Objective
This study assesses the effectiveness of face‐to‐face group positive psychotherapy for cancer survivors (PPC) compared to its online adaptation, online group positive psychotherapy for ...cancer survivors (OPPC), which is held via videoconference. A two‐arm, pragmatic randomized controlled trial was conducted to examine the effects of both interventions on emotional distress, post‐traumatic stress symptoms (PTSS), and post‐traumatic growth (PTG) among cancer survivors and analyze attrition to treatment.
Methods
Adult women with a range of cancer diagnoses were invited to participate if they experienced emotional distress at the end of their primary oncological treatment. Emotional distress, PTSS, and PTG were assessed at baseline, immediately after treatment, and 3 months after treatment. Intention‐to‐treat analyses were carried out using general linear mixed models to test the effect of the interventions overtime. Logistic regressions were performed to test differential adherence to treatment and retention to follow‐up.
Results
A total of 269 individuals participated. The observed treatment effect was significant in both modalities, PPC and OPPC. Emotional distress (b = −2.24, 95% confidence interval CI = −3.15 to −1.33) and PTSS (b = −3.25, 95% CI = −4.97 to −1.53) decreased significantly over time, and PTG (b = 3.08, 95% CI = 0.38‐5.78) increased significantly. Treatment gains were sustained across outcomes and over time. Analyses revealed no significant differences between modalities of treatment, after adjusting for baseline differences, finding that OPPC is as effective and engaging as PPC.
Conclusions
The OPPC treatment was found to be effective and engaging for female cancer early survivors. These results open the door for psycho‐oncology interventions via videoconference, which are likely to lead to greater accessibility and availability of psychotherapy.
Post-traumatic stress and growth are common responses to adverse life events such as cancer. In this article, we establish how cancer becomes a "fertile land" for the emergence of stress and growth ...responses and analyze the main mechanisms involved. Stress-growth responses on adjusting to cancer is potentially determined by factors like the phase of the illness (e.g., initial phases vs. period of survivorship), patient's coping strategies, meaning-making, and relationships with significant others. We also review the mechanisms of constructive and adaptative stress-growth balances in cancer to study the predictors, interrelated associations, triggering mechanisms, long-term results, and specific trajectories of these two responses to cancer. Finally, we update the evidence on the role of these stress-growth associations in psychologically adjusting to cancer. Together with this evidence, we summarize preliminary results regarding the efficacy of psychotherapeutic interventions that aim to facilitate a constructive psychological balance between stress and growth in cancer patients. Recommendations for future research and gaps in knowledge on stress-growth processes in this illness are also highlighted. Researchers are encouraged to design and use psychotherapeutic interventions according to the dynamic and changeable patients' sources of stress and growth along the illness. Relevant insights are proposed to understand the inconsistency of stress-growth literature and to promote psychotherapeutic interventions to facilitate a constructive balance between these key responses in cancer.
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.
Objective
To study the impact of the spontaneous use of Internet on breast cancer patients and on their relationship with health professionals.
Methods
A mixed methodology was used. Two ...questionnaires were designed through three focus groups, and then administered to 186 patients and 59 professionals in order to assess: (1) patients’ use of Internet for health-related information and (2) the impact of this information on patients’ psychological outcomes and on their relationship with professionals.
Results
Patients spent more time looking for illness-related information after diagnosis, using interactive communities more than static information websites. Patients and professionals disagreed about the use of Internet in terms of the knowledge it provides, and its psychological impact. The main barrier reported by patients regarding the sharing of online information with their professionals was the belief that it would damage their relationship.
Conclusions
Both professionals and patients have a protectionist conception of the therapeutic relationship. This attitude tends to dismiss the positive impact that the use of Internet and the new communication tools may have in cancer patients. New resources should provide an “Internet Prescription” and modes of interaction to facilitate a more open digital communication.
Objectives
Online resources are changing patient‐professional relationship and care delivery by empowering patients to engage in decisions in order to cope with their illness and modify behaviors. ...This review analyses the psychological factors associated with spontaneous and health professional–guided internet use in cancer patients.
Methods
Searches were performed in the PubMed (MEDLINE), PsycINFO, and Scopus databases. Studies were included if they involved cancer patients or focused on the relationship between cancer patients and health professionals, describing either patients' spontaneous use of interne or a guided‐structured eHealth psychosocial intervention.
Results
Seventy‐seven scientific papers were finally included. Results described emotional and behavioral outcomes in cancer patients who accessed online information. Internet has long been used spontaneously not only as a source of medical information or symptom management but also for decision making or emotional and social support. Health professionals can guide internet use, providing specific web‐based recommendations and developing intervention programs to better meet patients' needs, such as educational or information programs.
Conclusion
Online access is a complementary form of care that physicians can provide. Patients benefit from online resources, especially when both they and their health professionals increase their engagement with online interventions such as integrated systems or online communities.
Over the last decades, Positive Psychology (PP) has promoted the scientific study of positive life changes in the aftermath of cancer. These have been integrated within negative life changes, based ...on the same human experience framework. Innovative interventions have been designed, prioritizing the pathways to the reduction of emotional distress and psychopathology in cancer, through the facilitation of positive psychological functioning. These interventions have achieved promising results. A theoretical and integrative review of the PP-related constructs was performed in the relevant databases (PsycINFO, PubMed, Web of Science, Scopus, etc.). These constructs have been linked to positive life changes after cancer and their therapeutic potential. Finally, we provide a summary of a positive psychotherapy program for cancer survivors, indicating the therapeutic strategies that facilitate positive life changes in the aftermath of cancer. Positive life changes after suffering cancer are more the norm than the exception. These changes play an important role in psychosocial adjustment, adherence to cancer treatments, well-being and quality of life. Psychological treatment programs based on PP achieve promising results with cancer. These programs are capable of complementing and improving the outcomes achieved by traditional stress-management programs.
IntroductionPsychosocial interventions for patients with breast cancer (BC) have demonstrated their effectiveness at reducing emotional distress and improving quality of life. The current ...digitisation of screening, monitoring and psychosocial treatment presents the opportunity for a revolution that could improve the quality of care and reduce its economic burden. The objectives of this study are, first, to assess the effectiveness of an e-health platform with integrated and stepped psychosocial services compared with usual psychosocial care, and second, to examine its cost–utility.Methods and analysisThis study is a multicentre randomised controlled trial with two parallel groups: E-health intervention with integrated and stepped psychosocial services vs usual psychosocial care. An estimated sample of 338 patients with BC in the acute survival phase will be recruited from three university hospitals in Catalonia (Spain) and will be randomly assigned to one of two groups. All participants will be evaluated at the beginning of the study (T1: recruitment), 3 months from T1 (T2), 6 months from T1 (T3) and 12 months from T1 (T4). Primary outcome measures will include number of clinical cases detected, waiting time from detection to psychosocial intervention and proportion of cases successfully treated in the different steps of the intervention, as well as outcomes related to emotional distress, quality of life, post-traumatic stress and growth, treatment adherence and therapeutic alliance. Secondary outcomes will include the acceptability of the platform, patients’ satisfaction and usability. For the cost–utility analysis, we will assess quality-adjusted life years and costs related to healthcare utilisation, medication use and adherence, work absenteeism and infrastructure-related and transport-related costs.Ethics and disseminationThis study was approved by the Ethics committee of the Institut Català d’Oncologia network in Hospitalet, Spain. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences among the scientific community, workshops with patients and media press releases.Trial registration numberOnline Psychosocial Cancer Screening, Monitoring and Stepped Treatment in Cancer Survivors (ICOnnectat-B),NCT04372459.
Objective
The objective of this study is to describe major findings on posttraumatic growth (PTG) in cancer, by analyzing its various definitions, assessment tools, and examining its main ...psychological and clinical correlates.
Methods
A search in relevant databases (PsycINFO, Pubmed, ProQuest, Scopus, and Web of Science) was performed using descriptors related to the positive reactions in cancer. Articles were screened by title, , and full text.
Results
Seventy‐two met the inclusion criteria. Most articles (46%) focused on breast cancer, used the PTG inventory (76%), and had a cross‐sectional design (68%). The PTG resulted inversely associated with depressive and anxious symptoms and directly related to hope, optimism, spirituality, and meaning. Illness‐related variables have been poorly investigated compared to psychological ones. Articles found no relationship between cancer site, cancer surgery, cancer recurrence, and PTG. Some correlations emerged with the elapsed time since diagnosis, type of oncological treatment received, and cancer stage. Only few studies differentiated illness‐related–life‐threatening stressors from other forms of trauma, and the potentially different mechanisms connected with PTG outcome in cancer patients.
Conclusions
The evaluation of PTG in cancer patients is worthy, because it may promote a better adaption to the illness. However, many investigations do not explicitly refer to the medical nature of the trauma, and they may have not completely captured the full spectrum of positive reactions in cancer patients. Future research should better investigate issues such as health attitudes; the risks of future recurrences; and the type, quality, and efficacy of medical treatments received and their influence on PTG in cancer patients.
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.
Introducción: La atención psicosocial de las personas con enfermedad oncológica y la familia debe formar parte de todo modelo integral de atención que pretenda reducir el impacto vital del cáncer. ...Las intervenciones psicosociales han probado su eficacia en la ayuda a pacientes y familiares para afrontar las situaciones de alta complejidad psicosocial emergentes a consecuencia de un diagnóstico de cáncer. Objetivo: Definir y explicar el modelo de Atención Psicosocial del Comité Psicosocial del Instituto Catalán de Oncología (ICO) utilizando criterios de vulnerabilidad, complejidad y derivación; enmarcado y basado en los valores del ICO (centrados en las necesidades de pacientes con cáncer y sus familias). Método: El modelo que se presenta en este documento consta de cinco pilares: 1) Principios de la Práctica Psicosocial en Oncología; 2) Áreas de actuación en la Atención Psicosocial del paciente con cáncer y la familia; 3) Cribado de malestar emocional y derivación del paciente con cáncer y la familia para una atención psicooncológica específica; 4) Comité Psicosocial: (objetivos; funciones; organización; composición; disciplinas participantes; criterios de derivación y niveles de complejidad; y procedimiento); y 5) Índice de productividad. Resultados: Pacientes y familiares atendidos por el CPS mostraron mejoría estadísticamente significativa en los niveles del malestar emocional, pasando de una media inicial de 8,12/10 (EVA/ ENV) a una media 6,27/10 (EVA/ENV). Asimismo, se constata que las intervenciones derivadas del comité psicosocial redujeron el porcentaje de casos iniciales de alta complejidad, pasando de un 69,3% a un 49,3%. Conclusiones: El abordaje de la complejidad psicosocial mediante un modelo basado en criterios multi e interdisciplinarios consensuados ayuda en la toma de decisiones sobre las acciones a seguir y en la mejora del malestar emocional y complejidad de los pacientes y la familia.
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