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Andersson S, Belkić K, Mints M, Östensson E. Is self-sampling to test for high-risk papillomavirus an acceptable option among women who have been treated for high-grade cervical intraepithelial neoplasia? PLoS One 2018; 13:e0199038. [PMID: 29912903 PMCID: PMC6005489 DOI: 10.1371/journal.pone.0199038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/30/2018] [Indexed: 11/25/2022] Open
Abstract
Objective Self-sampling to test for high risk human papilloma virus (HPV) is becoming an increasingly important component of cervical cancer screening. The aim of this observational study is to examine how women treated for high-grade cervical intraepithelial neoplasia (CIN) view HPV self-sampling. Methods Invited to participate in the present study were patients who had undergone treatment of high-grade CIN (grade 2 or higher) and were followed-up at 6-months at the Karolinska University Hospital, Stockholm. The participants were instructed as to how to perform HPV self-sampling. Thereafter, the participants completed a questionnaire about HPV self-sampling and other cervical cancer screening methods, as well as about self-perceived risk of cervical cancer without regular gynecologic follow-up and about specific knowledge regarding HPV, CIN and cervical cancer. Results Altogether 479 women enrolled in this study. The participation rate was 96.6%. Nearly 75% of the participants stated they would consider performing the HPV self-sampling prior to their next gynecologic follow-up. Confidence in HPV self-sampling was a significant independent predictor of willingness to perform HPV self-sampling. However, confidence in HPV self-sampling was significantly lower than confidence in Papanicolaou smears and in HPV testing with samples collected by health professionals. Higher specific knowledge about HPV, CIN and cervical cancer was also a significant independent predictor of willingness to perform HPV self-sampling, as was having travelled longer distance to attend gynecologic follow-up. Participants with lower income and without completed university education expressed significantly higher confidence in HPV self-sampling and lower confidence in Papanicolaou smears than the other women. Conclusions To the best of our knowledge, this is the first study to examine the views of women treated for high-grade CIN vis-à-vis HPV self-sampling. The latter is an acceptable option for the vast majority of this cohort of women.
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Affiliation(s)
- Sonia Andersson
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Karen Belkić
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
- School of Community and Global Health, Claremont Graduate University, Claremont, California, United States of America
- Institute for Prevention Research, Keck School of Medicine, University of Southern California, Alhambra, California, United States of America
| | - Miriam Mints
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Ellinor Östensson
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- * E-mail:
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102
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Battersby NJ, Bouliotis G, Emmertsen KJ, Juul T, Glynne-Jones R, Branagan G, Christensen P, Laurberg S, Moran BJ. Development and external validation of a nomogram and online tool to predict bowel dysfunction following restorative rectal cancer resection: the POLARS score. Gut 2018; 67:688-696. [PMID: 28115491 DOI: 10.1136/gutjnl-2016-312695] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 12/22/2016] [Accepted: 12/28/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Bowel dysfunction is common following a restorative rectal cancer resection, but symptom severity and the degree of quality of life impairment is highly variable. An internationally validated patient-reported outcome measure, Low Anterior Resection Syndrome (LARS) score, now enables these symptoms to be measured. The study purpose was: (1) to develop a model that predicts postoperative bowel function; (2) externally validate the model and (3) incorporate these findings into a nomogram and online tool in order to individualise patient counselling and aid preoperative consent. DESIGN Patients more than 1 year after curative restorative anterior resection (UK, median 54 months; Denmark (DK), 56 months since surgery) were invited to complete The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 version3 (EORTC QLQ-C30 v3), LARS and Wexner incontinence scores. Demographics, tumour characteristics, preoperative/postoperative treatment and surgical procedures were recorded. Using transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines, risk factors for bowel dysfunction were independently assessed by advanced linear regression shrinkage techniques for each dataset (UK:DK). RESULTS Patients in the development (UK, n=463) and validation (DK, n=938) datasets reported mean (SD) LARS scores of 26 (11) and 24 (11), respectively. Key predictive factors for LARS were: age (at surgery); tumour height, total versus partial mesorectal excision, stoma and preoperative radiotherapy, with satisfactory model calibration and a Mallow's Cp of 7.5 and 5.5, respectively. CONCLUSIONS The Pre-Operative LARS score (POLARS) is the first nomogram and online tool to predict bowel dysfunction severity prior to anterior resection. Colorectal surgeons, gastroenterologist and nurse specialists may use POLARS to help patients understand their risk of bowel dysfunction and to preoperatively highlight patients who may require additional postoperative support.
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Affiliation(s)
- Nick J Battersby
- The Pelican Cancer Foundation, The Ark, Basingstoke, Hampshire, UK.,Department of Colorectal and Peritoneal Malignancy Surgery, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK
| | - George Bouliotis
- Department of Clinical Statistics, Imperial College London, London, UK
| | | | - Therese Juul
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Rob Glynne-Jones
- Radiotherapy Department, Mount-Vernon Cancer Centre, Mount-Vernon Hospital, Northwood, UK
| | - Graham Branagan
- Department of Colorectal Surgery, Salisbury NHS Foundation Trust, Salisbury, Wiltshire, UK
| | | | - Søren Laurberg
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Brendan J Moran
- The Pelican Cancer Foundation, The Ark, Basingstoke, Hampshire, UK.,Department of Colorectal and Peritoneal Malignancy Surgery, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK
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103
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Williamson S, Beaver K, Gardner A, Martin-Hirsch P. Telephone follow-up after treatment for endometrial cancer: A qualitative study of patients' and clinical nurse specialists' experiences in the ENDCAT trial. Eur J Oncol Nurs 2018; 34:61-67. [PMID: 29784140 DOI: 10.1016/j.ejon.2018.02.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Endometrial cancer is the sixth most common female cancer worldwide. There is little evidence that routine hospital surveillance increases survival or decreases morbidity following treatment. Gynaecology Oncology clinical nurse specialists (CNSs) are ideally placed to provide the care, information and support to enable women with a gynaecological cancer to self-manage and live well. A multi-centre randomised controlled trial (RCT) compared hospital follow-up (HFU) with telephone follow-up (TFU) by CNSs. The structured telephone intervention focused on information provision to meet patients psychosocial and information needs. This study aimed to explore the views of women who had received TFU and the CNS's who had delivered the service. METHOD A qualitative study to complement the RCT using semi-structured interviews was conducted. Twenty-five patients were randomly selected from participants in the TFU arm stratified by study site. Seven CNSs were interviewed. RESULTS Patient and CNS regarded TFU positively; Three themes emerged from the patient interviews; Convenient Care, Discrete Personalised Care, Confidence and Reassurance. Themes arising from the CNS interviews were Patient Centred Care, Holistic Care and, Confidence and Skills. Patients found that TFU with CNS's was convenient and enabled discussion of issues and information provision at time-points relevant to them. The CNS's found the structured format of TFU enabled them to utilise their skills and knowledge to identify and meet patients holistic needs. CONCLUSIONS Alternative models of care such as TFU provided by CNSs provides the care, information and support to enable women treated for endometrial cancer to self-manage and live well.
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Affiliation(s)
- S Williamson
- School of Health Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
| | - K Beaver
- School of Health Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK
| | - A Gardner
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire PR2 9HT, UK
| | - P Martin-Hirsch
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire PR2 9HT, UK
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Supported self-management for cancer survivors to address long-term biopsychosocial consequences of cancer and treatment to optimize living well. Curr Opin Support Palliat Care 2018; 12:92-99. [DOI: 10.1097/spc.0000000000000329] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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105
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Appleyard SE, Clarke C. An interpretative phenomenological analysis of the experiences of older people self-managing cancer pain at home. J Psychosoc Oncol 2018; 36:333-349. [PMID: 29388879 DOI: 10.1080/07347332.2017.1417949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cancer is predominantly an illness affecting older people, yet there is a higher risk of under-treated pain in this age group. Many older people are required to self-manage their cancer pain at home but this is currently an under-researched and poorly understood area. We explored the experiences of older adults who self-manage cancer pain at home using an Interpretative Phenomenological Analytic approach. Eight older adults (aged 72-85 years) were recruited from a hospital in the United Kingdom and interviewed using a semi-structured questionnaire. Themes which emerged from the analysis suggest the self-management of cancer pain involves a perceived loss of control followed by a temporal process of gaining control over pain. Subordinate themes reflected the physical and social restrictions caused by pain; leading to fears regarding familial burden. Participants utilized inner strengths, past experiences, and social support to cope. Successful self-management of cancer pain in late life is conceptualized utilizing a positive psychology framework.
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Affiliation(s)
- Sara E Appleyard
- a Clinical Psychology for Older People, Humber NHS Foundation Trust , Hull , UK
| | - Chris Clarke
- b Department of Psychological Health and Wellbeing , University of Hull , Hull , UK
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Banerjee SC, D'Agostino TA, Gordon ML, Hay JL. "It's Not JUST Skin Cancer": Understanding Their Cancer Experience From Melanoma Survivor Narratives Shared Online. HEALTH COMMUNICATION 2018; 33:188-201. [PMID: 27982699 PMCID: PMC5474216 DOI: 10.1080/10410236.2016.1250707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cancer survivors narrate their experiences in unique ways, articulating different aspects of the cancer journey. The purpose of this study was to analyze the content of cancer narratives that melanoma survivors share online in order to present the ways that survivors narrate their cancer experience, to identify survivors' motivations for sharing, and to better understand the ways in which survivors are impacted by and cope with the diagnosis and treatment of cancer. The sample consisted of 95 unique melanoma survivor narratives, accessed from the Melanoma Research Foundation in November 2015, that were inductively and deductively coded for key themes and subthemes. Emergent themes described different aspects of the melanoma experience during prediagnosis (identification of self-phenotype, searching for causes, suspicious findings, delay in diagnosis), diagnosis (communication of diagnosis, emotional responses), transition from diagnosis to beginning treatment (second opinion), treatment (positive reframing of attitude, proactive cancer management, side effects), and posttreatment phases (social support, vigilance behaviors posttreatment). Two themes that cut across all phases of the cancer journey included recognizing and dealing with uncertainty and survivors' motive for sharing narrative. These findings have implications for understanding how melanoma survivors may benefit personally from sharing their cancer experience online and for the potential for survivor narratives to motivate behavior change and facilitate coping among readers.
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Affiliation(s)
- Smita C Banerjee
- a Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center
| | - Thomas A D'Agostino
- a Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center
| | - Mallorie L Gordon
- a Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center
| | - Jennifer L Hay
- a Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center
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107
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Self-management interventions for cancer survivors: a systematic review. Support Care Cancer 2017; 26:1585-1595. [PMID: 29199362 DOI: 10.1007/s00520-017-3999-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/24/2017] [Indexed: 01/26/2023]
Abstract
PURPOSE Many cancer survivors experience problems with persisting symptoms such as pain, fatigue, anxiety and depression post-treatment. Self-management interventions are recommended for cancer patients as they can help individuals identify and manage these continuing symptoms. This systematic review examines the type, content and impact of self-management interventions for cancer survivors on health outcomes such as activity participation, self-efficacy, quality of life and symptom management. METHODS This was a systematic review of the English language scientific literature searched for randomised controlled trials (RCT), systematic reviews and meta-analyses of self-management programmes conducted with cancer survivors. Six databases were systematically searched. RESULTS Initial searches yielded 2633 citations. Following screening and a risk of bias assessment, six studies were included in the final review. Heterogeneity of the interventions precluded meta-analysis. Three studies reported significant differences between groups in a number of areas including fatigue, physical functioning, distress and self-efficacy at their first follow-up assessment. These studies included two psychosocial interventions and one exercise and diet intervention. Not all findings were sustained across studies at follow-up assessment. CONCLUSION It is not possible to draw definitive conclusions as to the impact the different types of self-management programme had on cancer survivors. The sustainability of the interventions reviewed was poor, suggesting that cancer survivors require interventions that can be applied into their daily activities.
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108
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Wise M, Marchand LR, Roberts LJ, Chih MY. Suffering in Advanced Cancer: A Randomized Control Trial of a Narrative Intervention. J Palliat Med 2017; 21:200-207. [PMID: 29135330 DOI: 10.1089/jpm.2017.0007] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Advanced cancer can erode patients' wellbeing. Narrative interventions have improved patients' wellbeing, but might not be feasible for widespread implementation. OBJECTIVES (1) Test the effects of miLivingStory, a telephone-based life review and illness narrative intervention with online resources and social networking, on community-dwelling advanced cancer patients' wellbeing. (2) Explore intervention use and satisfaction. PATIENTS AND SETTING Stage III or IV cancer patients having completed initial therapy were randomized to miLivingStory or to an active control group, miOwnResources. Data and Analysis: Primary outcomes measured at baseline, two and four months included subscales for the FACIT-Sp peace and meaning and the POMS-SF depressed, anxious, and angry mood, scored on 0-4-point Likert scales. Linear mixed modeling, controlling for baseline primary outcome scores, tested for group comparisons of repeated outcome measures. Pairwise comparisons tested for within- and between-group differences. Intervention use and satisfaction data were collected automatically and by survey. RESULTS Eighty-six primarily white, female patients with high baseline wellbeing completed the study. There were no between-group differences at baseline or at two months. At four months, miLivingStory had a direct and positive effect for peace (2.86 vs. 2.57, p = 0.029), a trend effect for lower depressed mood (0.55 vs. 0.77, p = 0.097), and appeared to protect against the control group's declining wellbeing between two and four months. miLivingStory use was low and assessed as helpful to quite helpful. CONCLUSIONS Telephone-based narrative interventions hold promise in improving advanced cancer patients' wellbeing. Further testing of delivery and implementation strategies is warranted.
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Affiliation(s)
- Meg Wise
- 1 Sonderegger Research Center, University of Wisconsin-Madison , Madison, Wisconsin
| | - Lucille R Marchand
- 2 Department of Family Medicine, University of Washington-Seattle , Seattle, Washington
| | - Linda J Roberts
- 3 Department of Human Development and Family Studies, University of Wisconsin-Madison , Madison, Wisconsin
| | - Ming-Yuan Chih
- 4 Department of Clinical Sciences, University of Kentucky , Lexington, Kentucky
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109
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Haviland J, Sodergren S, Calman L, Corner J, Din A, Fenlon D, Grimmett C, Richardson A, Smith PW, Winter J, Foster C. Social support following diagnosis and treatment for colorectal cancer and associations with health-related quality of life: Results from the UK ColoREctal Wellbeing (CREW) cohort study. Psychooncology 2017; 26:2276-2284. [PMID: 29094430 PMCID: PMC6220760 DOI: 10.1002/pon.4556] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/11/2017] [Accepted: 09/09/2017] [Indexed: 01/09/2023]
Abstract
Objective Social support is acknowledged as important in cancer survivorship, but little is known about change in support after cancer diagnosis and factors associated with this, particularly in colorectal cancer. The CREW cohort study investigated social support up to 2 years following curative intent surgery for colorectal cancer. Methods A total of 871 adults recruited pre‐treatment from 29 UK centres 2010 to 2012 consented to follow‐up. Questionnaires at baseline, 3, 9, 15, and 24 months post‐surgery included assessments of social support (Medical Outcomes Study‐Social Support Survey, MOS‐SSS) and health‐related quality of life (HRQoL). Socio‐demographic, clinical and treatment details were collected. Longitudinal analyses assessed social support over follow‐up, associations with participant characteristics, and HRQoL. Results Around 20% were living alone and 30% without a partner. Perceived social support declined in around 29% of participants, with 8% of these reporting very low levels overall from baseline to 2 years (mean MOS‐SSS overall score < 40 on a scale from 0 to 100). Older age, female gender, greater neighbourhood deprivation, presence of co‐morbidities, and rectal cancer site were significantly associated with reductions in perceived support. Poorer HRQoL outcomes (generic health/QoL, reduced wellbeing, anxiety, and depression) were significantly associated with lower levels of social support. Conclusions Levels of social support decline following colorectal cancer diagnosis and treatment in nearly a third of patients and are an important risk factor for recovery of HRQoL. Assessment of support early on and throughout follow‐up would enable targeted interventions to improve recovery, particularly in the more vulnerable patient groups at risk of poorer social support.
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Affiliation(s)
- Joanne Haviland
- Institute of Cancer Research Clinical Trials and Statistics Unit, Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Samantha Sodergren
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jessica Corner
- Executive Office, University of Nottingham, Nottingham, UK
| | - Amy Din
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Deborah Fenlon
- College of Health and Human Sciences, Swansea University, Swansea, Wales, UK
| | - Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter W Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, UK
| | - Jane Winter
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
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Grimmett C, Haviland J, Winter J, Calman L, Din A, Richardson A, Smith PWF, Foster C. Colorectal cancer patient's self-efficacy for managing illness-related problems in the first 2 years after diagnosis, results from the ColoREctal Well-being (CREW) study. J Cancer Surviv 2017; 11:634-642. [PMID: 28822053 PMCID: PMC5602065 DOI: 10.1007/s11764-017-0636-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/01/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE There is a growing emphasis on self-management of cancer aftercare. Little is known about patient's self-efficacy (confidence) to manage illness-related problems and how this changes over time. This paper describes the patterns of self-efficacy for managing illness-related problems amongst colorectal cancer patients in the 2 years following diagnosis. METHODS In this prospective cohort study, questionnaires were administered at baseline (pre-surgery), 3, 9, 15 and 24 months to 872 colorectal cancer patients. Self-efficacy (confidence to manage illness-related problems), anxiety, social support, affect, socio-demographics, physical symptoms and clinical and treatment characteristics were assessed. Group-based trajectory analysis identified trajectories of self-efficacy up to 24 months and predictors. RESULTS Four trajectories of self-efficacy were identified: group 1 (very confident) 16.0% (95% confidence interval (CI) 10.7-21.3%), group 2 (confident) 45.6% (95% CI 40.3-51.0%), group 3 (moderately confident) 29.5% (95% CI 25.1-33.8%) and group 4 (low confidence) 8.9% (95% CI 6.4-11.4%). Greater deprivation, domestic status, more co-morbidities, worse fatigue and pain, lower positivity and greater negativity were significantly associated with lower self-efficacy. There was an increase in mean scores for self-efficacy over time for the whole sample, but this did not reach the cut-off for minimally important differences. At 2 years, the lowest level of confidence to manage was for symptoms or health problems. CONCLUSION Around 40% of patients had suboptimal levels of confidence to manage illness-related problems with little change from the time of diagnosis across the four groups. IMPLICATIONS FOR CANCER SURVIVORS Screening for self-efficacy at diagnosis would enable targeted, early intervention which could in turn enhance health-related quality of life.
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Affiliation(s)
- Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Joanne Haviland
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, London, SW7 3RP, UK
| | - Jane Winter
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Amy Din
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Alison Richardson
- University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Peter W F Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK.
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111
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Srinivasan H, Kanayairam V, Ravichandran R. Chitin and chitosan preparation from shrimp shells Penaeus monodon and its human ovarian cancer cell line, PA-1. Int J Biol Macromol 2017; 107:662-667. [PMID: 28923565 DOI: 10.1016/j.ijbiomac.2017.09.035] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/29/2017] [Accepted: 09/13/2017] [Indexed: 11/24/2022]
Abstract
In the present study, chitin and chitosan preparation from shrimp shells Penaeus mondon and its ovarian cancer cell line (PA-1). FTIR spectrum sharp absorption peak at 1655cm-1 is assigned to ketone C=O (α) unsaturated with chitosan. X-ray diffraction showed the presence of chitin and chitosan were strongest peak at 18.91° (β) and 29.75° (α) characters. SEM observations of chitin and chitosan surface morphologies of P. monodon showed that microfibril and porous structures. Anticancer activity of chitin and chitosan against human ovarian cancer cell line showed that chitosan an exhibited notable higher activity than chitin. Anticancer activity of aquacultural waste of shrimp shells mediated chitosan, which was proved to be good novel pharmaceutical industries.
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Affiliation(s)
- Haripriya Srinivasan
- Unit of Aquatic Biodiversity, Department of Zoology, University of Madras, Guindy Campus, Chennai, 600 025, Tamil Nadu, India
| | - Velayutham Kanayairam
- Unit of Aquatic Biodiversity, Department of Zoology, University of Madras, Guindy Campus, Chennai, 600 025, Tamil Nadu, India
| | - Ramanibai Ravichandran
- Unit of Aquatic Biodiversity, Department of Zoology, University of Madras, Guindy Campus, Chennai, 600 025, Tamil Nadu, India.
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112
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Long-term effectiveness and moderators of a web-based tailored intervention for cancer survivors on social and emotional functioning, depression, and fatigue: randomized controlled trial. J Cancer Surviv 2017; 11:691-703. [PMID: 28698999 PMCID: PMC5671537 DOI: 10.1007/s11764-017-0625-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 06/15/2017] [Indexed: 12/16/2022]
Abstract
Purpose The web-based computer-tailored Kanker Nazorg Wijzer (Cancer Aftercare Guide) supports cancer survivors with psychosocial issues during cancer recovery. The current study investigates whether the 6-month effects in increasing emotional and social functioning and reducing depression and fatigue hold at 12 months from baseline. Moreover, it explores whether patient characteristics moderate the 6- and 12-month intervention effectiveness. Methods Cancer survivors from 21 Dutch hospitals (November 2013–June 2014) were randomized to an intervention (n = 231) or a wait-list control group (n = 231). Intervention effects on emotional and social functioning (EORTC QLQ-C30), depression (HADS), and fatigue (CIS) were evaluated through multilevel linear regression analyses. Results At 12 months from baseline, the intervention group no longer differed from the control group in emotional and social functioning, depression, and fatigue. Moderator analyses indicated that, at 6 months, the intervention was effective in improving social functioning for men (d = 0.34), reducing fatigue for participants ≤56 years (d = 0.44), and reducing depression for participants who received chemotherapy (d = 0.36). At 12 months, participants with a medium educational level reported higher social functioning (d = 0.19), while participants with a low educational level reported lower social functioning (d = 0.22) than participants with a similar educational level in the control group. Conclusions The intervention gave cancer patients a head start to psychological recovery after the end of cancer treatment. The control group caught up in the long run. Implications for cancer survivors The Cancer Aftercare Guide expedited recovery after cancer treatment. Being a low intensity, easy accessible, and relatively low cost intervention, it could serve as a relevant step in recovery and stepped care. Electronic supplementary material The online version of this article (doi:10.1007/s11764-017-0625-0) contains supplementary material, which is available to authorized users.
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Corbett T, Walsh JC, Groarke A, Moss-Morris R, Morrissey E, McGuire BE. Cancer-Related Fatigue in Post-Treatment Cancer Survivors: Theory-Based Development of a Web-Based Intervention. JMIR Cancer 2017; 3:e8. [PMID: 28676465 PMCID: PMC5516102 DOI: 10.2196/cancer.6987] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/12/2017] [Accepted: 02/15/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cancer-related fatigue (CrF) is the most common and disruptive symptom experienced by cancer survivors. We aimed to develop a theory-based, interactive Web-based intervention designed to facilitate self-management and enhance coping with CrF following cancer treatment. OBJECTIVE The aim of our study was to outline the rationale, decision-making processes, methods, and findings which led to the development of a Web-based intervention to be tested in a feasibility trial. This paper outlines the process and method of development of the intervention. METHODS An extensive review of the literature and qualitative research was conducted to establish a therapeutic approach for this intervention, based on theory. The psychological principles used in the development process are outlined, and we also clarify hypothesized causal mechanisms. We describe decision-making processes involved in the development of the content of the intervention, input from the target patient group and stakeholders, the design of the website features, and the initial user testing of the website. RESULTS The cocreation of the intervention with the experts and service users allowed the design team to ensure that an acceptable intervention was developed. This evidence-based Web-based program is the first intervention of its kind based on self-regulation model theory, with the primary aim of targeting the representations of fatigue and enhancing self-management of CrF, specifically. CONCLUSIONS This research sought to integrate psychological theory, existing evidence of effective interventions, empirically derived principles of Web design, and the views of potential users into the systematic planning and design of the intervention of an easy-to-use website for cancer survivors.
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Affiliation(s)
- Teresa Corbett
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP), School of Psychology, Faculty of Social, Human and Mathematical Sciences, Southampton, United Kingdom
| | - Jane C Walsh
- School of Psychology, NUI Galway, Galway, Ireland
| | | | - Rona Moss-Morris
- Health Psychology Section, Psychology Department, Institute of Psychiatry, King's College London, London, United Kingdom
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Holmes MM, Bishop FL, Calman L. "I just googled and read everything": Exploring breast cancer survivors' use of the internet to find information on complementary medicine. Complement Ther Med 2017; 33:78-84. [PMID: 28735830 DOI: 10.1016/j.ctim.2017.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 05/13/2017] [Accepted: 06/26/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Breast cancer survivors often turn to the internet as an information resource when deciding whether to use complementary and alternative medicine (CAM) but their use of online CAM-related resources is poorly understood. The objective was to explore breast cancer survivors' use of the internet when making decisions about CAM use. DESIGN A purposive sample of 11 breast cancer survivors (mean age=56) completed a quantitative questionnaire and a qualitative telephone interview. The theory of planned behaviour (TPB) was used to guide interview questions. Framework analysis and descriptive statistics were used. SETTING United Kingdom. RESULTS All participants found information on CAM using the internet and used some form of CAM after their diagnosis. Themes from the interviews went beyond the standard definitions of the TPB areas. Despite the lack of approval from their social network and healthcare team, participants used the internet to find information on CAM. Further, participants' cancer diagnosis changed their needs, transforming how they perceived and experienced the internet CONCLUSIONS: Participants' use of the internet was more complex than can easily be explained by the TPB and was inherently connected to the experience of self-management for the consequences of cancer and its treatment. As breast cancer survivors may not disclose their use of the internet to their healthcare team, healthcare professionals need to be aware that the information available on the internet plays a factor in the decision-making process to use CAM.
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Affiliation(s)
- Michelle M Holmes
- School of Psychology, University of Southampton, Building 44, University Road, Southampton, Hampshire, SO17 1BJ, UK.
| | - Felicity L Bishop
- School of Psychology, University of Southampton, Building 44, University Road, Southampton, Hampshire, SO17 1BJ, UK
| | - Lynn Calman
- Faculty of Health Sciences, University of Southampton, Building 67, University Road, Southampton, Hampshire, SO17 1BJ, UK
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Reb A, Ruel N, Fakih M, Lai L, Salgia R, Ferrell B, Sampath S, Kim JY, Raz DJ, Sun V. Empowering survivors after colorectal and lung cancer treatment: Pilot study of a Self-Management Survivorship Care Planning intervention. Eur J Oncol Nurs 2017; 29:125-134. [PMID: 28720259 DOI: 10.1016/j.ejon.2017.06.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE This study evaluates the feasibility and acceptability of a Self-Management Survivorship Care Planning (SM-SCP) intervention in colorectal and lung cancer survivors. METHODS This is a single-group, pre- and post-mixed methods study of an advance practice nurse-driven survivorship care intervention that integrates a survivorship care plan with self-management skills coaching. Colorectal and lung cancer survivors with stage I-III disease were enrolled at 3-6 months after completing treatments, and the intervention was administered in one in-person or telephone session. Survivor outcome measures included depression, anxiety, self-efficacy, QOL, and satisfaction. Paired t-tests were used for exploratory evaluations of pre-to post-intervention score changes. Content analysis was conducted to analyze the qualitative data to describe survivors' experience with the intervention. RESULTS Thirty participants (15 colorectal, 15 lung) enrolled and completed the study (73% retention). It took an average of 40 min to complete the TS/CP and 34.2 min to deliver the intervention. Exploratory analysis revealed significant differences from baseline to post-intervention in depression, anxiety, self-efficacy, physical functioning, role limitations-physical, pain, general health, health transition, physical health summary, and total QOL. Three qualitative themes emerged: 1) Feeling empowered about having a plan; 2) Struggling with psychosocial concerns; and 3) Suggestions for intervention content and delivery. CONCLUSIONS The SM-SCP intervention was feasible and acceptable for colorectal and lung cancer survivors after treatment completion. Survivorship care interventions have potential to fulfill the unmet needs of colorectal and lung cancer survivors. Their effectiveness might be greater by integrating conceptually-based models of care, such as self-management skills building.
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Affiliation(s)
- Anne Reb
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Nora Ruel
- Biostatistics Core, Department of Information Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Marwan Fakih
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Lily Lai
- Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Ravi Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Sagus Sampath
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States.
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Enhancing prostate cancer survivorship care through self-management. Urol Oncol 2017; 35:564-568. [PMID: 28619632 DOI: 10.1016/j.urolonc.2017.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/10/2017] [Indexed: 12/22/2022]
Abstract
The lack of clear roles for prostate cancer survivorship care providers places prostate cancer survivors at significant risk of inappropriate use of services delivered piecemeal by different providers, persistent bothersome symptoms, and silent suffering. Optimizing quality of care for prostate cancer survivors hinges on decreasing fragmentation of care, and providing quality symptom management. This is achieved through comprehensive, appropriate medical, surgical, pharmacological and psychosocial care, coupled with self-management, as highlighted in several recent resources addressing long-term and late effects of treatment. Although further study is warranted, prostate cancer survivors engaging in self-management may reduce the negative impact of prostate cancer in their lives through better quality of care (better symptom management and efficient use of services) and quality of life.
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Buckland N, Mackenzie L. Exploring the role of occupational therapy in caring for cancer survivors in Australia: A cross sectional study. Aust Occup Ther J 2017; 64:358-368. [DOI: 10.1111/1440-1630.12386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Lynette Mackenzie
- Discipline of Occupational Therapy; University of Sydney; Lidcombe New South Wales Australia
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118
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Skolarus TA, Metreger T, Hwang S, Kim HM, Grubb RL, Gingrich JR, Hawley ST. Optimizing veteran-centered prostate cancer survivorship care: study protocol for a randomized controlled trial. Trials 2017; 18:181. [PMID: 28420419 PMCID: PMC5395886 DOI: 10.1186/s13063-017-1925-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/30/2017] [Indexed: 11/17/2022] Open
Abstract
Background Although prostate cancer is the most common cancer among veterans receiving care in the Veterans Health Administration (VA), more needs to be done to understand and improve survivorship care for this large population. This study, funded by VA Health Services Research & Development (HSR&D), seeks to address the need to improve patient-centered survivorship care for veterans with prostate cancer. Methods/Design This is a two-armed randomized controlled trial (RCT) with a target enrollment of up to 325 prostate cancer survivors per study arm (total anticipated n = 600). Patients will be recruited from four VA sites. Patient eligibility criteria include age range of 40–80 years, one to ten years post-treatment, and currently experiencing prostate cancer symptom burden. We will compare the “Building Your New Normal” program, a personally-tailored automated telephone symptom management intervention for improving symptom self-management to usual care enhanced with a non-tailored newsletter about symptom management. Primary outcomes include changes in symptom burden, bother, and health services utilization at five and 12 months after enrollment. Secondary outcomes include long-term psychosocial outcomes (e.g. subjective health, perceived cancer control). We will use multivariable regression analysis to evaluate the impact of the intervention on primary and secondary outcomes. We will conduct a process evaluation to understand the effective intervention components and explore possibilities for broader implementation and dissemination. Discussion Our central hypothesis is that intervention group participants will have improved and more confident symptom self-management and prostate cancer quality of life following the intervention and that these outcomes will translate to more efficient use of health services. The study results will provide much needed information about how to optimize the quality of care, and life, of veteran prostate cancer survivors. Trial registration ClinicalTrials.gov ID NCT01900561; Registered on 22 July 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1925-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ted A Skolarus
- VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, 48105, USA.,Department of Urology, Dow Division of Health Services Research, University of Michigan, Ann Arbor, MI, USA
| | - Tabitha Metreger
- VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, 48105, USA
| | - Soohyun Hwang
- VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, 48105, USA
| | - Hyungjin Myra Kim
- VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, 48105, USA.,University of Michigan Center for Consulting for Statistics, Computing and Analytics Research, Ann Arbor, MI, USA
| | - Robert L Grubb
- Department of Surgery (Urology), St. Louis VA Medical Center, Washington University School of Medicine, 915 North Grand Blvd., St. Louis, MO, 63106, USA
| | - Jeffrey R Gingrich
- Department of Urology, VA Pittsburgh Healthcare System, University of Pittsburgh, 7180 Highland Drive, Pittsburgh, PA, 15206, USA
| | - Sarah T Hawley
- VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, 48105, USA. .,Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
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119
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Online support groups for young women with breast cancer: a proof-of-concept study. Support Care Cancer 2017; 25:2285-2296. [DOI: 10.1007/s00520-017-3639-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 02/10/2017] [Indexed: 11/25/2022]
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121
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Henshall C, Greenfield S, Gale N. The Role of Self-Management Practices as Mechanisms for Re-Establishing Normality in Cancer Survivors. QUALITATIVE HEALTH RESEARCH 2017; 27:520-533. [PMID: 27222037 DOI: 10.1177/1049732316651252] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article explores the relationship between cancer survivors' use of self-management practices and their search for normality. Using Frank's illness narratives and other theoretical literature on normality in chronic illness, it draws on findings from a qualitative study to explore different ways cancer survivors use self-management practices to re-establish normality in their lives post-cancer. The findings suggest that "normality" represents different things to cancer survivors. We suggest that normality in survivorship is not a static concept but is fluid, and at certain times, cancer survivors may display some or all of these different versions of normality. The findings show that self-management practices can help cancer survivors experiment with different health and lifestyle processes to help support their "normal" daily lifestyle activities, quality of life, and well-being.
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Mizuno M, Kataoka J, Oishi F. Relationship between the Physical and Psychosocial Conditions of Postoperative Gastrointestinal Cancer Patients and their Responses to an Informational Material. Asia Pac J Oncol Nurs 2017; 4:53-60. [PMID: 28217731 PMCID: PMC5297233 DOI: 10.4103/2347-5625.199072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective: Postoperative patients with gastrointestinal (GI) cancer have multiple adaptation tasks and care needs to improve their quality of life (QOL). Whether their supportive care needs differ according to their physical and psychosocial conditions is unclear. This study investigated patients’ (1) physical and psychosocial conditions (QOL, fatigue, anxiety, cognitive plight, and resilience) and (2) responses to an informational booklet describing cancer patients’ problems and adaptation tasks, and examined the association between the two factors. Methods: A questionnaire survey was conducted to postoperative patients with GI cancer. Results: The mean age of the 69 respondents was 63 years; 59.4% of the respondents were men. Nine patients who did not read the booklet showed high fatigue and cognitive plight and low QOL. The patients (36.2%) who chose “I vaguely understood the content” showed low scores for resilience and cognitive plight while those (8.5%) who chose “I will deal with my tasks as described in the scenarios” showed high scores for both of these variables. Conclusions: The condition of some patients continued to be highly affected by their cancer. In terms of understanding the contents of the booklet, resilience was significant, and cognitive plight did not necessarily have a negative impact. The provision of information by means of a booklet might not be suitable for patients who are highly affected by their cancer. Patients may need additional support to be able to make good use of the information provided in such a booklet.
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Affiliation(s)
- Michiyo Mizuno
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Jun Kataoka
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Fumiko Oishi
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Willems RA, Lechner L, Verboon P, Mesters I, Kanera IM, Bolman CAW. Working mechanisms of a web-based self-management intervention for cancer survivors: a randomised controlled trial. Psychol Health 2017; 32:605-625. [DOI: 10.1080/08870446.2017.1293054] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Roy A. Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Peter Verboon
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Ilse Mesters
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Iris M. Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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Abstract
OBJECTIVES To describe psychosocial concerns associated with the postoperative cancer patient and to discuss current psychosocial evidence-based approaches to manage these psychosocial concerns. DATA SOURCES Published peer-reviewed literature. CONCLUSION The postoperative phase of cancer care may be associated with a range of overlapping acute and chronic psychosocial concerns related to the surgery itself, the cancer diagnosis, and the need for ongoing cancer treatments. The postoperative period of cancer care represents an essential time to detect unmet psychosocial concerns and begin timely interventions for these concerns. IMPLICATIONS FOR NURSING PRACTICE Nurses are in a key position to detect, triage, refer, or manage psychosocial concerns in the postoperative patient with cancer. Current psychosocial evidence-based approaches may be used by surgical oncology nurses or other nurses who care for cancer patients during postoperative recovery.
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125
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Self-management education interventions for patients with cancer: a systematic review. Support Care Cancer 2017; 25:1323-1355. [PMID: 28058570 DOI: 10.1007/s00520-016-3500-z] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 11/14/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE This systematic review was intended to identify the effectiveness and inclusion of essential components of self-management education interventions to support patients with cancer in developing the skills needed for effective self-management of their disease and the acute or immediate, long-term, and late harmful effects of treatments. METHODS Self-management education interventions were included if they were randomized controlled trials (RCTs) containing at least one of the eight core elements outlined by the research team. A systematic search was conducted in Ovid MEDLINE (2005 through April 2015), Embase (2005 to 2015, week 15), the Cochrane Database of Systematic Reviews (Issue 4, April 2015), CINAHL (2005 to 2015) and PsychINFO (2005 to 2015). Keywords searched include 'self-management patient education' or 'patient education'. RESULTS Forty-two RCTs examining self-management education interventions for patients with cancer were identified. Heterogeneity of interventions precluded meta-analysis, but narrative qualitative synthesis suggested that self-management education interventions improve symptoms of fatigue, pain, depression, anxiety, emotional distress and quality of life. Results for specific combinations of core elements were inconclusive. Very few studies used the same combinations of core elements, and among those that did, results were conflicting. Thus, conclusions as to the components or elements of self-management education interventions associated with the strength of the effects could not be assessed by this review. CONCLUSION Defining the core components of cancer self-management education and the fundamental elements for inclusion in supporting effective self-management will be critical to ensure consistent and effective provision of self-management support in the cancer system.
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Ose D, Winkler EC, Berger S, Baudendistel I, Kamradt M, Eckrich F, Szecsenyi J. Complexity of care and strategies of self-management in patients with colorectal cancer. Patient Prefer Adherence 2017; 11:731-742. [PMID: 28435231 PMCID: PMC5391842 DOI: 10.2147/ppa.s127612] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Given the inherent complexity of cancer care, in which personal, social, and clinical aspects accumulate and interact over time, self-management support need to become more comprehensive. This study has the following two aims: 1) to analyze and describe the complexity of individual patient situations and 2) to analyze and describe already established self-management strategies of patients to handle this complexity. METHODS A qualitative study was conducted. Ten focus groups were performed collecting perspectives of the following three user groups: patients with colorectal cancer (n=12) and representatives from support groups (n=2), physicians (n=17), and other health care professionals (HCPs; n=16). Data were analyzed using qualitative content analysis. RESULTS The results showed that cancer patients are struggling with the complexity of their individual situations characterized by the 1) "complexity of disease", 2) "complexity of care", and 3) "complexity of treatment-related data". To deal with these multifaceted situations, patients have established several individual strategies. These strategies are "proactive demanding" (eg, to get support and guidance or a meaningful dialog with the doctor), "proactive behavior" (eg, preparation of visits), and "proactive data management" (eg, in terms of merging treatment-related data and to disseminate these to their health care providers). CONCLUSION Patients with colorectal cancer have to handle a high complexity of individual situations within treatment and care of their disease. Private and social challenges have a culminating effect. This complexity increases as patients experience a longer duration of treatment and follow-up as patients have to handle a significantly higher amount of data over time. Self-management support should focus more on the individual complexity in a patient's life. This includes assisting patients with strategies that have already been established by themselves (like preparation of visits).
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Affiliation(s)
- Dominik Ose
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
- Department of Population Health, Health System Innovation and Research, University of Utah, Salt Lake City, UT, USA
- Correspondence: Dominik Ose, University of Utah, Department of Population Health Sciences, Health System Innovation and Research, Williams Building, 295 Chipeta Way, Salt Lake City, UT 84108, USA, Tel +1 801 587 2263, Fax +1 801 581 3623, Email
| | - Eva C Winkler
- Program for Ethics and Patient-oriented Care in Oncology, National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Sarah Berger
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Ines Baudendistel
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Martina Kamradt
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Felicitas Eckrich
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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Liao KYH, Yeung NC, Wong CCY, Warmoth K, Lu Q. Fear of cancer recurrence and physical well-being among Chinese cancer survivors: the role of conscientiousness, positive reappraisal and hopelessness. Support Care Cancer 2016; 25:1141-1149. [DOI: 10.1007/s00520-016-3504-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
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128
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Cheng H, Sit JW, Cheng KK. A qualitative insight into self-management experience among Chinese breast cancer survivors. Psychooncology 2016; 26:1044-1049. [DOI: 10.1002/pon.4279] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Huilin Cheng
- School of Nursing; The Hong Kong Polytechnic University; Core A, Rm A129, Yuk Choi Road Kowloon Hong Kong SAR
| | - Janet W.H. Sit
- The Nethersole School of Nursing; The Chinese University of Hong Kong; 7/F, ELB733, Esther Lee Building, Tai Po Road Shatin, NT Hong Kong SAR
| | - Karis K.F. Cheng
- Alice Lee Centre for Nursing Studies, National University of Singapore; National University Health System, Singapore Level 2, Clinical Research Centre; Block MD11, 10 Medical Drive Singapore 117597
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Matheson L, Boulton M, Lavender V, Collins G, Mitchell-Floyd T, Watson E. The Experiences of Young Adults With Hodgkin Lymphoma Transitioning to Survivorship: A Grounded Theory Study. Oncol Nurs Forum 2016; 43:E195-E2014. [DOI: 10.1188/16.onf.e195-e2014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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130
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Tompkins C, Scanlon K, Scott E, Ream E, Harding S, Armes J. Survivorship care and support following treatment for breast cancer: a multi-ethnic comparative qualitative study of women's experiences. BMC Health Serv Res 2016; 16:401. [PMID: 27535665 PMCID: PMC4989374 DOI: 10.1186/s12913-016-1625-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 08/03/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND As the number of breast cancer survivors continues to rise, Western populations become more ethnically and socially diverse and healthcare resources become ever-more stretched, follow-up that focuses on monitoring for recurrence is no longer viable. New models of survivorship care need to ensure they support self-management and are culturally appropriate across diverse populations. This study explored experiences and expectations of a multi-ethnic sample of women with breast cancer regarding post-treatment care, in order to understand potential barriers to receiving care and inform new models of survivorship care. METHODS A phenomenological qualitative research design was employed. In-depth interviews were conducted with women from diverse socio-demographic backgrounds in England, who completed treatment for breast cancer in the 12 months prior to the study. Data were analysed using Framework Analysis. RESULTS Sixty-six women participated and reported expectations and needs were unmet at follow-up. Whilst there were more commonalities in experiences, discernible differences, particularly by ethnicity and age, were identified relating to three key themes: emotional responses on transition to follow-up; challenges communicating with healthcare professionals at follow-up; and challenges finding and accessing information and support services to address unmet needs. CONCLUSIONS There are cultural differences in the way healthcare professionals and women communicate, not necessarily differences in their post-treatment needs. We do not know if new models of care meet survivors' needs, or if they are appropriate for everyone. Further testing and potential cultural and linguistic adaptation of models of care is necessary to ensure their appropriateness and acceptability to survivors from different backgrounds. New ways of providing survivorship care mean survivors will need to be better prepared for the post-treatment period and the role they will have to play in managing their symptoms and care.
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Affiliation(s)
| | - Karen Scanlon
- Breast Cancer Care, 5-13 Great Suffolk Street, London, SE1 0NS UK
| | - Emma Scott
- King’s College London, Florence Nightingale Faculty of Nursing & Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA UK
| | - Emma Ream
- School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Duke of Kent Building, Guildford, GU2 7XH UK
| | - Seeromanie Harding
- King’s College London, Diabetes & Nutritional Sciences Division, Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH UK
| | - Jo Armes
- King’s College London, Florence Nightingale Faculty of Nursing & Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA UK
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Foster C, Grimmett C, May CM, Ewings S, Myall M, Hulme C, Smith PW, Powers C, Calman L, Armes J, Breckons M, Corner J, Fenlon D, Batehup L, Lennan E, R May C, Morris C, Neylon A, Ream E, Turner L, Yardley L, Richardson A. A web-based intervention (RESTORE) to support self-management of cancer-related fatigue following primary cancer treatment: a multi-centre proof of concept randomised controlled trial. Support Care Cancer 2016; 24:2445-53. [PMID: 26643072 PMCID: PMC4846690 DOI: 10.1007/s00520-015-3044-7] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/23/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a frequent and distressing symptom experienced after cancer treatment. RESTORE is the first web-based resource designed to enhance self-efficacy to manage CRF following curative-intent treatment. The aim of this study is to test the proof of concept and inform the design of an effectiveness trial. METHODS A multi-centre parallel-group two-armed (1:1) exploratory randomised controlled trial (RCT) with qualitative process evaluation was employed in the study. Participants (≥18 years; ≤5 years post treatment with moderate to severe fatigue) were recruited and randomly assigned to RESTORE or a leaflet. Feasibility and acceptability were measured by recruitment, attrition, intervention adherence, completion of outcome measures and process evaluation. Change in self-efficacy to manage CRF was also explored. Outcome measures were completed at baseline (T0), 6 weeks (T1) and 12 weeks (T2). Data were analysed using mixed-effects linear regression and directed content analysis. RESULTS One hundred and sixty-three people participated in the trial and 19 in the process evaluation. The intervention was feasible (39 % of eligible patients consented) and acceptable (attrition rate 36 %). There was evidence of higher fatigue self-efficacy at T1 in the intervention group vs comparator (mean difference 0.51 [-0.08 to 1.11]), though the difference in groups decreased by 12 weeks. Time since diagnosis influenced perceived usefulness of the intervention. Modifications were suggested. CONCLUSION Proof of concept was achieved. The RESTORE intervention should be subject to a definitive trial with some adjustments. Provision of an effective supportive resource would empower cancer survivors to manage CRF after treatment completion. TRIAL REGISTRATION ISRCTN67521059.
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Affiliation(s)
- Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
| | - Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Christine M May
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Sean Ewings
- Southampton Statistical Research Institute, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Michelle Myall
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Claire Hulme
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9LJ, UK
| | - Peter W Smith
- Southampton Statistical Research Institute, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Cassandra Powers
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Jo Armes
- Florence Nightingale School of Nursing & Midwifery, King's College, London, SE1 8WA, UK
| | - Matthew Breckons
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Jessica Corner
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Deborah Fenlon
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Lynn Batehup
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Elaine Lennan
- University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Carl R May
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | | | | | - Emma Ream
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7JP, UK
| | | | - Lucy Yardley
- Psychology, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
- University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK
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Foster C, Haviland J, Winter J, Grimmett C, Chivers Seymour K, Batehup L, Calman L, Corner J, Din A, Fenlon D, May CM, Richardson A, Smith PW. Pre-Surgery Depression and Confidence to Manage Problems Predict Recovery Trajectories of Health and Wellbeing in the First Two Years following Colorectal Cancer: Results from the CREW Cohort Study. PLoS One 2016; 11:e0155434. [PMID: 27171174 PMCID: PMC4865190 DOI: 10.1371/journal.pone.0155434] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/28/2016] [Indexed: 12/05/2022] Open
Abstract
Purpose This paper identifies predictors of recovery trajectories of quality of life (QoL), health status and personal wellbeing in the two years following colorectal cancer surgery. Methods 872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing, confidence to manage illness-related problems (self-efficacy), social support, co-morbidities, socio-demographic, clinical and treatment characteristics. Group-based trajectory analyses identified distinct trajectories and predictors for QoL, health status and wellbeing. Results Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2% wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing). Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors including disease characteristics, stoma, anxiety and social support. Conclusions Psychosocial factors including self-efficacy and depression before surgery predict recovery trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent of treatment or disease characteristics. This has significant implications for colorectal cancer management as appropriate support may be improved by early intervention resulting in more positive recovery experiences.
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Affiliation(s)
- Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- * E-mail:
| | - Joanne Haviland
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Jane Winter
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom
| | - Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Kim Chivers Seymour
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Lynn Batehup
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Jessica Corner
- Executive Office, University of Nottingham, Nottingham, NG7 2RD, United Kingdom
| | - Amy Din
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Deborah Fenlon
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Christine M. May
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom
| | - Peter W. Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
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Cancer survivors’ perspectives on adjustment-focused self-management interventions: a qualitative meta-synthesis. J Cancer Surviv 2016; 10:1012-1034. [DOI: 10.1007/s11764-016-0546-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
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Kim SH, Lee S, Kim SH, Ok ON, Kim IR, Choi E, Kang YK, Kim SJ, Lee MH. Unmet needs of non-Hodgkin lymphoma survivors in Korea: prevalence, correlates, and associations with health-related quality of life. Psychooncology 2016; 26:330-336. [PMID: 27073128 DOI: 10.1002/pon.4136] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/17/2016] [Accepted: 03/22/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVE We aimed to describe the prevalence and correlates of unmet needs among non-Hodgkin lymphoma (NHL) survivors in Korea and to identify their association with health-related quality of life (HRQOL). METHODS Participants were 826 NHL survivors from three hospitals in South Korea diagnosed at least 24 months prior to participating (mean, 6.3 years; range, 2.1-20.9 years). We used self-reported questionnaires, including the Need Scale for Cancer Patients Undergoing Follow-up Care (NS-C) developed in Korea and the EORTC QLQ-C30. We defined an unmet need as a moderate to high level of unmet need in the NS-C response scale. RESULTS Among six domains, unmet need prevalence ranged from 1.7% to 38.3%. Most commonly reported domains with unmet needs were 'treatment and prognosis' (38.3%) and 'keeping mind under control' (30.5%). The three most frequently reported individual unmet needs were 'being informed about prevention of recurrence' (50.7%), 'being informed about prevention of metastasis' (49.7%), and 'having self-confidence of overcoming cancer' (42.7%). Multivariate logistic analyses revealed that younger age, being unmarried, and low monthly income were associated with unmet needs of multiple domains. Participants with unmet needs demonstrated significantly poorer HRQOL, and the most clinically meaningful differences were found in social function and emotional function. CONCLUSIONS Korean NHL survivors have substantial unmet needs, especially those who are younger, unmarried, and have a lower income. Initiating supportive care programs for meeting unmet needs may enhance their HRQOL. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Soo Hyun Kim
- Department of Nursing, Inha University, Incheon, South Korea
| | - Suyeon Lee
- Department of Oncology, Asan Medical Center, Seoul, South Korea
| | - So Hee Kim
- Cancer Edu-Info Center, Asan Medical Center, Seoul, South Korea
| | - Oh Nam Ok
- Division of Hematology-Oncology, Samsung Medical Center, Seoul, South Korea
| | - Im-Ryung Kim
- Cancer Education Center, Samsung Medical Center, Seoul, South Korea
| | - Eunju Choi
- Department of Nursing, Inha University, Incheon, South Korea
| | - Yoon-Koo Kang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seok Jin Kim
- Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Moon Hee Lee
- Division of Hematology-Oncology, Inha University Hospital and College of Medicine, Incheon, South Korea
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Kirshbaum MN, Stead M, Bartys S. An exploratory study of reiki experiences in women who have cancer. Int J Palliat Nurs 2016; 22:166-72. [DOI: 10.12968/ijpn.2016.22.4.166] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Serena Bartys
- Centre for Applied Psychological and Health Research, Institute for Research in Citizenship and Applied Human Sciences, University of Huddersfield
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Zoffmann V, Hörnsten Å, Storbækken S, Graue M, Rasmussen B, Wahl A, Kirkevold M. Translating person-centered care into practice: A comparative analysis of motivational interviewing, illness-integration support, and guided self-determination. PATIENT EDUCATION AND COUNSELING 2016; 99:400-407. [PMID: 26547303 DOI: 10.1016/j.pec.2015.10.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 09/16/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. METHODS Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. RESULTS Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity tools. CONCLUSION Each approach has a primary application: MI, when ambivalence threatens positive change; IIS, when integrating newly diagnosed chronic conditions; and GSD, when problem solving is difficult, or deadlocked. PRACTICE IMPLICATIONS Professionals must critically consider the context in their choice of approach.
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Affiliation(s)
- Vibeke Zoffmann
- The Research Unit Women's and Children's Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Institute of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
| | - Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Solveig Storbækken
- Competence Center for Substance Abuse, the Bergen Clinics Foundation, Bergen, Norway
| | - Marit Graue
- Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway; Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia
| | - Astrid Wahl
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway
| | - Marit Kirkevold
- Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway; Department of Nursing Science, Institute of Health and Society, University of Oslo, Norway
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Lawn S, Zrim S, Leggett S, Miller M, Woodman R, Jones L, Kichenadasse G, Sukumaran S, Karapetis C, Koczwara B. Is self-management feasible and acceptable for addressing nutrition and physical activity needs of cancer survivors? Health Expect 2015; 18:3358-73. [PMID: 25545411 PMCID: PMC5810724 DOI: 10.1111/hex.12327] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Self-management is recommended for patients with chronic conditions, but its use with cancer survivors is underexplored. Optimal strategies for achieving lifestyle changes in cancer survivors are not known. OBJECTIVE We aimed to determine feasibility, acceptability and preliminary efficacy of self-management-based nutrition and physical activity interventions for cancer survivors. DESIGN, SETTING AND PARTICIPANTS Adult survivors (n = 25) during (Group 1 , n = 11) or post (Group 2, n = 14)-curative chemotherapy for solid tumours, most (n = 20, 80%) with breast cancer, were recruited prospectively from a single clinical centre. INTERVENTION The Flinders Living Well Self-Management Program, a generic self-management care planning programme, was utilized to establish patient-led nutrition and exercise goals within a tailored 12-week intervention. Fortnightly progress reviews occurred with assessments at baseline, 6 and 12 weeks. RESULTS Most participants (84%) found the intervention acceptable/very acceptable. Both groups showed a trend towards significant improvement in the self-management capability 'knowledge about changing risk factors' (P = 0.047); Group 2 showed a trend towards significantly improved 'psychological impacts' (P = 0.007). Goal ratings improved for both groups (P = 0.001). Quality of life improved for both groups for emotional functioning (P = 0.03). Physical functioning improved for Group 2 (P = 0.05); however, most symptom domains worsened for Group 1, as expected given their treatment stage. DISCUSSION AND CONCLUSIONS Self-management interventions are feasible for this population. In particular, building self-management capacity during the active phase of patients' cancer treatment provides health and psychosocial benefits. Larger randomized controlled trials are required to further determine efficacy. Further translational research is also needed to determine acceptability,feasibility, enablers and barriers for clinicians embedding this approach into routine cancer survivorship care.
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Affiliation(s)
- Sharon Lawn
- Flinders Human Behaviour & Health Research UnitMargaret Tobin Centre (Room 4T306)Flinders UniversityAdelaideSAAustralia
| | - Stephanie Zrim
- Medical OncologyFlinders UniversityAdelaideSAAustralia
- Present address:
Australian Research Centre for Health of Women and Babies (ARCH)The University of AdelaideWomen's & Children's HospitalLevel 1Queen Victoria Building72 King William StreetNorth Adelaide5006SAAustralia
| | - Stephanie Leggett
- Department of Nutrition and DieteticsFlinders UniversityAdelaideSAAustralia
| | - Michelle Miller
- Department of Nutrition and DieteticsFlinders UniversityAdelaideSAAustralia
| | - Richard Woodman
- Flinders Centre of Epidemiology and BiostatisticsFlinders UniversityAdelaideSAAustralia
| | - Lynnette Jones
- School of Physical EducationUniversity of OtagoDunedinNew Zealand
| | | | | | | | - Bogda Koczwara
- Medical OncologyFlinders UniversityAdelaideSAAustralia
- Flinders Centre for Innovation in CancerFlinders Medical Centre/Flinders UniversityAdelaideSAAustralia
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Myall M, May CR, Grimmett C, May CM, Calman L, Richardson A, Foster CL. RESTORE: an exploratory trial of a web-based intervention to enhance self-management of cancer-related fatigue: findings from a qualitative process evaluation. BMC Med Inform Decis Mak 2015; 15:94. [PMID: 26577690 PMCID: PMC4650501 DOI: 10.1186/s12911-015-0214-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 10/31/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer-related fatigue is a distressing symptom experienced by many after cancer treatment. An exploratory randomised controlled trial was conducted to test proof of concept of RESTORE: a web-based tool to enhance self-efficacy to manage cancer-related fatigue. This paper reports findings from a qualitative process evaluation to determine feasibility and acceptability of the intervention and trial processes. METHOD Qualitative process evaluation carried out at the end of the trial to explore participants' experiences using semi-structured telephone interviews with a purposive sample of participants from both trial arms. Normalisation Process Theory informed data collection and analysis. Analysis involved directed content analysis within a Framework Approach. RESULTS Nineteen participants took part. They understood the purpose and requirements of the trial and identified beneficial outcomes from taking part. For the majority, the work of the trial was easily accommodated into daily routines and did not require new skills. There were mixed views about the value of the information provided by RESTORE, depending on time since diagnosis and treatment. Personal factors, constraints of the intervention, and environmental context inhibited the integration and embedding of RESTORE into everyday life. Access to the intervention at an early stage in the treatment trajectory was important to effective utilisation, as were individual preferences for delivery of information. CONCLUSION The theoretical foundations of the intervention were sound. Participants derived benefits from the intervention but barriers to implementation and integration suggest that RESTORE and the trial processes require some modification before testing in a full trial. TRIAL REGISTRATION ISRCTN67521059 (10(th) October 2012).
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Affiliation(s)
- Michelle Myall
- University of Southampton, Faculty of Health Sciences, Southampton, SO17 1BJ, UK
| | - Carl R May
- University of Southampton, Faculty of Health Sciences, Southampton, SO17 1BJ, UK
| | - Chloe Grimmett
- University of Southampton, Faculty of Health Sciences, Southampton, SO17 1BJ, UK
| | - Christine M May
- University of Southampton, Faculty of Health Sciences, Southampton, SO17 1BJ, UK
| | - Lynn Calman
- University of Southampton, Faculty of Health Sciences, Southampton, SO17 1BJ, UK
| | - Alison Richardson
- University of Southampton, Faculty of Health Sciences, Southampton, SO17 1BJ, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Claire L Foster
- University of Southampton, Faculty of Health Sciences, Southampton, SO17 1BJ, UK.
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139
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Cnossen IC, van Uden-Kraan CF, Eerenstein SEJ, Jansen F, Witte BI, Lacko M, Hardillo JA, Honings J, Halmos GB, Goedhart-Schwandt NLQ, de Bree R, Leemans CR, Verdonck-de Leeuw IM. An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction. Support Care Cancer 2015; 24:1261-8. [PMID: 26306518 PMCID: PMC4729815 DOI: 10.1007/s00520-015-2896-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 08/09/2015] [Indexed: 12/23/2022]
Abstract
Purpose The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. Methods Health care professionals (HCPs) were invited to participate and to recruit TLPs. TLPs were informed on the self-care education program “In Tune without Cords” (ITwC) after which they gained access. A study specific survey was used (at baseline T0 and postintervention T1) on TLPs’ uptake. Usage, satisfaction (general impression, willingness to use, user-friendliness, satisfaction with self-care advice and strategies, Net Promoter Score (NPS)), sociodemographic, and clinical factors were analyzed. Results HCPs of 6 out of 9 centers (67 % uptake rate) agreed to participate and recruited TLPs. In total, 55 of 75 TLPs returned informed consent and the baseline T0 survey and were provided access to ITwC (73 % uptake rate). Thirty-eight of these 55 TLPs used ITwC and completed the T1 survey (69 % usage rate). Most (66 %) TLPs were satisfied (i.e., score ≥7 (scale 1–10) on 4 survey items) with the self-care education program (mean score 7.2, SD 1.1). NPS was positive (+5). Satisfaction with the self-care education program was significantly associated with (higher) educational level and health literacy skills (P = .004, P = .038, respectively). No significant association was found with gender, age, marital status, employment status, Internet use, Internet literacy, treatment modality, time since total laryngectomy, and quality of life. Conclusion The online self-care education program ITwC supporting early rehabilitation was feasible in clinical practice. In general, TLPs were satisfied with the program.
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Affiliation(s)
- Ingrid C Cnossen
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands
- Department of Clinical Psychology, VU University, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands
| | - Simone E J Eerenstein
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands
| | - Birgit I Witte
- Department of Epidemiology and Biostatistics, VU University Medical Center, PO Box 7057, 1007, MB, Amsterdam, The Netherlands
| | - Martin Lacko
- Department of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center (MUMC), PO Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - José A Hardillo
- Department of Otorhinolaryngology-Head and Neck Surgery, Erasmus University Medical Center (Erasmus MC), PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Jimmie Honings
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center (Radboud UMC), PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Gyorgy B Halmos
- Department of Otolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center Groningen (UMCG), PO Box 30001, 9700, RD, Groningen, The Netherlands
| | - Noortje L Q Goedhart-Schwandt
- Department of Otolaryngology-Head and Neck Surgery, Medical Center Leeuwarden (MCL), PO Box 888, 8901, BR, Leeuwarden, The Netherlands
| | - Remco de Bree
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center (UMCU), PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
- Department of Clinical Psychology, VU University, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands.
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Helping Patients to Help Themselves after Breast Cancer Treatment. Clin Oncol (R Coll Radiol) 2015; 27:640-6. [PMID: 26047887 DOI: 10.1016/j.clon.2015.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/11/2015] [Indexed: 01/11/2023]
Abstract
There is a rise in the number of women living with the long-term consequences of cancer and continuing to suffer unmet need as breast cancer survival improves. This paper includes an introduction to self-management and a discussion of the evidence around the effectiveness of the key intervention types that could help patients to help themselves after treatment. Self-management interventions are particularly beneficial in reducing bother from symptoms, without patients having to take on the additional burden of more unwanted side-effects frequently seen with pharmacological interventions. There is a need to prioritise the funding of these financially viable self-management strategies to ensure equity of access and that these interventions are available for those in need.
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Risendal BC, Dwyer A, Seidel RW, Lorig K, Coombs L, Ory MG. Meeting the challenge of cancer survivorship in public health: results from the evaluation of the chronic disease self-management program for cancer survivors. Front Public Health 2015; 2:214. [PMID: 25964922 PMCID: PMC4410485 DOI: 10.3389/fpubh.2014.00214] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 10/14/2014] [Indexed: 12/04/2022] Open
Abstract
Introduction Self-management has been identified as an important opportunity to improve health outcomes among cancer survivors. However, few evidence-based interventions are available to meet this need. Methods The effectiveness of an adapted version of the Chronic Disease Self-Management Program for cancer survivors called Cancer Thriving and Surviving was evaluated in a randomized trial. Outcomes were assessed at baseline and 6-months post program via written survey among 244 participants in Colorado. Repeated measures analysis was used to analyze pre/post program change. Results Statistically significant improvement was observed among those in the intervention in the following outcomes: Provider communication (+16.7% change); depression (−19.1%); energy (+13.8%); sleep (−24.9%) and stress-related problems (−19.2%); change over time was also observed in the controls for energy, sleep, and stress-related outcomes though to a lesser degree. Effect sizes of the difference in change over time observed indicate a net beneficial effect for provider communication (0.23); and decreases in depression (−0.18); pain (−0.19); problems related to stress (−0.17); and sleep (−0.20). Conclusion Study data suggest that the self-management support from adaptation of the CDSMP can reach and appeal to cancer survivors, improves common concerns in this population, and can fill an important gap in meeting the ongoing need for management of post-diagnosis issues in this growing segment of the U.S. population.
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Affiliation(s)
- Betsy C Risendal
- Community and Behavioral Health, Colorado School of Public Health , Aurora, CO , USA
| | - Andrea Dwyer
- Community and Behavioral Health, Colorado School of Public Health , Aurora, CO , USA
| | - Richard W Seidel
- Carilion Clinic, Virginia Tech Carilion School of Medicine , Roanoke, VA , USA
| | - Kate Lorig
- School of Medicine, Stanford University , Stanford, CA , USA
| | - Letoynia Coombs
- Colorado Health Outcomes, University of Colorado , Aurora, CO , USA
| | - Marcia G Ory
- Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health , College Station, TX , USA
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Foster C, Breckons M, Cotterell P, Barbosa D, Calman L, Corner J, Fenlon D, Foster R, Grimmett C, Richardson A, Smith PW. Cancer survivors' self-efficacy to self-manage in the year following primary treatment. J Cancer Surviv 2015; 9:11-9. [PMID: 25028218 PMCID: PMC4341005 DOI: 10.1007/s11764-014-0384-0] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 07/01/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE Cancer survivors are increasingly expected to manage the consequences of cancer and its treatment for themselves. There is evidence that self-efficacy is important for successful self-management and that this can be enhanced with support. The purpose of this study was to assess self-efficacy to manage problems in the year following primary treatment. METHODS This cross-sectional online survey included cancer survivors who had completed their treatment within the past 12 months. Self-efficacy was assessed and variables expected to be associated with self-efficacy were measured using validated scales including quality of life, well-being, illness perceptions, depression and social support. RESULTS One hundred eighty-two respondents (mean age 50; 81% female) completed the survey. They had been treated for a range of cancers; most commonly breast (45%). Self-efficacy scores varied between individuals and according to the illness-related task to be managed. Respondents were least confident in managing fatigue and most confident in accessing information about their cancer. Individuals most likely to report low self-efficacy were women, those experiencing higher levels of pain and/or depression, lower well-being scores, lower socio-economic status, low levels of social support, or a more negative perception of cancer. CONCLUSIONS Self-efficacy to self-manage problems faced as a consequence of cancer and its treatment can vary widely in the year following treatment. Fatigue may be particularly difficult to manage. IMPLICATIONS FOR CANCER SURVIVORS Variations in self-efficacy highlight the importance of assessing specific problems faced and people's confidence to manage them in order to tailor appropriate self-management support.
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Affiliation(s)
- C Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK,
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143
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The psychosocial needs of gynaecological cancer survivors: A framework for the development of a complex intervention. Eur J Oncol Nurs 2015; 19:349-58. [PMID: 25697547 DOI: 10.1016/j.ejon.2015.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 12/20/2014] [Accepted: 01/20/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE To develop and pilot test an intervention targeting the women's psychosocial needs during the follow-up period after surgical treatment for gynaecological cancer. METHODS The project consisted of four phases. Phase 1 involved development of an intervention on the basis of meetings with key healthcare professionals, a literature review and six semi-structured interviews with women who attended the existing follow-up program. The Guided Self-Determination (GSD) method developed in diabetes care was identified as an appropriate framework for the intervention. GSD consists of reflection sheets for patients and advanced professional communication skills. The GSD method was adapted to women in a follow-up program after gynaecologic cancer treatment (GSD-GYN-C). Phase 2 involved primary pilot testing of the intervention and the findings were used to modify the intervention in phase 3. This modification involved the development of additional reflection sheets and a fidelity assessment tool. A systematic training program was arranged for the GSD-GYN-C-nurses. Phase 4 involved secondary pilot testing where nurses and women confirmed the applicability of GSD-GYN-C and final adjustments were made. Selected measurements were tested for sensitivity during pilot testing. Data from phase 2 and 4 were also used to select the primary outcome and calculate power for a future randomized clinical trial (RCT). RESULTS Pilot testing supported our hypothesis that GSD-GYN-C may be transferable and useful to survivors of gynaecological cancer. CONCLUSION GSD-GYN-C was developed and validated and is now ready for evaluation in an RCT.
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144
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Shneerson C, Taskila T, Greenfield S, Gale N. A survey investigating the associations between self-management practices and quality of life in cancer survivors. Support Care Cancer 2015; 23:2655-62. [PMID: 25669966 DOI: 10.1007/s00520-015-2626-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 01/22/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore whether the use of self-management (SM) practices in cancer survivors impact on their health beliefs and quality of life (QoL). This is an important step in attempting to improve cancer survivors' health pathways and their experiences of living with cancer. METHODS A cross-sectional, postal survey study was undertaken amongst cancer survivors identified from a teaching hospital in the West Midlands, UK. The questionnaire collected demographic data from respondents and information on the number and types of SM practices-diet, exercise, complementary and alternative medicine (CAM), psychological therapies, support groups and spirituality/religion-cancer survivors used after completing their treatment. Information was also gathered regarding their QoL and internal health locus of control (HLC). RESULTS A total of 445 cancer survivors responded to the survey. Multi-linear regression analysis found a positive association between SM uptake and HLC; however, none was found between SM uptake and QoL. Treatment type, ethnicity and age were significantly associated with an increased use of SM practices. CONCLUSION The study findings have implications for health care providers, who need to be aware of the links between SM uptake and treatment type, ethnicity and age, when considering how best to incorporate SM into cancer survivors' lives. This can help cancer survivors who may benefit from using specific SM interventions that consider the socio-demographic and treatment-related factors impacting on them. Future research would benefit from assessing the motivations and benefits of cancer survivors of different ages, ethnicities and treatment modalities in terms of their decision-making about SM use. These findings suggest that SM uptake is associated with higher internal HLC in cancer survivors. However, the influence of treatment type, ethnicity and age plays a more significant role in determining SM uptake than HLC. Cancer survivors using SM may be more motivated to utilise SM practices in relation to their age, ethnicity and treatment type, generating positive health outcomes in the process. Policy-makers should be aware of the supportive role SM interventions can play in cancer care and survivorship, with future research focussing on the perceived benefit of these SM interventions to cancer survivors.
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Affiliation(s)
- C Shneerson
- School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK,
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145
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Foster C, Calman L, Grimmett C, Breckons M, Cotterell P, Yardley L, Joseph J, Hughes S, Jones R, Leonidou C, Armes J, Batehup L, Corner J, Fenlon D, Lennan E, Morris C, Neylon A, Ream E, Turner L, Richardson A. Managing fatigue after cancer treatment: development of RESTORE, a web-based resource to support self-management. Psychooncology 2015; 24:940-9. [DOI: 10.1002/pon.3747] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 12/03/2014] [Accepted: 12/16/2014] [Indexed: 11/10/2022]
Affiliation(s)
- C. Foster
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - L. Calman
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - C. Grimmett
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - M. Breckons
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - P. Cotterell
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - L. Yardley
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - J. Joseph
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - S. Hughes
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - R. Jones
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - C. Leonidou
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - J. Armes
- Florence Nightingale School of Nursing and Midwifery; Kings College London; London SW1 8WA UK
| | - L. Batehup
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - J. Corner
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - D. Fenlon
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - E. Lennan
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - C. Morris
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - A. Neylon
- Macmillan Cancer Support; London SE1 7UQ UK
| | - E. Ream
- School of Health Sciences; University of Surrey; Guildford GU2 7TE UK
| | - L. Turner
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - A. Richardson
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
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146
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Group medical consultations in the follow-up of breast cancer: a randomized feasibility study. J Cancer Surviv 2015; 9:450-61. [DOI: 10.1007/s11764-014-0421-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/16/2014] [Indexed: 11/25/2022]
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147
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Risendal B, Dwyer A, Seidel R, Lorig K, Katzenmeyer C, Coombs L, Kellar-Guenther Y, Warren L, Franco A, Ory M. Adaptation of the chronic disease self-management program for cancer survivors: feasibility, acceptability, and lessons for implementation. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:762-771. [PMID: 24903138 DOI: 10.1007/s13187-014-0652-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Self-management in chronic disease has been shown to improve patient-reported and health care-related outcomes. However, relatively little information about its utility in cancer survivorship is known. We evaluated the feasibility and acceptability of the delivery of an adaptation of the evidence-based Chronic Disease Self-management Program (Stanford) called Cancer Thriving and Surviving (CTS). Triangulated mixed methods were used to capture baseline characteristics and post-program experiences using a combination of closed- and open-ended survey items; emergent coding and simple descriptive statistics were used to summarize the data. Twenty-seven workshops were delivered by 22 CTS leaders to 244 participants between August 2011 and January 2013 in a variety of settings (48 % community, 30 % health care, 22 % regional/community cancer center). Representing a variety of cancer types, about half the participants were 1-3 years post-diagnosis and 45 % were 4 or more years from diagnosis. Program attendance was high with 84 % of participants attending four or more of the six sessions in the workshop. Overall, 95 % of the participants were satisfied with the program content and leaders, and would recommend the program to friends and family. These results confirm the feasibility and acceptability of delivery of a high-fidelity, peer-led model for self-management support for cancer survivors. Expansion of the CTS represents a powerful tool toward improving health-related outcomes in this at-risk population.
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Affiliation(s)
- B Risendal
- Community and Behavioral Health, Colorado School of Public Health, University of Colorado Cancer Center, 13001 E. 17th Street, MS F538, Aurora, CO, 80045, USA,
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148
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Balmer C, Griffiths F, Dunn J. A 'new normal': Exploring the disruption of a poor prognostic cancer diagnosis using interviews and participant-produced photographs. Health (London) 2014; 19:451-72. [PMID: 25323052 DOI: 10.1177/1363459314554319] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cancer survival is increasing, and many people are living years after cancer treatment. For example, it is predicted that 46 per cent of men and 56 per cent of women diagnosed in 2007 in England and Wales will survive their cancer for 5 years or more. However, 'survivors' may be living with significant physical, psychological and social disruption caused by their illness. Furthermore, huge disparities exist in the outcomes for different cancer 'types', and there has been little investigation of those living with 'poor prognostic' cancers. Our aim was to explore the experience of living after the diagnosis of a poor prognostic cancer. Data were gathered from 30 people via interviews and participants' own photographs. Our findings suggest that a full 'recovery' may be impossible after a cancer diagnosis. Such diagnoses will continue to threaten biographical trajectory and self-identity forever. 'Returning to normal' was considered highly important for participants, but a changed normality had to be accepted in which lives were managed carefully and a constant fear of recurrence created liminality and made 'survivorship' ambiguous. Experience was often complicated by the social response associated with cancer that hindered communication and increased isolation. Participant-produced photographs, used here for the first time specifically by a sample of people with poor prognosis cancer, proved to be an acceptable data collection method and have added a poignancy and 'completeness' to the data that have arguably led to a more comprehensive understanding.
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149
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Abstract
Patients with cancer can easily become overloaded with information about diagnosis, prognosis, treatments and side effects. One of a nurse's most important roles is to help patients and their families make sense of this, providing support and information through their cancer journey. However, many barriers exist, including the nurse's own knowledge limitations, time constraints and the patient's engagement with the nurse. This paper uses critical reflection to evaluate an incident from clinical practice involving a patient with prostate cancer suffering from a distressing side effect of treatment: urinary incontinence following a transurethral resection of the prostate (TURP). The paper examines nurse-patient communication, and evaluates how nurses can use communication strategies to minimise patient distress. Practical approaches to managing urinary incontinence are also discussed. This paper demonstrates that critical reflection is a valuable learning process that can alter clinical nursing practice to provide the best care for people with cancer.
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150
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Rebuilding self-confidence after cancer: a feasibility study of life-coaching. Support Care Cancer 2014; 23:651-9. [PMID: 25160492 DOI: 10.1007/s00520-014-2399-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 08/11/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Cancer survivors often experience decreased self-confidence which impacts negatively on their ability to self-manage the practical, social and emotional problems frequently faced as they emerge from end of treatment. This was a feasibility study of a life-coaching intervention, designed to rebuild confidence of survivors and support transition to life after cancer treatment. METHODS A one group pre-test, post-test design was used, recruiting participants from community organisations. Eligibility criteria are as follows: <1 year of completion of primary cancer treatment, aged >18, no metastases, and no mental health problems. Participants received one individualised face-to-face and five telephone coaching sessions over 3 months. Outcome measures are as follows: New General Self-Efficacy Scale, Hope Scale, Personal Well-being Index, Assessment of Survivorship Concerns, Quality of Life in Adult Cancer Survivors, Hospital Anxiety and Depression Scale, Social Difficulties Index, and a goal attainment score. Interviews explored feasibility, acceptability and impact of life-coaching and research design. RESULTS Nine women and two men were recruited, representing varying cancer diagnoses. All outcome measures were sensitive to change and indicated positive trends post-intervention. Participant interviews indicated the intervention was well received and had a positive impact. Lessons were learnt about study design, recruitment and intervention delivery. CONCLUSIONS Life-coaching has a potential to enable cancer survivors to manage the transition to life beyond cancer and effect change on a range of outcomes. The intervention was feasible to deliver and acceptable to survivors at a time when many struggle to make sense of life. It merits further evaluation through a randomised controlled trial.
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