Well-being Of Survivors Research Articles

Experience of oncology nurses with cancer survivors during transition from acute oncology treatment to primary care.

Cancer care for Canadian cancer survivors remains fragmented. Little is known about the experience of Canadian oncology nurses providing cancer care for cancer survivors, as they transition from acute treatment to primary care. This study aimed to (1) explore the experience of oncology nurses dealing with fragmented cancer care for cancer survivors in transition to survivorship; (2) identify oncology nurses' perspectives about what promotes or inhibits their delivery of quality cancer care; and (3) obtain their suggestions to improve cancer care. This study used a phenomenological design to explore the experience of oncology nurses in caring for cancer survivors during transition to survivorship and examine how the nurse participants describe their experience. Semi-structured interviews were used to collect data and an interpretative phenomenological analysis approach was used to develop themes from the data. Three oncology nurses participated in this study. The following five themes emerged: (1) Under personal transition: nursing assessment, symptoms management, patient education, resources offered, refusing label of cancer survivors, promoting adjustment to a new normal life, promoting return to work, and recognizing meaning of survivorship; (2) Under cancer survivor's care transition: promoting self-care management, communication, and maximal recovery of body functions; (3) Under nurse's positive experience promoting delivery of quality cancer care: caring for cancer survivors, experience and knowledge, and advocate for cancer survivors; (4) Under barriers that negatively affected delivery of cancer care: low socioeconomic status (especially low income), cultures and languages barriers, and limited time providing nursing care; and (5) Suggestions to improve cancer care: establishing a new position - primary nurse, increasing the number of healthcare professionals, and improving knowledge, skills, and experience. Oncology nurses' knowledge and experience provide a good foundation for quality cancer care and contribute to the health and wellbeing of cancer survivors.

Pain-related and psychological factors mediate the effect of personality on health-related quality of life. A study in breast cancer survivors with persistent pain.

Personality characteristics affect the long-term well-being and health-related quality of life (HrQoL) of breast cancer (BC) survivors. Persistent pain significantly affects psychosocial well-being and HrQoL in this patient group. We studied the effects of temperament and character via pain-related and psychological factors on dimensions of HrQoL in BC survivors. We studied 273 patients who had been treated for BC and who reported persistent pain at any site of the body in Brief Pain Inventory. The patients were recruited from a longitudinal cohort of patients 4-9 years after surgery for BC. Short-Form-36 inventory was used to assess physical and mental dimensions of HrQoL and Temperament and Character Inventory to assess dimensions of temperament and character. We used parallel mediation modeling for studying effects of temperament and character on physical and mental HrQoL. A significant total effect was found for harm avoidance (HA) temperament (βtotal = -0.665, p < 0.001) and character dimensions self-directedness (SD) (βtotal = 0.609, p = 0.001) and cooperativeness (CO) (βtotal = 0.584, p = 0.028) on physical and mental HrQoL. Additionally, different combinations of pain-related and psychological variables fully mediated the indirect effects of HA, SD, and CO on physical and mental HrQoL. HA temperament is a potential emotional vulnerability factor for psychological burden and impaired HrQoL in BC survivors. Character dimensions SD and CO may protect from the negative effect of mood on HrQoL. The results provide new insights about the risk-and target-factors for clinical interventions and effective pain management to improve psychosocial well-being and HrQoL in BC survivors.

PHYSICAL AND PSYCHOLOGICAL EFFECTS OF COVID-19 AMONG SURVIVORS IN PUNJAB, PAKISTAN

Patients with COVID-19 suffer considerable physical and psychological stress not only during the disease crisis but also after the illness. In this regard, the first practical step is to clearly understand the patients physical and psychological problems. Therefore, this study aimed to examine the physical and psychological effects of COVID-19 on survivors. To achieve this goal, a phenomenological study was conducted. Researchers utilized non-probability convenient sampling, and 12 participants were recruited from a cohort of individuals with confirmed COVID-19 infection and experiencing a history of mild to severe symptoms. The collected data was analyzed through themes of Effects on Physical Health, Effects on Psychological Health, and Social Stigma. The study found that contracting and recovering from coronavirus is an experience in which participants oscillate between relief, safety, confinement, and raw fear. A major focus was seen on the physical and psychological aspects of the diseased body. Stigma and financial stress after infection were also expressed. This study provided a better understanding of the physical and mental well-being of COVID-19 survivors after recovery based on real-world experience. Participants experienced their bodies being vulnerable and marked after COVID-19. They wavered between radiant joy in healing and uncertainty in assessing symptoms. Patient’s experiences, therefore, help us better understand how people cope with post- illness challenges and guide us to better ways to support them in the future. Keywords: Stigma, Physical Health, Psychological Health, Patients, Health impact, Post-COVID Syndrome.

82 Comparison of Parent vs. Burn-Injured Youth Scores on the Strengths and Difficulties Questionnaire

Abstract Introduction Research regarding the prevalence of psychopathology issues in burn-injured youth is limited. The Strength and Difficulties Questionnaire (SDQ) is valid for both self- and parent-report, and is widely used. This study sought to evaluate the level of agreement between the youth self-report and parental response. Methods Respondents included 36 adolescent/parent dyads. The youth included 11-18 years old, 14% African American, 19% Hispanic and 44% White, 19 females, 17 males with 58% reporting both visible &amp; hidden scars. The SDQ is a widely used behavioral screening tool assessing children’s positive &amp; negative attributes on 5 scales: 1) Emotional Symptoms, 2) Conduct Problems, 3) Hyperactivity/Inattention, 4) Peer Problems, 5) Prosocial Behavior as well as a Total Difficulties Score. Results Youth reported significantly higher scores than parents on Total Difficulty (P &amp;lt; 0.001). They had significantly higher scores on all scale scores – Emotional Problems (P = 0.01), Hyperactivity (P = 0.001), Conduct Problems (P = 0.041), Peer Problems (P=0.041), Internalizing (P = 0.005), and Externalizing Behaviors ((P &amp;lt; 0.001), but not the Pro-Social Scale (P=0.303). Correlations between self- and parent-report were significant only for the Hyperactivity scale, r=.40, p=0.017. Conclusions The large difference in youth vs. parent responses is of concern because study parents appear to be unaware of psychosocial issues challenging their children. This study mirrors other research which has documented a lack of awareness of parents regarding children’s reported anxiety disorder symptomology. Applicability of Research to Practice Healthcare providers &amp; parents should discuss burn-injured youths’ feelings regarding their progress. Providers should not rely solely on parents when determining the well-being of pediatric survivors. This survey can be completed easily by youth and parents in the aftercare setting and used as a tool for recommending intervention when difficulties are present.

Embedding lifestyle interventions into cancer care: has telehealth narrowed the equity gap?

Lifestyle interventions targeting energy balance (ie, diet, exercise) are critical for optimizing the health and well-being of cancer survivors. Despite their benefits, access to these interventions is limited, especially in underserved populations, including older people, minority populations and those living in rural and remote areas. Telehealth has the potential to improve equity and increase access. This article outlines the advantages and challenges of using telehealth to support the integration of lifestyle interventions into cancer care. We describe 2 recent studies, GO-EXCAP and weSurvive, as examples of telehealth lifestyle intervention in underserved populations (older people and rural cancer survivors) and offer practical recommendations for future implementation. Innovative approaches to the use of telehealth-delivered lifestyle intervention during cancer survivorship offer great potential to reduce cancer burden.

Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study.

Data were collected prospectively from cancer patients who had undergone breast surgery at our institution from 1 January 2015 to 31 December 2021. The validated Breast-Q questionnaires were utilized for conducting patient interviews and mean scores between three cohorts were compared using one-way ANOVA test / Kruskal-Wallis test. Overall, 210 patients were recruited in which 70 patients (33.3%) had undergone BCS, 71 patients (33.8%) had total mastectomy only and 69 (32.9%) patients had total mastectomy with reconstruction. Physical well-being scores were consistent between the three groups while patients operated with total mastectomy with reconstructive surgery scored higher in sexual and psychosocial health measures as compared to patients of total mastectomy. However, BCS patients were the most satisfied with their cosmetic outcome following patients of total mastectomy with reconstruction and without reconstruction. Reconstruction postmastectomy has a positive impact on sexual and psychosocial well-being of survivors; however, those who had breast conservation were more satisfied with cosmetic outcome post-surgery as compared with mastectomy with or without reconstruction.

Preserving fertility in young adolescents with cancer - an oncofertility perspective

Oncofertility is an emerging field at the intersection of oncology and reproductive medicine that aims to address the fertility-related consequences of cancer treatment. Advances in cancer diagnosis and treatment have led to significant improvements in survival rates, but many cancer treatments can cause infertility or premature ovarian failure, which can have a profound impact on the quality of life and overall well-being of cancer survivors. Oncofertility seeks to provide patients with the opportunity to preserve their reproductive potential before undergoing cancer treatment, thus ensuring that they have options for starting a family after treatment. This field encompasses a range of approaches, including fertility preservation techniques. While oncofertility is still a relatively new field, it has already made significant strides in improving the quality of life for cancer survivors. However, there are still many challenges that must be addressed, including access to oncofertility services and the development of new and more effective techniques. This paper will explore the current state of oncofertility research and highlight some of the key challenges and opportunities in this important field.

Mental well-being of COVID-19 survivors in Karachi, Pakistan: an exploratory case study

Mental well-being of COVID-19 survivors in Karachi, Pakistan: an exploratory case study

‘No Income, Temporary Visa, and Too Many Triggers’: Barriers in accommodating survivors of human trafficking and slavery in Australia

Access to stable housing has a significant effect on the wellbeing of survivors of human trafficking and modern slavery. Safe and sustainable accommodation provides a crucial foundation for survivors beginning their recovery; however, it is often very difficult to source for support services assisting them. This paper presents the findings of research that analysed the eligibility, suitability, availability, and accessibility of short-term accommodation and long-term housing options to better understand the barriers to accommodating survivors in Australia. It demonstrates that survivors were not eligible for many options due to their immigration status or lack of income. Within the limited options, there is a shortage of suitable accommodation due to the absence of survivor-specific services, and due to rules and requirements imposed by accommodation providers that are not supportive of survivors’ unique needs. These include restrictions on survivors’ freedom of movement, on the use of alcohol and other drugs, and on accommodating men, children, and extended family, as well as requirements related to engaging in activities. These barriers negatively impact survivors’ recovery and may lead to homelessness whilst increasing the risk of re-trafficking or other harm. Collaboration and coordination between actors within anti-slavery and housing policy spheres is urgently required to mitigate these barriers and prevent such harms.

Abstract 1983: Social/physical limitations and financial hardship among the US adult cancer survivors with multiple primary cancer

Abstract BACKGROUND: In the US, new malignancies among cancer survivors comprised a substantial proportion of total incident cancers, ranging from 11% in younger adults (aged 20-64 years) to 25% in adults aged 65 years and older. These survivors with multiple primary cancer (MPC) have poorer mental status than those with a single cancer diagnosis. However, limited studies have focused on this unique survivor population. We aimed to compare social and physical limitation as well as financial hardship between cancer survivors with MPC and those with single cancer diagnosis to provide more information about the well-being of cancer survivors with MPC in the US. METHODS: This study is based on the adult samples data from the US population-based 2021 National Health Interview Survey. Individuals with non-melanoma skin cancer or skin cancer of unknown type and those diagnosed before 18 years old are excluded. The MPC group was compared with the single cancer diagnosis group about social limitations (difficulty doing errands alone, difficulty participating in social activities and health-related work limitation), physical limitations (vision, hearing, mobility, communication, cognition and self-care) and medical financial hardship (care access failure due to finance, problems or worries in paying medical bills). Life satisfaction was also evaluated among the two groups. The Mann-Whitney U test and binary logistic regression were used to analyze differences between the two groups. Analyses were performed using SPSS (version 27.0; SPSS Inc., Chicago, Ill). 2-sided at P &amp;lt; .05 was considered as statistical significance. RESULTS: We identified 2633 adult cancer survivors, including 343 MPC survivors and 2290 survivors with a single cancer diagnosis. Compared to cancer survivors with single cancer diagnoses, cancer survivors with MPC have a significantly increased risk of social limitation, including difficulty doing errands alone (OR 1.80, P &amp;lt; .001) and participating in social activity (OR 1.88, P &amp;lt; .001), although no difference in health-related work limitation. Meanwhile, cancer survivors with MPC are significantly related to physical disabilities, including vision (OR 1.38, P = 0.014), hearing(OR 1.33, P = 0.022), mobility (OR 1.77, P &amp;lt; .001), communication (OR 1.50, P = 0.038), cognition (OR 1.26, P = 0.051) and self-care (OR 1.57, P = 0.017). Cancer survivors with MPC are also found to be associated with life dissatisfaction (OR 1.88, P = 0.001). We observed no significant differences in care access failure due to finance, problems or worries in paying medical bills. CONCLUSIONS: Cancer survivors with MPC are associated with increased risks for social function and physical disabilities and tend to report life dissatisfaction more than cancer survivors with single cancer. Survivors with MPC need more attention and support from the family, community and medical care. Citation Format: Jiazhang Xing. Social/physical limitations and financial hardship among the US adult cancer survivors with multiple primary cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1983.

Trauma of the Shared Environment: A Qualitative Analysis of the Experiences of Survivors of College Campus Sexual Assault.

Survivors of campus sexual assault are often tasked with healing while sharing an environment with their perpetrators. However, little is known about the effects of a shared environment on survivor well-being. A qualitative thematic analysis design was employed to address this gap. We conducted semi-structured interviews with nine female survivors who identified their perpetrators as fellow students at a large state university in the southeastern U.S. The five themes that emerged are situated within an ecological framework, which is also used to guide our recommendations for supporting survivors' well-being within higher education.

Co-occurrence of PTSD and affective symptoms in a large sample with childhood trauma subtypes: A network analysis.

Exposure to childhood trauma (CT) is associated with various deleterious mental health outcomes, increasing the risk of suicidal behaviors. The objective of this study is to investigate the different effects of three forms of CT, including emotional abuse (EA), physical abuse (PA), and sexual abuse (SA), on potential psychopathological symptoms among college students. A total of 117,769 students from 63 Chinese colleges participated in this study. There were 1,191 participants in the EA group (1.24%; 95% CI: 1.17-1.31%), 1,272 participants in the PA group (1.32%; 95% CI: 1.25-1.40%), and 3,479 participants in the SA group (3.62%; 95% CI: 3.50-3.73%). CT was measured by the Childhood Trauma Questionnaire-Short Form. Psychopathological symptoms (i.e., depression, anxiety, and PTSD) were measured by the PHQ-9, GAD-7, and Trauma Screening Questionnaire, respectively. Network analysis was applied to analyze psychopathological symptoms between three CT subgroups (EA, PA, and SA). The associations and centralities of the networks were calculated, and the network characteristics of the three subgroups were contrasted. The main symptoms across all three groups are uncontrollable worry, sad mood, irritability, and fatigue, which indicates these core symptoms play essential roles in maintaining the whole psychological symptoms network. Furthermore, there are significant differences in symptom associations between the three groups. The comparison of network structures of the three groups shows that the SA group reports more PTSD symptoms, the EA group reports more suicide-related symptoms, and the PA group reports more anxiety symptoms. Specific symptoms were disclosed across each group by the distinctive core psychopathological symptoms found in the CT subgroup networks. The present study's findings show different associations between CT and psychopathology and may help classify potential diagnostic processes. Therefore, local governments and academic institutions are recommended for early intervention to promote the psychological well-being of CT survivors.

The impact of necrotizing soft tissue infections on the lives of survivors: a qualitative study

PurposeNecrotizing soft tissue infections (NSTI) are potentially lethal infections marked by local tissue destruction and systemic sepsis, which require aggressive treatment. Survivors often face a long recovery trajectory. This study was initiated to increase understanding of the long-term impact of NSTI on health related quality of life (HRQoL), and how care may be improved.MethodsThematic analysis was applied to qualitative data from 25 NSTI-survivors obtained through two focus groups (n = 14) and semi-structured interviews (n = 11).ResultsThe median age of the participants was 49 years, 14 were female. The median time since diagnosis was 5 years. Initial misdiagnosis was common, causing delay to treatment. Survivors experienced long-term physical consequences (scarring, cognitive impairment, fatigue, sleeping problems, recurrent infections), psychological consequences (traumatic stress symptoms, fear of relapse, adjusting to an altered appearance, sexual issues) and social and relational consequences (changes in social contacts, a lack of understanding). The disease also had a major psychological impact on family members, as well as major financial impact in some. There was a strong desire to reflect on ‘mistakes’ in case of initial misdiagnosis. To improve care, patient and family centered care, smooth transitions after discharge, and the availability of understandable information were deemed important.ConclusionThis study reveals that NSTI have a large impact on physical and psychosocial wellbeing of survivors and their relatives. Except for a few differences (misdiagnosis, fear for re-infection and actual re-infection), the patient experience of patients with NSTI is largely similar to those of burn survivors. Thus, questionnaires to assess HRQoL in burn survivors may be used in future NSTI studies.

The 24-Hour Movement Paradigm: An integrated approach to the measurement and promotion of daily activity in cancer clinical trials

Increased physical activity (PA), improved sleep, and decreased sedentary behavior (SB) are essential components of supportive care for cancer survivors. However, researchers and health care professionals have achieved limited success in improving these behaviors among cancer survivors. One potential reasoning is that, over the past two decades, guidelines for promoting and measuring PA, sleep, and SB have been largely siloed. With greater understanding of these three behaviors, health behavior researchers have recently developed a new paradigm: the 24-Hour movement approach. This approach considers PA, SB, and sleep as movement behaviors along a continuum that represent low through vigorous intensity activity. Together these three behaviors form the sum of an individual's movement across a 24-hour day. While this paradigm has been studied in the general population, its usage is still limited in cancer populations. Here, we seek to highlight (a) the potential benefits of this new paradigm for clinical trial design in oncology; (b) how this approach can allow for greater integration of wearable technology as a means of assessing and monitoring patient health outside the clinical setting, improving patient autonomy through self-monitoring of movement behavior. Ultimately, implementation of the 24-Hour movement paradigm will allow health behavior research in oncology to better promote and assess critical health behaviors to support the long-term well-being for cancer patients and survivors.

Abstract A045: Investigating the biological determinants of poor mental health among ethnically diverse Black prostate cancer survivors: An iCCaRE consortium for prostate cancer in Black men project

Abstract Background: Black men across the world continue to bear the burden of prostate cancer (PCa). Although several factors account for this, studies have demonstrated that the adaptive constitutive biological factors associated with African ancestry contribute to the risk of disease development, disease aggression, and poor disease outcomes in Black men. However, the limited inclusion of Blacks in cancer biology studies limits the understanding of the extent to which biology influence outcomes among Blacks. Furthermore, beyond White-Black dichotomous disparity, there exists an under-exploited within-group geographical and ancestral disparities in the burden, clinical presentation, and outcomes of PCa among Black men globally. Aside from urological and sexual problems, Black PCa survivors experience poor mental health, with a concomitant reduction in the quality of life and overall survival. Hence, improving the overall well-being of PCa survivors requires an understanding of the biological determinants of mental health among diverse groups of Black PCa survivors. Methods: Structured questionnaires are being used to access fatigue, pain, depressive symptoms, health-related quality of life, and PCa-specific symptoms burden among within a cohort of ethnically diverse Black PCa survivors in Africa. This is linked with the salivary biomarkers of inflammation, hypothalamic-pituitary-adrenal axis activity, and tryptophan-kynurenine pathway in our studies population. Results: Data from fifty PCa survivors across different African ethnic groups (including, Yoruba, Igbo, Hausa) will be presented. This study will measure biological variables (e.g, inflammatory markers, cortisol, tryptophan, kynurenine, and serotonin) and survivors self-reported (e.g. health-related quality of life and psychoneurological symptoms) measures to better examine the interconnectedness between cancer-associated biomarkers and poor mental health. Conclusion: This study will lay an essential foundation for understanding the extent to which cancer associated-biological determinants contribute to the poor mental health of PCa survivors, unravels the within-group disparities in the mental health of Black PCa survivors, establish the contribution of genetics to poor mental health in Black PCa survivors and provide the opportunity for pharmacogenomic intervention that will improve the quality of life. Citation Format: Solomon O. Rotimi, Folakemi Odedina, Roxana Dronca, Kimlin Ashing, Ernest Kaninjing, Che Ngufor, Arnold Merriweather, Jennifer Crook, Manisha Salinas, Fathi Parisa, Sha’Reff Rashad, John McCall, Ebenezer Erefah, Ayinde Yahaya. Investigating the biological determinants of poor mental health among ethnically diverse Black prostate cancer survivors: An iCCaRE consortium for prostate cancer in Black men project [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A045.

Mindfulness for the self-management of negative coping, rumination and fears of compassion in people with cancer: An exploratory study.

Cancer and its treatments have the potential to significantly impact mental health, provoking feelings of anxiety, depression, and distress, which can last long after treatment is over. One of the most rapidly emerging influences in the healthcare field is mindfulness-based interventions (MBIs), which are designed to cultivate present moment awareness, attentional flexibility, compassion and acceptance, to reduce physical and psychological distress. However, there is limited research into the efficacy of MBIs or disease specific MBIs in shifting negative coping, ruminative thinking and fears of compassion as primary outcomes in individuals with cancer. This exploratory study was designed to evaluate inter- and intra-individual change in the management of negative coping, rumination and fears of compassion, following a cancer-specific mindfulness-based intervention. A single group, non-experimental, repeated measures study of 22 participants across six cancer care centres explored the efficacy of an 8-week Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca) course. The Reliable Change Index (RCI) examined reliable clinical improvement, deterioration, or no change in individuals on the Mental Adjustment to Cancer Scale (MACS), the Ruminative Responses Scale (RRS) and the Fears of Compassion Scale (FCS). About 82% of participants (n=18) saw an improvement in at least one measure. A significant decrease in primary outcome scores was observed in negative coping, ruminating and fears of self-compassion. There were significant correlations between the fear of self-compassion and depressive ruminating, fear of accepting compassion from others and showing it to others pre and post intervention. Our findings indicate that the MBCT-Ca programme may significantly reduce negative coping, ruminating and fears of self-compassion improving psychological health and wellbeing in cancer survivors.

Quantitative EEG as a Biomarker in Evaluating Post-Stroke Depression.

Introduction: Post-stroke depression (PSD) has complex pathophysiology determined by various biological and psychological factors. Although it is a long-term complication of stroke, PSD is often underdiagnosed. Given the diagnostic role of quantitative electroencephalography (qEEG) in depression, it was investigated whether a possible marker of PSD could be identified by observing the evolution of the (Delta + Theta)/(Alpha + Beta) Ratio (DTABR), respectively the Delta/Alpha Ratio (DAR) values in post-stroke depressed patients (evaluated through the HADS-D subscale). Methods: The current paper analyzed the data of 57 patients initially selected from a randomized control trial (RCT) that assessed the role of N-Pep 12 in stroke rehabilitation. EEG recordings from the original trial database were analyzed using signal processing techniques, respecting the conditions (eyes open, eyes closed), and several cognitive tasks. Results: We observed two significant associations between the DTABR values and the HADS-D scores of post-stroke depressed patients for each of the two visits (V1 and V2) of the N-Pep 12 trial. We recorded the relationships in the Global (V1 = 30 to 120 days after stroke) and Frontal Extended (V2 = 90 days after stroke) regions during cognitive tasks that trained attention and working memory. For the second visit, the association between the analyzed variables was negative. Conclusions: As both our relationships were described during the cognitive condition, we can state that the neural networks involved in processing attention and working memory might go through a reorganization process one to four months after the stroke onset. After a period longer than six months, the process could localize itself at the level of frontal regions, highlighting a possible divergence between the local frontal dynamics and the subjective well-being of stroke survivors. QEEG parameters linked to stroke progression evolution (like DAR or DTABR) can facilitate the identification of the most common neuropsychiatric complication in stroke survivors.

Effects of a family-focused dyadic psychoeducational intervention for stroke survivors and their family caregivers: a pilot study

BackgroundStroke is one of the leading causes of disability in China and worldwide, affecting the health and well-being of both stroke survivors and their family caregivers (i.e. stroke dyads). Dyadic interventions targeting both as active participants can be beneficial for the dyads’ health and well-being. Psychoeducation is a potentially acceptable approach to developing participants’ knowledge about their disease management to promote their recovery. This study aims to explore the feasibility, acceptability, and preliminary effects of a family-focused dyadic psychoeducational intervention for stroke dyads.MethodsThis study was a single-blinded, parallel-group randomised controlled trial. Totally, a convenience sample of 40 stroke dyads was recruited. The intervention included three in-hospital face-to-face education sessions and four weekly post-discharge follow-up telephone counselling sessions. Feasibility was assessed by the rates of recruitment, attritions, and adherence to the intervention. Acceptability was evaluated via semi-structured qualitative interviews. Preliminary intervention effects were evaluated on primary (survivors’ functioning and caregivers’ burden) and secondary (caregivers’ competence and dyads’ coping, depressive and anxiety symptoms, family functioning, and dyadic relationship) outcomes.ResultsIntervention feasibility was established with satisfactory recruitment (76.9%), attrition (10%), and intervention completion (75%) rates. Qualitative interviews suggested that the intervention was acceptable and useful to stroke dyads. The intervention effects on survivors’ functioning were significant in the memory and thinking (F = 8.39, p = 0.022, η = 0.18) and mobility (F = 5.37, p = 0.026, η = 0.12) domains, but not significant on their overall functioning (F = 2.39, p = 0.131). Caregiver burden in the intervention group was significantly greater reduced at post-test than the control group, with a large effect size (F = 7.55, p = 0.013, η = 0.28). For secondary outcomes, this intervention suggested a significant effect on caregivers’ competence (F = 5.20, p = 0.034, η = 0.22), but non-significant effects on other outcomes.ConclusionsThe family-focused dyadic psychoeducation programme was feasible and acceptable for stroke dyads and showed preliminary effects for stroke dyads. These findings support a larger-scale controlled trial to further examine its intervention effects over a longer-term follow-up.Trial registrationThis study was retrospectively registered as a randomised controlled trial in the ISRCTN Registry. Registration Date: October 10, 2022. Registration Number: ISRCTN18158500.

THE HOPES AND FEARS OF OLDER ADULT, LONG-TERM CANCER SURVIVORS: RACIAL AND GENDER DIFFERENCES

Abstract Understanding the impact of cancer on the hopes and fears of older adult (age 60+), long-term (5 years +) survivors is important for assessing their quality of life after cancer. Prior quantitative research has shown the important role that cancer plays in the health and psycho-social well-being of survivors in the years and even decades after diagnosis and treatment. This presentation extends that research by examining both quantitative data and survivors’ narratives revealing important issues survivors face such as altered sense of self/identity, feelings of social isolation, key sources of social support as well as cancer and other health-related concerns. These are examined in the context of broader existential issues related to their hopes and fears for the future and differences by race, gender and cancer type are also presented. The data analyzed are from an NCI funded, 10-year longitudinal study based on in-person interviews with 321 survivors of breast, colorectal and prostate cancer to document how cancer-related factors have affected their aspirations for the future. The findings are discussed in the context of how the issues that survivors identified as affecting their hopes and fears may be integrated into the dialogue clinical staff can have with older survivors and their families as part of after-cancer care.

Heart rate variability as an indicator of the beneficial effects of Qigong and mindfulness training on the mind-body well-being of cancer survivors.

Cancer-related fatigue (CRF) and fear of recurrence (FOR) are frequently experienced by cancer patients. This study aimed to improve cancer survivors' CRF, FOR, quality of life (QOL), and heart rate variability (HRV) through Qigong and mindfulness interventions. A quasi-experimental design was adopted, and 125 cancer survivors were recruited using snowball sampling. The participants were assigned to 1 of 3 groups (Qigong, mindfulness, and control) based on their needs and preferences. All groups received 4 h of nutrition education at the pretest (T0). CRF, FOR, and QOL questionnaires and HRV parameters were used as the measurement tools. Data were collected at the pretest (T0), posttest (T1), and follow-up (T2). Qigong had a better effect on improving CRF (ΔT1-T0 = - 0.108, ΔT2-T1 = - 0.008) and FOR (ΔT1-T0 = - 0.069, ΔT2-T1 = - 0.150) in the long term, while mindfulness improved QOL (ΔT1-T0 = 0.096, ΔT2-T1 = 0.013) better in the long term. Both Qigong and mindfulness had a short-term effect in improving SDNN (Q: ΔT1-T0 = 1.584; M: ΔT1-T0 = 6.979) and TP (Q: ΔT1-T0 = 41.601; M: ΔT1-T0 = 205.407), but the improvement in LF (Q: ΔT2-T1 = - 20.110; M: ΔT2-T1 = - 47.800) was better in the long term. HRV evaluation showed that Qigong and the mindfulness interventions had short-term effects in significantly improving overall physical and mental health, self-emotional regulation, and QOL and relieving fatigue and autonomic dysfunction. HRV may serve as an observational indicator of interventions to improve physical and mental health. The consistent practice of mind-body interventions is the primary means of optimizing overall health and well-being.