1
|
Zucchetti G, Ciappina S, Roccia E, Concas D, Giordano M, Battaglini C, Geuna T, Peirolo C, Faretta E, Fernandez I, Quarello P, Fagioli F. EMDR and standard psychotherapy for paediatric cancer patients and their families: a pilot study. Front Psychol 2024; 15:1407985. [PMID: 39045437 PMCID: PMC11263944 DOI: 10.3389/fpsyg.2024.1407985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/27/2024] [Indexed: 07/25/2024] Open
Abstract
Introduction This study examined the efficacy of eye movement desensitisation and reprocessing (EMDR) therapy compared with standard psychotherapy (SP) in treating post-traumatic stress disorder (PTSD) in paediatric oncology patients and their families in the early stage of cancer treatment. The secondary aim of this study was to assess whether EMDR therapy has a different impact on post-traumatic growth compared to SP. Methods Forty patients were randomly assigned to EMDR or SP groups. The Impact of Event Scale - Revised (IES-R) and the Distress Thermometer (DT) were used to assess PTSD symptoms at pre-treatment (at cancer diagnosis) and in the post-treatment stages (after 8 sessions). The Post-traumatic Growth Inventory-PTGI was administered in the post-treatment stage in order to evaluate positive changes. Results Both EMDR and SP are effective in reducing PTSD, but EMDR was significantly more effective than the SP in reducing scores on the IES-R, especially regarding the intrusive symptom subscale. Also, in the EMDR group there were higher scores of PTGI than in the standard group. Conclusion EMDR thus represents a promising treatment in the paediatric psycho-oncology setting.
Collapse
Affiliation(s)
- Giulia Zucchetti
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Sabrina Ciappina
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Elvia Roccia
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Deborah Concas
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Mario Giordano
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Chiara Battaglini
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Tiziana Geuna
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Claudia Peirolo
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | | | | | - Paola Quarello
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- University of Turin, Turin, Italy
| | - Franca Fagioli
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- University of Turin, Turin, Italy
| |
Collapse
|
2
|
Zanchi B, Trevor-Briscoe T, Sarti P, Rivi V, Bernini L, Burnazzi J, Ricci Bitti PE, Abbado A, Rostagno E, Pession A, Blom JMC, Scarponi D. The Impact of Music Therapy in a Pediatric Oncology Setting: An Italian Observational Network Study. Healthcare (Basel) 2024; 12:1071. [PMID: 38891146 PMCID: PMC11172261 DOI: 10.3390/healthcare12111071] [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: 03/15/2024] [Revised: 05/02/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Music Therapy (MT) is a non-pharmacological, art-based intervention that employs music experiences within a therapeutic alliance to attend to clients' physical, emotional, cognitive, and social requirements. This is the first study aiming at investigating the impact of MT on the psychological facets of children suffering from cancer. METHODS The study, combining the AQR and m-YPAS assessment tools, evaluated behavioral, sound-musical, and interactive parameters in pediatric oncology patients undergoing MT sessions during hospitalization. Fifty patients admitted to the Paediatric Oncology and Haematology Unit at Policlinico S. Orsola Hospital in Bologna, Italy, were enrolled, irrespective of their treatment regimen. Data collection occurred on the first day of the MT session between 3 p.m. and 5 p.m., with observations conducted by independent observers. In addition to traditional statistical analysis, network analysis was used to explore the combined interactions of all parameters, effectively discerning the distinctive roles played by each one during therapy sessions and their influence on all others. RESULTS Network analysis highlighted distinct patterns of interactions among parameters during the various sessions, emphasizing the role of positive emotions and a calm setting, the child's ability to take the initiative in sessions, their sense of agency, and the parent's role in guiding them. Significant differences were recorded at each time point between all variables considered. CONCLUSIONS The results of this innovative study may pave the way for future multicenter studies aimed at further exploring the role of MT in children undergoing both curative and palliative treatments for cancer.
Collapse
Affiliation(s)
- Barbara Zanchi
- Conservatorio Bruno Maderna, 47521 Cesena, Italy; (B.Z.); (T.T.-B.); (P.E.R.B.)
- Fondazione Policlinico Sant’ Orsola, 40138 Bologna, Italy; (L.B.); (J.B.); (A.A.)
- MusicSpace Italy Association, 40122 Bologna, Italy
| | - Timothy Trevor-Briscoe
- Conservatorio Bruno Maderna, 47521 Cesena, Italy; (B.Z.); (T.T.-B.); (P.E.R.B.)
- Fondazione Policlinico Sant’ Orsola, 40138 Bologna, Italy; (L.B.); (J.B.); (A.A.)
- MusicSpace Italy Association, 40122 Bologna, Italy
| | - Pierfrancesco Sarti
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (P.S.); (V.R.)
| | - Veronica Rivi
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (P.S.); (V.R.)
| | - Lorenzo Bernini
- Fondazione Policlinico Sant’ Orsola, 40138 Bologna, Italy; (L.B.); (J.B.); (A.A.)
- MusicSpace Italy Association, 40122 Bologna, Italy
| | - Jenny Burnazzi
- Fondazione Policlinico Sant’ Orsola, 40138 Bologna, Italy; (L.B.); (J.B.); (A.A.)
| | - Pio Enrico Ricci Bitti
- Conservatorio Bruno Maderna, 47521 Cesena, Italy; (B.Z.); (T.T.-B.); (P.E.R.B.)
- Department of Psychology, University of Bologna, 40127 Bologna, Italy
| | - Alessandra Abbado
- Fondazione Policlinico Sant’ Orsola, 40138 Bologna, Italy; (L.B.); (J.B.); (A.A.)
| | - Elena Rostagno
- Oncoematologia Pediatrica, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy;
| | - Andrea Pession
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Johanna M. C. Blom
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (P.S.); (V.R.)
- Centre for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | | |
Collapse
|
3
|
Wu JR, Chen VCH, Fang YH, Hsieh CC, Wu SI. The associates of anxiety among lung cancer patients: Dehydroepiandrosterone (DHEA) as a potential biomarker. BMC Cancer 2024; 24:476. [PMID: 38622547 PMCID: PMC11021003 DOI: 10.1186/s12885-024-12195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/27/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVE Anxiety is a prevalent comorbidity in lung cancer (LC) patients associated with a decline in quality of life. Dehydroepiandrosterone (DHEA), a neuroactive steroid, levels rise in response to stress. Prior research on the association between DHEA and anxiety has yielded contradictory results and no study has investigated this association in LC patients. METHODS A total of 213 patients with LC were recruited from a general hospital. Data on demographic and cancer-related variables were collected. Using the Chinese version of the Hospital Anxiety and Depression Scale (HADS), the degree of anxiety was determined. Cortisol, DHEA, and Dehydroepiandrosterone sulfate (DHEA-S) levels in saliva were measured. Adjusting for confounding variables, a multivariate regression analysis was conducted. RESULTS 147 men and 66 women comprised our group with an average age of 63.75 years. After accounting for demographic and treatment-related factors, anxiety levels were significantly correlated with, post-traumatic stress symptoms (PTSSs) (β = 0.332, p < 0.001) and fatigue (β = 0.247, p = 0.02). Association between anxiety and three factors, including DHEA, PTSSs, and fatigue, was observed in patients with advanced cancer stages (III and IV) (DHEA β = 0.319, p = 0.004; PTSS β = 0.396, p = 0.001; fatigue β = 0.289, p = 0.027) and those undergoing chemotherapy (DHEA β = 0.346, p = 0.001; PTSS β = 0.407, p = 0.001; fatigue β = 0.326, p = 0.011). CONCLUSIONS The association between anxiety and DHEA remained positive in advanced cancer stages and chemotherapy patients. Further study is necessary to determine whether DHEA is a potential biomarker of anxiety in LC patients.
Collapse
Affiliation(s)
- Jia-Rong Wu
- Department of Psychiatry, Chang Gung Memorial Hospital, 6, Sec. West Chia-Pu Road, 613, Pu-Zi City, Chiayi County, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, 6, Sec. West Chia-Pu Road, 613, Pu-Zi City, Chiayi County, Taiwan
- School of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Tao-Yuan, Taiwan
| | - Yu-Hung Fang
- Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, 6, Sec. West Chia-Pu Road, 613, Pu-Zi City, Chiayi County, Taiwan
| | - Ching-Chuan Hsieh
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang-Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Tao-Yuan, Taiwan
- Department of Surgery, Chang-Gung Memorial Hospital, 6, Sec. West Chia-Pu Road, 613, Pu-Zi City, Chiayi County, Taiwan
| | - Shu-I Wu
- Department of Medicine, Mackay Medical College, No.46, Sec.3, Zhongzheng Rd., Sanzhi Dist, 25245, New Taipei City, Taiwan.
- Department of Psychiatry, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., 104, Taipei City, Taiwan.
| |
Collapse
|
4
|
Ciappina S, Roccia E, Concas D, Faretta E, Fernandez I, Quarello P, Zucchetti G, Fagioli F. EMDR in pediatric hospital setting: a case report of an adolescent with cancer. Front Psychol 2024; 15:1347822. [PMID: 38586287 PMCID: PMC10996851 DOI: 10.3389/fpsyg.2024.1347822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/12/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Childhood cancer is rare, but it is the most frequent serious event with a high risk of traumatization for children, adolescents, parents and siblings. EMDR is widely studied as clinical intervention that addressed cancer-related stressors among cancer adult population, but to our knowledge, no researches have been conducted among children and adolescent with cancer. Methods The purpose of this case study is to describe for the first time the application of the EMDR protocol in a pediatric hospital setting with a 17-years-old Italian adolescent who received a diagnosis of leukemia. He accessed the psychological support service complaining of feelings of anxiety and general discomfort. EMDR protocol started after the diagnosis and ended after the usual eight phases. The Impact of Event Scale-Revised (IES-R) was used to assess stress disorders symptoms as outcome at the baseline (before the First Phase) and at the end of the EMDR protocol (after the Eight Phase). Results By using EMDR protocol the patient reported a decrease of emotional activation after a few EMDR sessions. Conclusion EMDR protocol may be effective for pediatric cancer patients in treating stress disorders symptoms and it can be proposed immediately after diagnosis as a standard care also in pediatric hospital setting.
Collapse
Affiliation(s)
- Sabrina Ciappina
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Elvia Roccia
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Deborah Concas
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | | | | | - Paola Quarello
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Giulia Zucchetti
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Franca Fagioli
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| |
Collapse
|
5
|
Evanski JM, Iadipaolo A, Ely SL, Zundel CG, Gowatch LC, Bhogal A, Owens Z, Cohen C, Goldberg E, Bluth MH, Taub J, Harper FWK, Rabinak CA, Marusak HA. Smaller Hippocampal Volume Is Associated With Reduced Posttraumatic Stress Symptoms in Children With Cancer and Survivors Following a Brief Novel Martial Arts-Based Intervention. Arch Clin Neuropsychol 2024; 39:167-174. [PMID: 37518896 DOI: 10.1093/arclin/acad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
PURPOSE Children with cancer and survivors frequently report posttraumatic stress symptoms (PTSS), which are associated with volumetric changes in stress-sensitive brain regions, including the hippocampus. METHODS We examined the impact of a novel, 4-week martial-arts-based meditative intervention on cancer-related PTSS in 18 pediatric patients and survivors and whether baseline hippocampal volumes correlate with PTSS severity and/or PTSS changes over time. RESULTS Overall, PTSS did not significantly change from baseline to post-intervention. Smaller hippocampal volume was correlated with more severe re-experiencing PTSS at baseline, and greater reductions in PTSS post-intervention. CONCLUSIONS Together, hippocampal volume may be a biomarker of PTSS severity and intervention response. Identifying hippocampal volume as a potential biomarker for PTSS severity and intervention response may allow for more informed psychosocial treatments.
Collapse
Affiliation(s)
- Julia M Evanski
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | | | - Samantha L Ely
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Clara G Zundel
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Leah C Gowatch
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Amanpreet Bhogal
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Zazai Owens
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | | | - Elimelech Goldberg
- Kids Kicking Cancer, Southfield, MI, USA
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Martin H Bluth
- Kids Kicking Cancer, Southfield, MI, USA
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Maimonides Medical Center, Brooklyn, NY, USA
| | - Jeffrey Taub
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Children's Hospital of Michigan, Detroit, MI 48201, USA
| | - Felicity W K Harper
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Christine A Rabinak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI 48201, USA
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| |
Collapse
|
6
|
Ferraz A, Santos M, Pereira MG. Portuguese Validation of the TAPQoL: A Health-Related Quality of Life Instrument for Children Aged 0-6 Years. Eur J Investig Health Psychol Educ 2024; 14:399-410. [PMID: 38391494 PMCID: PMC10888349 DOI: 10.3390/ejihpe14020027] [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: 12/20/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
In Portugal, there are few generic and specific instruments to assess health-related quality of life (HRQoL) in children, especially those of preschool age. This study aimed to adapt and validate the Portuguese version of the Preschool Children Quality of Life Questionnaire (TAPQoL) in a community and clinical sample of children aged 0-6 years. The parents of 409 healthy children and 137 children undergoing treatment for burns and acute lymphoblastic leukemia completed the TAPQoL and were assessed on psychological morbidity and family functioning. Exploratory and confirmatory factor analyses were performed, as well as analysis of the psychometric properties as shown by internal consistency measures, convergent validity, and average variance extracted. Confirmatory factor analysis confirmed an 11-factor structure with good psychometric properties. The current version of the TAPQoL is a valid and reliable instrument for assessing HRQoL in Portuguese preschool children in community and clinical settings.
Collapse
Affiliation(s)
- Ana Ferraz
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, 4710-057 Braga, Portugal
| | - Martim Santos
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, 4710-057 Braga, Portugal
| | - M Graça Pereira
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, 4710-057 Braga, Portugal
| |
Collapse
|
7
|
Leenders AEM, Kremer-Hooft van Huijsduijnen E, Robalo B, van Male R, De Luca A, Kemps R, Hoving E, Lequin MH, Grootenhuis MA, Partanen M. Unraveling the relations between post-traumatic stress symptoms, neurocognitive functioning, and limbic white matter in pediatric brain tumor patients. Neurooncol Adv 2024; 6:vdae026. [PMID: 38476931 PMCID: PMC10929421 DOI: 10.1093/noajnl/vdae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Background Pediatric brain tumor patients are at risk of developing neurocognitive impairments and associated white matter alterations. In other populations, post-traumatic stress symptoms (PTSS) impact cognition and white matter. This study aims to investigate the effect of PTSS on neurocognitive functioning and limbic white matter in pediatric brain tumor patients. Methods Sixty-six patients (6-16 years) completed neuropsychological assessment and brain MRI (1-year post-diagnosis) and parents completed PTSS proxy questionnaires (CRIES-13; 1-3 months and 1-year post-diagnosis). Mean Z-scores and percentage impaired (>1SD) for attention, processing speed, executive functioning, and memory were compared to normscores (t-tests, chi-square tests). Multi-shell diffusion MRI data were analyzed for white matter tractography (fractional anisotropy/axial diffusivity). Effects of PTSS on neurocognition and white matter were explored with linear regression models (FDR correction for multiple testing), including age at diagnosis, treatment intensity, and tumor location as covariates. Neurocognition and limbic white matter associations were explored with correlations. Results Attention (M = -0.49, 33% impaired; P < .05) and processing speed (M = -0.57, 34% impaired; P < .05) were significantly lower than healthy peers. PTSS was associated with poorer processing speed (β = -0.64, P < .01). Treatment intensity, age at diagnosis, and tumor location, but not PTSS, were associated with limbic white matter metrics. Neurocognition and white matter metrics were not associated. Conclusions Higher PTSS was associated with poorer processing speed, highlighting the need for monitoring, and timely referrals to optimize psychological well-being and neurocognitive functioning. Future research should focus on longitudinal follow-up and explore the impact of PTSS interventions on neurocognitive performance.
Collapse
Affiliation(s)
- Anne E M Leenders
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Bruno Robalo
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Rosa van Male
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Rachèl Kemps
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Eelco Hoving
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Maarten H Lequin
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Marita Partanen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| |
Collapse
|
8
|
Hasanah I, Nursalam N, Krisnana I, Ramdani WF, Haikal Z, Rohita T. Psychoneuroimmunological Markers of Psychological Intervention in Pediatric Cancer: A Systematic Review and New Integrative Model. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:119-137. [PMID: 37499937 DOI: 10.1016/j.anr.2023.07.001] [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: 03/03/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
PURPOSE Pediatric cancer is a serious problem and still becomes a global challenge today. Various complex stressors due to diagnosis, disease symptoms, and various side-effects from the treatment that children with cancer undergo will cause problems in the child's psychoneuroimmunological aspects. Psychological interventions designed to modulate the stress response include psychoneuroimmunological markers. Unfortunately, there is little evidence to support the effect of psychological interventions on psychoneuroimmunological markers. This systematic review aims to assess the effectiveness of psychological interventions on psychoneuroimmunological markers in children with cancer and to provide a new integrative model for further research. METHODS This systematic review uses four main databases (Scopus, PubMed, ScienceDirect, and ProQuest). The guideline used Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Selecting articles used the Rayyan application. The quality study was conducted using Joanna Briggs Institute (JBI)'s critical appraisal tools. The data were analyzed using the population, intervention, comparison, outcome, and study design (PICO) Synthesis based on similarities and differences in study characteristics to interpret the results. RESULTS The search results in this systematic review found 1653 articles, 21 of which matched the predetermined inclusion and exclusion criteria. Most of the designs used were randomized controlled trials (57.1%). Massage therapy was the most common type of psychological intervention (14.2%). Almost half of the studies measured psychological responses (38.0%), and psycho-physiological responses (42.9%), and only a small proportion assessed the effectiveness of psychological interventions on neuroimmunological markers in pediatric cancer. CONCLUSIONS We recommend the use of psychological interventions as an additional intervention in managing psychoneuroimmunological markers of pediatric cancer. This study offers a new integrative model demonstrating the interaction between stress and psychological intervention involving neuroendocrine and immune mechanisms. However, future researchers need to test all domains of these new integrative models. This will reveal the complex interactions among these components and understand their relevance to health outcomes.
Collapse
Affiliation(s)
- Idyatul Hasanah
- Faculty of Nursing, Airlangga University, Surabaya, 60115, Indonesia; Nursing Department, STIKES Yarsi Mataram, 83115, Indonesia
| | - Nursalam Nursalam
- Faculty of Nursing, Airlangga University, Surabaya, 60115, Indonesia.
| | - Ilya Krisnana
- Faculty of Nursing, Airlangga University, Surabaya, 60115, Indonesia
| | - Wawan F Ramdani
- Center for Woman, Family, and Disaster Studies, Universitas Aisyiyah Yogyakarta, Indonesia
| | - Zikrul Haikal
- Surgery Department, Faculty of Medicine, Universitas Mataram, 83125, Indonesia
| | - Tita Rohita
- Nursing Department, Faculty of Health Sciences, Galuh University, Ciamis, 46251, Indonesia
| |
Collapse
|
9
|
Emotion Regulation Flexibility and Electronic Patient-Reported Outcomes: A Framework for Understanding Symptoms and Affect Dynamics in Pediatric Psycho-Oncology. Cancers (Basel) 2022; 14:cancers14163874. [PMID: 36010870 PMCID: PMC9405711 DOI: 10.3390/cancers14163874] [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] [Received: 04/29/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary The individual’s ability to conceive and regulate the broad spectrum of their human emotions is closely linked to their mental health. The implications of a serious disease such as cancer represent an extraordinary burden to these internal coping mechanisms, especially in the case of young patients. Regarding their well-being and support, it is therefore of particular interest for caregivers to be able to follow the dynamics of the patient’s emotional world and perceptions. Technical progress enables new possibilities for data collection through tools for digital patient self-reports while simultaneously creating new challenges. Within the scope of this article, we provide an overview of the literature on this topic, outlining the current strengths and weaknesses and possible perspectives on digital aids, especially in terms of capturing the flexibility, fluctuations and early detection of symptom changes. Abstract Emotion dysregulation is regarded as a driving mechanism for the development of mental health problems and psychopathology. The role of emotion regulation (ER) in the management of cancer distress and quality of life (QoL) has recently been recognized in psycho-oncology. The latest technological advances afford ways to assess ER, affective experiences and QoL in child, adolescent and young adult (CAYA) cancer patients through electronic patient-reported outcomes (ePRO) in their daily environment in real-time. Such tools facilitate ways to study the dynamics of affect and the flexibility of ER. However, technological advancement is not risk-free. We critically review the literature on ePRO in cancer existing models of ER in pediatric psycho-oncology and analyze strength, weaknesses, opportunities and threats of ePRO with a focus on CAYA cancer research and care. Supported by personal study-based experiences, this narrative review serves as a foundation to propose a novel methodological and metatheoretical framework based on: (a) an extended notion of ER, which includes its dynamic, adaptive and flexible nature and focuses on processes and conditions rather than fixed categorical strategies; (b) ePRO as a means to measure emotion regulation flexibility and affect dynamics; (c) identifying early warning signals for symptom change via ePRO and building forecasting models using dynamical systems theory.
Collapse
|
10
|
Murphy S, Donma AJ, Kohut SA, Weisbaum E, Chan JH, Plenert E, Tomlinson D. Mindfulness Practices for Children and Adolescents Receiving Cancer Therapies. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:40-48. [PMID: 35466780 PMCID: PMC9163650 DOI: 10.1177/27527530211056514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Mindfulness is our innate capacity to pay full, conscious, and compassionate attention to something in the moment. It is also a skill that can be strengthened by mental practice. More recently, mindfulness-based interventions (MBIs) are identified within clinical practice guidelines as an intervention in the treatment of certain symptoms for children with cancer. However, there is little guidance available on the practice of using MBIs in the pediatric oncology population. The aim of this paper is to provide an overview of mindfulness, highlights symptoms where mindfulness practices may be of benefit, identifies trauma-sensitive considerations, and provides examples of MBIs that may be considered in the context of pediatric oncology. Methods: Collaboration of expert opinion, which included The Mindfulness Project Team, has enabled this collective informative paper. Results: Mindfulness has been recommended to help with the symptom of fatigue in children with cancer. Emotional symptoms such as anxiety, sadness, and anger may also benefit from the use of MBIs. Ideal MBIs for this population may include mindful movement, mindfulness of the senses, mindfulness of breath, mindfulness of emotions, and the body scan. These approaches can easily be adapted according to the age of the child. Many approaches have been administered with minimal training, with very few requiring a facilitator. However, hospitals have started to incorporate mindfulness experts within their care provision. Conclusion: Future research should continue to investigate the use of MBI programs for children with cancer.
Collapse
Affiliation(s)
- Shelley Murphy
- Department of Curriculum, Teaching and Learning, University of Toronto, Toronto, Ontario, Canada
| | - Ani Jamyang Donma
- Spiritual & Religious Care Department, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sara Ahola Kohut
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Elli Weisbaum
- Department of Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jacqueline H. Chan
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Erin Plenert
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Deborah Tomlinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
11
|
Barone R, Gulisano M, Cannata E, Padalino S, Saia F, Maugeri N, Pettinato F, Lo Nigro L, Casabona A, Russo G, Di Cataldo A, Rizzo R. Self- and Parent-Reported Psychological Symptoms in Young Cancer Survivors and Control Peers: Results from a Clinical Center. J Clin Med 2020; 9:jcm9113444. [PMID: 33120900 PMCID: PMC7693519 DOI: 10.3390/jcm9113444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 11/16/2022] Open
Abstract
Pediatric cancer survivors are at increased risk for psychological distress. We sought to understand the severity and symptoms' co-occurrence among pediatric survivors compared to controls by rating both self- and parent-reported symptomatology. Forty survivors (22 males; mean age at study time: 12.9 years) participated in the study. Most survivors (85%) had a diagnosis of acute lymphoblastic leukemia. Seventy-nine healthy controls with the same age and gender distribution as the patients were included. A standardized assessment of psychological functioning was conducted by self- and parent-reported symptoms evaluations. The self-reported anxious symptom severity was significantly higher in survivors. A significantly higher proportion of survivors compared to controls had clinically significant anxiety, depression, and combined anxiety symptoms (i.e., social anxiety, separation anxiety, or physical symptoms). In both study groups, the self-reported emotional and somatic symptoms were significantly associated. The multi-informant assessments of the psychological symptoms revealed distinct associations between the child- and parent-reported symptoms in the survivors' group: the survivors' self-reports of depressive symptoms, somatic symptoms, and functional impairment were significantly correlated with the parent reports of child behavioral concerns, somatic complaints, and functional impairment, respectively. Conclusion: Self-reported symptoms showed similar comorbidity profiles in survivors and control peers. The multi-informant assessments detected differences in the association of self- and parent-reported symptoms between the survivor and control groups. The present study showed that multi-informant assessment is critical to understanding symptom profiles and to informing intervention with particular regard to parental participation and support.
Collapse
Affiliation(s)
- Rita Barone
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
- Correspondence: ; Tel.: +39-095-378-2898
| | - Mariangela Gulisano
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Emanuela Cannata
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Sara Padalino
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Federica Saia
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Nicoletta Maugeri
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Fabio Pettinato
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Luca Lo Nigro
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Antonino Casabona
- Department of Biomedical and Biotechnological Sciences, Section of Physiology, School of Medicine, University of Catania, 95123 Catania, Italy;
| | - Giovanna Russo
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Andrea Di Cataldo
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Renata Rizzo
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| |
Collapse
|