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Girda E, Randall LM, Chino F, Monk BJ, Farley JH, O'Cearbhaill RE. Cervical cancer treatment update: A Society of Gynecologic Oncology clinical practice statement. Gynecol Oncol 2023; 179:115-122. [PMID: 37980766 PMCID: PMC11001261 DOI: 10.1016/j.ygyno.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/21/2023]
Abstract
Cervical cancer is the most commonly diagnosed gynecologic cancer worldwide. Although the incidence has declined with increased screening and higher uptake of human papillomavirus (HPV) vaccination in high-income countries, this disease remains the second highest cause of cancer mortality among women in low- and middle-income countries. In this clinical practice statement, we describe therapies for cervical cancer by treatment setting, as well as quality of life, financial toxicity, and disparities associated with this disease. In addition to chemotherapy and radiation, therapeutic strategies for cervical cancer include immune checkpoint blockade, antiangiogenics, and antibody-drug conjugates. Optimal treatment for recurrent cervical cancer remains an area of unmet need, necessitating further exploration of rational and innovative treatment approaches, including cell and immune-based therapies. Importantly, development of effective therapies for cervical cancer must incorporate strategies to ensure universal equitable access to HPV vaccination, screening, and treatment. Important consequences of the disease and treatment that impact quality of life must also be addressed. Patients with cervical cancer are at increased risk for financial toxicity, which can lead to downstream detrimental effects on physical, financial, and career outcomes. Underrepresentation of racial and ethnic minorities in gynecologic oncology clinical trials highlights the urgent need for collaborative and focused initiatives to bridge the significant divide and alleviate inequalities in the prevention and treatment of cervical cancer.
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Affiliation(s)
- Eugenia Girda
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States of America
| | - Leslie M Randall
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology and Massey Cancer Center, Virginia Commonwealth University Health, Richmond, VA, United States of America
| | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Bradley J Monk
- Arizona Oncology (US Oncology Network), University of Arizona, Creighton University, Phoenix, AZ, United States of America
| | - John H Farley
- Department of Obstetrics and Gynecology, St Joseph's Hospital and Medical Center, Phoenix, AZ, United States of America
| | - Roisin E O'Cearbhaill
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America; Department of Medicine, Weill Cornell Medical College, New York, NY, United States of America.
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2
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Baum J, Lax H, Lehmann N, Merkel-Jens A, Beelen DW, Jöckel KH, Dührsen U. Patient-reported patterns of follow-up care in the 'Aftercare in Blood Cancer Survivors' (ABC) study. J Cancer Res Clin Oncol 2023; 149:10531-10542. [PMID: 37291404 PMCID: PMC10423115 DOI: 10.1007/s00432-023-04889-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/20/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Follow-up care provides long-term support for cancer survivors. Little is known about follow-up care in hematologic malignancies. METHODS Our questionnaire-based study included blood cancer survivors diagnosed at the University Hospital of Essen before 2010, with a ≥ 3-year interval since the last intense treatment. The primary goal of the retrospective study was the identification and characterization of follow-up institutions. RESULTS Of 2386 survivors meeting the inclusion criteria, 1551 (65.0%) consented to participate, with a follow-up duration > 10 years in 731. The university hospital provided care for 1045 participants (67.4%), non-university oncologists for 231 (14.9%), and non-oncological internists or general practitioners for 203 (13.1%). Seventy-two participants (4.6%) abstained from follow-up care. The disease spectrum differed among follow-up institutions (p < 0.0001). While allogeneic transplant recipients clustered at the university hospital, survivors with monoclonal gammopathy, multiple myeloma, myeloproliferative disorders, or indolent lymphomas were often seen by non-university oncologists, and survivors with a history of aggressive lymphoma or acute leukemia by non-oncological internists or general practitioners. Follow-up intervals mirrored published recommendations. Follow-up visits were dominated by conversations, physical examination, and blood tests. Imaging was more often performed outside than inside the university hospital. Satisfaction with follow-up care was high, and quality of life was similar in all follow-up institutions. A need for improvement was reported in psychosocial support and information about late effects. CONCLUSIONS The naturally evolved patterns identified in the study resemble published care models: Follow-up clinics for complex needs, specialist-led care for unstable disease states, and general practitioner-led care for stable conditions.
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Affiliation(s)
- Julia Baum
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Hildegard Lax
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Nils Lehmann
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Anja Merkel-Jens
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Dietrich W Beelen
- Klinik für Knochenmarktransplantation, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Ulrich Dührsen
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
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3
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Gelbard RB, Nahmias J, Byerly S, Ziesmann M, Stein D, Haut ER, Smith JW, Boltz M, Zarzaur B, Callum J, Cotton BA, Cripps M, Gunter OL, Holcomb JB, Kerby J, Kornblith LZ, Moore EE, Riojas CM, Schreiber M, Sperry JL, Yeh DD. Establishing a core outcomes set for massive transfusion: An Eastern Association for the Surgery of Trauma modified Delphi method consensus study. J Trauma Acute Care Surg 2023; 94:784-790. [PMID: 36727810 DOI: 10.1097/ta.0000000000003884] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The management of severe hemorrhage has changed significantly over recent decades, resulting in a heterogeneous description of diagnosis, treatment, and outcomes in the literature, which is not suitable for data pooling. Therefore, we sought to develop a core outcome set (COS) to help guide future massive transfusion (MT) research and overcome the challenge of heterogeneous outcomes reporting. METHODS Massive transfusion content experts were invited to participate in a modified Delphi study. For Round 1, participants submitted a list of proposed core outcomes. In subsequent rounds, panelists used a 9-point Likert scale to score proposed outcomes for importance. Core outcomes consensus was defined as >85% of scores receiving 7 to 9 and <15% of scores receiving 1 to 3. Feedback and aggregate data were shared between rounds. RESULTS From an initial panel of 16 experts, 12 (75%) completed three rounds of deliberation to reevaluate variables not achieving predefined consensus criteria. A total of 64 items were considered, with 4 items achieving consensus for inclusion as core outcomes: blood products received in the first 6 hours, 6-hour mortality, time to mortality, and 24-hour mortality. CONCLUSION Through an iterative survey consensus process, content experts have defined a COS to guide future MT research. This COS will be a valuable tool for researchers seeking to perform new MT research and will allow future trials to generate data that can be used in pooled analyses with enhanced statistical power. LEVEL OF EVIDENCE Diagnostic Test or Criteria; Level V.
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Affiliation(s)
- Rondi B Gelbard
- From the Division of Trauma and Acute Care Surgery, Department of Surgery (R.B.G., J.B.H., J.K.), University of Alabama at Birmingham, Birmingham, Alabama; Division of Trauma, Burns and Surgical Critical Care (J.N.), University of California, Irvine, Orange, California; Department of Surgery (S.B.), University of Tennessee Health Science Campus, Memphis, Tennessee; Department of Surgery (M.Z.), University of Manitoba, Winnipeg, Manitoba, Canada; Department of Surgery (D.S.), R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; Division of Acute Care Surgery, Department of Surgery (E.R.H.), Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Surgery (J.W.S.), University of Louisville School of Medicine, Louisville, Kentucky; Division of Trauma, Acute Care and Critical Care Surgery, Department of Surgery (M.B.), Penn State Hershey Medical Center, Hershey, Pennsylvania; Department of Surgery (B.Z.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Pathology and Molecular Medicine (J.C.), School of Medicine, Queen's University, Kingston, Ontario, Canada; Department of Surgery (B.A.C.), University of Texas Health McGovern Medical School, Houston, Texas; Department of Surgery (M.C.), University of Colorado Hospital, Aurora, Colorado; Department of Surgery (O.L.G.), Division of Acute Care Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Surgery (L.Z.K.), Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California; Ernest E Moore Shock Trauma Center at Denver Health (E.E.M., D.D.Y.), University of Colorado Denver, Denver, Colorado; Department of Surgery (C.M.R.), Brooke Army Medical Center, San Antonio, Texas; Department of Surgery (M.S.), Oregon Health and Science University, Portland, Oregon; and Department of Surgery (J.L.S.), UPMC Presbyterian, Pittsburgh, Pennsylvania
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Thombs BD, Levis B, Carrier ME, Dyas L, Nordlund J, Tao L, Aguila K, Bourgeault A, Konrad V, Sauvé M, Connolly K, Henry RS, Østbø N, Levis AW, Kwakkenbos L, Malcarne VL, El-Baalbaki G, Hudson M, Wurz A, Culos-Reed SN, Platt RW, Benedetti A. Effects of a support group leader education program jointly developed by health professionals and patients on peer leader self-efficacy among leaders of scleroderma support groups: a two-arm parallel partially nested randomised controlled trial. Orphanet J Rare Dis 2022; 17:396. [PMID: 36307891 PMCID: PMC9616616 DOI: 10.1186/s13023-022-02552-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background More people with rare diseases likely receive disease education and emotional and practical support from peer-led support groups than any other way. Most rare-disease support groups are delivered outside of the health care system by untrained leaders. Potential benefits may not be achieved and harms, such as dissemination of inaccurate information, may occur. Our primary objective was to evaluate the effects of a rare-disease support group leader education program, which was developed collaboratively by researchers, peer support group leaders, and patient organization leaders, compared to waitlist control, on peer leader self-efficacy among scleroderma support group leaders.
Methods The trial was a pragmatic, two-arm partially nested randomised controlled trial with 1:1 allocation into intervention or waitlist control. Eligible participants were existing or candidate peer support group leaders affiliated with a scleroderma patient organization. Leader training was delivered in groups of 5–6 participants weekly for 13 weeks in 60–90 min sessions via the GoToMeeting® videoconferencing platform. The program included 12 general leader training modules and one module specific to scleroderma. Primary outcome was leader self-efficacy, measured by the Support Group Leader Self-efficacy Scale (SGLSS) immediately post-intervention. Secondary outcomes were leader self-efficacy 3 months post-intervention; emotional distress, leader burnout, and volunteer satisfaction post-intervention and 3 months post-intervention; and program satisfaction among intervention participants post-intervention.
Results One hundred forty-eight participants were randomised to intervention (N = 74) or waitlist (N = 74). Primary outcome data were provided by 146 (99%) participants. Mean number of sessions attended was 11.4 (standard deviation = 2.6). Mean program satisfaction score (CSQ-8) was 30.3 (standard deviation = 3.0; possible range 8–32). Compared to waitlist control, leader self-efficacy was higher post-intervention [SGLSS; 16.7 points, 95% CI 11.0–22.3; standardized mean difference (SMD) 0.84] and 3 months later (15.6 points, 95% CI 10.2–21.0; SMD 0.73); leader volunteer satisfaction was significantly higher at both assessments, emotional distress was lower post-intervention but not 3 months later, and leader burnout was not significantly different at either assessment.
Conclusions Peer support group leader education improved leader self-efficacy substantially. The program could be easily adapted for support group leaders in other rare diseases. Trial registration:NCT03965780; registered on May 29, 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02552-x.
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Affiliation(s)
- Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada. .,Department of Psychiatry, McGill University, Montreal, QC, Canada. .,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada. .,Department of Medicine, McGill University, Montreal, QC, Canada. .,Department of Psychology, McGill University, Montreal, QC, Canada. .,Biomedical Ethics Unit, McGill University, Montreal, QC, Canada.
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada.,Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Laura Dyas
- National Scleroderma Foundation, Michigan Chapter, Southfield, MI, USA
| | - Julia Nordlund
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Kylene Aguila
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | | | - Maureen Sauvé
- Scleroderma Society of Ontario and Scleroderma Canada, Hamilton, ON, Canada
| | | | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Nora Østbø
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Alexander W Levis
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Psychiatry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA.,San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | - Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Abbotsford, BC, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, Calgary, AB, Canada.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada
| | - Robert W Platt
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada
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5
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Ellis J, von Mücke Similon M, Korman MB, den Otter-Moore S, Murray A, Higgins K, Enepekides D, Jacobson M. Using the Delphi Method to Elucidate Patient and Caregiver Experiences of Cancer Care. J Patient Exp 2022; 9:23743735221092633. [PMID: 35450086 PMCID: PMC9016525 DOI: 10.1177/23743735221092633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective: Identify the most salient elements of the head and neck cancer
(HNC) care experience described by patients and caregivers in focus group interviews.
Methods: Three focus groups of patients and caregivers were facilitated by
research assistants and clinicians. Open-ended guiding questions captured/elicited aspects
of care that were appreciated, warranted improvement, or enhanced communication and
information. A four-step Delphi process derived consensus among focus group facilitators
(n = 5) regarding salient discussion points from focus group conversations.
Results: Seven salient themes were identified: (1) information provision,
(2) burden related to symptoms and treatment side effects, (3) importance of social
support, (4) quality of care at both hospital and provider levels, (5) caring for the
person, not just treating cancer, (6) social and emotional impact of HNC, and (7) stigma
and insufficient information regarding human papillomavirus-related HNC.
Conclusion: Participants reported varying needs and support preferences, a
desire for individualized communication, and to feel cared for as both a person and a
patient. Findings illuminate the intricate details underlying high-quality, compassionate,
person-centered HNC cancer care.
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Affiliation(s)
- Janet Ellis
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | - Melissa B Korman
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | - Alva Murray
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kevin Higgins
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Danny Enepekides
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Marlene Jacobson
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
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Santarelli S, Ambrose N, Taylor Z, Dreher P, May N. Prostate Cancer Support Groups: The Unadvertised Camaraderie. Cureus 2021; 13:e18208. [PMID: 34722024 PMCID: PMC8544621 DOI: 10.7759/cureus.18208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 09/22/2021] [Indexed: 11/25/2022] Open
Abstract
Prostate cancer (PCa), in particular, is known to cause significant psychosocial distress during the duration of a patient’s treatment due to its uncertainty and demasculinizing side effects. Prostate cancer support groups (PCSGs) have been proven to be beneficial, yet are underutilized by the majority of PCa patients and physicians. A thorough review of the literature was performed for articles pertaining to prostate cancer support groups. We sought to identify factors contributing to the psychological burden of the disease, factors that influenced patients to join, and barriers to participation in a PCSG. Additionally, the characteristics and format of PCSGs, as well as outcomes (i.e. quality of life), were evaluated.
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Affiliation(s)
- Shana Santarelli
- Urology, Philadelphia College of Osteopathic Medicine, Philadelphia, USA
| | | | | | | | - Noah May
- Urology, Main Line Health, Philadelphia, USA
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Rehberg K, Fleischmann A, Silber E, O’neill SC, Lewis FM, Tercyak KP. Facilitators of peer coaching/support engagement and dissemination among women at risk for and surviving with breast cancer. Transl Behav Med 2021; 11:153-160. [PMID: 31886505 PMCID: PMC7877295 DOI: 10.1093/tbm/ibz186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
One-on-one peer coaching/support programs hold promise in promoting healthy outcomes among women at risk for and surviving with breast cancer, with the potential to bridge gaps in "whole person care." Although popularly cited for their benefits, emerging evidence is mixed and suggests that peer support program impacts may be attenuated by individual- and community-specific factors. We evaluated a national not-for-profit breast cancer organization's peer support program outcomes (2015-2018) serving women from predominantly Jewish backgrounds to examine program engagement, facilitation, and satisfaction. Of the N = 392 women sampled, 37% utilized the peer support program: the majority were referred by a family member/friend (40%) or had connected with the program online (34%). Logistic regression modeling revealed that mothers (odds ratio [OR] = 1.82; 95% confidence interval [CI] = 1.04 to 3.19), women at increased genetic risk for breast cancer (OR = 2.07; 95% CI = 1.08 to 3.94), and those who connected with the organization through a family member/friend (OR = 1.97; 95% CI = 1.23 to 3.15) were significantly more likely to utilize peer support (all p's < .05). Satisfaction with peer support was high and reliably measured (M = 42.8 out of possible 50; α = .95). These findings emphasize opportunities for peer support programs to serve a range of needs among breast cancer previvors and survivors and increase health care's organizational capacity to reach and impact this community through trusted and well-trained lay coaches.
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Affiliation(s)
- Kathryn Rehberg
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | | | | | - Suzanne C O’neill
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | | | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
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Katz MS, Anderson PF, Thompson MA, Salmi L, Freeman-Daily J, Utengen A, Dizon DS, Blotner C, Cooke DT, Sparacio D, Staley AC, Fisch MJ, Young C, Attai DJ. Organizing Online Health Content: Developing Hashtag Collections for Healthier Internet-Based People and Communities. JCO Clin Cancer Inform 2020; 3:1-10. [PMID: 31251658 DOI: 10.1200/cci.18.00124] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Twitter use has increased among patients with cancer, advocates, and oncology professionals. Hashtags, a form of metadata, can be used to share content, organize health information, and create virtual communities of interest. Cancer-specific hashtags modeled on a breast cancer community, #bcsm, led to the development of a structured set of hashtags called the cancer tag ontology. In this article, we review how these hashtags have worked with the aim of describing our experience from 2011 to 2017. We discuss useful guidelines for the development and maintenance of health-oriented communities on Twitter, including possible challenges to community sustainability and opportunities for future improvement and research.
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Affiliation(s)
| | | | | | - Liz Salmi
- Beth Israel Deaconess Medical Center, Boston, MA.,Brain Cancer Quality of Life Collaborative, Sacramento, CA
| | | | | | | | | | - David T Cooke
- University of California Davis Medical Center, Sacramento, CA
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9
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Waddell KJ, Shah PD, Adusumalli S, Patel MS. Using Behavioral Economics and Technology to Improve Outcomes in Cardio-Oncology. JACC CardioOncol 2020; 2:84-96. [PMID: 34396212 PMCID: PMC8352113 DOI: 10.1016/j.jaccao.2020.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/03/2020] [Indexed: 12/20/2022] Open
Abstract
Patients with cancer are often at elevated risk for cardiovascular disease due to overlapping risk factors and cardiotoxic anticancer treatments. Their cancer diagnoses may be the predominant focus of clinical care, with less of an emphasis on concurrent cardiovascular risk management. Widely adopted technology platforms, including electronic health records and mobile devices, can be leveraged to improve the cardiovascular outcomes of these patients. These technologies alone may be insufficient to change behavior and may have greater impact if combined with behavior change strategies. Behavioral economics is a scientific field that uses insights from economics and psychology to help explain why individuals are often predictably irrational. Combining insights from behavioral economics with these scalable technology platforms can positively impact medical decision-making and sustained healthy behaviors. This review focuses on the principles of behavioral economics and how "nudges" and scalable technology can be used to positively impact clinician and patient behaviors.
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Affiliation(s)
- Kimberly J. Waddell
- Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
- Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Payal D. Shah
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Srinath Adusumalli
- Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mitesh S. Patel
- Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
- Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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10
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Jablotschkin M, Bartsch HH, Gschwendtner K, Hauer J, Horneber M, Weis J. Educational Program in Complementary and Alternative Medicine for Cancer Self-Help Groups. Complement Med Res 2019; 27:222-229. [PMID: 31743921 DOI: 10.1159/000504315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 10/23/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) among cancer patients is estimated to be approximately 40%. In self-help groups there is a need for information about CAM. This pilot study aimed to develop and evaluate a CAM educational program for cancer self-help groups. METHODS The educational program was developed in cooperation with health professionals and representatives of cancer self-help organizations. Participants were trained to increase their knowledge about CAM, to reflect their user behavior, and to use evidence-based information. Self-help group leaders were educated along the curriculum and motivated to carry out the course in their groups. Using questionnaires it was evaluated in terms of acceptance, feasibility, and satisfaction by participants. RESULTS A total of 171 self-help group leaders were educated. In a pilot run 7 implemented the course in their groups, with a total of 70 participants. Most of them (n = 60, 85.7%) appreciated its contents and material and would recommend it. Overall acceptance and satisfaction were high. CONCLUSIONS The educational program was implemented successfully in a small sample and showed positive results for acceptance and feasibility. In addition to consultation by experts, it can be a good option to inform cancer survivors about CAM.
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Affiliation(s)
- Martina Jablotschkin
- Comprehensive Cancer Center, Department of Cancer Self-Help Research, Medical Center, University Clinic Center Freiburg, Freiburg i.Br., Germany,
| | - Hans Helge Bartsch
- UKF Reha gGmbH, Department of Oncological Rehabilitation, Medical Center, University Clinic Center Freiburg, Freiburg i.Br., Germany
| | - Kathrin Gschwendtner
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Markus Horneber
- Department of Internal Medicine, Divisions of Oncology/Hematology and Pneumology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, Department of Cancer Self-Help Research, Medical Center, University Clinic Center Freiburg, Freiburg i.Br., Germany
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11
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van Egdom LSE, Oemrawsingh A, Verweij LM, Lingsma HF, Koppert LB, Verhoef C, Klazinga NS, Hazelzet JA. Implementing Patient-Reported Outcome Measures in Clinical Breast Cancer Care: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:1197-1226. [PMID: 31563263 DOI: 10.1016/j.jval.2019.04.1927] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/11/2019] [Accepted: 04/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are increasingly being used to improve care delivery and are becoming part of routine clinical practice. OBJECTIVE This systematic review aims to give an overview of PROM administration methods and their facilitators and barriers in breast cancer clinical practice. METHODS A systematic literature search was conducted in Embase, MEDLINE, PsycINFO, Cochrane Central, CINAHL, and Web of Science for potentially relevant articles from study inception to November 2017. Reference lists of screened reviews were also checked. After inclusion of relevant articles, data were extracted and appraised by 2 investigators. RESULTS A total of 2311 articles were screened, of which 34 eligible articles were ultimately included. Method and frequency of PROM collection varied between studies. The majority of studies described a promising effect of PROM collection on patients (adherence, symptom distress, quality of life, acceptability, and satisfaction), providers (willingness to comply, clinical decision making, symptom management), and care process or system outcomes (referrals, patient-provider communication, hospital visits). A limited number of facilitators and barriers were identified, primarily of a technical and behavioral nature. CONCLUSION Although interpreting the impact of PROM collection in breast cancer care is challenging owing to considerations of synergistic (multicomponent) interventions and generalizability issues, this review found that systematic PROM collection has a promising impact on patients, providers, and care processes/ systems. Further standardization and reporting on method and frequency of PROM collection might help increase the effectiveness of PROM interventions and is warranted to enhance their overall impact.
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Affiliation(s)
| | - Arvind Oemrawsingh
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lisanne M Verweij
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hester F Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Linetta B Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Cornelis Verhoef
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Niek S Klazinga
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jan A Hazelzet
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
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12
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Kimball SH, Hamilton T, Benear E, Baldwin J. Determining Emotional Tone and Verbal Behavior in Patients With Tinnitus and Hyperacusis: An Exploratory Mixed-Methods Study. Am J Audiol 2019; 28:660-672. [PMID: 31430190 DOI: 10.1044/2019_aja-18-0136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the emotional tone and verbal behavior of social media users who self-identified as having tinnitus and/or hyperacusis that caused self-described negative consequences on daily life or health. Research Design and Method An explanatory mixed-methods design was utilized. Two hundred "initial" and 200 "reply" Facebook posts were collected from members of a tinnitus group and a hyperacusis group. Data were analyzed via the LIWC 2015 software program and compared to typical bloggers. As this was an explanatory mixed-methods study, we used qualitative thematic analyses to explain, interpret, and illustrate the quantitative results. Results Overall, quantitative results indicated lower overall emotional tone for all categories (tinnitus and hyperacusis, initial and reply), which was mostly influenced by higher negative emotion. Higher levels of authenticity or truth were found in the hyperacusis sample but not in the tinnitus sample. Lower levels of clout (social standing) were indicated in all groups, and a lower level of analytical thinking style (concepts and complex categories rather than narratives) was found in the hyperacusis sample. Additional analysis of the language indicated higher levels of sadness and anxiety in all groups and lower levels of anger, particularly for initial replies. These data support prior findings indicating higher levels of anxiety and depression in this patient population based on the actual words in blog posts and not from self-report questionnaires. Qualitative results identified 3 major themes from both the tinnitus and hyperacusis texts: suffering, negative emotional tone, and coping strategies. Conclusions Results from this study suggest support for the predominant clinical view that patients with tinnitus and hyperacusis have higher levels of anxiety and depression than the general population. The extent of the suffering described and patterns of coping strategies suggest clinical practice patterns and the need for research in implementing improved practice plans.
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Affiliation(s)
- Suzanne H. Kimball
- Department of Communication Sciences and Disorders, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Toby Hamilton
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Erin Benear
- Department of Communication Sciences and Disorders, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Jonathan Baldwin
- Department of Medical Imaging and Radiation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
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13
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Ashmore JA, Ditterich KW, Conley CC, Wright MR, Howland PS, Huggins KL, Cooreman J, Andrews PS, Nicholas DR, Roberts L, Hewitt L, Scales JN, Delap JK, Gray CA, Tyler LA, Collins C, Whiting CM, Brothers BM, Ryba MM, Andersen BL. Evaluating the effectiveness and implementation of evidence-based treatment: A multisite hybrid design. AMERICAN PSYCHOLOGIST 2019; 74:459-473. [PMID: 30024215 PMCID: PMC6339615 DOI: 10.1037/amp0000309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The gap between treatment development and efficacy testing to scaled up implementations of evidence-based treatment (EBT) is an estimated 20 years, and hybrid research designs aim to reduce the gap. One was used for a multisite study in cancer control, testing coprimary aims: (a) determine the feasibility and utility of a flexible EBT implementation strategy and (b) determine the clinical effectiveness of an EBT as implemented by newly trained providers. Therapists from 15 diverse sites implemented the biobehavioral intervention (BBI) for cancer patients (N = 158) as part of standard care. For implementation, therapists determined treatment format, number of sessions, and so forth and reported session-by-session fidelity. Patients completed fidelity and outcome assessments. Results showed therapists BBI implementation was done with fidelity, for example, session "dose" (59%), core content coverage (60-70%), and others. Patient reported fidelity was favorable and comparable to the BBI efficacy trial. Effectiveness data show the primary outcome, patients' scores on the Profile of Mood States total mood disturbance, significantly improved (R² = 0.06, β = -0.24, p < .01) as did a secondary outcome, physical activity (R² = 0.02, β = 0.13, p < .05). This first use of a hybrid design in health psychology provided support for a novel strategy that allowed providers implementation flexibility. Still, the EBT was delivered with fidelity and in addition, therapists generated novel procedures to enhance setting-specific usage of BBI and its ultimate effectiveness with patients. This research is an example of translational research spanning theory and efficacy tests to dissemination and implementation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Kirk W. Ditterich
- Patient and Family Support Services, Tahoe Forest Cancer Center, Truckee, CA
| | | | | | | | | | - Jena Cooreman
- Department of Supportive Oncology, UC Davis Comprehensive Cancer Center, Davis, CA
| | | | - Donald R. Nicholas
- Department of Counseling Psychology, Social Psychology and Counseling, Ball State University, Muncie, IN
| | - Lind Roberts
- Providence St. John’s Cancer Center, Santa Monica, CA
| | - Larissa Hewitt
- Department of Pediatric Psychosocial Oncology, Dana Farber Cancer Institute, Boston, MA
| | - Joan N. Scales
- Psych-Oncology Services, University of Kentucky, Lexington, KY
| | - Jenny K. Delap
- Psych-Oncology Services, University of Kentucky, Lexington, KY
| | | | - Lynelle A. Tyler
- Patient and Family Support Services, Tahoe Forest Cancer Center, Truckee, CA
| | - Charlotte Collins
- Department of Adult Psychology and Behavioral Medicine, Geisinger Medical Center, Danville, PA
| | | | - Brittany M. Brothers
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN
| | - Marlena M. Ryba
- Department of Psychology, Ohio State University, Columbus, OH
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14
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Arch JJ, Stanton AL. Examining the "usual" in usual care: a critical review and recommendations for usual care conditions in psycho-oncology. Support Care Cancer 2019; 27:1591-1600. [PMID: 30788625 PMCID: PMC6534350 DOI: 10.1007/s00520-019-04677-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/28/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Within psycho-oncology clinical trials, usual care (UC) represents a common and important control condition. Yet recent shifts in oncology, coupled with insufficient description of such conditions, threaten to render UC increasingly difficult to define and interpret. This paper offers evidence of these shifts and recommendations for addressing them. METHODS The broader literature on usual care as a control condition in psychosocial/behavioral intervention trials was assessed, and usual care-controlled trials in psycho-oncology were selectively reviewed, toward to goal of conceptual synthesis. RESULTS We offer evidence that (1) UC control conditions are often insufficiently defined and assessed; and (2) the context of supportive care in oncology has shifted in a manner that contributes to this problem, with implications for interpreting and comparing findings across clinical trials. Three converging findings support these conclusions. First, the scientific literature increasingly documents the diversity in how "usual care" conditions are defined across psychosocial and behavioral trials, with important considerations for trial interpretation. Second, evidence suggests that the availability of psychosocial oncology care has increased over the past few decades. The increasing availability and variety of psychosocial care introduces potential confounds for UC conditions. Third, mental health care trends in the general population affect the supportive interventions available to oncology patients in UC conditions today versus in the past. CONCLUSIONS Shifts in psychosocial oncology and broader mental health care underscore the importance of carefully defining and assessing UC in psycho-oncology trials. Recommendations are offered for improving the design, evaluation, and interpretation of UC conditions, toward the ultimate goal of improving the quality of the evidence in psycho-oncology.
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Affiliation(s)
- Joanna J. Arch
- Department of Psychology and Neuroscience, University of
Colorado Boulder, 345 UCB Muenzinger, Boulder, CO 80309-0345;
; phone: 303-492-4634
- Division of Cancer Prevention and Control, University of
Colorado Cancer Center, Aurora, CO, 80045, USA
| | - Annette L. Stanton
- Department of Psychology, University of California Los
Angeles, Los Angeles, CA, 90095, USA;
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA, 90095, USA
- Jonsson Comprehensive Cancer Center, University of
California Los Angeles, Los Angeles, CA, 90095, USA
- Cousins Center for Psychoneuroimmunology, UCLA Semel
Institute for Neuroscience, Los Angeles, CA, 90095, USA
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15
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Morton C, Muller S, Bucknall M, Gilbert K, Mallen CD, Hider SL. Examining management and research priorities in patients with polymyalgia rheumatica: a primary care questionnaire survey. Clin Rheumatol 2019; 38:1767-1772. [PMID: 30617599 PMCID: PMC6544756 DOI: 10.1007/s10067-018-04405-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/16/2018] [Indexed: 11/25/2022]
Abstract
Introduction/objectives Polymyalgia rheumatica (PMR) is a common inflammatory disorder that is usually managed with oral glucocorticoids, which although effective can cause significant adverse events. Support group survey data suggests length of glucocorticoid treatment and managing side effects are key priority areas of management for patients. Recognising that not all patients will access patient support organisations, our objective was to identify priorities for PMR management and research among primary care PMR patients. Method All adults aged ≥ 50 years registered with 150 English general practices who had a first read code for PMR in their medical records in the preceding 3 years were mailed a self-completion questionnaire (n = 704). Survey items included questions regarding patient priorities for PMR management (from a pre-defined list of 10 items) and suggestions for future research (8 items, plus a free-text option), which were developed in collaboration with PMRGCAuk. Results Five hundred fifty patients responded (78%). The mean (SD) age was 74.1 (8.5) years and 361 (66%) were female. Priority research areas were focused on how to better manage pain, stiffness and fatigue (431, 78%), improving the diagnosis of PMR (393, 71%) and steroid management (342, 62%). Conclusions This survey of PMR patients suggests that symptom management, early diagnosis and managing medication are key areas for patients for future research. Researchers and funding organisations should be aware of these priorities if we are to generate research findings that are relevant to the widest range of stakeholders.
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Affiliation(s)
- Chris Morton
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.
| | - Sara Muller
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Milica Bucknall
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | | | - Christian D Mallen
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Samantha L Hider
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Stafford, UK
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16
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Legg M, Hyde MK, Occhipinti S, Youl PH, Dunn J, Chambers SK. A prospective and population-based inquiry on the use and acceptability of peer support for women newly diagnosed with breast cancer. Support Care Cancer 2018; 27:677-685. [PMID: 30056530 DOI: 10.1007/s00520-018-4358-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 07/17/2018] [Indexed: 11/30/2022]
Abstract
The degree to which peer support is used and accepted as a supportive care approach by women with breast cancer is unclear. We examine peer support use across three major modalities (i.e. support groups, online platforms, one-on-one) and identify enablers and barriers to peer support using the beliefs framework of the theory of planned behaviour. A population-based sample of women newly diagnosed with breast cancer (n = 3105) who were on average 54.08 weeks since diagnosis completed mailed surveys at baseline measuring beliefs about peer support and intention. Peer support use was measured via telephone interview at baseline and prospectively at 12-month follow-up (n = 2780). In all, 37% of women had used at least one peer support service since diagnosis (support group = 20%, online = 18%, one-on-one = 10%). A path analysis examined what beliefs enabled or acted as barriers to peer support use at follow-up adjusting for past behaviour (i.e. baseline use), sociodemographic characteristics, and treatment. In order of relative strength, enablers included beliefs that peer support is an outlet for honest expression of feelings (β = .35), a source of empathy (β = .30), approved by doctors (β = .07), and approved by family/partner (β = .04). Barriers were beliefs that it encourages dwelling about breast cancer (β = - .06) and involves exposure to negative stories about this disease (β = - .04). Strategies which communicate the potential emotional support benefits of a shared illness experience and social approval by others, particularly the medical profession, may help to promote acceptance of peer support and encourage service uptake in breast cancer.
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Affiliation(s)
- Melissa Legg
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia. .,Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia.
| | - Melissa K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
| | - Stefano Occhipinti
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia
| | - Philippa H Youl
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,University of the Sunshine Coast, Sippy Downs, Australia
| | - Jeff Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia.,Institute for Resilient Regions, University of Southern Queensland, Springfield, Australia.,School of Social Science, University of Queensland, Brisbane, Australia
| | - Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia.,Institute for Resilient Regions, University of Southern Queensland, Springfield, Australia.,Prostate Cancer Foundation of Australia, Sydney, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, Australia
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17
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Boyes A, Turon H, Hall A, Watson R, Proietto A, Sanson-Fisher R. Preferences for models of peer support in the digital era: A cross-sectional survey of people with cancer. Psychooncology 2018; 27:2148-2154. [PMID: 29808504 DOI: 10.1002/pon.4781] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/27/2018] [Accepted: 05/22/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Many people with cancer report an unmet need for peer support, yet participation rates are low. This study examined cancer patients' preferences for participating in peer support, and the characteristics associated with having or wanting to participate in peer support. METHODS Adult cancer patients were recruited from outpatient oncology clinics at 5 hospitals in Australia. Participants were invited to self-complete 2 questionnaires: one at recruitment assessing their demographic and cancer characteristics, and another 4 weeks later assessing their preferences for participating in cancer-related peer support. RESULTS The peer support questionnaire was completed by 177/273 (65%) of participants. Most (59%, n = 104) had or wanted to participate in peer support. More than half reported that it was important the people they connected with had the same cancer treatment (56%, n = 99) or type of cancer (53%, n = 94) as themselves. Half had or wanted to participate in 1-to-1 peer support (52%, n = 92). Half had or wanted to connect with peers face-to-face (53%, n = 93). Only 13% (n = 23) were receptive to connecting with peers over the internet. Being aged ≤65 years was significantly associated (OR = 2.3; 95% CI: 1.1-5.1) with reporting a preference for participating in peer support. CONCLUSIONS Cancer patients are interested in participating in peer support, particularly those who are younger. Despite the digital era, traditional forms of peer support continue to be important in supporting people with cancer. Greater understanding of the barriers to cancer patients' involvement in potentially low cost and high reach web-based models of peer support is required.
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Affiliation(s)
- Allison Boyes
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Heidi Turon
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alix Hall
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Rochelle Watson
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Anthony Proietto
- Cancer Services Unit, Hunter New England Local Health District, Newcastle, Australia
| | - Robert Sanson-Fisher
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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18
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McDonough MH, Patterson MC, Weisenbach BB, Ullrich-French S, Sabiston CM. The difference is more than floating: factors affecting breast cancer survivors' decisions to join and maintain participation in dragon boat teams and support groups. Disabil Rehabil 2018. [PMID: 29521150 DOI: 10.1080/09638288.2018.1449259] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: Peer support can be helpful in rehabilitation from breast cancer, but participation in peer support groups is low. Groups that provide support opportunities in physical activity contexts are an attractive alternative for some survivors. This study examined survivors' reasons for joining and maintaining participation on a dragon boat team, along with perceptions of barriers and attractions to traditional peer support groups. Materials and methods: Seventeen breast cancer survivors were interviewed on five occasions over their first two seasons of a newly formed dragon boating team to explore their perceptions of peer support groups and dragon boating. Data were inductively analyzed using thematic analysis. Results: Categories surrounding physical, psychological, social and community features were identified with several themes emerging within each. Advantages of dragon boating included opportunities to get a combination of physical, psychosocial and community benefits; health improvement and behavior change; and obtaining social support without the focus being on cancer. Peer support groups were identified as having advantages for forming relationships and avoiding barriers associated with physical activity. Conclusions: While neither type of program meets all needs, practical considerations are identified for incorporating advantages of both programs to improve participation. Implications for rehabilitation Further understanding of perceptions, and attractions and challenges to taking part in group programs will inform development of accessible programs that target multiple rehabilitation needs. Physical activity can provide a positive, alternative focus that takes the emphasis off of cancer, which is more accessible to some survivors. Physical activity also provides opportunities to build relationships around a common, positive goal, which can be a foundation for providing support for coping with cancer.
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Affiliation(s)
| | | | - Beth B Weisenbach
- b Department of Health & Kinesiology , Purdue University , West Lafayette , IN , USA
| | - Sarah Ullrich-French
- c Department of Educational Leadership, Sport Studies, and Educational/Counseling Psychology , Washington State University , Pullman , WA , USA
| | - Catherine M Sabiston
- d Faculty of Kinesiology & Physical Education , University of Toronto , Toronto , Canada
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19
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Zhang S, Bantum EO, Owen J, Bakken S, Elhadad N. Online cancer communities as informatics intervention for social support: conceptualization, characterization, and impact. J Am Med Inform Assoc 2017; 24:451-459. [PMID: 27402140 PMCID: PMC5565989 DOI: 10.1093/jamia/ocw093] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 05/11/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives: The Internet and social media are revolutionizing how social support is exchanged and perceived, making online health communities (OHCs) one of the most exciting research areas in health informatics. This paper aims to provide a framework for organizing research of OHCs and help identify questions to explore for future informatics research. Based on the framework, we conceptualize OHCs from a social support standpoint and identify variables of interest in characterizing community members. For the sake of this tutorial, we focus our review on online cancer communities. Target audience: The primary target audience is informaticists interested in understanding ways to characterize OHCs, their members, and the impact of participation, and in creating tools to facilitate outcome research of OHCs. OHC designers and moderators are also among the target audience for this tutorial. Scope: The tutorial provides an informatics point of view of online cancer communities, with social support as their leading element. We conceptualize OHCs according to 3 major variables: type of support, source of support, and setting in which the support is exchanged. We summarize current research and synthesize the findings for 2 primary research questions on online cancer communities: (1) the impact of using online social support on an individual's health, and (2) the characteristics of the community, its members, and their interactions. We discuss ways in which future research in informatics in social support and OHCs can ultimately benefit patients.
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Affiliation(s)
- Shaodian Zhang
- Department of Biomedical Informatics, Columbia University, New York, USA
| | - Erin O'Carroll Bantum
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jason Owen
- Veterans Administration Palo Alto Health Care System, Menlo Park, California, USA
| | - Suzanne Bakken
- Department of Biomedical Informatics, Columbia University, New York, USA
| | - Noémie Elhadad
- Department of Biomedical Informatics, Columbia University, New York, USA
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20
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Giese-Davis J, Brandelli Y, Kronenwetter C, Golant M, Cordova M, Twirbutt S, Chang V, Kraemer HC, Spiegel D. Illustrating the Multi-Faceted Dimensions of Group Therapy and Support for Cancer Patients. Healthcare (Basel) 2016; 4:healthcare4030048. [PMID: 27490581 PMCID: PMC5041049 DOI: 10.3390/healthcare4030048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/07/2016] [Accepted: 07/26/2016] [Indexed: 12/27/2022] Open
Abstract
In cancer support groups, choice of therapy model, leadership style, and format can impact patients’ experiences and outcomes. Methodologies that illustrate the complexity of patients’ group experiences might aid in choosing group style, or testing therapeutic mechanisms. We used this naturalistic study as a beginning step to explore methods for comparing cancer group contexts by first modifying a group-experience survey to be cancer-specific (Group Experience Questionnaire (GEQ)). Hypothesizing that therapist-led (TL) would differ from non-therapist-led (NTL), we explored the GEQ’s multiple dimensions. A total of 292 patients attending three types of groups completed it: 2 TL groups differing in therapy style ((1) Supportive-Expressive (SET); (2) The Wellness Community (TWC/CSC)); (3) a NTL group. Participants rated the importance of “Expressing True Feelings” and “Discussing Sexual Concerns” higher in TL than NTL groups and “Discussing Sexual Concerns” higher in SET than other groups. They rated “Developing a New Attitude” higher in TWC/CSC compared to NTL. In addition, we depict the constellation of group qualities using radar-charts to assist visualization. These charts facilitate a quick look at a therapy model’s strengths and weaknesses. Using a measure like the GEQ and this visualization technique could enable health-service decision making about choice of therapy model to offer.
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Affiliation(s)
- Janine Giese-Davis
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
- Department of Oncology, University of Calgary, 2202 2nd St. S.W., Calgary, AB T2S 3C1, Canada.
- Department of Psychosocial Resources, Tom Baker Cancer Centre, 2202 2nd St. S.W., Calgary, AB T2S 3C1, Canada.
| | - Yvonne Brandelli
- Department of Oncology, University of Calgary, 2202 2nd St. S.W., Calgary, AB T2S 3C1, Canada.
- Department of Psychosocial Resources, Tom Baker Cancer Centre, 2202 2nd St. S.W., Calgary, AB T2S 3C1, Canada.
| | - Carol Kronenwetter
- California Pacific Medical Center, Breast Health Center, 3698 California Street, San Francisco, CA 94118, USA.
| | - Mitch Golant
- The Wellness Community/Cancer Support Community, Research & Training Institute, Cancer Support Community, 4100 Chamounix Drive, Philadelphia, PA 19131, USA.
| | - Matthew Cordova
- Veterans Administration Medical Center Martinez, 150 Muir Rd., Martinez, CA 94553, USA.
- Pacific Graduate School of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304-1337, USA.
| | - Suzanne Twirbutt
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Vickie Chang
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Helena C Kraemer
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305, USA.
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21
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Cancer survivorship services for indigenous peoples: where we stand, where to improve? A systematic review. J Cancer Surviv 2015; 10:330-41. [DOI: 10.1007/s11764-015-0479-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
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Prestin A, Vieux SN, Chou WYS. Is Online Health Activity Alive and Well or Flatlining? Findings From 10 Years of the Health Information National Trends Survey. JOURNAL OF HEALTH COMMUNICATION 2015; 20:790-798. [PMID: 26042588 DOI: 10.1080/10810730.2015.1018590] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Internet increasingly enables diverse health communication activities, from information seeking to social media interaction. Up-to-date reporting is needed to document the national prevalence, trends, and user profiles of online health activities so that these technologies can be best used in health communication efforts. This study identifies prevalence, trend, and factors associated with seeking health information, e-mailing health care providers, and using social media for health purposes. Four iterations of HINTS survey data, collected in 2003, 2005, 2008, and 2012, were analyzed to assess population-level trends over the last decade, and current prevalence of Internet-based health communication activities. Sociodemographic and health correlates were explored through weighted logistic regression modeling. Findings demonstrated that Internet use has steadily increased, with 78% of U.S. adults online in 2012; however several digital divide factors--among them education, age, and race/ethnicity--still predict access. Once online, 70% of adults use the Internet as their first source for health information, and while 19% have e-mailed health care providers, engagement in health communication on social media is still relatively low. Distinct user profiles characterize each type of communication, with age, population density, and gender emerging as important predictors across online health activities. These findings have important implications for health communication research and practice.
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Affiliation(s)
- Abby Prestin
- a Division of Cancer Control and Population Sciences , National Cancer Institute, National Institutes of Health , Rockville , Maryland , USA
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Deshayes S, Auboire L, Jaussaud R, Lidove O, Parienti JJ, Triclin N, Imbert B, Bienvenu B, Aouba A. Prevalence of Raynaud phenomenon and nailfold capillaroscopic abnormalities in Fabry disease: a cross-sectional study. Medicine (Baltimore) 2015; 94:e780. [PMID: 25997047 PMCID: PMC4602884 DOI: 10.1097/md.0000000000000780] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Fabry disease (FD) is a lysosomal disorder leading to progressive systemic involvement, including microvascular damage that leads to neurological and cardiovascular disorders. We hypothesize that the latter could be documented at an early stage by performing a microcirculation study with nailfold capillaroscopy and evaluation of Raynaud phenomenon.The objective was to measure the prevalence of Raynaud phenomenon and nailfold capillaroscopic abnormalities in FD.This cross-sectional study included a standardized questionnaire and a nailfold capillaroscopy that assessed previously reported patterns in FD (dystrophic and giant capillaries, avascular fields, irregular architecture, dilatation and density of capillaries, hemorrhage), and was conducted on 32 Fabry patients and 39 controls. Capillaroscopic photographs were reviewed by 2 independent blinded investigators.Twelve Fabry patients (38%) suffered from Raynaud phenomenon, 5 were males (ie, 50% of male Fabry patients), compared with 2 controls (13%) (P < 0.001), of whom none were males (P < 0.001). Raynaud phenomenon was concomitant or before the occurrence of pain in the extremities in 42% of Fabry patients.More ramified capillaries were significantly observed in Fabry patients (12/32, 38%) than in controls (5/39, 13%, P = 0.016).Secondary Raynaud phenomenon should lead to screening for FD, especially in men. By extension, in high-risk populations for FD, the presence of Raynaud phenomenon and ramified capillaries should be assessed.
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Affiliation(s)
- Samuel Deshayes
- From the Departments of Internal Medicine (SD, BB) and Biostatistics (JJP), C.H.U. Côte de Nacre, Caen; University of Tours, Inserm Imagerie et Cerveau UMR U930, Tours (LA); Department of Internal Medicine and Infectious Diseases, C.H.U. Robert Debré, Reims, France (RJ); Department of Internal Medicine, Hôpital de la Croix Saint-Simon, Paris (OL); APMF, Vendresse (NT); Department of Internal Medicine, C.H.U. Michallon, Grenoble, France (BI)
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Lepore SJ, Buzaglo JS, Lieberman MA, Golant M, Greener JR, Davey A. Comparing standard versus prosocial internet support groups for patients with breast cancer: a randomized controlled trial of the helper therapy principle. J Clin Oncol 2014; 32:4081-6. [PMID: 25403218 DOI: 10.1200/jco.2014.57.0093] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Internet support group (ISG) members benefit from receiving social support and, according to the helper therapy principle, by providing support to others. To test the mental health benefits of providing support to others, this trial compared the efficacy of a standard ISG (S-ISG) and an enhanced prosocial ISG (P-ISG). METHODS A two-armed randomized controlled trial with 1-month pretest and post-test assessments was conducted with women (N = 184) diagnosed in the past 36 months with nonmetastatic breast cancer who reported elevated anxiety or depression. Women were randomly assigned to either the S-ISG or P-ISG condition. Both conditions included six professionally facilitated live chat sessions (90-minute weekly sessions) and access to an asynchronous discussion board; P-ISG also included structured opportunities to help and encourage others. RESULTS Relative to the S-ISG, participants in the P-ISG condition exhibited more supportive behaviors (emotional, informational, and companionate support), posted more messages that were other-focused and fewer that were self-focused, and expressed less negative emotion (P < .05). Relative to the S-ISG, participants in the P-ISG condition had a higher level of depression and anxiety symptoms after the intervention (P < .05). CONCLUSION Despite the successful manipulation of supportive behaviors, the P-ISG did not produce better mental health outcomes in distressed survivors of breast cancer relative to an S-ISG. The prosocial manipulation may have inadvertently constrained women from expressing their needs openly, and thus, they may not have had their needs fully met in the group. Helping others may not be beneficial as a treatment for distressed survivors of breast cancer.
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Affiliation(s)
- Stephen J Lepore
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA.
| | - Joanne S Buzaglo
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
| | - Morton A Lieberman
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
| | - Mitch Golant
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
| | - Judith R Greener
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
| | - Adam Davey
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
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Garrett BM, Oliffe JL, Bottorff JL, McKenzie M, Han CS, Ogrodniczuk JS. The value of prostate cancer support groups: a pilot study of primary physicians' perspectives. BMC FAMILY PRACTICE 2014; 15:56. [PMID: 24673983 PMCID: PMC3972516 DOI: 10.1186/1471-2296-15-56] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 03/25/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND In Canada, prostate cancer (PCa) is the most common male cancer, and prostate cancer support groups (PCSGs) have prevailed for more than 20 years providing support to men with PCa and their families. While the format, focus and benefits of attending PCSGs have been reported little is known about primary physicians' (PPs) perceptions of these groups. This article describes Canadian primary physicians' views about face-to-face and web-based PCSGs. METHODS Canadian based primary physicians (n = 140) attending a 2012 Continuing Medical Education Conference participated in a pilot survey questionnaire study. The 56-item questionnaire used in this study included six sets of attitudinal items to measure primary physicians' beliefs about positive and negative influences of PCSGs, reasons for attending PCSGs, the attributes of effective PCSGs, and the value of face-to-face and web-based PCSGs. RESULTS Results showed that PCSGs were positively valued, particularly for information sharing, education and psychosocial support. Poor inclusivity, privacy, and accessibility were identified as potential barriers, and recommendations were made for better marketing and web-based PCSGs to increase engagement with potential attendees. CONCLUSIONS Findings suggest PPs highly valued the role and potential benefits of PCSGs. Information provision and an educational role were perceived as key benefits amid the need to improve local and provincial marketing of PCSGs. The potential for web-based PCSGs to help in the support of PCa patients was also recognized.
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Affiliation(s)
- Bernard M Garrett
- School of Nursing, University of British Columbia, T201, 2211 Wesbrook Mall, V6T 2B5 Vancouver, BC, Canada.
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Xu Y, Testerman LS, Owen JE, Bantum EO, Thornton AA, Stanton AL. Modeling intention to participate in face-to-face and online lung cancer support groups. Psychooncology 2013; 23:555-61. [DOI: 10.1002/pon.3449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 10/08/2013] [Accepted: 10/21/2013] [Indexed: 01/07/2023]
Affiliation(s)
- Yangmu Xu
- Department of Psychology; Loma Linda University; Loma Linda CA USA
| | | | - Jason E. Owen
- Department of Psychology; Loma Linda University; Loma Linda CA USA
| | - Erin O. Bantum
- Cancer Research Center of Hawaii; University of Hawai'i at Manoa; Honolulu HI USA
| | - Andrea A. Thornton
- Resnick Neuropsychiatric Hospital; University of California; Los Angeles CA USA
| | - Annette L. Stanton
- Psychology & Psychiatry/Biobehavioral Sciences; University of California; Los Angeles CA USA
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Kent EE, Alfano CM, Smith AW, Bernstein L, McTiernan A, Baumgartner KB, Ballard-Barbash R. The roles of support seeking and race/ethnicity in posttraumatic growth among breast cancer survivors. J Psychosoc Oncol 2013; 31:393-412. [PMID: 23844921 DOI: 10.1080/07347332.2013.798759] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Posttraumatic growth (PTG) after cancer can minimize the emotional impact of disease and treatment; however, the facilitators of PTG, including support seeking, are unclear. The authors examined the role of support seeking on PTG among 604 breast cancer survivors ages 40 to 64 from the Health Eating, Activity, and Lifestyle (HEAL) Study. Multivariable linear regression was used to examine predictors of support seeking (participation in support groups and confiding in health care providers) as well as the relationship between support seeking and PTG. Support program participation was moderate (61.1%) compared to the high rates of confiding in health professionals (88.6%), and African Americans were less likely to report participating than non-Hispanic Whites (odds ratio = .14, confidence intervals [0.08, 0.23]). The mean (SD) PTG score was 48.8 (27.4) (range 0-105). Support program participation (β = 10.4) and confiding in health care providers (β = 12.9) were associated (p < .001) with higher PTG. In analyses stratified by race/ethnicity, PTG was significantly higher in non-Hispanic Whites and African American support program participants (p < .01), but not significantly higher in Hispanics/Latinas. Confiding in a health care provider was only associated with PTG for non-Hispanic Whites (p = .02). Support program experiences and patient-provider encounters should be examined to determine which attributes facilitate PTG in diverse populations.
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Affiliation(s)
- Erin E Kent
- Division of Cancer Control and Population Sciences and Center for Cancer Training, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
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Lippka Y, Patschan O, Todenhöfer T, Schwentner C, Gutzeit A, Merseburger AS, Horstmann M. Bladder cancer discussed on the internet: a systematic analysis of gender differences of initial posters on an online discussion board. SPRINGERPLUS 2013; 2:445. [PMID: 24102040 PMCID: PMC3790904 DOI: 10.1186/2193-1801-2-445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 08/29/2013] [Indexed: 11/23/2022]
Abstract
Objectives To evaluate gender differences of initial posters in threads dealing with bladder cancer on an online discussion board. Method 529 threads opened between 09/2005 and 03/2012 were screened on the largest German speaking bladder cancer online discussion board. 366 threads fulfilled the requirements for this study. Gender, age, number, status of concern and oncological situation of initiating posters as well as their motives and language style were analyzed following a standardized protocol. Results Threads were initiated in 45% (164/366) by men and in 55% (202/366) by women. Mean age of male initiating posters was 50 years and of female posters 44 years (p < 0.001). Of males 80% (132/164) were concerned patients and 20% (32/164) relatives or friends. Of females they were 39% (78/202) and 61% (124/202), respectively (p < 0.001). In general motives for initial posting were focused on medical information and did not differ between both genders. 81% of the posters asked for medical information or therapeutic recommendations regarding diagnosis, treatment and prognosis. However, women significantly more often expressed their wish for emotional support (p = 0.034) and in tendency wanted to share their experiences with others (p = 0.057). Language analysis revealed that women significantly more often used a tentative language style than men (p = 0.003). Conclusion Even though women are less often affected by bladder cancer, they are more active –especially for their concerned family members - on the evaluated discussion board than men. Whereas both genders equally often ask for medical information, women more often want to share their experiences and look for emotional support.
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Affiliation(s)
- Yannick Lippka
- Institute of Radiology, Kantonsspital Winterthur, Brauerstr. 15, Winterthur, 8401 Switzerland
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Mosher CE, Hanna N, Jalal SI, Fakiris AJ, Einhorn LH, Birdas TJ, Kesler KA, Champion VL. Support service use and interest in support services among lung cancer patients. Lung Cancer 2013; 82:162-7. [PMID: 23932457 DOI: 10.1016/j.lungcan.2013.06.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/12/2013] [Accepted: 06/29/2013] [Indexed: 01/10/2023]
Abstract
OBJECTIVES This study examined support service use and interest in support services among lung cancer patients (N = 165) at two comprehensive medical centers in the midwestern United States. MATERIALS AND METHODS Patients completed an assessment of support service use (i.e., receipt of mental health services, complementary and alternative medicine [CAM], and help from a spiritual leader), interest in support services, and physical and psychological symptoms. RESULTS Only 40% of patients with significant anxiety and depressive symptoms and 28% of the entire sample reported current mental health service use. However, nearly half (47%) of all patients were receiving support from a spiritual leader. Having late-stage lung cancer and a religious affiliation predicted receipt of spiritual support. Few patients who were not receiving mental health services or spiritual support were interested in these services (range = 4-18%). Conversely, although interest in CAM was expressed by a substantial minority of patients (27%) who were not using these services, rates of CAM use were relatively low (22%). CONCLUSIONS Findings suggest that distressed lung cancer patients underuse mental health services, but many patients receive help from spiritual leaders. Given the lack of interest in mental health services among patients who are not receiving them, efforts are needed to enhance palatability of services and identify and reduce barriers to evidence-based service use.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN 46202, USA.
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Monti DA, Kash KM, Kunkel EJ, Moss A, Mathews M, Brainard G, Anne R, Leiby BE, Pequinot E, Newberg AB. Psychosocial benefits of a novel mindfulness intervention versus standard support in distressed women with breast cancer. Psychooncology 2013; 22:2565-75. [DOI: 10.1002/pon.3320] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 04/30/2013] [Accepted: 05/03/2013] [Indexed: 01/06/2023]
Affiliation(s)
- Daniel A. Monti
- Jefferson-Myrna Brind Center of Integrative Medicine; Thomas Jefferson University; Philadelphia PA USA
| | - Kathryn M. Kash
- Department of Psychiatry and Human Behavior; Thomas Jefferson University; Philadelphia PA USA
| | - Elisabeth J. Kunkel
- Department of Psychiatry and Human Behavior; Thomas Jefferson University; Philadelphia PA USA
| | - Aleeze Moss
- Jefferson-Myrna Brind Center of Integrative Medicine; Thomas Jefferson University; Philadelphia PA USA
| | - Michael Mathews
- Jefferson-Myrna Brind Center of Integrative Medicine; Thomas Jefferson University; Philadelphia PA USA
| | - George Brainard
- Department of Neurology; Thomas Jefferson University; Philadelphia PA USA
| | - Ranni Anne
- Department of Radiation Oncology; Thomas Jefferson University; Philadelphia PA USA
| | - Benjamin E. Leiby
- Department of Pharmacology and Experimental Therapeutics; Thomas Jefferson University; Philadelphia PA USA
| | - Edward Pequinot
- Department of Pharmacology and Experimental Therapeutics; Thomas Jefferson University; Philadelphia PA USA
| | - Andrew B. Newberg
- Jefferson-Myrna Brind Center of Integrative Medicine; Thomas Jefferson University; Philadelphia PA USA
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Forsythe LP, Kent EE, Weaver KE, Buchanan N, Hawkins NA, Rodriguez JL, Ryerson AB, Rowland JH. Receipt of psychosocial care among cancer survivors in the United States. J Clin Oncol 2013; 31:1961-9. [PMID: 23610114 PMCID: PMC3661934 DOI: 10.1200/jco.2012.46.2101] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Given the importance of psychosocial care for cancer survivors, this study used population-based data to characterize survivors who reported a discussion with health care provider(s) about the psychosocial effects of cancer and who reported using professional counseling or support groups (PCSG) and tested associations between receipt of psychosocial care and satisfaction with care. PATIENTS AND METHODS We examined survivors of adult cancers from the 2010 National Health Interview Survey (N = 1,777). Multivariable logistic regression models examined factors associated with receipt of and satisfaction with psychosocial care. RESULTS Most survivors (55.1%) reported neither provider discussions nor use of PCSG; 31.4% reported provider discussion only, 4.4% reported use of PCSG only, and 8.9% reported both. Non-Hispanic blacks (v non-Hispanic whites), married survivors, survivors of breast cancer (v prostate or less prevalent cancers), those treated with chemotherapy, and survivors reporting past research study/clinical trial participation were more likely to report provider discussion(s) (P < .01). Hispanics (v non-Hispanic whites), survivors age 40 to 49 years (v ≤ 39 years), survivors of breast cancer (v melanoma or less prevalent cancers), those diagnosed ≤ 1 year ago (v > 5 years ago), survivors treated with radiation, and past research participants were more likely to report use of PCSG (P < .05). Survivors reporting any psychosocial care were more likely to be "very satisfied" with how their needs were met (P < .001). CONCLUSION Many survivors do not report a discussion with providers about the psychosocial effects of cancer, which reflects a missed opportunity to connect survivors to psychosocial services. These data can benchmark the success of efforts to improve access to cancer-related psychosocial care.
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Affiliation(s)
- Laura P Forsythe
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Owen JE, Bantum EO, Criswell K, Bazzo J, Gorlick A, Stanton AL. Representativeness of two sampling procedures for an internet intervention targeting cancer-related distress: a comparison of convenience and registry samples. J Behav Med 2013; 37:630-41. [PMID: 23645145 DOI: 10.1007/s10865-013-9509-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 04/06/2013] [Indexed: 11/29/2022]
Abstract
Internet interventions often rely on convenience sampling, yet convenience samples may differ in important ways from systematic recruitment approaches. The purpose of this study was to evaluate potential demographic, medical, and psychosocial differences between Internet-recruited and registry-recruited cancer survivors in an Internet-based intervention. Participants were recruited from a cancer registry (n = 80) and via broad Internet outreach efforts (n = 160). Participants completed a set of self-report questionnaires, and both samples were compared to a population-based sample of cancer survivors (n = 5,150). The Internet sample was younger, better educated, more likely to be female, had longer time since diagnosis, and had more advanced stage of disease (p's < .001), and the registry-sample was over-represented by men and those with prostate or other cancer types (p's < .001). The Internet sample also exhibited lower quality of life and social support and greater mood disturbance (p's < .001). Understanding how convenience and systematic samples differ has important implications for external validity and potential for dissemination of Internet-based interventions.
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Affiliation(s)
- Jason E Owen
- Department of Psychology, Loma Linda University, 11130 Anderson St., Loma Linda, CA, 92350, USA,
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Evaluation of different features of an eHealth application for personalized illness management support: cancer patients' use and appraisal of usefulness. Int J Med Inform 2013; 82:593-603. [PMID: 23507561 DOI: 10.1016/j.ijmedinf.2013.02.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 12/18/2012] [Accepted: 02/22/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The purpose of this paper was to describe patients' use of a multi-component eHealth application, WebChoice, designed to support cancer patients in illness management. With WebChoice patients can monitor their symptoms, obtain individually tailored, evidence-based self-management support, ask questions to a clinical nurse specialist, communicate with other patients in a Forum, and use a diary. METHODS To better understand what components were most helpful, we analyzed user logs of breast and prostate cancer patients who participated in the experimental arm of an RCT to test effects of WebChoice on clinical outcomes. Patients could freely use the system for one year. After 6 months into the study, participants received questionnaires asking about reasons for using the different WebChoice components and their usefulness. RESULTS 103 (64%) patients actively used WebChoice, on average 60 times. The Forum and asking questions to the nurse were used the most, yet there were large individual variations in use patterns. Also, patients used different WebChoice components for different reasons. The e-mail communication with nurses was valued highest. DISCUSSION Differences were found between breast and prostate cancer patients and between patients with a first time diagnosis and metastases or recurrences. The large variations among patients in their use of WebChoice components demonstrate that patients' needs for support vary. CONCLUSION The use patterns and patients' appraisals of usefulness in this study provide important insights into cancer patients' information and communication behavior that are important for further improvements and the design of eHealth applications for illness management support.
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Børøsund E, Cvancarova M, Ekstedt M, Moore SM, Ruland CM. How user characteristics affect use patterns in web-based illness management support for patients with breast and prostate cancer. J Med Internet Res 2013; 15:e34. [PMID: 23454601 PMCID: PMC3636230 DOI: 10.2196/jmir.2285] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 09/25/2012] [Accepted: 11/26/2012] [Indexed: 11/17/2022] Open
Abstract
Background Frequently eHealth applications are not used as intended and they have high attrition rates; therefore, a better understanding of patients’ need for support is warranted. Specifically, more research is needed to identify which system components target different patient groups and under what conditions. Objective To explore user characteristics associated with the use of different system components of a Web-based illness management support system for cancer patients (WebChoice). Methods For this secondary post hoc analysis of a large randomized controlled trial (RCT), in which WebChoice was tested among 325 breast cancer and prostate cancer patients who were followed with repeated measures for 1 year, usage patterns of 162 cancer patients in the intervention arm with access to WebChoice were extracted from the user log. Logistic regression was performed to identify patterns of associations between system use and patient characteristics. Latent class analyses (LCA) were performed to identify associations among the use of different system components and levels of social support, symptom distress, depression, self-efficacy, and health-related quality of life. Results Approximately two-thirds (103/162, 63.6%) of the patients logged on to WebChoice more than once, and were defined as users. A high level of computer experience (odds ratio [OR] 3.77, 95% CI 1.20-11.91) and not having other illnesses in addition to cancer (OR 2.10, 95% CI 1.02-4.34) increased the overall probability of using WebChoice. LCA showed that both men with prostate cancer and women with breast cancer who had low scores on social support accompanied with high levels of symptom distress and high levels of depression were more likely to use the e-message component. For men with prostate cancer, these variables were also associated with high use of the self-management advice component. We found important differences between men with prostate cancer and women with breast cancer when associations between WebChoice use and each user characteristic were analyzed separately. High use of all components was associated with low levels of social support among women with breast cancer, but not among men with prostate cancer. High use of e-messages, advice, and the discussion forum were associated with high levels of depression among women with breast cancer, but not among men with prostate cancer. For men with prostate cancer (but not women with breast cancer), high use of symptom assessments, advice, and the discussion forum were associated with high levels of symptom distress. However, it is unclear whether these findings can be attributed to differences related to diagnosis, gender, or both. Conclusions This study provides evidence that different user characteristics are associated with different use patterns. Such information is crucial to target Web-based support systems to different patient groups. LCA is a useful technique to identify subgroups of users. In our study, e-messages and self-management advice were highly used components for patients who had low levels of social support and high illness burden, suggesting that patients with these characteristics may find such tools particularly useful. Trial Registration ClinicalTrials.gov NCT00710658; http://clinicaltrials.gov/ct2/show/NCT00710658 (Archived by WebCite at http://www.webcitation.org/6EmEWZiwz)
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Affiliation(s)
- Elin Børøsund
- Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, Oslo 0424, Norway.
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Boehmer U, Glickman M, Winter M, Clark MA. Breast cancer survivors of different sexual orientations: which factors explain survivors' quality of life and adjustment? Ann Oncol 2013; 24:1622-30. [PMID: 23448806 DOI: 10.1093/annonc/mdt035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Little is known about differences by sexual orientation in explanatory factors of breast cancer survivors' quality of life, anxiety, and depression. PATIENTS AND METHODS Survivors were recruited from a cancer registry and additional survivors recruited through convenience methods. Data were collected via telephone survey from all 438 survivors, who were disease free and diagnosed with non-metastatic breast cancer an average of 5 years earlier. To explain quality of life, anxiety, and depression, we focused on sexual orientation as the primary independent factors, in addition, considering demographic, psychosocial, clinical, and functional factors as correlates. RESULTS Sexual orientation had indirect associations with each of the outcomes, through disease-related and demographic factors as well as psychosocial and coping resources. The various explanatory models explain between 36% and 50% of the variance in outcomes and identified areas of strengths and vulnerabilities in sexual minority compared with heterosexual survivors. CONCLUSIONS This study's findings of strengths among specific subgroups of sexual minority compared with heterosexual survivors require further explorations to identify the reasons for this finding. Most of the identified vulnerabilities among sexual minority compared with heterosexual survivors of breast cancer are amenable to change by interventions.
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Affiliation(s)
- U Boehmer
- Department of Community Health Sciences, Boston University, School of Public Health, Boston, MA 02118, USA.
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Galway K, Black A, Cantwell M, Cardwell CR, Mills M, Donnelly M. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database Syst Rev 2012; 11:CD007064. [PMID: 23152241 PMCID: PMC6457819 DOI: 10.1002/14651858.cd007064.pub2] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND A cancer diagnosis may lead to significant psychological distress in up to 75% of cases. There is a lack of clarity about the most effective ways to address this psychological distress. OBJECTIVES To assess the effects of psychosocial interventions to improve quality of life (QoL) and general psychological distress in the 12-month phase following an initial cancer diagnosis. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE, EMBASE, and PsycINFO up to January 2011. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. Electronic searches were carried out across all primary sources of peer-reviewed publications using detailed criteria. No language restrictions were imposed. SELECTION CRITERIA Randomised controlled trials of psychosocial interventions involving interpersonal dialogue between a 'trained helper' and individual newly diagnosed cancer patients were selected. Only trials measuring QoL and general psychological distress were included. Trials involving a combination of pharmacological therapy and interpersonal dialogue were excluded, as were trials involving couples, family members or group formats. DATA COLLECTION AND ANALYSIS Trial data were examined and selected by two authors in pairs with mediation from a third author where required. Where possible, outcome data were extracted for combining in a meta-analyses. Continuous outcomes were compared using standardised mean differences and 95% confidence intervals, using a random-effects model. The primary outcome, QoL, was examined in subgroups by outcome measurement, cancer site, theoretical basis for intervention, mode of delivery and discipline of trained helper. The secondary outcome, general psychological distress (including anxiety and depression), was examined according to specified outcome measures. MAIN RESULTS A total of 3309 records were identified, examined and the trials subjected to selection criteria; 30 trials were included in the review. No significant effects were observed for QoL at 6-month follow up (in 9 studies, SMD 0.11; 95% CI -0.00 to 0.22); however, a small improvement in QoL was observed when QoL was measured using cancer-specific measures (in 6 studies, SMD 0.16; 95% CI 0.02 to 0.30). General psychological distress as assessed by 'mood measures' improved also (in 8 studies, SMD - 0.81; 95% CI -1.44 to - 0.18), but no significant effect was observed when measures of depression or anxiety were used to assess distress (in 6 studies, depression SMD 0.12; 95% CI -0.07 to 0.31; in 4 studies, anxiety SMD 0.05; 95% CI -0.13 to 0.22). Psychoeducational and nurse-delivered interventions that were administered face to face and by telephone with breast cancer patients produced small positive significant effects on QoL (in 2 studies, SMD 0.23; 95% CI 0.04 to 0.43). AUTHORS' CONCLUSIONS The significant variation that was observed across participants, mode of delivery, discipline of 'trained helper' and intervention content makes it difficult to arrive at a firm conclusion regarding the effectiveness of psychosocial interventions for cancer patients. It can be tentatively concluded that nurse-delivered interventions comprising information combined with supportive attention may have a beneficial impact on mood in an undifferentiated population of newly diagnosed cancer patients.
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Affiliation(s)
- Karen Galway
- School of Nursing andMidwifery, Queen’sUniversity Belfast, Belfast, UK.
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Durant KT, McCray AT, Safran C. Identifying gender-preferred communication styles within online cancer communities: a retrospective, longitudinal analysis. PLoS One 2012; 7:e49169. [PMID: 23155460 PMCID: PMC3498295 DOI: 10.1371/journal.pone.0049169] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 10/08/2012] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The goal of this research is to determine if different gender-preferred social styles can be observed within the user interactions at an online cancer community. To achieve this goal, we identify and measure variables that pertain to each gender-specific social style. METHODS AND FINDINGS We perform social network and statistical analysis on the communication flow of 8,388 members at six different cancer forums over eight years. Kruskal-Wallis tests were conducted to measure the difference between the number of intimate (and highly intimate) dyads, relationship length, and number of communications. We determine that two patients are more likely to form an intimate bond on a gender-specific cancer forum (ovarian P = <0.0001, breast P = 0.0089, prostate P = 0.0021). Two female patients are more likely to form a highly intimate bond on a female-specific cancer forum (Ovarian P<0.0001, Breast P<0.01). Typically a male patient communicates with more members than a female patient (Ovarian forum P = 0.0406, Breast forum P = 0.0013). A relationship between two patients is longer on the gender-specific cancer forums than a connection between two members not identified as patients (ovarian forum P = 0.00406, breast forum P = 0.00013, prostate forum P = .0.0003). CONCLUSION The high level of interconnectedness among the prostate patients supports the hypothesis that men prefer to socialize in large, interconnected, less-intimate groups. A female patient is more likely to form a highly intimate connection with another female patient; this finding is consistent with the hypothesis that woman prefer fewer, more intimate connections. The relationships of same-gender cancer patients last longer than other relationships; this finding demonstrates homophily within these online communities. Our findings regarding online communication preferences are in agreement with research findings from person-to-person communication preference studies. These findings should be considered when designing online communities as well as designing and evaluating psychosocial and educational interventions for cancer patients.
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Affiliation(s)
- Kathleen T Durant
- Silverlink Communications, Boston, Massachusetts, United States of America.
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Corwin D, Wall K, Koopman C. Psycho-Spiritual Integrative Therapy: Psychological Intervention for Women With Breast Cancer. JOURNAL FOR SPECIALISTS IN GROUP WORK 2012. [DOI: 10.1080/01933922.2012.686961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Trapp SK, Woods JD, Grove A, Stern M. Male coping processes as demonstrated in the context of a cancer-related social support group. Support Care Cancer 2012; 21:619-27. [DOI: 10.1007/s00520-012-1565-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 07/23/2012] [Indexed: 01/11/2023]
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Hamilton AS, Miller MF, Arora NK, Bellizzi KM, Rowland JH. Predictors of Use of Complementary and Alternative Medicine by Non-Hodgkin Lymphoma Survivors and Relationship to Quality of Life. Integr Cancer Ther 2012; 12:225-35. [DOI: 10.1177/1534735412449733] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hypotheses. This study hypothesized that non-Hodgkin lymphoma (NHL) patients who used complementary and alternative medicine (CAM) would have higher health-related quality of life (HRQOL) and a greater perceived sense of control than nonusers. However, since CAM may predict HRQOL, and perceived control may be both associated with CAM use as well as being an independent predictor of HRQOL, the authors also sought to test whether perceived control mediated the relationship between CAM use and HRQOL. Study design. This was a cross-sectional study design. NHL survivors diagnosed between June 1, 1998 and August 31, 2001 were selected from the population-based SEER (Surveillance, Epidemiology, and End Results) cancer registry for Los Angeles County and were mailed a survey in 2003 that assessed CAM use and predictors of CAM use. The response rate was 54.8%; 319 provided complete data for analysis. Methods. Categories of CAM were defined according to the National Center for Complementary and Alternative Medicine guidelines. The authors measured survivors’ cancer-related control using the Perceived Personal Control scale, a 4-question scale that was adapted from previously validated scales. HRQOL was measured using the mental component summary and physical component summary scores from the SF-36 v2.0. Bivariate and multivariable logistic and linear regression models were used to assess factors associated with CAM use and the association of CAM use with psychosocial health outcomes, respectively. Results. Sixty-one percent of respondents reported using at least one CAM modality within the past 4 weeks, and 40% did so after excluding personal prayer and support groups. Younger age and higher education were significantly associated with greater CAM use as were higher perception of cancer-related control ( P = .004) and more positive mental functioning ( P = .016). Perception of control significantly mediated the association between CAM use and mental functioning ( P < .001). Conclusions. CAM use may be related to more positive mental health–related quality of life by increasing patients’ perception of perceived control over their health; however, cause and effect cannot be determined. Physicians should be aware that cancer survivors have a need to take an active role in improving their health.
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Affiliation(s)
| | - Melissa F. Miller
- Uniting the Wellness Communities & Gilda’s Club Worldwide, Fairfax, VA, USA
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Van Uden-Kraan CF, Drossaert CHC, Taal E, Smit WM, Bernelot Moens HJ, Van de Laar MAFJ. Determinants of engagement in face-to-face and online patient support groups. J Med Internet Res 2011; 13:e106. [PMID: 22155649 PMCID: PMC3278092 DOI: 10.2196/jmir.1718] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 08/01/2011] [Accepted: 08/25/2011] [Indexed: 11/17/2022] Open
Abstract
Background Although peer-to-peer contact might empower patients in various ways, studies show that only a few patients actually engage in support groups. Objective The objective of our study was to explore factors that facilitate or impede engagement in face-to-face and online peer support, using the Theory of Planned Behavior. Methods A questionnaire was completed by 679 patients being treated for arthritis, breast cancer, or fibromyalgia at two Dutch regional hospitals. Results Our results showed that only a minority of the patients engaged in organized forms of peer support. In total 10% (65/679) of the respondents had engaged in face-to-face meetings for patients in the past year. Only 4% (30/679) of the respondents had contact with peers via the Internet in the past year. Patients were more positive about face-to-face peer support than about online peer support (P < .001). In accordance with the Theory of Planned Behavior, having a more positive attitude (P < .01) and feeling more supported by people in the social environment (P < .001) increased the intention to participate in both kinds of peer support. In addition, perceived behavioral control (P = .01) influenced the intention to participate in online peer support. Nevertheless, the intention to engage in face-to-face and online peer support was only modestly predicted by the Theory of Planned Behavior variables (R2 = .33 for face-to-face contact and R2 = .26 for online contact). Conclusion Although Health 2.0 Internet technology has significantly increased opportunities for having contact with fellow patients, only a minority seem to be interested in organized forms of peer contact (either online or face-to-face). Patients seem somewhat more positive about face-to-face contact than about online contact.
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Affiliation(s)
- Cornelia F Van Uden-Kraan
- Department of Otolaryngology / Head and Neck Surgery, VU University Medical Centre, Amsterdam, Netherlands
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Gross AF, Smith FA, Stern TA. Is depression an appropriate response to having cancer? A discussion of diagnostic criteria and treatment decisions. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2011; 9:382-7. [PMID: 17998958 DOI: 10.4088/pcc.v09n0508] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Coreil J, Corvin JA, Nupp R, Dyer K, Noble C. Ethnicity and cultural models of recovery from breast cancer. ETHNICITY & HEALTH 2011; 17:291-307. [PMID: 22011254 DOI: 10.1080/13557858.2011.616188] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Recovery narratives describe the culturally shared understandings about the ideal or desirable way to recover from an illness experience. This paper examines ethnic differences in recovery narratives among women participating in breast cancer support groups in Central Florida, USA. It compares groups serving African-American, Latina, and European American women, with the objective of better understanding the appeal of ethnic-specific illness support groups for culturally diverse populations. DESIGN A mixed-method study design combined qualitative and quantitative measures, including in-depth interviews, participant observation at support group meetings, collection of printed documents, and a structured survey. RESULTS Core elements of the recovery narrative drew from the dominant societal cancer discourse of optimism and personal transformation through adversity; however, important ethnic differences were evident in the meaning assigned to these themes. Groups gave distinctive salience to themes of faith and spirituality, empowerment through the migration experience, and becoming a better person through the journey of recovery. CONCLUSION The findings suggest that ethnic cancer support groups draw upon dominant societal discourses about cancer, but they espouse distinctive recovery narratives that are consonant with the groups' cultural models of illness. Similarity between ethnic members' individual recovery narratives and that of the group may contribute to the appeal of ethnic illness support groups for culturally diverse populations.
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Affiliation(s)
- Jeannine Coreil
- Department of Community and Family Health, University of South Florida, Tampa, FL 33612, USA.
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Price MA, Butow PN, Costa DSJ, King MT, Aldridge LJ, Fardell JE, DeFazio A, Webb PM. Prevalence and predictors of anxiety and depression in women with invasive ovarian cancer and their caregivers. Med J Aust 2011; 193:S52-7. [PMID: 21542447 DOI: 10.5694/j.1326-5377.2010.tb03929.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the prevalence and predictors of depression and anxiety in women with ovarian cancer and their caregivers, to compare levels of depression and anxiety with community norms, and to explore the relationship between patients and their nominated caregivers. DESIGN, SETTING AND PARTICIPANTS Prospective cohort study of 798 women with invasive ovarian cancer recruited between 1 January 2002 and 30 June 2006 through the nationwide Australian Ovarian Cancer Study, and 373 of their caregivers. MAIN OUTCOME MEASURES Depression and anxiety as assessed with the Hospital Anxiety and Depression Scale, and the role of demographic variables, disease and treatment variables, psychosocial variables, and use of mental health and support services as potential predictors. RESULTS Rates of anxiety and depression among patients were significantly lower than in previous reports, although clinical depression rates (5.9%) were significantly higher than community norms (3.0%; chi2 = 24.0; P < 0.001). Caregivers also reported higher levels of depression (chi2 = 21.1; P < 0.001) and anxiety (chi2 = 17.6; P < 0.001) compared with norms. There was no difference within patient-caregiver pairs for depression (P = 0.1), while caregivers reported significantly higher anxiety than patients (P < 0.01). In patients, higher symptom burden, lower optimism and current specialist mental health treatment all significantly predicted both depression and anxiety, while lower social support was a significant predictor of patient anxiety only. In caregivers, lower social support and lower optimism were significant predictors of depression and anxiety. Patients being treated for mental health was also a predictor of their caregiver's depression. CONCLUSIONS While depression is significantly more common in women with ovarian cancer than in the general population, it is caregivers of such patients who report much higher levels of both subclinical and clinical depression and anxiety.
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Affiliation(s)
- Melanie A Price
- Centre for Medical Psychology and Evidence-based Decision-Making, School of Psychology, University of Sydney, NSW.
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Dorsey ER, Voss TS, Shprecher DR, Deuel LM, Beck CA, Gardiner IF, Coles MA, Burns RS, Marshall FJ, Biglan KM. A U.S. survey of patients with Parkinson's disease: satisfaction with medical care and support groups. Mov Disord 2011; 25:2128-35. [PMID: 20824736 DOI: 10.1002/mds.23160] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Relatively little is known about patient satisfaction with Parkinson's disease (PD) care and the use of support groups in the United States. We surveyed members of the Muhammad Ali Parkinson's Disease Registry to assess satisfaction with medical care and to evaluate support group use. Satisfaction was measured on a 5-point Likert scale, with high satisfaction defined as a four or five. We used multiple logistic regression to identify factors associated with high satisfaction and support group use. The response rate was 38% (726 of 1923). Most (57%) expressed high satisfaction with PD care. Individuals were most satisfied with the time their provider spent with them (61%) and PD education (56%) but least satisfied with prognostic information (35%) and information about non-drug interventions (28%). Patients seeing a PD specialist were three times more satisfied with their care than those seeing a general neurologist (OR = 3.00, 95% CI: 1.92-4.71; P < 0.0001). Support group use is common, and 61% of survey respondents had attended one at any point. Caucasian race (OR = 2.85, 95% CI: 1.45-5.61), PD duration (OR = 1.05 per year, CI: 1.01-1.10), and PD specialist care (OR = 1.80, CI: 1.16-2.77) were associated with greater support group attendance. Overall, 49% reported high satisfaction with their support group. The greatest concerns were specific needs not being addressed (15%) and insufficient expertise within the group (14%). Most individuals with Parkinson's disease expressed high levels of satisfaction, especially with specialist care. Specialty care and improved education, in the clinic or through support groups, may enhance satisfaction and health care quality.
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Affiliation(s)
- E Ray Dorsey
- Department of Neurology, University of Rochester Medical Center, Rochester, New York 14620, USA.
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What should a support program for people with lung cancer look like? Differing attitudes of patients and support group facilitators. J Thorac Oncol 2010; 5:1227-32. [PMID: 20548247 DOI: 10.1097/jto.0b013e3181e004b2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Patients with lung cancer have higher levels of unmet need for psychosocial support than those with other cancers. However, uptake of existing support programs by patients with lung cancer is low. We explored this issue by seeking the views of patients and support group facilitators. METHODS Surveys of a convenience sample of 100 patients with lung cancer and all support group facilitators registered with Cancer Council Victoria (n = 145) were performed. Respondents were asked about preferred content, location, running, and potential barriers to attendance of a lung cancer support program. RESULTS The response rate from facilitators was 51%. Fifty-three percent of patients reported willingness to attend a support program, although only 12% had previously attended a group. Patients showed a preference for any program to be held at a hospital (p = 0.01), whereas facilitators preferred a community setting (p < 0.001). Patients preferred facilitation by a health professional, rather than a volunteer p < 0.001), whereas facilitators preferred a volunteer. Patients preferred sessions primarily focused on cancer information provision rather than emotional support, whereas facilitators rated emotional support as highly as cancer information. Overall, patients perceived fewer barriers to attendance than facilitators. Both agreed that a group environment, discussing their cancer, parking, and travel were barriers to attendance. CONCLUSIONS Disparities in the views of patients and facilitators about the preferred location, type of facilitator, and content of a support program may in part explain the poor uptake of existing support programs by patients with lung cancer and should be considered in the design of future programs.
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Armenian SH, Sun CL, Teh JB, Arora M, Baker KS, Francisco L, Forman SJ, Bhatia S. Ethnic differences in chronic health conditions after hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study. Cancer 2010; 116:4152-9. [PMID: 20564108 PMCID: PMC2930121 DOI: 10.1002/cncr.25157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hispanics have a greater risk of early treatment failure after hematopoietic stem cell transplantation (HCT) compared with non-Hispanic whites. However, long-term morbidity among Hispanics has not been described. METHODS Health-related outcomes were examined in 159 Hispanic patients and 825 non-Hispanic white patients who underwent HCT between 1974 and 1998 and survived a mean of 8.7 years. Patients completed a detailed questionnaire about sociodemographic factors and the occurrence of chronic health conditions. RESULTS Exposure to total body irradiation (TBI) (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.06-3.56; P = .03), the presence of chronic graft versus host disease (GvHD) (OR, 3.99; 95% CI, 1.94-8.24; P = .002), and health insurance coverage (OR, 3.46; 95% CI, 1.5-8.01; P = .004), were associated significantly with severe/life-threatening conditions. Compared with non-Hispanic white patients, Hispanic patients were 53% less likely to report severe/life-threatening conditions (OR, 0.47; 95% CI, 0.27-0.83; P = .009) after adjusting for relevant clinical variables. This effect size was mitigated (OR, 0.56; 95%CI, 0.29-1.08; P = .08) after adjusting for health insurance coverage. CONCLUSIONS Hispanics were less likely to report severe/life-threatening health conditions after HCT than non-Hispanic whites-a difference that decreased in magnitude and significance after taking health insurance into consideration. Although the current results confirmed the role of TBI and chronic GvHD, in the current study, the role of a lack of health insurance coverage was identified as a mediator of the lower prevalence of self-reported long-term morbidity in Hispanics.
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Affiliation(s)
- Saro H Armenian
- Department of Population Sciences, City of Hope National Medical Center, Duarte, CA 91010-3000, USA
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Locock L, Brown JB. 'All in the same boat'? Patient and carer attitudes to peer support and social comparison in Motor Neurone Disease (MND). Soc Sci Med 2010; 71:1498-505. [PMID: 20719422 DOI: 10.1016/j.socscimed.2010.06.043] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 06/01/2010] [Accepted: 06/07/2010] [Indexed: 10/19/2022]
Abstract
This paper explores attitudes to peer support among people with Motor Neurone Disease (MND) and their family carers. It reports findings from a secondary analysis of data from two UK interview studies conducted by the authors. The process of secondary analysis is reported in detail. 48 people with MND and 22 carers were interviewed in 2005-2007. The authors identified narrative extracts on peer support from their own datasets and exchanged them for independent thematic analysis. Subsequent discussion, drawing on literature on support groups and social comparison, led to an exploration of two overarching themes: valuing camaraderie and comparison, and choosing isolation. Findings suggest that social comparison theory is a useful framework for analysing attitudes to MND support groups, but that on its own it is insufficient. 'Valuing camaraderie and comparison' explains how support groups offer practical and social support, as well as beneficial opportunities for social comparison. Seeing others coping well with the condition can provide hope, while downward comparison with those worse off can also make people feel better about their own situation. However, most people are also shocked and saddened by seeing others with the condition. Tension of identity can occur when group membership starts to define the individual as 'a person with MND, rather than the person I am that happens to have MND'. Choosing isolation can be a deliberate defensive strategy, to protect oneself from witnessing one's possible future. Levels of involvement may change over time as people struggle with their changing needs and fears.
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Affiliation(s)
- Louise Locock
- Health Experiences Research Group, University of Oxford, Old Rd Campus, Headington, Oxford OX3 7LF, UK.
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Salzer MS, Palmer SC, Kaplan K, Brusilovskiy E, Ten Have T, Hampshire M, Metz J, Coyne JC. A randomized, controlled study of Internet peer-to-peer interactions among women newly diagnosed with breast cancer. Psychooncology 2010; 19:441-6. [DOI: 10.1002/pon.1586] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Toward a cancer-specific model of psychological distress: population data from the 2003–2005 National Health Interview Surveys. J Cancer Surviv 2010; 4:291-302. [DOI: 10.1007/s11764-010-0120-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Accepted: 02/11/2010] [Indexed: 10/19/2022]
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