Psycho‐Oncology最新文献

{"title":"Identifying the Financial Toxicity Experiences of Childhood Cancer Survivors Through Partnership With a Community Organization Serving Rural and Minoritized Families.","authors":"Catherine Benedict, Kelley Bloomer, Elle Billman, Mary Smith, Heidi Boynton, Lidia Schapira, Stephanie M Smith","doi":"10.1002/pon.70120","DOIUrl":"10.1002/pon.70120","url":null,"abstract":"<p><strong>Background: </strong>Financial toxicity (FT) refers to cancer-related economic distress and hardship, and disproportionately affects adolescent/young adult (AYA) survivors and minoritized groups. This study explored the FT experiences of AYA survivors of childhood cancer and their parents, and the perspective of staff members of a community-based cancer support organization in a rural region with majority Hispanic/Latino (H/L) residents and high rates of non-English language preference.</p><p><strong>Methods: </strong>A needs assessment study was conducted in partnership with Jacob's Heart, a nonprofit organization that serves predominantly H/L families of childhood cancer in a rural region in California. English- and Spanish-speaking AYA survivors, parents, and Jacob's Heart staff members completed semi-structured interviews. Qualitative data were analyzed using an applied thematic analysis approach.</p><p><strong>Results: </strong>Participants included 12 AYAs, 11 parents, and 7 organization staff. Material hardship was characterized by direct and indirect medical costs (e.g., time, transportation), which impacted parents' employment, required balancing caregiving and financial needs, and caused economic strain. Behavioral effects of FT included adaptations to meet basic needs; cost-coping behaviors included skipping medical visits. Parents and survivors experienced financial stress and worry, exacerbated by disruption in parents' employment and income, transportation pressures of living in a rural area, challenges obtaining or maintaining insurance coverage, and lack of a safety net. Support needs and resources were described.</p><p><strong>Conclusions: </strong>AYA survivors of childhood cancer and their parents experience long-lasting FT across multiple domains, which is exacerbated by socioeconomic and structural factors. Interventions targeting FT should partner with community-based organizations to reach vulnerable populations.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 3","pages":"e70120"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650336","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":"A Dyadic Analysis of Optimism, Pessimism, and Fear of Cancer Recurrence in Couples Coping With Early-Stage Breast Cancer.","authors":"Michael Morreale, Alyssa L Fenech, Hannah A Brownlee, Scott D Siegel, Jean-Philippe Laurenceau","doi":"10.1002/pon.70125","DOIUrl":"10.1002/pon.70125","url":null,"abstract":"<p><strong>Purpose: </strong>Fear of cancer recurrence (FCR) is a common yet unaddressed concern among breast cancer (BC) survivors and their intimate partners. Moderate-to-severe FCR has been associated with numerous negative health outcomes and diminished functioning among survivors and their intimate partners. Therefore, it is essential to understand what factors are associated with higher FCR for both patients and partners. Dispositional traits, such as optimism and pessimism, have been associated with FCR severity at the individual (intrapersonal) level. However, few studies have focused on this link in a dyadic, interpersonal context. To address this gap, the present study sought to investigate the association between optimism, pessimism, and FCR in BC survivors and their intimate partners.</p><p><strong>Methods: </strong>Optimism, pessimism, and FCR were assessed for 79 couples (n = 158 paired individuals) in which one partner was an early-stage BC survivor who had recently completed adjuvant treatment. The intrapersonal (actor) and interpersonal (partner) associations between optimism or pessimism and FCR were simultaneously investigated using actor-partner interdependence modeling.</p><p><strong>Results: </strong>A significant positive intrapersonal effect was observed between pessimism and FCR for both survivors and partners, but not between optimism and FCR. No significant interpersonal effects were observed between either optimism or pessimism and FCR.</p><p><strong>Conclusions: </strong>Findings indicated that higher levels of pessimism (rather than optimism) are uniquely associated with higher FCR in early-stage BC survivors and their partners. Understanding the role of pessimism in FCR susceptibility will allow for more efficient and timely support of BC survivors and their intimate partners following a cancer diagnosis.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 3","pages":"e70125"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700638","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":"Contextual Adaptation of a Complex Intervention for the Management of Cancer Pain in Oncology Outpatient Services: A Case Study Example of Applying the ADAPT Guidelines.","authors":"Olivia C Robinson, Suzanne H Richards, Emily Shoesmith, Simon Pini, Marie Fallon, Matthew R Mulvey","doi":"10.1002/pon.70132","DOIUrl":"10.1002/pon.70132","url":null,"abstract":"<p><strong>Objectives: </strong>Standardising pain assessment in oncology outpatient services (OOS) leads to improvements in patients' pain and quality of life. The Edinburgh Pain Assessment Tool (EPAT) is a standardised cancer pain management tool that has been implemented on inpatient oncology wards (the original setting). Routine use of EPAT reduced post-surgical pain in cancer patients (the original scenario) and led to more appropriate analgesic prescribing. We describe here a case study of adapting the EPAT intervention for use in tertiary OOS in the United Kingdom (UK) National Health Services (NHS), using the ADAPT guidelines.</p><p><strong>Methods: </strong>The adaptation process followed Moore et al.'s ADAPT guidance: Step 1: We assessed rationale for adapting EPAT by reviewing existing literature of pain management in OOS. Step 2: Semi-structured interviews with 20-healthcare professionals (HCPs) to understand current practice and how the intervention might fit the new context (OOS). Step 3: Identified the 'core' and 'peripheral' components of EPAT, undertook four co-design workshops with 7-HCPs to reconfigure EPAT to fit OOS (adapted version is referred to as EPAT+). Four HCPs trialled the EPAT+ intervention in practice to refine the intervention.</p><p><strong>Results: </strong>Combining qualitative data from interviews with feedback from the co-design workshops and preliminary testing the prototype intervention highlighted several key adaptation goals for EPAT+. These included: (1) reduce length/time to complete EPAT+ due to time constraints in outpatient appointments, (2) the importance of pain re-assessment and using EPAT to facilitate patients to self-monitor their pain at home, and (3) the creation of new peripheral components to support communication with primary care providers.</p><p><strong>Conclusions: </strong>Using a theoretical driven conceptual guidance provided important learning on how to adapt an existing cancer pain management tool to a new setting (OOS). The result is a novel complex theory- and evidence-based intervention that will be formally tested in a cluster randomised pilot trial.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 3","pages":"e70132"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693136","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 and Budget Impact of a Tailored Psychological Intervention Program Targeting Cancer Patients With Adjustment Disorder: A Randomised Controlled Trial.","authors":"K Holtmaat, F E van Beek, L M A Wijnhoven, J A E Custers, E J Aukema, S E J Eerenstein, I M van Oort, J E M Werner, J A Wegdam, I L E Jansen-Engelen, I H J T de Hingh, S Verheul, D T van der Beek, G Wekking, I Steggerda, V M H Coupé, N Horevoorts, A M de Korte, C Lammens, B I Lissenberg-Witte, B H de Rooij, J B Prins, I M Verdonck-de Leeuw, F Jansen","doi":"10.1002/pon.70123","DOIUrl":"10.1002/pon.70123","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the efficacy of psychological interventions targeting cancer patients diagnosed with an adjustment disorder is scarce.</p><p><strong>Aims: </strong>This study aimed to investigate the efficacy and budget impact of a tailored psychological intervention program (AD-program) targeting cancer patients with adjustment disorder (AD).</p><p><strong>Methods: </strong>Patients (n = 59) were randomised to the intervention or control group. The AD-program consisted of three modules: psychoeducation (1-4 sessions) and two additional modules (maximum of 6 sessions per module) provided when needed. The primary outcome was psychological distress (HADS). Secondary outcomes were mental adjustment to cancer (MAC) and health-related quality of life (EORTC QLQ-C30). Measures were completed at baseline and 3 and 6 months after randomisation. The budget impact analyses were based on the population size, the costs of the AD-program, and other costs potentially affected by the AD-program.</p><p><strong>Results: </strong>The mean psychological distress score in the intervention group (n = 33) decreased over time (M = 19.2 at T0, M = 15.6 at T6). This decrease was not significantly different from decrease in the control condition (n = 26, M = 17.5 at T0, M = 15.9 at T6, p > 0.05). Also, there were no significant differences between the two conditions on the secondary outcomes. The budget impact of the AD-program was estimated at 7-28 million euros per year (to treat 14,430 patients).</p><p><strong>Conclusions: </strong>The effect of the AD-program was not statistically significant in this RCT. Limitations include that this study was underpowered due to recruitment difficulties during the COVID-19 pandemic. More research on the efficacy and implementation of the AD-program is warranted.</p><p><strong>Trial registration: </strong>Netherlands Trial Register identifier: NL7763. Registered on 3 June 2019.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 3","pages":"e70123"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634410","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":"Beyond Treatment: Prevalence, Predictors, and Changes in Anxiety and Depression Among Parents of Childhood Cancer Survivors.","authors":"Hannah Kurz, Verena Paul, Mona L Nasse, Konstantin A Krauth, Daniela Kandels, Stefan Rutkowski, Gabriele Escherich, Laura Inhestern, Corinna Bergelt","doi":"10.1002/pon.70115","DOIUrl":"10.1002/pon.70115","url":null,"abstract":"<p><strong>Background: </strong>Childhood cancer remains a significant psychological burden for parents. Even after end of treatment, parents of childhood cancer survivors remain at high risk of developing anxiety and depression. However, knowledge about the prevalence and changes of these conditions post-treatment is limited.</p><p><strong>Aims: </strong>This study aimed to assess the proportion of parents exhibiting clinically relevant symptoms of anxiety and/or depression, explore gender differences, examine factors associated with these conditions and their longitudinal data.</p><p><strong>Methods: </strong>Five hundred and sixteen parents of childhood cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system tumors) were evaluated after treatment and again 12-18 months later. Anxiety (GAD-7) and depression (PHQ-9) symptoms were assessed. Generalized linear mixed models were used to analyze factors influencing these conditions and their changes.</p><p><strong>Results: </strong>At baseline, 30% of parents reported clinically relevant depression, and 34% reported anxiety, both decreasing to 16% at follow-up. Mothers reported higher anxiety and depression scores, with more meeting clinically relevant thresholds. Low family functioning, psychotherapy, physical illness, and a recent diagnosis were significant predictors of both conditions. Additional predictors for depression included unemployment, single-parent status, and fear of progression, while female gender was a predictor for anxiety in the final model. Greater symptom improvements were associated with higher baseline symptoms, whereas longer time since diagnosis was linked to less improvement.</p><p><strong>Conclusion: </strong>Anxiety and depression represent significant burdens for parents of childhood cancer survivors, with several modifiable risk factors identified. Targeted psychosocial support, early screening, and tailored interventions may reduce distress and improve family well-being.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 3","pages":"e70115"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537645","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":"Psychological Safety in the Medical Care of Black Breast and Ovarian Cancer Patients and Families.","authors":"Jane Q Yap, Kirsten A Riggan, Ewan K Cobran, Michele Y Halyard, Sarah E James, Marion K Kelly, Daphne T Phillips, Megan A Allyse","doi":"10.1002/pon.70127","DOIUrl":"10.1002/pon.70127","url":null,"abstract":"<p><strong>Background: </strong>Psychological safety is critical to early and continued engagement with healthcare providers, yet no studies have explored this concept in relationship to cancer care. Black/African American (\"Black\") individuals experience disparities in breast and ovarian cancer beyond what can be explained biologically.</p><p><strong>Aims: </strong>We explored factors influencing psychological safety among Black breast and ovarian cancer patients and their family members.</p><p><strong>Methods: </strong>Socioeconomically diverse patients with a personal diagnosis or family history of breast and/or ovarian cancer were invited to complete a semi-structured qualitative interview on their cancer and healthcare experiences between September 2020 and April 2021. Informed by principles of grounded theory, interview transcripts were qualitatively analyzed for thematic content related to psychological safety.</p><p><strong>Results: </strong>Black breast and ovarian cancer patients and their family members described personal and community experiences and structural components of the healthcare system that suggested they may receive differential cancer care due to their race, placing them on guard. This posture was mediated by several self-identified factors that added to or detracted from their comfort, including provider racial and gender concordance in healthcare, personalized care, and effective communication. The priorities and perceptions of care in participants receiving care in safety net clinics were more focused on what was feasible given resource limitations rather than what was ideally desired.</p><p><strong>Conclusions: </strong>Implementation of strategies to promote psychological safety with Black cancer patients may foster improved patient experiences, as well as encourage early screening, patient engagement, and treatment continuation.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 3","pages":"e70127"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670678","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":"Drivers of Job Loss Among Chinese Breast Cancer Survivors: A Qualitative Analysis.","authors":"Susan Chimonas, Yashasvini Sampathkumar, Xiaoxiao Huang, Christina Tran, Zhenlan Wang, Ting-Ting Kuo, Shoshana M Rosenberg, Javier González, Francesca Gany, Victoria Blinder","doi":"10.1002/pon.70122","DOIUrl":"10.1002/pon.70122","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to understand the reasons for the high risk of job loss previously identified among foreign-born Chinese breast cancer survivors in the United States Qualitative interviews were conducted to explore challenges leading to job loss during/after treatment and to help identify potential interventions to promote job retention and re-employment.</p><p><strong>Patients and methods: </strong>The research team conducted semi-structured interviews with foreign-born Chinese breast cancer survivors in New York City. A total of 12 participants, previously enrolled in the Breast Cancer and the Workforce study, were interviewed between February and November 2018. Purposive sampling was used to identify participants diverse across job type and work history. Thematic content analysis was conducted on translated interview transcripts.</p><p><strong>Results: </strong>Since diagnosis, 8/12 participants had experienced job loss (6/6 in service/production, 1/5 retail/administrative, and 1/1 professional/managerial). Many described being unable to work due to treatment side-effects, inflexible schedules, and a perception that work accommodations were unavailable. Only one participant who had lost her job went on to secure stable re-employment.</p><p><strong>Conclusions: </strong>Job type, language barriers, and cultural attitudes towards work accommodations contributed to a high job-loss rate in this population. Those who remained employed had received work accommodations. Lack of awareness or belief in obtaining accommodations was a critical factor in job loss.</p><p><strong>Implications for cancer survivors: </strong>These findings highlight the necessity of advocacy for work accommodations for cancer patients and culturally competent care. Addressing these issues could improve job retention and financial stability for breast cancer survivors, particularly among immigrant and minority groups.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 3","pages":"e70122"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606031","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":"Frailty and Sleep in Adult Survivors of Childhood Cancer: A Childhood Cancer Survivor Study Report.","authors":"Lauren C Daniel, Margaret M Lubas, Huiqi Wang, Mariana Szklo-Coxe, Kirsten K Ness, AnnaLynn M Williams, Daniel A Mulrooney, Rebecca Howell, Wendy Leisenring, Yutaka Yasui, Leslie L Robison, Gregory T Armstrong, Eric J Chow, Kevin R Krull, Tara M Brinkman","doi":"10.1002/pon.70098","DOIUrl":"10.1002/pon.70098","url":null,"abstract":"<p><strong>Background: </strong>Young adult survivors of childhood cancer exhibit rates of frailty similar to adults several decades older without a cancer history. Frailty has been associated with sleep disturbances in non-cancer populations, but the relationship has not been examined in childhood cancer survivors who are known to exhibit elevated rates of sleep problems.</p><p><strong>Aims: </strong>Examine associations between frailty and poor sleep quality in long-term survivors of childhood cancer.</p><p><strong>Methods: </strong>This study utilized data from 9044 participants (> 5 years from diagnosis, M_age = 40.8 years [SD = 9.5]) in the Childhood Cancer Survivor Study. Survivors' frailty status, chronic health conditions (CHC), health behaviors, mental health, and pain were collected in 2014-2016, and self-reported sleep quality in 2017-2019. Multivariable logistic regression models examined frailty status as a predictor of clinically significant poor sleep. All models were adjusted for age at diagnosis, age at survey, sex, race/ethnicity, smoking, risky/heavy alcohol use, and physical inactivity. Separate models included treatment-related variables, CHC burden (number/severity), and emotional health/pain as co-variates.</p><p><strong>Results: </strong>Frail survivors had 6-fold (95% CI 4.48-7.96) increased odds of future poor sleep quality. Little attenuation of this association was observed when accounting for cancer diagnosis (Odds Ratio [OR] 5.80, 95% CI 4.47-7.52), treatment exposures (OR 5.80, 95% CI 4.43-7.71), or chronic health condition burden (OR 5.12, 95% CI 3.98-6.59), but adjustment for emotional health/pain (OR 2.88, 95% CI 2.18-3.82) attenuated the association appreciably.</p><p><strong>Conclusions: </strong>Frail childhood cancer survivors have a higher prevalence of clinically significant poor sleep quality. Addressing poor physiologic reserve may impact sleep in frail childhood cancer survivors.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 2","pages":"e70098"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383064","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 Systematic Review of Barriers to Breast Cancer Screening, and of Interventions Designed to Increase Participation, Among Women of Black African and Black Caribbean Descent in the UK.","authors":"Anietie E Aliu, Robert S Kerrison, Afrodita Marcu","doi":"10.1002/pon.70093","DOIUrl":"10.1002/pon.70093","url":null,"abstract":"<p><strong>Background: </strong>Compared with the general population, Black African and Black Caribbean women, living in the UK, are less likely to participate in breast cancer screening.</p><p><strong>Aims: </strong>The aims of this review were to: (1) systematically describe the barriers to breast cancer screening, experienced by women of Black African and Black Caribbean descent, living in the UK and (2) identify which barriers interventions attempting to reduce inequalities have targeted, and whether they have been effective at increasing participation in breast cancer screening, among women of Black African and Black Caribbean descent.</p><p><strong>Methods: </strong>We conducted a mixed-methods systematic review of primary research published in peer-reviewed journals. Seven databases were searched, yielding eight articles for inclusion in the review.</p><p><strong>Results: </strong>Barriers to breast cancer screening participation were categorised into six analytical themes: 'Understanding of, and concerns about, breast screening, the procedure and the reliability of test results', 'Misconceptions about, and lack of understanding of, the causes of breast cancer and personal risk', 'Emotional responses to cancer and screening', 'General barriers to accessing healthcare services (including breast screening)', 'Beliefs about cancer as a treatable disease' and 'Religious beliefs, cultural taboos and stigma'. These findings derive largely from studies with women who were not eligible for screening. Four studies testing interventions to promote uptake among ethnic minority groups were identified. None of them targeted Black African or Black Caribbean women, specifically; however, it was possible to extract data, for these groups, from the studies.</p><p><strong>Conclusion: </strong>Further research with women who are eligible for screening (but do not attend) is needed to verify the findings of this review. Studies targeting barriers experienced by Black women, particularly, are needed to reduce inequalities.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 2","pages":"e70093"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075111","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":"Feasibility and Acceptability of the Fear-Less Screening and Stratified-Care Model for Fear of Cancer Recurrence Among People Affected by Early-Stage Cancer.","authors":"Mei Jun Tran, Michael Jefford, Tsien Fua, Ben Smith, Lachlan McDowell, Haryana M Dhillon, Fiona Lynch, Joanne Shaw, Alan White, David Wiesenfeld, Orla McNally, Maria Ftanou","doi":"10.1002/pon.70070","DOIUrl":"10.1002/pon.70070","url":null,"abstract":"<p><strong>Objectives: </strong>Fear of cancer recurrence (FCR) is a prevalent unmet need for people affected by cancer, in the context of limited healthcare resources. Stratified-care models have potential to meet this need, while reducing resource demands. This study aimed to evaluate the feasibility and acceptability of screening procedures and interventions within the Fear-Less stratified-care model among those impacted by early-stage cancer.</p><p><strong>Methods: </strong>People affected by breast, head and neck, or gynaecological cancer, who had completed curative treatment, were screened for FCR. Individuals experiencing moderate FCR (scored 13-21 on the Fear of Cancer Recurrence Inventory-Short Form; FCRI-SF) were offered a purpose-developed clinician-guided self-management intervention, while those experiencing severe FCR (FCRI-SF score ≥ 22) were offered individual therapy (ConquerFear). Re-screening and evaluation measures were completed post-intervention.</p><p><strong>Results: </strong>Seventy-six (70%) of 109 eligible people completed screening, with 53/76 participating in the Fear-Less model evaluation. Thirty-nine of 53 participants reported FCR and were referred to an intervention; 30/39 (77%) accepted the referral. Fifteen (83%) of 18 participants completing the self-management intervention reported reading ≥ 75% of the resource at 5 weeks, with 10/18 (56%) reporting clinically meaningful (≥ 10%) reductions on the FCRI-SF post-intervention. Qualitative feedback indicated screening and the stratified-care received were acceptable.</p><p><strong>Conclusions: </strong>Screening procedures and interventions forming the Fear-Less model appear feasible and acceptable for identifying and treating FCR among people affected by early-stage cancer. Although further research is required to evaluate its efficacy, this model has the potential to meet a major unmet need, where psychosocial services are limited amid increased demand.</p><p><strong>Trial registration: </strong>This study was retrospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622000818730) on 10/6/2022.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 2","pages":"e70070"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426054","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}