Psychological Adjustment, Adaptation, and Perception of Social Support in French Adolescents and Young Adults After the Diagnosis of Cancer.

Purpose: The third Cancer Plan (2014-2019) has helped with the recognition of adolescents and young adults (AYAs) with cancer's medical and psychosocial specificities and has enabled the creation of dedicated structures in France. Methods: The study involved 43 AYA patients (Nmen = 21; Nwomen = 22) between 15 and 27 years old (Mage = 19.9), diagnosed with all types of cancer, and were recruited in two French cancer centers. Online questionnaires were filled in 2 months after the beginning of treatment. AYAs completed measures of depressive and anxiety symptoms, perceived social support, and coping strategies. Results: Results demonstrated moderate depressive symptoms (M = 10.7, standard deviation [SD] = 7.0) and suggested a good satisfaction (M = 30, SD = 9.5) and a mild availability (M = 27, SD = 10.3) of the social support. Spearman's correlations demonstrated that coping strategies are related to depressive symptoms, for which acceptance (p < 0.01) of the disease played a key role in their psychological adjustment. Perceived social support subscales were positively correlated with the use of distraction as a coping strategy (p < 0.05). Kruskal-Wallis test demonstrated the preferential use of instrumental (p < 0.05) and emotional support (p < 0.01), denial (p < 0.01), and self-blame (p < 0.01) for women and the use of acceptance (p < 0.05) and humor (p < 0.05) for men; and there were no significant differences between patients hospitalized in the two cancer center facilities. Conclusion: Finally, a better understanding of the psychological adjustment and processes among French AYAs with cancer will help families and processionals to better adjust AYA-specific needs at the beginning of cancer treatment. ClinicalTrials.gov.: NCT03964116.

[An updated synthesis of the international recommendations about the use of non-pharmacological interventions in the treatment of fatigue]. / Synthèse actualisée des recommandations internationales sur le traitement de la fatigue par des interventions non pharmacologiques.

INTRODUCTION: Fatigue is a frequent and disturbing symptom in oncology but remains undertreated. Given the absence of effective drug treatment, non-pharmacological interventions have a prominent place in the treatment of fatigue. However, they are relatively unknown by professionals who lack of clear points of reference to refer patients with confidence. This article aims to improve the knowledge about this therapeutic field through an updated synthesis of the levels of recommendations and available evidence. METHODS: A three-step approach was conducted, including (1) a synthesis of international guidelines on non-pharmacological interventions in the treatment of fatigue among adults in oncology, (2) a systematic review of recent data in the literature, (3) a comparison between the synthesis of guidelines and the systematic review with the aim of updating the levels of evidence. RESULTS: Five guidelines were synthesized; 111 systematic reviews were analyzed. Their comparison mainly showed: (1) a convergence in favor of the use of physical activity, educational interventions and cognitive-behavioral therapies, with levels of evidence ranging from moderate to high; (2) a consolidation of short-term efficacy evidence to support the use of mindfulness-based approaches and yoga; 3) the persistence of a lack of sufficiently reliable data to establish the efficacy of other types of intervention. DISCUSSION: Supported by international guidelines and recent data, the use of non-pharmacological interventions in the treatment of fatigue is critical and has to become better known.

Let's talk about empathy!

BACKGROUND: Research faces a challenge to find a shared, adequate and scientific definition of empathy. OBJECTIVE: Our work aimed to analyze what clinical empathy is in the specific context of cancer care and to identify the effect of empathy in it. METHOD: This study gives voice to physicians with extensive experience in cancer care. This original research combines qualitative data collection and quantitative data analysis. Semi-structured individual interviews were conducted with 25 physicians. The content of the interviews was analyzed according to the Content Analysis Technique. RESULTS: Empathy is described according to six dimensions that give a strong role to interpersonal and cognitive skills. This description integrates previous and various conceptualizations of clinical empathy. Physicians detail the beneficial effects of clinical empathy on patients' outcomes and well-being as well as physicians' practices. Physician interviews also revealed the relationship between empathic concerns and physicians' emotional difficulties. CONCLUSION: Empathy in cancer care is a complex process and a multicomponent competence. PRACTICE IMPLICATIONS: This operational description of clinical empathy has three main implications: to draw up a training program for physicians, to detail recommendations for physicians' work-related quality of life and to develop new tools to measure empathy.