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Keenan E, Morris R, Vasiliou VS, Thompson AR. A qualitative feasibility and acceptability study of an acceptance and commitment-based bibliotherapy intervention for people with cancer. J Health Psychol 2024; 29:410-424. [PMID: 38158736 PMCID: PMC11005316 DOI: 10.1177/13591053231216017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Self-directed bibliotherapy interventions can be effective means of psychological support for individuals with cancer, yet mixed findings as to the efficacy of these interventions indicate the need for further research. We investigated the experience of individuals with cancer after using a new self-help book, based on Acceptance and Commitment Therapy (ACT). Ten participants with cancer (nine females and one male, 40-89 years old) were given access to a bibliotherapy self-help ACT-based book and participated in post-intervention semi-structured interviews. Five themes were generated from reflexive thematic analysis: (1) The value of bibliotherapy (2) Timing is important (3) Resonating with cancer experiences (4) Tools of the book (5) ACT in action. The book was found to be acceptable (self-directed, accessible, understandable content, good responsiveness to exercises) and feasible (easy to use, ACT-consistent). Although not explicitly evaluated, participants' reports indicated defusion, present moment awareness, and consideration of values, as the ACT processes that contributed to adjustment, via helping them to regain control over their lives and become more present within the moment. Findings also indicate that the intervention may be best accessed following completion of initial medical treatment.
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Affiliation(s)
- Emma Keenan
- Cardiff and Vale University Health Board and Cardiff University
| | - Reg Morris
- Cardiff and Vale University Health Board and Cardiff University
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2
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Dirar A, Mekonnen W, Berhanu Z. The Experiences of Cervical Cancer Patients During Follow-Up Care in Ethiopia: A Qualitative Study. Cancer Manag Res 2022; 14:2507-2518. [PMID: 36035503 PMCID: PMC9416456 DOI: 10.2147/cmar.s373379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of the study was to explore the experiences among cervical cancer patients during follow-up care. Patients and Methods A qualitative study was conducted with purposively selected cervical cancer patients receiving follow-up treatment at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Data were collected using semi-structured interviews and analyzed via thematic analysis. Results The results obtained in this study indicated that women experienced a variety of physical and psychosocial difficulties in the context of cervical cancer care. The data analysis resulted in five themes. Women have undergone difficulties indicated as lack of satisfaction with the health care experience, dealing with treatment side effects, struggle in work and daily life, having stress, disruption in social relationships, and financial difficulties incurred because of their illness and treatment. Conclusion This study highlights that cervical cancer patient’s experience is the outcome of a complex interplay by personal, clinical, psychological, and social spheres. Thus, interdisciplinary approach between health and psychosocial professionals is needed during follow-up care in order to help women experience better psychosocial adjustment.
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Affiliation(s)
- Anteneh Dirar
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | | | - Zena Berhanu
- School of Social Work, Addis Ababa University, Addis Ababa, Ethiopia
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3
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Meaning in Life and the Acceptance of Cancer: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095547. [PMID: 35564946 PMCID: PMC9104184 DOI: 10.3390/ijerph19095547] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/04/2022]
Abstract
Meaning in life and acceptance of cancer are critical for patients to adjust to a cancer diagnosis and to improve psychological wellbeing. Little is known about the relationship between meaning in life and the acceptance of cancer. This study provides a systematic review of the associations between meaning in life and the acceptance of cancer in cancer patients. CINAHL, MEDLINE, PsycINFO, and SCOPUS databases were searched until 15 March 2021. Studies were included if they quantitatively examined the association between meaning in life and the acceptance of cancer in adult cancer patients/survivors and if they were published in peer-reviewed journals or in books. The study quality was assessed using Joanna Briggs Institute critical appraisal tools. Of the 4907 records identified through database searches, only 3 studies quantitatively examined the associations between meaning in life and the acceptance of cancer. The total sample involved 464 women with cancer. All three studies reported positive correlations between meaning in life and the acceptance of cancer (ranging from r = 0.19 to r = 0.38), whereas meaning in life did not predict the acceptance of cancer. Overall, the meaning in life–acceptance relationship has not been sufficiently investigated, though it has relevant theoretical and clinical implications for coping with cancer. High-quality studies are needed to better understand the relationship between meaning in life and the acceptance of cancer.
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Delivery of cancer care via an outpatient telephone support line: a cross-sectional study of oncology nursing perspectives on quality and challenges. Support Care Cancer 2022; 30:9079-9091. [PMID: 35980464 PMCID: PMC9387415 DOI: 10.1007/s00520-022-07327-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023]
Abstract
RATIONALE Patient support lines (PSLs) assist in triaging clinical problems, addressing patient queries, and navigating a complex multi-disciplinary oncology team. While providing support and training to the nursing staff who operate these lines is key, there is limited data on their experience and feedback. METHODS We conducted a cross-sectional study of oncology nurses' (ONs') perspectives on the provision of care via PSLs at a tertiary referral cancer center via an anonymous, descriptive survey. Measures collected included nursing and patient characteristics, nature of questions addressed, perceived patient and nursing satisfaction with the service, common challenges faced, and initiatives to improve the patient and nursing experience. The survey was delivered online, with electronic data collection, and analysis is reported descriptively. RESULTS Seventy-one percent (30/42) of eligible ONs responded to the survey. The most common disease site, stage, and symptom addressed by PSLs were breast cancer, metastatic disease, and pain, respectively. The most common reported issue was treatment-related toxicity (96.7%, 29/30). Sixty-seven percent (20/30) of respondents were satisfied with the care provided by the service; however, many areas for potential improvement were identified. Fifty-nine percent (17/29) of respondents recommended redefining PSLs' responsibilities for improved use, with 75% (6/8) ONs identifying high call volumes due to inappropriate questions as a barrier to care. Sixty percent (18/30) of ONs reported having hospital-specific management plans for common issues would improve the care provided by the PSL. CONCLUSION Despite high rates of satisfaction with the care provided by the PSL, our study identified several important areas for improvement which we feel warrant further investigation.
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Bangerter LR, Looze M, Barry B, Harder K, Griffin J, Dezutter M, Khera N, Ailawadhi S, Schaepe K, Fischer K. A hybrid method of healthcare delivery research and human-centered design to develop technology-enabled support for caregivers of hematopoietic stem cell transplant recipients. Support Care Cancer 2021; 30:227-235. [PMID: 34255180 DOI: 10.1007/s00520-021-06347-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/06/2021] [Indexed: 11/28/2022]
Abstract
Health information technology (HIT) is a widely recognized strategy to encourage cancer patients and caregivers to participate in healthcare delivery in a sustainable and cost-effective way. In the context of autologous hematopoietic cell transplant (HSCT), HIT-enabled tools have the potential to effectively engage, educate, support, and optimize outcomes of patients and caregivers in the outpatient setting. This study sought to leverage human-centered design to develop a high-fidelity prototype of a HIT-enabled psychoeducational tool for HSCT caregivers. Phase 1 focuses on breadth and depth of information gathering through a systematic review and semi-structured interviews to determine optimal tool use. Phase 2 engages in human-centered design synthesis and visualization methods to identify key opportunities for the HIT design. Phase 3 employs human-centered design evaluation, engaging caregivers to respond to low-fidelity concepts and scenarios to help co-design an optimal tool for HSCT. This study outlines a hybrid method of healthcare delivery research and human-centered design to develop technology-enabled support for HSCT caregivers. Herein, we present a design methodology for developing a prototype of HIT-enabled psychoeducational tool which can be leveraged to develop future eHealth innovations to optimize HSCT.
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Affiliation(s)
| | - Monica Looze
- Mayo Clinic Robert D. and Patricia E Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Barbara Barry
- Mayo Clinic Robert D. and Patricia E Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Kathleen Harder
- Center for Design in Health, University of Minnesota, Minneapolis, MN, USA
| | - Joan Griffin
- Mayo Clinic Robert D. and Patricia E Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Meredith Dezutter
- Mayo Clinic Robert D. and Patricia E Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Nandita Khera
- Division of Hematology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | | | - Karen Schaepe
- Mayo Clinic Robert D. and Patricia E Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Kristin Fischer
- Mayo Clinic Robert D. and Patricia E Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
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6
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Sutherland S, Durley KE, Gillies K, Glogowska M, Lasserson DS, Pugh C, Lowney AC. 'You see the empty bed which means it's either a transplant or a death': a qualitative study exploring the impact of death in the haemodialysis community. BMJ Open 2021; 11:e046537. [PMID: 34158299 PMCID: PMC8220525 DOI: 10.1136/bmjopen-2020-046537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore the impact of the death of a patient in the haemodialysis unit on fellow patients. METHODS We interviewed patients on dialysis in a tertiary dialysis centre using semistructured interviews. We purposively sampled patients who had experienced the death of a fellow patient. After interviews were transcribed, they were thematically analysed by independent members of the research team using inductive analysis. Input from the team during analysis ensured the rigour and quality of the findings. RESULTS 10 participants completed the interviews (6 females and 4 males with an age range of 42-88 years). The four core themes that emerged from the interviews included: (1) patients' relationship to haemodialysis, (2) how patients define the haemodialysis community, (3) patients' views on death and bereavement and (4) patients' expectations around death in the dialysis community. Patients noticed avoidance behaviour by staff in relation to discussing death in the unit and would prefer a culture of open acknowledgement. CONCLUSION Staff acknowledgement of death is of central importance to patients on haemodialysis who feel that the staff are part of their community. This should guide the development of appropriate bereavement support services and a framework that promotes the provision of guidance for staff and patients in this unique clinical setting. However, the authors acknowledge the homogenous sample recruited in a single setting may limit the transferability of the study. Further work is needed to understand diverse patient and nurse experiences and perceptions when sharing the knowledge of a patient's death and how they react to loss.
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Affiliation(s)
- Sheera Sutherland
- Oxford Kidney Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kirsty E Durley
- Department of Palliative Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kirsty Gillies
- Oxford Kidney Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Margaret Glogowska
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Daniel S Lasserson
- Population Evidence and Technologies, Warwick Medical School, University of Warwick, Coventry, UK
| | - Christopher Pugh
- Oxford Kidney Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - Aoife C Lowney
- Department of Palliative Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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7
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Sender A, Friedrich M, Leuteritz K, Stuckenberg E, Richter D, Stöbel-Richter Y, Lordick F, Geue K. Psychosocial aftercare of adolescent and young adult cancer survivors in Germany: Awareness, utilisation, satisfaction and associated factors. Psychooncology 2021; 30:1311-1321. [PMID: 33739567 DOI: 10.1002/pon.5678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/02/2021] [Accepted: 02/25/2021] [Indexed: 11/10/2022]
Abstract
AIM This study systematically assesses the awareness of, utilisation of and satisfaction with psychosocial care for adolescents and young adult (AYA) cancer survivors in aftercare. METHODS Survivors between 18 and 39 years were surveyed in aftercare. Awareness of, utilisation of and satisfaction with psychological counselling (PC), social-legal counselling (SLC) and other psychosocial care (OPC) were measured using self-developed questionnaires. Multivariate analyses were conducted to determine factors correlated with awareness and use of psychosocial care. RESULTS Five hundred and fourteen survivors participated; the mean age at diagnosis was 29.6 years (SD = 6.14). 54% of cancer survivors were aware of PC, 45% of SLC and 24% of OPC. Those who possessed knowledge about these services used it to a considerable extent (63%-74%), and the majority (66%-75%) was highly satisfied. No common factors could be found that increase the likelihood of being aware of these three services (R2 = 0.028-0.138). Female gender (OR = 2.08-2.18) and high anxiety (OR = 1.19-1.38) were identified as common factors that increase the likelihood of utilising psychosocial services (R2 = 0.160-0.395). CONCLUSION AYA who are aware of psychosocial services in aftercare are motivated to use them and express high satisfaction with use. For the utilisation of psychosocial services, anxiety and female gender can be identified as common factors. The visibility of psychosocial services for aftercare should be increased given the high number of unaware AYA survivors. The active and repeated addressing of psychosocial issues and regular provision of information (e.g., written guides on survivorship) by caregivers should be made a standard of care for AYA cancer survivors.
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Affiliation(s)
- Annekathrin Sender
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Katja Leuteritz
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Erik Stuckenberg
- St. Elisabeth and St. Barbara Hospital, Medical Clinic II, Halle (Saale), Germany
| | - Diana Richter
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Yve Stöbel-Richter
- University of Leipzig, Integrated Research and Treatment Center, Behavioral Medicine, Leipzig, Germany.,University of Zittau/Goerlitz, Faculty of Managerial and Cultural Studies, Goerlitz, Germany
| | - Florian Lordick
- University of Leipzig, Medical Center, University Cancer Center Leipzig, Leipzig, Germany
| | - Kristina Geue
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
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8
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Baijens LWJ, Walshe M, Aaltonen LM, Arens C, Cordier R, Cras P, Crevier-Buchman L, Curtis C, Golusinski W, Govender R, Eriksen JG, Hansen K, Heathcote K, Hess MM, Hosal S, Klussmann JP, Leemans CR, MacCarthy D, Manduchi B, Marie JP, Nouraei R, Parkes C, Pflug C, Pilz W, Regan J, Rommel N, Schindler A, Schols AMWJ, Speyer R, Succo G, Wessel I, Willemsen ACH, Yilmaz T, Clavé P. European white paper: oropharyngeal dysphagia in head and neck cancer. Eur Arch Otorhinolaryngol 2020; 278:577-616. [PMID: 33341909 PMCID: PMC7826315 DOI: 10.1007/s00405-020-06507-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
Purpose To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. Results Twenty-four sections on HNC-specific OD topics. Conclusion This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.
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Affiliation(s)
- Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. .,GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Magdeburg, Otto-von-Guericke University, Magdeburg, Germany
| | - Reinie Cordier
- Department of Special Needs Education, University of Oslo, Oslo, Norway.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Patrick Cras
- Department of Neurology, Born Bunge Institute, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Lise Crevier-Buchman
- Voice, Speech, Swallowing Lab, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital UVSQ and Research lab CNRS-UMR7018, Hôpital Foch, Suresnes, France
| | - Chris Curtis
- Swallows Head and Neck Cancer Charity, Blackpool, UK
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan University of Medical Sciences, Poznan, Poland
| | - Roganie Govender
- Head and Neck Cancer Centre, University College London Hospital, London, UK
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Kevin Hansen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kate Heathcote
- Robert White Centre for Airway, Voice and Swallow, Poole Hospital NHS Foundation Trust, Dorset, UK
| | - Markus M Hess
- Deutsche Stimmklinik, Hamburg, Germany.,Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sefik Hosal
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Atılım University, Medicana International Ankara, Ankara, Turkey
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - C René Leemans
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands
| | - Denise MacCarthy
- Division of Restorative Dentistry and Periodontology, Faculty of Health Sciences, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Beatrice Manduchi
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Jean-Paul Marie
- Department of Otorhinolaryngology, Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Reza Nouraei
- Department of Ear Nose and Throat Surgery, The Robert White Centre for Airway Voice and Swallowing, Poole Hospital NHS Foundation Trust, University of Southampton, Southampton, UK
| | - Claire Parkes
- Department of Speech and Language Therapy, St. James's Hospital, Dublin, Ireland
| | - Christina Pflug
- Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Walmari Pilz
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Nathalie Rommel
- Department Neurosciences, Experimental Otorhinolaryngology, Deglutology, University of Leuven, Leuven, Belgium
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Renee Speyer
- Department of Special Needs Education, University of Oslo, Oslo, Norway.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands.,Faculty of Health, School of Health and Social Development, Victoria, Australia
| | - Giovanni Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy.,Department of Oncology, University of Turin, Orbassano, TO, Italy
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anna C H Willemsen
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.,Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Taner Yilmaz
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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9
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Płotka A, Chęcińska A, Zając-Spychała O, Więckowska B, Kramer L, Szymańska P, Adamczewska-Wawrzynowicz K, Barełkowska M, Wachowiak J, Derwich K. Psychosocial Late Effects in Adolescent and Young Adult Survivors of Childhood Cancer Diagnosed with Leukemia, Lymphoma, and Central Nervous System Tumor. J Adolesc Young Adult Oncol 2020; 10:443-453. [PMID: 32857663 DOI: 10.1089/jayao.2020.0086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose: The prevalence of psychosocial late effects and quality of life in adolescent and young adult (AYA)-aged survivors of pediatric cancer have been studied. Methods: The study was conducted in AYA survivors who had been diagnosed with leukemia, lymphoma, or brain tumor, had completed treatment at least 1 year before the study, and were 15-39 years old at study enrollment. The control group consisted of healthy volunteers. A questionnaire comprised a demographic form, eight questions concerning mental health and the disease, and survey The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. Controls received a questionnaire without questions concerning an illness. Results: Most of survivors believed that cancer treatment might have a serious influence on their health. Survivors significantly more frequently declared using drugs: neuroleptics, tranquilizers, and antidepressants than controls. Survivors of leukemia demonstrated significantly more problems in cognitive functioning than lymphoma survivors. Females were significantly more disabled in emotional functioning than males. Young adults more often reported dysfunction in emotional functioning compared to adolescents. Survivors who were assessed ≥10 years since therapy reported significantly more disadvantage in social functioning than those assessed <10 years since treatment completion. Survivors reported significantly more disadvantages in social functioning than controls. Allogeneic hematopoietic stem cell transplantation survivors more often suffered cognitive limitations. Irradiated survivors more often attended psychological therapy. Conclusions: Survivors of pediatric cancer are vulnerable to consequences of oncological treatment, making their quality life significantly worse in comparison with healthy controls. They need to be monitored, supported, and educated.
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Affiliation(s)
- Anna Płotka
- University Hospital of Lord's Transfiguration, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Chęcińska
- Heliodor Swiecicki University Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, and Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Więckowska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Lucyna Kramer
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Paulina Szymańska
- Department of Pediatric Oncology, Hematology and Transplantology, and Poznan University of Medical Sciences, Poznan, Poland
| | | | - Monika Barełkowska
- Department of Pediatric Oncology, Hematology and Transplantology, and Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, and Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Derwich
- Department of Pediatric Oncology, Hematology and Transplantology, and Poznan University of Medical Sciences, Poznan, Poland
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10
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Ousseine YM, Bouhnik AD, Peretti-Watel P, Sarradon-Eck A, Memoli V, Bendiane MK, Durand MA, Mancini J. The impact of health literacy on medico-social follow-up visits among French cancer survivors 5 years after diagnosis: The national VICAN survey. Cancer Med 2020; 9:4185-4196. [PMID: 32329183 PMCID: PMC7300405 DOI: 10.1002/cam4.3074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 12/18/2022] Open
Abstract
Background Long‐term medico‐social follow‐up of cancer survivors is a challenge because of frequent subsequent troubles. In particular survivors with lower health literacy (HL) have poorer health and might more often use primary care services. However, the impact of HL on cancer survivors’ medico‐social follow‐up visits is not known. Our aim was to study medico‐social follow‐up and its associated determinants with a focus on HL 5 years after diagnosis. Methods VICAN is a national survey of French adult cancer survivors 5 years after a primary cancer. The Single‐Item Literacy Screener was used to define functional HL in this sample. We also asked patients to report the frequency of follow‐up visits with a general practitioner (GP) and/or social worker (SW) regarding their cancer disease. Results The 4045 participants were 57.4 ± 12.9 years old at diagnosis (range 20‐82) and 1495 (37%) were classified as having inadequate HL. Most cancer survivors (66.7%) were followed up by a GP regarding their cancer while only 14.5% had contact with a SW. After adjustment for sociodemographic, medical, and psychosocial characteristics, medico‐social follow‐ups (GP and SW visits) were more frequent among survivors with low HL. Furthermore, low income, unemployment, impaired mental health, treatment by chemotherapy, and perception of sequelae and fatigue were also associated with more frequent medico‐social follow‐up. Cancer localization association with medico‐social follow‐up was heterogeneous. Conclusion French cancer survivors with limited HL, lower socioeconomic status, and more severe cancer were more likely to use GP care and social services. Raising awareness and training GPs and SWs on medico‐social follow‐up for patients with limited HL seem necessary to support these vulnerable survivors.
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Affiliation(s)
- Youssoufa M Ousseine
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Anne-Déborah Bouhnik
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | | | - Aline Sarradon-Eck
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,Institut Paoli-Calmettes, UMR1252 SESSTIM CANBIOS, Marseille, France
| | - Victoria Memoli
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Marc-Karim Bendiane
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Marie-Anne Durand
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | - Julien Mancini
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,APHM, Hop Timone, BIOSTIC, Marseille, France
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11
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Abstract
Caring for patients who are dying is both a challenging and demanding role. This is further intensified by the expectation that in addition to attending to physical issues, nurses are expected to manage the emotional and psychological aspects of the situation. The inconsistent nature of the care pathways between differing specialist services can often mean that open access to specialist services is not possible. As such, staff may find themselves inadvertently supplementing and often reinforcing interventions offered by specialist (psychological) services with little consideration given to capacity, experience and resources. As the most ‘consistently present’ professionals in such settings, it is important for nursing colleagues to be aware of the emotional and psychological themes common to patients who are dying. Thus, allowing patients access to supportive conversation with professionals as and when required, ameliorating unnecessary distress.
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Affiliation(s)
- Feryad A Hussain
- Clinical Psychologist, Cancer and End-of-Life Services, Black Country Partnership NHS Foundation Trust, West Bromwich
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12
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Ahmadi F, Mohamed Hussin NA, Mohammad MT. Religion, Culture and Meaning-Making Coping: A Study Among Cancer Patients in Malaysia. JOURNAL OF RELIGION AND HEALTH 2019; 58:1909-1924. [PMID: 29948793 PMCID: PMC6842329 DOI: 10.1007/s10943-018-0636-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The present study aimed to explore the use of meaning-making coping mechanisms (existential, spiritual and religious coping) among ethnic Malay cancer patients in Malaysia and to investigate the impact of culture on their choice of coping methods. Twenty-nine participants with various kinds of cancer were interviewed. Four kinds of coping resources emerged from analyses of the interview transcripts: (1) relying on transcendent power, (2) supernatural or mystical beliefs, (3) finding oneself in relationships with others and (4) nature. In this article, the two first resources are in focus. The present findings suggest that Malay culture, which is imbued with Islamic belief, strongly influences cancer patients' coping methods and ways of looking at their experience of being cancer patients.
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Affiliation(s)
- Fereshteh Ahmadi
- Department of Social Work and Psychology, Faculty of Health and Occupational Studies, University of Gävle, 801 76 Gävle, Sweden
| | - Nur Atikah Mohamed Hussin
- Social Work Section, School of Social Sciences, Universiti Sains Malaysia, 11800 Pulau Pinang, Malaysia
| | - Mohd Taufik Mohammad
- Social Work Section, School of Social Sciences, Universiti Sains Malaysia, 11800 Pulau Pinang, Malaysia
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13
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Best-Evidence Rehabilitation for Chronic Pain Part 2: Pain during and after Cancer Treatment. J Clin Med 2019; 8:jcm8070979. [PMID: 31284377 PMCID: PMC6678417 DOI: 10.3390/jcm8070979] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/24/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022] Open
Abstract
Pain during, and especially after, cancer remains underestimated and undertreated. Moreover, both patients and health care providers are not aware of potential benefits of rehabilitation strategies for the management of pain during and following cancer treatment. In this paper, we firstly provided a state-of-the-art overview of the best evidence rehabilitation modalities for patients having (persistent) pain during and following cancer treatment, including educational interventions, specific exercise therapies, manual therapies, general exercise therapies and mind-body exercise therapies. Secondly, the findings were summarized from a clinical perspective and discussed from a scientific perspective. In conclusion, best evidence suggests that general exercise therapy has small pain-relieving effects. Supporting evidence for mind-body exercise therapy is available only in breast cancer patients. At this moment, there is a lack of high-quality evidence to support the use of specific exercises and manual therapy at the affected region for pain relief during and after cancer treatment. No clinically relevant results were found in favor of educational interventions restricted to a biomedical approach of pain. To increase available evidence these rehabilitation modalities should be applied according to, and within, a multidisciplinary biopsychosocial pain management approach. Larger, well-designed clinical trials tailored to the origin of pain and with proper evaluation of pain-related functioning and the patient’s pain experience are needed.
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14
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Lagergren P, Schandl A, Aaronson NK, Adami HO, de Lorenzo F, Denis L, Faithfull S, Liu L, Meunier F, Ulrich C. Cancer survivorship: an integral part of Europe's research agenda. Mol Oncol 2019; 13:624-635. [PMID: 30552794 PMCID: PMC6396379 DOI: 10.1002/1878-0261.12428] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022] Open
Abstract
Cancer survivorship has traditionally received little prioritisation and attention. For a long time, the treatment of cancer has been the main focus of healthcare providers’ efforts. It is time to increase the amount of attention given to patients’ long‐term well‐being and their ability to return to a productive and good life. This article describes the current state of knowledge and identifies research areas in need of development to enable interventions for improved survivorship for all cancer patients in Europe. The article is summed up with 11 points in need of further focus.
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Affiliation(s)
- Pernilla Lagergren
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Surgery and Cancer, Imperial College London, UK
| | - Anna Schandl
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Quality and Patient Safety, Karolinska University Hospital, Stockholm, Sweden
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Norway
| | - Francesco de Lorenzo
- European Cancer Patient Coalition, Brussels, Belgium.,Italian Federation of Cancer Patients Organisations, Rome, Italy
| | | | - Sara Faithfull
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Lifang Liu
- Fédération of European Academies of Medicine, Brussels, Belgium
| | | | - Cornelia Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
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15
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Schepisi G, De Padova S, De Lisi D, Casadei C, Meggiolaro E, Ruffilli F, Rosti G, Lolli C, Ravaglia G, Conteduca V, Farolfi A, Grassi L, De Giorgi U. Psychosocial Issues in Long-Term Survivors of Testicular Cancer. Front Endocrinol (Lausanne) 2019; 10:113. [PMID: 30858829 PMCID: PMC6397854 DOI: 10.3389/fendo.2019.00113] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/07/2019] [Indexed: 01/20/2023] Open
Abstract
Testicular cancer is the most frequent tumor in young males aged 15-39 years. As cure rates are currently around 90%, the prevalence of survivors is increasing. However, a disease-free condition does not necessarily correspond to a life free of physical and psychosocial health problems. The aim of this review was to explore psychosocial morbidity among testicular cancer survivors. A literature search was conducted in three electronic databases (PubMed, Medline, and Embase). The results of the search on cancer survivors were then combined with those of the search on psychosocial concerns and work performance. Eighty-four publications met the inclusion criteria. Physical, psychological, work-related problems and changing perspectives about work and life in general influenced life and career decisions among testicular cancer survivors. Individual health, sexual relationships and work problems, affect several important aspects of survival and significantly influence the QoL of long-term survivors.
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Affiliation(s)
- Giuseppe Schepisi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
- *Correspondence: Giuseppe Schepisi
| | - Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Delia De Lisi
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | - Chiara Casadei
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Elena Meggiolaro
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Federica Ruffilli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Giovanni Rosti
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Cristian Lolli
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Giorgia Ravaglia
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Vincenza Conteduca
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Alberto Farolfi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Luigi Grassi
- Hospital Psychiatry Unit, Department of Biomedical and Specialty Surgical Sciences, Integrated Department of Mental Health and Addictive Behavior, Institute of Psychiatry, St. Anna University Hospital and NHS Community Health Trusts, University of Ferrara, Ferrara, Italy
| | - Ugo De Giorgi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
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16
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Martínez Arroyo O, Andreu Vaíllo Y, Martínez López P, Galdón Garrido MJ. Emotional distress and unmet supportive care needs in survivors of breast cancer beyond the end of primary treatment. Support Care Cancer 2018; 27:1049-1057. [DOI: 10.1007/s00520-018-4394-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/31/2018] [Indexed: 01/16/2023]
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17
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Cancer-coping profile predicts long-term psychological functions and quality of life in cancer survivors. Support Care Cancer 2018; 27:933-941. [DOI: 10.1007/s00520-018-4382-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
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18
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Nipp RD, El-Jawahri A, D'Arpino SM, Chan A, Fuh CX, Johnson PC, Lage DE, Wong RL, Pirl WF, Traeger L, Cashavelly BJ, Jackson VA, Ryan DP, Hochberg EP, Temel JS, Greer JA. Symptoms of posttraumatic stress disorder among hospitalized patients with cancer. Cancer 2018; 124:3445-3453. [PMID: 29905935 DOI: 10.1002/cncr.31576] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/01/2018] [Accepted: 05/07/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patients with cancer experience many stressors placing them at risk for posttraumatic stress disorder (PTSD) symptoms, yet little is known about factors associated with PTSD symptoms in this population. This study explored relationships among patients' PTSD symptoms, physical and psychological symptom burden, and risk for hospital readmissions. METHODS We prospectively enrolled patients with cancer admitted for an unplanned hospitalization from August 2015-April 2017. Upon admission, we assessed patients' PTSD symptoms (Primary Care PTSD Screen), as well as physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire 4 [PHQ-4]) symptoms. We examined associations between PTSD symptoms and patients' physical and psychological symptom burden using linear regression. We evaluated relationships between PTSD symptoms and unplanned hospital readmissions within 90-days using Cox regression. RESULTS We enrolled 954 of 1,087 (87.8%) patients approached, and 127 (13.3%) screened positive for PTSD symptoms. The 90-day hospital readmission rate was 38.9%. Younger age, female sex, greater comorbidities, and genitourinary cancer type were associated with higher PTSD scores. Patients' PTSD symptoms were associated with physical symptoms (ESAS physical: B = 3.41; P < .001), the total symptom burden (ESAS total: B = 5.97; P < .001), depression (PHQ-4 depression: B = 0.67; P < .001), and anxiety symptoms (PHQ-4 anxiety: B = 0.71; P < .001). Patients' PTSD symptoms were associated with a lower risk of hospital readmissions (hazard ratio, 0.81; P = .001). CONCLUSIONS A high proportion of hospitalized patients with cancer experience PTSD symptoms, which are associated with a greater physical and psychological symptom burden and a lower risk of hospital readmissions. Interventions to address patients' PTSD symptoms are needed and should account for their physical and psychological symptom burden. Cancer 2018. © 2018 American Cancer Society.
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Affiliation(s)
- Ryan D Nipp
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Areej El-Jawahri
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Sara M D'Arpino
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Andy Chan
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Charn-Xin Fuh
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - P Connor Johnson
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Daniel E Lage
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Risa L Wong
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - William F Pirl
- Department of Psychiatry, Sylvester Comprehensive Cancer Center and University of Miami, Miami, Florida
| | - Lara Traeger
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Barbara J Cashavelly
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Vicki A Jackson
- Division of Palliative Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - David P Ryan
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Ephraim P Hochberg
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Jennifer S Temel
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Joseph A Greer
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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19
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Existential distress and meaning-focused interventions in cancer survivorship. Curr Opin Support Palliat Care 2018; 12:46-51. [DOI: 10.1097/spc.0000000000000324] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Abate C, Lippé S, Bertout L, Drouin S, Krajinovic M, Rondeau É, Sinnett D, Laverdière C, Sultan S. Could we use parent report as a valid proxy of child report on anxiety, depression, and distress? A systematic investigation of father-mother-child triads in children successfully treated for leukemia. Pediatr Blood Cancer 2018; 65. [PMID: 29049860 DOI: 10.1002/pbc.26840] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Systematic assessment of emotional distress is recommended in after care. Yet, it is unclear if parent report may be used as a proxy of child report. The aim of this study was to assess agreements and differences and explore possible moderators of disagreement between child and parent ratings. METHODS Sixty-two young survivors treated for acute lymphoblastic leukemia (9-18 years) and both parents responded to the Beck Youth Inventory (anxiety and depression) and the distress rating scale on the child's status. Parents completed the Brief Symptom Inventory-18 on their own psychological status. Systematic analyses of agreement and differences were performed. RESULTS Mother-child and father-child agreements were fair on anxiety, depression, and distress (median intraclass correlation coefficient = 0.37). Differences between parents and children were medium sized (median d = 0.55) with parents giving higher scores than their children on anxiety, depression, and distress. Mothers reported distress more frequently than fathers (39 vs. 17%) when children reported none. The child being female and lower parental income were associated with lower agreement in fathers when rating child distress. Higher levels of parental psychological symptoms were consistently associated with lower agreement. CONCLUSIONS Parent-child differences when rating adolescent survivors' difficulties may be more important than previously thought. Parent report probably cannot be considered as a valid proxy of older child report on such internalized domains as anxiety, depression, or distress in the after-care clinic. Parents' report is also likely to be influenced by their own mood, a factor that should be corrected for when using their report.
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Affiliation(s)
- Cybelle Abate
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Sarah Lippé
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Maja Krajinovic
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Québec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Québec, Canada
| | - Serge Sultan
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Québec, Canada
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21
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De Angelis R, Grande E, Inghelmann R, Francisci S, Micheli A, Baili P, Meneghini E, Capocaccia R, Verdecchia A. Cancer Prevalence Estimates in Italy from 1970 to 2010. TUMORI JOURNAL 2018; 93:392-7. [PMID: 17899871 DOI: 10.1177/030089160709300411] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Aims and background The growing number of cancer survivors in Italy is expected to continue to increase as a consequence of population aging and survival improvements, but few estimates are currently available, particularly on the national and regional scale. The purpose of this work is to present detailed and updated prevalence estimates in Italy over the period 1970-2010 by cancer site (all cancers combined, stomach, colon and rectum, lung, breast and prostate) and gender. Methods Prevalence was derived with the MIAMOD statistical method, using cancer-specific mortality and relative survival as input data. Survival data from the Italian cancer registries were modeled to derive a national estimate for each cancer site and sex. To estimate prevalence trends, survival was assumed to improve in the future with the same rate observed in the period 1978-1994. A double scenario for survival - increasing or stationary - was considered to decompose the prevalence growth from 1995 to 2005 by its determinants: demographic changes, incidence and survival dynamics. The prevalence estimates were also decomposed by disease duration (2, 5 and 10 years) and by age (0-44, 45-59, 60-74 and 75-99). Results The proportion of cancer survivors in 2010 is expected to be about 4% in women and 3% in men, about twice the values attained in 1990. The highest dynamics was observed for prostate cancer, with a three-fold increase just in the 1995-2005 period (from 212 to 623 per 100,000), whereas in absolute terms breast cancer presented the highest levels (1,700 per 100,000 in 2010). The overall number of cancer prevalent cases is expected to rise by about 48% in the decennium 1995-2005 (from 1,152,000 to 1,709,000), and this growth is mainly attributable to incidence dynamics (+21%), then to survival improvements (+14%) and population aging (13%). In 2005, the 2-year prevalent cases were estimated to be 20% of all cancer survivors, 21% between 2 and 5 years from the diagnosis, 23% between 5 and 10 years, with 36% surviving for more than 10 years. Prevalence proportion was very high in the elderly (12.6% for 75-84 years and 8% for 60-74 years). Conclusions Updated prevalence data with appropriate coverage of the national territory are essential to define priorities in health care management and to develop cancer control programs. Prevalence by disease duration and by age should be the basis for planning research on the quality of life of cancer survivors, as long as cancer continues to become an even more chronic disease.
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Affiliation(s)
- Roberta De Angelis
- Reparto di Epidemiologia dei Tumori, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
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22
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Provision of integrated psychosocial services for cancer survivors post-treatment. Lancet Oncol 2017; 18:e39-e50. [PMID: 28049576 DOI: 10.1016/s1470-2045(16)30659-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 12/25/2022]
Abstract
Meeting the psychosocial needs of patients with cancer has been recognised as a priority within oncology care for several decades. Many approaches that address these needs have been developed and described; however, until recently much of this work had focused on patients during treatment and end-of-life care. With continued improvement in therapies, the population of cancer survivors who can expect to live for 5 or more years after cancer diagnosis has increased dramatically, as have associated concerns about how to meet their medical, psychosocial, and health behaviour needs after treatment. Guidelines and models for general survivorship care routinely address psychosocial needs, and similar guidelines for psychosocial care of patients with cancer are being extended to address the needs of survivors. In this Series paper, we summarise the existing recommendations for the provision of routine psychosocial care to survivors, as well as the challenges present in providing this care. We make specific recommendations for the integration of psychosocial services into survivorship care.
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23
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van Stam MA, van der Poel HG, Bosch JLHR, Tillier CN, Horenblas S, Mols F, Aaronson NK. Prevalence and correlates of mental health problems in prostate cancer survivors: A case-control study comparing survivors with general population peers. Urol Oncol 2017; 35:531.e1-531.e7. [PMID: 28457651 DOI: 10.1016/j.urolonc.2017.03.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/22/2017] [Accepted: 03/27/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The purpose of this study was to identify factors associated with mental health (MH) problems in prostate cancer (PC) survivors. Toward this end, we evaluated (1) differences in the prevalence of MH problems between PC survivors and age-matched men from the general population (GenPop) and (2) correlates of MH in PC survivors and the GenPop. METHODS AND MATERIALS In this observational case-control study, we age-matched PC survivors (n = 644, alive≥5y after diagnosis of a stage I-IV carcinoma) recruited from Dutch community hospitals (Patient Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship registry) with GenPop peers (n = 644) selected from a population-based sample recruited in general practices (NIVEL). MH was operationalized using the 5-item Mental Health Inventory of the Short Form Health Survey (SF-36). Potential correlates of MH included sociodemographic characteristics, health-related quality of life scores, and clinical characteristics (PC survivors only). We used analysis of (co)variance and chi-square tests to address the 2 research questions. RESULTS We observed clinically relevant MH symptoms in 14% of the PC survivors and 6% of the GenPop controls (P<0.01, odds ratio = 2.45 [1.66-3.62]). The most important correlates of lower MH scores in the PC survivors were being widowed, a lower educational level, lower general health perceptions, more bodily pain and urinary bother, and less sexual satisfaction. The most important correlates of lower MH scores in the GenPop were as follows: lower general health perceptions, more role limitations because of physical problems, and more bodily pain. CONCLUSIONS Our results indicate that long-term PC survivors have poorer MH, as assessed by the 5-item Mental Health Inventory questionnaire, than men of a comparable age from the GenPop without a history of PC. Attention to potentially modifiable factors associated with MH problems in PC survivors, such as urinary function and its related bother, bodily pain, and sexual satisfaction, may help to prevent or limit MH problems in this survivor population.
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Affiliation(s)
- Marie-Anne van Stam
- Urology Department, University Medical Center Utrecht, Utrecht, The Netherlands; Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Henk G van der Poel
- Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J L H Ruud Bosch
- Urology Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Corinne N Tillier
- Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Simon Horenblas
- Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Floor Mols
- Department of Medical and Clinical Psychology, Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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24
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Koutri I, Avdi E. The suspended self: Liminality in breast cancer narratives and implications for counselling. EUROPEAN JOURNAL OF COUNSELLING PSYCHOLOGY 2016. [DOI: 10.5964/ejcop.v5i1.92] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In the field of chronic and serious illness, meaning-making with regards to the illness experience has been shown to be a core process for patients. This study focuses on women's narratives of their experiences of living with breast cancer. Within the framework of narrative psychology, illness narratives are considered to provide the main means through which patients make sense of their illness experience and construct its place in their life story. In this paper, we present findings from a narrative study that aimed to explore the different meanings that breast cancer holds for Greek women. In the broader study, four basic narrative types about breast cancer emerged from the analysis. In this paper, we focus on one of these narrative types, in which illness is constructed as an entrance into a state of liminality and where the women's sense of self seems to be “suspended”. The core features of this narrative type are described and arguments are developed regarding its usefulness. We argue that this is a narrative type that deserves further attention, particularly as it seems to reflect a socially non-preferred storyline, which might result in these women's stories being sidestepped or silenced. The implications of this narrative type for healthcare and counselling in cancer care are discussed.
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Geerse OP, Wynia K, Kruijer M, Schotsman MJ, Hiltermann TJN, Berendsen AJ. Health-related problems in adult cancer survivors: development and validation of the Cancer Survivor Core Set. Support Care Cancer 2016; 25:567-574. [PMID: 27743119 PMCID: PMC5196012 DOI: 10.1007/s00520-016-3439-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 10/02/2016] [Indexed: 12/28/2022]
Abstract
Purpose Improved survival rates from cancer have increased the need to understand the health-related problems of cancer treatment. We aimed to develop and validate the “Cancer Survivor Core Set” representing the most relevant health-related problems in adult cancer survivors using the International Classification of Functioning, Disability, and Health (ICF). Methods First, a Delphi study was conducted to select ICF categories representing the most relevant health-related problems. There were three Dutch expert panels, one each for lung, colorectal, and breast cancer. Each panel comprised lay experts and professionals. The experts reached within- and between-panel consensus in two rounds (≥70 % agreement). Second, a validation study was performed. Generic cancer survivorship questionnaires assessing health-related problems or quality of life among cancer survivors were selected. Items of selected questionnaires were linked to the best-fitting ICF category and to the selected ICF categories from the Delphi study, respectively. Results In total, 101 experts were included, of which 76 participated in both rounds, reaching consensus on 18 ICF categories. The Distress Thermometer and Problem List, the Impact of Cancer (v2), and the Quality of Life in Adult Cancer Survivors questionnaires were selected for the validation study, which led to the inclusion of one additional ICF category. Conclusions The developed Cancer Survivor Core Set consisted of 19 ICF categories representing the most relevant health-related problems in adult cancer survivors: five from the “body functions and structures” component, eight from the “activities and participation” component, and six from the “environmental factors” component. Highlights • Many adult cancer survivors have persistent health-related problems. • The Cancer Survivor Core Set was developed using the Delphi method. • The patients’ perspectives were prioritized in this Delphi study • Content validity was confirmed by validated cancer survivorship questionnaires. • The Cancer Survivor Core Set may help optimize care for cancer survivors. Electronic supplementary material The online version of this article (doi:10.1007/s00520-016-3439-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- O P Geerse
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - K Wynia
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M Kruijer
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M J Schotsman
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - T J N Hiltermann
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - A J Berendsen
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Tierney DK, Palesh O, Johnston L. Sexuality, Menopausal Symptoms, and Quality of Life in Premenopausal Women in the First Year Following Hematopoietic Cell Transplantation. Oncol Nurs Forum 2016; 42:488-97. [PMID: 26302277 DOI: 10.1188/15.onf.488-497] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe sexuality, menopausal symptoms, and quality of life (QOL) in premenopausal women in the first year following hematopoietic cell transplantation (HCT)
. DESIGN One-year prospective longitudinal study. SETTING Stanford University Medical Center in California.
. SAMPLE 63 premenopausal female recipients of HCT with a mean age of 34.5 years. METHODS Three instruments were used. MAIN RESEARCH VARIABLES Sexuality, menopausal symptoms, and QOL
. FINDINGS At one year post-HCT, women reported absent to low desire and arousal, adequate lubrication less than half of the time, absent or rare orgasm, pain during vaginal penetration more than half the time, and dissatisfaction with overall sex life. Women also reported moderate to severe vasomotor symptoms, including hot flashes, night sweats, and sweating. Twenty-one women were avoiding sexual activity, and 25 women were not sexually active. Mean QOL scores significantly increased (p = 0.028) in the first year, signifying an improvement in QOL. Variables predictive of improved QOL at one year post-HCT include decreased psychosocial and physical symptoms, sexual satisfaction, and pre-HCT QOL score
. CONCLUSIONS One year post-HCT, women reported sexual dysfunction, sexual dissatisfaction, and menopausal symptoms, which negatively affect QOL. IMPLICATIONS FOR NURSING Nurses and other healthcare providers working with recipients of HCT can provide anticipatory guidance on potential changes in sexuality and menopausal symptoms to facilitate adaptation by reducing discordance between expectations and new realities
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Michel G, Vetsch J. Screening for psychological late effects in childhood, adolescent and young adult cancer survivors: a systematic review. Curr Opin Oncol 2016; 27:297-305. [PMID: 26049268 DOI: 10.1097/cco.0000000000000196] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW In the past years, increasing evidence showed that many childhood cancer survivors suffer from psychological distress long after treatment ended. However, psychosocial issues are often neglected during follow-up care. Including screening for psychological distress before follow-up appointments might help addressing the topic in survivors who need support. Our aim was to systematically review the available evidence on screening for psychological distress in childhood cancer survivors. RECENT FINDINGS We found eight studies that investigated different screening tools for their utility in detecting psychological distress in childhood cancer survivors. The Brief Symptom Inventory-18 with an adapted cutoff score for childhood cancer survivors, and the newly developed short form of the Beck Depression Index were both shown to be of a potential benefit as brief screening tools in follow-up care. SUMMARY We identified promising screening tools to be used to detect psychological distress in childhood cancer survivors. However, there is still a lack of studies addressing applicability and effectiveness when screening is routinely implemented into follow-up care. To improve quality of follow-up care, and identify and treat survivors with psychological distress, screening tools should now be implemented and their adequacy further tested in day-to-day clinic life.
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Affiliation(s)
- Gisela Michel
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
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Lown EA, Phillips F, Schwartz LA, Rosenberg AR, Jones B. Psychosocial Follow-Up in Survivorship as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S514-84. [PMID: 26700918 PMCID: PMC5242467 DOI: 10.1002/pbc.25783] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 01/08/2023]
Abstract
Childhood cancer survivors (CCS) have a high risk of medical late effects following cancer therapy. Psychosocial late effects are less often recognized. Many CCS do not receive long-term follow-up (LTFU) care, and those who do are rarely screened for psychosocial late effects. An interdisciplinary team conducted a systematic review of qualitative and quantitative studies to assess social, educational, vocational, psychological, and behavioral outcomes along with factors related to receipt of LTFU care. We propose that psychosocial screening be considered a standard of care in long-term follow-up care and that education be provided to promote the use LTFU care starting early in the treatment trajectory.
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Affiliation(s)
- E. Anne Lown
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
| | - Farya Phillips
- School of Social Work, The University of Texas at Austin, Austin, Texas
| | - Lisa A. Schwartz
- The Children’s Hospital of Philadelphia and The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Abby R. Rosenberg
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Barbara Jones
- School of Social Work, The University of Texas at Austin, Austin, Texas
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Hvidt EA. The existential cancer journey: Travelling through the intersubjective structure of homeworld/alienworld. Health (London) 2015; 21:375-391. [DOI: 10.1177/1363459315617312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the past couple of decades, there has been significant interest in the research literature and patient narratives that focus on describing the cancer journey as involving existential and spiritual transformative experiences. The purpose of this article is to contribute with a new and deepened understanding of the existing literature by offering a philosophical informed analytic conceptualization that highlights the ‘liminal’, transformative and ‘generative’ dimension of the cancer journey. For that purpose, qualitative data drawn from a qualitative study investigating existential experiences of a group of Danish patients in rehabilitation were analysed employing the American phenomenologist Anthony J. Steinbock’s interpretation of the Husserlian concepts homeworld/alienworld ( Heimwelt/Fremdwelt). Data used in this article derived from qualitative interviews (11 individual interviews and 9 focus group interviews) with cancer patients participating in rehabilitation week courses at a Danish rehabilitation centre. The analysis led to the development of three themes: ‘The heavy break with the homeworld’, ‘Realizing a new homefellowship’ and ‘Transformation of the homeworld’. Findings suggest that journeying with cancer involves a ‘liminal’ experiencing of having to navigate in a borderless and unfamiliar territory between a homeworld and an alienworld before ultimately arriving at a sense of transformation in which meaning is derived from both lifeworlds. It is argued that such an understanding of the intersubjectivity between lifeworlds highlights the need for health care professionals communicating with patients throughout their cancer journey about whether and how the illness experiences have been integrated into their lifeworld and whether help is needed in order to achieve existential rehabilitation.
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High-level construal benefits, meaning making, and posttraumatic growth in cancer patients. Palliat Support Care 2015; 14:510-8. [DOI: 10.1017/s1478951515001224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:The present study sought to explore the role of meaning making and high-level construal in the relationship between meaning discrepancy and posttraumatic growth among Chinese cancer patients.Method:The participants were 193 individuals diagnosed with cancer. Meaning discrepancy, meaning making, high-level construal in meaning making, and posttraumatic growth were measured. Bootstrapping and structural equation modeling were performed to test the mediation effects of high-level construal on the meaning-making process.Results:Mediation analysis revealed that perceived discrepancies were associated with individuals' meaning-making efforts. Meaning-making efforts prompted participants to adopt a high-level construal orientation, which in turn enhanced posttraumatic growth.Significance of results:Our study empirically tested construal level theory in a population suffering from severe chronic trauma. The results demonstrate the important role of high-level construal in the meaning-making process of cancer patients, suggesting a specific effective strategy to foster posttraumatic growth. It seems encouraging to indicate that adopting such high-level construal may be included as part of psychological interventions for cancer patients.
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Recklitis CJ, Blackmon JE, Chang G. Screening young adult cancer survivors for distress with the Distress Thermometer: Comparisons with a structured clinical diagnostic interview. Cancer 2015; 122:296-303. [PMID: 26457669 DOI: 10.1002/cncr.29736] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/11/2015] [Accepted: 09/22/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population. METHODS A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis. RESULTS The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%). CONCLUSIONS The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303. © 2015 American Cancer Society.
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Affiliation(s)
- Christopher J Recklitis
- Dana-Farber Cancer Institute, Perini Family Survivors' Center, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Jaime E Blackmon
- Dana-Farber Cancer Institute, Perini Family Survivors' Center, Boston, Massachusetts
| | - Grace Chang
- Department of Psychiatry, VA Boston Healthcare System, Brockton, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Lechner SC, Whitehead NE, Vargas S, Annane DW, Robertson BR, Carver CS, Kobetz E, Antoni MH. Does a community-based stress management intervention affect psychological adaptation among underserved black breast cancer survivors? J Natl Cancer Inst Monogr 2015; 2014:315-22. [PMID: 25749598 DOI: 10.1093/jncimonographs/lgu032] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In this randomized trial, Project CARE, we examined whether participation in a cognitive-behavioral stress management and breast cancer wellness and education program improved psychological outcomes among a sample of underserved black breast cancer survivors. METHODS Both complementary medicine interventions were 10-sessions, manualized, group-based, and were culturally adapted for black women in the community from evidence-based interventions. Participants were 114 black women (mean age = 51.1, 27-77 years) who had completed breast cancer treatment 0-12 months before enrollment (stages 0-IV, mean time since cancer diagnosis = 14.1 months). Women were enrolled upon completion of curative treatment (ie, surgical, chemotherapy, radiation oncology) and randomized to receive cognitive-behavioral stress management or cancer wellness and education program. RESULTS There was a remarkable 95% retention rate from baseline to 6-month follow-up. Participants in both conditions showed statistically significant improvement on indices of psychological well-being, including overall quality of life (Functional Assessment of Cancer Therapy-Breast), intrusive thoughts (Impact of Event Scale-Revised), depressive symptoms (Center for Epidemiologic Studies-Depression), and stress levels (Perceived Stress Scale) over the 6-month postintervention follow-up (all repeated measures analysis of variance within-subjects time effects: P < .05, except for overall mood; Profile of Mood States-Short Version). Contrary to hypotheses, however, condition × time effects were not statistically significant. CONCLUSIONS Findings suggest that improvements in multiple measures over time may have been due to intensive training in stress management, extensive provision of breast cancer information, or participation in an ongoing supportive group of individuals from a similar racial background. Implications bear on decisions about appropriate control groups, the timing of intervention delivery during the treatment trajectory, and perceived support from the research team.
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Affiliation(s)
- Suzanne C Lechner
- Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC).
| | - Nicole E Whitehead
- Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
| | - Sara Vargas
- Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
| | - Debra W Annane
- Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
| | - Belinda R Robertson
- Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
| | - Charles S Carver
- Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
| | - Erin Kobetz
- Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
| | - Michael H Antoni
- Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
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Jayadevappa R, Chhatre S, Gallo JJ, Wittink M, Morales KH, Bruce Malkowicz S, Lee D, Guzzo T, Caruso A, Van Arsdalen K, Wein AJ, Sanford Schwartz J. Treatment preference and patient centered prostate cancer care: Design and rationale. Contemp Clin Trials 2015; 45:296-301. [PMID: 26435200 DOI: 10.1016/j.cct.2015.09.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/27/2015] [Accepted: 09/30/2015] [Indexed: 11/28/2022]
Abstract
Prostate cancer is a slow progressing cancer that affects millions of men in the US. Due to uncertainties in outcomes and treatment complications, it is important that patients engage in informed decision making to choose the "optimal treatment". Patient centered care that encompasses informed decision-making can improve treatment choice and quality of care. Thus, assessing patient treatment preferences is critical for developing an effective decision support system. The objective of this patient-centered randomized clinical trial was to study the comparative effectiveness of a conjoint analysis intervention compared to usual care in improving subjective and objective outcomes in prostate cancer patients. We identified preferred attributes of alternative prostate cancer treatments that will aid in evaluating attributes of treatment options. In this two-phase study, in Phase 1 we used mixed methods to develop an adaptive conjoint task instrument. The conjoint task required the patients to trade-off attributes associated with treatments by assessing their relative importance. Phase 2 consisted of a randomized controlled trial of men with localized prostate cancer. We analyzed the effect of conjoint task intervention on the association between preferences, treatment and objective and subjective outcomes. Our conjoint task instrument can lead to a values-based patient-centered decision aid tool and help tailor treatment decision making to the values of prostate cancer patients. This will ultimately improve clinical decision making, clinical policy process, enhance patient centered care and improve prostate cancer outcomes.
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Affiliation(s)
- Ravishankar Jayadevappa
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, United States.
| | - Sumedha Chhatre
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, United States
| | - Joseph J Gallo
- Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Marsha Wittink
- Department of Psychiatry, University of Rochester Medical Center, United States
| | - Knashawn H Morales
- Department of Biostatistics and Epidemiology, University of Pennsylvania, United States
| | - S Bruce Malkowicz
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, United States
| | - David Lee
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States
| | - Thomas Guzzo
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States
| | - Adele Caruso
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States
| | - Keith Van Arsdalen
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, United States
| | - Alan J Wein
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States
| | - J Sanford Schwartz
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States
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Threader J, McCormack L. Cancer-related trauma, stigma and growth: the 'lived' experience of head and neck cancer. Eur J Cancer Care (Engl) 2015; 25:157-69. [PMID: 25899673 DOI: 10.1111/ecc.12320] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 11/29/2022]
Abstract
Head and neck cancer is associated with multiple layers of distress including stigma. Stigma attraction or devalued social identity is twofold: (1) it is a cancer associated with lifestyle risk factors and (2) treatment often results in confronting facial disfigurement. Subjective interpretations from nine head and neck cancer patients were analysed using Interpretative Phenomenological Analysis. An overarching superordinate theme--Distress, Stigma and Psychological Growth--encompassed four subordinate themes. Two themes captured the expressed trauma and terror as a result of diagnosis and treatment, and two the redefining of self despite stigma through meaning making. Distress was interpreted as a catalyst for awakening new life interpretations and combined with social support to facilitate two distinct pathways of growth: (1) psychological growth without support; (2) psychological and relational growth with support. Previously unfelt empathetic understanding and altruism for others with cancer emerged from the impact of stigma on 'self'. Acceptance allowed a new sense of identity that recognised cancer-related traumatic distress as integral to growth for these participants. The present study offers a unique insight into cancer-related trauma and stigma and the potential to redefine a more accepting, empathic and altruistic 'self' for psychological growth. Implications are discussed.
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Affiliation(s)
- J Threader
- Research School of Psychology, Australian National University, Canberra, ACT, Australia
| | - L McCormack
- Faculty of Science and IT, School of Psychology, University of Newcastle, Callaghan, NSW, Australia
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Li W, Miao M, Gan Y, Zhang Z, Cheng G. The relationship between meaning discrepancy and emotional distress among patients with cancer: the role of posttraumatic growth in a collectivistic culture. Eur J Cancer Care (Engl) 2015; 25:491-501. [PMID: 25711851 DOI: 10.1111/ecc.12298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2015] [Indexed: 11/30/2022]
Affiliation(s)
- W.J. Li
- Department of Oncology; Beijing Hospital; Beijing China
| | - M. Miao
- Department of Psychology; Peking University; Beijing China
| | - Y.Q. Gan
- Department of Psychology; Peking University; Beijing China
| | - Z.J. Zhang
- Department of Oncology; Beijing Hospital; Beijing China
| | - G. Cheng
- Department of Oncology; Beijing Hospital; Beijing China
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Clinton-McHarg T, Paul C, Boyes A, Rose S, Vallentine P, O'Brien L. Do cancer helplines deliver benefits to people affected by cancer? A systematic review. PATIENT EDUCATION AND COUNSELING 2014; 97:302-309. [PMID: 25304186 DOI: 10.1016/j.pec.2014.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 09/05/2014] [Accepted: 09/10/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To determine the: (1) proportion of studies that describe characteristics of helpline service delivery, compared to the proportion that report trials testing efficacy or effectiveness of helplines in changing user outcomes; (2) proportion of efficacy or effectiveness studies that meet EPOC criteria for methodological rigor; and (3) potential benefits of cancer helplines for people affected by cancer based on findings from rigorous efficacy or effectiveness trials. METHODS Electronic databases (Medline, PsycINFO, EMBASE and CINAHL) were searched to identify English-language studies describing original research published from 1991 to 2011. RESULTS Twenty-eight publications met the review inclusion criteria. From these studies, data on: the characteristics of cancer helpline users; call content; and user satisfaction, were extracted. The potential for helplines to improve the psychosocial outcomes of callers was examined for the three intervention trials. CONCLUSION There is a lack of robust evidence regarding the level and types of benefits that cancer helplines may deliver to callers affected by cancer. Given increased emphasis on delivering best-practise supportive care, building the evidence base in this field may assist cancer helplines to increase their service uptake, reach, and benefit to callers. PRACTISE IMPLICATIONS There is a need for more rigorous intervention-focussed studies in this field across a broader range of cancer populations. Future studies should focus on relevant patient-centred outcomes, such as improved knowledge and greater involvement in decision-making, while incorporating process measures to account for intervention fidelity and clinical performance.
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Affiliation(s)
- Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia
| | - Christine Paul
- Priority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia.
| | - Allison Boyes
- Priority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia
| | - Shiho Rose
- Priority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia
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Victoria Cerezo M, Ortiz-Tallo M, Cardenal V, De La Torre-Luque A. Positive psychology group intervention for breast cancer patients: a randomised trial. Psychol Rep 2014; 115:44-64. [PMID: 25153949 DOI: 10.2466/15.20.pr0.115c17z7] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study assessed the effects of a psychological group intervention based on positive psychology in women with breast cancer. 175 women were randomly assigned either to an experimental group, receiving the 14-session intervention (n = 87), or to a wait list group (n = 88) that did not receive any type of intervention. For treatment, a group intervention was applied, based on improving psychological strengths and enhancing positive psychology-based styles of coping. Strength-related outcomes, self-esteem, well-being, and happiness were assessed before and after the intervention. The experimental group showed higher scores on all of the study variables after the intervention. Participants reported improved self-esteem, emotional intelligence-related abilities, resilience, and optimism, as well as positive affectivity, well-being, and happiness. The results show a beneficial effect of this psychological intervention based on positive psychology on female breast cancer patients' psychological health.
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Martin LA, Moye J, Street RL, Naik AD. Reconceptualizing cancer survivorship through veterans' lived experiences. J Psychosoc Oncol 2014; 32:289-309. [PMID: 24611460 DOI: 10.1080/07347332.2014.897782] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study assessed the biopsychosocial impact of cancer on Veteran older adult survivors by garnering their accounts of their illness experiences. A narrative analysis of 73 cancer diagnosis and treatment stories reveals five “paths” Veterans are taking 18 months postdiagnosis. These paths indicate that cancer survivorship cannot be conceptualized as a one-size-fits-all experience but rather is a process of Veterans understanding and making sense of the effects of cancer on their lives. Our future goal is to develop a screening tool to help clinicians identify a patient's “path" to tailor survivorship care to meet specific needs.
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Affiliation(s)
- Lindsey Ann Martin
- a Michael E. DeBakey VA Medical Center, Health Services Research & Development , Houston , TX , USA
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A correlational study of suicidal ideation with psychological distress, depression, and demoralization in patients with cancer. Support Care Cancer 2014; 22:3165-74. [PMID: 24935648 PMCID: PMC4218975 DOI: 10.1007/s00520-014-2290-4] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 05/15/2014] [Indexed: 11/02/2022]
Abstract
PURPOSE This study aims to study the effects of depression and demoralization on suicidal ideation and to determine the feasibility of the Distress Thermometer as a screening tool for patients with cancer who experience depression and demoralization, and thus to establish a model screening process for suicide prevention. METHODS Purposive sampling was used to invite inpatients and outpatients with lung cancer, leukemia, and lymphoma. Two hundred participants completed the questionnaire, which included the Distress Thermometer (DT), Patient Health Questionnaire-9 (PHQ-9), Demoralization Scale-Mandarin Version (DS-MV), and Beck Scale for Suicide Ideation. All data obtained were analyzed using SPSS 18.0 and SAS 9.3. RESULTS Tobit regression analysis showed that demoralization influenced suicidal ideation more than depression did (t = 2.84, p < 0.01). When PHQ-9 ≥ 10 and DS-MV ≥42 were used as criteria for the DT, receiver operating characteristic analysis revealed that the AUC values were 0.77-0.79, with optimal cutoff points for both of DT ≥5; sensitivity 76.9 and 80.6 %, respectively; and specificity of 73.9 and 72.2 %, respectively. CONCLUSIONS Demoralization had more influence on suicidal ideation than depression did. Therefore, attention should be paid to highly demoralized patients with cancer or high demoralization comorbid with depression for the purposes of suicide evaluation and prevention. The DT scale (with a cutoff of ≥5 points) has discriminative ability as a screening tool for demoralization or depression and can also be used in clinical settings for the preliminary screening of patients with cancer and high suicide risk.
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Kim Y, van Ryn M, Jensen RE, Griffin JM, Potosky A, Rowland J. Effects of gender and depressive symptoms on quality of life among colorectal and lung cancer patients and their family caregivers. Psychooncology 2014; 24:95-105. [PMID: 24831223 DOI: 10.1002/pon.3580] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/16/2014] [Accepted: 04/28/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Cancer patients and their family caregivers often report elevated levels of depressive symptoms, along with poorer mental and physical health (quality of life: QOL). Although the mutuality in distress between patients and their caregivers is relatively well known, unknown are the degree to which caregivers' depressive symptoms independently predict their patient's QOL and vice versa, and whether the relations vary by cancer type or gender. METHODS Colorectal or lung cancer patients and their caregivers (398 dyads) provided complete data for study variables (212 colorectal cancer patient dyads, 186 lung cancer patient dyads; 257 male patient dyads, 141 female patient dyads). Patients' depressive symptoms and QOL were measured approximately 4 and 12 months post-diagnosis; caregivers' depressive symptoms and QOL were measured approximately 5 months post-diagnosis. RESULTS The actor-partner interdependence model confirmed that each person's depressive symptom level was uniquely associated with his/her own concurrent QOL. Female patients' depressive symptoms were also related to their caregivers' poorer physical and better mental health, particularly when the pair's depressive symptoms were at similarly elevated level. On the other hand, male patients' elevated depressive symptoms were related to their caregivers' poorer mental health. CONCLUSIONS Findings suggest that QOL among patients and their family caregivers is interdependent. In light of this interdependency, psychosocial interventions for managing depressive symptoms should target both patients and their family caregivers, from which both may benefit by not only alleviating depressive symptoms but also improving QOL.
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Adachi Y, Kimura H, Sato N, Nagashima W, Nakamura K, Aleksic B, Yoshida K, Fujimoto Y, Nakashima T, Ozaki N. Preoperative Level of Depression is a Predictor of Postoperative Levels of Depression in Patients with Head and Neck Cancer. Jpn J Clin Oncol 2014; 44:311-7. [DOI: 10.1093/jjco/hyu002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Abstract
BACKGROUND Hematologic malignancies occur frequently in young adults. With treatment, many patients are able to survive. Issues of dependency and peer group membership present unique challenges to this subset of cancer survivors. Interest in cancer survivorship has grown, but little is known about the quality of life (QOL) of young adult survivors. OBJECTIVE The objectives of this study were to examine QOL among young adult survivors in relation to middle-aged and older adults, identify common areas of concern, and explore the association of individual characteristics with levels of QOL. METHODS This was a descriptive correlational study using a convenience sample of 48 patients, aged 18 to 35 years at time of diagnosis. Data collection consisted of a 1-time telephone interview utilizing the City of Hope Quality of Life of Cancer Survivors questionnaire and 3 open-ended questions. RESULTS No significant correlations were found between QOL dimensions and current age, age at treatment completion, or time since treatment completion. Social well-being was related to age and spiritual well-being to race. A substantial proportion of the sample identified the need for additional education and peer group support. CONCLUSIONS Results support the importance of developing survivorship programs tailored to the needs of the young adult patient. This may include ongoing opportunities to meet with other survivors and referrals to appropriate support resources. Data suggest that the need for survivorship services exists beyond the first few years after treatment completion. IMPLICATIONS FOR PRACTICE Young adult patients who may be at higher risk for decreased QOL can be targeted for earlier intervention.
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Laranjeira CA, Leão PP, Leal I. The "silenced" voices of women cancer survivors: bodily experiences from an existential perspective. Res Theory Nurs Pract 2014; 27:173-92. [PMID: 24422332 DOI: 10.1891/1541-6577.27.3.173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study explores women's embodiment from an existential-phenomenological approach. Gynecological cancer was chosen as the condition of interest to understand socially formed gender via female bodies as a lived experience of socially and historically situated women. This empirical material is based on individual interviews with 10 Portuguese cancer survivors. A phenomenological-hermeneutical method, inspired by Ricoeur (1976), was used to extract the meaningful content from the women's experiences. These narratives include life changes and recovery transitions in and through the lived body. By seeing cancer survival in terms of the lived body, this study opens the possibility of articulating a deeper and clearer understanding of people's experience of cancer trauma with gender-sensitive health services.
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Affiliation(s)
| | - Paula Ponce Leão
- ISPA-University Institute of Apllied Psychology, Lisboa, Portugal
| | - Isabel Leal
- ISPA-University Institute of Apllied Psychology, Lisboa, Portugal
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Park CL, George LS. Assessing meaning and meaning making in the context of stressful life events: Measurement tools and approaches. JOURNAL OF POSITIVE PSYCHOLOGY 2013. [DOI: 10.1080/17439760.2013.830762] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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George LS, Park CL. Are meaning and purpose distinct? An examination of correlates and predictors. JOURNAL OF POSITIVE PSYCHOLOGY 2013. [DOI: 10.1080/17439760.2013.805801] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Effekte systematischer Informationen über psychosoziale Angebote während der ambulanten Strahlentherapie. Strahlenther Onkol 2013; 189:579-85. [DOI: 10.1007/s00066-013-0366-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 04/11/2013] [Indexed: 10/26/2022]
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Bézy O. De la vulnérabilité psychique aux risques psychopathologiques dans l’« après-cancer ». PSYCHO-ONCOLOGIE 2013. [DOI: 10.1007/s11839-013-0401-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hernández M, Antonio Cruzado J. La atención psicológica a pacientes con cáncer: de la evaluación al tratamiento. CLÍNICA Y SALUD 2013. [DOI: 10.5093/cl2013a1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Distress screening remains important during follow-up after primary breast cancer treatment. Support Care Cancer 2013; 21:2107-15. [PMID: 23455455 DOI: 10.1007/s00520-013-1764-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 02/11/2013] [Indexed: 01/16/2023]
Abstract
BACKGROUND To improve psychosocial care, the National Comprehensive Cancer Network recommends the use of the Distress Thermometer (DT) to detect distress among cancer patients. OBJECTIVES The objectives of this study were to describe the prevalence of distress in breast cancer survivors (BCSs) and to investigate demographic, treatment, and psychosocial variables associated with distress and problems most often reported on the problem list. Moreover, we assessed how many BCSs requested referral to a professional for additional support. METHODS In a cross-sectional study, 258 BCSs identified at an outpatient clinic of a university hospital were asked to complete the following questionnaires: DT, Quality of Life Questionnaire, Hospital Anxiety and Depression Scale, and Illness Cognition Questionnaire. RESULTS Of the 258 identified BCSs, 129 (50 %) completed all questionnaires. After a mean follow-up period of 5.6 (SD, 10) years, 47 (36 %) of these 129 BCSs experienced distress as assessed by the DT. BCSs experienced significantly more distress in the first 2 years than in the period between 2 and 5 years after surgery. Also, more distress was experienced in BCSs treated with surgery, radiotherapy, and chemotherapy compared to those treated with surgery only. Problems most frequently encountered were fatigue (57 %), decrease in muscle strength (47 %), and lack of physical fitness (42 %). Thirty one (69 %) of the distressed BCSs requested or considered referral to a professional. Regression analysis showed that reduced quality of life, reduced cognitive function, and fatigue were predictors of distress. CONCLUSION The current study found that more than one third of all BCSs experienced distress. Screening remains an important part of BCSs' care. The professional should be aware of the potential problems and distress patients may experience.
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