Psychological Care Research Articles

Existing psychological supportive care interventions for cervical cancer patients: a systematic review and meta-analysis.

Cervical cancer patients commonly experience psychological supportive care needs, necessitating diverse interventions to enhance psychological well-being and alleviate physical symptoms. This systematic review, covering English-published articles from January 1999 to April 2023, assessed the impact of psychological supportive care interventions on anxiety and depression. Twenty-Six studies, including 11,638 patients, were analyzed, comprising randomized controlled trials; quasi-experimental, and pre-post-test designs from PubMed; Science Direct; Wiley online library; Google Scholar; Cochrane Library; and JSTOR. The extraction of data was done by two independent authors and a third independent author checked the data extraction. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 2020 statement was adopted. The population, intervention, comparator, and outcomes (PICO) search strategy was applied. Effective Public Health Practice Project (EPHPP) tool was used to assess the quality of selected articles. Various interventions, such as psychological nursing, exercise, counselling, psycho-curative approaches, peer and family education, psychotherapy, and medication, were identified. Two studies incorporated homework sessions, predominantly administered by nursing staff. Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were commonly used instruments. Statistical analysis revealed a significant difference in anxiety and depression scores between treatment and control groups (p < 0.005) post-intervention across all studies. A subsequent meta-analysis of eight homogeneous studies, utilizing a random-effects model, showed a moderate-to-high overall effect size (1.35, 95% CI: 0.75 to 1.94), indicating a statistically significant positive impact. Various studies exhibited variability in effect sizes ranging from low to high. While the meta-analysis included 936 participants, the forest plot visually represents individual study effect sizes and the combined effect size. Preliminary evidence supports the positive impact of psychological supportive care interventions on cervical cancer outcomes, urging further research, especially exploring long-term effects and employing rigorous study designs.

Collaboration between the French TMAS and CRAPEM on the management of psychiatric emergencies at sea

Doctors at the French Telemedical Assistance Service (TMAS) provide support to ship captains via teleconsultation for the management of medical emergencies during navigation. In response to this emerging demand for psychological or psychiatric care, TMAS doctors have been calling as and when required on a specialised platform known as the Resource Center for Psychological Assistance at Sea (CRAPEM), based in Saint Nazaire, France, since 2020. The study objective was to compare the management of psychiatric emergencies at sea by TMAS doctors alone versus TMAS doctors assisted by CRAPEM. We conducted a retrospective, descriptive epidemiological study between 1 January 2020 and 31 December 2021. We extracted data from AppliCCMM on patient characteristics, ship characteristics, management characteristics including final decision (treatment on board, disembarkation, diversion, evacuation or death) from previously identified diagnostic coding. Decisions were compared for “case” versus “control” using Chi-2 tests. Differences were considered significant if the P value was below 0.05. The analysis therefore focused on 21 patient cases and 63 patient controls. A comparison of the final decisions shows that patients in the CRAPEM group receive significantly (p < 0.001) less treatment on board. This difference is probably related to the fact that the patients for whom TMAS doctors seek advice from CRAPEM have more serious conditions. CRAPEM is a new organization aimed at improving the management of psychiatric illnesses in seafarers and, in our case, acute-phase psychological and psychiatric emergencies. Given the specific characteristics of the maritime environment, its intervention improves the management of patients at sea.

Sex Differences in Screening Positive for Post-Traumatic Stress Disorder After Combat Injury.

U.S. military women were at risk of combat exposure and injury from asymmetric warfare during the conflicts in Iraq and Afghanistan. Previous research has yielded mixed results when examining sex differences in PTSD following operational deployment. To date, no study has explored sex differences in PTSD after combat injury. This retrospective study included U.S. military service men and women who experienced a combat injury in Iraq or Afghanistan (March 2003 to March 2013) and completed a Post-Deployment Health Assessment (PDHA) within 1 year of injury. The PDHA is administered at the end of deployment and includes the 4-item Primary Care PTSD Screen. The prevalence of screening positive for PTSD was evaluated by sex using a chi-square test. Multivariable logistic regression was used to assess the association between sex and PTSD while adjusting for covariates. The study sample included 16,215 injured military personnel (666 women and 15,549 men). The average time between injury and PDHA was 132 days (SD = 91.0). Overall, women had a higher prevalence of screening positive for PTSD than men (48.3% vs. 40.9%, P < .001). In multivariable regression, women had higher odds than men of screening positive for PTSD (odds ratio, 1.34; 95% confidence interval, 1.14-1.57). Psychiatric history was the strongest predictor of screening positive for PTSD regardless of sex (odds ratio, 1.59; 95% confidence interval, 1.45-1.74). In this novel study of military service members, women were more likely to screen positive for PTSD than men after combat injury. Strategies to mitigate PTSD, enhance resiliency, and incorporate psychological care into injury rehabilitation programs for women may be needed for future U.S. military conflicts where they will play a larger role in combat operations.

THANATOPHORIC DYSPLASIA: Birth, death, and the experience of family support and neonatal palliative care

Tanatophoric dysplasia is a usually lethal genetic syndrome in the perinatal period, which has a significant psychological impact on the pregnant woman and family. It necessitates careful monitoring by the health professionals involved in the care. The objective of this work is to present an experience report on the psychological and multidisciplinary monitoring of a pregnant woman diagnosed with type 2 tanatophoric dysplasia during prenatal screening. The methodology of the present study involves presenting a clinical case with a description of the clinical and psychological conditions of the pregnant woman, along with the interventions carried out by the health professionals involved in the case. The pregnant woman sought psychological care after receiving the diagnosis of type 2 tanatophoric dysplasia. Subsequently, the psychologist coordinated with other health professionals involved in the case and the institution where the delivery would take place, leading to the development of a collaborative planning and management approach. Upon discussion, the pregnant woman and her family opted for palliative care for the newborn. The team of professionals aligned their approach to meet the family’s wishes and needs. The newborn received supportive measures but survived for only a few hours before passing away. The integrated performance of the health team professionals and the flexibility of the hospital institution allowed the adequate planning of care actions and facilitated a positive reception experience for the family. This case highlights the importance of psychological support, individualized planning, and the relevance of teamwork in providing comprehensive care during such challenging circumstances.

ANALYSIS OF THE STATE OF PSYCHIATRIC CARE IN UKRAINE

The aim of the study. To analyze the current state of psychiatric care in Ukraine against the background of its reform; to investigate the dynamics of individual indicators of mental health and the activity of institutions providing psychiatric care for the period 2008-2021. Material and methods. The materials of the study were official statistical data from the reports of the State Statistics Service of Ukraine, the Center for Medical Statistics of the Central Health Service of the Ministry of Health of Ukraine for 2008–2021, and the Institute of Health Indicators and Evaluation (IHME, USA) on the global burden of diseases. Bibliographic, epidemiological, medical-statistical, analytical methods were used in the research. The results. The relevance of studying the current state of the organization of psychiatric care in Ukraine is primarily determined by the growing need of the population in connection with the negative impact of the consequences of the war on mental health. It was established that the prevalence of mental disorders in Ukraine in the period from 2008 to 2017 decreased by 17.8% and amounted to 3944.8; primary morbidity decreased by 38.7% and amounted to 300.9 cases per 100,000 population in 2017. Mortality from mental disorders in the period 2008-2017 decreased by 2.7 times to 2.3 cases per 100,000 population. However, in 2021 it was already 2.4. According to the second stage of the health care reform, there is a reduction in inpatient psychiatric facilities and their bed fund (by 40-50% on average). Medical facilities that provide psychiatric care lack qualified specialists (53-73% of positions are filled). Conclusions. Deinstitutionalization, which is carried out in Ukraine, is consistent with the Concept of the state target program of mental health care in Ukraine for the period until 2030. When reducing beds in psychoneurological hospitals, it is necessary to create conditions for alternative treatment of mentally ill patients in order to maintain the availability of care. The dynamics of changes in mental health indicators and the activity of healthcare institutions have regional features that must be taken into account when calculating the need for various types of psychiatric care. Optimizing psychiatric care is hindered by a lack of psychiatrists and psychologists, but the involvement of family doctors in the provision of psychological care and the introduction of mobile interdisciplinary teams will help.

Work injuries and mental health challenges: A meta‐analysis of the bidirectional relationship

AbstractThe link between work injuries and mental health challenges significantly impacts individuals, organizations, and society. However, an integrated understanding of their relationship is lacking due to fragmented research across various disciplines. Drawing from uncertainty in illness theory, our comprehensive meta‐analysis (147 samples, N = 1,457,562) clarifies the bidirectional relationship between work injuries and mental health challenges. We estimate the average strength of the association, compare temporal ordering (work injuries preceding mental health challenges, and vice versa), explore underlying mechanisms, and identify potential moderating factors. Results from a random‐effects model reveal a moderate association between work injuries and mental health challenges (k = 147, ρ = .21, 95% CI = .19, .24, 95% CR = −.11, .50). Notably, the relationship is stronger when work injuries precede mental health challenges (k = 40, ρ = .23, 95% CI = .18, .29, 95% CR = −.10, .52) compared to the reverse (k = 18, ρ = .11, 95% CI = .03, .19, 95% CR = −.23, .42). Negative cognitions and perceived job demand underlie the bidirectional relationships between work injuries and mental health challenges. These findings highlight the interconnected nature of work injuries and mental health challenges, illustrating the need for comprehensive rehabilitation approaches that integrate physical and psychological care, and paving the way for future research and interventions.

ONCOLOGY PATIENT'S ATTITUDE TOWARDS THE PERCEPTION OF AN EXISTENTIAL BEING, THAT IS: A finite being

The conception of birth, considered a spontaneous act, which results after a long heating process that refers to gestation, as well as the human life cycle, is, on an existential level, a heating process, but for another spontaneous act, death. In this study, we sought to understand the perceptions about finiteness that cancer patients in palliative care have. Being a qualitative, phenomenological study, semi-structured interviews were used, and Bardin's content analysis approach was used. Six patients admitted to an oncology clinic in a hospital in the west of Santa Catarina were interviewed. The results of this study demonstrate that cancer patients present the perception of presenting their own death, since the impact of the diagnosis causes adverse reactions, making it possible to question their own existence, as well as the restrictions that the disease imposes and the coping resources used, recognizing the responsibility of your choices will reflect the death process, since being aware of death makes you think about life. It is considered the need to promote spaces for listening and welcoming the anxieties of cancer patients in the hospital environment, with psychological care being essential to carry out interventions and improve comprehensive care for patients, helping to find or create meaning in existence, taking into account consideration of the cultural, spiritual and social context. Likewise, pay attention to total pain care, so that everyone who goes through a terminal illness has the relief and lightness of living until the act of death.

Anxiety and fear of COVID-19 as potential mechanisms to explain vaccine hesitancy among adults.

Vaccine hesitancy is a significant global problem resulting from the interaction of multiple factors, including mental health factors. However, the association of COVID-19 vaccine hesitancy with mental health has not been well-examined, especially in Arab culture. This study aims to identify the correlation between anxiety/fear of COVID-19 and vaccine hesitancy among Saudi adults. An online-based survey was administered to 558 participants from all regions of Saudi Arabia using the snowball technique. However, this sample may not be representative of the Saudi adult population. Participants responded to the Questionnaire of Vaccine Hesitancy, the COVID-19-Anxiety Questionnaire (C-19-A), and the Fear of COVID-19 Scale (FCV-19S). Data were analyzed on vaccine uptake, vaccine hesitancy, coronavirus infection, and demographic variables. The predictive factors of vaccine hesitancy were examined in one model using multiple regression analysis by the Enter method (P= 0.05). COVID-19 anxiety and fear have significant correlations with vaccine hesitancy (Phi=0.33, P=0.017; Phi=0.29, P=0.013, respectively). Anxiety and fear were higher among unhesitating participants (t =2.469, P=0.014; t=2.025, P=0.043, respectively). Participants who had previously been infected with coronavirus were more likely to be hesitant (X2=23.126, P=0.000). Participants who scored high in anxiety were more likely to be vaccinated (F=3.979, P=0.019) and have a secondary school or college education (F=4.903 P=0.002). COVID-19 anxiety, gender, and coronavirus infection significantly predicted vaccine hesitancy. Anxiety and fear of COVID-19 are among the most important factors correlated with vaccine hesitancy; unhesitant people are more likely to have anxiety and fear. COVID-19 anxiety significantly predicted vaccine hesitancy. We recommend integrating psychological care into vaccination plans to help increase the uptake rate during potential subsequent pandemics. Relevant intervention programs can be designed to help increase vaccine acceptance, deal with vaccine hesitancy, and relieve psychological symptoms during major pandemics. Psychologists can provide awareness messages, counselling seminars, online mentoring, or telemental health outreach.

Abstract PO4-12-01: Navigation program for timely needs assessment and referral to appropriate services among young breast cancer patients in Mexico

Abstract Background: International guidelines on young women with breast cancer (YWBC) endorse patient navigation (PN) and education interventions to reduce barriers that hinder early access to information and healthcare. In Mexico, the first PN program for YWBC was created by Joven &amp; Fuerte in 2020 for the systematic identification of patients’ medical and support needs and their referral to the appropriate services. This study aims to evaluate whether the PN program facilitates referral and timely access to specialty or supportive care services, to identify the associated barriers, and to assess patients’ satisfaction. Methods: This prospective cohort included women ≤40 years, recently diagnosed with BC (≤3 months [m]), treated at Instituto Nacional de Cancerologia from Nov-20 to Jun-23. Participants were exposed to a PN program in which a series of target questions and validated surveys were applied at baseline, 3 m and 6 m to systematically identify their needs. At each timepoint, the navigator had an in-person or remote meeting with each patient to provide general BC information, share the detected needs, and provide referral to the required services. Patients’ attendance to referrals and related barriers at baseline and 3 m were assessed at 3 m and 6 m, respectively. Results: 207 patients had completed baseline navigation at the time of the analysis, while 138 (67%) and 123 (59%) had completed 3 m and 6 m navigation, respectively. Median age at diagnosis was 36 years (21-40). Most patients had ≥high school education (57%), were unemployed (67%), were single/divorced (52%), had ≥1 child (72%), and had public (79%) or no (21%) health insurance. The services patients were referred to according to their needs and their rates of attendance are detailed in the Table. The most mentioned barriers for attendance to referrals at both baseline and 3 m were patient-physician miscommunication (n=36 and n=32), personal decision not to attend (n=18 and n=8), and forgetfulness (n=6 and n=8). Moreover, attendance to referrals made in 2022-2023 was significantly higher than in 2020-2021, when COVID-19 restrictions were in place (72% vs 48%; p&amp;lt; .001). Feedback on the PN program was provided in 172/207 (83%), 96/138 (70%), and 123/123 (100%) cases at baseline, 3 m and 6 m, respectively. At all timepoints, nearly all patients were very satisfied/satisfied with the program (98-99%); believed the needs detection survey had explored aspects they deemed relevant at the moment (91-98%); affirmed the program had eased their referral to all (73-80%) or some (19-27%) of the services they believed they needed; and stated the program aided them to better cope with their illness (97-99%). Most (82-88%) rated their satisfaction with the information provided by the program ≥90/100. Conclusion: The main needs observed in this YWBC cohort comprised access to support groups, nutritional counseling, psychological care, and wig providers. The vast majority of patients were highly satisfied with the information and guidance provided by the PN program. Although PN timely identified patients’ health needs and informed them on their individual referral recommendations, attendance rates to the required services were suboptimal in most cases. Factors for non-attendance included possibly the COVID-19 pandemic, as well as personal and health system aspects, which should be further explored to effectively address them and increase timely access to comprehensive, patient-centered care. Table. Patients’ referral and attendance to specialty and supportive care services Citation Format: Fernanda Mesa-Chavez, Lucero Labra, Ana Rodriguez, Alan Fonseca, Marlid Cruz-Ramos, Alejandra Platas, Paula Cabrera-Galeana, Cynthia Villarreal-Garza. Navigation program for timely needs assessment and referral to appropriate services among young breast cancer patients in Mexico [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 PO4-12-01.

Mental health in Parkinson’s: Uncovering real-world patient experiences in psychological support and care

Mental health in Parkinson’s: Uncovering real-world patient experiences in psychological support and care

Loneliness and Emotional Levels of the Elderly: Correlation Study in Karang Werda Peer Group

Introduction: The elderly are a vulnerable group who experience the aging process, physical and psychological health problems. Prolonged loneliness results in decreased immunity, sleep disturbances, emotional mental disorders, depression, and even suicide. Purpose: This study was to analyze the correlation between loneliness and the emotional level of the elderly in Karang Werda, Balung District, Jember Regency. Methods: This study used quantitative research methods with a correlational descriptive approach and a cross sectional design. The sample is 108 elderly with the Stratified Random Sampling technique. Loneliness data collection using the UCLA Loneliness Scale Version 3 and emotional levels using the Emotion Regulation Questionnaire (ERQ). Results: It was found that (79%) of the elderly experienced mild loneliness and (79%) had a good emotional level. The correlation between loneliness and emotional level result obtained (p= 0,003, r= -0.202). Conclusion: There is a correlation between loneliness and the emotional level of the elderly in Karang Werda, Balung District, Jember Regency. It is hoped that the elderly can relate well to the surrounding environment and actively participate in group activities. Nurses must carry out routine psychological care for the elderly and provide appropriate interventions.

Emotional Distress, Cognitive Complaints, and Care Needs among Advanced Cancer Survivors Treated with Immune Checkpoint Blockade: A Mixed-Method Study.

There is a need for a better understanding of survivorship-related issues in advanced cancer survivors treated with immune checkpoint blockade (ICB). The purpose of this study was to identify survivorship-related issues, with a focus on psychological distress, cognitive complaints, physical sequelae, impact on family dynamics, and care needs in unresectable, advanced cancer survivors treated with ICB. Semi-structured interviews and patient-reported outcome measures (PROMs) were conducted in survivors followed up at the University Hospital Brussels. We performed content analysis on the semi-structured interviews and analyzed the PROMs descriptively. 70 cancer survivors (71.4%) consented to participate between July 2022 and November 2023. Clinical fear of cancer recurrence (FCR) was present in 54.3% of the cancer survivors, and 18.6% had elevated cognitive complaints. We identified triggers related to clinically important psychological distress, such as immune-related adverse events, the progression/recurrence of disease, difficulties in adjusting to life after treatment, and co-existing life stressors, alongside persistent physical issues and unmet psychological and nutritional care needs. Our results indicate the existence of persistent psychological, physical, and cognitive issues, and support the need for routine screening for FCR. The identified triggers related to severe psychological distress can aid clinicians in timely referring the patient, thereby enhancing survivorship care.

Patient concerns and palliative psychology interventions within an inpatient palliative care service

Multi-professional inpatient palliative care services are increasingly complementing palliative care in hospitals alongside palliative care units. The present study aims to investigate the nature and frequency of patient concerns and palliative psychological interventions in the context of palliative psychological work, as well as the perceived quality of outcomes in an inpatient palliative service. Palliative psychological interventions for terminally ill patients at the inpatient palliative care service at Leipzig University Hospital were investigated in a prospective follow-up evaluation study. Psychological distress (distress thermometer) as well as the perceived quality of the results of the palliative psychological support (from the therapist`s perspective) were recorded. Patient concerns and psychological conversation topics and interventions were recorded. Descriptive and regression analytic procedures were used. Over a year, 355 patients in the inpatient palliative care service received psychological support, 304 participated in the study (mean age 63.8 years, 55% male, 89% oncological disease). An average of 3 palliative psychological interviews were conducted; 64% of patients reported high psychological distress (M=6.5). The most common patient concerns and topics within the interviews were dealing with emotions (87%), resources (83%), conflicting care and autonomy issues (77%) and hope (76%); significantly less common were spiritual concerns (2%) or the patient's legacy (9%). The most frequently used palliative psychological interventions included: support in illness processing and acceptance (74%) or in emotional-relieving interventions (98%) as in normalisation (75%), active listening (97%) or emotional containment (95%). Regression analysis showed that an oncological (vs. non-oncological) disease, a high number of palliative psychological interviews and interventions, comprehensive information regarding the palliative dimension of the diagnosis as well as undisturbed contact in the initial interview had a positive effect on the perceived outcome quality. The study results show that palliative psychologists play an important role in inpatient palliative care teams and should be involved as early as possible in the course of the disease. There is a need for improvement, especially in the palliative psychological care of non-oncological patients.

IntEgrating Smoking Cessation treAtment into usual online Psychological care for people with common mEntal illness: Protocol for an online randomised feasibility and pilot study (ESCAPE digital)

BackgroundIn the UK, smoking prevalence in people with depression (34%) and anxiety (29%) is more than double that of the general population (13%). People who stop smoking improve their mental health with comparable effect sizes found for antidepressants. In England, online psychological therapy is a standard treatment for depression and anxiety. Online therapy is an acceptable setting for smoking cessation support; however, integrated smoking and mental health support is not available. This novel study aims to assess the acceptability and feasibility of an online smoking cessation intervention, and trial procedures, offered alongside online mental health treatment as it offers increased reach to people with common mental health difficulties who smoke. MethodsA two-armed; Intervention (Integrated SilverCloud smoking cessation support) and control group (SilverCloud usual care), pragmatic, randomised controlled feasibility trial. We aim to recruit 500 adult smokers eligible for online mental health treatment. Follow-up will be conducted at 3-months and 6-months. We will assess the acceptability and feasibility of the trial procedures (i.e., recruitment, data completeness, self-reported acceptability and satisfaction) and the intervention (i.e., self-reported quit attempt, engagement with the smoking cessation and mental health programs, smoking cessation medicine and e-cigarette use, self-reported acceptability and satisfaction) and pilot clinical outcomes (i.e., biologically validated smoking abstinence, anxiety, depression, quality of health). ConclusionIf the Trial is successful, a randomised controlled effectiveness trial will follow to examine whether integrated smoking cessation and mental health treatment increases smoking abstinence and improves depression and anxiety compared to usual care.Trial registration: ISRCTN10612149 (https://doi.org/10.1186/ISRCTN10612149), 02/02/2023.

Reflective evaluations of perinatal bereavement care provision in the US and UK: An exploratory qualitative comparative study

There is increased recognition of the need to improve standards of perinatal bereavementcare, due to its frequency and potential sequelae. As part of a Fulbright Scholar award, United States (US) and United Kingdom (UK) researchers collaborated to explore similarities and differences in perinatal bereavement care between two nations. Using an explorative qualitative comparative method, key categories within perinatal bereavement provision were identified and analysed. Themed findings include: (1) Differences in definitions of miscarriage and stillbirth impact care pathways; (2) For the experiencer grief is the same regardless of legal lines drawn; (3) The meaning of loss is personal and ‘fetal personhood’ needs to be acknowledged during care; (4) Appropriate psychological care is required whether miscarriage or stillbirth is experienced. We conclude that perinatal bereavement care should include screening for Postnatal Depression (PND) and Post-Traumatic-Stress-Disorder (PTSD), and support should be equally available to all women who experience perinatal bereavement, irrespective of type of loss. Acknowledging that cultures react to loss in different ways, we recommend that strategies are developed to build human resilience. For example, Compassionate-Mind-Training (CMT), which helps people copewith trauma through cultivating compassion and teaching self-care strategies to buildresilience, reduce self-criticism, and decrease threat-based emotions.

Psychological Care for People with Inflammatory Bowel Diseases: Exploring Consumers’ Perspectives to Inform Future Service Co-design

BackgroundThere is a need to improve psychological care for people with Inflammatory Bowel Diseases (IBD), noting the high psychosocial burden of disease.AimsThis study qualitatively explored the views of people living with IBD to help inform future co-design of services that better meet the psychological needs of consumers.MethodsAdults with IBD were recruited to attend virtual focus groups to discuss what they want most in an IBD-specific psychological service. The discussions were recorded and transcribed, and data were analyzed using conventional qualitative content analysis. Draft results were summarized midway and reviewed by remaining focus groups and a final expert consumer. A quantitative dataset was created of comment frequencies.ResultsThirty-one participants took part in the study: 10 focus groups were held with an average of three participants per group. The analysis identified 254 codes, 38 sub-categories and six categories. Five main categories were identified for an IBD-specific psychological service: People-Centered Healthcare (commented on by 90% of participants), Education and Preparation (83%), Social Connection (83%), Psychological Input (93%), and Accessible Services (97%). Results were summarized in a set of proposed clinical guidelines.ConclusionsThe findings of this study identify important insights from people living with IBD regarding priorities for psychological services. IBD services should focus on improving education, addressing social connection, and integrating psychological input, as well as becoming more people-centered and accessible. It is hoped that IBD services consult the proposed clinical guidelines to inform co-designed service improvements.Graphical

Adult survivors’ perceptions of their childhood and the influences of being treated for acute lymphoblastic leukaemia with allogeneic hematopoietic stem cell transplantation as a child: A phenomenographic study

PurposeAdults who had acute lymphoblastic leukaemia (ALL) as children and were treated with allogeneic hematopoietic stem cell transplantation (aHSCT) may have been affected in their lives due to several long-term complications. From a clinical point of view, it is of interest to study how survivors describe their perceptions of their childhood today. The aim was therefore to describe how adults perceived their childhood and the influences of being treated for ALL with aHSCT as a child. MethodSemi-structured telephone interviews were undertaken with 18 adults who had been treated for childhood ALL with aHSCT and were included in a national cohort of childhood ALL survivors, diagnosed between 1985 and 2007 at an age between 0 and 17 years. A phenomenographic analysis was used. ResultsThree categories emerged: Feeling different, Feeling security and Feeling guilty. The informants felt that they had been different from other children but had felt security with the healthcare professionals and in care. They felt guilty because both their siblings' and parents’ lives had been affected, but at the same time many perceived that they and their family members had become closer to one another. ConclusionsThe results emphasised that adults who had been treated for childhood ALL with aHSCT were affected both in negative and positive ways during their childhood. This indicates the importance for early psychosocial care interventions directed to children during their treatment, but also the need for person-centred psychological care in long-term outpatient clinics.

Psychodiabetology: The Challenge of the Future?

The number of people suffering from diabetes, including type 1, is constantly increasing both in Poland and worldwide. Type 1 diabetes is a chronic disease characterized by uncertain prognosis and relapses, as well as permanent, irreversible, and progressive changes in health status. The ongoing disease results in dysfunction or disability, and the patient requires specialized supervision, care, and rehabilitation. However, the success of therapy does not depend solely on the perfection of treatment, but also on the patient's readiness to change their lifestyle and cooperate with the therapeutic team. The patient's constant alertness in making therapeutic decisions does not always lead to expected treatment results, and the risk of hypoglycemia associated with intensive insulin treatment depletes the patient's motivation for treatment, leading over time to the development of 'therapeutic burnout' and psychiatric disorders. This narrative review is an attempt to summarize the knowledge and possible future solutions in diabetes type 1 in Poland as well as highlight the importance of comprehensive care, including psychological care, which appears fundamental in a chronic disease such as type 1 diabetes. Therefore, the aim of the study was to present generational changes and psychosocial problems of patients with type 1 diabetes and to identify urgent challenges in diabetic care. Attention should be paid to the deteriorating mental condition of the young generations, who, in the course of diabetes, are exposed to additional psychological and psychiatric health problems. The next generation of patients will require more psychological care, which is why the challenge of the future is to create psychodiabetology centers.

Unmet supportive care needs among cancer patients: exploring cancer entity-specific needs and associated factors

PurposeRecognizing unmet care needs among cancer patients is crucial for improving a person-centered and tailored approach to survivorship care. This study aimed to explore the prevalence of unmet supportive care needs, pinpointing entity-specific areas of burden, and to identify factors associated with unmet needs within a diverse sample of cancer patients.MethodsIn this cross-sectional sub-study of a large multicenter study, 944 adult cancer patients reported supportive care needs via the well-validated SCNS. Most frequent diagnoses included breast (n = 276), prostate (n = 237), hematological (n = 90) and gynecological cancer (n = 74), which were analyzed for entity-specific care needs.ResultsAcross most cancer entities, health system and information, and psychological needs were most commonly reported, with fear of the cancer spreading and information regarding cancer control/diminishment ranking as the most prevalent individual concerns. Notable differences in entity-specific needs emerged for gynecological cancer patients, who exhibited more psychological (p = 0.007, OR = 2.01) and physical needs (p = 0.005, OR = 2.02), and prostate cancer patients, who showed higher sexuality needs (p < 0.001, OR = 2.95) but fewer psychological (p < 0.001, OR = 0.55), physical (p < 0.001, OR = 0.31) and patient care needs (p = 0.006, OR = 0.62). Non-distressed participants had fewer supportive care needs in each domain (all p < 0.001). Patients with functional impairments and female respondents reported increased unmet needs across most domains.ConclusionThe high prevalence of patients feeling inadequately informed about their disease and care aspects, particularly among those with functional impairments, reflects a key challenge in the healthcare system. Specific interventions and improvements in patient-doctor communication are essential to address cancer entity-specific care needs.

Body mass index assessment of preschool children during the COVID-19 pandemic

Introduction: the COVID-19 pandemic has brought socioeconomic, behavioral and clinical losses that can compromise the nutritional status of children, and studies on the subject are essential. Objective: to assess the Body Mass Index of preschool children during the COVID-19 pandemic. Methods: the data in this study comes from a cohort of children created to prospectively investigate determinants of growth and development in the period from birth to 1,000 days of life in a municipality in the interior of Paraíba, Brazil. For this study, data were collected from children at 4 years of age examining repercussions of the COVID-19 pandemic on maternal and child life. Data on the children (biological characteristics, health conditions, food consumption, screen time, behaviors during the COVID-19 pandemic, satisfaction with school and home life) and their mothers (overweight/obesity, sociodemographic characteristics, childcare, attitudes and practices related to the COVID-19 pandemic) were included, and the Body Mass Index-for-age average (Z-score) was compared using hierarchical multiple linear regression. Results: not breastfeeding in the first hour of life (p = 0.046) and regular consumption of filled cookies, sweets or candies (p = 0.042) were the characteristics of the children that represented the highest means of the outcome. Children whose mothers were diagnosed as overweight/obese (p = 0.034), who had not completed high school (p = 0.042), who had difficulty caring for the child and guiding them in health aspects (p = 0.010), as well as those whose mothers needed psychological care (p = 0.047) and mental health medication (p = 0.036) during the COVID-19 pandemic, also had higher mean scores. Conclusion: maternal mental health (psychological care and use of medication) during the COVID-19 pandemic had an impact on the child’s nutritional status.