Patient perceptions of altering chemotherapy treatment due to peripheral neuropathy.

PURPOSE: Clinical practice guidelines recommend altering neurotoxic chemotherapy treatment in patients experiencing intolerable chemotherapy-induced peripheral neuropathy (CIPN). The primary objective of this survey was to understand patient's perspectives on altering neurotoxic chemotherapy treatment, including their perceptions of the benefits of preventing irreversible CIPN and the risks of reducing treatment efficacy. METHODS: A cross-sectional online survey was distributed via social networks to patients who were currently receiving or had previously received neurotoxic chemotherapy for cancer. Survey results were analyzed using descriptive statistics and qualitative analysis. RESULTS: Following data cleaning, 447 participants were included in the analysis. The median age was 57 years, 93% were white, and most were from the UK (53%) or USA (38%). Most participants who were currently or recently treated expected some CIPN symptom resolution (86%), but 45% of those who had completed treatment more than a year ago reported experiencing no symptom resolution. Participants reported that they would discontinue chemotherapy treatment for less severe CIPN if they knew their symptoms would be permanent than if symptoms would disappear after treatment. Most patients stated that the decision to alter chemotherapy or not was usually made collaboratively between the patient and their treating clinician (61%). The most common reason participants were reluctant to talk with their clinician about CIPN was fear that treatment would be altered. Participants noted a need for improved understanding of CIPN symptoms and their permanence, better patient education relating to CIPN prior to and after treatment, and greater clinician understanding and empathy around CIPN. CONCLUSIONS: This survey highlights the importance of shared decision-making, including a consideration of both the long-term benefits and risks of altering neurotoxic chemotherapy treatment due to CIPN. Additional work is needed to develop decision aids and other communication tools that can be used to improve shared decision making and help patients with cancer achieve their treatment goals.

Is Lockdown Bad for Social Anxiety in COVID-19 Regions?: A National Study in The SOR Perspective.

Lockdown measures have been widely used to control and prevent virus transmission in pandemic regions. However, the psychological effects of lockdown measures have been neglected, and the related theoretical research lags behind the practice. The present study aimed to better understand the mechanism of social anxiety in pandemic regions where the lockdown measures were imposed, based on the conceptual framework of the Stimulus-Organism-Response (SOR). For that, this research investigated how lockdown measures and psychological distance influenced social anxiety in the pandemic region. The Chinese national data was analyzed for the outcome. The results showed that (1) psychological distance mediated the relationship between pandemic COVID-19 severity and social anxiety, (2) lockdown measures buffered the detrimental effect of the COVID-19 pandemic severity on social anxiety, (3) lockdown measures moderated the mediation effect of psychological distancing on social anxiety caused by the COVID-19 pandemic. In conclusion, under the SOR framework, the lockdown measures had a buffer effect on social anxiety in pandemic regions, with the mediating role of psychological distancing.