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Clougher D, Ciria-Suarez L, Medina JC, Anastasiadou D, Racioppi A, Ochoa-Arnedo C. What works in peer support for breast cancer survivors: A qualitative systematic review and meta-ethnography. Appl Psychol Health Well Being 2024; 16:793-815. [PMID: 37493002 DOI: 10.1111/aphw.12473] [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: 01/23/2023] [Accepted: 07/06/2023] [Indexed: 07/27/2023]
Abstract
Breast cancer is associated with adverse physical and psychological consequences. Although research has identified the various benefits linked to psychosocial interventions, mixed results have been found in relation to peer support. The aim of the present systematic review and meta-ethnography is to explore the qualitative evidence on the experience of breast cancer survivors in peer support. A systematic search of the literature was conducted until June 2023, and a meta-ethnographic approach was used to synthesize the included papers. Eleven articles were included, collecting the experience of 345 participants. The following four core areas involved in peer support implementation were identified from the synthesis: Peer support can create understanding and a mutual therapeutic and emotional connection; peer support can facilitate an educational and supportive patient-centered journey; peer support should monitor group members for unpleasant emotional experiences; peer support should have professional supervision of recruitment and training to prioritize quality. These results can be used as patient-centered insights by healthcare professionals to provide evidence-informed peer support programs and address current limitations in the field.
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Affiliation(s)
- Derek Clougher
- eHealth ICOnnecta't and Psycho-Oncology Services, Institut Català d'Oncologia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Laura Ciria-Suarez
- eHealth ICOnnecta't and Psycho-Oncology Services, Institut Català d'Oncologia, Barcelona, Spain
- Psycho-Oncology and Digital Health Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Joan C Medina
- eHealth ICOnnecta't and Psycho-Oncology Services, Institut Català d'Oncologia, Barcelona, Spain
- Psycho-Oncology and Digital Health Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Dimitra Anastasiadou
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Racioppi
- Psycho-Oncology and Digital Health Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Cristian Ochoa-Arnedo
- eHealth ICOnnecta't and Psycho-Oncology Services, Institut Català d'Oncologia, Barcelona, Spain
- Psycho-Oncology and Digital Health Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
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Serra-Blasco M, Souto-Sampera A, Medina JC, Flix-Valle A, Ciria-Suarez L, Arizu-Onassis A, Ruiz-Romeo M, Jansen F, Rodríguez A, Pernas S, Ochoa-Arnedo C. Cognitive-enhanced eHealth psychosocial stepped intervention for managing breast cancer-related cognitive impairment: Protocol for a randomized controlled trial. Digit Health 2024; 10:20552076241257082. [PMID: 39070895 PMCID: PMC11273701 DOI: 10.1177/20552076241257082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/08/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction Breast cancer often leads to cancer-related cognitive impairment (CRCI), which includes both objective and subjective cognitive deficits. While psychosocial interventions benefit quality of life and distress reduction, their impact on cognitive deficits is uncertain. This study evaluates the integration of a cognitive module into a digital psychosocial intervention for breast cancer patients. Methods In this randomized controlled trial (RCT), 88 recently diagnosed breast cancer (BC) patients will receive the ICOnnecta't program (control group) - a digital stepped intervention addressing a variety of psychosocial needs. The experimental group (n = 88) will receive ICOnnecta't plus a cognitive module. Assessments at baseline, 3, 6, and 12 months will measure the interventions' impact on cognition, emotional distress, medication adherence, quality of life, post-traumatic stress, work functioning and healthcare experience. Feasibility and cost-utility analyses will also be conducted. Results The cognitive module includes three levels. The first level contains a cognitive screening using FACT-Cog Perceived Cognitive Impairment (PCI). Patients with PCI <54 progress to a cognitive psychoeducational campus (Level 2) with content on cognitive education, behavioural strategies and mindfulness. Patients with persistent or worsened PCI (≥6) after 3 months move to Level 3, an online cognitive training through CogniFit software delivered twice a week over 12 weeks. Conclusions This study assesses whether integrating a cognitive module into a digital psychosocial intervention improves objective and subjective cognition in breast cancer patients. Secondary outcomes explore cognitive improvement's impact on psychosocial variables. The research will contribute to testing efficacious approaches for detecting and addressing cognitive dysfunction in breast cancer patients. Trial registration ClinicalTrials.gov, NCT06103318. Registered 26 October 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06103318?term=serra-blasco&draw=2&rank=4.
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Affiliation(s)
- Maria Serra-Blasco
- ICOnnecta’t Digital Health Program, Catalan Institute of Oncology, Hospitalet del Llobregat, Spain
- The Bellvitge Biomedical Research Institute IDIBELL, Psychooncology and Digital Health Group, Hospitalet del Llobregat, Spain
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
| | - Arnau Souto-Sampera
- ICOnnecta’t Digital Health Program, Catalan Institute of Oncology, Hospitalet del Llobregat, Spain
- The Bellvitge Biomedical Research Institute IDIBELL, Psychooncology and Digital Health Group, Hospitalet del Llobregat, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Joan C. Medina
- The Bellvitge Biomedical Research Institute IDIBELL, Psychooncology and Digital Health Group, Hospitalet del Llobregat, Spain
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Aida Flix-Valle
- ICOnnecta’t Digital Health Program, Catalan Institute of Oncology, Hospitalet del Llobregat, Spain
- The Bellvitge Biomedical Research Institute IDIBELL, Psychooncology and Digital Health Group, Hospitalet del Llobregat, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Laura Ciria-Suarez
- ICOnnecta’t Digital Health Program, Catalan Institute of Oncology, Hospitalet del Llobregat, Spain
- The Bellvitge Biomedical Research Institute IDIBELL, Psychooncology and Digital Health Group, Hospitalet del Llobregat, Spain
| | - Alejandra Arizu-Onassis
- The Bellvitge Biomedical Research Institute IDIBELL, Psychooncology and Digital Health Group, Hospitalet del Llobregat, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Marina Ruiz-Romeo
- The Bellvitge Biomedical Research Institute IDIBELL, Psychooncology and Digital Health Group, Hospitalet del Llobregat, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Femke Jansen
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, VUmc Cancer Center Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, The Netherlands
| | - Ana Rodríguez
- Breast Cancer Functional Unit, Catalan Institute of Oncology, Hospitalet del Llobregat, Spain
| | - Sonia Pernas
- Breast Cancer Functional Unit, Catalan Institute of Oncology, Hospitalet del Llobregat, Spain
| | - Cristian Ochoa-Arnedo
- ICOnnecta’t Digital Health Program, Catalan Institute of Oncology, Hospitalet del Llobregat, Spain
- The Bellvitge Biomedical Research Institute IDIBELL, Psychooncology and Digital Health Group, Hospitalet del Llobregat, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
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Ma Z, Shi Y, Yao S, Lu N, Cheng F. Effectiveness of telemedicine-based psychosocial intervention for breast cancer patients: a systematic review and meta-analysis. Support Care Cancer 2023; 31:595. [PMID: 37768402 DOI: 10.1007/s00520-023-08052-3] [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: 02/05/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVES This review aimed to synthesize the available evidence on the effectiveness of telemedicine-based psychosocial interventions among breast cancer (BC) patients regarding quality of life (QOL), depression, anxiety, distress, fatigue, sleep disorders, sexual function, and fear of cancer recurrence (FCR). METHODS A search of 10 databases was conducted to identify RCTs of the effects of telemedicine-based psychosocial interventions on outcomes. Selection of studies, quality appraisal, and data extraction were performed by two reviewers independently. GRADE and Cochrane risk of bias assessment tools were used for quality appraisal. Heterogeneity was determined by I2, standardized mean differences (SMD) were used to determine intervention effects, and meta-analyses, subgroup analysis, and sensitivity analysis were performed. RESULTS In total, 29 RCTs were included. Telemedicine-based psychosocial interventions improved the primary outcomes of QOL (SMD = 0.32), distress (SMD = - 0.22), and anxiety (SMD = - 0.16) in BC patients with moderate effect size. There were some improvements in the secondary outcomes of sleep disorders (SMD = - 056), sexual function (SMD = 0.19), and FCR (SMD = - 0.41). After sensitivity analysis, the effect size of fatigue was moderate (SMD = - 0.24). CONCLUSION Telemedicine-based psychosocial interventions are superior to usual care in BC patients with improved QOL, sexual function, and less distress, anxiety, fatigue, sleep disorders, and FCR. Due to the heterogeneity of the results for QOL, anxiety, fatigue, sleep disturbance, and FCR, these results should be interpreted cautiously. In the future, more rigorous RCTs need to be designed to identify better delivery models and intervention times to further test their effectiveness.
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Affiliation(s)
- Zhuyue Ma
- School of Nursing, Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Yanyan Shi
- School of Nursing, Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Shanshan Yao
- Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Control &, Nanjing Medical University Cancer Hospital, Nanjing, 210018, Jiangsu, China
| | - Ningning Lu
- School of Nursing, Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Fang Cheng
- Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research &, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Research, Nanjing, 210018, Jiangsu, China.
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Ochoa-Arnedo C, Arizu-Onassis A, Medina JC, Flix-Valle A, Ciria-Suarez L, Gómez-Fernández D, Souto-Sampera A, Brao I, Palmero R, Nadal E, González-Barboteo J, Serra-Blasco M. An eHealth ecosystem for stepped and early psychosocial care in advanced lung cancer: Rationale and protocol for a randomized control trial. Internet Interv 2023. [DOI: 10.1016/j.invent.2023.100620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kruse CS, Pacheco GJ, Vargas B, Lozano N, Castro S, Gattu M. Leveraging Telehealth for the Management of Breast Cancer: A Systematic Review. Healthcare (Basel) 2022; 10:2015. [PMID: 36292461 PMCID: PMC9602569 DOI: 10.3390/healthcare10102015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Breast cancer affects 2.3 million women and kills 685,000 globally, making it the most prevalent cancer. The telemedicine modality has been used to treat the symptoms associated with breast cancer recovery. OBJECTIVES To analyze the effectiveness of telemedicine to help women recover from the treatment-associated effects and promote overall recovery from breast cancer. METHODS Four databases were queried for published literature from the last 10 years. The systematic literature review was conducted in accordance with the Kruse Protocol and reported in accordance with PRISMA 2020. RESULTS Five interventions were identified in the literature, with the most dominant being eHealth and mHealth. The other interventions were telephone, video teleconference, and a combination of eHealth and mHealth. There were positive effects of these telemedicine interventions in 88% of the studies analyzed. Telemedicine is shown to positively affect physical and mental health, sleep outcomes, quality of life, and body image. The largest barriers to the adoption of telemedicine interventions are training, cost, workflow, time of providers, and low reimbursement. CONCLUSION Telemedicine offers promise to both providers and breast cancer survivors to improve the physical and mental health detriments of both cancer and its associated treatments. It also helps women develop healthy habits to reduce the risk of reoccurrence.
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Affiliation(s)
- Clemens Scott Kruse
- School of Health Administration, Texas State University, 601 University Drive, San Marcos, TX 78666, USA
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Shah YB, Kjelstrom S, Martinez D, Leitenberger A, Manasseh D, Bollmann‐Jenkins M, Partridge A, Kaklamani V, Chlebowski R, Larson S, Weiss M. Risk factors for heightened COVID-19-Related anxiety among breast cancer patients. Cancer Med 2022; 12:3577-3588. [PMID: 36057956 PMCID: PMC9538212 DOI: 10.1002/cam4.5184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/11/2022] [Accepted: 08/19/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has disrupted medical care, increased isolation, and exacerbated anxiety in breast cancer patients. Since March 2020, Breastcancer.org experienced a sustained surge in requested pandemic-related information and support. To characterize the pandemic-related experiences of breast cancer patients, we surveyed the Breastcancer.org Community early in the COVID-19 era. METHODS Breastcancer.org Community members were invited to complete an online questionnaire regarding their experience during the pandemic. Self-reported data on demographics, comorbidities, care disruptions, anxiety, coping ability, telemedicine use, and satisfaction with care were collected. Results were analyzed using Stata 16.0 (Stata Corp., Inc). RESULTS Included were 568 current and previous breast cancer patients, primarily with U.S. residence. Overall, 43.8% reported at least one comorbidity associated with severe COVID-19 illness and 61.9% experienced care delays. Moderate to extreme anxiety about contracting COVID-19 was reported by 36.5%, increasing with number of comorbidities (33.0% vs. 55.4%, p = 0.021), current breast cancer diagnosis (30.4% vs. 42.5%, p = 0.011), and poorer coping ability (15.5% vs. 53.9%, p < 0.0001). Moderate to extreme anxiety about cancer care disruptions was reported by 29.1%, increasing with current breast cancer diagnosis (19.1% vs. 38.9%, p < 0.0001), actual delayed care (18.9% vs. 35.3%, p < 0.0001), and poorer coping ability (13.1% vs. 57.7%, p < 0.0001). Most utilized telehealth and found it helpful, but also expressed increased anxiety and subjectively expressed that these were less preferable. CONCLUSION Early in the COVID-19 pandemic, anxiety was reported by a large proportion of breast cancer patients, with increased prevalence in those with risk factors. Attention to mental health is critical, as emotional distress not only harms quality of life but may also compromise outcomes.
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Affiliation(s)
- Yash B. Shah
- Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA,Breastcancer.orgArdmorePennsylvaniaUSA
| | - Stephanie Kjelstrom
- Main Line Health Center for Population Health ResearchLankenau Institute for Medical ResearchWynnewoodPennsylvaniaUSA,College of Population HealthThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
| | - Diana Martinez
- Department of PsychiatryColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | | | | | | | - Ann Partridge
- Department of Medical OncologyDana‐Farber Cancer InstituteBostonMassachusettsUSA
| | | | - Rowen Chlebowski
- The Lundquist Institute, Harbor‐UCLA Medical CenterTorranceCaliforniaUSA
| | - Sharon Larson
- Main Line Health Center for Population Health ResearchLankenau Institute for Medical ResearchWynnewoodPennsylvaniaUSA,College of Population HealthThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
| | - Marisa Weiss
- Breastcancer.orgArdmorePennsylvaniaUSA,Radiation OncologyLankenau Medical CenterWynnewoodPennsylvaniaUSA
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A Digital Cancer Ecosystem to Deliver Health and Psychosocial Education as Preventive Intervention. Cancers (Basel) 2022; 14:cancers14153724. [PMID: 35954388 PMCID: PMC9367518 DOI: 10.3390/cancers14153724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/04/2022] Open
Abstract
Health education and psychosocial interventions prevent emotional distress, and the latter has been shown to have an impact on survival. In turn, digital health education interventions may help promote equity by reaching a higher number of cancer patients, both because they avoid journeys to the hospital, by and having a better efficiency. A total of 234 women recently diagnosed with breast cancer in a comprehensive cancer center used the digital ecosystem ICOnnecta’t from March 2019 to March 2021. ICOnnecta’t consists of four care levels, provided to patients according to their level of distress. The second level of this intervention consists of an educational campus, which was analyzed to track users’ interests and their information-seeking behavior. Overall, 99 out of 234 women (42.3%) used the educational campus. There were no significant differences in sociodemographic and clinical variables between the campus users and non-users. Among users, the median number of resources utilized per user was four (interquartile range: 2−9). Emotional and medical resources were the contents most frequently viewed and the audiovisual format the most consulted (p < 0.01). Resources were used mainly within the first three months from enrolment. Users who were guided to visit the virtual campus were more active than spontaneous users. Offering an early holistic health educational platform inside a digital cancer ecosystem, with health professionals involved, can reach more patients, promoting equity in the access of cancer information and prevention, from the very beginning of the disease.
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