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Siao CL, Chang WC, Chen CH, Lee YH, Lai YH. Symptoms, distress, finances, social support, resource utilization, and unmet care needs of patients with gynecological cancer. Eur J Oncol Nurs 2024; 72:102686. [PMID: 39317144 DOI: 10.1016/j.ejon.2024.102686] [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: 05/27/2024] [Revised: 08/09/2024] [Accepted: 08/17/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE This study explored the unmet care needs of gynecological cancer patients, including overall and subdomain needs (i.e., physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and information needs), and related factors. METHODS In this cross-sectional study, gynecological cancer patients treated at a medical center in northern Taiwan were recruited. Data on demographics, symptoms, distress, finances, social support, resource utilization, and care needs were collected. Spearman's correlation and the Mann-Whitney U test were used for analysis. RESULTS This study of 118 cancer patients found that 73% had unmet psychological and emotional needs, followed by 54% with unmet health system and information needs. The most common physical symptoms were insomnia, fatigue, and pain, with 51.7% experiencing moderate or high levels of distress. Overall, the patients received considerable social support, both instrumental and emotional, primarily through medical information booklets (39.0%), cancer information websites (28.8%), and rehabilitative resources (20.3%). Factors associated with unmet care needs included younger age, non-ovarian cancer, symptoms (pain, fatigue, appetite loss, insomnia, dyspnea, nausea, and vomiting), distress, finances, social support, and the use of cancer information websites. CONCLUSION Psychological and emotional unmet needs is prevalent among patients with gynecological cancer; psychological support is crucial. Younger patients and those with non-ovarian cancer had more unmet care needs. These needs are linked to severe symptoms, distress, financial difficulties, limited social support, and low use of cancer information websites. Enhancing support for this population through targeted interventions is necessary.
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Affiliation(s)
- Chia-Li Siao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Wen-Chun Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chi-Hau Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Yun-Hsiang Lee
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
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Faris MM, Dhillon HM, Campbell R, Halkett GKB, Miller A, Chan RJ, Haydon HM, Sansom-Daly UM, Koh ES, Ownsworth T, Nowak AK, Kelly B, Leonard R, Pike KE, Legge DM, Pinkham MB, Agar MR. Unmet needs in people with high-grade glioma: defining criteria for stepped care intervention. JNCI Cancer Spectr 2024; 8:pkae034. [PMID: 38730547 PMCID: PMC11218915 DOI: 10.1093/jncics/pkae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/03/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND We aimed to define levels of unmet supportive care needs in people with primary brain tumor and to reach expert consensus on feasibility of addressing patients' needs in clinical practice. METHODS We conducted secondary analysis of a prospective cohort study of people diagnosed with high-grade glioma (n = 116) who completed the Supportive Care Needs Survey-Short Form during adjuvant chemoradiation therapy. Participants were allocated to 1 of 3 categories: no need ("no need" for help on all items), low need ("low need" for help on at least 1 item, but no "moderate" or "high" need), or moderate/high need (at least 1 "moderate" or "high" need indicated). Clinical capacity to respond to the proportion of patients needing to be prioritized was assessed. RESULTS Overall, 13% (n = 5) were categorized as no need, 23% (n = 27) low need, and 64% (n = 74) moderate/high need. At least 1 moderate/high need was reported in the physical and daily living domain (42%) and the psychological (34%) domain. In recognition of health system capacity, the moderate/high need category was modified to distinguish between moderate need ("moderate" need indicated for at least 1 item but "high" need was not selected for any item) and high need (at least 1 "high" need indicated). Results revealed 24% (n = 28) moderate need and 40% (n = 46) high need. Those categorized as high need indicated needing assistance navigating the health system and information. CONCLUSIONS Using four step allocations resulted in 40% of patients indicating high need. Categories may facilitate appropriate triaging and guide stepped models of healthcare delivery.
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Affiliation(s)
- Mona M Faris
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
- Centre for Medical Psychology & Evidence-Based Decision-Making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rachel Campbell
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Georgia K B Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Annie Miller
- Community advisory group, Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Helen M Haydon
- Centre for Online Health, The University of Queensland, Brisbane, QLD, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Ursula M Sansom-Daly
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Kensington, NSW, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Eng-Siew Koh
- South West Sydney Clinical School, UNSW Medicine, University of New South Wales, Liverpool, NSW, Australia
- Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Tamara Ownsworth
- School of Applied Psychology & Menzies Health Institute of Queensland, Brisbane, QLD, Australia
| | - Anna K Nowak
- Medical School, University of Western Australia, Crawley, WA, Australia
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Robyn Leonard
- Brain Cancer Collective, NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Kerryn E Pike
- School of Applied Psychology & Menzies Health Institute of Queensland, Brisbane, QLD, Australia
- Griffith Centre for Mental Health, Griffith University, Queensland, Australia
- School of Psychology & Public Health and John Richards Centre for Rural Ageing Research, La Trobe University, Victoria, Australia
| | - Dianne M Legge
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
- Olivia Newton-John Cancer and Wellness Centre, Austin Hospital, Heidelberg, VIC, Australia
| | - Mark B Pinkham
- Division of Cancer Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Meera R Agar
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) Research Centre, Faculty of Health, University of Technology, Sydney, NSW, Australia
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O'Connell JE, Gilmartin E, Roche D, Rogers SN. Conversational artificial intelligence: the interface with the patient concerns inventory. Br J Oral Maxillofac Surg 2024; 62:391-395. [PMID: 38777718 DOI: 10.1016/j.bjoms.2024.02.002] [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: 01/29/2024] [Accepted: 02/14/2024] [Indexed: 05/25/2024]
Abstract
The patient concerns inventory (PCI) allows patients to highlight the issues they would like to discuss at their outpatient consultation. It improves patient-clinician communication and has proven benefits. While the PCI is effective, patient experiences could be improved with better access to it and the ability to more easily and frequently express their concerns. This, of course, is in the context of ever-increasing healthcare challenges and limited resources. Use of conversational artificial intelligence (CAI) represents an opportunity to improve information flow between patients and professionals remote from the consultation. This paper highlights the potential for CAI to provide an 'always-on' platform, using natural language interface technology and based on the PCI, which patients can access via their mobile devices. We also discuss potential pitfalls and concerns, along with outlining a current clinical trial assessing, in the first instance, usability of this technology.
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Affiliation(s)
- J E O'Connell
- Oral and Maxillofacial/Head and Neck Surgeon, St James Hospital, Dublin 8, Ireland.
| | - E Gilmartin
- ADAPT Centre, SCSS, Trinity College Dublin, University of Dublin, Dublin 2, Ireland.
| | - D Roche
- ADAPT SCSS, Trinity College Dublin, Dublin 2, Ireland.
| | - S N Rogers
- FRCS (maxfac) MD, Faculty of Health and Social Care, Edge Hill University, Ormskirk, L39 4QP, United Kingdom; Liverpool Head and Neck Centre, Liverpool University Hospital NHS Foundation Trust, Lower Lane, Liverpool, UK.
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Miniotti M, Botto R, Soro G, Olivero A, Leombruni P. A Critical Overview of the Construct of Supportive Care Need in the Cancer Literature: Definitions, Measures, Interventions and Future Directions for Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:215. [PMID: 38397704 PMCID: PMC10887927 DOI: 10.3390/ijerph21020215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
The growing amount of evidence about the role of supportive care in enhancing cancer patients' outcomes has made healthcare providers more sensitive to the need for support that they experience during cancer's trajectory. However, the lack of a consensus in the definition of supportive care and lack of uniformity in the theoretical paradigm and measurement tools for unmet needs does not allow for defined guidelines for evidence-based best practices that are universally accepted. Contemporary cancer literature confirms that patients continue to report high levels of unmet supportive care needs and documents the low effectiveness of most of the interventions proposed to date. The aim of this critical review is to consolidate the conceptual understanding of the need for supportive care, providing definitions, areas of expertise and a careful overview of the measurement tools and intervention proposals developed to date. The possible reasons why the currently developed interventions do not seem to be able to meet the needs, and the issues for future research were discussed.
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Affiliation(s)
- Marco Miniotti
- ‘Rita Levi Montalcini’ Department of Neuroscience, University of Turin, 10126 Turin, Italy; (R.B.); (G.S.); (A.O.); (P.L.)
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Contri A, Paltrinieri S, Torreggiani M, Chiara Bassi M, Mazzini E, Guberti M, Campanini I, Ghirotto L, Fugazzaro S, Costi S. Patient-reported outcome measure to implement routine assessment of cancer survivors' unmet needs: An overview of reviews and COSMIN analysis. Cancer Treat Rev 2023; 120:102622. [PMID: 37713972 DOI: 10.1016/j.ctrv.2023.102622] [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] [Received: 03/09/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/17/2023]
Abstract
As the number of cancer survivors (CSs) is increasing worldwide, providing services relevant to the specific, unmet needs of these individuals is crucial. There are currently various patient-reported outcome measures (PROMs) whose aim is to identify the unmet needs of CSs. Still, limited guidance supports healthcare providers in choosing the most valid and reliable PROMs for this purpose. We conducted this overview of systematic reviews (SRs) on the psychometric properties of PROMs addressing the unmet needs of adult CSs suffering from non-cutaneous cancers. We searched databases for SRs published between 2012 and January 2023. Two SRs were included, covering 14 PROMs tested on 19,151 CSs. These were assessed according to the COSMIN methodology for SRs of PROMs for the quality of their measurement properties and risk of bias, thus providing guidance in selecting PROMs that appropriately reflect the unmet needs of CSs.
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Affiliation(s)
- Angela Contri
- Clinical and Experimental Medicine PhD Program, Via del Pozzo n.74, 41100 Modena, Italy.
| | - Sara Paltrinieri
- Public Health Sciences PhD Program, Department of Clinical Sciences and Community Health, University of Milan, Via Commenda, 19, 20122 Milan, Italy; Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, via Amendola 2, 42122 Reggio Emilia, Italy.
| | - Martina Torreggiani
- Nursing and Allied Profession Research Unit, Azienda USL-IRCCS Reggio Emilia, Via Giovanni Amendola, 2, 42122 Reggio Emilia, Italy.
| | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Via Giovanni Amendola, 2, 42122 Reggio Emilia, Italy.
| | - Elisa Mazzini
- Medical Directorate Hospital Network, Azienda USL-IRCCS di Reggio Emilia, Via Giovanni Amendola, 2, 42122 Reggio Emilia, Italy.
| | - Monica Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS Reggio Emilia, Via Giovanni Amendola, 2, 42122 Reggio Emilia, Italy.
| | - Isabella Campanini
- LAM-Motion Analysis Laboratory, S. Sebastiano Hospital, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Via Circondaria 29, 42015 Correggio, Italy.
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL - IRCCS Di Reggio Emilia, Via Giovanni Amendola, 2, 42122 Reggio Emilia, Italy.
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, via Amendola 2, 42122 Reggio Emilia, Italy.
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, via Amendola 2, 42122 Reggio Emilia, Italy; Department of Surgical, Medical, Dental and Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, via del Pozzo, 71, 41124 Modena, Italy
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Campbell R, Faris M, Shaw J, Halkett GKB, Legge D, Koh ES, Nowak AK, Agar MR, Ownsworth T, Pike KE, Chan RJ, Dhillon HM. Exploring the clinical utility of a brief screening measure of unmet supportive care needs in people with high-grade glioma. Neurooncol Pract 2023; 10:454-461. [PMID: 37720397 PMCID: PMC10502777 DOI: 10.1093/nop/npad035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Background People living with high-grade glioma (HGG) have diverse and complex needs. Screening aims to detect patients with some level of unmet need requiring triaging and further assessment. However, most existing measures of unmet need are not suitable for screening in this population due to their length. We aimed to explore the clinical utility of a brief screening tool (SCNS-ST9) in people with HGG in detecting unmet needs. Methods Secondary analysis of data collected in a prospective cohort study of 116 people with HGG who completed the Supportive Care Needs Survey (SCNS-SF34) and a brain cancer-specific needs survey (BrTSCNS) during chemoradiation (T1) and 6 months later (T2). The SCNS-ST9 contains a subset of 9 items from the SCNS-SF34. Data analysis determined the number of individuals with unmet needs on the SCNS-SF34 and the BrTSCNS, not identified as having some level of need by the SCNS-ST9. Results Overall, 3 individuals (T1: 2.6% [3/116]; T2: 4.8% [3/63]) at each time point reported other unmet needs on the SCNS-SF34 that were missed by the SCNS-ST9. Domain-specific screening items missed a higher proportion of individuals (3.2%-26%), particularly in the psychological and health systems domains. Only 1 individual with brain cancer-specific needs was missed by SCNS-ST9 overall. Conclusion Findings demonstrate the sensitivity and clinical utility of a brief screening tool (SCNS-ST9) of unmet needs in people with HGG. Routine use of this screening tool, supported by clinical pathways, may improve access to support services, potentially reducing the burden of disease for these patients.
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Affiliation(s)
- Rachel Campbell
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Mona Faris
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Georgia K B Halkett
- Curtin School of Nursing/ Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Dianne Legge
- Curtin School of Nursing/ Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
- Oliva Newton-John Cancer and Wellness Centre, Austin Hospital, Heidelberg, VIC, Australia
| | - Eng-Siew Koh
- South West Sydney Clinical School, UNSW Medicine, University of New South Wales, Liverpool, NSW, Australia
- Liverpool and Macarthur Cancer Therapy Centers, Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Anna K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- Medical School, University of Western Australia, Nedlands, WA, Australia
| | - Meera R Agar
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), University of Technology Sydney, Sydney, NSW, Australia
- Cancer Symptom Trials Group, University of Technology Sydney, Sydney, NSW, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and Menzies Health Institute Queensland, Australia
| | - Kerryn E Pike
- School of Applied Psychology and Menzies Health Institute Queensland, Australia
- Griffith Centre for Mental Health, Griffith University, Queensland, Australia
- School of Psychology and Public Health and John Richards Center for Rural Ageing Research, La Trobe University, Victoria, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| | - Haryana M Dhillon
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, The University of Sydney, NSW, Australia
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Dhakal K, Chen C, Wang P, Mboineki JF, Getu MA, Boyes A, Sharma C, Ghimire BR, Adhikari A, Adhikari B, Shrestha DL. The supportive care needs survey short form 34 (SCNS-SF34): translation and cultural adaptation into the Nepali language among patients with cervical cancer in Nepal. Health Qual Life Outcomes 2023; 21:98. [PMID: 37612750 PMCID: PMC10463532 DOI: 10.1186/s12955-023-02147-5] [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: 09/12/2022] [Accepted: 06/14/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND A questionnaire developed in one language must be translated and adapted when it will be used with patients speaking a different language and care should be taken to maintain equivalence between the source language (SL) version and its translated version. The objective of this study was to test the linguistic and cultural validity of a Nepali language version of the Supportive Care Need Survey - Short Form 34 (SCNS-SF34) used with the Nepali population. METHODS Translation of the SCNS-SF34 was carried out by following Beaton's guidelines and Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) by a research team. The translated version was administered to patients with cervical cancer in Nepal. The following steps were performed as part of the study: translation, content validity assessment, reliability assessment and measurement of errors. RESULTS The study reports item content validity (I-CVI) was > 0.78 and scale content validity (S-CVI) was - 0.89, 0.91 and 0.90 respectively in semantic, cultural, and conceptual aspects. The study found a content validity ratio (CVR) of 0.9 to 1, Cronbach's α of 0.90, correlation significant at the 0.01 level (2-tailed), and clarity of the questionnaire at 91.29%. The standard error of measurement (SEM) and small detectable changes (SDC) for overall care need scores were measured 2.70 and 7.47 respectively. All items were accepted as per the original SCNS-SF34. Following the respondents' suggestions, simpler Nepali words were chosen in some items to replace the words in the preliminary Nepali version of SCNS-SF34. CONCLUSION Preliminary findings show that the Nepali translation of SCNS-SF34 is practical and applicable to the Nepali population. Financial supportive care needs, supportive care for caretakers and problems during patient hospital stays are essential to include in the questionnaire to further explore supportive care needs.
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Affiliation(s)
- Kamala Dhakal
- Nursing department, The first affiliated hospital of Zhengzhou University, Jianshe Dong Lu, Zhengzhou, 450000, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan Province, China
- Tribhuvan University, Maharajgunj Nursing Campus, Maharajgunj, Kathmandu, Nepal
| | - Changying Chen
- Nursing department, The first affiliated hospital of Zhengzhou University, Jianshe Dong Lu, Zhengzhou, 450000, China.
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan Province, China.
- Institute for Hospital Management of Hanan, Longhuzhonghuan Lu, Zhengzhou, Henan, 450000, China.
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan Province, China.
| | | | - Mikiyas Amare Getu
- Nursing department, The first affiliated hospital of Zhengzhou University, Jianshe Dong Lu, Zhengzhou, 450000, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Allison Boyes
- The University of Newcastle (UON) University Drive, Callaghan, NSW, 2308, Australia
| | - Chandrakala Sharma
- Tribhuvan University, Maharajgunj Nursing Campus, Maharajgunj, Kathmandu, Nepal
| | | | - Abish Adhikari
- Kathmandu Cancer Center, Tathali, Nala Road, Bhaktapur, Nepal
| | - Bibhav Adhikari
- Little Angels' College of Management, Hattiban, Lalitpur, Nepal
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Wu WW, Tang CC, Jou ST, Hung GY. Scale Validation of the Mandarin-Language Supportive Care Needs Survey-Adolescent Form. Semin Oncol Nurs 2023; 39:151442. [PMID: 37173234 DOI: 10.1016/j.soncn.2023.151442] [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: 09/20/2022] [Revised: 03/30/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES To (1) modify the Mandarin-language 34-item Supportive Care Needs Survey-Adult Form into the Adolescent Form and (2) examine the psychometric properties of the Adolescent Form. DATA SOURCES A multiphase, iterative scale validation process was used in this methodological study. Participants who were 13 to 18 years old and receiving cancer treatment in inpatient or outpatient settings, or receiving follow-up care in outpatient settings, were recruited using a convenience sampling method. Confirmatory factor analysis demonstrated good fitness of indices, and all factor loadings for the 18-item Adolescent Form were >0.50, which supported the scale's construct validity. The Adolescent Form score was significantly correlated with the symptom distress score (r = 0.56, P < .01) and quality of life score (r = -0.65, P < .01), which indicated the scale's convergent validity. The correlated item-total correlations (0.30-0.78), Cronbach's alpha (.93), and test-retest reliability coefficient (0.79) confirmed the scale's stability. CONCLUSION This study successfully modified the 34-item Adult Form into the 18-item Adolescent Form. Given its adequate psychometric properties, this concise scale has great promise as a useful, feasible, and age-appropriate tool for evaluating care needs among adolescents with cancer who speak Mandarin. IMPLICATIONS FOR NURSING PRACTICE This scale can screen for unmet care needs in busy pediatric oncology settings or large-scale clinical trials. It allows for cross-sectional comparison of unmet care needs between adolescent and adult populations and for longitudinal follow-up into how unmet care needs change from adolescence into adulthood.
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Affiliation(s)
- Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chia-Chun Tang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Shiann-Tang Jou
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan; Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Giun-Yi Hung
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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9
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Bertino EM, Grogan MM, Benedict JA, Agne JL, Janse S, Eastep C, Sullivan D, Gast KC, Naughton MJ, Presley CJ. Feasibility of an embedded palliative care clinic model for patients with an advanced thoracic malignancy. Support Care Cancer 2023; 31:167. [PMID: 36781558 PMCID: PMC9925518 DOI: 10.1007/s00520-023-07621-w] [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: 10/28/2022] [Accepted: 01/30/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Early palliative care (PC) with standard oncology care has demonstrated improved patient outcomes, but multiple care delivery models are utilized. This study prospectively evaluated the feasibility of an embedded PC clinic model and collected patient-reported outcomes (PROs) and caregiver needs. METHODS In this observational study of embedded outpatient PC for patients with advanced thoracic malignancies treated at The Ohio State University Thoracic Oncology clinic, patients received same-day coordinated oncology and palliative care visits at one clinic location. PC encounters included comprehensive symptom assessment and management, advanced care planning, and goals of care discussion. Multiple study assessments were utilized. We describe the feasibility of evaluating PROs and caregiver needs in an embedded PC model. RESULTS Forty patients and 28 caregivers were enrolled. PROs were collected at baseline and follow-up visits. Over a 12-month follow-up, 36 patients discontinued study participation due to hospice enrollment, death, study withdrawal, or COVID restrictions. At baseline, 32 patients (80%) rated distress as moderate-severe with clinically significant depression (44%) and anxiety (36%). Survey completion rates significantly decreased over time: 3 months (24 eligible, 66% completed), 6 months (17 eligible; 41% completed), 9 months (9 eligible; 44% completed), and 12 months (4 eligible; 50% completed). CONCLUSION We found that an embedded PC clinic was feasible, although there were challenges encountered in longitudinal collection of PROs due to high study attrition. Ongoing assessment and expansion of this embedded PC model will continue to identify strengths and challenges to improve patient and caregiver outcomes.
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Affiliation(s)
- Erin M Bertino
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Madison M Grogan
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Jason A Benedict
- Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Julia L Agne
- Department of Internal Medicine, Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sarah Janse
- Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Christine Eastep
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Diana Sullivan
- Department of Internal Medicine, Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Kelly C Gast
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Michelle J Naughton
- Cancer Prevention and Control, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Carolyn J Presley
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
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Rincones O, Bamgboje-Ayodele A, Arnold A, Delaney GP, Durcinoska I, Avery S, Sandell T, Della-Fiorentina SA, Pearson J, Girgis A. Cancer Care Team's Management of Clinical Alerts Generated by Electronically Collected Patient Reported Outcomes: We Could Do Better. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2001. [PMID: 36767367 PMCID: PMC9915302 DOI: 10.3390/ijerph20032001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Electronically administered patient-reported outcome measures (ePROMs) are effective digital health tools for informing clinicians about cancer patients' symptoms and facilitating timely patient-centred care. This paper describes the delivery of healthcare activities supported by the PROMPT-Care model, including ePROMs generated clinical alerts, cancer care team (CCT) response to alerts, and patients' perceptions of the CCT response and ePROMs system. This mixed-methods study includes cancer patients from four cancer therapy centres in New South Wales, Australia. Quantitative and qualitative data were collected regarding clinical alert activity, CCT response, and patient perceptions of the CCT responses and ePROMs system. Qualitative data were thematically analysed. Of the 328 participants whose care was informed by the digital health tool, 70.8% (n = 233) generated at least one alert during the trial period, with 877 alerts generated in total. Although 43.7% (n = 383) were actioned by the CCT, at least 80% of participants found follow-up CCT phone calls beneficial, with multiple benefits confirmed in interviews. The cancer care delivery arm of the PROMPT-Care trial involving clinical alerts to the CCT was positively perceived by most participants, resulting in a diverse range of benefits. However, further work is required, informed by implementation science, to improve the percentage of actioned clinical alerts.
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Affiliation(s)
- Orlando Rincones
- Ingham Institute for Applied Medical Research, South West Sydney Clinical Campuses, UNSW Medicine & Health, University of New South Wales, Liverpool, NSW 2170, Australia
| | - Adeola Bamgboje-Ayodele
- Ingham Institute for Applied Medical Research, South West Sydney Clinical Campuses, UNSW Medicine & Health, University of New South Wales, Liverpool, NSW 2170, Australia
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Anthony Arnold
- Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW 2500, Australia
| | - Geoff P. Delaney
- Ingham Institute for Applied Medical Research, South West Sydney Clinical Campuses, UNSW Medicine & Health, University of New South Wales, Liverpool, NSW 2170, Australia
- Liverpool Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
| | - Ivana Durcinoska
- Ingham Institute for Applied Medical Research, South West Sydney Clinical Campuses, UNSW Medicine & Health, University of New South Wales, Liverpool, NSW 2170, Australia
| | - Sandra Avery
- Liverpool Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
| | - Tiffany Sandell
- Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW 2500, Australia
| | - Stephen A. Della-Fiorentina
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2116, Australia
| | - Joanne Pearson
- Liverpool Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
| | - The PROMPT-Care Co-Authorship Group
- Ingham Institute for Applied Medical Research, South West Sydney Clinical Campuses, UNSW Medicine & Health, University of New South Wales, Liverpool, NSW 2170, Australia
- Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW 2500, Australia
- Liverpool Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2116, Australia
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research, South West Sydney Clinical Campuses, UNSW Medicine & Health, University of New South Wales, Liverpool, NSW 2170, Australia
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11
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Bellas O, Kemp E, Edney L, Oster C, Roseleur J. The impacts of unmet supportive care needs of cancer survivors in Australia: A qualitative systematic review. Eur J Cancer Care (Engl) 2022; 31:e13726. [PMID: 36226338 DOI: 10.1111/ecc.13726] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/26/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Cancer incidence and survivorship are increasing worldwide. With more people living through and beyond cancer, there is a subsequent increase in their supportive care needs. This systematic review of qualitative studies aimed to describe the impacts of unmet supportive care needs on cancer survivors in Australia. METHODS Databases MEDLINE, EMBASE and Scopus were searched, and after screening and applying eligibility criteria, 27 qualitative studies were included. Findings were synthesised according to the Supportive Care Framework for Cancer Care, including informational, physical, practical, emotional, psychological, social and spiritual need domains. RESULTS The systematic review identified impacts of unmet informational, physical, practical, emotional and psychological needs. Frequently identified impacts of unmet informational needs were feelings of abandonment and isolation, distress, confusion and regret. Common impacts of unmet physical and practical needs were financial burden and return-to-work difficulties. Over half of all unmet supportive care needs caused emotional and psychological impacts. CONCLUSIONS Findings identify the detrimental emotional and psychological impacts resulting from a range of unmet supportive care needs. The review highlights the interconnections between supportive care need domains thereby enhancing the understanding of the impacts of unmet SCNs. Findings may inform policy and practice change to improve supportive cancer care.
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Affiliation(s)
- Olivia Bellas
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Emma Kemp
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.,College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Laura Edney
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Candice Oster
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Jackie Roseleur
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
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12
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Kanatas A, Lowe D, Rogers SN. The Patient Concerns Inventory in head and neck oncology: a structured review of its development, validation and clinical implications. Eur Arch Otorhinolaryngol 2022; 279:5097-5111. [PMID: 35842858 PMCID: PMC9519723 DOI: 10.1007/s00405-022-07499-0] [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: 03/17/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022]
Abstract
Introduction The Patient Concerns Inventory (PCI) is a condition specific prompt list that was initially developed for head and neck cancer (HNC) and is referred to as the PCI–HN. There have been numerous publications regarding the PCI–HN, since it was first published in 2009. To date, there has not been a review of its development, validation and clinical implications. A collation of relevant papers into key sections allows multidisciplinary teams and researchers to have an overview of the PCI–HN’s background, evaluation and utility. This is essential if colleagues are to have confidence in the tool and be able to reflect on how to optimise its use in clinical practice. Methods Five search engines were used: EMBASE, Medline, PubMed, CINAHL and Handle-on-QOL for the specific term ‘Patient Concerns Inventory’ up to and including 1st February 2022. In addition, an accumulation of PCI–HN data of 507 HNC patients was drawn from previous studies in Liverpool and Leeds between 2007 and 2020 and was analysed specifically for this paper. Results 54 papers relating to the PCI–HN were identified. The review is structured into eight sections: (1) What is the PCI–HN and how does it work; (2) Feasibility and acceptability; (3) Psychometrics; (4) Items selected and frequency (5) Associations with Health-Related Quality of Life (HRQOL) and casemix; (6) Other observational studies; (7) Randomised trial evaluation; (8) General discussion and further research. Conclusions As the term PCI is quite ubiquitous and produces many hits when searching the literature, this review provides a very concise and convenient historical context for the PCI–HN and collates the current literature.
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Affiliation(s)
- Anastasios Kanatas
- Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK
| | | | - Simon N. Rogers
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, L39 4QP UK
- Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK
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13
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Adeola BA, Ivana D, Orlando R, Wu VS, Anthony A, Geoff P D, Afaf G. Supporting cancer patients to self-manage: Extent of use and perceptions of "trusted" online self-management resources. PATIENT EDUCATION AND COUNSELING 2022; 105:2240-2247. [PMID: 35351325 DOI: 10.1016/j.pec.2022.03.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/21/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Online resources can support patient self-management practices, but are not systematically used in routine clinical practice. We evaluated cancer patients' satisfaction with, and use of, tailored online resources. METHODS Patients completed monthly validated electronic patient reported outcome measures (ePROMs) of distress, unmet needs and symptoms. Patients with ePROM scores above pre-determined thresholds received an email directing them to relevant online self-management resources. Perceptions and experiences with these resources were evaluated via an online survey 3, 6 and 9 months after their initial monthly ePRO; and a subset of patients was also interviewed. Webpage use was monitored through Google Analytics and ClickMeter. RESULTS Overall, 221 patients completed evaluation surveys and 31 completed interviews. Patients spent 0-10 min on average accessing resources, with 93% indicating they would reuse them. The most viewed page was physical wellbeing (n = 680); exercise and nutrition resources were most popular; and 69% of patients were satisfied with information content, reporting resources were easy to understand and navigate. CONCLUSIONS Online resources are perceived as acceptable and useful. Design and delivery recommendations can improve their support of self-management. PRACTICE IMPLICATIONS Incorporating automated online self-management resources into routine clinical workflows is a viable model to support routine follow up care.
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Affiliation(s)
- Bamgboje-Ayodele Adeola
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; South West Sydney Clinical Campuses, UNSW Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Durcinoska Ivana
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Rincones Orlando
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Verena Shuwen Wu
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Arnold Anthony
- Illawarra Shoalhaven Local Health District, NSW, Australia.
| | - Delaney Geoff P
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; South West Sydney Clinical Campuses, UNSW Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia; South Western Sydney Local Health District, NSW, Australia.
| | - Girgis Afaf
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; South West Sydney Clinical Campuses, UNSW Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia.
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14
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Loizidou M, Sefcikova V, Ekert JO, Bone M, Samandouras G. Reforming support systems of newly diagnosed brain cancer patients: a systematic review. J Neurooncol 2022; 156:61-71. [PMID: 34826034 PMCID: PMC8714629 DOI: 10.1007/s11060-021-03895-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 11/05/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Despite the increasing incidence of currently incurable brain cancer, limited resources are placed in patients' support systems, with reactive utilisation late in the disease course, when physical and psychological symptoms have peaked. Based on patient-derived data and emphasis on service improvement, this review investigated the structure and efficacy of the support methods of newly diagnosed brain cancer patients in healthcare systems. METHODS This systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Articles from PubMed, Embase, and CENTRAL databases were screened with six pre-established eligibility criteria, including assessment within 6 months from diagnosis of a primary malignant brain tumour. Risk of bias was evaluated using the Newcastle-Ottawa Scale and Critical Appraisal Skills Program (CASP) Qualitative Studies Checklist. RESULTS Of 5057 original articles, 14 were eligible for qualitative synthesis. Four studies were cross-sectional and ten were descriptive. Information given to patients was evaluated in seven studies, communication with patients in nine, and patient participation in treatment decisions in eight. Risk of bias was low in ten studies, moderate in two, and high in two. CONCLUSIONS Techniques promoting individualised care increased perceived support, despite poor patient-physician communication and complexity of the healthcare system. Extracted data across 14 included studies informed a set of guidelines and a four-step framework. These can help evaluate and reform healthcare services to better accommodate the supportive needs of this patient group.
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Affiliation(s)
- Maria Loizidou
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK.
| | - Viktoria Sefcikova
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Justyna O Ekert
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Matan Bone
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
| | - George Samandouras
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
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15
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Assessing unmet needs in advanced cancer patients: a systematic review of the development, content, and quality of available instruments. J Cancer Surviv 2021; 16:960-975. [PMID: 34363187 PMCID: PMC9489568 DOI: 10.1007/s11764-021-01088-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/13/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Advances in treatment, including biological and precision therapies, mean that more people are living with advanced cancer. Supportive care needs likely change across the cancer journey. We systematically identified instruments available to assess unmet needs of advanced cancer patients and evaluated their development, content, and quality. METHODS Systematic searches of MEDLINE, CINAHL, Embase, PubMed, and PsycINFO were performed from inception to 11 January 2021. Independent reviewers screened for eligibility. Data was abstracted on instrument characteristics, development, and content. Quality appraisal included methodological and quality assessment, GRADE, feasibility, and interpretability, following consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines. RESULTS Thirty studies reporting 24 instruments were identified. These were developed for general palliative patients (n = 2 instruments), advanced cancer (n = 8), and cancer irrespective of stage (n = 14). None focused on patients using biological or precision therapies. The most common item generation and reduction techniques were amending an existing instrument (n = 11 instruments) and factor analysis (n = 8), respectively. All instruments mapped to ≥ 5 of 11 unmet need dimensions, with Problems and Needs in Palliative Care (PNPC) and Psychosocial Needs Inventory (PNI) covering all 11. No instrument reported all of the COSMIN measurement properties, and methodological quality was variable. CONCLUSIONS Many instruments are available to assess unmet needs in advanced cancer. There is extensive heterogeneity in their development, content, and quality. IMPLICATIONS FOR CANCER SURVIVORS Given the growth of precision and biological therapies, research needs to explore how these instruments perform in capturing the needs of people using such therapies.
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16
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Arnold BL, Girgis PA, Dhillon AH, Descallar J, Halkett AG. Does a communication skills program enable symptom and distress screening?: The impact of training on radiation therapists' confidence, knowledge, and use of distress screening. J Med Imaging Radiat Sci 2021; 52:399-408. [PMID: 34183301 DOI: 10.1016/j.jmir.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 05/16/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Due to the prevalence of distress following a cancer diagnosis, routine symptom and distress screening is recommended as best practice. RTs perceive psychosocial support and screening to be part of their role, however feel they lack the education and skills to perform this confidently. The study aimed to evaluate the impact of providing communication skills training (RT Prepare CST) on the perceived barriers, knowledge, attitude, role, and confidence of radiation therapists (RTs) in using routine symptom and distress screening. METHODS A single-arm, pre-post intervention design was implemented. All RTs at one regional and one rural centre participated in RT Prepare CST. RTs completed a questionnaire: pre-intervention (T1); immediately post-intervention (T2); and, three months post-intervention (T3). Cochran's Q and McNemar's tests for non-parametric data were conducted to compare outcomes over time. RESULTS Of 39 RTs approached, 37 (95%) consented to participate with 36 (92%) completing questionnaires at all three time points. Significant and sustained improvements post-intervention were noted from T1-T3 including: confidence in describing the PROMPT-Care tool to patients (p=0.002), discussing psychosocial issues (p=0.014); recognising signs of anxiety/depression (p<0.001); dealing with signs of anxiety (p=0.002), depression (p=0.015) and distress (p=0.008) as well as agreeing 'the tool is useful in identifying psychosocial problems' (p=0.029). CONCLUSIONS RT Prepare CST was effective in increasing confidence, knowledge and attitudes of RTs in the psychosocial care of patients with a change in RT behaviour noted by a significant increase in the number of patients screened following the intervention. Providing routine CST and emotional cues training to RTs enhances their ability to care for patients holistically, equipping them with skills to be included within a psychosocial model of care. Engaged leadership and role models are essential to sustain the learnings from education programs and provide an environment to discuss and define roles within radiation therapy departments.
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Affiliation(s)
- Belinda L Arnold
- Illawarra Shoalhaven Local Health District, New South Wales, Australia; Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia.
| | - Prof Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia
| | - A/Prof Haryana Dhillon
- Centre for Medical Psychology & Evidence-based Decision-making School of Psychology, Faculty of Science. The University of Sydney, Sydney, New South Wales, Australia
| | - Joseph Descallar
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia
| | - A/Prof Georgia Halkett
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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17
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Arnold BL, Halkett G, Dhillon H, Girgis A. Do radiation therapists feel able to routinely screen for symptoms and distress in people with cancer: barriers impacting practice. J Med Radiat Sci 2021; 68:149-156. [PMID: 33729701 PMCID: PMC8168062 DOI: 10.1002/jmrs.465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/26/2021] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate radiation therapists' (RTs) perceptions regarding the perceived barriers, knowledge, attitudes, confidence and role in administering an electronic screening tool to routinely screen for cancer patients' symptoms and distress. METHODS RTs at two radiation therapy departments completed a cross-sectional paper/pen survey to assess their demographic and workplace characteristics, perceptions of barriers, knowledge, attitudes, confidence and opinion of their role in symptom and distress screening. Responses were evaluated using simple frequencies and free-text responses using thematic analysis. RESULTS Of 39 RTs approached, 37 (95%) participated. The majority had not previously attended any emotional cues (77%) or psychosocial training (86%); 68% reported confidence discussing psychosocial concerns and recognising signs of anxiety and depression in patients, and 65% felt discussing patients' psychosocial concerns was part of their role. Administering the tool to patients was agreed to be the role of RTs by 38% of participants. Lack of education about psychosocial issues was the highest-ranked barrier to delivering the patient screening tool, with 74% of RTs responding 'it has made it difficult'. CONCLUSION Whilst RTs are willing to play a role in patients' psychosocial support, they do not feel able to fulfil this role adequately because they lacked knowledge and confidence to administer symptom and distress screening. This research has highlighted the need for RT education on psychosocial concerns and recognising and responding to emotional cues. Understanding the impact education may have on the knowledge, attitude, confidence and role of RTs performing routine symptom and distress screening is required.
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Affiliation(s)
- Belinda L. Arnold
- Wollongong HospitalIllawarra Shoalhaven Local Health DistrictWollongongNew South WalesAustralia
- Centre for Oncology Education and Research Translation (CONCERT)Ingham Institute for Applied Medical ResearchUNSW SydneyLiverpoolNew South WalesAustralia
| | - Georgia Halkett
- Curtin School of Nursing, Faculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Haryana Dhillon
- Centre for Medical Psychology & Evidence‐based Decision‐makingSchool of PsychologyFaculty of ScienceThe University of SydneyCamperdownNew South WalesAustralia
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT)Ingham Institute for Applied Medical ResearchUNSW SydneyLiverpoolNew South WalesAustralia
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18
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Afework T, Wondimagegnehu A, Alemayehu N, Kantelhardt EJ, Addissie A. Validity and reliability of the Amharic version of supportive care needs survey - short form 34 among cancer patients in Ethiopia. BMC Health Serv Res 2021; 21:484. [PMID: 34020635 PMCID: PMC8138921 DOI: 10.1186/s12913-021-06512-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/10/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Supportive care needs survey short form has a total of 34 items that have 5 domains that measure the unmet needs of cancer patients. It is important to validate this tool since there are differences in culture, geographic areas, and clinical care service which influence patients' needs. Therefore, this study aimed to assess the construct validity and reliability of the tool. METHODS The study was conducted among 170 cancer patients from April 1st to 30th 2019 in Hawassa hospital, South Ethiopia. Confirmatory factor analysis was done using fit indices. Convergent and discriminant validity was evaluated using average variance extracted and maximum shared variance respectively. Known group validity was checked using the Mann-Whitney U test. The reliability of the instrument was examined using Cronbach's alpha. RESULTS Domains except for health system and information, and patient care and support maintained convergent and divergent validity. The remaining validity was maintained after removing items that were redundant and double loading. The average variance extracted of domains varied from 0.52-0.81. The Square of correlation between constructs was lower than the average variance extracted for the constructs. The tool had reliability r = 0.932. The root mean square error of approximation was 0.057, comparative fit index 0.954, and the other fit indices were also indicating a good fit. Known groups difference was seen by age and type of treatment taken across the different domains. CONCLUSION After the health system and information, and patient care, and support domain validity issues were corrected by removing 8 items, the reduced tool was found to be a valid and reliable tool. The validated tool will be valuable if included in routine cancer care in our clinical settings.
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Affiliation(s)
- Tsion Afework
- School of Public Health, Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Abigiya Wondimagegnehu
- School of Public Health, Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Natnael Alemayehu
- Faculty of Medicine, Palliative Care Unit, Hawassa University, Hawassa, Ethiopia
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle (Saale), Germany
- Department of Gynecology, Martin-Luther-University, Halle (Saale), Germany
| | - Adamu Addissie
- School of Public Health, Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle (Saale), Germany
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19
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Girgis A, Durcinoska I, Arnold A, Descallar J, Kaadan N, Koh ES, Miller A, Ng W, Carolan M, Della-Fiorentina SA, Avery S, Delaney GP. Web-Based Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care): Multicenter Pragmatic Nonrandomized Trial. J Med Internet Res 2020; 22:e19685. [PMID: 33118954 PMCID: PMC7661255 DOI: 10.2196/19685] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/04/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
Background Despite the acceptability and efficacy of e–patient-reported outcome (ePRO) systems, implementation in routine clinical care remains challenging. Objective This pragmatic trial implemented the PROMPT-Care (Patient Reported Outcome Measures for Personalized Treatment and Care) web-based system into existing clinical workflows and evaluated its effectiveness among a diverse population of patients with cancer. Methods Adult patients with solid tumors receiving active treatment or follow-up care in four cancer centers were enrolled. The PROMPT-Care intervention supported patient management through (1) monthly off-site electronic PRO physical symptom and psychosocial well-being assessments, (2) automated electronic clinical alerts notifying the care team of unresolved clinical issues following two consecutive assessments, and (3) tailored online patient self-management resources. Propensity score matching was used to match controls with intervention patients in a 4:1 ratio for patient age, sex, and treatment status. The primary outcome was a reduction in emergency department presentations. Secondary outcomes were time spent on chemotherapy and the number of allied health service referrals. Results From April 2016 to October 2018, 328 patients from four public hospitals received the intervention. Matched controls (n=1312) comprised the general population of patients with cancer, seen at the participating hospitals during the study period. Emergency department visits were significantly reduced by 33% (P=.02) among patients receiving the intervention compared with patients in the matched controls. No significant associations were found in allied health referrals or time to end of chemotherapy. At baseline, the most common patient reported outcomes (above-threshold) were fatigue (39%), tiredness (38.4%), worry (32.9%), general wellbeing (32.9%), and sleep (24.1%), aligning with the most frequently accessed self-management domain pages of physical well-being (36%) and emotional well-being (23%). The majority of clinical feedback reports were reviewed by nursing staff (729/893, 82%), largely in response to the automated clinical alerts (n=877). Conclusions Algorithm-supported web-based systems utilizing patient reported outcomes in clinical practice reduced emergency department presentations among a diverse population of patients with cancer. This study also highlighted the importance of (1) automated triggers for reviewing above-threshold results in patient reports, rather than passive manual review of patient records; (2) the instrumental role nurses play in managing alerts; and (3) providing patients with resources to support guided self-management, where appropriate. Together, these factors will inform the integration of web-based PRO systems into future models of routine cancer care. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000615482; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370633 International Registered Report Identifier (IRRID) RR2-10.1186/s12885-018-4729-3
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Affiliation(s)
- Afaf Girgis
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Ivana Durcinoska
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Anthony Arnold
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia
| | - Joseph Descallar
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Nasreen Kaadan
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, Australia
| | - Eng-Siew Koh
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, Australia
| | - Andrew Miller
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia.,Centre for Oncology Informatics, University of Wollongong, Wollongong, Australia
| | - Weng Ng
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Martin Carolan
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia
| | - Stephen A Della-Fiorentina
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia.,Macarthur Cancer Therapy Centre, Campbelltown Hospital, Sydney, Australia
| | - Sandra Avery
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, Australia
| | - Geoff P Delaney
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Sydney, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, Australia
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Ettridge K, Caruso J, Roder D, Prichard I, Scharling-Gamba K, Wright K, Miller C. A randomised online experimental study to compare responses to brief and extended surveys of health-related quality of life and psychosocial outcomes among women with breast cancer. Qual Life Res 2020; 30:407-423. [PMID: 32990882 DOI: 10.1007/s11136-020-02651-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Collecting patient-reported outcomes is important in informing the well-being of women with breast cancer. Consumer perceptions are important for successful implementation of monitoring systems, but are rarely formally assessed. We compared reactions to two different surveys (assessing psychosocial outcomes and/or Health-related Quality of Life (HrQoL) outcomes) among Australian women with breast cancer. METHODS Women (18 + years) within 5 years diagnosis of breast cancer were randomly allocated to complete one of two online surveys: (i) minimum HrQoL measures or (ii) minimum HrQoL measures plus psychosocial outcomes (body image, depression, anxiety stress, fear of cancer recurrence, decisional difficulties and unmet need). Participants completed questions regarding their perceptions of the survey, including qualitative feedback. RESULTS Data were available for 171 participants (n(i) = 89; n(ii) = 82), with 92% (n = 158) providing 95-100% complete data. Perceptions were comparable between survey groups, and high (80-100%) regarding time burden, ease of completion, comprehensible, appropriateness and willingness to participate again and moderately high (67-74%) regarding willingness to answer more questions and relevance. Qualitative feedback indicated gaps across both surveys, including financial/work-related issues, satisfaction with information and care, need for nuanced questions, and impact of side effects/treatment, and from the minimum set only, emotional well-being and support. Impairment in some HrQoL and psychosocial outcomes were observed among participants. CONCLUSIONS Assessment of HrQoL and psychosocial outcomes was well received by consumers. Results alleviate concern regarding possible patient burden imposed by longer more in-depth surveys. The importance placed on assessment brevity should not outweigh the need to assess outcomes that consumers consider important.
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Affiliation(s)
- Kerry Ettridge
- South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, Australia.
| | - Joanna Caruso
- South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, Australia
| | - David Roder
- University of South Australia, Adelaide, SA, Australia
| | - Ivanka Prichard
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Katrine Scharling-Gamba
- South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, Australia
| | - Kathleen Wright
- South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, Australia
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Validation of the Supportive Care Needs Survey Screening Tool Chinese Version for Patients With Head and Neck Cancer in Taiwan. J Nurs Res 2020; 27:e50. [PMID: 31688277 DOI: 10.1097/jnr.0000000000000360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The increasing number of cancer survivors and the trend of shifting cancer treatments into outpatient clinics have increased rapidly the supportive care needs of patients with cancer. However, no brief assessment tool is available to screen for these needs. PURPOSE In this study, we aimed to (a) translate and develop a nine-item Chinese version of the Supportive Care Needs Survey Screening Tool (SCNS-ST9-C) and (b) examine the psychometric properties of this tool in a sample of patients with head and neck cancer (HNC) in Taiwan. METHODS In this two-phase instrument validation study, the SCNS-ST9-C was translated and evaluated for content, face validity, and feasibility in Phase I and was examined for internal consistency reliability and construct validity (including factor structure and theoretically supported correlations) on a sample of patients with HNC in Phase II. RESULTS In Phase I, the SCNS-ST9-C was translated and developed by three bilingual doctoral-prepared nurse researchers (Chinese and English). A standardized score system ranging from 0 to 100 was built, with higher scores indicating higher unmet supportive care needs. Good content and face validity were confirmed by five cancer care experts and 20 patients with HNC, respectively. In Phase II, 116 subjects were recruited. A clear four-factor structure, which incorporated one of the original five dimensions (sexuality care needs, with one item) into the dimension of psychological and emotional care needs, was identified using exploratory factor analysis. Good internal consistency reliability for the overall SCNS-ST9-C was supported by a Cronbach's α of .75 and its four subscales (domains). Good construct validity was also confirmed by the theoretically supported correlations. Better performance status and longer time since treatment completion correlated negatively with the SCNS-ST9-C (i.e., lower unmet care needs), whereas higher distress (anxiety, depression, and symptoms) correlated positively with the SCNS-ST9-C (i.e., greater unmet care needs). Female patients reported higher overall unmet care needs and psychological and emotional care needs and higher scores on the care and support needs subscale than male patients. CONCLUSIONS The SCNS-ST9-C is a brief, low-burden, and psychometrically valid instrument that may be applied in ethnically Chinese settings. This tool takes 1-2 minutes to complete. Further testing of the psychometrics of this instrument in different cancer populations is recommended.
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22
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Interpreting and Acting on the PRO Scores From the Patient-reported Outcomes for Personalized Treatment and Care (PROMPT-Care) eHealth System. Med Care 2020; 57 Suppl 5 Suppl 1:S85-S91. [PMID: 30985601 DOI: 10.1097/mlr.0000000000001094] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Patient-reported Outcomes for Personalized Treatment and Care (PROMPT-Care) is the first eHealth system in Australia that is fully electronically integrated into hospital oncology information systems, enabling real-time, routine collection of patient-reported outcomes (PROs) to support and enable cancer patients to achieve and maintain improved health, well-being, and cancer outcomes. Five previously published papers detail the impetus for developing this eHealth system, its development, and testing of its acceptability and feasibility, the development of algorithms to standardize the cancer care pathways which underpin patient care, and the protocol for evaluating the efficacy of PROMPT-Care. METHODS This manuscript provides "how-to" guidance to inform future system development, focusing on selecting relevant PROs and measuring them in cancer patients, score interpretation, and determining recommended care in response to scores which are above the predetermined threshold. DISCUSSION Electronic PRO systems are increasingly used in cancer clinical care settings, with the potential to support timely patient-centered care when implemented appropriately. KEY POINTS PRO selection should consider patient response burden, and prioritizing PROs that are amenable to clinical intervention. Having clear, evidence-based, care pathways, and actionable recommendations in response to above-threshold PRO scores facilitate PRO integration into the clinical workflow. Centers should determine thresholds for clinical action for each PRO which provide an acceptable balance between false positives and false negatives; and develop care pathway recommendations which consider the availability of local services and resources, are feasible in the clinical setting, clear, concise, manageable, based on evidence-based guidelines, and adaptable to local environments.
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Salchow J, Mann J, Koch B, von Grundherr J, Jensen W, Elmers S, Straub LA, Vettorazzi E, Escherich G, Rutkowski S, Dwinger S, Bergelt C, Sokalska-Duhme M, Bielack S, Calaminus G, Baust K, Classen CF, Rössig C, Faber J, Faller H, Hilgendorf I, Gebauer J, Langer T, Metzler M, Schuster S, Niemeyer C, Puzik A, Reinhardt D, Dirksen U, Sander A, Köhler M, Habermann JK, Bokemeyer C, Stein A. Comprehensive assessments and related interventions to enhance the long-term outcomes of child, adolescent and young adult cancer survivors - presentation of the CARE for CAYA-Program study protocol and associated literature review. BMC Cancer 2020; 20:16. [PMID: 31906955 PMCID: PMC6945396 DOI: 10.1186/s12885-019-6492-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022] Open
Abstract
Background Improved, multimodal treatment strategies have been shown to increase cure rates in cancer patients. Those who survive cancer as a child, adolescent or young adult (CAYA), are at a higher risk for therapy-, or disease-related, late or long-term effects. The CARE for CAYA-Program has been developed to comprehensively assess any potential future problems, to offer need-based preventative interventions and thus to improve long-term outcomes in this particularly vulnerable population. Methods The trial is designed as an adaptive trial with an annual comprehensive assessment followed by needs stratified, modular interventions, currently including physical activity, nutrition and psycho-oncology, all aimed at improving the lifestyle and/or the psychosocial situation of the patients. Patients, aged 15–39 years old, with a prior cancer diagnosis, who have completed tumour therapy and are in follow-up care, and who are tumour free, will be included. At baseline (and subsequently on an annual basis) the current medical and psychosocial situation and lifestyle of the participants will be assessed using a survey compiled of various validated questionnaires (e.g. EORTC QLQ C30, NCCN distress thermometer, PHQ-4, BSA, nutrition protocol) and objective parameters (e.g. BMI, WHR, co-morbidities like hyperlipidaemia, hypertension, diabetes), followed by basic care (psychological and lifestyle consultation). Depending on their needs, CAYAs will be allocated to preventative interventions in the above-mentioned modules over a 12-month period. After 1 year, the assessment will be repeated, and further interventions may be applied as needed. During the initial trial phase, the efficacy of this approach will be compared to standard care (waiting list with intervention in the following year) in a randomized study. During this phase, 530 CAYAs will be included and 320 eligible CAYAs who are willing to participate in the interventions will be randomly allocated to an intervention. Overall, 1500 CAYAs will be included and assessed. The programme is financed by the innovation fund of the German Federal Joint Committee and will be conducted at 14 German sites. Recruitment began in January 2018. Discussion CAYAs are at high risk for long-term sequelae. Providing structured interventions to improve lifestyle and psychological situation may counteract against these risk factors. The programme serves to establish uniform regular comprehensive assessments and need-based interventions to improve long-term outcome in CAYA survivors. Trial registration Registered at the German Clinical Trial Register (ID: DRKS00012504, registration date: 19th January 2018).
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Affiliation(s)
- J Salchow
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - J Mann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Koch
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J von Grundherr
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Jensen
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Elmers
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L A Straub
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Vettorazzi
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Escherich
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Rutkowski
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Dwinger
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Bergelt
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - S Bielack
- Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | | | - K Baust
- University Hospital Bonn, Bonn, Germany
| | - C F Classen
- University Hospital Rostock, Rostock, Germany
| | - C Rössig
- University Children's Hospital Münster, Münster, Germany
| | - J Faber
- Mainz University Medical Center, Mainz, Germany
| | - H Faller
- University Hospital Würzburg, Würzburg, Germany
| | | | - J Gebauer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - T Langer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - M Metzler
- University Hospital Erlangen, Erlangen, Germany
| | - S Schuster
- University Hospital Erlangen, Erlangen, Germany
| | - C Niemeyer
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Puzik
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Reinhardt
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - U Dirksen
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - A Sander
- Hannover Medical School, Hannover, Germany
| | - M Köhler
- Medical Faculty University Hospital Magdeburg, Magdeburg, Germany
| | | | - C Bokemeyer
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stein
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kohlmann K, Janko M, Ringel F, Renovanz M. Self-efficacy for coping with cancer in glioma patients measured by the Cancer Behavior Inventory Brief Version. Psychooncology 2019; 29:582-585. [PMID: 31733018 DOI: 10.1002/pon.5292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/28/2019] [Accepted: 11/14/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Karoline Kohlmann
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany.,Department of Neurology, University Medical Center Bonn, Bonn, Germany
| | - Mareile Janko
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany
| | - Mirjam Renovanz
- Interdisciplinary Section of Neuro-Oncology, Departments of Neurosurgery and Neurology, University Hospital Tuebingen, Tuebingen, Germany
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25
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Girgis A, Durcinoska I, Koh ES, Ng W, Arnold A, Delaney GP. Development of Health Pathways to Standardize Cancer Care Pathways Informed by Patient-Reported Outcomes and Clinical Practice Guidelines. JCO Clin Cancer Inform 2019; 2:1-13. [PMID: 30652587 DOI: 10.1200/cci.18.00024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE High-quality symptom management and supportive care are essential components of comprehensive cancer care. We aimed to describe the development of an evidence-based automated decisional algorithm for patients with cancer that had specific, actionable, clinical, evidence-based recommendations to improve patient care, communication, and management. METHODS We reviewed existing literature and clinical practice guidelines to identify priority domains of patient care and potential clinical recommendations. Two multidisciplinary clinical advisory groups used a two-stage consensus decision-making approach to determine domains of care and patient-reported outcome (PRO) measures and subsequently developed automated algorithms with clear clinical recommendations amendable to intervention in clinical settings. RESULTS Algorithms were developed to inform management of patient symptoms, distress, and unmet needs. Three PRO measures were chosen: Distress Thermometer and problem checklist, Edmonton Symptom Assessment Scale, and the Supportive Care Needs Survey-Screening Tool 9. PRO items were mapped to five domains of patient well-being: physical, emotional, practical, social and family, and maintenance of well-being. A total of 15 actionable clinical recommendations tailored to specific issues of concern were established. CONCLUSION Using automated algorithms and clinical recommendations provides a platform for streamlining and systematizing the use of PROs to inform risk-stratified guideline-informed care. The series of algorithms, which set out systematized care pathways for the clinical care of patients with cancer, can be used to potentially inform patient-centered care.
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Affiliation(s)
- Afaf Girgis
- Afaf Girgis, Ivana Durcinoska, and Geoff P. Delaney, The University of New South Wales, Sydney; Eng-Siew Koh, Weng Ng, and Geoff P. Delaney, Liverpool Hospital, Liverpool; and Anthony Arnold, Wollongong Hospital, Wollongong, NSW, Australia
| | - Ivana Durcinoska
- Afaf Girgis, Ivana Durcinoska, and Geoff P. Delaney, The University of New South Wales, Sydney; Eng-Siew Koh, Weng Ng, and Geoff P. Delaney, Liverpool Hospital, Liverpool; and Anthony Arnold, Wollongong Hospital, Wollongong, NSW, Australia
| | - Eng-Siew Koh
- Afaf Girgis, Ivana Durcinoska, and Geoff P. Delaney, The University of New South Wales, Sydney; Eng-Siew Koh, Weng Ng, and Geoff P. Delaney, Liverpool Hospital, Liverpool; and Anthony Arnold, Wollongong Hospital, Wollongong, NSW, Australia
| | - Weng Ng
- Afaf Girgis, Ivana Durcinoska, and Geoff P. Delaney, The University of New South Wales, Sydney; Eng-Siew Koh, Weng Ng, and Geoff P. Delaney, Liverpool Hospital, Liverpool; and Anthony Arnold, Wollongong Hospital, Wollongong, NSW, Australia
| | - Anthony Arnold
- Afaf Girgis, Ivana Durcinoska, and Geoff P. Delaney, The University of New South Wales, Sydney; Eng-Siew Koh, Weng Ng, and Geoff P. Delaney, Liverpool Hospital, Liverpool; and Anthony Arnold, Wollongong Hospital, Wollongong, NSW, Australia
| | - Geoff P Delaney
- Afaf Girgis, Ivana Durcinoska, and Geoff P. Delaney, The University of New South Wales, Sydney; Eng-Siew Koh, Weng Ng, and Geoff P. Delaney, Liverpool Hospital, Liverpool; and Anthony Arnold, Wollongong Hospital, Wollongong, NSW, Australia
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26
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Fox J, Janda M, Bennett F, Langbecker D. An outreach telephone program for advanced melanoma supportive care: Acceptability and feasibility. Eur J Oncol Nurs 2019; 42:110-115. [PMID: 31493669 DOI: 10.1016/j.ejon.2019.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE People with advanced melanoma face an uncertain trajectory as new treatments now have the potential to provide longer-term survival for some. However, the disease course is variable and unpredictable, with many expressing a need for better supportive care. This study aimed to investigate the acceptability and feasibility of extending an existing melanoma-specific self-referral or 'passive' telephone consultation support service to an 'active' outreach call to offer a supportive care program tailored to the needs of the patient. METHOD Participants were enrolled by their oncology nurse into a single group pre-post intervention study. Participants received an outreach telephone call focused on knowledge and skill development. Participants completed questionnaires at baseline and four weeks post-intervention. Post-intervention interviews with patients and involved staff were used to explore acceptability and feasibility of the outreach service call. RESULTS Of 18 participants approached, 15 enrolled and 14 received the intervention. Staff time required for intervention delivery provided evidence for feasibility. Participants perceived the intervention as acceptable, and beneficial. In interviews, having someone with melanoma-specific knowledge to talk with was a key benefit of the outreach call program. Many participants expressed that they would have wished to receive the outreach call at an earlier stage, for example at the time of recurrence of/progression to advanced melanoma. CONCLUSIONS Extending an existing self-referral support service model to use a more 'active' outreach approach is acceptable and feasible. The next step in the evaluation process for this intervention is a randomised controlled trial to determine effectiveness and cost-effectiveness.
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Affiliation(s)
- Jennifer Fox
- School of Nursing, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Qld, 4075, Australia.
| | - Monika Janda
- Centre for Health Service Research, Faculty of Medicine, Institute of Health and Biomedical Innovation, The University of Queensland, Woolloongabba, Qld, 4102, Australia; School of Public Health and Social Work, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.
| | - Fiona Bennett
- Melanoma Patients Australia, Mater Foundation, 620 Stanley Street, Woolloongabba, Brisbane, 4102, Australia.
| | - Danette Langbecker
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Ground floor, Building 33, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Qld, 4102, Australia.
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Klungrit S, Thanasilp S, Jitpanya C. Supportive care needs: An aspect of Thai women with breast cancer undergoing chemotherapy. Eur J Oncol Nurs 2019; 41:82-87. [PMID: 31358262 DOI: 10.1016/j.ejon.2019.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/26/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE This study was conducted to explore supportive care needs of Thai women with breast cancer undergoing chemotherapy. METHODS Through qualitative interviews, a convenience sample of ten women with invasive and advanced invasive breast cancer who were undergoing chemotherapy were interviewed. Treatment for all women took place at a regional hospital in lower northern Thailand. Ten participants were interviewed, some more than once, for a total of 18 interviews. A qualitative approach with a semi-structured interview guideline was used in data collection. Content analysis was used to analyze the data. RESULTS Four major themes were found: 1) the need for physical comfort and health safety, 2) the need for encouragement, 3) the need for solution of financial problems, and 4) the need for communication and useful information. This qualitative investigation found that supportive care needs of Thai women with breast cancer undergoing chemotherapy are essential for nurses to know in order to provide high quality care. CONCLUSIONS Improvement of supportive care quality for women with breast cancer who are undergoing chemotherapy in Thai culture should include: 1) access to supportive care needs assessment, 2) proactive dissemination of necessary information for better management of their lives, 3) aids to daily living and psychosocial support, and 4) facilitation of easy access to welfare and finance help. Provision of supportive care from both families and health care teams could improve the quality of life and so ease the women's lives for Thai women with breast cancer undergoing chemotherapy.
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Affiliation(s)
- Supanee Klungrit
- Faculty of Nursing, Chulalongkorn University, Borommaratchachonnani Srisataphat Building, 11th, Floor, Rama I Road, Wangmai Sub-district, Phathumwan District, Bangkok, 10330, Thailand.
| | - Sureeporn Thanasilp
- Faculty of Nursing, Chulalongkorn University, Borommaratchachonnani Srisataphat Building, 11th, Floor, Rama I Road, Wangmai Sub-district, Phathumwan District, Bangkok, 10330, Thailand.
| | - Chanokporn Jitpanya
- Faculty of Nursing, Chulalongkorn University, Borommaratchachonnani Srisataphat Building, 11th, Floor, Rama I Road, Wangmai Sub-district, Phathumwan District, Bangkok, 10330, Thailand.
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Tian L, Cao X, Feng X. Evaluation of psychometric properties of needs assessment tools in cancer patients: A systematic literature review. PLoS One 2019; 14:e0210242. [PMID: 30620770 PMCID: PMC6324833 DOI: 10.1371/journal.pone.0210242] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/19/2018] [Indexed: 02/05/2023] Open
Abstract
Background Although a wide range of needs assessment tools for cancer patients have been developed, no standardized and commonly accepted instruments were recommended to use in clinical care. This systematic review was conducted to assess the quality of psychometric properties of needs assessment tools among cancer patients in order to help oncology healthcare professionals select the most appropriate needs assessment tools in routine clinical practice. Methods Searches were conducted in the electronic databases of PUBMED from 1966, CINAHL from 1960, EMBASE from 1980 and PsychINFO from 1967 as well as additional sources. The quality of psychometric properties of the recruited needs assessment tools was evaluated using the agreed quality criteria for measurement properties of health status questionnaires. Results Thirty-seven studies which evaluated the psychometric properties of 20 needs assessment tools were identified. Internal consistency was tested in 32 studies with 9 studies indicating negative rating and 4 studies intermediate rating. Less than half of the studies (13 studies) assessed test-retest reliability, and only 4 studies reported positive rating. Content validity was the most tested psychometric property appraised in 33 studies and indicated positive rating in all the evaluated studies. Structural validity was adequately evaluated in 28 studies with 23 studies reporting intermediate rating. More than half of the studies (29 studies) tested hypothesis testing and 13 studies were rated positive. Cross-cultural validity results were obtained in 13 studies with 7 studies showing negative rating. No data was available on measurement error and criterion validity. Only one study appraised responsiveness and showed intermediate rating. The Supportive Care Needs Survey-Short Form (SCNS-SF) is the most widely used instrument for needs assessment in cancer patients. It had strong evidence for internal consistency, content validity, structural validity and hypothesis testing, and moderate evidence for reliability and cross-cultural validity. Cancer Survivors’ Unmet Needs Measure (CaSUN) reported strong or moderate evidence for internal consistency, reliability, content and structural validity, and hypothesis testing. Furthermore, Supportive Cancer Care Needs Assessment Tool for Indigenous People (SCNAT-IP) had strong evidence for content validity, and moderate evidence for internal consistency, structural validity and hypothesis testing. Conclusions Despite several needs assessment tools exist to assess care needs in cancer patients, further improvement of already existing and promising instruments is recommended.
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Affiliation(s)
- Lang Tian
- Department of hepatobiliary surgery, Sichuan Cancer Hospital, Chengdu, Sichuan province, People’s Republic of China
- * E-mail: (LT); (XC)
| | - Xiaoyi Cao
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan province, People’s Republic of China
- * E-mail: (LT); (XC)
| | - Xielin Feng
- Department of hepatobiliary surgery, Sichuan Cancer Hospital, Chengdu, Sichuan province, People’s Republic of China
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Girgis A, Durcinoska I, Gerges M, Kaadan N, Arnold A, Descallar J, Delaney GP. Study protocol for a controlled trial of an eHealth system utilising patient reported outcome measures for personalised treatment and care: PROMPT-Care 2.0. BMC Cancer 2018; 18:845. [PMID: 30139331 PMCID: PMC6107942 DOI: 10.1186/s12885-018-4729-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 08/07/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Routine assessment and clinical utilisation of patient-reported outcome (PRO) measures can lead to improved patient outcomes. The PROMPT-Care eHealth system facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions, patient self-management, and shared care. Pilot testing demonstrated acceptability and feasibility of PROMPT-Care Version 1.0. This study aims to implement PROMPT-Care Version 2.0 and determine its efficacy in reducing emergency department (ED) presentations, and improving chemotherapy delivery and health service referrals, compared to usual care. METHODS Groups eligible to participate in the intervention arm of this controlled trial are patients receiving cancer care (including follow-up). PROMPT-Care patients will complete monthly assessments (distress, symptoms, unmet needs) until voluntary withdrawal or death. In Version 1.0, the care team accessed patients' clinical feedback reports in 'real time' to guide their care, and patients received links to support their self-management, tailored to their PRO responses. Version 2.0 was extended to include: i) an additional alert system notifying the care team of ongoing unresolved clinical issues, ii) patient self-management resources, and iii) an auto-populated Treatment Summary and Survivorship Care Plan (SCP). The control population will be patients extracted from hospital databases of the general cancer patient population who were seen at the participating cancer therapy centres during the study period, with a ratio of 1:4 of intervention to control patients. A minimum sample size of 1760 (352 intervention and 1408 control) patients will detect a 14% reduction in the number of ED presentations (primary outcome) in the PROMPT-Care group compared with the control group. Intervention patients will provide feedback on system usability and value of the self-management materials; oncology staff will provide feedback on usefulness of PROMPT-Care reports, response to clinical alerts, impact on routine care, and usefulness of the SCPs; and GPs will provide feedback on the usefulness of the SCPs and attitudes towards shared-care models of survivorship care planning. DISCUSSION This study will inform the PROMPT-Care system's impact on healthcare utilisation and utility as an alternative model for ongoing supportive care. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ( ACTRN12616000615482 ) on 12th May 2016 ( www.anzctr.org.au ).
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Affiliation(s)
- Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT) Ingham Institute for Applied Medical Research, Sydney, NSW Australia
- South Western Sydney Clinical School, The University of New South Wales, Sydney, Australia
| | - Ivana Durcinoska
- Centre for Oncology Education and Research Translation (CONCERT) Ingham Institute for Applied Medical Research, Sydney, NSW Australia
- South Western Sydney Clinical School, The University of New South Wales, Sydney, Australia
| | - Martha Gerges
- Centre for Oncology Education and Research Translation (CONCERT) Ingham Institute for Applied Medical Research, Sydney, NSW Australia
- South Western Sydney Clinical School, The University of New South Wales, Sydney, Australia
| | - Nasreen Kaadan
- Centre for Oncology Education and Research Translation (CONCERT) Ingham Institute for Applied Medical Research, Sydney, NSW Australia
- South Western Sydney Clinical School, The University of New South Wales, Sydney, Australia
- Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW Australia
| | - Anthony Arnold
- Centre for Oncology Education and Research Translation (CONCERT) Ingham Institute for Applied Medical Research, Sydney, NSW Australia
- Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, NSW Australia
| | - Joseph Descallar
- Centre for Oncology Education and Research Translation (CONCERT) Ingham Institute for Applied Medical Research, Sydney, NSW Australia
- South Western Sydney Clinical School, The University of New South Wales, Sydney, Australia
- Department of Statistics, Macquarie University, Sydney, NSW Australia
| | - Geoff P. Delaney
- Centre for Oncology Education and Research Translation (CONCERT) Ingham Institute for Applied Medical Research, Sydney, NSW Australia
- South Western Sydney Clinical School, The University of New South Wales, Sydney, Australia
- Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW Australia
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Renovanz M, Hechtner M, Kohlmann K, Janko M, Nadji-Ohl M, Singer S, Ringel F, Coburger J, Hickmann AK. Compliance with patient-reported outcome assessment in glioma patients: predictors for drop out. Neurooncol Pract 2017; 5:129-138. [PMID: 31385978 DOI: 10.1093/nop/npx026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Patient-reported outcomes are of high importance in clinical neuro-oncology. However, assessment is still suboptimal. We aimed at exploring factors associated with the probability for a) drop out of study and b) death during follow-up. Methods Patients were assessed twice during follow-up visits scheduled within 3 to 5 months of each other by using 3 validated patient-reported outcome measures (t1: first assessment, t2: second assessment). As "death" was seen as a competing risk for drop out, univariate competing risk Cox regression models were applied to explore factors associated with dropping out (age, gender, WHO grade, living situation, recurrent surgery, Karnofsky Performance Status, time since diagnosis, and patient-reported outcomes assessed by Distress Thermometer, EORTC-QLQ-C30, EORTC-QLQ-BN20, and SCNS-SF-34G). Results Two hundred forty-six patients were eligible, 173 (70%) participated. Patients declining participation were diagnosed with glioblastomas more often than with other gliomas (56% vs 39%). At t2, 32 (18%) patients dropped out, n = 14 death-related, n = 18 for other reasons. Motor dysfunction (EORTC-QLQ-BN20) was associated with higher risk for non-death-related drop out (HR: 1.02; 95% CI, 1.00-1.03; P = .03). Death-related drop out was associated with age (HR: 1.09; 95% CI, 1.03-1.14; P = .002), Karnofsky Performance Status (HR: 0.92; 95% CI, 0.88-0.96; P < .001), lower physical functioning (EORTC-QLQ-C30; HR: 0.98; 95% CI, 0.96-1.00; P = .04) and lower motor functioning (EORTC-QLQ-BN20; HR: 1.020; 95% CI, 1.00-1.04; P = .02). Conclusion Patients with motor dysfunction and poorer clinical condition seem to be more likely to drop out of studies applying patient-reported outcome measures. This should be taken into account when planning studies assessing glioma patients and for interpretation of results of patient-reported outcome assessments in clinical routine.
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Affiliation(s)
- Mirjam Renovanz
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Marlene Hechtner
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Karoline Kohlmann
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Mareile Janko
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Minou Nadji-Ohl
- Department of Neurosurgery Klinikum Stuttgart, Katharinenhospital, Stuttgart Germany
| | - Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Jan Coburger
- Department of Neurosurgery, University Medical Center Ulm/Günzburg, Günzburg Germany
| | - Anne-Katrin Hickmann
- Department of Neurosurgery Klinikum Stuttgart, Katharinenhospital, Stuttgart Germany.,Department of Neurosurgery Hirslanden Klinikum, Luzern Switzerland
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31
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Girgis A, Durcinoska I, Levesque JV, Gerges M, Sandell T, Arnold A, Delaney GP. eHealth System for Collecting and Utilizing Patient Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) Among Cancer Patients: Mixed Methods Approach to Evaluate Feasibility and Acceptability. J Med Internet Res 2017; 19:e330. [PMID: 28970188 PMCID: PMC5667931 DOI: 10.2196/jmir.8360] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 12/19/2022] Open
Abstract
Background Despite accumulating evidence indicating that collecting patient-reported outcomes (PROs) and transferring results to the treating health professional in real time has the potential to improve patient well-being and cancer outcomes, this practice is not widespread. Objective The aim of this study was to test the feasibility and acceptability of PROMPT-Care (Patient Reported Outcome Measures for Personalized Treatment and Care), a newly developed electronic health (eHealth) system that facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research. Methods We developed an eHealth system in consultation with content-specific expert advisory groups and tested it with patients receiving treatment or follow-up care in two hospitals in New South Wales, Australia, over a 3-month period. Participants were recruited in clinic and completed self-report Web-based assessments either just before their upcoming clinical consultation or every 4 weeks if in follow-up care. A mixed methods approach was used to evaluate feasibility and acceptability of PROMPT-Care; data collected throughout the study informed the accuracy and completeness of data transfer procedures, and extent of missing data was determined from participants’ assessments. Patients participated in cognitive interviews while completing their first assessment and completed evaluation surveys and interviews at study-end to assess system acceptability and usefulness of patient self-management resources, and oncology staff were interviewed at study-end to determine the acceptability and perceived usefulness of real-time PRO reporting. Results A total of 42 patients consented to the study; 7 patients were withdrawn before starting the intervention primarily because of changes in eligibility. Overall, 35 patients (13 on treatment and 22 in follow-up) completed 67 assessments during the study period. Mean completeness of patient-reported data was 93%, with 100% accuracy of data transfer. Ten patients completed cognitive interviews, 28 completed evaluation surveys, and 14 completed evaluation interviews at study-end. PROMPT-Care patient acceptability was high—100% (28/28) reported the time to complete the Web-based assessments (average 15 min) as about right, most willing to answer more questions (79%, 22/28 yes), 96% (27/28) found the Web-based assessment easier or same as completing a paper copy, and they valued the self-management resources . Oncology staff (n=5) also reported high acceptability and potential feasibility of the system. Conclusions Patients and oncology staff found the PROMPT-Care system to be highly acceptable, and the results suggest that it would be feasible to implement it into an oncology setting. Suggested modifications to the patient assessment survey, clinician access to the reports, and system requirements will be made as part of the next stage of large-scale testing and future implementation of the system as part of routine care. Trial registration Australian New Zealand Clinical Trials Registry ACTRN1261500135294; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369299&isReview=true (Archived by WebCite at http://www.webcitation.org/6lzylG5A0).
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Affiliation(s)
- Afaf Girgis
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,South Western Sydney Clinical School, Faculty of Medicine, The University of New South Wales, Liverpool, Australia
| | - Ivana Durcinoska
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Janelle V Levesque
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,South Western Sydney Clinical School, Faculty of Medicine, The University of New South Wales, Liverpool, Australia
| | - Martha Gerges
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,South Western Sydney Clinical School, Faculty of Medicine, The University of New South Wales, Liverpool, Australia
| | - Tiffany Sandell
- Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia
| | - Anthony Arnold
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia
| | - Geoff P Delaney
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,South Western Sydney Clinical School, Faculty of Medicine, The University of New South Wales, Liverpool, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia
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- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia
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32
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McCallum M, Jolicoeur L, Lefebvre M, Babchishin LK, Le T, Lebel S. Filling in the gaps: Sociodemographic and medical predictors of sexual health and other supportive care needs, and desire for help in gynecological cancer survivors. Can Oncol Nurs J 2017; 27:251-258. [PMID: 31148785 PMCID: PMC6516400 DOI: 10.5737/23688076273251258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE The goal of the present study was to evaluate predictors of unmet supportive care needs and readiness for help among gynecological cancer patients. METHODS A sample of 113 gynecological cancer survivors completed a measure of needs and desire for help. Regression analyses identified sociodemographic and medical predictors of patient needs and desire for help. RESULTS Younger age and shorter time since treatment were the strongest predictors of many unmet needs. Younger age and chemotherapy predicted greater unmet sexual health needs. Shorter time since treatment predicted readiness for help with informational needs. CONCLUSIONS Post-treatment unmet needs are diverse and may be greater in younger and recently treated survivors. Chemotherapy treatment may contribute to greater sexual health needs.
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Affiliation(s)
| | | | | | | | - Tien Le
- Division of Gynecologic-Oncology, The Ottawa Hospital, Ottawa, ON
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, ON
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33
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Han Y, Zhou Y, Wang J, Zhao Q, Qin H, Fan Y, Song Y, Boyes A, Cui S. Psychometric testing of the Mandarin version of the 34-item Short-Form Supportive Care Needs Survey in patients with cancer in mainland China. Support Care Cancer 2017; 25:3329-3338. [PMID: 28551842 DOI: 10.1007/s00520-017-3750-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 05/12/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Although the Supportive Care Needs Survey is one of the most comprehensive and robust cancer-specific needs assessment instruments, no version exists specifically for cancer patients in mainland China. This study tested the psychometric properties of the Mandarin version of the 34-item Short-Form Supportive Care Needs Survey (SCNS-SF34-C (Mandarin)) in mainland Chinese cancer patients. METHODS From December 2015 to May 2016, patients were recruited from two cancer centers in Guangzhou, China, to complete the SCNS-SF34-C (Mandarin). Exploratory factor analysis (EFA) was used to test the factor structure. The internal consistency, convergent validity, and discriminant validity of the resulting factor structure were evaluated by traditional psychometric analysis. RESULTS A total of 861 patients completed the SCNS-SF34-C (Mandarin). Item 14 was removed for its low factor loadings on every factor in the initial EFA. Using the remaining 33 items, the reiterated EFA produced a five-dimension structure that was consistent with the dimensions of the original version of the SCNS-SF34 (health system and information, psychological, patient care and support, physical and daily living, and sexuality), accounting for 69.757% of the total variance. Cronbach's alpha coefficients ranged from 0.854 to 0.942 for the five domains and 0.947 for the whole scale. Convergent validity was verified by significant correlations with all corresponding instruments. It discriminated between groups based on age, sex, marital status, and stage of disease. CONCLUSIONS Preliminary evidence suggests that the SCNS-SF34-C (Mandarin) is a reliable and valid instrument for assessing the supportive care needs of cancer patients in mainland China.
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Affiliation(s)
- Yuan Han
- Cancer Center of Guangzhou Medical University, No. 78, Hengzhi Gang Road, Guangzhou, China.,School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Ying Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Jing Wang
- School of Nursing, The University of Texas Health Science Center, Houston, USA
| | - Qian Zhao
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Huiying Qin
- Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou, China
| | - Yuying Fan
- Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou, China
| | - Yalan Song
- Cancer Center of Guangzhou Medical University, No. 78, Hengzhi Gang Road, Guangzhou, China
| | - Allison Boyes
- Priority Research Centre for Health Behavior, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia.,Hunter Cancer Research Alliance, Newcastle, Australia
| | - Shuzhong Cui
- Cancer Center of Guangzhou Medical University, No. 78, Hengzhi Gang Road, Guangzhou, China.
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34
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Girgis A, Delaney GP, Arnold A, Miller AA, Levesque JV, Kaadan N, Carolan MG, Cook N, Masters K, Tran TT, Sandell T, Durcinoska I, Gerges M, Avery S, Ng W, Della-Fiorentina S, Dhillon HM, Maher A. Development and Feasibility Testing of PROMPT-Care, an eHealth System for Collection and Use of Patient-Reported Outcome Measures for Personalized Treatment and Care: A Study Protocol. JMIR Res Protoc 2016; 5:e227. [PMID: 27884813 PMCID: PMC5146324 DOI: 10.2196/resprot.6459] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/16/2016] [Accepted: 10/28/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient-reported outcome (PRO) measures have been used widely to screen for depression, anxiety, and symptoms in cancer patients. Computer-based applications that collect patients' responses and transfer them to the treating health professional in real time have the potential to improve patient well-being and cancer outcomes. OBJECTIVE This study will test the feasibility and acceptability of a newly developed eHealth system which facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research. METHODS The eHealth system is being developed in consultation with 3 overarching content-specific expert advisory groups convened for this project: the clinical advisory group, technical advisory group, and evaluation advisory group. The following work has already been completed during this phase of the study: the Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) eHealth system was developed, patient-reported outcomes were selected (distress, symptoms, unmet needs), algorithms to inform intervention thresholds for clinical and self-management were determined, clinician PRO feedback summary and longitudinal reports were designed, and patient self-management resources were collated. PROsaiq, a custom information technology system, will transfer PRO data in real time into the hospital-based oncology information system to support clinical decision making. The PROMPT-Care system feasibility and acceptability will be assessed through patients completing PROMPT-Care assessments, participating in face-to-face cognitive interviews, and completing evaluation surveys and telephone interviews and oncology staff participating in telephone interviews. RESULTS Over the course of 3 months, the system will be pilot-tested with up to 50 patients receiving treatment or follow-up care and 6 oncology staff at 2 hospitals in New South Wales, Australia. Data will be collected to determine the accuracy and completeness of data transfer procedures, extent of missing data from participants' assessments, acceptability of the eHealth system and usefulness of the self-management resources (via patient evaluation surveys and interviews), and acceptability and perceived usefulness of real-time PRO reporting (via oncology staff interviews) at the completion of the pilot phase. CONCLUSIONS This research investigates implementation of evidence into real world clinical practice through development of an efficient and user-friendly eHealth system. This study of feasibility and acceptability of the newly developed eHealth system will inform the next stage of larger scale testing and future implementation of the system as part of routine care. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN1261500135294; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369299&isReview=true (Archived by WebCite at http://www.webcitation.org/6lzylG5A0).
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Affiliation(s)
- Afaf Girgis
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Department of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Geoff P Delaney
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Department of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia
| | - Anthony Arnold
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia
| | - Alexis Andrew Miller
- Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia.,Centre for Oncology Informatics, University of Wollongong, Wollongong, Australia
| | - Janelle V Levesque
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Department of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Nasreen Kaadan
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia
| | - Martin G Carolan
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Nicole Cook
- Cancer Institute New South Wales, Sydney, Australia
| | - Kenneth Masters
- Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia
| | - Thomas T Tran
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia
| | - Tiffany Sandell
- Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia
| | - Ivana Durcinoska
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Martha Gerges
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Sandra Avery
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia
| | - Weng Ng
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia
| | | | - Haryana M Dhillon
- Faculty of Science, Central Clinical School, The University of Sydney, Sydney, Australia
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Renovanz M, Hickmann AK, Coburger J, Kohlmann K, Janko M, Reuter AK, Keric N, Nadji-Ohl M, König J, Singer S, Giese A, Hechtner M. Assessing psychological and supportive care needs in glioma patients - feasibility study on the use of the Supportive Care Needs Survey Short Form (SCNS-SF34-G) and the Supportive Care Needs Survey Screening Tool (SCNS-ST9) in clinical practice. Eur J Cancer Care (Engl) 2016; 27. [DOI: 10.1111/ecc.12598] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/20/2022]
Affiliation(s)
- M. Renovanz
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - A.-K. Hickmann
- Center for Endoscopic and Minimally Invasive Neurosurgery; Hirslanden; Zürich Switzerland
- Department of Neurosurgery Klinikum Stuttgart; Katharinenhospital; Stuttgart Germany
| | - J. Coburger
- Department of Neurosurgery; University Medical Center; Ulm/Günzburg Germany
| | - K. Kohlmann
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - M. Janko
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - A.-K. Reuter
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - N. Keric
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - M. Nadji-Ohl
- Department of Neurosurgery Klinikum Stuttgart; Katharinenhospital; Stuttgart Germany
| | - J. König
- Division of Epidemiology and Health Services Research; Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - S. Singer
- Division of Epidemiology and Health Services Research; Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
- German Cancer Consortium (DKTK); Mainz Germany
| | - A. Giese
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - M. Hechtner
- Division of Epidemiology and Health Services Research; Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
- German Cancer Consortium (DKTK); Mainz Germany
- German Cancer Research Center (DKFZ); Heidelberg Germany
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36
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Li WWY, Lam WWT, Shun SC, Lai YH, Law WL, Poon J, Fielding R. Psychometric assessment of the Chinese version of the Supportive Care Needs Survey short-form (SCNS-SF34-C) among Hong Kong and Taiwanese Chinese colorectal cancer patients. PLoS One 2013; 8:e75755. [PMID: 24146774 PMCID: PMC3795709 DOI: 10.1371/journal.pone.0075755] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 08/16/2013] [Indexed: 11/21/2022] Open
Abstract
Background Accurate assessment of unmet supportive care needs is essential for optimal cancer patient care. This study used confirmatory factor analysis (CFA) to test the known factor structures of the short form of Supportive Care Need Survey (SCNS-34) in Hong Kong and Taiwan Chinese patients diagnosed with colorectal cancer (CRC). Methods 360 Hong Kong and 263 Taiwanese Chinese CRC patients completed the Chinese version of SCNS-SF34. Comparative measures (patient satisfaction, anxiety, depression, and symptom distress) tested convergent validity while known group differences were examined to test discriminant validity. Results The original 5-factor and recent 4-factor models of the SCNS demonstrated poor data fit using CFA in both Hong Kong and Taiwan samples. Subsequently a modified five-factor model with correlated residuals demonstrated acceptable fit in both samples. Correlations demonstrated convergent and divergent validity and known group differences were observed. Conclusions While the five-factor model demonstrated a better fit for data from Chinese colorectal cancer patients, some of the items within its domain overlapped, suggesting item redundancy. The five-factor model showed good psychometric properties in these samples but also suggests conceptualization of unmet supportive care needs are currently inadequate.
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Affiliation(s)
- Wylie Wai Yee Li
- Centre for Psycho-Oncology Research and Training, Division of Behavioural Health, School of Public Health, The University of Hong Kong, Hong Kong
| | - Wendy Wing Tak Lam
- Centre for Psycho-Oncology Research and Training, Division of Behavioural Health, School of Public Health, The University of Hong Kong, Hong Kong
- * E-mail:
| | - Shiow-Ching Shun
- Department of Nursing, National Taiwan University, Taipei, Taiwan
| | - Yeur-Hur Lai
- Department of Nursing, National Taiwan University, Taipei, Taiwan
| | - Wai-Lun Law
- Department of Surgery, The University of Hong Kong, Hong Kong
| | - Jensen Poon
- Department of Surgery, The University of Hong Kong, Hong Kong
| | - Richard Fielding
- Centre for Psycho-Oncology Research and Training, Division of Behavioural Health, School of Public Health, The University of Hong Kong, Hong Kong
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BRÉDART A, KOP JL, GRIESSER AC, ZAMAN K, PANES-RUEDIN B, JEANNERET W, DELALOYE JF, ZIMMERS S, JACOB A, BERTHET V, FISZER C, DOLBEAULT S. Validation of the 34-item Supportive Care Needs Survey and 8-item Breast module French versions (SCNS-SF34-Fr and SCNS-BR8-Fr) in breast cancer patients. Eur J Cancer Care (Engl) 2012; 21:450-9. [DOI: 10.1111/j.1365-2354.2012.01356.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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