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Brédart A, Kop JL, Depauw A, Caron O, Sultan S, Leblond D, Fajac A, Buecher B, Gauthier-Villars M, Noguès C, Flahault C, Stoppa-Lyonnet D, Dolbeault S. Short-term psychological impact of the BRCA1/2 test result in women with breast cancer according to their perceived probability of genetic predisposition to cancer. Br J Cancer 2013; 108:1012-20. [PMID: 23462725 PMCID: PMC3619058 DOI: 10.1038/bjc.2012.599] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: The effect of BRCA1/2 gene test result on anxiety, depression, cancer-related thought intrusion or avoidance and perceived control over cancer risk was assessed in breast cancer (BC) patients, according to their perceived probability of genetic predisposition to cancer. Methods: Two hundred and forty-three (89% response rate) women with BC completed questionnaires after an initial genetic counselling visit (T1), of which 180 (66%) completed questionnaires again after receiving the BRCA1/2 results (T2). The discrepancy between women's perceived probability of cancer genetic predisposition at T1 and the geneticist's computed estimates was assessed. Results: In all, 74% of women received a negative uninformative (NU), 11% a positive BRCA1/2 and 15% an unclassified variant (UV) result. On hierarchical regression analysis, in women with a positive BRCA1/2 result (vs NU or UV), a lower perceived probability of cancer genetic predisposition than objective estimates at T1 predicted lower levels of anxiety at T2 (β=−0.28; P<0.01), whereas in women receiving a UV result (vs NU or positive BRCA1/2), a lower perceived probability of cancer genetic predisposition than objective estimates at T1 predicted higher levels of anxiety (β=0.20; P<0.01), depression (β=0.19; P<0.05) and intrusion (β=0.18; P<0.05) at T2. Conclusion: The type of BRCA1/2 test result differently affects distress according to women's perceived probability of genetic predisposition before testing.
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Dauchy S, Ellien F, Lesieur A, Bezy O, Boinon D, Chabrier M, Charles C, Dolbeault S, Joly F, Heuguerot A, Lemaitre L, Machavoine JL, Marx E, Marx G, Piollet-Calmette I, Pucheu S, Reich M, Seigneur E. Quelle prise en charge psychologique dans l’après-cancer ? PSYCHO-ONCOLOGIE 2013. [DOI: 10.1007/s11839-013-0409-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Fasse L, Flahault C, Brédart A, Dolbeault S, Sultan S. Deuil et vulnérabilité psychique chez les personnes âgées. PSYCHO-ONCOLOGIE 2012. [DOI: 10.1007/s11839-012-0395-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Zimmers S, Brédart A, Dolbeault S. [Psychological support for women after breast cancer]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2012:50-52. [PMID: 22730889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Mastectomy in the context of breast cancer treatment, with or without reconstruction, makes the women confront the experience of serious disease. Psychological support, from the announcement of the diagnosis, through to the postoperative period, enables some women to accept more easily the disease and the physical changes.
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Hequet D, Zarca K, Dolbeault S, Couturaud B, Reyal F, De La Rochefordiere A, Sigal B, Asselain B, Hajage D, Alran S. 491 Medical and Personal Reasons of No Breast Reconstruction After Mastectomy – Results in 1937 Breast Cancer Patients with 70% of No Reconstruction in a Single Cancer Institute. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70556-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Brédart A, Kop JL, Fall M, Pelissier S, Simondi C, Dolbeault S, Livartowski A, Tardivon A. Perception of care and experience of examination in women at risk of breast cancer undergoing intensive surveillance by standard imaging with or without MRI. PATIENT EDUCATION AND COUNSELING 2012; 86:405-413. [PMID: 21795009 DOI: 10.1016/j.pec.2011.06.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 05/11/2011] [Accepted: 06/28/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Intensive surveillance in women at breast cancer risk is currently investigated in a French prospective, non-randomized, multicenter study, in which standard imaging--mammography±ultrasound ('Mx') and standard imaging combined with magnetic resonance imaging ('MRI') are compared with regard to perception of care and examination experience. METHODS 1561 women were invited to complete the STAI-State Anxiety Inventory and breast cancer risk perception items at baseline (T0), and MGQ (MammoGraphy Questionnaire) and MRI discomfort items within 2 days after examinations (T1). RESULTS Baseline compliance was high (>91%). Women from the 'MRI' group were significantly younger and displayed higher education level and risk perception. MRI discomfort related to the duration, immobility, prone position or noise was experienced by more than 20% of women. In multivariate analyses, 'MRI' was associated with more favorable examination psychological experience (p≤.001), especially in women younger than 50; baseline STAI-State anxiety was associated with lower MGQ scores (p≤.001) and higher MRI discomfort (p≤.001). CONCLUSION In spite of the discomfort experienced with MRI, perception of care and experience with this surveillance procedure was more positive than with standard imaging. PRACTICE IMPLICATIONS Information and support may assuage some of the adverse effects of an uncomfortable examination technique.
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Lelorain S, Brédart A, Dolbeault S, Sultan S. A systematic review of the associations between empathy measures and patient outcomes in cancer care. Psychooncology 2012; 21:1255-64. [PMID: 22238060 DOI: 10.1002/pon.2115] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 11/21/2011] [Accepted: 11/23/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Despite a call for empathy in medical settings, little is known about the effects of the empathy of health care professionals on patient outcomes. This review investigates the links between physicians' or nurses' empathy and patient outcomes in oncology. METHOD With the use of multiple databases, a systematic search was performed using a combination of terms and subject headings of empathy or perspective taking or clinician-patient communication, oncology or end-of-life setting and physicians or nurses. Among the 394 hits returned, 39 studies met the inclusion criteria of a quantitative measure of empathy or empathy-related constructs linked to patient outcomes. RESULTS Empathy was mainly evaluated using patient self-reports and verbal interaction coding. Investigated outcomes were mainly proximal patient satisfaction and psychological adjustment. Clinicians' empathy was related to higher patient satisfaction and lower distress in retrospective studies and when the measure was patient-reported. Coding systems yielded divergent conclusions. Empathy was not related to patient empowerment (e.g. medical knowledge, coping). CONCLUSION Overall, clinicians' empathy has beneficial effects according to patient perceptions. However, in order to disentangle components of the benefits of empathy and provide professionals with concrete advice, future research should apply different empathy assessment approaches simultaneously, including a perspective-taking task on patients' expectations and needs at precise moments. Indeed, clinicians' understanding of patients' perspectives is the core component of medical empathy, but it is often assessed only from the patient's point of view. Clinicians' evaluations of patients' perspectives should be studied and compared with patients' reports so that problematic gaps between the two perspectives can be addressed.
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Brédart A, Kop JL, Fall M, Pelissier S, Simondi C, Dolbeault S, Livartowski A, Tardivon A. Anxiety and specific distress in women at intermediate and high risk of breast cancer before and after surveillance by magnetic resonance imaging and mammography versus standard mammography. Psychooncology 2011; 21:1185-94. [DOI: 10.1002/pon.2025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 05/20/2011] [Accepted: 05/21/2011] [Indexed: 11/10/2022]
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Dolbeault S, Boistard B, Meuric J, Copel L, Brédart A. Screening for distress and supportive care needs during the initial phase of the care process: a qualitative description of a clinical pilot experiment in a French cancer center. Psychooncology 2011; 20:585-93. [DOI: 10.1002/pon.1946] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Revised: 12/14/2010] [Accepted: 02/04/2011] [Indexed: 11/10/2022]
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Dolbeault S, Flahault C, Baffie A, Fromantin I. Psychological profile of patients with neglected malignant wounds: a qualitative exploratory study. J Wound Care 2010; 19:513-4, 516, 518-21. [DOI: 10.12968/jowc.2010.19.12.513] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Brédart A, Dolbeault S, Savignoni A, Besancenet C, This P, Flahault C, Falcou MC, Asselain B, Copel L. Session 3: Prévalence des difficultés sexuelles après le traitement d'un cancer du sein non métastatique et facteurs associés : une étude exploratoire réalisée à l'Institut Curie. Bull Cancer 2010. [DOI: 10.1016/s0007-4551(15)30912-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dolbeault S, Brédart A, Cayrou S. Groupes psycho-éducationnels à destination de patients atteints de cancer: quels fondements, quels objectifs, quel format en pratique ? PSYCHO-ONCOLOGIE 2010. [DOI: 10.1007/s11839-010-0266-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Brédart A, Dolbeault S, Savignoni A, Besancenet C, This P, Giami A, Michaels S, Flahault C, Falcou MC, Asselain B, Copel L. Prevalence and associated factors of sexual problems after early-stage breast cancer treatment: results of a French exploratory survey. Psychooncology 2010; 20:841-50. [PMID: 20568085 DOI: 10.1002/pon.1789] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 05/05/2010] [Accepted: 05/10/2010] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The objective of this study was to assess the prevalence and associated factors of sexual activity, sexual problems or sexual satisfaction in French early-stage breast cancer survivors (BCS). METHODS Eight hundred and fifty eligible, post-treatment (6 months-5 years) female patients, aged 18-70 years, randomly selected from a consultation list, were invited to fill in questionnaires exploring quality of life (EORTC QLQ-C30 and QLQ-BR23), body image scale, and sexuality (Sexual Activity Questionnaire-SAQ; Relationship and Sexuality Scale; French Sexual Behaviour Survey-CSF). RESULTS Fifty-three percent of BCS agreed to participate. Participating women (n=378) were younger, more often premenopausal at diagnosis and with a more recent diagnosis than non-respondents. The prevalence of sexual problems was significantly higher in BCS compared with adjusted data from a French female representative sample (p<0.0001). In logistic regression, no sexual activity (R(2) =0.37) or sexual dissatisfaction (R(2) =0.28) were associated with the feeling of emotional separation in the couple or of partner's fear of sexual intercourse, lower emotional functioning, poorer body image, or co-morbidities. In sexually active women (71% of respondents), lower frequency of sexual activity (R(2) =0.26), lower sexual pleasure (R(2) =0.22), or higher sexual discomfort (R(2) =0.22) were associated with the feeling of emotional separation in the couple or of partner's fear of sexual intercourse, lower emotional functioning, age (>50 years), nausea, or insomnia (all Hosmer-Lemeshow tests: p=NS). CONCLUSIONS Psychological factors including the perception of the couple relationship appeared prominent in BCS women's experience of sexual problems.
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Dolbeault S, Cayrou S, Brédart A, Viala AL, Desclaux B, Saltel P, Gauvain-Piquard A, Hardy P, Dickes P. The effectiveness of a psycho-educational group after early-stage breast cancer treatment: results of a randomized French study. Psychooncology 2009; 18:647-56. [PMID: 19039808 DOI: 10.1002/pon.1440] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Many women with breast cancer need psychological help to cope more effectively after treatment. Cognitive and behavioural techniques are not yet well established in France. A multi-site randomized study was conducted to evaluate the effects of a psycho-educational group intervention in this population. METHODS Two hundred and three patients, recruited after primary treatment, were randomly assigned either to a treatment group (psycho-educational intervention) or to a waiting-list control group. The 8-week programme of 2 h sessions comprised of thematic discussions, information and training in stress management techniques. Evaluation at baseline, after 8 sessions, and 1 month after programme completion, included evaluations using the STAI, POMS, MAC, EORTC QLQ-C30 and EORTC QLQ-BR23 breast module scales. RESULTS We observed a significant reduction in anxiety (STAI, POMS) among group participants, a reduction in anger, depression and fatigue (POMS), a significant improvement in vigor and interpersonal relationships (POMS), in emotional and role functioning, in health status and fatigue level (EORTC QLQ-C30). In contrast, coping strategies (MAC) were not significantly different between groups. No group-related negative effects were observed and the global satisfaction levels were very high. CONCLUSION This study demonstrates the feasibility and effectiveness of a psycho-educational intervention, which can accelerate the reduction of those negative affects which are present at the end of treatment. It represents an excellent complement or an alternative to individual psycho-oncologic therapeutic support, widely proposed in France, and should now be tested in groups with other types of cancer and at other disease phases.
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Brédart A, Dolbeault S, Savignoni A, Simard S, Gomme S, Asselain B, Copel L. Pilot evaluation of a French interdisciplinary supportive care department. Support Care Cancer 2009; 17:1507-16. [PMID: 19343371 DOI: 10.1007/s00520-009-0617-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Accepted: 03/15/2009] [Indexed: 12/30/2022]
Abstract
PURPOSE OF THE STUDY This pilot study was designed to evaluate the impact of management by the Interdisciplinary Supportive Care Department for Cancer Patients (Département Interdisciplinaire de Soins de Support pour le Patient en Oncologie-DISSPO) at the Institut Curie in Paris, France on patient quality of life and satisfaction with care. MATERIALS AND METHODS Patients hospitalised for cancer treatment and referred to DISSPO during their hospitalisation were invited to complete the European Organization for Research and Treatment of Cancer core quality of life (EORTC QLQ-C30) and patient satisfaction (EORTC IN-PATSAT32) questionnaires during the week following their initial management by DISSPO (T0) and 2 months later (T1). These patients were compared with control patients matched for age, gender, ward and period of hospitalisation in terms of quality of life and satisfaction with care. MAIN RESULTS One hundred fourteen (77%) DISSPO patients at T0 and 72 (48%) patients at T1 and 102 (89%) control patients at T0 and 66 (57%) at T1 returned their completed questionnaires. Baseline characteristics of DISSPO patients and control patients were significantly different in terms of duration of the current hospitalisation, interval between the date of diagnosis of the cancer and inclusion in the study (both longer for DISSPO patients) and Karnofsky performance status (lower for DISSPO patients). For the 43 pairs of patients who completed the questionnaires at the two time points, significant independent positive effects of management by DISSPO and age (less than or equal to 60 years) were demonstrated for patient satisfaction in relation to the availability of the nursing and paramedical team. In particular, patients over the age of 60 not managed by DISSPO presented a significant reduction of patient satisfaction scores over the 2 months compared to age-matched patients managed by DISSPO. CONCLUSIONS Management of cancer patients by an interdisciplinary supportive care department appears to have a positive impact on patient satisfaction in relation to availability of the nursing and paramedical team. These results need to be confirmed in a larger study.
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Ollivier L, Dolbeault S, Leclère J, Neuenschwander S. Améliorer la prise en charge des patients dans les services d’imagerie médicale en oncologie. PSYCHO-ONCOLOGIE 2008. [DOI: 10.1007/s11839-008-0066-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pivot X, Rixe O, Morere J, Coscas Y, Cals L, Namer M, Serin D, Dolbeault S, Eisinger F, Roussel C, Blay J. Breast cancer screening in France: results of the EDIFICE survey. Int J Med Sci 2008; 5:106-12. [PMID: 18566655 PMCID: PMC2407526 DOI: 10.7150/ijms.5.106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 05/23/2008] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The EDIFICE survey aimed to investigate the compliance of the general population to the screening tests available in France for the 4 most common cancers: breast, colorectal, prostate and lung. Implementation of breast cancer screening has been generalized in France since 2003: women aged between 50 and 74 years are systematically invited to perform a mammography every second year. Results pertaining to breast cancer are reported hereafter. METHODS This nationwide observational survey was carried out in France from 18 January to 2 February 2005 among representative samples of 773 women aged between 40 and 75 years and 600 general practitioners (GPs). Information collected included socio-demographic characteristics, attitude towards cancer screening and actual experience of cancer screening, as well as GPs' practice regarding screening. The precision of the results is +/- 4.3% for a 95% confidence interval. RESULTS Among the 507 participating women aged between 50 and 74 years, 92.5% (469/507) had undergone at least one mammography: 54.6% (256/469) underwent this test on their own initiative and 44.6% (209/469) of women performed it in the framework of a systematic screening plan. Most women participating in the systematic screening (89.0% i.e. 186/209) had a mammography within the last dating from less than 2 years versus 73.8% (189/256) of those who performed it outside the screening program (Chi(2) test; p<0.01). Interestingly, 422 women (61.9% i.e. 422/682 women aged between 40-75 years with at least one mammography) had performed a mammography before the recommended age for screening. There was a significant correlation (p = 0.009) between the existence of a first mammography before 50 years of age and subsequent screening on women's own initiative (54.6% of 469 screened women). Main reasons for not performing the screening test every second year (77 women aged between 50-74 years) included: feeling unconcerned and/or unmotivated (p = 0.0001), no cancer anxiety (p = 0.020) and no recommendation by the GP (p = 0.015); Of the 600 participating GPs, 68.6% (412/600) systematically recommended a mammography to their patients. GPs' perceptions of the reasons for women's avoidance of the screening test were unwillingness to be aware of mammography results (44.4% - 266/600) and the belief that mammography was painful (52.5% - 315/600). CONCLUSION The main result of the EDIFICE survey is the high rate of women's attendance at mammography screening. The EDIFICE survey pointed out that systematic and organized screening played a major role in the regularity of screening tests for breast cancer every second year. GPs and gynaecologist are key actors in heightening public awareness.
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Eisinger F, Cals L, Calazel-Benque A, Blay JY, Coscas Y, Dolbeault S, Namer M, Pivot X, Rixe O, Serin D, Roussel C, Morère JF. Impact of organised programs on colorectal cancer screening. BMC Cancer 2008; 8:104. [PMID: 18412950 PMCID: PMC2373301 DOI: 10.1186/1471-2407-8-104] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Accepted: 04/15/2008] [Indexed: 11/14/2022] Open
Abstract
Purpose Colorectal cancer (CRC) screening has been shown to decrease CRC mortality. Organised mass screening programs are being implemented in France. Its perception in the general population and by general practitioners is not well known. Methods Two nationwide observational telephone surveys were conducted in early 2005. First among a representative sample of subjects living in France and aged between 50 and 74 years that covered both geographical departments with and without implemented screening services. Second among General Practionners (Gps). Descriptive and multiple logistic regression was carried out. Results Twenty-five percent of the persons(N = 1509) reported having undergone at least one CRC screening, 18% of the 600 interviewed GPs reported recommending a screening test for CRC systematically to their patients aged 50–74 years. The odds ratio (OR) of having undergone a screening test using FOBT was 3.91 (95% CI: 2.49–6.16) for those living in organised departments (referent group living in departments without organised screening), almost twice as high as impact educational level (OR = 2.03; 95% CI: 1.19–3.47). Conclusion CRC screening is improved in geographical departments where it is organised by health authorities. In France, an organised screening programs decrease inequalities for CRC screening.
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Eisinger F, Blay JY, Morère JF, Rixe O, Calazel-Benque A, Cals L, Coscas Y, Dolbeault S, Namer M, Serin D, Roussel C, Pivot X. Cancer screening in France: subjects' and physicians' attitudes. Cancer Causes Control 2007; 19:431-4. [PMID: 18085414 PMCID: PMC2323031 DOI: 10.1007/s10552-007-9102-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 12/05/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Since screening for cancer has been advocated, funded, and promoted in France, it is important to evaluate the attitudes of subjects in the general population and general practitioners (GPs) toward cancer screening strategies. METHODS EDIFICE is a nationwide opinion poll that was carried out by telephone among a representative sample of 1,504 subjects living in France and aged between 40 and 75 years and among a representative sample of 600 GPs. The questionnaire administered to subjects queried about previous screening for cancer. RESULTS Ninety-three percent of women stated that they had undergone at least one mammography. Although rated "A" recommendation-strongly recommended-by the US Preventive Services Task Force, screening for colorectal cancer received less attention than prostate cancer screening which is rated "I"-insufficient evidence-(reported screening rates of 25% and 36%, respectively). Six percent of subjects stated that they had undergone lung cancer screening. GPs' attitudes toward cancer screening showed similar inconsistencies. CONCLUSIONS It thus appears that understanding of cancer screening practices in the French general population does not match scientific evidence. To a lesser extent, this also holds for GPs.
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Adam V, Brédart A, Didier F, Dolbeault S, Oppenheim D, Reich M, Scaffidi E, Seigneur E. 8e Congrès mondial de psycho-oncologie, du 16 au 21 octobre 2006. Oncologie psychosociale multidisciplinaire: dialogue et interaction. PSYCHO-ONCOLOGIE 2007. [DOI: 10.1007/s11839-007-0022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Machavoine JL, Bonnet V, Leichtnam-Dugarin L, Dolbeault S, Marx E, Dauchy S, Flahault C, Bendrihen N, Pelicier N, Syp L, Pérennec ME, Dilhuydy JM, Marx G, Chaussumier C, Brusco S, Carretier J, Delavigne V, Fervers B, Philip T. [Psychological aspects of cancer Information dedicated to patients and relatives]. Bull Cancer 2007; 94:203-11. [PMID: 17338095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
In response to the evolution of the information-seeking behaviour of patients and concerns from health professionals regarding cancer patient information, the French National Federation of Comprehensive Cancer Centres (FNCLCC) introduced, in 1998, an information and education program dedicated to patients and relatives, the SOR SAVOIR PATIENT program (SSP). The methodology of this program adheres to established quality criteria regarding the elaboration of patient information. Cancer patient information, developed in this program, is based on clinical practice guidelines produced by the FNCLCC and the twenty French cancer centres, the National League against Cancer, The National Cancer Institute, the French Hospital Federation, the National Oncology Federation of Regional and University Hospitals, the French Oncology Federation of General Hospitals, many learned societies, as well as an active participation of patients, former patients and caregivers. The information and dialogue handbook SOR SAVOIR PATIENT Vivre pendant et après un cancer reporting on the psychological aspects of cancer was worked out and published on the Web in 2005. The guide aims to provide cancer patients with support and advice about the psychological impact of the disease. It provides information on the possible personal consequences of the disease and treatments, in every domain: psychological, emotional, interpersonal, familial or professional. Patients are also advised of the emotional challenges associated with cancer, of the support they may expect at every stage of the disease, from diagnosis to treatment, and of psychological outcome after the disease is over. The document also provides healthcare professionals with a valuable, concise source of validated information on the psychological aspects of cancer, thus facilitating communication between carers and patients. Information provided in the present article has been selected from the information and dialogue handbook SOR SAVOIR PATIENT Vivre pendant et après un cancer. The document addresses the issue of the psychological support made available to the patients during and after the disease. The SOR SAVOIR PATIENT guide can be downloaded from the FNCLCC website at: http://www.fnclcc.fr
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This P, de la Rochefordière A, Bredart A, Asselain B, Poinsot R, Dolbeault S, Sigal-Zafrani B. Quality of Life in a Randomized Control Trial? Comments Concerning MA 17. J Clin Oncol 2006; 24:4038; author reply 4038-9. [PMID: 16921063 DOI: 10.1200/jco.2005.05.1987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tran M, Raynard B, Bataillard A, Duguet A, Garabige V, Lallemand Y, Meuric J, Rossignol G, Schneider S, Simon M, Bachmann P, Nitenberg G, Combret D, Piquet MA, Arnaud-Battandier F, Bredeau O, Petit F, Triqueneau O, Dolbeault S, Bonnet-Pommatau L. [Standards, Options and Recommendations 2005 for a good practice in enteral nutrition in oncology (summary report.)]. Bull Cancer 2006; 93:715-22. [PMID: 16886237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
CONTEXT The "Standards, Options and Recommendations" (SOR) project, which started in 1993, is a collaboration between the French Federation of Cancer Centers (FNCLCC), the 20 French Regional Cancer Centers, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. OBJECTIVE To develop good practice guidelines for a good practice of enteral nutrition in oncology, in collaboration with three French learned societies involved in this area. METHOD The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts who define the CPGs according to the definitions of the Standards, Options and Recommendations project. Once the guideline has been defined, the document is submitted for review by independent reviewers. RESULTS The good practices suggested in the document approach seven topics: indications and counter-indications, conditions of the installation of the enteral nutrition, monitoring, prevention of complications, education of the patient, specificities of enteral nutrition in children and at home. In the setting of enteral nutrition, feeding tubes, type of insertion, enteral nutrition products, material and techniques of administration are described as well as the criteria permitting their selection.
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Leclère J, Ollivier L, Dolbeault S, Neuenschwander S. [Communication between radiologist and cancer patients]. ACTA ACUST UNITED AC 2006; 87:99-104. [PMID: 16484930 DOI: 10.1016/s0221-0363(06)73978-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Along with advances in medicine and social evolution, we are seeing an increase in the number of patients afflicted with cancer, and a change in the doctor-patient relationship. Patients' rights are now registered in the Hospitalised Patient's Charter, the Huriet Act and the Act of March 4, 2002. The evolution in cancer diseases is monitored by a range of imaging examinations, putting the radiologist in the front line. Lesions are typically first detected by the radiologist. This task is complicated by the fact that radiologists usually have no formal training with regards to the disclosure of cancer diagnoses to patients. There is a great risk of inappropriate responses which can have a profoundly damaging effect on the patient's state of mind. Even if we have the best of ideals and intentions, there is a great need for us to examine and improve our modes of interaction, in dealing with the patient's need for information. The radiologist possesses technical know-how, but technique alone is not enough - the right amount of information, based on clinical competence, is required; but so is empathy towards the patient, and respect for his or her wishes and rights.
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Poinsot R, Altmeyer A, Conroy T, Savignoni A, Asselain B, Léonard I, Marx E, Cosquer M, Sévellec M, Gledhill J, Rodary C, Mercier M, Dickès P, Fabbro M, Antoine P, Guerif S, Schraub S, Dolbeault S, Brédart A. [Multisite validation study of questionnaire assessing out-patient satisfaction with care questionnaire in ambulatory chemotherapy or radiotherapy treatment]. Bull Cancer 2006; 93:315-27. [PMID: 16567319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2005] [Accepted: 11/17/2005] [Indexed: 05/08/2023]
Abstract
Patient satisfaction is now recognised as an important quality of care outcome which is particularly relevant in oncology. Adapted from the EORTC In-Patsat32, the Out-Patsat35 is a 35-item satisfaction with care questionnaire measuring cancer outpatients' perception of hospital doctors and nurses, as well as aspects of care organisation and services. This study assessed the psychometric properties of this scale. Patients undergoing ambulatory chemotherapy (CT) or radiotherapy (RT) in 7 cancer centres in France were invited to complete at home the Out-Patsat35 as well as EORTC QLQ-C30 for psychometric testing. Of 416 eligible patients recruited, 96% returned the questionnaire. Most patients (71% in CT; 69% in RT) completed this scale within 15 minutes and the mean rate of item omission was only 4.4%. Confirmatory analyses revealed good convergent validity and excellent internal consistency, although some subscales within the Out-Patsat35 were relatively highly correlated. Items and subscales of the Out-Patsat35 and of the QLQ-C30 were not significantly correlated, underlying that the two questionnaires are assessing quite distinct concepts. The subscales of the Out-Patsat35 were not related to age, gender and education, suggesting a cultural evolution in French cancer patients towards a greater homogeneity in their opinion toward care. This study supports the acceptability to patients, and the psychometric properties of the EORTC Out-Patsat35 questionnaire.
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76
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Dolbeault S, Flahault C, Stoppa-Lyonnet D, Brédart A. Communication in genetic counselling for breast/ovarian cancer. Recent Results Cancer Res 2006; 168:23-36. [PMID: 17073189 DOI: 10.1007/3-540-30758-3_3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Cancer genetic counselling represents a very special situation of interaction between the geneticist and the counselee, marked by a number of specificities that account for its complexity. Cancer genetic counselling has multiple repercussions, such as identification of a deleterious genetic mutation associated with a high probability of developing breast and/or ovarian cancer, the implementation of preventive measures ranging from close surveillance to the decision to perform mutilating prophylactic surgical procedures, or the impact of the information on the other members of the counselee's family also concerned by the genetic risk. This chapter is based on a review of the literature that has been rapidly growing over recent years and on our clinical expertise as psycho-oncologists and geneticists. We will first present the reasons that make the information so critical. These reasons are both objective (complexity of the genetic information per se, difficulties of understanding the concept of risk) and subjective (information given to people with an emotionally charged family history and a perception of risks closely linked to their representation of cancer). At the same time, the counsellees are charged with the transmission of this information to members of their own family. We will then discuss the various modalities of communication in this setting. While unidirectional transfer of information from the geneticist to the counselee has been the preferred method in cancer genetics for a long time, a model based on patient-centered communication is more adequate in predictive medicine and allows shared decision making. In all cases, the different professionals involved in the process have to learn how to work in a performing cohesion. We also present the main guidelines on the subject and the various underlying objectives with regard to information delivery and the subject's personal experience. Although the psychological impact of genetic counselling consultations raises a number of questions, the results of preliminary studies are reassuring, demonstrating psychological benefits. However, a number of aspects concerning communication in predictive medicine remain to be investigated and improved.
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Abstract
PURPOSE OF REVIEW This review summarises current knowledge on the impact on patient satisfaction of initiatives undertaken to enhance the communication between doctors and their patients in oncology. RECENT FINDINGS Recent studies have assessed the effectiveness of different approaches aimed at improving doctor-patient communication in oncology. These have been assessed on outcomes related to the patient (e.g., anxiety, quality of life, medical knowledge, satisfaction) or to the doctor (e.g., communication behaviour, attitudes). Patient satisfaction has been recognised as a particularly relevant outcome, and a positive effect of recent initiatives to improve the interaction between cancer patients and their doctors on patient satisfaction has been suggested. SUMMARY To better respond to cancer patients' health care needs, various strategies focusing on doctor-patient communication have been developed. Addressing patients' overall needs and sharing complex information in an emotionally charged context and under time constraints is a daily challenge for the oncology clinician, resulting often in cancer patients' dissatisfaction. Recent interventions elaborated to facilitate doctor-patient communication in oncology focus on patients, such as handing out of videos or written preparatory information; on doctors, such as patients' self-rating feedback to doctors or communication skills trainings; or on both, such as the audiotaping of the consultation or the provision of decision aids. Although these strategies offer promising results, further research should be implemented to assess their appropriateness across sociocultural contexts and their long-term effectiveness in clinical practice.
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Ollivier L, Leclère J, Dolbeault S, Neuenschwander S. Doctor-patient relationship in oncologic radiology. Cancer Imaging 2005; 5 Spec No A:S83-8. [PMID: 16361141 PMCID: PMC1665303 DOI: 10.1102/1470-7330.2005.0025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Progress in medicine and changes in our society have led to an increasing number of patients with cancer and a change in the doctor-patient relationship. Patients rights are now defined in several countries by laws. The course of cancer involves numerous imaging examinations in which the radiologist is primarily involved. It is often the radiologist who discovers abnormalities and who must break the news to the patient. This task is made all the more difficult by the radiologist's lack of specific training in the management of difficult situations such as announcing bad news. There is a high risk of inappropriate responses that can have a seriously damaging effect on the patient's state of mind. Even with the best intentions, it can be very profitable to review and improve our relational modalities and to more effectively meet the patient's increasing demand for information. The radiologist's technical know-how is not sufficient, as he must also be able to give just the right amount of information based on his clinical competence, and his relationship with patients while respecting their wishes and their rights.
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This P, Salmon RJ, Dolbeault S, de la Rochefordière A, Sigal-Zafrani B, Stoppa-Lyonnet D. Hormone replacement therapy after prophylactic adnexectomy. Hered Cancer Clin Pract 2005; 3:181-2. [PMID: 20223046 PMCID: PMC2837062 DOI: 10.1186/1897-4287-3-4-181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2005] [Accepted: 09/25/2005] [Indexed: 11/19/2022] Open
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80
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Brédart A, Mignot V, Rousseau A, Dolbeault S, Beauloye N, Adam V, Elie C, Leonard I, Asselain B, Conroy T. Satisfaction par rapport aux soins en oncologie évaluée par le QLQ-SAT32 de l’EORTC : comparaison entre auto-passation et entretien téléphonique. Rev Epidemiol Sante Publique 2005. [DOI: 10.1016/s0398-7620(05)84756-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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81
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Brédart A, Mignot V, Rousseau A, Dolbeault S, Beauloye N, Adam V, Elie C, Leonard I, Asselain B, Conroy T. [Cancer patient's satisfaction assessment using the EORTC QLQ-SAT32: comparison between self-assessment and interview response]. Rev Epidemiol Sante Publique 2005; 53 Spec No 1:1S31-8. [PMID: 16327738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND For pertinent investigation of patient satisfaction it is important to know what type of data collection procedure yields optimal results. In this study, we compared a self- versus interview administration of the European Organisation for Research and Treatment of Cancer (EORTC) patient satisfaction questionnaire (QLQ-SAT32), noting response and item omission rates. We also assessed the correlation and agreement between responses according to these modalities of questionnaire administration. METHODS 123 patients recruited in two anti-cancer Centers in France were asked to complete the QLQ-SAT32 at home within 2 weeks of hospital discharge and were randomly allocated to participate in a telephone interview-administration of the QLQ-SAT32, either before or after self-completing the QLQ-SAT32. RESULTS 104 patients completed both modalities of questionnaire administration. Agreement proved excellent for the doctors' and nurses' subscales and satisfactory for the services' subscale and the general satisfaction single item. However, a significant difference in response rate showed up between Centers (different interviewers) and the interview modality revealed an item omission rate higher than for the self-administration modality. CONCLUSION Self- and interview-administration of the QLQ-SAT32 provided similar responses however different response rate between interviewers and higher item omission rate in interviews suggests a biasing effect of that modality of data collection.
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Cayrou S, Desclaux B, Guillerd P, Tanneau E, Heim F, Saltel P, Gauvain-Piquard A, Dolbeault S. Groupes psycho-éducationnels pour femmes atteintes de cancers du sein en France : thèmes et techniques. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/s1155-1704(05)81207-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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83
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Dauchy S, Dolbeault S, Marx G, Kimmel F, Pelicier N. [Evaluation of cancer treatments: What is its psychosocial impact?]. Bull Cancer 2005; 92:286-90. [PMID: 15820924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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85
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Ollivier L, Guex P, Leclère J, Dolbeault S, Neuenschwander S. 5221 Dialogue entre le radiologue et le patient atteint d’un cancer. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s0221-0363(04)76727-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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86
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Brédart A, Mignot V, Rousseau A, Dolbeault S, Beauloye N, Adam V, Elie C, Léonard I, Asselain B, Conroy T. Validation of the EORTC QLQ-SAT32 cancer inpatient satisfaction questionnaire by self- versus interview-assessment comparison. PATIENT EDUCATION AND COUNSELING 2004; 54:207-212. [PMID: 15288916 DOI: 10.1016/s0738-3991(03)00210-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2003] [Revised: 06/20/2003] [Accepted: 07/06/2003] [Indexed: 05/24/2023]
Abstract
Doubts are expressed on the validity of patient satisfaction questionnaires. High satisfaction levels are consistently reported. Within the European Organisation for Research and Treatment of Cancer (EORTC) quality of life group, we developed a cancer inpatient satisfaction questionnaire (QLQ-SAT32), adopting several precautions to overcome the ceiling effect commonly reported in satisfaction ratings. Since patients are often more critical when expressing themselves in an interview, in order to study the validity of the QLQ-SAT32, we assessed the agreement between self- and interview-administered QLQ-SAT32 responses. One hundred and twenty three patients were asked to complete the QLQ-SAT32 at home within 2 weeks of hospital discharge and were randomly allocated to participate in a telephone interview-administration of the QLQ-SAT32, either before or after self-completing the QLQ-SAT32. One hundred and four of them completed both modalities of questionnaire administration. Correlation and agreement between self- and interview-administered QLQ-SAT32 ratings were examined, for each subscale and the general satisfaction item of the QLQ-SAT32, using Spearman correlation, intra-class correlation coefficients (ICC) or weighted kappa coefficients. Agreement showed excellent for the doctors' and nurses' subscales and satisfactory for the services' subscale and the general satisfaction single item. The telephone interview-administration modality did not prove an adequate procedure to assess the validity of a patient satisfaction questionnaire.
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Dolbeault S, Laurence V. [Notification of the diagnosis of breast cancer]. LA REVUE DU PRATICIEN 2004; 54:841. [PMID: 15274456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Brédart A, Cayrou S, Dolbeault S. Re: Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J Natl Cancer Inst 2002; 94:1810-1; author reply 1811-2. [PMID: 12464657 DOI: 10.1093/jnci/94.23.1810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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89
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Cayrou S, Dolbeault S. [Development of relaxation techniques in oncology]. Bull Cancer 2002; 89:845-56. [PMID: 12441276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
The aim of this article is to answer a certain number of questions posed by medical staff in oncology concerning relaxation techniques and their implementation in cancer centers. At present, these techniques are underdeveloped in France but are recognized more and more in other countries, as noted by a recent meta-analysis. After having defined the relaxation techniques and their targeted actions, we present a series of studies which evaluated the efficacy of relaxation in various domaines: stress management, management of treatment side effects, and management of advanced cancerous disease symptoms. Relaxation techniques have many advantages, various indications specific to oncology, and few limits for their implementation. Finally, we formulate some questions and suggestions for improving practice and research of this technique in oncology.
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Abstract
This article reviews the development of the subspeciality of psycho-oncology and its contributions to patient care, encouraging more attention to and research into the care of the total patient: the physical, psychological, social and spiritual aspects of care. The result is enhanced quality of life as the patient is studied in the domains of living that are important, extending across the continuum of care from diagnosis to palliative care. In addition, cancer prevention and early detection depends largely on changing attitudes and behaviours that put people at greater risk. This is an important area of research for psycho-oncologists. In the past two decades, research has contributed to our understanding of the psychological responses that accompany a cancer diagnosis. Oncologists better recognise psychological distress and psychiatric disorders such as anxiety, depression and delirium (in hospitalised patients) as frequent comorbid disorders. The development of valid assessment tools for the patients' self-report has been important. Increasingly, outcome measures in controlled trials of new therapies include quality of life, and no longer look at survival alone. The future will continue to bring new challenges to psycho-oncology as patients face new challenges in treatment. A major aim of the next century will be to bring this integrated approach to all patients in an affordable manner.
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Rizzo N, Hispard E, Dolbeault S, Dally S, Leverge R, Girre C. Impact of long-term ethanol consumption on CYP1A2 activity. Clin Pharmacol Ther 1997; 62:505-9. [PMID: 9390106 DOI: 10.1016/s0009-9236(97)90045-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Ethanol is a well-known inducer of CYP2E1; whether or not it is an inducer of other cytochromes has not been investigated systematically. The aim of our study was to evaluate the impact of ethanol consumption on the activity of CYP1A2, which has been shown to be influenced by drugs (inhibited or induced). We evaluated CYP1A2 activity by the ratio of the molar urinary concentrations of the three end products of paraxanthine demethylation of caffeine to the molar concentration of a paraxanthine 8-hydroxylation product. This urinary metabolite ratio has previously been shown to correlate with caffeine clearance. The caffeine metabolites were measured in urine collected during the 3 hours after oral administration of 200 mg caffeine. The caffeine test was performed in 12 smokers (> 25 cigarettes/day) and 12 nonsmokers, all of whom were alcoholic inpatients (daily intake > 100 mg absolute ethanol), within the first 3 days of their hospital stay and after 14 days of abstinence from ethanol. In alcoholic patients who were smokers the molar urinary concentration ratio was 3.14 +/- 0.97 before withdrawal and 4.01 +/- 0.92 after 14 days of abstinence from ethanol. In contrast, in alcoholic patients who were nonsmokers it was 2.62 +/- 0.95 and 2.18 +/- 0.96 before and after withdrawal, respectively. In volunteers who were smokers the molar urinary concentration ratio was 5.02 +/- 1.51, whereas in volunteers who were nonsmokers it was 3.22 +/- 1.46. Our results confirm the well-known induction of CYP1A2 activity by tobacco smoking and show that this induction is masked by long-term ethanol consumption.
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