Search Results (50)

Background: Nurse coaching can reduce stress throughout the complex psychosocial process associated with the cancer journey, which affects numerous spheres, such as neurological, psychological, physical, and emotional ones. The purpose of this paper is to review the literature to assess the extent of stress reduction among cancer care adopting nurse coaching interventions. Methods: This systematic review and meta-analysis was registered in PROSPERO with id no. CRD420261290368 and performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The search approach was performed by mixing keywords with Boolean operators like “coaching intervention”, “oncology nursing” and “stress” throughout the CINAHL, Embase, PubMed, Scopus and Web of Science databases. We assessed stress levels alongside the nurse coaching interventions using the National Comprehensive Cancer Network (NCCN) Distress Thermometer. Results: A total of three studies were included, comprising 112 participants. Heterogeneity among studies was very high and statistically significant (p < 0.001; τ² = 1.02; I² = 96.2%, with a 95% CI: [85.89; 99.90]); thus, a random-effects model (REML) was applied. A small, non-significant reduction in stress levels following the nurse coaching intervention, with an overall SMD of −0.35 (SE = 0.60; 95% CI: [−1.52, 0.82]; p = 0.556), was recorded. Conclusions: Attention to standardization of core coaching components, while preserving flexibility and personalization, will be critical to advancing implementation in routine oncology care. Overall, nurse coaching represents a promising adjunct to comprehensive cancer care, with the potential to support psychological well-being, empower patients and caregivers, and address the broader determinants of stress throughout the cancer experience. Full article

Urological cancers are associated with reduced quality of life and high psychological burden, yet affected patients receive less psychosocial support than other cancer groups. Electronic health literacy (eHL) may facilitate independent access to resources, but its role for psychological outcomes and quality of life in this group is unclear. This study examined associations between eHL, psychological symptoms, and quality of life during transition from inpatient to outpatient care. A prospective, single-centre observational study was conducted. Eligible inpatients (urological cancer, Distress Thermometer ≥5 and/or request for psycho-oncological support) received an initial psycho-oncology consultation and completed surveys during inpatient treatment (T1) and three months later (T2). Measures included socio-demographics, PO-BADO, eHL (eHEALS), distress, depression (PHQ-2), anxiety (GAD-2), and quality of life (EORTC QLQ-C30). Of 108 patients completing T1, 71 completed T2. After controlling for age, eHL was not significantly associated with distress, depression, anxiety, or quality of life. Age did not moderate these relationships. In this sample, eHL showed no significant associations with psychological outcomes or quality of life. However, higher age was linked to lower eHL, suggesting that older patients may face barriers to digital health engagement. Age-related differences in eHL should be considered when designing digital support services for urological cancer patients. Full article

Background/Objectives: The Distress Thermometer for Parents represents an excellent tool for the rapid assessment of emotional distress in parents of children with a variety of chronic diseases. This study aimed to evaluate the efficacy of the Distress Thermometer for Parents in assessing emotional distress in parents and caregivers of children with feeding and swallowing difficulties feeding swallowing disorders or, dysphagia, in the Greek Cypriot community. Methods: It involved 200 Greek Cypriot participants: 100 parents/caregivers of children with FSD and 100 parents/caregivers of children without such difficulties. Demographic and clinical data were collected and test–retest reliability was evaluated. Results: The DT-P demonstrated excellent reliability (Cronbach’s α = 0.928) and strong test–retest consistency (r = 1.00, p < 0.001). ROC analysis showed strong discrimination for detecting distress, with an AUC of 0.76 for parents of children under 24 months and 0.77 for parents of children over 2 years (p < 0.01). Parents reported a medium level of distress (M = 3.67, SD = 2.89), with “Emotional Problems” (M = 2.03, SD = 2.28) and “Practical Problems” (M = 1.79, SD = 2.12) contributing most significantly. Independent t-tests revealed significantly higher distress levels in parents in the clinical group compared to the parents in the typical group (p < 0.001), confirming the DT-P’s sensitivity and validity. Conclusions: The Greek version of the DT-P is a reliable and valid tool assessing distress in parents of children with PFD. This study highlights significantly higher distress levels in these parents compared to those of typically developing children, emphasizing the need for targeted support. Full article

Background/Objectives: Many patients assigned to adjuvant radiotherapy for non-metastatic breast cancer already received taxane-based chemotherapy, which can cause peripheral neuropathy (PNP). This study investigated potential associations between moderate-to-severe or mild PNP and distress. Methods: Ninety-eight breast cancer patients who received taxane-based chemotherapy and completed the National Comprehensive Cancer Network Distress Thermometer were included in this retrospective study. The severity of PNP plus 17 factors were evaluated for associations with distress. Results: Mean distress scores (higher scores representing higher levels of distress) were 6.17 (SD ± 2.41) in patients with moderate-to-severe PNP, 4.21 (SD ± 2.54) in patients with mild PNP and 4.04 (SD ± 2.24) in patients without PNP. On univariable analyses, higher distress scores were significantly associated with moderate-to-severe PNP (vs. mild or no PNP, p < 0.001), Karnofsky performance score ≤ 80 (p = 0.001), history of autoimmune disease (p = 0.035), and hypertension (p = 0.002). Trends were found for age ≥65 years (p = 0.056), type of chemotherapy (p = 0.078), and beta-blocker medication (p = 0.072). On multivariable analysis, moderate-to-severe PNP (p = 0.036), Karnofsky performance score ≤ 80 (p = 0.013), and hypertension (p = 0.045) were significant. Conclusions: Since moderate-to-severe chemotherapy-induced PNP was associated with a significantly higher level of distress when compared to mild or nor PNP, these patients should be offered early psychological support and personalized monitoring. Full article

Gliomas are incurable, heterogeneous brain tumors, with rare forms often constituting diagnostic and treatment challenges. Molecular diagnostics, mainly implemented through the World Health Organization (WHO) 2021 guidelines, have refined the classification, but highlight difficulties in diagnosing rare gliomas remain. This case series analyzes four patients with rare gliomas treated at the University Hospital, Ulm, between 2002 and 2024. Patients were selected based on unique histopathological features and long-term clinical follow-up. Clinical records, imaging, and histological data were reviewed. Molecular diagnostics followed WHO 2021 guidelines. Quality of life was assessed using standardized tools including the EQ-5D-5L, EQ VAS, the Distress Thermometer, and the Montreal Cognitive Assessment (MoCA). In the first case, a 51-year-old male’s diagnosis evolved from pleomorphic xanthoastrocytoma to a high-grade glioma with pleomorphic and pseudopapillary features, later identified as a neuroepithelial tumor with a PATZ1 fusion over 12 years. Despite multiple recurrences, extensive surgical interventions led to excellent outcomes. The second case involved a young female with long-term survival of astroblastoma, demonstrating significant improvements in both longevity and quality of life through personalized care. The third case involved a patient with oligodendroglioma, later transforming into glioblastoma, emphasizing the importance of continuous diagnostic reevaluation and adaptive treatment strategies, contributing to prolonged survival and quality of life improvements. Remarkably, the patient has achieved over 20 years of survival, including 10 years of being both therapy- and progression-free. The fourth case presents a young woman with neurofibromatosis type 1, initially misdiagnosed with glioblastoma based on histopathological findings. Subsequent molecular diagnostics revealed a subependymal giant cell astrocytoma-like astrocytoma, highlighting the critical role of early advanced diagnostic techniques. These cases underscore the importance of precise molecular diagnostics, individualized treatments, and ongoing diagnostic reevaluation to optimize outcomes. They also address the psychological impact of evolving diagnoses, stressing the need for comprehensive patient support. Even in complex cases, extensive surgical interventions can yield favorable results, reinforcing the value of adaptive, multidisciplinary strategies based on evolving tumor characteristics. Full article

Background/Objectives: Parents of children with acute lymphoblastic leukaemia (ALL) experience emotional distress throughout their child’s treatment course. This study describes the psychological experience of Australian and New Zealand parents of children diagnosed with ALL. Methods: This prospective, longitudinal study assessed distress, anxiety, depression, anger and the need for help in parents of children with newly diagnosed ALL across eight sites between October 2018 and November 2022. Psychological symptoms were quantified using the Emotion Thermometer (ET) tool and Patient-Reported Outcome Measurement Information System (PROMIS) questionnaires. Participants were recruited within ninety days of chemotherapy commencement, with surveys distributed bimonthly thereafter. Results: One hundred and seventeen participants completed 327 survey responses spanning 0 to 62 months post-diagnosis. Parental distress peaked within the first 6 months and 40% of parents reported clinically significant symptoms across four or more domains as measured by our questionnaires. Anxiety was the most consistently elevated symptom, with over 50% of responses above the clinical cut-off. Depression and the need for help also peaked closer to diagnosis and declined over time. In contrast, anger remained stable, with 27% reporting clinically significant scores across all time points. Increased time since diagnosis was significantly associated with reductions in distress, anxiety and depression scores. Conclusions: Australian and New Zealand parents experience high levels of psychological distress within the first six months following their child’s diagnosis of ALL. A notable minority continue to report elevated distress levels over time, identifying a need for improved psychological support for family wellbeing throughout the ALL treatment trajectory. Full article

Background: Recent advances in psychophysiology have underscored the importance of autonomic nervous system modulation in managing short-term stress. While several interventions have demonstrated efficacy in reducing short-term stress and anxiety symptoms, there remains a gap in understanding how different short-term techniques compare in terms of both psychological and physiological outcomes. This study investigated the effects of a single session of the Brain Wave Modulation Technique (BWM-T) compared with a psychoeducational session on short-term stress management. Methods: A total of 72 university students participated in this study (mean age = 27.5 years, 79% female). They were randomly assigned to either an experimental group (n = 36) receiving BWM-T or a control group (n = 36) receiving a standard psychoeducational short-term stress management session. Pre- and post-intervention measures included HRV parameters, perceived stress (using the Distress Thermometer, DT), and anxiety (using the STAI-Y State Anxiety Scale, S-ANX). Results: Both groups experienced significant reductions in perceived stress (DT: MD = 1.42, p < 0.001) and anxiety (S-ANX: MD = 6.93, p < 0.001). However, only the experimental group demonstrated physiological changes indicative of improved autonomic function: decreased low-frequency (LF) power (MD = −0.369, p < 0.05) and a lower LF/HF ratio (MD = −1.09, p < 0.05). These findings highlight the unique physiological benefits of BWM-T, beyond the general psychological improvements seen in both interventions. Conclusions: BWM-T appears to be a promising, effective short-term intervention for reducing short-term stress and enhancing autonomic regulation. Further studies are needed to evaluate its long-term effects and potential for broader implementation. Full article

Background/Objectives: Through survey and analysis of pancreas cancer patient–caregiver dyads, we aimed to identify patient and caregiver characteristics that influence and determine the impact of caregiver coping strategies, self-esteem, and resilience on caregiver distress. Methods: This was a cross-sectional, observational study including pancreatic cancer patients and their caregivers. Demographics of patients and caregivers were collected. Caregivers completed validated instruments (National Comprehensive Cancer Network (NCCN) Distress Thermometer, Caregiver Reaction Assessment (CRA), Perceived Stress Scale 4 (PSS-4), Patient Reported Outcomes Measurement Information System-Anxiety/Depression Short Form (PROMIS-Anxiety/Depression), Brief Resilience Scale (BRS), Zarit Caregiver Burden Interview (CBI-12), and Brief Coping Orientation to Problems Experienced (COPE)) investigating anxiety, depression, perceived stress, caregiver burden, use of approach and avoidant coping, resilience, and self-esteem. Descriptive statistics, univariate, and multiple linear regression models were used to analyze the data. Results: One hundred and fourteen patient–caregiver dyads were included in this study. The majority of patients were male (55%), 65% of caregivers were female, and 64% of patients were receiving palliative intent treatment. Younger caregiver age, more personal care tasks, higher patient distress, and caregiving for a parent were characteristics related to caregiver avoidant coping. Fewer caregiving activities and early clinical stage were associated with caregiver approach coping. High caregivers’ self-esteem was significantly associated with fewer personal care tasks to perform and with caregivers of patients with higher levels of education. Avoidant coping and low resilience were both significantly correlated to distress, anxiety, depression, caregiver burden, and perceived stress. Additionally, low self-esteem was associated with a high perceived caregiver burden. Conclusions: Overall, caregiver factors such as age, relationship with the patient, and number of care tasks and activities influence caregivers coping and self-esteem. Additionally, patient education and clinical stage impacted caregiver coping and self-esteem. Developing interventions to address caregiver coping, self-esteem, and resilience will prove beneficial in improving caregiver distress, anxiety, depression, burden, and perceived stress. Full article

Background: Psychological distress impacts 35–40% of cancer patients, significantly affecting their quality of life, treatment adherence, and relationships with healthcare professionals. Given this, there is a critical need to enhance nursing competencies to effectively monitor and address psychological distress. Previous studies have highlighted discrepancies in capabilities based on nurses’ training status, emphasizing trained nurses’ critical role in providing appropriate psycho–social referrals. Objective: To evaluate the impact that trained nurses have on the detection of distress and the timely referral of patients for a psycho–oncology consultation. Methods: A blinded, random, descriptive, monocentric pilot study was conducted. The participants were adult patients in Day Hospital 1 of the National Cancer Institute Regina Elena, Rome, irrespective of illness stage. Tools used included a socio-demographic and clinical data form, distress thermometer (DT), and visual analogic scale (VAS). Patients were randomly divided into two groups: Group A, where questionnaires were administered by trained nurses, and Group B, where non-trained nurses administered questionnaires. Nurses indicated whether patients needed a psycho–oncology consultation. All patients were then seen by a psycho–oncology specialist to determine whether the nurse’s referral was appropriate. Patients and psycho–oncologists were all unaware of the nurses’ training status. The effectiveness of the training was measured by the degree of agreement between evaluators. Results: This study involved 20 patients and four nurses. The average DT score was 5, mainly related to physical and emotional problems. Agreement between evaluators was higher in the trained nurses’ group. Conclusions: Specific training on DT enabled nurses to acquire advanced skills to accurately refer patients for psychological consultations. Full article

Background/Objectives: Inpatient exercise-based rehabilitation has been shown to improve health-related quality of life (HRQOL) in cancer survivors. However, there is a lack of studies on the impact of community-based cancer rehabilitation programs on health-related quality of life, especially in Asian countries. Methods: This was a retrospective cohort study involving patients with cancer at an outpatient community-based rehabilitation center. There were 197 patients who were recruited and enrolled in a physician-led rehabilitation program which included physiotherapists, occupational therapists, nutritionists and exercise physiologists. Results: Most of the patients had a diagnosis of breast cancer (61.4%), while 76 (38.6%) had a diagnosis of other cancers. On initial assessment, we found a mean Distress Thermometer (DT) level of 3.37 (SD = 2.41) and a mean Functional Assessment of Cancer Therapy-General-7 Item Version (FACT-G7) score of 11.83 (SD = 4.01). On follow-up assessment after 3–6 months of rehabilitation, there was a significant reduction in mean DT level to 2.42 (SD = 2.25) and an improvement in mean FACT-G7 score to 13.09 (SD = 4.77). Multivariate regression analysis revealed that significant factors for improvement in FACT-G7 scores were age (p = 0.046) and number of exercise therapy sessions (p < 0.001). Conclusions: This study demonstrates the positive impact of a community-based cancer rehabilitation program on HRQOL among cancer patients. Full article

Objective: Neurooncological patients are well-known to experience an increased psycho-oncological burden with a negative impact on distress, therapy adherence, quality of life, and finally survival. But still, psycho-oncological screening and support is rare, with ongoing discussion about specific screening time points and impact factors. Therefore, we analysed the psycho-oncologic treatment demand at specific disease-related time points throughout therapy. Methods: In this longitudinal, prospective, single-centre study, patients with malignant brain tumours were screened for increased distress (using the Distress Thermometer), anxiety, depression (Hospital Anxiety and Depression Scale questionnaire), and health-related quality of life interference (EORTC QLQ C30-BN20 questionnaire) at specific longitudinal time points during therapy. The results were correlated with sociodemographic and clinical data. Results: From 2013 to 2017, 2500 prospective screening data points from 512 malignant brain tumour patients were analysed. DT was identified as a significant predictor for psycho-oncological treatment demand (p < 0.001). Particularly significant time points concerning psycho-oncological burden were primary diagnosis and tumour recurrence. Next to these known factors, here, patients < 65 years old and female patients (p = 0.018 and p = 0.017) reflected increased screening results, whereas partnership and professional activity (p = 0.043; p = 0.017) were identified as contributing factors to a significantly decreased treatment demand. Conclusions: The increased need for psycho-oncological support for neurooncological patients is underlined. Psycho-oncological support should particularly be offered at the time points of primary diagnosis and tumour recurrence. To support the positive effect of caregivers, they should be involved at an early stage. Full article

In this study, we investigated the prevalence of mental health problems among patients with cancer and whether oncology nurse navigation improved their mental health outcomes and medical experience. In this randomized controlled clinical trial, we recruited 128 outpatients with cancer via purposive sampling from a teaching hospital in northern Taiwan. Participants were randomly assigned to the navigation group (N = 61) or the usual care group (N = 67). Data were collected from January 2019 to July 2020 using questionnaires, including the self-reported Distress Thermometer, Hospital Anxiety and Depression Scale, Demoralization Scale, and Patient Assessment of Chronic Illness Care. Data were collected at baseline and after three and six months of the intervention. Descriptive and analytical statistical analyses were performed. The prevalence rates of anxiety, depression, distress, and demoralization were 17.9%, 15.7%, 29.7%, and 29.7%, respectively. After three months, the participants in the navigation group exhibited significantly reduced levels of anxiety, demoralization, and emotional distress (reduced by 92%, 75%, and 58%, respectively) and reported a better medical experience (odds ratio = 1.40) than those in the usual care group. Full article

(1) Introduction: Cancer diagnosis has been related to depression, anxiety, and distress, as well as to post-traumatic growth (PTG). One of the mediating variables for emotional response is thought style (rumination, cognitive avoidance, and cognitive engagement). (2) Aim: To identify the relationship between thought style and emotional responses to cancer. A secondary aim was to identify the relationship between emotional responses and inflammatory immunological biomarkers. (3) Method: A total of 115 patients with cancer were included in the study. Before initiating cancer treatment, patients were assessed using the Hospital Anxiety and Depression Scale (HADS), distress thermometer, and Post-Traumatic Growth Inventory (PTGI). Patients provided their most recent blood biometry. (4) Results: Rumination correlated with anxiety, depression, and distress. Cognitive avoidance correlated with PTG (−0.240) and distress (−0.209). Cognitive engagement correlated with PTG (0.393). Regarding thought style and biomarkers, a negative correlation was observed for absolute neutrophils with cognitive avoidance (−0.271) and rumination (0.305). Regarding biomarkers and emotional responses, there was a negative correlation between PTG and absolute lymphocytes (−0.291). There was also a correlation between PTG and neutrophils (0.357) and neutrophil-to-lymphocyte ratio (NLR) (0.295). (5) Conclusions: Thought style is related to the emotional response to a cancer diagnosis; rumination is related to depression, distress, and anxiety; and cognitive engagement is related to PTG. PTG is related to inflammation and immunological biomarkers. Full article

A growing interest in person-centered care from a biopsychosocial perspective has led to increased attention to structural screening. The aim of this study was to develop an easy-to-comprehend screening instrument using single items to identify a broad range of health-related problems in adult burn survivors. This study builds on earlier work regarding content generation. Focus groups and expert meetings with healthcare providers informed content refinement, resulting in the Aftercare Problem List (APL). The instrument consists of 43 items divided into nine health domains: scars, daily life functioning, scars treatment, body perceptions, stigmatization, intimacy, mental health, relationships, financial concerns, and a positive coping domain. The APL also includes a Distress Thermometer and a question inquiring about preference to discuss the results with a healthcare provider. Subsequently, the APL was completed by 102 outpatients. To test face validity, a linear regression analysis showed that problems in three health domains, i.e., scars, mental health, and body perceptions, were significantly related to higher distress. Qualitative results revealed that a minority found the items difficult which led to further adjustment of the wording and the addition of illustrations. In summation, this study subscribes to the validity of using single items to screen for burn-related problems. Full article

(1) Background: International cancer treatment guidelines recommend low-threshold psycho-oncological support based on nurses’ routine distress screening (e.g., via the distress thermometer and problem list). This study aims to explore factors which are associated with declining psycho-oncological support in order to increase nurses’ efficiency in screening patients for psycho-oncological support needs. (2) Methods: Using machine learning, routinely recorded clinical data from 4064 patients was analyzed for predictors of patients declining psycho-oncological support. Cross validation and nested resampling were used to guard against model overfitting. (3) Results: The developed model detects patients who decline psycho-oncological support with a sensitivity of 89% (area under the cure of 79%, accuracy of 68.5%). Overall, older patients, patients with a lower score on the distress thermometer, fewer comorbidities, few physical problems, and those who do not feel sad, afraid, or worried refused psycho-oncological support. (4) Conclusions: Thus, current screening procedures seem worthy to be part of daily nursing routines in oncology, but nurses may need more time and training to rule out misconceptions of patients on psycho-oncological support. Full article