Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun:11:e2400474.
doi: 10.1200/GO-24-00474. Epub 2025 Jun 18.

Baseline Distress and Effectiveness of Survivor Video Narratives on Cancer-Associated Distress in Botswana: A Pilot Study

Yehoda M Martei  1 , Maanasa Gurram  2 , Lebogang T Mokokwe  3   4 , Ngwao Ngwako  4 , Keaobaka Kebuang  5 , Dipho I Setlhako  5 , Peter Vuylsteke  4 , Baaitse Bontswanetse  5 , Tumisang Segadimo  5 , Mosepele Mosepele  4 , Lawrence N Shulman  1 , Frances Barg  6 , Babe E Gaolebale  5
Affiliations

Baseline Distress and Effectiveness of Survivor Video Narratives on Cancer-Associated Distress in Botswana: A Pilot Study

Yehoda M Martei et al. JCO Glob Oncol. 2025 Jun.

Abstract

Purpose: To evaluate baseline distress among patients with breast cancer in Botswana, and assess the impact of culturally tailored peer survivor video narratives on distress and its mediators.

Methods: We enrolled patients with stage I-IV breast cancer at Princess Marina Hospital. A Setswana-translated National Comprehensive Cancer Network distress thermometer (DT) and problem list (PL) were used for distress screening. DT score of ≥4 was considered a positive screen for moderate to high (moderate-high) distress. We analyzed independent PL factors associated with moderate-high distress using logistic regression. Participants then watched one to two videos and completed a postintervention DT/PL assessment after each video at 4 and 8 weeks. We conducted descriptive statistics to explore the impact of the videos.

Results: One hundred six participants were enrolled, of whom 103 completed baseline DT and 106 completed baseline PL. Sixty-seven percent (69/103) of participants screened positive for moderate-high distress at baseline. Fear (odds ratio [OR], 11.25 [95% CI, 1.66 to 76.49]; P = .01) and appearance (OR, 4.96 [95% CI, 1.03 to 23.80]; P = .046) were PL factors significantly associated with moderate-high distress in the multivariable model. Sixty-eight and 47 participants completed postvideo assessments at approximately 4 and approximately 8 weeks, respectively. The greatest impact was observed at 8 weeks after watching two videos-29.8% of participants with moderate-high distress had no or mild distress. Similarly, there was a 29% (44%-15%; P = .005) and 17% (32%-15%; P = .03) absolute decrease from baseline to 8 weeks, in the proportion of patients who identified fear and appearance as sources of distress, respectively.

Conclusion: Two thirds of patients with breast cancer screened positive for moderate-high distress. Fear and appearance were sources of distress significantly associated with a positive screen. Our results show promising potential of peer survivor videos to mitigate distress and its potential mediators among patients with breast cancer.

PubMed Disclaimer

Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

Lawrence N. Shulman

Consulting or Advisory Role: Genentech

No other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
Patient flow diagram showing the number of participants enrolled at baseline and the number of participants who completed interval DT and PL assessments after the video interventions. DT, distress thermometer; NCCN, National Comprehensive Cancer Network; PL, problem list.
FIG 2
FIG 2
Frequency of problems identified by >25% of participants enrolled.
FIG 3
FIG 3
Impact of survivor video narratives on proportion of patients who selected fear and appearance as sources of distress at baseline, and at 4 and 8 weeks (after video intervention).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Dinapoli L, Colloca G, Di Capua B, et al. : Psychological aspects to consider in breast cancer diagnosis and treatment. Curr Oncol Rep 23:38, 2021 - PMC - PubMed
    1. Coughlin SS, Ayyala DN, Tingen MS, et al. : Financial distress among breast cancer survivors. Curr Cancer Rep 2:48-53, 2020 - PMC - PubMed
    1. Negussie F, Giru BW, Yusuf NT, et al. : Psychological distress and associated factors among cancer patients in public hospitals, Addis Ababa, Ethiopia: A cross-sectional study. BMC Psychol 11:41, 2023 - PMC - PubMed
    1. Okeke B, Hillmon C, Jones J, et al. : The relationship of social determinants and distress in newly diagnosed cancer patients. Sci Rep 13:2153, 2023 - PMC - PubMed
    1. Hamilton J, Kruse H, Holcomb L, et al. : Distress and psychosocial needs: Demographic predictors of clinical distress after a diagnosis of cancer. Clin J Oncol Nurs 22:390-397, 2018 - PubMed