Psycho‐Oncology最新文献

{"title":"An Explorative Study of the Unspoken Grieving Experiences of Bereaved Family Members-An Indian Perspective.","authors":"Dhayanandan Shanmugam, S G Raman, M Janarthinakani, Bhargavi Ilangovan, Shafika Banoo, Jegan Niwas K","doi":"10.1002/pon.70191","DOIUrl":"https://doi.org/10.1002/pon.70191","url":null,"abstract":"<p><strong>Background: </strong>A vast majority of advanced cancer care, including palliative and end-of-life care, is provided by the family members. Loss of loved ones leads to practical, emotional and psychological distress and thereby poor quality of life.</p><p><strong>Aim: </strong>The present study aims to explore the psycho social experiences of bereaved family members in the Indian context.</p><p><strong>Methods: </strong>In this prospective observational qualitative study, bereaved family members were (N = 42) interviewed using a semi-structured in-depth interview schedule, after obtaining consent. Interviews were digitally recorded, transcribed and translated by the researcher. Manual thematic analysis was used for analysing the data collected.</p><p><strong>Results: </strong>The thematic analysis of the transcripts revealed six key themes: Heightened distress, family expectations, emotional conflicts versus collusion, challenges during COVID pandemic, coping with self and others, and gratification from caregiving. Many family members maintained a positive outlook on the care they provided and shared effective coping strategies. However, most reported heightened distress due to the loss of their loved one and struggled with emotional expectations during the grieving process. Negative experiences with collusion and its consequences were also noted. The COVID-19 pandemic's impact, particularly in limiting access to support, was another significant challenge for many family members.</p><p><strong>Conclusion: </strong>caregiving during illness or loss presents significant challenges, including emotional strain, family issues, and external stressors like the COVID-19 pandemic. However, caregivers often find fulfilment and develop effective coping strategies to manage these difficulties. It is essential to address both the emotional and practical aspects of caregiving, particularly during crises, to support family members throughout their journey.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 6","pages":"e70191"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'As Important as Medication'. A Qualitative Investigation of the Beliefs, Barriers and Facilitators of Physical Activity for Women With Metastatic Breast Cancer.","authors":"Zainab Faatimah Haider, Rebecca J Beeken, Anam Ayaz-Shah, Kelly E Lloyd, Samuel George Smith","doi":"10.1002/pon.70193","DOIUrl":"10.1002/pon.70193","url":null,"abstract":"<p><strong>Background: </strong>Women with metastatic breast cancer (MBC) experience a range of physical and psychological challenges. Physical activity is safe and supports quality of life in individuals with MBC. However, most women with MBC are not meeting physical activity recommendations.</p><p><strong>Aims: </strong>To inform the development of an accessible and effective physical activity intervention, we investigated the beliefs, barriers and facilitators of physical activity of women with MBC.</p><p><strong>Methods: </strong>We conducted semi-structured telephone interviews with UK women living with MBC. Participants were asked open-ended questions about physical activity levels, beliefs, barriers, facilitators, support and preferences. Reflexive thematic analysis was used to analyse the transcripts and themes were mapped onto the Theoretical Domains Framework.</p><p><strong>Results: </strong>23 women with MBC (mean age = 53.7 years; White British = 69.7%) were interviewed between May 2022 and October 2024. Average time since diagnosis was 6 years, 1 month. Most had bone metastases (68.8%). Our analysis generated five themes. Participants generally believed physical activity was important (1) but were limited by physical symptoms (2) and psychological barriers (3). Most women noted a significant lack of physical activity support from healthcare providers (4). They discussed how physical activity could be more accessible for their diverse needs (5), including increasing provision of tailored support.</p><p><strong>Conclusions: </strong>Improvements in physical activity support for women with MBC are needed. Our findings provide several implications for future interventions. This includes implementing physical activity recommendations, improving knowledge about risks and benefits, and incorporating psycho-social and tailored support which consider the unique needs of the MBC population.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 6","pages":"e70193"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Mobile Application for Gynecological Cancer Patients on Their Physical and Psychosocial Adaptation: A Randomized Controlled Trial.","authors":"Okan Vardar, Pınar Serçekuş","doi":"10.1002/pon.70194","DOIUrl":"10.1002/pon.70194","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the effect of a mobile application developed for gynecological cancer patients on their physical and psychosocial adaptation.</p><p><strong>Methods: </strong>This is a parallel groups, single blind, randomized, controlled study. The patients included in the study were contacted through social media sites of an association with a high number of members and followers. Block randomization was used and 32 patients were assigned to an intervention group and 32 into a control group. The intervention group used the mobile application and the control group received routine care. Data were gathered with a descriptive characteristics form, The M.D. Anderson Symptom Inventory, The Adaptation to Chronic Illness Scale, The Hospital Anxiety and Depression Scale, The Assessment of Survivor Concerns, The Eastern Cooperative Oncology Group Performance Status. The intervention lasted 8 weeks and a total of three follow-ups were performed: one follow-up before the intervention and two follow-ups after the intervention.</p><p><strong>Results: </strong>Symptom severity, anxiety risk and cancer-related worry decreased and physical, social and psychological adaptation increased in the intervention group compared to the control group.</p><p><strong>Conclusions: </strong>The mobile application developed for gynecological cancer patients can reduce symptom severity, anxiety risk and cancer-related worry and improves physical, social and psychological adaptation. It can be recommended that mobile applications with reliable content should be utilized to enhance physical and psychosocial adaptation of gynecological cancer patients receiving chemotherapy in addition to healthcare.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 6","pages":"e70194"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeon Perspectives on Addressing Mental Health Among Total Laryngectomy Patients.","authors":"Carlos X Castellanos, Matthew E Lin, Tyler J Gallagher, Mark S Swanson, Daniel I Kwon","doi":"10.1002/pon.70162","DOIUrl":"https://doi.org/10.1002/pon.70162","url":null,"abstract":"<p><strong>Objective: </strong>Head and neck cancer patients, particularly those undergoing total laryngectomy, exhibit high rates of depression and suicide, even compared to other cancer patients. Thus, this study seeks to understand head and neck surgeons' perceived roles in and treatment patterns regarding mental health sequelae among total laryngectomy patients.</p><p><strong>Methods: </strong>An anonymous survey regarding provider perspectives about the mental health experiences of total laryngectomy patients was designed and distributed via email to American Head and Neck Society members and academic otolaryngology head and neck surgery departments. Descriptive statistics were utilized to describe results.</p><p><strong>Results: </strong>Respondents (n = 63) reported frequently seeing mental health issues among total laryngectomy patients (on average, 48% of patients) and believed otolaryngologists should frequently screen for these conditions (85%). However, a significant subset of the sample (39%) reported feeling uncomfortable addressing mental health issues and cited factors such as lack of expertise (73%) or lack of resources to address mental health (73%). Overall, most respondents agreed that this population could receive better mental healthcare (88%). Referral to speech-language pathologists (80%), community-based support groups (54%), and referral to a mental health provider (n = 35, 54%) were frequently recommended post-operative prophylactic measures.</p><p><strong>Conclusion: </strong>This national cross-sectional survey of head and neck surgeons demonstrated that while physicians acknowledge and appreciate the need for mental health services among laryngectomy patients, a significant minority feel unprepared to address mental health due to a lack of training and resources. Additional research is needed to identify methods to effectively address this gap in care for laryngectomy patients.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70162"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Findings From a Survey Measuring Informational Needs and Quality of Life of Women Living With Metastatic Breast Cancer.","authors":"Rachel Starkings, Lesley Fallowfield, Stephanie Russ, Valerie Jenkins","doi":"10.1002/pon.70177","DOIUrl":"https://doi.org/10.1002/pon.70177","url":null,"abstract":"<p><strong>Background: </strong>People living with metastatic breast cancer (MBC) may have different support requirements to those with early stage breast cancer (EBC). These differences can be substantial, particularly as care pathways and information are often designed around the latter. There is limited understanding of how these discrepancies impact patients with MBC.</p><p><strong>Aims: </strong>In the LIMBER study (Living with Metastatic Breast Cancer), we explored the distinct and unmet needs of people living with MBC.</p><p><strong>Methods: </strong>In collaboration with people living with MBC and healthcare professionals (HCPs), we developed an online survey comprising fixed and free text responses. Fixed responses and overall study demographics from the main LIMBER study have been published elsewhere. A framework analysis of the free text comments is reported here.</p><p><strong>Results: </strong>The resulting thematic map has seven main themes - friends and family, reactions of others, healthcare professionals, systems & processes, knowledge & information, outlook & goals and wellbeing. Participants reflected that comments made by friends and family were often well-meaning but showed misunderstanding of the disease. This was particularly noticeable in understanding the difference between MBC and EBC. There were references to the lack of support and information from HCPs.</p><p><strong>Conclusions: </strong>The analysis of free text comments from this survey demonstrates the impact that MBC can have, particularly without robust support or accessible information. Understanding areas where patients have outstanding needs provides insight into how best to promote coping strategies and improved quality of life, while informing those who provide informal and formal care.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70177"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-Creating and Refining a Values Assessment Tool (VAsT) for Women With Metastatic Breast Cancer.","authors":"Lorinda A Coombs, Victoria Crowder, Madison Black, Kelly Tan, Emily M Ray, Renée M Ferrari, Erin E Kent, Daniel S Reuland, Ashley Leak Bryant","doi":"10.1002/pon.70173","DOIUrl":"https://doi.org/10.1002/pon.70173","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with metastatic breast cancer (mBC) and their families often have differing perspectives on treatment goals. This highlights the need for systematically eliciting patients' and care partners' values to ensure values-aligned treatment decisions. This study aimed to inform the development of a values assessment tool to facilitate communication of priorities and preferences with oncology clinicians.</p><p><strong>Methods: </strong>Two rounds of semi-structured interviews were conducted with women with mBC from the Southeastern and Northeastern U.S. Recruitment included at least 50% of participants identifying as African American/Black, Latinx, Asian, American Indian, or Native American.</p><p><strong>Results: </strong>The initial round of 13 interviews yielded eight candidate domains. After confirmatory interviews with additional participants, the researchers identified nine final domains relevant to treatment decisions for mBC: desire not to appear sick; desire to help other women with breast cancer by participating in clinical research; financial concerns; living to care for a loved one; maintaining sexuality; maintaining quality of life; maximizing time away from medical appointments; minimizing and managing side effects; and slowing disease progression with an effective treatment.</p><p><strong>Conclusion: </strong>Eliciting treatment decision values across multiple domains and effectively communicating them with clinicians is a crucial aspect of patient-centered care to align values with care goals. To help patients identify and express their values to clinicians, we are developing a values assessment tool specifically for mBC. Future research will pilot this tool to assess its impact on communication between clinicians and patients and health outcomes for women with mBC.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70173"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Cancer Specialist Nursing Program: A Social Return on Investment Analysis Value for Money of the Prostate Cancer Specialist Nursing Program.","authors":"Kim Edmunds, Yufan Wang, Sally Sara, Bernie Riley, Nicole Heneka, Haitham Tuffaha","doi":"10.1002/pon.70181","DOIUrl":"10.1002/pon.70181","url":null,"abstract":"<p><strong>Background: </strong>In Australia, Prostate cancer (PCa) has a high survival rate (96%) meaning men with PCa may live with the impact of the disease for many years, even decades. The Prostate Cancer Foundation of Australia (PCFA) manages two Prostate Cancer Specialist Nursing (PCSN) programs: (1) A health service-based program and (2) A telenursing service. There is a paucity of economic evidence regarding the benefits of these programs so Social Return on Investment (SROI) methodology was used to determine social value and return on investment.</p><p><strong>Methods: </strong>A SROI economic evaluation model was developed in consultation with the PCSN team augmented with published evidence to identify the costs and outcomes, and estimate the benefits associated with the delivery of the PCSN program over 2 years. Attribution, dead weight loss and discounting were calculated and sensitivity analyses were conducted to test the rigour of the model.</p><p><strong>Results: </strong>The value generated by the PCSN programs over the 2-year period resulted in a SROI ratio of 1:1.62 for the health service-based PCSN program, indicating that for every dollar invested, a return of AUD $1.62 was obtained. The SROI ratios for the Telenursing program and the combined programs were 1:2.34 and 1:1.65, respectively.</p><p><strong>Conclusion: </strong>Our study provides evidence that further expansion of the PCSN program is likely to have a positive return on investment and benefit the 250,000 men currently living with PCa in Australia. Findings such as these are important in informing cancer care policy and funding decisions.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70181"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professional Grief in Cancer Care-A Scoping Review.","authors":"Svenja Wandke, Hannah Führes, Mareike Rutenkröger, Klaus Lang, Martin Härter, Karin Oechsle, Isabelle Scholl","doi":"10.1002/pon.70156","DOIUrl":"10.1002/pon.70156","url":null,"abstract":"<p><strong>Objective: </strong>Healthcare professionals (HCPs) in cancer care often face patient deaths, yet there is a notable absence of comprehensive evidence regarding their grief. This scoping review seeks to identify key aspects of professional grief in cancer care and give an overview pertaining its' conceptualization and frequency and intensity.</p><p><strong>Methods: </strong>The primary search covered three databases (MEDLINE, PSYNDEX, and PsycINFO). Two independent reviewers assessed 2248 records, selecting 34 eligible articles.</p><p><strong>Results: </strong>Most studies originated from North America and Israel, with limited evidence from the global south, East Asia and Europe, as well as few quantitative studies. HCPs exhibit classic grief symptoms (such as sadness) and distinct features (e.g., feelings of guilt) in response to patient deaths, though a clear definition and measures of professional grief are lacking. Grief frequency varies highly (from 23% to 100%).</p><p><strong>Conclusions: </strong>Future research should refine definitions and measures to better support HCPs in effectively managing professional grief in cancer care.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70156"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordance of Cancer Screening Attendance Among Spouse Couples: A Cross-Sectional Survey of the Tohoku Medical Megabank Project.","authors":"Naoki Nakaya, Kumi Nakaya, Toshimasa Sone, Mana Kogure, Rieko Hatanaka, Ippei Chiba, Sayuri Tokioka, Masato Takase, Yoko Izumi, Nobuo Fuse, Atsushi Hozawa","doi":"10.1002/pon.70158","DOIUrl":"https://doi.org/10.1002/pon.70158","url":null,"abstract":"<p><strong>Objectives: </strong>Owing to spousal pairs often exhibiting similar health behaviors, this study examined the concordance of cancer screening attendance between spouses using cross-sectional data from a large biobank study in Japan, which included 2022 spousal pairs.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Self-administered data were collected to determine whether participants had undergone screening for colorectal, gastric, and lung cancers in the past year. The following two analyses were conducted: the exposure was whether the husband attended cancer screening, and the outcome was whether the wife attended; the exposure was whether the wife attended, and the outcome was whether the husband attended. Multiple logistic regression analyses were performed, adjusting for confounding factors in the exposed individuals.</p><p><strong>Results: </strong>The multivariate odds ratio (95% confidence interval, p-value) for wives attending colorectal cancer screening when their husbands had attended was 2.7 (2.2-3.3, p < 0.0001), indicating a significant positive association. Similarly, when wives were the exposure and husbands were the outcomes, the odds ratio was 2.6 (2.2-3.2, p < 0.0001). Notably, these associations were consistent across colorectal, gastric, and lung cancer screenings.</p><p><strong>Conclusions: </strong>The findings of this study support the hypothesis that the attendance of one spouse at cancer screening significantly positively influences that of the other spouse, regardless of the type of cancer screening or the age of the spouses. Novel intervention strategies can be developed that specifically target spousal pairs and potentially enhance the effectiveness of cancer prevention initiatives compared to those targeting individuals alone.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70158"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Barriers to Inclusivity: Systematic Analysis of Exclusion Criteria and Potential Bias in Clinical Cancer Trials for Psychiatric and Neurological Conditions in European Protocols.","authors":"Margherita Dahò, Veronica Coppini, Maria Vittoria Ferrari, Giulia Ferraris, Virginia Sanchini, Dario Monzani, Roberto Grasso, Chiara Agnello, Giuseppe Badalamenti, Laura Algeri, Gabriella Pravettoni","doi":"10.1002/pon.70182","DOIUrl":"https://doi.org/10.1002/pon.70182","url":null,"abstract":"<p><strong>Background: </strong>Cancer clinical trials often employ exclusion criteria that can impact vulnerable populations, particularly individuals with psychological, psychiatric, or neurological conditions.</p><p><strong>Aims: </strong>This study aimed to analyze the prevalence and nature of exclusion criteria in clinical trials for prostate, breast, and lung cancers.</p><p><strong>Methods: </strong>The EU Clinical Trials Register identified 51 protocols uploaded between 2022 and 2024. Thematic content analysis categorized exclusion criteria, and the justifications provided, while frequency analysis quantified their prevalence.</p><p><strong>Results: </strong>After excluding five protocols (two non-English and three inaccessible), the final dataset comprised 46 protocols: 13 for prostate cancer (22.8%), 24 for breast cancer (42.1%), and 9 for lung cancer (15.8%). Exclusion criteria targeting vulnerable populations were present in 78.3% of protocols, categorized into five themes: psychiatric conditions (24.6%), neurological conditions (22.8%), other psychological conditions (22.8%), legal/guardianship status (5.3%), and unspecified conditions (24.6%). Compliance concerns (39.1%) were the most common justification, followed by informed consent challenges (32.6%), safety risks (13%), drug interference (10.9%), and not in the best interest (4.3%). Notably, 29.1% of protocols lacked justification for exclusions, raising ethical and transparency concerns.</p><p><strong>Conclusions: </strong>The exclusion of vulnerable populations may limit the inclusivity and generalizability of cancer research. Heuristic biases and systemic practices can potentially influence this. Exploring the role of these factors and considering adaptive trial designs, along with providing detailed justifications for exclusion criteria, could support more equitable and representative clinical research.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70182"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}