Cognitive-Behavioral Treatment of Tomophobia (Fear of Medical Procedures) Using an Innovative, Virtual-Reality-Augmented Approach: A Case Study in a Patient with Breast Cancer

Game playing: A method for reducing young children's fear of medical procedures

The Cancer Worry Scale was revised to be used in breast cancer genetic counseling (CWS-GC). This scale is used to identify dimensions that are relevant in the genetic counseling context, such as worry about developing breast cancer, impact of worries on daily life, and risk perception in women attending a counseling session for BRCA1/2 mutations. The aim of this study was to estimate the psychometric properties of the CWS-GC in a sample of Italian women. A total of 304 women aged 19 to 90 years, 58% with history and 42% with no history of breast or ovarian cancer, participated in the study. Validity, reliability, and sensitivity to change of the CWS-GC were assessed. Confirmatory factor analysis suggested a 2-factor structure of the CWS-GC measuring cancer worry and risk perception and with Cronbach's α coefficients of .90 and .70, respectively. Criterion validity was attested by substantial yet not overlapping correlations with anxiety and fear of medical procedures. In a subsample of 50 women, test-retest reliability at a 4-week interval ranged from 0.70 to 0.87, and the CWS-GC was able to detect small to medium changes 1 month after genetic counseling. Overall, the CWS-GC showed good psychometric characteristics in this population. The CWS-GC would be appropriate for use by healthcare professionals to better understand how women react and adapt to information on genetic cancer risk to provide them with emotional support and encourage surveillance behaviors.

Background and objective: Breast cancer is a treatable disease resulting in complete cure. Late presentation is not uncommon in third world countries. The factors leading to delay in reporting to the hospital must be studied. The objective of this research was to identify the factors responsible for late presentation of fungating breast cancer patients at a tertiary care hospital of Pakistan.Methods: It was a descriptive, cross-sectional study conducted at Jinnah hospital Lahore from January 2020 to December 2022. A total of 56 respondents were selected through non-probability purposive sampling technique. A pre-tested structured questionnaire was administered, data were gathered after taking informed consent and data confidentiality was ensured. The collected data were analyzed using SPSS version 23. The stage 1 and 2 carcinoma breast patients are excluded from the study. The sample size was calculated by using WHO calculator.Results: A total of 56 cases of fungating breast growths were included in the present study carried out for a period of two years. Among 56 cases the mean age of patients was 45+9 years. The study found that the reasons leading for the delay in seeking treatment were poor socioeconomic status, belief in traditional faith healers, cultural myths, reliance on alternative medicine, fear of medical procedures, resistance from family members, and lack of accessibility.Conclusion: The delayed presentation of breast cancer leading to fungating growth is a significant concern that needs to be addressed. By identifying the reasons for delayed presentation, healthcare providers and policymakers can develop targeted interventions to improve early detection and prompt treatment, eventually improving the prognosis and quality of life of breast cancer patients.Key Words: delayed presentation, fungating breast cancer, reasons, tertiary care facility.

Background: For both the patient and their partner, high levels of cohesion/communication are beneficial to coping with cancer. Prognosis alignment in couples has implications for medical care and end of life planning. The objectives of this study were to: assess areas of psychosocial distress endorsed by the patient and her partner and to determine each individual’s understanding of prognosis. Methods: Women with metastatic breast cancer and their partners completed a couples’ tailored biopsychosocial screening and alignment in perception of prognosis immediately before the initial consultation with a Medical Oncologist. In addition, the couples were offered a standardized couples’ session before the medical consultation, individual couples’ counseling, and a strengths-based group intervention. As a component of biopsychosocial screening, each patient and her partner were asked individually their understanding of the patient’s prognosis as “What is your understanding of the medical situation?” They were asked their understanding of the likelihood of cure with supporting text and percentages provided: 76-100%; 51-75%; 26-50%, or 0-25%. Results: To date 241 women and their partners are included in this analysis. All the patients had metastatic breast cancer and were being evaluated by a Medical Oncologist. The majority of the patients, 67%, were > 50 years of age (Range 18-79years), 85% had an advanced degree (> high school); 93% selected English as their preferred language, and 100% completed the prognosis question. Five of the top 10 causes of distress were shared by the patient and her partner. These included: Feeling anxious or fearful, worry about the future, sleeping, fatigue, and managing multiple demands. Additional concerns of the patient included: side effects of treatment, understanding my treatment options, how my family will cope, fear of medical procedures and physical appearance. The partners endorsed: Best help my partner, losing control, talk about end of life, feeling down and depressed, and finances. The partner understood the prognosis to be more favorable than the patient. Conclusions: It is feasible to introduce a prognosis question for both patient and her partner as standard of care. Given the importance of open communication amongst the patient, partner, and physician regarding advanced care planning, there is the potential to decrease the devastation of decisional regret in both patient and partner. Citation Format: Joanne Mortimer, Kimberly Romig, Claudia Cuevas, Lynne Thomas, James Waisman, Karen Clark, Marianne Razavi, Matthew Loscalzo. The “Couples Coping with Cancer Together Program” provides insight into individual’s distress and an opportunity to discuss prognosis in a manner that is normalized as standard of care [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-11-05.

IntroductionChildren’s medical fear refers to the negative emotional experiences, including fear, anxiety and nervousness, that arise when children are confronted with medical procedures and related events during healthcare encounters. This phenomenon exerts substantial negative impacts on treatment adherence, procedural cooperation and therapeutic outcomes, thereby emerging as a critical focus in modern paediatric medicine and psychiatric care. The establishment of precise assessment protocols serves as the cornerstone for developing effective intervention strategies. Despite the proliferation of assessment instruments targeting paediatric medical anxiety, there remains a notable paucity of rigorous methodological evaluation regarding their psychometric properties and clinical utility. This systematic review aims to bridge the existing gap between theoretical frameworks and clinical application by conducting a comprehensive evaluation of measurement properties of instruments designed to assess children’s medical fear, with particular attention to their reliability, validity and clinical applicability across diverse patient populations and healthcare settings.Methods and analysisThis study protocol has been developed in strict accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, ensuring methodological rigour and transparency. A comprehensive search of literature will be conducted across four English databases (PubMed, Web of Science, CINAHL via EBSCOhost and PsycINFO via ProQuest) and three Chinese databases (China National Knowledge Infrastructure, WanFang Data and SinoMed) from inception to 30 September 2025. The systematic review will incorporate comprehensive evaluation of measurement instruments assessing children’s medical fear across multiple modalities, including self-report measures, observer-rated scales, behavioural observation protocols and semi-structured clinical interviews. The psychometric evaluation framework will encompass five critical domains: reliability, validity, responsiveness to clinical change, interpretability of scores and clinical utility in diverse healthcare settings. We will include primary quantitative studies published in English or Chinese.Ethics and disseminationEthics approval will not be required. The results of this systematic review will be submitted for publication in a peer-reviewed journal.PROSPERO registration numberCRD420250656564.

The effect of serious game on the level of anxiety, fear, knowledge of hospitalized children and level of anxiety in their parents.

A Pregnant Woman’s Fear of Her Baby

Implementation science and breast cancer control: A Breast Health Global Initiative (BHGI) perspective from the 2010 Global Summit

This study explored the relationships among medical fears, coping behaviour patterns and acute pain perceptions in 17 children with cancer who were encountering a painful medical procedure. The children completed the Child Medical Fear Scale (CMFS) before undergoing a lumbar puncture (LP), which was videotaped. The children's coping behaviour during the procedure was rated independently and classified as active or passive behaviour. Immediately following the LP, the children, using a pictorial scale, reported their pain perceptions. Most of the children's scores on the CMFS indicated a moderately low level of fear of medical experiences. A majority of the children perceived a great deal of pain during the LP. During the five phases of the painful medical procedure, more than half of the children exhibited a combination of active and passive behaviour. No significant differences were found between exhibited active or passive coping behaviour and reported medical fear levels; however, children who exhibited passive coping behaviour patterns reported more pain than those who demonstrated active coping behaviour. Implications for practice relate to the need for continual preparation and support of children during a painful procedure.

The Effects of a Therapeutic Play/Play Therapy Program on the Fear and Anxiety Levels of Hospitalized Children After Liver Transplantation

We compared the efficacy of multimedia computer hospitalization preparation instruction to a conventional slide show in reduction of children's medical fears. Changes in hospitalization knowledge and intervention satisfaction were also assessed. Eighty-four 3rd-grade children were randomly assigned to either the computer or slide show groups. Computer instruction was equally effective to that of conventional procedures in producing significant decreases in medical fears. Children in both conditions also demonstrated similar significant gains in hospitalization knowledge. Children reported significantly greater satisfaction with the computer program. Implications regarding the use of computer-based hospital preparation are discussed.

The Impact of a Nursing Coping Kit and a Nursing Coping Bouncy Castle on the Medical Fear Levels of Uzbek Refugee Children

Fear of pain associated with medical procedures and illnesses

BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the United Arab Emirates, highlighting the need for a deeper understanding of public perceptions and challenges.AIMTo assess the attitudes and barriers toward organ donation.METHODSA cross-sectional study was adopted and included 607 samples consisting of students, faculty, and staff who were selected from three universities in Ajman and who had signed consent forms. A validated self-administered questionnaire that included 13 attitudes and 14 barrier items was used as a tool. The reliability of the tool was 0.89 (Cronbach's alpha). In the analysis of attitude scores, responses were rated on a scale from 0 to 4, with 0 representing 'strongly disagree' and 4 representing 'strongly agree' for supportive attitudes towards organ donation. Participants with a total attitude score of 39 or higher indicated agreement or strong agreement with all items, reflecting a generally supportive attitude toward organ donation. Lower scores suggested that the respondent was neutral or disagreed with one or more items, indicating a less supportive attitude toward organ donation. Knowledge about organ donation was assessed by self-administered questionnaire that included 13 items. Analysis was done using SPSS version 29. χ2 was used to assess associations between variables.RESULTSMost participants were young (≤ 30 years old, 83.7%), female (79.2%), from World Health Organization Eastern Mediterranean Region countries (69.5%), Muslim (82.4%), students (80.6%), single (83.9%), and from a nursing college (33.1%). The majority had no personal or family history of organ donation (93.2% and 93.9%, respectively). Supportive attitudes toward organ donation were significantly associated with religion (P = 0.003), working status (P = 0.009), university (P = 0.019), and knowledge (P < 0.001). Additionally, those with a personal or family history of organ donation were significantly more supportive (56.8% vs 33.3%, P = 0.004). Lack of awareness was the most reported barrier for organ donation (64.1%) followed by being afraid of organ donation due to medical procedures required (51.9%).CONCLUSIONThe findings suggest that supportive attitudes toward organ donation are influenced by demographic factors, personal experiences, and knowledge levels. Lack of awareness and fear of medical procedures were the most reported barriers to organ donation. These results highlight the need for targeted educational programs to increase awareness and promote positive attitudes toward organ donation.

Looking for a Needle in a Haystack: The Importance of Having Optimal Display Luminance Level for Breast Cancer Detection on Digital Breast Tomosynthesis