No abstract

Major professional organizations have called for psychosocial risk screening to identify specific psychosocial needs of children with cancer and their families and facilitate the delivery of appropriate evidence-based care to address these concerns. However, systematic screening of risk factors at diagnosis is rare in pediatric oncology practice. Subsequent to a brief summary of psychosocial risks in pediatric cancer and the rationale for screening, this review identified three screening models and two screening approaches (Distress Thermometer [DT], Psychosocial Assessment Tool [PAT]), among many more papers calling for screening. Implications of broadly implemented screening for all patients across treatment settings are discussed.

Interventions using delivery methods varying from traditional counseling to computers achieved moderate to strong efficacy and merit replication. Survivor needs related to transition to adult-oriented health care and school reentry were not addressed by existing interventions. This review also revealed the absence of health behavior interventions for survivors in middle childhood and late adolescence. Intervention formats that are cost-effective and reduce participant burden should be prioritized for further testing. To broaden the reach and appeal of interventions, alternative delivery methods, such as mobile phone software applications, should be evaluated.

Background While poor adherence to hormonal therapies such as aromatase inhibitors (AIs) is widely documented, less is known about whether health beliefs predict treatment non-adherence. This study aimed to evaluate the relationship between health beliefs (perceived susceptibility to breast cancer, perceived benefits of AI treatment, perceived barriers to AI treatment) and adherence to AIs. Methods Postmenopausal women with early stage estrogen receptor positive breast cancer who were currently on an AI completed the three-factor Health Beliefs and Medication Adherence in Breast Cancer (HBMABC) scale and questionnaires about their demographics and symptoms. Adherence data (treatment gaps and premature discontinuation) were abstracted from participants’ medical charts. Logistic regression analyses were conducted to evaluate the relationship between health beliefs and adherence. Results Among 437 participants, 93 (21.3%) were non-adherent. Those who perceived greater barriers to their AI treatment were more likely to display AI non-adherence behaviors by the end of their treatment period than those who reported fewer barriers to AI therapy (adjusted odds ratio 1.71, 95% confidence interval: 1.03 – 2.86, p = 0.04). In contrast, perceived susceptibility to cancer recurrence and perceived benefits of AIs did not predict AI adherence. Minorities had lower perceived susceptibility to breast cancer recurrence and higher perceived barriers to AI treatment (p < 0.05 for both). Conclusions Greater perceived barriers predicted non-adherence to AIs. Interventions addressing women’s negative beliefs about the challenges of AI treatment are needed to help optimize adherence in breast cancer survivors.

Perceptions of ageing related to arthralgia and depressive symptoms predicted non-adherence to AIs. These findings suggest that interventions that address negative beliefs about ageing due to AI-related arthralgia and depressive mood can potentially improve rates of adherence to AIs.