Josée Savard

Laval University | ULAVAL · School of Psychology

Purpose Insomnia affects 30–60% of cancer patients and tends to become chronic when left untreated. While cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment, this intervention is not readily accessible. This qualitative study investigated current practices in the assessment and management of insomnia in five h...

Background: Sleep disturbance is common and distressing among cancer survivors. Black breast cancer survivors (BBCS) suffer disproportionately from sleep disturbance, yet there is limited research on how to address this issue. Purpose: This study aimed to understand the multifaceted experiences of sleep disturbance among BBCS and how to cultural...

Study objectives To assess the effects of Cognitive Behavioral Therapy for insomnia (CBTi) on subjective and objective measures of sleep, sleep-state misperception and cognitive performance. Methods We performed a randomized-controlled trial with a treatment group and a wait-list control group to assess changes in insomnia symptoms after CBTi (8 w...

Cognitive-Behavioral Therapy for Insomnia (CBT-I) is the gold-standard treatment for insomnia, which is common among breast cancer survivors (BCS). This pilot randomized controlled trial tested the first CBT-I intervention for Spanish-speaking BCS delivered using eHealth. Participants (N = 30) were Spanish-speaking BCS with insomnia symptoms recrui...

Objective: Care for fear of cancer recurrence (FCR) is considered the most common unmet need among cancer survivors. Yet the prevalence of FCR and predisposing factors remain inconclusive. To support targeted care, we provide a comprehensive overview of the prevalence and severity of FCR among cancer survivors and patients, as measured using the s...

La thérapie cognitivocomportementale de l’insomnie (TCC-I) demeure difficile d’accès pour les patients atteints de cancer. Sa digitalisation semble une solution prometteuse pour bénéficier au plus grand nombre. La faisabilité d’un programme TCC-I québécois a été démontrée en France, tout en révélant les limites d’un dispositif suivi en autonomie et...

Background Insomnia and cognitive impairment are both common conditions experienced by people diagnosed with cancer. Individually, these conditions have negative impacts on functioning, but the combined burden has yet to be evaluated. The purpose of this research was to estimate rates of comorbid insomnia and perceived cognitive impairments, examin...

Purpose/objective: The goals of the present study were (a) to document the prevalence of anxiety-related disorders and anxiety symptoms at 4, 8, and 12 months postinjury in individuals with mild traumatic brain injury (mTBI) while considering preinjury history of anxiety disorders and (b) to verify whether the presence of anxiety in the first mont...

Study Objectives High rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data...

Study Objectives: To assess the effects of Cognitive Behavioral Therapy for insomnia (CBTi) on subjective and objective sleep, sleep-state misperception as well as self-reported and objective cognitive performance. Methods: We performed a randomized controlled trial with a treatment group and a wait-list control group to assess changes in insomnia...

Le cancer entraîne plusieurs impacts néfastes sur la santé physique et mentale. Les stratégies d’adaptation utilisées jouent un rôle important dans l’adaptation à la maladie. Puisqu’il peut avoir un impact sur la façon de réagir à un stresseur, le perfectionnisme pourrait être associé à l’utilisation de certaines stratégies. L’objectif de l’étude e...

Objective The ongoing COVID-19 global pandemic is a stressful experience that is particularly likely to negatively affect cancer patients. The goal of this qualitative study was to explore how breast cancer patients experienced the first wave of the COVID-19 outbreak.Methods As part of a larger study, 23 women accepted to take part in an individual...

Background Insomnia affects up to 63% of patients with cancer. Cognitive behavioral therapy for insomnia (CBT-I) is considered to be the non-pharmacological gold standard treatment, but it remains underutilized in France. Self-administered interventions offer new ways to overcome some of the barriers that restrict access to efficacious supportive c...

Background: Androgen deprivation therapy (ADT) may affect cognitive function in men with prostate cancer (PCa). This study examined whether insomnia symptoms mediate the relationship between ADT and perceived cognitive function and whether depressive symptoms, fatigue severity, and physical activity moderate the strength of this relationship. Met...

Study objectives: Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for cancer-related insomnia, but its accessibility is very limited in routine care. A stepped care approach has been recommended as a cost-effective way to make CBT-I more widely accessible. However, no controlled study has yet been publishe...

Background Insomnia is a frequent complaint in patients with cancer. Sleep problems can affect immune functioning in healthy individuals. Our aim was to evaluate the association between sleep disturbance and the risk of febrile neutropenia, leukopenia and infections in patients treated with chemotherapy in an adjuvant setting for breast cancer.Meth...

Perceived cognitive impairment (PCI) and sleep disturbances (such as insomnia) are commonly reported barriers preventing cancer survivors from resuming normal functioning. Cognitive-behaviour therapy for insomnia (CBT-I) is the treatment of choice for insomnia among cancer survivors. Literature suggests that treatment with CBT-I may lead to an impr...

Background Insomnia affects between 30 to 60% of cancer patients and tends to become chronic when left untreated. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for cancer-related insomnia. Yet, this treatment is not readily accessible. A stepped care intervention beginning with a self-administered (web-ba...

Background: Insomnia affects between 30 to 60% of cancer patients and tends to become chronic when left untreated. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for cancer-related insomnia. Yet, this treatment is not readily accessible. A stepped care intervention beginning with a self-administered (web-b...

Background Insomnia affects between 30 to 60% of cancer patients and tends to become chronic when left untreated. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for cancer-related insomnia. Yet, this treatment is not readily accessible. A stepped care intervention beginning with a self-administered (web-ba...

Purpose: Insomnia affects 30-60% of cancer patients and tends to become chronic when left untreated. While cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment, this intervention is not readily accessible. This qualitative study investigated current practices in the assessment and management of insomnia in five...

Background: The current Coronavirus disease 2019 (COVID-19) pandemic is a highly stressful event that may lead to significant psychological symptoms, particularly in cancer patients who are at a greater risk of contracting viruses. This study examined the frequency of stressors experienced in relation to the ongoing coronavirus pandemic and its re...

Objective This study investigated the stress-buffering effect of social support on immune function and infectious risk in women with breast cancer, during and after chemotherapy. Method Data were collected from 50 women with breast cancer before and after their chemotherapy, as well as three months later. Stress was measured by daily hassles relat...

Le cancer du sein est une maladie prévalente associée au développement et au maintien de nombreux symptômes pouvant affecter la qualité de vie. Il est important d’explorer ce qui peut influencer les symptômes ressentis. Cette étude longitudinale vise à étudier l’association entre le perfectionnisme (c.-à-d., aspirations perfectionnistes et préoccup...

Importance Insomnia is a significant public health problem, but there is little information on its natural history. Objective To assess the incidence, persistence, and remission rates of insomnia over a 5-year naturalistic follow-up period. Design, Setting, and Participants This cohort study included participants with and without sleep problems s...

Background: Cancer-related fatigue (CRF) and insomnia are highly comorbid. This association implies that treatment aimed at improving one may also simultaneously target the other. This secondary analysis examined whether severity of insomnia affects sleep outcomes in response to a light therapy intervention in cancer survivors with CRF. Methods:...

Objective Psychosocial interventions can reduce cancer‐related fatigue effectively. However, it is still unclear if intervention effects differ across subgroups of patients. These meta‐analyses aimed at evaluating moderator effects of (1) sociodemographic characteristics, (2) clinical characteristics, (3) baseline levels of fatigue and other sympto...

Objective Despite its high prevalence, cancer‐related insomnia typically remains untreated because of a lack of access to cognitive‐behavioral therapy for insomnia (CBT‐I), the treatment of choice for this condition. While face‐to‐face CBT‐I appears to be optimal in terms of efficacy, self‐administered formats may be more cost‐effective. The goal o...

Purpose This study evaluated the effects of coping skills training (CST) on symptoms of depression and anxiety in cancer patients, and investigated moderators of the effects. Methods Overall effects and intervention-related moderators were studied in meta-analyses of pooled aggregate data from 38 randomized controlled trials (RCTs). Patient-relate...

Study Objectives The study objectives were to examined accidental risks associated with insomnia or hypnotic medications, and how these risk factors interact with sex and age. Methods A population-based sample of 3413 adults (Mage = 49.0 years old; 61.5% female), with or without insomnia, were surveyed annually for five consecutive years about the...

Objective/Background: Breast cancer patients display high rates of insomnia and chemotherapy treatments appear to contribute significantly to the development of sleep disturbances among this population. The efficacy of cognitive-behavioral therapy for insomnia (CBT-I) is now well established for treating insomnia comorbid with cancer but is not wid...

Background: Insomnia is very common in cancer patients receiving chemotherapy. Poor sleep is associated with immune alterations but the actual impact on health resulting from such immune changes has rarely been studied. The aim of this study was to evaluate, in women treated with chemotherapy for breast or gynecological cancer, the relationships b...

Compte tenu des effets néfastes des pensées négatives sur la détresse psychologique et la peur de la récidive du cancer (PRC), la pensée positive est souvent proposée comme une option de rechange avantageuse. Toutefois, l’optimisme irréaliste, un construit apparenté, est associé à la détresse psychologique. Cette étude a pour objectifs d’examiner l...

Objective We previously investigated the capacity of the original version of the Edmonton Symptom Assessment System-Revised (ESAS-r) and the Canadian Problem Checklist (CPP) to screen for clinical levels of insomnia in cancer patients. The original ESAS-r includes an item assessing drowsiness and an “other symptom” item, both of which are rated on...

Cette étude, menée chez des femmes traitées pour un cancer du sein par chimiothérapie, vise à : (1) dresser un portrait longitudinal global de l’évolution de l’AP mesurée subjectivement (Godin Leisure-Time Exercise Questionnaire; GLTEQ) et objectivement (actigraphe) du pré-traitement jusqu’à six mois post-traitement; (2) étudier la présence de diff...

Background Cognitive therapy (CT) and bright light therapy (BLT) have been found to be effective to treat depressive symptoms in breast cancer patients. No study has investigated the baseline patients’ characteristics that are associated with better outcomes with CT vs. BLT in this population. This study aimed to assess, in breast cancer patients,...

Study Objectives Chronic insomnia tends to “wax and wane” over lifetime. The presence of residual insomnia symptoms is common, especially among naturally remitted individuals. This study aims to examine the features of these residual symptoms and their potential association with future relapse. Methods A population-based data set on the natural hi...

Objectives: To evaluate the effects of exercise interventions on sleep disturbances and sleep quality in patients with mixed cancer diagnoses, and identify demographic, clinical, and intervention-related moderators of these effects. Methods: Individual patient data (IPD) and aggregated meta-analyses of randomized controlled trials (RCTs). Using...

Purpose A healthy lifestyle following a cancer diagnosis is associated with reduced risk for a cancer recurrence. Better understanding the interrelationships between multiple health behaviors (HB) in cancer survivors could inform the development of more effective interventions to promote a healthy lifestyle. Methods This prospective study assessed...

Background Breast cancer patients tend to experience numerous concurrent psychological symptoms that form clusters. It has been proposed that a common psychological mechanism may underlie the membership of symptoms in a given cluster, but this hypothesis has never been investigated. Maladaptive emotion regulation (ER) is one possible common mechani...

Objectives: This study examined the cross-sectional and prospective relationships between subjective (cognitive reappraisal, expressive suppression and experiential avoidance) and objective (high-frequency heart rate variability [HF-HRV]) measures of emotion regulation (ER) and a set of psychological symptoms (anxiety, depression, fear of cancer re...

Study objectives Thirty to 60% of cancer patients have insomnia symptoms, a condition which may lead to numerous negative consequences and for which an efficacious management is required. This randomized controlled trial aimed to assess the efficacy of a 6-week home-based aerobic exercise program (EX) compared to that of a 6-week self-administered...

Objectives High rates of sleep difficulties have been found in patients with advanced cancer. However, not much is known about factors that are associated with sleep impairments in this population and that could constitute their potential risk factors or consequences. This study conducted in patients with cancer receiving palliative care aimed to e...

Insomnia in oncology remains insufficiently assessed and managed despite its high prevalence and long-term persistence without a specific treatment. Cognitive-behavioural therapies have been proven to be efficacious and mindfulness-based interventions offer promising results for this condition. However, they are not often offered and accessible in...

Background Cancer patients commonly report experiencing fear of cancer recurrence (FCR), which may lead to several negative consequences. This study aimed at examining whether clinical levels of FCR are linked to a greater use of health care services. Method This is a secondary analysis of a longitudinal study of 962 cancer patients on the epidemi...

Background: High rates of sleep-wake difficulties have been found in patients with cancer receiving palliative care. Pharmacotherapy is the most frequently used treatment option to manage these difficulties despite numerous adverse effects and the absence of empirical evidence of its efficacy and innocuity in palliative care. Objective: This pil...

Introduction Cancer-related fatigue (CRF) and insomnia are highly comorbid, suggesting that these two symptoms may share physiological, psychological, and behavioral mechanisms. The objective of this secondary analysis was to examine the impact of a 4-week light therapy intervention on insomnia severity in cancer survivors with clinical levels of f...

Purpose: Cancer-related fatigue (CRF) is a common and distressing symptom that can persist after cancer treatment has concluded. Bright light therapy has shown preliminary efficacy in reducing CRF, but its impact on other psychosocial factors is unclear. The purpose was to examine the impact of a 1-month light therapy intervention on fatigue, mood...

Table S3. Representativeness and publication bias of the pooled effects of studies providing data for the POLARIS study and those not providing data.

Figure S1. Forest plots of the effects of psychosocial interventions on quality of life, emotional function, and social function

Table S1. Characteristics of the 22 included randomized controlled trials on the effect of psychosocial interventions, in alphabetical order of first author.

Table S2. Demographic, clinical, personal and intervention‐related characteristics, quality of life, emotional function, and social function of patients in the intervention and control group.

The objectives of this study were to document the frequency of major and minor depressive episodes in the first year after traumatic brain injury (TBI), taking into account TBI severity and premorbid history of major depression, and to describe trajectories of depressive episodes. Participants were 227 adults who were hospitalized following TBI (76...

Objective: This individual patient data (IPD) meta-analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF) and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention-related characteristics. Methods: Rel...

Background: Prostate cancer is the most commonly diagnosed cancer in north-American men. Few dietary or lifestyle interventions have been tested to prevent prostate cancer progression. Omega-3 fatty acid supplementation represents a promising intervention for prostate cancer patients. The aim of the study is to evaluate the effects of long-chain o...

Objective: This randomized controlled trial (RCT), conducted in patients with breast cancer, aimed to compare the effects of cognitive therapy (CT), bright light therapy (BLT), and a waiting-list control condition (WLC) on depressive symptoms. Method: Sixty-two women were randomly assigned to an 8-week CT (n = 25), BLT (n = 26), or WLC (n = 11). Pa...

Objective: This randomized controlled trial (RCT), conducted in patients with breast cancer, aimed to compare the effects of cognitive therapy (CT), bright light therapy (BLT), and a waiting-list control condition (WLC) on depressive symptoms. Method: Sixty-two women were randomly assigned to an 8-week CT (n = 25), BLT (n = 26), or WLC (n = 11)....

Significant disruptions in sleep–wake cycles have been found in advanced cancer patients in prior research. However, much remains to be known about specific sleep–wake cycle variables that are impaired in patients with a significantly altered performance status. More studies are also needed to explore the extent to which disrupted sleep–wake cycles...

Introduction: This study aims to empirically validate the French-Canadian version of the Expanded Prostate Cancer Index Composite (EPIC), a measure of health-related quality of life for prostate cancer patients. Methods: 251 participants completed a battery of self-report scales including the French-Canadian version of the EPIC, after having rec...

Objective Prevalence rates of sleep difficulties in advanced cancer patients have varied widely across studies (12 to 96%), and none of these employed a diagnostic interview to distinguish different types of sleep–wake disorders. Moreover, very limited information is available on subjective and objective sleep parameters in this population. Our stu...

This paper describes the development, content, and preliminary results of a group cognitive-behavioral therapy (CBT) for fear of cancer recurrence (FCR). A manualized CBT intervention was developed and offered to 38 patients with various cancer types and stages in two hospitals. Four weekly group CBT sessions were administered by two licensed psych...