Psycho‐Oncology最新文献

{"title":"Effects of Web-Based Acceptance and Commitment Therapy on Health-Related Outcomes Among Patients With Lung Cancer: A Feasibility Randomized Controlled Trial.","authors":"Yalin Zhang, Chunhua Liu, Xiaoli Chen, Yun Zhang, Yunhuan Li, Xiaolin Hu","doi":"10.1002/pon.70045","DOIUrl":"10.1002/pon.70045","url":null,"abstract":"<p><strong>Objective: </strong>To identify the feasibility, acceptability, and effectiveness of web-based acceptance and commitment therapy (ACT) on health-related outcomes in patients with lung cancer.</p><p><strong>Methods: </strong>A feasibility, prospective, parallel, individual-based, assessor-blinded randomized controlled trial was designed. This study was conducted at a third-level hospital in Sichuan Province, China. A total of 101 participants were enrolled and randomly assigned to usual care group or 7-weekly web-based acceptance and commitment therapy group. The primary outcome was feasibility and acceptability of the intervention, and the secondary outcomes including quality of life, psychological flexibility, anxiety, depression, fatigue, and sleep disturbance. Generalized estimating equations were used to evaluate the group differences. All analyses followed the principle of intention-to-treat.</p><p><strong>Results: </strong>Web-based ACT presented good feasibility and acceptability in this study, with an attrition rate of 13.86%, a median compliance rate of 71.43%, and a satisfaction rate of 65.9%. Compared with control group, participants in intervention group reported statistically significant increases in quality of life (MD = 15.10, 95% CI: [10.09, 20.11], d = 0.37), psychological flexibility (MD = -8.42, 95% CI: [-10.81, -6.03], d = -1.47), anxiety (MD = -1.27, 95% CI: [-2.50, -0.05], d = -0.44), depression (MD = -2.11, 95% CI: [-3.28, -0.95], d = -0.76), and sleep disturbance (MD = -1.85, 95% CI: [-3.10, -0.59], d = 0.13) at postintervention, however, the improvement in fatigue was not statistically significant (MD = -2.02, 95% CI: [-9.02, 4.98], d = -0.12).</p><p><strong>Conclusions: </strong>Web-based ACT was an approach with good feasibility and acceptability, and it could effectively improve quality of life, psychological flexibility, anxiety, depression, and sleep disturbance in patients with lung cancer. In order to achieve better results, there is a need to design a more tailored intervention plan and a more operational platform.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 12","pages":"e70045"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839018","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":"Trajectories of Cancer Survivors' Spiritual Well-Being Through the Transition From Treatment to Early Survivorship.","authors":"Crystal L Park, Zachary E Magin, Keith M Bellizzi, Tara Sanft","doi":"10.1002/pon.70040","DOIUrl":"https://doi.org/10.1002/pon.70040","url":null,"abstract":"<p><strong>Background: </strong>Spirituality is an important domain of well-being for cancer survivors, yet we know little about the different trajectories of survivors' spiritual well-being across the transition from active treatment to survivorship. Further, the specific psychosocial resources and coping efforts that might predict distinct trajectories of spiritual well-being have yet to be identified.</p><p><strong>Aims: </strong>In this study, we characterized trajectories of survivors' spiritual well-being (peace, meaning, faith) across the first year of survivorship and examined whether social support and coping strategies predicted these trajectories.</p><p><strong>Methods: </strong>Participants (N = 482) completed five surveys over the course of a year following a diagnosis of breast (63.5%), prostate (25.7%), or colorectal cancer (10.8%). We used latent class linear mixed modeling to identify spiritual well-being trajectory classes (FACIT-Sp) and employed multinomial logistic regression models to examine whether social support and specific coping styles predicted class membership.</p><p><strong>Results: </strong>While the majority of our sample had moderate levels of spiritual well-being, over one-third reported very low levels of peace. Distinct latent classes for peace (four classes), meaning (five classes), and faith (five classes) were identified among adult cancer survivors transitioning from treatment to survivorship. Higher social support and adaptive coping predicted greater likelihood of belonging to classes that maintained higher levels of peace, meaning, and faith following cancer treatment.</p><p><strong>Conclusions: </strong>Cancer survivors show unique trajectories of spiritual well-being as they transition from active treatment to survivorship. Social support and coping may be important resources for maintaining spiritual well-being during this critical transition period.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 12","pages":"e70040"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780699","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":"Social Support, Depression and Anxiety in Cancer Patient-Relative Dyads in Early Survivorship: An Actor-Partner Interdependence Modeling Approach.","authors":"Myriel Hermann, Ute Goerling, Charis Hearing, Anja Mehnert-Theuerkauf, Beate Hornemann, Peter Hövel, Sabrina Reinicke, Hanna Zingler, Tanja Zimmermann, Jochen Ernst","doi":"10.1002/pon.70038","DOIUrl":"10.1002/pon.70038","url":null,"abstract":"<p><strong>Objective: </strong>Cancer places a psychological burden on both patients and their relatives. Perceived social support influences the extent of psychological distress. Our aim was to investigate associations between positive support, detrimental interactions, depression and anxiety in patient-relative dyads in the initial period after diagnosis.</p><p><strong>Methods: </strong>Patients with a solid tumor and their relatives participated in this prospective, multicenter observational study. Participants answered validated measures including the Illness-specific Social Support Scale (SSUK-8), the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder Scale (GAD-7). We analyzed cross-sectional data from the initial time following diagnosis with paired t-tests and actor-partner interdependence models.</p><p><strong>Results: </strong>A total of 347 dyads of patients (mean age 59.9 years) and their relatives (mean age 56.7 years) participated. Compared to their relatives, patients reported significantly higher levels of depression (patients: M = 6.31, SD = 4.94; relatives: M = 5.44, SD = 4.77) and lower levels of anxiety (patients: M = 4.40, SD = 4.10; relatives: M = 4.98, SD = 4.47) as well as more positive support (patients: M = 14.31, SD = 2.07; relatives: M = 12.46, SD = 3.29) and a lower frequency of detrimental interactions (patients: M = 3.21, SD = 2.97; relatives: M = 3.66, SD = 2.93). Intrapersonal effects: Positive support was associated with lower distress only for relatives, whereas detrimental interactions were associated with higher distress for both patients and relatives (all p < 0.05). Interpersonal effects: More positive support and fewer detrimental interactions experienced by relatives were associated with lower patient distress (all p < 0.05).</p><p><strong>Conclusions: </strong>Better support for relatives may not only reduce their own distress, but also patients' distress. Relatives experience similar levels of distress and poorer social support than patients.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 12","pages":"e70038"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792104","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 Content Analysis of Cancer-Related Changes in Perceptions of Self, Relationships, and Health Among LGBTQI+ Cancer Survivors Across the Life Course: Findings From OUT: The National Cancer Survey.","authors":"Austin R Waters, Shaun R Jones, Manuela Uppalapati, Akshay Gududuru, Madeline H Bono, Hillary K Hecht, N F N Scout, Erin E Kent","doi":"10.1002/pon.70044","DOIUrl":"https://doi.org/10.1002/pon.70044","url":null,"abstract":"<p><strong>Background: </strong>The LGBTQI+ population makes up at least 7.6% of the US population. LGBTQI+ populations are at increased risk of experiencing LGBTQI+-related discrimination and cis-heteronormativity in healthcare leading to poorer health outcomes throughout the cancer care continuum. We aimed to explore LGBTQI+ cancer survivors' perspectives of how cancer has changed their perceptions of self and relationships using data from OUT: The National Cancer Survey.</p><p><strong>Methods: </strong>We conducted an inductive qualitative content analysis of responses to four open-ended questions from OUT: The National Cancer Survey. Data were collected from September 2020 to April 2021. Eligible participants were 18 years of age or older at time of survey, had been previously diagnosed with cancer, identified as LGBTQI+, and currently lived in the US. Open-ended survey questions asked about the impact of cancer on LGBTQI+ cancer survivors' perceptions of self and relationships. To maximize inter-rater reliability, 20% of the survey responses were double coded. Chi-squared tests assessed differences in changes across the life-course.</p><p><strong>Results: </strong>Of the participants in the OUT survey (N = 2382), 86.9% (N = 2069) provided responses to at least one of the four open-ended questions. The content analysis sample participants were primarily aged 40-59 (39.3%) and 60-79 (49.4%), gay (54.7%), cisgender men (59.4), White (89.7%), and not on active treatment (77.4%). A total of 5179 codes were applied to the 2069 responses. A total of 5 overarching categories and 18 sub-categories were identified. Themes included: (1) changes in perceptions of self; (2) changes to relationships; (3) changes to health and (4) LGBTQI+ specific unmet needs. The most commonly reported categories were changes in perceptions of self (77%, n = 1593) and changes to health (47%, n = 972). Most cancer-related changes were more frequently reported by young adult survivors.</p><p><strong>Conclusions: </strong>This content analysis illuminates the unique challenges that the LGBTQI+ population faces while navigating through the cancer care continuum.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 12","pages":"e70044"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855164","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":"Understanding Return to Work After a Cancer-Related Sickness Absence. Perceptions of Barriers and Facilitators Among all Relevant Stakeholders.","authors":"Amaya Ayala-García, Laura Serra, Dolors Rodriguez-Arjona, Fernando G Benavides, Mireia Utzet","doi":"10.1002/pon.70036","DOIUrl":"10.1002/pon.70036","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to examine the themes acting as barriers or facilitators, from diagnosis and sickness absence (SA) to RTW and work retention, after a cancer-related SA from the perspectives of all stakeholders in the Spanish setting.</p><p><strong>Methods: </strong>Descriptive qualitative approach with a socio-constructivist perspective. Theoretical sampling was carried out until saturation. Six discussion groups (4-8 people/group) were conducted: three groups of people with a cancer-related SA in Catalonia (Spain), one with oncology care professionals, and two with company representatives. An additional individual interview was conducted with a primary care physician. The sessions were held virtually and were recorded, transcribed verbatim, and analyzed using thematic analysis and mixed coding.</p><p><strong>Results: </strong>Barriers to RTW and work retention detected by stakeholders included insufficient information and guidance on the impact of cancer on work and SA management, lack of general knowledge and recognition of side effects, lack of consideration of job tasks by medical tribunals, and working in precarious employment. Facilitators included workplace support, psycho-oncologists, patient associations, and working for a public company.</p><p><strong>Conclusions: </strong>Both work interruption due to an SA and RTW, are key moments for determining cancer survivors' work retention. We found a general perception of lack of involvement of the social security system, companies, and health professionals in Spain in the impact of cancer on work.</p><p><strong>Implications for cancer survivors: </strong>Integrating the work sphere in cancer care from the beginning of cancer treatment, and by all stakeholders, could facilitate successful future RTW.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 12","pages":"e70036"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792171","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":"Patient and Staff Experiences of Embedding Electronic Patient Reported Outcome Measures for Distress Screening and Quality of Life Assessment, Into Routine Melanoma Care: A Mixed-Methods Study.","authors":"Kathy Dempsey, Robyn Saw, Iris Bartula, Serigne N Lo, Alexander M Menzies, Georgina V Long, Craig Lawn, Julian Chung, Thomas Pennington, Frances Boyle, Andrew Spillane, Mbathio Dieng, Dina Saks, Julia Lai-Kwon, Jake R Thompson, Rachael L Morton","doi":"10.1002/pon.70053","DOIUrl":"https://doi.org/10.1002/pon.70053","url":null,"abstract":"<p><strong>Objective: </strong>Patient reported outcome measures (PROMs) are commonly collected in melanoma research. However, they are not used to guide immediate clinical care in Australia. This study explored the views and experiences of patients with Stage III melanoma and clinic staff during implementation of an electronic Patient-Reported Outcome Measures in melanoma (ePROMs-MEL) pilot to assess distress and quality of life.</p><p><strong>Methods: </strong>A prospective mixed-methods study in specialist melanoma clinics in Sydney, Australia between May 2021 and February 2023. Forty-two post-ePROMs implementation surveys and 17 semi-structured interviews were undertaken among patients and staff (including oncologists, melanoma nurses and clinic managers). Survey responses were tabulated using Likert scales and interview transcripts analysed thematically.</p><p><strong>Results: </strong>Of the 31 patient survey responses, over 90% reported ePROMs were easy to complete and measured important components of their health and wellbeing. Of the 11 staff surveys, over 50% reported ePROMs to be useful when allied health referrals were accessible but found implementation disruptive to clinic workflows. Six themes about ePROMs in clinical care emerged during data analysis: (1) promoting self-reflection; (2) conversation-starters; (3) timing and setting; (4) fit for purpose questionnaires; (5) resource issues; (6) value and limitations of ePROMs.</p><p><strong>Conclusion: </strong>Patients overwhelmingly supported the real-time collection of ePROMs for their immediate care. In contrast, staff support was conditional on resources to maximise clinical care efficiency and minimise administrative burden.</p><p><strong>Trial registration: </strong>Australia and New Zealand Clinical Trials Registry: anzctr.org.au/ACTRN12620001149954.aspx.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 12","pages":"e70053"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855182","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":"Short-Term Effectiveness of a Stepped-Care Model to Address Fear of Cancer Recurrence in Patients With Early-Stage Melanoma.","authors":"Jake R Thompson, Lisa Gomes, Grace Kouvelis, Andrea L Smith, Serigne N Lo, Nadine A Kasparian, Robyn P M Saw, Mbathio Dieng, Linda Seaman, Linda K Martin, Pascale Guitera, Donna Milne, Helen Schmid, Anne E Cust, Iris Bartula","doi":"10.1002/pon.70041","DOIUrl":"https://doi.org/10.1002/pon.70041","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effectiveness of the Melanoma Care Programme when implemented into routine clinical practice coupled with fear of cancer recurrence (FCR) screening and a stepped-care model of intervention delivery.</p><p><strong>Methods: </strong>Using a Type-I hybrid effectiveness-implementation design, individuals with stage 0-II melanoma and a Fear of Cancer Recurrence Inventory FCR severity score of ≥ 13 were offered the Melanoma Care Programme. The programme included a psychoeducational booklet and 3 to 5 psychotherapeutic telehealth sessions with a clinical psychologist, timed around routine dermatological appointments. Multivariable linear mixed modelling was used to analyse the effect of the intervention at 1-week post-intervention on patient-reported outcomes, including FCR severity (primary outcome), symptoms of depression, anxiety, and stress, melanoma-related knowledge, and health-related quality of life.</p><p><strong>Results: </strong>One hundred and twelve participants completed the intervention from 146 participants screened for FCR. Adjusted multivariable linear mixed modelling demonstrated that participants who received the intervention reported a reduced FCR severity at 1-week post-intervention (mean change: -3.81 [95% CI: -4.67, -2.95], p < 0.001) compared to baseline. Participants also reported improvements in melanoma-related knowledge (mean change: 0.64 [95% CI: 0.13, 1.15], p = 0.014), depressive symptoms (mean change: -1.41 [95% CI: -1.92, -0.90], p < 0.001), anxiety (mean change: -1.05 [95% CI: -1.48, -0.61], p < 0.001), stress (mean change: -1.58 [95% CI: -2.22, -0.93], p < 0.001), and health-related quality of life (mean change: 4.05 [95% CI: 2.84, 5.26], p < 0.001).</p><p><strong>Conclusions: </strong>The Melanoma Care Programme maintained effectiveness when implemented into routine clinical practice with the addition of FCR screening and a stepped care model of delivery.</p><p><strong>Trial registration: </strong>This study is registered with the Australia and New Zealand Clinical Trials Register (ACTRN12621000145808).</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 12","pages":"e70041"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839020","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":"Spirituality in Patients With Cancer: A Synthesis of a Program of Research.","authors":"Betty Ferrell, Tami Borneman, Marianna Koczywas, Paul Galchutt","doi":"10.1002/pon.70033","DOIUrl":"10.1002/pon.70033","url":null,"abstract":"<p><strong>Background: </strong>Spiritual care is a key domain of quality palliative care as defined by national palliative care guidelines.</p><p><strong>Aims: </strong>The aim of this project was to synthesize data and research experience by the authors over 30 years related to spirituality in patients with cancer. The research objectives for this analysis were to: Describe spirituality in patients with cancer. Determine the outcomes of palliative care interventions on spirituality and related variables in patients with cancer in these studies conducted by the authors. Summarize methodological issues in conducting research related to spirituality in oncology patients.</p><p><strong>Methods: </strong>A synthesis of 15 prior studies conducted by the authors was completed and also compared to current literature regarding spirituality in cancer and other serious illness.</p><p><strong>Results: </strong>Findings demonstrate the broad scope of spirituality, key spiritual concerns in cancer and methodological approaches to assessing spirituality.</p><p><strong>Conclusion: </strong>Spirituality is a major concern for patients, yet limited training has been provided for clinicians who deliver this care. Additional studies are needed to advance this important aspect of palliative care.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 12","pages":"e70033"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751479","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":"Effect of Behavioral Activation on Stigma and Quality of Life in Patients With Advanced Esophageal and Gastric Cancer: A Randomized Controlled Trial.","authors":"Runze Huang, Han Ge, Guodong Nie, Anlong Li, Lijun Liu, Ling Cheng, Mingjun Zhang, Huaidong Cheng","doi":"10.1002/pon.70021","DOIUrl":"10.1002/pon.70021","url":null,"abstract":"<p><strong>Background: </strong>Esophageal cancer and gastric cancer patients require researchers' attention to address and resolve the issue of stigma. The aim of this study was to investigate whether behavioral activation (BA), an emerging psychosocial intervention method, can mitigate the stigma experienced by these patients and enhance their quality of life (QoL).</p><p><strong>Methods: </strong>One hundred fifty-three patients with advanced esophageal cancer and gastric cancer were recruited and randomly assigned to either the BA plus care as usual group (BA + CAU group) or the care as usual group (CAU group). Pre- and post-intervention questionnaires, including the Social Impact Scale (SIS), as well as all functional areas and global health and QoL modules from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version3).</p><p><strong>Results: </strong>Generalized estimating equation analysis revealed that compared to usual care alone, combining BA with usual care significantly reduced stigma (time-by-group interaction, T1: β = -10.584, p < 0.001; T2: β = -22.619, p < 0.001) while improving physical, role, emotional, social functioning and global health and QoL particularly at T2 time point. Additionally, it also has the potential to decelerate the progressive decline of cognitive functioning. Furthermore, correlation analysis demonstrated a significant association between stigma levels and all functional areas as well as global health and QoL.</p><p><strong>Conclusion: </strong>The issue of stigma among esophageal cancer and gastric cancer patients warrants increased attention due to its close relationship with patient QoL. This study presents a promising psychosocial intervention approach suitable for clinical application that deserves further promotion among cancer patients.</p><p><strong>Trial registration: </strong>NCT06348940.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 11","pages":"e70021"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639660","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":"Psychometric Properties of the Generalized Anxiety Disorder Scale (GAD-7) in Older Adults With Advanced Cancer.","authors":"Rebecca M Saracino, Lee A Kehoe, Michael B Sohn, Lu Wang, Supriya Mohile, Megan Wells, Karen Mustian, Gary Morrow, Thomas Bradley, Adedayo Onitilo, Jeffrey Giguere, Kelly M McConnell","doi":"10.1002/pon.70012","DOIUrl":"10.1002/pon.70012","url":null,"abstract":"<p><strong>Objectives: </strong>Over half of new cancer diagnoses occur in patients aged 65 or older, with up to 40% experiencing anxiety. The American Society of Clinical Oncology recommends using the Generalized Anxiety Disorder Scale (GAD-7) for anxiety screening, but the GAD-7 psychometric properties in this population are unknown. This study examined the GAD-7's reliability, validity, and item parameters, comparing its utility with the GAD-2 in older adults with cancer.</p><p><strong>Methods: </strong>This cross-sectional secondary analysis of a nationwide multi-site two-arm cluster randomized trial in older adults (≥ 70) with advanced cancer. The GAD-7 was administered at baseline. Properties were evaluated with Cronbach's α, Pearson correlation coefficients, and a 2-parameter logistic model. Logistic regression models compared the GAD-2 and GAD-7.</p><p><strong>Results: </strong>The sample included 718 participants (Mean age = 77, SD = 5) with mild anxiety (M = 3.74, SD = 4.74). Internal consistency was strong (Cronbach's alpha = 0.89) and item-total correlations ranged 0.53 to 0.78. Item 2 (Not being able to stop or control worrying) was the most discriminating and item 5 (Being so restless that it is hard to sit still) was least discriminating. Area Under the Curve (AUC) analyses demonstrated the GAD-2 had a 0.93-0.96 AUC.</p><p><strong>Conclusions: </strong>Establishing the psychometric properties of anxiety screening measures is crucial in the older adults with cancer to maximize referral efficiency and accuracy. This study indicates that the GAD-7 is reliable and valid for older adults with cancer. Analyses suggest the GAD-2 may be as sufficient as the GAD-7 in identifying anxiety in older adults with cancer, thereby reducing assessment burden.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"33 11","pages":"e70012"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558604","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}