“One stroke,with twenty-two people”: exploring prostate cancer survivors' participation in dragon boating

Abstract

Purpose: This study qualitatively explores prostate cancer survivors’ experience in joining a dragon boating team and its possible impact on their wellbeing.

Design: Qualitative data analysis.

Sample: Eleven prostate cancer survivors from a dragon boat team.

Methods: Semi-structured interviews and thematic analysis.

Findings: The findings support physical benefits of dragon boating, however, the positive impact on the men’s psychosocial wellbeing was more salient. Participation in dragon boating was important for establishing a social support system and positively reframing their cancer experience.

Practice Implications: Dragon boating is a novel health promotion strategy for men with PC. Seeking to replicate the positive characteristics of dragon boating in the design of future physical activity interventions should be explored.     

Distress in post-treatment hematological cancer survivors: Prevalence and predictors

Abstract

Objectives: To calculate the prevalence of psychosocial distress, and identify factors that predict distress, in early post-treatment hematological cancer survivors.

Design: Cross-sectional survey containing self-report measures.

Sample/Methods: Post-treatment hematological cancer survivors in remission (>18?years) (n?=?409) completed questionnaires. Distress was measured with the distress thermometer (DT). Logistic regression was used to identify predictors of distress.

Findings: Overall 21.9% (n?=?93) of respondents reported significant distress (DT?≥4). Significant distress was twice as high in those born overseas (OR = 2.09, p?=?.03), 3.5 times higher in those with lower social support (OR = 3.51, p = <.001) and five times higher in those with increased fear of recurrence (OR = 0.17, p = <.001).

Implications for Psychosocial Providers: Early identification of distress may decrease psychosocial issues in the post-treatment period, especially as psychosocial services have been shown to improve wellbeing for those who are distressed.     

Through our eyes: A photovoice intervention for adolescents on active cancer treatment

Abstract

Research Approach: Photovoice, a participatory action research methodology, is a novel and promising intervention for adolescents with cancer. Photovoice was used as an intervention for eliciting and addressing the psychosocial needs of adolescents on active cancer treatment.

Participants: Six adolescents, aged thirteen to seventeen years old, who were on active treatment or had completed treatment in the three months prior to recruitment participated in a seven-week photovoice group that took place from March to May 2017.

Methodological Approach: Each of the seven sessions was recorded and later transcribed. A content analysis was used to identify themes that were analyzed using an integrated framework developed earlier. The framework broadly categorized the themes into six domains: (i) physical changes, (ii) psychosocial impacts, (iii) short-term social impacts, (iv) long-term social impacts, (v) impacts on holistic well-being, and (vi) informational needs.

Interpretation: Photovoice is an effective intervention for eliciting and addressing the psychosocial needs of adolescents on active cancer treatment.     

Treatment challenges and support needs of underserved Hispanic patients diagnosed with lung cancer and head-and-neck cancer

Abstract

Purpose: We explored the treatment challenges and support needs that Hispanic underserved lung cancer and head-and-neck cancer patients face while undergoing cancer treatment.

Design: Qualitative design - ethnography.

Sample: Using a sample of 29 participants, we conducted semi-structured interviews with nine lung cancer and head-and-neck cancer survivors and seven health care providers and focus group interviews with six caregivers and seven patient navigators.

Method: Relevant themes were extracted with Ethnographic content analysis.

Findings: Participants reported treatment challenges and support needs in four areas: medical, financial, socio-cultural, and mental health. Health care providers and navigators primarily identified medical and financial challenges that impact treatment adherence, while patients and caregivers expressed the need for support for mental health problems (i.e., depression, anxiety).

Implications for psychosocial providers: Understanding the experiences of underserved Hispanic cancer survivors can aid in creating psychosocial interventions that successfully target treatment-related challenges and provide them with the support they need.     

Causal Attribution,Control, and Adjustment to Breast Cancer

Abstract

The aim of the present study is to compare the effectiveness of experiential-existential group psychotherapy with a social support group for women with a primary breast cancer on psychosocial adjustment. A total of 67 well-adjusted women, who had been operated not earlier than 4 months before start of the study, were randomized into one of the two conditions: participating in the group psychotherapy or in the support group. They were questioned at the start of the study, at the end of the intervention, and 1 year after completion of the intervention. Results at follow-up were mixed: Positive changes were reported for Body Image and Recreation, regardless of type of intervention. Other psychosocial adjustment indicators did not change. In general, we may conclude that well-adjusted women diagnosed with breast cancer do not specifically benefit from these types of interventions.     

Effects of social constraints and web-based psychoeducation on cancer-related psychological adjustment early-after breast cancer diagnosis

Abstract

Purpose: Social constraints are interactions between individuals that result in preventing one’s disclosure of thoughts and emotions needed to facilitate cognitive processing of a traumatic event such as a breast cancer diagnosis. This study explored women’s perceived social constraints from spouse/partners (S/P) and family/friends (F/F) in the first months after diagnosis while engaged in a study of CaringGuidance? After Breast Cancer Diagnosis, a web-based, psychoeducational, self-management intervention aimed at women’s psychological adjustment.

Design: Randomized, controlled, pilot study.

Sample: 100 women within 0–3?months of first, stage 0–II breast cancer diagnosis.

Methods: Subjects were randomized to self-guided use of CaringGuidance? for three months plus usual care or usual care alone. Social constraints (S/P) and (F/F), distress, depressive-symptoms, intrusive/avoidant thoughts, and coping were measured at baseline, 1, 2, and 3?months.

Findings: The CaringGuidance? group experienced a significantly greater decrease in perceived social constraints from S/P and F/F over three months than the usual care group. Change in social constraints from F/F significantly moderated change in depressive-symptoms and intrusive/avoidant thoughts, but the same was not true for change in S/P constraints.

Conclusions: CaringGuidance? holds promise as an intervention for newly diagnosed women to self-manage perceptions of social constraints.

Implications for Psychosocial Providers: Providers should assess newly diagnosed women’s perceptions of social constraining behavior from F/F, recognizing the potential significant impact of these interactions on psychological adjustment.     

A multi-center randomized controlled trial to reduce unmet needs,depression, and anxiety among hematological cancer patients and their support persons

Abstract

Purpose: Individuals diagnosed with a high-grade hematological malignancy are at high risk for psychosocial distress. This study aimed to examine the effectiveness of a web-based information tool and nurse delivered telephone support in reducing: (i) unmet information needs; (ii) depression; and (iii) anxiety, among hematological cancer patients and their support persons (SPs).

Methods: Patients with a new diagnosis of acute myeloid leukemia, acute lymphoblastic leukemia, Burkitt lymphoma, or lymphoblastic lymphoma and their SPs were enrolled in a prospective multi-site randomized trial. Participants received either access to an online information tool and telephone support from a hematology nurse, or usual care. Outcome data were collected 2, 4, 8, and 12?weeks post-recruitment. The primary endpoint was unmet information needs.

Results: Data from 60 patients and 15 SPs were included in the analysis. There were no statistically significant differences in unmet information needs, depression or anxiety between intervention and control groups for patients. Patients in both groups demonstrated a decrease in information needs over the intervention period. Post hoc analyses revealed that patients who did not achieve remission with the first cycle of treatment experienced increased anxiety from 4?weeks until the end of the study (p?=?0.008).

Conclusions: A web-based information tool and nurse delivered telephone support did not reduce unmet information needs, depression or anxiety among hematological cancer patients, however this finding is inconclusive given the low power of the study.

Implications for Psychosocial Providers or Policy: Patients who do not achieve remission are at high risk of anxiety, and may benefit from targeted psychological intervention.     

Coexistence of urinary incontinence and major depressive disorder with health-related quality of life in older Americans with and without cancer

Purpose

This study evaluates the prevalence and factors associated with major depressive disorder (MDD) in a population of cancer survivors and the impact of co-occurring MDD and urinary incontinence (UI) on health-related quality of life (HRQOL).

Methods

The prevalence of MDD risk among cancer survivors (breast, prostate, bladder, colorectal, lung, and endometrial/uterine cancers) and those without cancer was estimated using the Surveillance, Epidemiology and End Results Program-Medicare Health Outcomes Survey (SEER-MHOS) linked database (n?=?9,282 with cancer/n?=?289,744 without cancer). Risk for MDD was measured using three items from the Diagnostic Interview Schedule, and HRQOL was measured by the SF-36. UI was defined as self-reported leakage of urine causing a problem in previous 6 months. Factors associated with MDD were investigated using logistic regression, and the impact of co-occurring MDD and UI on HRQOL scores was determined using linear regression.

Results

The prevalence of MDD risk ranged from 19.2 % for prostate to 34.1 % for lung. Lung cancer diagnosis was associated with risk of MDD. Being ≥5 years from diagnosis was associated with decreased risk of MDD (prevalence odds ratio (POR)?=?0.82, 95 % confidence interval (95 % CI) 0.71, 0.95). The coexistence of both UI and MDD was associated with a decrease across HRQOL subscales; including 40 points on role-emotional (RE) score.

Conclusions

Cancer survivors reporting co-occurrence of UI and MDD experienced significant decrements in HRQOL.

Implications of Cancer Survivors

Understanding the combined effect of UI and MDD may help clinicians to better recognize and alleviate their effects on cancer survivors’ HRQOL.     

Comparing the efficacy of integrative body-mind-spirit intervention with cognitive behavioral therapy in patient-caregiver parallel groups for lung cancer patients using a randomized controlled trial

Abstract

Purposes/objectives: This paper reports the comparative efficacies of integrative body-mind-spirit intervention (I-BMS) and cognitive behavioral therapy (CBT) in patient-caregiver parallel groups for Chinese patients with lung cancer.

Design: Randomized controlled trial (RCT).

Methods: One hundred and fifty-seven patient-caregiver dyads with no marked functional impairment were randomized into one of the two interventions with eight weekly patient-caregiver parallel groups. Assessments were conducted at baseline, within one, eight- and sixteen-weeks post-intervention. Effects of treatment group across time were analyzed by multilevel modeling.

Findings: CBT led to greater reduction in emotional vulnerability than I-BMS. I-BMS resulted in greater increase in overall QoL and spiritual self-care, and more reduction in depression than CBT. Patients in both interventions experienced improvement in physical, emotional and spiritual, except social, domains of QoL.

Conclusion: I-BMS was more efficacious for diverse domains of QoL, and CBT was more effective for emotional well-being, despite the relatively small between-group effect sizes.

Implications for psychosocial providers/policy: (1) With the expanding repertoire of psychosocial interventions for families facing lung cancer, it has become imperative to investigate the comparative efficacies of empirically supported and culturally adapted interventions. (2) Our findings show that I-BMS was more effective for diverse domains of QoL, while CBT was more efficacious with emotional well-being, although both interventions led to significant improvements in physical, emotional and spiritual domains of patient QoL. (3) Patient-caregiver parallel groups have been shown to be effective for enhancing QoL of Chinese lung cancer patients. (4) Care professionals are encouraged to dispense interventions based on the idiosyncratic needs and preferences of the patients to maximize the treatment effects.     

Web-based counseling for families with parental cancer: Baseline findings and lessons learned

Abstract

Purpose: This is the first study in Switzerland to report on psychological adjustment in children of a parent with cancer using a web-based intervention during cancer therapy.

Design/Sample: Twenty-two families participated in this randomized controlled web-based intervention program.

Methods: Quality of life and emotional–behavioral well-being of children were examined using child self-reports, and parent proxy-reports. Furthermore, family communication and satisfaction and feedback on the web-based program were assessed.

Findings: Children’s first stage adjustment to parental cancer did not show detrimental patterns. The “lesson learned” in this setting emphasizes the challenge to reach families in need. The web-based program was appreciated as an additional source of information and support in this mostly highly functioning population.

Conclusion: While feasibility was shown, it remains unclear how to contact families with lower psychosocial functioning.     

A dyadic analysis of loneliness and health-related quality of life in Latinas with breast cancer and their informal caregivers

Abstract

Objective: The primary aim of this investigation is to provide a novel dyadic test of a model of loneliness and health-related quality of life (HRQoL) in a sample of Latinas with breast cancer and their informal caregivers.

Design: At baseline, dyads completed measures of loneliness and HRQoL. At a 3-month follow-up, they returned to complete the HRQoL measure. Associations were tested with the Actor–Partner Interdependence Model.

Sample: About 234 Latinas with breast cancer diagnosed within the past year and their informal caregivers participated in the investigation.

Findings: Loneliness was concurrently and negatively associated with HRQoL at baseline for both survivors and caregivers. Survivors’ baseline loneliness, controlling for their baseline HRQoL, negatively predicted their HRQoL at 3?months. Survivors’ HRQoL at baseline also predicted caregivers’ HRQoL at 3?months.

Conclusion: Loneliness is a risk factor for declines in HRQoL among cancer survivors. Their caregivers are also at risk for degraded HRQoL when the survivor experiences compromised HRQoL. Loneliness complicates the HRQoL of the cancer survivor–caregiver dyad.     

Predicting social withdrawal,anxiety and depression symptoms in pediatric brain tumor survivors

Objective: Pediatric brain tumor survivors (PBTSs) are at risk for impairments in social adjustment and psychological distress. This study investigated longitudinal associations between symptoms of social withdrawal and anxiety/depression in PBTS, as well as medical, demographic, and personal characteristics that may also influence reports of social withdrawal and anxiety/depression.

Method: About 91 PBTS (51% male, mean age 11.21?years, off-treatment) participated. At baseline and 8?months follow-up, primary caregivers of PBTS completed measures of social withdrawal, anxiety, and depression symptoms. Medical information (e.g. tumor type and location, cranial irradiation therapy) and child personal characteristics (e.g. child’s age and gender, executive function, social skills) were obtained at baseline.

Results: Baseline reports of depression symptoms and social skills predicted social withdrawal 8?months later. Social withdrawal at baseline predicted greater combined anxiety and depression symptoms 8?months later. Depression alone predicted greater anxiety symptoms at follow-up. Anxiety symptoms and poor global executive functioning predicted greater depression symptoms at follow-up.

Conclusions: The social adjustment and psychological distress of PBTSs are interrelated and can influence each other across time. These findings support the importance of multifaceted interventions targeting both psychological distress and social adjustment, in order to support the optimal psychosocial adjustment of PBTSs.     

Psychosocial interventions to support partners of men with prostate cancer: a systematic and critical review of the literature

Purpose

Prostate cancer poses many challenges for both the man and his partner. Partners have reported a range of issues that impact their own mental health following their partner’s diagnosis of prostate cancer. The aim of this review is to summarise and critically evaluate the current literature reporting psychosocial intervention studies for partners of prostate cancer patients.

Methods

An extensive literature search of electronic databases was conducted (OvidMEDLINE 1946, 26th September 2013, and psychINFO 1967, 26th September 2013) using the keywords prostate cancer AND intervention* OR therapy* OR psychosocial intervention* OR support* AND couple* or Spouse* or Partner* or Intimate partner* matched to the title as well as secondary scanning of reference lists. Studies were included if they described interventions for partners of prostate cancer patients, either solely for the partners or as a couple, intended to alleviate distress and enhance the partner’s or couple’s quality of life, and reported a measurable outcome for partners.

Results

A total of 11 prostate cancer-specific intervention studies that included partners and reported separate results for the partners were found. Only one of these interventions was partner specific, the other eight involved the patient-partner dyad. The studies identified primarily focussed on two areas: emotional distress and sexual intimacy, and mixed findings were reported for efficacy of interventions.

Conclusions

Despite strong evidence that partners of men with prostate cancer experience difficulties associated with the impact of prostate cancer, there is limited research that has investigated the efficacy of psychosocial interventions for partners. Of the reviewed studies, it is evident that interventions targeting the reduction of emotional distress, improved communication and sexual intimacy between the couple and utilisation of strategies that enable partners to express their distress, learn new strategies and implement behavioural change show the most promising results in enhancing partner well-being.

Implications for Cancer Survivors

Significant progress is required in developing and evaluating appropriate and effective psychosocial support interventions for partners of prostate cancer survivors as partners appear to have significant unmet needs in this area.     

Protocol paper: Multi-site,cluster-randomized clinical trial for optimizing functional outcomes of older cancer survivors after chemotherapy

BackgroundCancer survivors over the age of 65 have unique needs due to the higher prevalence of functional and cognitive impairment, comorbidities, geriatric syndromes, and greater need for social support after chemotherapy. In this study, we will evaluate whether a Geriatric Evaluation and Management-Survivorship (GEMS) intervention improves functional outcomes important to older cancer survivors following chemotherapy.MethodsA cluster-randomized trial will be conducted in approximately 30 community oncology practices affiliated with the University of Rochester Cancer Center (URCC) National Cancer Institute Community Oncology Research Program (NCORP) Research Base. Participating sites will be randomized to the GEMS intervention, which includes Advanced Practice Practitioner (APP)-directed geriatric evaluation and management (GEM), and Survivorship Health Education (SHE) that is combined with Exercise for Cancer Patients (EXCAP©®), or usual care. Cancer survivors will be recruited from community oncology practices (of participating oncology physicians and APPs) after the enrolled clinicians have consented and completed a baseline survey. We will enroll 780 cancer survivors aged 65 years and older who have completed curative-intent chemotherapy for a solid tumor malignancy within four weeks of study enrollment. Cancer survivors will be asked to choose one caregiver to also participate for a total up to 780 caregivers. The primary aim is to compare the effectiveness of GEMS for improving patient-reported physical function at six months. The secondary aim is to compare effectiveness of GEMS for improving patient-reported cognitive function at six months. Tertiary aims include comparing the effectiveness of GEMS for improving: 1) Patient-reported physical function at twelve months; 2) objectively assessed physical function at six and twelve months; and 3) patient-reported cognitive function at twelve months and objectively assessed cognitive function at six and twelve months. Exploratory health care aims include: 1) Survivor satisfaction with care, 2) APP communication with primary care physicians (PCPs), 3) completion of referral appointments, and 4) hospitalizations at six and twelve months. Exploratory caregiver aims include: 1) Caregiver distress; 2) caregiver quality of life; 3) caregiver burden; and 4) satisfaction with patient care at six and twelve months.DiscussionIf successful, GEMS would be an option for a standardized APP-led survivorship care intervention.Trial RegistrationClinicalTrials.gov NCT05006482, registered on August 9, 2021.     

Goal disturbance in early-stage breast cancer survivors

Purpose: Cancer-related goal disturbance can influence long-term outcomes in cancer patients and survivors; however, few studies have examined the factors that contribute to goal disturbance in early survivorship.

Design: The current study examined the relationships between demographic variables, cancer- and treatment-related factors, and behavioral and psychological symptoms (i.e., fatigue, pain, cognitive complaints, depressive symptoms, and anxiety) and goal disturbance in breast cancer survivors 1?year after treatment completion.

Methods: Women diagnosed with early-stage breast cancer (n?=?171) completed assessments following primary treatment (i.e., surgery, radiation, and chemotherapy) and again 6?months and 1?year later. We focused on the 1-year post-treatment assessment when participants were asked if they had experienced a cancer-related goal disturbance.

Findings: Approximately, 27% of women reported a cancer-related goal disturbance. Analyses indicated that both receipt of chemotherapy and behavioral and psychological symptoms—analyzed as a composite score and individually—were associated with a higher probability of reporting a goal disturbance.

Conclusions: Chemotherapy and behavioral and psychological symptoms were unique correlates of goal disturbance, suggesting that the impact of chemotherapy extends beyond its influence on persistent symptoms.

Implications: Elucidating factors that inhibit the pursuit of meaningful activities in early survivorship is critically important to understanding the long-term psychosocial impacts of cancer diagnosis and treatment.     

Self-efficacy mediates the relationship between behavioral processes of change and physical activity in older breast cancer survivors

Background

The degree to which breast cancer survivors use behavioral processes of change has not been investigated. Additionally, the relationship between behavioral processes and other theory-based mediators of adult physical activity behavior has not been extensively studied among breast cancer survivors. The objectives of this study were to: (1) determine the extent to which breast cancer survivors use behavioral processes associated with physical activity behavior change, and (2) examine the inter-relationships between behavioral processes, self-efficacy, and physical activity behavior among breast cancer survivors.

Methods

Sixty-nine breast cancer survivors completed surveys examining behavioral processes and exercise-specific self-efficacy. Six months later they completed a self-report physical activity questionnaire.

Results

Findings showed the majority of breast cancer survivors did not use approximately half of the behavioral processes on a regular basis, and self-efficacy completely mediated the relationship between behavioral processes and physical activity.

Conclusion

Health care professionals may help enhance self-efficacy and ultimately increase physical activity behavior in breast cancer survivors by teaching behavior skills such as enlisting social support.     

Quality of life and fatigue among colorectal cancer survivors according to stoma status - the national VICAN survey

Abstract

Objective: To assess colorectal cancer survivors' quality of life (QoL) and fatigue according to stoma status.

Methods: In this large-scale national survey, we examined and compared QoL (SF-12) and fatigue (QLQ-C30) of colorectal cancer survivors according to stoma status and against population norms. Of the 487 colorectal cancer survivors who participated in the VICAN survey, 43 had a reversed stoma. We randomly selected 43 survivors without stoma as a comparison group.

Findings: Colorectal cancer survivors had lower QoL scores compared to population norms. Fatigue affected survivors even two years after diagnosis. Participants with a reversed stoma scored lower on the physical QoL scale than participants without stoma.

Conclusion: QoL and fatigue are impaired during a considerable period after cancer diagnosis and differ according to stoma status.

Implications for psychosocial providers: Interventions aimed at improving QoL and fatigue for colorectal cancer survivors should be offered on a long-term basis, even two years after diagnosis.     

ProsCan for Men: Randomised controlled trial of a decision support intervention for men with localised prostate cancer

Background  

Prostate cancer is the most common male cancer in the Western world but is highly heterogeneous in disease progression and outcomes. Consequently, the most substantial morbidity may actually arise from the adverse psychosocial impact of distress in decision-making and long term quality of life effects such as impotence. This paper presents the design of a randomised controlled trial of a decision support/psychosocial intervention for men newly diagnosed with localised prostate cancer.     

Do men and their wives see it the same way? Congruence within couples during the first year of prostate cancer

Objective: The purpose of this study was to determine the psychosocial adjustment congruence within couples through the first year of prostate cancer experience, and to explore the personal variables that could predict congruence within couples. Method: Eighty‐one couples were interviewed at the time of diagnosis; 69 participated at 3 months and 61 at 12 months. Paired t‐tests were used to examine dyadic congruence on seven domains of psychosocial adjustment. Repeated Measures ANOVAs were used to examine the congruence over time. Multiple regressions were used to determine whether mood disturbance, urinary and sexual bother, sense of coherence, and social support were predictors of congruence within couples on each of the adjustment domains. Results: At time 1, couples had incongruent perceptions in 3 of 7 domains: health care, psychological, and social adjustment. Three months later, health care, psychological, and sexual domains showed incongruence within couples. One year after the diagnosis, there were incongruent perceptions only in sexual and psychological domains. There was little variation of the congruence within couples over time. Husbands and wives' mood disturbance, urinary and sexual bother, sense of coherence, and social support accounted for 25–63% of variance in couple congruence in the adjustment domains in the study periods. Conclusion: The findings suggested that there is couple congruence. Domains in which incongruence was observed are important targets for clinical interventions. Greater attention needs to be directed to assisting couples to recognize the differences between their perceptions, especially the ones related to the sexual symptoms and psychological distress. Copyright © 2010 John Wiley & Sons, Ltd.