A Support System for Adolescent and Young Adult Patients with Cancer at a Comprehensive Cancer Center

Ishiki, Hiroto; Hirayama, Takatoshi; Horiguchi, Saki; Iida, Ikumi; Kurimoto, Tamae; Asanabe, Mihoko; Nakajima, Miho; Sugisawa, Akiko; Mori, Akira; Kojima, Yoshiyuki; Udagawa, Ryoko; Takahashi, Hayato; Oki, Mami; Shimizu, Mariko; Yanai, Yuko; Touma, Shoko; Nozawa, Keiko; Kojima, Rebekah; Inamura, Naoko; Maehara, Asami; Suzuki, Tatsuya; Satomi, Eriko

doi:10.31662/jmaj.2021-0106

Cited by 6 publications

(1 citation statement)

References 58 publications

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“…First, this study had a single-center retrospective cohort design. Results might not be generalizable to other settings because the NCCH support system for AYA patients with cancer was robust [ 42 – 45 ]. Further prospective multicenter studies are needed.…”

Section: Discussionmentioning

confidence: 99%

Mental health care use and related factors in adolescents and young adults with cancer

Hirayama¹,

Ikezawa

Okubo

et al. 2023

Support Care Cancer

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Purpose The actual state of mental health care use and related factors in adolescent and young adult (AYA) patients with cancer is not well understood in Japan. This study aimed to (1) examine the actual state of mental health care use among AYA patients with cancer and (2) describe socio-demographic and related factors associated with mental health care use. Methods We retrospectively reviewed the medical records of AYA patients with cancer aged 15–39 who first visited the National Cancer Center Hospital in Japan (NCCH) between January 2018 and December 2020. Logistic regression was used to analyze the association between social background characteristics and mental health care use. The association between the patient's course of cancer treatment and mental health care use was analyzed to help identify which patients might benefit from early mental health intervention. Results Among 1,556 patients, 945 AYA patients with cancer were registered. The median age at the time of the study was 33 years (range, 15–39 years). The prevalence of mental health care use was 18.0% (170/945). Age 15–19 years, female gender, urogenital cancer, gynecological cancer, bone or soft tissue cancer, head and neck cancer, and stage II–IV disease were associated with mental health care use. Regarding treatment, palliative treatment, chemotherapy, and hematopoietic stem cell transplantation were associated with mental health care use. Conclusion Factors associated with mental health care use were identified. Our findings potentially contribute to psychological support interventions for AYA patients with cancer.

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Section: Discussionmentioning

confidence: 99%

Mental health care use and related factors in adolescents and young adults with cancer

Hirayama¹,

Ikezawa

Okubo

et al. 2023

Support Care Cancer

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Feasibility and preliminary effectiveness of a psychosocial support program for adolescent and young adult cancer patients in clinical practice: a retrospective observational study

Hirayama¹,

Fujimori²,

Ito

et al. 2023

Support Care Cancer

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Purpose Adolescent and young adult cancer patients (AYAs) often experience profound psychological distress, with various unmet supportive care needs that can be alleviated with appropriate screening and attention by healthcare workers. The Distress Thermometer and Problem List-Japanese version (DTPL-J) is our previously developed screening tool to facilitate individual support of AYAs. This study evaluated the feasibility and preliminary effectiveness of a psychosocial support program based on the DTPL-J for AYAs in clinical practice. Methods This multicenter, retrospective, observational study included 19 of 126 wards and 9 of 75 outpatient clinics at 8 institutions in Japan. Over 200 patients were expected to participate during the eligibility period. Patients participated in a support program at least once, and approximately once a month based on the DTPL-J results. The program was evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) implementation framework. Results The screening rate of the 361 participants was 90.3%, suggesting high feasibility. Distress Thermometer scores, the number of supportive care needs, and the rates of AYAs with high distress were significantly reduced 1 month after screening (p < 0.05), suggesting the preliminary effectiveness of the program. The program was continued at the 8 institutions as part of routine care after the study. Conclusion Analysis using the RE-AIM suggested the sufficient feasibility and preliminary effectiveness of a psychosocial support program based on the DTPL-J for AYAs. Trial registration University Hospital Medical Information Network (UMIN CTR) UMIN000042857. Registered 25 December 2020—Retrospectively registered.

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Development and evaluation of the feasibility, validity, and reliability of a screening tool for determining distress and supportive care needs of adolescents and young adults with cancer in Japan

Hirayama¹,

Fujimori²,

Yanai³

et al. 2022

Pall Supp Care

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Objectives This study aims to (i) develop a screening tool for determining distress and supportive care needs of adolescent and young adult cancer patients (AYAs) based on the NCCN's Distress Thermometer and Problem List (DTPL), (ii) evaluate its feasibility, discriminant validity, and test–retest reliability in clinical settings, and (iii) report prevalence of distress and unmet needs. Method In the development phase, after translation of the Japanese version of the DTPL (DTPL-J) from English into Japanese and back translation, cognitive debriefing was performed. Items in the problem list were modified to better reflect AYAs’ concerns after interviews. The modified items were reviewed and accepted unanimously by healthcare professionals. In the feasibility phase, the DTPL-J for AYAs was used in a clinical setting for 3 months. Descriptive statistics of participants’ demographics, selected items, and DT scores were calculated to report prevalence of distress and unmet needs. Response and referral rates to experts were assessed to evaluate feasibility. Some items were compared with patient demographics to assess discriminant validity. Among the patients who responded at least twice, correlations between two consecutive screenings were assessed to evaluate test–retest reliability. Results The DTPL-J consisted of 49 items in five categories. Of 251 patients, 232 (92.4%) were provided the DTPL-J and 230 (91.6%) responded. Based on the DT cutoff of ≥4, 69 of 230 patients (30%) had high distress. Anxiety (n = 85, 36.6%) was the most commonly selected item. Primary nurses referred 45 (21.7%) patients to an attending physician or another expert. Referral rates after DTPL-J use were higher than rates before use, but the difference was not statistically significant (p = 0.06). The items compared were consistent with their social background. A positive correlation was observed between two responses for some items. Significance of results The feasibility, discriminant validity, and test–retest reliability of the tool were suggested.

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A Support System for Adolescent and Young Adult Patients with Cancer at a Comprehensive Cancer Center

Cited by 6 publications

References 58 publications

Mental health care use and related factors in adolescents and young adults with cancer

Mental health care use and related factors in adolescents and young adults with cancer

Feasibility and preliminary effectiveness of a psychosocial support program for adolescent and young adult cancer patients in clinical practice: a retrospective observational study

Development and evaluation of the feasibility, validity, and reliability of a screening tool for determining distress and supportive care needs of adolescents and young adults with cancer in Japan

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