Giulia Ongaro
@ieo.it
Applied research division for cognitive and psychological science
European Institute of Oncology
Scopus Publications
Scopus Publications
Serena Oliveri, Giulia Ongaro, Ilaria Cutica, Giulia Menicucci, Debora Belperio, Francesca Spinella, and Gabriella Pravettoni
Springer Science and Business Media LLC
Abstract Background Prenatal information may be obtained through invasive diagnostic procedures and non-invasive screening procedures. Several psychological factors are involved in the decision to undergo a non-invasive prenatal testing (NIPT) but little is known about the decision-making strategies involved in choosing a specific level of in-depth NIPT, considering the increased availability and complexity of NIPT options. The main aim of this work is to assess the impact of psychological factors (anxiety about pregnancy, perception of risk in pregnancy, intolerance to uncertainty), and COVID-19 pandemic on the type of NIPT chosen, in terms of the number of conditions that are tested. Methods A self-administered survey evaluated the decision-making process about NIPT. The final sample comprised 191 women (Mage = 35.53; SD = 4.79) who underwent a NIPT from one private Italian genetic company. Based on the test date, the sample of women was divided between “NIPT before COVID-19” and “NIPT during COVID-19”. Results Almost all of the participants reported being aware of the existence of different types of NIPT and more than half reported having been informed by their gynecologist. Results showed no significant association between the period in which women underwent NIPT (before COVID-19 or during COVID-19) and the preferences for more expanded screening panel. Furthermore, regarding psychological variables, results showed a significant difference between perceived risk for the fetus based on the NIPT type groups, revealing that pregnant women who underwent the more expanded panel had a significantly higher level of perceived risk for the fetus than that reported by pregnant women who underwent the basic one. There was no statistically significant difference between the other psychological variables and NIPT type. Conclusions Our findings indicate the paramount role of gynecologist and other health care providers, such as geneticists and psychologists, is to support decision-making process in NIPT, in order to overcome people’s deficits in genetic knowledge, promote awareness about their preferences, and control anxiety related to the unborn child. Decision-support strategies are critical during the onset of prenatal care, according to the advances in prenatal genomics and to parent’s needs.
Clizia Cincidda, Silvia Francesca Maria Pizzoli, Giulia Ongaro, Serena Oliveri, and Gabriella Pravettoni
MDPI AG
Background: A cancer diagnosis can impact patients’ and caregivers’ lives, posing different challenging situations. In particular, breast cancer and prostate cancer are two types of cancer involving families and especially spouses in challenges linked with the diagnosis and treatment process. Caregivers are usually involved in the treatment decision-making (TDM) process concerning patients’ clinical pathway, cancer treatment, and ongoing therapies. To date, no contributions provide an exhaustive overview of the role of caregivers in cancer care and their involvement in the TDM process related to the therapies. Methods: We performed a systematic review of caregiver and patients experiences and perceptions of caregiver involvement in cancer TDM. Articles were searched on Public/Publisher MEDLINE (PubMed), Excerpta Medica Database (Embase), Medical Literature Analysis and Retrieval System Online (Medline), and American Psychological Association APA PsycINFO. Results: 17 studies were included, 10 on prostate cancer and 7 on breast cancer. According to the reviewed studies, patients and caregivers experienced the cancer diagnosis with a sense of unity. Most patients preferred to have an active or collaborative role with caregivers in TDM, feeling it was important to consult or share the decision made with their caregivers. Caregivers preferred to collaborate with patients or let patients decide by themselves after considering their opinions. Caregiver involvement could have a positive influence on the patient’s medical decisions, even if cancer diagnosis and treatments overwhelmed patients and caregivers. Conclusions: These findings highlight the importance of using a perspective that focuses on the relationship between a patient and caregivers when they receive a cancer diagnosis and have to make a treatment decision. Targeting caregiver–patient dyads, rather than individuals, is important since a supported relationship could have a protective effect on psychological distress, quality of life (QOL), and relationship satisfaction. Moreover, dyads may benefit from interventions that focus on the needs of both the patient and caregiver.
Giulia Ongaro, Serena Petrocchi, Mariarosaria Calvello, Bernardo Bonanni, Irene Feroce, and Gabriella Pravettoni
MDPI AG
BRCA1/2 germline mutations predispose carriers to an increased risk of breast, ovarian, prostate, pancreatic, and skin cancer. Men and women are equally likely to pass on or inherit the pathogenic variant. However, there is evidence that male relatives are less involved in cascade screening than female ones. At the same time, little attention has been given to the research on psychological determinants of men’s adherence to cascade screening in BRCA1/2-positive families. Applying some principles of the Health Action Process Approach model, the present research tested a model of relationships on the adherence to BRCA1/2 cascade testing guidelines. The sample comprised 115 men’s first-degree relatives of women with verified germline mutations (Mage = 41.93; SD = 17.27). A pre–post test design was applied. Significant associations emerged between the intention to uptake BRCA1/2 genetic testing and age, parental status, breast cancer risk perception, self-referred outcome expectancies, perceived benefit, coping self-efficacy, and planning. Higher perceived benefit predicted increases in intention, and higher intention and coping self-efficacy predicted increases in planning. Intention was a positive total mediator of the relationship between benefit and planning. On a theoretical level, our findings partially supported the Health Action Process Approach as a valuable model based on which interventions could be developed in the context of cascade screening for BRCA1/2 genetic testing. Those results supported the importance of integrated genetic counselling sessions with a strict collaboration between geneticists and psychologists together with interventions planned to increase men’s self-monitoring ability to support their self-efficacy.
S. Petrocchi, G. Ongaro, M. Calvello, I. Feroce, B. Bonanni and G. Pravettoni
Background This is a registered study protocol on a randomized controlled trial (RCT) testing an intervention aimed to improve men’s adherence to evidence-based guidelines on BRCA1/2 germline genetic testing. BRCA1- and BRCA2-associated Hereditary Breast and Ovarian Cancer Syndrome (HBOC) increases the relative and absolute risk of developing breast and ovarian cancer and, to a lesser extent, prostate and pancreatic cancer. Men face BRCA-related cancer risks as women do, although with a different magnitude, and they may also transmit the mutations to their children. Notwithstanding, men are under-tested compared to women and the communication is not tailored on their needs. The present RCT applies principles of the Health Action Process Approach (HAPA) in testing the psychological determinants of the men’s adherence to evidence based guidelines on BRCA1/2 germline genetic and testing the efficacy of two messages. Methods A total of 264 participants will be involved, among the men’s relatives of women with verified germline mutations. The study entails a pre- post- evaluation with randomization of the participants in two conditions corresponding to the two messages. Discussion The expected results provide answers related to the impact of action self-efficacy, outcome expectancy (personal or familiar), risk perception, health risk aversion, intolerance of uncertainty, perceived barriers, and coping self-efficacy on informed decision-making. Data gathered from this study may inform health care providers, policy makers, and public health managers about the communication strategy for men and about the psychological variables influencing decision-making. Trail registration Name of the Registry: Clinical Trials. Trial registration number: NCT04683068. Date of registration: 16/12/2020. URL of trial registry record: https://www.clinicaltrials.gov/.
G. Ongaro, E. Brivio, Clizia Cincidda, S. Oliveri, F. Spinella, D. Steinberger, I. Cutica, A. Gorini and G. Pravettoni
BACKGROUND
Rapid advances in genomic knowledge and widespread access to the web contributed to the development of genetic services by private companies or medical laboratories. In the European landscape, though, there is not a single coherent regulatory approach to genetic testing (GT). The study aimed to investigate differences and similarities between two populations of GT users, Italians and Germans, in terms of health-related behaviors, psychological characteristics, and attitudes toward genetic information.
METHODS
Ninety-nine Italian GT users from one private genetic company and 64 Germans GT users from one medical laboratory, completed an ad hoc self-administered questionnaire.
RESULTS
Results showed significant differences in health-related behaviors (unhealthy eating behaviors, smoking behaviors, and frequency in medical check-ups), with Germans reporting higher levels of unhealthy eating habits and smoking behaviors than Italians; Italian users also were more medically controlled. Furthermore, German participants were less willing to change their lifestyle following the GT results compared to Italian participants. Regarding psychological variables, German users felt more confident about their physical well-being and they seemed more motivated than Italians to avoid becoming unhealthy. Finally, two samples differed in the way they accessed genetic testing (with the Italians guided predominately by a physician in contrast with the Germans who were recommended by friends) and managed genetic testing results (with Italian participants significantly more willing to share results with doctors than German participants, who preferred sharing with the family).
CONCLUSION
The analysis of cultural and organizational differences could help in defining adequate guidelines for counseling, and provide inputs for regulators in different European contexts.
Serena Oliveri, Clizia Cincidda, Giulia Ongaro, Ilaria Cutica, Alessandra Gorini, Francesca Spinella, Francesco Fiorentino, Marina Baldi, and Gabriella Pravettoni
Springer Science and Business Media LLC
AbstractDespite the widespread diffusion of direct-to-consumer genetic testing (GT), it is still unclear whether people who learn about their genetic susceptibility to a clinical condition change their behaviors, and the psychological factors involved. The aim of the present study is to investigate long-term changes in health-related choices, individual tendencies and risk attitudes in an Italian sample of GT users. In the context of the Mind the Risk study, which investigated a sample of Italian adults who underwent GT in a private laboratory, 99 clients participated in the follow up assessment. They completed a self-administered questionnaire investigating: (a) clinical history and motivation for testing, (b) lifestyle and risk behaviors, (c) individual tendencies toward health, and (d) risk-taking attitude and risk tolerance. Such variables were measured at three different time-points: T0—before GT, T1—at 6 months after genetic results, and T2—at 1 year from results. Results showed that, at baseline, participants who stated they intended to modify their behavior after GT results, effectively did so over time. This result held both for participants who received a positive or negative test result. In general, a healthier diet was the most frequently observed long-term behavioral change. As regards psychological variables, a risk-taking attitude and risk tolerance did not seem to affect the decision to change the lifestyle. Finally, we found an overall reduction in anxiety and worry over health over time, but also a reduction in the motivation for health promotion and prevention, health esteem, and positive expectations for their health in the future.
S. Petrocchi, P. Iannello, G. Ongaro, A. Antonietti, and G. Pravettoni
Springer Science and Business Media LLC
Abstract The present study aimed to test a model of relations to ascertain the determinants of distress caused by lockdown for COVID-19. It was hypothesized that the exposure to the COVID-19 increased distress directly and through the mediation of worry, health-related information seeking, and perception of the utility of the lockdown. It was also expected that higher levels of ambiguity intolerance corresponded to higher distress directly and through the mediation of worry, health information seeking behaviors, and perceived utility of the lockdown. Finally, it was expected that risk aversion positively influenced distress directly and through the increasing of worry, health-related information seeking behavior, and more positive perception of the utility of the lockdown The study was conducted in Italy during the mandatory lockdown for COVID-19 pandemic on 240 individuals (age range 18–76). Data recruitment was conducted via snowball sampling. COVID-19 exposure was positively associated with worry and health-related information seeking. Risk-aversion was positively associated with health-related information seeking and perceived utility of the lockdown to contain the spread of the virus. Worry and health-related information seeking were positively associated with distress, whereas the perceived utility of the lockdown was negatively associated with distress. Intolerance for the ambiguity was directly linked to distress with a positive sign. Findings suggest that risk aversion represents both a risk factor and a protective factor, based on what kind of variable mediates the relationship with distress, and that the intolerance to the ambiguity is a risk factor that busters distress.
Ilaria Durosini, Stefano Triberti, Giulia Ongaro, and Gabriella Pravettoni
SAGE Publications
Based on Salovey and Mayer’s conceptualization of emotional intelligence, Davies and colleagues developed the BEIS-10 scale, a 10-items self-report questionnaire that explores individual dispositions that people have about exploring one’s own and others’ emotions. To date, no studies assess the validity of the BEIS-10 scale in the Italian context. This article aims to fill this gap, exploring the validity, reliability, and construct validity of the Italian version of this scale. 244 Italian adults participated in the study and 67 respondents completed a second administration of the scale after two-weeks. The recommended statistical procedures were followed to validate the Italian version of the BEIS-10 scale and, after a back-translation process and a pilot testing, the five-factor structure of the scale was tested through a confirmatory factor analysis. Results highlighted that the five-factor model of emotional intelligence proposed by Davies and colleagues (2010) is confirmed in the Italian population. Data showed good reliability, good stability over time, and evidence of construct validity of the BEIS-10 scale. The BEIS-10 scale could be completed in a couple of minutes and it is particularly useful for collecting data in contexts in which time is an issue.
Rosanne Janssens, Reinhard Arnou, Elise Schoefs, Serena Petrocchi, Clizia Cincidda, Giulia Ongaro, Serena Oliveri, Meredith Y. Smith, Evelyne Louis, Marie Vandevelde,et al.
Frontiers Media SA
Background: The lung cancer (LC) treatment landscape has drastically expanded with the arrival of immunotherapy and targeted therapy. This new variety of treatment options, each with its own characteristics, raises uncertainty regarding the key aspects affecting patients’ health-related quality of life (HRQL). The present qualitative study aimed to investigate how LC patients perceive their HRQL and the factors that they consider to be most influential in determining their HRQL.Methods: This qualitative research incorporates four focus group discussions, with six LC patients in each group. In total, 24 stage III and IV LC patients were included in the discussions, with Italian (n = 12) and Belgian (n = 12) patients, age range: 42–78, median age = 62 (IQR = 9.3 years), SD = 8.5; 62% men. Using thematic analysis, transcripts and notes from the FGDs were analyzed using NVivo software (edition 12).Results: Three main themes capturing determinants of HRQL were identified. First, patients agreed on the importance of physical aspects (symptoms and side-effects) in determining their HRQL. In particular, skin conditions, nausea, fatigue, risk of infections, sensory abnormalities, pain, and changes in physical appearance were highlighted. Second, patients worried about psychological aspects, negatively impacting their wellbeing such as uncertainties regarding their future health state, and a lower degree of autonomy and independence. Third, patients underlined the importance of social aspects, such as communication with healthcare providers and social interaction with friends, family and peers.Conclusion: This study demonstrates that physical, psychological, and social aspects are key factors driving LC patients’ HRQL. Gaining a better understanding of how LC patients perceive their HRQL and how it is affected by their illness and therapy will aid patient-centric decision-making across the drug life cycle, by providing stakeholders (drug developers, regulators, reimbursement bodies, and clinicians) insights about the treatment and disease aspects of importance to LC patients as well as the unmet needs LC patients may have regarding available treatment modalities. Finally, this study underscores a need for individual treatment decision-making that is considerate of uncertainties among LC patients about their future health state, and ways for improving communication between healthcare providers and patients to do so.
Giulia Ongaro, Clizia Cincidda, Valeria Sebri, Lucrezia Savioni, Stefano Triberti, Roberta Ferrucci, Barbara Poletti, Bernardo Dell’Osso, and Gabriella Pravettoni
Frontiers Media SA
The Italian state adopted serious safety measures to manage the COVID-19 pandemic in the year 2020. The lockdown was associated with negative psychological consequences in healthy populations, mostly in terms of anxiety, distress, depression, and even traumatic symptoms. This longitudinal study aimed at briefly documenting the psychological impact among an Italian sample, in terms of worry and its impact on psychological well-being levels, of the first wave of COVID-19, taking into account the changes in the lockdown scenario. A three-time follow-up survey was administered to 177 subjects (Female: 78%, Mage = 36.33), during (T0), at the end (T1), and 3 months after the end of the first lockdown (T2). Since the first wave of COVID-19, results showed a decrease in worry and the perception of virus diffusion’s controllability over time while psychological well-being increased. Furthermore, factors such as personality traits (neuroticism and agreeableness) and dysfunctional coping strategies predicted increases in worry levels at the end of the lockdown and 3 months after in the Italian context. However, worry levels during and at the end of the lockdown did not predict well-being levels 3 months after the end of the lockdown. Based on these findings, mental health policymakers should design tailored interventions able to improve the perception of virus diffusion management, as well as address the psychological needs of Italian citizens and support it, including a plan for the follow-up evaluation.
Valeria Sebri, Clizia Cincidda, Lucrezia Savioni, Giulia Ongaro, and Gabriella Pravettoni
Informa UK Limited
Abstract In the earliest months of 2020, the COVID-19 emergency reached a pandemic status of international concern. In this situation, people tended to think more about current difficulties and their negative consequences due to the fear of infection and changed daily life during quarantine. The aim of this study was to explore the severity of worry in relation to individual characteristics and emotions during COVID-19 outbreak in the Italian people. Socio-demographic questions and standardized self-report questionnaires were administered online. Results highlighted a moderate level of worry, anxiety and distress. People with higher perceptions of COVID-19 severity exhibited higher levels of worry in contrast to those who perceived a greater control over the possibility of infection. Multiple regression analysis indicated that coping styles, emotion regulation strategies and personality traits significantly contributed to explain the variance in worry scores. Findings supported that cognitive reappraisal, emotion-focused coping and extraversion were protective factors for worry, while expressive suppression, dysfunctional and problem-focused coping, and neuroticism were related to high worry. However, neuroticism and dysfunctional coping were particularly important predictors of worry. This paper also considers possible psychological interventions that might be implemented in order to deal with mental health issues emanating from the COVID-19 pandemic.
Chiara Ionio, Martina Smorti, Eleonora Mascheroni, Giulia Ongaro, Elena Cattaneo, Angelo Gemignani, Silvia Von Wunster, and Lucia Bonassi
Informa UK Limited
ABSTRACT Objective: The present work aimed to evaluate: (a) the psychometric properties of the Centrality of Event Scale in Italian primiparous and multiparous women; (b) individual differences in those demographic variables that influence change in women’s identity and the maternal role acquisition during pregnancy; (c) the association between the extent to which pregnancy has an impact on woman’s life story and identity and prenatal attachment; (c) how the centrality of the pregnancy event is related to the experience of PTSD during pregnancy. Background: Pregnancy is a crucial phase in women’s life that involves many changes for a woman’s role and identity. Methods 319 pregnant women were assessd during the third trimester of pregnancy. Results: Exploratory Factor Analyses confirmed a one-factor solution of the CES. Moreover, the perception of pregnancy as central in women’s lives is significantly related to prenatal attachment. Finally, the perception of pregnancy as central in women’s lives is positively correlated to PTSD symptoms. Conclusion: Our findings provide evidence on the validity of the scale with pregnant women samples, which may contribute for a better understanding of the impact of pregnancy on women’s identity and life story, as well as the underlying psychological challenges related to pregnancy.
Serena Oliveri, Giulia Ongaro, Ilaria Durosini, Giuseppe Curigliano, and Gabriella Pravettoni
Springer Science and Business Media LLC
Purpose During the last two decades, the number of breast implants used in aesthetic, oncologic, and risk-reducing surgery has increased substantially mainly due to the improvement and confirmed safety of these devices. Since the identification of the first case of anaplastic large cell lymphoma associated with a breast implant (BIA-ALCL) 20 years ago, there has been an increase in the number of reports of this very rare disease, demonstrating a clear association with breast implants. While the majority of cases are localized and cured by implant removal and full capsulectomy, a small percentage require chemotherapy and the mortality rate is very low. Nevertheless, the evidence linking BIA-ALCL to implant surface texturing has raised concerns about the long-term safety of these devices resulting in patient and regulatory authority concerns globally. Methods and Results In this commentary, we report the current debate on BIA-ALCL and the main European government’s actions, with a special focus on the emotional impact that media coverage has on cancer patients. We comment the emotional impact of such risk for patients with breast implant, the hard process of patient’s acceptance for mastectomy and reconstructive surgery, and how this is an essential part of recovery and return to the normal living for many women. Conclusion We conclude by providing guidelines for patient–physician communication and patients’ psychological support on this topic of delicate actuality. Our contribution aims at guiding the medical community in managing risk communication about BIA-ALCL with a multidisciplinary approach, according to the most recently available published evidence.
Eleonora Mascheroni, Flavia Faccio, Lucia Bonassi, Chiara Ionio, Fedro Alessandro Peccatori, Camilla Pisoni, Chiara Cassani, Giulia Ongaro, Elena Cattaneo, Giuseppe Nastasi,et al.
Springer Science and Business Media LLC
Young cancer survivors often wish to bear a child after oncological treatments, as they might not have started or completed their families. As young cancer survivors have a higher risk of developing psychological difficulties, this study investigated whether there were significant differences in psychological aspects between pregnant women who received a cancer diagnosis in the past and pregnant women without a history of cancer. A total of 123 pregnant women, of which 36 were cancer survivors and 87 women without a history of cancer, were recruited during their last trimester at different hospitals in Northern Italy. Patients were asked to complete a socio-demographic profile and questionnaires measuring mood states, post-traumatic symptoms, centrality of the pregnancy and cancer event, quality of life, and prenatal attachment. Cancer survivors had significantly higher levels of PTSD symptoms, perceived pregnancy as more central to their identity and life story, perceived lower quality of life and had lower intensity of prenatal attachment compared with the control group. Centrality of the cancer event did not correlate with any psychological variables. Preliminary results suggest that a past cancer diagnosis can influence the mother’s psychological functioning and the development of the relationship with their child.
Serena Oliveri, Ludovica Scotto, Giulia Ongaro, Stefano Triberti, Paolo Guiddi, and Gabriella Pravettoni
Wiley
Recent research emphasizes the role of environmental factors in the emergence of oncological diseases. Specifically, Dellino and colleagues demonstrated that cancer-associated translocations in cells are influenced by the environment they are in, which in turn is influenced by the environment where the full organism lives. Broadly speaking, this “environment” could be conceptualized as the individual's lifestyle choices, such as smoking, food intake, and being more or less healthy. Any oncologist or genomic specialist could easily see that these lines are a rough simplification of an extremely complex process: Despite the importance of a healthy lifestyle and prevention, the exact relationships between cancer onset and the patient's lifestyle choices are still to be understood exhaustively by the scientific community. However, the oversimplification of scientific affirmations is the exact starting point of the present contribution. The implications of the study cited above have been recently reinterpreted by the press in Italy, with a number of articles being published at approximately the same time. These articles reported a brief interview with the authors and the main message was that lifestyle and choices of general life circumstances (eg, living in a healthy place, avoiding work-related stress, and having a child) have a predominant role in the formation of tumors, quoting these press articles “you do not get cancer by chance,” which sounds like a daring attempt, to summarize the scientific work from Dellino and colleagues. Risk factors or risk habits for oncological diseases exist (eg, bad nutrition, no physical activity, smoking, and alcohol or junk food intake), and evidence of their role in cancer development fosters many preventative initiatives. Nevertheless, we must go with adequate reflection in terms of the effects that an imprecise scientific communication may have on patients' experience. Indeed, if we consider critically the message coming from the Italian press, we could easily see it is targeted to healthy people: It is an encouraging message for those without cancer who would like to prevent such a risk in their future life. To those people, the message says: “What you are doing now may be really important!” Such a message is certainly positive and relevant in order to support prevention and the adoption of healthy lifestyles. It could be inserted in the current movement of “quantified self,” which, starting from the concept that health depends 100% on our behavior, engages the individual in the selftracking (through technologies) of all the biological, physical, behavioral, or environmental information. The downsides of the quantified self are turning individuals into cold, emotionless, and sometimes meaningless numbers and equating people's self-worth to the various “number-achievements” computed each day. However, any communication on cancer and oncology is expected to reach not only those people who still have the opportunity to prevent it but even those who are currently fighting the disease, patients or survivors. Both cancer diagnosis and long-term adjustment to the disease are associated with notable emotional experience, which may Received: 11 July 2019 Revised: 6 September 2019 Accepted: 9 September 2019 DOI: 10.1002/pon.5224
Antonio Maria Corato, Stefano De Carli, Chiara Fabris, and Giulia Ongaro
Franco Angeli
Alessandra Mauri, Maddalena Tomas, Giulia Ongaro, and Olga Riccato
Franco Angeli