Childhood cancer treatment completion is a significant milestone. However, coming off treatment may be a time of psychological vulnerability for parents. This review assesses published research (1979-2009) on the psychosocial impact of treatment completion on parents. Fifteen articles met all inclusion criteria and demonstrated that while they celebrate treatment completion, parents (particularly mothers) can experience significant distress, including fear of recurrence, fatigue, and loneliness. Distress appears to ease with time, possibly as the perceived risk of relapse declines. Continued psychosocial support specifically targeting parents' risk perceptions, physical and emotional fatigue, social isolation, and parenting concerns post-treatment is warranted.
Primary prevention and early detection continue to be of paramount importance in addressing the public health threat of skin cancer. The aim of this systematic review was to provide a comprehensive overview of the prevalence and correlates of skin cancer-related health behaviors in the general population. To achieve this aim, 91 studies published in international peer-reviewed journals over the past three decades were reviewed and synthesized. Reported estimates of sunscreen use varied considerably across studies, ranging from 7 to 90%. According to self-report, between 23 and 61% of individuals engage in skin self-examination at least once per year, and the documented prevalence of annual clinical skin examination ranges from 8 to 21%. Adherence to sun protection and screening recommendations is associated with a range of factors, including: female gender, sun-sensitive phenotype, greater perceived risk of skin cancer, greater perceived benefits of sun protection or screening, and doctor recommendation for screening. The literature suggests that a large proportion of the general population engage in suboptimal levels of sun protection, although there is substantial variability in findings. The strongest recommendation to emerge from this review is a call for the development and widespread use of standardized measurement scales in future research, in addition to more studies with a population-based, multivariate design. It is also recommended that specific targeted interventions are developed to increase the prevalence of preventative and early intervention behaviors for the control of skin cancer.
A cluster, stratified randomized design was used to evaluate the impact of universal, indicated, and combined universal plus indicated cognitive- behavioral approaches to the prevention of depression among 13- to 15-year-olds initially reporting elevated symptoms of depression. None of the intervention approaches differed significantly from a no-intervention condition or from each other on changes in depressive symptoms, anxiety, externalizing problems, coping skills, and social adjustment. All high-symptom students, irrespective of condition, showed a significant decline in depressive symptoms and improvement in emotional well-being over time although they still demonstrated elevated levels of psychopathology compared with the general population of peers at 12-month follow-up. There were also no significant intervention effects for the universal intervention in comparison with no intervention for the total sample of students in those conditions.
Objective: To conduct a systematic review of the literature to identify the prevalence of, and demonstrated risk factors for, psychological distress among individuals affected by, or at high risk of developing, melanoma. For a substantial subset of patients, the diagnosis and/or treatment of cutaneous malignant melanoma may cause significant psychological distress. Data Sources: Using the MEDLINE, PsycINFO, and CINAHL databases, published studies (1988 to March 2008) of individuals affected by melanoma were included if they examined the demographic, clinical, psychological, and/or social correlates of emotional distress. Study Selection: Searches were restricted to publications in English and were supplemented by citation lists in retrieved articles and contact with researchers. Data Extraction: A total of 356 articles were critically appraised by 2 reviewers to assess eligibility and clinical evidence level. A total of 44 studies met the inclusion criteria. Data Synthesis: Approximately 30% of patients with melanoma reported clinically relevant levels of psychological distress, as measured by a range of validated scales, with symptoms of anxiety more prevalent than depression. A number of empirically demonstrated risk factors for distress were identified, including female sex, younger age, lower education, visibility of affected body site, lack of social support, and negative appraisal of melanoma. Conclusions: Routine psychological screening of patients with melanoma is widely recommended as standard practice; however, standard screening measures may have limited sensitivity and specificity as demonstrated by the wide range of results reported in this review. Development of a brief screening tool that incorporates empirically supported risk factors is recommended to improve the timely identification and support of those patients most susceptible to adverse psychological outcomes.
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