Psychological and clinical correlates of posttraumatic growth in cancer. A systematic and critical review

Objective The objective of this study is to describe major findings on posttraumatic growth (PTG) in cancer, by analyzing its various definitions, assessment tools, and examining its main psychological and clinical correlates. Methods A search in relevant databases (PsycINFO, Pubmed, ProQuest, Scopus, and Web of Science) was performed using descriptors related to the positive reactions in cancer. Articles were screened by title, abstract, and full text. Results Seventy-two met the inclusion criteria. Most articles (46%) focused on breast cancer, used the PTG inventory (76%), and had a cross-sectional design (68%). The PTG resulted inversely associated with depressive and anxious symptoms and directly related to hope, optimism, spirituality, and meaning. Illness-related variables have been poorly investigated compared to psychological ones. Articles found no relationship between cancer site, cancer surgery, cancer recurrence, and PTG. Some correlations emerged with the elapsed time since diagnosis, type of oncological treatment received, and cancer stage. Only few studies differentiated illness-related-life-threatening stressors from other forms of trauma, and the potentially different mechanisms connected with PTG outcome in cancer patients. Conclusions The evaluation of PTG in cancer patients is worthy, because it may promote a better adaption to the illness. However, many investigations do not explicitly refer to the medical nature of the trauma, and they may have not completely captured the full spectrum of positive reactions in cancer patients. Future research should better investigate issues such as health attitudes; the risks of future recurrences; and the type, quality, and efficacy of medical treatments received and their influence on PTG in cancer patients

Stress and Growth in Cancer: Mechanisms and Psychotherapeutic Interventions to Facilitate a Constructive Balance

Post-traumatic stress and growth are common responses to adverse life events such as cancer. In this article, we establish how cancer becomes a "fertile land" for the emergence of stress and growth responses and analyze the main mechanisms involved. Stress-growth responses on adjusting to cancer is potentially determined by factors like the phase of the illness (e.g., initial phases vs. period of survivorship), patient's coping strategies, meaning-making, and relationships with significant others. We also review the mechanisms of constructive and adaptative stress-growth balances in cancer to study the predictors, interrelated associations, triggering mechanisms, long-term results, and specific trajectories of these two responses to cancer. Finally, we update the evidence on the role of these stress-growth associations in psychologically adjusting to cancer. Together with this evidence, we summarize preliminary results regarding the efficacy of psychotherapeutic interventions that aim to facilitate a constructive psychological balance between stress and growth in cancer patients. Recommendations for future research and gaps in knowledge on stress-growth processes in this illness are also highlighted. Researchers are encouraged to design and use psychotherapeutic interventions according to the dynamic and changeable patients' sources of stress and growth along the illness. Relevant insights are proposed to understand the inconsistency of stress-growth literature and to promote psychotherapeutic interventions to facilitate a constructive balance between these key responses in cancer

Stress and Growth in Cancer: Mechanisms and Psychotherapeutic Interventions to Facilitate a Constructive Balance

Post-traumatic stress and growth are common responses to adverse life events such as cancer. In this article, we establish how cancer becomes a “fertile land” for the emergence of stress and growth responses and analyze the main mechanisms involved. Stress-growth responses on adjusting to cancer is potentially determined by factors like the phase of the illness (e.g., initial phases vs. period of survivorship), patient’s coping strategies, meaning-making, and relationships with significant others. We also review the mechanisms of constructive and adaptative stress-growth balances in cancer to study the predictors, interrelated associations, triggering mechanisms, long-term results, and specific trajectories of these two responses to cancer. Finally, we update the evidence on the role of these stress-growth associations in psychologically adjusting to cancer. Together with this evidence, we summarize preliminary results regarding the efficacy of psychotherapeutic interventions that aim to facilitate a constructive psychological balance between stress and growth in cancer patients. Recommendations for future research and gaps in knowledge on stress-growth processes in this illness are also highlighted. Researchers are encouraged to design and use psychotherapeutic interventions according to the dynamic and changeable patients’ sources of stress and growth along the illness. Relevant insights are proposed to understand the inconsistency of stress-growth literature and to promote psychotherapeutic interventions to facilitate a constructive balance between these key responses in cancer

Positive psychotherapy for distressed cancer survivors: posttraumatic growth facilitation reduces posttraumatic stress

Background/Objective:There is increasing evidence that positive life changes,such as post-traumatic growth (PTG),can result from the experience of coping with cancer.However,no interventions have been specically designed to facilitate the development of PTG in cancer.In this article,we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors.It aims to facilitate PTG as a way of achieving signicant reductions in the symptoms of emotional distress and posttraumatic stress.In addition,the corroboration of this PTG facilitation is assessed using interpersonal indicators.Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained signicantly better results after treatment than the control group,showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benets were maintained at 3 and 12 months' follow-up. Participants' PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote signicant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition,PTG facilitation induced by PPC is corroborated by signicant others

Stress Management or Post-traumatic Growth Facilitation to Diminish Distress in Cancer Survivors? A Randomized Controlled Trial

This randomized controlled trial compared the efficacy of cognitive behavioral stress management (CBSM) and positive psychotherapy in cancer (PPC) to reduce post-traumatic stress symptoms (PTSS) and distress, and to promote post-traumatic growth (PTG) in cancer survivors. Participants were 140 adult women randomly allocated to CBSM (n = 73) or PPC (n = 67). PTSS, distress, and PTG were assessed at pre- and post-intervention, and at 3- and 12-month follow-ups. Analysis showed PPC was more effective in decreasing PTSS (b = -7.61, p < .001) and distress (b = -3.66; p < .001) than CBSM, but neither therapy significantly increased PTG (b = 0.77, p = .76). The relational veracity of PTG and its role predicting reduced PTSS was observed only in the PPC arm. In conclusion, PPC appears to be a valid therapeutic option for assimilating and accommodating the experience of cancer after treatment completion

Video Conference vs Face‐to‐Face Group Psychotherapy for Distressed Cancer Survivors : A Randomized Controlled Trial

Objective This study assesses the effectiveness of face‐to‐face group positive psychotherapy for cancer survivors (PPC) compared to its online adaptation, online group positive psychotherapy for cancer survivors (OPPC), which is held via videoconference. A two‐arm, pragmatic RCT was conducted to examine the effects of both interventions on emotional distress, posttraumatic stress (PTSS) and posttraumatic growth (PTG) among cancer survivors and analyze attrition to treatment. Methods Adult women with a range of cancer diagnoses were invited to participate if they experienced emotional distress at the end of their primary oncological treatment. Emotional distress, PTSS and PTG were assessed at baseline, immediately after treatment and three months after treatment. Intention‐to‐treat analyses were carried out using general linear mixed models to test the effect of the interventions overtime. Logistic regressions were performed to test differential adherence to treatment and retention to follow‐up. Results A total of 269 individuals participated. The observed treatment effect was significant in both modalities, PPC and OPPC. Emotional distress (b = − 2.24, 95%CI = ‐3.15‐ −1.33) and PTSS (b = − 3.25, 95%CI = ‐4.97‐ −1.53) decreased significantly over time, and PTG (b = 3.08, 95%CI = 0.38‐5.78) increased significantly. Treatment gains were sustained across outcomes and over time. Analyses revealed no significant differences between modalities of treatment, after adjusting for baseline differences, finding that OPPC is as effective and engaging as PPC. Conclusions The OPPC treatment was found to be effective and engaging for female cancer early survivors. These results open the door for psycho‐oncology interventions via videoconference, which are likely to lead to greater accessibility and availability of psychotherapy

Half of the patients with subepithelial tumours present borderline or pathologic anxiety-distress and carcinophobia: multicentre cohort study

Background and aims: minor nonspecific gastrointestinal sub-epithelial lesions (usually defined by the term 'tumor') are usually associated with a malignant illness and cancer. The aim of this study was to assess anxiety-distress and carcinophobia in patients referred to specialized monographic outpatient clinics for evaluation and treatment of this type of lesion.Methods: prospective, multicenter, cohort study. Specific self-reported questionnaires were used to report threat-ening life-experiences and to assess levels of distress (The Hospital Anxiety and Depression Scale) and cancer-related worries (The Cancer Worry Scale).Results: forty participants were included and analyzed at baseline. Pathologic and borderline anxiety were detected in 13 % (5/40, 95 % CI: 4-27 %) and 35 % (14/40, 95 % CI: 21-52 %) of participants, respectively, whereas, cancer-relat-ed worries (moderate to very high) were observed in 48 % (19/40, 95 % CI: 32-64 %) of participants. Pathologic global distress was identified in 25 % (10/40, 95 % CI: 13-42 %) of subjects. Higher educational level (university studies), a lack of lifetime psychiatric comorbidity and a lack of family history of cancer were associated with less anxiety, global distress and carcinophobia.Conclusions: almost half of the patients diagnosed with a minor nonspecific gastrointestinal subepithelial lesion pre-sented anxiety-distress and/or carcinophobia. Specific associ-ations with anxiety-distress reaction and fears were detected

Consenso sobre el estándar de atención psicooncológica, complejidad psicosocial y actividad asistencial en el Instituto Catalán de Oncología

Introducción: La atención psicosocial de las personas con enfermedad oncológica y la familia debe formar parte de todo modelo integral de atención que pretenda reducir el impacto vital del cáncer. Las intervenciones psicosociales han probado su eficacia en la ayuda a pacientes y familiares para afrontar las situaciones de alta complejidad psicosocial emergentes a consecuencia de un diagnóstico de cáncer. Objetivo: Definir y explicar el modelo de Atención Psicosocial del Comité Psicosocial del Instituto Catalán de Oncología (ICO) utilizando criterios de vulnerabilidad, complejidad y derivación; enmarcado y basado en los valores del ICO (centrados en las necesidades de pacientes con cáncer y sus familias). Método: El modelo que se presenta en este documento consta de cinco pilares: 1) Principios de la Práctica Psicosocial en Oncología; 2) Áreas de actuación en la Atención Psicosocial del paciente con cáncer y la familia; 3) Cribado de malestar emocional y derivación del paciente con cáncer y la familia para una atención psicooncológica específica; 4) Comité Psicosocial: (objetivos; funciones; organización; composición; disciplinas participantes; criterios de derivación y niveles de complejidad; y procedimiento); y 5) Índice de productividad. Resultados: Pacientes y familiares atendidos por el CPS mostraron mejoría estadísticamente significativa en los niveles del malestar emocional, pasando de una media inicial de 8,12/10 (EVA/ENV) a una media 6,27/10 (EVA/ENV). Asimismo, se constata que las intervenciones derivadas del comité psicosocial redujeron el porcentaje de casos iniciales de alta complejidad, pasando de un 69,3% a un 49,3%. Conclusiones: El abordaje de la complejidad psicosocial mediante un modelo basado en criterios multi e interdisciplinarios consensuados ayuda en la toma de decisiones sobre las acciones a seguir y en la mejora del malestar emocional y complejidad de los pacientes y la familia

Recomanacions pràctiques per a la presa de decisions ètiques i clíniques en l’entorn residencial en context de la crisi de COVID-19 [fullet]

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Centres residencials; Presa de decisions clíniques; Presa de decisions ètiquesCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Centros residenciales; Toma de decisiones clínicas; Toma de decisiones éticasCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Residential centers; Clinical decision making; Ethical decision makingLa situació derivada de la Pandèmia COVID-19 afecta de forma específica als centres residencials, per la vulnerabilitat de les persones usuàries (geriàtriques, de discapacitat o de salut mental), per la limitació dels recursos i la pressió de la resta d'àrees del sistema, així com per l'impacte en els professionals -empitjorant una situació tradicionalment ja difícil relacionada amb els recursos-. Aquest document té com a objectiu proporcionar algunes eines per a la presa de decisions ètiques i clíniques, a uns professionals de l’àmbit residencial que, en un context de crisi i limitació dels recursos interns i de l'entorn, estan fent tot el possible per oferir una atenció de qualitat a les persones usuàries

Famílies botàniques de plantes medicinals

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia, Assignatura: Botànica Farmacèutica, Curs: 2013-2014, Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són els recull de 175 treballs d’una família botànica d’interès medicinal realitzats de manera individual. Els treballs han estat realitzat per la totalitat dels estudiants dels grups M-2 i M-3 de l’assignatura Botànica Farmacèutica durant els mesos d’abril i maig del curs 2013-14. Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pel professor de l’assignatura i revisats i finalment co-avaluats entre els propis estudiants. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica