Objective: Research on the relationship between post-traumatic stress disorder (PTSD)/post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in cancer patients and survivors is increasing. Methods:We conducted a systematic review and meta-analysis of 51 studies that assessed the relationship between PTSD/PTSS and PTG, in cancer patients/survivors. Five databases were searched through 29 April 2019. The purpose of this manuscript is to report a summary of this literature, the aggregate effect size of the relationship between PTSD and PTG, and the examination of potential moderators that may impact the relationship between PTSD and PTG. Results:The aggregate weighted effect size for the association between PTSD/PTSS and PTG was small, r = .08, but significantly different from zero. We examined whether time since diagnosis, stage of cancer, type of measure used to assess PTSD/ PTSS, or type of measure used to assess PTG explained the significant heterogeneity among the individual effect sizes. The relationship was significantly stronger for the small subset of studies that included only stage 4 patients compared with those that included only non-stage 4 patients. Additionally, the strongest relationship was for those studies that used the Impact of Events Scale-Revised to assess PTSD. Conclusions:The relationship between PTSD/PTSD and PTG is modestly positive and robust. There is evidence that the threat of advanced cancer is more strongly associated with growth, but none supporting that more time since cancer diagnosis allows survivors the opportunity to positively reinterpret and find meaning in the traumatic aspects of the disease resulting in more growth. K E Y W O R D S cancer, oncology, post-traumatic growth, post-traumatic stress disorder 1 | BACKGROUND Individuals with many illnesses live longer than they would have years ago. As a result, psychological effects of cancer diagnosis and treatment are more often reported than they were in the past. In response, in 1994, the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), broadened its criteria for posttraumatic stress disorder (PTSD) by incorporating an additional criterion-being diagnosed with a life-threatening illness-to those that constitute a traumatic event. Some have argued that cancer is This work was conducted at Stony Brook University.
Background The most common, persistent concern among breast cancer survivors is the fear that their disease will return, yet few interventions targeting fear of cancer recurrence (FCR) have been developed. This pilot study examined the feasibility, acceptability, and preliminary efficacy of a home-delivered cognitive bias modification (CBM) intervention to reduce FCR. The intervention, Attention and Interpretation Modification for Fear of Breast Cancer Recurrence (AIM-FBCR), targeted two types of cognitive biases (i.e., attention and interpretation biases). Methods Breast cancer survivors (n=110) were randomized to receive eight sessions of one of two versions of AIM-FBCR or a control condition program. Computer-based assessments of cognitive biases and a self-report measure of FCR were administered pre-intervention, post-intervention, and 3 months post-intervention. Results Improvements in health worries (p=.019) and interpretation biases (rates of threat endorsement, p<.001; and reaction times for threat rejection, p=.007) were found in those who received AIM-FBCR as compared to the control arm. While only 26% of participants who screened into the study agreed to participate, the trial otherwise appeared feasible and acceptable, with 83% of those who began the intervention completing at least 5 of 8 sessions, and 90% reporting satisfaction with the computer-based program used. Conclusions This pilot study suggests the promise of AIM-FBCR in reducing FCR in breast cancer survivors. Future research should attempt to replicate these findings in a larger-scale trial using a more sophisticated, user-friendly program and additional measures of improvement in more diverse samples. ClinicalTrials.gov Identifier: NCT01517945.
PURPOSE: With onset of the COVID-19 pandemic, telehealth became the primary modality for health care appointments. This study examined patient experiences with and preferences for telehealth at a cancer genetic counseling clinic throughout the first 6 months of the pandemic (March-August 2020). METHODS: An anonymous survey assessed patient demographics; usage and prior experience with technology; emotional responses, technical experiences, and satisfaction with the telehealth appointment (via the Genetic Counseling Satisfaction Scale and Visit-Specific Satisfaction Questionnaire); preference for future telehealth; and recommendation of telehealth to others. RESULTS: Among 380 respondents, most were highly satisfied with the telehealth appointment (with 65.6% and 66.4% of participants completing the Genetic Counseling Satisfaction Scale and Visit-Specific Satisfaction Questionnaire, respectively). Multivariable analyses indicated several notable findings. Adjusting for relevant covariates, participants with less education felt significantly more concerned about telehealth than those with highest educational attainment. Participants age 40-69 years were generally more comfortable, relieved, and grateful that their appointment was scheduled as telehealth than were those older than 70 years. Women were marginally more relieved and grateful for telehealth appointments than men. As the pandemic progressed, significantly more participants were highly satisfied with their telehealth appointment and participants trended toward having greater preferences for future telehealth use. Most participants (78.6%) would recommend telehealth to others, although 50.8% preferred future in-person appointments. CONCLUSION: As the pandemic progressed, patients expressed increasing preferences for and satisfaction with telehealth. Service delivery models that incorporate individual patient preferences should be developed with special consideration to factors such as age, sex, and education level.
Controlling the COVID-19 pandemic has required communities to engage in prosocial action, including behaviors that may inconvenience individuals, but protect the collective (e.g., mask wearing, social distancing). The purpose of this study was to understand to what extent COVID-19 prosocial beliefs and behavior differ by race/ethnicity and why this might be the case. A US nationally representative sample of 410 adults completed a survey about COVID-19 beliefs and prevention behaviors between June 12 and 18, 2020. Compared to White respondents, Black respondents perceived the risk of COVID-19 to be greater to the US population; and both Black and Latinx respondents thought it was more important to protect a variety of non-close others (e.g., people in their city or state). Black and Latinx respondents engaged in several prevention behaviors, including social distancing, to a greater extent than White respondents. There were indirect effects of Black vs. White race on engaging in protective behaviors through greater perceived risk to others and beliefs in the importance of protecting distal others. Results indicate that targeted messages promoting prevention, including vaccination with pro-social messages, may resonate with communities of color. They also suggest that lower levels of prosocial beliefs among White people have likely hindered the US response to the epidemic.
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