Publications by authors named "Marianna Masiero"

28 Publications

  • Page 1 of 1

"We-Diseases" and Dyadic Decision-Making Processes: A Critical Perspective.

Public Health Genomics 2021 Nov 23:1-5. Epub 2021 Nov 23.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy.

This is a critical perspective paper discussing the theoretical bases and methodological issues regarding dyadic decision-making processes in the oncological domain. Decision-making processes are of a central interest when one partner in a couple has cancer, and patients and partners make decisions together under an interactive and dynamic process. Given that, the attention in research is progressively shifting from patient and partner considered as individuals to a more holistic view of patient-partner considered as a dyad. The consideration of the dyadic nature of the decision-making represents a challenge from a theoretical and methodological point of view. The Interdependence Theory and the Dyadic Model of decision-making provide the theoretical bases to consider, respectively, the interdependence of the dyadic decision-making and the mechanisms affecting the couple-based decision-making. Dyadic processes require also an appropriate data analysis strategy that is discussed in the study as well. Conclusions of the present critical review suggest to develop a new line of research on dyadic decision-making in the oncological domain, testing the Dyadic Model presented in the study and considering the interdependence of the data with appropriate levels of analysis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000518596DOI Listing
November 2021

Assessing Predictors of Tamoxifen Nonadherence in Patients with Early Breast Cancer.

Patient Prefer Adherence 2021 15;15:2051-2061. Epub 2021 Sep 15.

Division of Medical Senology, IEO European Institute of Oncology IRCCS, Milan, Italy.

Adjuvant endocrine therapy (AET) is generally proposed to all patients with hormone receptor-positive breast cancer to reduce the risk of recurrence and death. Adherence to therapy is crucial. However, non-adherence to AET is common, with estimates of up to 50% of patients not successfully completing a five-year course of treatment, and it is significantly associated with lower survival rates and a higher risk of recurrence. Currently, no gold standard is available to assess adherence. Several studies, most of them retrospective in nature, have used both direct and indirect methods to monitor the adherence to therapy in breast cancer. The indirect method is more widely used, and it is based on pharmacy prescription refills and patient administered questionnaires. On the other hand, direct methods such as a measurement of the level of the drug or its metabolites in blood or urine are much more precise, but more expensive and not routinely implemented. In this review, we analyzed the results of the major studies focused on the adherence to tamoxifen in breast cancer patients. We identified several factors associated with poor adherence, such as the side effects of therapy, the lack of shared decision-making between the physician and patient, the context in which the discussion takes place, and whether the patients are enrolled in a clinical trial. Moreover, we discussed possible methods to improve adherence to adjuvant therapy in breast cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/PPA.S285768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450184PMC
September 2021

A Comprehensive Model of Tobacco Cigarette Smoking in Adolescence: The Role of Attachment Style and Personality.

J Psychol 2021 29;155(7):589-605. Epub 2021 Jun 29.

University of Milan.

Several previous studies have investigated the association between smoking, attachment style and personality, but they were either focused on personality or on attachment style and considered these variables separately. Starting from such findings, the study aims to investigate both factors, as they might not be independent, in order to clarify their role in the onset of smoking behavior in adolescence. This study was conducted on a convenience sample of 338 adolescents [male: 55% (186) - female: 45% (152)] (aged 16.63 ± 1.63). All participants completed a set of standardized questionnaires that assessed attachment style, personality and smoking behavior (starting age, daily cigarettes, nicotine dependence). Results showed that the dismissing attachment style, novelty seeking, and older age were associated with a higher likelihood of having a cigarette smoking experience; while self-directedness and gender (being female) were associated with a lower likelihood of having a cigarette smoking experience ( < .001). The secure and avoidant attachment styles were associated with a late smoking onset, whereas dismissing attachment and reward dependence were associated with an earlier smoking onset ( < .009). These findings highlight the possibility of developing a psycho-cognitive profile of adolescent smokers, and help to describe a smoking trajectory that may aid in designing tailored interventions and treatments to discourage smoking.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/00223980.2021.1934374DOI Listing
September 2021

Increasing Smoking Cessation Adherence: Do We Need to Consider the Role of Executive Function and Rumination?

Eur J Psychol 2020 Mar 3;16(1):1-11. Epub 2020 Mar 3.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy.

Despite the cost and health consequences, a large number of people continue to smoke cigarettes worldwide every day. Notwithstanding, there have been a number of interventions to help people stop smoking but, in general, these have produced only limited success, and better interventions are needed. Accruing evidence affirmed that rumination and executive function play a pivotal role in cigarette smoking behavior, and in this editorial, we describe and discuss the key findings between these constructs and smoking, and argue that an impairment in executive functions does not act alone, but interacts with rumination by directing attention to depressive thoughts, thereby reducing the ability of smokers to engage in constructive behaviors, such as quitting smoking. Finally, we offer a new theory-driven model based on a deep understanding of the interactions between executive functions and rumination and potential moderator effects.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5964/ejop.v16i1.2279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913029PMC
March 2020

Quality of life and psycho-emotional wellbeing in bladder cancer patients and their caregivers: a comparative analysis between urostomy versus ileal orthotopic neobladder.

Ecancermedicalscience 2021 5;15:1163. Epub 2021 Jan 5.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy.

Background: The impact of neobladder and urostomy on bladder cancer patient's health-related quality of life (HR-QoL) is controversial and many issues currently remain under-investigated. Initial studies pointed out that the emotional responses of caregivers might be '', influencing emotional reactions in bladder cancer patients undergoing radical cystectomy.

Methods: Three hundred and eighty-two bladder cancer patients (aged = 67.29 years; SD = 9.23) (16.9% (65) were female and 82.9% (319) were male) and their caregivers were enrolled. Data were collected prospectively: at T0 (1 month before the surgery), at T1 (2 weeks after the surgery, at patient discharge from the hospital) and at T2 (6-month follow-up). At each time point (T0, T1 and T2), a set of questionnaires (EORT QLQ-C30 and emotion thermometer) were given to patients and their caregivers.

Results: All patients reported a general improvement in the HR-QoL and global health status/QoL from T0 to T2 ( < 0.001). No significant differences were observed between neobladder and urostomy. At T0, the emotional thermometer total scoring in caregivers was positive in relation to HR-QoL ( < 0.001) and negative in relation to the patient's perception of QoL ( < 0.001) and global health (p < 0.001). Similar trends were observed at T1 and T2.

Conclusions: These results suggest that patients and their caregiver's emotional reactions to cancer are deep-rooted and strongly interconnected, and they provide innovative insights for the clinical management of bladder cancer patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3332/ecancer.2021.1163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929779PMC
January 2021

Preliminary observations regarding the expectations, acceptability and satisfaction of whole-body MRI in self-referring asymptomatic subjects.

Br J Radiol 2021 Feb 1;94(1118):20191031. Epub 2020 Dec 1.

Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

Objective: To evaluate the satisfaction of asymptomatic subjects who self-referring Whole-Body Magnetic Resonance Imaging (WB-MRI) for early cancer diagnosis.

Methods: Subjects completed a pre-examination questionnaire, while waiting for their WB-MRI examination, recording demographics, expected discomfort, perceived knowledge and usefulness of the procedure and health risk perceptions, as well as a post-examination questionnaire, measuring discomfort experienced, acceptability and satisfaction with WB-MRI. We examined which factors influenced discomfort and satisfaction associated with WB-MRI.

Results: 65 asymptomatic subjects (median age 51; 29 females) completed the questionnaire. Before WB-MRI, 29% of subjects expected discomfort of some form with claustrophobia (27.7%) and exam duration (24.6%) being the most common concerns. Experienced discomfort due to shortness of breath was significantly lower than expected. This difference was significantly associated with the personal risk perception to get a disease ( = 0.01) and educational level ( = 0.002). More specifically, higher level of perceived personal risk of getting a disease and lower level of education were associated with higher expected than experienced discomfort. Similarly, experiencing less claustrophobia than expected was significantly associated with gender ( = 0.005) and more pronounced among females. A majority (83%) of subjects expressed high levels of satisfaction with WB-MRI for early cancer diagnosis and judged it more acceptable than other diagnostic exams.

Conclusions: Asymptomatic subjects self-referring to WB-MRI for early cancer diagnosis showed high levels of satisfaction and acceptability with the examination. Nevertheless, a relevant proportion of participants reported some form of discomfort. Interestingly, participants with higher perceived personal risk to get a disease, lower education and females showed to expect higher discomfort than experienced.

Advances In Knowledge: Scope exists for measures to assess expected feelings and develop personalized interventions to reduce the stress anticipated by individuals deciding to undergo WB-MRI for early cancer diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1259/bjr.20191031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934315PMC
February 2021

Short Bouts of Physical Activity Are Associated with Reduced Smoking Withdrawal Symptoms, but Perceptions of Intensity May Be the Key.

Healthcare (Basel) 2020 Oct 23;8(4). Epub 2020 Oct 23.

School of Biosciences & Medicine, Faculty of Health and Medical Sciences, University of Surrey, Surrey GU2 7XH, UK.

The primary aim of this study was to assess the effectiveness of a short bout (10 min) of moderate-intensity exercise to reduce withdrawal symptomatology, craving and negative affect; while the secondary aim was to assess how the effectiveness of a short bout of moderate exercise can be modulated by the perception of intensity in physically active and low-activity smokers. Fifty low-activity and physically active smokers were recruited (24 male and 26 female) and randomized in three different conditions. Prescribed (objective) moderate intensity (OBJ) and perceived moderate intensity (PER), and passive waiting (PW). After the intervention (T3), smokers reported less desire to smoke in the PER (p < 0.001) and OBJ (p < 0.001) conditions, relative to the PW condition. At T3 smokers in the PER condition reported less negative affect than smokers in the PW condition relative to the baseline (T1) (p < 0.007). Further, smokers in the PER condition reported less negative affect than smokers in the PW condition (p < 0.048). Physically active (PA) smokers perceived less exertion than low-activity (LA) smokers, and the effects were stronger in the PER condition relative to OBJ. Generally, our results suggest that a short bout of moderate exercise helps both LA and PA smokers. These findings provided a novel insight into the psychological mechanisms that affect the efficacy of the exercise in smoking cessation and suggest that exercise should be tailored according to individual perception of intensity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/healthcare8040425DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712184PMC
October 2020

Psychological and Behavioral Correlates of Readiness to Stop Smoking.

J Addict Nurs 2020 Jul/Sep;31(3):194-202

Claudio Lucchiari, PhD, Department of Philosophy, University of Milan, Italy. Marianna Masiero, PhD, Department of Biomedical and Clinical Sciences, University of Milan, Italy, and Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy. Gabriella Pravettoni, PhD, Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, and Department of Oncology and Hema-Oncology, University of Milan, Milan, Italy.

Accruing evidence strongly suggests that the motivation to give up smoking is a crucial predictor of tobacco cessation attempt. However, even motivated people often fail in their attempts and relapse is very common, even if most people who smoke are confident that the desire to quit is enough to change and maintain abstinence. According to this framework, the main objective of the current study was to identify psychological and lifestyle patterns that might characterize people who smoke cigarettes with different motivations to quit. A secondary aim was to compare the characteristics of people who are currently smoking with people who stopped or never smoked. A convenient sample of 360 volunteers (179 women, 181 men), with a mean age of 55 years (SD = 14.33), participated in this study. Participants completed a battery of psychological and behavioral scales aimed at assessing psychological characteristics as well as dependence level and readiness to stop. Our results strongly suggest that the behavior of people who smoke differs as a function of specific psychological variables. People who currently smoke may fall into two different clusters: In the first one, they have a healthy lifestyle and high self-perceived vitality and vigor, whereas those who fall in the second report lower psychological well-being and an unhealthier lifestyle. Unfortunately, the actual lifestyle does not seem to modulate the motivation to quit, and consequently, people keep on smoking anyway, although some participants tend to adopt compensative behaviors. However, the adoption of a healthier lifestyle might favor a successful cessation attempt once a ready-to-stop motivation level is achieved.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/JAN.0000000000000349DOI Listing
March 2021

Benefits of e-cigarettes in smoking reduction and in pulmonary health among chronic smokers undergoing a lung cancer screening program at 6 months.

Addict Behav 2020 04 30;103:106222. Epub 2019 Nov 30.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan 20141, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

Introduction: Electronic cigarettes (e-cigarettes) might be a valid and safe device to support smoking cessation. However, the available evidence is divergent. The aim of the present work was to assess the effects of an e-cigarette program on pulmonary health (cough, breath shortness, catarrh) and to evaluate the effectiveness of e-cigarettes in reducing tobacco consumption.

Methods: The study is a double-blind randomized controlled trial. Two hundred and ten smokers were randomized into three groups: nicotine e-cigarette (8 mg/mL nicotine concentration), nicotine-free e-cigarettes (placebo), and control with 1:1:1 ratio. All participants received a 3 months cessation program that included a cognitive-behavioral intervention aimed at supporting people in changing their behavior and improving motivation to quit.

Results: Pulmonary health, assessed with self-reported measures, clinical evaluations and the Leicester Cough Questionnaire, improved in participants who stopped smoking compared to their own baseline. No differences in pulmonary health were found between groups. Statistical tests showed a significant effect of Group (F (2, 118) = 4.005, p < .020) on daily cigarette consumption: after 6 months participants in the nicotine e-cigarette group smoked fewer cigarettes than any other group. Moreover, participants in this group showed the lowest level of exhaled carbon monoxide (CO) (M = 12.012, S.D. = 8.130), and the lowest level of dependence (M = 3.12, S.D. = 2.29) compared to the nicotine-free e-cigarette and control conditions.

Conclusions: After 6 months about 20% of the entire sample stopped smoking. Participants who used e-cigarettes with nicotine smoked fewer tobacco cigarettes than any other group after 6 months (p < .020). Our data add to the efficacy and safety of e-cigarettes in helping smokers reducing tobacco consumption and improving pulmonary health status.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.addbeh.2019.106222DOI Listing
April 2020

Validation of the Italian version of the abbreviated expanded prostate Cancer index composite (EPIC-26) in men with prostate Cancer.

Health Qual Life Outcomes 2019 Aug 29;17(1):147. Epub 2019 Aug 29.

Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

Background: This study aims to validate and evaluate the psychometric properties and reliability of the Italian version of the Expanded Prostate Cancer Index Composite - Short Form (EPIC-26), a measure of quality of life (QoL) for prostate cancer patients.

Methods: Two hundred and eighty-four prostate cancer patients completed the Italian version of the EPIC-26 questionnaire at 45 days (T1) and 3 months (T2) after robot-assisted radical prostatectomy (RARP). Psychometric properties were evaluated using structural equation modeling: the goodness of fit of the correlated five-factor model (CFFM) for the EPIC-26 was assessed using the confirmatory factor analysis (CFA), while longitudinal invariance was conducted to assess the ability of the EPIC-26 to measure QoL construct over time. Test-retest reliability was assessed as well by considering intraclass correlations.

Results: At T1, the CFFM model displayed a good fit to data. Similarly, the model showed an adequate fit also at T2. Results of the reliability analysis attested the acceptable internal consistency and test-retest reliability of each dimension: all Cronbach's alphas could be classified as acceptable (i.e., above .65) except for low Cronbach's alpha for hormonal dysfunction at T1 (i.e., .638) and urinary irritation at both waves. (i.e., respectively .585 and .518). Finally, psychometric properties were invariant over time and each of the five dimensions of QoL displayed from moderate (all ICCs above .500) to good test-retest reliability (i.e. ICC for urinary incontinence = .764).

Conclusions: Results of the CFA and the measurement invariance analysis demonstrated the validity of the Italian version of the EPIC-26 to assess QoL in prostate cancer patients. Its reliability and good psychometric qualities are well-supported, thus providing a valid tool to assess health-related quality of life and its change over time in prostate cancer patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12955-019-1214-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716830PMC
August 2019

The Attentional Bias in Current and Former Smokers.

Front Behav Neurosci 2019 10;13:154. Epub 2019 Jul 10.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCSS, Milan, Italy.

Attentional bias has been defined as the propensity of a person to allocate selective attention automatically to salient cues (Field and Powell, 2007). In the case of smoking, this bias implies that smokers are implicitly attracted by smoking-related stimuli, which produce behavioral, memory, and emotional effects (Volkow et al., 2006; Giardini et al., 2009). In more detail, scientific evidence pointed out that smoking is strongly supported by attentional bias that activates craving and urgency to smoke a cigarette. However, poor and conflicting data are available regarding the role of this cognitive bias on former smokers. The main aim of this study is to explore the occurrence of the attentional bias on of both current and former smokers, also with the aim to identify associations with behavioral, psychological and cognitive characteristic of participants. We collected data on 245 current, volunteers (male 50.6%; female 49.4%) aged 54.81 (SD = 14.352, range = 18-63), divided in current smokers (98), former smokers (102) and non-smokers (45). A combination of neuropsychology tests (Emotional Smoke Stroop Task and Go/no-Go task), and standardized questionnaires [Behavioral Inhibition System-Behavioral Approach System (BIS-BAS), Fagerström Test for Nicotine Dependence (FTND), Barratt Impulsiveness Scale, Motivational questionnaire] were used to assess the attentional bias, psychological variables, and smoking-related characteristics. Responses at the Emotional Smoke Stroop task revealed that current and former smokers are actually slower than non-smokers are when facing smoking cues, while performances at other Stroop conditions and at the Go/no-Go task are not statistically different. These results confirmed the occurrence of the attentional bias in current smokers, and above all points out that the same effect is present in former smokers. We found only small and selective correlations between attentional bias and psychological variables (e.g., impulsiveness and inhibition). In particular, impulsivity is not directly associated with the AB intensity. Also, smoking characteristics (e.g., years of smoking and dependence level) and the length of the period of abstinence do not seem to modulate implicit cognition of smoking cue. Our data support the idea that the attentional bias may be considered relevant in sustaining smoking and favoring relapse.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fnbeh.2019.00154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637300PMC
July 2019

Preventing chemotherapy-induced alopecia: a prospective clinical trial on the efficacy and safety of a scalp-cooling system in early breast cancer patients treated with anthracyclines.

Br J Cancer 2019 08 15;121(4):325-331. Epub 2019 Jul 15.

Program of Breast Health, European Institute of Oncology, IRCCS, Milan, Italy.

Background: Chemotherapy-induced alopecia (CIA) is a distressing side effect of cancer therapy. The trial aimed to assess feasibility and effectiveness of scalp-cooling system DigniCap® to prevent CIA in primary breast cancer patients receiving an anthracycline containing adjuvant chemotherapy (CT).

Methods: Hair loss (HL) was evaluated by patient self-assessment and by the physician according to the Dean's scale at baseline and after each cycle of CT. The primary efficacy endpoint was the patient self-assessment HL score evaluated at least 3 weeks after completing CT. A Dean's scale score of 0-2 (i.e. HL ≤50%) was considered a success.

Results: From July 2014 to November 2016, 139 consecutive breast cancer patients were enrolled and received at least one treatment with scalp cooling. Fifty-six out of 131 evaluated patients successfully prevented HL (43%, 95% CI: 34-51%). Twenty-four patients (32%) discontinued the scalp cooling because of alopecia or scalp-cooling related AE, three patients had missing information on CIA, and 48 patients (64%) had a HL greater than 50% after CT. No serious AEs were reported.

Conclusions: DigniCap® System resulted as a promising medical device to be safely integrated in supportive care of early breast cancer patients. Longer follow-up is needed to assess long-term safety and feasibility.

Clinical Trial Registration Number: NCT03712696.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41416-019-0520-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738323PMC
August 2019

Not Just a Pill: Toward a Tailored Antismoking Intervention for Respiratory Diseases.

J Addict Nurs 2019 Apr/Jun;30(2):E1-E4

Marianna Masiero, PhD, Department of Biomedical and Clinical Sciences, University of Milan, Italy; and Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy. Chiara Renzi, PhD, Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy. Mazzocco Ketti, PhD, and Gabriella Pravettoni, Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy; and Department of Oncology and Hemato-Oncology, University of Milan, Italy.

Tobacco cigarette smoking is a serious epidemic that kills several million people each year. Nevertheless, a significant percentage of patients with respiratory diseases continue to smoke after diagnosis, despite the assistance offered, thus reducing the efficacy of the treatments prescribed by the health providers and dramatically increasing the mortality rate. International guidelines have advocated the importance of including smoking cessation protocols in the management of patients' respiratory conditions and pointed out the need to deliver integrated and tailored interventions. Consistently with this framework, the commentary proposes a new clinical approach to smoking cessation in patients with respiratory diseases. This approach integrates, according to P5 personalized medicine, pharmacological and psychological aspects affecting smoking behaviors, overcoming the traditional approach mainly based on the pharmacological interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/JAN.0000000000000276DOI Listing
January 2020

The role of emotions in cancer patients' decision-making.

Ecancermedicalscience 2019 28;13:914. Epub 2019 Mar 28.

Department of Oncology and Hemato-oncology, University of Milan, 20122 Milan, Italy.

Introduction: Despite the attempt to make decisions based on evidence, doctors still have to consider patients' choices which often involve other factors. In particular, emotions seem to influence the way that options and the surrounding information are interpreted and used.

Objective: The objective of the present review is to provide a brief overview of research on decision making and cancer with a specific focus on the role of emotions.

Method: Thirty-nine studies were identified and analysed. Most of the studies investigated anxiety and fear. Worry was the other psychological factor that, together with anxiety, played a crucial role in cancer-related decision-making.

Results: The roles of fear, anxiety and worry were described for detection behaviour, diagnosis, choice about prevention and curative treatments and help-seeking behaviour. Results were inconsistent among the studies. Results stressed that cognitive appraisal and emotional arousal (emotion's intensity level) interact in shaping the decision. Moderate levels of anxiety and worry improved decision-making, while low and high levels tended to have no effect or a hindering effect on decision making. Moderating factors played an under-investigated role.

Conclusions: Decision making is a complex non-linear process that is affected by several factors, such as, for example, personal knowledge, past experiences, individual differences and certainly emotions. Research studies should investigate further potential moderators of the effect of emotions on cancer-related choice. Big data and machine learning could be a good opportunity to test the interaction between a large amount of factors that is not feasible in traditional research. New technologies such as eHealth and virtual reality can offer support for the regulation of emotions and decision making.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3332/ecancer.2019.914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467455PMC
March 2019

Psycho-cognitive predictors of burnout in healthcare professionals working in emergency departments.

J Clin Nurs 2018 Jul 1;27(13-14):2691-2698. Epub 2018 Jun 1.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.

Background: Healthcare professionals working in emergency departments commonly experience high work pressure and stress due to witnessing human suffering and the unpredictable nature of the work. Several studies have identified variables that affect burnout syndrome, but poor data are available about the predictors of the different dimensions of burnout (depersonalisation, emotional exhaustion, professional inefficacy and disillusionment). Some research has suggested that alexithymia, coping style and decision-making style may predict burnout.

Design: We conducted a noninterventional study to investigate whether and how alexithymia, coping style and decision-making style are associated with the different dimensions of burnout.

Methods: We recruited a convenience sample of 93 healthcare professionals working in an Italian emergency departments. Participants completed a questionnaire assessing their level of burnout (the Link Burnout Questionnaire), and possible burnout predictors: decision-making style, alexithymia and the coping style. Four bivariate linear regressions were performed to define the predictors that characterised the dimensions of burnout.

Results: We found that an avoidant decision-making style and a difficulty to identify and describe feelings (a difficulty close to alexithymia even though not as severe) are strong predictors of some burnout dimensions. Individuals who experience relational depersonalisation are more likely to turn to religion as a way to cope.

Conclusions: Our research shows that, to some extent, difficulties in emotion regulation and the attitude to avoid or postpone decisions characterised burnout.

Relevance To Clinical Practice: These results might be used to develop tailored psycho-educational interventions. This might help healthcare professionals to develop personal skills to cope with the critical conditions that characterise their work and to enable them to recognise potential risk factors that favour burnout. This has pivotal implications for the maintenance of the patient-healthcare professional relationship and in reducing clinical errors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocn.14376DOI Listing
July 2018

E-cigarettes May Support Smokers With High Smoking-Related Risk Awareness to Stop Smoking in the Short Run: Preliminary Results by Randomized Controlled Trial.

Nicotine Tob Res 2019 01;21(1):119-126

Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

Introduction: E-cigarettes may be positively used in tobacco cessation treatments. However, neither the World Health Organization nor the American Food and Drug Administration has recognized them as effective cessation aids. Data about the efficacy and safety of e-cigarettes are still limited and controversial.

Methods: This was a double-blind randomized controlled study. The main focus of this article is on a secondary outcome of the study, that is, the assessment of effectiveness and safety of e-cigarettes in achieving smoking cessation in a group of chronic smokers voluntarily involved in long-term lung cancer screening. Participants were randomized into three arms with a 1:1:1 ratio: e-cigarettes (Arm 1), placebo (Arm 2), and control (Arm 3). All subjects also received a low-intensity counseling.

Results: Two hundred ten smokers were randomized (70 to nicotine e-cigarettes, 70 nicotine-free placebo e-cigarettes, and 70 to control groups). About 25% of participants who followed a cessation program based on the use of e-cigarettes (Arm 1 and Arm 2) were abstinent after 3 months. Conversely, only about 10% of smokers in Arm 3 stopped. A Kruskal-Wallis test showed significant differences in daily cigarettes smoking across the three arms (K-W = 6.277, p = .043). In particular, participants in Arm 1 reported a higher reduction rate (M = -11.6441, SD = 7.574) than participants in Arm 2 (M = -10.7636, SD = 8.156) and Arm 3 (M = -9.1379, SD = 8.8127).

Conclusions: Our findings support the efficacy and safety of e-cigarettes in a short-term period. E-cigarettes use led to a higher cessation rate. Furthermore, although all participants reported a significant reduction of daily cigarette consumption compared to the baseline, the use of e-cigarettes (including those without nicotine) allowed smokers to achieve better results.

Implications: E-cigarettes increased the stopping rate as well as the reduction of daily cigarettes in participants who continued smoking. In fact, although all participants reported a significant reduction of tobacco consumption compared to the baseline, the use of e-cigarettes allowed smokers to achieve a better result. It could be worthwhile to associate this device with new ICT-driven models of self-management support in order to enable people to better handle behavioral changes and side effects. This is true for ready-to-quit smokers (such as our participants) but can also be advantageous for less motivated smokers engaged in clinical settings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ntr/nty047DOI Listing
January 2019

Health Orientation, Knowledge, and Attitudes toward Genetic Testing and Personalized Genomic Services: Preliminary Data from an Italian Sample.

Biomed Res Int 2016 25;2016:6824581. Epub 2016 Dec 25.

Interdisciplinary Research Center on Decision Making Processes (IRIDe), Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia (IEO), Via Ripamonti 435, 20141 Milan, Italy.

. The study aims at assessing personality tendencies and orientations that could be closely correlated with knowledge, awareness, and interest toward undergoing genetic testing. A sample of 145 subjects in Italy completed an online survey, investigating demographic data, health orientation, level of perceived knowledge about genetic risk, genetic screening, and personal attitudes toward direct to consumer genetic testing (DTCGT). . Results showed that respondents considered genetic assessment to be helpful for disease prevention, but they were concerned that results could affect their life planning with little clinical utility. Furthermore, a very high percentage of respondents (67%) had never heard about genetic testing directly available to the public. Data showed that personality tendencies, such as personal health consciousness, health internal control, health esteem, and confidence, motivation to avoid unhealthiness and motivation for healthiness affected the uptake of genetic information and the interest in undergoing genetic testing. . Public knowledge and attitudes toward genetic risk and genetic testing among European countries, along with individual personality and psychological tendencies that could affect these attitudes, remain unexplored. The present study constitutes one of the first attempts to investigate how such personality tendencies could motivation to undergo genetic testing and engagement in lifestyle changes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2016/6824581DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220460PMC
January 2017

Optimistic bias in young adults for cancer, cardiovascular and respiratory diseases: A pilot study on smokers and drinkers.

J Health Psychol 2018 04 13;23(5):645-656. Epub 2016 Sep 13.

1 University of Milan, Italy.

Optimistic bias defines the tendency for human beings to underrate risk when it pertains to themselves compared with their view of risk pertaining to other people in the same conditions. The aim of this work is to investigate the optimistic bias in risk perception and health-related behaviours for three specific conditions in a young adult sample: cancer, respiratory disorders and cardiovascular diseases. Young adults showed an optimistic bias related to cancer, and to cardiovascular diseases. Our findings suggest that optimistic bias is linked to specific behavioural patterns, largely widespread in young adults, such as tobacco cigarette smoking and alcohol consumption.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1359105316667796DOI Listing
April 2018

Helping patients to reduce tobacco consumption in oncology: a narrative review.

Springerplus 2016 20;5(1):1136. Epub 2016 Jul 20.

Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy ; Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.

The present overview focuses on evidence of smoking cessation approaches in oncology settings with the aim to provide health personnel a critical perspective on how to help their patients. This narrative review is structured in two main sections: the first one describes the psycho-cognitive variables involved in the decision to continue smoking after a cancer diagnosis and during the treatment; the second section relates methods and tools may be recommended, being evidence-based, to support smoking cessation in oncology settings. Active smoking increases not only susceptibility to common cancers in the general population, but also increases disease severity and comorbidities in cancer patients. Nowadays, scientific evidence has identified many strategies to give up smoking, but a lack of knowledge exists for treatment of nicotine dependence in the cancer population. Health personnel is often ambiguous when approaching the problem, while their contribution is essential in guiding patients towards healthier choices. We argue that smoking treatments for cancer patients deserve more attention and that clinical features, individual characteristics and needs of the patient should be assessed in order to increase the attempts success rate. Health personnel that daily work and interact with cancer patients and their caregivers have a fundamental role in the promotion of the health changing. For this reason, it is important that they have adequate knowledge and resources in order to support cancer patients to stop tobacco cigarette smoking and promoting and healthier lifestyle.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40064-016-2798-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4954805PMC
August 2016

Research studies on patients' illness experience using the Narrative Medicine approach: a systematic review.

BMJ Open 2016 07 14;6(7):e011220. Epub 2016 Jul 14.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy Department of Oncology and Hemato-Oncology, University of Milan, Milano, Lombardia, Italy.

Objective: Since its birth about 30 years ago, Narrative Medicine approach has increased in popularity in the medical context as well as in other disciplines. This paper aims to review Narrative Medicine research studies on patients' and their caregivers' illness experience.

Setting And Participants: MEDLINE, Psycinfo, EBSCO Psychological and Behavioural Science, The Cochrane Library and CINAHL databases were searched to identify all the research studies which focused on the Narrative Medicine approach reported in the title, in the abstract and in the keywords the words 'Narrative Medicine' or 'Narrative-based Medicine'.

Primary And Secondary Outcome Measures: number of participants, type of disease, race and age of participants, type of study, dependent variables, intervention methods, assessment.

Results: Of the 325 titles screened, we identified 10 research articles fitting the inclusion criteria. Our systematic review showed that research on Narrative Medicine has no common specific methodology: narrative in Medicine is used as an intervention protocol as well as an assessment tool. Patients' characteristics, types of disease and data analysis procedures differ among the screened studies.

Conclusions: Narrative Medicine research in medical practice needs to find clear and specific protocols to deepen the impact of narrative on medical practice and on patients' lives.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2016-011220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4947803PMC
July 2016

Pediatric Blood Cancer Survivors and Tobacco Use across Adolescence and Emerging Adulthood: A Narrative Review.

Front Psychol 2016 21;7:392. Epub 2016 Mar 21.

Department of Oncology and Hemato-Oncology, University of MilanMilan, Italy; Applied Research Division for Cognitive and Psychological Science, European Institute of OncologyMilano, Italy.

Scholars underline the pivotal role of tobacco cigarette smoking in carcinogenesis process for blood tumors. A controversial debate is represented by the diffusion of tobacco use in young cancer survivors that had a previous diagnosis of blood tumor during the childhood. Compared with their peers, scientific evidence highlights that pediatric survivors have more difficult to give-up cigarette smoking. Furthermore, tobacco-smoking is frequently linked with others risk behaviors as drinking or substance abuse. In reviewing the main knowledge on this topic, authors affirm the need for increasing research on blood cancer survivors in order to depict psychological characteristics of pediatric blood cancer survivors. Improving health decision-making skills in young survivors could reduce the risk to adopt un-healthy behaviors and increase psychological wellbeing. Furthermore, authors propose tailored antismoking interventions based on the knowledge of the psychological and cognitive factors that support smoking during the transition toward emerging-adulthood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyg.2016.00392DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800409PMC
April 2016

The Role of Frontal-Subcortical Circuitry in Neuropsychological Deficit of Attention: Hypothesis and Results in Two Coagulation Disorders.

Front Hum Neurosci 2016 9;10:89. Epub 2016 Mar 9.

Department of Oncology and Hemato-oncology, University of MilanMilan, Italy; Applied Research Division for Cognitive and Psychological Science, European Institute of OncologyMilan, Italy.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fnhum.2016.00089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783412PMC
March 2016

Benefits of E-Cigarettes Among Heavy Smokers Undergoing a Lung Cancer Screening Program: Randomized Controlled Trial Protocol.

JMIR Res Protoc 2016 Feb 3;5(1):e21. Epub 2016 Feb 3.

Università Degli Studi di Milano, Department of Philosophy, Milano, Italy.

Background: Smoking is a global public health problem. For this reason, experts have called smoking dependence a global epidemic. Over the past 5 years, sales of electronic cigarettes, or e-cigarettes, have been growing strongly in many countries. Yet there is only partial evidence that e-cigarettes are beneficial for smoking cessation. In particular, although it has been proven that nicotine replacement devices may help individuals stop smoking and tolerate withdrawal symptoms, e-cigarettes' power to increase the quitting success rate is still limited, ranging from 5% to 20% dependent on smokers' baseline conditions as shown by a recent Cochrane review. Consequently, it is urgent to know if e-cigarettes may have a higher success rate than other nicotine replacement methods and under what conditions. Furthermore, the effects of the therapeutic setting and the relationship between individual characteristics and the success rate have not been tested. This protocol is particularly innovative, because it aims to test the effectiveness of electronic devices in a screening program (the COSMOS II lung cancer prevention program at the European Institute of Oncology), where tobacco reduction is needed to lower individuals' lung cancer risks.

Objective: This protocol was designed with the primary aim of investigating the role of tobacco-free cigarettes in helping smokers improve lung health and either quit smoking or reduce their tobacco consumption. In particular, we aim to investigate the impact of a 3-month e-cigarettes program to reduce smoking-related respiratory symptoms (eg, dry cough, shortness of breath, mouth irritation, and phlegm) through reduced consumption of tobacco cigarettes. Furthermore, we evaluate the behavioral and psychological (eg, well-being, mood, and quality of life) effects of the treatment.

Methods: This is a prospective, randomized, placebo-controlled, double-blind, three-parallel group study. The study is organized as a nested randomized controlled study with 3 branches: a nicotine e-cigarettes group, a nicotine-free e-cigarettes group, and a control group. The study is nested in a screening program for early lung cancer detection in heavy smokers.

Results: The study is open and is still recruiting.

Conclusions: Stopping or reducing tobacco consumption should be a main goal of any health organization. However, traditional antismoking programs are expensive and not always effective. Therefore, favoring a partial or complete shift to e-cigarettes in heavy smokers (eg, persons at high risk for a number of diseases) could be considered a moral imperative. However, before following this path, sound and reliable data on large samples and in a variety of contexts are required.

Trial Registration: Clinicaltrials.gov NCT02422914; https://clinicaltrials.gov/ct2/show/NCT02422914 (Archived by WebCite at http://www.webcitation.org/6etwz1bPL).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/resprot.4805DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4757781PMC
February 2016

The choice dilemma in chronic hematological conditions: Why choosing is not only a medical issue? A psycho-cognitive perspective.

Crit Rev Oncol Hematol 2016 Mar 28;99:134-40. Epub 2015 Dec 28.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy.

Research in cognitive psychology focused on risk perception and decision making was shown to facilitate treatment choice and patient's satisfaction with decision in a number of medical conditions, increasing perceived alliance between patient and physician, and adherence to treatment. However, this aspect has been mostly neglected in the literature investigating choice of treatment for chronic hematological conditions. In this paper, a patient centered model and a shared decision making (SDM) approach to treatment switch in chronic hematological conditions, in particular chronic myeloid leukemia, atrial fibrillation, and β-thalassemia is proposed. These pathologies have a series of implications requiring important decisions about new available treatments. Although new generation treatments may provide a significant improvement in patient's health and health-related quality of life (HrQoL), a significant percentage of them is uncertain about or refuse treatment switch, even when strongly suggested by healthcare guidelines. Possible cognitive and emotional factors which may influence decision making in this field and may prevent appropriate risk-and-benefits evaluation of new treatment approaches are reviewed. Possible adaptive strategies to improve quality of care, patient participation, adherence to treatment and final satisfaction are proposed, and implications relatively to new treatment options available are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.critrevonc.2015.12.010DOI Listing
March 2016

Experiencing brain cancer: what physicians should know about patients.

Ecancermedicalscience 2015 12;9:591. Epub 2015 Nov 12.

Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Via Festa del Perdono 7, Milan 20122, Italy ; Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan 20141, Italy.

Unlabelled: During the last 20 years, numerous studies have highlighted the need to consider Quality of Life (QoL) issues in the treatment of brain cancer. However, gaps in scientific knowledge are still present as we have poor data surrounding the whole experience in patients and regarding their needs. The present study was aimed at evaluating QoL in brain cancer patients and correlated aspects. In particular, we aimed to assess QoL, mood state, and emotional issues in order to describe the patients' experience to find out the critical aspects involved.

Methods: We obtained data from 85 patients during chemotherapy treatment at the National Neurological Institute 'C. Besta' of Milan, Italy. We used standardised questionnaires to assess different aspects of patients' QoL. In particular, the functional assessment of cancer therapy-brain (FACT-Br) and the Hamilton scale were used. We also performed a semi-structured ad hoc interview in order to collect -narrative data about patients' experience.

Results: Our data depict a difficult adjustment process to the illness, even though positive elements emerged. Indeed, patients reported a satisfying self-perceived QoL, although specific concerns are still present. Further, even if many patients report depressive symptoms, only a minority have a severe condition.

Conclusion: Brain cancer may heavily affect patients' QoL and well being. However, some element of the context may improve the -adjustment to the disease. In particular, we found that most patients found psychosocial resources to cope with cancer and that spiritual well being also seems to play a key role. These issues deserve further studies in order to obtain significant clinical recommendations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3332/ecancer.2015.591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659704PMC
December 2015

Living at Risk: Factors That Affect the Experience of Direct-to-Consumer Genetic Testing.

Mayo Clin Proc 2015 Oct;90(10):1323-6

Interdisciplinary Research Center on Decision Making Processes, Department of Health Sciences, University of Milan, Milan, Italy; Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.mayocp.2015.06.014DOI Listing
October 2015

Personal fable: optimistic bias in cigarette smokers.

Int J High Risk Behav Addict 2015 Mar 20;4(1):e20939. Epub 2015 Mar 20.

Department of Health Sciences, University of Milan, Milan, Italy ; Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.

Background: Several empirical studies have shown the attitude of smokers to formulate judgments based on distortion in the risk perception. This alteration is produced by the activation of the optimistic bias characterized by a set of the unrealistic beliefs compared to the outcomes of their behavior. This bias exposes individuals to adopt lifestyles potentially dangerous for their health, underestimate the risks and overestimate the immediate positive effects.

Objectives: This study aimed to analyze the relationship between optimistic bias and smoking habits. In particular, it was hypothesized that smokers develop optimistic illusions, able to facilitate the adoption and the maintenance over time of the unhealthy lifestyles, such as cigarette smoking, and the former smokers could acquire a belief system centered on own responsibility.

Patients And Methods: The samples (n = 633, female = 345, male = 288) composed of smokers (35.7%), ex-smokers (32.2%) and nonsmokers (32.1%). Each participant filled out two questionnaires including The Fagerström test and the motivational questionnaire as well as a set of items measured on a Likert scales to evaluate health beliefs.

Results: The results confirmed the presence of the optimistic bias in comparative judgments, and the attitude to overestimate the effectiveness of their preventive behaviors in the smokers.

Conclusions: Cognitive bias in risk perception may influence health behaviors in negative way and reinforce cigarette smoking over the time. Future research should be conducted to identify the better strategies to overtake this cognitive bias to improve the quitting rate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/ijhrba.20939DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393561PMC
March 2015
-->