Psychological, Cognitive and Physical Dimensions of Adjustment to Cancer: Perspectives of Cancer Survivors and Caregivers

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 10576

Special Issue Editors

Department of Social Sciences and Management, Open University, Rua Almirante Barroso, 38, 1000-013 Lisboa, Portugal
Interests: psycho-oncology; reproductive concerns; unmet needs; quality of life; distress; survivors; caregivers; young adult female survivors; adolescent and young adults survivors; fear of progression; psychoeducation; cognitive behavior therapy
Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal
Interests: neuropsychology and psychophysiology; psycho-oncology; cancer-related cognitive impairment and its impact on work-related outcomes; cognitive rehabilitation with cancer survivors; attentional bias in cancer survivors

Special Issue Information

Dear Colleagues, 

As Guest Co-Editors, we are pleased to announce this Special Issue of the journal Healthcare called “Psychological, cognitive and physical dimensions of adjustment to cancer: Perspectives of cancer survivors and caregivers”.

This Special Issue welcomes original research articles with cross-sectional, longitudinal and intervention studies, as well as meta-analyses, systematic reviews and psychometric studies.

The global burden caused by cancer is significant and increasing. However, with the advances of medicine over the years and, specifically, advances in cancer treatments, the illness trajectory and prognosis of cancer have changed substantially, and there has been an increase in the longevity of diagnosed patients.

Despite this, most cancer survivors still experience distress, depression, anxiety, a diminished quality of life, fear of cancer recurrence, unmet needs, cognitive impairment or other long-term psychological effects to a great extent. Such conditions represent a challenge not only to the cancer survivors, but also to their informal caregivers. Additionally, because informal caregivers lack professional skills and formal knowledge of caregiving, they can also report a wide range of unmet needs (e.g. psychological, emotional, practical issues), stress and deterioration in quality of life.

Therefore, we invite you to submit manuscripts to this Special Issue that address any of these variables. This invitation is directed to all healthcare professionals (i.e., psychologists, physicians, nurses, physical therapists, occupational therapists, social workers) who are involved in the care of cancer survivors and their caregivers.

Prof. Dr. Sara Monteiro
Prof. Dr. Isabel M. Santos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cancer survivors
  • caregivers
  • cancer patient/caregiver dyads
  • anxiety
  • depression
  • quality of life
  • unmet needs
  • reproductive concerns
  • cancer-related cognitive impairment
  • survivorship and rehabilitation
  • cognitive rehabilitation in cancer
  • dyadic interventions
  • children and adolescents
  • adolescents and young adults
  • adults
  • older adults

Published Papers (8 papers)

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18 pages, 453 KiB  
Article
Life beyond Loss: A Retrospective Analysis of the Impact of Meaning of Life Therapy on the Grieving Process of Cancer Patients’ Family Caregivers
by Maria João Freitas, Sónia Remondes-Costa, Elisa Veiga, Gerly Macedo, Ricardo João Teixeira and Manuela Leite
Healthcare 2024, 12(4), 471; https://doi.org/10.3390/healthcare12040471 - 14 Feb 2024
Viewed by 1109
Abstract
Oncological disease in the palliative stage is a huge challenge for patients and their family caregivers (FCs) due to the fact that it confronts them with death, as well as physical, psychological, and existential suffering. Meaning of Life Therapy (MLT) is a brief [...] Read more.
Oncological disease in the palliative stage is a huge challenge for patients and their family caregivers (FCs) due to the fact that it confronts them with death, as well as physical, psychological, and existential suffering. Meaning of Life Therapy (MLT) is a brief structured psycho-existential intervention aiming to help patients in a meaning-making life review process, promoting end-of-life adaptation. The Life Letter (LL) resulting from MLT is an element that facilitates communication between the patient and their caregivers. The goal of this study was to understand the impact of MLT on the grieving processes of eight FCs and to study their perceptions of the role of the LL on grief through semi-structured interviews. The results of our qualitative analysis indicate that MLT was perceived by the FCs as a positive experience despite the conspiracy of silence being identified as a drawback. The LL was interpreted as a communicational element, promoting emotional closeness with the cancer patients and serving as a valuable tool in the FCs’ adaptation to loss. Our research findings show that the needs of FCs, especially after experiencing the loss of their relative, are dynamic and specific. This is why it is urgent to develop interventions that consider the idiosyncrasies of end-of-life cancer patients and their FCs in order to avoid frustrated farewells, lonely deaths, and maladaptive grieving processes. This is the direction in which MLT should evolve. Full article
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10 pages, 222 KiB  
Article
The Association between Relationship Satisfaction Concordance and Breast Cancer Survivors’ Physical and Psychosocial Well-Being
by Eric A. Vachon, Ellen Krueger, David A. Haggstrom and Victoria L. Champion
Healthcare 2024, 12(2), 134; https://doi.org/10.3390/healthcare12020134 - 08 Jan 2024
Viewed by 618
Abstract
The purpose of this article is to examine the association of relationship satisfaction concordance between breast cancer survivors (BCSs) and their partners with matched controls on physical and psychosocial outcomes. Dyads of BCSs, age-matched controls, and partners were recruited as part of a [...] Read more.
The purpose of this article is to examine the association of relationship satisfaction concordance between breast cancer survivors (BCSs) and their partners with matched controls on physical and psychosocial outcomes. Dyads of BCSs, age-matched controls, and partners were recruited as part of a larger, cross-sectional QOL survey study. Relationship concordance was measured by the ENRICH marital satisfaction score, with each dyad’s score equaling the absolute value of the difference in satisfaction between survivor/control and their partner (lower score = greater concordance). Dependent variables for survivors/controls were social constraint, physical function, depression, fatigue, attention function, and sleep disturbance. Relationship satisfaction and concordance were used as the primary independent variables, while controlling for dyad category, race, education, income, and age within multiple linear regression models. The sample consisted of 387 dyads (220 BCSs, 167 controls). Relationship satisfaction concordance ranged from 0 to 53.4 (mean = 10.2). The BCS dyads had significantly worse concordance (11.1) than the controls (9.1) (p = 0.050). Within the multiple regression models, lower concordance was significantly associated with increased social constraint (p = 0.029), increased depression (p = 0.038), and increased fatigue (p = 0.006). Poor relationship satisfaction and concordance were significantly associated with poor physical and psychosocial outcomes. The maintenance of relationships should remain a focus through difficulties of cancer and into survivorship for survivors, partners, and providers. Full article
16 pages, 1283 KiB  
Article
Subjective Well-Being in Cancer Patients: The Roles of Social Support, Purpose in Life, Resilience, and Informativeness
by Lovorka Brajković, Karla Milat-Panža and Vanja Kopilaš
Healthcare 2023, 11(24), 3181; https://doi.org/10.3390/healthcare11243181 - 16 Dec 2023
Viewed by 736
Abstract
The aim of this research was to determine the relationship between subjective well-being (life satisfaction, positive and negative experiences, and prosperity) and various psychosocial factors (social support received from family members and partners, purpose in life, resilience and information) in cancer patients and [...] Read more.
The aim of this research was to determine the relationship between subjective well-being (life satisfaction, positive and negative experiences, and prosperity) and various psychosocial factors (social support received from family members and partners, purpose in life, resilience and information) in cancer patients and to examine the possibility of predicting components of subjective well-being based on these mentioned factors in cancer patients. A total of 338 adult cancer patients from Croatia participated in the study (41.1% male and 58.9% female). To measure the constructs, the Diener Subjective Well-Being Scale, the Social Support Scale at work and in the family, the Purpose in Life Scale, the Short Resilience Scale, and the EORTC-QLQ information questionnaire were used. Results showed a high level of life satisfaction and prosperity, as well as more frequent positive compared to negative experiences. A medium to high level of social support received from family members and from the partner was determined. High levels of purpose in life and medium levels of resilience and information were found. A high correlation was found among the components of the construct of subjective well-being, and a low to medium correlation among the predictors. Positive associations were found between the criteria of life satisfaction and prosperity with psychosocial factors. Negative associations were established between the positive/negative experience variables and the factors. Furthermore, the purpose in life was determined as an important predictor of all three components of subjective well-being, social support (both sources) as important for predicting life satisfaction, resilience for experiencing positive and negative experiences, and social family support for predicting the prosperity of cancer patients. Full article
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13 pages, 940 KiB  
Article
Emotional Distress in Portuguese Cancer Patients: The Use of the Emotion Thermometers (ET) Screening Tool
by Sónia Silva, Tiago Paredes, Ricardo João Teixeira, Tânia Brandão, Klára Dimitrovová, Diogo Marques, Joana Sousa, Monick Leal, Albina Dias, Carole Neves, Graciete Marques and Natália Amaral
Healthcare 2023, 11(19), 2689; https://doi.org/10.3390/healthcare11192689 - 06 Oct 2023
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Abstract
Cancer patients may experience significant distress. The “Emotion Thermometers” (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental [...] Read more.
Cancer patients may experience significant distress. The “Emotion Thermometers” (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental organization (NGO), and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of distress, age, gender, disease phase and 33 items of the problem list. Four items—sadness, depression, sleep and breathing—were found to be significantly related to a higher level of distress. Additionally, women and patients who were in the palliative phase also had significantly higher levels of distress. The results confirm the need for early emotional screening in cancer patients, as well as attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psychosocial services. Full article
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12 pages, 657 KiB  
Article
Estimation of a Structural Equation Modeling of Quality of Life Mediated by Difficulty in Daily Life in Survivors of Breast Cancer
by Aki Watanabe, Takayuki Kawaguchi, Ayumi Nobematsu, Satoshi Sasada, Nozomi Kanari, Tatsuya Maru and Takeshi Kobayashi
Healthcare 2023, 11(14), 2082; https://doi.org/10.3390/healthcare11142082 - 21 Jul 2023
Cited by 1 | Viewed by 858
Abstract
Background: The purpose of this study was to clarify the structural relationship of quality of life (QOL) in survivors of breast cancer, including difficulty in daily life and negative experiences in daily activities, as health-related indicators. Methods: Participants were survivors of breast cancer [...] Read more.
Background: The purpose of this study was to clarify the structural relationship of quality of life (QOL) in survivors of breast cancer, including difficulty in daily life and negative experiences in daily activities, as health-related indicators. Methods: Participants were survivors of breast cancer for more than 2 years after primary breast cancer surgery and belonged to self-help groups. The assessment used FACT-B (QOL), HADS (anxiety and depression), SOC (sense of coherence), WHODAS 2.0 (difficulties in daily life), and CAOD (negative experiences in daily activities). Bayesian structural equation modeling (BSEM) was performed to analyze the hypothesized model. If the causal model was significant, multiplication of the path coefficient from emotional distress (anxiety and depression) to QOL, and from SOC to emotional distress, was considered a direct effect on QOL, and from SOC to difficulty in daily life, from difficulty in daily life to negative experiences in daily activities, and from negative experiences in daily activities to anxiety and depression were considered indirect effects on QOL. Results: The participants comprised 73 survivors of breast cancer. The goodness of fit of the model in the BSEM was satisfactory. The direct effect was 0.274, and the indirect effect was 0.164. Conclusions: An additional finding of this study is that coping with difficulty in daily life and negative experiences in daily activities related to QOL may improve QOL. Full article
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29 pages, 1209 KiB  
Article
CanCOG®: Cultural Adaptation of the Evidence-Based UCLA Cognitive Rehabilitation Intervention Program for Cancer Survivors in Portugal
by Ana F. Oliveira, Milaydis Sosa-Napolskij, Ana Torres, Diâner Felipe Queiroz, Ana Bártolo, Helena Sousa, Sara Monteiro, Kathleen Van Dyk, Linda M. Ercoli and Isabel M. Santos
Healthcare 2023, 11(1), 141; https://doi.org/10.3390/healthcare11010141 - 02 Jan 2023
Viewed by 1905
Abstract
Cognitive difficulties are highly prevalent and negatively impact cancer survivors’ quality of life. The UCLA Cognitive Rehabilitation Intervention Program (in short, UCLA program) is an evidence-based intervention developed and tested in the US to address the cognitive complaints of cancer survivors. Since there [...] Read more.
Cognitive difficulties are highly prevalent and negatively impact cancer survivors’ quality of life. The UCLA Cognitive Rehabilitation Intervention Program (in short, UCLA program) is an evidence-based intervention developed and tested in the US to address the cognitive complaints of cancer survivors. Since there are no cognitive rehabilitation programs available for Portuguese cancer-related settings, this study aimed to culturally adapt the UCLA program to Portugal. Nine steps were implemented for this cultural adaptation: needs assessment, initial contacts, translation, cultural adaptation, independent review by a panel of experts (n = 6), focus group discussions with cancer survivors (n = 11), systematization of inputs and improvement of the final materials, fidelity check, and preliminary acceptability assessment. The findings suggested that changes to the original materials were needed. A Portuguese name, “CanCOG®—Reabilitação Cognitiva no Cancro” (in English “CanCOG®—Cognitive Rehabilitation in Cancer”), and a logo were created to make it more memorable and appealing for the Portuguese population. The language was adjusted to ensure content accessibility and semantic and conceptual equivalence. Finally, references to several cultural aspects, such as habits, customs, and traditions, were adapted to fit the new cultural context. The UCLA program may be a promising tool to help alleviate the cognitive difficulties reported by cancer survivors in different cultural contexts. Future research is needed to confirm the feasibility, acceptability, and preliminary efficacy of its Portuguese version, “CanCOG®—Reabilitação Cognitiva no Cancro”. Full article
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10 pages, 576 KiB  
Article
Validation of the Portuguese Version of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) in Portuguese Cancer Survivors
by Sandra Silva, Ana Bártolo, Isabel M. Santos, Débora Paiva and Sara Monteiro
Healthcare 2022, 10(12), 2466; https://doi.org/10.3390/healthcare10122466 - 07 Dec 2022
Cited by 2 | Viewed by 1461
Abstract
In 2020, around 60,000 people were diagnosed with cancer in Portugal, and many of them suffered some level of Fear of Progression (FoP) of the disease. Although this FoP is realistic, and is part of the normal and appropriate response to this type [...] Read more.
In 2020, around 60,000 people were diagnosed with cancer in Portugal, and many of them suffered some level of Fear of Progression (FoP) of the disease. Although this FoP is realistic, and is part of the normal and appropriate response to this type of disease, there is no instrument to assess and understand whether it is exaggerated in the face of the situation. The present study aimed to translate and validate the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) for the Portuguese population. The sample consisted of 220 volunteers, aged 18 years or over and diagnosed with cancer for at least six months. Participants completed the FoP-Q-SF, the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C). The FoP-Q-SF demonstrated high internal reliability (α = 0.86) and the confirmatory factor analysis supported the one-dimensional structure of the FoP-Q-SF. Convergent validity was supported with significant positive correlations with psychological distress, especially anxiety (0.68). The FoP-Q-SF has been found to be a valid instrument to measure FoP in Portuguese cancer survivors. Full article
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22 pages, 660 KiB  
Systematic Review
Dermatological Side Effects of Cancer Treatment: Psychosocial Implications—A Systematic Review of the Literature
by Vera Almeida, Daniela Pires, Marta Silva, Maribel Teixeira, Ricardo João Teixeira, André Louro, Maria Alzira Pimenta Dinis, Maria Ferreira and Ana Teixeira
Healthcare 2023, 11(19), 2621; https://doi.org/10.3390/healthcare11192621 - 25 Sep 2023
Cited by 3 | Viewed by 1355
Abstract
Cancer is a leading cause of mortality and morbidity all over the world and the second major cause of death in Portugal. Dermatological side effects resulting from cancer treatment have a psychosocial impact on patients’ lives, such as quality of life (QoL), body [...] Read more.
Cancer is a leading cause of mortality and morbidity all over the world and the second major cause of death in Portugal. Dermatological side effects resulting from cancer treatment have a psychosocial impact on patients’ lives, such as quality of life (QoL), body image, cognitive fusion and social inhibition. This systematic review aimed to explore and synthesize the psychosocial impact of dermatological side effects of cancer treatment, answering the following research objectives: (i) Do the dermatological side effects of the cancer treatment present any psychosocial impact for the patients? (ii) How does the psychosocial impact of the dermatological toxicities of the cancer treatment manifest in patients’ lives? Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and guided a systematic search through the PubMed, Cochrane Library and PyscNet databases. The considered studies correlate dermatological side effects of cancer treatments and their psychological/psychosocial outcomes. The studies found were all published in peer-reviewed journals. The results obtained established that cancer treatment causes the most varied skin changes, consequently reducing self-esteem and QoL; disturbing body image; and contributing to cases of stress, depression and anxiety. There is still limited literature that profoundly investigates the experience of living with these skin toxicities. The development of research lines to improve knowledge in this field will allow for significant improvements in healthcare for patients undergoing cancer treatment who need to focus more on the psychosocial implications of skin toxicities. The novelty of this review lies in adding knowledge summarizing the psychosocial implications of dermatological side effects of cancer treatment to support healthcare providers in the development of integrative therapeutic strategies for these patients in their clinical practice. Full article
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