The effectiveness of personalised surveillance and aftercare in breast cancer follow-up: a systematic review

Purpose: Breast cancer follow-up (surveillance and aftercare) varies from one-size-fits-all to more personalised approaches. A systematic review was performed to get insight in existing evidence on (cost-)effectiveness of personalised follow-up.Methods: PubMed, Scopus and Cochrane were searched between 01–01-2010 and 10–10-2022 (review registered in PROSPERO:CRD42022375770). The inclusion population comprised nonmetastatic breast cancer patients ≥ 18 years, after completing curative treatment. All intervention-control studies studying personalised surveillance and/or aftercare designed for use during the entire follow-up period were included. All review processes including risk of bias assessment were performed by two reviewers. Characteristics of included studies were described.Results: Overall, 3708 publications were identified, 64 full-text publications were read and 16 were included for data extraction. One study evaluated personalised surveillance. Various personalised aftercare interventions and outcomes were studied. Most common elements included in personalised aftercare plans were treatment summaries (75%), follow-up guidelines (56%), lists of available supportive care resources (38%) and PROs (25%). Control conditions mostly comprised usual care. Four out of seven (57%) studies reported improvements in quality of life following personalisation. Six studies (38%) found no personalisation effect, for multiple outcomes assessed (e.g. distress, satisfaction). One (6.3%) study was judged as low, four (25%) as high risk of bias and 11 (68.8%) as with concerns.Conclusion: The included studies varied in interventions, measurement instruments and outcomes, making it impossible to draw conclusions on the effectiveness of personalised follow-up. There is a need for a definition of both personalised surveillance and aftercare, whereafter outcomes can be measured according to uniform standards.</p

The Relation Between Religion/Spirituality and Mental Health Is Mediated by Self-Compassion:Evidence From Two Longitudinal Studies in the Dutch-Speaking General Population

This research investigates the mediating role of self-compassion on the relation between religion/spirituality (R/S) and mental health. Self-compassion is hereby defined as a positive attitude toward the self, expressed as the tendency to be gentle, caring, and understanding toward oneself especially when faced with personal shortcomings or failures. The two-continua model of mental health, in which psychopathology and wellbeing are seen as two related but different dimensions of mental health. Two independent longitudinal studies are reported. Study 1 assessed 874 participants and Study 2 assessed 1,029 participants of the Dutchspeaking general population. A path analysis was conducted using Preacher and Hayes software to test a mediational model in both samples separately. The results of both studies showed that R/S was significantly associated with respectively less depression symptoms and less anxiety symptoms. Additionally, results showed that R/S was significantly positively related to well-being. More positive feelings and less anxiety toward God/the divine predicted more subsequent mental well-being and less depression and anxiety. Furthermore, the mediating effect of self-compassion on the relationship between R/S and depression/ anxiety symptoms was observed as well as the mediating effect of self-compassion on the relationship between R/S and well-being. To support mental health it seems to be the most optimal to focus on both R/S and self-compassion interventions within health care treatment programs.</p