COVID-19 pandemic distress among a sample of Italian psycho-oncologists: risk of isolation and loneliness.

PURPOSE: To measure the prevalence and characteristics of distress and hope for the future among psycho-oncologists, who faced the coronavirus disease 2019 (COVID-19) emergency along with other healthcare workers. METHODS: A web-based study was conducted among members of the Italian Society of Psycho-Oncology between May 29 and June 5, 2020. RESULTS: A total of 237 members, aged 28-72 years, completed the COVID-19 Peritraumatic Distress Index (CPDI), Impact of Event Scale-Revised (IES-R), and HOPE questionnaires; 86.92% were female, 58.65% worked in hospitals, 21.10% were exposed to COVID-19, 11.39% experienced peritraumatic distress, and 3.38% had posttraumatic stress disorder symptoms. Peritraumatic distress was associated with living alone (adjusted odds ratio [AOR] 3.05; 95% confidence interval [CI] 1.41-8.13), using sleep remedies (AOR 3.79; 95% CI 1.41-10.21), and the perception of being avoided by family or friends because of work (AOR 2.69; 95% CI 1.02-7.11); high HOPE-Agency scores were associated with the absence of peritraumatic stress (AOR 0.40; 95% CI 0.16-0.96) after adjustment for age and sex. CONCLUSIONS: Psycho-oncologists showed greater resilience than other healthcare workers as they are trained to help others, but also to review their own values and behavior in light of stressful events. Of interest is the association between peritraumatic distress and social isolation, real or perceived. Healthcare institutions should pay attention to the mental well-being of their employees by promoting distress screening using simple tools such as the CPDI and implementing support interventions. Psycho-oncology associations should introduce policies aimed at developing a sense of social connectedness by providing an interactive system of orientation and scientific reference.

Improving physicians' communication skills and reducing cancer patients' anxiety: a quasi-experimental study.

AIMS AND BACKGROUND: This study is aimed at evaluating the effectiveness of a physician-centered communication skills training program on cancer patient anxiety levels. METHODS AND STUDY DESIGN: In this quasi-experimental study, physicians from 9 units of 5 general hospitals and 1 cancer research institute were recruited. The unit heads chose which physicians would attend the training program (treatment group) and which would not (control group). The effectiveness of the course was evaluated by assessing the evolution of state anxiety in a sample of cancer patients before and after clinical consultations. RESULTS: Thirty-eight physicians and 339 outpatients were assessed. Patients from the treatment and control groups did not differ in pre-examination anxiety or psychological distress levels. Patients examined by physicians from the treatment group displayed a higher decrease in state-anxiety levels compared with those examined by physicians from the control group. A higher proportion of high anxiety levels was found in women, in less educated patients, and in those with a high distress level. CONCLUSIONS: Our findings suggest the effectiveness of the communication skills training program with reference to patient anxiety levels. Given the potential gap between training and clinical impact, further studies investigating the effect of communication training on patient outcomes are needed.

Cancer and anorexia nervosa in the adolescence: a family-based systemic intervention.

Objective. Anorexia nervosa is difficult to diagnose in cancer patients since weight loss, aversion for food, and eating disturbances are frequent in patients undergoing chemotherapy and radiotherapy. Nevertheless, efforts are mandatory to recognize and manage this condition which may occur also in cancer patients with a special regard to adolescents. Methods. Through the clinical history of Anna, a 15-year-old adolescent with advanced cancer, we describe the effectiveness of a family-based systemic intervention to manage anorexia nervosa occurring in concomitance to osteosarcoma. Results. Through a two-year psychotherapy period involving different techniques applied to the whole family such as family genogram, family collage, and sculpture of family time, Anna was relieved from her condition. Conclusions. Upon early diagnosis and appropriate treatment, anorexia nervosa can be effectively approached in adolescent cancer patients. The presence of a life-threatening medical condition such as cancer may provide motivation for a patient to control disordered eating behavior in the context of an appropriate family-based systemic intervention. The general frame of anorexia occurring in cancer-bearing adolescents is reviewed and discussed.

[Parents, children and parenting in cancer patients: a still poorly addressed issue in the global management of neoplastic diseases]. / Genitori e figli: il 'parenting' nei pazienti oncologici. Un aspetto ancora poco considerato nella gestione delle malattie neoplastiche.

More than 25% of cancer patients in western countries have less than 18 years old children. While increasing attention has been given to various psychosocial issues related to neoplastic disease, the impact of parental cancer on psychosocial 'functioning' of children and adolescents are still poorly explored. Similarly, the role of parenting concerns on quality of life, compliance to the disease and treatments and therapeutic choices are not sufficiently addressed. Usually, cancer patients are reluctant to openly inform their children about their disease. Such "protective" attitude may cause anxiety and psichological distress in children and affect the coping capability of the whole family. Lack of communication may increase the sense of sadness, grief and despair, experienced by children whose parents are ill and induce long-term psychological consequences. Parenthood, on the other side, carries additional concerns to cancer patients which may render disease management more challenging and painful. The oncology team must favour, through appropriate support programs, communication between patients and their children to ensure a better psychological outcome from a stressful situation deeply affecting quality of life of patients and their families.