Publications by authors named "Ashlee Loughan"

Article Synopsis
  • This study compares sleep-wake patterns in patients with primary brain tumors using a subjective measure (Consensus Sleep Diary) and an objective measure (ActiGraph actigraphy) over 14 nights among 30 participants.
  • While some sleep-wake time parameters showed equivalency in results, many sleep disruptions and general sleep quality showed significant differences and low correlation between the two methods.
  • The researchers concluded that using both subjective and objective sleep measures gives a more accurate picture of sleep health in these patients.
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Purpose: The diagnosis of a primary brain tumor (PBT) causes significant distress for the caregiver-patient dyad, warranting increased supportive care intervention. Although researchers have previously assessed caregivers' perceptions of their own supportive care needs, no study to date has identified how patients perceive the caregiving experience and/or patients' recommendations for integrating supportive care of caregivers in neuro-oncology. This qualitative study examined caregiver distress as well as caregiver supportive care needs from the patients' perspective to inform future intervention development.

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Background: Post-traumatic growth (PTG) has been extensively explored within general oncology, yet little is known about the experience of PTG in neuro-oncology. This study aimed to determine the representation of patients with primary brain tumors (PBT) in the PTG literature.

Methods: PsycINFO, PubMed, and CINAHL were systematically searched from inception to December 2022.

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Background: Cognitive-Behavioral Therapy for Insomnia (CBT-I), the frontline treatment for insomnia, has yet to be evaluated among patients with primary brain tumors (PwPBT) despite high prevalence of sleep disturbance in this population. This study aimed to be the first to evaluate the feasibility, safety, and acceptability of implementing telehealth group CBT-I as well as assessing preliminary changes in subjective sleep metrics in PwPBT from baseline to follow-up.

Methods: Adult PwPBT were recruited to participate in six 90-min telehealth group CBT-I sessions.

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BACKGROUND: Negative physical health results from the emotional stress of providing care to a family member with a primary malignant brain tumor; however, the downstream effects on caregivers' healthcare utilization (HCU) are unknown. This analysis examined associations between caregivers' emotional health and markers of HCU during the 6 months after patients' diagnoses. METHODS: Caregivers' self-report HCU data from a longitudinal study with 116 neuro-oncology caregivers were analyzed.

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Background: Sleep disturbance is among the most common symptoms endorsed by patients with primary brain tumor (PwPBT), with many reporting clinically elevated insomnia and poor management of their sleep-related symptoms by their medical team. Though Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the front-line treatment for sleep disturbance, CBT-I has yet to be evaluated in PwPBT. Thus, it is unknown whether CBT-I is feasible, acceptable, or safe for patients with primary brain tumors.

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Background: To achieve patient-centric quality care in neuro-oncology, all aspects of the disease and its impact on quality survival need to be considered. This includes the psychological consequences of a brain tumor diagnosis and subsequent life-altering experiences. Far too often the voice of our patients is unheard.

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Background: Fear of cancer recurrence (FCR) is a psychological consequence of cancer diagnosis that impacts quality of life in neuro-oncology. However, the instruments used to assess FCR have not been tested for validity in patients with brain tumors. The present study explored the psychometric properties of a brief FCR scale in patients with primary brain tumor (PBT) and their caregivers.

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Brain metastases (BMs) account for a disproportionately high percentage of cancer morbidity and mortality. Historically, studies have focused on improving survival outcomes, and recent radiation oncology clinical trials have incorporated HRQOL and cognitive assessments. We are now equipped with a battery of assessments in the radiation oncology clinic, but there is a lack of consensus regarding how to incorporate them in modern clinical practice.

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Objective: Caregivers of patients with primary brain tumor (PBT) describe feeling preoccupied with the inevitability of their loved one's death. However, there are currently no validated instruments to assess death anxiety in caregivers. This study sought to examine (1) the psychometric properties of the Death and Dying Distress Scale (DADDS), adapted for caregivers (DADDS-CG), and (2) the prevalence and correlates of death anxiety in caregivers of patients with PBT.

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Background: The Mini-Mental Status Examination (MMSE) is routinely used in neuro-oncology clinics to rule out cognitive impairment. However, the MMSE is known to have poor sensitivity to mild cognitive impairment, raising concern regarding its continued use. More comprehensive cognitive screeners are available, such as the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and may be better able to assess for cognitive dysfunction.

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Background: Managing Cancer and Living Meaningfully (CALM) is an evidence-based, brief, semi-structured psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study to date has investigated its feasibility, acceptability, and preliminary effectiveness in adults with malignant glioma, despite the well-documented incidence of psychological distress in this vulnerable and underserved population.

Methods: Fourteen patients with glioma and elevated symptoms of depression and/or death anxiety enrolled in the trial: 83% glioblastoma, 75% female, M = 56 years (SD = 15.

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Purpose: Brain tumor patients report an overwhelming sense of uncertainty when navigating the course of their terminal disease. Historically, organizational experts and/or treating physicians have established neuro-oncology programs. However, given the disease burden and incurable nature of current medical treatments, patient-centric care should be prioritized alongside institutional and academic objectives.

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Article Synopsis
  • Unlike pediatric medulloblastoma (MB), there have been few studies on older patients with MB due to its low occurrence in adults and adolescents, leading to treatment approaches based on children's experiences, which may not be fully relevant.
  • Recent advancements in understanding the genomic factors of MB, particularly the sonic hedgehog (SHH) pathway alterations that affect a significant percentage of adult patients, are paving the way for more tailored treatments.
  • The AMBUSH trial has been initiated to investigate the efficacy of SHH pathway inhibitors in adult and adolescent patients with MB, categorizing them based on risk and molecular subgroups while ensuring comprehensive treatment for all participants.
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Objective: We assessed agreement between patient- and informant-report on the Behavior Rating Inventory of Executive Function - Adult (BRIEF-A) in patients with primary brain tumors (PBT) and differences on BRIEF-A in neurocognitive (intact v. impaired), psychological (asymptomatic v. distressed), and functional (independent v.

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Objective: This study investigated death anxiety in patients with primary brain tumor (PBT). We examined the psychometric properties of two validated death anxiety measures and determined the prevalence and possible determinants of death anxiety in this often-overlooked population.

Methods: Two cross-sectional studies in neuro-oncology were conducted.

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Background: CogMed Working Memory Training (CWMT) is a computer-based program shown to improve working memory (WM) among those with cognitive impairments. No study to date has investigated its feasibility, acceptability, and satisfaction in adult patients with glioma, despite the well-documented incidence of WM impairment in this population.

Methods: Twenty patients with glioma and objective and/or perceived WM deficits enrolled in the study: 52% high-grade, 60% female, Mage = 47 (range = 21-72 years).

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Purpose: Primary brain tumor (PBT) patients report sleep disturbance due to their disease and treatment, yet few studies have utilized validated measures to understand the extent of patients' concerns and preferences for treatment. The purpose of this quality improvement project was to determine the prevalence and associated risk factors of sleep disturbance among PBT patients in our clinic and to evaluate interest in treatment for sleep disturbance.

Methods: PBT patients completed validated measures of sleep disturbance and health during routine neuro-oncology visits.

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Article Synopsis
  • The COVID-19 pandemic accelerated the use of telemedicine for neuro-oncology patients, leading to the exploration of teleneuropsychology (TNP) conducted directly at patients' homes (DTH-TNP).
  • A study involving voluntary surveys from patients and providers at two medical institutions found that 79 out of 119 scheduled patients completed DTH-TNP, with high satisfaction rates (98%) among patients and neuropsychologists mostly meeting their assessment goals (98%).
  • Although some challenges like internet issues and patient dysregulation were noted, the study suggests that DTH-TNP is an acceptable and feasible option for neuro-oncology care, calling for further research to assess its reliability and validity.
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Objective: Fear of cancer recurrence (FCR) is related to psychological distress and poor quality of life in cancer patients and their caregivers. However, no studies have investigated FCR in neuro-oncology. Given the varied prognosis, treatment, and disease trajectory of brain cancer, FCR may affect patients and their caregivers differently.

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Background: A diagnosis of cancer may increase mortality salience and provoke death-related distress. Primary brain tumor (PBT) patients may be at particular risk for such distress given the certainty of tumor progression, lack of curative treatments, and poor survival rates. This study is the first to examine the prevalence of death-related distress and its correlates in PBT patients.

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Objectives: To fill gaps in the literature on the effects of mindfulness for healthcare professionals (HCPs), the current pragmatic trial investigated feasibility, acceptability, and effectiveness of Mindfulness for Interdisciplinary Healthcare Professional (MIHP) students on stress and work-relevant outcomes in the absence of offering school-based incentives.

Design: A partially randomized waitlist-controlled design (intention-to-treat sample: 22 in the mindfulness group, 26 in the control group) was employed.

Intervention: MIHP is an eight-week intervention that incorporates meditation training, yoga, and discussion on the application of mindfulness principles to stressors commonly faced by HCPs and students.

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Primary brain tumor (PBT) patients may experience existential distress; however, few studies have examined this issue. The objectives of this study were to (1) systematically review PBT representation in psycho-oncology literature regarding fear/anxiety related to progression, recurrence, and death and (2) preliminarily assess the prevalence of fear of dying in a sample of PBT patients. Systematic searching of three databases yielded 1555 articles for review.

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Background: Health-care professional (HCP) students experience high levels of burnout, characterized by work- and school-related stress. Burnout is associated with a host of negative psychological and health outcomes. It may also contribute to cognitive dysfunction and decreased work productivity and may be related to trait mindfulness.

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Background: Neurocognitive assessments have become integral to comprehensive neuro-oncology care. Existing screening tools may be insensitive to cognitive changes caused by medical treatments. Research supports the clinical value and psychometric properties of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in various medical populations; however, there is minimal evidence for its use in neuro-oncology.

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