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Alnefaie SM, Alotaibi MS, Alsobaie AE, Alotaibi WB, Alwuthaynani MI, Alotibi AR, Alayyaf FA, Almnjwami RF. Assessment of Patients' Quality-of-Life Post-Thyroidectomy. Cureus 2024; 16:e52744. [PMID: 38384638 PMCID: PMC10881216 DOI: 10.7759/cureus.52744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION The assessment of quality of life (QOL) after thyroidectomy has been a focus of medical research, aiming to understand its impact on patients' overall well-being and functional status. Studies have examined the physical, psychological, and social dimensions of QOL, providing valuable insights into the outcomes of thyroidectomy and improving patient care. The aim of the study is to evaluate the long-term impact of different aspects of patients' quality of life post-thyroidectomy. METHODS This cross-sectional study was conducted in Taif City and included 100 participants post-thyroidectomy. Data were collected from medical records and telephone interviews using the modified Arabic version of the EROTC QLQ-H&N43 questionnaire. The collected data were analyzed using R software version 4.2.2. RESULTS The majority of the 100 participants were female (76%), and most were over 50 years old (38%). The types of surgery performed included hemithyroidectomy (36%), subtotal thyroidectomy (6%), and total thyroidectomy (58%). Participants reported difficulties related to their senses, body satisfaction, sexual satisfaction, eating, speaking, and social interactions. Pain in the mouth and jaw, as well as swallowing difficulties, showed variations among the surgery groups. Other symptoms, such as tooth problems, dry mouth, and swelling in the neck, did not differ significantly among the groups. Numbness in the hands or feet was associated with a subtotal or total thyroidectomy. Difficulties with enjoying meals, eating in front of others, and communication issues showed variations among the surgery groups. CONCLUSION This study provided insights into the QOL of thyroidectomy survivors in Taif City. Participants reported challenges related to sensory, body, and sexual issues, as well as difficulties with eating, speaking, and social interactions. The findings highlight the need for interventions and support to address these challenges and optimize the QOL of thyroidectomy patients. Furthermore, research is warranted to explore specific factors contributing to these difficulties and to develop targeted interventions for better patient outcomes.
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Affiliation(s)
- Sahar M Alnefaie
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
| | - Muath S Alotaibi
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
| | | | - Wafi B Alotaibi
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
| | | | - Ahmed R Alotibi
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
| | - Fahad A Alayyaf
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
| | - Rasan F Almnjwami
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
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Haymart P, Levin NJ, Haymart MR. The psychosocial impact of thyroid cancer. Curr Opin Endocrinol Diabetes Obes 2023; 30:252-258. [PMID: 37288721 PMCID: PMC10526714 DOI: 10.1097/med.0000000000000815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE OF REVIEW This review discusses the psychosocial impact of thyroid cancer diagnosis and management. It summarizes recent findings, presents management options, and briefly discusses future directions. RECENT FINDINGS A thyroid cancer diagnosis and its downstream management can impact patients in a variety of ways, including contributing to distress, worry, worse quality of life, and in some cases, anxiety and depression. Racial/ethnic minorities, those with lower education, women, adolescents/young adults, and individuals with a prior mental health conditions are a few of the patient groups at greater risks for adverse psychosocial effects from their thyroid cancer diagnosis and management. Findings are mixed, but some studies suggest treatment, for example, more intensive treatment as opposed to less, may be associated with a greater psychosocial impact. Clinicians providing care to thyroid cancer patients use a variety of resources and techniques, some more effective than others, to provide support. SUMMARY A thyroid cancer diagnosis and its subsequent treatment can greatly impact a patient's psychosocial wellbeing, particularly for at-risk groups. Clinicians can help their patients by informing them of the risks associated with treatments and by offering education and resources for psychosocial support.
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Affiliation(s)
- Parker Haymart
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Nina Jackson Levin
- School of Social Work, Department of Anthropology, University of Michigan, Ann Arbor, MI
| | - Megan R. Haymart
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
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Underwood HJ, Mott NM, Saucke MC, Roman BR, Voils CI, Pitt SC. What do patients want to know about surgery for low-risk thyroid cancer? A qualitative study. Surgery 2023; 173:226-231. [PMID: 36336505 PMCID: PMC10353734 DOI: 10.1016/j.surg.2022.05.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/20/2022] [Accepted: 05/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Shared decision-making about treatment for low-risk thyroid cancer requires patients and surgeons to work together to select treatment that best balances risks and expected outcomes with patient preferences and values. To participate, patients must be activated and ask questions. We aimed to characterize what topics patients prioritize during treatment decision-making. METHODS We identified substantive questions by patients with low-risk (cT1-2, N0) thyroid cancer during audio-recorded consultations with 9 surgeons at 2 unique health care systems. Logistics questions were excluded. Qualitative content analysis was used to identify major themes among patients' questions and surgeon responses. RESULTS Overall, 28 of 30 patients asked 253 substantive questions, with 2 patients not asking any substantive questions (median 8, range 0-25). Patients were 20 to 71 years old, mostly White (86.7%) and female (80.0%). The questions addressed extent of surgery, hormone supplementation, risk of cancer progression, radioactive iodine, and etiology of thyroid cancer. When patients probed for a recommendation regarding extent of surgery, surgeons often responded indirectly. When patients asked how surgery could impact quality of life, surgeons focused on oncologic benefits and surgical risk. Patients commonly asked about hormone supplementation and radioactive iodine. CONCLUSION Patient questions focused on the decision regarding extent of surgery, quality of life, and nonsurgical aspects of thyroid cancer care. Surgeon responses do not consistently directly answer patients' questions but focus on the risks, benefits, and conduct of surgery itself. These findings suggest an opportunity to help surgeons with resources to improve shared decision-making by providing information that patients prioritize.
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Affiliation(s)
- Hunter J Underwood
- Department of Surgery, School of Medicine, University of Michigan, Ann Arbor, MI. https://twitter.com/@HJUnderwoodMD
| | - Nicole M Mott
- Department of Surgery, School of Medicine, University of Michigan, Ann Arbor, MI. https://twitter.com/@nmmott
| | - Megan C Saucke
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI. https://twitter.com/@megan_saucke
| | - Benjamin R Roman
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Corrine I Voils
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI. https://twitter.com/@VoilsCorrine
| | - Susan C Pitt
- Department of Surgery, School of Medicine, University of Michigan, Ann Arbor, MI.
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Cai M, Gou J. The supportive care needs and its influencing factors among thyroid cancer patients after surgery: A cross-sectional study. Front Surg 2023; 10:1108425. [PMID: 36969762 PMCID: PMC10030498 DOI: 10.3389/fsurg.2023.1108425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 02/20/2023] [Indexed: 03/29/2023] Open
Abstract
Objective To study the supportive care needs (SCNS) of thyroid cancer (TC) patients after surgery, and to identity its influencing factors. Methods By convenience sampling method, total of 115 patients undergoing thyroid surgery who met the inclusion criteria from May 2021 to July 2021 were selected as the research objects. The general information questionnaire, Supportive Care Need Survey Short-Form (SCNS-SF34), functional subscale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) were used to investigate these patients. Results The average score for the items of SCNS-SF34 in 102 TC patients was 2.15 ± 0.71. The domain with the highest item average score was "health system information needs" (2.48 ± 1.17). The domain with the highest unsatisfied rate was "psychological needs" (69.6%). The item with the highest average score was "fear of cancer spreading" in the psychological needs domain (2.80 ± 1.48). The scores of physical function (r = -0.431, P < 0.001), role function (r = -0.428, P < 0.001), cognitive function (r = -0.531, P < 0.001), emotional function (r = -0.388, P < 0.001), social function (r = -0.464, P < 0.001) were correlated with the total score of SCNS-SF34. The univariate analysis of SCNS-SF34 scores showed that TC patients who were women (t = 2.013, P = 0.047), older (F = 1.353, P = 0.013), and with longer hospital stays (F = 3.705, P = 0.028) had higher demand of SCNS. The results of multiple linear regression analysis showed that the significant variables that entered the regression equation were gender, age, length of stay in hospital, cognitive function and social function (P < 0.05). Conclusion TC patients after surgery have many SCNS in different domains. It is necessary to focus on women, older patients, patients with long hospital stays and poor functioning. The implementation of a supportive care screening tool is recommended and the individualized interventions need to be developed to provide targeted support and care.
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Vaz-Luis I, Masiero M, Cavaletti G, Cervantes A, Chlebowski RT, Curigliano G, Felip E, Ferreira AR, Ganz PA, Hegarty J, Jeon J, Johansen C, Joly F, Jordan K, Koczwara B, Lagergren P, Lambertini M, Lenihan D, Linardou H, Loprinzi C, Partridge AH, Rauh S, Steindorf K, van der Graaf W, van de Poll-Franse L, Pentheroudakis G, Peters S, Pravettoni G. ESMO Expert Consensus Statements on Cancer Survivorship: promoting high-quality survivorship care and research in Europe. Ann Oncol 2022; 33:1119-1133. [PMID: 35963481 DOI: 10.1016/j.annonc.2022.07.1941] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The increased number of cancer survivors and the recognition of physical and psychosocial challenges, present from cancer diagnosis through active treatment and beyond, led to the discipline of cancer survivorship. DESIGN AND METHODS Herein, we reflected on the different components of survivorship care, existing models and priorities, in order to facilitate the promotion of high-quality European survivorship care and research. RESULTS We identified five main components of survivorship care: (i) physical effects of cancer and chronic medical conditions; (ii) psychological effects of cancer; (iii) social, work and financial effects of cancer; (iv) surveillance for recurrences and second cancers; and (v) cancer prevention and overall health and well-being promotion. Survivorship care can be delivered by structured care models including but not limited to shared models integrating primary care and oncology services. The choice of the care model to be implemented has to be adapted to local realities. High-quality care should be expedited by the generation of: (i) focused and shared European recommendations, (ii) creation of tools to facilitate implementation of coordinated care and (iii) survivorship educational programs for health care teams and patients. The research agenda should be defined with the participation of health care providers, researchers, policy makers, patients and caregivers. The following patient-centered survivorship research areas were highlighted: (i) generation of a big data platform to collect long-term real-world data in survivors and healthy controls to (a) understand the resources, needs and preferences of patients with cancer, and (b) understand biological determinants of survivorship issues, and (ii) develop innovative effective interventions focused on the main components of survivorship care. CONCLUSIONS The European Society for Medical Oncology (ESMO) can actively contribute in the efforts of the oncology community toward (a) promoting the development of high-quality survivorship care programs, (b) providing educational material and (c) aiding groundbreaking research by reflecting on priorities and by supporting research networking.
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Affiliation(s)
- I Vaz-Luis
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy-Cancer Campus, Villejuif; UMR 981, Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy-Cancer Campus, Villejuif, France.
| | - M Masiero
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
| | - G Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - A Cervantes
- Department of Medical Oncology, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - E Felip
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - A R Ferreira
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon; Catolica Medical School, Universidade Católica Portuguesa, Lisbon, Portugal
| | - P A Ganz
- UCLA Jonsson Comprehensive Cancer Center and UCLA Fielding School of Public Health, Los Angeles, USA
| | - J Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - J Jeon
- Exercise Medicine Center for Cancer and Diabetes Patients (ICONS), Department of Sport Industry, Cancer Prevention Center, Yonsei Cancer Center, Shinchon Severance Hospital, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - C Johansen
- Centre for Cancer Late Effect Research (CASTLE), Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - F Joly
- Department of Medical Oncology, Centre François Baclesse, U1086 Anticipe, Unicaen Normandy Universtity, Caen, France
| | - K Jordan
- Department for Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam; Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - B Koczwara
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - P Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Surgery and Cancer, Imperial College London, London, UK
| | - M Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - D Lenihan
- International Cardio-Oncology Society, Tampa, USA
| | - H Linardou
- Fourth Oncology Department & Comprehensive Clinical Trials Center, Metropolitan Hospital, Athens, Greece
| | | | - A H Partridge
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Rauh
- Department of Medical Oncology, Centre Hospitalier Emile Mayrisch, Esch, Luxembourg
| | - K Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - W van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer institute, Erasmus University Medical Center, Rotterdam
| | - L van de Poll-Franse
- Division of Psychosocial Research & Epidemiology, Department of Psycological Research, The Netherlands Cancer Institute, Amsterdam; Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht; CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - S Peters
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
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Olischläger DLT, den Boer LXY, de Heus E, Brom L, Dona DJS, Klümpen HJ, Stapelfeldt CM, Duijts SFA. Rare cancer and return to work: experiences and needs of patients and (health care) professionals. Disabil Rehabil 2022:1-12. [PMID: 35850601 DOI: 10.1080/09638288.2022.2099589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Patients with a rare cancer often face delays in their diagnostic and treatment trajectory, which may affect their work. In this study, we explored experiences and needs of: 1) patients with a rare cancer regarding return to work (RTW) and work retention, and 2) (health care) professionals (HCPs) regarding work-related support of patients with a rare cancer, throughout their disease trajectory. METHODS Semi-structured, in-depth interviews with working-age patients with a rare cancer (n = 16), and HCPs (n = 9) were conducted. During the interviews, a predefined topic list was used. Interviews were transcribed verbatim and analysed by means of thematic analysis. RESULTS In total, three themes emerged from the interviews: 1) Awareness in patients and HCPs as a first step towards work, 2) Being/becoming an expert is a tough job, and 3) Enhancing employability through early personalized guidance. CONCLUSIONS Patients with a rare cancer are confronted with uncertainties regarding work, due to an overall lack of knowledge and experience with these types of cancer. Raising awareness among patients, HCPs and employers about rare cancer and its implications, and providing timely individualized, supportive occupational care are required to improve rare cancer patients' ability to work.Implications for rehabilitationRecognizing and paying attention to the work-related consequences of a rare cancer diagnosis and its treatment is essential to facilitate rare cancer patients' occupational rehabilitation process.Multidisciplinary collaboration and involvement of HCPs specialized in rare cancer are required to provide suitable work-related support.A personalized approach is necessary to adequately address rare cancer patients' RTW and work retention needs.
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Affiliation(s)
- Daphne L T Olischläger
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Li Xiang Y den Boer
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Linda Brom
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Desiree J S Dona
- Department of Human Resources, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Heinz-Josef Klümpen
- Department of Medical Oncology, Amsterdam University Medical Centers (location VUmc), Amsterdam, The Netherlands
| | | | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Psychology, Amsterdam UMC location Vrije Universiteit, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Cancer treatment and Quality of life, Amsterdam, The Netherlands
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Abstract
Thyroid disease affects an estimated 20 million Americans, with 1 in 8 women developing a thyroid disorder during her lifetime. Although most patients with thyroid cancer have a good prognosis and effective treatments for benign thyroid disease are available, disparities exist in thyroid care and result in worse outcomes for racial and ethnic minorities. Inequities in the diagnosis and treatment of thyroid disease are due to the complex interplay of systems-, physician-, and patient-level factors. Thus, innovative strategies that take an ecological approach to addressing racial disparities are needed to achieve equitable care for all patients with thyroid disease.
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Affiliation(s)
- Debbie W Chen
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, 24 Frank Lloyd Wright Drive, PO Box 451, Ann Arbor, MI 48106, USA.
| | - Michael W Yeh
- Section of Endocrine Surgery, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
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Alyousef MY, Ghandour MK, Al-Mohawes M, Alnwaisir M, Islam T, Al Qahtani K. Long-Term Quality of Life (5-15 Years Post-Thyroidectomy) of Thyroid Carcinoma Patients in Two Tertiary Care Hospitals. Cureus 2022; 14:e22005. [PMID: 35282529 PMCID: PMC8908066 DOI: 10.7759/cureus.22005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose Early detection of thyroid cancer has reduced mortality and improved survival of patients. Increased detection has raised the incidence of early stage disease. Some physicians underestimate the suffering of these patients due to the concept of "good cancer.” The unmet needs of the survivors still need to be addressed. The objective of this paper was to evaluate the long-term quality of life (QOL) of thyroid cancer survivors. Methods A cross-sectional telephone survey of 211 thyroid cancer survivors who underwent thyroidectomy performed between 2006 and 2016 in two academic tertiary care hospitals was conducted using a validated Arabic version of the European Organization for Research and Treatment of Cancer head and neck cancer specific quality of life questionnaire (EROTC QLQ) - H&N43 questionnaire using a scale of 1-4, with 4 being most severe. Results On almost half (48.5%) of patients, thyroidectomy was performed in 2013 or earlier. Patients’ perceptions of problems were very low, with a mean score of 1.56 ± 0.7). Worry about the test results (2.37 ± 1.19), future health (2.36 ± 1.22), tingling or numbness in hands or feet (2.32 ± 1.22), pain in the shoulder (2.04 ± 1.18), and dry, itchy skin (2.04 ± 1.18) were the only items that received a mean score of more than 2. No statistically significant differences in patients’ problems were observed according to either tumor histopathology or type of thyroidectomy. Conclusion The overall QOL score for the patients was very good. The persistent problems identified need to be addressed in the long-term follow-up. Survivorship care plans need to be developed incorporating proper interventions.
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Turkdogan S, Roy CF, Chartier G, Payne R, Mlynarek A, Forest VI, Hier M. Effect of Perioperative Patient Education via Animated Videos in Patients Undergoing Head and Neck Surgery: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2022; 148:173-179. [PMID: 34967863 PMCID: PMC8719273 DOI: 10.1001/jamaoto.2021.3765] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Patient education and engagement is a pivotal component of surgical recovery. Ensuring proper patient education involves a thorough understanding of one's diagnosis and recovery plan, while reducing language and learning barriers to help patients make informed decisions and improve their hospital experience. Objective To assess whether using an animated surgical guide will help patients who are undergoing head and neck surgery feel more satisfied with their surgery and recovery process. Design, Setting, and Participants A randomized clinical trial was conducted between January and August 2020 at a single tertiary care academic center in Montreal, Canada. A consecutive sample of individuals who were undergoing any of the following surgical procedures was recruited: head and neck cancer resection with or without reconstruction, parotidectomy, thyroidectomy, parathyroidectomy, laryngectomy, or transoral robotic resection. The treating team was masked to group allocation, while study participants in the nonintervention group were unaware of the multimedia platform to avoid introducing bias in their survey responses. Interventions Patients were randomly allocated to either the treatment arm, in which they obtained access to a multimedia patient education platform, or the control arm, in which they received traditional patient education methods via clinical visits. Main Outcomes and Measures Primary analysis compared patient satisfaction scores on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire INFO 25, a validated questionnaire on the perceived quality of information received by patients with cancer (possible scores ranging from 20 to 80). Results A total of 100 patients (50 in each arm; 63 women [63%]; 6 African American [6%, 12 Hispanic/Latino [12%], 11 Middle Eastern [11%], and 78 White [78%] individuals) completed the preintervention and postintervention questionnaires. In those who received access to the patient education platform, there was an 11.3-point (Cohen d = 1.02; control group score, 61.1 of 80; treatment group score, 72.4 of 80) difference of greater postoperative satisfaction scores at 1 month. While both groups felt that they received an adequate amount of information concerning their disease process, patients in the treatment arm had significantly better satisfaction with information concerning their medical tests, treatments, and other services. Conclusions and Relevance This randomized clinical trial of patients undergoing head and neck cancer treatment demonstrates that multimedia patient education platforms may enhance current traditional methods, providing complementary information on patients' treatment plans and recovery process, mental health, family life, and supplementary services. Further research is currently underway to confirm whether this platform will lead to decreased hospital stay, shorter complication rates, and long-term effects. Trial Registration ClinicalTrials.gov Identifier: NCT04048538.
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Affiliation(s)
- Sena Turkdogan
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada
| | - Catherine F. Roy
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada,Department of Nursing, Jewish General Hospital, Montreal, Québec, Canada
| | - Richard Payne
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada,Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
| | - Alex Mlynarek
- Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
| | | | - Michael Hier
- Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
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Dionisi-Vici M, Fantoni M, Botto R, Nervo A, Felicetti F, Rossetto R, Gallo M, Arvat E, Torta R, Leombruni P. Distress, anxiety, depression and unmet needs in thyroid cancer survivors: a longitudinal study. Endocrine 2021; 74:603-610. [PMID: 34143334 PMCID: PMC8571224 DOI: 10.1007/s12020-021-02786-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/03/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Despite a good prognosis, thyroid cancer (TC) survivors often report psychological distress and decreased quality of life. This longitudinal study aims to evaluate TC survivors' levels of distress, anxiety, depression and unmet needs, checking potential life events. METHODS Distress Thermometer, Hospital Anxiety Depression Scale, Supportive Care Need Survey (short form) and Interview for Recent Life Events were administered to 73 TC survivors (T0) and 44 of them were re-tested one year later (T1). Participants were at 0-5, 5-10 or >10 years from the end of their cancer-related treatments. RESULTS At T0, distress, anxiety and depression mean scores were 6.4, 6.8 and 5.3, while at T1 they were 5.5, 4.8 and 5.1. Only anxiety scores decreased significantly between T0 and T1. 50.7% of patients had unmet psychological needs at T0 and 50.0% at T1. Most participants were satisfied in the communicative/ informative (T0:79.5%; T1: 77.3%) and social/health care areas (T0:74.0%; T1:75.0%). The most experienced stressful events detected concerned their working areas. CONCLUSIONS Results confirmed that patients reported distress, anxiety and depression concerns even many years after the end of treatments. Both medical and psychological surveillance are relevant to improving TC survivors' wellbeing.
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Affiliation(s)
- Margherita Dionisi-Vici
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | | | - Rossana Botto
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy.
| | - Alice Nervo
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Francesco Felicetti
- Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Ruth Rossetto
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Marco Gallo
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Emanuela Arvat
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Paolo Leombruni
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
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11
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de Heus E, van der Zwan JM, Husson O, Frissen AR, van Herpen CML, Merkx MAW, Duijts SFA. Unmet supportive care needs of patients with rare cancer: A systematic review. Eur J Cancer Care (Engl) 2021; 30:e13502. [PMID: 34409667 DOI: 10.1111/ecc.13502] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/04/2021] [Accepted: 07/27/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Patients with rare cancers may experience different unmet needs than those with common cancer. The objective of this systematic review was to (1) investigate unmet supportive care needs of rare cancer patients throughout the disease trajectory and (2) identify predictive factors for these unmet needs. METHODS PubMed, PsycINFO and CINAHL were searched for publications (January 2011 to March 2021) focusing on unmet needs of patients with rare cancer. Two reviewers independently selected studies, extracted data and performed quality assessment. Findings were synthesised. RESULTS The search yielded 4,598 articles, of which 59 articles met eligibility criteria and 57 were of medium or high quality. Rare cancer patients most frequently reported unmet needs in the healthcare system and information domain (up to 95%), followed by the psychological domain (up to 93%) and the physical and daily living domain (up to 80%). Unmet needs were mainly reported in the posttreatment phase. The most frequently identified predictors were higher anxiety, younger age and higher neuroticism. CONCLUSION Patients with rare cancer have unmet needs throughout their disease trajectory. Supportive care needs of rare cancer patients should be addressed individually, depending on the rare cancer subdomain and phase of disease and from diagnosis onwards.
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Affiliation(s)
- Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Maarten van der Zwan
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Olga Husson
- Division of Psychosocial Research and Epidemiology and Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anne-Roos Frissen
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Carla M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Matthias A W Merkx
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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12
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Creff G, Jegoux F, Bendiane MK, Babin E, Licaj I. Returning to work by thyroid cancer survivors 5 years after diagnosis: the VICAN survey. J Cancer Surviv 2021; 16:801-811. [PMID: 34382180 DOI: 10.1007/s11764-021-01074-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/09/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Return to work (RTW) following cancer diagnosis is a challenge for both the patient and society. As thyroid cancer (TC) incidence is increasing, this study aims to assess difficulties in returning to work and income changes in TC survivors 5 years post-diagnosis. METHODS This study belongs to the national VICAN survey conducted in France among TC patients diagnosed between January and June 2010. Data were collected through phone interviews, medical surveys and from the national medico-administrative register in 2012 and 2015. We used multivariate logistic regressions to investigate TC impact on employment and income changes. RESULTS Of 146 patients, 121(82.9%) were women; the mean age was 42 years (SD = 8.34), 119 (81.3%) were diagnosed at an early stage, and 142(97.6%) underwent thyroidectomy. At 5 years post-diagnosis, 116 (79.7%) of the TC survivors were professionally active, 22 (15.4%) were unemployed and 8 (4.90%) were receiving disability. Among the patients employed at the time of diagnosis (n = 122), 15 (12.3%) had not returned to work 5 years post-diagnosis. Between 2 and 5 years post-diagnosis, there was no significant improvement in rates of RTW. At 5 years post-diagnosis, 90 (61.6%) reported an income decline. All TC survivors who have not returned to work were women and declared higher fatigue. Moreover, in multivariate analyses, not returning to work was associated with weight gain (OR = 8.41 (1.21; 58.23)) and working arrangements (6.90 (1.18-38.48)), while income decline was associated with comorbidities (OR = 2.28 (1.07; 4.86)) and to be engaged in manual work (OR = 2.28 (1.07; 4.88)). CONCLUSION This study highlights that, despite a good prognostic, up to 12.3% of TC survivors had not returned to work and 61.6% reported an income decline, 5 years post-diagnosis. Weight gain, fatigue, to be a woman and working-type arrangement were associated with higher probability of not returning to work. IMPLICATIONS FOR CANCER SURVIVORS TC affects a young working population. Our study identified potentially vulnerable TC survivors and important modifiable factors which may help TC survivors to be professionally active and, therefore, increase their overall quality of life.
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Affiliation(s)
- G Creff
- Department of Otolaryngology-Head and Neck Surgery, Rennes University Hospital, Rennes, France.
| | - F Jegoux
- Department of Otolaryngology-Head and Neck Surgery, Rennes University Hospital, Rennes, France
| | | | - E Babin
- Head and Neck Department, University Hospital Centre Caen, Caen, France.,Cancer & Cognition Platform, Ligue Contre le Cancer, Caen, France
| | - I Licaj
- Cancer & Cognition Platform, Ligue Contre le Cancer, Caen, France.,Clinical Research Department, Centre François Baclesse, Caen, France.,Department of Community Medicine, Faculty of Health Sciences, The UiT Arctic University of Norway, Tromsø, Norway
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13
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Koot A, Netea-Maier R, Ottevanger P, Hermens R, Stalmeier P. Needs, Preferences, and Values during Different Treatment Decisions of Patients with Differentiated Thyroid Cancer. J Pers Med 2021; 11:jpm11070682. [PMID: 34357149 PMCID: PMC8304194 DOI: 10.3390/jpm11070682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The purpose of this study was to identify the needs, preferences, and values of patients with differentiated thyroid cancer (DTC) and the physicians treating patients with DTC regarding two different treatment decisions, namely: the extent of primary surgery (low-risk patients) and the tyrosine kinase inhibitor (TKI) treatment (high-risk patients). Methods: A qualitative study was conducted. There were two physician focus groups discussing the extent of primary surgery. One included endocrinologists (n = 4) and surgeons (n = 5), and the other included nuclear medicine physicians (n = 3) treating patients with low-risk DTC. The physicians focus group discussing waiting or starting TKIs included endocrinologists (n = 2) and oncologists (n = 5) treating patients with advanced radioactive iodide (RAI) refractory DTC. Moreover, one patient focus group per treatment decision took place. In total 13 patients and 19 physicians participated. Interviews were audio-taped, fully transcribed verbatim, and analyzed. Results: Several themes were identified. Patients, but not physicians, mentioned the importance of a strong doctor–patient relationship. Patients in both treatment decision groups wanted to receive more detailed information, whereas physicians preferred providing more general information. Patients in the TKI decision group focused on palliative care, whereas physicians focused more on the effect and benefit of TKIs. Conclusions: Considering the identified themes in DTC, based on the patients’ needs, preferences, and values, enables us to improve doctor–patient communication and to develop decision support tools.
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Affiliation(s)
- Anna Koot
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
- Correspondence: ; Tel.: +31-651637081
| | - Romana Netea-Maier
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Petronella Ottevanger
- Department of Internal Medicine, Division of Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Rosella Hermens
- Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Peep Stalmeier
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
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14
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Chen DW, Reyes-Gastelum D, Hawley ST, Wallner LP, Hamilton AS, Haymart MR. Unmet Information Needs Among Hispanic Women with Thyroid Cancer. J Clin Endocrinol Metab 2021; 106:e2680-e2687. [PMID: 33660770 PMCID: PMC8208677 DOI: 10.1210/clinem/dgab128] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/16/2021] [Indexed: 01/07/2023]
Abstract
CONTEXT Thyroid cancer is the second most common cancer in Hispanic women. OBJECTIVE To determine the relationship between acculturation level and unmet information needs among Hispanic women with thyroid cancer. DESIGN Population-based survey study. PARTICIPANTS Hispanic women from Los Angeles Surveillance Epidemiology and End Results registry with thyroid cancer diagnosed in 2014-2015 who had previously completed our thyroid cancer survey in 2017-2018 (N = 273; 80% response rate). MAIN OUTCOME MEASURES Patients were asked about 3 outcome measures of unmet information needs: (1) internet access, (2) thyroid cancer information resources used, and (3) ability to access information. Acculturation was assessed with the Short Acculturation Scale for Hispanics (SASH). Health literacy was measured with a validated single-item question. RESULTS Participants' median age at diagnosis was 47 years (range 20-79) and 48.7% were low-acculturated. Hispanic women were more likely to report the ability to access information "all of the time" if they preferred thyroid cancer information in mostly English compared to mostly Spanish (88.5% vs 37.0%, P < 0.001). Low-acculturated (vs high-acculturated) Hispanic women were more likely to have low health literacy (47.2% vs 5.0%, P < 0.001) and report use of in-person support groups (42.0% vs 23.1%, P = 0.006). Depending on their level of acculturation, Hispanic women accessed the internet differently (P < 0.001) such that low-acculturated women were more likely to report use of only a smartphone (34.0% vs 14.3%) or no internet access (26.2% vs 1.4%). CONCLUSIONS Low-acculturated (vs high-acculturated) Hispanic women with thyroid cancer have greater unmet information needs, emphasizing the importance of patient-focused approaches to providing medical information.
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Affiliation(s)
- Debbie W Chen
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - David Reyes-Gastelum
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sarah T Hawley
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Lauren P Wallner
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Megan R Haymart
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
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15
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Büttner M, Rimmele H, Bartès B, Singer S, Luster M. Management of thyroid cancer: results from a German and French patient survey. Hormones (Athens) 2021; 20:323-332. [PMID: 33184762 DOI: 10.1007/s42000-020-00260-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/06/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Various national and international guidelines for the management of thyroid cancer exist. The aim of this survey was to evaluate whether patients experience differences regarding the management of thyroid cancer in Germany and in France. METHODS An online survey addressing diagnosis, treatment, aftercare, and information needs of thyroid cancer survivors was set up by the German and the French nationwide thyroid cancer self-help organizations. The survey consisted of up to 70 questions depending on the given answers. Descriptive statistics and univariate comparisons, if appropriate, for comparing thyroid cancer survivors in Germany and France were performed. RESULTS In total, 1254 thyroid cancer survivors took part in the survey, of whom 1005 were included in the analysis, 618 from Germany and 387 from France. Remarkable differences between the two countries were observed regarding waiting times, diagnostics, surgical complications, radioiodine treatment, and aftercare of the patients. A high disease burden and lack of information regarding the condition and its treatment were reported in both countries. CONCLUSION This large survey showed that despite various guidelines for the management of thyroid cancer, thyroid cancer survivors' experiences are noticeably different between two big European countries. Lack of information and unmet needs are still tasks to be addressed in order to optimize thyroid cancer care.
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Affiliation(s)
- Matthias Büttner
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Harald Rimmele
- Bundesverband Schilddrüsenkrebs-Ohne Schilddrüse leben e.V, Berlin, Germany
| | | | - Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany
- University Cancer Centre, Mainz, Germany
| | - Markus Luster
- Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
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16
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Lubitz CC, Kiernan CM, Toumi A, Zhan T, Roth MY, Sosa JA, Tuttle RM, Grubbs EG. Patient Perspectives on the Extent of Surgery and Radioactive Iodine Treatment for Low-Risk Differentiated Thyroid Cancer. Endocr Pract 2021; 27:383-389. [PMID: 33840638 PMCID: PMC10028733 DOI: 10.1016/j.eprac.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 01/07/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To understand patient perspective regarding recommended changes in the 2015 American Thyroid Association (ATA) guidelines. Specifically, in regard to active surveillance (AS) of some small differentiated thyroid cancer (DTC), performance of less extensive surgery for low-risk DTC, and more selective administration of radioactive iodine (RAI). METHODS An online survey was disseminated to thyroid cancer patient advocacy organizations and members of the ATA to distribute to the patients. Data were collected on demographic and treatment information, and patient experience with DTC. Patients were asked "what if" scenarios on core topics, including AS, extent of surgery, and indications for RAI. RESULTS Survey responses were analyzed from 1546 patients with DTC: 1478 (96%) had a total thyroidectomy, and 1167 (76%) underwent RAI. If there was no change in the overall cancer outcome, 606 (39%) of respondents would have considered lobectomy over total thyroidectomy, 536 (35%) would have opted for AS, and 638 (41%) would have chosen to forego RAI. Moreover, (774/1217) 64% of respondents wanted more time with their clinicians when making decisions about the extent of surgery. A total of 621/1167 of patients experienced significant side effects with RAI, and 351/1167 of patients felt that the risks of treatment were not well explained. 1237/1546 (80%) of patients felt that AS would not be overly burdensome, and quality of life was the main reason cited for choosing AS. CONCLUSION Patient perspective regarding choice in the management of low-risk DTC varies widely, and a large proportion of DTC patients would change aspects of their care if oncologic outcomes were equivalent.
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Affiliation(s)
- Carrie C Lubitz
- Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
| | - Colleen M Kiernan
- Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, Tennessee
| | - Asmae Toumi
- Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts
| | - Tiannan Zhan
- Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts
| | - Mara Y Roth
- Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle Cancer Care Alliance, Seattle, Washington
| | - Julie A Sosa
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - R Michael Tuttle
- Endocrinology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elizabeth G Grubbs
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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17
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van Egmond S, Wakkee M, Hoogenraad M, Korfage IJ, Mureau MAM, Lugtenberg M. Complex skin cancer treatment requiring reconstructive plastic surgery: an interview study on the experiences and needs of patients. Arch Dermatol Res 2021; 314:25-36. [PMID: 33611719 PMCID: PMC8741685 DOI: 10.1007/s00403-021-02204-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 01/12/2021] [Accepted: 02/06/2021] [Indexed: 11/29/2022]
Abstract
To provide patient-centered care, it is essential to explore what patients consider important and to adjust care accordingly. This may specifically be relevant for patients with complex skin cancer, for whom the care process is often more complicated and psychological and social problems may play a larger role. The objective was to explore the experiences and needs of patients who had undergone surgical treatment by a dermatologist for a complex skin cancer with a subsequent reconstruction by a plastic surgeon. An interview study was conducted among 16 patients who had undergone surgical treatment by a dermatologist and reconstruction by a plastic surgeon for basal cell carcinoma, cutaneous squamous cell carcinoma, or lentigo maligna. The interviews focused on patients’ experiences and needs regarding care using a predefined topic list. All interviews were audio-taped, transcribed verbatim and inductively analyzed using Atlas.ti. Patients reported a need for a skilled and friendly physician who tailors information and communication to their individual situation. A need for continuity of care and improved collaboration between healthcare providers was also emphasized. Furthermore, patients experienced complications and unmet expectations and expressed a need for shared decision-making at various steps throughout the treatment process (depending on age). Patients also considered completeness of tumor removal, follow-up visits with multiple specialists to be planned the same day and recognition of the psychological impact of the disease on the partner important. To improve patient-centered care for complex skin cancer patients, more efforts should be directed towards improving continuity of care and collaboration. Furthermore, it is advocated for physicians to be sensitive to the individual needs of patients and their partner and adjust information, communication and (supportive) care accordingly.
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Affiliation(s)
- Sven van Egmond
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Marlies Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marit Hoogenraad
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Ida J Korfage
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - Marc A M Mureau
- Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marjolein Lugtenberg
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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18
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Papaleontiou M, Zebrack B, Reyes-Gastelum D, Rosko AJ, Hawley ST, Hamilton AS, Ward KC, Haymart MR. Physician management of thyroid cancer patients' worry. J Cancer Surviv 2020; 15:418-426. [PMID: 32939685 DOI: 10.1007/s11764-020-00937-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/05/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE The purpose of this study is to understand physician management of thyroid cancer-related worry. METHODS Endocrinologists, general surgeons, and otolaryngologists identified by Surveillance, Epidemiology, and End Results (SEER) patients were surveyed 2018-2019 (response rate 69% (448/654)) and asked to rate in general their patients' worry at diagnosis and actions they take for worried patients. Multivariable-weighted logistic regressions were conducted to determine physician characteristics associated with reporting thyroid cancer as "good cancer" and with encouraging patients to seek help managing worry outside the physician-patient relationship. RESULTS Physicians reported their patients as quite/very worried (65%), somewhat worried (27%), and a little/not worried (8%) at diagnosis. Half of the physicians tell patients their thyroid cancer is a "good cancer." Otolaryngology (odds ratio (OR) 1.87, 95% confidence interval (CI) 1.08-3.21, versus endocrinology), private practice (OR 2.48, 95% CI 1.32-4.68, versus academic setting), and Los Angeles (OR 2.24, 95% CI 1.45-3.46, versus Georgia) were associated with using "good cancer." If patients are worried, 97% of physicians make themselves available for discussion, 44% refer to educational websites, 18% encourage communication with family/friends, 13% refer to support groups, and 7% refer to counselors. Physicians who perceived patients being quite/very worried were less likely to use "good cancer" (OR 0.54, 95% CI 0.35-0.84) and more likely to encourage patients to seek help outside the physician-patient relationship (OR 1.82, 95% CI 1.17-2.82). IMPLICATIONS FOR CANCER SURVIVORS Physicians perceive patient worry as common and address it with various approaches, with some approaches of unclear benefit. Efforts are needed to develop tailored interventions targeting survivors' psychosocial needs.
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Affiliation(s)
- Maria Papaleontiou
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm 453S, Ann Arbor, MI, 48109, USA
| | - Bradley Zebrack
- School of Social Work, University of Michigan, 1080 S. University, Room 2778, Ann Arbor, MI, 48109, USA
| | - David Reyes-Gastelum
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Rd., Bldg. 16, 400S-20, Ann Arbor, MI, 48109, USA
| | - Andrew J Rosko
- Department of Otolaryngology - Head and Neck Surgery, 1904 Taubman Center, 1500 E Medical Center Dr. SPC 5312, Ann Arbor, MI, 48109, USA
| | - Sarah T Hawley
- Division of General Medicine, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm G034, Ann Arbor, MI, 48109, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St., SSB318E, MC9239, Los Angeles, CA, 90089-9239, USA
| | - Kevin C Ward
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE RM 764, GCR Building Mailstop; 1518-002-7AA, Atlanta, GA, 30322, USA
| | - Megan R Haymart
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm 408E, Ann Arbor, MI, 48109, USA.
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19
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Looking under the hood of "the Cadillac of cancers:" radioactive iodine-related craniofacial side effects among patients with thyroid cancer. J Cancer Surviv 2020; 14:847-857. [PMID: 32506220 DOI: 10.1007/s11764-020-00897-5] [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: 12/13/2019] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Despite having a generally favorable prognosis, differentiated thyroid cancer is known to have a significant, long-term impact on the quality of life of survivors. We wished to investigate short- and long-term effects among thyroid cancer survivors following radioactive iodine therapy. METHODS We conducted eight focus groups (N = 47) to understand patients' experiences of short- and long-term effects after radioactive iodine treatment and the impact these treatment-related side effects had on patients' quality of life. We elicited responses regarding experiences with side effects following radioactive iodine treatment, particularly salivary, lacrimal, and nasal symptoms. We transcribed audiotapes and conducted qualitative analyses to identify codes and themes. RESULTS We identified eight broad themes from the qualitative analyses. Themes reflecting physical symptoms included dry mouth, salivary gland dysfunction, altered taste, eye symptoms such as tearing or dryness, and epistaxis. Psychosocial themes included lack of knowledge and preparation for treatment, regret of treatment, and distress that thyroid cancer is labeled as a "good cancer." CONCLUSIONS Thyroid cancer survivors reported a wide range of radioactive iodine treatment-related effects and psychosocial concerns that appear to reduce quality of life. The psychosocial concerns reported by participants underscore the significant unmet information and support needs prior to and following RAI treatment among individuals diagnosed with thyroid cancer. IMPLICATIONS FOR CANCER SURVIVORS Future research is needed to help both patients and physicians understand the effect of radioactive iodine on quality of life, and to better assess the benefits versus the risks of radioactive iodine therapy.
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20
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Goerling U, Faller H, Hornemann B, Hönig K, Bergelt C, Maatouk I, Stein B, Teufel M, Erim Y, Geiser F, Niecke A, Senf B, Wickert M, Büttner-Teleaga A, Weis J. Information needs in cancer patients across the disease trajectory. A prospective study. PATIENT EDUCATION AND COUNSELING 2020; 103:120-126. [PMID: 31474389 DOI: 10.1016/j.pec.2019.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 08/01/2019] [Accepted: 08/08/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE As satisfaction with information received is an important precondition of adherence to treatment in cancer patients, we aimed to examine the level of perceived information, information satisfaction and information needs, and examine the prospective association between information satisfaction and anxiety. METHODS In a multicenter study in Germany, 1398 cancer patients were evaluated in terms of this at baseline, after 6 and 12 months. RESULTS At baseline, the majority of patients reported to feel well-informed. Nevertheless, a considerable proportion reported to wish more information. The proportion of patients reporting unmet information needs declined over time (p < 0.001). Anxiety at baseline is negatively associated with information satisfaction after 6 months (β = -0.10, p < 0.01). Conversely, information satisfaction at baseline is negatively associated with anxiety after 6 months (β = -0.10, p < 0.01). At 12 months, only the negative path leading from anxiety to information satisfaction was significant (β = -0.12, p < 0.01). CONCLUSION We found high levels of information received and high information satisfaction. Nevertheless, there was a considerable quantity of unmet information needs. A bidirectional relationship between information satisfaction and anxiety symptoms emerged after 6 months. PRACTICE IMPLICATIONS These results underline the priority of providing information and emotional support to cancer patients to improve satisfaction with information.
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Affiliation(s)
- Ute Goerling
- Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Helath, Invalidenstrasse 80, 10115 Berlin, Germany.
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, Klinikstrasse 3, 97070 Würzburg, Germany
| | - Beate Hornemann
- University Clinic Centre Dresden, Comprehensive Cancer Center, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Clinic, Comprehensive Cancer Center Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Corinna Bergelt
- University Clinic Centre Hamburg, Hubertus Wald - University Cancer Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - Imad Maatouk
- Department Internal Medicine and Psychosomatics, University Clinic Centre Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany
| | - Barbara Stein
- Department Psychosomatic Medicine, Clinic Centre Nürnberg, Paracelsus University, Prof. Ernst-Nathan-Strasse 1, 90419 Nürnberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, Virchowstrasse 174, 45030 Essen, Germany
| | - Yesim Erim
- Department Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Schwabbachanlage 6, 91054 Erlangen, Germany
| | - Franziska Geiser
- Department Psychosomatic Medicine, University Clinic Centre Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - Alexander Niecke
- Department Psychosomatic Medicine & Centre Psychooncology (CePO), University Clinic Centre Cologne, Kerpener Strasse 62, 50937 Köln, Germany
| | - Bianca Senf
- University Clinic Centre Frankfurt, Comprehensive Cancer Center, Theodor-Stern-Kai 7, 60590 Frankfurt/a.M., Germany
| | - Martin Wickert
- University Clinic Centre Tübingen, Comprehensive Cancer Center, Herrenberger Strasse 23, 72070 Tübingen, Germany
| | - Antje Büttner-Teleaga
- Institute for Cognitive Science, Woosuk University, 565-701 Samrye-up, Wanjugun, Jeonbuk, South Korea
| | - Joachim Weis
- Department Self-help Research, University Clinic Centre Freiburg, Comprehensive Cancer Center, Hugstetter Strasse 49, 79106 Freiburg, Germany
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Pitt SC, Wendt E, Saucke MC, Voils CI, Orne J, Macdonald CL, Connor NP, Sippel RS. A Qualitative Analysis of the Preoperative Needs of Patients With Papillary Thyroid Cancer. J Surg Res 2019; 244:324-331. [PMID: 31306889 PMCID: PMC6815701 DOI: 10.1016/j.jss.2019.06.072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/18/2019] [Accepted: 06/14/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Thyroid cancer patients report unmet needs after diagnosis. However, little is known about their specific needs. Therefore, we sought to characterize the needs of patients with thyroid cancer before undergoing surgery. MATERIAL AND METHODS We conducted semistructured interviews with 32 patients with papillary thyroid cancer after their preoperative surgical consultation. Data were analyzed using thematic content analysis. RESULTS The central need of patients with thyroid cancer was a strong patient-surgeon relationship characterized by informational and emotional support, and respect for the patient as a person. Patients preferred disease- and treatment-related information to be individualized and to take into account aspects of their daily life. They wanted adequate time for asking questions with thoughtful answers tailored to their case. Patients additionally desired emotional support from the surgeon characterized by empathy and validation of their cancer experience. They particularly wanted surgeons to address their fears and anxiety. Patients also highly valued the surgeons' ability to see beyond their disease and acknowledge them as a unique person with respect to their occupation, psychosocial state, and other individual characteristics. When surgeons met patients' needs, they felt reassured, comfortable with their cancer diagnosis, and prepared for treatment. Suboptimal support increased patients' anxiety particularly when they felt the surgeon minimized their concerns. CONCLUSIONS Preoperatively, patients with thyroid cancer desire a strong patient-surgeon relationship. They rely on the surgeon to provide adequate informational and emotional support and respect them as individuals. In turn, patients feel reassured and prepared for treatment.
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Affiliation(s)
- Susan C Pitt
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
| | - Elizabeth Wendt
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Megan C Saucke
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Corrine I Voils
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; William Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Jason Orne
- Qualitative Health Research Consultants, LLC, Madison, Wisconsin
| | | | - Nadine P Connor
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Rebecca S Sippel
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Jo HS, Park K, Jung SM. A scoping review of consumer needs for cancer information. PATIENT EDUCATION AND COUNSELING 2019; 102:1237-1250. [PMID: 30772114 DOI: 10.1016/j.pec.2019.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/30/2019] [Accepted: 02/05/2019] [Indexed: 05/08/2023]
Abstract
OBJECTIVE This study was a scoping review of research on cancer-related health information seeking and needs of patients, survivor, non-patients, and caregivers. METHODS This study used the COSI model to search for articles published from 2007 to 2017. RESULTS In total, 117 articles with titles and abstracts including the following terms were selected: cancer, health, information, seeking. Non-patients obtained information from the Internet, doctors, and media, whereas patients obtained information from doctors, the Internet, and media. Information needs were the highest for treatment, prognosis, and psychosocial support. Patients had the highest need for information on prognosis and treatment, whereas non-patients had the highest need for general cancer information, prevention, and cancer examination. Caregivers sought information about treatment, psychosocial support, and prevention. CONCLUSION This study revealed an increase in the number of research articles identifying cancer patients' information needs. Cancer patients rely on health professionals for information; thus, relevant materials are needed. Furthermore, not only medical but also psychosocial support information is needed. PRACTICE IMPLICATIONS There is a need for cancer information from health professionals, and thus for patient-centered training materials. Furthermore, a survey system to evaluate consumers' cancer information needs should be developed.
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Affiliation(s)
- Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Keeho Park
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Su Mi Jung
- Department of Health Policy and Management, Kangwon National University College of Medicine, Chuncheon, South Korea.
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van Eenbergen MC, van den Hurk C, Mols F, van de Poll-Franse LV. Usability of an online application for reporting the burden of side effects in cancer patients. Support Care Cancer 2019; 27:3411-3419. [DOI: 10.1007/s00520-019-4639-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 01/07/2019] [Indexed: 12/16/2022]
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Hyde L, Mackenzie L, Boyes AW, Evans TJ, Symonds M, Sanson-Fisher R. Prevalence and correlates of patient-centred preparatory information provision to computed tomography and magnetic resonance imaging outpatients: A cross-sectional study. PATIENT EDUCATION AND COUNSELING 2018; 101:1814-1822. [PMID: 29884532 DOI: 10.1016/j.pec.2018.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 05/23/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Responsiveness to information preferences is key to high-quality, patient-centred care. This study examined the top ten preparatory information items not delivered in accordance with medical imaging outpatients' preferences, and patient characteristics associated with reporting a greater number of unmet information preferences. METHODS Magnetic resonance imaging and computed tomography outpatients were recruited consecutively in one major public hospital waiting room. Participants self-administered a touchscreen computer questionnaire assessing their sociodemographic and scan characteristics, and unmet preferences for 33 guideline-endorsed preparatory information items. RESULTS Of 317 eligible patients, 280 (88%) consented to participate. Given equal rankings, the top ten unmet information preferences included 13 items which were endorsed by at least 25% of participants, and commonly related to receiving 'too little' information. One item related to the pre-scan period, seven items to the scan period and five items to the post-scan period. None of the patient characteristics examined were significantly associated with reporting a greater number of unmet information preferences. CONCLUSION There is room to improve responsiveness to medical imaging outpatients' preparatory information preferences. Improvements should be targeted at individuals, rather than groups defined by sociodemographic or scan characteristics. PRACTICE IMPLICATIONS A standardised approach to addressing individual patient's information preferences is needed.
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Affiliation(s)
- Lisa Hyde
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia.
| | - Lisa Mackenzie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Allison W Boyes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia
| | | | - Michael Symonds
- Hunter New England Imaging, John Hunter Hospital, New Lambton Heights, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia
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25
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Efficace F, Boccadoro M, Palumbo A, Petrucci MT, Cottone F, Cannella L, Zamagni E, Niscola P, Kyriakou C, Caravita T, Offidani M, Mandelli F, Cavo M. A prospective observational study to assess clinical decision-making, prognosis, quality of life and satisfaction with care in patients with relapsed/refractory multiple myeloma: the CLARITY study protocol. Health Qual Life Outcomes 2018; 16:127. [PMID: 29914509 PMCID: PMC6006751 DOI: 10.1186/s12955-018-0953-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 06/04/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Treatment decision-making in patients with relapsed/refractory multiple myeloma (RRMM) is challenging for a number of reasons including, the heterogeneity of disease at relapse and the number of possible therapeutic approaches. This study broadly aims to generate new evidence-based data to facilitate clinical decision-making in RRMM patients. The primary objective is to investigate the prognostic value of patient self-reported fatigue severity for overall survival. METHODS This multicenter prospective observational study will consecutively enroll 312 patients with multiple myeloma who have received at least 1 prior line of therapy and are considered as RRMM according to the International Myeloma Working Group (IMWG) criteria. Eligible RRMM participants will be adults (≥ 18 years old) patients and will be enrolled irrespective of comorbidities and performance status. At the time of study inclusion, data to calculate the frailty score are to be available. Patients will be followed up for 30 months and patient-reported outcome (PRO) assessment is planned at baseline and thereafter at 3, 6, 12, and 24 months. The following PRO validated questionnaires will be used: the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), the EORTC QLQ-MY20 and the EORTC QLQ-INFO25. Satisfaction with care and preference for involvement in treatment decisions will also be evaluated. Clinical, laboratory and treatment related information will be prospectively collected in conjunction with pre scheduled PRO assessments. Cox regression analyses will be used to assess the prognostic value of baseline fatigue severity (EORTC QLQ-C30) and other patient-reported health-related quality of life parameters. DISCUSSION Clinical decision-making in RRMM is a challenge and outcome prediction is also an important aspect to enhance personalized treatment planning. Given the paucity of PRO data in this population, this prospective observational study aims to provide novel information that may facilitate patients' management in routine practice. TRIAL REGISTRATION This trial is registered as identifier NCT03190525 .
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Affiliation(s)
- Fabio Efficace
- Health Outcomes Research Unit, Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy.
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Antonio Palumbo
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Maria Teresa Petrucci
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Rome, Italy
| | - Francesco Cottone
- Health Outcomes Research Unit, Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy
| | - Laura Cannella
- Health Outcomes Research Unit, Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy
| | - Elena Zamagni
- Seragnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Pasquale Niscola
- Haematology Unit and Pathology Department, S. Eugenio Hospital Rome, Rome, Italy
| | - Charalampia Kyriakou
- Department of Haematology, London North West and University College London Hospitals, London, UK
| | - Tommaso Caravita
- Haematology Unit and Pathology Department, S. Eugenio Hospital Rome, Rome, Italy
| | - Massimo Offidani
- Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Franco Mandelli
- Health Outcomes Research Unit, Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy
| | - Michele Cavo
- Institute of Hematology Seragnoli, DIMES, University of Bologna, Bologna, Italy
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Hovén E, Lannering B, Gustafsson G, Boman KK. Information needs of survivors and families after childhood CNS tumor treatment: a population-based study. Acta Oncol 2018; 57:649-657. [PMID: 29191069 DOI: 10.1080/0284186x.2017.1406136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study examines information needs and satisfaction with provided information among childhood central nervous system (CNS) tumor survivors and their parents. MATERIAL AND METHODS In a population-based sample of 697 adult survivors in Sweden, 518 survivors and 551 parents provided data. Information needs and satisfaction with information were studied using a multi-dimensional standardized questionnaire addressing information-related issues. RESULTS Overall, 52% of the survivors and 48% of the parents reported no, or only minor, satisfaction with the extent of provided information, and 51% of the survivors expressed a need for more information than provided. The information received was found useful (to some extent/very much) by 53%, while 47% did not find it useful, or to a minor degree only. Obtaining written material was associated with greater satisfaction and usefulness of information. Dissatisfaction with information was associated with longer time since diagnosis, poorer current health status and female sex. The survivors experienced unmet information needs vis-à-vis late effects, illness education, rehabilitation and psychological services. Overall, parents were more dissatisfied than the survivors. CONCLUSION These findings have implications for improvements in information delivery. Information in childhood CNS tumor care and follow-up should specifically address issues where insufficiency was identified, and recognize persistent and with time changing needs at the successive stages of long-term survivorship.
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Affiliation(s)
- Emma Hovén
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Lannering
- Department of Women’s and Children’s Health Pediatric Unit, University of Gothenburg, Gothenburg, Sweden
| | - Göran Gustafsson
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Krister K. Boman
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Department of Women’s and Children’s Health, Clinical Psychology in Health Care, Uppsala University, Uppsala, Sweden
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Mayer DK, Nasso SF, Earp JA. Defining cancer survivors, their needs, and perspectives on survivorship health care in the USA. Lancet Oncol 2017; 18:e11-e18. [PMID: 28049573 DOI: 10.1016/s1470-2045(16)30573-3] [Citation(s) in RCA: 206] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 08/01/2016] [Accepted: 08/12/2016] [Indexed: 12/21/2022]
Abstract
More people are living after a diagnosis of cancer than ever before and now account for around 5% of the US population. The specialty of cancer survivorship has been developing and growing since the mid-1980s, but the term survivor is open to debate by people living with cancer and those caring for them. Regardless of the term used, many ongoing physical, psychological, and social needs affect quality of life for people who are living with cancer and those who have survived the disease. Survivors prefer to have these needs addressed by their oncologist but also want their primary care provider to have a role. However, survivors also believe there are communication and coordination barriers between care providers. The existing method for delivering cancer care is becoming unsustainable and is not adequately configured to deliver high-quality cancer care to this growing population in the USA, especially when confronted with projected health-care shortages by 2020. In this Series paper, we define the term cancer survivor, discuss survivors' ongoing needs and preferences for care over time, and consider the implications for delivering coordinated cancer care in the USA.
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Affiliation(s)
- Deborah K Mayer
- University of North Carolina School of Nursing, University of North Carolina, Chapel Hill, NC, USA; University of North Carolina Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
| | | | - Jo Anne Earp
- University of North Carolina Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Fletcher C, Flight I, Chapman J, Fennell K, Wilson C. The information needs of adult cancer survivors across the cancer continuum: A scoping review. PATIENT EDUCATION AND COUNSELING 2017; 100:383-410. [PMID: 27765377 DOI: 10.1016/j.pec.2016.10.008] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/29/2016] [Accepted: 10/08/2016] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To provide an updated synthesis of the literature that investigates the self-reported information needs of people diagnosed with cancer across the cancer continuum. METHODS We conducted a scoping review of the literature published from August 2003 to June 2015 and expanded an existing typology summarizing the information needs of people diagnosed with cancer. RESULTS The majority of the included studies (n=104) focused on questions relevant to the diagnosis/active treatment phase of the cancer continuum (52.9%) and thus the most frequently identified information needs related to this phase (33.4%). Information needs varied across the continuum and the results highlight the importance of recognising this fact. CONCLUSION People diagnosed with cancer experience discrete information needs at different points from diagnosis to survival. Much of the research conducted in this area has focused on their information needs during the diagnosis and treatment of cancer, and literature relating to information needs following completion of treatment is sparse. PRACTICE IMPLICATIONS Further research is needed to discern the specific nature of the treatment concerns and identify the information needs that survivors experience during recurrence of cancer, metastasis or changes in diagnosis, and the end of life phase of the cancer continuum.
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Affiliation(s)
- Chloe Fletcher
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia
| | - Ingrid Flight
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia.
| | - Janine Chapman
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia
| | - Kate Fennell
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia; Cancer Council SA, Adelaide, Australia
| | - Carlene Wilson
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia; Cancer Council SA, Adelaide, Australia
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Jabbour J, Milross C, Sundaresan P, Ebrahimi A, Shepherd HL, Dhillon HM, Morgan G, Ashford B, Abdul-Razak M, Wong E, Veness M, Palme CE, Froggatt C, Cohen R, Ekmejian R, Tay J, Roshan D, Clark JR. Education and support needs in patients with head and neck cancer: A multi-institutional survey. Cancer 2017; 123:1949-1957. [DOI: 10.1002/cncr.30535] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/26/2016] [Accepted: 12/09/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Joe Jabbour
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
| | - Chris Milross
- Department of Radiation Oncology and Medical Services; Chris O'Brien Lifehouse; Camperdown New South Wales Australia
- Department of Medicine; Sydney Medical School, The University of Sydney; Sydney New South Wales Australia
| | - Puma Sundaresan
- Department of Medicine; Sydney Medical School, The University of Sydney; Sydney New South Wales Australia
- Department of Radiation Oncology; Crown Princess Mary Cancer Centre, Westmead Hospital; Westmead New South Wales Australia
| | - Ardalan Ebrahimi
- Department of Head and Neck Surgery; Liverpool Hospital; Liverpool New South Wales Australia
| | - Heather L. Shepherd
- Centre for Medical Psychology and Evidence-Based Decision-making; The University of Sydney; Camperdown New South Wales Australia
- Psycho-Oncology Cooperative Research Group (POCOG), School of Psychology, The University of Sydney; Camperdown New South Wales Australia
| | - Haryana M. Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-making; The University of Sydney; Camperdown New South Wales Australia
- Psycho-Oncology Cooperative Research Group (POCOG), School of Psychology, The University of Sydney; Camperdown New South Wales Australia
| | - Gary Morgan
- Department of Head and Neck Surgery; Crown Princess Mary Cancer Centre, Westmead Hospital; Westmead New South Wales Australia
| | - Bruce Ashford
- Department of Head and Neck Surgery; Wollongong Hospital; Wollongong New South Wales Australia
| | - Muzib Abdul-Razak
- Department of Head and Neck Surgery; Crown Princess Mary Cancer Centre, Westmead Hospital; Westmead New South Wales Australia
| | - Eva Wong
- Department of Head and Neck Surgery; Crown Princess Mary Cancer Centre, Westmead Hospital; Westmead New South Wales Australia
| | - Michael Veness
- Department of Medicine; Sydney Medical School, The University of Sydney; Sydney New South Wales Australia
- Department of Radiation Oncology; Crown Princess Mary Cancer Centre, Westmead Hospital; Westmead New South Wales Australia
| | - Carsten E. Palme
- Department of Head and Neck Surgery; Crown Princess Mary Cancer Centre, Westmead Hospital; Westmead New South Wales Australia
| | - Cate Froggatt
- Sydney Head and Neck Cancer Institute; Chris O'Brien Lifehouse; Camperdown New South Wales Australia
| | - Ruben Cohen
- Department of Head and Neck Surgery; Liverpool Hospital; Liverpool New South Wales Australia
| | - Rafael Ekmejian
- Department of Medicine; University of New South Wales; Kensington New South Wales Australia
| | - Jessica Tay
- Department of Medicine; University of New England; Armidale New South Wales Australia
| | - David Roshan
- Department of Medicine; University of New South Wales; Kensington New South Wales Australia
| | - Jonathan R. Clark
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
- Sydney Head and Neck Cancer Institute; Chris O'Brien Lifehouse; Camperdown New South Wales Australia
- South West Clinical School; University of New South Wales; New South Wales Australia
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30
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Hyun YG, Alhashemi A, Fazelzad R, Goldberg AS, Goldstein DP, Sawka AM. A Systematic Review of Unmet Information and Psychosocial Support Needs of Adults Diagnosed with Thyroid Cancer. Thyroid 2016; 26:1239-50. [PMID: 27350421 DOI: 10.1089/thy.2016.0039] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Patient education and psychosocial support to patients are important elements of comprehensive cancer care, but the needs of thyroid cancer survivors are not well understood. METHODS The published English-language quantitative literature on (i) unmet medical information and (ii) psychosocial support needs of thyroid cancer survivors was systematically reviewed. A librarian information specialist searched seven electronic databases and a hand search was conducted. Two reviewers independently screened citations from the electronic search and reviewed relevant full-text papers. There was consensus between reviewers on the included papers, and duplicate independent abstraction was performed. The results were summarized descriptively. RESULTS A total of 1984 unique electronic citations were screened, and 51 full-text studies were reviewed (three from the hand search). Seven cross-sectional, single-arm, survey studies were included, containing data from 6215 thyroid cancer survivor respondents. The respective study sizes ranged from 57 to 2398 subjects. All of the studies had some methodological limitations. Unmet information needs were variable relating to the disease, diagnostic tests, treatments, and co-ordination of medical care. There were relatively high unmet information needs related to aftercare (especially long-term effects of the disease or its treatment and its management) and psychosocial concerns (including practical and financial matters). Psychosocial support needs were incompletely met. Patient information on complementary and alternative medicine was very limited. CONCLUSIONS In conclusion, thyroid cancer survivors perceive many unmet information needs, and these needs extend to aftercare. Psychosocial information and supportive care needs may be insufficiently met in this population. More work is needed to improve knowledge translation and psychosocial support for thyroid cancer survivors.
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Affiliation(s)
- Yong Gyu Hyun
- 1 Department of Volunteer Resources, University Health Network, Toronto, Canada
| | - Ahmad Alhashemi
- 2 Clinical Endocrinology Fellowship, Division of Endocrinology, Department of Medicine, University of Toronto , Toronto, Canada
| | - Rouhi Fazelzad
- 3 University Health Network Library and Information Services , Princess Margaret Cancer Centre, Toronto, Canada
| | - Alyse S Goldberg
- 2 Clinical Endocrinology Fellowship, Division of Endocrinology, Department of Medicine, University of Toronto , Toronto, Canada
| | - David P Goldstein
- 4 Department of Otolaryngology-Head and Neck Surgery, University Health Network and University of Toronto , Toronto, Canada
| | - Anna M Sawka
- 5 Division of Endocrinology, Department of Medicine, University Health Network and University of Toronto , Toronto, Canada
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31
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Drost FM, Mols F, Kaal SEJ, Stevens WBC, van der Graaf WTA, Prins JB, Husson O. Psychological impact of lymphoma on adolescents and young adults: not a matter of black or white. J Cancer Surviv 2016; 10:726-35. [PMID: 26856728 PMCID: PMC4920833 DOI: 10.1007/s11764-016-0518-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/20/2016] [Indexed: 01/11/2023]
Abstract
PURPOSE The purpose of the study is to examine differences in perceived impact of cancer (IOC) between adolescents and young adults (AYAs; 18-35 years at cancer diagnosis), adults (36-64 years) and elderly (65-84 years) with a history of (non-)Hodgkin lymphoma. Furthermore, to investigate the association of socio-demographic, clinical and psychological characteristics with IOC; and the association between IOC and health-related quality of life (HRQoL) among AYAs only. METHODS This study is part of a population-based PROFILES registry survey among lymphoma patients diagnosed between 1999 and 2009. Patients (n = 1.281) were invited to complete the IOCv1 and EORTC-QLQ-C30 questionnaires. Response rate was 67 % (n = 861). RESULTS AYA lymphoma survivors scored higher on the positive IOC summary scale, compared to adult and elderly patients (p < 0.001), while no significant differences were observed for negative IOC. Among AYAs, females, survivors with a partner, and survivors with elevated psychological distress levels scored significantly higher on the negative IOC summary scale. The negative IOC summary scale was negatively associated with all EORTC QLQ-C30 functioning scales (β ranging from -0.39 to -0.063; p < 0.05). The positive IOC summary scale was negatively associated with the EORTC QLQ-C30 subscale 'Emotional functioning' (β = -0.24; p < 0.05). CONCLUSION AYA, adult and elderly with a history of (non-)Hodgkin lymphoma experienced different types of IOC in terms of positive and negative aspects. IMPLICATIONS FOR CANCER SURVIVORS Although AYAs experience a more positive IOC compared to older survivors, some AYAs experience more negative IOC and may require developmentally appropriate interventions to address their specific concerns.
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Affiliation(s)
- F M Drost
- CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - F Mols
- CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Netherlands Cancer Registry, Eindhoven, The Netherlands
| | - S E J Kaal
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W B C Stevens
- Department of Haematology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - J B Prins
- Department of Medical Psychology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - O Husson
- Department of Medical Psychology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Piredda M, Migliozzi A, Biagioli V, Carassiti M, De Marinis MG. Written Information Improves Patient Knowledge About Implanted Ports. Clin J Oncol Nurs 2016; 20:E28-33. [PMID: 26991720 DOI: 10.1188/16.cjon.e28-e33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Implanted ports are frequently used for patients with cancer who require IV chemotherapy. In addition to verbal communication with healthcare providers, patients with cancer may benefit from written information. OBJECTIVES This pre/post study evaluated the effectiveness of an informational booklet by improving knowledge about ports and assessed the history, need, and preferences for information. METHODS Patients with cancer who had an implanted port for at least six months were provided with an informational booklet about ports. Knowledge about ports was tested before (T0) and after (T1) patients read the booklet. Information needs and preferred sources of information were also assessed at T0. Patients reported their opinions of the booklet at T1. FINDINGS The sample included 129 patients; 49% were male, with a mean age of 59 years. Most patients want to receive as much information as possible, preferably before the port is implanted. However, 43% of patients reported they had received little information about ports. After reading the booklet, patients' knowledge, which was measured with a validated seven-item instrument, improved from T0 to T1 (p < 0.001, effect size = 0.689). Oncology nurses, by providing written and verbal information, can increase patients' knowledge about implanted ports and their confidence in caring for their ports.
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Aschebrook-Kilfoy B, James B, Nagar S, Kaplan S, Seng V, Ahsan H, Angelos P, Kaplan EL, Guerrero MA, Kuo JH, Lee JA, Mitmaker EJ, Moalem J, Ruan DT, Shen WT, Grogan RH. Risk Factors for Decreased Quality of Life in Thyroid Cancer Survivors: Initial Findings from the North American Thyroid Cancer Survivorship Study. Thyroid 2015; 25:1313-21. [PMID: 26431811 PMCID: PMC4684649 DOI: 10.1089/thy.2015.0098] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The prevalence of thyroid cancer survivors is rising rapidly due to the combination of an increasing incidence, high survival rates, and a young age at diagnosis. The physical and psychosocial morbidity of thyroid cancer has not been adequately described, and this study therefore sought to improve the understanding of the impact of thyroid cancer on quality of life (QoL) by conducting a large-scale survivorship study. METHODS Thyroid cancer survivors were recruited from a multicenter collaborative network of clinics, national survivorship groups, and social media. Study participants completed a validated QoL assessment tool that measures four morbidity domains: physical, psychological, social, and spiritual effects. Data were also collected on participant demographics, medical comorbidities, tumor characteristics, and treatment modalities. RESULTS A total of 1174 participants with thyroid cancer were recruited. Of these, 89.9% were female, with an average age of 48 years, and a mean time from diagnosis of five years. The mean overall QoL was 5.56/10, with 0 being the worst. Scores for each of the sub-domains were 5.83 for physical, 5.03 for psychological, 6.48 for social, and 5.16 for spiritual well-being. QoL scores begin to improve five years after diagnosis. Female sex, young age at diagnosis, and lower educational attainment were highly predictive of decreased QoL. CONCLUSION Thyroid cancer diagnosis and treatment can result in a decreased QoL. The present findings indicate that better tools to measure and improve thyroid cancer survivor QoL are needed. The authors plan to follow-up on these findings in the near future, as enrollment and data collection are ongoing.
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Affiliation(s)
| | - Benjamin James
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Sapna Nagar
- Division of Endocrine Surgery, Department of General Surgery, Beaumont Hospitals, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
| | - Sharone Kaplan
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Vanessa Seng
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Habibul Ahsan
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois
| | - Peter Angelos
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Edwin L. Kaplan
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Marlon A. Guerrero
- Department of Surgery, University of Arizona School of Medicine, Tucson, Arizona
| | - Jennifer H. Kuo
- Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - James A. Lee
- Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - Elliot J. Mitmaker
- Department of Surgery and Oncology, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, New York
| | - Jacob Moalem
- Department of Surgery, McGill University Health Centre, Montreal, Canada
| | - Daniel T. Ruan
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Wen T. Shen
- Department of Surgery, University of California, San Francisco, San Francisco, California
| | - Raymon H. Grogan
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
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Lamers RED, Cuypers M, Husson O, Vries M, Kil PJM, Ruud Bosch JLH, Poll‐Franse LV. Patients are dissatisfied with information provision: perceived information provision and quality of life in prostate cancer patients. Psychooncology 2015; 25:633-40. [DOI: 10.1002/pon.3981] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 07/16/2015] [Accepted: 08/19/2015] [Indexed: 01/22/2023]
Affiliation(s)
| | - Maarten Cuypers
- Department of Social PsychologyTilburg University Tilburg The Netherlands
| | - Olga Husson
- CoRPS—Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical Psychology and NeuropsychologyTilburg University The Netherlands
- Eindhoven Cancer RegistryComprehensive Cancer Center The Netherlands (CCCN) Eindhoven The Netherlands
| | - Marieke Vries
- Department of Social PsychologyTilburg University Tilburg The Netherlands
| | - Paul J. M. Kil
- Department of UrologySt. Elisabeth Hospital Tilburg The Netherlands
| | - J. L. H. Ruud Bosch
- Departement of UrologyUniversity Medical Center Utrecht Utrecht The Netherlands
| | - Lonneke V. Poll‐Franse
- CoRPS—Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical Psychology and NeuropsychologyTilburg University The Netherlands
- Eindhoven Cancer RegistryComprehensive Cancer Center The Netherlands (CCCN) Eindhoven The Netherlands
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Fischbeck S, Imruck BH, Blettner M, Weyer V, Binder H, Zeissig SR, Emrich K, Friedrich-Mai P, Beutel ME. Psychosocial Care Needs of Melanoma Survivors: Are They Being Met? PLoS One 2015; 10:e0132754. [PMID: 26296089 PMCID: PMC4546620 DOI: 10.1371/journal.pone.0132754] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 06/17/2015] [Indexed: 11/24/2022] Open
Abstract
Patients who have survived malignant melanoma for more than five years may lack the opportunity to talk about their burden. As a consequence their psychosocial care needs remain undetected and available supportive interventions may not be utilised. Therefore, the psychosocial burden of this patient group needs to be assessed using specific screening instruments. The aim of this study was to investigate the psychosocial burden of long-term melanoma survivors, their psychosocial care needs and the determinants of these needs. We wanted to find out if the use of professional support corresponds to the care needs defined by experts. Using the cancer registry of Rhineland-Palatinate, melanoma patients diagnosed at least 5 years before the survey were contacted by physicians. N = 689 former patients completed the Hornheide Questionnaire (short form HQ-S) to identify psychosocial support need (scale cut off ≥ 16 or item-based cut-off score) and the potential psychosocial determinants of these needs. Additionally, they were asked about their utilisation of the professional support system. More than one third (36%) of them was in need for professional psychosocial support. The highest burden scores concerned worry about tumour progression. Younger age (< 50), higher general fatigue, higher symptom burden, lower general health, negative social interactions and unfulfilled information needs were significant predictors of the need for psychosocial intervention. Related to the percentage of survivors identified as 'in need', the professional support system was underused. Further studies should investigate whether using the HQ-S to routinely identify burdened melanoma patients could lead to better fulfilment of their intervention needs, ultimately enhancing health-related quality of life.
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Affiliation(s)
- Sabine Fischbeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Barbara H. Imruck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Maria Blettner
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Veronika Weyer
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sylke R. Zeissig
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), Cancer Registry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Katharina Emrich
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), Cancer Registry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Peter Friedrich-Mai
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Sim JA, Shin JS, Park SM, Chang YJ, Shin A, Noh DY, Han W, Yang HK, Lee HJ, Kim YW, Kim YT, Jeong SY, Yoon JH, Kim YJ, Heo DS, Kim TY, Oh DY, Wu HG, Kim HJ, Chie EK, Kang KW, Yun YH. Association between information provision and decisional conflict in cancer patients. Ann Oncol 2015; 26:1974-1980. [PMID: 26116430 DOI: 10.1093/annonc/mdv275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/16/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In this study, we aimed to identify demographic and clinical variables that correlate with perceived information provision among cancer patients and determine the association of information provision with decisional conflict (DC). PATIENTS AND METHODS We enrolled a total of 625 patients with cancer from two Korean hospitals in 2012. We used the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire (QLQ-INFO26) to assess patients' perception of the information received from their doctors and the Decisional Conflict Scale (DCS) to assess DC. To identify predictive sociodemographic and clinical variables for adequate information provision, backward selective logistic regression analyses were conducted. In addition, adjusted multivariate logistic regression analyses were carried out to identify clinically meaningful differences of perceived level of information subscales associated with high DC. RESULTS More than half of patients with cancer showed insufficient satisfaction with medical information about disease (56%), treatment (73%), other services (83%), and global score (80%). In multiple logistic regression analyses, lower income and education, female, unmarried status, type of cancer with good prognosis, and early stage of treatment process were associated with patients' perception of inadequate information provision. In addition, Information about the medical tests with high DCS values clarity [adjusted odds ratio (aOR), 0.54; 95% confidence interval (CI) 0.30-0.97] and support (aOR, 0.53; 95% CI 0.33-0.85) showed negative significance. For inadequate information perception about treatments and other services, all 5 DCS scales (uncertainty, informed, values clarity, support, and effective decision) were negatively related. Global score of inadequate information provision also showed negative association with high DCS effective decision (aOR, 0.43; 95% CI 0.26-0.71) and DCS uncertainty (aOR, 0.46; 95% CI 0.27-0.77). CONCLUSION This study found that inadequate levels of perceived information correlated with several demographic and clinical characteristics. In addition, sufficient perceived information levels may be related to low levels of DC.
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Affiliation(s)
- J A Sim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul
| | - J S Shin
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Education & Human Resources Development, Seoul National University Hospital, Seoul, Korea
| | - S M Park
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul
| | - Y J Chang
- Research Institute and Hospital, National Cancer Center, Goyang-si
| | - A Shin
- Department of Preventive Medicine
| | - D Y Noh
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - W Han
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - H K Yang
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - H J Lee
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - Y W Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - Y T Kim
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul
| | - S Y Jeong
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - J H Yoon
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul; Liver Research Institute, Seoul National University College of Medicine, Seoul
| | - Y J Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul; Liver Research Institute, Seoul National University College of Medicine, Seoul
| | - D S Heo
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - T Y Kim
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - D Y Oh
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - H G Wu
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Departments of Radiation Oncology
| | - H J Kim
- Departments of Radiation Oncology
| | - E K Chie
- Departments of Radiation Oncology
| | - K W Kang
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Nuclear Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - Y H Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;.
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Abstract
BACKGROUND The number of thyroid cancer (TC) survivors is increasing exponentially worldwide. However, little research details the unmet information, support needs, and survivorship concerns of TC patients. METHODS Two thousand TC survivors completed an online survey examining the importance of and recollection of receiving care addressing three areas at the time of diagnosis and treatment: medical/physical issues, practical matters, and emotional/psychological concerns. A summed score was generated of (1) the "important" responses for each category, and (2) if they remembered receiving that information/support. Regression analyses explored the relationship between each total score of importance and a patient's demographics, treatment, and recollection of receiving each domain of information/support. RESULTS Respondents were generally female (88.6%), part white (91.1%), and had eventual total thyroidectomy (95.8%) and radioiodine (80.6%). Mean age at diagnosis was 42.1 years and average time from diagnosis 5.43 years. Less than 50% of patients recalled receiving information regarding long-term and health effects after treatment, or any practical matter or emotional/psychological concern. Multivariate linear modeling with forward stepwise regression revealed that age, sex, and survivorship time were important predictors for recollecting having received information and support for medical/physical issues, practical needs, and emotional/psychological concerns after controlling for treatment and other demographic factors (all 0.001 or <0.001). Similar modeling demonstrated that female sex and feeling that they received care in a given category (medical/physical issues, practical needs, or emotional/psychological concerns) predicted the importance placed on those specific needs when controlled for other variables (all 0.001 or <0.001). CONCLUSION TC patients place high importance on most types of information and concerns. However, the majority of information and support needs are unmet, which varies based on demographic and treatment factors as well as the importance placed on each specific topic of information. Qualitative research is needed to further focus and refine these unmet needs that should be followed by targeted interventions.
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Affiliation(s)
| | - Melanie Goldfarb
- 2Endocrine Tumor Program, John Wayne Cancer Institute at Providence St. John's Health Center, Santa Monica, California
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Cuypers M, Lamers RED, Kil PJM, van de Poll-Franse LV, de Vries M. Impact of a web-based treatment decision aid for early-stage prostate cancer on shared decision-making and health outcomes: study protocol for a randomized controlled trial. Trials 2015; 16:231. [PMID: 26012700 PMCID: PMC4458038 DOI: 10.1186/s13063-015-0750-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 05/11/2015] [Indexed: 12/02/2022] Open
Abstract
Background At an early stage, prostate cancer patients are often eligible for more than one treatment option, or may choose to defer curative treatment. Without a pre-existing superior option, a patient has to weigh his personal preferences against the risks and benefits of each alternative to select the most appropriate treatment. Given this context, in prostate cancer treatment decision-making, it is particularly suitable to follow the principles of shared decision-making (SDM), especially with the support of specific instruments like decision aids (DAs). Although several alternatives are available, present tools are not sufficiently compatible with routine clinical practice. To overcome existing barriers and to stimulate structural implementation of DAs and SDM in clinical practice, a web-based prostate cancer treatment DA was developed to fit clinical workflow. Following the structure of an existing DA, Dutch content was developed, and values clarification methods (VCMs) were added. The aim of this study is to investigate the effect of this DA on (shared) treatment choice and patient-reported outcomes. Methods/design Nineteen Dutch hospitals are included in a pragmatic, cluster randomized controlled trial, with an intervention and a control arm. In the intervention group, the DA will be offered after diagnosis, and a summary of the patients’ preferences, which were identified with the DA, can be discussed by the patient and his clinician during later consultation. Patients in the control group will receive information and decisional support as usual. Results from both groups on decisional conflict, treatment choice and the experience with involvement in the decision-making process are compared. Patients are requested to fill in questionnaires after treatment decision-making but before treatment is started, and 6 and 12 months later. This will allow the development of treatment satisfaction, decisional regret, and quality of life to be monitored. Clinicians from both groups will evaluate their practice of information provision and decisional support. Discussion This study will describe a web-based prostate cancer treatment DA with VCMs. The effect of this DA on the decision-making process and subsequent patient reported outcomes will be evaluated. Trial registration The Netherlands National Trial Register: NTR4554, registration date 1 May 2014.
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Affiliation(s)
- Maarten Cuypers
- Department of Social Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands.
| | - Romy E D Lamers
- Department of Urology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands.
| | - Paul J M Kil
- Department of Urology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands.
| | - Lonneke V van de Poll-Franse
- Department of Medical Psychology and Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands. .,Comprehensive Cancer Centre Netherlands South, Zernikestraat 29, 5612 HZ, Eindhoven, The Netherlands.
| | - Marieke de Vries
- Department of Social Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands. .,Department of Social Psychology, Tilburg Institute for Behavioral Economics Research (TIBER), Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands.
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Satisfaction with information and unmet information needs in men and women with cancer. J Cancer Surviv 2015; 10:62-70. [DOI: 10.1007/s11764-015-0451-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/08/2015] [Indexed: 11/12/2022]
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Gamper EM, Sztankay M. Lebensqualität und psychische Belastungen von Schilddrüsenkrebspatienten. ONKOLOGE 2015. [DOI: 10.1007/s00761-015-2918-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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