Yvonne W Leung

Yvonne W Leung
University of Toronto | U of T · Department of Psychiatry

PhD

About

66
Publications
6,627
Reads
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1,208
Citations
Additional affiliations
September 2018 - present
University of Toronto
Position
  • Professor (Assistant)
September 2017 - present
de Souza Institute
de Souza Institute
Position
  • Researcher
July 2014 - April 2016
University Health Network
Position
  • Scientific Associate

Publications

Publications (66)
Article
This report describes the implementation of a comprehensive distress screening program at the Kuwait Cancer Control Center (KCCC), the first such initiative in the Middle East. A Kuwait-adapted version of the Distress Assessment and Response Tool (K-DART) was used in this screening program. Paper-based K-DART surveys were piloted in the lymphoma cl...
Article
Background: The negative psychosocial impacts of cancer diagnoses and treatments are well documented. Virtual care has become an essential mode of care delivery during the COVID-19 pandemic, and online support groups (OSGs) have been shown to improve accessibility to psychosocial and supportive care. de Souza Institute offers CancerChatCanada, a t...
Preprint
UNSTRUCTURED The recent onset of the COVID-19 pandemic and the social distancing requirement has created a further demand for virtual groups. Advances in artificial intelligence (AI) may offer novel solutions to the management challenges such as the lack of emotional connections within virtual groups’ interventions. Using typed text from Online Sup...
Article
Full-text available
Health professionals working in oncology face the challenge of a stressful work environment along with impacts of providing care to those suffering from a life-threatening illness and encountering high levels of patient loss. Longitudinal exposure to loss and suffering can lead to grief, which over time can lead to the development of compassion fat...
Preprint
BACKGROUND The negative psychosocial impacts of cancer diagnoses and treatments are well documented. Virtual care has become an essential mode of care delivery during the COVID-19 pandemic and online support groups (OSGs) are shown to improve accessibility to psychosocial and supportive care. The de Souza Institute offers CancerChatCanada, a therap...
Article
Full-text available
Background and Objectives: Individuals with cancer, especially advanced cancer, are faced with numerous difficulties associated with the disease, including an earlier death than expected. Those who are able to confront and accept the hardships associated with the disease in a way that aligns with their beliefs benefit from more positive psychologic...
Article
Purpose Although some studies have shown increasing radiologists’ mammography volumes improves performance, there is a lack of evidence specific to digital mammography and breast screening program performance targets. This study evaluates the relationship between digital screening volume and meeting performance targets. Methods This retrospective...
Article
Healthcare systems across the world are transitioning into patient-centered healthcare models to ensure improved health outcomes, increased operational efficiencies and respectful patient engagement. Digital health technologies are at the forefront of this transition in facilitating a role for the patient in the clinical dimensions of the healthcar...
Article
Full-text available
Background Suicide rates are up to four times greater in cancer compared to the general population, yet best practices for institutional suicide prevention are unknown. The objective of this study was to examine the association between suicide risk screening (SRS), clinician response, and suicide mortality at a comprehensive cancer treatment centre...
Article
Introduction Randomized controlled trials have shown that screening with computed tomography reduces lung cancer mortality but is most effective when applied to high-risk individuals. Accurate lung cancer risk prediction models effectively select individuals for screening. Few pilots or programs have implemented risk models for enrolling individual...
Preprint
Full-text available
Health professionals in cancer care often face the challenge of stressful work environment, along with the impacts of providing care to those suffering from a life- threatening illness. Prevalence rates of compassion fatigue (CF) are moderate to high, yet health professionals have little knowledge on the topic. Purpose: The objective of this study...
Article
Full-text available
Background Cancer and its treatment can significantly impact the short- and long-term psychological well-being of patients and families. Emotional distress and depressive symptomatology are often associated with poor treatment adherence, reduced quality of life, and higher mortality. Cancer support groups, especially those led by health care profes...
Article
Background Lung cancer is the leading cause of cancer deaths in Ontario. The National Lung Screening Trial demonstrated that screening with low-dose computed tomography (LDCT) reduces lung cancer mortality. Methods In June 2017, Ontario Health (Cancer Care Ontario) initiated a pilot for lung cancer screening to inform implementation of a province-...
Preprint
Background: Cancer and its treatment can significantly impact the short- and long-term psychological well-being of patients and families. Emotional distress and depressive symptomatology are often associated with poor treatment adherence, reduced quality of life, and higher mortality. Cancer support groups, especially those led by health care profe...
Article
Full-text available
Background: We assessed whether the presence and severity of common cancer symptoms are associated with the health utility score (hus) generated from the EQ-5D (EuroQol Research Foundation, Rotterdam, Netherlands) in patients with cancer and evaluated whether it is possible pragmatically to integrate routine hus and symptom evaluation in our cance...
Article
Objective: This pilot study aimed to evaluate the feasibility, acceptability, and psychosocial outcomes of a text-based online group therapy intervention, i-Restoring Body Image after Cancer (i-ReBIC). i-ReBIC was developed to reduce body image distress and psychosexual dysfunction among women diagnosed and treated for breast or gynecological canc...
Article
Purpose Caregivers of patients with cancer cope with socioemotional challenges, which can adversely affect their well-being. We developed an intervention, expressive writing and reading (EWR), to promote emotional processing and social connectedness among caregivers. In a single-arm pilot study, we assessed its feasibility and perceived usefulness....
Article
Full-text available
Purpose This study seeks to determine whether specific screening for constipation will increase the frequency of clinician response within the context of an established symptom screening program. Methods A “constipation” item was added to routine Edmonton Symptom Assessment System (ESAS) screening in gynecologic oncology clinics during a 7-week tr...
Article
Background Having a first‐degree relative (FDR) with colorectal cancer (CRC) is a significant risk factor for CRC. Counseling for FDRs regarding CRC risk factors and personalized risk is important to improve knowledge and screening compliance. Methods A 3‐arm randomized controlled trial compared tailored in‐person and telephone CRC counseling inte...
Article
Context:: Cancer-related pain is associated with significant suffering and is one of the most challenging symptoms to manage. Studies indicate that front-line clinicians often lack the knowledge on best practices in cancer pain management. Objectives:: The current project, a quality improvement (QI) initiative, evaluated the outcome of an online...
Article
Esophageal cancer and its treatment can cause serious morbidity/toxicity. These effects on health-related quality of life (HRQOL) can be measured using disease-specific scales such as FACT-E, generic scales such as EQ-5D-3L, or through symptoms. In a two-year cross-sectional study, we compared HRQOL across esophageal cancer patients treated in an a...
Article
Women with a family history of breast cancer (BC) often overestimate their BC risk. Heightened psychological distress may interfere with risk comprehension and screening adherence. The primary purpose of this study was to test the efficacy of a 12‐week manual‐based supportive‐expressive (SE) group intervention for this population. Methods Using a...
Article
Full-text available
Background: Personal health information, including diagnoses and hospital admissions, is routinely collected in administrative databases. Patients enrolling on clinical trials consent to separate collection and storage of their personal health information. We evaluated patient preferences for linking long-term data from administrative databases wi...
Article
155Background: In Ontario, Canada, longitudinal patient self-reporting of 9 common cancer symptoms and a global health scale (Edmonton Symptom Assessment System, ESAS) is mandated and used clinically as a screening tool for multidisciplinary precision care (chemo/rads/surg). However, a common GI symptom, dysphagia, is not assessed in the same setti...
Article
Introduction: Economic analyses of upcoming treatments for lung cancer benefit from real-world health utility scores (HUSs) in an era of targeted therapy. Methods: A longitudinal cohort study at Princess Margaret Cancer Centre evaluated 1571 EQ5D-3L-derived HUSs in 475 outpatients with metastatic lung cancer across various disease states. Patien...
Article
Background: Routine screening for problematic symptoms is emerging as a best practice in cancer systems globally. The objective of this observational study was to assess the feasibility and diagnostic accuracy of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive testing (CAT) for fatigue and sleep-disturbance...
Article
Full-text available
Purpose: Systematic screening for distress in oncology clinics has gained increasing acceptance as a means to improve cancer care, but its implementation poses enormous challenges. We describe the development and implementation of the Distress Assessment and Response Tool (DART) program in a large urban comprehensive cancer center. Method: DART...
Article
Background: Chemotherapy (chemo) is associated with a significant risk of toxicity, which often peaks between ambulatory visits. Consequently, effective remote symptom management support is essential to optimize self-management and resource use, including emergency department visits and hospitalizations (ED+H) during chemo. The aim of this study wa...
Article
67 Background: Patient-reported outcome measures (PROMs) are used to collect cancer-related symptom and symptomatic toxicity data. Understanding factors that affect the acceptability of PROMs is useful for improving the participation of such routine screening practices. We investigated the association between patient’s functional status on their ac...
Article
73 Background: Efficient methods of tracking dyspnea can improve quality of care. We asked lung cancer patients to assess five validated patient-reported outcome (PRO) tools and determine whether these tools captured different domains of their dyspnea experience. Methods: This cross-sectional study of adult lung cancer outpatients of all stages uti...
Article
144 Background: Clinical trials collect outcome data until the trial ends. Subsequent health data is often available in government or health care administrative databases, yet this information is often not made available to researchers. We assessed patient preferences of long-term linkage of such administrative databases to clinical trials database...
Article
Methods: 202 cancer out-patients (120 curative and 82 palliative) at the Princess Margaret Cancer Centre completed a PROM survey using a touchscreen tablet regarding their symptoms of pain. Ten questions assessed patient acceptance of completing PROM surveys. Results: The median age was 60 (range 21-86) and 48% were female. There were no clinica...
Article
Methods: A pain PRO-tool was administered cross-sectionally using tablet technology across outpatient clinics in a comprehensive cancer centre. Questions were adapted from the Brief Pain Inventory (BPI) and Edmonton Symptom Assessment System (ESAS), recording responses on pain severity and interference in life. PRO-tool completion rates and preval...
Article
Full-text available
Background: Individuals with coronary artery disease (CAD) and musculoskeletal comorbidities (MSKCs) have much to gain from physical activity, yet are less likely to be referred to cardiac rehabilitation (CR) than those without MSKCs. Whether patients with MSKCs achieve demonstrated benefits of CR participation such as improved quantity and qualit...
Article
Suicide rates are elevated in individuals with cancer, although suicidal intention is not typically assessed in cancer centers. We evaluated in a large comprehensive cancer center the utility of an electronic Distress Assessment and Response Tool (DART), in which suicidal intention is assessed with a single item. Patients attending cancer clinics c...
Article
Elevated blood pressure is a leading risk factor for cardiovascular disease and mortality. Internet-based interventions (e-counselling) have the potential to deliver a wide range of preventive counselling services. The purpose of this review was to (1) assess the efficacy of e-counselling in reducing blood pressure and (2) identify key components o...
Article
Objective To systematically review the evidence of pre-operative exercise, known as ‘prehabilitation’, on peri- and postoperative outcomes in adult surgical populations. Design Systematic review and meta-analysis. Data sources CENTRAL, Medline, EMBASE, CINAHL, PsycINFO and PEDro were searched from 1950 to 2011. Methods Two reviewers independentl...
Article
Full-text available
Background: Depression is associated with increased cardiac morbidity and mortality in the general population and in patients with coronary heart disease (CHD). Recent evidence suggests that patients with new-onset depression post-CHD diagnosis have worse outcomes than do those who had previous or recurrent depression. This meta-analysis investiga...
Article
While systematic referral strategies have been shown to significantly increase cardiac rehabilitation (CR) enrollment to approximately 70%, whether utilization rates increase among patient groups who are traditionally underrepresented has yet to be established. This study compared CR utilization based on age, marital status, rurality, socioeconomic...
Article
Full-text available
Cardiac rehabilitation (CR) participation results in significant health benefits. However, there is wide variation in program duration, and little is known about the optimal duration of CR for patient outcomes. The objective of this study was to compare quality of life (QoL) of patients who participated in CR programs of < or ≥6 months duration ver...
Article
The purpose of this study was to review the current evidence regarding the relationship between geographic indicators and cardiac rehabilitation (CR) utilization among coronary heart disease (CHD) patients. Seventeen articles were identified for inclusion, where nine studies assessed rurality, 10 studies assessed travel time/distance, and two of th...
Article
Full-text available
This study evaluated the sociodemographic, clinical and behavioral correlates of post-traumatic growth (PTG) in coronary artery disease (CAD) patients, and the degree of PTG compared to other patient groups. Using a prospective design, 1497 CAD outpatients completed a survey assessing potential PTG correlates. A total of 1268 responded to a nine-mo...
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Full-text available
Recent research has reported an association between in-hospital depression and poorer long-term prognosis and a greater risk of in-hospital complications. The purpose of the current study was to examine the relationship between past and incident depressive symptoms and in-hospital complications in acute coronary syndrome (ACS) inpatients. A group o...
Article
People of South-Asian origin have an increased prevalence of coronary artery disease. Although cardiac rehabilitation (CR) is effective, South Asians are among the least likely people to participate in these programs. Automatic referral increases CR use and may reduce access inequalities. This study qualitatively explored whether CR referral knowle...
Article
Full-text available
Despite recommendations in clinical practice guidelines, evidence suggests that utilization of cardiac rehabilitation (CR) following indicated cardiac events is low. Referral strategies, such as automatic referral, have been advocated to improve CR utilization. In this Review, we evaluate the effects of referral strategies on rates of CR referral a...
Article
Background: Despite potential bias, researchers often rely on patient self-reported data of health care use. However, the validity and accuracy of self-reported data on cardiac rehabilitation (CR) use are unknown. Objective: To assess the concordance between patient self-report and site-verified CR referral, enrollment and participation. Method...
Article
Over one-third of cardiac patients practice Mind-Body Therapy (MBT), particularly women. Considering women are less likely to engage in conventional physical activity, few studies have examined why MBT is well-accepted by women. To qualitatively explore gender differences in the motivations for, and perceived effects of MBT, and the inter-relations...
Article
While the benefits of mind-body therapy (MBT) for cardiac secondary prevention continues to be investigated, the prevalence of such practices by cardiac patients is not well known. The aim of this study was to quantitatively examine the prevalence of MBT practice and its sociodemographic, clinical, psychosocial and behavioral correlates among patie...
Article
Objective: The purpose of this study was to investigate the factor structure and psychometric properties of the Cardiac Rehabilitation Barriers Scale (CRBS). Design, setting, and participants: In total, 2636 cardiac inpatients from 11 hospitals completed a survey. One year later, participants completed a follow-up survey, which included the CRBS. A...
Article
Depression has been implicated in the occurrence of recurrent coronary events and cardiac or all-cause mortality in acute coronary syndrome (ACS) patients. The authors describe the frequency and type of antidepressant use and its correlates 18 months after ACS hospital discharge. A sample of 661 ACS inpatients, recruited from three hospitals, compl...
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Full-text available
This longitudinal study examined exercise behavior patterns (i.e., maintainers, irregular, and inactive) in cardiac patients, and investigated the sociodemographic, clinical, psychosocial, and environmental correlates of exercise patterns. A total of 661 cardiac in-patients from three hospitals consented to participate (75% response rate) and were...
Article
Full-text available
Qigong meditation is an ancient form of meditation that has been linked with various health benefits. We were interested in whether or not this form of meditation has a relationship with personality. To this end, we administered the Eysenck Personality Inventory (EPI) to eighty Qigong meditation practitioners and seventy-four non-practitioners. The...

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