Psycho‐Oncology最新文献

{"title":"Psychological Screening and Support for Patients Enrolled in Early-Phase Cancer Clinical Trials and the Possible Barriers: A Real-World Tertiary Center Implementation Study.","authors":"Matthew D Robinson, Ruiyang Yan, Amy Smith, Harriet Morley, Louise Carter, Donna Graham, Matt Krebs, Fiona Thistlethwaite, Natalie Cook","doi":"10.1002/pon.70446","DOIUrl":"10.1002/pon.70446","url":null,"abstract":"<p><strong>Introduction: </strong>One in three patients with cancer suffers from clinically significant depression and/or anxiety. Early-phase cancer clinical trials (EPCCTs) frequently include patients with advanced disease with limited treatment options. However, screening for psychological symptoms is not routinely performed in this setting. Here, we describe a mixed-methods implementation study exploring the feasibility of improving access to psychological screening in EPCCTs and assessing how electronic patient-reported outcome measures (ePROMs) can be utilized to identify those requiring intervention.</p><p><strong>Methods: </strong>Perceived benefits and challenges associated with psychological screening in EPCCTs were explored from the clinician, psycho-oncology team, and patient and carer's perspectives, via clinician surveys and a patient and carer focus group. A standard workflow was created to enable routine psychological screening, alongside a stepped-care model for providing support. An ePROM, consisting of PHQ-2 and GAD-7 questionnaires, was distributed to patients enrolling on EPCCTs.</p><p><strong>Results: </strong>Of the 17 clinicians who responded, 88% felt that routine psychological assessments were important, and 100% were willing to complete assessments with patients. Perceived barriers were identified relating to 4 main themes: resources, support services, training and staff misconceptions. Invitations to ePROMs were sent to 92 patients over 12 months and 59 (64.1%) have responded at baseline; of these, 13 (22.0%) patients have received intervention based on PHQ-2/GAD-7 score. Initial challenges associated with ePROM completion related to technological difficulties, missed notifications and form expiration.</p><p><strong>Conclusion: </strong>Our findings suggest that routine psychological assessments in EPCCTs may help identify previously undiagnosed psychological burden in patients, and facilitate their access to appropriate, timely support. This implementation study indicates this approach can be feasibly delivered through the use of ePROMs.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70446"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623618","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":"Motivation to Participate in a Nutrition and Physical Activity Intervention During Chemotherapy for Breast Cancer: A Qualitative Study.","authors":"Leah S Puklin, Maura Harrigan, Courtney McGowan, Leah M Ferrucci, Brenda Cartmel, Michelle Zupa, Maryann Deyling, Tara Sanft, Mona Sharifi, Melinda L Irwin","doi":"10.1002/pon.70472","DOIUrl":"https://doi.org/10.1002/pon.70472","url":null,"abstract":"<p><strong>Objective: </strong>To explore the motivations for participating in a combined nutrition and exercise intervention starting during chemotherapy for breast cancer.</p><p><strong>Methods: </strong>The Lifestyle, Exercise, and Nutrition early after Diagnosis (LEANer) trial randomized 173 women newly diagnosed with stage I-III breast cancer to a yearlong nutrition and exercise intervention (N = 87) or usual care (N = 86) during chemotherapy to assess the effect on chemotherapy adherence. Upon completion of the trial, using a stratified purposeful sampling method, a subset of women randomized to the intervention arm completed a one-time, individual, semi-structured interview. Interviews were transcribed verbatim and analyzed using thematic analysis.</p><p><strong>Results: </strong>Among the 29 interviews, we identified four key themes related to women's motivations for participating in a lifestyle intervention during chemotherapy. These included (1) Proactivity - a pursuit of opportunities to improve and prioritize health; (2) Altruism - a desire to help others with breast cancer and advance the science around lifestyle factors and treatment outcomes; (3) Lack of perceived harm - the benefits outweighed risks; and (4) Oncologist recommendation - an endorsement from their clinical provider played a critical role.</p><p><strong>Conclusions: </strong>Women with breast cancer were motivated to participate in a nutrition and exercise intervention initiated during chemotherapy because of factors relating to optimizing their own health, altruistic desires, perceived lack of harm, and their oncologist's recommendation. Compared to post-treatment, the opportunity to be proactive and having an oncologist recommendation emerged as unique motivators. Understanding these drivers of motivation can enhance recruitment and promote engagement and adherence in future interventions during active cancer treatment.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70472"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779362","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":"Trajectory Analysis of Family Resilience and Family Vulnerability in Lung Cancer Surgery Patients: A Longitudinal Qualitative Study.","authors":"Jie Zhu, Xu-Ting Li, Shu-Rui Gao, Hui Yan, Man Ye","doi":"10.1002/pon.70459","DOIUrl":"https://doi.org/10.1002/pon.70459","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis and surgery of lung cancer may cause greater role changes and more volatile adaptive process in the family.</p><p><strong>Aims: </strong>To analyze the overall trajectory and characteristics at various periods in family resilience and vulnerability among lung cancer surgery patients.</p><p><strong>Methods: </strong>Twenty-four lung cancer surgery patients from a tertiary A hospital in Hunan Province were selected using the purposive sampling method. Semi-structured, in-depth interviews were conducted at five time points: admission (T0), 2 weeks after surgery (T1), 3 months after surgery (T2), 6 months after surgery (T3), and 1 year after surgery (T4). Nvivo12.0 was utilized to store and analyze the data.</p><p><strong>Results: </strong>Family resilience and vulnerability of lung cancer surgery patients exhibited a trajectory of initial decline followed by stabilization, which can be divided into three periods: shock and initial coping period (T0), adjustment and adaption period (T1-T2), and stabilization period (T3-T4). For each period, family resilience and vulnerability showed different traits.</p><p><strong>Conclusion: </strong>This study confirms that family resilience in lung cancer patients is an evolving and dynamic process with characteristics at different periods. Medical staff should focus on both the trends and characteristics of family resilience and vulnerability and provide targeted support.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70459"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779391","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":"Identifying Longitudinal Trajectories of Quality of Life and Associated Risk and Protective Factors Among Cancer Patients.","authors":"Jiwon Kim, Karen Llave, Maja Kuharic, Nicola Lancki, Kathryn Jackson, Kimberly A Webster, David Cella","doi":"10.1002/pon.70453","DOIUrl":"10.1002/pon.70453","url":null,"abstract":"<p><strong>Objective: </strong>The 7-item Functional Assessment of Cancer Therapy-General (FACT-G7) is a validated, brief measure of health-related quality of life (QoL) used in oncology settings. While many conceptualize QoL as a static trial endpoint, growing evidence underscores its dynamic nature over time to inform point-of-care interventions. Grounded in the Wilson and Cleary model, this study aims to (1) identify distinct trajectories of QoL over a 12-month period using FACT-G7, and (2) incorporate clinical, mental health, sociodemographic, and healthcare system related factors to uncover risk and protective factors that shape patients' QoL trajectories.</p><p><strong>Methods: </strong>Using FACT-G7 scores over a 12-month period from a sample of 4104 cancer patients (aged 19-92, M = 60.50, SD = 12.95) receiving cancer treatment, growth mixture modeling was fitted to identify subgroups of QoL trajectories. Multinomial logistic regression was conducted to examine the predictors of class membership.</p><p><strong>Results: </strong>Results revealed a three-class model provided optimal fit: high QoL (40.1%), average QoL (40.3%), and low QoL (19.6%). Psychosocial factors - particularly loneliness (OR = 1.70, 95% CI:1.35-2.13) and financial difficulties (OR = 1.47, 95% CI:1.27-1.71) - strongly predicted membership in the low QoL trajectory. Clinical factors, including comorbidities (Charlson Comorbidity Index; CCI) and symptom burden severity (PRO-CTCAE), were associated with poorer QoL trajectories, with insomnia and nausea demonstrating the strongest negative effects. Conversely, higher satisfaction with cancer care and cancer-related self-efficacy were protective factors associated with higher QoL trajectories.</p><p><strong>Conclusions: </strong>The findings identify modifiable risk and protective factors that can inform targeted early interventions to improve long-term QoL outcomes across the cancer care continuum.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70453"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623563","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":"Labels, Language and Other Strategies to Improve Communication About Lowest Grade Ductal Carcinoma in Situ: Qualitative Interviews With Women and Physicians.","authors":"Suzanna Apostolovski, Nicole J Look Hong, Frances C Wright, Anna R Gagliardi","doi":"10.1002/pon.70442","DOIUrl":"10.1002/pon.70442","url":null,"abstract":"<p><strong>Objective: </strong>Women diagnosed with ductal carcinoma in situ (DCIS) and clinicians have reported challenges in communication about DCIS, contributing to women's confusion and anxiety. This study explored how to improve communication about DCIS including alternative labels, language and other strategies.</p><p><strong>Methods: </strong>We interviewed women from July 2024-January 2025 who had DCIS and clinicians from across Canada, and analyzed themes using Communication Accommodation Theory.</p><p><strong>Results: </strong>Participants included 12 women (67% aged 45 to 65, 58% non-White) and 16 clinicians of diverse specialties (87% women, 63% mid career). Women and clinicians held divergent views about an alternative label for DCIS. Women preferred \"abnormal cells\" over \"DCIS\" to avoid the word cancer. Clinicians preferred precursor labels (e.g., stage 0 cancer, pre-cancer) over abnormal cells and felt confident explaining DCIS using precursor labels, which triggered women's concern. Women and clinicians held convergent views on how to improve communication about DCIS including language (use lay language rather than technical jargon, explicitly distinguishing DCIS from invasive breast cancer, address the risk of spread beyond the breast ducts and mortality) and other strategies (take time to educate women, using visual aids, providing take-home information, tailoring pathology reports to patients).</p><p><strong>Conclusions: </strong>This study adds to prior research that identified challenges to communication about DCIS but did not fully examine how to improve communication. Several implications emerged for policy (consider formal label change) and practice (share communication aids or other tools with clinicians and patients). Future research should develop and evaluate the impact of these approaches.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70442"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581625","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":"Exercise Interventions for Improving Sleep Quality in Patients With Cancer: A Systematic Review and Network Meta-Analysis.","authors":"Liang Li, Zhengxin Hui, Yinping Zhang, Xing Wang, Tonggang Fan","doi":"10.1002/pon.70466","DOIUrl":"https://doi.org/10.1002/pon.70466","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the effects of different exercise interventions on sleep quality improvement in patients with cancer and compare the relative effectiveness of various exercise programs using a network meta-analysis, providing evidence-based guidance for developing personalized exercise intervention strategies in clinical practice.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and other databases for randomized controlled trials on exercise interventions for sleep quality in patients with cancer, published from database inception to September 2025. Two researchers independently performed literature screening, data extraction, and Cochrane risk-of-bias assessment. Network meta-analysis was performed with Stata 18.0 software, and the relative effectiveness of exercise interventions was ranked using surface under the cumulative ranking curve values.</p><p><strong>Results: </strong>Forty-five randomized controlled trials covering nine exercise interventions were included. Network meta-analysis revealed statistically significant differences in sleep quality improvement among progressive muscle relaxation exercise, aerobic exercise, and walking (p < 0.05). Surface under the cumulative ranking curve rankings were as follows: progressive muscle relaxation exercise (98.6%) > aerobic exercise (70.7%) > walking (68%) > tai chi qigong (53%) > dance (51.2%) > yoga (48.7%) > combination exercise (41.1%) > resistance exercise (30.2%) > high-intensity interval training (25.3%) > control group (13.1%).</p><p><strong>Conclusions: </strong>Progressive muscle relaxation exercises are the preferred recommendation for sleep intervention in patients with cancer. Aerobic exercise and walking are alternative options. Individual patient conditions should be considered to tailor intervention plans in clinical practice.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70466"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779402","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":"Mental Health Screening Tools for Cancer Patients, and Their Caregivers: An Umbrella Review.","authors":"Laura Ciria-Suarez, Melissa Heifez, Sara Martín-Parra, Ilaria Durosini, Dario Monzani, Veronica Coppini, Maria Vittoria Ferrari, Mareike Rutenkröger, Marie Lange, Guilhem Paillard-Brunet, Nikolina Dodlek, Andreas Charalambous, Lotte van der Weijst, Oscar Mollo, Gabriella Pravettoni, Cristian Ochoa-Arnedo","doi":"10.1002/pon.70465","DOIUrl":"https://doi.org/10.1002/pon.70465","url":null,"abstract":"<p><strong>Background: </strong>Cancer negatively affects patients' physical status as well as their mental health, increasing the burden of family members and caregivers as well. Thus, the screening of psychological and cognitive functioning is key for the referral to mental health specialists.</p><p><strong>Aim: </strong>Identify available and validated screening tools to assess psychological, psychosocial and cognitive impairment in cancer patients (adults and children), caregivers and family members.</p><p><strong>Methods: </strong>An umbrella review was conducted according to PRISMA guidelines. The search strategy was applied to five databases. Reviewers screened titles/abstracts, and the articles included in this initial phase were retrieved for full-text assessment. All conflicts during the screening phase were discussed, and a third reviewer was consulted if discrepancies were not solved. A narrative synthesis and tabulated summaries of results were conducted.</p><p><strong>Results: </strong>A total of 2304 records were initially identified through systematic searches. Following screening and eligibility assessment, 67 systematic reviews were included. Across the included reviews, 586 different tools were identified and classified into nine thematic domains: (1) Anxiety and Depression, (2) General Mental Disorders, (3) Distress and Fear of Cancer Recurrence, (4) Body Image, Sexuality, and Self-Perception, (5) Caregiving and Social Impact, (6) Cognitive Functioning, (7) Coping Assessment, (8) Unmet Needs, and (9) Other miscellaneous constructs.</p><p><strong>Conclusions: </strong>A wide variety of mental health screening tools are available, covering key psychosocial and cognitive aspects relevant to cancer care. Although most instruments were not specifically developed for oncological populations, many have been validated in this context and appear to perform adequately.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70465"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779433","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":"Dyadic Associations Between Stress and Sleep Quality and Moderating Effects of Emotional Intimacy and in Survivors of Young Adult Cancer and Their Spouses: An Observational Study.","authors":"Haejeong An, Seokhun Kim, Michael Roth, Kathrin Milbury, Dalnim Cho","doi":"10.1002/pon.70439","DOIUrl":"10.1002/pon.70439","url":null,"abstract":"<p><strong>Background: </strong>Survivors of young adult (YA) cancer often experience substantial stress during the transition to survivorship, which may impair sleep. Although the stress-sleep link is well established, its role within survivor-spouse dyads remains unclear. Emotional intimacy may influence how couples regulate stress and affect sleep. This study examined dyadic associations between stress and sleep among survivors of YA cancer and their spouses and significant others (hereafter spouses) and tested emotional intimacy as a moderator.</p><p><strong>Methods: </strong>A total of 103 survivor of YA cancer-spouse dyads completed self-reported measures of stress, emotional intimacy, and sleep quality. An actor-partner interdependence moderation model was used to test how each person's stress was related to their own and their spouse's sleep quality and the moderating role of emotional intimacy.</p><p><strong>Results: </strong>In our model, higher stress was associated with poorer sleep quality among both survivors (β = 0.405, p < 0.001) and spouses (β = 0.172, p = 0.041), indicating significant actor effects, whereas no partner effects from stress were observed. Emotional intimacy moderated the stress-sleep association among survivors (β = -0.224, p = 0.004), but not among spouses (β = -0.012, p = 0.892).</p><p><strong>Conclusions: </strong>Stress emerged as a key intrapersonal determinant of sleep quality for both survivors of young adult cancer and their spouses, indicating that stress management may benefit sleep in both groups. Emotional intimacy buffered stress-related sleep disruption among survivors, but not spouses, highlighting role-specific mechanisms. Tailored approaches may improve sleep and quality of life.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70439"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575238","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":"FOCUS On Us: Adapting a Psychosocial Intervention for LGBTQ+ Cancer Patients and Caregivers Using Community Feedback.","authors":"Theresa A Hastert, Nora N Akcasu, Milena E Insalaco, Lelaina Nagle, Valerie Chiodo, Linda Donahue, Heidi Miller, Matt Poquadeck, Francisco Cartujano-Barrera, Felicity W K Harper, Hayley S Thompson, Charles S Kamen","doi":"10.1002/pon.70455","DOIUrl":"10.1002/pon.70455","url":null,"abstract":"<p><strong>Background: </strong>Despite LGBTQ+ cancer survivors and caregivers reporting worse physical and mental health-related quality of life than their heterosexual and cisgender peers, few interventions exist to improve their wellbeing.</p><p><strong>Aims: </strong>We are adapting the evidence-based FOCUS Program for LGBTQ+ survivors and caregivers using the ADAPT-ITT framework. Here we present results of \"theater test\" focus groups conducted as part of the Adaptation phase of that framework.</p><p><strong>Methods: </strong>We conducted 9 focus groups with 45 LGBTQ+ cancer survivors and caregivers from across the United States. Participants were asked to provide general and LGBTQ+ -specific feedback on the 5 FOCUS domains (family involvement, outlook, coping effectiveness, uncertainty reduction, and symptom management) as well as on the format and delivery of the intervention. Interviews were audio and video recorded, transcribed, and coded via qualitative thematic analysis using the Framework Method to capture both a priori and emergent themes.</p><p><strong>Results: </strong>Proposed LGBTQ+ -specific modifications included acknowledging chosen family; addressing legal issues, experiences of minority stress, and concerns related to body image and gender identity; identifying and addressing gaps in LGBTQ+ -specific support resources; providing guidance on finding credible LGBTQ+ -specific information; and engaging in self-advocacy with providers. More general topic suggestions included addressing the challenges of long-distance caregiving, avoiding toxic positivity, and navigating and appraising the quality of online resources.</p><p><strong>Conclusions: </strong>Participant feedback informed the development of an adapted, manualized intervention (\"FOCUS On Us\"). This work addresses a critical gap in supportive cancer care by adapting an evidence-based intervention to provide information and resources designed specifically for LGBTQ+ cancer survivors and caregivers.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70455"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639774","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":"Trust, Mistrust, Distrust and the Patient-Provider Relationship in Cancer: A Systematic Review.","authors":"Aaron Shaykevich, Kiersten Crawford, Juan Diego Betancur, Roger Wong","doi":"10.1002/pon.70456","DOIUrl":"https://doi.org/10.1002/pon.70456","url":null,"abstract":"<p><strong>Background: </strong>Ensuring that cancer patients have trust in their healthcare provider is important for effective cancer care. However, it has not yet been documented in a systematic review how trust is associated with the larger patient-provider relationship among cancer patients. Additionally, while trust, mistrust, and distrust are often discussed interchangeably, they represent distinct concepts for patient behavior and outcomes. Therefore, this systematic review examined how trust, mistrust, and distrust affect the patient-provider relationship among cancer patients in the United States.</p><p><strong>Methods: </strong>A systematic search of three databases (PubMed, Scopus, and PsycInfo) was conducted through February 2025. Studies were limited to those that examined current cancer patients in the U.S. and evaluate the impact of trust, mistrust, or distrust on patient-provider relationship. The studies were screened using Rayyan and Covidence. A narrative synthesis approach was used to integrate findings.</p><p><strong>Results: </strong>A total of forty-four studies were included. Many studies assessed patient trust, and trust was associated with perceptions of provider competence and willingness for provider-led decision making. Mistrust and distrust were less frequently studied but were more consistently reported to reduce adherence to medical treatments. A gap in the literature was identified, as no studies exclusively examined pediatric cancer patients, and no studies primarily consisted of individuals identifying as Hispanic, Asian, Native American, or other underrepresented racial and ethnic groups.</p><p><strong>Conclusion: </strong>Trust, mistrust, and distrust each uniquely shape cancer patients' relationships with healthcare providers. While trust improves perceptions of providers, it does not always lead to increased engagement or adherence to medical advice. Conversely, mistrust and distrust appear to be more strongly associated with adherence. More research is needed across a wide range of populations and provider types to guide interventions in oncology care.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 4","pages":"e70456"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639764","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}