Influence of Self-Efficacy on Cancer-Related Fatigue and Health-Related Quality of Life in Young Survivors of Childhood Cancer

Peer2Me - evaluation of a peer supported program for adolescent and young adult (AYA) cancer patients: study protocol of a randomised trial using a comprehensive cohort design

BACKGROUND

Developing cancer in young adulthood is a non-normative life event and associated with adverse physical, social and psychological consequences. High psychological distress is common in AYA cancer patients including anxiety, depression or fear of recurrence. At the same time, it is well known that AYA often report unmet needs for support, particularly in terms of informational exchange and emotional support from peers in order to benefit from shared experiences and enhance self-efficacy. Especially in the AYA group, interactions with other same-aged cancer patients may represent an essential resource in terms of coping with the disease, as family members and friends are often overwhelmed and struggling with helplessness. Currently, there is a lack of professional support services using peer support (e.g. psycho-oncological support, aftercare consultations, social legal counselling) or evaluated peer support interventions in Germany. Our aim is to assess the effectiveness of the Peer2Me intervention for AYAs, in which acute patients (mentees) are accompanied by an AYA survivor (mentor) over a period of three months.

METHODS

A prospective Comprehensive Cohort Design with repeated measures will be used to evaluate the effectiveness of Peer2Me for AYA. A sample of 180 patients in active cancer treatment aged 18 to 39 years will be enrolled and randomized to the intervention or control condition (a single AYA-specific consultation). Following mentor training, mentees and mentors are matched by diagnosis, age, and gender. The primary outcome is self-efficacy; secondary outcomes include measures of anxiety, depression, health literacy, life satisfaction and social support life. Outcomes will be measured at baseline before the intervention (t1), immediately after completion of the three-month intervention (t2) and three months after completion the intervention (t3). For the final analyses, we will use an intention-to-treat approach (ITT) and compare patients in the assigned treatment groups.

DISCUSSION

Peer2Me might be an important addition to existing professional psychosocial support services for young cancer patients. At the end of the study, a psycho-oncological intervention for young cancer patients undergoing acute treatment should be available, from which both mentors and mentees could benefit. The long-term continuity of Peer2Me should be ensured through collaboration with different partners.

TRIAL REGISTRATION

The study was retrospectively registered on February 4, 2022 at clinicaltrials.gov (NCT05336318).

Psychometric properties of the Turkish Version General Self-Efficacy Scale in children and adolescents with cancer

OBJECTIVES

The study aimed to evaluate the validity and reliability of the Turkish version of the General Self-Efficacy Scale in children and adolescents aged 8-18 undergoing cancer treatment.

METHODS

The sample of this methodological and descriptive study consisted of 128 children and adolescents between the ages of 8 and 18 in the pediatric hematology-oncology wards and outpatient units of a university hospital. The study was implemented in a university hospital in Turkey between March 2023 and November 2023. Data were collected through face-to-face interviews with children and adolescents attending the clinic or outpatient clinic. Data were collected using the information form and General Self-Efficacy Scale psychometric tests, Cronbach's alpha, Test-retest, validity and reliability analysis). Item-total score correlation was used.

RESULTS

In the exploratory factor analysis, Kaiser Meyer Olkin was p 0.77, for which Bartlett's test of sphericity was significant (p < 0.001). Exploratory factor analysis revealed a ten-item unidimensional structure with satisfactory representation. Item-total score correlations of the scale ranged between 0.32 and 0.52. In the confirmatory factor analysis, the model fit indices of this scale were obtained as follows: χ2/sd = 1.36, Goodness-of-Fit Index = 0.94, Comparative Fit Index = 0.92, Adjusted Goodness-of-Fit Index = 0.90, and Cronbach alpha value, indicating the internal consistency of the entire scale, was 0.76.

CONCLUSIONS

The scale is a valid and reliable tool for assessing self-efficacy in children and adolescents between the ages of eight and eighteen undergoing cancer treatment.

PRACTICE IMPLICATIONS

The study will provide precious information for experimental interventions and follow-up studies to assess the self-efficacy of children and adolescents with cancer.

The relationship between physical activity, self-efficacy and quality of life in colorectal cancer survivors: a multicenter cross-sectional study

PURPOSE

This study aimed to investigate the current situation and factors influencing physical activity, self-efficacy, and quality of life in Chinese colorectal cancer survivors. Additionally, this study explored the associations between physical activity, self-efficacy, and quality of life.

METHODS

A multicenter, cross-sectional study was conducted, involving 173 colorectal cancer survivors with a mean age of 59 years. Self-reported data on basic demographic characteristics, physical activity, self-efficacy, and quality of life were collected.

RESULTS

Among 173 colorectal cancer survivors, 90 (52.0%) were engaged in manual work. The self-efficacy score was found to be 25.99 ± 7.10, while the global health status score was 54.96 ± 21.56. Global health status was associated with sex, residence, chemoradiotherapy, and monthly income (p < 0.01). The self-efficacy score exhibited a significant positive correlation with quality of life, while demonstrating a negative correlation with symptom scores (p < 0.01). Recreational PA scores were positively associated with global health status (P < 0.05). Self-efficacy, recreational physical activity during winter, and whether the participants underwent chemoradiotherapy explained 29.3% of the variance in quality of life among colorectal cancer survivors.

CONCLUSIONS

Colorectal cancer survivors exhibited low levels of physical activity, self-efficacy, and quality of life. Their health is influenced by self-efficacy, recreational physical activity, and chemoradiotherapy. When developing intervention plans for colorectal cancer survivorship, it is crucial to consider survivors' self-efficacy and the type of physical activity in which they engage.

Effectiveness of exergaming in reducing cancer-related fatigue among children with acute lymphoblastic leukemia: a randomized controlled trial

BACKGROUND

Little is known about the effectiveness of the newly emerging technology of exergaming in reducing Cancer Related Fatigue (CRF).

OBJECTIVES

The study's primary aim was to examine the effectiveness of exergaming in reducing CRF; the secondary aims were to improve functional capacity/endurance and promote physical activity (PA) among children with acute lymphoblastic leukemia (ALL).

METHODS

In this Randomized Controlled Trial (RCT), 45 children aged 6-14 years were randomly assigned into group-I, n = 22, and group II, n = 23. Group-I played exergaming of moderate intensity for 60 min, twice a week for three weeks. Group II was given an instructional session regarding the benefits of PA with advice to practice PA for 60 min twice a week. CRF, functional capacity/endurance, and PA were measured using the pediatric quality of life multidimensional fatigue scale (Ped-QLMFS), six-minute walk test (6-MWT), and Godin-Shepard Leisure Time Physical Activity Questionnaire (QSLTPAQ) respectively. All measurements were taken thrice; in the first, third, and fifth weeks of intervention.

RESULTS

Group-I demonstrated a significant reduction of CRF, and a significant increase of functional capacity/endurance compared to group-II over the five weeks study period. The effect of time × intervention interaction was significant. Based on Cohen's guidelines, CRF and functional capacity/endurance had large effect sizes (η² = 0.41, p = .00) and (η² = 0.27, p = .00) respectively.

CONCLUSION

The protocol of exergaming used in this RCT effectively reduces CRF and promotes functional capacity/endurance and PA in children with ALL undergoing chemotherapy. It may provide an alternative treatment modality to decrease the healthcare load.Key messagesCancer-related fatigue (CRF) is described as physical exhaustion, sleep disturbance, emotional distress, and cognitive dysfunction.Exergaming reduces CRF and promotes functional capacity/endurance and physical activity in children with acute lymphoblastic leukemia undergoing chemotherapy.Exergaming may provide an alternative treatment modality to decrease the healthcare load.

Exploring the dynamic interconnectedness of protective and perpetuating factors of cancer-related fatigue

OBJECTIVE

Approximately 25% of cancer patients suffer from cancer-related fatigue (CRF) after cancer treatment. CRF is a multi-factorial condition affected by several interrelated protective and perpetuating factors. As most studies merely assessed bivariate associations, more insight into the complex relationships among these constructs is needed. We applied the multivariate network approach to gain a better understanding of how patients' fatigue, perpetuating and protective factors are dynamically interconnected.

METHOD

Between February and August 2022, 30 cancer patients filled out a carefully developed ecological momentary assessment questionnaire (EnergyInSight) five times a day for at least 21 days while being on the waitlist for psychological care for CRF. We performed a multi-level vector autoregression analysis to examine the interconnectedness among fatigue, protective factors (allowing rest, acceptance, and self-efficacy) and perpetuating factors (worrying, catastrophizing, and feeling guilty).

RESULTS

In the contemporaneous network (concurrent associations), higher acceptance and self-efficacy were associated with lower fatigue, whereas all other factors were associated with higher fatigue. The strongest relationships were between worrying and feeling guilty and between acceptance and allowing rest. In the temporal network (lagged associations), fatigue was related to two factors: higher self-efficacy preceded lower fatigue, and higher fatigue preceded increased allowing rest.

CONCLUSIONS

Taking all included factors into account, the networks identified self-efficacy and allowing rest as key protective factors of CRF. Patients may benefit from psychological interventions that cultivate self-efficacy, as it seems to pave the way to reduced fatigue.

Posttraumatic growth in children aged 8-18 years with malignancies in China

OBJECTIVE

To establish a nomogram prediction model for posttraumatic growth (PTG) in children aged 8-18 years with malignancies in China and to convenient intuitively judge psychological tendencies.

METHODS

We recruited 358 children aged 8-18 years with malignancies in China as the study participants. Data from 250 cases collected from June 2019 to November 2019 were used as the model group, data from 108 cases collected from December 2019 to January 2020 were used as the validation group. Logistic regression was used to analyze the influencing factors of PTG in the model group. A prediction model was then established using a nomogram. The centrality measurement index(C-index) and receiver operating characteristic curves (ROC) were used to verify the model.

RESULTS

Among the 250 children in the model group, 65 children with malignancies had PTG, with an occurrence of 26%. The model showed that the child's age, diagnosis, coping style and self-efficacy level and the educational level of the caregiver were core predictors of PTG (P < 0.05). The ROC of the model was 0.837, the best cutoff value was 0.566. The C-indexes of the internal and external validation were 0.837 (95% CI: 0786 ~ 0.886) and 0.813 (95% CI: 0732 ~ 0.894), respectively.

CONCLUSIONS

The prediction model of PTG in children aged 8-18 years with malignancies in China has good discrimination and consistency and can accurately predict PTG. It can be used to clinically assess the psychological status of children in the future.