Prognostic Awareness in Terminally Ill Cancer Patients: A Narrative Literature Review of the Processes Involved.

High prognostic awareness (PA) is seen by many as a threat to terminal patients' psychological well-being. Whether this concern is supported by evidence or not is still a matter of discussion, given the heterogeneity of existing findings. This ambiguity points to the importance of considering contextual processes involved in the relationship between high PA and psychological outcomes, as a possible mediator and moderator mechanism. Aiming to capture a holistic image of the relationship between PA and the psychological experiences of patients, we adapted a narrative method to synthesize and discusses patient-related (physical symptoms, coping strategy, spirituality) and external (family support, received medical care) processes as potential explaining mechanisms.

How Much Stress Does a Surgeon Endure? The Effects of the Robotic Approach on the Autonomic Nervous System of a Surgeon in the Modern Era of Thoracic Surgery.

(1) Objective: the purpose of this study was to evaluate and quantify the stress to which a surgeon is subjected during his/her surgical activity; we compared the individual clinical and psychological responses to stress of two surgeons during their surgical activities via robotic and open approaches. (2) Materials and methods: This was a prospective observational study in which we progressively collected data concerning the surgical performances of two different thoracic surgeons (October 2021-June 2022). We evaluated 20 lung resections performed via robot-assisted surgery and 20 lung resections performed via an open approach by each surgeon; in particular, we evaluated a panel of pre-, peri-, and postoperative data concerning the interventions, the patients, and other outcomes concerning the autonomic nervous system (ANS) and psychological responses to stress of the surgeons during their surgical activities. (3) Results: When analyzing data concerning the ANS activity of two surgeons, during robotic activity we found lower maximum, minimum, and mean heart rates; lower mean respiratory frequencies; lower body temperatures; and lower mean desaturations compared to the open approach activity for both surgeons. The psychological monitoring showed that the open approach created more physical fatigue and frustration but higher levels of satisfaction and performance evaluation. The robot-assisted surgeries showed higher levels of anxiety. (4) Conclusions: for different reasons, the robotic approach stimulated the ANS to a lesser degree, causing less stress for surgeons and ensuring greater comfort.

The Burden of the Pain: Adverse Mental Health Outcomes of COVID-19 in Women With and Without Cancer.

The coronavirus disease 2019 (COVID-19) pandemic had a negative psychological impact on the population at scale, yet it is possible that vulnerable patient populations may experience a heavier burden with increased feelings of anxiety and distress. Cancer patients have to trade-off between the fear of exposing themselves to the virus and the need to continue life-saving medical procedures. The present study investigated the prevalence of generalized anxiety and post-traumatic stress symptoms (PTSS) in a population of Italian cancer patients and healthy participants in the months following the COVID-19 outbreak. Using standardized measures of PTSS (impact of event scale revised; IES-R) and generalized anxiety (generalized anxiety scale; GAD-7), we found that patients experienced higher levels of adverse mental health outcomes. Several variables were found to negatively affect PTSS and anxiety in this population, including the younger age of respondents, having children, and the impossibility to attend regular medical check-ups. These findings stress the importance of maintaining a clear and regular communication with patients throughout future waves of the pandemic and ensure continuity of care in this vulnerable population. Furthermore, this study indicates the need to establish psychological interventions aimed at patients with cancer, targeting especially younger generations who are more likely to experience adverse psychological outcomes.

Genetic testing users in Italy and Germany: Health orientation, health-related habits, and psychological profile.

BACKGROUND: Rapid advances in genomic knowledge and widespread access to the web contributed to the development of genetic services by private companies or medical laboratories. In the European landscape, though, there is not a single coherent regulatory approach to genetic testing (GT). The study aimed to investigate differences and similarities between two populations of GT users, Italians and Germans, in terms of health-related behaviors, psychological characteristics, and attitudes toward genetic information. METHODS: Ninety-nine Italian GT users from one private genetic company and 64 Germans GT users from one medical laboratory, completed an ad hoc self-administered questionnaire. RESULTS: Results showed significant differences in health-related behaviors (unhealthy eating behaviors, smoking behaviors, and frequency in medical check-ups), with Germans reporting higher levels of unhealthy eating habits and smoking behaviors than Italians; Italian users also were more medically controlled. Furthermore, German participants were less willing to change their lifestyle following the GT results compared to Italian participants. Regarding psychological variables, German users felt more confident about their physical well-being and they seemed more motivated than Italians to avoid becoming unhealthy. Finally, two samples differed in the way they accessed genetic testing (with the Italians guided predominately by a physician in contrast with the Germans who were recommended by friends) and managed genetic testing results (with Italian participants significantly more willing to share results with doctors than German participants, who preferred sharing with the family). CONCLUSION: The analysis of cultural and organizational differences could help in defining adequate guidelines for counseling, and provide inputs for regulators in different European contexts.

Shared decision-making and the lessons learned about decision regret in cancer patients.

The commentary presents reflections on the literature on post-treatment cancer patient regret. Even though a lot of effort has been made to increase patient satisfaction by engaging them in medical decisions, patient regret remains present in clinical settings. In our commentary, we identify three main aspects of shared decision-making that previously have been shown to predict patient regret. Based on these findings, we provide recommendations for physicians involved in the shared decision-making process. In addition, we make methodological suggestions for future research in the field.

Incidence of PTSD and generalized anxiety symptoms during the first wave of COVID-19 outbreak: an exploratory study of a large sample of the Italian population.

BACKGROUND: During the COVID-19 pandemic, between March and May 2020, in Italy, people were asked to shelter in place and most had to put their life on hold, while news of the spread of the virus constantly were broadcasted. The change in habits and the potential exposure to a dangerous virus can be categorized as a catastrophic event, which are usually traumatic and therefore have psychological consequences for the people involved. OBJECTIVE: Assuming the COVID-19 pandemic as a possible traumatic event, this study aims to explore the contingent behavioural and psychological impact of COVID-19 spread and related lockdown on the Italian general population, through measuring anxiety and post-traumatic stress symptoms . METHODS: An ad hoc-survey was set up for the this exploratory research, including the standardized Italian versions of the Impact of Event Scale Revised (IES-R) and the Generalized Anxiety Scale (GAD-7), and ad hoc items concerning behavioural reactions due to the pandemic spread and related mass quarantine. Participants were recruited across convenient web-based and mobile app channels using a snowball sampling technique. Data was collected from March 25th to May 1st, 2020. PARTICIPANTS: One-thousand one hundred and ninety-five individuals (851 women and 342 men) completed 60% or more of the survey and were considered for analyses. Mean age was 40 years (s.d. = 14.948). Participants resided in 78 Italian provinces (out of 107 territorial divisions), with 25.7% residing in the Milan province and 9.2% from the Monza and Brianza provinces, closest to the epicentre of the Italian outbreak. RESULTS: During the worst months of the first wave of the Pandemic, the Italian population suffered high level of distress (GAD-7 m = 6.89, s.d. = 5.08; IER-R mean score = 27.86, s.d. 17.46), respectively indicating mild presence of anxiety symptoms, and high levels of PTSD symptoms. Gender seems to be a discriminating variable with women scoring significantly higher than man, both for anxiety symptoms (H (1) = 82.91, p < .001) and all dimensions of PTSD symptoms (intrusion H (1) = 71.23, p < .001, avoidance H (1) = 61.28, p < .001), and hyperarousal (H (1) = 67.348, p < .001). People from Generations Y and Z show to be at higher risk of developing PTSD (V = .746, F (3,1041) =1017.19, p = .001) and GAD symptoms (F (3,1041) = 5.113, p = .002) than older generations. CONCLUSIONS: Gender and generation appeared to be the most consistent risk factor for higher levels of generalized anxiety and PTSD symptoms in the current pandemic. Other variables - such as information seeking behaviours, parental and marriage status, chronic conditions - yielded less consistent evidence. Results indicate the need of including psychological interventions as a standard tool during the emergency management of a catastrophic events such as a pandemic.

Knowledge, Use, and Perceptions of Metaphors Among Allied Health Faculty.

Allied health professionals spend a considerable amount of time listening to and communicating with patients while providing care. The inclusion of appropriate communication skills as a part of the core curriculum for allied health professions is crucial. Metaphorical representations are used by both patients and healthcare providers when communicating. Patients express their symptoms using metaphors and health professionals may use metaphors to facilitate the provider-patient interaction. It is reasonable to expect that allied health faculty would intentionally train their students in the use of metaphor. However, research on knowledge, use, and perception of metaphors among allied health faculty is absent. To address the gap, our study, by using a 13-question online anonymous survey, aimed to: 1) assess how well faculty of nutrition, respiratory therapy, athletic training, and occupational therapy programs recognize metaphors, and 2) determine if faculty use metaphors when they have to explain a clinical concept. A total of 366 participants completed the survey. Participants agreed on the value of metaphorical communication and showed a willingness to use metaphors in educational settings to teach a clinical concept. Participants were often not able to correctly identify metaphors when used in sentences.

Patients Living With Breast Cancer During the Coronavirus Pandemic: The Role of Family Resilience, Coping Flexibility, and Locus of Control on Affective Responses.

The coronavirus disease 2019 (COVID-19) pandemic has strongly affected oncology patients. Many screening and treatment programs have been postponed or canceled, and such patients also experience fear of increased risk of exposure to the virus. In many cases, locus of control, coping flexibility, and perception of a supportive environment, specifically family resilience, can allow for positive emotional outcomes for individuals managing complex health conditions like cancer. This study aims to determine if family resilience, coping flexibility, and locus of control can mitigate the negative affect caused by the pandemic and enhance positive affect in breast cancer patients. One hundred and fifty-four female patients with breast cancer completed the Walsh's Family Resilience Questionnaire, the Perceived Ability to Cope With Trauma Scale, the Positive-Negative Affect Schedule, and the Mini Locus of Control Scale. Family resilience and internality of locus of control contribute significantly to positive affective responses. Family resilience is responsible for mitigating the negative affect perceived during the pandemic and is enhanced by external locus of control. Evidence suggests that clinical psychologists should develop and propose programs to support oncology patients' family resilience, coping flexibility, and internal locus of control, allowing for decreased stress and improved adaptability for effectively managing cancer treatment during the pandemic.

Immersive Versus Non-immersive Experience: Exploring the Feasibility of Memory Assessment Through 360° Technology.

Episodic memory is essential to effectively perform a number of daily activities, as it enables individuals to consciously recall experiences within their spatial and temporal environments. Virtual Reality (VR) serves as an efficacious instrument to assess cognitive functions like attention and memory. Previous studies have adopted computer-simulated VR to assess memory, which realized greater benefits compared to traditional procedures (paper and pencil). One of the most recent trends of immersive VR experiences is the 360° technology. In order to evaluate its capabilities, this study aims to compare memory performance through two tasks: immersive task and non-immersive task. These tasks differ based on the participant's view of the 360° picture: (1) head-mounted display (HMD) for immersive task and (2) tablet for non-immersive task. This study seeks to compare how memory is facilitated in both the 360° immersive picture as well as the non-immersive 360° picture. A repeated measure design was carried out in a sample of 42 participants, randomized into two groups of 21. Group 1 first observed Picture A (immersive) followed by Picture B (non-immersive) while Group 2 began with Picture B and then looked at Picture A. Each 360° picture contains specific items with some items appearing in both. Memory evaluation is assessed immediately after the exposure (recall task), then again after a 10-min delay (recognition task). Results reveal that Group 1, which began with the immersive task, demonstrated stronger memory performance in the long term as compared to Group 2, which began with the non-immersive task. Preliminary data ultimately supports the efficacy of the 360° technology in evaluating cognitive function.

New Frontiers for Cognitive Assessment: An Exploratory Study of the Potentiality of 360° Technologies for Memory Evaluation.

One of the most recent trends in technology field is the 360° technology. In order to investigate its potentiality for the evaluation of memory function, we compared participants' performance in two memory tasks between an encoding delivered through an immersive 360° environment and a non-immersive 360° one. Specifically, we investigated if the immersive 360° environment would facilitate memory encoding in comparison to the non-immersive 360° one. Forty-two participants visualized two 360° pictures of a bedroom containing specific items and items shared by the two rooms, either in the "non-immersive → immersive" order or in the "immersive → non-immersive" one. Results showed that the immersive set-up was able to strengthen the mnestic trace only when participants performed the tasks in the "non-immersive → immersive" order. A possible explanation is a potential familiarity with the technologies used to explore the 360° environments. Overall, these results only partially supported the effectiveness of immersive 360° technology in facilitating episodic memory encoding; future studies should further explore the potentiality of this innovative technology.

Bridging Minds: A Mixed Methodology to Assess Networked Flow.

The main goal of this contribution is to present a methodological framework to study Networked Flow, a bio-psycho-social theory of collective creativity applying it on creative processes occurring via a computer network. First, we draw on the definition of Networked Flow to identify the key methodological requirements of this model. Next, we present the rationale of a mixed methodology, which aims at combining qualitative, quantitative and structural analysis of group dynamics to obtain a rich longitudinal dataset. We argue that this integrated strategy holds potential for describing the complex dynamics of creative collaboration, by linking the experiential features of collaborative experience (flow, social presence), with the structural features of collaboration dynamics (network indexes) and the collaboration outcome (the creative product). Finally, we report on our experience with using this methodology in blended collaboration settings (including both face-to-face and virtual meetings), to identify open issues and provide future research directions.

Effect Of Telephone Calls And Text Messages On Goal Attainment In A Ehealth Coaching Service.

Yukendu is a personal mobile coaching service that supports people in reaching good levels of psychological and physical wellbeing through the use of an app and a telephone-based relationship with a health coach. The aim of this contribution is to describe the results obtained in a sample of 171 clients (female, n=150) and investigate the main factors in attaining their health-related goals. Results show that 61,98% (n=106) of the sample attained the results they wanted totally or partially. The regression model (number of phone calls, text messages, plan duration, achieved weight loss) accounts for 56,9% of data variance in achieved weight loss. Significant predictors of achieved weight loss are average number of calls (B=.388, p<.05), texts exchange (B=.331, p<.05) and plan duration (B=.291). These results suggest therefore that in the first phase of health behavioral change, eHealth coaching efficacy lies primarily in the communication between coach and coachee.

A (Cyber)place For Wellbeing: Managing Interactions in eHealth.

Yukendu is a personal mobile coaching service that supports people in reaching good levels of psychological and physical wellbeing through the use of an app and a relationship with a health coach. Presenting Yukendu's app functioning, this paper aims not only to show that by means of web 2.0 tools is possible to manage in a functional way effective eHealth coaching interactions, but also that relationships between a coach and a coachee managed in such a way give birth to what we could call a 'cyber-wellbeing-place'.

Positive Technology for Healthy Living and Active Ageing.

Information and communication technologies are widely and rapidly spreading in people's daily lives. But what is the possible role of the mass proliferation of digital devices in supporting healthy living and active ageing? Are they useful in fostering personal growth and individual integration of the elderly, by promoting satisfaction, opportunities for action, and self-expression? Rather, do they enhance automation, impose constraints on personal initiative, and result in compulsive consumption of information? In this chapter, we suggest that possible answers to these questions will be offered by the "Positive Technology" approach, i.e., the scientific and applied approach to using technology so that it improves the quality of our personal experiences through its structuring, augmentation, and/or replacement. First, we suggest that it is possible to use technology to manipulate the quality of experience with the goal of increasing wellness and generating strengths and resilience in individuals, organizations, and society. Then, we classify positive technologies according to their effects on these three features of personal experience - Hedonic: technologies used to induce positive and pleasant experiences; Eudaimonic: technologies used to support individuals in reaching engaging and self-actualizing experiences; Social/Interpersonal: technologies used to support and improve the connectedness between individuals, groups, and organizations. Finally, we discuss the possible role of positive technologies for healthy living and active ageing by presenting different practical applications of this approach.

Sitting/setting on a fence: the use of (video)recording in producing data to study edge environments.

The presence of interactive technologies both in field and laboratory research settings makes new instruments and new methodological perspectives to have a complete view of the processes taking place in the setting. This contribution suggests that recording data and taking the researcher position in the setting into consideration may enrich the data production process.

Evaluation of a personal mobile coaching service for health tracking.

Yukendu is a personal mobile coaching service that supports people in reaching good levels of psychological and physical well-being. The aim of this contribution is to describe the peculiarities of Yukendu and its multi-step evaluation process.

Assessment Needs Analysis for Developing Mobile Apps to Encourage Proactive Preventive Medicine Education Among Young Military Personnel.

OBJECTIVE: International travel to underdeveloped areas where both hygienic conditions and sufficient medical care are often in short supply can pose severe health risks. Infectious disease is one of the most common health risks for military forces deployed overseas. Careful personal hygiene and early symptom recognition serve as important steps in averting potential illness. With the ubiquitous deployment threat of chemical and biological warfare agents, the benefit of early detection and action can ultimately be critical for survival. Nowadays game-based learning models, made available on mobile devices in the form of apps, can provide relevant medical knowledge, and they can effectively reach a young military population. The aims of this preliminary research project are twofold: (1) We want to investigate whether young U.S. Army personnel would be open to the use of mobile apps while deployed abroad, and (2) we want to share the research design adopted with the intent of providing a baseline methodology that can be used in future larger studies. SUBJECTS AND METHODS: We recruited and interviewed Reserve Officers' Training Corps cadets at a university in the United States. Focus groups have been adopted as a research tool for collecting data. Open and close-ended questions were used during the focus group. Four domains were investigated: Cell phone usage, game console perceptions, game genre preferences, and gaming habits and perceptions. RESULTS: The analysis of the focus group data reported that young military personnel often play with videogames and that they prefer first person Action/Combat genre. The data also showed that they do not consider playing videogames to be a leisure activity but a part of their lives. CONCLUSION: The preliminary results of this study suggest that games on cell phones could be considered as a platform for teaching young military personnel medical-related concepts and health safety procedures.

Between Cyberplace and Cyberspace: the researcher's role in virtual setting research.

Disciplines such as Internet Research, the Psychology of Cyberspace and the Social Psychology of Cyberplaces call for an epistemological reflection not merely on the universe of objects they deal with, but also, and perhaps especially, on the research settings used to investigate them. With this work, we intend to make a contribution to the debate on three issues: psychosocial interpretation of the new environments, the "mediated" nature of the researcher-setting-study object relationship, and cyberplaces as settings for mediated interaction research.