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Liu YY, Zhao Y, Yin YY, Cao HP, Lu HB, Li YJ, Xie J. Effects of transitional care interventions on quality of life in people with lung cancer: A systematic review and meta-analysis. J Clin Nurs 2024; 33:1976-1994. [PMID: 38450810 DOI: 10.1111/jocn.17092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 12/08/2023] [Accepted: 01/07/2024] [Indexed: 03/08/2024]
Abstract
AIM To identify and appraise the quality of evidence of transitional care interventions on quality of life in lung cancer patients. BACKGROUND Quality of life is a strong predictor of survival. The transition from hospital to home is a high-risk period for patients' readmission and death, which seriously affect their quality of life. DESIGN Systematic review and meta-analysis. METHODS The PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases were searched from inception to 22 October 2022. The primary outcome was quality of life. Statistical analysis was conducted using Review Manager 5.4, results were expressed as standard mean difference (SMD) with a 95% confidence interval (CI). The risk of bias of the included studies was assessed using the Cochrane risk of bias assessment tool. This study was complied with PRISMA guidelines and previously registered in PROSPERO (CRD42023429464). RESULTS Fourteen randomized controlled trials were included consisting of a total of 1700 participants, and 12 studies were included in the meta-analysis. It was found that transitional care interventions significantly improved quality of life (SMD = 0.21, 95% CI: 0.02 to 0.40, p = .03) and helped reduce symptoms (SMD = -0.65, 95% CI: -1.13 to -0.18, p = .007) in lung cancer patients, but did not significantly reduce anxiety and depression, and the effect on self-efficacy was unclear. CONCLUSIONS This study shows that transitional care interventions can improve quality of life and reduce symptoms in patients, and that primarily educational interventions based on symptom management theory appeared to be more effective. But, there was no statistically significant effect on anxiety and depression. RELEVANCE TO CLINICAL PRACTICE This study provides references for the application of transitional care interventions in the field of lung cancer care, and encourages nurses and physicians to apply transitional care plans to facilitate patients' safe transition from hospital to home. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Yan-Yan Liu
- School of Nursing, Jilin University, Changchun, Jilin Province, PR China
| | - Yong Zhao
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, PR China
| | - Ying-Ying Yin
- Department of Orthopaedics, Xijing Hospital the Air Force Medical University, Xi'an City, Shaanxi Province, PR China
| | - Hui-Ping Cao
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, PR China
| | - Han-Bing Lu
- School of Nursing, Jilin University, Changchun, Jilin Province, PR China
| | - Ya-Jie Li
- School of Nursing, Jilin University, Changchun, Jilin Province, PR China
| | - Jiao Xie
- School of Nursing, Jilin University, Changchun, Jilin Province, PR China
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Miao S, Qiu H. The microbiome in the pathogenesis of lung cancer: The role of microbiome in lung cancer pathogenesis. APMIS 2024; 132:68-80. [PMID: 37974493 DOI: 10.1111/apm.13359] [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: 06/16/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
As one of the malignant tumors with high incidence rate and high mortality, lung cancer seriously threatens the life safety of patients. Research shows that microorganisms are closely related to lung cancer. The microbiome is symbiotic with the host and plays a vital role in the functions of the human body. Microbiota dysbiosis is correlated with development of lung cancer. However, the underlying mechanisms are poorly understood. This paper summarizes the composition characteristics of the gut-lung axis microbiome and intratumoral microbiome in patients with lung cancer. We then expound five potential carcinogenic mechanisms based on microorganisms, such as genotoxicity, metabolism, inflammation, immune response, and angiogenesis. Next, we list three high-throughput sequencing methods, and finally looks forward to the prospect of microorganisms as novel targets for early diagnosis and treatment of lung cancer.
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Affiliation(s)
- Sainan Miao
- School of Nursing, Anhui Medical University, Hefei, China
| | - Huan Qiu
- School of Nursing, Anhui Medical University, Hefei, China
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EL-Andari R, Fialka NM, Jogiat U, Laing B, Bédard ELR, Nagendran J. Resource allocation during the coronavirus disease 2019 pandemic and the impact on patients with lung cancer: a systematic review. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2023; 37:ivad190. [PMID: 38015831 PMCID: PMC10697737 DOI: 10.1093/icvts/ivad190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic resulted in unprecedented tolls on both economies and human life. Healthcare resources needed to be reallocated away from the care of patients and towards supporting the pandemic response. In this systematic review, we explore the impact of resource allocation during the COVID-19 pandemic on the screening, diagnosis, management and outcomes of patients with lung cancer during the pandemic. METHODS PubMed and Embase were systematically searched for articles investigating the impact of the COVID-19 pandemic on patients with lung cancer. Of the 1605 manuscripts originally screened, 47 studies met the inclusion criteria. RESULTS Patients with lung cancer during the pandemic experienced reduced rates of screening, diagnostic testing and interventions but did not experience worse outcomes. Population-based modelling studies predict significant increases in mortality for patients with lung cancer in the years to come. CONCLUSIONS Reduced access to resources during the pandemic resulted in reduced rates of screening, diagnosis and treatment for patients with lung cancer. While significant differences in outcomes were not identified in the short term, ultimately the effects of the pandemic and reductions in cancer screening will likely be better delineated in the coming years. Future consideration of the long-term implications of resource allocation away from patients with lung cancer with an attempt to provide equitable access to healthcare and limited interruptions of patient care may help to provide the best care for all patients during times of limited resources.
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Affiliation(s)
- Ryaan EL-Andari
- Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Nicholas M Fialka
- Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Uzair Jogiat
- Division of Thoracic Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Bryce Laing
- Division of Thoracic Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Eric L R Bédard
- Division of Thoracic Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Jayan Nagendran
- Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
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Teteh DK, Ferrell B, Okunowo O, Downie A, Erhunmwunsee L, Montgomery SB, Raz D, Kittles R, Kim JY, Sun V. Social determinants of health and lung cancer surgery: a qualitative study. Front Public Health 2023; 11:1285419. [PMID: 38026333 PMCID: PMC10644827 DOI: 10.3389/fpubh.2023.1285419] [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: 08/29/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Social determinants of health (SDOH) are non-clinical factors that may affect the outcomes of cancer patients. The purpose of this study was to describe the influence of SDOH factors on quality of life (QOL)-related outcomes for lung cancer surgery patients. Methods Thirteen patients enrolled in a randomized trial of a dyadic self-management intervention were invited and agreed to participate in semi-structured key informant interviews at study completion (3 months post-discharge). A conventional content analysis approach was used to identify codes and themes that were derived from the interviews. Independent investigators coded the qualitative data, which were subsequently confirmed by a second group of independent investigators. Themes were finalized, and discrepancies were reviewed and resolved. Results Six themes, each with several subthemes, emerged. Overall, most participants were knowledgeable about the concept of SDOH and perceived that provider awareness of SDOH information was important for the delivery of comprehensive care in surgery. Some participants described financial challenges during treatment that were exacerbated by their cancer diagnosis and resulted in stress and poor QOL. The perceived impact of education varied and included its importance in navigating the healthcare system, decision-making on health behaviors, and more economic mobility opportunities. Some participants experienced barriers to accessing healthcare due to insurance coverage, travel burden, and the fear of losing quality insurance coverage due to retirement. Neighborhood and built environment factors such as safety, air quality, access to green space, and other environmental factors were perceived as important to QOL. Social support through families/friends and spiritual/religious communities was perceived as important to postoperative recovery. Discussion Among lung cancer surgery patients, SDOH factors can impact QOL and the patient's survivorship journey. Importantly, SDOH should be assessed routinely to identify patients with unmet needs across the five domains. SDOH-driven interventions are needed to address these unmet needs and to improve the QOL and quality of care for lung cancer surgery patients.
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Affiliation(s)
- Dede K. Teteh
- Department of Health Sciences, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, United States
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Oluwatimilehin Okunowo
- Division of Biostatistics, Department of Computational and Quantitative Medicine, Beckman Research Institute of City of Hope, Duarte, CA, United States
| | - Aidea Downie
- School of Public Health, Brown University, Providence, RI, United States
| | - Loretta Erhunmwunsee
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | | | - Dan Raz
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Rick Kittles
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, United States
| | - Jae Y. Kim
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
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Taylor S, Stanworth M, Eastwood C, Gomes F, Khatoon B, Yorke J. Understanding the experiences of lung cancer patients during the COVID-19 pandemic: a qualitative interview study. Qual Life Res 2023; 32:701-711. [PMID: 36342627 PMCID: PMC9638463 DOI: 10.1007/s11136-022-03283-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE The study explores experiences of lung cancer patients during COVID-19 and considers how changes to care delivery and personal lives affected patient needs. METHODS Semi-structured telephone interviews were conducted to explore experiences of lung cancer patients during COVID-19. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Interview participants were purposively selected based on age, gender, treatment status, timing of diagnosis (pre/post first COVID-19 lockdown) from a sample of lung cancer patients (any histological subtype/any cancer stage/any point in treatment) who had completed a questionnaire exploring how participants' lives were impacted by the pandemic and their thoughts on clinical care and remote communication. RESULTS Thirty lung cancer patients who participated in the questionnaire study were approached and participated in an interview. Three themes were identified: (1) Adapting to new modes of communication (focusing on experiences of remote communication); (2) Experience of care delivery during the pandemic (describing how all aspects of care delivery had been affected); (3) Impact of the COVID-19 pandemic on quality of life (QOL) (focus on the psychological impact and feeling of reduced support). Themes 1 and 2 are heavily interlinked and both had bearing on patients' QOL experience. CONCLUSION Lung cancer patients were impacted psychologically by changes to care delivery and changes in their personal life. The findings highlight some benefits to remote consultations but the stage of the treatment pathway and illness trajectory should be considered when determining if this is appropriate. Participants felt support from peers, family and friends was limited during the pandemic.
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Affiliation(s)
- Sally Taylor
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK. .,School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Melissa Stanworth
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
| | - Charlotte Eastwood
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
| | - Fabio Gomes
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.,Medical Oncology Department, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
| | - Binish Khatoon
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.,School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Janelle Yorke
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.,School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
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Leonardi B, Sagnelli C, Natale G, Leone F, Noro A, Opromolla G, Capaccio D, Ferrigno F, Vicidomini G, Messina G, Di Crescenzo RM, Sica A, Fiorelli A. Outcomes of Thoracoscopic Lobectomy after Recent COVID-19 Infection. Pathogens 2023; 12:pathogens12020257. [PMID: 36839529 PMCID: PMC9958887 DOI: 10.3390/pathogens12020257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The COVID-19 outbreak had a massive impact on lung cancer patients with the rise in the incidence and mortality of lung cancer. METHODS We evaluated whether a recent COVID-19 infection affected the outcome of patients undergoing thoracoscopic lobectomy for lung cancer using a retrospective observational mono-centric study conducted between January 2020 and August 2022. Postoperative complications and 90-day mortality were reported. We compared lung cancer patients with a recent history of COVID-19 infection prior to thoracoscopic lobectomy to those without recent COVID-19 infection. Univariable and multivariable analyses were performed. RESULTS One hundred and fifty-three consecutive lung cancer patients were enrolled. Of these 30 (19%), had a history of recent COVID-19 infection prior to surgery. COVID-19 was not associated with a higher complication rate or 90-day mortality. Patients with recent COVID-19 infection had more frequent pleural adhesions (p = 0.006). There were no differences between groups regarding postoperative complications, conversion, drain removal time, total drainage output, and length of hospital stay. CONCLUSIONS COVID-19 infection did not affect the outcomes of thoracoscopic lobectomy for lung cancer. The treatment of these patients should not be delayed in case of recent COVID-19 infection and should not differ from that of the general population.
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Affiliation(s)
- Beatrice Leonardi
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Giovanni Natale
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Francesco Leone
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Antonio Noro
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Giorgia Opromolla
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | | | - Francesco Ferrigno
- COVID-19 Hospital “M. Scarlato”, Department of Pneumology, 84018 Scafati, Italy
| | - Giovanni Vicidomini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Gaetana Messina
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | | | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-0815665228
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Xiao K, Yeung JC, Bolger JC. The safety and acceptability of using telehealth for follow-up of patients following cancer surgery: A systematic review. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:9-15. [PMID: 36114050 PMCID: PMC9458545 DOI: 10.1016/j.ejso.2022.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/31/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Although virtual consultations have played an increasing role in delivery of healthcare, the COVID-19 pandemic has hastened their adoption. Furthermore, virtual consultations are now being adopted in areas that were previously considered unsuitable, including post-operative visits for patients undergoing major surgical procedures, and surveillance following cancer operations. This review aims to examine the feasibility, safety, and patient satisfaction with virtual follow-up appointments after cancer operations. METHODS A systematic review was conducted along PRISMA guidelines. Studies where patients underwent surgical resection of a malignancy with at least one study arm describing virtual follow-ups were included. Studies were assessed for quality. Outcomes including adverse events, detection of recurrence and patient and provider satisfaction were assessed and compared for those undergoing virtual or in-person post-operative visits. RESULTS Eleven studies, with 3369 patients were included. Cancer types included were gynecological, colorectal, esophageal, lung, thyroid, breast, prostate and major HPB resections. Detection of recurrence and readmission rates were similar when comparing virtual consultations with in-person visits. Most studies showed high patient and healthcare provider satisfaction with virtual consultations following cancer resection. Concerns were raised about the integration of virtual consultations into workflows in fee-for-service settings, where reimbursement for virtual care may be an issue. CONCLUSION Virtual follow-up care can provide timely and safe consultations in surgical oncology. Virtual consultations are as safe as in-person visits for assessing complications and recurrence. Where appropriate, virtual consultations can safely be integrated into the post-operative care pathway for those undergoing resection of malignancy.
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Affiliation(s)
- Karren Xiao
- Division of Thoracic Surgery, University Health Network, Toronto, ON, Canada
| | - Jonathan C Yeung
- Division of Thoracic Surgery, University Health Network, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Jarlath C Bolger
- Division of Thoracic Surgery, University Health Network, Toronto, ON, Canada; Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.
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