Search

Objetivo: Describir los efectos de intervenciones psicológicas sobre ansiedad, depresión, malestar emocional y/o calidad de vida (CdV) de pacientes con cáncer colorrectal. Método: Revisión narrativa de la literatura en MEDLINE, PsycINFO, CINAHL y Cochrane Library, 2011-2021. Resultados: Se obtuvieron 553 artículos, de los cuales se incluyeron doce. La mayoría fueron intervenciones breves, individuales y presenciales. La Terapia Cognitivo-Conductual fue la intervención más reportada, mostrando efectos positivos en CdV, específicamente en pacientes con estoma; la Terapia de Aceptación y Compromiso y la terapia centrada en soluciones también identificaron mejorías en CdV. La terapia de reminiscencia y una intervención para la autoeficacia redujeron la ansiedad y depresión. No se comprobó la efectividad del entrenamiento en relajación y de escritura; la psicoeducación mostró efectos inconsistentes. Conclusión: Existe una escasez de estudios realizados durante los últimos años,los cuales no evidencian un consenso del modelo terapéutico que produzca mejores consistentes en el bienestar psicológico.

Introducción. Las necesidades psicosociales en pacientes con cáncer pueden influir en el éxito del tratamiento multidisciplinario. El objetivo de esta investigación fue determinar las necesidades psicosociales de pacientes con cáncer de mama reportadas por el equipo de salud. Método. Se utilizó un diseño transversal no experimental con un muestreo por disponibilidad. Se realizó una encuesta en línea en todo el país. Participantes. 254 profesionales, principalmente cirujanos oncólogos y oncólogos médicos de instituciones de salud pública y privada. Resultados. La mayor parte de los profesionales de la salud preguntan directamente a sus pacientes sobre sus problemas emocionales; sin embargo, muy pocos utilizan escalas o cuestionarios validados. La mayoría de los participantes refirieron que en la institución donde eran atendidos se cuenta con servicios de salud mental. Los factores asociados con el malestar emocional, ansiedad y depresión son otros problemas psicológicos, así como ciertos síntomas físicos, entre los cuales se encuentran los problemas de apetito, memoria y sueño. Conclusiones. Se recomienda una mayor difusión de las guías clínicas de psicooncología para el equipo médico, así como programas de atención psicosocial en pacientes con cáncer de mama basados en evidencia.

Family and meaning-making resources are culturally congruent and help support Latinx coping with cancer.To explore Latinx advanced cancer patients' perspectives on the role of family and meaning/purpose in adjustment to advanced cancer.A qualitative study was conducted. In-depth interviews were performed and transcripts were analyzed using the method from applied thematic analysis.Participants were patients with any advanced cancer diagnosis, recruited from Memorial Sloan Kettering Cancer Center (MSKCC), New York; Lincoln Medical Center (LMC), New York; and Ponce Health Science University (PHSU), Puerto Rico.Sociodemographic and semistructured interview.Results highlight the need to include syntonic cultural values such as family and meaning for Latinx individuals coping with advanced cancer in psychological interventions.

Introducción: Los síntomas de ansiedad y depresión son considerados frecuentemente como dos de las principales afectaciones en la etapa de sobrevida al cáncer, por lo que su detección válida y confiable es crítica para ofrecer una oportuna atención psicosocial. Objetivo: Validar la Escala Hospitalaria de Ansiedad y Depresión (HADS) en una muestra de sobrevivientes de cáncer de mama mexicanas. Método: Se empleó un diseño transversal con un muestreo no probabilístico. Se incluyeron 188 mujeres, pacientes ambulatorias de un hospital de especialidad en oncología de la Ciudad de México. Resultados: Las participantes, con una edad promedio de 52.8 años, y con 4.4 años de supervivencia al cáncer, estaban en su mayor parte diagnosticadas en estadios tempranos de la enfermedad. El análisis factorial confirmatorio de la HADS identificó dos factores, corroborando así la estructura original de este instrumento, con coeficiente alfa global .83 y una varianza explicada de 53%. Discusión: La HADS mostró tener propiedades psicométricas adecuadas e indicadores de ajuste correctos que lo convierten en un instrumento válido y confiable para su uso en la atención clínica y la investigación sobre las sobrevivientes de cáncer de mama mexicanas.

espanolIntroduccion: La pandemia por COVID-19 puede tener consecuencias psicosociales importantes en la poblacion. Objetivo: Determinar los niveles de sintomas de ansiedad, depresion y conductas de autocuidado durante la pandemia de COVID-19 en poblacion general. Metodo: Encuesta en linea distribuida durante tres semanas mediante muestreo no probabilistico. Se empleo el Cuestionario sobre la Salud del Paciente PHQ-9, la Escala del Trastorno de Ansiedad Generalizada GAD-7 y la Escala analoga visual de conductas de autocuidado. Se realizaron analisis descriptivos y de comparacion entre los grupos con ansiedad y depresion. Resultados: Se incluyeron 1508 participantes, 20.8 % presento sintomas de ansiedad grave y 27.5 %, sintomas de depresion grave. Ser mujer, soltero(a) no tener hijos, presentar comorbilidad medica y antecedentes de atencion a la salud mental estuvieron relacionados con la presencia de mayores niveles de sintomas de ansiedad y depresion; 66 a 80 % de la poblacion cumplia con las recomendaciones de autocuidado. Se identifico la necesidad de recibir atencion de salud mental. Conclusion: Se observo mayor numero de individuos con sintomas de ansiedad y depresion moderadas a graves que en otras pandemias. Los efectos psicologicos de la pandemia de COVID-19 se consideran un problema de salud mental publica emergente, por lo que se recomienda la implementacion de programas para su atencion. EnglishIntroduction: The COVID-19 pandemic can have important psychosocial consequences in the population. Objective: To determine the levels of anxiety, depression and self-care symptoms during the COVID-19 pandemic in the general population. Method: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and Visual analog scale for self-care behaviors were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. Results: Out of 1508 included participants, 20.8% had symptoms of severe anxiety, while 27.5% showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were risk factors for developing symptoms of anxiety and depression; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. Conclusion: A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public health problem, and implementation of programs for their care is therefore recommended.

Latinos are more likely to be diagnosed with advanced cancer and have specific existential and communication needs. Concepts within Meaning-Centered Psychotherapy (MCP) interventions and Communications Skills Training (CST) assist patients in attending to these needs. However, Latino-tailored MCP interventions have yet to be adapted for advanced cancer patients and caregivers. A cross-sectional survey was administered to Latino advanced cancer patients and caregivers where participants rated the importance of the goals and concepts of MCP and CST. Fifty-seven (n = 57) Latino advanced cancer patients and fifty-seven (n = 57) caregivers completed the survey. Most participants rated MCP concepts as extremely important, ranging from 73.75% to 95.5%. Additionally, 86.8% favored finding meaning in their life after a cancer diagnosis. Participants (80.7%) also selected the concept of finding and maintaining hope to cope with their cancer diagnosis. Finally, participants found CST concepts and skills acceptable, ranging from 81.6% to 91.2%. Results indicate the acceptability of Meaning-Centered Therapy and Communication Skills Training among Latino advanced cancer patients and caregivers coping with advanced cancer. These results will inform the topics to be discussed in a culturally adapted psychosocial intervention for advanced cancer patients and their informal caregivers.

ObjectivesThis brief report aims to describe and determine the association of family functioning (e.g., cohesion and expressiveness) with psychosocial needs among Spanish Latinx patients coping with advanced cancers.MethodsDescriptive and correlation analyses were performed on data from 103 patients coping with advanced cancer (Stages III and IV). The measures used were the Family Relationships Index, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Cancer Therapy: General.ResultsResults indicated that most of the participants had low family function (65%). Participants with higher family functioning (35%) had high levels of quality of life [r(103) .318, p r(95) −.653, p r(95) −.733, p r(95) −.585, p = .000]. A total of 22.3% of Latinx advanced cancer patients reported poor cohesiveness; those with low cohesiveness also had higher levels of depression [r(103) −.28, p = .004] and anxiety [r(103) −.27, p = .005]. Correlations between expressiveness and hopelessness were significant; namely, those with higher expressiveness had lower hopelessness [r(103) −.274, p = .005].Significance of resultsFindings present a high correlation between family functioning and psychosocial symptoms.

Latinx advanced cancer patients and caregivers are less likely to have adequate access to culturally congruent psychosocial interventions. Culturally relevant and adapted interventions are more effective within minority groups. We obtained patients’ and caregivers’ initial evaluations of the Caregivers–Patients Support to Latinx coping with advanced-cancer (CASA) protocol. A qualitative study was conducted, and an acceptance questionnaire and semi-structured interviews were conducted to culturally adapt the psychosocial intervention for Latinx coping with cancer. The semi-structured interview described and demonstrated intervention components and elicited feedback about each one. Latinx advanced cancer patients (Stage III and IV) and caregivers (n = 14 each) completed the acceptance survey, and N = 7 each completed semi-structured interviews. A total of 12 of the 14 patients and caregivers (85.7%) reported high acceptance of the goals and purposes of the intervention protocol. They also reported willingness to daily use of the content of the intervention components: Communication Skills, the Willingness of Meaning, Life has Meaning, Freedom of Will, Identity, Creative Sources of Meaning, and Homework. Most of the participants reported high acceptance (n = 9) of integrating family caregivers into therapy and the high acceptance (n = 10) of the length of the 4-session intervention.

Background: Anxiety and depression symptoms are known to increase cancer symptom burden, yet little is known about the longitudinal integrations of these among Hispanic/Latinx patients. The goal of this study was to explore the trajectory and longitudinal interactions among anxiety and depression, cancer symptom burden, and health-related quality of life in Hispanic/Latinx cancer patients undergoing chemotherapy. Methods: Baseline behavioral assessments were performed before starting chemotherapy. Follow-up behavioral assessments were performed at 3, 6, and 9 months after starting chemotherapy. Descriptive statistics, chi-square tests, Fisher’s exact tests, and Mann–Whitney tests explored associations among outcome variables. Adjusted multilevel mixed-effects linear regression models were also used to evaluate the association between HADS scores, follow-up visits, FACT—G scale, MDASI scale, and sociodemographic variables. Results: Increased cancer symptom burden was significantly related to changes in anxiety symptoms’ scores (adjusted β^ = 0.11 [95% CI: 0.02, 0.19]. Increased quality of life was significantly associated with decreased depression and anxiety symptoms (adjusted β^ = −0.33; 95% CI: −0.47, −0.18, and 0.38 adjusted β^= −0.38; 95% CI: −0.55, −0.20, respectively). Conclusions: Findings highlight the need to conduct periodic mental health screenings among cancer patients initiating cancer treatment.

OBJECTIVE: This study compares barriers to psychosocial services use between Latina and non-Latina White survivors after receiving a diagnosis of breast cancer and examines the association of these barriers with use of psychosocial services. METHODS: A sample of 265 Latina and non-Latina White survivors who received treatment in a comprehensive cancer center in New York City completed a mailed questionnaire. The questionnaire measured quality of life, interest in help for distress, psychosocial services use, and barriers to use of psychosocial services. Bivariate and adjusted logistic regression models were conducted analyze the data. RESULTS: More than half of the sample reported preferring to return to their normal routine, felt that they could take care of their emotional problems themselves, and preferred to seek support from their family or friends. Latinas were more likely to seek counseling from a spiritual leader and report that there are no counselors who speak their language and understand their values or background and that mental health services are too expensive. CONCLUSIONS: It is crucial to study and address potential barriers that contribute to health disparities and discrepancies in patient’s access and use of psychosocial healthcare.Findings highlight the need to educate providers about patients’ psychosocial needs; patients need to receive information about the benefits of psychosocial and mental health services, to normalize mental health service use and diminish stigma. Finally, culturally and linguistic sensitive services for Latina patients are warranted.

Racial and ethnic minorities (REMs) continue to be underrepresented in clinical trials despite the 1993 National Institutes of Health's Revitalization Act mandating the representation of women and underrepresented minority groups in clinical trials. Although Blacks represent 15% and Hispanics 13% of the cancer population, their clinical trial enrollment rates are disproportionately low at 4% to 6% and 3% to 6%, respectively. A systematic review exploring interventions aimed at improving cancer clinical trial (CCT) enrollment for REMs was conducted.A systematic search of PubMed, Cochrane CENTRAL, and Ovid PsycINFO was conducted for English-language studies since 1993. Inclusion criteria included peer-reviewed, US-based studies with interventions aimed to recruit underrepresented minority adult patients into cancer clinical trials. REM groups were defined as Black, Hispanic, Asian, American Indian, and Native Hawaiian/other Pacific Islander.The systematic search identified 3123 studies, of which nine met inclusion criteria. Interventions included patient navigation/coaching (n = 4), a clinical trial educational video (n = 2), institutional research infrastructure changes (n = 1), a relationship building and social marketing recruitment model (n = 1), and cultural competency training for providers (n = 1). A statistically significant improvement in accrual was shown in three of the patient navigation interventions, one of the clinical trial educational videos and an institutional research infrastructure change.This systematic review illustrates several potential mechanisms by which to increase CCT recruitment for patients of REM backgrounds in various clinical settings. More randomized controlled trials are needed to further explore the benefits of these interventions for REMs.

IntroductionLiterature suggests couple-based interventions that target quality of life and communication can lead to positive outcomes for patients with cancer and their partners. Nevertheless, to date, an intervention to address the needs of Latino families coping with advanced cancer has not been developed. Meta-analytic evidence suggests that culturally adapted evidenced-based intervention targeting a specific cultural group is four times more effective. Our goal is to culturally adapt a novel psychosocial intervention protocol entitled‘Caregivers-PatientsSupport to Latinx coping advanced-cancer’ (CASA). We hypothesised that combine two evidence-based interventions and adapting them, we will sustain a sense of meaning and improving communication as patients approach the end of life among the patient–caregiver dyad.Methods and analysisTo culturally adapt CASA, we will follow an innovative hybrid research framework that combines elements of an efficacy model and best practices from the ecological validity model, adaptation process model and intervention mapping. As a first step, we adapt a novel psychosocial intervention protocol entitled protocol entitled‘Caregivers-PatientsSupport to Latinx coping advanced-cancer’ (CASA). The initial CASA protocol integrates two empirically based interventions, meaning-centred psychotherapy and couple communication skills training. This is an exploratory and prepilot study, and it is not necessary for a size calculation. However, based on recommendations for exploratory studies of this nature, a priori size of 114 is selected. We will receive CASA protocol feedback (phase 1b: refine) by conducting 114 questionnaires and 15 semistructured interviews with patients with advanced cancer and their caregivers. The primary outcomes of this study will be identifying the foundational information needed to further the develop the CASA (phase IIa: proof-of-concept and phase IIb: pilot study).Ethics and disseminationThe Institutional Review Board of Ponce Research Institute approved the study protocol #1907017527A002. Results will be disseminated through peer-reviewed publications.

Hispanics are the largest U.S. immigrant group and Mexican Americans are the largest U.S. Hispanic population. Hispanics, particularly Mexican Americans, are among the highest risk groups for obesity, placing them at increased risk for cardiovascular disease and certain types of cancer. Obesity lifestyle interventions incorporating Motivational Interviewing techniques and specific adaptations for the population of interest can have a significant impact on reducing health risks. This paper presents a community-engaged, culturally-sensitive nutrition and dietary counseling intervention conducted between 2016 and 2018 at the Consulate General of Mexico in New York City and reports preliminary findings regarding participant satisfaction and self-reported changes in eating and exercise habits. In addition, it describes the community and academic partners' roles and processes in program development, discusses strengths and challenges posed by a multi-sector partnership and describes adaptations made using the Behavioral Model for Vulnerable Populations to increase the program's sustainability and potential for scalability.

Background: Latino patients with advanced cancer need culturally responsive, effective psychotherapeutic interventions that can assist them in coping with their diagnosis and improve spiritual and existential well-being and psychological adjustment. Objective: This study describes the cultural and linguistic adaptation of individual meaning-centered psychotherapy for Latinos with advanced cancer. Design: A mixed-methods, concurrent integrative approach was used for this study, using the ecological validity and cultural adaptation process models as frameworks for cultural adaptation. Setting/Subjects and Measurements: Quantitative and qualitative data were collected through (1) a survey of mental health professionals (n = 70) who offer services to Latino cancer patients; (2) a questionnaire for Latino patients with advanced cancer (n = 54), measuring relevant intervention concepts; and (3) in-depth interviews with 24 Latino patients. Results: Quantitative findings showed that most of the goals and concepts were highly acceptable for patients and providers. The qualitative findings supported adaptations to include using more simple definitions; changing phrases that are challenging to translate and comprehend; using words that are common to all Latino cultures, providing more than one option if needed; simplifying the questions/reflections, as needed; changing the metaphors to be culturally congruent; and modifying content to make it responsive to Latino cultural values and norms. Conclusions: Findings demonstrate the need for adaptation to achieve the aims of the intervention, accounting for both linguistic and cultural considerations, emphasizing issues related to literacy, cultural and linguistic diversity, cultural values, and culturally congruent content. The mixed-methods approach is described to provide recommendations for clinicians, researchers, and program developers.

BACKGROUND: This study examined differences in colorectal cancer screening across sociodemographic, migration, occupational, and health-related factors in a sample of male taxi drivers. METHODS: Male drivers eligible for colorectal cancer screening (CRCS) (≥ 50 years old) were recruited in 55 community-based health fairs conducted during November 2015 to February 2017 in 16 taxi garages or community locations located in Queens, Brooklyn, Manhattan and Bronx. Participants completed a survey that included sociodemographic, migration, occupational, health-related, and cancer screening practices. For this study 33 questions were analyzed. RESULTS: The sample consisted of 137 male drivers, 27% of them had undergone CRCS. Occupation-related factors, including night shifts and driving high numbers of weekly hours, were associated with lower CRCS rates; having a family history of cancer, health insurance, a regular source of primary care, and a routine check-up in the last year, were associated with higher CRCS rates. DISCUSSION: The findings suggest that drivers with health insurance and better access to primary care are more likely to be up-to-date with CRCS. The results provide important information that can inform occupation-based public health interventions.

There is a known end-of-life related disparity among Latino individuals, and there is a need to develop culturally sensitive interventions to help patients and caregivers cope with advanced cancer. Latino patients and caregivers coping with advanced cancer were asked to list important end-of-life topics to culturally inform a psychosocial intervention adaptation process. A qualitative study was conducted, and semi-structured interviews were performed, audio-recorded, and transcribed. Recordings and transcriptions were reviewed and analyzed using thematic content coding. The semi-structured interview described and demonstrated intervention components and elicited feedback about each. Free listing method was used to assess important topics among Latino advanced cancer patients (n = 14; stage III and IV) and caregivers. Patients and caregivers were given a list of 15 topics and asked which topics they deemed important to integrate into the intervention. Overall, more than half of the participants considered it important to include 13 of the 15 topics related to daily activities (eight subcategories), psychosocial support (three subcategories), discussing diagnosis and support (three subcategories), and financial difficulties (one subcategory). Patient-caregivers reported importance in most end-of-life topics. Future research and intervention development should include topics related to psychosocial support, daily activities, discussing diagnosis and support, and financial difficulties.

The purpose of this pilot study was to assess the feasibility and acceptability of a mobile smoking cessation intervention in Puerto Rico. This was a single-arm pilot study with 26 smokers in Puerto Rico who were enrolled in Decídetexto, a mobile smoking cessation intervention. Decídetexto incorporates three integrated components: (1) a tablet-based software that collects smoking-related information to develop an individualized quit plan, (2) a 24-week text messaging counseling program with interactive capabilities, and (3) pharmacotherapy support. Outcome measures included self-reported 7-day point prevalence abstinence at Months 3 and 6, pharmacotherapy adherence, satisfaction with the intervention, and changes in self-efficacy. The average age of the participants was 46.8 years (SD 12.7), half of them (53.8%) were female. Most participants (92.3%) smoked daily and half of them (53.8%) used menthol cigarettes. All participants requested nicotine patches at baseline. However, only 13.0% of participants used the patch &gt, 75% of days. At Month 3, 10 participants (38.4%) self-reported 7-day point prevalence abstinence (88.5% follow-up rate). At Month 6, 16 participants (61.5%) self-reported 7-day point prevalence abstinence (76.9% follow-up rate). Most participants (90%, 18/20) reported being satisfied/extremely satisfied with the intervention at Month 6. Self-efficacy mean scores significantly increased from 40.4 (SD 12.1) at baseline to 57.9 (SD 11.3) at Month 3 (p &lt, 0.01). The study suggests that Decídetexto holds promise for further testing among Puerto Rican smokers.

This study explores the relationship between spiritual well-being (SWB) (meaning/peace & faith), depression, and quality of life (QOL). Cancer survivors often use their spirituality as a way of coping. Among a sample of 97 Latina breast cancer survivors (LBCS) SWB was assessed with the Functional Assessment of Chronic Illness Therapy - Spiritual Well-being Scale (FACIT-Sp), QOL was measured using the Functional Assessment of Cancer Therapy: General (FACT-G), and depression was measured with the Patient Health Questionnaire (PHQ-9). Study findings revealed that SWB, specifically the meaning/peace factor, is the main predictor of an increase in QOL and a reduction in depression among LBCS.

Introduction The COVID-19 pandemic can have important psychosocial consequences in the population. Objective To determine the levels of anxiety, depression and self-care symptoms during the COVID-19 pandemic in the general population. Method Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and Visual analog scale for self-care behaviors were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. Results Out of 1508 included participants, 20.8% had symptoms of severe anxiety, while 27.5% showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were risk factors for developing symptoms of anxiety and depression; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. Conclusion A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public health problem, and implementation of programs for their care is therefore recommended.

BackgroundMeaning-centered psychotherapy (MCP) is a structured psychotherapeutic intervention that aims to improve existential and spiritual well-being in patients with advanced cancer. To validate it, several efficacy studies with predominantly non-Hispanic white patients have been done. Puerto Ricans residing on the island are a largely overlooked segment of the US Latinx population. They have a strong national identity and are embedded in a collectivist culture which shares the Spanish language, cultural traditions, and an emphasis on familism, a cultural factor that values the role of the family in ensuring the well-being of its members.ObjectiveThe purpose of this study is to present a case study focused on a Puerto Rican advanced cancer patient who underwent MCP to assess the comprehension and acceptance of the MCP intervention.MethodWe used a mixed-methods study design that included the taking of ethnographic notes, and pre- and post-test assessments of the scores the patient received on all the measures (using validated scales). The ethnographic notes were analyzed to determine the participant's comprehension and acceptance of the MCP intervention. Content analysis was performed on the ethnographic notes by three independent coders using a deductive coding approach. Pre- and post-interview assessments were conducted to explore changes in distress, spiritual well-being, and self-perceived quality of life.ResultsA Latino patient with stage III cancer, low income, and low literacy skills showed low comprehension of the concepts of meaning, the finite, legacy, and moderate comprehension and acceptance of the concepts of the search for hope, purpose in life, connecting with life, courage, life's limitations, and sources of meaning. However, the patient showed high comprehension of death and dying (i.e., meaningful death). The patient showed low acceptance of death and dying concepts and high acceptance of the integration of family members into the therapy.Significance of ResultsAdditional studies are needed to address cultural themes and to improve the comprehensibility and acceptance of the manual's content and the central MCP concepts. The findings suggest that MCP has the potential of being a feasible form of psychotherapy for Latinx patients suffering from distress, low spiritual well-being, and low self-perceived QOL.

Cancer patient satisfaction with the healthcare team is of great relevance for assessing the quality of the care provided by the health system. In Mexico, no valid and reliable tool is available to assess this construct.To validate the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction (FACIT-TS-PS) instrument, version 4, in cancer patients.Cross-sectional design, non-probability convenience sampling. The sample consisted of 200 cancer-diagnosed patients, with mean age of 45.86 ± 15.01 years. Exploratory and confirmatory factor analyses were conducted.The exploratory factor analysis identified four factors, with a Cronbach alpha of 0.945, and an explained variance of 68.15 %. The confirmatory factor analysis indicated that the proposed theoretical model adjusts to the data with an error close to zero and, in addition, it is balanced and carefully measures overall patient satisfaction with the treatment.FACIT-TS-PS was shown to be a valid and reliable instrument for use in clinical care and research in Mexican cancer patients. Its use is recommended in the evaluation of oncology multidisciplinary healthcare teams in Mexico.La satisfacción del paciente oncológico con el equipo de salud es de relevancia para evaluar la calidad de la atención del sistema de salud. En México no se dispone de una herramienta válida y confiable para evaluar este constructo.Validar el Instrumento de Evaluación de Funcionalidad en el Tratamiento para Enfermedades Crónicas-Satisfacción con el Tratamiento-Satisfacción del Paciente (FACIT-TS-PS) versión 4, en pacientes mexicanos con cáncer.Diseño transversal, muestreo no probabilístico, por disponibilidad. La muestra consistió en 200 pacientes diagnosticados con cáncer, con edad promedio de 45.86 ± 15.01 años. Se realizó un análisis factorial exploratorio y confirmatorio.Se identificaron cuatro factores con un alfa de Cronbach de 0.945 y una varianza explicada de 68.15 %. El análisis factorial confirmatorio indicó que el modelo teórico propuesto se ajusta a los datos con error próximo a cero y que, además, es equilibrado y mide cuidadosamente la satisfacción global del paciente con el tratamiento.FACIT-TS-PS mostró ser un instrumento válido y confiable para su uso en la atención clínica e investigación dirigida a pacientes mexicanos con cáncer. Se recomienda su utilización en la evaluación de equipos de salud multidisciplinarios en oncología en México.

Although Arabs are a growing population in the United States, they are a hidden minority when compared to larger, more studied groups like Latinos and Caribbean immigrants of African descent (CIAD). There is limited research pertaining to patients' unmet socioeconomic and supportive care needs when undergoing breast cancer treatment, particularly among immigrants and migrants. This is a comparative study of a nested cohort of 36 Arabs, 145 Latinos and 128 CIAD breast cancer patients participating in the Integrated Cancer Care Access Network and their areas of needed assistance. The patients were recruited from eleven community cancer clinics in New York City and through community based organizations. Patients most commonly reported needing financial, transportation, and food assistance. Arabs were more likely than their CIAD and Latino counterparts to have health insurance and legal aid needs. Arabs also has the highest proportion of patients unaware of their own cancer stage, at odds with their report of lower information needs than the other groups. Additional culturally tailored Arabic language interventions are needed to educate Arabic speaking breast cancer patients to help facilitate access to available services.

ObjectiveThe purpose of this study was to describe the preferences, the use, satisfaction of mental health services (MHS) among a sample of Puerto Rican patients with cancer undergoing oncology treatment.MethodsA convenience sample of 120 patients diagnosed with cancer was recruited. Self-report questionnaires assessed socio-demographic and background questions, and the Mental Health Service Preference, Utilization and Satisfaction Questionnaire (MHSPUS). The Socio-demographic and Background Questionnaire inquired about participants' demographic and socioeconomic characteristics, and included questions such as history of psychiatric diagnosis and spiritual practices. Univariate and Chi square analyses were used for descriptive purposes. Logistic regressions were used to explore associations between sociodemographic factors and MHS preferences and use.ResultsThe majority of the sample were females (53.8%), 61 and older (53.8%), and married or living with partner (57.1%), and reported an income equal to or less than $12,000 per year (44.4%), which places them under the US federal poverty line. Most of the participants (66.7%) reported being receptive to seeking services. Findings showed a significant association between living situation and past (p < .05) and lifetime use (p < .05) of MHS and past use of MHS. Participants living alone were more like to have used MHS in the past and during their lifetime. Adjusted logistic regression analyses revealed that living with someone was a protective factor for not using MHS in their lifetime (OR = 0.28; C1 = 0.08-0.95). Participants preferred to receive MHS at the oncology clinic, preferably on the date of their oncology appointments and during morning hours.ConclusionFindings support the integration of mental health services within the oncology practice setting.

e18574 Background: Minorities continue to be underrepresented in clinical trials despite the National Institute of Health’s Revitalization Act, passed in 1993, mandating the representation of women and underrepresented minority groups in clinical trials. Studies have shown that although Blacks represent 15% and Hispanics 13% of the cancer population, their clinical trial enrollment rates in are disproportionately low at 4-6% and 3-6% respectively. We conducted a systematic review exploring interventions aimed at improving clinical trial enrollment for racial and ethnic minorities. Methods: A systematic search of PubMed, Cochrane CENTRAL, and Ovid PsycINFO was conducted for English-language studies of humans since 1993. Inclusion criteria included peer-reviewed, U.S.-based studies with interventions aimed to recruit underrepresented minority adult cancer patients into cancer clinical trials. We defined underrepresented minority groups as Black, Hispanic/Latino, Asian, American Indian/Alaska Native and Native Hawaiian/other Pacific Islander. Results: A total of 2471 titles and abstracts were identified and 2324 were excluded based on the eligibility criteria. A full text review was conducted of the remaining 147 articles, of which only 9 met criteria for our review. The interventions included patient navigation/coaching (n = 4), a clinical trial educational video (n = 2), institutional research infrastructure changes (n = 1), a relationship building and social marketing recruitment model (n = 1) and cultural competency training for providers (n = 1). Studies were conducted in a variety of practice settings including national cancer institutes and community practices. The quality of evidence was limited by the heterogeneity of study methods, patient representation and bias. Several studies had a homogeneous population of Black patients. Most studies (n = 7) were single arm trials that compared results to either historical controls or those cited in the existing literature; two studies were randomized controlled trials. A statistically significant improvement in accrual was shown in three of the patient navigation interventions, one of the clinical trial educational videos, the institutional research infrastructure change and the relationship building and social marketing recruitment model. The common threads to many of these successful interventions were support through the cancer care continuum, cultural congruency of research staff and culturally catered clinical trial educational materials. Conclusions: This systematic review illustrates several mechanisms by which to increase cancer clinical trial recruitment for cancer patients of underrepresented minority backgrounds in a variety of clinical settings. Randomized controlled trials with representation of multiple races/ethnicities are needed to further explore the benefits of these interventions.

Background: Latino cancer patients are at risk of poor psychological adjustment. Therapeutic effectiveness in treating Latino cancer patients with advanced cancer requires managing distress, therapeutic skill, and cultural competency. This mixed-methods study explored mental health providers’ perceptions of the challenging aspects of counseling and caring for Latino patients with advanced cancer. Methods: Mental health providers providing services to Latino or Hispanic cancer patients received an emailed web-based survey with open- and closed-ended questions. Providers included psychiatrists, psychologists, social workers, counselors, and other mental health professionals. We invited 154 providers to participate from July 2015 to January 2017. One hundred and four accessed the survey, and 66 eligible providers responded, for a response rate of 43%. Analyses were used to explore whether clinical experience factors and training characteristics were associated with perceiving conversations about cancer (diagnosis, prognosis, and end-of-life) as challenging. Second, the challenging aspects of these conversations were explored qualitatively. Four independent coders coded responses; an inductive content analysis was utilized to analyze the data. Results: Mental health providers describe encountering many challenges in their therapeutic discussions with Latino cancer patients. Conclusions: It is imperative to understand the factors associated with the perceived difficulty of these conversations, as well as the characteristics of these conversations, to develop culturally sensitive interventions and programs for patients and training interventions for providers.

In Puerto Rico, cancer incidence increases significantly, and is accompanied with a greater risk of experiencing high levels of depressive symptoms, emotional distress, and reduced quality of life when compared to other minority ethnic groups. Studies suggest that interventions to attend distress in Latino patient population would benefit from including components that seek to improve patients’ spiritual well-being. The purpose of this study is to identify the level of comprehension and acceptance of Meaning-Centered Psychotherapy (MCP) concepts. A mixed method design was conducted with in-depth interviews and open pilot data. A total of nine participants with advanced or metastatic cancer were sampled from an Oncology Clinic in the south of Puerto Rico. Six semi-structured interviews and six ethnographic notes with audiotape sessions were selected and transcribed. All material was analyzed, resulting in a sample of six semi-structured interview and six ethnographic note peer sessions. Patients showed low comprehension of the MCP concepts of meaning, the finite, and legacy. Patients showed low acceptance of death and its related concepts. They also reported high acceptance of integrating family members to their therapy. In order to tailor the intervention and improve comprehension, the content should include examples, shorter questions, and brief definitions. Additionally, there is a need to address death and its related concepts in end of life.

In Puerto Rico, during the period 1990 to 2010, the incidence of all types of cancer had a statistically significant gradual increase of a rate of 0.3% per year. Similarly there was an increase in survival rates of 1% to 2%. This meant an increase in the demand for integrated services given its importance and its role in the survival process. Currently the treatment for the cancer condition is more specialized and complex. Hence, there is a great need to train qualified professionals to address the psychosocial needs of cancer patients and survivors. However, in Puerto Rico, training resources in psycho-oncology are scarce. A total of 113 graduate students participated in an online survey about research training needs. The results suggest that this is the first study in documenting these needs. The results demonstrate a high level of interest in clinical practice and research in psycho-oncology (80.2%, n = 81), but there is poor general knowledge and opportunities in specialized training (13.6%, n = 14) for students interested in the field of psycho-oncology. These results demonstrate the need to create new training opportunities in the area of psycho-oncology.

Treatment adherence, with minimal numbers of missed appointments, is an important determinant of survival among cancer patients. This study aims to determine if unmet financial, logistic, and supportive care needs predict self-reported adherence to cancer treatment appointments of chemotherapy and/or radiation among low-income ethnic minority patients.The sample included 1098 underserved Latino and Black patients recruited from cancer clinics in New York City through the Cancer Portal Project. Participants completed a survey which included sociodemographic, health-related questions and a needs assessment, in their preferred language. Patients' adherence to chemotherapy and/or radiation treatment appointments was assessed using a self-report.A sample of 1098 patients (581 Latino and 517 Black cancer patients) was recruited. Forty-two Latino cancer patients (7.4%) and 78 Black cancer patients (15.5%) reported missing treatment appointments. Patients, who experienced four or more unmet needs (odds ratios [OR] = 2.02-3.36), and those with unmet housing needs (OR = 3.10-3.31), were more likely to report missing cancer treatment appointments, regardless of their ethnicity/race. Black patients with unmet supportive care (OR = 2.27) and health insurance needs (OR = 3.80) were more likely to miss appointments. Amongst Latinos, legal health-related issues (OR = 2.51) was a significant predictor of missed appointments.Among ethnic minority cancer patients, unmet socioeconomic and supportive care needs, housing needs in particular, predicted patient-reported missed radiation, and/or chemotherapy appointments. Future research should focus on exploring the impact of practical and supportive unmet needs on adherence and development of interventions aiming to improve cancer treatment adherence.

Going through adverse life events can help a person learn how to cope with life’s challenges, overcome them, learn from the adverse experiences, grow, and be positively transformed by them. Spirituality is a resource that supports adaptation and resilience to improve quality of life in patients with cancer or other chronic illnesses. For Latinos, spirituality is an important core cultural value. As such, it is crucial to pay close attention to how cultural values play a role in health-related concerns when caring for Latino cancer patients, and to how spirituality, being an important aspect of Latino culture, influences how Latinos adjust and cope with cancer. Understanding how to facilitate resilience in the face of potentially negative life events, such as cancer, can not only help Latino cancer patients in active treatment, but can also impact effectiveness of managing and coping with the consequences of cancer during survivorship.

This study aims to determine the psychosocial correlates of self-reported adherence to cancer treatment appointments and treatment delays and interruptions. The sample included 622 immigrant cancer patients from New York City. Patients completed a survey that included sociodemographic and health-related questions, questions assessing missed appointments and delays/or interruptions, and quality of life and depression scales. After controlling for sociodemographic characteristics, having a positive depression screen and poor physical and emotional well-being were significant predictors of missed appointments and delays and/or interruptions of treatment. Non-adherence to treatment appointments in immigrant cancer patients is a complex outcome related to important modifiable or treatable factors.

This study examined the use of psychosocial services (i.e., social work, psychiatric, psychological, and spiritual/pastoral services) among Latina and Non-Latina white breast cancer survivors.Survivors who received treatment in a Comprehensive Cancer Center in New York completed a mailed questionnaire about interest in help for distress, and psychosocial service use. Descriptive and non-parametric statistics were used to explore ethnic differences in use of, and interest in, psychosocial services.Thirty-three percent of breast cancer survivors reported needing mental health or psychosocial services after their cancer diagnosis (33% Latinas, 34% whites); 34% of survivors discussed with their oncologist or cancer care provider their emotional problems or needs after the diagnosis (30% Latinas, 36% whites). Only 40% of the survivors who reported needing services received a referral for psychosocial services (42% Latinas, 39% whites). Sixty-six percent of survivors who reported needing services had contact with a counselor or mental health professional (psychiatrist, psychologist, or social worker) after their diagnosis (57% Latinas, 71% whites), and 61% of those needing services reported receiving psychosocial services (53% Latinas, 67% whites). Whites were significantly more likely than Latinas to have contact with a social worker (33% vs. 17%, respectively) and to receive psychotropic medication (15% vs. 0%, respectively). However, Latinas were significantly more likely to receive spiritual counseling than whites (11% vs. 3%, respectively).Our study revealed gaps for both groups; however, the gaps differed by group. It is crucial to study and address potential differences in the psychosocial services availability, acceptability, and help-seeking behaviors of ethnically diverse cancer patients and survivors.

Psychotherapeutic interventions focusing on addressing the needs and experiences of Latino cancer patients are scarce. This chapter discusses the formative process of the cultural and linguistic adaptation of meaning-centered psychotherapy (MCP) for Latinos with advanced cancer, as well as the considerations for and the process of adapting a psychotherapeutic intervention. A brief review of the efficacy of other psychotherapeutic interventions developed, adapted, and delivered to Latino cancer patients and also the concepts and applicability of individual meaning-centered psychotherapy are described. This chapter presents the initial phase of the adaptation of MCP, including conceptual frameworks, plan, process and methods used in adapting the original evidence-based treatment for Latino patients with advanced cancer. The mixed-method approach is described to provide future recommendations for clinicians, researchers, and program developers.

Addressing language and cultural nuance is required to improve the quality of care among all patients. The tenth version of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS) recommends implementing ongoing assessments to integrate specific actions into measurement and continuous quality improvement activities. To this end, we have created the Interventional Cultural and Language Assistance Program (ICLAP). As part of ICLAP, we conducted a cross-sectional needs assessment survey with 564 consecutive patients receiving outpatient Positron emission tomography-computed tomography (PET/CT) imaging at a comprehensive cancer center in the five most prevalent languages of New York City: English, Spanish, Russian, Chinese, and Arabic. The purpose of this study is to describe the language assistance characteristics and needs of a sample of patients receiving care in the cancer center. We examined the relationship between race, ethnicity, birthplace, communication and language assistance characteristics and the satisfaction with the care received. Our results show that race and ethnicity, birthplace, cultural beliefs, language assistance, and communication characteristics were all factors associated with patients' satisfaction with care, illustrating that there is an unmet need among cancer patients to have cultural and linguistic sensitive services.

Having more health knowledge has a crucial and positive impact on cancer outcomes. Patients’ cancer knowledge influences their ability to participate actively in decision-making processes for medical care and in treatment choices. The purpose of this study was to determine the demographic and medical correlates of lack of cancer stage knowledge and desire for information among Latino cancer patients. The sample included 271 underserved Latino cancer patients recruited from four cancer clinics in New York City. Participants completed a needs assessment survey in their preferred language, which included sociodemographic and health-related questions. Close to two-thirds of the sample (65 %) had no knowledge of their stage, and 38 % were unaware of the metastatic state of their tumor. Only 15 % of the patients expressed that they would like additional information about their diagnosis and/or treatment. After controlling for sociodemographic characteristics, being an immigrant with limited English proficiency and monolingual in Spanish were predictors of stage unawareness and less desire/need for cancer information. Patients needing interpretation for health care were less likely to know whether their tumor had metastasized and their cancer stage and to desire information about their cancer diagnosis and/or treatment. This study shows considerably low levels of stage awareness among Latinos diagnosed with cancer. This lack of knowledge might adversely impact their treatment decisions and disease management. Future studies should focus on identifying barriers to acquisition of disease information and other disease-specific informational deficits.

Racial disparities exist in health care, even when controlling for relevant sociodemographic variables. Recent data suggest disparities in patient-physician communication may also contribute to racial disparities in health care. This study aimed to systematically review studies examining the effect of black race and racial concordance on patient-physician communication.A comprehensive search using the PRISMA guidelines was conducted across seven online databases between 1995 and 2016. The search resulted in 4672 records for review and 40 articles for final inclusion in the review. Studies were included when the sample consisted of black patients in healthcare contexts and the communication measure was observational or patient-reported. Data were extracted by pairs of authors who independently coded articles and reconciled discrepancies. Results were synthesized according to predictor (race or racial concordance) and communication domain.Studies were heterogeneous in health contexts and communication measures. Results indicated that black patients consistently experienced poorer communication quality, information-giving, patient participation, and participatory decision-making than white patients. Results were mixed for satisfaction, partnership building, length of visit, and talk-time ratio. Racial concordance was more clearly associated with better communication across all domains except quality, for which there was no effect.Despite mixed results due to measurement heterogeneity, results of the present review highlight the importance of training physicians and patients to engage in higher quality communication with black and racially discordant patients by focusing on improving patient-centeredness, information-giving, partnership building, and patient engagement in communication processes.

Latinos are a diverse population comprised of multiple countries of origin with varying cultural profiles. This study examines differences in colonoscopy completion across place of birth and migration-related factors in a sample of predominantly Dominican and Puerto Rican Latinos living in New York City after receiving a recommendation for colonoscopy screening and navigation services. The sample included 702 Latinos recruited for two cancer screening projects targeting Latinos eligible for colonoscopy who seek healthcare in New York City. Participants completed a survey that included sociodemographic, health-related questions, psychosocial assessments and cancer screening practices, in Spanish or English. Migration, acculturation, and language factors were found to predict colonoscopy completion. The results indicated that Latinos born in the Dominican Republic and Central America were more likely to complete a screening colonoscopy than their counterparts born in the US. Further, those who emigrated at an older age, who have resided in the US for less than 20 years, preferred Spanish and those with lower US acculturation levels were also more likely to complete a screening colonoscopy. The findings suggest that Latinos who are less acculturated to the US are more likely to complete a screening colonoscopy after receiving a physician recommendation for colonoscopy screening. The results provide important information that can inform clinical practice and public health interventions. Continued attention to cultural and migration influences are important areas for cancer screening intervention development.

The association between food insecurity and health-related quality of life (QOL) of racial/ethnic minority patients with cancer has not been examined. The purpose of this study is to determine the relationship between food insecurity and health-related QOL reported by racial/ethnic minority patients with cancer.A consecutive sample of 1,390 underserved ethnic minority patients receiving cancer care in 10 cancer clinics and hospitals in New York City participated in this study. Health-related QOL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G) and food security was assessed by the US Department of Agriculture Core Food Security Module.Of the 1,390 patients, 581 (41.8%) were classified as food secure, 571 (41.1%) with low food security, and 238 (17.1%) with very low food security. Health-related QOL decreased with each lower food security level. Patient self-reported physical, functional, social, and emotional well-being subscale scores decrease significantly with increasing food insecurity. After controlling for demographic and medical-related factors, the decreases in QOL, physical, functional, social and emotional well-being scores with increasing food insecurity remained significant.Food insecurity was associated with lower QOL in this sample of underserved racial/ethnic minority patients with cancer. Underserved ethnic minority patients diagnosed with cancer are a vulnerable patient population, at significant risk for inadequate food access and the related lower QOL.