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Reynolds LM, Barnett B, Weleff J, Morunga E, Wells A, Stack A, Akroyd A, Hoeh N, Sundram F, Muthukumaraswamy S, Lawrence N, Evans WJ. The perceptions of cancer health-care practitioners in New Zealand and the USA toward psychedelic-assisted therapy with cancer patients: A cross-sectional survey. Palliat Support Care 2022:1-10. [PMID: 36325995 DOI: 10.1017/s1478951522001481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES A resurgence of research investigating the administration of psychedelic compounds alongside psychotherapy suggests that this treatment is a promising intervention for anxiety, depression, and existential distress in people with cancer. However, psychedelic treatment that induces a mind-altering experience potentially poses barriers to vulnerable cancer patients, and health-care practitioners may have concerns about referring their patients to trials investigating this approach. The aim of the current study was to investigate the perceptions of cancer health-care practitioners based in New Zealand and the USA related to psychedelic-assisted therapy. METHODS This study utilized a cross-sectional survey of cancer health-care practitioners in New Zealand and the USA via convenience sampling to identify their perceptions about the concept of conducting psychedelic-assisted therapy with cancer patients. RESULTS Participants perceived that (1) psychedelic-assisted therapy has the potential to provide benefit for cancer patients, (2) research in this area across a variety of domains is important, (3) work should consider spiritual and indigenous perspectives of health, and (4) there was willingness to refer patients to trials in this area, especially patients with advanced disease who were no longer going through curative treatment. Participants in the USA had greater awareness of psychedelics than the New Zealand sample; however, New Zealand participants more strongly believed that spiritual/indigenous factors should be considered in psychedelic-assisted therapy. SIGNIFICANCE OF RESULTS Cancer health-care practitioners in our sample considered research investigating the potential for psychedelic-assisted therapies to be important and may be more open to studies that start in palliative and end-of-life contexts.
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Affiliation(s)
- Lisa M Reynolds
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Brian Barnett
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA
| | - Jeremy Weleff
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Eva Morunga
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
- Cancer and Blood Service, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand
| | - Alesha Wells
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Aideen Stack
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Amelia Akroyd
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Nicholas Hoeh
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | - Frederick Sundram
- Department of Psychological Medicine, The University of Auckland, Grafton, Auckland, New Zealand
| | | | - Nicola Lawrence
- Cancer and Blood Service, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand
- The Department of Oncology, The University of Auckland, Auckland, New Zealand
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Chin S, Cavadino A, Akroyd A, Tennant G, Dobson R, Gautier A, Reynolds L. An Investigation of Virtual Reality Nature Experiences in Patients With Metastatic Breast Cancer: Secondary Analysis of a Randomized Controlled Trial. JMIR Cancer 2022; 8:e38300. [PMID: 35867398 PMCID: PMC9356329 DOI: 10.2196/38300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/24/2022] [Accepted: 06/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Connection with nature has well-established physical and psychological benefits. However, women with metastatic breast cancer (MBC) are often unable to access nature because of physical limitations, psychological barriers, and treatment demands. Virtual reality (VR) nature experiences offer an alternative means of connecting with nature and may be of particular benefit to patients with cancer who are house- or hospital-bound. OBJECTIVE This study aims to explore whether VR nature experiences are associated with physical and psychological benefits for women with MBC who are disconnected with nature. METHODS This secondary analysis of a previous randomized controlled crossover trial recruited participants from the emailing lists of breast cancer support organizations. Participants were provided VR headsets for daily use in their homes for over 3 weeks. In the first week, participants used 1 of 2 VR nature experiences (Ripple or Happy Place) daily, followed by a 1-week washout period, before using the other VR experience every day for the final week. Outcomes assessed changes between baseline and postintervention scores in quality of life (EQ-5D-5L), pain (Brief Pain Inventory Short Form), fatigue (Functional Assessment of Chronic Illness Therapy-fatigue), depression (Depression, Anxiety, and Stress Scale-depression), anxiety (Depression, Anxiety, and Stress Scale-anxiety), and spiritual well-being (Functional Assessment of Chronic Illness Therapy- Spiritual Well-being) and investigated whether benefits were greater in participants who were not strongly connected with nature at baseline. RESULTS A total of 38 women with MBC completed the VR interventions and were included in the analyses. Participants reported significantly less fatigue (P=.001), less depression (P<.001), and greater quality of life (P=.02) following the interventions than at baseline. Women with a weaker connection to nature reported greater fatigue (P=.03), depression (P=.006), and anxiety (P=.001), and poorer spirituality (P=.004) than their strongly connected counterparts. Only those with a weaker baseline connection with nature showed improvements in depression following the intervention (P=.03), with similar trends observed in fatigue (P=.07) and quality of life (P=.10). CONCLUSIONS This study provides preliminary evidence that feeling connected with nature is associated with better physical and psychological status in patients with MBC and that VR nature interventions might be beneficial for this clinical population. Future studies should focus on activities that encourage connection with nature (rather than simply exposure to nature) and investigate the aspects of VR nature interventions that have the greatest therapeutic potential. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12619001480178; https://tinyurl.com/et6z3vac.
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Affiliation(s)
- Stanley Chin
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Alana Cavadino
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Amelia Akroyd
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Geraldine Tennant
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Rosie Dobson
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
| | | | - Lisa Reynolds
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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Reynolds LM, Akroyd A, Sundram F, Stack A, Muthukumaraswamy S, Evans WJ. Cancer Healthcare Workers' Perceptions toward Psychedelic-Assisted Therapy: A Preliminary Investigation. Int J Environ Res Public Health 2021; 18:ijerph18158160. [PMID: 34360453 PMCID: PMC8346095 DOI: 10.3390/ijerph18158160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
Recent clinical trials suggest that psychedelic-assisted therapy is a promising intervention for reducing anxiety and depression and ameliorating existential despair in advanced cancer patients. However, little is known about perceptions toward this treatment from the key gatekeepers to this population. The current study aimed to understand the perceptions of cancer healthcare professionals about the potential use of psychedelic-assisted therapy in advanced cancer patients. Twelve cancer healthcare professionals including doctors, nurses, psychologists and social workers took part in a semi-structured interview which explored their awareness and perceptions toward psychedelic-assisted therapy with advanced cancer patients. Data were analysed using thematic analysis. Four inter-connected themes were identified. Two themes relate to the role and responsibility of being a cancer healthcare worker: (1) ‘beneficence: a need to alleviate the suffering of cancer patients’ and (2) ‘non-maleficence: keeping vulnerable cancer patients safe’, and two themes relate specifically to the potential for psychedelic-assisted therapy as (3) ‘a transformative approach with the potential for real benefit’ but that (4) ‘new frontiers can be risky endeavours’. The findings from this study suggest intrigue and openness in cancer healthcare professionals to the idea of utilising psychedelic-assisted therapy with advanced cancer patients. Openness to the concept appeared to be driven by a lack of current effective treatment options and a desire to alleviate suffering. However, acceptance was tempered by concerns around safety and the importance of conducting rigorous, well-designed trials. The results from this study provide a useful basis for engaging with healthcare professionals about future research, trial design and potential clinical applications.
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Affiliation(s)
- Lisa M. Reynolds
- Department of Psychological Medicine, The University of Auckland, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand; (A.A.); (F.S.); (A.S.)
- Correspondence:
| | - Amelia Akroyd
- Department of Psychological Medicine, The University of Auckland, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand; (A.A.); (F.S.); (A.S.)
| | - Frederick Sundram
- Department of Psychological Medicine, The University of Auckland, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand; (A.A.); (F.S.); (A.S.)
| | - Aideen Stack
- Department of Psychological Medicine, The University of Auckland, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand; (A.A.); (F.S.); (A.S.)
| | - Suresh Muthukumaraswamy
- School of Pharmacy, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand;
| | - William J. Evans
- Mana Health, 7 Ruskin Street, Parnell, Auckland 1052, New Zealand;
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Akroyd A, Gunn KN, Rankin S, Douglas M, Kleinstäuber M, Rief W, Petrie KJ. Optimizing patient expectations to improve therapeutic response to medical treatment: A randomized controlled trial of iron infusion therapy. Br J Health Psychol 2020; 25:639-651. [PMID: 32519431 DOI: 10.1111/bjhp.12435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 05/03/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Patient expectations have the ability to influence health outcomes and have been shown to play an important role as part of the placebo effect to influence the response to medical treatments. Increasing positive expectations have been proposed as an intervention to improve treatment response, although evidence for this to date is limited. We investigated whether a brief 10-min intervention directly targeting patient expectations prior to an iron infusion could enhance expectations and improve treatment response, in terms of patients' reported fatigue. DESIGN Randomized controlled trial. METHODS Forty-three patients diagnosed with iron deficiency anaemia were randomized to a brief expectation intervention or active control group prior to an intravenous iron infusion. Chalder Fatigue Scale scores were assessed prior to randomization and at one and four weeks. RESULTS The expectation intervention significantly improved patients' expectations about the effectiveness of the intravenous iron infusion, t(21) = -3.95, p = .001. While there were no significant differences between groups in fatigue at the one-week follow-up, fatigue was significantly lower in the intervention group at the four-week follow-up compared to the control group, F(1, 25) = 6.25, p = .019. This was largely influenced by a significant reduction in physical, as opposed to mental fatigue scores. CONCLUSIONS Boosting patients' positive expectations may be an effective way of enhancing patient response to treatment. In particular, targeting patient expectations with a brief intervention prior to medical treatments may result in a greater and longer therapeutic effect.
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Affiliation(s)
- Amelia Akroyd
- Department of Psychological Medicine, University of Auckland, New Zealand
| | - Kerry N Gunn
- Department of Anaesthesia, Auckland City Hospital, New Zealand
| | - Sarah Rankin
- Department of Psychological Medicine, University of Auckland, New Zealand
| | - Meihana Douglas
- Department of Psychological Medicine, University of Auckland, New Zealand
| | - Maria Kleinstäuber
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Winfried Rief
- Division of Clinical Psychology, University of Marburg, Germany
| | - Keith J Petrie
- Department of Psychological Medicine, University of Auckland, New Zealand
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Jones ASK, Kleinstäuber M, Akroyd A, Mittendorf A, Bognuda P, Merrie AEH, Eva L, Fernandez J, Petrie KJ. Using animated visualization to improve postoperative mobilization: A randomized controlled trial. Health Psychol 2019; 38:748-758. [PMID: 31368756 DOI: 10.1037/hea0000761] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Enhanced recovery after surgery (ERAS) programs fast-track recovery for surgical procedures, including colorectal and gynecological oncology surgery. Early mobilization is a postoperative ERAS module that can be self-managed by patients, but poor adherence is common. Visualization is increasingly being used to improve patient understanding and adherence to health behaviors. This study tested whether an animated visualization intervention could improve adherence to postoperative mobilization. METHOD Ninety six colorectal and gynecological oncology surgery patients were randomized to intervention, active control, or standard care groups. Intervention participants saw an animated intervention on a computer tablet at Day 1 postsurgery. All participants wore fitness trackers from day of discharge to 7 days postdischarge, and completed psychological measures at baseline, Day 1 postsurgery, and 7 days postdischarge. RESULTS Step count data was available for 57 colorectal surgery participants. A main effect of group demonstrated that intervention participants had a significantly higher average daily step count from discharge across the week following discharge (Madj = 2,294.60, 95% confidence interval [CI] [1,746.11, 2,744.89]) compared with control participants (Madj = 1,347.25, 95% CI [826.51, 1,871.20]; p = .05). At postsurgery, intervention participants reported significantly greater perceived quality of recovery and less difficulty in being mobile compared with control participants. There were no between-group differences in self-reported exercise or perceptions of surgery and recovery. CONCLUSION This brief intervention appears effective in improving perceptions of early mobilization, and initial evidence suggests improvements in adherence to postsurgical mobilization. This intervention has high clinical applicability and could be incorporated into postoperative standard care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Annie S K Jones
- Department of Psychological Medicine, Faculty of Medical and Health Sciences
| | - Maria Kleinstäuber
- Department of Psychological Medicine, Faculty of Medical and Health Sciences
| | - Amelia Akroyd
- Department of Psychological Medicine, Faculty of Medical and Health Sciences
| | | | - Penny Bognuda
- Gynaecological Oncology Department, National Women's Health, Auckland District Health Board
| | | | - Lois Eva
- Gynaecological Oncology Department, National Women's Health, Auckland District Health Board
| | - Justin Fernandez
- Department of Engineering Science, Faculty of Engineering, University of Auckland
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences
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