seattle, Washington
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
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Patterns and Predictors of Healthcare Use among Adolescent and Young Adult Cancer Survivors versus a Community Comparison Group. Cancers (Basel) 2021; 13:cancers13215270. [PMID: 34771435 PMCID: PMC8582416 DOI: 10.3390/cancers13215270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022] Open
Abstract
Simple Summary Adolescent and young adult cancer survivors face several significant physical/mental health late effects following cancer treatment. These effects may be minimized through healthcare use tailored to young survivors’ needs. Using a cross-sectional study design, we examined the healthcare use of 93 adolescent/young adult cancer survivors (aged 15–39 years), relative to a comparison group of adolescents and young adults recruited from the local community (n = 183). Our cancer survivor group reported greater use of medical and mental health services, and medications during the past six months relative to the comparison group. Our cancer survivor group also reported less psychological distress, and similar work/study participation relative to the comparison group. Survivors who were female, diagnosed with brain/solid tumors and who had finished treatment more recently reported greater healthcare use. Future research is needed to determine whether the healthcare accessed by adolescent and young adult cancer survivors is appropriate and meets their needs. Abstract Healthcare use (HCU) during survivorship can mitigate adolescent and young adult (AYA) cancer survivors’ (aged 15–39 years) risk of medical and psychosocial late effects, but this is understudied. We surveyed 93 Australian AYA post-treatment cancer survivors (Mage = 22.0 years, SD = 3.5; 55.9% female) and a comparison sample of 183 non-matched AYAs (Mage = 19.7, SD = 3.2; 70.5% female) on their HCU, medication use, depression/anxiety, and general functioning. Relative to our comparison AYAs, a higher proportion of our survivor group reported medical HCU (community-delivered: 65.6% versus 47.0%, p = 0.003; hospital-delivered: 31.2% versus 20.3%, p = 0.044) and mental HCU (53.8% vs. 23.5%; p < 0.0001) in the past six months. A higher proportion of our survivors reported taking medications within the past six months than our comparison AYAs (61.3% vs. 42.1%, p = 0.003) and taking more types (p < 0.001). Vitamin/supplement use was most common followed by psychotropic medications. Our survivor group reported lower depression (p = 0.001) and anxiety symptoms (p = 0.003), but similar work/study participation (p = 0.767) to our comparison AYAs. Across groups, psychological distress was associated with higher mental HCU (p = 0.001). Among survivors, those who were female, diagnosed with brain/solid tumors and who had finished treatment more recently reported greater HCU. Future research should establish whether this level of HCU meets AYAs’ survivorship needs.
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Jackson Levin N, Zhang A, Reyes-Gastelum D, Chen DW, Hamilton AS, Zebrack B, Haymart MR. Change in worry over time among Hispanic women with thyroid cancer. J Cancer Surviv 2021; 16:844-852. [PMID: 34633638 DOI: 10.1007/s11764-021-01078-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to assess change in worry over time in Hispanic women with thyroid cancer. METHODS Worry about recurrence, quality of life, family at risk, death, and harm from treatments was assessed in 273 Hispanic women with thyroid cancer diagnosed in 2014-2015. Subjects were recruited from Surveillance, Epidemiology, and End Results (SEER) Los Angeles. Participants were surveyed at two points in time (time 1: 2017-2018 and time 2: 2019). Multivariable logistic regression was used to determine correlates with high worry (somewhat, quite a bit, very much) versus low worry (not at all, a little) at time 2. RESULTS For the five worry items, 20.1-39.6% had high worry at both time 1 and time 2. An additional 7.6-13.4% had low worry at time 1 that became high worry at time 2. In multivariable logistic regression controlling for age, recurrence status, education level, and number of complications or side effects symptoms, younger age (20-39) as compared to older (40-79) was associated with high worry about thyroid cancer recurrence (OR 2.16, 95% CI 1.12-4.17). History of recurrent or persistent disease was associated with high worry about harms from treatment (OR 2.94, 95% CI 1.29-6.67). Greater number of complications or side effects of symptoms was associated with more worry across all five items. CONCLUSIONS Some Hispanic women with thyroid cancer have persistently high worry, with young adult Hispanic women vulnerable to worry about recurrence. IMPLICATIONS FOR CANCER SURVIVORS Hispanic women with thyroid cancer may benefit from targeted psychosocial support during survivorship, with interventions informed by patient and cancer characteristics.
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Affiliation(s)
- Nina Jackson Levin
- School of Social Work and Department of Anthropology, University of Michigan, 1080 S. University Ave, Room B660, Ann Arbor, MI, 48109, USA
| | - Anao Zhang
- School of Social Work, University of Michigan, 1080 S. University, Room 3704, Ann Arbor, MI, 48109, USA
| | - David Reyes-Gastelum
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Bldg. 16, 400S-20, MI, 48109, Ann Arbor, USA
| | - Debbie W Chen
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Domino's Farms (Lobby C, Suite 1300), 24 Frank Lloyd Wright Drive, PO Box 451, Ann Arbor, MI, 48106, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St., SSB318E, MC9239, Los Angeles, CA, 90089-9239, USA
| | - Bradley Zebrack
- School of Social Work, University of Michigan, 1080 S. University, Room 2778, Ann Arbor, MI, 48109, USA
| | - Megan R Haymart
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm 408E, Ann Arbor, MI, 48109, USA.
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49
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Ozturk CS, Toruner EK. Effectiveness of technology-based psychosocial interventions for child, adolescents and young adults undergoing cancer treatment: A meta-analysis of randomised controlled trials. Eur J Cancer Care (Engl) 2021; 31:e13515. [PMID: 34632662 DOI: 10.1111/ecc.13515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/08/2021] [Accepted: 09/24/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Cancer can have various psychosocial effects on children and young adults. Technology-based psychosocial interventions are increasingly popular in paediatric oncology for psychosocial health. OBJECTIVE The objective of this study is to investigate the effectiveness of technology-based psychosocial interventions applied to children, adolescent and young adults undergoing cancer treatment. METHODS Eight electronic databases including PubMed, Cochrane Library (including Cochrane Central Register of Controlled Trials [CENTRAL]), CINAHL Plus with Full Text, PsycINFO, MEDLINE, ProQuest, Science Direct and Scopus were searched to identify eligible randomised controlled trials from 1 January 2010 up to 9 April 2021. Search results were limited to 'children, adolescent and young adults' 6-24 years undergoing cancer treatment. Randomised controlled studies in which technology-based psychosocial interventions were applied were examined. Of 4,927 articles, 12 articles met the inclusion criteria. Hedges' g effect size was computed for each study. Effect sizes and moderator variables were tested using random-effects models. This study is registered with PROSPERO, number CRD42020177787. RESULTS The outcomes were anger, anxiety, coping, depression, distress, quality of life and resilience. Compared with standard care, technology-based psychosocial interventions had a large effect and significantly on anger (g = -1.327, 95% CI: [-2.43, 0.22], anxiety (g = -0.89, 95%CI: [-1.34, -0.18], and depression (g = -1.05, 95% CI: [-1.65,-0.46]. Also, it was found that the duration of interventions had a significant moderator and effect size of the distress and resilience outcomes increased as the duration increased. CONCLUSION This meta-analysis demonstrated that technology-based psychosocial interventions served as an effective intervention as it appears to have implications reducing anger, anxiety and depression in paediatric oncology. Nevertheless, randomised controlled studies with larger samples still needed to establish evidence-based psycho-oncological interventions for paediatric oncology. Future research should develop interventions more graduated by duration.
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Affiliation(s)
- Cigdem Sari Ozturk
- Health Sciences Faculty, Nursing Department, Gazi University, Ankara, Turkey
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50
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Geue K, Mehnert-Theuerkauf A, Stroske I, Brock H, Friedrich M, Leuteritz K. Psychosocial Long-Term Effects of Young Adult Cancer Survivors: Study Protocol of the Longitudinal AYA-LE Long-Term Effects Study. Front Psychol 2021; 12:688142. [PMID: 34659005 PMCID: PMC8511386 DOI: 10.3389/fpsyg.2021.688142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: About 3% of new cancer cases affect young adults aged between 15 and 39 years. The young age, the increasing incidence and the relatively good prognosis of this population lead to the growing importance to investigate the psychosocial long-term and late effects. The aims of the AYA-LE long-term effects study are: first, to assess the temporal course and related factors of life satisfaction and psychological distress of adolescent and young adult (AYA) cancer survivors; and second, to examine a specific topic in each of the yearly surveys in a more differentiated way. Methods: This study represents a continuation of the longitudinal AYA-LE study. The existing sample of AYA cancer patients (t1: N = 577; t2: N = 514; aged between 18 and 39 years at diagnosis; all major tumor entities) was extended by four further survey points (t3: 2018, t4: 2019, t5: 2020, t6: 2021). In addition, a comparison sample of young adults without cancer was collected. We measured longitudinal data for outcomes such as quality of life, psychological distress, and fatigue with standardized questionnaires. Furthermore, each survey point included a different cross-sectional topic (e.g., health behavior, occupational situation, and compliance). Discussion: The AYA-LE long-term effects study will show the long-term consequences of cancer in young adulthood. We expect at least complete data of 320 participants to be available after the sixth survey, which will be completed in 2021. This will provide a comprehensive and differentiated understanding of the life situation of young adults with cancer in Germany. The findings of our study enable a continuous improvement of the psychosocial care and specific survivorship programs for young cancer patients.
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Affiliation(s)
- Kristina Geue
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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