Validación ecológica del programa FORT (Fear of Cancer Recurrence Therapy): una adaptación del español mexicano al español castellano: reporte preliminar / Ecological validation of Fear of Cancer Recurrence Therapy from Mexican to european Spanish for breast cancer patients: Preliminary repor

Introducción: El miedo a la recaída es uno de los problemas psicológicos en los pacientes con cáncer, más específicos. El aumento en la esperanza de vida en el paciente oncológico, y la supervivencia, hace que cada vez más conozcamos las consecuencias emocionales, y vivir con el llamado Síndrome de la Espada de Damocles es sin duda una de las más importantes. Este miedo a la recaída puede llegar a ser invalidante y por ello cada vez más se elaboran programas terapéuticos para poderlo combatir. Uno de los más conocidos es el FORT (Fear of Recurrence Therapy) elaborado por Maheu y Lebel y que en este momento está siendo adaptado a otros lenguajes y culturas. Una de ellas es la adaptación de Gálvez en México. Objetivo: Nuestro objetivo en el presente trabajo preliminar es presentar los primeros datos de adaptación de esta terapia del español mexicano al europeo. Método: El procedimiento seguido es la validación ecológica propuesta por Bernal en base al consenso de dos psicooncólogas expertas. Resultados: Después de valorar el cambio de diferentes conceptos y terminologías, se han valorado de forma independiente por parte de ambas psicooncólogas, las 8 dimensiones de Bernal con un alto índice Kappa (de 0,8 a 1). Conclusiones: Este es un estudio preliminar al que le va a seguir los mismos pasos para el manual de la paciente por parte de profesionales y de pacientes con cáncer de mama (AU)

Introduction: Fear of recurrence is one of the most specific psychological problems faced by cancer patients. Their increase in life expectancy, and survival, makes them increasingly aware of the emotional consequences, and living with the so-called Sword of Damocles Syndrome is undoubtedly one of the most important. Fear of recurrence can become disabling and affect their emotional well-being, leading to the development of therapeutic programs like FORT (Fear of Recurrence Therapy) developed by Maheu and Lebel. This therapy is being adapted to different languages and cultures, including Mexican Spanish by Gálvez. Objective: In this preliminary work, we aim to present the first data on adapting FORT from Mexican Spanish to European Spanish. Methods: The procedure used was to follow the ecological validation method proposed by Bernal, by two skilled psychooncologists. Results: The assessment of different concepts and terminologies by the two psychooncologists in an independent way, the analysis yielded a high Kappa index (from 0.8 to 1) for the 8 dimensions of Bernal. Conclusions: This preliminary study will be followed by a similar process for the patient manual by professionals and breast cancer patients (AU)

Psychosocial care for cancer survivors: A global review of national cancer control plans.

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.

Use of telehealth for psychosocial oncology: A mixed methods study about barriers to and opportunities with Latino patients from Latin America, Spain, and the United States.

OBJECTIVES: Telehealth for mental healthcare expanded rapidly with the COVID-19 pandemic's onset; however, global access disparities emerged. Telehealth challenges and opportunities for Latino cancer patients from different geographical regions must be explored. METHODS: A cross-sectional online survey (March-July 2021) of mental health providers, serving Latino cancer patients in Latin America, United States, and Spain, contained close-ended questions related to the use of telehealth during the pandemic and open-ended questions on recommending/not recommending telehealth. RESULTS: In a sample of 148 providers from 21 countries, 60.5% reported that at least some of their patients had difficulties with Internet speed and connectivity and lacked knowledge about using electronic devices (43.2%) or the Internet (45.4%). Lacking privacy at home (66.0%) and childcare (26.0%) were reported patient challenges. Internet connectivity or speed were issues for providers (43.2%) themselves. Improving patient reach was a reported telehealth benefit (64.2%). Geographical access (43.2%) and physical limitations (35.8%) were considerations in offering telehealth. Considerations for not recommending telehealth were patient age (24.3%) and lacking technological knowledge (29.1%). CONCLUSIONS: Telehealth for mental healthcare may improve patient access issues caused by geographical and transportation conditions and patient functionality. Findings provide insight into telehealth benefits and challenges in Latino patient populations. Future studies should examine patient access and use by region.

International collaboration for assessing unmet needs of cancer survivors and family caregivers: Lens of healthcare professionals.

OBJECTIVE: Cancer patients and their family caregivers have reported various needs that are not met. Recognition of the unmet needs by healthcare professionals may be a first step to adequately and systematically addressing them. Thus, the International Psycho-Oncology Society Survivorship Online Survey was developed to measure healthcare professionals' evaluation about the unmet needs of their patients and family caregivers around the globe. METHODS: The survey was developed in English and translated to additional 14 different languages. The survey was distributed on the web-based REDCap application to over 50 psycho-oncology societies and their networking platforms as well as social media and to authors who have published in psycho-oncology journals globally. RESULTS: A total of 1472 participants from 36 countries at least partially completed the survey. Healthcare professionals evaluated needs for managing one's emotional distress and patients' medical care and symptoms as the most common concerns for both patients and their family caregivers across all patient age groups. Less than two-thirds of the participating healthcare professionals reported that their institution had services or programs to address the needs of the patients or caregivers. CONCLUSIONS: Findings suggest several directions for further analyses to provide more specific information that would be readily translated into clinical practices, research, and policy aimed to enhance the quality of life of cancer patients, survivors, and family caregivers around the globe. In addition, this collaborative effort also hints at the importance of establishing international networks to promote equity in care for people touched by cancer worldwide.

A single-session Mindfulness-Based Swinging Technique vs. cognitive disputation intervention among women with breast cancer: A pilot randomised controlled study examining the efficacy at 8-week follow-up.

Objective: Previously Mindfulness-Based Swinging Technique (MBST)'s immediate efficacy for overcoming psychological concerns has recently received empirical support, yet its longer-term efficacy needed to be evaluated among women with breast cancer. The objective of this study was to assess and report the efficacy of MBST intervention among breast cancer patients for hopelessness, anxiety, depression, self-efficacy, oxygen (SpO2) intensity, and heart rate-beats per minute (HR-bpm) at an 8-week period. Method: The State-Trait Anxiety Inventory, The Emotion Thermometer, Hospital Anxiety and Depression Scale, Self-Efficacy for Managing Chronic Disease, and Beck's Hopelessness Scale were used for assessing the intervention's outcome; 149 BC patients were randomly assigned into two groups (equal-mean-age, p = 0.262). The participants in the control group (CG, n = 73) received Cognitive Behavioural Therapy (CBT)-Cognitive-Disputation (CBT-CD) for 20 min, and intervention group (IG, n = 76) received MBST intervention. No additional psychological interventions were given between week-1 and week-8. Result: Outcomes of the 8-week post-treatment follow-up exhibited significantly higher improvements in all evaluated-measurements for CG, and some for IG with large effect size in the following: anxiety (CG p < 0.05, r = 0.57; IG p < 0.05, r = 0.44) and depression levels (CG p < 0.05, r = 0.43). It increased self-efficacy for managing disease (CG p < 0.05, r = 0.49; IG p < 0.05, r = 0.41) and hopefulness (CG p < 0.05, r = 0.59; IG p < 0.05, r = 0.46), and saturation levels measured by pulse-meter/oximeter (CG p < 0.05, r = 0.49; IG p < 0.05, r = 0.32). Conclusions: Both CBT-CD and MBST have been found to be efficacious interventions to shorten the psychotherapy duration for reducing clinical anxiety and hopelessness as well as increase self-efficacy for BC women. This may have a distinct clinical importance for supporting BC patient's adherence-to-treatment since CBT-CD could be an alternative technique to MBST as a brief intervention. In future studies, the effectiveness of MBST through adapting to virtual reality and other online delivery methods should be examined.

Cancer Prevention and Diagnosis Knowledge among Spanish-speaking Older Latino/as Residing in Tampa, Florida.

Objective: Cancer remains the leading cause of death among Latino/as in the United States, and advancing age is a major risk factor for developing most cancer types. Given the growing population of Latino/as immigrants aged ≥60 years and the current lack of relevant data, this study aims to understand the cancer prevention and perception of cancer diagnosis among older Latinos to ensure that they receive effective prevention, intervention, and psychosocial care. Method: A survey exploring attitudes about cancer was developed and administered in Spanish. Using convenience sampling, 168 individuals identifying as Latino/as were surveyed in Tampa, Florida. Descriptive analysis was conducted to understand study population characteristics. Frequencies were assessed to understand the participants' responses to cancer-related attitude questions. The effects of age, country of origin, length of stay in the United States, and marital status on the participants' cancer-related attitudes were assessed using logistic regression. Results: The mean age of the study participants was 67.9 years, 34.5% were male, and the mean length of stay in the United States was 25.8 years. In total, 29% and 24.4% of the participants knew that breast cancer and prostate cancer, respectively, can be diagnosed early. Individuals with an elementary education were less likely to have sufficient knowledge of cancer prevention and diagnosis. Additionally, 93.5% of the population was aware that tobacco use can lead to cancer, and 84.5% knew that exposure to tobacco smoke can affect both the smoker and their family. Conclusion: Older Latino/as possess knowledge about cancer causes yet lack knowledge regarding cancer prevention and diagnosis, potentially creating barriers and causing them to avoid treatment. Focusing on cancer-related health education among older Latino/as is a step toward appropriate and equitable cancer care.

Efficacy of New Mindfulness-Based Swinging Technique Intervention: A Pilot Randomised Controlled Trial Among Women With Breast Cancer.

Objective: Combining 3rd-wave-therapies with Cognitive-Behavioural-Therapy (CBT) has increased in recent years. Usually these therapies require longer sessions which therefore increases the psychotherapy drop-out rate for cancer patients for multiple medical reasons. This inspired intervention of a shorter 20 min-long mindfulness-therapy (MBST) to be developed for Breast-Cancer-patients (BC). Method: This pilot randomised controlled trial was to assess the immediate-outcome of the MBST-intervention for its efficacy for BC-patients by using the Pearson Chi-square test, Fisher-Freeman-Halton exact test, and McNemar test for categorical variables; Mann-Whitney U and Wilcoxon test for the continuous variables. The Emotion Thermometer, State Trait Anxiety Inventory, Hospital Anxiety and Depression Scale, Self-Efficacy for Managing Chronic Disease, and Beck's Hopelessness Scale were used for measuring the intervention outcomes. One hundred seventy-three BC patients were randomly assigned in two-groups (equal-mean-age, p = 0.417). Control-Group (CG, n = 82) received cognitive-disputation-technique a form-of-CBT, and Intervention-Group (IG, n = 74) received MBST. The directives are given to IG: psychoeducation about Mindfulness, and to imagine themselves swinging-in a peaceful environment. When the patients imagine their swing going up, they physically take a deep-breath, and when going down they physically release their breath, and this process is repeated. Result: Outcomes post-treatment showed significant higher-improvement in IG in all the assessed-measurements, with large-effect-size: anxiety (p < 0,05, r = 0,67) and depression-levels (p < 0,05, r = 0,71); anxiety-trait (p < 0,05; r = 0,79) reduced, it increases self-efficacy for managing-disease (p < 0,05, r = 0,82) as-well-as hopefulness (p < 0,05, r = 0,61) and saturation-level measured by pulse-meter/oximeter (p < 0,05, r = 0,51). Conclusion: MBST is an efficacious intervention to reduce psychotherapy session time for immediate relief from clinical anxiety and hopelessness as well as increase self-efficacy and improve tranquillity for BC-women. It may have a particular clinical significance for supporting patient's adherence to treatment. Although in this pilot sample MBST was found to be effective for short-term-outcome, its efficacy for longer-term-outcome should be examined in future trials. Additionally, breathing laps can be increased possibly for a greater result on rise of saturation levels of patients.

Risk perception, treatment adherence, and personality during COVID-19 pandemic: An international study on cancer patients.

OBJECTIVE: To explore the role of personality traits in moderating the relation between COVID-19 risk perception and treatment adherence, and between risk perception and psychosocial distress in patients diagnosed with cancer. METHODS: An online survey (n = 1281) was conducted worldwide in seven countries (Austria, Germany, Hong Kong, Italy, Spain, Sweden, and Turkey). Inclusion criteria were to be 18 years of age or older, have received a cancer diagnosis, and be in treatment or follow-up. A few moderated regression models were performed with both personality traits and Hierarchical Taxonomy of Psychopathology super-spectra as moderators. RESULTS: Detachment, negative affectivity, psychoticism and all the super-spectra significantly moderated the relation between coronavirus risk perception and psychosocial distress, after the adjusting effect of confidence in safeguards. Only negative affectivity moderated the association between coronavirus risk perception and treatment adherence. CONCLUSIONS: Personality traits may foster the understanding of how a patient might adjust to cancer treatment and, more generically, to highly stressful events such as the COVID-19 pandemic. Further research is needed to confirm the results in different cancer stages and types.

Fear of Cancer Recurrence, Health Anxiety, Worry, and Uncertainty: A Scoping Review About Their Conceptualization and Measurement Within Breast Cancer Survivorship Research.

Objective: Fear of Cancer Recurrence (FCR), Health Anxiety (HA), worry, and uncertainty in illness are psychological concerns commonly faced by cancer patients. In survivorship research, these similar, yet different constructs are frequently used interchangeably and multiple instruments are used in to measure them. The lack of clear and consistent conceptualization and measurement can lead to diverse or contradictory interpretations. The purpose of this scoping review was to review, compare, and analyze the current conceptualization and measurements used for FCR, HA, worry, and uncertainty in the breast cancer survivorship literature to improve research and practice. Inclusion Criteria: We considered quantitative, qualitative, and mixed methods studies of breast cancer survivors that examined FCR, HA, worry, or uncertainty in illness as a main topic and included a definition or assessment of the constructs. Methods and Analysis: The six-staged framework was used to guide the scoping review process. Searches of PubMed, CINAHL, and PsycINFO databases were conducted. The principle-based qualitative analysis and simultaneous content analysis procedures were employed to synthesize and map the findings. Findings: After duplicate removal, the search revealed 3,299 articles, of which 82 studies met the inclusion criteria. Several critical attributes overlapped the four constructs, for example, all were triggered by internal somatic and external cues. However, several unique attributes were found (e.g., a sense of loss of security in the body is observed only among survivors experiencing FCR). Overall, findings showed that FCR and uncertainty in illness are more likely to be triggered by cancer-specific factors, while worry and HA have more trait-like in terms of characteristics, theoretical features, and correlates. We found that the measures used to assess each construct were on par with their intended constructs. Eighteen approaches were used to measure FCR, 15 for HA, 8 for worry, and 4 for uncertainty. Conclusion: While consensus on the conceptualization and measurement of the four constructs has not yet been reached, this scoping review identifies key similarities and differences to aid in their selection and measurement. Considering the observed overlap between the four studied constructs, further research delineating the unique attributes for each construct is warranted.

"People Give Opinions, but the Decision Belongs to the Patient": Examining Cancer Treatment Decisions Among Latinos/as in Central Florida.

Latinos/as, the fastest-growing ethnic group in the United States, experience high cancer rates. Factors contributing to treatment decisions among Latinos diagnosed with cancer must be studied. This paper aims to identify treatment decisions among Latinos with cancer and examine factors influencing these decisions. A qualitative exploratory study using semi-structured interviews of 60 Latino/as diagnosed with cancer was conducted. Close-ended responses were analyzed using percentages and frequency distributions, while open-ended responses were analyzed using open coding and thematic categorization. Surgery was the most commonly chosen treatment among participants because it was perceived as providing the highest chance of prolonging life. Only 57% of participants were provided with treatment options. Latinos/as typically prefer modest, paternalistic patient-physician relationships. Therefore, providing culturally appropriate information is valuable. This study underscores the need for health providers to present all available treatment options to enhance cancer treatment outcomes.

Uso de internet para evaluar el distrés psicológico en pacientes con cáncer de mama / Use of internet to assess psychological distress in breast cancer patients

Objetivo: El objetivo de este estudio es determinar la prevalencia de síntomas de distrés y la estrategia de adaptación entre una amplia muestra de pacientes de habla hispana con cáncer de mama mediante el uso de internet. Métodos: Se diseñó un estudio transversal con pacientes con cáncer de mama (n = 434) reclutadas a través de Internet (http://www.cancermama.org). Las participantes completaron un cuestionario demográfico y médico, y también se usaron cuestionarios de evaluación psicológica ampliamente utilizados en Psicooncología, la HADs (Escala de Ansiedad y Depresión Hospitalaria) y la escala MAC (La Escala de Ajuste Mental al Cáncer), en su versión reducida de 29 ítems (Mini-MAC). Resultados: En nuestro estudio el resultado global de la HADs como medida de distrés en línea es confiable en nuestro estudio. La tasa de prevalencia general de distrés para nuestra muestra fue del 50%, sin diferencias según nivel socio-demográfico o variables médicas. En cuanto a puntuación de ansiedad 66,2% y 34% alcanzaron nivel clínico de ansiedad y depresión, respectivamente. Estos resultados se relacionaron con los de la Mini-MAC según lo esperado. Conclusiones: Estos resultados dan apoyo al uso de Internet como herramienta válida para la evaluación de los trastornos psicológicos en pacientes con cáncer de mama. Internet nos brinda la posibilidad de identificar pacientes de alto riesgo a través de screening psicológico con el fin de realizar intervenciones tempranas, y las puntuaciones globales de distrés pueden ser una herramienta precisa. Sin embargo se necesitan más estudios para analizar la situación de consulta en internet como un estímulo provocador de ansiedad

Objective: The object of this study is to determine the prevalence of distress symptoms and coping strategy among a large sample of Spanish-speaking breast cancer patients recruited on-line. Methods: We designed a cross-sectional study with breast cancer survivors (n=434) that were accrued via Internet (http://www.cancermama.org). Participants completed a demographic and medical questionnaire, and they were also evaluated using self-reporting measures of psychological distress and adjustment to cancer; the 14-item Hospital Anxiety and Depression Scale (HADS) and the 29-item version of the Mental Adjustment to Cancer Scale (Mini-MAC), respectively. Results: Global HAD as a measure of distress on-line is reliable in our study. The overall prevalence rate of distress for our sample was 50%, with no differences for socio-demographics or medical status variables. Concerning to anxiety punctuation 66.2% were clinical cases and 34.5% reached the clinical level for depression. These results were associated with Mini-MAC scales as expected. Conclusions: These results offer support for the use of Internet as valid tool for the psychological distress assessment in patients with breast cancer Spanish-speaking patients. Internet brings us the possibility to identify high-risk patients through psychological screening in order to provide early interventions, and Global HAD punctuation may be an accurate tool. However more studies are needed to analyze internet illness consulting situation as an anxious provoking space

Cancer knowledge among Spanish women participating in literacy schemes.

Access to information on cancer prevention and treatment is often difficult for ethnic or low socio-economic groups. This study aimed to ascertain level of knowledge about cancer, and breast cancer in particular, in Spanish women from low socio-economic groups participating in literacy schemes. A study specific questionnaire was administered to 541 women All participants were married with a median of 2 children, and a total family income of less than 10,000 euros per year. The main themes covered: understanding of and access to screening, knowledge about cancer risk, diagnosis and prognosis. The majority of these women (66%) feel they have no control over getting cancer and 26% report that it can be caught from others. Most believe that a mammogram is the best method of diagnosis (87%) but a minority (14%) agree with the statement that breast cancer can be caused by breast feeding. In general, younger women are better informed and more optimistic about prognosis. In Spain there are problems in disseminating information about cancer to lower social-economic groups. These results confirm that more cancer education needs to be directed to low income and socially deprived groups.