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Peng HL, Chen YH, Lee HY, Tsai WY, Chang YL, Lai YH, Chen SC. Factors associated with shame and stigma among head and neck cancer patients: a cross-sectional study. Support Care Cancer 2024; 32:357. [PMID: 38750287 DOI: 10.1007/s00520-024-08568-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 05/10/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Head and neck cancer (HNC) patients often suffer from shame and stigma due to treatment limitations or due to societal factors. The purpose of this study was to assess perceived body image, depression, physical and psychosocial function, and self-stigma, as well as to identify factors that predicted shame and stigma in patients with HNC. METHODS This cross-sectional study recruited 178 HNC patients from the outpatient radiation department of a medical center in Northern Taiwan. Patients were assessed for patient reported outcomes using the Body Image Scale (BIS), the Hospital Anxiety and Depression Scale-Depression Subscale (HADS-Depression Subscale), the University of Washington Quality of Life Scale (UW-QOL) version 4.0, and the Shame and Stigma Scale (SSS). Data were analyzed by descriptive analysis, Pearson's product-moment correlation, and multiple regression. RESULTS The two top-ranked subscales of shame and stigma were: "speech and social concerns" and "regret". Shame and stigma were positively correlated with a longer time since completion of treatment, more body image concerns, and higher levels of depression. They were negatively correlated with being male and having lower physical function. Multiple regression analysis showed that female gender, a longer time since completing treatment, higher levels of body image concern, greater depression, and less physical function predicted greater shame and stigma. These factors explained 74.7% of the variance in shame and stigma. CONCLUSION Patients' body image concerns, depression, time since completing treatment, and physical function are associated with shame and stigma. Oncology nurses should assess and record psychological status, provide available resources, and refer appropriate HNC patients to counselling.
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Affiliation(s)
- Hsi-Ling Peng
- Department of Nursing, Asia Eastern University of Science and Technology, Taipei, Taiwan
| | - Yen-Hui Chen
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Han-Yen Lee
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Ying Tsai
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ya-Lan Chang
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, 1 Jen-Ai Rd., Sec. 1, Taipei, 100, Taiwan.
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Shu-Ching Chen
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- School of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1 Road, Guishan, Taoyuan, 333, Taiwan.
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Zhu J, Tan CX, Guo JY, Yang RH, Ye M. A qualitative study on experiences of stigma among postoperative oral cancer patients. Support Care Cancer 2024; 32:286. [PMID: 38613655 DOI: 10.1007/s00520-024-08491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 04/07/2024] [Indexed: 04/15/2024]
Abstract
AIM This study aimed to explore the characteristics of stigma in postoperative oral cancer patients to provide a reference for the formulation of targeted intervention measures. METHODS A qualitative study was conducted on 25 postoperative oral cancer patients in a tertiary A hospital in Hunan, China, from March to July 2021. Semi-structured face-to-face interviews focused on experiences of stigma were performed. The interview data was analyzed using the NVivo V.12 software based on the reflexive intuitive thematic analysis method. The paper complies with the COREQ. RESULTS The stigma experience of postoperative oral cancer patients can be divided into 3 themes: (1) triggers (impaired appearance and oral function and psycho-social pressure); (2) forms (overall isolation, unpleasant feeling of inferiority, and unpleasant social discrimination); (3) coping strategies (positive psychological adjustment, seeking social support and coming out of the unpleasant shadows). CONCLUSION Postoperative oral cancer patients clearly articulated that stigma was present in their lives and they experienced multiple forms of stigma. Further work is needed to increase education and awareness about oral cancer to guide them to take positive coping and reduce stigma.
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Affiliation(s)
- Jie Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
- Xiangya Nursing School of Central South University, Changsha, 410013, Hunan, China
| | - Chu-Xia Tan
- Xiangya Nursing School of Central South University, Changsha, 410013, Hunan, China
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China
| | - Jia-Yi Guo
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
- Xiangya Nursing School of Central South University, Changsha, 410013, Hunan, China
| | - Rong-Hong Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
- Intensive Care Unit of Stomatology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Man Ye
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
- Xiangya Nursing School of Central South University, Changsha, 410013, Hunan, China.
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Chung CF, Huang BS, Wang YM, Huang YT, Chen SC. Quality of life in patients with nasopharyngeal carcinoma receiving IMRT vs IMPT: a multicenter prospective longitudinal study. Support Care Cancer 2024; 32:203. [PMID: 38430411 DOI: 10.1007/s00520-024-08412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/26/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE Nasopharyngeal carcinoma (NPC) patients may experience symptom distress and depression during and after radiation therapy, which negatively impacts quality of life (QOL). We sought to identify trajectories of symptom distress, depression, social support, and QOL in patients with NPC receiving intensity-modulated radiation therapy (IMRT) vs intensity-modulated proton therapy (IMPT). METHODS A multicenter prospective longitudinal study recruited NPC patients from two leading medical centers in Taiwan. The 121 NPC patients were followed from before RT (T0), at 4 weeks after beginning RT (T1), at 6 weeks of RT or the end of treatment (T2), and at 4 weeks post-RT (T3). Generalized estimating equation analysis was used to identify the factors related to QOL. RESULTS Patients' symptom distress and depression increased from T0, peaked at T2, and decreased at T3. Physical-QOL and psychosocial-QOL decreased from T0 to T2, then increased by T3. Patients who had early-stage cancer, received a lower RT dose, had less symptom distress, and had less depression were more likely to have better QOL. Greater physical-QOL was associated with IMPT receipt, higher education level, early cancer stage, lower radiation dose, less symptom distress, and less depression. Patients who had good physical performance, received a lower radiation dose, had less symptom distress, and had less depression were more likely to have better psychosocial-QOL. CONCLUSION Radiation dose, symptom distress, and depression were the most important factors affecting QOL in patients with NPC. Understanding the factors associated with the trajectory of QOL can guide care during radiation treatment.
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Affiliation(s)
- Ching-Fang Chung
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Bing-Shen Huang
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
- Department of Radiation Oncology, and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Yu-Ming Wang
- Department of Radiation Oncology, and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
- Department of Medicine, College of Medicine, Chang Gung University, Kaohsiung, Taiwan, Republic of China
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Shu-Ching Chen
- Department of Radiation Oncology, and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, Republic of China.
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
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Lee LH, Yang CI, Chen MK, Hsieh MY, Chen YJ. Exploring return to work for patients with head and neck cancer. Work 2024; 77:231-241. [PMID: 37638463 DOI: 10.3233/wor-220707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND The number of survivors of head and neck cancer (HNC) has steadily increased due to major advances in cancer care. However, cancer survivors who experience job loss face different challenges regarding return to work (RTW). Relatively few studies have integrated the experience encountered by patients. OBJECTIVE This mixed-methods study aimed to explore the experience and challenges of RTW in patients with HNC. METHODS Data were collected with structured questionnaires (n = 120) and semi-structured face-to-face interviews (n = 12). RESULTS Relationships were found between patient's physical status, perceived stress, and social support. Patients who continued work, or not, had significant differences in reported physical function and stress. Four themes emerged from the qualitative data, including the perceived meaning of work, challenges for RTW, preparing for RTW, and social support. After diagnosis and treatment, patients perceived the meaning of work, such as personal value, responsibility, and financial need. They faced many challenges to RTW, including declining physical strength, workload, schedule rearrangement, speech difficulty, and changed appearance. In order to RTW, they prepared extensively and needed support from family and friends. CONCLUSION This study revealed the experiences and challenges of RTW patients with HNC. The results allowed us to identify patients' concerns and ways that healthcare providers could improve the RTW process. Future studies may develop tailored approaches for RTW in healthcare and government policies.
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Affiliation(s)
- Li-Hung Lee
- Department of Nursing, Hung Kuang University, Taichung, Taiwan
| | - Cheng-I Yang
- Department of Nursing, Hung Kuang University, Taichung, Taiwan
| | - Mu-Kuan Chen
- Department of Otorhinolaryngology - Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ming-Yu Hsieh
- Department of Otorhinolaryngology - Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Yen-Ju Chen
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
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Chang YL, Huang BS, Lin CY, Chung CF, Chen SC. Effects of a return to work program on the health and barriers to returning to work in head and neck cancer patients: A randomized controlled trial. Asia Pac J Oncol Nurs 2023; 10:100320. [PMID: 38059206 PMCID: PMC10696387 DOI: 10.1016/j.apjon.2023.100320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/11/2023] [Indexed: 12/08/2023] Open
Abstract
Objective The aim of the study was to evaluate the effects of a return to work (RTW) program on perceived health status, barriers to returning to work, fear of cancer progression, social support, physical function, and psychosocial function in head and neck cancer (HNC) patients. Methods A randomized controlled trial with repeated measures was conducted. The 70 HNC patients were randomly assigned into two groups: 35 in the experimental group (RTW) and 35 in the control group (usual care). Patients were assessed at four time points: baseline (T0) (6 months after completing treatment), and then at 9-, 12-, and 15-months (T1, T2, and T3, respectively) after completing treatment. Patients completed a self-reported questionnaire, including measures of perceived health status, barriers to returning to work, fear of cancer progression, social support, physical function, and psychosocial function. Results Patients in the experimental group had significantly greater perceived health status and better psychosocial function compared to those in the control group. Compared to T0, at T4, participants in both groups had significantly lower levels of barriers to returning to work, fear of cancer progression, social support, and higher levels of physical function. Conclusions The RTW program effectively improved perceived health status and psychosocial function in HNC patients. Survivorship care should include a transitional return-to-work program to help patients transition back to work. Trial registration NCT04322695.
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Affiliation(s)
- Ya-Lan Chang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Bing-Shen Huang
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Fang Chung
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Tsai PL, Wang CP, Fang YY, Chen YJ, Chen SC, Chen MR, Ko JY, Lin JJ, Lou PJ, Lai YH. Return to work in head and neck cancer survivors: its relationship with functional, psychological, and disease-treatment factors. J Cancer Surviv 2023; 17:1715-1724. [PMID: 35900687 DOI: 10.1007/s11764-022-01224-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Return to work (RTW) is important for survivors of head and neck cancer (HNC). The purposes of the study were to investigate the RTW ratio among HNC survivors and identify factors significantly affecting RTW in this population. METHODS A cross-sectional study with consecutive sampling was conducted in a medical center in Taiwan, with 111 patients with HNC who had completed major treatments within 5 years and were employed before their cancer diagnosis enrolled as participants. Cervical range of motion (CROM) functionality, handgrip and hip flexor strength, maximal mouth opening (MMO), selected symptoms, depression, and disease/treatment-related factors were assessed. All of the factors were analyzed using t-test, chi-square test, and multiple logistic regression. RESULTS Less than half (44.1%, n = 49) of the participants had returned to work. The t-test/chi-square test results showed the RTW group to be younger in age and better educated; have better handgrip/hip flexor strength, MMO, and CROM; have less speech difficulty and pain; and have less-advanced cancer than the non-RTW group. Further analysis of the above significant variables by logistic regression revealed early cancer stage, dominant handgrip strength, and less speech difficulty were the robust factors related to RTW. CONCLUSIONS The RTW ratio is low in HNC survivors. RTW in HNC survivors is a multifactorial and complicated issue and needs to be further examined. IMPLICATIONS FOR CANCER SURVIVORS Assessing the factors related to RTW systematically and developing comprehensive interventions and rehabilitation programs to reduce related dysfunctions are necessary to enhance RTW ability in HNC survivors.
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Affiliation(s)
- Pi-Ling Tsai
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chen-Ping Wang
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan
| | - Yuan-Yuan Fang
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Ju Chen
- Department of Nursing, College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
| | - Shu-Ching Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Min-Ru Chen
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jenq-Yuh Ko
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan
| | - Jiu-Jenq Lin
- College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Jen Lou
- College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan.
- College of Medicine, National Taiwan University, Taipei, Taiwan.
- National Taiwan University Cancer Center, Taipei, Taiwan.
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Tiblom Ehrsson Y, Kisiel MA, Yang Y, Laurell G. Predicting Return to Work after Head and Neck Cancer Treatment Is Challenging Due to Factors That Affect Work Ability. Cancers (Basel) 2023; 15:4705. [PMID: 37835399 PMCID: PMC10571884 DOI: 10.3390/cancers15194705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Striving to return to work is of great importance to many cancer survivors. The purpose of the study is to prospectively investigate the factors that hinder and facilitate return to work (RTW) at 3 and 12 months after the end of treatment in head and neck cancer (HNC) survivors and whether these factors influence the ability to continue working after treatment. Participants (n = 227) aged ≤ 65 years at diagnosis with HNC were included. Data were collected before the start of treatment and at 3 and 12 months after the end of treatment. The Rubin causal model was used for statistical analysis. Within the 3-month follow-up period, 92 participants had RTW and 30 had retired. At the 12-month follow-up, 80 of these participants were still working, another 51 participants had RTW, and five participants working still suffered from cancer. The hindrance to RTW within 3 months was advanced tumour stage (stage III and IV) (p = 0.0038). Hindrances to RTW at the 12-month follow-up were oral cancer (p = 0.0210) and larynx cancer (p = 0.0041), and facilitators were living in a relationship (p = 0.0445) and a white-collar job (p = 0.00267). Participants with early tumour stage (stage I and II) (p = 0.0019) and a white-collar job (p = 0.0185) had earlier RTW. The conclusion is that disease factors were the most important hindrances to RTW, and type of work and living with a spouse or partner were nonclinical factors influencing RTW.
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Affiliation(s)
- Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85 Uppsala, Sweden;
| | - Marta A. Kisiel
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden;
| | - Yukai Yang
- Department of Statistics, Uppsala University, 751 20 Uppsala, Sweden;
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85 Uppsala, Sweden;
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Zhang Y, Wang Y, Wu A, Tao X, Li M, Yan D, Wen F, Hou L. The Prevalence and Determinants of Return to Work in Head and Neck Cancer Survivors: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:418-431. [PMID: 36689058 DOI: 10.1007/s10926-022-10090-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Yuanyuan Zhang
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Yueping Wang
- Shanghai JiaoTong University School of Medicine Affiliated Ninth People's Hospital, No.639 Zhizaoju Road, Shanghai, China
| | - Anqi Wu
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
- Shanghai JiaoTong University School of Medicine Affiliated Shanghai Children ' s Medical Center, No.1678 Dongfang Road, Shanghai, China
| | - Xingjuan Tao
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Mengyao Li
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Dexiu Yan
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Fule Wen
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Lili Hou
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China.
- Shanghai JiaoTong University School of Medicine Affiliated Ninth People's Hospital, No.639 Zhizaoju Road, Shanghai, China.
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Lee LY, Huang BS, Lin CY, Su YH, Chung CF, Chang YL, Chen SC. Effects of a Nurse-led Survivorship Care Program on the Health and Resilience of Primary Caregivers of Patients With Advanced Head and Neck Cancer: A Randomized Controlled Trial. Semin Oncol Nurs 2023; 39:151425. [PMID: 37055297 DOI: 10.1016/j.soncn.2023.151425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVES The present study aimed to evaluate the effects of a nurse-led survivorship care program (SCP) on emotional distress, social support, physical health, mental health, and resilience in primary caregivers of patients with advanced head and neck cancer. DATA SOURCES A randomized controlled trial was conducted. One hundred patient-primary caregiver dyads were randomized into the nurse-led SCP group (experimental) or the usual care group (control). Participants completed a self-reported questionnaire, including measures of emotional distress, social support, physical health, mental health, and resilience. After 6 months, the experimental group reported a significant improvement in emotional distress, social support, physical health, mental health, and resilience. Compared with the control group, measures of emotional distress, physical health, overall resilience, and the resilience aspects of equanimity and perseverance improved in the experimental group. CONCLUSION An SCP may feasibly help alleviate emotional distress, improve social support, increase physical and mental health, and strengthen resilience in the primary caregivers of patients with head and neck cancer. Health care providers should encourage primary caregivers to join an SCP. IMPLICATIONS FOR NURSING PRACTICE The nurse-led SCP can be applied before patients complete treatment, which may increase the positive effect on physical health and adaptation.
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Affiliation(s)
- Li-Yun Lee
- Associate Professor, Department of Nursing, College of Nursing and Health Sciences, DaYeh University, Changhua, Taiwan; Associate Professor, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Chaiyi, Taiwan
| | - Bing-Shen Huang
- Attending Physician, Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Associate Professor, Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Attending Physician, Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Associate Professor, Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Hui Su
- Head Nurse, Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Fang Chung
- Case Manager, Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ya-Lan Chang
- Case Manager, Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Professor, School of Nursing and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Research Fellow, Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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10
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Zecena Morales C, Lisy K, McDowell L, Piper A, Jefford M. Return to work in head and neck cancer survivors: a systematic review. J Cancer Surviv 2023; 17:468-483. [PMID: 36396907 DOI: 10.1007/s11764-022-01298-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Cancer survivors face higher rates of unemployment compared with individuals without a history of cancer. Compared to other cancer types, head and neck cancer (HNC) survivors face unique disease and treatment-specific issues that may limit return to work (RTW). This review aimed to determine employment outcomes of HNC survivors post-treatment and identify factors associated with RTW. METHODS A systematic search was conducted in MEDLINE, CINAHL and PsycINFO in December 2021. Inclusion criteria included adults (≥ 18 years); completed treatment for HNC; data available on RTW post-treatment. Both quantitative and qualitative studies were considered. Studies were critically appraised and data synthesised narratively. RESULTS Twenty-nine publications were included: 22 quantitative, four qualitative and three mixed methods. The proportion of HNC survivors who RTW ranged from 32 to 90%, with participants taking 3.6-11 months to RTW. Working in a professional role and having a supportive work environment were positively associated with RTW. CONCLUSIONS The proportion of HNC survivors who RTW varies significantly which may be due to the heterogeneity between the studies including difference in clinical characteristics of the participants and/or sample size. Future studies that are longitudinal, adequately powered and measure a range of clinical and demographic variables are needed to better understand the RTW experience and assist development of effective RTW strategies. IMPLICATIONS FOR CANCER SURVIVORS This review suggests potential areas for intervention, including enhanced symptom management and engaging with employers to foster supportive work environments to support RTW of HNC survivors.
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Affiliation(s)
- Claudia Zecena Morales
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
| | - Lachlan McDowell
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Amanda Piper
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia.
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11
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Zhang D, Wang J, Tao Z, Shi Y, Wang H, Chang T, Jiang X, Li X. Factors influencing employment rates and states after liver transplantation in China: A multi-centre cross-sectional study. Nurs Open 2023; 10:2582-2592. [PMID: 36448338 PMCID: PMC10006614 DOI: 10.1002/nop2.1517] [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: 10/13/2021] [Revised: 10/06/2022] [Accepted: 11/20/2022] [Indexed: 12/02/2022] Open
Abstract
AIM The aim of this study was to assess employment rates and states and the factors influencing liver transplant recipients in China. DESIGN A cross-sectional study. METHODS A total of 212 liver transplant recipients were included in this study. Questionnaires for general situation information and the Hospital Anxiety and Depression Scale, Perceived Social Support Scale and Chronic Disease Self-Efficacy Scale were used. RESULTS Among the liver transplantation, 212 recipients were included in the study, 125 (59%) were employed after liver transplantation compared with 148 (69.8%) who were employed before liver transplantation. Among the 125 recipients that returned to work, only 38.2% thought their employment states were good before liver transplantation, while 81.6% thought that their employment states were good after liver transplantation. Gender, age and employment status before transplantation, aetiology of liver disease, number of physical activities, per capita monthly income, comorbidity and depression were significantly associated with return to work. Self-efficacy, social support, liver function and nature of work were significantly associated with employment state.
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Affiliation(s)
- Dan Zhang
- Nursing Department, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jing Wang
- Nursing Department, Tianjin First Central Hospital, Tianjin, China
| | - Zijun Tao
- Nursing Department, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ying Shi
- Nursing Department, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Huili Wang
- Nursing Department, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Tiantian Chang
- Nursing Department, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaoyu Jiang
- Nursing Department, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaofei Li
- Transplantation and Hepatobiliary Department, the First Hospital of China Medical University, Shenyang, Liaoning, China
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12
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Factors in oral-related quality of life of betel quid users receiving oral mucosal screening: a cross‑sectional study in Taiwan. BMC Oral Health 2023; 23:88. [PMID: 36782200 PMCID: PMC9924842 DOI: 10.1186/s12903-023-02800-x] [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: 10/15/2022] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Betel quid (BQ) chewing is associated with poor oral hygiene, psychological impairment, and acute and long-term addictive effects, resulting in worse oral-related quality of life (OHRQoL). The purpose of this study was to characterize the factors associated with OHRQoL among BQ users receiving oral mucosal screening. METHODS A cross-sectional study was conducted. Data were collected by random sampling of BQ users who visited outpatient departments receiving oral mucosal screening in a medical center Taiwan. The oral health assessment tool, the state anxiety inventory, the betel quid dependence scale, and the oral health impact profile were used to measure oral health status, anxiety, BQ dependence, and OHRQoL, respectively. Pearson's product-moment coefficient was used to examine the relationship between OHRQoL and the selected independent variables. Independent-samples t-test was used to compare OHRQoL by annual family income, the presence of chronic disease, and BQ dependence. Hierarchical multiple linear regression analysis was used to identify factors associated with OHRQoL. RESULTS A total of 175 BQ users were surveyed. Factors associated with OHRQoL included oral health status, anxiety, and BQ dependence. BQ users reporting low oral health status, greater anxiety, and more BQ dependence were more likely to have worse OHRQoL. CONCLUSIONS Poor oral health status, anxiety, and BQ dependence negatively impact on OHRQoL among patients with BQ use receiving oral mucosal screening.
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13
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Bernstein RT, Garner-Purkis A, Gallagher JE, Newland-Pedley, Scambler S. A systematic review of social impacts of treatment and rehabilitation of head and neck cancer patients. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2023. [DOI: 10.1016/j.adoms.2023.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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14
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Chiu SE, Cho KA, Huang BS, Lin CY, Chung CF, Chang YL, Chen SC. Factors Facilitating or Creating Barriers to Returning to Work in Head and Neck Cancer Patients Within the First 6 Months After Treatment. Clin Nurs Res 2023; 32:197-208. [PMID: 35833270 DOI: 10.1177/10547738221106292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Head and neck cancer (HNC) patients who are unable to return to work after completing treatment might face financial loss and reduced self-esteem. The aim of this study was to identify factors influencing a return to work in HNC cancer patients in the first 6 months after treatment. This cross-sectional study examined HNC patients who completed treatment from the outpatient radiation department of a single cancer center in northern Taiwan. Patients were assessed according to psychological distress, patient-perceived health status, barriers to returning to work, and facilitators of returning to work. Of the 106 HNC patients surveyed, 54.7% successfully returned to work. Barriers to returning to work included poor self-perception of health, greater psychological distress, and age ≥50 years. Patients who had higher psychological distress, returned to work after start of the pandemic, or received reconstruction surgery were less likely to experience a positive environment facilitating a return to work.
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Affiliation(s)
- Su-Erh Chiu
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuei-An Cho
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Bing-Shen Huang
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Fang Chung
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ya-Lan Chang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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15
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Yu J, Smith J, Marwah R, Edkins O. Return to work in patients with head and neck cancer: Systematic review and meta-analysis. Head Neck 2022; 44:2904-2924. [PMID: 36121026 PMCID: PMC9826518 DOI: 10.1002/hed.27197] [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: 03/11/2022] [Revised: 08/05/2022] [Accepted: 08/31/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The aim of this review was to determine the prevalence of return to work (RTW) amongst head and neck cancer (HNC) survivors and to determine its impact on quality of life (QoL). METHODS A literature search was conducted in PubMed, Scopus, Embase and CINAHL in March 2021. Articles were included if they reported the number of patients with HNC receiving definitive treatment who were working at the time of diagnosis and returned to work. RESULTS There were 21 articles deemed eligible for inclusion. Meta-analysis suggested that 67% of patients with HNC who were employed at diagnosis RTW (95% CI 62%-73%, I2 = 97.53%). Patients who RTW were demonstrated to have lower levels of anxiety and depressive symptoms on the Hospital Anxiety and Depression Scale. CONCLUSIONS Return to work is an important clinical outcome which must be considered in the survivorship care of patients with HNC.
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Affiliation(s)
- Justin Yu
- Townsville University HospitalTownsvilleQueenslandAustralia,Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Justin Smith
- Townsville University HospitalTownsvilleQueenslandAustralia,James Cook UniversityCollege of Medicine and DentistryTownsvilleAustralia
| | - Ravi Marwah
- Townsville University HospitalTownsvilleQueenslandAustralia,James Cook UniversityCollege of Medicine and DentistryTownsvilleAustralia
| | - Oskar Edkins
- Townsville University HospitalTownsvilleQueenslandAustralia
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16
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Abstract
Over the past decade, cancer incidence has increased globally while its mortality has decreased. Accordingly, healthcare practitioners aim to provide comprehensive care to cancer patients. The biopsychosocial model suggests medical professionals' understanding of how psychosocial factors influence the entire course of cancer is critical. However, until now, an integrative review summarising the full scope of these psychosocial domains has been lacking. This review substantiates that cancer patients, survivors, their caregivers, and oncology professionals face substantial psychosocial challenges. Cancer patients and survivors may experience deterioration of self-concept, disturbance of body image, sexual problems and difficulties in social relationships while attempting to cope with casual issues. The burdens of care provision and the impact on the health of caregivers of cancer patients are also noteworthy. Improving the quality of patient-doctor communication and overcoming burnout are significant challenges for oncology healthcare professionals.
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Affiliation(s)
- Youyang Wang
- Department of Psychological Medicine, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China
| | - Wei Feng
- Department of Psychological Medicine, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China
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17
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Factors influencing family function in spousal caregivers of head and neck cancer patients within 6 months posttreatment. Support Care Cancer 2022; 30:7313-7322. [PMID: 35606476 DOI: 10.1007/s00520-022-07158-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Spousal caregiving of head and neck cancer (HNC) patients challenges relationship quality and may negatively impact family function. Our purpose was to identify factors associated with family dysfunction in spousal caregivers (SCs) of HNC patients within the first 6 months after treatment. We explored whether patient or SC characteristics differ by level of family dysfunction. METHODS We conducted a cross-sectional study of HNC patient-SC dyads in Taiwan from July 2020 to January 2022 using patient-reported outcomes. Patients were assessed using a set of structured questionnaires to measure performance status, demographic and clinical characteristics, physical function, and social-emotional function. SCs were measured on their hardiness, coping styles, spousal relationship, quality of life, and family function. RESULTS Of the 132 dyads surveyed, 62.1% of SCs reported a functional family, 34.8% reported a moderately dysfunctional family, and 3.0% reported a highly dysfunctional family. Patient factors associated with family dysfunction (highly dysfunctional or moderately dysfunctional) included lower family annual income and worse social-emotional function. Associated SC factors were lower hardiness, less use of active coping, and worse spousal relationships. CONCLUSIONS Lower family annual income, less patient social-emotional function, less SC hardiness, less SC active coping, and worse SC perceived spousal relationship were associated with perceived family dysfunction. Providing patient-SC dyads with sufficient social resources and problem-solving training may help them positively cope with cancer and enhance family function.
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18
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Factors impacting posttraumatic growth in head-and-neck cancer patients with oncologic emergencies. Support Care Cancer 2022; 30:4515-4525. [PMID: 35112211 DOI: 10.1007/s00520-021-06772-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To identify factors associated with posttraumatic growth (PTG) of head-and-neck cancer squamous cancer (HNC) patients with oncologic emergencies (OE) within the first six months post-treatment. METHODS We conducted a cross-sectional study of HNC patients in Taiwan from May 2019 to April 2021 using patient-reported outcomes. Patients were assessed for symptom distress, anxiety, fear of recurrence (FCR), and PTG. Multiple regression analysis was conducted to identify factors associated with PTG. The independent-samples t-test was used to compare PTG and its five specific domains in patients with low FCR, high FCR, low anxiety, and high anxiety. RESULTS Of the 114 patients surveyed, 46.5% reported little-to-no PTG, and 53.5% had moderate-to-high PTG. Greater PTG was associated with greater FCR, longer time since OE, less anxiety, having a cancer recurrence, and greater educational attainment. These factors explained 38.6% of the variance in PTG. CONCLUSION A notable proportion of HNC patients with OE-reported PTG but almost half-reported little-to-no PTG. PTG occurred most in the domain of appreciation of life. The study results also suggest that training patients in coping skills and inviting them to group growth experiences can help them increase PTG and cope with cancer-related psychological threats related to OE.
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19
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Lee LY, Huang BS, Lin CY, Chung CF, Chang YL, Chen SC. Trajectories of resilience and related factors in primary caregivers of patients with advanced head and neck cancer: A longitudinal cohort study. J Nurs Scholarsh 2021; 54:191-201. [PMID: 34773378 DOI: 10.1111/jnu.12728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 10/07/2021] [Accepted: 10/15/2021] [Indexed: 01/23/2023]
Abstract
PURPOSE Primary caregivers (PC) of patients with advanced head and neck cancer (HNC) report stress during caregiving time post-treatment. We sought to identify the trajectories of resilience from initial completion of treatment to 1-year post-treatment in PC of patients with advanced HNC and to determine the factors associated with trajectories of resilience. DESIGN In this prospective cohort study with convenience sampling, patient-PC dyads were recruited from a medical center in northern Taiwan between August 2015 and July 2020. METHODS We recruited 120 patient-PC dyads and followed up at treatment completion and 1, 6, and 12 months post-treatment. Generalized estimating equation analysis was performed to identified factors related to resilience. FINDINGS PCs' overall resilience increased from initial completion of treatment to peak at 1-year post-treatment. Patient factors associated with greater overall resilience included older age, higher performance status, and shorter time since cancer diagnosis; PC factors included reporting more social support, better physical health, and better mental health. CONCLUSIONS PC mental health was the most important factor in the resilience trajectory of patients with advanced HNC cancer. CLINICAL RELEVANCE Quantifying the relevant factors of trajectories of resilience will help to identify vulnerable PCs and guide survivorship care in the early stages of the post-treatment period.
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Affiliation(s)
- Li-Yun Lee
- Department of Nursing, College of Nursing and Health Sciences, DA-YEH University, Changhua, Taiwan, Republic of China
| | - Bing-Shen Huang
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Chien-Yu Lin
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Ching-Fang Chung
- Case Manager, Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Ya-Lan Chang
- Case Manager, Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Shu-Ching Chen
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.,School of Nursing and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, Republic of China.,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
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20
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Tan CJ, Yip SYC, Chan RJ, Chew L, Chan A. Investigating how cancer-related symptoms influence work outcomes among cancer survivors: a systematic review. J Cancer Surviv 2021; 16:1065-1078. [PMID: 34424498 PMCID: PMC9489549 DOI: 10.1007/s11764-021-01097-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/09/2021] [Indexed: 01/07/2023]
Abstract
Purpose The purpose of this study is to investigate how different cancer-related symptoms influence work outcomes among cancer survivors. Methods A literature search was performed in PubMed, EMBASE, CINAHL, PsycINFO, and Scopus to identify studies published between 1st January 1999 and 30th October 2020 that investigated the impact of specific cancer-related symptoms on work outcomes among cancer survivors who have completed primary antineoplastic treatment. Study findings were extracted and grouped by symptoms and work outcomes, allowing comparison of associations between these outcomes. Results Seventy-three articles representing 68 studies were eligible for inclusion. From these studies, 27 cancer-related symptoms, 9 work outcomes, and 68 unique associations between specific symptoms and work outcomes were identified. Work status (return to work and employment rates) was most commonly studied, and symptom burden was mainly measured from the patient’s perspective. Higher symptom burden was generally associated with trends of poorer work outcomes. Significant associations were reported in most studies evaluating body image issues and work status, oral dysfunction and work status, fatigue and work ability, and depression and work ability. Conclusion Several cancer-related symptoms were consistently associated with inferior work outcomes among cancer survivors. Body image issues and oral dysfunction were shown to be associated with poorer employment rates, while fatigue and depression were linked to lower levels of work performance. Implications for Cancer Survivors Failure to return to work and decreased productivity post-cancer treatment can have negative consequences for cancer survivors and society at large. Findings from this review will guide the development of work rehabilitation programs for cancer survivors. Protocol registration PROSPERO identifier CRD42020187754 Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01097-5.
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Affiliation(s)
- Chia Jie Tan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lita Chew
- Department of Pharmacy, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
| | - Alexandre Chan
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore. .,Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, 101 Theory, Suite 100, Irvine, CA, 92612, USA.
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21
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Tseng YT, Hsieh CH, Hung CW, Chen CC, Lee SH, Lee LY, Chen SC. Supportive Care and Unmet Needs in Upper Gastrointestinal Cancer Patients: Screening and Related Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158124. [PMID: 34360415 PMCID: PMC8345742 DOI: 10.3390/ijerph18158124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 01/02/2023]
Abstract
Upper gastrointestinal (UGI) cancer treatment can cause physical and psychological distress and may result in unmet needs. The purposes of this study were to (1) examine the levels of gastrointestinal (GI) symptom distress, social support, and supportive care needs; (2) screen the priorities of unmet supportive care needs; and (3) identify the factors associated with supportive care needs among UGI cancer patients receiving chemotherapy. This cross-sectional study examined UGI cancer patients who received treatment from the outpatient chemotherapy department of a single cancer center in northern Taiwan. Questionnaires were used to collect data regarding GI symptom distress, social support, unmet needs, and supportive care needs. The top three unmet needs were "fears about the cancer spreading", "uncertainty about the future", and "being informed about things you can do to help yourself to get well". Descriptive statistics examined the levels of GI symptom distress, social support, supportive care needs, and priorities of unmet supportive care needs. Stepwise regression was conducted to determine significant factors related to supportive care needs. Greater supportive care needs were found to be associated with higher levels of disease-related worries, increased treatment-related symptoms, and a lower level of physical performance. These factors explained 48.0% of the variance in supportive care needs. Disease-related worries and treatment-related symptoms strongly influence overall supportive care needs and each domain of supportive care needs. Symptom management and psychological support for patients receiving outpatient chemotherapy may help patients meet needs.
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Affiliation(s)
- Ya-Ting Tseng
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-T.T.); (C.-W.H.); (C.-C.C.); (S.-H.L.)
| | - Chia-Hsun Hsieh
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan;
- Division of Hematology/Oncology, Department of Internal Medicine, New Taipei Municipal Tucheng Chang Gung Memorial Hospital, New Taipei 236, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chien-Wei Hung
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-T.T.); (C.-W.H.); (C.-C.C.); (S.-H.L.)
| | - Chia-Chia Chen
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-T.T.); (C.-W.H.); (C.-C.C.); (S.-H.L.)
| | - Shu-Hui Lee
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-T.T.); (C.-W.H.); (C.-C.C.); (S.-H.L.)
| | - Li-Yun Lee
- Department of Nursing, College of Nursing and Health Sciences, Da-Yeh University, Changhua 515, Taiwan;
| | - Shu-Ching Chen
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- Correspondence:
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22
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Chen YJ, Lai YH, Lee YH, Tsai KY, Chen MK, Hsieh MY. Impact of illness perception, mental adjustment, and sociodemographic characteristics on return to work in patients with head and neck cancer. Support Care Cancer 2020; 29:1519-1526. [PMID: 32720008 DOI: 10.1007/s00520-020-05640-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/17/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE To examine the effects of emotional distress, illness perception, and mental adjustment on return to work (RTW) among patients with head and neck cancer (HNC) and identify factors associated with RTW. METHODS A cross-sectional study with convenience sampling was conducted in Taiwan. Structured questionnaires were used to collect data on RTW status and to explore possible factors related to RTW. RTW status was assessed by a single question. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, illness perception was assessed by the Brief Illness Perception Questionnaire, and mental adjustment was assessed using the Mini-mental Adjustment to Cancer Scale. Sociodemographic and disease background data were also collected and analyzed. Factors related to RTW were identified by multivariate logistic regression. RESULTS A total of 150 patients with HNC were recruited into the study. Of them, 58 (38.7%) returned to work after treatment. Compared to those who did not RTW, patients who did RTW had lower levels of emotional distress (anxiety and depression), better illness perception (cognitive illness representations and illness comprehensibility), and better mental adjustment (hopelessness and helplessness, anxious preoccupation, avoidance, and fatalism). Multivariable analysis indicated that anxiety (OR = 0.863, p < 0.05), avoidance (OR = 1.280, p < 0.001), cognitive illness representations (OR = 0.891, p < 0.01), illness comprehensibility (OR = 1.271, p < 0.05), higher education level (OR = 3.048-3.609, p < 0.05), married status (OR = 5.220, p < 0.05), tumor site in oral cavity (OR = 5.057, p < 0.05), and no reconstruction (OR = 3.415, p < 0.05) were significantly associated with RTW. CONCLUSION The issue of RTW among patients with HNC is related to multidimensional factors, including sociodemographic, psychological, and disease-related situations. We suggest that programs for emotional rehabilitation and occupational counseling need to be developed to assist patients with HNC to RTW at an early stage.
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Affiliation(s)
- Yen-Ju Chen
- Department of Nursing, Da-Yeh University, Changhua, Taiwan.
| | - Yeur-Hur Lai
- Department of Nursing, College of Medicine, National Taiwan University & Hospital, Taipei, Taiwan
| | - Yun-Hsiang Lee
- Department of Nursing, College of Medicine, National Taiwan University & Hospital, Taipei, Taiwan
| | - Kuo-Yang Tsai
- Department of Nursing, Da-Yeh University, Changhua, Taiwan.,Department of Otorhinolaryngology - Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Mu-Kuan Chen
- Department of Oral and Maxillofacial Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Yu Hsieh
- Department of Oral and Maxillofacial Surgery, Changhua Christian Hospital, Changhua, Taiwan
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23
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Chen SC, Huang BS, Hung TM, Lin CY, Chang YL, Chung CF. Factors Associated With Resilience Among Primary Caregivers of Patients With Advanced Cancer Within the First 6 Months Post-Treatment in Taiwan: A Cross-Sectional Study. J Nurs Scholarsh 2020; 52:488-496. [PMID: 32649038 DOI: 10.1111/jnu.12582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To identify factors associated with resilience in primary caregivers of patients with advanced oral cavity cancer within the first 6 months post-treatment. DESIGN A cross-sectional study. METHODS We recruited patient-primary caregiver dyads from the outpatient radiation department of a medical center in Northern Taiwan. Patients were assessed using a set of structured questionnaires to measure performance status and demographic and clinical characteristics. Primary caregivers were measured in their social support, resilience, and care characteristics. RESULTS Of the 148 dyads surveyed, 33.8% of primary caregivers reported moderately low to moderate resilience, and 61.5% reported low resilience. Greater resilience of primary caregivers was associated with the primary caregiver factors of younger age, lower educational level, and more affectionate social support; and greater resilience was associated with the patient factors of better performance status and older age. These factors explained 40.4% of the variance in resilience. CONCLUSIONS Patients' performance status and primary caregivers' affectionate social support strongly influence overall resilience and each domain of resilience. CLINICAL RELEVANCE Providing primary caregivers with sufficient social resources and a support group can help them cope with the demands of caregiving for loved ones with oral cavity cancer.
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Affiliation(s)
- Shu-Ching Chen
- Lambada Beta-At-Large, Professor, School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, and Professor, School of Nursing, College of Medicine, Chang Gung University, and Research Fellow, Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, all in Taoyuan, Taiwan, Republic of China
| | - Bing-Shen Huang
- Attending Physician, Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, and Assistant Professor, Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, both in Taoyuan, Taiwan, Republic of China
| | - Tsung-Min Hung
- Attending Physician, Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Chien-Yu Lin
- Attending Physician, Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, and Associate Professor, Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, both in Taoyuan, Taoyuan, Taiwan, Republic of China
| | - Ya-Lan Chang
- Case Manager, Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Ching-Fang Chung
- Case Manager, Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
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Chen YY, Wang CC, Wu WT, Lai CH, Ho CL, Hsu YY, Chen WL. Trajectories of returning to work and its impact on survival in survivors with oral cancer: A 5-year follow-up study. Cancer 2019; 126:1225-1234. [PMID: 31809559 DOI: 10.1002/cncr.32643] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/26/2019] [Accepted: 11/01/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND A return to work (RTW) is a challenge for survivors of oral cancer. Further light could be shed on the RTW of patients with oral cancer, which remains largely uninvestigated. The objective of this study was to investigate the trajectories of RTW and their impact on survival in workers with oral cancer. METHODS In total, 12,222 workers who were newly diagnosed with oral cancer were identified during the period from 2004 to 2015 and were included in this cohort study. The associations between independent variables and RTW were analyzed using Cox proportional hazard models. RESULTS Overall, 8793 workers returned to work in the first years after a diagnosis of oral cancer. Chemotherapy (hazard ratio [HR], 0.88; 95% CI, 0.78-0.99) and radiation therapy (HR, 0.83; 95% CI, 0.75-0.92) were inversely associated with RTW. Patients who had received surgical treatment (HR, 1.24; 95% CI, 1.01-1.53) were more likely to RTW. Employees with stage I (HR, 1.66; 95% CI, 1.47-1.87), stage II (HR, 1.52; 95% CI, 1.35-1.72), and stage III (HR, 1.32; 95% CI, 1.16-1.51) disease were associated with an increased likelihood of RTW in the fifth year after diagnosis. Kaplan-Meier survival analysis demonstrated better survival for the RTW group versus the non-RTW group in patients with stage III and IV oral cancer (P < .001). The fully adjusted HR indicated that the RTW group had significantly better outcomes than the non-RTW group in all-cause mortality (P < .001; HR, 0.36; 95% CI, 0.33-0.39). CONCLUSIONS Sociodemographic and medical factors affect the RTW of cancer survivors. RTW may have a beneficial effect on survival of patients with oral cancer.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of General Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan, Republic of China
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ching-Liang Ho
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ya-Yuan Hsu
- Division of Labor Market, Institute of Labor, Occupational Safety, and Health, Ministry of Labor, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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