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1.
Curr Oncol ; 29(9): 6714-6723, 2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36135096

RESUMO

Patients with head and neck cancer face important life-altering effects in appearance and function, affecting distress and quality of life and requiring the involvement of a multidisciplinary team. Psycho-oncology makes an important contribution to the field, as head and neck cancers carry a huge adaptational toll. To illustrate the value of this discipline, we report two cases of patients with advanced head and neck cancer for which the treatment-related body changes were of major significance. A commentary by the treating surgeons and psycho-oncologists precedes a general discussion about the clinical management of such patients. The article outlines strategies to address health literacy, doctor-patient communication, treatment decision-making, and emotional distress; placing the person at the center of oncological care. It calls for the broad application of principles of psychological first aid by healthcare professionals in oncology.


Assuntos
Neoplasias de Cabeça e Pescoço , Psico-Oncologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Oncologia , Qualidade de Vida
2.
Oncology (Williston Park) ; 36(9): 552-556, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36107784

RESUMO

A 40-year-old unmarried Brazilian woman, Ms A, received a diagnosis of papillary renal cell carcinoma (RCC) in February 2020; she underwent nephrectomy the following month. In August, she began to experience generalized pain with subsequent scans revealing metastatic disease to the supraclavicular lymph node, liver, and vagina. In October 2020, Ms A started first-line systemic combination treatment with nivolumab (Opdivo; 3 mg/kg) plus ipilimumab (Yervoy; 1 mg/kg) every 3 weeks for 4 doses, followed by nivolumab (3 mg/kg) every 2 weeks, to be taken for 2 years. In April 2021, follow-up testing revealed a partial response to therapy, and a complete response was evident in August 2021. Ms A was first screened for biopsychosocial distress by the supportive care team in October 2020, and she completed the Edmonton Symptom Assessment System (ESAS) evaluation.During her fourth cycle of treatment in October 2020, the patient was assessed with the ESAS. During her medical visits, Ms A also expressed concern regarding her physical symptoms and admitted frequent self-monitoring for signs of recurrence or progression. Her oncologist prescribed tramadol for pain and the supportive care team recommended increased engagement in physical activity. Upon further assessment, the patient reported a belief that her psychosocial symptoms, worry about recurrence or progression, and time spent self-monitoring were a normal part of her cancer experience.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Tramadol , Adulto , Carcinoma de Células Renais/tratamento farmacológico , Feminino , Humanos , Ipilimumab/uso terapêutico , Neoplasias Renais/tratamento farmacológico , Nivolumabe/uso terapêutico , Dor , Psico-Oncologia , Tramadol/uso terapêutico
3.
Curr Opin Oncol ; 34(4): 270-278, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35730502

RESUMO

PURPOSE OF REVIEW: Cancer-related fatigue (CRF) and sleep disturbances are common symptoms among patients with cancer. They are often conceptualized as a part of a larger symptom cluster, also comprising pain and emotional distress. Despite their prevalence and long-lasting effects, CRF and sleep disturbances are still poorly addressed in clinical settings. Specific interventions are needed to manage these symptoms. RECENT FINDINGS: In addition to conventional pharmacological therapies, other kinds of interventions are increasingly being developed in oncology. This review will discuss three categories of interventions for patients with cancer and their interest in alleviating CRF and sleep disturbances: physical exercises (e.g., aerobic, resistance training, running, free weights), psychological interventions (e.g., cognitive-behavioural therapy, psychoeducational interventions), and mind-body interventions (e.g., yoga, mindfulness, hypnosis). The multicomponent aspect of these interventions seems particularly important to address these symptoms. SUMMARY: The findings detailed in this review will allow the scientific community, as well as health professionals working in oncology settings, to be informed about new nonpharmacological therapeutic options to help patients to manage their symptoms. It could eventually help to improve existing interventions for these patients.


Assuntos
Neoplasias , Psico-Oncologia , Fadiga/etiologia , Fadiga/terapia , Humanos , Terapias Mente-Corpo , Neoplasias/complicações , Neoplasias/psicologia , Neoplasias/terapia , Sono
4.
Acta Med Okayama ; 76(2): 195-202, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35503448

RESUMO

The clinical benefit of perospirone for treatment of delirium in patients with advanced cancer is not sufficiently clear. The objective of this study was to compare the safety and effectiveness of perospirone to those of risperidone for the treatment of delirium in patients with advanced cancer. This is a secondary analysis of a multicenter prospective observational study in nine psycho-oncology consultation services in Japan. The study used the Delirium Rating Scale (DRS) Revised-98 to measure effectiveness and the CTCAE (Common Terminology Criteria for Adverse Events) version 4 to assess safety. Data from 16 patients who received perospirone and 53 patients who received risperidone were analyzed. The mean age was 70 years in the perospirone group and 73 years in the risperidone group. Both groups showed a significant decrease in the total score of DRS-R-98 after three days of treatment (perospirone: 11.7 (7.9-15.4) to 7.0 (3.3-10.7), difference -4.7, effect size=0.72, p=0.003; risperidone: 15.5 (13.6-17.4) to 12.2 (10.1-14.2), difference -3.3, effect size=0.55, p=0.00). The risperidone group showed significant improvements in sleep-wake cycle disturbance, orientation, attention, and visuospatial ability. In the perospirone group, there was a significant improvement of sleep-wake cycle disturbance. The median daily dose of perospirone was 4 mg/day. There were fewer episodes of somnolence as an adverse event in the perospirone group. Low-dose perospirone was thus found to be effective for the treatment of delirium in patients with advanced cancer and may be associated with fewer episodes of over-sedation as an adverse event.


Assuntos
Antipsicóticos , Delírio , Neoplasias , Idoso , Antipsicóticos/efeitos adversos , Delírio/induzido quimicamente , Delírio/etiologia , Humanos , Isoindóis , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Psico-Oncologia , Risperidona/efeitos adversos , Tiazóis
5.
Eur J Oncol Nurs ; 58: 102145, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35504233

RESUMO

PURPOSE: Disease- and treatment-related consequences in Head and Neck Cancer (HNC) can result in psychological issues for which specialist psychological support, dubbed psycho-oncology, is recommended. Health and Social Care Professionals (HSCPs) function as a crucial link between survivors and these services, through onward referral pathways. However, little is known about these HSCPs' perspectives on barriers to accessing psycho-oncology in HNC. The current study sought to investigate such perspectives. METHODS: Eleven HSCPs from national cancer centres across Ireland were recruited using purposive sampling. A qualitative, cross-sectional research design was implemented utilising virtual semi-structured interviews. Interviews were audio-recorded, transcribed, and analysed using inductive, reflexive thematic analysis. RESULTS: The researcher identified four themes relating to barriers to psycho-oncology access: Lack of Access and Perceived Elitism in Onward Referral; Communication Barriers; Stigma Associated with Mental Illness and Psychological Services, and Inadequate Signposting and Advertising of Existing Psycho-Oncology Services. These findings indicate that HSCPs face multiple barriers when attempting to refer HNC survivors to psycho-oncology services. Some of these barriers relate to survivors, others to HSCPs themselves, and some to professionals within psycho-oncology services. CONCLUSIONS: By removing barriers in onward referral faced by HSCPs, HNC survivors may more readily link in with pre-existing psycho-oncology services in the future. The following may assist with removing such barriers: increased inter-professional dialogue between HSCPs and psycho-oncology services and communication skills training; mental health stigma reduction campaigns targeted at survivors, HSCPs, and wider society; and increased signposting of available psycho-oncology services and in-service training for HSCPs.


Assuntos
Neoplasias de Cabeça e Pescoço , Psico-Oncologia , Estudos Transversais , Neoplasias de Cabeça e Pescoço/terapia , Pessoal de Saúde/psicologia , Acesso aos Serviços de Saúde , Humanos , Pesquisa Qualitativa
6.
Bull Cancer ; 109(5): 548-556, 2022 May.
Artigo em Francês | MEDLINE | ID: mdl-35527072

RESUMO

Psycho-oncology is evolving in line with oncology progress and increasing complexity, but also with change in cancer care organization. Alongside the more traditional psycho-oncological interventions, such as the support or verbal psychotherapy of various inspirations (psychodynamic, integrative, systemic, existential) and body-mediated approaches, that allow the patient to be accompanied throughout his/her cancer care trajectory, psycho-oncology is now benefiting from the development of more structured interventions, often brief and targeted at a specific situation or symptom. This article reviews three of these new psychotherapeutic approaches, which are largely developed in the Anglo-Saxon world: the management of fear of recurrence by CBT third wave strategies, ACT therapy or, more recently, EMDR to answer to psychotraumatic situations. We describe here the principles, the main indications in oncology patients and the expected clinical benefits. It also presents tools such as Questionnaire Prompt Lists for optimizing the communication between patients and health professionals, which constitute a psychotherapeutic intervention by itself.


Assuntos
Neoplasias , Psico-Oncologia , Feminino , Humanos , Masculino , Oncologia , Neoplasias/terapia , Psicoterapia , Inquéritos e Questionários
7.
Psychooncology ; 31(4): 558, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35396890
8.
Psychooncology ; 31(4): 559-561, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35396891

RESUMO

OBJECTIVE: This issue celebrates the 30th anniversary of Psycho-Oncology as a journal, a home for scholarship integrating the psychological, social and behavioural dimensions of cancer. Psycho-oncology developed as an evidence-based discipline to offer an alternative to unproven therapies and to optimise coping and support for patients with cancer and their families. METHODS: A review of key articles was undertaken for this editorial. RESULTS: Empirical studies have defined the prevalence of morbidity arising from cancer and the acute, longer-term and late effects of its varied treatments. Interventions have been adapted to respond to existential challenges, death anxiety, fear of recurrence, disease progression, palliative care and have been continued into bereavement. Mixed modality treatments have combined psychotropic and psychotherapeutic interventions. Survivorship studies have examined rehabilitation, fertility, sexuality, body image and relational impacts of illness. CONCLUSION: This journal has helped the discipline to flourish by publishing the innovative outputs of its community of researchers.


Assuntos
Neoplasias , Psico-Oncologia , Adaptação Psicológica , Bolsas de Estudo , Humanos , Neoplasias/psicologia , Neoplasias/terapia , Psico-Oncologia/métodos , Sobrevivência
9.
Psychooncology ; 31(4): 553, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35396892
12.
BMC Health Serv Res ; 22(1): 543, 2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35459202

RESUMO

BACKGROUND: The annual incidence of new cancer cases has been increasing worldwide for many years, and is likely to continue to rise. In Germany, the number of new cancer cases is expected to increase by 20% until 2030. Half of all cancer patients experience significant emotional and psychosocial distress along the continuum of their disease, treatment, and aftercare, and also as long-term survivors. Consequently, in many countries, psycho-oncological programs have been developed to address this added burden at both the individual and population level. These programs promote the active engagement of patients in their cancer therapy, aftercare and survivorship planning and aim to improve the patients' quality of life. In Germany, the "new form of care isPO" ("nFC-isPO"; integrated, cross-sectoral psycho-oncology/integrierte, sektorenübergreifende Psycho-Onkologie) is currently being developed, implemented and evaluated. This approach strives to accomplish the goals devised in the National Cancer Plan by providing psycho-oncological care to all cancer patients according to their individual healthcare needs. The term "new form of care" is defined by the Innovation Fund (IF) of Germany's Federal Joint Committee as "a structured and legally binding cooperation between different professional groups and/or institutions in medical and non-medical care". The nFC-isPO is part of the isPO project funded by the IF. It is implemented in four local cancer centres and is currently undergoing a continuous quality improvement process. As part of the isPO project the nFC-isPO is being evaluated by an independent institution: the Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Germany. The four-year isPO project was selected by the IF to be eligible for funding because it meets the requirements of the federal government's National Cancer Plan (NCP), in particular, the "further development of the oncological care structures and quality assurance" in the psycho-oncological domain. An independent evaluation is required by the IF to verify if the new form of care leads to an improvement in cross-sectoral care and to explore its potential for permanent integration into the German health care system. METHODS: The nFC-isPO consists of six components: a concept of care (C1), care pathways (C2), a psycho-oncological care network (C3), a care process organization plan (C4), an IT-supported documentation and assistance system (C5) and a quality management system (C6). The two components concept of care (C1) and care pathways (C2) represent the isPO clinical care program, according to which the individual cancer patients are offered psycho-oncological services within a period of 12 months after program enrolment following the diagnosis of cancer. The remaining components (C3-C6) represent the formal-administrative aspects of the nFC-isPO that are intended to meet the legally binding requirements of patient care in the German health care system. With the aim of systematic development of the nFC-isPO while at the same time enabling the external evaluators to examine its quality, effectiveness and efficiency under conditions of routine care, the project partners took into consideration approaches from translational psycho-oncology, practice-based health care research and program theory. In order to develop a structured, population-based isPO care program, reference was made to a specific program theory, to the stepped-care approach, and also to evidence-based guideline recommendations. RESULTS: The basic version, nFC-isPO, was created over the first year after the start of the isPO project in October 2017, and has since been subject to a continuous quality improvement process. In 2019, the nFC-isPO was implemented at four local psycho-oncological care networks in the federal state North Rhine-Westphalia, in Germany. The legal basis of the implementation is a contract for "special care" with the German statutory health insurance funds according to state law (§ 140a SCB V; Social Code Book V for the statutory health insurance funds). Besides the accompanying external evaluation by the IMVR, the nFC-isPO is subjected to quarterly internal and cross-network quality assurance and improvement measures (internal evaluation) in order to ensure continuous quality improvement process. These quality management measures are developed and tested in the isPO project and are to be retained in order to ensure the sustainability of the quality of nFC-isPO for later dissemination into the German health care system. DISCUSSION: Demands on quality, effectiveness and cost-effectiveness of in the German health care system are increasing, whereas financial resources are declining, especially for psychosocial services. At the same time, knowledge about evidence-based screening, assessment and intervention in cancer patients and about the provision of psychosocial oncological services is growing continuously. Due to the legal framework of the statutory health insurance in Germany, it has taken years to put sound psycho-oncological findings from research into practice. Ensuring the adequate and sustainable financing of a needs-oriented, psycho-oncological care approach for all newly diagnosed cancer patients, as required by the NCP, may still require many additional years. The aim of the isPO project is to develop a new form of psycho-oncological care for the individual and the population suffering from cancer, and to provide those responsible for German health policy with a sound basis for decision-making on the timely dissemination of psycho-oncological services in the German health care system. TRIAL REGISTRATION: The study was pre-registered at the German Clinical Trials Register (https://www.drks.de/DRKS00015326) under the following trial registration number: DRKS00015326 ; Date of registration: October 30, 2018.


Assuntos
Neoplasias , Psico-Oncologia , Alemanha/epidemiologia , Humanos , Programas Nacionais de Saúde , Neoplasias/terapia , Qualidade de Vida
13.
Psychooncology ; 31(8): 1365-1373, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35460322

RESUMO

OBJECTIVE: In response to the COVID-19 pandemic, use of telehealth to deliver care was recommended across the Australian health system. This study aims to explore the barriers and enablers to delivery of psycho-oncology services via telehealth and attitudes to use of telehealth in psycho-oncology. METHODS: Twenty-one psycho-oncology clinicians participated in semi-structured telephone interviews. Transcribed interviews were thematically analysed using the framework method. RESULTS: Three key themes were identified which described the overall experience of delivering psycho-oncology services via telehealth: (1) Context Matters-for whom is telehealth effective, when is it less effective; (2) Therapy content and telehealth implementation; (3) Recommendations for Sustainability. CONCLUSIONS: These insights into the barriers and enablers to delivering psycho-oncology services via telehealth inform future research and clinical practice. While there is support for the continued use of telehealth in psycho-oncology, there are significant improvements needed to ensure effective implementation and continued benefit.


Assuntos
COVID-19 , Telemedicina , Austrália , Humanos , Pandemias , Psico-Oncologia , Encaminhamento e Consulta
14.
BMC Health Serv Res ; 22(1): 531, 2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35449058

RESUMO

BACKGROUND: Evaluating the development phase of a complex intervention programme can be challenging. A prospective evaluation approach is presented based on the example of the new complex psycho-oncological care programme isPO (integrated, cross-sectoral Psycho-Oncology). Prior to programme implementation, we examined (1) if isPO was developed as intended, and (2) if it was relevant and transferable into the newly developed psycho-oncological care networks in North-Rhine Westphalia, Germany. Further, we investigated which implementation facilitators and barriers were anticipated and which implementation strategies were planned by the programme designers (multidisciplinary professionals and cancer supporting organizations who developed the isPO programme components and the networks). METHODS: A mixed-methods approach was applied. Qualitative data were collected by quarterly progress reports, interviews and a focus group with the programme designers. Evaluation criteria for document analyses of the quarterly progress reports were developed and applied. Content analysis was applied for analysing interviews and focus group. Quantitative data were gained from evaluating the programme training for the isPO service providers by short written questionnaires that were analysed descriptively. RESULTS: An implementable prototype of the isPO programme has been developed within 15 months, however no piloting was conducted. The programme's complexity proved to be challenging with regard to coordination and communication of the numerous programme designers. This was intensified by existing interdependencies between the designers. Further, there was little communication and participation between the programme designers and the prospective users (patients and service providers). Due to these challenges, only context-unspecific implementation strategies were planned. CONCLUSION: The required resources for developing a new complex care programme and the need of a mature implementation strategy should be sufficiently addressed. Programmes may benefit from prospective evaluation by gaining insightful knowledge concerning the programme's maturity and anticipating implementation facilitators and barriers. A mixed-methods evaluation design was crucial for achieving profound insight into the development process. TRIAL REGISTRATION: The study has been registered in the German Clinical Trials Register (No. DRKS00015326 ) on 30.10.2018.


Assuntos
Comunicação , Psico-Oncologia , Grupos Focais , Alemanha , Humanos , Inquéritos e Questionários
15.
Psicooncología (Pozuelo de Alarcón) ; 19(1): 45-62, 28 mar. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-203937

RESUMO

Introducción: Aunque se han publicado muchos estudios que han intentado demostrar la eficacia de diferentes tratamientos psicológicos en pacientes con cáncer; hasta la fecha no se ha revisado la evidencia disponible sobre la eficacia de la Realidad Virtual (RV) para disminuir el distrés en niños y adolescentes con cáncer. Objetivo:El objetivo principal es evaluar la efectividad de la intervención con Realidad virtual en la disminución del distrés que padecen los niños y adolescentes con cáncer ante los procedimientos médicos, la hospitalización, o la propia enfermedad. Resultados:De los 22 artículos encontrados, se han seleccionado para la revisión un total de 8, que seguían un diseño experimental o cuasiexperimental en pacientes niños y jóvenes diagnosticados de cáncer tratados con RV. Conclusiones: Los resultados, aunque heterogéneos, sugieren mejorías a medio–largo plazo en las variables de ansiedad, depresión, aceptación, calidad de vida, distrés y flexibilidad psicológica. Además, la RV ha resultado ser más eficaz que otras técnicas. De este modo, a pesar de las limitaciones encontradas en este estudio, se han obtenido resultados prometedores para futuras revisiones y/ o metaanálisis (AU)


Introduction: Although many studies have been published that have attempted to demonstrate the efficacy of different psychological treatments in cancer patients, to date there has been no review of the available evidence on the efficacy of Virtual Reality (VR) in reducing distress in children and adolescents with cancer. Objective: The main aim is to evaluate the effectiveness of virtual reality intervention in reducing the distress suffered by children and adolescents with cancer in the face of medical procedures, hospitalization, or the disease itself. Results: Of the 22 articles found, a total of 8 were selected for the review, which followed an experimental or quasi-experimental design in children and young people diagnosed with cancer treated with VR. Conclusions: The results, although heterogeneous, suggest medium to long-term improvements in the variables of anxiety, depression, acceptance, quality of life, distress, and psychological flexibility. Moreover, VR has proved to be more effective than other techniques. Thus, despite the limitations found in this study, promising results have been obtained for future reviews and/or meta-analysis (AU)


Assuntos
Humanos , Realidade Virtual , Neoplasias/terapia , Atenção , Psico-Oncologia/métodos , Resultado do Tratamento
16.
Curr Probl Cancer ; 46(3): 100849, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35325803

RESUMO

Patients with both cancer and a severe mental illness (SMI) have a higher risk of advanced stage cancer at diagnosis and poorer survival in comparison to individuals with cancer alone. The present study explores if similar disparities exist in terms of psycho-oncological support. Latent class analysis (LCA) was used to group 10,945 patients with any type of cancer, of which 72 (0.7%) had been diagnosed with a SMI (ICD10-codes F20-F22, F24, F25, F28-F31, F32.3, F33.3), and 1056 (9.6%) with another mental disorder. Subgrouping was based on presence of SMI, other mental illnesses, stage of cancer at its first detection, screening for distress and receipt of information on psycho-oncology, consultation with a psychotherapist and/or psychiatrist, prescription of different psychotropic medication, and use of a patient care attendant. Five subgroups were identified. Patients with SMI were most likely to suffer from further mental comorbidities, to be prescribed antipsychotics, antidepressants, or mood stabilizers, and be in need of a patient care attendant. In comparison to patients without SMI, the larger one of 2 subgroups of patients with SMI had a low probability to be screened for distress and informed about psycho-oncological support services. A smaller subgroup of patients with SMI was probable to be diagnosed with an advanced stage of cancer. In subgroups without patients with mental disorders, screening for distress and offering psycho-oncological support seemed to be economized unless benzodiazepines or opioids were prescribed. Contrary to published evidence, distress screening and offering psycho-oncological support is neglected in patients with SMI unless an advanced stage of cancer is being diagnosed.


Assuntos
Transtornos Mentais , Neoplasias , Humanos , Programas de Rastreamento , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Neoplasias/complicações , Neoplasias/epidemiologia , Neoplasias/terapia , Psico-Oncologia
17.
Artigo em Alemão | MEDLINE | ID: mdl-35181794

RESUMO

Cancer is not only a challenge for the patient, but can also be associated with psychosocial distress for relatives, especially partners and minor children. Although studies on the long-term effects of cancer on partners, the partnership, and child development are still rare, there are indications that the psychological distress on relatives may become chronic, and that parental illness is a risk factor for a child to develop mental disorders. In addition, a deterioration in partnership satisfaction also increases the risk of separation.Psycho-oncology care should therefore not only consider the patient's psychosocial burden but also that of the partner, as well as its effect on the partnership. Appropriate offers, for example to increase partnership and sexual satisfaction, communication, or dyadic coping, should be made. Children should also be treated as relatives in care. Focusing on both the child's distress and on improving the parent-child relationships and parenting behavior can help children to cope with parental illness in the long term. Thus, cancer should be viewed on the individual, dyadic, and family level, and psychosocial care services should be provided at all levels.


Assuntos
Adaptação Psicológica , Neoplasias , Família , Alemanha , Humanos , Neoplasias/psicologia , Neoplasias/terapia , Poder Familiar , Psico-Oncologia , Estresse Psicológico/psicologia
18.
Psychooncology ; 31(6): 1031-1040, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35102653

RESUMO

OBJECTIVE: To understand: (1) psycho-oncology providers' perspectives on and observations of the psychological responses of their cancer patients during the pandemic, and (2) psycho-oncology providers' own experiences delivering care. METHODS: In this concurrent mixed methods study, a survey was distributed to psychosocial providers who were members of the American Psychosocial Oncology Society (APOS). Survey respondents were invited to participate in a one-on-one audio-recorded interview via phone or secure Zoom®. RESULTS: seventy-six self-identified psycho-oncology providers responded to the survey and 11 participated in a one-on-one interview. Approximately half reported that patients responded in unique ways to COVID-19 stress relative to other populations. Three themes emerged from qualitative analyses: (1) unique burden on patients, (2) cancer patients' pandemic response and its relationship to their cancer experience, and (3) unexpected positive changes. Providers emphasized that the cancer experience may have prepared patients for the existential distress of the pandemic and described patients' resiliency. Two themes emerged regarding delivery of care: (1) new professional and personal challenges and (2) provider resiliency. CONCLUSIONS: Although providers observed that the pandemic placed new burdens on patients, they emphasized that the cancer experience may have prepared patients for the existential distress of the pandemic and described patients' resiliency. To overcome challenges, psycho-oncology providers used innovative strategies to support patients and foster their own mental health.


Assuntos
COVID-19 , Neoplasias , COVID-19/epidemiologia , Humanos , Neoplasias/psicologia , Pandemias , Psico-Oncologia , Inquéritos e Questionários , Estados Unidos
19.
Eur J Cancer Care (Engl) ; 31(2): e13555, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35137480

RESUMO

OBJECTIVE: In routine oncological treatment settings, psychological distress, including mental disorders, is overlooked in 30% to 50% of patients. High workload and a constant need to optimise time and costs require a quick and easy method to identify patients likely to miss out on psychological support. METHODS: Using machine learning, factors associated with no consultation with a clinical psychologist or psychiatrist were identified between 2011 and 2019 in 7,318 oncological patients in a large cancer treatment centre. Parameters were hierarchically ordered based on statistical relevance. Nested resampling and cross validation were performed to avoid overfitting. RESULTS: Patients were least likely to receive psycho-oncological (i.e., psychiatric/psychotherapeutic) treatment when they were not formally screened for distress, had inpatient treatment for less than 28 days, had no psychiatric diagnosis, were aged 65 or older, had skin cancer or were not being discussed in a tumour board. The final validated model was optimised to maximise sensitivity at 85.9% and achieved an area under the curve (AUC) of 0.75, a balanced accuracy of 68.5% and specificity of 51.2%. CONCLUSION: Beyond conventional screening tools, results might contribute to identify patients at risk to be neglected in terms of referral to psycho-oncology within routine oncological care.


Assuntos
Neoplasias , Neoplasias Cutâneas , Idoso , Humanos , Aprendizado de Máquina , Oncologia , Neoplasias/psicologia , Neoplasias/terapia , Psico-Oncologia , Encaminhamento e Consulta , Neoplasias Cutâneas/terapia
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