pinecone/core-2020-05-10-deduplication huggingface dataset:
Sharing bad news of a lung cancer diagnosis: Understanding through Communication Privacy Management Theory

Objective: To understand the process of information disclosure and privacy as patients share their news of lung cancer with significant others.
Methods:  Twenty patients with lung cancer and 17 family members/friends accompanying them at diagnosis-giving completed either individual or dyad semi-structured interviews. Initial thematic analysis, then Petronio’s Communication Privacy Management theory was used to inform interpretation.  
Results: Patients described a sense of ownership of the news of their cancer and sought control of how, when and with whom it was shared. Family members expressed a need to follow the patients’ rules in sharing this news which limited their own support systems.  Patients and family members had to live within the relational communication boundaries in order to maintain their trusting relationship and avoid potential disruptions.
Conclusion: Patients as individuals are strongly interlinked with significant others which impacts on their experience of disclosing private information. This shapes their psychological processes and outcomes impacting on their illness experience. This should be considered when developing interventions to support patients with sharing bad news.This project was funded by Dimbleby Cancer Care Research FundThis is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1002/pon.402
Perceived diagnostic delay and cancer-related distress: a cross sectional study of patients with colorectal cancer.

Objective: This study aimed to examine the effect of perceived diagnostic delay on cancer-related distress, and determine whether fear of cancer-recurrence and quality of life mediate this relationship.\ud
Methods: Cross-sectional study in which 311 colorectal cancer (CRC) survivors in Scotland completed a survey which included questions on cancer-related distress (IES-R), perceived diagnostic delay, quality of life (trial outcome index of the FACT-C: FACT-C TOI) and fear of cancer recurrence. 15 patients withheld consent to data matching with medical records, leaving a sample size of 296. Participants were an average of 69 years old (range 56 to 81) and between 3.5 to 12 years post-diagnosis. Multiple regressions were used to test predictors of distress, and regression and bootstrapping to test for mediation.\ud
Results: Perceived diagnostic delay was correlated with higher cancer-related distress, while objective markers of diagnostic delay (disease stage at diagnosis and treatment received) were not. Some of the relationship between perceived diagnostic delay and cancer-related distress was mediated by quality of life, but not by fear of cancer recurrence. \ud
Conclusions: Perceived diagnostic delay was associated with higher cancer-related distress among CRC survivors. While poorer quality of life partly explained such associations, fear of cancer recurrence, stage at diagnosis and treatment did not. The exact features of diagnostic delay that are associated with cancer-related distress remain unclear. Future research should examine the experiences patients go through prior to diagnosis that may increase distress, in an effort to improve our understanding of the factors affecting emotional wellbeing among CRC survivors
Current state and future prospects of research on fear of cancer recurrence

This work was supported by a Dissemination and Planning grant (# PCS 142019) from the Canadian Institutes of Health Research and by a Meeting grant from the University of Ottawa to Sophie Lebel.1. Despite a rapidly growing research interest in FCR, lack of consensus on definition and measurement including clinical FCR, sparse model development and testing, and limited available clinical interventions have impeded knowledge transfer into patient services. 2. To move forward, a 2-day colloquium was held in Ottawa, Canada in August 2015 to progress knowledge and identify future research directions. 3. A comprehensive research program was proposed, including development of a clinical definition, an updated review of screening measures, and a review of existing interventions. 4. A new special interest group was created with the International Psychosocial Oncology Society (IPOS) to facilitate the implementation of this research program and future international collaborations.PostprintPeer reviewe
A qualitative study exploring health perceptions and factors influencing participation in health behaviors in colorectal cancer survivors

Purpose: The purpose of the study was to explore colorectal cancer survivors’ health perceptions following
cessation of active treatment for cancer and to explore the factors influencing participation in
health-promoting behaviors that may help reduce cardiovascular disease risk.
Methods: Face-to-face interviews were conducted with participants that had completed active treatment
for cancer within the previous 2 years. Participants were colorectal cancer survivors (N = 24,
men = 11, women = 13, M age = 69.38 years, SD = 4.19) recruited from a private hospital in Perth,
Australia on the basis that they had existing morbidities that put them at increased risk of cardiovascular
disease. Interview transcripts were analyzed using thematic analysis.
Results: Five main themes emerged: back to normal; the pleasures in life: ‘is it worth it?’; beliefs
about health behavior; skepticism of eating guidelines; and lack of motivation. The majority of participants
felt they were in good health and had made a full recovery. Participants questioned whether it
was worth changing their lifestyle given their life stage and referred to the desire to enjoy life. Lay
health beliefs, skepticism of eating guidelines, and a lack of motivation were barriers to change.
Conclusions: Interventions should target lay beliefs and skepticism in relation to health behaviors in
order to reinforce the importance and value of participating in health-related behavior.
Implications for Cancer Survivors: Findings may inform the development of effective, patientcentered
interventions that target lay health beliefs and build motivation for health behavior change.Full Tex
Avoidant Coping and Self-efficacy Mediate Relationships between Perceived Social Constraints and Symptoms among Long-term Breast Cancer Survivors

Objective

Many breast cancer survivors feel constrained in discussing their cancer experience with others. Limited evidence suggests that social constraints (e.g., avoidance and criticism) from loved ones may negatively impact breast cancer survivors' global health, but research has yet to examine relationships between social constraints and common physical symptoms. Informed by social cognitive processing theory, this study examined whether perceived social constraints from partners and healthcare providers (HCPs) were associated with fatigue, sleep disturbance, and attentional functioning among long-term breast cancer survivors (N = 1052). In addition, avoidant coping and self-efficacy for symptom management were examined as potential mediators of these relationships.
Methods

Long-term breast cancer survivors (mean years since diagnosis = 6) completed questionnaires assessing social constraints from partners and HCPs, avoidant coping, self-efficacy for symptom management, and symptoms (i.e., fatigue, sleep disturbance, and attentional functioning). Structural equation modeling was used to evaluate the hypothesized relationships among variables in two models: one focused on social constraints from partners and one focused on social constraints from HCPs.
Results

Both models demonstrated good fit. Consistent with theory and prior research, greater social constraints from both partners and HCPs were associated with greater symptom burden (i.e., greater fatigue and sleep disturbance, poorer attentional functioning). In addition, all relationships were mediated by avoidant coping and self-efficacy for symptom management.
Conclusions

Findings are consistent with social cognitive processing theory and suggest that symptom management interventions may be enhanced by addressing the impact of social constraints from survivors' partners and HCPs on their coping and self-efficacy
The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review.

Objectives

To explore the experiences of caregivers of terminally ill patients with delirium, to determine the potential role of caregivers in the management of delirium at the end of life, to identify the support required to improve caregiver experience and to help the caregiver support the patient.

Methods

Four electronic databases were searched?PsychInfo, Medline, Cinahl and Scopus from January 2000 to July 2015 using the terms ?delirium?, ?terminal restlessness? or ?agitated restlessness? combined with ?carer? or ?caregiver? or ?family? or ?families?. Thirty-three papers met the inclusion criteria and remained in the final review.

Results

Papers focused on (i) caregiver experience?distress, deteriorating relationships, balancing the need to relieve suffering with desire to communicate and helplessness versus control; (ii) the caregiver role?detection and prevention of delirium, symptom monitoring and acting as a patient advocate; and (iii) caregiver support?information needs, advice on how to respond to the patient, interventions to improve caregiver outcomes and interventions delivered by caregivers to improve patient outcomes.

Conclusion

High levels of distress are experienced by caregivers of patients with delirium. Distress is heightened because of the potential irreversibility of delirium in palliative care settings and uncertainty around whether the caregiver?patient relationship can be re-established before death. Caregivers can contribute to the management of patient delirium. Additional intervention studies with informational, emotional and behavioural components are required to improve support for caregivers and to help the caregiver support the patient. Reducing caregiver distress should be a goal of any future intervention.Marie Curie
The efficacy of interventions to improve psychosocial outcomes following surgical treatment for breast cancer: a systematic review and meta-analysis

Objective\ud
\ud
Breast cancer is the most commonly diagnosed cancer in women across the world. The majority of women diagnosed with the disease undergo surgery, which is often associated with significant psychosocial morbidity. The aim of this meta-analysis was to identify the efficacy of psychosocial interventions for women following breast cancer surgery.\ud
Method\ud
\ud
A comprehensive literature search was undertaken using keyword and subject headings within 7 databases. Included studies employed a quantitative methodology presenting empirical findings focusing on interventions for female breast cancer patients following surgery.\ud
Results\ud
\ud
Thirty-two studies were included and based on conventional values of effect sizes. Small effects emerged for the efficacy of psychosocial interventions in relation to anxiety (Hedges g = 0.31), depression (0.38), quality of life (0.40), mood disturbance (0.31), distress (0.27), body image (0.40), self-esteem (0.35), and sexual functioning (0.22). A moderate to large effect emerged for the efficacy of interventions in promoting improvements in sleep disturbance (0.67). Clear evidence emerged for the efficacy of cognitive behavioral therapy in promoting improvements in anxiety, depression, and quality of life.\ud
Conclusion\ud
\ud
This is the first meta-analysis to demonstrate the efficacy of interventions on a range of psychosocial outcomes following breast cancer surgery. The meta-analysis highlighted that cognitive behavioral therapy was consistently the most effective psychosocial intervention promoting improvements in anxiety, depression, and quality of life. However, there are shortcomings in existing studies; the length of the follow-up period is typically short and the generalizability of findings was limited by small samples, both of which should be addressed in future studies
Cost-effectiveness of a pragmatic exercise intervention for women with breast cancer: Results from a randomized controlled trial

<b>Objective</b>\ud
\ud
 - To report on the cost-effectiveness of the Exercise for Health trial, comparing an exercise intervention with usual care during and following treatment for women with breast cancer. \ud
\ud
<b>Methods</b>\ud
\ud
 - Women with breast cancer were randomized to an eight-month exercise intervention (involving regular contact with an exercise physiologist over the phone, n=67, or home-delivered face-to-face, n=67) or usual care (n=60) group and were assessed pre-intervention (five weeks post-surgery), mid-intervention (six months post-surgery) and 10 weeks post-intervention (12 months post-surgery). The benefit measures were ‘number of improvers’ in quality of life (QoL; FACT-B+4) and quality-adjusted life years (QALYs; EQ-5D-3L). Data on provider, patient and government costs were used to consider two cost scenarios: 1) a service provider model and, 2) a private model. \ud
\ud
<b>Results</b>\ud
\ud
 - There were 69 improvers in the intervention group compared with 21 in the usual care group (odds ratio 2.09, 95% CI: 1.08, 4.01, p=0.033). The incremental cost per improver was AU$2,282-$2,644. QALY gain for the intervention group versus the usual care group was 0.009, with incremental cost per QALY gain for model one and two being AU$105,231 and AU$90,842, respectively. However, sensitivity analyses indicate that incremental cost per QALY gained was volatile to EQ-5D-3L weights. \ud
\ud
<b>Conclusions</b>\ud
\ud
 - Findings suggest that a pragmatic exercise intervention yields more women with markedly improved QoL after breast cancer than usual care and may be cost-effective.  The results are less certain in terms of incremental cost per QALYs, however this may be an inappropriate measure for reflecting exercise benefit for women with breast cancer
The relationship between cancer patient's fear of recurrence and radiotherapy : a systematic review and meta-analysis

The authors are also grateful to the Breast Cancer Now for supporting this research (grant reference number 6873).OBJECTIVE: This review aims to provide an overview of the current knowledge available on the nature and extent of the relationship between external-beam radiotherapy (RT) and fear of cancer recurrence (FoR). METHODS: PubMed, MEDLINE and EMBASE databases were searched to identify relevant studies. Systematic review procedures were followed including a quality assessment. Meta-analysis of suitable studies was conducted. RESULTS: Twenty-five eligible studies were included in the systematic review and 15 of them were included in further meta-analysis. Meta-analysis of the available data confirmed a weak relationship between RT and FoR (15 studies, 9567 patients, overall r = 0.053, 95%, CI: 0.021-0.085, P = 0.001). Subgroup analysis based on cancer site (breast cancer versus other types of cancer) revealed that the correlation between RT and FoR was statistically significant in 'other cancer' group (P˂0.001) but was nonsignificant in 'breast cancer' group (P = 0.538). CONCLUSIONS: While meta-analysis reports a statistically significant association between cancer patient's FoR and the receipt of RT, these results should be interpreted with caution due to significant variability between studies. Further longitudinal studies should be conducted to address the trajectory of FoR over RT in greater detail. PostprintPeer reviewe
A descriptive survey of cancer helplines in the United Kingdom: Who they are, the services offered, and the accessibility of those services

This is an Open Access Article. It is published by Wiley under the Creative Commons Attribution 4.0 NonCommercial‐NoDerivs License (CC BY-NC-ND). Full details of this licence are available at: http://creativecommons.org/licenses/by-nc-nd/4.0/Abstract\ud
Background There are more than 1500 UK health helplines in operation, yet we have scant knowledge about the resources in place to support the seeking and delivering of cancer‐related telephone help and support. This research aimed to identify and describe cancer and cancerrelated helpline service provision: the number of helplines available, the variety of services provided,\ud
and the accessibility of those services.\ud
Method This study used online national questionnaire survey sent to 95 cancer and cancerrelated helplines in the United Kingdom.\ud
Results A total of 69 (73%) of 95 surveyed cancer and cancer‐related helplines completed the survey. Most helplines/organizations were registered charities, supported by donations; 73.5% of\ud
helplines had national coverage. Most helplines served all age‐groups, ethnic groups, and men and women. Only 13.4% had a number that was free from landlines and most mobile networks, and 56.6% could only be contacted during working hours. More than 50% of helplines reported no provisions for callers with additional needs, and 55% had no clinical staff available to callers.\ud
Ongoing support and training for helpline staff was available but variable.\ud
Conclusion Although cancer helplines in the United Kingdom offer reasonably broad coverage across the country, there are still potential barriers to accessibility. There are also opportunities to optimize the training of staff/volunteers across the sector. There are further prospects for\ud
helplines to enhance services and sustain appropriate and realistic quality standards
Factors Predicting Emotional Cue-Responding Behaviors of Nurses in Taiwan: An Observational Study

Objective

Responding to emotional cues is an essential element of therapeutic communication. The purpose of this study is to examine nurses' competence of responding to emotional cues (CRE) and related factors while interacting with standardized patients with cancer.
Methods

This is an exploratory and predictive correlational study. A convenience sample of registered nurses who have passed the probationary period in southern Taiwan was recruited to participate in 15-minute videotaped interviews with standardized patients. The Medical Interview Aural Rating Scale was used to describe standardized patients' emotional cues and to measure nurses' CRE. The State-Trait Anxiety Inventory was used to evaluate nurses' anxiety level before the conversation. We used descriptive statistics to describe the data and stepwise regression to examine the predictors of nurses' CRE.
Results

A total of 110 nurses participated in the study. Regardless of the emotional cue level, participants predominately responded to cues with inappropriate distancing strategies. Prior formal communication training, practice unit, length of nursing practice, and educational level together explain 36.3% variances of the nurses' CRE.
Conclusions

This study is the first to explore factors related to Taiwanese nurses' CRE. Compared to nurses in other countries, Taiwanese nurses tended to respond to patients' emotional cues with more inappropriate strategies. We also identified significant predictors of CRE that show the importance of communication training. Future research and education programs are needed to enhance nurses' CRE and to advocate for emotion-focused communication
Trajectories of quality of life, life satisfaction, and psychological adjustment after prostate cancer

To describe trajectories of health-related quality of life (QoL), life satisfaction, and psychological adjustment for men with prostate cancer over the medium to long term and identify predictors of poorer outcomes using growth mixture models.One-thousand sixty-four (82.4% response) men diagnosed with prostate cancer were recruited close to diagnosis and assessed over a 72-month (6-year) period with self-report assessment of health-related QoL, life satisfaction, cancer-related distress, and prostate specific antigen anxiety. Urinary, bowel, and sexual function were also assessed using validated questionnaires.Poorer physical QOL was predicted by older age, lower education, lower income, comorbidities, and receiving hormone therapy. Lower life satisfaction was related to younger age, lower income, not being partnered, and comorbidities. Poorer psychological trajectories were predicted by younger age, lower income, comorbidities, and receiving radical prostatectomy or brachytherapy. Better urinary, bowel, and sexual function were related to better global outcomes over time. Anxiety about prostate specific antigen testing was rare.Distinct trajectories exist for medium- to long-term QoL, life satisfaction, and psychological adjustment after prostate cancer; with age and socioeconomic deprivation playing a differential role in men's survivorship profile and the impact of functional status on outcomes increasing over time. These results reinforce the need for an appraisal of men's life course in addition to treatment side effects when planning survivorship care after cancer.Suzanne K. Chambers, Shu Kay Ng, Peter Baade, Joanne F. Aitken, Melissa K. Hyde, Gary Wittert, Mark Frydenberg, Jeff Dun
Prevalence of oncologists in distress: systematic review and meta-analysis

Objective: High mortality from cancer and rising patient numbers can trigger distress among oncologists because of a heavy and emotionally demanding workload. This systematic review and meta-analysis assesses the prevalence of high levels of distress among oncologists.\ud
\ud
Methods: The PRISMA protocol is registered at the PROSPERO international prospective register (Ref. 2015:CRD42015016325). We categorized data items according to the following distress factors: burnout, psychiatric morbidity, stress, depression, disrupted sleep, stress-induced physical symptoms, and substance use. We meta-analysed the prevalence of burnout and psychiatric morbidity using random effects models with MetaXL software.\ud
\ud
Results: The meta-analyses showed that 32% of 4876 oncologists had high burnout (±CI 28% to 36%) and 27% of 2384 had high psychiatric morbidity (±CI 23% to 32%). Studies also showed that 42 to 69% feel stressed at work, > 12% of oncologists screen positive for depression, many oncologists suffer from sleep deprivation, up to 30% drink alcohol in a problematic way, up to 20% of junior oncologists use hypnotic drugs and some frequently experience stress-induced complaints such as ulcers, gastric problems, headaches and arrhythmia.\ud
\ud
Conclusions: Occupational distress reduces career satisfaction, affects patient care and increases the chances of oncologists switching to another area of medicine therefore future research should explore appropriate interventions.\ud
\ud
Keywords: stress, burnout, psychiatric morbidity, sleep, meta-analysis, oncology, cancer