"God is going to help me get through this": spirituality perspectives from Hispanic adolescent and young adult cancer survivors.

PURPOSE: Describe spirituality's role in a sample of Hispanic adolescent and young adult (AYA) cancer survivors. METHODS: This phenomenology-informed convergent parallel mixed-methods study aimed to explore participants' lived experiences with hope during cancer treatments and cancer survivorship. A purposive sample of Hispanic AYAs who completed cancer treatments 2-5 years ago were virtually recruited for participation. Participants completed virtual semi-structured interviews about their experiences with hope during cancer treatments and cancer survivorship and prepared narratives about their experiences. Thematic analyses were iteratively performed across the data set to identify final themes. RESULTS: Ten Hispanic AYA cancer survivors (mean age 30.2, SD = 4.5) years participated in this pilot study. Seven participants (70%) were female, and three participants (30%) were male. Six participants (60%) experienced non-hematologic malignancies, and four participants (40%) experienced hematologic malignancies. Eight (80%) participants' language preference was Spanish, while two (20%) participants' language preference was English. The theme spirituality and subthemes living by faith, god as a resource, and spiritual gratitude were identified as concepts participants linked to their conceptualization of hope during cancer treatment and survivorship. CONCLUSIONS: Hope and spirituality may be conceptually linked to coping behaviors among Hispanic AYA cancer survivors. Hope through faith may be a learned spiritual value in Hispanic AYAs and might play a role in their spiritual and cognitive development. Further research is needed to explore the potentially protective value of hope and spirituality for the Hispanic AYA population.

Hopelessness and Social Support among Cancer Patients in Saudi Arabia.

BACKGROUND: Receiving a cancer diagnosis can be extremely stressful for patients, as it is a life-threatening disease. However, when this topic is discussed or researched, the psychological state of cancer patients is often ignored or forgotten. The study aimed to measure the levels of hopelessness and social support among cancer patients. It also aimed to assess the relationship between different demographic variables, hopelessness, and social support of these patients. METHODS: The study followed a cross-sectional quantitative design. The setting included Princess Norah Oncology Center, at King Abdul-Aziz Medical City, Jeddah.   A convenience sampling technique including 300 cancer patients was followed. Data collection included a demographic questionnaire, the Beck Hopelessness Scale (BHS), and the Multidimensional Scale of Perceived Social Support (MSPSS).  Ethical principles of anonymity and confidentiality were followed. RESULTS: The total number of respondents was 300, with 50% being male and 50% being female. The mean age of patients was 52.6±14.83 years. The most prevalent types of cancer were breast cancer (21.4%), colorectal (15.2%), and lymphoma (12.1%) respectively. Most of the patients were married (71.3%). The mean value of the BHS was 4.5, whereas the mean value of the MSPSS was 67.7. Moreover, the type of cancer showed a significant association between family support and total social support. In colorectal cancer patients, the total social support (71.2 ± 20.1) and family support (26.2 ± 5.0) provided was the highest followed by leukemia (70.3 ± 15.5 and 25.2 ± 5.1) and breast cancer (68.3-± 20.3. and 24.3 ± 6.8). CONCLUSION: The findings of the present study suggest that the levels of hopelessness in cancer patients are moderate, and the levels of social support received by participants are high. In addition, the relationship between the levels of hopelessness and the levels of social support received is inversely proportional.

"Pathways": A hope-enhancing intervention for patients undergoing treatment for advanced lung cancer.

OBJECTIVE: Observational data suggest hope is associated with the quality of life and survival of people with cancer. This trial examined the feasibility, acceptability, and preliminary outcomes of "Pathways," a hope intervention for people in treatment for advanced lung cancer. METHODS: Between 2020 and 2022, we conducted a single-arm trial of Pathways among participants who were 3-12 weeks into systemic treatment. Pathways consisted of two individual sessions delivered during infusions and three phone calls in which participants discussed their values, goals, and goal strategies with a nurse or occupational therapist. Participants completed standardized measures of hope and goal interference pre- and post-intervention. Feasibility was defined as ≥60% of eligible patients enrolling, ≥70% of participants completing three or more sessions, ≥70% of participants completing post-assessments, and mean acceptability ratings ≥7 out of 10 on intervention relevance, helpfulness, and convenience. Linear regression fixed effects models with covariates modeled pre-post changes in complete case analysis and multiple imputation models. RESULTS: Fifty two participants enrolled: female (59.6%), non-Hispanic White (84.6%), rural (75.0%), and with low educational attainment (51.9% high school degree or less). Except for enrollment (54%), feasibility and acceptability markers were surpassed (77% adherence, 77% retention, acceptability ratings ≥8/10). There was moderate improvement in hope and goal interference from pre-to post-intervention (d = 0.51, p < 0.05 for hope; d = -0.70, p < 0.005 for goal interference). CONCLUSIONS: Strong feasibility, acceptability, and patient-reported outcome data suggest Pathways is a promising intervention to increase hope and reduce cancer-related goal interference during advanced lung cancer treatment.

'Surgery is my only hope': A qualitative study exploring perceptions of living with obesity and the prospect of having bariatric surgery.

The health benefits of bariatric surgery are well documented; however, the occurrence of weight-regain after surgery, along with the development of mental health difficulties poses a question of how contemporary psychology could assist to prepare people living with obesity prior to undergoing bariatric surgery. This research explored individuals' (in the immediate pre-operative and post-operative population) attitudes, beliefs and experiences towards obesity and their journey to bariatric surgery. Seventeen adult participants (males n = 4; age range: 26-64 years) were recruited and participated in a semi-structured interview. Twelve individuals participated prior to undergoing bariatric surgery. Five individuals participated in the early post-operative period (<3 months post-surgery). People living with obesity displayed high optimism for positive outcomes, with participants hoping that bariatric surgery would be different to previous attempts at weight regulation, with there being a clear shift in the locus of control for weight management from self to healthcare professionals. Whilst this is adaptive, there was the presence of seemingly unrealistic optimism, with many pre-surgery participants not relaying the realistic possibility of post-surgery weight-regain. Despite the optimism individuals feel about bariatric surgery, participants felt that the psychological factors influencing eating behaviours are not being addressed by healthcare. These findings suggest that mindfulness, mindful eating, and self-compassion approaches should be incorporated into clinical practice to support weight regulation and adaption to physiological changes after bariatric surgery.

The effect of psychological resilience and spiritual well-being on the experience of hope in parents of children with cancer.

PURPOSE: Hope in pediatric oncology guides parents as an inner guidance compass through their child's challenging journey toward cancer treatment. This study was designed to examine the effects of psychological resilience, spiritual well-being, and some child- and parent-related factors on parents' experience of hope while their child is undergoing cancer treatment. DESIGN AND METHODS: This cross-sectional, correlational study was conducted between March and July 2022 in the pediatric oncology-hematology ward of a university hospital in Turkey. Parents of 120 children with cancer were included in the study. Data were collected using the child and parent questionnaire, Herth Hope Index, Connor-Davidson Resilience Short Form, and Spiritual Well-Being Scale. Correlation and multiple linear regression analysis were used to analyze the data. In addition, the content analysis method was used to analyze the open-ended structured questions. Ethical approval was obtained for the study. RESULTS: In the study, 57.5% of the parents who participated were mothers. The mean age of the children was 9.46 ± 5.00 years. 30.8% of the children were diagnosed with Acute Lymphoblastic Leukemia, and the mean duration of treatment was 20.42 ± 13.75 months. According to multiple linear regression analysis, child gender (ß = -0.16), number of children (ß = -0.16), cancer diagnosis (ß = -0.24), resilience (ß =0.31), and parental spiritual well-being (ß =0.40) were the determinant factors affecting parents' experiences of hope. All these predictors explained 55% of the change in parents' hope levels. In addition, two main themes (increasing and decreasing factors) were identified regarding parents' experiences of hope. CONCLUSIONS: Insights from this study have the potential to shape interventions specifically designed to maintain parents' hope throughout their child's cancer treatment journey. IMPLICATIONS FOR PRACTICE: This study may provide insights for the design of intervention programs in pediatric oncology hematology wards aimed at strengthening the hope and improving coping mechanisms of parents with children coping with cancer.

Hope and illness expectations: A cross-sectional study in patients with advanced cancer.

BACKGROUND: The fear of taking away hope hinders clinicians' willingness to share serious news with patients with advanced disease. Unrealistic illness expectations, on the other hand, can complicate decision making and end-of-life care outcomes. Exploration of the association between hope and illness expectations can support clinicians in better communication with their patients. AIM: The aim of this study was to explore whether realistic illness expectations are associated with reduced hope in people with advanced cancer. DESIGN: This is a cross-sectional secondary analysis of baseline data from a primary palliative care cluster-randomized trial CONNECT (data collected from July 2016 to October 2020). Hope was measured by Herth Hope Index. Illness expectations were measured by assessing patients' understanding of their treatment goals, life expectancy, and terminal illness acknowledgement. Multivariable regression was performed, adjusting for demographical and clinical confounders. SETTING/PARTICIPANTS: Adult patients with advanced solid cancers recruited across 17 oncology clinics. RESULTS: Data from 672 patients were included in the study, with mean age of 69.3 years (±10.2), 53.6% were female. Proportion of patients indicating realistic expectations varied based on which question was asked from 10% to 46%. Median level of hope was 39 (IQR = 36-43). Multivariate non-inferiority regression did not find any significant differences in hope between patients with more and less realistic illness expectations. CONCLUSIONS: Our results suggest that hope can be sustained while holding both realistic and unrealistic illness expectations. Communication about serious news should focus on clarifying the expectations as well as supporting people's hopes.

Compreensão de crianças e pré-adolescentes sobre forças de caráter: um estudo qualitativo / La comprensión de niños y pre-adolescentes sobre las fortalezas de carácter: un estudio cualitativo / Children and pre-adolescents' comprehension of character strengths: a qualitative study

RESUMO. Este estudo tem por objetivo analisar o conhecimento de crianças e pré-adolescentes em relação aos termos que designam as forças de caráter e compreender como percebem a expressão desses traços nos próprios comportamentos e nos de outras pessoas. Foram entrevistados 17 participantes, de oito a 13 anos (M = 10,6; DP = 1,5). Para cada força foram feitas sete perguntas, que investigavam a definição do termo e exemplos da expressão da força nos outros e nos próprios entrevistados. As entrevistas foram gravadas e transcritas para análise de conteúdo, ao fim gerando categorias para cada força. As forças descritas com maior facilidade pelos participantes e suas respectivas definições foram criatividade (capacidade de criar coisas), curiosidade e amor ao aprendizado (busca de conhecimento e novas experiências), honestidade (falar a verdade), amor (comportamento de dar carinho), bondade (ajudar e cuidar do outro), trabalho em equipe (realização de trabalhos colaborativos em brincadeiras ou atividades escolares), perdão (08 categorias a respeito de sua definição, sem destaque para alguma) e esperança (desejar acontecimento futuro). Esses achados podem tornar mais acessível o desenvolvimento e a avaliação das forças nessa faixa etária.

RESUMEN. Este estudio buscó analizar el conocimiento de niños y pre-adolescentes sobre los términos que fueron designados como fortalezas de carácter, y comprender cómo perciben estos rasgos en sus proprios comportamientos y en los de otras personas. Diecisiete participantes entre ocho y trece años fueron entrevistados (M = 10.6; SD = 1.5). Para cada fortaleza, se hicieron siete preguntas, que investigaron la definición del término y ejemplos prácticos de su expresión. Las entrevistas fueron grabadas y transcritas para el análisis de contenido, creando categorías para cada fortaleza. Las fortalezas descritas por los participantes con mayor facilidad y sus respectivas definiciones fueron: creatividad (capacidad de crear cosas), curiosidad y amor por el aprendizaje (búsqueda de conocimiento y nuevas experiencias), honestidad (decir la verdad), amor (comportamientos afectivos), amabilidad (ayudar y cuidar a los demás), trabajo en equipo (desempeño del trabajo colaborativo en juegos o actividades escolares), perdón (ocho categorías con respecto a su definición, sin énfasis en ninguna) y esperanza (deseo por un evento futuro). Estos hallazgos pueden facilitar el desarrollo y la evaluación de las fortalezas con este grupo de edad.

ABSTRACT This study aims to analyze the children and pre-adolescents' knowledge regarding terms that designate character strengths and to understand how they perceive the expression of these traits in their and other people's behavior. Seventeen participants aged eight to thirteen were interviewed (M = 10.6; SD = 1.5). For each strength, seven questions were asked, which investigated the definition and examples of the strength expression. The interviews were recorded and transcribed for content analysis, generating categories for each strength. The strengths most easily described by the participants and their respective definitions were: creativity (ability to create things), curiosity and love for learning (searching for knowledge and new experiences), honesty (speaking the truth), love (acts involving affection), kindness (helping and caring for others), teamwork (collaborative works in games or school activities), forgiveness (eight categories regarding their definition, without highlighting any) and hope (longing for a future event). These findings may make developing and evaluating character strengths in this age group more accessible.

A review focusing on the role of pyroptosis in prostate cancer.

As one of the types of programmed cell death, pyroptosis has become a focus of research in recent years. Numerous studies have shown that pyroptosis plays a regulatory role in tumor cell invasiveness, differentiation, proliferation, and metastasis. It has been demonstrated that pyroptosis is involved in the regulation of signaling pathways implicated in the pathogenesis of prostate cancer (PCa). Furthermore, the loss of expression of pyroptosis-related genes in PCa has been reported, and pyroptosis-related genes have demonstrated a considerable ability in predicting the prognosis of PCa. Therefore, the potential role of pyroptosis in regulating the development of PCa warrants further investigation and attention. In this review, we summarize the basics of the role of pyroptosis and also discuss research into the mechanisms of action associated with pyroptosis in PCa. It is hoped that by exploring the potential of the pyroptosis pathway in intervening in PCa, it will provide a viable direction for the diversification of PCa treatment.

What Are the Ethical Obligations Related to a Request for Nonbeneficial Treatment?

It is common for a headline to proclaim promising results of a new cancer drug and for medical oncology offices to be flooded with calls from patients hoping that this new "miracle" drug offers them a chance of cure. Conf.

A Life-Affirming Palliative Care Model for Severe and Enduring Anorexia Nervosa.

Some individuals with severe and enduring anorexia nervosa experience dramatically degraded quality of life in the face of refractory illness and compulsory treatment. We propose a palliative care (PC) model for this group of patients that aims to support their unique goals of care, improve social-professional function, reduce physical suffering, and honor the whole person. Far from representing a pre-hospice model, a PC model for those with severe and enduring anorexia nervosa instead provides an alternative to current practices in hopes of meaningfully improving quality of life and outcomes.

The associations between spiritual well-being, hope and psychological symptoms in Chinese childhood cancer patients: A path analysis.

AIMS: We aimed to test a model in which hope and spiritual well-being acted as protective factors against anxiety and depressive symptoms in childhood cancer patients (CCPs). We hypothesized that hope and spiritual well-being were mutually reinforcing factors that would both reduce anxiety and depressive symptoms. METHODS: Using path analysis, the hypothetical model was tested on a cross-sectional sample of 412 Chinese CCPs aged 8-17 years. Self-reported measures were used to obtain data on participants' social and clinical characteristics, spiritual well-being, hope, anxiety and depressive symptoms. RESULTS: The hypothetical model was supported. Results suggested that sex, treatment type and diagnosis predicted spiritual well-being; diagnosis and time since diagnosis predicted hope. Spiritual well-being and hope were mutually predictive and mutually reinforcing, and were both negatively associated with anxiety and depressive symptoms. This model predicted 40% of the variance in spiritual well-being, 37% in hope, 39% in depressive symptoms, and 28% in anxiety. CONCLUSION: Spiritual well-being and hope were mutually reinforcing and served as protective factors against anxiety and depressive symptoms. These support the value for integrating spiritual and hope elements in developing interventions for CCPs to improve their spiritual and psychological well-being along the disease trajectory.

Complementary and Alternative Medicine Use in Patients With Cancer and Immigration Background.

PURPOSE: Studies have shown that patients with cancer are more likely to use complementary and alternative medicine (CAM) than noncancer patients for symptom relief and hope. We aimed to evaluate factors of race, ethnic groups, and immigration status in attitude of patients with cancer in seeking out CAM. PATIENTS AND METHODS: This is a prospective questionnaire study where information on demographics, cancer information, race/ethnicity, immigration duration, and psychosocial factors was correlated with the CAM use in a community cancer center located in the borough of Brooklyn, at New York City. RESULTS: Among 658 patients, the prevalence of CAM use was 66.11%. CAM use was 71.98% in females and 54.34% in males (P = .113 × 10-4). Patients of African descent had higher CAM use (72.73%) than the White patients (63.53%; P = .0371). There was no difference of CAM use between the US born (68.77%) and the immigrants (63.98%, P = .199) as a whole; however, comparing with the US born (66.50%), Asian-born immigrants had lower CAM use (53.77%, P = .0161), whereas Latin-American born had a numerical trend toward higher CAM use (74.83%, P = .0608). The number of years of living in the United States was not associated with more CAM use. Prayer and spirituality was the most common CAM subtype used (25.91%). There was no difference in CAM use in the respective non-White ethnic groups whether they were US born or non-US born. CONCLUSION: In this cohort of patients with cancer enriched with immigration background, CAM use was the highest in African American patients. The use of CAM in the non-White patients was associated with their ethnic background, regardless whether they were US born or not. Cultural roots appeared to be a strong influencing factor for the usage of CAM.

The power of hope.

My patient was in his late 20s and dying of an advanced sarcoma. He came to our institution seeking a miracle-a cure for his incurable cancer. Despite second and third opinions, he never relinquished his hope that science would cure him. In this story, I explore how hope allowed my patient, and others like him, to reclaim their narratives and maintain their personhood in the face of serious illness.

A new immune checkpoint-associated nine-gene signature for prognostic prediction of glioblastoma.

Glioblastoma (GBM) is a highly malignant neurological tumor that has a poor prognosis. While pyroptosis affects cancer cell proliferation, invasion and migration, function of pyroptosis-related genes (PRGs) in GBM as well as the prognostic significance of PRGs remain obscure. By analyzing the mechanisms involved in the association between pyroptosis and GBM, our study hopes to provide new insights into the treatment of GBM. Here, 32 out of 52 PRGs were identified as the differentially expressed genes between GBM tumor versus normal tissues. And all GBM cases were assigned to 2 groups according to the expression of the differentially expressed genes using comprehensive bioinformatics analysis. The least absolute shrinkage and selection operator analysis led to the construction of a 9-gene signature, and the cancer genome atlas cohort of GBM patients were categorized into high risk and low risk subgroups. A significant increase in the survival possibility was found in low risk patients in comparison with the high risk ones. Consistently, low risk patients of a gene expression omnibus cohort displayed a markedly longer overall survival than the high risk counterparts. The risk score calculated using the gene signature was found to be an independent predictor of survival of GBM cases. Besides, we observed significant differences in the expression levels of immune checkpoints between the high risk versus low risk GBM cases, providing instructive suggestions for immunotherapy of GBM. Overall, the present study developed a new multigene signature for prognostic prediction of GBM.

Recent management trends of subependymal giant cell astrocytoma associated with tuberous sclerosis complex.

Subependymal giant cell astrocytomas (SEGA) are benign cranial tumours typically found in patients with tuberous sclerosis complex (TSC). Surgical resection has been the standard treatment for SEGA, however, medical management through mTOR inhibitors has now predominantly replaced surgery as the primary treatment modality. Additionally, newer treatment modalities have emerged with the hopes of providing safer methods for treating the tumour such as laser interstitial thermal therapy (LITT). However, very few reports have addressed these newer methods and analysed the results.

Hope and pediatric health.

Snyder's Hope Theory and its application in pediatric health have been receiving increased attention recently. Within the last three years, research has primarily focused on adolescents and/or young adults, and pediatric cancer populations. Generally, higher hope scores are associated with positive outcomes in pediatric studies. There has also been increased interest in the role of hope in pediatric health interventions, with some studies indicating that hope is malleable and that changes in hope are associated with changes in health outcomes. Limitations in this research area include (1) a few longitudinal and follow-up studies assessing the stability of changes in hope, (2) the need to determine directionality regarding hope and health outcome relations, and (3) some inconsistencies in the conceptualization of hope.

Assessing the Needs of Adolescents and Young Adults Receiving Cancer Treatment: A Mixed Methods Study.

Purpose: This study was designed to assess the most salient health care needs of adolescents and young adults (AYAs) who undergo cancer treatment. Understanding their age-related needs helps providers offer appropriate support when support is vital: as they accept diagnosis and undergo treatment. Methods: A mixed methods design was used to obtain quantitative and qualitative data on the overall needs of AYA cancer patients. Participants, aged 16-29, who enrolled early in their cancer treatment, completed the Stanford Adolescent and Young Adult Cancer (SAYAC) Program survey and a subsequent one-on-one semistructured interview. Results: The quantitative and qualitative data were analyzed separately. The data revealed that AYAs adjusted and adapted to their cancer diagnosis to meet their health care needs. Three themes emerged from the data: acquisition of knowledge and experience, participation in decision-making and self-management behaviors, and gaining perspectives on life inside and outside of the hospital. The quantitative data revealed that the participants agreed or strongly agreed on the importance of being involved in the decision-making process, incorporating hopes and dreams into their treatment, and feeling supported by their family. Conclusion: Understanding the needs of AYAs who undergo cancer treatment is vital to their overall well-being. Using different data collection methods, including interviews, can clarify AYA needs and lead to improved individualized care.