Objectives Adolescents and young adults (AYAs) are diagnosed with cancer during a critical life period full of psychosocial challenges. They may experience a significant impact of the cancer diagnosis on their psychological health, also in the long term. We aimed to (a) evaluate psychological distress in AYA cancer survivors and compare levels of distress with controls and (b) describe socio‐demographic and cancer‐related characteristics associated with psychological distress. Methods We sent a questionnaire to AYA cancer survivors (aged 16‐25 y at diagnosis, survived ≥5 y) registered in the Cancer Registry Zurich and Zug, Switzerland. Psychological distress was measured using the Brief Symptom Inventory‐18 (BSI‐18) assessing anxiety, depression, and somatization and a global severity index (GSI) (cutoff score indicating psychological distress: T ≥ 57). Distress levels were compared between survivors and controls. We used logistic regression to determine associations of socio‐demographic and cancer‐related characteristics with distress. Results Of 160 AYA cancer survivors, 34 (21%) reported being distressed (27% in women, 17% in men; P = 0.129). Compared with controls, survivors did not report higher levels of distress (all P values > 0.05). Survivors with migration background and survivors with late effects reported higher levels on GSI, somatization, and anxiety. Higher levels of depression were associated with being female, not being in a partnership, and having late effects. Conclusions A substantial subgroup of AYA cancer survivors reported psychological distress. Systematically screening for distress and providing psychological follow‐up for survivors at risk may help to provide adequate psychological support.
Results emphasize the need for individualized support services to improve survivors' HRQoL in vulnerable subgroups. We recommend adapted care for women and migrants, in addition to educational and employment support systems.
Objective Evidence suggests benefits of long‐term follow‐up care attendance for childhood cancer survivors, but studies show poor inclusion of survivorship issues and needs. While information needs of childhood cancer survivors have been addressed previously, few studies specifically investigated the supportive care needs of survivors beyond the domain of information and communication. Therefore, this qualitative study aimed to assess the unmet needs of childhood cancer survivors with regards to their long‐term survivorship. Methods Childhood Cancer Switzerland invited survivors of childhood cancer to participate in our study. We used semistructured interviews to assess survivors' experiences regarding the impact of their disease and the (un)met needs during their survivorship. Data analysis followed the principles of qualitative content analysis. Results Interviews were conducted with 28 childhood cancer survivors (mean age 31 years, age at diagnosis 9 years, time since end of treatment 19 years). Key themes in relation to unmet needs of survivors were (1) lacking psychosocial support, (2) lacking collaboration and decentralization of care, (3) starting from zero, and (4) need for centralized, specialized, and individualized services. Conclusions Our findings revealed a demand for integrating psychosocial support in long‐term follow‐up care and a strong need for personalized, centralized, and interdisciplinary long‐term follow‐up care. Current established interdisciplinary clinics should be further extended to provide centralized, personalized, and evidence‐based long‐term follow‐up care including adequate psychosocial support for all childhood cancer survivors.
Objective: Physiological and psychological sequelae are frequent after a cancer diagnosis and also on the long term. Screening could help detect psychological distress early and thus enable timely provision of adequate treatment. The emotion thermometer (ET) is a validated screening tool including five dimensions (distress, anxiety, depression, anger, and need-for-help). Reviewing the literature, we aimed to describe (a) the validity and (b) the application of the ET.Methods: Six databases were systematically searched for studies using the ET in individuals diagnosed with cancer. Included studies were critically appraised for methodological quality. ET validity and application were narratively synthesized.Results: We identified 580 records eligible for title-abstract screening. Seventeen studies based on 13 different populations were included. Validation studies (5 of 17) concluded that the ET is sensitive to distress detection, delivering prompt and accurate results with no negative impact on clinic visit time. Furthermore, its use is accepted in patients and clinicians. The remaining 12 exploratory studies applied the ET for screening purposes (3 of 12), as outcome measure (6 of 12), or as predictor variable measure (3 of 12). Most studies were conducted in Europe (11 of 17), and 7 of the 12 exploratory studies used the recommended cutoff (greater than or equal to 4). Study populations were mostly female (9 of 13) with a mean age greater than 50 years (12 of 13) at study. Conclusions:Publications on distress screening with the ET are scarce, especially among young populations. However, research and studies' recommendations support the ET's utility as a valid and feasible tool for distress screening including anxiety and depression and suggest its implementation as part of a structured program for early screening in cancer care.
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