1
|
Corish S, Fulton BA, Galbraith L, Coltart K, Duffton A. Impact of patient information format on the experience of cancer patients treated with radiotherapy. Tech Innov Patient Support Radiat Oncol 2024; 30:100252. [PMID: 38779037 PMCID: PMC11109017 DOI: 10.1016/j.tipsro.2024.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/23/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Radiotherapy (RT) stands as one of the main cancer treatments. The impact of RT and cancer treatment can have a physical and psychological impact on patients and their carers. To gain patient's trust, and ensure they feel valued, information should be provided before, during, and after RT. Patient and public involvement (PPI) has been lacking, and increased engagement with PPI groups could improve this. This rapid review aims to analyse the literature, and describe and report patient perception, experience, and satisfaction regarding the information received concerning their course of RT. Methods To allow the synthesis of results, a pragmatic decision was made to use a rapid review approach to analyse the literature, providing more timely information to inform future work. This rapid review utilised systematic review methods and was conducted according to a pre-defined protocol including clear inclusion criteria (PROSPERO registration: CRD42023415916).Electronic databases CINAHL, AMED, Pubmed/MEDLINE, EMBASE, and PsycINFO were searched using a comprehensive search for published studies from January 2012 to November 2023. Two independent reviewers applied the eligibility criteria. Evidence from literature was extracted and transcribed into qualitative data and Braun and Clarke's six-step thematic analysis (TA) was employed to determine themes by one reviewer and checked by a second [26]. Due to the heterogeneity of the included literature, the analysis of this review is presented primarily through narrative synthesis. Results Sixty eight articles met the inclusion criteria for this review. Emerging themes included; a desire for information based on patient characteristics, information format, patient preparedness, timing e.g. timing of information and changing priorities over time, health care professional (HCP) involvement, barriers to information, and motivators for better information delivery. Conclusions Several factors can influence a patient's desire for information, from whom and when they receive it, to what format they would prefer to receive it. There is benefit to be gained in employing PPI and patient advocacy to inform future studies that aim to further understand the themes that emerged from this review. Such studies can therefore inform HCPs in providing patient-specific information and support by utilising multiple teaching strategies available to them.
Collapse
Affiliation(s)
| | - Ben A Fulton
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | | | | | - Aileen Duffton
- Beatson West of Scotland Cancer Centre, Glasgow, UK
- Institute of Cancer Science, University of Glasgow, UK
| |
Collapse
|
2
|
Kukafka R, Kim S, Kim SH, Yoo SH, Sung JH, Oh EG, Kim N, Lee J. Digital Health Interventions for Adult Patients With Cancer Evaluated in Randomized Controlled Trials: Scoping Review. J Med Internet Res 2023; 25:e38333. [PMID: 36607712 PMCID: PMC9862347 DOI: 10.2196/38333] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/15/2022] [Accepted: 10/25/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Digital care has become an essential component of health care. Interventions for patients with cancer need to be effective and safe, and digital health interventions must adhere to the same requirements. OBJECTIVE The purpose of this study was to identify currently available digital health interventions developed and evaluated in randomized controlled trials (RCTs) targeting adult patients with cancer. METHODS A scoping review using the JBI methodology was conducted. The participants were adult patients with cancer, and the concept was digital health interventions. The context was open, and sources were limited to RCT effectiveness studies. The PubMed, CINAHL, Embase, Cochrane Library, Research Information Sharing Service, and KoreaMed databases were searched. Data were extracted and analyzed to achieve summarized results about the participants, types, functions, and outcomes of digital health interventions. RESULTS A total of 231 studies were reviewed. Digital health interventions were used mostly at home (187/231, 81%), and the web-based intervention was the most frequently used intervention modality (116/231, 50.2%). Interventions consisting of multiple functional components were most frequently identified (69/231, 29.9%), followed by those with the self-manage function (67/231, 29%). Web-based interventions targeting symptoms with the self-manage and multiple functions and web-based interventions to treat cognitive function and fear of cancer recurrence consistently achieved positive outcomes. More studies supported the positive effects of web-based interventions to inform decision-making and knowledge. The effectiveness of digital health interventions targeting anxiety, depression, distress, fatigue, health-related quality of life or quality of life, pain, physical activity, and sleep was subject to their type and function. A relatively small number of digital health interventions specifically targeted older adults (6/231, 2.6%) or patients with advanced or metastatic cancer (22/231, 9.5%). CONCLUSIONS This scoping review summarized digital health interventions developed and evaluated in RCTs involving adult patients with cancer. Systematic reviews of the identified digital interventions are strongly recommended to integrate digital health interventions into clinical practice. The identified gaps in digital health interventions for cancer care need to be reflected in future digital health research.
Collapse
Affiliation(s)
| | - Sanghee Kim
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
| | - Soo Hyun Kim
- Department of Nursing, Inha University, Inchon, Republic of Korea
| | - Sung-Hee Yoo
- College of Nursing, Chonnam National University, Gwangju, Republic of Korea
| | - Ji Hyun Sung
- College of Nursing, Kosin University, Busan, Republic of Korea
| | - Eui Geum Oh
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
| | - Nawon Kim
- Yonsei Medical Library, Yonsei University, Seoul, Republic of Korea
| | - Jiyeon Lee
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
| |
Collapse
|
3
|
Leino-Kilpi H, Inkeroinen S, Cabrera E, Charalambous A, Fatkulina N, Katajisto J, Sigurðardóttir ÁK, Sourtzi P, Suhonen R, Zabalegui A, Valkeapää K. Instruments for Patient Education: Psychometric Evaluation of the Expected Knowledge (EKhp) and the Received Knowledge of Hospital Patients (RKhp). J Multidiscip Healthc 2020; 13:1481-1505. [PMID: 33204098 PMCID: PMC7667700 DOI: 10.2147/jmdh.s271043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/28/2020] [Indexed: 02/01/2023] Open
Abstract
Purpose In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients’ expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial). Patients and Methods The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language experts. International data collection was performed in 2009–2012 with a total sample of 1,595 orthopedic patients. Orthopedic patients were selected due to the increase in their numbers, and need for educational activities. Here we report the psychometrics of the instruments for potential international use and future development. Results Content validities were confirmed by each participating country. Confirmatory factor analyses supported the original theoretical, six-dimensional structure of the instruments. For some subscales, however, there is a need for further clarification. The summative factors, based on the dimensions, have a satisfactory internal consistency. The results support the use of the instruments in patient education in orthopedic nursing, and preferably also in other fields of surgical nursing care. Conclusion EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted.
Collapse
Affiliation(s)
- Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Saija Inkeroinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Esther Cabrera
- School of Health Sciences, TecnoCampus, University Pompeu Fabra, Barcelona, Spain.,Department of Care Management and Social Work, Sechenov University, Moscow, Russia
| | - Andreas Charalambous
- Department of Nursing Science, University of Turku, Turku, Finland.,Nursing Department, Cyprus University of Technology, Limassol, Cyprus
| | - Natalja Fatkulina
- Department of Nursing, Klaipeda University, Klaipėda, Lithuania.,Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Árún K Sigurðardóttir
- School of Health Sciences, University of Akureyri, Akureyri, Iceland.,Akureyri Hospital, Akureyri, Iceland
| | - Panayota Sourtzi
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,Welfare Division, City of Turku, Turku, Finland
| | - Adelaida Zabalegui
- Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Kirsi Valkeapää
- Department of Nursing Science, University of Turku, Turku, Finland.,Human Performance Division, Finnish Defense Research Agency, Järvenpää, Finland
| |
Collapse
|
4
|
Koeppen J, Sinclair PM. Education-based interventions for anxiety during the treatment and management of chronic disease: a systematic review protocol. JBI Evid Synth 2020; 18:2357-2362. [DOI: 10.11124/jbisrir-d-19-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
5
|
Anatchkova M, Donelson SM, Skalicky AM, McHorney CA, Jagun D, Whiteley J. Exploring the implementation of patient-reported outcome measures in cancer care: need for more real-world evidence results in the peer reviewed literature. J Patient Rep Outcomes 2018; 2:64. [PMID: 30588562 PMCID: PMC6306371 DOI: 10.1186/s41687-018-0091-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 12/04/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To explore the existing evidence of the real-world implementation of patient-reported outcomes (PROs) in oncology clinical practice and address two aims: (1) summarize available evidence of PRO use in clinical practice using a framework based on the International Society for Quality of Life Research (ISOQOL) PRO Implementation Guide; and (2) describe reports of real-world, standardized PRO administration in oncology conducted outside of scope of a research study. METHODS A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was developed to guide the systematic literature review (SLR) that was conducted in MEDLINE and Embase databases. A two step search strategy was implemented including two searches based on previously completed reviews. Studies published from 2006 to 2017 were synthesized using a framework based on the ISOQOL PRO Implementation Guide. RESULTS After screening 4427 abstracts, 36 studies met the eligibility criteria. Most elements of the ISOQOL PRO Implementation Guide were followed. Two notable exceptions were found: 1) providing PRO score interpretation guidelines (39% of studies); and 2) providing patient-management guidance for addressing issues identified by PROs (25% of studies). Of the 22 studies with an intervention component, 19 (86%) reported intervention effects on study outcomes. The European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30 (EORTC QLQ-C30) was the most commonly used PRO (n = 10, 28%); use of 38 other PRO measures was also reported. Only three studies (8%) reported real-world PRO implementation. CONCLUSION Reports of real-world PRO implementation are limited. Reports from studies conducted in clinical settings suggest gaps in information on PRO score interpretation and the use of PRO results to inform patient management. Before the promise of practice-based PRO assessment in oncology can be truly realized, investigators need to advance the state-of-the-art of real-time PRO score interpretation as well as developing guidance on how to use PRO insights to drive clinically-meaningful patient-management strategies.
Collapse
|
6
|
Li Z, Geng W, Yin J, Zhang J. Effect of one comprehensive education course to lower anxiety and depression among Chinese breast cancer patients during the postoperative radiotherapy period - one randomized clinical trial. Radiat Oncol 2018; 13:111. [PMID: 29898748 PMCID: PMC6000931 DOI: 10.1186/s13014-018-1054-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/28/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND We investigated the effectiveness of one education course to lower the severity of anxiety and depression symptoms among breast cancer (BC) patients during radiotherapy (RT). METHODS All 290 one-sided BC patients were evenly randomized into intervention or control arm. "Intervention" patient was additionally provided with one three-hour course on psychological stresses and management skills. Changes of anxiety and depression score and their 3-level severity category ('normal', 'borderline' and 'abnormal' scored 0-7, 8-10 and 11-21, respectively) from HADS questionnaire over RT were evaluated by multivariable linear and ordinal logistic regressions. RESULTS Response rates were 94 and 100% by "intervention" and "control" arm, respectively. Means of score changes by "intervention" and "control" (n = 145) were + 0.59 (SD = 2.47) and + 0.11 (SD = 2.55) for anxiety and + 0.81 (SD = 2.81) and + 0.45 (SD = 2.77) for depression scores, respectively. 'Abnormal' anxiety and depression patients were 4.1 and 6.9% at baseline and 4.8 and 6.9% at end of RT at 'control' arm; those rates were 6.6 and 7.4%, and 8.8 and 10.3% at 'intervention' arm, respectively. Both changes on anxiety and depression measurements between two arms were all insignificant (p > 0.20). CONCLUSIONS One education course did not reduce the score and severity of anxiety and depression symptoms over RT period. TRIAL REGISTRATION Chinese Clinical Trial Registry #: ChiCTR-IIR-16008818 at www.chictr.org.cn .
Collapse
Affiliation(s)
- Zhensheng Li
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, 169 Tianshan Street, Shijiazhuang, 050035 China
| | - Wenhui Geng
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, 169 Tianshan Street, Shijiazhuang, 050035 China
| | - Junpu Yin
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, 169 Tianshan Street, Shijiazhuang, 050035 China
| | - Jun Zhang
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, 169 Tianshan Street, Shijiazhuang, 050035 China
| |
Collapse
|
7
|
Radojevic MZ, Folic M, Jankovic S. A Questionnaire for Assessing Fear of Radiotherapy in Oncology Patients. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.1515/sjecr-2017-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Radiotherapy is a frequently prescribed and highly effective form of treatment of oncology patients. However, many patients feel rational or irrational fear of the application of radiotherapy, which may provoke mental and physical stress, anxiety, growing anger and hostility, thus reducing quality of life. The aim of this study was to develop, reliability test and validate a questionnaire for assessing the level of fear of radiotherapy in oncology patients.
We performed a prospective qualitative study based on the development, validation and reliability testing of the questionnaire developed for assessing radiotherapy-caused fear in oncology patients treated in the Centre for Oncology and Radiology, Department of Radiotherapy, Clinical Centre Kragujevac.
The study included 154 patients and the final version of the questionnaire integrated 15 questions. After the elimination of inappropriate questions the Cronbach coefficient α was 0.946. The questionnaire consists of two factors which represent 57.423% and 6.925%, making a total of 64.348% of the variance of the questionnaire.
The results of our study show that the questionnaire used is a unique, reliable and valid instrument for assessing the level of fear of radiotherapy in oncology patients the application of which will allow us to identify patients with elevated levels of fear of radiotherapy.
Collapse
Affiliation(s)
| | - Marko Folic
- Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
- Clinical Pharmacology Department, Clinical Centre Kragujevac , Kragujevac , Serbia
| | - Slobodan Jankovic
- Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
- Clinical Pharmacology Department, Clinical Centre Kragujevac , Kragujevac , Serbia
| |
Collapse
|
8
|
Hefner J, Csef EJ, Kunzmann V. Fear of Progression in Outpatients With Chronic Myeloid Leukemia on Oral Tyrosine Kinase Inhibitors. Oncol Nurs Forum 2016; 43:190-7. [PMID: 26906130 DOI: 10.1188/16.onf.190-197] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To assess fear of progression (FoP) in outpatients with chronic myeloid leukemia (CML) on oral tyrosine kinase inhibitors (TKIs).
DESIGN Prospective and descriptive.
SETTING A university-based outpatient cancer clinic in Wuerzburg, Germany.
SAMPLE 37 outpatients with CML on oral TKIs.
. METHODS FoP was assessed with a questionnaire. Clinical data were extracted from the medical charts.
. MAIN RESEARCH VARIABLES Frequency and contents of FoP.
FINDINGS Sum scores and levels of FoP in the sample population (N = 37) were as high as in cancer populations with more unfavorable life expectancies. Regarding single items, fear that medication may harm the body was most prevalent, regardless of group affiliation. The actual fear of disease progression was only ranked sixth out of 12 items for the total sample and was ranked second by the second-generation TKI group.
CONCLUSIONS In a sample of outpatients with CML, FoP was frequent and most often generated by fears of treatment side effects.
IMPLICATIONS FOR NURSING Nurses should be vigilant about FoP in this population. Established questionnaires may help to identify and evaluate this frequent source of distress. Specific communication could reveal unmet informational needs and may help to initiate interventions. Additional studies are needed to confirm the numbers in a larger cohort of patients, to examine the prevalence during the course of disease, to search for potential influences on the outcome (i.e., via adherence), and to extract the best interventions.
Collapse
|