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1.
Psychooncology ; 32(11): 1684-1693, 2023 11.
Article in English | MEDLINE | ID: mdl-37749754

ABSTRACT

OBJECTIVE: National Cancer Control Plans (NCCPs) are high-level policy documents that prioritise actions to be taken to improve cancer control activities. As the number of cancer survivors grows globally, there is an urgent need to assess whether and how psychosocial care across the cancer care continuum is included in NCCPs. This review aimed to ascertain the extent to which NCCPs referenced psycho-oncology care for cancer survivors in the post-treatment phase. METHODS: NCCPs were obtained from the International Cancer Control Partnership (ICCP) portal (in November 2021) and reviewed in two phases. In Phase 1, all available NCCPs were screened to determine whether they mentioned psycho-oncology or survivorship. In Phase 2, reviewers extracted data from the NCCPs identified in Phase 1 on the degree that each plan articulated objectives/goals to improve psychosocial care in the post-treatment survivorship phase. RESULTS: We screened 237 NCCPs. Of these, initial potential reference to psycho-oncology and survivorship content were identified in 97 plans (41%). In Phase 1, 57/97 (59%) had reference to psycho-oncology or survivorship content within defined criteria. In Phase 2, 27/97 (28%) had little mention of psycho-oncology specifically in survivorship, 47/97 (48%) had some (general or brief) mention, and the remaining 23/97 (24%) had substantial content/specific sections and clearly articulated goals and/or objectives. Common goals for improving psychosocial care in the post-treatment period included building capacity of healthcare professionals, implementing rehabilitation models, and increasing the utilisation of community services. CONCLUSIONS: Most NCCPs did not reference psycho-oncology and only one-quarter contained clear objectives specifically in the post-treatment survivorship phase.


Subject(s)
Cancer Survivors , Neoplasms , Psychiatric Rehabilitation , Humans , Delivery of Health Care , Neoplasms/psychology , Psycho-Oncology
2.
Lancet Oncol ; 24(1): e11-e56, 2023 01.
Article in English | MEDLINE | ID: mdl-36400101

ABSTRACT

Cancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years. We have deployed this knowledge to help inform Europe's Beating Cancer Plan and the EU Cancer Mission, and to set out an evidence-driven, patient-centred cancer research roadmap for Europe. The high-resolution cancer research data we have generated show current activities, captured through different metrics, including by region, disease burden, research domain, and effect on outcomes. We have also included granular data on research collaboration, gender of researchers, and research funding. The inclusion of granular data has facilitated the identification of areas that are perhaps overemphasised in current cancer research in Europe, while also highlighting domains that are underserved. Our detailed data emphasise the need for more information-driven and data-driven cancer research strategies and planning going forward. A particular focus must be on central and eastern Europe, because our findings emphasise the widening gap in cancer research activity, and capacity and outcomes, compared with the rest of Europe. Citizens and patients, no matter where they are, must benefit from advances in cancer research. This Commission also highlights that the narrow focus on discovery science and biopharmaceutical research in Europe needs to be widened to include such areas as prevention and early diagnosis; treatment modalities such as radiotherapy and surgery; and a larger concentration on developing a research and innovation strategy for the 20 million Europeans living beyond a cancer diagnosis. Our data highlight the important role of comprehensive cancer centres in driving the European cancer research agenda. Crucial to a functioning cancer research strategy and its translation into patient benefit is the need for a greater emphasis on health policy and systems research, including implementation science, so that the innovative technological outputs from cancer research have a clear pathway to delivery. This European cancer research Commission has identified 12 key recommendations within a call to action to reimagine cancer research and its implementation in Europe. We hope this call to action will help to achieve our ambitious 70:35 target: 70% average 10-year survival for all European cancer patients by 2035.


Subject(s)
COVID-19 , Neoplasms , Humans , Pandemics , COVID-19/epidemiology , Health Services Research , Europe/epidemiology , Europe, Eastern , Neoplasms/diagnosis , Neoplasms/epidemiology , Neoplasms/therapy
3.
Breast ; 62: 123-134, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35176683

ABSTRACT

Fear of cancer recurrence (FCR) is a normal response in cancer survivors and one of the most prevalent reactions reported by up to 87% of them. However, elevated levels of FCR impair well-being, quality of life and professional functioning, and lead to anxiety, depression or PTSD. COVID-19 pandemic can exacerbate FCR symptoms, given the restricting access to follow-up investigations and treatment, the isolation restrictions imposed and the possibility of the medical system becoming overworked. This scoping review's objective was to synthesize the literature investigating the factors associated with higher levels of FCR in cancer survivors during the COVID-19 pandemic. The focus was on FCR in breast cancer patients, including most of the studies (5 out of 9) on this topic. However, given the novelty of the subject, the increased interest in it, and the fact that there are few studies in this field, the review included 4 other studies with mixed samples of patients with breast cancer and other oncological pathologies. Following rigorous methodological criteria, 9 studies with quantitative or mixed methodology were included (N = 4831 patients). The results indicate that high levels of FCR are associated with distress and concerns regarding the pandemic impact, with most common concerns of patients being changes in treatment plan (delays and interruptions), dysfunctional communication with medical staff or difficult access to food or medicine. The most common correlates of FCR during the pandemic are marital status, childlessness, low financial status, level of education, type of cancer diagnosis, generalized anxiety and depression.


Subject(s)
Breast Neoplasms , COVID-19 , Breast Neoplasms/pathology , Fear , Female , Humans , Neoplasm Recurrence, Local/epidemiology , Pandemics , Quality of Life , SARS-CoV-2
4.
Lung Cancer ; 150: 221-239, 2020 12.
Article in English | MEDLINE | ID: mdl-33227525

ABSTRACT

European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC) are written by experts representing all disciplines involved in cancer care in Europe. They give patients, health professionals, managers and policymakers a guide to essential care throughout the patient journey. Lung cancer is the leading cause of cancer mortality and has a wide variation in treatment and outcomes in Europe. It is a major healthcare burden and has complex diagnosis and treatment challenges. Care must only be carried out in lung cancer units or centres that have a core multidisciplinary team (MDT) and an extended team of health professionals detailed here. Such units are far from universal in European countries. To meet European aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.


Subject(s)
Lung Neoplasms , Delivery of Health Care , Europe , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/therapy , Quality of Health Care
5.
Crit Rev Oncol Hematol ; 142: 187-199, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31445441

ABSTRACT

BACKGROUND: ECCO Essential Requirements for Quality Cancer Care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to cancer patients. They are written by European experts representing all disciplines involved in cancer care. This paper concerns the integration of primary care into care for all cancers in Europe. Primary care integration.


Subject(s)
Neoplasms/therapy , Primary Health Care , Quality of Health Care , Societies, Medical , Europe , Humans , Medical Oncology
6.
Qual Life Res ; 28(1): 277-282, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30284181

ABSTRACT

PURPOSE: The distress thermometer (DT) and the emotion thermometers (ET) are short screening instruments for use in oncological practice. The aim of this study was to provide normative values and to analyze the correlational structure of the ET. METHODS: A representative sample of the adult German general population (N = 2437) completed the ET, the PHQ-4, the FACIT-fatigue scale, and the demoralization scale. RESULTS: The percentages of people above the cutoff (≥ 4) and the mean scores of the five ET scales were as follows: distress: 39.0%, M = 3.15 ± 2.62, anxiety: 12.3%, M = 1.36 ± 1.93, depression: 16.1%, M = 1.65 ± 2.11, anger: 24.5%, M = 2.33 ± 2.16, and need for help: 10.7%, M = 1.18 ± 1.90. Women reported significantly higher levels of burden than men, with effect sizes between 0.07 (anger) and 0.36 (anxiety). All ET dimensions were interrelated (r between 0.44 and 0.69) and significantly correlated with the other scales (r between 0.36 and 0.68). CONCLUSIONS: The normative scores can help qualify assessments of groups of patients. The new four dimensions of the ET provide relevant additional information that is not already covered by the DT.


Subject(s)
Anxiety/diagnosis , Emotions/physiology , Mass Screening/methods , Quality of Life/psychology , Stress, Psychological/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Female , Germany , Humans , Male , Middle Aged , Young Adult
7.
J BUON ; 22(5): 1345-1351, 2017.
Article in English | MEDLINE | ID: mdl-29135124

ABSTRACT

PURPOSE: Research indicates the heightened need of cancer patients to return to work, which would be beneficial for their emotional/mental health and well-being. The major aim of this study was to identify the overall effect of losing the job upon different dimensions of well-being, and possible gender differences related to this influence. METHODS: A sample of 800 Romanian cancer patients was screened in 2014 (461 female and 338 male). RESULTS: Our results indicate that losing one's job after being diagnosed with cancer affects male more than female patients on the physical, emotional, and functional dimensions of well-being. Furthermore, male patients perceive a higher level of interference between illness/treatment and paid work than female patients, and perceive themselves less able to work than female cancer patients. Also the fulfillment derived from work perceived by male patients is lower than that of female cancer patients. CONCLUSION: Counselors and therapists should focus on enlarging the patients' pool of alternative sources of meaning, thus enhancing their well-being and implicitly their clinical recovery.


Subject(s)
Employment/trends , Neoplasms/epidemiology , Female , Gender Identity , Humans , Male , Middle Aged , Romania , Stress, Psychological
8.
Psychooncology ; 25(12): 1418-1423, 2016 12.
Article in English | MEDLINE | ID: mdl-26810239

ABSTRACT

Significant levels of distress usually accompany the entire cancer experience, affecting the patients' general functioning and adaptation to illness. OBJECTIVE: The major objective of the present study was to investigate potential demographic and intrapersonal moderators of the relationship between knowing the cancer diagnosis and the level of depression experienced. METHOD: The present research has a transversal comparative repeated cross-sectional design (2006-2014), sampling following the proportional quota method. Research was conducted in the four major oncological institutes in Romania, obtaining a national sample of cancer patients, maintaining gender and ethnic rates, and permitting the investigation of the stability of the results from one assessment to the other. RESULTS: Results indicate that in the Romanian context, knowing the diagnosis is associated with a lower level of depression than not knowing the diagnosis, the results being similar in both assessments (2006-2014). Furthermore, from the explored demographic factors (gender, residence, age, and education), only age has a main effect upon depression (depression increasing with age), while education is the only factor from those analyzed, which has a moderator effect. Regarding the analyzed intra-individual variables, only dysfunctional attitudes, emotion-focused coping, and lack of emotional support from the family (loneliness) have main effects upon the level of depression (i.e., higher levels of dysfunctional attitudes, emotion-focused coping, and loneliness are associated with higher levels of depression), while neither of them has a moderator effect on the relationship between knowing the diagnosis and depression. CONCLUSION: These results are important in the improvement of the doctor-patient relationship, the management of cancer-related distress, and implicitly for the course of illness. Copyright © 2016 John Wiley & Sons, Ltd.


Subject(s)
Depressive Disorder/psychology , Neoplasms/diagnosis , Neoplasms/psychology , Truth Disclosure , Adaptation, Psychological , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Cost of Illness , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Physician-Patient Relations , Risk Factors , Romania , Sick Role , Social Support , Young Adult
9.
Subst Use Misuse ; 49(6): 677-83, 2014 May.
Article in English | MEDLINE | ID: mdl-24328837

ABSTRACT

Even with the relatively high rate of illicit drug use in Romania, drug prevention remains a relatively low political and professional priority. Policies focus primarily on the criminalization of drug use rather than on prevention and treatment. By studying official Romanian drug policies and legislative documents, as well as national and European reports on the state of the ''drug problem,'' this article focuses on the impact of policy on drug use, treatment, and prevention, with an emphasis on the criminalization of drug use and the resultant trends and practical impacts. The reported lifetime use of illicit drugs has been rising slowly but steadily over the last few years. Contraction of communicable diseases among intravenous drug users is also trending upwards. And with the emphasis on criminalization of drug use and the accompanying marginalization of users, drug-law-related offences are also likely to increase. Unmet needs in drug prevention, a declining tendency to seek drug treatment, and an increase in drug-related deaths are also indicators of the negative effects of the current policy on drug use, criminalization, infections, and the lack of effective prevention. As Romania continues to face serious financial limitations, evidence-based research on drug use is needed; best practice guidelines have to be followed in order to improve access to drug prevention, treatment, and harm-reduction services.


Subject(s)
Health Policy/legislation & jurisprudence , Health Policy/trends , Policy Making , Substance-Related Disorders/prevention & control , Humans , Romania , Substance-Related Disorders/therapy
10.
Support Care Cancer ; 21(5): 1273-80, 2013 May.
Article in English | MEDLINE | ID: mdl-23151651

ABSTRACT

PURPOSE: Romania still has to adapt and develop psychosocial assessment protocols which would allow standardized screening for the sixth vital sign in cancer patients, namely distress and quality of life. The present study screens for the psychosocial and communication needs of cancer outpatients in palliative care and in rehabilitation. These data are also compared with those obtained from a sample of cancer inpatients. METHODS: Subjects for this study were recruited from cancer care services from the Transylvania region in Romania. A total of 203 persons with cancer were included in the screening. Of this number, 68 were in the hospitalized group, 71 were from the rehabilitation group, and 64 were palliative care cases. FACT-G 4.0 and BDI screening instruments were used in these clinical samples. Statistical analysis performed was: associational and comparative statistics, one-way analysis of variance. RESULTS: Statistically and clinically significant results were found in relation to symptoms of depression, physical and functional well-being, and overall quality of life. However, with regard to psychosocial well-being, there were no clinically relevant or significant differences among cancer patients under hospital treatment, or in rehabilitation and palliative care programs. More than 40 % of the cancer patients included in our pilot screening were not open to talk about their illness and their related needs. CONCLUSIONS: Cancer is an unmet psychosocial challenge to patients and to the specialized services, regardless of care type. The urgency of psychosocial screening in the Romanian cancer care system is revealed. Based on these findings, there is a need for psychosocial screening and related supportive care services that need to be integrated into Romania's cancer care programs. A recommendation is to pilot psychosocial and supportive care model within the four regional cancer care institutions.


Subject(s)
Health Services Needs and Demand/statistics & numerical data , Neoplasms/psychology , Quality of Life , Stress, Psychological/epidemiology , Adult , Aged , Aged, 80 and over , Analysis of Variance , Communication , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Humans , Male , Mass Screening/methods , Middle Aged , Neoplasms/pathology , Neoplasms/therapy , Palliative Care/methods , Pilot Projects , Romania , Stress, Psychological/etiology , Young Adult
11.
Drug Alcohol Rev ; 28(4): 419-25, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19594796

ABSTRACT

ISSUES: A tremendous growth occurred in the reported drug use and abuse in Romania from 1995 to 1999. Lack of concern by government and little policy attention contributed to the surprising delay of drug policy and drug prevention system development. General public stigmatize drug users and drug consumption is considered a matter of personal fault and responsibility. There is some but not sufficient research and evaluation on drug use, abuse problem. APPROACH: Drug use, abuse and prevention are discussed from research-based, user-focused and prevention system development perspectives. Prevalence and trends of drug use, abuse in the past decade (1995-2005) are summarized. Prevention issues are discussed based on research data from adolescents, parents and teachers. The Romanian primary drug prevention system has been evaluated based on our experiences in drug use prevention activities carried out in schools and recreational environments. KEY FINDINGS: Public and scientific perspectives on drug consumption in Romania, between 1995 and 1999, were dominated by an idealistic, non-realistic perception. Since 1995, drug use among adolescents increased almost four times in less than 4 years. The first law against drug traffic and consumption was issued only in 2000. Now primary drug prevention strategies are in action, but in general they are lacking standard evaluation procedures. IMPLICATIONS/CONCLUSION: Conclusions are drafted for new perspectives in prevention activities. More long-term, user-focused, demand-centred prevention activities should be carried out in more and more diversified settings and evaluation should be thoroughly considered.


Subject(s)
Drug and Narcotic Control/legislation & jurisprudence , Health Policy/legislation & jurisprudence , Substance-Related Disorders/prevention & control , Adolescent , Harm Reduction , Humans , Romania/epidemiology , Substance-Related Disorders/epidemiology , Young Adult
12.
Support Care Cancer ; 17(8): 1101-7, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19139925

ABSTRACT

OBJECTIVES: In recent psycho-oncological literature, few studies are concerned with the consequences of cancer diagnosis non-disclosure. The aims of this study were to analyze factors that may explain the non-disclosure of cancer diagnosis to patients by physicians and to compare personal characteristics of cancer patients, on the basis of cancer diagnosis disclosure versus non-disclosure. METHODS: A total of 420 hospitalized cancer patients were included in our study; 342 with malignant and 78 with benign tumors. Two hundred thirty-eight women and 185 men completed a self-report questionnaire that included standardized measures of depressive symptoms (BDI), hopelessness, ways of coping, negative life events and anomie. Data were controlled for demographic, medical, and psychosocial factors. RESULTS: Malignant cancer (OR:11.88), severe and moderate depression (OR:10.57 and OR:4.81), lack of chemotherapy (OR:4.20) and low anomie (OR:2.77) after overall adjustment predicted cancer diagnosis non-disclosure to patients. CONCLUSION: Our results underline the persistent need for delivering patient-focused health services in oncological care based on respect for the patients' right to autonomy.


Subject(s)
Neoplasms/diagnosis , Patient Rights , Patient-Centered Care/methods , Truth Disclosure , Adaptation, Psychological , Delivery of Health Care/methods , Delivery of Health Care/standards , Depression/etiology , Female , Humans , Male , Middle Aged , Neoplasms/pathology , Personal Autonomy , Severity of Illness Index , Surveys and Questionnaires
13.
Psychiatr Hung ; 21(2): 138-46, 2006.
Article in Hungarian | MEDLINE | ID: mdl-16929078

ABSTRACT

Psychotherapy and psycho-social interventions in oncological rehabilitation, based on confirmed results of several controlled studies designed and conducted in a bio-psycho-social research framework, have been proved to reduce the psycho-social vulnerability of cancer patients and to enhance health related quality of life in this patient population. It is also supposed that psychological intervention increases survival outcomes of cancer patients through immune-modulation. Findings of psycho-neuro-immunological research have underlined that the human neurological and immunological system, mainly the NK, CD4 and CD8 cell activity and cytotoxicity, are mediators and modulators in the progress of malignant tumors. Positive outcomes of psycho-social rehabilitation in oncology reinforce not only its effectiveness in reducing stress and anxiety, strengthening active coping mechanisms and immune functions, and improving quality of life but also its cost-effectiveness in view of relatively low investment and the high, multiplied health related benefits.


Subject(s)
Neoplasms/psychology , Psychotherapy , Quality of Life , Survival , Adaptation, Psychological , Humans , Neoplasms/mortality , Survival Analysis , Treatment Outcome
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