Cancer Experience Research Articles

Communicatively constructing resilience: Exploring family resilience in the experience of hereditary cancer

AbstractObjectiveThe goal was to explore how families communicate to cope with hereditary cancer conditions and identify factors that may enhance resilience and recommended decision‐making.BackgroundFamilies with Hereditary Breast and Ovarian Cancer syndrome (HBOC), Lynch syndrome (LS), and Li‐Fraumeni syndrome (LFS) have an increased lifetime risk of developing cancer. We use the communication theory of resilience (CTR) to examine how families engage in resilience and make health decisions about hereditary cancer risks over time.MethodWe conducted 42 dyadic interviews with families with HBOC, LS, and LFS. Themes emerged through qualitative analysis for each of the resilience processes outlined by CTR (crafting normalcy, communication networks, identity anchors, alternative logics, and foregrounding productive action while legitimizing negative feelings), illustrating how family members manage stressors associated with hereditary cancer over time.ResultsParticipants described enacting each of the five CTR processes to manage the acute and chronic stressors associated with hereditary cancer. We described themes that emerged within each of the five resilience processes.ConclusionFindings demonstrate the ways in which families managing hereditary cancer risks enact resilience processes and how these processes may have a complex relationship to coping and medical decision‐making.ImplicationsFindings demonstrate areas for intervention to support familial resilience.

P2.16D.01 Changes in Students' Perceptions of Cancer Through Cancer Education and Lectures by External Instructors with Cancer Experience

P2.16D.01 Changes in Students' Perceptions of Cancer Through Cancer Education and Lectures by External Instructors with Cancer Experience

Summer Camp Clinical Placements in Young Families Nursing: An Interpretive Description Study.

Obtaining meaningful clinical experiences with paediatric and perinatal (young families) populations is increasingly challenging for nursing programs. Care for this population has largely moved to outpatient and tertiary settings. Therefore, a current trend is to use non-traditional clinical settings. While summer camps offer rich learning experiences for nursing students, they are seldom used as clinical placements. Faculty at an Atlantic Canadian university sought a novel way to engage students in young families' learning by partnering with overnight summer camps, staffed by counsellors, camp administrators, and on-site nurses. Campers included those with lived experience of cancer, diabetes, physical and developmental challenges, and socioeconomic challenges. This study assesses how young families course outcomes were met by an innovative clinical experience within a Bachelor of Nursing program and describes the perceptions and experiences of those involved. Study participants included students (n = 4), camp directors (n = 3), a camp nurse (n = 1), and the clinical educator (n = 1). Data collection involved semi-structured interviews and a focus group. Interpretive description methodology was used to identify themes and patterns related to overarching research questions. Students met the outcomes and overall participant perceptions and experiences were positive. However, some participants shared constructive critiques for future consideration. Nursing students who completed a young families clinical placement at summer camps met course outcomes, and those involved reported both positive experiences and constructive critiques for future consideration.

Factors for Consideration for Hematological Cancer Patients When Planning for Place of Death: A Constructive Grounded Theory Study.

Planning for place of death is considered troublesome for patients with hematological cancer. Qualitative studies have focused on healthcare professionals and caregivers. To date, no study has been conducted from the patient's perspective of planning for place of death in the last year of life. To develop an understanding of how patients with hematological cancer experience planning for place of death in their last year of life. The study used constructivist grounded theory, semistructured interviews, a constant comparison technique, and memoing to collect and analyze data. The 21 participants were attending a cancer center, cancer unit, or hospice in the United Kingdom. This article describes one core category, factors influencing planning for death, within the incurable hematology cancer illness trajectory through the following 2 subcategories: personal factors-driving away, developing a legacy, designing a death plan, and disease determining; and environmental factors-dependent determination, displacement of the home, and discernment of services. This critical study illustrates that planning for place of death is complex and multifaceted in conjunction with an unpredictable incurable illness trajectory. Preferences for the place of death will change over time depending on the illness trajectory experienced by patients with hematological cancer and the level of physical and emotional energy and independence afforded to discuss and plan.

Women's Experience and Management of Cancer-Related Fatigue and Psychological Distress During Treatment for Gynaecological Cancer: A Qualitative Study.

To explore women's experience and management of cancer-related fatigue and psychological distress during treatment for gynaecological cancer. Qualitative descriptive study. Face-to-face semistructured individual interviews were conducted with 23 women in mainland China undergoing treatment for gynaecological cancer between July and October 2023. Data were analysed using content analysis. Three categories were identified: overwhelming experience of cancer-related fatigue, diverse experiences of psychological distress and strategies for managing cancer-related fatigue and psychological distress. Participants reported physical exhaustion and emotional fatigue, disrupting their normal lives. Psychological distress included distress due to cancer treatment, psychological burden associated with social relationships, frustration with being ill and worries about disease progression and recurrence. Strategies for managing symptoms were mainly nonpharmacological, with some unable to find suitable methods. This study found that participants had a complex experience of cancer-related fatigue and psychological distress, influenced by social expectations regarding women's roles and treatment impacts on reproductive health and femininity. These findings underscore the need for comprehensive interventions involving family members or fellow patients to reduce both symptoms. Nurses should focus on addressing cancer-related fatigue and psychological distress in women receiving treatment for gynaecological cancer, particularly in adolescents and young adults. It is essential to provide comprehensive care to improve their physical and psychological well-being. This study explored how women with gynaecological cancer experience and manage cancer-related fatigue and psychological distress. The findings highlight the need for holistic care that addresses physical and psychological symptoms. Nurses should consider the impact of reproductive health and femininity on symptom experiences and management. Furthermore, the findings could inform the development of evidence-based interventions to improve the physical and psychological well-being of women with gynaecological cancer. Standards for Reporting Qualitative Research checklist. No patient or public contribution.

'Balancing Challenges and Personal Resources': A Qualitative Study of Women's Experiences of Arm Impairment After Axillary Surgery for Breast Cancer.

To explore how women previously treated for breast cancer experience living with arm impairment after axillary surgery. Descriptive qualitative study. The inductive starting point for the analysis was followed by a deductive approach as the categories were related to the components of the sense of coherence framework. Twenty-eight relapse-free Swedish-speaking females participated in six focus group discussions conducted between September and December 2022. All participants had undergone sentinel lymph node biopsy with or without completion axillary dissection4 years earlier. Data were analysed using qualitative content analysis. Three categories and an overall theme were identified. The categories 'Sense-making', 'Daily life' and 'Driving force' reflect actions to understand and prevent arm symptoms, adaptations made in daily life and the empowering resources adopted to meet challenges. The overall theme, 'Balancing challenges and personal resources', comprised a process that began at diagnosis and remained ongoing for some participants. Most participants considered their new life situations manageable. However, those with more pronounced arm impairment reported that they did not always receive adequate aid, and that their daily lives were negatively affected. Returning to everyday life after axillary surgery for breast cancer is associated with varying degrees of challenges. Individuals with persistent arm impairment find returning to normal life more challenging. Therefore, further improvements in person-centred care are of utmost importance. Members of the Swedish Breast Cancer Association were involved in the creation of the interview guide. This study emphasises the requirement for providing further individualised support to those living with more severe arm impairment after axillary surgery. This study was reported in accordance with the Standards for Reporting Qualitative Research.

The PAR3TY Project: Revealing Unique Cancer Experiences and Insights of Teenagers and Young Adults through Patient Engagement, Participation, and Performance.

Cancer in teenagers and young adults (TYAs) coincides with major life transitions and presents unique psychosocial challenges. Understanding the experiences and needs of TYAs is critical. TYAs want to play an active role in improving cancer for TYAs; however, few opportunities exist for TYAs to do so. Using a tri-partite methodology, an international team collaborated with four TYA co-researchers in this pilot study to explore how performative staging strategies help convey TYA experiences with cancer. Using creative video, TYA co-researchers shared cancer experiences and insights in novel, impactful ways. The process provided intrinsic benefits for co-researchers to connect with other TYAs and creatively share their experiences and perspectives. Furthermore, it provided space for dialogue between TYAs and cancer care allies where TYAs could convey the nuances of their cancer experiences and how cancer care could be improved. This tri-partite methodology can support TYAs to actively engage in a process of connection, reflection, creation, and dissemination to improve cancer experiences for TYAs.

Involving children and young people in supportive cancer care research: the value of FDS grant funding and charitable partnerships

INTRODUCTION Involvement of children and young people in research has a multitude of benefits for children, researchers and the quality of the research itself. Despite the benefits of involvement, this is not always completed or reported in practice. METHODS This paper looks at the involvement of children and young people during a research study exploring the acceptability of photobiomodulation for mucositis management. It considers the importance of costing involvement into grant funding, and the value of charitable partnerships in conducting research with patient and public involvement. RESULTS Children and young people with experience of cancer, and their parents, were involved at the stages of grant application, research design, data analysis and dissemination. Involvement of families resulted in changes to inclusion criteria, plain language summaries and participant information documents. They provided insight into data analysis, and designed and filmed co-created video outputs to support acceptability of the treatment, dissemination of the research and research involvement of other children. Involvement was supported both practically and financially by charitable partnership with the Candlelighters children’s cancer charity as well as research grant funding from the Royal College of Surgeons of England’s Faculty of Dental Surgery. CONCLUSIONS Child and parent contributors shaped the research project, resulting in changes to the study design, data analysis and co-creation of video resources. Charitable partnership and flexibility of involvement supported diversity in the context of paediatric cancer research. Researchers should consider what they can contribute in return to child contributors and charities who provide support.

Understanding the Intersection of Identity and Cancer Experience Among Racially, Ethnically, Gender and Sexual Minoritized Adolescents and Young Adults With Cancer.

Adolescents and young adults (AYAs, 18-39years) 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. 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. 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. 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.

Descriptive and content analysis of breast cancer vlogs on YouTube.

258 Background: Vlogs, or “video blogs,” are personally-created experiential videos based on wide-ranging topics, usually posted to YouTube. Many women with breast cancer (BC) document their cancer experiences in YouTube vlogs. These may have the potential to serve as peer-to-peer support and provide community. This study provides a descriptive and content analysis of vlogs by women with BC. Methods: YouTube was searched in incognito mode in 11/2023 using the search terms “breast cancer vlog.” A maximum of 10 videos/creator were included based on viewership and date created.Video characteristics collected included: title, length, number of views, likes, comments, and playlist inclusion. Videos were assessed for sponsorship, presence of explanation and discussion on BC, type of content, and themes. Creator characteristics included age, location, and engagement approaches. Descriptive and content analysis were performed to assess and analyze video content and potential areas where peer-to-peer support may be provided. Results: 90 vlogs by 13 creators were included, all originating from personal accounts. Mean video length, number of views, and number of comments were 21.4 minutes (SD 9.1), 266,780 (SD 534,465), and 1485 (SD 3422), respectively. 38.9% included hashtags. 12.2% included paid sponsorships. Most common filming location was at home (96.7%), followed by the hospital (31.1%), or in the car (21.1%). Home vlogs were most often set in the living room (44.3%), bedroom (33.0%), or kitchen (20.6%). 56.7% included visuals of treatment as well as physical findings. Creators addressed motivation for vlogging in 48.9%; the two most common reasons were wanting to build a community and helping others in a similar situation. In 46.7%, creators explicitly expressed emotion. Most common themes were treatment (85.6%), mental health (81.1%), side effects (72.2%), appearance (63.3%), and family relationships (36.7%). Subthemes included young age, finances, and the importance of online community support. Patient-directed advice was offered in 60.0%, mostly on treatment-related issues. In 56.7%,creators provided explicit treatment definitions. Chemotherapy was discussed in 70.0%; surgery in 57.8%, primarily mastectomy; radiation in 30.0%; general side effects in 71.1%. 24.4% were about a new diagnosis. When mentioned (44.4%), most common creator location was the USA. When mentioned (30.0%), most common age demographic was 20-29 years old. Conclusions: Vlogs by women with BC receive significant levels of engagement. The dedication to building community demonstrated by vlog creators, and the personal nature of their storytelling, advice, and suggestions, may make these vlogs a potential resource for peer-to-peer support.

Expanding oncology navigation capacity through digital and in-person volunteer support: ACS Community Access to Resources, Education, and Support (ACS CARES).

205 Background: The American Cancer Society (ACS) CARES (Community Access to Resources, Education, and Support) is a novel nationwide non-clinical navigation program for people with cancer and caregivers. ACS CARES includes a multi-channel approach providing direct, individualized, non-clinical assistance through a native app, telephonic, and in-person support. This study examines the feasibility of leveraging non-clinical virtual and in-person volunteers to expand navigation capacity. Methods: This pragmatic study evaluates the implementation of volunteer navigation of patients and caregivers accessing virtual navigation via the ACS CARES app and in-person/telephonic navigation for patients at 3 pilot cancer centers. Virtual and in-person volunteers aim to deliver timely information and support for health-related social needs (HRSNs) identified using a HRSN assessment, which was adapted from the NCCN distress thermometer and problem list. Initial process measures include number and demographics of patients served, HRSNs, and time spent by volunteers. Results: In the first year, 4,673 individuals utilized the ACS CARES app (54% people with cancer, 31% caregivers, 15% supporters). Since launching the virtual connection feature on 11/30/2023, we have trained 122 virtual volunteers (20% Black, 78% female, 8% Hispanic) who have made 182 connections with app users. App users prioritized matches based on shared cancer experience (47.7%), caregiving for an adult with cancer (28.8%), need for help finding information (12.4%), desire for a Spanish-speaking volunteer (3%), other (8.1%, geographic location, caring for a child with cancer volunteers averaged). Community volunteers averaged 11 messages per connection over 35 days. From 10/23/2023 to 4/30/2024, 31 volunteers at 3 cancer centers navigated 195 patients who were 55% female, 22% Black, with an average age of 53.02. The most common HRSNs were finances and transportation. Volunteers spent an average of 105 min per patient per in-person meeting, 35 min per patient per follow-up call, 38 min per patient coordinating care and sending encrypted messages, and 75 min per patient identifying and providing resources to address barriers to care. Conclusions: Preliminary data indicates feasibility of leveraging the multi-channel approach of CARES to address gaps in access to navigation. App utilization data analysis is ongoing. In-person support will be expanded to 9 additional cancer centers in September.

Long-term opioid prescribing and the incidence of opioid-related hospitalizations or emergency department visits among patients with metastatic cancer.

200 Background: Many patients with metastatic cancer experience cancer-related pain which is commonly managed using opioids. Although opioids are an effective tool for cancer pain management, their use can result in adverse effects which may be related to long-term use and are understudied in this population. Therefore, we aimed to describe long-term opioid prescribing (LTOP) practices among patients with metastatic cancer and investigate the incidence of opioid-related hospitalizations and emergency department (ED) visits among recipients of long-term prescribing. Methods: This retrospective cohort study used population-based data from Alberta, Canada to identify patients diagnosed with stage IV cancers between 2004-2017 who had at least 1-year of follow-up and were opioid naïve at diagnosis. LTOP was defined as receipt of a ≥90-day supply of opioids with less than a 30-day gap in supply within a 180-day period. Prescribing practices were characterized according to timing (early vs. end-of-life [EoL] onset), morphine equivalent dose, duration, and concurrent medication use. The EoL phase of disease was defined as the year preceding death. The incidence rate of opioid-related encounters was compared between different characteristics of LTOP. Results: The study included a total of 10927 patients, 2521 (23%) of whom received long-term opioid prescribing after diagnosis. LTOP became more common as patients approached EoL, with most patients (53%) having LTOP initiated only within their last year of life. 85 patients (3.4%) experienced an opioid-related hospitalization or ED visit after initiation of LTOP, with an incidence rate of 2.36 (95% CI 1.92, 2.86) encounters per 100 person-years. Higher opioid dosage and concurrent prescribing of anxiolytics, benzodiazepines, antidepressants, and neuroleptic medications were significantly associated with a higher incidence of opioid-related encounters. Conclusions: Long-term opioid prescribing is commonly experienced by patients living with metastatic cancer as a chronic disease. The concurrent use of psychoactive drugs during LTOP was associated with experiencing opioid-related hospitalizations/ED visits.

Association between food insecurity, financial toxicity, and healthcare utilization in adolescents and young adults with cancer.

305 Background: Adolescents and young adults with cancer experience high rates of financial toxicity (FT) and unmet health-related social needs (HRSN: food, housing, transportation insecurity). FT and unmet HRSN, specifically FI, are modifiable factors that impact health outcomes; however, the relationship between FI, FT, and healthcare utilization (emergency department (ED) visits or hospitalizations) remains unclear. Leveraging systematic screening for FT and HRSN using the electronic health record (EHR) patient portal among AYAs with cancer, we examined the association between FI, FT, and healthcare utilization measures among AYAs with cancer. Methods: AYAs (ages 15-39) who utilize the EHR patient portal were prompted to complete an 8-item standardized HRSN survey (i.e., food insecurity, housing instability, transportation difficulties) and a 2-item previously established FT survey during e-check in between November 2022 and April 2024. ED visits and hospitalizations were extracted from the EHR directly. Descriptive statistics and associations using chi-square tests were used to describe the patients and examine associations between FI or FT and ED visits or hospitalizations. Results: Of 691 AYAs who completed the HRSN survey, 16% (n=109) screened positive for FI. Among AYAs with FI, 42% (n=46) had at least one ED visit compared with 28% (n=163) among AYAs without FI (p<0.01). Among AYAs with FI, 39% (n=43) were hospitalized at least once compared to 31% (n=179) among AYAs without FI (p=0.07). Of 439 AYAs who responded to the FT survey, 66% (n=290) met criteria for high FT. Within this group, 26% (n=74) had at least one ED visit compared with 17% (n=26) who screened negative (p=0.06). Among AYAs with high FT, 22% (n=65) were hospitalized at least once, compared with 19% (n=28) among those with low or moderate FT (p=0.38). Among 384 AYAs who responded to both the HRSN and FT surveys, 19% (n=74) screened positive for FI, 92% (n=68) of whom also had high financial toxicity. The table describes characteristics of screened AYAs by language and race/ethnicity. Conclusions: FI may be a risk factor for increased ED visits during cancer treatment among AYAs. Systematic screening to identify FI, FT, and other HRSN is important to facilitate referral for resources, support services, or interventions. Sociodemographic characteristics of AYA participants in FI and FT screening. Characteristic +FI -FI +FT -FT N=109 (%) N=582 (5) p-value N=290 (%) N=149 (%) p-value Language <0.01 <0.01 English 82 (75) 496 (85) 241 (83) 134 (90) Spanish 24 (22) 45 (8) 29 (10) 1(1) Other 3 (3) 41 (7) 20 (7) 14 (9) Race/Ethnicity <0.01 <0.01 Hispanic, any race 67 (61) 175 (30) 125 (43) 16 (11) Non-Hispanic Black 12 (11) 62 (11) 30 (10) 10 (7) Non-Hispanic White 16 (15) 219 (38) 78 (27) 84 (56) Other 14 (13) 126 (22) 57 (20) 39 (26)

The Experience of Patients with Endocrine Therapy for Breast Cancer: A Patient Journey Map Based on Qualitative Research.

(1) Background: While there is extensive documentation on the medical experience of breast cancer, a thorough understanding of the various stages of endocrine therapy remains insufficient. The aim of this study was to map the experiences and coping styles of breast cancer patients during endocrine therapy. (2) Methods: Qualitative research was conducted to gather insights into the experiences of breast cancer patients undergoing endocrine therapy. The themes were organized through content analysis and induction. Subsequently, patients were invited for face-to-face interviews at a top-three hospital in Guangzhou to supplement and validate the findings from the literature review. The patient journey was then mapped based on both the literature review and the semi-structured interviews. (3) Results: A total of 24 studies were included that described patients' experiences and behaviors during the early, middle, and late stages of treatment, leading to the formation of a preliminary framework. Interviews were conducted with 20 patients, which confirmed and enriched the findings from the literature review. Based on these results, a stage trajectory for endocrine therapy in breast cancer was established. (4) Conclusions: The patient journey map developed in this study clearly and intuitively illustrates the thought and emotion matrix, as well as the behavior matrix, of breast cancer patients undergoing endocrine therapy. This provides a theoretical foundation for enhancing clinical services tailored to the needs of these patients.

Clinical outcomes and synergistic effect between radiotherapy and immunotherapy in patients with extensive-stage small cell lung cancer: a real-world study

BackgroundPatients with extensive-stage small cell lung cancer (ES-SCLC) experience significant therapeutic challenges and limited survival rates. This study aimed to investigate the efficacy of combining immunotherapy (IT) with chemotherapy (CT) for treating ES-SCLC and to explore the synergistic effect between radiotherapy (RT) and IT.MethodsThis retrospective analysis examined patients with ES-SCLC who received treatment at three centers. Furthermore, propensity score-matched (PSM) analysis was conducted. The Kaplan‒Meier method and Cox proportional hazards regression were used to compare the survival outcomes.ResultsA total of 257 eligible patients with ES-SCLC were included in the analysis. Among all patients, the median overall survival (mOS) was 18.0 m in the chemoimmunotherapy (CT + IT) group and 15.7 m in the CT group (p = 0.208). The median real-world progression-free survival (mrwPFS) was 7.7 m and 6.8 m (p = 0.043) in the CT + IT and CT group, respectively. Moreover, the mOS was 22.0 m in the chemoradiotherapy (CT + RT) group and 13.6 m in the CT group (p < 0.001). The mrwPFS was 7.4 m and 6.0 m (p = 0.175) in the CT + RT group and CT group, respectively. The multivariate analyses revealed that sex, liver metastasis and RT were independent prognostic factors for OS (p < 0.05), while liver metastasis and IT were found to be independent predictive factors of real-world progression-free survival (rwPFS) (p < 0.05). After PSM, the mOS was 23.2 m in the CT + IT group and 13.0 m in the CT group (p = 0.008). The mrwPFS was 7.3 m and 6.2 m (p = 0.096) in the CT + IT group and the CT group, respectively. Moreover, the mOS was 21.4 m in the CT + RT group and 12.5 m in the CT group (p < 0.001). The mrwPFS was 7.3 m and 5.2 m (p = 0.220) in the CT + RT group and the CT group, respectively. Additionally, our study revealed that in the PD-1 group, RT significantly improved patient survival (36.0 m vs. 15.8 m, p = 0.041).ConclusionAn increasing number of treatment options are being explored for ES-SCLC, and CT is the cornerstone of treatment for this disease. Combining CT with IT and RT has demonstrated remarkable efficacy and excellent safety profiles, and such treatments are worthy of further exploration.

Peace, equanimity and acceptance in the cancer experience: validation of the German version (PEACE-G) and associations with mental health, health-related quality of life and psychological constructs

BackgroundSystematic reviews and meta-analyses reveal the importance of an accepting attitude towards cancer for mental health and functional coping. The aim of this study was to examine the psychometric properties of the German translation of the Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE) questionnaire (Mack et al., 2008) and to investigate its associations with mental health, health-related quality of life (HRQoL) and related constructs.MethodsThe German version of the PEACE (PEACE-G) was created and validated with cancer patients in a cross-sectional two center questionnaire study. Construct validity was tested with confirmational factor analyses (CFA); Cronbach’s alpha was used to determine internal consistency of items. We further examined associations with depression (PHQ-8), anxiety (GAD-7), distress (NCCN distress thermometer), HRQoL (SF-12), psychological flexibility (AAQ-II), resilience (RS-11) and acceptance scales, to evaluate concurrent and divergent validity.ResultsN = 213 cancer patients with different tumor entities participated in this study. Results of the CFA replicated the two-factor solution of the original PEACE (peaceful acceptance and struggle with illness) with satisfactory psychometric properties. Peaceful acceptance showed negative associations with depression, anxiety, distress, psychological inflexibility, and positive associations with HRQoL, acceptance, resilience, and mindfulness. Results of sensitivity analyses indicate a third factor (injustice/anger).ConclusionsThe results demonstrate the validity and reliability of PEACE-G in cancer patients and point to the essential role of acceptance- and mindfulness-based interventions in psycho-oncology. Further studies are needed to investigate the different facets of struggle with the cancer illness.

The Effects of Laughter Therapy on Perceived Stress and Quality of Life in Women With Breast Cancer Receiving Chemotherapy: A Parallel-Group Randomized Controlled Pilot Trial.

Women with breast cancer experience various symptoms secondary to chemotherapy that reduce their quality of life and increase their stress levels. To evaluate the effects of laughter therapy on perceived stress levels and quality of life in women with breast cancer receiving chemotherapy using a parallel-group randomized controlled pilot trial. Forty-two women were randomly assigned to intervention and control groups. The intervention group received 40 minutes of laughter therapy twice a week for 8 weeks. The control group received routine treatment. The women in both groups completed the Perceived Stress Scale and SF-12 Health Survey at baseline, week 5, and week 9 after randomization. There was a significant decrease in the mean Perceived Stress Scale scores in the intervention group compared with those in the control group at weeks 5 and 9 compared with baseline, and the difference between groups by measurement week was significant (P < .001). Women in the intervention group had higher Physical Component Summary-12 and Mental Component Summary-12 scores in weeks 5 and 9 compared with those in the control group, and there was a significant difference between groups in terms of change in the Physical Component Summary-12 and Mental Component Summary-12 mean scores over time (P < .001). Laughter therapy is possible to use as a nursing intervention to reduce the perceived stress levels and increase the quality of life of women receiving chemotherapy for breast cancer. Nurses can apply laughter therapy in the symptom management of women receiving chemotherapy.

Scanxiety in survivors of pancreatic cancer

Purpose To understand the scanxiety experience in pancreatic cancer (PC) survivors following curative surgical resection. Design A qualitative study with a hermeneutic phenomenological approach was used. Methods Eighteen PC survivors participated. Data from in-depth, semi-structured interviews were analyzed and themes emerged from systematic line-by-line coding of the interview transcripts. Findings Two key themes emerged: ‘the recurring cycle of scanxiety’ and ‘hope for lifelong remission’. Participants experienced similar patterns of scanxiety that impacted everyday life. Hope was an essential stabilizing component of the cancer-scan experience, and enabled participants to conceptualize a cure, despite the high likelihood of recurrent, incurable disease. A conceptual framework was developed to provide further insight. Implications Everyday life is significantly affected during times of PC surveillance scans. This study enhances our understanding of the cancer-scan experience and provides a framework to guide care.

Relevance of the common‐sense model for people living with a genetic predisposition for breast and ovarian cancer

AbstractObjectivesBRCA1/2 pathogenic variants have been associated with an increased risk for breast, ovarian, pancreatic, prostate cancer as well as melanoma. The present research uses the Leventhal's common‐sense model of self‐regulation (CSM), a theoretical framework highlighting the role of mental representations on responses to a health‐threat. We aim at understanding the personal meaning and representation of living with an hereditary breast and ovarian cancer predisposition.MethodSemi‐structured interviews of 15 BRCA carriers were analysed using the interpretative phenomenological analysis.ResultsMental representations develops in childhood and are influenced by childhood emotional responses to the familial experience of the BRCA predisposition. Pre‐existing beliefs about BRCA, even erroneous, are deeply anchored and not called into question by medical informations given during the genetic counselling. This is particularly true when medical information is perceived as too complex, inconsistent or in contradiction with familial experience. These beliefs about the consequences of being carriers of the BRCA gene influence emotional and behavioural experiences leading to experience fear, anxiety, lack of hope for future or self‐identity change. For participants with a traumatic familial experience of cancer, the lack of treatment for this genetic disease generates a perpetual overestimation of cancers’ risk and the feeling of an unending danger associated with early death despite breast and ovarian prophylactic surgery. When strong negative representations of the BRCA predisposition are experienced, dysfunctional health behaviours, such as drugs consumption or overuse of medical consultations, could appear consecutively to emotional disorders.

Psychological Distress Among Women With Breast Cancer in Saudi Arabia: A Phenomenological Study.

Breast cancer has a negative impact on the psychological status of women.. In Saudi Arabia, there is limited research exploring the experience of women with breast cancer regarding the psychological influence of breast cancer. To explore the experience of women with breast cancer regarding the psychological distress of breast cancer in Saudi Arabia. A descriptive phenomenological study was used. Semi-structured interviews were utilized to gather information from a purposive sample of 11 patients with breast cancer who were receiving treatment at the Princess Noorah Oncology Center (PNOC) at King Abdulaziz Medical City in Jeddah, Saudi Arabia. The study employed thematic analysis to discern significant themes concerning psychological stress. Results: The study revealed that patients' psychological distress was a significant factor influencing their daily lives. This study also revealed four themes: psychological distress from the diagnosis and treatment side effects of breast cancer, daily and work-related activities reduction, the importance of social support, and the coping strategies employed by women with cancer. Breast cancer leads to significant psychological distress. Interventional programs are needed to address the psychological distress that women with cancer experience and provide the necessary support for them to employ positive coping strategies.