Psycho-Oncology最新文献

{"title":"A randomized clinical trial: Efficacy of group-based acceptance and commitment therapy program for breast cancer patients with high fear of progression.","authors":"Fatemeh Hassani Alimolk, F. McDonald, Mohammad Asghari-Jafarabadi, F. Ahmadi, Saeedeh Zenoozian, M. Lashkari, Pandora Patterson","doi":"10.1002/pon.6339","DOIUrl":"https://doi.org/10.1002/pon.6339","url":null,"abstract":"BACKGROUND\u0000Fear of progression (FOP) is a common and significant concern among cancer patients, encompassing worries about cancer progression during active treatment. Elevated levels of FOP can be dysfunctional. This study aims to assess the efficacy of an Acceptance and Commitment Therapy (ACT)-based intervention on FOP, anxiety sensitivity (AS), and quality of life (QOL) in breast cancer patients.\u0000\u0000\u0000METHODS\u0000A clinical trial was conducted involving 80 stage I-III active-treatment breast cancer patients with a score greater than 34 on the Fear of Progression Questionnaire-Short Form scale. These patients were randomly assigned in a 1:1 ratio to either an intervention group, which received weekly 70-min sessions of 5-ACT-bsed group-therapy, or a control group that received usual treatment. Variables including FOP, AS, QOL, and ACT-related factors were assessed using ASQ, QLQ-C30, Cognitive Fusion Questionnaire, and Acceptance and Action Questionnaire-II at three time points: baseline, post-intervention, and 3-month follow-up. The efficacy of the intervention was evaluated using mixed model analysis across all time-points.\u0000\u0000\u0000RESULTS\u0000The fidelity and acceptability of the ACT-based manual were confirmed using significant methods. A significant reduction in FOP was observed only in the ACT group at post-intervention (P-valueACT < 0.001; Cohen dACT = 1.099). Furthermore, the ACT group demonstrated a more significant reduction in FOP at follow-up. Furthermore, all secondary and ACT-related variables, except for the physical symptoms subscale, showed significant improvement in the ACT group compared to the control group.\u0000\u0000\u0000CONCLUSIONS\u0000Our ACT-based manual showed promise for reducing FOP, AS, and improving QOL, and ACT-related variables in breast cancer patients 3 months following the intervention.","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":"117 1","pages":"e6339"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive impairment in cervical cancer survivors—Exploring the discrepancy between subjective and objective assessment","authors":"E. Areklett, S. Andersson, E. Fagereng, K. Bruheim, J. Stubberud, K. Lindemann","doi":"10.1002/pon.6300","DOIUrl":"https://doi.org/10.1002/pon.6300","url":null,"abstract":"Cancer‐related cognitive impairment has severe implications for the quality of life and societal participation of cervical cancer survivors (CCS). However, there is no research on the association between subjective and objective cognitive impairment (CI) in cervical cancer. This cross‐sectional study aimed to examine the frequency and severity of objective CI in CCS reporting significant subjective CI and explore the discrepancy between subjective and objective CI.Sixty‐five CCS reporting significant subjective CI, defined as 1.5 SD below the normative mean, underwent neuropsychological (NP) assessment covering attention, verbal memory, processing speed, verbal fluency, and executive functions. CCS were compared to healthy age‐matched controls (n = 74). A subjective versus objective discrepancy score was calculated based on the standardized scores within each group.The CCS group performed significantly poorer across all NP tests compared to healthy controls (all p‐values <0.001) and 81.5% had scores below cut‐off as defined by the International Cognition and Cancer Task Force. However, compared to published normative data, most CCS performed within the clinically normal range. Processing speed and verbal memory were the most affected cognitive domains. By calculating a discrepancy score, both groups on average displayed a quite accurate concordance between subjective and objective cognitive functioning.Although CI is evident in CCS, our results confirm that objective and subjective CI represent different constructs and highlight the limitations of normative data. Differentiating subjective and objective CI is important when tailoring effective interventions in the survivorship care of CCS.","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":"27 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139897639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of aerobic exercise on neurocognitive function in postmenopausal women receiving endocrine therapy for breast cancer: The Exercise Program in Cancer and Cognition randomized controlled trial","authors":"Catherine M. Bender, S. Sereika, Amanda L. Gentry, Cheryl Cuglewski, J. Duquette, George Grove, Meredith H Cummings, Myeong‐ga Cho, A. Brufsky, Priscilla McAuliffe, R. Budway, Emilia J. Diego, Steven Evans, Margaret Rosenzweig, Anna L. Marsland, Yvette P. Conley, Kirk Erickson","doi":"10.1002/pon.6298","DOIUrl":"https://doi.org/10.1002/pon.6298","url":null,"abstract":"The Exercise Program in Cancer and Cognition Study was a randomized controlled trial designed to determine whether 6 months of moderate‐intensity aerobic exercise improves neurocognitive function in women with breast cancer (BC) receiving endocrine therapy (ET).Postmenopausal women with hormone receptor+, early‐stage BC, within two years post‐primary therapy were randomized to the exercise intervention (six months, ≥150 min of moderate‐intensity aerobic exercise/week) or usual care control condition. Outcomes were assessed at pre‐randomization and after intervention completion. Groups were compared using linear mixed‐effects modeling.Participants (N = 153) were  = 62.09 ± 8.27 years old, with stage I BC (64.1%) and a median of 4.7 months post‐diagnosis. We found a group‐by‐time interaction (p = 0.041) and a trend for the main effect of time (p = 0.11) for processing speed with improved performance in the exercise group and no change in the controls. Similar main effects of time were observed for learning and memory (p = 0.024) and working memory (p = 0.01). Better intervention adherence was associated with improved processing speed (p = 0.017).Six months of moderate‐intensity aerobic exercise improves processing speed in postmenopausal women with BC receiving ET who initiate exercise within 2 years of completing primary therapy (surgery +/− chemotherapy). This is the first large‐scale study to examine the effects of aerobic exercise on neurocognitive function in women with BC. Additional research is needed to address the long‐term effects of aerobic exercise on cognitive function.","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":"25 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer-related help-seeking in cancer survivors living in regional and remote Australia.","authors":"Belinda C Goodwin,&nbsp;Suzanne Chambers,&nbsp;Joanne Aitken,&nbsp;Nicholas Ralph,&nbsp;Sonja March,&nbsp;Michael Ireland,&nbsp;Arlen Rowe,&nbsp;Fiona Crawford-Williams,&nbsp;Leah Zajdlewicz,&nbsp;Jeff Dunn","doi":"10.1002/pon.5643","DOIUrl":"https://doi.org/10.1002/pon.5643","url":null,"abstract":"<p><strong>Objectives: </strong>To measure rates of detection via screening, perceived self-imposed delays in seeking medical attention, and support seeking in a sample of regional and remote people with a cancer diagnosis and to test whether an association exists between these behaviours and minimising problems and resignation, a need for self-control and reliance and fatalism. Correlations and binary logistic regressions were conducted to test the associations between demographic characteristics, attitudes and behaviours.</p><p><strong>Results: </strong>Females were more likely to have had their cancer detected via screening (OR = 10.02, CI = 3.49-28.78). Younger participants (r = -0.103, p = 0.009) were slightly more likely to seek at least one form of support and online support was sought more often by younger patients (r = -0.269, p < 0.001), females (r = 0.152, p < 0.001), those from higher socio-economic (SES) areas (r = 0.100, p = 0.012), and those with higher education levels (r = 0.247, p < 0.001). Younger (r = -0.161, p < 0.001), and female (r = 0.82, p = 0.013), participants were also slightly more likely to seek support specifically through cancer support groups. No significant relationships between minimising problems and resignation, needs for control and self-reliance or fatalism and detection via screening, support seeking, or perceived self-imposed delays to seeking medical attention were apparent, with the exception that those with higher fatalism (predetermined health) were slightly less likely to report seeking support or information online (OR = 0.79, CI = 0.65-0.95) and slightly more likely to report using Cancer Council's support services (OR = 1.24, CI = 1.02-1.52).</p><p><strong>Conclusions: </strong>Strategies to improve the accessibility and appropriateness of support available for regional and remote cancer patients should consider interventions that remove barriers to access associated with age, gender, and education as opposed to those which address the attitudinal traits measured here.</p>","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":" ","pages":"1068-1076"},"PeriodicalIF":3.6,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pon.5643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25326452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unmet needs of carers of patients diagnosed with sarcoma: A qualitative study.","authors":"Rhys Weaver,&nbsp;Moira O'Connor,&nbsp;Georgia Kb Halkett,&nbsp;Richard Carey Smith","doi":"10.1002/pon.5651","DOIUrl":"https://doi.org/10.1002/pon.5651","url":null,"abstract":"<p><strong>Objective: </strong>Sarcoma is a rare cancer that may result in reduced mobility, social isolation, poorer mental health, and ongoing medical issues for patients. Family carers play a crucial role in supporting patients throughout their sarcoma journey. Despite the aggressive and debilitating nature of the disease, the unmet needs of these carers are yet to be explored. The aim of this study was to explore the unmet needs of carers of patients diagnosed with sarcoma.</p><p><strong>Methods: </strong>An exploratory qualitative research design with a social constructionist epistemology was used. Participants were carers of patients diagnosed with a sarcoma (n = 33). Semi-structured interviews were conducted with carers of patients who completed treatment for sarcoma and also bereaved carers (BC). Interviews were transcribed verbatim and analysed using thematic analysis.</p><p><strong>Findings: </strong>Four overarching themes were identified: support with medical aspects of caregiving, support for self, needing information about the patient, and financial support. Participants recognised that they needed psychosocial support, however, many were reluctant to access support as they perceived this to be prioritising their own needs instead of the patients'. They also needed more information about the patients' disease and how to navigate the health system.</p><p><strong>Conclusions: </strong>Family carers for patients with sarcoma have onerous responsibilities that affect their ability to access care for themselves and their family. Providing more holistic patient care and carer-specific information and training could reduce carer burden. Establishing support groups specific to carers and BC of patients diagnosed with sarcoma could provide opportunities for social interaction and psychosocial support.</p>","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":" ","pages":"1095-1103"},"PeriodicalIF":3.6,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pon.5651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25334913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worry about somatic symptoms as a sign of cancer recurrence: prevalence and associations with fear of recurrence and quality of life in survivors of childhood cancer.","authors":"Sarah J Cunningham,&nbsp;Michaela Patton,&nbsp;Fiona Schulte,&nbsp;Patricia A Richardson,&nbsp;Lauren C Heathcote","doi":"10.1002/pon.5647","DOIUrl":"https://doi.org/10.1002/pon.5647","url":null,"abstract":"<p><strong>Objective: </strong>Somatic symptoms (e.g., pain, fatigue) are common after childhood cancer and are associated with greater fear of cancer recurrence and poorer health-related quality of life (HRQoL). Qualitative studies indicate that survivors of childhood cancer (SCCs) worry about somatic symptoms as indicating cancer recurrence, which could in part explain associations between symptoms and poorer psychosocial outcomes. However, the prevalence, characteristics, and impact of symptom worry has not been quantitatively studied.</p><p><strong>Methods: </strong>SCCs (N = 111; 52% female; Mage at study = 17.67 years, range = 8-25 years; Mage at diagnosis = 6.70 years) across a variety of diagnoses were recruited from a pediatric cancer center in Canada and completed self-report measures of symptom worry, symptom frequency, general anxiety, fear of cancer recurrence, and HRQoL.</p><p><strong>Results: </strong>A majority (62%) of SCCs worried about at least one symptom as a sign of recurrence. Pain was the most worrisome symptom, but SCCs also reported worrying about symptoms that are rarely associated with cancer recurrence such as hunger, dizziness, and feeling cold. Symptom worry was more strongly associated with fear of cancer recurrence than the mere frequency of those symptoms, and this relationship held while controlling for treatment factors and general anxiety. Symptom worry and frequency each explained unique variance in HRQoL.</p><p><strong>Conclusions: </strong>Worry about somatic symptoms as a sign of cancer recurrence is common and may be impactful after childhood cancer. Excessive worry about somatic symptoms could be an important target to reduce fear of recurrence and increase HRQoL in SCCs.</p>","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":" ","pages":"1077-1085"},"PeriodicalIF":3.6,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pon.5647","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25336718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stronger therapeutic alliance is associated with better quality of life among patients with advanced cancer.","authors":"Teresa Thomas,&nbsp;Andrew Althouse,&nbsp;Lauren Sigler,&nbsp;Robert Arnold,&nbsp;Edward Chu,&nbsp;Douglas B White,&nbsp;Margaret Rosenzweig,&nbsp;Kenneth Smith,&nbsp;Thomas J Smith,&nbsp;Yael Schenker","doi":"10.1002/pon.5648","DOIUrl":"https://doi.org/10.1002/pon.5648","url":null,"abstract":"<p><strong>Objective: </strong>Patient-oncologist therapeutic alliance is a foundation of quality cancer care, although there is limited research demonstrating its relationship with patient outcomes. We investigated the relationship between therapeutic alliance and patient quality of life with a secondary goal of determining whether the association varied by patients' baseline level of psychological distress.</p><p><strong>Methods: </strong>Cross-sectional analysis of baseline data from a randomized clinical trial of 672 patients with advanced cancer participating in a primary palliative care intervention trial. Patients completed baseline self-reported measures of therapeutic alliance (The Human Connection Scale, range: 16-64), overall quality of life (Functional Assessment of Cancer Therapy-Palliative Care, range: 0-184), and psychological distress (Hospital Anxiety and Depression Scale, range: 0-42). First, we determined the relationship between therapeutic alliance and quality of life using multivariable regression adjusting for confounders. We then examined if psychological distress was an effect modifier in this relationship by adding interaction effects of depression and anxiety symptoms on therapeutic alliance into the regression model.</p><p><strong>Results: </strong>Patients reported high levels of therapeutic alliance (56.4 ± 7.4) and moderate quality of life (130.3 ± 25.5). Stronger therapeutic alliance was associated with better quality of life after adjusting for other confounding factors (β = 3.7, 95% confidence interval = 2.1, 5.3, p < 0.01). The relationship between therapeutic alliance and quality of life was generally consistent regardless of psychological distress.</p><p><strong>Conclusions: </strong>Collaborative, trusting relationships between patients with advanced cancer and their oncologists are associated with better patient quality of life. Future research should investigate the causal, longitudinal nature of these relationships.</p>","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":" ","pages":"1086-1094"},"PeriodicalIF":3.6,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pon.5648","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25337144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'A little bitty spot and I'm a big man': patients' perspectives on refusing diagnosis or treatment for lung cancer.","authors":"Barbara F Sharf,&nbsp;Linda A Stelljes,&nbsp;Howard S Gordon","doi":"10.1002/pon.885","DOIUrl":"https://doi.org/10.1002/pon.885","url":null,"abstract":"<p><p>Patient refusal of physicians' recommendations may partially account for variations in lung cancer treatment affecting survival. Reasons for refusal have not been well researched, and patients who refuse are often labeled derogatorily as irrational or enigmatically non-compliant. This study explored why patients refused recommendations for further diagnosis or treatment of lung cancer. We conducted in-depth interviews with nine patients, identified and recruited over a 2-year period, with documented refusal of doctors' recommendations. Recruiting was hampered by deaths, logistics, and refusal to participate. Questions focused on participants' understanding of disease, medical recommendations, and perceptions of decision-making. Transcripts were analyzed using a grounded theory approach. Participants emphasized self-efficacy, minimizing threat, fatalism or faith, and distrust of medical authority; explanations were often multi-dimensional. Comments included complaints about communication with physicians, health system discontinuities, and impact of social support. Explanations of participants' decisions reflected several ways of coping with an undesirable situation, including strategies for reducing, sustaining, and increasing uncertainty. Problematic Integration Theory helps to explain patients' difficulties in managing uncertainty when assessments of disease outcomes and treatment recommendations diverge. Implications for clinical communication include increasing trust while delivering bad news, understanding the source of resistance to recommendations, and discussing palliative care.</p>","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":" ","pages":"636-46"},"PeriodicalIF":3.6,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pon.885","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24986235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hong Kong families and breast cancer: beliefs and adaptation strategies.","authors":"Peggy Simpson","doi":"10.1002/pon.893","DOIUrl":"https://doi.org/10.1002/pon.893","url":null,"abstract":"<p><p>In Chinese society the family not the individual is the basic structural and functional unit. Family beliefs significantly determine the impact of the illness, choice of coping patterns and ultimately the physical and behavioral reactions of both the women and their family members. The purpose of this study was to identify the family beliefs about breast cancer and how the beliefs influenced family functioning. Twenty Hong Kong Chinese families where the woman had breast cancer (N=59) were interviewed using a minimally structured schedule. Interpretive phenomenology was the qualitative methodology used in the study. Gadamer's philosophical hermeneutics related to the process of understanding, application and interpretation was used to guide the analysis. Patterns of disharmony related to stress and emotion, diet, exercise, genetics and fate were evident in the family beliefs about the causes of breast cancer and guided the cognitive, emotional and behavioral strategies they adopted to negotiate the illness experience.</p>","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":" ","pages":"671-83"},"PeriodicalIF":3.6,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pon.893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24921729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician-patient communication among Southern European cancer physicians: the influence of psychosocial orientation and burnout.","authors":"Luzia Travado,&nbsp;Luigi Grassi,&nbsp;Francisco Gil,&nbsp;Cidália Ventura,&nbsp;Cristina Martins","doi":"10.1002/pon.890","DOIUrl":"https://doi.org/10.1002/pon.890","url":null,"abstract":"<p><p>Physician-patient communication is a critical factor for comprehensive care in oncology. Although a number of studies have been carried out in Northern Europe and the US on this subject, no data are available in Southern European countries. As a part of a multicenter Southern European Psycho-Oncology study (SEPOS), the present investigation was conducted to examine communication skills and related variables (i.e. psychosocial orientation, and burnout) among 125 physicians from Italy, Portugal, and Spain. The Self-Confidence in Communication Skills (SCCS) scale was given to assess physicians' perception of their communication skills and the Expected Outcome of Communication (EOC) scale was administered to examine the physicians' expectations about the effects of communicating with their patients. Doctors' psychosocial orientation was measured by using the Physician Belief Scale (PBS) and burnout was measured by using the Maslach Burnout Inventory (MBI). Although the physicians reported receiving minimal training in communication during their education, they tended to perceive themselves as skilled in patient communication, apart from some areas (e.g. dealing with denial, managing uncertainty, assessing anxiety and depression, and promoting patient-family openness). Low psychosocial orientation and burnout symptoms (i.e. emotional exhaustion, depersonalization, and poor personal accomplishment in their job) were associated with lower confidence in communication skills and higher expectations of a negative outcome, following physician-patient communication. The results suggest that there is a need for training cancer physicians in communication and for increasing a more definite psychosocially oriented approach in cancer care in Mediterranean countries.</p>","PeriodicalId":516935,"journal":{"name":"Psycho-Oncology","volume":" ","pages":"661-70"},"PeriodicalIF":3.6,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pon.890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24906183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}