Video conference vs face-to-face group psychotherapy for distressed cancer survivors: A randomized controlled trial.

OBJECTIVE: This study assesses the effectiveness of face-to-face group positive psychotherapy for cancer survivors (PPC) compared to its online adaptation, online group positive psychotherapy for cancer survivors (OPPC), which is held via videoconference. A two-arm, pragmatic randomized controlled trial was conducted to examine the effects of both interventions on emotional distress, post-traumatic stress symptoms (PTSS), and post-traumatic growth (PTG) among cancer survivors and analyze attrition to treatment. METHODS: Adult women with a range of cancer diagnoses were invited to participate if they experienced emotional distress at the end of their primary oncological treatment. Emotional distress, PTSS, and PTG were assessed at baseline, immediately after treatment, and 3 months after treatment. Intention-to-treat analyses were carried out using general linear mixed models to test the effect of the interventions overtime. Logistic regressions were performed to test differential adherence to treatment and retention to follow-up. RESULTS: A total of 269 individuals participated. The observed treatment effect was significant in both modalities, PPC and OPPC. Emotional distress (b = -2.24, 95% confidence interval [CI] = -3.15 to -1.33) and PTSS (b = -3.25, 95% CI = -4.97 to -1.53) decreased significantly over time, and PTG (b = 3.08, 95% CI = 0.38-5.78) increased significantly. Treatment gains were sustained across outcomes and over time. Analyses revealed no significant differences between modalities of treatment, after adjusting for baseline differences, finding that OPPC is as effective and engaging as PPC. CONCLUSIONS: The OPPC treatment was found to be effective and engaging for female cancer early survivors. These results open the door for psycho-oncology interventions via videoconference, which are likely to lead to greater accessibility and availability of psychotherapy.

A systematic and comprehensive review of internet use in cancer patients: Psychological factors.

OBJECTIVES: Online resources are changing patient-professional relationship and care delivery by empowering patients to engage in decisions in order to cope with their illness and modify behaviors. This review analyses the psychological factors associated with spontaneous and health professional-guided internet use in cancer patients. METHODS: Searches were performed in the PubMed (MEDLINE), PsycINFO, and Scopus databases. Studies were included if they involved cancer patients or focused on the relationship between cancer patients and health professionals, describing either patients' spontaneous use of interne or a guided-structured eHealth psychosocial intervention. RESULTS: Seventy-seven scientific papers were finally included. Results described emotional and behavioral outcomes in cancer patients who accessed online information. Internet has long been used spontaneously not only as a source of medical information or symptom management but also for decision making or emotional and social support. Health professionals can guide internet use, providing specific web-based recommendations and developing intervention programs to better meet patients' needs, such as educational or information programs. CONCLUSION: Online access is a complementary form of care that physicians can provide. Patients benefit from online resources, especially when both they and their health professionals increase their engagement with online interventions such as integrated systems or online communities.

ICOnnecta't: Development and Initial Results of a Stepped Psychosocial eHealth Ecosystem to Facilitate Risk Assessment and Prevention of Early Emotional Distress in Breast Cancer Survivors' Journey.

Psychosocial interventions prevent emotional distress and facilitate adaptation in breast cancer (BC). However, conventional care presents accessibility barriers that eHealth has the potential to overcome. ICOnnecta't is a stepped digital ecosystem designed to build wellbeing and reduce psychosocial risks during the cancer journey through a European-funded project. Women recently diagnosed with BC in a comprehensive cancer center were offered the ecosystem. ICOnnecta't consists of four care levels, provided according to users' distress: screening and monitoring, psychoeducation campus, peer-support community, and online-group psychotherapy. Descriptive analyses were conducted to assess the platform's implementation, while multilevel linear models were used to study users' psychosocial course after diagnosis. ICOnnecta't showed acceptance, use and attrition rates of 57.62, 74.60, and 29.66%, respectively. Up to 76.19% of users reported being satisfied with the platform and 75.95% informed that it was easy to use. A total of 443 patients' needs were detected and responsively managed, leading 94.33% of users to remain in the preventive steps. In general, strong social support led to a better psychosocial course. ICOnnecta't has been successfully implemented. The results showed that it supported the development of a digital relation with healthcare services and opened new early support pathways.

Stressful Life Events and Distress in Breast Cancer: A 5-Years Follow-Up / Acontecimientos vitales estresantes y malestar emocional en cáncer de mama: seguimiento a 5 años

AbstractBackground/Objective: Environmental factors such as psychosocial stress have demonstrated to have an impact on the breast cancer (BC) course. This study aims to explore the impact of psychotherapy and stressful life events (SLE) on BC survivors’ illness trajectories. Method: 68 women with BC underwent Positive Psychotherapy or Cognitive-Behavioral Stress Management and 37 patients were included as a control group. The effects of distress reduction and SLE on their 5-year recurrence were investigated. Additional analyses examined the effect of receiving vs. not receiving psychotherapy and of the type of therapy on survival and disease-free interval, DFI. Results: A one-point decrease of the Hospital Anxiety and Depression Scale (HADS) after psychotherapy predicted a lower risk of 5-year recurrence, OR = 0.84, p = .037, 95% CI = 0.71-0.99). Also, a one point-increase in the number threating SLE (OR = 1.92; p = .028, 95% CI = 1.07-3.43) was related to higher 5-year recurrence. Conclusions: The findings highlight the necessity of studying not only a given situation (i.e., psychotherapy, SLE) but its specific impact on individuals.

ResumenAntecedentes/Objetivo: El estrés psicosocial ha demostrado tener un impacto en la evo-lución del cáncer de mama (CM). Este estudio tiene como objetivo explorar el impacto de la psicoterapia y de los acontecimientos vitales estresantes (AVE) en la supervivencia de pacientes con CM. Método: 113 mujeres con CM recibieron psicoterapia positiva o terapia cognitivo-conductual para controlar el estrés y 37 se incluyeron como grupo con-trol. Se analizaron los efectos de la reducción de la Escala de Ansiedad y Depresión Hos-pitalaria (HADS) y de los AVE sobre la recurrencia a los cinco años, así como el efecto de recibir psicoterapia y del tipo de enfoque sobre la supervivencia. Resultados: La reduc-ción de un punto en la HADS después de recibir psicoterapia predijo un menor riesgo de recurrencia, OR = 0,84, p = 0,037, IC 95% = 0,71-0,99. Además, cada aumento en el nú-mero de AVE vividos como amenazantes (OR = 1,92; p = 0,028, 95% CI = 1,07-3,43) se relacionó con una mayor recurrencia. Conclusiones: Los resultados indican la necesidad de estudiar no solo la presencia de un evento potencialmente impactante en la conducta (psicoterapia o AVE) sino el efecto específico que ha tenido en cada individuo.

Profesionales sanitarios: afrontando el impacto emocional por la COVID-19 en un centro monográfico de cáncer / Healthcare professionals: dealing with the emotional impact of COVID-19 in a cancer monographic center

INTRODUCCIÓN: El impacto psicológico de la pandemia de la COVID-19 es incuestionable, especialmente entre los grupos de mayor vulnerabilidad. Uno de estos grupos es el de profesionales sanitarios. El objetivo es describir la puesta en marcha de un plan de intervención psicológica destinado en la protección de la salud mental de los profesionales sanitarios durante la crisis de la COVID-19 realizada por la Unidad de Psicooncología, en un hospital monográfico de cáncer. MÉTODO: Proceso de tres fases: 1) revisión narrativa de la literatura; 2) descripción de la elaboración de un plan de atención y soporte psicológico a profesionales, tanto individual como grupal; 3) descripción de la puesta en práctica del plan centrado fundamentalmente en facilitar un espacio reparador y normalizador del sufrimiento, legitimando y normalizando sus reacciones emocionales, proporcionando estrategias simples para hacer frente a la situación. RESULTADOS: Se realizaron 67 intervenciones en 20 espacios grupales, y 20 intervenciones individuales, lideradas por profesionales especialistas en Psicología Clínica. Participaron profesionales de la medicina, enfermería, auxiliares de enfermería y de administración. El miedo a contagiarse o contagiar a otro se consideró la principal manifestación, junto con el miedo a la atención inadecuada de los pacientes. El malestar emocional al inicio de la pandemia se puntuó con una EVA de 5/10 (pésimo-excelente). El 100 % de los profesionales que asistieron a las sesiones consideraron que les ayudaron mucho, puntuando con una EVA de 8/10. Asimismo, mostraron una satisfacción muy alta (9/10). El 100 % consideraron que este tipo de sesiones deberían realizarse de nuevo en situaciones similares futuras. CONCLUSIONES: El plan de soporte psicológico ofrecido a los sanitarios durante la pandemia impresiona (subjetivamente) terapéutico. Se recomiendan realizar estrategias de atención y prevención permanentes y estables con el objetivo de proteger la salud mental de colectivos más vulnerables, así como estudios específicos en caso de nuevas pandemias

INTRODUCTION: The psychological impact of the COVID-19 pandemic is unquestionable, especially among the most vulnerable groups. Healthcare workers conform one of these groups. The aim of this paper is to describe the implementation of a psychological intervention plan designed to protect the mental health of healthcare professionals during the COVID-19 crisis, carried out by the Psycho-Oncology Unit in a monographic cancer hospital. METHOD: This is a 3-phase process: 1) narrative review of the literature; 2) description of the development of a plan of care and psychological support for professionals, both individually and in groups; 3) description of the implementation of the plan focused primarily on providing a restorative space for suffering relief, and for both legitimizing and normalizing emotional reactions providing simple strategies to cope with the situation. RESULTS: A total of 67 interventions were performed for 20 groups and 20 individuals by a clinical psychologist. Medical, nursing, nursing assistance, and administrative staff participated. Fear of self contagion or contagion to another was considered the main manifestation, together with fear of inadequate patient care. Emotional distress at the onset of the pandemic was assessed with an EVA score of 5/10 (very bad-excellent). In all, 100 % of the professionals who attended the sessions felt that they were very helpful, scoring an EVA of 8/10. They also showed very high satisfaction levels (9/10). A total of 100 % considered that this type of session should be done again in similar situations in the future. CONCLUSIONS: The psychological support plan offered to healthcare workers during the pandemic is (subjectively) therapeutic. Permanent prevention strategies focused on protecting mental health in the most vulnerable groups are recommended, as well as specific studies in case of a new pandemic