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Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 22332

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Special Issue Editors

Dr. Maria Luisa Martino

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Guest Editor

Department of Humanities, Federico II University, 80133 Naples, Italy
Interests: cancer; traumatic experience; meaning-making; narrative; adaptation and integration; clinical health psychology; psychological intervention

Dr. Daniela Lemmo

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Co-Guest Editor

Department of Humanities, Federico II University, 80133 Naples, Italy
Interests: clinical health psychology; preventive choices; cancer screening; critical experience; meaning-making; narrative; adaptation process; psychological intervention

Special Issue Information

Dear Colleagues,

To date, current advances in science, medicine, and technology make it possible to screen and treat illnesses previously considered incurable and life-threatening. These advances transformed most acute illnesses into chronic one, such as cancer conditions, favoring early diagnosis and long-lasting survival. The increase of cancer survival rates generates a rise in people living in a chronic condition. The patient is involved in adaptation and engagement processes that open to complex psychological needs, such as: changes in daily routine, drug intake, side effects, fear of recurrence, and follow-up checks. These conditions impose the psychic challenge of constructing a new continuity/balance of life narrative by integrating the recovery of personal health within a condition of chronicity. The increase of the average of life expectancy, therefore, opens two scenarios in which clinical health psychology is called to think new epistemological frameworks and models of psychological-clinical intervention. On the one hand, connected to the adaptation and integration processes in chronic oncological conditions; on the other hand, related to preventive processes aimed at reducing the risks associated with the development of chronic condition, ensuring an early diagnosis of the cancer. Cancer should be gradually thought at the center of a continuum between prevention and chronicity. Within the One Health framework it is relevant to define the main trajectories by which clinical health psychology can be inscribed in social contexts and practices involved in cancer prevention, treatment and chronicity. In this Special Issue, we invite authors to enrich the actual national and international debate with contributions that deepen one or more of the three aforementioned domains: prevention, treatment, and chronicity. Research papers, longitudinal studies, reviews, case reports, brief reports, conducted through qualitative, quantitative, or mixed methods within different types of cancer and/or illness experiences-are welcome.

Dr. Maria Luisa Martino
Dr. Daniela Lemmo
Guest Editors

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Keywords

cancer
oncological prevention
health behaviors
chronicity
critical-traumatic experience
mental health
adaptation process
meaning and sense making
qualitative and quantitative method
clinical health psychology

Published Papers (11 papers)

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Research

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19 pages, 985 KiB

Open AccessArticle

Evaluating Somatic Experiencing^® to Heal Cancer Trauma: First Evidence with Breast Cancer Survivors

by Denise Vagnini, Massimo Maria Grassi and Emanuela Saita

Int. J. Environ. Res. Public Health 2023, 20(14), 6412; https://doi.org/10.3390/ijerph20146412 - 20 Jul 2023

Cited by 2 | Viewed by 2871

Abstract

Somatic Experiencing^® is a bio-psychological method for the treatment and prevention of trauma and chronic stress, which has never been investigated with breast cancer (BC) survivors. Eight weeks of web-based synchronous group sessions were structured between April and June 2022. Potential participants were recruited using a convenience sampling approach and through the collaboration of a public hospital in northern Italy and a non-profit association of BC women. Thirty-five eligible participants were enrolled and divided into an intervention group (n = 21) and a control group (n = 14). Anxiety, depression, distress (HADS), coping strategies (Mini-MAC), trauma reworking skills (PACT), and body image (BIS) were assessed at T0 and after 8 weeks (T1). Qualitative items concerning the most significant moments and learnings were completed at T1 by the intervention group. An independent t-test confirmed no between-group psychological differences at T0. As hypothesized, paired-sample t-tests showed decreases in anxiety, depression, distress (p < 0.05), and anxious preoccupation coping strategy (p < 0.001), but also improvements in forward focus (p < 0.05) and body image (p < 0.001) in the intervention group. The controls worsened over time with increases in hopeless/helplessness (p < 0.001) and avoidance (p < 0.05) coping strategies. Textual analyses extracted five dominant themes that summarized the meaning of the experience for participants. The preliminary results suggest the effectiveness of the intervention. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

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15 pages, 356 KiB

Open AccessArticle

A Qualitative Analysis of the Experiences of Young Patients and Caregivers Confronting Pediatric and Adolescent Oncology Diagnosis

by Ines Testoni, Anna Elena Nicoletti, Matilde Moscato and Ciro De Vincenzo

Int. J. Environ. Res. Public Health 2023, 20(14), 6327; https://doi.org/10.3390/ijerph20146327 - 8 Jul 2023

Cited by 2 | Viewed by 2246

Abstract

Epidemiological studies show that new cases of young oncology patients are increasing by 400,000 every year. Psychological literature has shown that receiving an oncological diagnosis can cause significant psychological stress and discomfort. However, the experiences of young patients and their caregivers as they confront this challenge are not yet fully understood. This paper adopts a qualitative methodological approach to explore how young patients with an oncological diagnosis and their parents make sense of the experiential challenges they face. Thus, the research realized 18 semi-structured interviews, 11 of which were with pediatric and adolescent oncology patients, and 7 of which were with 6 mothers and 1 father. The qualitative thematic analysis revealed that the oncological diagnosis triggers different emotions taking the scene in the attempt to cope with the threats of meaning that the diagnosis poses. However, such intense experience promotes transformative feelings in parents and young patients, leading to important personal growth. Lastly, this article discusses the need to improve palliative psychological care competences in pediatric oncology. By providing comprehensive psychological care to young oncology patients and their families, healthcare providers can mitigate the psychological stress and pain associated with the diagnosis and treatment of cancer. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

12 pages, 806 KiB

Open AccessArticle

Mental Health of Prostate Cancer Patients: Content Review on YouTube^TM

by Benedetta Muzii, Francesco Di Bello, Fabio Carraturo, Tiziana Di Perna, Gianluigi Califano, Simone Morra, Francesco Mangiapia, Cristiano Scandurra, Luigi Giuliani, Giuseppe Celentano, Roberto La Rocca, Massimiliano Creta, Nicola Longo, Nelson Mauro Maldonato and Claudia Collà Ruvolo

Int. J. Environ. Res. Public Health 2023, 20(6), 4721; https://doi.org/10.3390/ijerph20064721 - 7 Mar 2023

Cited by 3 | Viewed by 1392

Abstract

The aim of this study is to evaluate YouTube™ content in terms of the quality of information available about prostate cancer (PCa) in relation to incidence, symptomatology, and potential treatments for patients’ mental health. We searched on YouTube™ for terms related to mental health combined with those relating to prostate cancer. Tools for audio–visual-content PEMAT A/V, Global Quality Score, and DISCERN score were applied for the assessment of videos’ quality. A total of 67 videos were eligible. Most of the analyzed YouTube™ videos were created by physicians (52.2%) in contrast to other author categories (48.8%). According to the PEMAT A/V, the median score for Understandability was 72.7% and the overall median score for Actionability was 66.7%; the median DISCERN score was 47, which correspond to a fair quality. Only videos focusing on the topic “Psychological Effects and PCa treatment” were significantly more accurate. The General Quality Score revealed that the majority of YouTube™ videos were rated as “generally poor” (21, 31.3%) or “poor” (12, 17.9%). The results suggest that the content of YouTube™ videos is neither exhaustive nor reliable in the current state, illustrating a general underestimation of the mental health of prostate cancer patients. A multidisciplinary agreement to establish quality standards and improve communication about mental health care is needed. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

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12 pages, 376 KiB

Open AccessArticle

The Experience of COVID-19 in a Sample of Gynecological Cancer Patients Undergoing Chemotherapy: A Focus on the Psychological Implications

by Gaia Perego, Valentina Elisabetta Di Mattei, Martina Mazzetti, Francesca Milano, Carola Gatti, Paola Maria Vittoria Rancoita, Paola Taranto, Emanuela Rabaiotti, Raffaella Cioffi and Massimo Candiani

Int. J. Environ. Res. Public Health 2023, 20(5), 3851; https://doi.org/10.3390/ijerph20053851 - 21 Feb 2023

Viewed by 1280

Abstract

Cancer patients are at an increased risk of developing severe consequences due to the COVID-19 infection. However, psychological outcomes in this population have been overlooked in the literature. The present study aims to identify significant psychological differences between gynecological cancer patients undergoing chemotherapy before and during the pandemic. Additionally, we explore the correlations between COVID-19-related concerns and anxiety, depression, distress, and quality of life levels. Forty-two patients completed the STAI-Y, the EORTC QLQ-C30, the BDI II, the DT, and an ad-hoc questionnaire that investigated COVID-19-related concerns. The analyses did not show significant differences in the psychometric scales between the two groups, highlighting a considerable resilience against mental health and quality of life deterioration during the COVID-19 pandemic in gynecologic cancer patients. However, COVID-19-related concerns were positively associated with anxiety and inversely related to emotional functioning levels. These results emphasize the importance of a comprehensive patient care and the need to implement a multidisciplinary approach that includes psychological support in the treatment plan. Moreover, it is essential to encourage clear communication to convey comprehensive information about the impact of the pandemic on physical and psychological levels, as well as to offer psychoeducational tools to face the pandemic. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

21 pages, 2328 KiB

Open AccessArticle

The Role and Function of Autobiographical Memory Narratives during the Emotional Processing of Breast Cancer Treatment: An Empirically-Derived Memory Coding System

by Maria Luisa Martino, Daniela Lemmo, Joshua Moylan, Caroline Stevenson, Laura Bonalume, Maria Francesca Freda and Jefferson A. Singer

Int. J. Environ. Res. Public Health 2023, 20(2), 1492; https://doi.org/10.3390/ijerph20021492 - 13 Jan 2023

Cited by 5 | Viewed by 1905

Abstract

Breast cancer (BC) in younger age is a critical and potentially traumatic experience that can interrupt the continuity of self-narrative during a crucial phase. In the Narrative Identity framework the translation of memories into autobiographical narratives is an internal and external process that plays a key role in meaning-making, social relationships and self-coherence. The aim of this study is to examine the role and function that autobiographical memory narratives (AMN) play in the process of adaptation to BC medical treatment. Seventeen BC women below 50 years received prompts to provide autobiographical memory narratives at four phases during their treatment (pre-hospitalization-T1-post-surgery-T2-chemo-radio therapy-T3-follow-up-T4). The Emotional Processing Scale (EPS) was also administered. In all, 68 AMN were collected. A three step procedure of data analysis was conducted. The first one, an empirically-derived memory coding manual to analyze key dimensions of AMN was developed: Agency; Emotional Regulation and Interpersonal Relations. Findings show a particular vulnerability in narrative identity faced by BC women during the shift from T1-T3. In the second one, an emotional coping profile for each woman focusing on the shift from T1-T3 was created. For the third step, these profiles were compared with the EPS scores. The final results suggest the capacity of the AMNs to differentiate the women’s emotional adaptation over the course of the BC treatment. Despite the study’s limitations, it supports the use of AMN as clinical device to construct a deeper knowledge and profiling trajectory of how women have internalized and elaborated past encounters with illness and help providers, as well as their prior experience of bodily/psychological health and integrity. This information adds to an understanding of their current efforts at recovery and adaptation. In this way we believe that the recollection of narrative memories, not only at the end of the cancer treatment but also during its process, could help the women to mend the broken continuity of their narrative self, as they seek to maintain a healthy balance of internal resources across their past, present, and projected future. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

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17 pages, 874 KiB

Open AccessArticle

The Body after Cancer: A Qualitative Study on Breast Cancer Survivors’ Body Representation

by Valeria Sebri, Ilaria Durosini, Davide Mazzoni and Gabriella Pravettoni

Int. J. Environ. Res. Public Health 2022, 19(19), 12515; https://doi.org/10.3390/ijerph191912515 - 30 Sep 2022

Cited by 22 | Viewed by 2318

Abstract

Objective: The relationship with the body is a relevant issue for breast cancer survivors. Oncological treatments damage their bodies due to scars, weight gain, and other side effects. Starting from the efficacy of psychological interventions for breast cancer survivors, a tailored psychological support program was provided to promote overall well-being after illness dealing with bodily signals and related emotions and thoughts. This study presents changes in the description of the relationship with their bodies as well as participants’ emotions and thoughts before and after a psychological intervention. Methods and Measures: Eighteen women answered questions related to their bodies before and after the psychological intervention. Results were analyzed in accordance with the procedure of the Word Association Analysis through the T-Lab software and the Qualitative Thematic Analysis. Results: Participants reported a great awareness of their bodies and the desire to take care of them daily. In particular, the body is now perceived as a helper to sustain breast cancer survivors in their everyday activities. Conclusion: The words and the themes that characterized the participants’ reports highlighted the impact of cancer diagnosis and oncological therapies on breast cancer survivors. The participation in the psychological intervention focused on self-compassion towards their body helps women to create an improved body perception. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

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9 pages, 319 KiB

Open AccessArticle

Failures in Reflective Functioning and Reported Symptoms of Anxiety and Depression in Bereaved Individuals: A Study on a Sample of Family Caregivers of Palliative Care Patients

by Vittorio Lenzo, Alberto Sardella, Alessandro Musetti, Maria Cristina Petralia, Irene Grado and Maria C. Quattropani

Int. J. Environ. Res. Public Health 2022, 19(19), 11930; https://doi.org/10.3390/ijerph191911930 - 21 Sep 2022

Cited by 5 | Viewed by 1491

Abstract

Introduction. This study aims at examining the role of failures in reflective functioning in predicting anxiety and depression among family caregivers of palliative care patients deceased for at least one year. Methods. A sample of 157 bereaved participants (77.1% females, mean age = 43.50 ± 14.04 years) completed the Hospital Anxiety and Depression Scale (HADS) and the Reflective Functioning Questionnaire (RFQ). Results. Results of the correlational analysis showed that anxiety was positively correlated with uncertainty about mental states, indicating one type of impairment in reflective functioning. Anxiety was also negatively correlated with the certainty about mental states. Depression was negatively correlated with certainty but not with uncertainty about mental states. The results of regression analysis indicated that gender and certainty about mental states were statistically significant predictors of anxiety, with the final model explaining 23% of the variance. The results also showed that gender, the condition of being the main caregiver, and the certainty about mental states were significant predictors of depression, with the final model predicting 14% of the variance. Conclusions. Overall, the results of this study point out that the bereaved individuals who scored low on certainty about mental states reported more symptoms of anxiety and depression. Psychological interventions to prevent mental disorders and to promote psychological health in the context of palliative care should carefully consider these findings. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

18 pages, 388 KiB

Open AccessArticle

The Relationship between Healthcare Providers and Preventive Practices: Narratives on Access to Cancer Screening

by Daniela Lemmo, Maria Luisa Martino, Anna Rosa Donizzetti, Maria Francesca Freda and Daniela Caso

Int. J. Environ. Res. Public Health 2022, 19(17), 10942; https://doi.org/10.3390/ijerph191710942 - 1 Sep 2022

Cited by 3 | Viewed by 1832

Abstract

Cancer screening programs are public health interventions beneficial to early diagnoses and timely treatments. Despite the investment of health policies in this area, many people in the recommended age groups do not participate. While the literature is mainly focused on obstacles and factors enabling access to health services, a gap from the point of view of the target population concerns healthcare providers. Within the “Miriade” research–action project, this study aims to explore the dimensions that mediate the relationship between healthcare providers and preventive practices through the narrations of 52 referents and healthcare providers involved in breast, cervical and colorectal cancer screening. We conducted ad hoc narrative interviews and used theory-driven analysis based on Penchansky and Thomas’ conceptualization and Saurman’s integration of six dimensions of healthcare access: affordability, availability, accessibility, accommodation, acceptability and awareness. The results show that 21 thematic categories were representative of the access dimensions, and 5 thematic categories were not; thus, we have classified the latter as the dimension of affection. The results suggest trajectories through which psychological clinical intervention might be constructed concerning health, shared health decisions and access to cancer screening. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

12 pages, 317 KiB

Open AccessArticle

Investigating PTG in Cancer Patients: The Role of Time Dimension in the Experience of Personal Growth

by Chiara Fioretti, Viola Vinciarelli, David Faggi, Lucia Caligiani, Francesca Tessitore, Gianluca Castelnuovo and Mauro Cozzolino

Int. J. Environ. Res. Public Health 2022, 19(15), 9619; https://doi.org/10.3390/ijerph19159619 - 4 Aug 2022

Cited by 3 | Viewed by 1734

Abstract

This study explored the experience of growth related to being a cancer patient by implementing a thematic analysis. An online questionnaire was completed by 69 patients narrating their growth experience related to cancer. Collected narratives were analyzed by running a deductive thematic analysis, starting from the five domains of the Post-Traumatic Growth Inventory (PTGI) and searching for the presence or absence of topics. Descriptive statistics and correlational analysis were performed. The five factors of the PTGI were identified in the narratives. The thematic analysis we performed defined a further theme that we labeled the “time dimension”, which saturated 37.7% of the entire sample. The presences of four sub-themes related to the “time dimension” were also found: “tracing a new temporal rhythm”, “the value of deserved time”, “facing the caducity of life” and “a view on the future”. Each sub-theme significantly correlated with the theme of the “time dimension”. This emergent theme does not correlate in our results with other domains of personal growth in cancer previously described in the scientific literature, emerging as an independent variable not significantly associated with other domains of post-traumatic growth. Our results suggest further investigation in the role of the time dimension in the practical and emotional experience of growth with regard to cancer. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

9 pages, 2146 KiB

Open AccessArticle

Early Diagnosis of Melanoma and Breast Cancer in Women: Influence of Body Image Perception

by Jessica Ranieri, Dina Di Giacomo, Federica Guerra, Eleonora Cilli, Alessandra Martelli, Valeria Ciciarelli, Alessandra Ventura and Maria Concetta Fargnoli

Int. J. Environ. Res. Public Health 2022, 19(15), 9264; https://doi.org/10.3390/ijerph19159264 - 28 Jul 2022

Cited by 1 | Viewed by 1595

Abstract

The diagnosis of melanoma and breast cancer may impact many aspects of life with significant reductions in emotional functioning and quality of life. The aim of the study was to analyze the emotional traits of female patients with oncological in early-stage diagnosis, investigating predictors for psychological distress and analyzing body image perception. An observational study was conducted, A sample of 84 female cancer patients (age range 30–55 years) with melanoma (n = 42) and breast cancer diagnosis (n = 42). The examined emotional variables were psychological distress; depression, stress, and anxiety; metacognitions; and body self-perception. Findings showed higher psychological distress in breast cancer than in melanoma patients (p = 0.00), which was related to lower positive self-perception of body image (p = 0.03). Furthermore, psychological distress was negatively correlated with consequences of clinical treatment on body image, and low well-being affected the social interaction and well-being with own body. There was no significant difference between cancer staging and timing from diagnosis. Prevention and therapeutic psychological protocols might be adapted and tailored to the unmet needs of the patients in medical treatments to promote and enhance the Quality of Life in survivorship. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

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Review

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21 pages, 419 KiB

Open AccessReview

A Theoretically Informed Critical Review of Research Applying the Concept of Liminality to Understand Experiences with Cancer: Implications for a New Oncological Agenda in Health Psychology

by Paul Stenner and Raffaele De Luca Picione

Int. J. Environ. Res. Public Health 2023, 20(11), 5982; https://doi.org/10.3390/ijerph20115982 - 29 May 2023

Cited by 4 | Viewed by 2144

Abstract

Liminality was described more than 20 years ago as a major category explaining how cancer is experienced. Since then, it has been widely used in the field of oncology research, particularly by those using qualitative methods to study patient experience. This body of work has great potential to illuminate the subjective dimensions of life and death with cancer. However, the review also reveals a tendency for sporadic and opportunistic applications of the concept of liminality. Rather than being developed in a systematic way, liminality theory is being recurrently ‘re-discovered’ in relatively isolated studies, mostly within the realm of qualitative studies of ‘patient experience’. This limits the capacity of this approach to influence oncological theory and practice. In providing a theoretically informed critical review of liminality literature in the field of oncology, this paper proposes ways of systematizing liminality research in line with a processual ontology. In so doing, it argues for a closer engagement with the source theory and data, and with more recent liminality theory, and it sketches the broad epistemological consequences and applications. Full article

(This article belongs to the Special Issue Clinical Health Psychology for Cancer Experience: Current Challenges among Prevention, Treatment and Chronicity)

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