Cancer Survivorship

Background/Objective: There is increasing evidence that positive life changes, such as post-traumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months' follow-up. Participants' PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others.

Introduction: To investigate the understanding and practice of person-centred care by health care professionals and support staff at a cancer centre and to learn how patients and family members understand and experience person-centred care. Methods: The study was conducted in two phases. Phase 1 used large wall mounted posters and marking pens in public areas of the cancer centre to gather comments from staff, volunteers, students , patients, family members, and visitors to answer the question, ''What does person-centred care mean to you?'' Phase 2 used a six-question, open-ended, paper-based questionnaire for staff and patients. A manual coding technique was used to derive themes from both posters and questionnaires. Results: We derived 97 themes from the posters and 134 themes from 44 returned questionnaires (survey response rate of 37%). When the themes were combined and reprioritized, we learned that person-centred care is: (1) care that is caring, compassionate, and empathetic; (2) person or patient is the centre of focus; (3) care is unique to the individual's needs; and (4) person or patient is a part of their care. Furthermore, all staff should provide person-centred care. Conclusions: Our findings describe what our staff, patients, and family members believe person-centred care is, and how it should be delivered. Based on this research study, we recommend promoting additional dialogue and continuing education opportunities for health care professionals and other front-line staff who will assist them to complete the statement, ''I demonstrate person-centred care by.'' to their own satisfaction in the future. R ESUM E Introduction : Etudier la compr ehension et la pratique des soins centr es sur la personne par les professionnels de la sant e et le personnel de soutien dans un centre de traitement du cancer et ap-prendre comment les patients et les membres de leurs familles com-prennent et ressentent les soins centr es sur la personne. M ethodologie : L' etude a et e r ealis ee en deux phases. Dans la phase 1, de grandes affiches ont et e install ees sur les murs, avec des mar-queurs, dans les aires communes du centre afin de recueillir les com-mentaires des employ es, des b en evoles, des etudiants, des patients, des membres des familles et des visiteurs et leurs r eponses a la question: « Que signifient les soins centr es sur la personne pour vous? ». L' etape 2 a utilis e un questionnaire papier de six questions ouvertes pour les employ es et les patients. Une technique de codage manuel a et e utilis ee afin de recenser les th emes des affiches et des questionnaires. R esultats : Nous avons recens e 97 th emes sur les affiches et 134 dans les 44 questionnaires retourn es (taux de r eponse de 37%). Apr es re-groupement des th emes et r etablissement des priorit es, nous avons conclu que les soins centr es sur la personne sont d efinis comme suit: 1) des soins marqu es par la sollicitude, la compassion et l'empa-thie; 2) la personne/le patient est le centre d'int er^ et; 3) des soins adapt es aux besoins de la personne, et 4) la personne/le patient fait partie des soins. De plus, l'ensemble du personnel doit participer aux soins centr es sur la personne. Conclusion : Nos constats d ecrivent ce que les employ es, les patients et les membres de leurs familles dans notre centre croient que sont les soins centr es sur la personne, et comment ils devraient ^ etre rendus. Sur la base de cette recherche, nous recommandons de favoriser une augmentation du dialogue et des occasions de perfectionnement professionnel pour les professionnels de la sant e et les autres membres du personnel de premi ere ligne afin de les aider a terminer la phrase: « J'offre des soins centr es sur la personne par. » a leur propre satisfaction a l'avenir.

Context: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery.

This integrative review aimed to analyze the research into positive psychological functioning after breast cancer, and to integrate the most relevant findings relating to sociodemographic, medical and psycho-social factors. Relevant outcomes were identified from electronic databases (Medline, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, and Wiley Online Library) up to July 2015. A Google search was performed to identify unindexed literature. Dissertations and theses were searched on Proquest Dissertations and Theses, DIALNET and TDX. Selection criteria included empirical studies assessing relationships between breast cancer and positive functioning, without restrictions on type of participants. In total, 134 studies met the inclusion criteria. The sociodemographic, medical, and psychosocial characteristics associated with well-being, posttraumatic growth, finding benefit and meaning were being young, undergoing chemotherapy, and having social support. The last two of these characteristics were time-oriented. The culture of the different samples and positive dispositional characteristics like optimism had an influence on the women's coping styles. Socioeconomic status and level of education were also associated with positive psychological functioning. The perceived impact of breast cancer on patient, as well as the perceived support from significant others can result in better functioning in women with breast cancer. The results highlight that oncology health professionals should take into account not only the individual and medical characteristics, but also the stage of the oncological process and the psychosocial environment of patients in order to promote their positive functioning.

This integrative review aimed to analyze the research into positive psychological functioning after breast cancer, and to integrate the most relevant findings relating to sociodemographic, medical and psycho-social factors. Relevant outcomes were identified from electronic databases (Medline, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, and Wiley Online Library) up to July 2015. A Google search was performed to identify unindexed literature. Dissertations and theses were searched on Proquest Dissertations and Theses, DIALNET and TDX. Selection criteria included empirical studies assessing relationships between breast cancer and positive functioning, without restrictions on type of participants. In total, 134 studies met the inclusion criteria. The sociodemographic, medical, and psychosocial characteristics associated with well-being, posttraumatic growth, finding benefit and meaning were being young, undergoing chemotherapy, and having social support. The last two of these characteristics were time-oriented. The culture of the different samples and positive dispositional characteristics like optimism had an influence on the women's coping styles. Socioeconomic status and level of education were also associated with positive psychological functioning. The perceived impact of breast cancer on patient, as well as the perceived support from significant others can result in better functioning in women with breast cancer. The results highlight that oncology health professionals should take into account not only the individual and medical characteristics, but also the stage of the oncological process and the psychosocial environment of patients in order to promote their positive functioning.

Serious and life-threatening illnesses like cancer produce stress symptoms in patients. However, the disease also has an impact on significant others in the patient's life. This is now recognized in the literature, and alongside research on survivors' growth from adversity, increasing attention is being paid to growth among significant others. This chapter adds to this body of work by reviewing the evidence regarding the transmission of growth in the patient to his or her significant others. The review suggests that growth in significant others is reported as being either vicarious or secondary. Couple factors such as gender or dyadic role seem to be relevant predictors of posttraumatic growth among spouses of cancer patients. The chapter concludes by discussing a possible rationale for this phenomenon.

Background
Substantial uncertainty exists about prevalence of mood disorders in patients with cancer, including those in oncological, haematological, and palliative-care settings. We aimed to quantitatively summarise the prevalence of depression, anxiety, and adjustments disorders in these settings.

Methods
We searched Medline, PsycINFO, Embase, and Web of Knowledge for studies that examined well-defined depression, anxiety, and adjustment disorder in adults with cancer in oncological, haematological, and palliative-care settings. We restricted studies to those using psychiatric interviews. Studies were reviewed in accordance with PRISMA guidelines and a proportion meta-analysis was done.

Findings
We identified 24 studies with 4007 individuals across seven countries in palliative-care settings. Meta-analytical pooled prevalence of depression defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) criteria was 16·5% (95% CI 13·1—20·3), 14·3% (11·1—17·9) for DSM-defined major depression, and 9·6% (3·6—18·1) for DSM-defined minor depression. Prevalence of adjustment disorder alone was 15·4% (10·1—21·6) and of anxiety disorders 9·8% (6·8—13·2). Prevalence of all types of depression combined was of 24·6% (17·5—32·4), depression or adjustment disorder 24·7% (20·8—28·8), and all types of mood disorder 29·0% (10·1—52·9). We identified 70 studies with 10 071 individuals across 14 countries in oncological and haematological settings. Prevalence of depression by DSM or ICD criteria was 16·3% (13·4—19·5); for DSM-defined major depression it was 14·9% (12·2—17·7) and for DSM-defined minor depression 19·2% (9·1—31·9). Prevalence of adjustment disorder was 19·4% (14·5—24·8), anxiety 10·3% (5·1—17·0), and dysthymia 2·7% (1·7—4·0). Combination diagnoses were common; all types of depression occurred in 20·7% (12·9—29·8) of patients, depression or adjustment disorder in 31·6% (25·0—38·7), and any mood disorder in 38·2% (28·4—48·6). There were few consistent correlates of depression: there was no effect of age, sex, or clinical setting and inadequate data to examine cancer type and illness duration.

Interpretation
Interview-defined depression and anxiety is less common in patients with cancer than previously thought, although some combination of mood disorders occurs in 30—40% of patients in hospital settings without a significant difference between palliative-care and non-palliative-care settings. Clinicians should remain vigilant for mood complications, not just depression.

Funding
None.

Objective: The objective of this study is to describe major findings on posttraumatic growth (PTG) in cancer, by analyzing its various definitions, assessment tools, and examining its main psychological and clinical correlates. Methods: A search in relevant databases (PsycINFO, Pubmed, ProQuest, Scopus, and Web of Science) was performed using descriptors related to the positive reactions in cancer. Articles were screened by title, abstract, and full text. Results: Seventy‐two met the inclusion criteria. Most articles (46%) focused on breast cancer, used the PTG inventory (76%), and had a cross‐sectional design (68%). The PTG resulted inversely associated with depressive and anxious symptoms and directly related to hope, optimism, spirituality, and meaning. Illness‐related variables have been poorly investigated compared to psychological ones. Articles found no relationship between cancer site, cancer surgery, cancer recurrence, and PTG. Some correlations emerged with the elapsed time since diagnosis, type of oncological treatment received, and cancer stage. Only few studies differentiated illness‐ related–life‐threatening stressors from other forms of trauma, and the potentially different mechanisms connected with PTG outcome in cancer patients. Conclusions: The evaluation of PTG in cancer patients is worthy, because it may promote a better adaption to the illness. However, many investigations do not explicitly refer to the medical nature of the trauma, and they may have not completely captured the full spectrum of positive reactions in cancer patients. Future research should better investigate issues such as health attitudes; the risks of future recurrences; and the type, quality, and efficacy of medical treatments received and their influence on PTG in cancer patients.

Being diagnosed with cancer and undergoing subsequent treatment can produce high levels of distress among patients. Several psychotherapeutic approaches have sought to help cancer patients manage these negative impacts. In addition, however, there is now increasing evidence regarding the collateral positive outcomes of the cancer experience, it being concluded that positive life changes may also result from such adversity. Consequently, therapies focusing on the emergence of these positive changes have also been developed. In this chapter we describe a positive psychotherapy for cancer survivors, one which aims to facilitate posttraumatic growth as a way of achieving a significant reduction in negative emotional states (emotional distress or posttraumatic symptoms). A further goal of this positive psychology approach in cancer is to work with positive emotions and positive functioning so as to promote healthy lifestyles, a return to work, and social supportive behaviors.

AIM:
To report an analysis of the concept of self-advocacy among individuals with cancer to clarify its meaning, to differentiate this meaning with related concepts, and to unify understanding of the concept in cancer research and practice.

BACKGROUND:
Cancer survivors are increasingly required to assume an active role in their health care. A thorough analysis of how survivors advocate for themselves is a crucial aspect in supporting survivors' ability to engage and manage their care throughout all stages of cancer survivorship.

DESIGN:
Walker and Avant's eight-step process of conducting a concept analysis was used.

DATA SOURCES:
PubMed, PsycINFO, and CINAHL databases were searched for articles, reviews, editorials, and grey literature directly addressing self-advocacy.

REVIEW METHODS:
A broad inquiry into the literature from 1960 to 2012 that produces a definition of self-advocacy. Model and contrary cases of self-advocacy demonstrate the concept's application and intricacies.

RESULTS:
Antecedents to self-advocacy include particular personal characteristics, learned skills, and attainable support. The essential element of self-advocacy and what differentiates it from related concepts, is the internalization of these antecedent resources into self-advocacy thoughts and actions while incorporating personal values and priorities in a way that upholds the survivors' goals and beliefs. A full realization of self-advocacy facilitates a cancer survivor attaining a strong self-concept, sense of control, and adaptation to a life with cancer.

CONCLUSIONS:
Self-advocacy is a process of internalizing skills and resources to act in a way that supports survivors' needs and goals.

The purpose of this literature review is to provide a better understanding of the impact that environmental design can have on the process of cancer prevention, diagnosis, treatment, and survivorship. Cancer is considered a chronic disease in the United States, and more than 1.6 million new cases are diagnosed annually. New strategies of cancer care propose patient-centered services to achieve the best outcome, and researchers have found that environmental design can be an important part of improving this care. Searches were conducted in the PubMed and Google Scholar databases as well as in specific healthcare design journals such as Health Environments Research & Design, Environmental Psychology, and Environment and Behavior. The criteria for articles included in the review were (a) English-language articles related to facility design, which addressed (b) the topics of built environment in relation to cancer diagnosis, treatment, and survivorship, and were (c) published in peer-reviewed journals between 2000 and 2017. Finally, 10 articles were selected, and the contents were analyzed. The selected articles demonstrate that environmental design is one of the critical factors for success throughout the whole continuum of cancer care from diagnosis to end-of-treatment. Some of the specific conclusions from the review are that "neighborhood-oriented" design strategies can be beneficial (by providing accessibility to all facilities along the patient's path), that access to nature for patients, staff, and visitors alike is associated with better outcomes, and that provisions for natural lighting and noise reduction are associated with cancer patients' well-being.

Introduction-To compare preadolescents with and without cancer on current smoking status, future intentions to smoke, and tobacco-related risk factors, as well as to explore the relationship between cancer status and tobacco-related variables with intentions.

Background Evidence suggests that fear of cancer recurrence (FCR) is one of the most frequently cited unmet needs among cancer survivors and is associated with psychological distress, stress-response symptoms, and lower quality of life, as well as increased use of health care resources. Despite these factors, few manualized interventions exist to address FCR among cancer survivors. Purpose To develop, manualize, and pilot test the feasibility and preliminary efficacy of a 6-week cognitive-existential (CE) group intervention designed to address FCR in women with breast or ovarian cancer. Methods This study was a single-arm multi-site study with pre-, post-, and 3-month follow-up measurement occasions. Results A total of 56 breast or ovarian cancer survivors enrolled in the study; 44 completed the CE group intervention. Following the intervention, women experienced