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- Reproduction-related cognitive processing and distress among young adult women: the role of personal breast cancer historyPublication . Bártolo, Ana; Santos, Isabel M.; Guimarães, Raquel; Reis, Salomé; Monteiro, SaraBreast cancer diagnosis can threaten fertility and biological motherhood in women of reproductive age due to the gonadotoxic efects of treatments. Much evidence documents these women fertility-related concerns and distress, but no study has attempted to understand how implicit cognitive processes can contribute to this maladjustment. In this research, we explored whether reproduction-related stimuli interfere with cognition among cancer survivors with infertility risk using an emotional Stroop task. Furthermore, we investigated the relationship between reproduction-related cognitive processing and psychological morbidity. Young cancer survivors aged 18–40 years who received anticancer treatments and an age-matched noncancer control group without known fertility problems were compared. Color-naming times and error rates were assessed. Participants in both groups were slower naming the color of reproduction-related words in comparison to unrelated negative valence words. Although in the same direction, this diference did not reach statistical signifcance for positive and neutral unrelated word lists. Further analysis suggested that biased attention toward reproduction-related information was associated with higher depression levels in young women with personal breast cancer history, but not in healthy women. These fndings suggest that biased processing of reproduction-related cues might be a vulnerability factor after a breast cancer diagnosis. Additionally, this study puts in evidence the potential usefulness of using experimental tasks to investigate attentional bias in a context where fertility is at risk.
- Validation of the Portuguese version of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) in Portuguese cancer survivorsPublication . Silva, Sandra; Bártolo, Ana; Santos, Isabel M.; Paiva, Débora; Monteiro, SaraIn 2020, around 60,000 people were diagnosed with cancer in Portugal, and many of them suffered some level of Fear of Progression (FoP) of the disease. Although this FoP is realistic, and is part of the normal and appropriate response to this type of disease, there is no instrument to assess and understand whether it is exaggerated in the face of the situation. The present study aimed to translate and validate the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) for the Portuguese population. The sample consisted of 220 volunteers, aged 18 years or over and diagnosed with cancer for at least six months. Participants completed the FoP-Q-SF, the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and the Post-Traumatic Stress Disorder ChecklistCivilian Version (PCL-C). The FoP-Q-SF demonstrated high internal reliability (α = 0.86) and the confirmatory factor analysis supported the one-dimensional structure of the FoP-Q-SF. Convergent validity was supported with significant positive correlations with psychological distress, especially anxiety (0.68). The FoP-Q-SF has been found to be a valid instrument to measure FoP in Portuguese cancer survivors.
- Avaliação em psico-oncologia: uma ferramenta para a prática clínicaPublication . Monteiro, Sara; Bártolo, Ana; Santos, Isabel M.
- CanCOG®: cultural adaptation of the evidence-based UCLA cognitive rehabilitation intervention program for cancer survivors in PortugalPublication . Oliveira, Ana F.; Sosa-Napolskij, Milaydis; Torres, Ana; Queiroz, Diâner Felipe; Bártolo, Ana; Sousa, Helena; Monteiro, Sara; Van Dyk, Kathleen; Ercoli, Linda M.; Santos, Isabel M.Cognitive difficulties are highly prevalent and negatively impact cancer survivors' quality of life. The UCLA Cognitive Rehabilitation Intervention Program (in short, UCLA program) is an evidence-based intervention developed and tested in the US to address the cognitive complaints of cancer survivors. Since there are no cognitive rehabilitation programs available for Portuguese cancer-related settings, this study aimed to culturally adapt the UCLA program to Portugal. Nine steps were implemented for this cultural adaptation: needs assessment, initial contacts, translation, cultural adaptation, independent review by a panel of experts (n = 6), focus group discussions with cancer survivors (n = 11), systematization of inputs and improvement of the final materials, fidelity check, and preliminary acceptability assessment. The findings suggested that changes to the original materials were needed. A Portuguese name, "CanCOG®-Reabilitação Cognitiva no Cancro" (in English "CanCOG®-Cognitive Rehabilitation in Cancer"), and a logo were created to make it more memorable and appealing for the Portuguese population. The language was adjusted to ensure content accessibility and semantic and conceptual equivalence. Finally, references to several cultural aspects, such as habits, customs, and traditions, were adapted to fit the new cultural context. The UCLA program may be a promising tool to help alleviate the cognitive difficulties reported by cancer survivors in different cultural contexts. Future research is needed to confirm the feasibility, acceptability, and preliminary efficacy of its Portuguese version, "CanCOG®-Reabilitação Cognitiva no Cancro".
- Attentional bias toward reproduction-related stimuli and fertility concerns among breast cancer survivorsPublication . Bártolo, Ana; Santos, Isabel M.; Guimarães, Raquel; Reis, Salomé; Monteiro, SaraThe current study examined whether an attentional bias exists for reproduction-related visual cues among breast cancer survivors and its relationship with fertility concerns and emotional distress. Breast cancer survivors (n ¼ 38) aged 18–40 were compared to 37 healthy women recruited from the general population. Attentional bias was investigated using a visual dot-probe task and response times (RT) were measured. Participants also completed several questionnaires, including the Reproductive Concerns After Cancer Scale (RCACS) and the Hospital Anxiety and Depression Scale (HADS). Biased cognitive processing toward reproduction-related stimuli was observed for all young women. However, attentional bias was a significant predictor of concerns about partner disclosure of fertility status, with higher bias scores associated with higher levels of concern only for breast cancer survivors. The desire to have a (or another) biological child was also a significant predictor of higher concerns related with fertility potential for all young women. Higher vigilance regarding reproduction-related cues seems to lead to higher concerns among women with breast cancer history whose fertility is threatened. This result may have important research and clinical implications. Interventions focused on goal-oriented attention self-regulation and problemsolving can help to manage fertility concerns and distress in the course of the disease.
- Towards a better understanding of the factors associated with distress in elderly cancer patients: a systematic reviewPublication . Silva, Sandra; Bártolo, Ana; Santos, Isabel M.; Pereira, Anabela; Monteiro, SaraThis study presents a systematic review of the sociodemographic, clinical, and psychosocial factors associated with distress in elderly cancer patients. Relevant studies were identified using four electronic databases: PubMed, Scopus, Web of Science and ProQuest. Cross-sectional and longitudinal studies exploring factors associated with distress in people over 60 years of age were included and independently assessed using the Joanna Briggs Institute Critical Assessment Checklists. A total of 20 studies met the inclusion criteria. Research showed that being a woman, being single, divorced or widowed, having low income, having an advanced diagnosis, having functional limitations, having comorbidities, and having little social support were factors consistently associated with emotional distress. Data further showed that the impact of age, cancer type, and cancer treatment on symptoms of anxiety and/or depression in elderly patients is not yet well established. The findings of this review suggest that the emotional distress of elderly cancer patients depends on a myriad of factors that are not exclusive, but coexisting determinants of health. Future research is still needed to better understand risk factors for distress in this patient population, providing the resources for healthcare providers to better meet their needs.
- Psychosocial assessment of lung cancer patients and their caregiversPublication . Clara, Cátia; Monteiro, Sara; Bártolo, AnaLung cancer (LC) is one of the most common types of cancer disease worldwide. Studies in the field show that the appearance of a pathology of this form causes changes not only in the patient’s life, namely psychological problems, functional limitations and poorer health due to the clinical consequences of treatments, but also in their family, where caregivers often face the challenge of providing long-term daily care that induces a physical, psychosocial and financial burden (Borges et al., 2017; Hewitt et al., 2003; Tan et al., 2018). The main objective of the present study is to compare and relate the two groups (patients and caregivers) considering the quality of life (QoL) and symptoms of psychological distress (anxiety and depression). The total sample consisted of 30 patient/caregiver dyads. The instruments used were: Hospital Anxiety and Depression Scale; European Organization for Research and Treatment of Quality of Life Questionnaire (EORTC QLQ C-30) and its specific module for lung cancer (LC13); Caregiver Oncology Quality of Life Questionnaire (CarGOQoL) and Zarit Burden Interview Scale (ZBI). The results suggest the influence of depressive symptomatology on patients’ QoL [F(1)=6.390; p<0.05] and depressive and anxious symptomatology and burden on caregivers’ QoL [F(3)=7.815; p<0.001]. A positive association was found between depressive symptomatology of patients and caregivers (r=0.458; p=0.011) and differences in anxious symptomatology were also observed, with a higher result in the patient’s group.
- Toward an understanding of the factors associated with reproductive concerns in younger female cancer patients: evidence from the literaturePublication . Bártolo, Ana; Santos, Isabel M.; Monteiro, SaraBackground: Cancer treatments may compromise fertility and family building in reproductive-age women. Previous research has shown that younger women with cancer experienced several reproductive health concerns. Objective: The aim of this study was to conduct a focused review of existing research about the subjective perceptions of reproductive concerns among young women with cancer (aged 15-49 years) and identify their potential predictors and outcomes. Methods: A systematic synthesis of mixed-methods research was conducted including peer-reviewed articles in English. Relevant studies were identified through the electronic databases Scopus, Web of Science, PubMed, ProQuest, and Psychology & Behavioral Sciences Collection (through EBSCOhost). Results: A total of 22 reports met the eligibility criteria (8 qualitative and 14 quantitative). Research showed that younger women reported concerns related to their fertility status and/or own health after conception, their children’s health, and their dyadic relationships. Redefinition of the motherhood role and the family future were also a source of concern. However, there is variance among women in concerns and experiences based on life stages and expectations. Conclusions: Reproductive concerns seem to be affected by personal circumstances and previous therapeutics. These concerns constitute a potential risk factor, simultaneously, for psychosocial maladjustment and adherence to endocrine therapy and fertility care. Implications for Practice: This article proposes a conceptual framework to understand the dimensions and potential predictors and outcomes of perceived concerns among reproductive-age cancer patients. Our data allow us to look at these concerns from a multifactorial perspective, identifying areas to be addressed in providing clinical care, namely, by nurses accompanying patients over an extended period.
- Taking care of an adolescent and young adult cancer survivor: a systematic review of the impact of cancer on family caregiversPublication . Neves, Maria Carolina; Bártolo, Ana; Prins, Judith B.; Sales, Célia; Monteiro, SaraResearch usually investigates adolescents and young adults (AYA) with cancer in combination with younger and older cancer patients and survivors. However, AYAs with cancer are a unique group, and their caregivers' experience may also differ from other caregivers of cancer survivors. This systematic review aims to understand the impact of a cancer diagnosis on family caregivers, comparing the experience of caregivers of AYA childhood cancer survivors (AYA CCS) and caregivers of AYA with cancer. Relevant studies were identified through PubMed, Scopus, and Web of Science databases, and their quality was assessed using the Joanna Briggs Institute's critical appraisal checklists. Sixteen studies (17 reports) met the inclusion criteria. Findings were synthesized separately for caregivers of AYA CCS and caregivers of AYA with cancer. Results showed that caregivers in both groups experienced high distress after the diagnosis. Partners of AYAs with cancer experienced diminished quality of life (QoL) and over half reported moderate to high fear of cancer recurrence (FCR). Findings indicated that cancer negatively impacts family caregivers, regardless of the patient's age at diagnosis. However, findings are heterogeneous, and most do not focus on QoL or FCR. More research is needed on the impact of cancer among these family caregivers.
- Effectiveness of psycho-educational interventions with telecommunication technologies on emotional distress and quality of life of adult cancer patients: a systematic reviewPublication . Bártolo, Ana; Pacheco, Emelda; Rodrigues, Fabiana; Pereira, Anabela; Monteiro, Sara; Santos, Isabel M.Purpose: To provide a comprehensive review of psycho-educational interventions using telecommunication technologies developed for adult cancer patients, assessing their effectiveness in reducing emotional distress and improving quality of life (QoL). Materials and methods: A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified through the electronic databases PubMed, Scopus, Web of Science, ProQuest, Psychology & Behavioral Sciences Collection (through EBSCOhost), and CENTRAL. Results: Eight studies involving 1016 participants met inclusion criteria. The majority of the studies included (n¼6) used a randomized design and were published between 2007 and 2016. Interventions used a variety of delivery resources, such as telephone, e-mail and websites, but all were aiming to respond to information needs and develop stress control skills. A trend toward reducing distress and improving QoL was found, but estimated effect sizes were typically small (d<0.5). Telephonically delivered psycho-educational interventions presented the highest between-group effects on these outcomes during survival, but were limited by sample size. Conclusions: The efficacy of interventions using distance approaches in the cancer setting is still not wellestablished. Further research should be conducted through well-designed studies with more interactive features that minimize the lack of face-to-face interaction.