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Objective: The empty pelvis syndrome (EPS) is common after pelvic exenteration (PE), causing fluid collections, bowel obstruction, perineal sinuses, and fistulas. The best approach to fill the pelvis to mitigate this remains controversial, and the impact of EPS on health‐related quality of life (HrQoL) is unknown. This study is the first to begin to explore lived‐experiences of EPS complications. Methods: Unstructured EPS virtual focus group meetings were conducted with a convenience sample of patients who underwent PE, as an extension of a modified‐Delphi study. Interpretative phenomenological analysis was conducted on verbatim transcripts to generate group experiential themes. Results: Twelve patients (eight UK, one Dutch, and three Belgian) participated in four focus groups. Eight EPS complications were reported, (two pelvic collections, five chronic perineal sinuses, and one bowel obstruction). Group experiential themes were 'Out of Options', depicting patients forced to accept complications or limited survival; 'The New Normal', with EPS potentially delaying adaptation to post‐PE HrQoL; 'Information Influencing Adaptation,' emphasising the significance of patients understanding EPS to cope with its effects; and 'Symptoms,' reporting manifestations of EPS, the resultant physical limitations, and an intangible feeling that patients lost part of themselves. Conclusions: EPS may influence patient decision‐making, regret, adaptation, and information‐seeking. It can cause a variety of unpleasant symptoms and physical limitations, which may include phantom phenomenon. This work supports ongoing purposeful HrQoL research to better define these themes. [ABSTRACT FROM AUTHOR]

Objective: This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS). Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)‐LATER cohort (diagnosed 1963–2001) part 2 (age ≥ 18 years, diagnosed < 18 years, ≥ 5 years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self‐Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self‐Rating Scale for Post‐Traumatic Stress Disorder, TNO‐AZL Questionnaire for Adult Health‐Related Quality of Life, and Short Form‐36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p < 0.004). Results: A total of 1382 CCS participated, all diagnosed ≥ 15 years ago. The mean age of participating CCS was 36 years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self‐esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self‐esteem (10×), and perceived burden (9×). Self‐esteem (all β ≤ 0.47) and perceived burden (all β ≤ 0.38) demonstrated strongest associations of medium/large size. Conclusions: Perceptions of childhood cancer, illness cognitions, self‐esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio‐demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self‐esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges. [ABSTRACT FROM AUTHOR]

Purpose: The needs of head and neck cancer (HNC) carers tends to be poorly addressed as most support systems are directed towards patients. This systematic review synthesises the existing qualitative evidence from carers for adult HNC patients to explore their experiences and needs as a basis to inform the initial development of an item prompt list for HNC carers for use in routine clinical practice. Methods: Seven electronic databases were searched from their inception until November 2022, supplemented by citation chaining and snowballing. Primary qualitative or mixed‐methods studies reporting the experiences of carers for HNC patients, elicited using interviews, were included. Screening and selection, data extraction and quality assessment (Critical Appraisal Skills Programme Checklist) were independently conducted by two researchers. Data were analysed using inductive thematic synthesis and confidence evaluated using GRADE CERQual. Results: Thirty studies met the inclusion criteria. Two overarching themes and nine subthemes emerged: (i) the experiences of loss associated with being a carer (loss of: role and everyday routine, certainty leading to emotional distress, security as fear of recurrence prevailed, finances, intimacy and togetherness, enjoyment from social activities); and (ii) factors promoting coping and adjustment to role of carer (information, supportive mechanisms, personal attributes). Conclusion: New insight into the experiences of HNC carers provides the basis for item generation of a HNC carer prompt tool. Implications for Cancer Survivors: With such a range of potential unmet concerns, the development of a prompt list should help to elicit these and provide additional means to targeted support. [ABSTRACT FROM AUTHOR]

Objectives: Adolescents and young adults (AYAs, 18–39 years) with cancer identifying as racially/ethnically minoritized or 2SLGBTQIA+ (Two‐Spirit, lesbian, gay, bisexual, transgender, queer, intersex, asexual and "+" referring to other queer identities) have been underrepresented in cancer research. This study explores the aspects of identity that hold significance for these minoritized AYAs and how these facets impact their healthcare experiences. Methods: Eligible participants comprised English‐speaking AYAs who self‐identified as racially/ethnically minoritized and/or 2SLGBTQIA+, were diagnosed with cancer between the ages of 15–39, currently aged > 18, and had received or were receiving cancer care within Canadian healthcare system. Additionally, four patient partners meeting the same criteria were recruited as research collaborators. Semi‐structured one‐on‐one virtual interviews guided by an interview script were conducted, and qualitative analysis employed a framework approach. Results: We recruited 23 participants from 4 Canadian provinces (mean age: 28, Range: 20–44); 17 identified as racially/ethnically minoritized, one as sexual/gender minoritized, and five as racially/ethnically and sexually/gender minoritized. Participants emphasized that their culture/ethnicity, religion/spirituality, sexuality, gender, family, career, and being an immigrant are important aspects of their identity, with only one participant recognizing their identity as a "person with cancer". A cancer diagnosis altered the aspects of identity deemed most significant by participants. Both visible and invisible aspects of identity shaped participants' experiences and influenced their level of trust in the healthcare system. Conclusion: Racially, ethnically, gender, or sexually minoritized AYAs with cancer place considerable importance on aspects of their identity that are shaped by their respective communities. Recognizing and respecting these identities are paramount for healthcare professionals to deliver safe and inclusive care. [ABSTRACT FROM AUTHOR]

Objective: We sought to examine the associations between a social needs measure and physical, and mental health among cancer survivors in the United States. Methods: We conducted a cross‐sectional analysis using the 2022 Behavioral Risk Factor Surveillance System survey involving 16,930 eligible cancer survivors. The primary outcomes of interest were self‐reported physical and mental health in the past 30 days. A social needs measure was our primary exposure of interest. Multivariate logistic regression was used to examine the associations of interest. Results: Overall, 56% and 73% survivors with several days of poor physical and mental health, respectively, reported having two or more social needs. In multivariate analysis, those having at least one social need were more likely to report several days of poor physical (one need: OR, 1.62; 95% CI, 1.31–2.00, two or more needs: OR, 3.52; 95% CI, 2.84–4.35) and mental health (one need: OR, 3.07; 95% CI, 2.07–4.57, two or more needs: OR, 9.69; 95% CI, 6.83–13.74). Among survivors with two or more social needs, having exercised in the past 30 days were 41% and 59% less likely to experience poor physical and mental health, respectively (p‐value < 0.05). However, having at least one chronic disease was associated with several days of poor physical/mental health among those with two or more needs (p‐value < 0.05). Conclusion: Having social needs was associated with self‐reporting of several days of poor physical and mental health among cancer survivors. Integrated care should include mental/physical health management addressing cancer survivors' various social needs. [ABSTRACT FROM AUTHOR]

Background: Lynch syndrome carriers ('carriers') are presented with complex, emotionally laden choices regarding management of increased genetic cancer risks. Decision aids encourage active involvement in values‐based health decisions. This paper aimed to address the research question: How do Lynch syndrome carriers make sense of their chances of developing cancer, and what are the implications for providing support with decision making about genetic cancer risk management? Methods: Adult carriers were recruited through a genetics service or involvement with Lynch Syndrome UK. Semi‐structured interviews explored lived experiences of carriers' access to care with a focus on decision support. Themes were constructed using framework analysis. These were developed into a conceptual model with recommendations for codevelopment of improved information and support including a tailored decision aid to complement integrated healthcare. Results: Twenty participants included 12 women and eight men, half with a history of cancer. Six overarching themes were: (1) finding balance with Lynch; (2) living 'on higher alert'; (3) managing uncertainty: 'I've thought about it a lot'; (4) burden of responsibility: 'It's on me'; (5) access to joined‐up care and support: 'There's something missing'; and (6) influence/pressure from others. Conclusions: This qualitative interview study provided in‐depth insights from Lynch syndrome carriers about their lived experiences, informed by their values. Recommendations to empower carriers to make sense of genetic cancer risks and support decisions included accessible, trusted information, educated healthcare professionals, shared decision making, and joined‐up integrated care pathways complemented by tailored decision aids. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to (1) identify similarities and differences in psychosocial burdens and support needs experienced by parent, partner and adult‐child caregivers and (2) identify support needs of family caregivers regarding peer support programs. Methods: Semi‐structured interviews (n = 30) were conducted with family caregivers of cancer patients. Interviews were transcribed and analyzed by inductive content analysis to identify themes. Results: Ten categories of burden were identified for all three groups of caregivers. Partners emphasized the time burden through caregiving, parents and adult‐child caregivers accentuated the emotional burden. All caregivers wished for peer‐to‐peer exchange which will provide the feeling not to be alone, to share emotions and to prepare for what will come next. Preferences for matching with peers with similar prognosis for their sick relative and similar living conditions were found. Conclusions: Partner, parent and adult‐child caregivers describe similar burdens of caregiving. They wish for peer support programs that allow them to share their experiences with persons who understand their situation. Therefore, caregivers desire a good match with peers to enhance the positive outcome of peer exchange. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer survivors (BCS) have higher rates of depression which is associated with lower adherence to medications, diet, and physical activity. Managing diabetes (DM) requires adherence to several of these self‐management behaviors (SMB), and BCS have an increased risk of DM. We investigated whether depressive symptoms were associated with adherence to DM SMB in a cohort of BCS. Methods: BCS with DM were surveyed semiannually for 2 years. Depression was assessed with the Hospital Anxiety and Depression Scale (HADS). Adherence to DM medication, diet, and physical activity was self‐reported using the Medication Adherence Report Scale (MARS), Summary of Diabetes Self‐Care Activities Assessment (SDSCA), and International Physical Activity Questionnaire (IPAQ), respectively. Using generalized linear equation modeling, the association of depressive symptoms with nonadherence to SMB was assessed, adjusting for age, race, marital status, education level, and beliefs about cancer and DM risk. Results: Among 244 BCS with DM, those who were nonadherent to medication, diet, and/or physical activity had higher depression scores (p < 0.01). In adjusted analyses, higher depression scores were independently associated with dietary (OR = 1.16, p < 0.001) and physical activity nonadherence (OR = 1.18, p < 0.001) but not with medication nonadherence. Concerns about medications was independently associated with medication nonadherence (OR = 1.17, p = 0.024). Conclusions: Higher depression scores are associated with nonadherence to DM SMB in this cohort of BCS. These findings highlight the importance of addressing depressive symptoms in BCS to help improve adherence to DM medications, diet, and physical activity. [ABSTRACT FROM AUTHOR]

Objectives: As part of a wider study describing the impact of a breast cancer diagnosis on lifestyle behaviours, this paper describes the impact of a breast cancer diagnosis on alcohol consumption and factors influencing consumption. Methods: Cross‐sectional online survey of 140 people (138 women) and interviews with 21 women diagnosed with breast cancer in the last 10 years. Results: Of the 100 survey participants who drank alcohol 25% were drinking at increasing or higher risk levels and 17% strongly wanted to change their drinking behaviour. The habitual aspects of alcohol consumption were the strongest predictor of current alcohol consumption behaviours. Social norms and perceptions about conflicting information were substantial barriers to change. Conclusions: Breast cancer survivors need accurate information about the risks of alcohol consumption and guidelines in order to make informed decisions about making changes to their behaviour. Interventions to support breast cancer survivors to reduce alcohol consumption need to focus on the development of healthy habits and may benefit from a focus which includes partners and friends. [ABSTRACT FROM AUTHOR]

Objectives: Systemic cancer treatments pose threats to fertility, leading to concerns regarding fertility and parenthood in young adult women with breast cancer (YAWBC). This systematic review aimed to synthesize existing evidence on reproductive concerns (RCs) among YAWBC and identify areas where further research in needed. Methods: A systematic review was conducted. Nine English and Chinese databases were searched for studies from inception to June 2023. A meta‐analysis was employed to pool RC levels measured using the Reproductive Concerns After Cancer scale (RCAC scale; possible total scores: 18–90). Narrative synthesis was conducted in cases where a meta‐analysis could not be performed. Results: Twenty‐four cross‐sectional studies across seven countries were included in this review. The prevalence of RCs among YAWBC ranged from 21.75% to 80%. The pooled mean total score on the overall RCAC scale was 55.84 (95% confidence interval: 53.26–58.43). "Personal health," "child's health," and "fertility potential" were the top three types of RCs among YAWBC. Sociodemographic, clinical, and psychosocial factors were found to be associated with RCs among YAWBC. Additionally, significant correlations among RCs, nonadherence to treatment, depression, and quality of life were also identified among YAWBC. Conclusion: RCs are a common issue among YAWBC, and age, parenthood status, fertility desire, and chemotherapy treatment are important factors associated with RCs among these women. Further research is needed to clarify RC‐related factors to provide evidence aimed at tailoring interventions to mitigate RCs among YWBC. [ABSTRACT FROM AUTHOR]

Objective: Despite available support, sexuality needs are the most frequently reported unmet need among men with prostate cancer, which may be due to low help‐seeking rates. Using the Ecological Systems Framework as a theoretical foundation, we conducted a scoping review of the available literature to understand what factors impact help‐seeking behaviour for sexual issues after prostate cancer treatment among men who had received treatment. Methods: Following PRISMA guidelines, a systematic search on Medline, PsychInfo, Embase, Emcare, and Scopus was conducted to identify studies of adult prostate cancer patients post‐treatment, which reported barriers and/or facilitators to help‐seeking for sexual health issues. Quality appraisals were conducted using Joanna Briggs Institute appraisal tools, and results were qualitatively synthesised. Results: Of the 3870 unique results, only 30 studies met inclusion criteria. In general, studies were considered moderate to good quality, though only six used standardised measures to assess help‐seeking behaviour. Barriers and facilitators for sexual help‐seeking were identified across all five levels of the Ecological Systems Framework, including age, treatment type, and previous help seeking experience (individual level), healthcare professional communication and partner support (microsystem), financial cost and accessibility of support (meso/exosystem), and finally embarrassment, masculinity, cultural norms, and sexuality minority (macrosystem). Conclusions: Addressing commonly reported barriers (and inversely, enhancing facilitators) to help‐seeking for sexual issues is essential to ensure patients are appropriately supported. Based on our results, we recommend healthcare professionals include sexual wellbeing discussions as standard care for all prostate cancer patients, regardless of treatment received, age, sexual orientation, and partnership status/involvement. [ABSTRACT FROM AUTHOR]

Objective: Oncologists' psychological health is a major challenge due to the consequential concerning the quality of the care they provide. However, only critical states of their health have been really examined by scientists. This study sought to plug this gap by investigating the mediating role of psychological flourishing in the relationship between the perception of the professional social context (i.e., perceived workplace isolation and organizational support) and positive attitudes at work among oncologists (i.e., work engagement, task adjustment and empathy). Methods: The study was a cross‐sectional, including 541 French oncologists. Participants completed a self‐report questionnaire. Structural Equation Modeling was employed to test the hypotheses. Results: The analysis revealed that workplace isolation and organizational support perceptions were related to oncologists' work engagement, task adjustment and empathy. Additionally, psychological flourishing acted as a partial mediator between these perceptions of professional social context and oncologists' work‐related attitudes. Conclusions: This research underlined the potential of enhancing the psychological flourishing of oncologists by improving organizational support and mitigating their sense of isolation, and in turn, to enhance some dimensions of their positive attitudes at work. [ABSTRACT FROM AUTHOR]

Objective: Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool‐Patients (MPDT‐P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT‐P. Methods: The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT‐P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach. Results: The two‐factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three‐factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future. Conclusions: Integrating the MPDT‐P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts. [ABSTRACT FROM AUTHOR]

Objective: To compare and rank the effectiveness of four primary categories of exercise modalities (aerobic, resistance, mind‐body, and combined exercise [CE]) in improving the Quality of life (QoL) of women with breast cancer in a network meta‐analysis (NMA). Methods: Articles published in English and indexed in the PubMed (MEDLINE), EBSCO, Web of Science, SPORTDiscus, The Cochrane Library, Google Scholar, PsycINFO, EMBASE, and CINAHL Plus databases were identified from inception to 12 October 2023. Studies that met the eligibility criteria were assessed for risk of bias. A frequentist NMA was conducted to appraise the efficacy of different exercise types. Results: This study included 56 studies with 3904 participants. Aerobic, mind‐body, and combined exercises effectively improved QoL compared to controls. The surface under the cumulative ranking curve (SUCRA) indicated that CE best improved patients' QoL (SUCRA = 96.7%). Analysis of the secondary outcomes suggests that exercise reduced patients' depression (standardized mean difference [SMD] = −0.38, 95% confidence interval [CI] = −0.70 to −0.06, p < 0.001; I2 = 79%) and anxiety (SMD = −0.50, 95% CI = −0.69 to −0.31, p < 0.001; I2 = 27.4%) but did not affect self‐esteem. Conclusion: All exercise types but resistance were effective in improving the QoL of women with breast cancer, CE (the combination of aerobic and resistance exercise) had the highest likelihood of being optimal for improving QoL. [ABSTRACT FROM AUTHOR]

Background: Cancer in a loved one can have negative effects on child health and development. Child Life Specialists (CLSs) specialize in assisting children understand and cope with difficult medical scenarios but are generally not available in adult care facilities to support the needs of patient‐families with minor children. We conducted a mixed‐methods study of the implementation of a pilot CLS program at a tertiary oncology centre. Methods: We collected administrative and clinical data on referred families; encounter data; and patient‐reported questionnaire data before and 2 months after engagement with the program. Results: Over the initial 10 months, 98 families were referred, 91 of whom engaged through a total of 257 clinical encounters. The cancer patient in the family was most commonly a woman with a mean age of 45 years and in the role of mother. Breast cancer was the most common diagnosis (24%) and 78% of patients had stage IV disease. Most families had >1 child at home, and children were most commonly school‐aged (5–14y). Phone and Hospital/Clinic visits accounted for the largest portion of CLS time. Interventions ranged from diagnosis education through to bereavement support. Most cancer patients indicated that the program was helpful to them and their families. There were trends of moderate improvements on patient reported outcomes. Conclusion: Our study was able to provide an understanding of the initial CLS program operations to guide program development and future study. Such a program holds promise as an important aspect of adult oncology family‐centered care. [ABSTRACT FROM AUTHOR]

Objectives: This Special issue of Psycho‐Oncology highlights examples of the application of implementation science to research in psycho‐oncology. The aim is to demonstrate the different ways that implementation science is being used to generate evidence that can more readily translate evidence into changes in clinical practice. We hope this issue fosters greater interest in using the tools of implementation science to improve the lives of people affected by cancer. Methods: The papers in the issue were selected from among those that responded to a call for submissions on the application of implementation science frameworks and methods to issues in psycho‐oncology. The focus included but was not limited to research on: understanding barriers and facilitators of intervention/practice adoption; assessing implementation outcomes, evaluating implementation strategies, and improving behavioural and/or clinical outcomes. Results: The 11 papers in this issue were grouped for presentation purposes into four common topics: barriers and facilitators to implementation; feasibility as a key implementation outcome; the design, selection and adaptation of implementation strategies; and building the foundation for psycho‐oncology research translation via systematic reviews that focus on implementation strategy design. Conclusion: These papers demonstrate the breadth of current applications of implementation science to research in psycho‐oncology. Alongside the studies featured in this issue, including cost‐effectiveness analyses, tests of nationally‐focused strategies and proactive planning for adaptation, we look forward to other innovations that will promote further growth of both disciplines to improve the integration of psycho‐oncology interventions across healthcare systems. [ABSTRACT FROM AUTHOR]

Objective: To identify predictors of sexual satisfaction in patients with advanced cancer and their family caregivers. Methods: Cross‐sectional study using baseline survey data from a randomized controlled trial in six European countries. Patients with advanced cancer and their family caregiver completed measures on sexual satisfaction (one item from Functional Assessment of Cancer Therapy ‐ General questionnaire for patients and Caregiver Quality of Life Index‐Cancer scale for family caregivers) and health‐related characteristics. Multivariable linear regressions were performed for all predictors (identified based on literature) with sexual satisfaction as dependent variable. Results: The sample comprised 431 patient‐family caregiver dyads. Patients with prostate or gynecological cancer reported lower sexual satisfaction (respectively B = −0.267 95% CI: −1.674, −0.594 and B = −0.196, 95% CI −2.103, −0.452). Higher emotional (B = 0.278, 95% CI 0.024, 0.057) physical (B = 0.305, 95% CI 0.012, 0.025) and social functioning (B = 0.151, 95% CI 0.001, 0.013), global health (B = 0.356, 95% CI 0.007, 0.013) and social wellbeing (B = 0.161, 95% CI 0.013, 0.082) among patients were associated with higher sexual satisfaction. Among family caregivers, sexual satisfaction was lower with increased age (B = −0.142, 95% CI −0.022, −0.004). Higher emotional functioning (B = 0.027, 95% CI 0.011, 0.043) and quality of life (B = 0.165, 95% CI −0.165, 0.716) were associated with higher sexual satisfaction in family caregivers. Conclusions: The results underscore that sexual wellbeing of patients and family caregivers is related to health related factors in physical, emotional, and social domains. Patients and family caregivers could benefit from a dyadic approach to address sexual wellbeing. [ABSTRACT FROM AUTHOR]

Objective: Clinical fear of cancer recurrence (FCR) was recently defined by a group of experts during a Delphi study. Five criteria were agreed upon, namely: (a) high levels of preoccupation, (b) high levels of worry, (c) that are persistent, (d) hypervigilance and hypersensitivity to physical sensations that e) may result in functional impairment. No existing instruments comprehensively capture all these criteria for clinical FCR. Methods: To remedy this gap, a set of three patient‐reported outcome instruments including a one‐item screener, self‐report questionnaire, and semi‐structured clinical interview, named the Ottawa Clinical Fear of Recurrence instruments, were developed. To do so, the research team first conducted a literature review of potential items. Additional FCR experts discussed the content of the screener and interview. The self‐report's items were assessed for content validity by the same expert panel using Likert ratings and the Content Validity Index to narrow down the number of items. The three instruments were piloted with a group of cancer survivors to assess face validity following the European Organization for Research and Treatment of Cancer recommendations. Results: The literature review and content validity assessment led to a final draft pre‐pilot of 23 potential items for the self‐report questionnaire. The instruments were piloted. Pilot study participants suggested changing wording and response options (particularly for the self‐report) for greater clarity. Conclusions: Based on the feedback received, minor modifications were made, mostly for the self‐report. In general, content and face validity for the three instruments were good for both experts and cancer survivors. [ABSTRACT FROM AUTHOR]

Background: Pediatric cancer patients' oncology teams regularly take on a primary care role, but due to the urgent nature of cancer treatment, developmental screenings may be deprioritized. This leaves patients at risk of developmental diagnoses and referrals being delayed. Aims: Clarify the current developmental surveillance and screening practices of one pediatric oncology team. Materials and methods: Researchers reviewed charts for patients (n = 66) seen at a pediatric oncology clinic in a suburban academic medical center to determine engagement in developmental screening (including functioning around related areas such as speech, neurocognition, etc.) and referrals for care in these areas. Results: Developmental histories were collected from all patients through admission history and physical examination (H&P), but there was no routinized follow‐up. Physicians did not conduct regular developmental screening per American Academy of Pediatrics guidelines for any patients but identified n = 3 patients with needs while the psychology team routinely surveilled all patients seen during this time (n = 41) and identified n = 18 patients as having delays. Discussion: Physicians did not routinely screen for development needs beyond H&P and were inconsistent in developmental follow‐up/referrals. Integrated psychologists were key in generating referrals for developmental‐based care. However, many oncology patients were not seen by psychologists quickly or at all, creating a significant gap in care during a crucial developmental period. Conclusion: The case is made for further routinization of ongoing developmental screening in pediatric oncology care. Key points: For pediatric oncology patients, oncology providers may take on a primary care role to surveil, screen, and refer for developmental concerns per guidelines issued by the American Academy of Pediatrics.This quality improvement study sought to explore the developmental monitoring practices of one pediatric oncology clinic.Only a portion of pediatric oncology patients diagnosed with cancer between 6 months and 5 years 11 months received developmental surveillance, screenings, and/or referrals from the oncology team beyond patients' initial history and physical.Patients who were seen by the integrated psycho‐oncology team were the most likely to have received developmental surveillance, screening, and referrals. Integrated psycho‐oncology providers may serve to address gaps in developmental monitoring practices in pediatric oncology clinics. [ABSTRACT FROM AUTHOR]

Objective: Low and middle income countries of Africa account for a disproportionate amount of the global health burden of cancer. Providing patients access to psychosocial oncology and palliative care through policy structures such as the National Cancer Control Plans (NCCP) is essential to improving the care provided to patients and their families. The first phase of this study sought to determine the extent to which palliative care and psychosocial oncology were integrated in NCCPs in African countries. Methods: A qualitative thematic analysis of the plans was used using Nvivo, with two‐raters coding and continuous team discussions. Data were organized into an infographic map showing the coverage of themes across African countries. Results: Fifty‐eight NCCPs and NCD plans were analyzed in the 54 countries in Africa. The findings illustrate a lack of standardization across countries' NCCPs in addressing psychosocial oncology and palliative care themes. Certain areas presented good coverage across several plans, such as barriers to access, education, awareness, and health behaviors, coordination of care, families, caregivers and community involvement, and palliative care. Other themes presented low coverage, such as doctor‐patient communication, mental health, bereavement, psychosocial care, survivorship care, and traditional medicine. Conclusions: One may consider further developing NCCP areas as they pertain to psychosocial oncology and palliative care to ensure their proper place on the policy agenda for a healthier Africa. [ABSTRACT FROM AUTHOR]

Objectives: Childhood cancer survivors' social reintegration may be hampered in low and middle‐income countries. The nature and extent of social challenges and prejudices that survivors encounter in such settings are largely unknown. This study explores caregivers' perspectives on social reintegration and stigmatization of Kenyan childhood cancer survivors. Methods: Caretakers of childhood cancer survivors (<18 years) were interviewed using mixed‐methods questionnaires during home or clinic visits between 2021 and 2022. Stigma was assessed with an adjusted Social Impact Scale and risk factors were investigated. Results: Caretakers of 54 survivors (median age 11 years) were interviewed. Families' income (93%) decreased since start of treatment. Caretakers (44%) often lost their jobs. Financial struggles (88%) were a burden that provoked conflicts within communities (31%). School fees for siblings became unaffordable (52%). Families received negative responses (26%) and were left or avoided (13%) by community members after cancer disclosure. Survivors and families were discriminated against because the child was perceived fragile, and cancer was considered fatal, contagious, or witchcraft. Survivors repeated school levels (58%) and were excluded from school activities (19%) or bullied (13%). Performance limitations of daily activities (p = 0.019), male sex (p = 0.032), solid tumors (p = 0.056) and a short time since treatment completion (p = 0.047) were associated with increased stigma. Caretakers recommended educational programs in schools and communities to raise awareness about cancer treatment and curability. Conclusions: Childhood cancer survivors and their families experienced difficulties with re‐entry and stigmatization in society. Increasing cancer and survivorship awareness in schools and communities should facilitate social reintegration and prevent stigmatization. [ABSTRACT FROM AUTHOR]

Background: Fear of progression (FOP) is a common and significant concern among cancer patients, encompassing worries about cancer progression during active treatment. Elevated levels of FOP can be dysfunctional. This study aims to assess the efficacy of an Acceptance and Commitment Therapy (ACT)-based intervention on FOP, anxiety sensitivity (AS), and quality of life (QOL) in breast cancer patients. Methods: A clinical trial was conducted involving 80 stage I-III active-treatment breast cancer patients with a score greater than 34 on the Fear of Progression Questionnaire-Short Form scale. These patients were randomly assigned in a 1:1 ratio to either an intervention group, which received weekly 70-min sessions of 5-ACT-bsed group-therapy, or a control group that received usual treatment. Variables including FOP, AS, QOL, and ACT-related factors were assessed using ASQ, QLQ-C30, Cognitive Fusion Questionnaire, and Acceptance and Action Questionnaire-II at three time points: baseline, post-intervention, and 3-month follow-up. The efficacy of the intervention was evaluated using mixed model analysis across all time-points. Results: The fidelity and acceptability of the ACT-based manual were confirmed using significant methods. A significant reduction in FOP was observed only in the ACT group at post-intervention (P-valueACT < 0.001; Cohen dACT = 1.099). Furthermore, the ACT group demonstrated a more significant reduction in FOP at follow-up. Furthermore, all secondary and ACT-related variables, except for the physical symptoms subscale, showed significant improvement in the ACT group compared to the control group. Conclusions: Our ACT-based manual showed promise for reducing FOP, AS, and improving QOL, and ACT-related variables in breast cancer patients 3 months following the intervention. [ABSTRACT FROM AUTHOR]

Background: Adolescents and young adults (AYAs; ages 15–29 years) diagnosed with cancer are increasingly recognized as an oncology population with distinct psychosocial needs. However, few specialized psychosocial interventions for AYAs currently exist. This study reports on the development of a novel group‐based psychotherapy intervention to address the psychosocial needs of AYAs. The objective was to evaluate the acceptability, feasibility, and preliminary effects of the intervention. Methods: The manualized group psychotherapy program is delivered virtually over an 8‐week period by registered psychologists. Four groups (n = 5–11 AYAs per group) with a total of N = 33 participants (Mage = 20.97 years, SD = 3.68, range = 15–29 years, 76% women) were conducted. Recruitment and retention data assessed intervention feasibility. Patient‐reported psychosocial outcomes were measured at baseline and immediately following the intervention to assess preliminary effects. Acceptability was assessed following the intervention using a self‐report measure of participant satisfaction. Results: Overall, the completion rate of the intervention was 85% (n = 28). All participants "strongly agreed" (88%) or "agreed" (13%) that they were satisfied with the group. Meeting, sharing experiences, and expressing feelings with other AYAs were identified as the most helpful aspects. Participants reported significant improvements in emotional (p < 0.05) and functional (p < 0.01) quality of life from baseline to immediately post‐intervention with medium effect sizes (d = 0.58–0.70). Conclusions: Findings suggest that the intervention is feasible, acceptable, and shows promise for improving psychosocial outcomes for AYAs. Further research will refine the intervention and establish efficacy in a randomized trial. [ABSTRACT FROM AUTHOR]

Objective: Masculinities have been explored in men with testicular cancer (TC), though limited contemporary research is available on traditional masculine norms important to masculine self‐perception. The purpose of this research was to explore the discourse of TC experience in relation to masculine self‐perception. Methods: A qualitative descriptive study was conducted consisting of semi‐structured interviews with 21 men. Men were aged between 31 and 47 (Mage = 35.7). Most men were diagnosed with Stage 1 cancer (66.6%), all men had finished active treatment and time since diagnosis ranged from 17.3 to 71.8 months (M = 47.2). Independent coding was conducted by two researchers and was refined in coding meetings with authors. Themes were developed in a predominantly deductive manner, and analysis of themes was undertaken using a reflexive analysis approach. Results: Traditional masculine norms showed differing relationships to masculine self‐perception. Two main themes were identified [1] Maintained or enhanced masculine self‐perception and [2] threats to masculine self‐perception. Subthemes demonstrated that maintaining emotional control, strength and 'winning' was important to men, and reduced physical competencies (i.e., strength, sexual dysfunction, virility) challenged self‐perception. Strict adherence to traditional norms in response to threatened self‐perception related to psychological distress. Conclusion: Leveraging traditionally masculine norms such as physical strength and control and developing flexible adaptations of masculinities should be encouraged with men with TC to retain self‐perception and potentially enable better coping. Masculine self‐perception of gay/bisexual men may centre around sexual functioning, though further research is required. [ABSTRACT FROM AUTHOR]

Objective: Nuanced distress screening tools can help cancer care services manage specific cancer groups' concerns more efficiently. This study examines the sensitivity and specificity of a tool specifically for women with gynaecological cancers (called the Gynaecological Cancer Distress Screen or DT‐Gyn). Methods: This paper presents cross‐sectional data from individuals recently treated for gynaecological cancer recruited through Australian cancer care services, partner organisations, and support/advocacy services. Receiver operating characteristics analyses were used to evaluate the diagnostic accuracy of the DT‐Gyn against criterion measures for anxiety (GAD‐7), depression (patient health questionnaire), and distress (IES‐R and K10). Results: Overall, 373 individuals aged 19–91 provided complete data for the study. Using the recognised distress thermometer (DT) cut‐off of 4, 47% of participants were classified as distressed, while a cut‐off of 5 suggested that 40% had clinically relevant distress. The DT‐Gyn showed good discriminant ability across all measures (IES‐R: area under the curve (AUC) = 0.86, 95% CI = 0.82–0.90; GAD‐7: AUC = 0.89, 95% CI = 0.85–0.93; K10: AUC = 0.88, 95% CI = 0.85–0.92; PHQ‐9: AUC = 0.85, 95% CI = 0.81–0.89) and the Youden Index suggested an optimum DT cut‐point of 5. Conclusions: This study established the psychometric properties of the DT‐Gyn, a tool designed to identify and manage the common sources of distress in women with gynaecological cancers. We suggest a DT cut point ≥5 is optimal in detecting 'clinically relevant' distress, anxiety, and depression in this population. [ABSTRACT FROM AUTHOR]

Background: Cognitive‐behavioral therapy for insomnia (CBT‐I) is considered the gold standard treatment for insomnia. Prior trials have delivered CBT‐I across a range of treatment sessions. Understanding the economics of varying treatment approaches is essential for future implementation considerations. Methods: We conducted a retrospective cost‐effectiveness analysis from the provider's perspective, comparing the implementation of a three‐session CBT‐I program for cancer survivors (CBT‐I‐CS) versus a stepped care treatment approach consisting of an initial single sleep education session followed by CBT‐I‐CS if elevated insomnia symptoms persisted. The effectiveness measure used was the percentage of participants whose insomnia had remitted by the end of each program. Results: Stepped care delivery was more effective than CBT‐I‐CS alone, resulting in 35.4% more remitted patients by the end of the overall program. For a $480 willingness to pay threshold per percentage of remitted patients, stepped care CBT‐I‐CS reached a 98% probability of being cost‐effective, while CBT‐I‐CS alone had only a 2% probability. Larger group sessions in the first step of a stepped care delivery model resulted in more favorable cost‐effectiveness. Conclusions: A stepped care delivery model may be a more cost‐effective approach if it can be implemented efficiently. These findings inform policies aimed at improving cancer survivors' access to much‐needed insomnia treatment in settings where financial resources for CBT‐I may be limited, and be an important barrier to treatment dissemination. Clinical Trial Registration: These analyses were not registered. [ABSTRACT FROM AUTHOR]

Objectives: To promote posttraumatic growth (PTG) in colorectal cancer (CRC) couples, a couple‐based PTG intervention was conducted, and the intervention had previously proved be feasible in CRC couples. The current study was conducted to validate the effects of intervention in CRC couples. Method: This is a randomized controlled study that included 174 CRC couples. All participants were randomized to either the intervention (usual care plus 5‐week PTG intervention, n = 87) or the control group (usual care, n = 87). Data were collected from CRC couple dyads at baseline and immediately post‐intervention periods. Primary outcome refers to positive changes, and secondary outcomes include marital satisfaction, quality of life (QOL), and anxiety and depression. Multilevel modeling was applied to analyze the intervention effects. Results: Participants in the program showed increased PTG, marital satisfaction, and QOL both physically and mentally, and decreased levels of anxiety and depression over time. And spousal caregivers showed greater improvement in marital satisfaction and physical QOL compared with patients. In addition, significant intervention effects were shown in the participants' benefit finding, physical health and depressive symptoms. Conclusion: The study confirmed the effect of the PTG intervention on CRC couples' benefit finding, physical health and depressive symptoms. However, this study only measured outcome variables at two time‐points. Future studies should add follow‐up assessments to evaluate long‐term effects of the intervention in CRC couples. Registration number: ChiCTR2300067809. [ABSTRACT FROM AUTHOR]

Objective: Emotional distress has been correlated with greater healthcare utilization and economic costs in cancer; however, the prospective relationship between positive distress screens and future healthcare utilization is less clear. Taken together, there is a critical need to synthesize studies examining the prospective relationship between emotional distress and future healthcare use to inform distress management protocols and motivate institutional resource allocation to distress management. The aim of the systematic review is to explore the relationship between emotional distress, measured via validated emotional distress questionnaires, and subsequent healthcare utilization in patients diagnosed with cancer. Methods: A systematic search of seven databases was conducted on 29 March 2022 and updated 3 August 2023. Eligibility criteria were: (1) peer‐reviewed, (2) quantitative or mixed methods, (3) adults (≥18 years) diagnosed with cancer, (4) cancer distress questionnaire(s) completed prior to healthcare utilization, and (5) written in English. Exclusion criteria included: (1) non‐emotional aspects of distress (i.e., spiritual or physical distress), (2) healthcare utilization characterized via economic or monetary variables, and (3) caregiver or non‐cancer populations. Results: Nineteen peer‐reviewed articles were included in the review. There was significant heterogeneity in emotional distress instruments and type of healthcare utilization used. Most studies examining general distress or anxiety found that increased distress was predictive of greater future healthcare utilization. Conclusion: The results suggest that individuals with higher levels of general distress and anxiety are at increased risk for future healthcare utilization. [ABSTRACT FROM AUTHOR]

Objective: Quality survivorship information is an essential component of cancer care. However, survivors often report not receiving this information and healthcare professionals report limited practical guidance on how to effectively deliver survivorship information. Therefore, this study used realist review methods to identify mechanisms reported within the published literature for communicating survivorship information and to understand the contextual factors that make these mechanisms effective. Methods: Full‐text papers published in CINAHL, PubMed, Web of Science, Scopus, Cochrane Library, and Academic Search Ultimate were included. Studies included in this review were conducted in Australia between January 2006 and December 2023, and reported on how information regarding survivorship care was communicated to adult cancer survivors living in the community. This review utilized realist methodologies: text extracts were converted to if‐then statements used to generate context‐mechanism‐outcome theories. Results: Fifty‐one studies were included and six theories for mechanisms that underpin the effective delivery of survivorship information were formed. These include: (1) tailoring information based on the survivors' background, (2) enhancing communication among providers, (3) employing dedicated survivorship staff, (4) providing survivorship training, (5) reducing the burden on survivors to navigate their care, and (6) using multiple modalities to provide information. Conclusions: Findings can inform practical guidance for how survivorship care information is best delivered in practice. Clinicians can apply this guidance to improve their individual interactions with cancer survivors, as can policymakers to develop healthcare systems and procedures that support effective communication of cancer survivorship information. [ABSTRACT FROM AUTHOR]

Objective: Demoralization has garnered increasing attention in recent years as a significant psychological distress. This study aims to identify latent classes of demoralization in lung cancer patients using Latent Class Analysis (LCA) from a person‐centered perspective and to explore the factors influencing the latent classes of demoralization. Methods: A cross‐sectional study using convenience sampling was conducted among 567 lung cancer patients in three tertiary hospitals in China. LCA was employed to classify heterogeneous classes of demoralization. Multinomial logistic regression analyses were performed to explore the associations between demographic and clinical characteristics, as well as physical symptoms, resilience, family function, and coping strategies, with class membership in the identified heterogeneous subgroups of lung cancer patients. Results: Three latent classes of demoralization were identified: the high demoralization group (Class 1, 14.8%), the moderate demoralization‐distress and helplessness group (Class 2, 37.2%), and the low demoralization group (Class 3, 48.0%). In comparison to Class 3, lung cancer patients with hypertension, higher core symptom burden, poorer resilience, dysfunctional family dynamics, and resignation coping were more likely to belong to Class 1 and Class 2. Conclusions: The demoralization patterns in lung cancer patients were varied. Targeted intervention should be developed based on the characteristics of each class, and timely attention should be paid to high‐risk patients. [ABSTRACT FROM AUTHOR]

Objective: Support people of cancer patients are at significant risk for psychological distress. Additionally, cancer patients' well‐being is reciprocally associated with support peoples' psychological well‐being. Informed by Uncertainty in Illness Theory, this study tests whether support person psychological well‐being is influenced by provider communication and uncertainty reduction. Methods: We tested a multiple mediation model to investigate how empathic communication facilitates psychological adjustment in support people of cancer patients and how this process is mediated by support peoples' illness uncertainty and caregiver burden. Support people of cancer patients (N = 121; including spouses, adult children, etc.) completed an online questionnaire about their perceptions of oncologists' empathy, uncertainty about the cancer patients' illness, perceived caregiving burden, and their psychological adjustment to diagnoses. Results: Path analysis revealed that (1) more perceived oncologist empathy was associated with less illness uncertainty, (2) more illness uncertainty was associated with worse psychological adjustment and more perceived caregiver burden, and (3) more burden was associated with worse adjustment (χ2(2) = 1.19, p = 0.55; RMSEA < 0.01; CFI = 1.00; SRMR = 0.02). Conclusions: Given the reciprocal nature of well‐being between cancer patients and their support people, it is critical to understand and bolster support people's psychological well‐being. Results demonstrated how empathic provider communication can support psychological well‐being for support people of cancer patients. Additionally, this study offers theoretical contributions to understandings of illness uncertainty in caregiver populations. [ABSTRACT FROM AUTHOR]

Objectives: Unmet supportive care needs are associated with psychological symptoms such as depression and anxiety. However, so far, few studies have explored the protective psychological factors of unmet needs. Therefore, this study intends to explore the protective effect of self‐compassion on unmet needs of Chinese cancer patients and to examine the predictive role of self‐compassion on these needs during treatment. Methods: A longitudinal study was performed at Shaanxi Provincial Cancer Hospital in Xi'an, China. A total of 153 heterogeneous cancer patients were assessed after the first diagnosis (T1), at the beginning (T2) and end (T3) of medical treatment. Hierarchical linear regression analyses were used to examine the research questions. Results: Cross‐sectional regression analyses showed that self‐compassion at T1 was significantly related to psychological needs at T1. Negative self‐compassion at T1 was significantly related to total unmet needs, psychological needs, health system, and information and sexual needs. Longitudinal regression analyses showed that self‐compassion at T1 significantly predicted total unmet needs; health system and information (HSI) needs at T2, psychological needs at T3, and negative self‐compassion at T1 significantly predicted total unmet needs, HSI needs, physical needs, and patient care needs at T2 when controlling for unmet needs at T1. Positive self‐compassion was not a predictor of unmet needs. Conclusions: Self‐compassion can be a protective factor of unmet needs in cancer patients. Future intervention studies should focus on improving the overall level of self‐compassion and reducing the level of negative self‐compassion in cancer patients to reduce patients' unmet needs. [ABSTRACT FROM AUTHOR]

Objective: There is a dearth of literature describing young adult (YA) cancer survivors' experiences with cancer‐related cognitive impairment (CRCI). We aimed to elucidate CRCI among YA cancer survivors and identify potentially modifiable risk factors. Methods: We conducted individual qualitative interviews with YA cancer survivors aged 18–30 years at study enrollment and used applied thematic analysis to identify themes across three topics (i.e., affected cognitive abilities, risk and protective factors influencing the impact of CRCI, and strategies for coping with CRCI). Results: YA cancer survivors (N = 20) were, on average, 23 years old at diagnosis and 26 years old when interviewed. Diverse cancer types and treatments were represented; most participants (85%) had completed cancer treatment. Participants described experiences across three qualitative topics: (1) affected cognitive abilities (i.e., concentration and attention, prospective memory, and long‐term memory), (2) Risk factors (i.e., fatigue, sleep problems, mood, stress/distractions, and social isolation) and protective factors (i.e., social support), and (3) coping strategies, including practical strategies that helped build self‐efficacy (e.g., writing things down, reducing distractions), beneficial emotion‐focused coping strategies (e.g., focus on health, faith/religion), strategies with mixed effects (i.e., apps/games, medications/supplements, and yoga), and "powering through" strategies that exacerbated stress. Conclusions: YA cancer survivors experience enduring cognitive difficulties after treatment. Specific concerns highlight the importance of attention and executive functioning impairments, long‐term memory recall, and sensitivity to distractions. Future work is needed to improve assessment and treatment of CRCI among YA cancer survivors. [ABSTRACT FROM AUTHOR]

Objective: Pain is common among people with advanced cancer. While opioids provide significant relief, incorporating psycho‐behavioral treatments may improve pain outcomes. We examined patients' experiences with pain self‐management and how their self‐management of chronic, cancer‐related pain may be complemented by behavioral mobile health (mHealth) interventions. Methods: We conducted semi‐structured qualitative interviews with patients with advanced cancer and pain. Each participant reviewed content from our behavioral mHealth application for cancer pain management and early images of its interface. Participants reflected on their experiences self‐managing cancer pain and on app content. Interviews were transcribed verbatim and analyzed using a combination of inductive and deductive thematic analysis. Results: Patients (n = 28; 54% female; mean age = 53) across two geographic regions reported using psychological strategies (e.g., reframing negative thoughts, distraction, pain acceptance, social support) to manage chronic cancer‐related pain. Patients shared their perspectives on the integration of psycho‐behavioral pain treatments into their existing medical care and their experiences with opioid hesitancy. Patient recommendations for how mHealth interventions could best support them coalesced around two topics: 1.) convenience in accessing integrated pharmacological and psycho‐behavioral pain education and communication tools and 2.) relevance of the specific content to their clinical situation. Conclusions: Integrated pharmacological and psycho‐behavioral pain treatments were important to participants. This underscores a need to coordinate complimentary approaches when developing cancer pain management interventions. Participant feedback suggests that an mHealth intervention that integrates pain treatments may have the capacity to increase advanced cancer patients' access to destigmatizing, accessible care while improving pain self‐management. [ABSTRACT FROM AUTHOR]

Objective: Distress screening is standard practice among oncology patients, yet few routine distress screening programs exist for cancer caregivers. The objective of this study was to demonstrate the feasibility, acceptability, and preliminary efficacy of Cancer Support Source‐CaregiverTM (CSS‐CG, 33‐item), an electronic distress screening and automated referral program with a consultation (S + C) to improve caregiver unmet needs, quality of life, anxiety, depression, and distress relative to Enhanced Usual Care (EUC; access to educational materials). Method: 150 caregivers of patients with varying sites/stages of cancer were randomized to S + C or EUC and completed assessments at baseline, 3‐months post‐baseline, and 6‐months post‐baseline. A subset of participants (n = 10) completed in‐depth qualitative interviews. Results: S + C was feasible: among 75 caregivers randomized to S + C, 66 (88%) completed CSS‐CG and consultation. Top concerns reported were: (1) patient's pain and/or physical discomfort; (2) patient's cancer progressing/recurring; and (3) feeling nervous or afraid. Differences between groups in improvements on outcomes by T2 and T3 were modest (ds < 0.53) in favor of S + C. Qualitative data underscored the helpfulness of S + C in connecting caregivers to support and helping them feel cared for and integrated into cancer care. Conclusions: S + C is feasible, acceptable, and yields more positive impact on emotional well‐being than usual care. Future studies will examine programmatic impact among caregivers experiencing higher acuity of needs, and benefits of earlier integration of S + C on caregiver, patient, and healthcare system outcomes. [ABSTRACT FROM AUTHOR]

Objective: Cancer‐related cognitive impairment has severe implications for the quality of life and societal participation of cervical cancer survivors (CCS). However, there is no research on the association between subjective and objective cognitive impairment (CI) in cervical cancer. This cross‐sectional study aimed to examine the frequency and severity of objective CI in CCS reporting significant subjective CI and explore the discrepancy between subjective and objective CI. Methods: Sixty‐five CCS reporting significant subjective CI, defined as 1.5 SD below the normative mean, underwent neuropsychological (NP) assessment covering attention, verbal memory, processing speed, verbal fluency, and executive functions. CCS were compared to healthy age‐matched controls (n = 74). A subjective versus objective discrepancy score was calculated based on the standardized scores within each group. Results: The CCS group performed significantly poorer across all NP tests compared to healthy controls (all p‐values <0.001) and 81.5% had scores below cut‐off as defined by the International Cognition and Cancer Task Force. However, compared to published normative data, most CCS performed within the clinically normal range. Processing speed and verbal memory were the most affected cognitive domains. By calculating a discrepancy score, both groups on average displayed a quite accurate concordance between subjective and objective cognitive functioning. Conclusion: Although CI is evident in CCS, our results confirm that objective and subjective CI represent different constructs and highlight the limitations of normative data. Differentiating subjective and objective CI is important when tailoring effective interventions in the survivorship care of CCS. [ABSTRACT FROM AUTHOR]

Objective: Assess the feasibility of conducting a cluster randomized controlled trial (RCT) comparing technology‐delivered mindfulness‐based intervention (MBI) programs against a waitlist control arm targeting advanced cancer patients and their informal caregivers. Methods: Two‐arm cluster RCT within Kaiser Permanente Northern California. We recruited patients with metastatic solid malignancies or hematological cancers and their informal caregivers. Intervention‐group participants chose to use either a commercially available mindfulness app (10–20 min/day) or a webinar‐based mindfulness course for 6 weeks. The waitlist control group received usual care. We assessed feasibility measures and obtained participant‐reported data on quality of life (QoL; primary outcome) and distress outcomes (secondary) pre‐ and postintervention. Results: A hundred and three patients (median age 67 years; 70% female; 81% White) and 39 caregivers (median age 66 years; 79% female; 69% White) were enrolled. Nearly all participants chose the mindfulness app over the webinar‐based program. Among the participants in the intervention arm who chose the mobile‐app program and completed the postintervention (6‐week) survey, 21 (68%) patients and 7 (47%) caregivers practiced mindfulness at least 50% of the days during the 6‐week study period. Seventy‐four percent of intervention participants were "very" or "extremely" satisfied with the mindfulness program. We observed improvements in anxiety, QoL, and mindfulness among patients in the intervention arm compared to those in the control group. Conclusions: We demonstrated the feasibility of conducting a cluster RCT of mHealth MBI for advanced cancer patients and their caregivers. Such remote interventions can be helpful particularly during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

This article discusses the need for education and assessment of psycho-existential symptoms in cancer care to prevent suicidality. The authors highlight the high prevalence of suicidal thoughts and the desire to hasten death among oncology patients, often accompanied by existential distress. They emphasize the importance of addressing deficits in knowledge and expertise among health professionals in responding to suicidal patients. The article also explores the role of screening for psycho-existential symptoms and identifies key symptoms, such as hopelessness and pointlessness, as central targets for intervention. The authors suggest that meaning-centered therapies can be effective in addressing these symptoms. Overall, the article emphasizes the importance of recognizing and addressing the psychological and existential challenges faced by cancer patients to prevent suicidality. [Extracted from the article]

Key Points: We conducted semi‐structured interviews with providers at four New York‐Presbyterian (NYP) hospitals: Weill Cornell Medicine (WCM), NYP‐Queens, NYP‐Brooklyn Methodist Hospital, and Columbia University Medical Center.Emergent themes identified factors that influenced healthcare delivery at the institutional, provider, and patient levels.Most frequently reported barriers included a lack of formal protocols for communicating and offering psychosocial resources to patients (institutional), lack of vital staff such as, social workers and patient navigators (institutional), time constraints (provider), and stigma regarding mental health care (patient).Most frequently cited facilitators to delivering psychosocial care included having a trained social worker on staff (institutional), awareness of psychosocial needs (provider), and engagement (patient).Our findings highlight opportunities to improve the provision of psychosocial care for adults with metastatic breast cancer (mBC) at multiple levels. [ABSTRACT FROM AUTHOR]

Objective: Few evidence‐based interventions addressing high levels of fear of cancer recurrence (FCR) have been implemented. Understanding how these might be implemented is crucial to bridge the research‐practice gap. This study investigated the feasibility of implementing the blended Survivors' Worries of Recurrent Disease (SWORD) intervention in real‐world psycho‐oncology practice. Methods: SWORD was offered for 15 months (2021–2022) as the standard care for clinical FCR in a university hospital, a general hospital, and psycho‐oncological center. We evaluated using a mixed‐methods design six feasibility outcomes based on Bowen's framework: demand, limited effectiveness, degree of execution, acceptability, practicality, and integration. Anonymous data were collected for all oncology patients on referral. Study participants completed questionnaires before and after treatment, including the Cancer Worry Scale (CWS‐6) as the primary measure of effectiveness. Qualitative data included interviews with patients and psychologists, and field notes. Results: Regarding demand, 81 of 644 patients referred (13%) were eligible for SWORD. The uptake of SWORD was 79% (n = 63/80) and the completion rate 73% (n = 46/63). SWORD was effective in reducing FCR (p < 0.001, ηp2 = 0.694). Regarding execution, a variability in the length, planning and number of treatment sessions was found between different settings. Adherence to the treatment manual's content was high (89%). Regarding acceptability, most patients were satisfied with SWORD (average 8.2/10) and psychologists valued the blended format. Psychologists reported SWORD was practical to deliver given their knowledge and skills. Although differences between settings were found, SWORD integrated well into practice. Referral for FCR and a reluctance to contract new eHealth providers were barriers for implementation. Conclusions: Despite differences between healthcare settings, the implementation of SWORD was evaluated well. The feasibility of SWORD in different settings should inform a national implementation strategy. [ABSTRACT FROM AUTHOR]

Background: Issues relating to certification of the Psycho‐oncology profession require clarification in order to provide high quality comprehensive psychosocial care within oncology. We conducted a survey identifying existing training, professional registration requirements and accreditation programs, at national levels, for the specialty of psycho‐oncology as well as the mandatory presence of this specialist in cancer teams. Methods: This survey was conducted within the International Psycho‐Oncology Society Federation of psycho‐oncology societies and included representatives of each national federated society and some countries not belonging to the Federation. Survey questions were emailed requesting specific details, from the registered contact person, for each country, about psycho‐oncology training, professional registration and accreditation. Results: Of 43 countries contacted (34 Federated and 9 non‐federated members), 39 replied and answered the questionnaire (90, 7%). Disparities were reported between countries, with details indicating differences from having no national program, to quite detailed and legally accredited requirements. The majority of countries had no formally recognized profession of "Psycho‐oncologist," while some countries reported that it is mandatory (or recommended to have) a specialist in psycho‐oncology in cancer centers and, thus, that an accredited, nationally recognized and certified training in this specialty exists. Conclusions: The study underlines the need to create a curriculum for the specialty (certification and accreditation) for the profession of psycho‐oncology. Given the lack of internationally recognized core standards, ideas and proposals for minimum standards of good care and the training required to deliver this, are explored to clarify who may use the designation "Clinical Psycho‐oncologist." [ABSTRACT FROM AUTHOR]

Objective: As social support has been shown to have beneficial effects on coping with cancer, our study aims to close the research gap on perceived social support in adolescent and young adult (AYA) cancer survivors. Methods: AYAs evaluated their perceived positive social support (PS) and detrimental interactions (DI) by completing the Illness‐Specific Social Support Scale (ISSS‐8) upon completion of acute treatment (t1) as well as 1 year (t2) and 7 years (t6) later. Temporal changes of social support were examined. Sociodemographic, psychological and medical factors were investigated as predictors for PS and DI by using mixed effects models. Results: We analyzed data from 319 cancer survivors (74.9% women). At baseline, survivors reported an average score of 13.73 (SD = 2.52) for PS and 3.92 (SD = 2.85) for DI. Average perceived PS changed over time, while DI remained stable. Males, AYAs without a partner and AYAs with clinically meaningful anxiety or depression levels reported fewer PS. Higher effort to cope with the disease and clinically significant anxiety and depression levels were associated with more perceived DI. Conclusions: Existing social networks and perceived social support should be evaluated regularly in AYA‐cancer survivorship. The identification and discussion of mental health of AYAs should also be a standard component in survivor consultations both during treatment and follow‐up care, as elevated depression and anxiety levels were associated with fewer PS and more perceived DI. [ABSTRACT FROM AUTHOR]

Objectives: Ovarian cancer survivorship is complex and is associated with greater symptom burden, fear of reoccurrence, sexual dysfunction, lower quality of life and heightened existential distress in contrast to other cancers. This systematic review aimed to investigate the effectiveness for, and perspective of, psychosocial interventions encompassing psychological, social, and emotional support, tailored to, or involving ovarian cancer survivors at all stages of disease. Methods: Adhering to the PRISMA‐SR statement guidelines, a systematic search was conducted across PsycINFO, MEDLINE, Embase, Emcare, CINAHL, Scopus, Cochrane Library databases, Google, and Google Scholar. Two reviewers independently undertook a two‐stage screening process. The Mixed Methods Appraisal Tool was utilised to assess the methodological quality of included studies. Data were extracted using customised data extraction tools and narratively synthesised. Results: Thirteen studies were included in this review. Generally positive effects of psychosocial interventions were observed across a range of outcome domains (meaning enhancing, cognitive, social, emotional, and cancer‐specific). However, the characteristics of interventions and outcome measures varied across studies. Psychoeducational interventions were identified as the most common psychosocial approach, while Acceptance and Commitment Therapy showed promise in addressing the disease's high symptom burden. Women's perspectives of psychosocial interventions were described as "useful" and promoted positive self‐regard. Conclusion: While the evidence base largely support positive effects of psychosocial interventions for ovarian cancer survivors, this finding is constrained by heterogeneity of interventions and modest gains. Future research may explore the standardisation of psychosocial interventions for this demographic, investigating its effects on less explored but prevalent concerns among ovarian cancer survivors such as fear of cancer recurrence and sexual dysfunction. [ABSTRACT FROM AUTHOR]

Objective: Cancer predisposition syndromes are being more frequently recognized in the etiology of pediatric oncology and genetic‐related technologies are evolving rapidly, leading to an increasing availability of genetic testing for families. This systematic review assessed the psychological impact of genetic testing on children and parents in the context of childhood cancer. Methods: Searches were performed using three databases (Web of Science, Pubmed and Embase) to identify relevant empirical studies. Following Cochrane guidelines, we screened 3838 articles and identified 18 eligible studies, representing the perspectives of children and/or parents. Results: The included studies described the impact of genetic testing in different contexts (e.g. predictive testing and diagnostic testing) and in different subgroups, (e.g. carriers and non‐carriers). Overall, the studies did not identify clinically‐relevant long‐term increases in negative emotions (depression, anxiety, distress, uncertainty, guilt) as a result of genetic testing. Negative emotions were typically time‐limited and generally occurred in families with particular characteristics (e.g. those with a history of multiple cancer diagnoses, families receiving an unfavorable result for one child and a favorable result in siblings, and those with pre‐existing mental health difficulties). Positive emotions (hopefulness, relief and peace of mind) were also reported. Knowing their genetic risk status appeared to help to foster empowerment among families, regardless of the result and any associated emotions. Conclusions: Genetic testing in pediatric oncology does not appear to cause significant additional harm and can lead to positive outcomes. Clinicians need to be especially attentive when counseling families at increased risk of distress. [ABSTRACT FROM AUTHOR]

Objective: To undertake an economic evaluation of a telehealth psychological support intervention for patients with primary brain tumor (PBT). Methods: A within‐trial cost‐utility analysis over 6 months was performed comparing a tailored telehealth‐psychological support intervention with standard care (SC) in a randomized control trial. Data were sourced from the Telehealth Making Sense of Brain Tumor (Tele‐MAST) trial survey data, project records, and administrative healthcare claims. Quality‐adjusted life years (QALYs) were calculated based on the EuroQol‐5D‐5L. Non‐parametric bootstrapping with 2000 iterations was used to determine sampling uncertainty. Multiple imputation was used for handling missing data. Results: The Tele‐MAST trial included 82 participants and was conducted in Queensland, Australia during 2018–2021. When all healthcare claims were included, the incremental cost savings from Tele‐MAST were ‐AU$4,327 (95% CI: −$8637, −$18) while incremental QALY gains were small at 0.03 (95% CI: −0.02, 0.08). The likelihood of Tele‐MAST being cost‐effective versus SC was 87% at a willingness‐to‐pay threshold of AU$50,000 per QALY gain. When psychological‐related healthcare costs were included only, the incremental cost per QALY gain was AU$10,685 (95% CI: dominant, $24,566) and net monetary benefits were AU$534 (95% CI: $466, $602) with a 65% likelihood of the intervention being cost‐effective. Conclusions: Based on this small randomized controlled trial, the Tele‐MAST intervention is a cost‐effective intervention for improving the quality of life of people with PBT in Australia. Patients receiving the intervention incurred significantly lower overall healthcare costs than patients in SC. There was no significant difference in costs incurred for psychological health services. [ABSTRACT FROM AUTHOR]

Objectives: Insufficient preparedness for bereavement can affect a family's psychological health status after bereavement. However, factors associated with preparedness remain unclear. This study aimed to identify factors associated with preparedness for bereavement in families of patients with cancer. Methods: We conducted a secondary analysis of a nationwide bereaved family survey in Japan, analyzing data from 9123 family members of patients with cancer. Logistic regression analysis was conducted to explore how sociodemographic factors, health status, and perceived care for patients and families were associated with preparedness for bereavement. Results: Of the 9123 families, 1338 (15.1%) were not prepared for bereavement. Factors associated with insufficient preparedness for bereavement (all p < 0.001) were found as follows: patients' spouses (OR = 2.54), receiving care in acute hospitals (OR = 1.83), worse psychological health status during caregiving (OR = 2.13), lower social support for family members (OR = 1.90), wrong patients' awareness of medical condition from family's perspective (OR = 1.75–2.12), family preference of more aggressive treatment rather than palliative care (OR = 1.71) or not sure (OR = 2.31), not wanting to know information about the patient's prognosis (OR = 1.64–1.77), end‐of‐life discussion with physician 1 month before patient's death (OR = 1.45), and late or early end‐of‐life discussions with physician and family (OR = 1.78–1.95). Conclusions: This study's results might assist clinicians in assessing and identifying families who are not prepared for bereavement; however, preparedness for bereavement may have been associated with other factors. [ABSTRACT FROM AUTHOR]

Objective: An estimated one‐third of cancer patients experience a clinically significant psychological disorder, however it is unclear to what extent this is reflected in research funding. To address this a systematic analysis the allocation of psycho‐oncology research funding globally between 2016 and 2020 was conducted. Methods: A global dataset of 66,388 cancer research awards, from 2016 to 2020 inclusive and totalling $24.5 billion USD was assembled from public and philanthropic funders. Each award was previously categorised by cancer site type and research theme, including psychosocial research and these awards were further sub‐categorised for this analysis. Results: There was $523m of funding awarded for psychological research across 1122 studies: 2.14% of all cancer research funding during this period ($24.5 billion). Median funding per award was $97,473 (IQR $36,864 – $453,051). Within psychological research, mental health received most funding ($174m, 33.5% of psychological funding). Cognitive behavioural therapy (CBT) focused research was the specific psychological support with the highest proportion of funding at $14 million. By country of funder, the USA provided most investment ($375.5 m, 71.8%). Conclusions: Psycho‐oncology research received relatively little funding, for example, when compared with pre‐clinical cancer research. There needs to be a shift from pre‐clinical science to research that benefits cancer patients in the shorter‐term. Low‐ and middle‐income countries, and ethnic minorities in higher‐income settings, were underrepresented despite having a large cancer burden, indicating inequities that need to be addressed. [ABSTRACT FROM AUTHOR]

Objective: The fear of cancer recurrence (FCR) is an ongoing and common psychological problem faced by cancer patients. The objective of this study was to explore the variation trend of FCR and its influencing factors in Chinese newly diagnosed cancer patients from admission to 2 months after discharge. Demographic and tumor characteristics, as well as experiential avoidance (EA), were used as predictors. Method: A longitudinal design and a consecutive sampling method were used to select 266 newly diagnosed cancer patients admitted to a tertiary cancer hospital in China from July to December 2022. Measurements of FCR and EA were obtained at admission (T1), 1 month after discharge (T2), and 2 months post‐discharge (T3). Generalized estimating equations were used to identify factors associated with FCR for longitudinal data analysis. Results: A total of 266 participants completed the follow‐up. Both FCR and EA scores of patients with newly diagnosed cancer showed a significant trend of first increasing and then decreasing at baseline and follow‐up (p < 0.001). The junior secondary and less education level, rural residence, advanced tumor and high EA level were risk factors for higher FCR. Conclusions: Our findings suggest that the FCR levels of most newly diagnosed cancer patients in China are different at the three time points and affected by different factors, with the highest level at 1 month after discharge. These results have significant implications for future identifying populations in need of targeted intervention based on their FCR trajectories. [ABSTRACT FROM AUTHOR]

Objectives: The number of colorectal cancer (CRC) survivors is increasing and current models of survivorship care are unsustainable. There is a drive to implement alternative models of care including shared care between general practitioners (GPs) and hospital‐based providers. The primary objective of this study was to explore perspectives on facilitators and barriers to shared care. The secondary objective was to explore experiences of telehealth‐delivered care. Method: Qualitative data were collected via semi‐structured interviews with participants in the Shared Care for Colorectal Cancer Survivors (SCORE) randomised controlled trial. Interviews explored patient experiences of usual and shared survivorship care during the SCORE trial. In response to the COVID pandemic, participant experiences of telehealth appointments were also explored. Interviews were recorded and transcribed for thematic analysis. Results: Twenty survivors of CRC were interviewed with an even number in the shared and usual care arms; 14 (70%) were male. Facilitators to shared care included: good relationships with GPs; convenience of GPs; good communication between providers; desire to reduce public health system pressures. Barriers included: poor communication between clinicians; inaccessibility of GPs; beliefs about GP capacity; and a preference for follow‐up care with the hospital after positive treatment experiences. Participants also commonly expressed a preference for telehealth‐based follow‐up when there was no need for a clinical examination. Conclusions: This is one of few studies that have explored patient experiences with shared and telehealth‐based survivorship care. Findings can guide the implementation of these models, particularly around care coordination, communication, preparation, and personalised pathways of care. [ABSTRACT FROM AUTHOR]

Objective: Psychological distress is common in men with testicular cancer (TC), and masculinities may work to explain this. This study aimed to compare masculinities and distress in TC and healthy control (HC) populations and explore relationships between correlates of distress (psychological flexibility and coping style) and masculinities in TC. Methods: A cross‐sectional, online survey was completed by 92 men with TC (Mage = 34.8) and 90 HC (Mage = 30.7). Measures included psychological distress (Patient‐Reported Outcomes Measurement Information System Depression/Anxiety, fear of cancer recurrence inventory‐short form), masculinities (gender role conflict‐short form, inventory of subjective masculinity experiences/subjective masculinity stress scale, masculinity in chronic disease inventory), coping style (mini‐mental adjustment to cancer) and psychological flexibility (comprehensive assessment of acceptance commitment therapy). Linear regressions were conducted to compare groups and analyse associations. Results: There were no differences in masculinities or psychological distress between populations (all p > 0.05 and all Cohen's d < 0.20), except for subjective masculine stress and restrictive affectionate behaviour between men. For men with TC, restrictive affection/emotion, conflicts between family/work and subjective masculine stress were associated with psychological distress (rs 0.21–0.58). Optimistic action was negatively associated with depression/anxiety, helplessness/hopelessness coping (rs −0.27 to −0.42) and positively associated with psychological flexibility (r = 0.35). Conclusions: Masculinities are implicated in psychological distress in men with TC. Psychological flexibility as well as leveraging masculine beliefs (e.g., optimistic action) may be modifiable targets to reduce distress in men with TC. [ABSTRACT FROM AUTHOR]