Psycho‐Oncology最新文献

{"title":"'Finding Comfort in Discomfort': A Qualitative Study of Cancer Clinicians and Researchers' Experiences of Conducting a Cancer Rapid Autopsy Program.","authors":"Erin Tutty, Philomena Horsley, Rowan Forbes Shepherd, Laura Forrest","doi":"10.1002/pon.70175","DOIUrl":"https://doi.org/10.1002/pon.70175","url":null,"abstract":"<p><strong>Background: </strong>Rapid autopsy offers a tantalising opportunity to better characterise metastatic disease and determine how malignancies evade treatment. The CASCADE (CAncer tiSsue Collection After DEath) rapid autopsy program at the Peter MacCallum Cancer Centre, established in 2012, has conducted more than 100 autopsies. The experiences of clinicians and researchers who conduct this program can offer insight into how a unique program can be conducted sensitively and how their involvement impacts them personally and professionally.</p><p><strong>Purpose: </strong>To explore experiences of the clinicians and researchers involved in the CASCADE cancer rapid autopsy program.</p><p><strong>Materials and methods: </strong>A qualitative approach employing semi-structured interviews was used to collect data from clinicians and researchers working at the Peter MacCallum Cancer Centre. Inductive thematic analysis with team-based codebook development was used to generate findings.</p><p><strong>Results: </strong>Participants (N = 20) described the benefits and burdens of involvement in a cancer rapid autopsy program, including strategies used to 'find comfort in discomfort'. Offering participation in CASCADE enhanced patient-clinician rapport. The goals of the CASCADE program helped participants overcome confronting experiences in the autopsy room and use of autopsy-derived tissue in the laboratory. Peer-support is essential to avoid burnout.</p><p><strong>Conclusion: </strong>The benefits outweighed the burdens of delivering a cancer rapid autopsy program, however, it is important that staff are well supported in their roles.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70175"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036640","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":"Efficacy of Music Therapy on Quality of Life in Cancer Patients: A Systematic Review and Meta-Analysis.","authors":"Ting Luo, Suting Zhang, Mi Zhao, Hong Song, Shuo Wang, Jing Han","doi":"10.1002/pon.70165","DOIUrl":"https://doi.org/10.1002/pon.70165","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aims to evaluate the efficacy of music therapy on quality of life (QoL), anxiety, and depression in cancer patients.</p><p><strong>Methods: </strong>Nine electronic databases, encompassing six English and three Chinese databases were systematically searched for randomized controlled trials (RCTs) from the date of database inception to September 1, 2024. All RCTs that involved participants aged at least 18 years with any type of cancer, who received music therapy and had QoL as an outcome measure, were screened. The revised Cochrane's risk of bias tool was applied to evaluate the risk of bias. The Review Manager software was applied to execute this meta-analysis. Subgroup analyses were performed based on the type and duration of the music therapy.</p><p><strong>Results: </strong>Fourteen RCTs involving 1104 patients were included in this meta-analysis. The results showed that compared with usual care, wait list or health education, music therapy could significantly improve the QoL of cancer patients (standardized mean difference (SMD = 1.36); 95% confidence interval (CI: 0.77-1.96); p < 0.01; Grading of Recommendations Assessment, Development, and Evaluation assessment [GRADE]: moderate), with passive music therapy being superior to active-passive music therapy, can be protective against anxiety (SMD = -1.37; 95% CI:-2.29 to -0.45; p < 0.01; GRADE: moderate) and depression (SMD = -1.86; 95% CI:-3.65 to -0.08; p = 0.04; GRADE: low).</p><p><strong>Conclusion: </strong>Music therapy was effective in improving the QoL of patients with cancer, with passive music therapy being superior to active-passive music therapy. Meanwhile, anxiety and depression were relieved as well. Further studies with rigorous study designs are needed to verify our conclusions.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70165"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009030","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":"Effects of Web-Based Interventions on Anxiety and Depression in Patients With Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Myoungsuk Kim, Kyung Ja Kang, Seang Ryu","doi":"10.1002/pon.70167","DOIUrl":"https://doi.org/10.1002/pon.70167","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effects of web-based interventions on anxiety and depression in patients with breast cancer by conducting a meta-analysis of relevant randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>We searched the PubMed, Web of Science, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature, Embase, and PsycINFO databases from their inception to January 5, 2024. When substantial heterogeneity was observed among the studies, a random-effects model was applied to calculate effect sizes in terms of the standardized mean difference (SMD) and assessed the quality of the included studies using the updated Cochrane risk-of-bias tool for RCTs.</p><p><strong>Results: </strong>Fourteen RCTs were included in this study. The meta-analysis indicated that web-based intervention alleviated anxiety (SMD = -0.26, 95% CI = -0.44 to -0.07, p < 0.01, I² = 68%) and depression (SMD = -0.15, 95% CI = -0.25 to -0.06, p = 0.19, I² = 26%) in patients with breast cancer. There was substantial heterogeneity in anxiety, and the analysis of potential causes revealed that the intervention method was a factor influencing the variability in the actual effect size.</p><p><strong>Conclusions: </strong>This study showed that web-based interventions may help reduce anxiety and depression in patients with breast cancer. It also suggested the potential of these interventions as a strategy for alleviating symptoms in non-face-to-face settings. However, the limited number of studies and high heterogeneity in the subgroup analysis made it difficult to assess the effects of different intervention methods. Further high-quality research is needed to provide more reliable data on the effectiveness of various intervention methods.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70167"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044814","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":"A Multi-Level Analysis of Barriers and Promoting Factors to Cascade Screening Uptake Among Male Relatives of BRCA1/2 Carriers: A Qualitative Study.","authors":"G Ongaro, J G Hamilton, V Groner, J L Hay, M Calvello, S Oliveri, B Bonanni, I Feroce, G Pravettoni","doi":"10.1002/pon.70160","DOIUrl":"10.1002/pon.70160","url":null,"abstract":"<p><strong>Background: </strong>Pathogenic variants in the BRCA1/2 genes significantly elevate risks of breast, ovarian, prostate, and pancreatic cancer. Clinical guidelines recommend cascade screening (CS) to identify at-risk family members and advance genetically targeted disease prevention. However, despite the benefits of CS, testing uptake remains suboptimal, particularly among male first-degree relatives (FDRs) of female BRCA1/2 carriers.</p><p><strong>Aims: </strong>Little is known about factors that hinder or enhance the implementation of CS in at-risk men in BRCA-positive families. This qualitative study explored multifaceted barriers and promoting factors influencing CS in 11 untested male FDRs.</p><p><strong>Methods: </strong>Participants engaged in semi-structured interviews exploring their experiences and perspectives regarding CS uptake. Thematic analysis, guided by the Health Action Process Approach, revealed a complex interplay of barriers and promoting factors at individual, interpersonal, provider, and environmental levels.</p><p><strong>Results: </strong>Key barriers included limited awareness and communication, inaccurate knowledge regarding genetic testing, logistical constraints, and concerns regarding potential psychological outcomes. Potential promoting factors encompassed factors such as men's stage of life, actionability of genetic testing results, perceived benefit of prevention, familial cohesion, and provider direct recommendations.</p><p><strong>Conclusions: </strong>These findings contribute to a deeper understanding of the factors shaping CS uptake within BRCA-positive families and hold implications for targeted interventions to enhance CS uptake and improve the management of hereditary cancer syndromes. Gender-specific education and public awareness campaigns are crucial, highlighting male cancer risk and surveillance strategies. Exploring alternative delivery methods, such as direct provider engagement with at-risk males, can address challenges of low CS uptake, moving beyond traditional patient-mediated approaches.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70160"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079643","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":"Relationships Between Insomnia and Quality of Life in Patients With Advanced Liver Cancer: A Secondary Analysis of a Multicenter Cross-Sectional Study.","authors":"Zimeng Li, Lili Song, Jiahua Leng, Ying Pang, Yi He, Zhongge Su, Yu Wang, Yuhe Zhou, Yongkui Lu, Yu Jiang, Xinkun Han, Lihua Song, Liping Wang, Xiaojun Lv, Yan Wang, Juntao Yao, Xiaohong Liu, Xiaoyi Zhou, Shuangzhi He, Yening Zhang, Jinjiang Li, Bingmei Wang, Lili Tang","doi":"10.1002/pon.70157","DOIUrl":"10.1002/pon.70157","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the symptom burden of advanced liver cancer, explore factors related to quality of life (QoL), and investigate the relationship between insomnia and QoL.</p><p><strong>Methods: </strong>This is a secondary analysis of a multicenter cross-sectional study that included data from patients with advanced liver cancer (n = 364) recruited from 10 cancer centers across China. Participants were required to complete Patient Health Questionnaire-9 (PHQ-9), MD Anderson Symptom Inventory (MDASI), Insomnia Severity Index (ISI), 5-level EQ-5D (EQ-5D-5L). Factors associated with QoL were identified through a multiple stepwise linear regression model and the LASSO regression approach. The mediating effect between insomnia and quality of life was tested using the bootstrap method.</p><p><strong>Results: </strong>The three most prevalent symptoms were fatigue (17.0%), sleep disturbance (16.2%), and pain (15.8%). Insomnia, depression, and the 13 core symptoms in the MDASI were strongly correlated with reduced QoL (all p < 0.001). The mediating effect analysis showed that depression, dry mouth, pain, forgetfulness and fatigue were partial mediating variables between insomnia and QoL.</p><p><strong>Conclusion: </strong>Various physical and psychological symptoms could affect the QoL in patients with advanced liver cancer. Insomnia and related symptoms such as depression, dry mouth, pain, forgetfulness and fatigue should be identified and appropriately addressed to improve QoL for this population.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70157"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041992","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":"Cancer-Specificity of Sex Differences and Sex-Specific Impact of Sociodemographic Characteristics in Cancer Patients' Health-Related Quality of Life: A Cross-Sectional Study.","authors":"Anna Margarete Maria Thurner, Daniela Krepper, Sandra Nolte, Monika Sztankay, Maria Agthe, Johannes Maria Giesinger","doi":"10.1002/pon.70170","DOIUrl":"10.1002/pon.70170","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) is a multi-dimensional concept commonly assessed in patient-centered research on the impact of cancer and its treatment. Apart from disease and treatment characteristics, HRQoL is also influenced by sociodemographic variables. However, detailed evaluations of the impact of sociodemographic variables on HRQoL are scarce. Therefore, our study aims to (1) examine whether the magnitude of sex differences in HRQoL differs between cancer patients and the general population and (2) investigate if there is a sex-specific association between sociodemographic characteristics and cancer patients' HRQoL scores.</p><p><strong>Methods: </strong>For this retrospective, cross-sectional study, we relied on two datasets, with one providing HRQoL data from Austrian cancer patients (N = 574) and another containing normative data from the Austrian general population (N = 1002). HRQoL was assessed using the EORTC QLQ-C30 questionnaire.</p><p><strong>Results: </strong>Sex differences in HRQoL were observed in both cancer patients and the general population, with the magnitude of observed sex differences varying between the two groups in two EORTC QLQ-C30 scales, that is, statistically significant differences were found for Nausea/Vomiting (p = 0.009) and Sleep Disturbances (p = 0.042). Analyzing sex differences in cancer patients with regard to in the association of sociodemographic variables with EORTC QLQ-C30 scales, we found the strength of certain associations to be sex-specific, including associations of living situation with physical (p = 0.001), role (p = 0.004), and social functioning (p = 0.011).</p><p><strong>Conclusion: </strong>Our findings indicate that most sex differences in cancer patients' HRQoL reflect sex differences that also occur in the general population and are therefore, not cancer-specific, which is essential for the interpretation of cancer patients' HRQoL data. Sex-specific differences may also be, in part, associated with the sex-specific impact of sociodemographic variables on cancer patients' HRQoL. Detailed analyses of HRQoL data, including reference data from the general population, may allow for a better understanding of sex-specific treatment needs.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70170"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102506","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":"Harnessing Social Media to Develop Conceptual Domains of Quality of Life for Adolescents With Advanced Cancer.","authors":"Andrea Johnson, Kimberley Widger","doi":"10.1002/pon.70155","DOIUrl":"https://doi.org/10.1002/pon.70155","url":null,"abstract":"<p><strong>Background: </strong>Many adolescents will not survive their cancer diagnosis and will live with advanced cancer (cancer i.e. difficult to cure). Due to the advancement of cancer therapies, many adolescents will live with advanced cancer for long periods of time. Enhancing QoL is a well-established goal of their clinical oncology and palliative care however, there has been little research to conceptualize QoL in ways meaningful to them. There has also been a lack of QoL research focused on the inclusion of their voices and experiences into QoL construct development.</p><p><strong>Objectives: </strong>The aim of this study was to develop proposed conceptual domains of QoL relevant to adolescents with advanced cancer.</p><p><strong>Methods: </strong>This study was a qualitative study grounded in Interpretive Description. We used social media content created by adolescents living with advanced cancer to inform the development of QoL domains. Adolescents are increasingly using social media to share their experiences and we believed social media would facilitate access to rich data.</p><p><strong>Results: </strong>235 social media posts recorded by 14 adolescents were included in the analysis. This analysis generated domains relevant to the QoL of adolescents with advanced cancer: (1) Perceived Health, (2) The Lived Body, (3) Emotional Wellbeing, (4) Normalcy, (5) Purpose and Direction and (6) Re-Orientation.</p><p><strong>Conclusions: </strong>The QoL of adolescents with advanced cancer is poorly understood. This research has generated unique conceptual domains of QoL relevant to this population of adolescents. These concepts will inform the future development of a patient-reported outcome measure (PROM) that can measure their QoL.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70155"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030815","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":"Effectiveness of Nurse-Led Psychoeducation on Knowledge and Psychological Distress in Cancer Patients Undergoing Radiological Imaging: A Randomized Controlled Trial.","authors":"Anjali Dahiya, Poonam Joshi, Surya Kant Tiwari, Rakesh Garg, Sameer Rastogi, Kamlesh Kumari Sharma","doi":"10.1002/pon.70164","DOIUrl":"https://doi.org/10.1002/pon.70164","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer undergoing radiological imaging often experience psychological distress due to procedural uncertainty and fear of unfavorable diagnoses.</p><p><strong>Aims: </strong>This study aimed to evaluate the effectiveness of a nurse-led psychoeducational intervention on knowledge and psychological distress among cancer patients undergoing imaging in India.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted with 120 adult cancer patients who underwent radiological imaging. Participants were randomly assigned to the intervention group, receiving nurse-led psychoeducation, or the control group, receiving standard care. The primary outcomes were knowledge of radiological imaging, assessed using a validated questionnaire, and psychological distress, measured using the Depression Anxiety Stress Scale-21. Data were collected at the baseline and immediately after imaging.</p><p><strong>Results: </strong>The post-intervention knowledge scores significantly improved in the intervention group compared to the control group (10.48 ± 1.99 vs. 8.51 ± 2.14; p < 0.001). Anxiety levels decreased significantly in the intervention group, with the proportion of participants experiencing no anxiety increasing from 67.74% to 93.55% (p = 0.001). After adjusting for baseline anxiety, the intervention group had significantly lower odds of anxiety than the control group (OR = 0.09, 95% CI: 0.02, 0.35; p = 0.001). No significant differences were observed in depression or stress levels between the groups.</p><p><strong>Conclusion: </strong>Nurse-led psychoeducation effectively improved knowledge and reduced anxiety in patients with cancer undergoing radiological imaging. Integrating such interventions into pre-imaging protocols can enhance patient preparedness and reduce psychological distress. Further research should explore the long-term effects and adaptability of this intervention in diverse healthcare settings.</p><p><strong>Trial registration: </strong>CTRI/2021/06/034458.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70164"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050767","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":"Cancer in Severe Mental Illness Patients: A Retrospective Study.","authors":"Théodore Vinais, Thibaut Gellé, Pierre-Marie Preux, Philippe Nubukpo, Aurélie Lacroix","doi":"10.1002/pon.70183","DOIUrl":"10.1002/pon.70183","url":null,"abstract":"<p><strong>Objective: </strong>Severe mental illness (SMI), including schizophrenia, bipolar disorder or depression, constitute a risk factor for premature death. SMI patients die more frequently and earlier of cancer than the general population. Chronic inflammation, lack of cancer screening and substance abuse could explain these premature deaths in SMI patients. The role of SMI in cancer incidence remains uncertain. This study aims to identify the temporal occurrence between SMI and cancer in the case of dual pathology, and to investigate possible associations between specific diagnoses of SMI and cancer locations.</p><p><strong>Methods: </strong>We retrieved medical data on more than 2000 SMI patients in care in 2022 with follow-up for up to 54 years and searched for cancer diagnoses and addictive comorbidities.</p><p><strong>Results: </strong>Most SMI patients with cancer had been diagnosed with SMI prior to cancer (85.8%). The most represented cancer was breast cancer (27.2%) followed by cutaneous cancer (16.6%) and prostate cancer (10.6%). No associations were found between pre-existing SMI and cancer diagnoses as a whole. No associations were found when considering specific psychiatric diagnoses of SMI and precise cancer locations. Psychoactive substance consumption was similar among the different SMI pathologies and were not associated with specific cancer except for alcohol and breast cancer as well as tobacco and lung cancer.</p><p><strong>Conclusion: </strong>This study highlights the need to reconsider the complex interaction between SMI and cancer, including their temporal relationship and mutual impact. The link between specific psychiatric diagnoses and cancers should be investigated in larger studies cross-referencing psychiatric files and cancer-specific database.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70183"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994877","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":"Impaired Cognition and Illness Beliefs in Breast Cancer Survivors Comorbid With Diabetes.","authors":"Devarshi Vasa, Lauren Guerra, Abigail Feinberg, Mita S Goel, Yael Tobi Harris, Jenny J Lin, Jacqueline H Becker","doi":"10.1002/pon.70186","DOIUrl":"https://doi.org/10.1002/pon.70186","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivors (BCS) are at greater risk for cognitive impairment due to their cancer status, treatment history, and frequent comorbid illnesses such as diabetes (DM). Given the critical role of cognition in illness beliefs, cognitive impairments can contribute to inaccurate risk perceptions, misunderstanding of information, and limited symptom awareness, which have significant implications for disease self-management. In a cohort of BCS with DM, we investigated the relationship between cognitive impairments and illness beliefs about DM.</p><p><strong>Methods: </strong>We measured illness beliefs in our cohort of BCS with DM using the Illness Perception Questionnaire (IPQ). Cognition was assessed utilizing a well-validated neuropsychological battery (i.e., WAIS-IV, Trail Making Test-A&B, Hopkins Verbal Learning Test) measuring attention, working memory, executive functioning, processing speed, and learning and memory. Cognitive impairment was classified as z-scores ≤ -1.5 standard deviations below the normative mean adjusting for age, sex, and education. Wilcoxon tests assessed the associations between cognitive impairments and illness beliefs, subsequently adjusted for age, race, and breast cancer stage using multivariable regression models.</p><p><strong>Results: </strong>Of the 244 BCS with DM [mean (SD) age: 66.5 (7) years], 26.3% had impairments in attention, 19.1% in working memory, 24.1% in executive functioning, 9.9% in processing speed, 26.9% in memory recall, and 17.5% in memory retention. Impairments in attention, working memory, or executive functioning were associated with greater belief that DM is episodic (p = 0.003, 0.01, 0.003), short-term (p = 0.04, 0.04, 0.009), and less controllable (p = 0.006, < 0.001, 0.03). Impairments in attention and working memory were also linked to stronger beliefs that DM was due to chance (p = 0.003, 0.02). Those with processing speed impairments more often believed DM was episodic (p = 0.003) and less controllable (p = 0.004). Memory retention impairments were similarly associated with lower perceived control (p = 0.03), and memory recall impairments with the belief that DM is short-term (p = 0.01). All associations remained significant after adjustment for age, race, and breast cancer stage.</p><p><strong>Conclusions: </strong>BCS with DM and impairments in cognition, particularly in attention, working memory, and executive functioning, are more likely to hold suboptimal beliefs about their DM. These findings highlight the importance of screening for cognitive impairments in these patients in order to identify those at risk for poor disease self-management and outcomes. Future studies should explore interventions or compensatory strategies to best support BCS with DM and cognitive impairments.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 5","pages":"e70186"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128402","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}