Spirituality and Sustaining Hope in Adolescents with Cancer : The Patients' View

Purpose: The trauma of the diagnosis of cancer during adolescence may affect the young people's spiritual sphere. Projects aiming to the global care of adolescents with cancer should consider also their spiritual needs: at our center, the dedicated multidisciplinary team of professionals includes a chaplain with a specific training. This article describes, throughout the patients' dialogs, how a chaplain can help patients to give voice to their emotions and thoughts about their sense of life and illness. Methods: From January 2016 to December 2017, 33 adolescent patients with solid tumors had from 2 to 12 one-to-one talks with the chaplain. We selected six specific clinical cases in which some important topics were discussed between the chaplain and the patients. Results: Patients' own voices were reported to describe some specific spiritual issues, particularly as regards how spirituality could sustain them in their need to continue to hope. Examples of specific questions during talks were as follows: "Why doesn't God do something?"; "What is the point of all this pain?"; "Why have I become ill? Why me?"; "What do you think will happen to me after I die?" Conclusions: This experience underlines the importance of the inclusion of the spiritual assistant within the multidisciplinary team dedicated to young people with cancer. The daily and constantly available presence of the chaplain in the ward, from the beginning of any treatment, can permit a good relationship with patients and help them to keep hope and move forward

Sul buon uso delle illusioni in oncologia: Esperienze e comunicazioni di fine vita in pazienti adolescenti [About the good use of illusions in oncology. End-of-life experiences and communications in adolescent patients]

The issue of quality of life, particularly of patients affected by cancer, is very controversial, especially with adolescent patients who have no prospects of recovery. This article aims to describe the psychological mechanisms, which affect teenage patients with terminal cancer, in order to allow the best quality of life possible. The adaptation of teenager patients suffering from terminal illnesses is also related to other non-medical issues such as psychological, legal and ethical considerations. A correct and balanced communication with such patients is needed, in order of maintaining a positive mental approach ("hope") so that the teens are able to come to terms with the hard reality. Several case studies are presented, that according to the authors show the importance of developing an area of illusion, which allows patients to face up to the extreme distress and anxiety of their reality, without completely denying the reality itself. These hypotheses at the moment need more empirical evidences but they demonstrate the complex mental process involved with terminally ill adolescent patients coming to terms with their situations and show the importance of considering such process in all aspects of clinical care and treatment, in order to best address their physical and psychological well-being

Dreams and illusions in adolescents with terminal cancer

Being diagnosed with cancer in adolescence generally has important emotional consequences: adolescent cancer patients need to be seen as special cases with particular medical and psychosocial needs. This is especially true when a young patient is faced with a progressive, incurable disease. Herein, we report the story of a 17-year-old girl with a metastatic refractory soft tissue sarcoma who tells her dream to the psychologist of the ward. Telling this narrative is the opportunity to discuss the complex topic of how adolescent cancer patients adapt to the terminal stage of their disease; for example, the patient needs to talk to someone about their fear of dying; the healthcare operators need to be able properly listen and communicate; the patient's trust in the future despite their clinical condition; the necessity to leave space for hope; the useful role of the imagination sphere; the issue of whether and how to tell a person who is terminally ill the truth about their condition

Dreams and illusions in adolescents with terminal cancer

Being diagnosed with cancer in adolescence generally has important emotional consequences: adolescent cancer patients need to be seen as special cases with particular medical and psychosocial needs. This is especially true when a young patient is faced with a progressive, incurable disease. Herein, we report the story of a 17-year-old girl with a metastatic refractory soft tissue sarcoma who tells her dream to the psychologist of the ward. Telling this narrative is the opportunity to discuss the complex topic of how adolescent cancer patients adapt to the terminal stage of their disease; for example, the patient needs to talk to someone about their fear of dying; the healthcare operators need to be able properly listen and communicate; the patient's trust in the future despite their clinical condition; the necessity to leave space for hope; the useful role of the imagination sphere; the issue of whether and how to tell a person who is terminally ill the truth about their condition

Cannabinoids use in adolescents and young adults with cancer : a single-center survey

Objective: To present an investigation into the intake of cannabinoids in a population of adolescents and young adults with cancer. Methods: Sixty-six patients took part in the research: 27 reported having used cannabinoids, 21 before diagnosis; among the latter, 10 increased use during treatment. Results: Benefits were reported by 19% of responders regarding anxiety control, 24% for nausea, 29% for pain control and improvement of sleep, and 48% for appetite improvement. Conclusions: Cannabis use by patients may often be unknown to caregivers. Studying this subject may help to better define important therapeutic aspects of these substances

Do clinical variables predict poor post-operative satisfaction in patients who demand cosmetic surgery?

Objectives: Although most patients are satisfied with cosmetic surgery and experience a positive psychosocial outcome, evidence suggests that some - known as “insatiable patients” or “polysurgical addicts” - are chronically dissatisfied despite technically satisfactory surgical results, leading to problems for both patients (i.e. social isolation, depressed mood, adjustment problems, familial dysfunction, self-destructive behaviors) and surgeons (harassment by patients for further surgical procedures, complaints and legal action). Body image disturbances and personality disorders were shown to be associated with patient’s dissatisfaction. However, as argued by Honigman et al. (2004), these conclusions are mostly based on clinical impressions, and no study so far has analyzed the predictors of poor satisfaction. Thus, this study is aimed at filling this gap and at assessing the impact of the following clinical variables on patient’s post-operative dissatisfaction: number of pathological personality traits; covert narcissism; severity of body uneasiness; worries about particular body parts and intensity of these concerns; psychological well-being. Methods: Seventy-seven patients (91% F), aged 18–57 (Mage = 32.68) scheduled for profile, breast and body contouring cosmetic surgery from two Italian hospitals completed four self-report questionnaires before surgery and a measure of patient satisfaction 13 months after surgery. Results: Among all the variables considered, the number of pathological personality traits (cluster B’s in particular), the severity of body uneasiness and the intensity of worries about body parts showed a predictive power on patients’ dissatisfaction. Conclusion: Our data suggest that a thorough pre-operative clinical assessment may allow the pre-operative identification of patients with low levels of post-operative satisfaction

Summer is you : Adolescents and young adults with cancer sing about their desire for summer

Creative spirit and art are used as part of the Youth Project in Milan, a program dedicated to adolescents and young adults (AYA) with cancer. The \u201cSummer is you\u201d music project involved 45 patients (15\u201326 years old): with professional help, the patients wrote music and lyrics, sang their song, and recorded a video clip, sharing with us not only their hopes and fears, but also their romantic encounters and their urge to travel (https://youtu.be/Q5FSCMUVg0E). This project exploited the power of music to bring young people with cancer together in a novel form of support that can complement the more conventional psychological approaches

Disturbi dell’immagine corporea e disturbi di personalità in chirurgia plastica estetica, e valutazione dell’impatto dell’intervento sul disagio legato all’immagine corporea

Introduzione: Lo studio si prefigge di indagare: a) l’impatto degli interventi di chirurgia estetica sul disagio legato all’immagine corporea attraverso un confronto pre-post dei punteggi ottenuti al Body Uneasiness Test (Global Severity Index – GSI – di BUT); b) la prevalenza dei disturbi dell’immagine corporea (DIC) e dei disturbi di personalità (DP), nonché le loro frequenze congiunte. Metodi: Il campione iniziale è composto da 229 soggetti (90% F, range d’età 18-59) sottoposti a diversi tipi di interventi di chirurgia estetica presso due ospedali milanesi, tra il 2009 e il 2011. Prima dell’intervento i soggetti hanno compilato il BUT e il Personality Diagnostic Questionnaire - 4+. Il BUT è stato risomministrato 12 mesi dopo l’intervento (N=214). Risultati: Nonostante l’intervento abbia un impatto positivo sul disagio legato all’immagine corporea, il suo effetto dipende dal terzile di appartenenza del soggetto nella distribuzione del GSI pre-opeatorio. Infatti, tutti i soggetti che presentano un DIC nella fase pre-operatoria continuano a presentarlo anche a distanza di oltre un anno dall’intervento (41%). Il 20% dei soggetti presenta almeno una diagnosi di DP (Mdiagnosi=1.55). I DP dei Cluster B e C sono quelli prevalenti. In tutti i soggetti in cui è presente un DP c’è anche la co-presenza di un DIC. Conclusioni: I dati supportano l’utilità di una valutazione clinica da parte dei professionisti della salute mentale per tutti i candidati a un intervento di chirurgia estetica

An evaluation of the dual-pathway model of binge eating in italian adolescent boys: a longitudinal structural equation modeling approach

Introduction Studies conducted with American and Australian samples of pre-adolescents and adolescent girls support the tenets of Stice and colleagues’ dual-pathway (DP) model. The DP model is a cohesive framework for understanding how sociocultural pressures are translated into behavioural and negative affect risk factors potentially promoting binge eating. Males are likely to exhibit sub-threshold binge eating disorder and are roughly equal to females in regard to the number of cases of any binge eating. To date, only preliminary support has been provided for the validity of the DP model's core predictions with adolescent males. Objectives The current prospective study examined the suitability of the DM model in other western cultures (such as an Italian one) where adolescent boys are characterised by high levels of eating and body-related disturbances in response to sociocultural pressure. Method 221 Italian adolescent boys (Mage = 14.9) were examined at Baseline and after 1-year through semi-structured clinical interviews and self-reported measures. Data were analysed via a latent variable longitudinal structural equation modeling approach. Results Perceived pressure and internalization of societal ideals regarding male body shape led to body dissatisfaction, which in turn led to dietary restriction. Both body dissatisfaction and dietary restriction predicted negative affect, which in turn predicted binge eating. However, data did not support the relationship between body mass index and body dissatisfaction or between dietary restriction and binge eating

Age-appropriate multidisciplinary approach to young children with cancer undergoing radiotherapy : the SIESTA procedure

A standardized multidisciplinary step-by-step approach to improve the compliance of young (or difficult) children having to undergo radiotherapy was described and applied. The procedure is called SIESTA, which stands for show-imagination-evaluation-support-treatment-anesthesia. Preliminary assessments suggest that the SIESTA approach was effective: the rate of young patients ( 646 years) requiring anesthesia decreased from 27% (14/52 cases) in 2011-2012 (before the procedure was adopted) to 13% (6/46) in 2018