The physical and psychosocial consequences for patients undergoing blood SCT for the treatment of cancer and their families have been extensively documented. There has, however, been far less investigation into the psychosocial consequences for sibling donors who are both family members and undergoing an invasive medical procedure. The aim of this study was therefore to explore the psychosocial impact of PBSC donation before, during and after donation, and to gain insight into donors' experiences of the preparation for, and procedures associated with, donation. Participants included 13 men and 9 women, with a mean age of 53.1 (SD ¼ 9.4) years, who underwent PBSC or BM donation between 2007 and 2010. Data were collected via face-to-face or telephone interviews and a questionnaire. Results revealed that a broad range of both positive and negative emotions were experienced at different time points during donation. The psychosocial impact of donation was also influenced by the interactions between factors such as pragmatic aspects of the donation process; family dynamics; perceived adequacy of preparation and emotional support; and uncertainty related to health outcomes for the recipient and donor. Routine provision of psychosocial support to donors as well as recipients is therefore important.
Immunotherapies and targeted therapies have revolutionised treatment of metastatic melanoma and improved survival rates. However, survivors treated with novel therapies are vulnerable to high levels of fear of cancer recurrence or progression (FCR). Existing FCR interventions have rarely been trialled in people with advanced cancer. The current study aimed to evaluate the acceptability and feasibility of Fear-Less: a stepped-care model to treat FCR in people with metastatic melanoma treated with immunotherapy or targeted therapy. Sixty-one outpatients with metastatic melanoma were screened using the Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) and Fear of Progression Questionnaire Short Form (FoP-Q-SF). Survivors with subthreshold FCR were stratified to a self-management intervention while those with clinical levels of FCR were provided with an individual therapy, Conquer Fear. Survivor experience surveys and rescreening were administered post-intervention completion. Results indicated that Fear-Less was an acceptable and feasible FCR intervention. Results provided preliminary support for the potential impact of Fear-Less in reducing FCR. Fear-Less is a promising first step in providing an acceptable and feasible stepped-care model to treat FCR in survivors with metastatic disease.
Given that SOC was related to depression and QoL dimensions post-transplantation, it may be important for health care professionals to conduct psychosocial assessments to determine patient SOC. This would enable provision of tailored psychological support prior to and following stem cell transplantation.
Objective: To describe the outcomes and clinical experience of a 12‐week pilot study of routine distress screening of newly admitted patients to an acute haematology and oncology ward. Design, patients and setting: Bedside measurement of psychological distress, and collection of demographic and clinical data for 115 newly admitted patients in an acute haematology and oncology ward of The Alfred hospital in Melbourne between 5 June and 25 August 2006. Main outcome measures: Psychosocial distress as measured by the Distress Thermometer and Problem Checklist, and 18‐item Brief Symptom Inventory; rate of referral to psychology and social work services in the 12 weeks before and 12 weeks during the pilot study; ward staff feedback on the benefits and challenges associated with routine distress screening. Results: 51% of patients were identified as being significantly distressed, of whom 47% had not received psychosocial support before screening. A significantly higher number of emotional and physical problems were reported by significantly distressed patients. Referrals to psychology and social work services during the pilot study increased, highlighting that screening directed more patients into care. Staff were generally positive about the ability of routine screening to help them care for their patients, and most agreed that some form of routine screening should continue. Conclusion: The use of routine distress screening by inpatient cancer services can significantly improve their capacity to offer psychosocial care.
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is an intervention that targets common mechanisms that maintain symptoms across multiple disorders. The UP has been shown to be effective across many disorders, including generalized anxiety disorder, major depressive episode (MDE), and panic disorder, that commonly codevelop following trauma exposure. The present study represented the first randomized controlled trial of the UP in the treatment of trauma‐related psychopathology, including posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Adults (N = 43) who developed posttraumatic psychopathology that included PTSD, MDE, or an anxiety disorder after sustaining a severe injury were randomly assigned to receive 10–14 weekly, 60‐min sessions of UP (n = 22) or usual care (n = 21). The primary treatment outcome was PTSD symptom severity, with secondary outcomes of depression and anxiety symptom severity and loss of diagnosis for any trauma‐related psychiatric disorder. Assessments were conducted at intake, posttreatment, and 6‐month follow‐up. Posttreatment, participants who received the UP showed significantly larger reductions in PTSD, Hedges’ g = 1.27; anxiety, Hedges’ g = 1.20; and depression symptom severity, Hedges’ g = 1.40, compared to those receiving usual care. These treatment effects were maintained at 6‐month follow‐up for PTSD, anxiety, and depressive symptom severity. Statistically significant posttreatment loss of PTSD, MDE, and agoraphobia diagnoses was observed for participants who received the UP but not usual care. This study provides preliminary evidence that the UP may be an effective non–trauma‐focused treatment for PTSD and other trauma‐related psychopathology.
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