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Zhu Y, Zhu T, Wang H, Zhu JM, Zheng DD, Yin P, Li BK. Implications of perceived empathy from spouses during pregnancy for health-related quality of life among pregnant women: a cross-sectional study in Anhui, China. BMC Pregnancy Childbirth 2024; 24:269. [PMID: 38609869 PMCID: PMC11010408 DOI: 10.1186/s12884-024-06419-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Empathy is a critical component of nursing care, impacting both nurses' and patients' outcomes. However, perceived empathy from spouses during pregnancy and its impact on health-related quality of life (HRQoL) are unclear. This study aimed to examine pregnant women's perceived empathy from their spouses and assess the relation of perceived empathy on HRQoL. METHODS This cross-sectional study, performed in the obstetric clinics or wards of four well-known hospitals in Anhui Province, China, included 349 pregnant women in the second or third trimester; participants were recruited by convenience sampling and enrolled from October to December 2021. A general information questionnaire, the Interpersonal Reactivity Index (IRI), a purpose-designed empathy questionnaire and the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) were used to evaluate the pregnant women's general information, perceptions of empathy and HRQoL. Data were analysed using SPSS 22 at a threshold of P < 0.05. Descriptive analysis, Pearson correlation analysis, Student's t test, ANOVA, and multiple regression analysis were used for analysis. RESULTS The pregnant women's total empathy, physical component summary (PCS) and mental component summary (MCS) scores were 41.6 ± 9.0, 41.6 ± 7.6, and 47.7 ± 9.1, respectively. Correlation analysis revealed that the purpose-designed empathy questionnaire items were significantly positively correlated with perspective taking and empathic concern but were not correlated with the personal distress dimension and were only partially correlated with the fantasy dimension. Maternal physical condition during pregnancy, planned pregnancy, and occupational stress were predictors of the PCS score (β = 0.281, P < 0.01; β = 0.132, P = 0.02; β = -0.128, P = 0.02). The behavioural empathy item of our purpose-designed empathy questionnaire and empathic concern were important predictors of the MCS score (β = 0.127, P = 0.02; β = 0.158, P < 0.01), as well as other demographic and obstetric information, explaining 22.0% of the variance in MCS scores totally (F = 12.228, P < 0.01). CONCLUSIONS Pregnant women perceived lower empathy from their spouses and reported lower HRQoL. Perceived empathy, particularly behavioural empathy, may significantly impact pregnant women's MCS scores but has no effect on their PCS scores. Strategies that foster perceived empathy from spouses among pregnant women are essential for facilitating healthy pregnancies and potentially improving maternal and child health.
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Affiliation(s)
- Yu Zhu
- School of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Ting Zhu
- Pharmacy Department, Suzhou Municipal Hospital, Suzhou, 234099, China
| | - Hui Wang
- School of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Ji-Min Zhu
- School of Life Sciences, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Dan-Dan Zheng
- Obstetrical Department, First Affiliated Hospital of Anhui, University of Chinese Medical, Hefei, 230022, China
| | - Ping Yin
- Nursing Department, Anhui No. 2 Provincial People's Hospital, Hefei, 230041, China.
| | - Bai-Kun Li
- School of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230012, China.
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Pedersen M, Engedal MS, Tolver A, Larsen MT, Kornblit BT, Lomborg K, Jarden M. Effect of non-pharmacological interventions on symptoms and quality of life in patients with hematological malignancies - A systematic review. Crit Rev Oncol Hematol 2024; 196:104327. [PMID: 38484899 DOI: 10.1016/j.critrevonc.2024.104327] [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: 12/23/2022] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Non-pharmacological interventions have the potential to enhance health-related quality of life (HRQoL) through symptom management. This systematic review aims to identify, collate, and assess randomized controlled trials investigating the effect of non-pharmacological interventions on symptoms and HRQoL within hematology. METHODS MEDLINE/PUBMED, EMBASE, CINAHL, PSYCINFO and COCHRANE were searched up to April 2021. Outcomes were changes in symptoms and HRQoL. RESULTS Sixty-five studies were categorized into five intervention types: Mind/body (n=9), Web-based (n=9), Music/art (n=6), Consultation-based (n=4), and Physical activity (n=37). We found significantly reduced fatigue (n=12 studies), anxiety (n=8) and depression (n=7), with 11 studies showing significant improvements in HRQoL. CONCLUSIONS The evidence for non-pharmacological interventions shows substantial variation in efficacy and methodological quality. While specific symptoms and HRQoL outcomes significantly favored the intervention, no particular intervention can be emphasized as more favorable, given the inability to conduct a meta-analysis.
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Affiliation(s)
- Maja Pedersen
- Department of Hematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen 2100, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.
| | - Mette Schaufuss Engedal
- Department of Hematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen 2100, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
| | - Anders Tolver
- Department of Mathematical Sciences, Data Science Laboratory, University of Copenhagen, Universitetsparken 5, Copenhagen 2200, Denmark
| | - Maria Torp Larsen
- Department of Hematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Brian Thomas Kornblit
- Department of Hematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Kirsten Lomborg
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark; Department of Clinical Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev 2730, Denmark
| | - Mary Jarden
- Department of Hematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, Copenhagen 2100, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
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3
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Powis M, Hack S, Fazelzad R, Hodgson D, Kukreti V. Survivorship care for patients curatively treated for Hodgkin's and non-Hodgkin's lymphoma: a scoping review. J Cancer Surviv 2023:10.1007/s11764-023-01500-3. [PMID: 38048010 DOI: 10.1007/s11764-023-01500-3] [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: 09/11/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023]
Abstract
PURPOSE We undertook a scoping review of the literature to synthesize what is known about lymphoma survivorship and develop a comprehensive set of lymphoma-specific survivorship recommendations. METHODS We searched the peer-reviewed literature from January 1995 to April 2022, focused on topics relevant to survivorship care in patients ≥ 18 years of age, treated curatively for non-Hodgkin's and Hodgkin's lymphoma, and in remission for at least 2 years. RESULTS We retained 92 articles; themes included late effects of treatment (53.3%, 49/92), particularly fatigue and sleep disturbances, and fertility, as well as psychosocial considerations of survivors (27.2%; 25/92), screening for secondary malignancies (22.8%; 21/92), outcomes of interventions to improve survivorship care (10.9%; 10/92), and best practices and elements for survivorship plans (8.7%; 8/92). While there were published guidelines for screening for recurrence and secondary malignancies, despite the considerable number of articles on the psychosocial aspects of survivorship care, there remains limited guidance on screening frequency and management strategies for anxiety and depression, sleep disturbances, and treatment-related fatigue within the lymphoma population. CONCLUSION We have developed a comprehensive set of lymphoma-survivorship recommendations; however, work is needed to adapt them to local healthcare contexts. IMPLICATIONS FOR SURVIVORS While there is a focus in the literature on the long-term psychosocial impacts of cancer and its treatment on lymphoma survivors, there remains no concrete recommendations on effective screening and management of detriments to quality of life such as anxiety, depression, fatigue, and distress, and availability of local resources vary widely.
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Affiliation(s)
- Melanie Powis
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre- University Health Network, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 700 University Ave, Suite 6-223, Toronto, ON, M5G 1X6, Canada
| | - Saidah Hack
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre- University Health Network, Toronto, ON, Canada
| | - Rouhi Fazelzad
- Library and Information Services, University Health Network, Toronto, ON, Canada
| | - David Hodgson
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre- University Health Network, Toronto, ON, Canada
| | - Vishal Kukreti
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre- University Health Network, Toronto, ON, Canada.
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 700 University Ave, Suite 6-223, Toronto, ON, M5G 1X6, Canada.
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
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4
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Klaassen-Dekker A, Drossaert CHC, Van Maaren MC, Van Leeuwen-Stok AE, Retel VP, Korevaar JC, Siesling S. Personalized surveillance and aftercare for non-metastasized breast cancer: the NABOR study protocol of a multiple interrupted time series design. BMC Cancer 2023; 23:1112. [PMID: 37964214 PMCID: PMC10647159 DOI: 10.1186/s12885-023-11504-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Follow-up of curatively treated primary breast cancer patients consists of surveillance and aftercare and is currently mostly the same for all patients. A more personalized approach, based on patients' individual risk of recurrence and personal needs and preferences, may reduce patient burden and reduce (healthcare) costs. The NABOR study will examine the (cost-)effectiveness of personalized surveillance (PSP) and personalized aftercare plans (PAP) on patient-reported cancer worry, self-rated and overall quality of life and (cost-)effectiveness. METHODS A prospective multicenter multiple interrupted time series (MITs) design is being used. In this design, 10 participating hospitals will be observed for a period of eighteen months, while they -stepwise- will transit from care as usual to PSPs and PAPs. The PSP contains decisions on the surveillance trajectory based on individual risks and needs, assessed with the 'Breast Cancer Surveillance Decision Aid' including the INFLUENCE prediction tool. The PAP contains decisions on the aftercare trajectory based on individual needs and preferences and available care resources, which decision-making is supported by a patient decision aid. Patients are non-metastasized female primary breast cancer patients (N = 1040) who are curatively treated and start follow-up care. Patient reported outcomes will be measured at five points in time during two years of follow-up care (starting about one year after treatment and every six months thereafter). In addition, data on diagnostics and hospital visits from patients' Electronical Health Records (EHR) will be gathered. Primary outcomes are patient-reported cancer worry (Cancer Worry Scale) and overall quality of life (as assessed with EQ-VAS score). Secondary outcomes include health care costs and resource use, health-related quality of life (as measured with EQ5D-5L/SF-12/EORTC-QLQ-C30), risk perception, shared decision-making, patient satisfaction, societal participation, and cost-effectiveness. Next, the uptake and appreciation of personalized plans and patients' experiences of their decision-making process will be evaluated. DISCUSSION This study will contribute to insight in the (cost-)effectiveness of personalized follow-up care and contributes to development of uniform evidence-based guidelines, stimulating sustainable implementation of personalized surveillance and aftercare plans. TRIAL REGISTRATION Study sponsor: ZonMw. Retrospectively registered at ClinicalTrials.gov (2023), ID: NCT05975437.
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Affiliation(s)
- A Klaassen-Dekker
- Health Technology and Services Research Department, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
| | - C H C Drossaert
- Health & Technology Department, University of Twente, Enschede, The Netherlands
| | - M C Van Maaren
- Health Technology and Services Research Department, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | | | - V P Retel
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - J C Korevaar
- Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, The Hague, The Netherlands
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - S Siesling
- Health Technology and Services Research Department, Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Rosa WE, McDarby M, Buller H, Ferrell BR. Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer. Cancers (Basel) 2023; 15:4076. [PMID: 37627105 PMCID: PMC10452546 DOI: 10.3390/cancers15164076] [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: 06/14/2023] [Revised: 07/28/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of this study was to examine interdisciplinary clinicians' perceptions of priorities in serious illness communication and shared decision-making with racially and culturally minoritized persons at end of life. Clinicians (N = 152) read a detailed case study about a patient self-identifying as Black and American Indian who describes mistrust of the healthcare system. Participants then responded to three open-ended questions about communication strategies and approaches they would employ in providing care. We conducted a thematic analysis of participants' responses to questions using an iterative, inductive approach. Interdisciplinary clinicians from nursing (48%), social work (36%), and chaplaincy (16%), responded to the study survey. A total of four themes emerged: (1) person-centered, authentic, and culturally-sensitive care; (2) pain control; (3) approaches to build trust and connection; and (4) understanding communication challenges related to racial differences. Significant efforts have been made to train clinicians in culturally inclusive communication, yet we know little about how clinicians approach "real world" scenarios during which patients from structurally minoritized groups describe care concerns. We outline implications for identifying unconscious bias, informing educational interventions to support culturally inclusive communication, and improving the quality of end-of-life care for patients with cancer from minoritized groups.
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Affiliation(s)
- William E. Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10017, USA;
| | - Meghan McDarby
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10017, USA;
| | - Haley Buller
- City of Hope, Duarte, CA 91010, USA; (H.B.); (B.R.F.)
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Bregio C, Finik J, Baird M, Ortega P, Roter D, Karliner L, Diamond LC. Exploring the Impact of Language Concordance on Cancer Communication. JCO Oncol Pract 2022; 18:e1885-e1898. [PMID: 36112970 PMCID: PMC9653203 DOI: 10.1200/op.22.00040] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/13/2022] [Accepted: 07/24/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE Patients with cancer who have limited English proficiency are more likely to experience inequities in cancer knowledge, timely care, and access to clinical trials. Matching patients with language-concordant clinicians and working with professional interpreters can effectively reduce language-related disparities, but little data are available regarding the impact of language-concordant interactions in oncology care. This study aimed to assess the use of the Roter Interaction Analysis System (RIAS) in language-concordant and -discordant interactions for patients with non-English language preference presenting for an initial oncology visit at four New York City hospitals. METHODS We used the RIAS, a validated tool for qualitative coding and quantitative analysis, to evaluate interactions between 34 patients and 16 clinicians. The pairings were stratified into dyads: English language-concordant (n = 12); professionally interpreted (n = 11); partially language-concordant (n = 4, partially bilingual clinicians who communicated in Spanish and/or used ad hoc interpreters); and Spanish language-concordant (n = 7). A trained Spanish-speaking coder analyzed the recordings using established RIAS codes. RESULTS Spanish language-concordant clinicians had almost two-fold greater number of statements about biomedical information than English language-concordant clinicians. Spanish language-concordant patients had a higher tendency to engage in positive talk such as expressing agreement. The number of partnership/facilitation-related statements was equivalent for English and Spanish language-concordant groups but lower in professionally interpreted and partially language-concordant dyads. CONCLUSION Language concordance may facilitate more effective biomedical counseling and therapeutic relationships between oncology clinicians and patients. Future research should further explore the impact of language concordance on cancer-specific health outcomes.
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Affiliation(s)
- Celyn Bregio
- Pritzker School of Medicine, University of Chicago, Chicago, IL
| | - Jackie Finik
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Morgan Baird
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Pilar Ortega
- Department of Medical Education, University of Illinois College of Medicine, Chicago, IL
- Department of Emergency Medicine, University of Illinois College of Medicine, Chicago, IL
| | - Debra Roter
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Leah Karliner
- Center for Aging in Diverse Communities, University of California, San Francisco, CA
- Multiethnic Health Equity Research Center, University of California, San Francisco, CA
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA
| | - Lisa C. Diamond
- Hospital Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
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Berkley A. Support for adult survivors of lymphoma: a literature review. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S12-S16. [PMID: 36149416 DOI: 10.12968/bjon.2022.31.17.s12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND After the completion of chemotherapy, survivors of lymphoma are at risk of developing late effects of their cancer treatment, which can negatively impact their quality of life. Despite the recommendations for support after active treatment ceases, there is a recognised risk that survivors' needs may not be met. AIM To review the existing literature surrounding professional support in survivorship to establish whether people's needs are being met. METHOD A literature review and thematic analysis of 22 primary research articles. FINDINGS Specialist support and primary care involvement were identified as the two main themes of professional support. Provider-related barriers and individual differences impact the effectiveness of the available support in survivorship. CONCLUSION Following guidelines and understanding an individual's personal needs following treatment will help to ensure that survivors receive the right support. Further research with survivors of lymphoma is required to improve outcomes in the future.
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Affiliation(s)
- Ashleigh Berkley
- Haematology Staff Nurse, Singleton Hospital, Swansea Bay University Health Board, Swansea
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8
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Rosa WE, Banerjee SC, Kastrinos AL, Parker PA. Empathic communication: The premise of inclusive care for historically excluded populations. Cancer 2022; 128:2836-2837. [PMID: 35471553 DOI: 10.1002/cncr.34237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/29/2022] [Indexed: 11/07/2022]
Affiliation(s)
- William E Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Smita C Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Amanda L Kastrinos
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Patricia A Parker
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
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Gribkova Y, Davis CH, Greenbaum AA, Lu S, Berger AC. Effect of the COVID‐19 pandemic on surgical oncology practice—Results of an SSO survey. J Surg Oncol 2022; 125:1191-1199. [PMID: 35249232 PMCID: PMC9088533 DOI: 10.1002/jso.26839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 02/21/2022] [Indexed: 11/24/2022]
Abstract
Background and Objectives The COVID‐19 pandemic significantly affected healthcare delivery, shifting focus away from nonurgent care. The aim of this study was to examine the impact of the pandemic on the practice of surgical oncology. Methods A web‐based survey of questions about changes in practice during the COVID‐19 pandemic was approved by the Society of Surgical Oncology (SSO) Research and Executive Committees and sent by SSO to its members. Results A total of 121 SSO members completed the survey, 77.7% (94/121) of whom were based in the United States. Breast surgeons were more likely than their peers to refer patients to neoadjuvant therapy (p = 0.000171). Head and neck surgeons were more likely to refer patients to definitive nonoperative treatment (p = 0.044), while melanoma surgeons were less likely to do so (p = 0.029). In all, 79.2% (95/120) of respondents are currently using telemedicine. US surgeons were more likely to use telemedicine (p = 0.004). Surgeons believed telemedicine is useful for long‐term/surveillance visits (70.2%, 80/114) but inappropriate (50.4%, 57/113) for new patient visits. Conclusion COVID‐19 pandemic resulted in increased use of neoadjuvant therapy, delays in operative procedures, and increased use of telemedicine. Telemedicine is perceived to be most efficacious for long‐term/surveillance visits or postoperative visits.
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Affiliation(s)
- Yelizaveta Gribkova
- Rutgers Robert Wood Johnson University Medical School New Brunswick New Jersey USA
| | - Catherine H. Davis
- Rutgers Robert Wood Johnson University Medical School New Brunswick New Jersey USA
- Division of Surgical Oncology Rutgers Cancer Institute of New Jersey New Brunswick New Jersey USA
| | - Alissa A. Greenbaum
- Rutgers Robert Wood Johnson University Medical School New Brunswick New Jersey USA
- Division of Surgical Oncology Rutgers Cancer Institute of New Jersey New Brunswick New Jersey USA
| | - Shou‐en Lu
- Department of Biostatistics Rutgers University School of Public Health New Brunswick New Jersey USA
| | - Adam C. Berger
- Rutgers Robert Wood Johnson University Medical School New Brunswick New Jersey USA
- Division of Surgical Oncology Rutgers Cancer Institute of New Jersey New Brunswick New Jersey USA
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Greenzang KA, Kelly CA, Al-Sayegh H, Ma C, Mack JW. Thinking ahead: Parents' worries about late effects of childhood cancer treatment. Pediatr Blood Cancer 2021; 68:e29335. [PMID: 34520114 PMCID: PMC8541904 DOI: 10.1002/pbc.29335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Many childhood cancersurvivors experience at least one late effect of treatment, and both late effects and persistent cancer-related worry can negatively impact quality of life in survivorship. Little is known about the prevalence or impact of parental worry about late effects early in treatment. This study evaluated parental perceived likelihood, impact, and worry about late effects of childhood cancer. PROCEDURE We surveyed 96 parents of pediatric cancer patients at Dana-Farber/Boston Children's Cancer and Blood Disorders Center within a year of diagnosis. Parents were asked about their experiences with late effects communication, general worry about late effects, and specific late effect worries. RESULTS Most (96%) parents valued information about late effects, and 93% considered late effects in their treatment decision-making. Yet, 24% could not recall receiving any information about late effects, and only 51% felt well prepared for potential late effects. Though only 20% of parents considered their child at high risk of experiencing late effects, 61% were extremely/very worried about late effects. Those who felt their child was at high risk of experiencing late effects were more likely to worry (OR = 4.7, P = 0.02). CONCLUSIONS Many parents feel inadequately informed about late effects of cancer treatment, and only one-fifth of parents consider late effects to be likely for their child. However, a majority of parents worry about late effects, including ones they think their child is unlikely to experience. Although some worry is anticipated, disproportionate worry may be mitigated by addressing both educational shortfalls and emotional concerns.
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Affiliation(s)
- Katie A. Greenzang
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts;,Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts;,Division of Pediatric Hematology/Oncology, Boston Children’s Hospital;,Department of Pediatrics, Boston Children’s Hospital;,Harvard Medical School, Harvard University
| | - Colleen A. Kelly
- Department of Pediatrics, Boston Children’s Hospital;,Harvard Medical School, Harvard University,Boston University School of Medicine, and Boston Medical Center
| | - Hasan Al-Sayegh
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts;,Division of Pediatric Hematology/Oncology, Boston Children’s Hospital
| | - Clement Ma
- Centre for Addiction and Mental Health, Toronto, Canada,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jennifer W. Mack
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts;,Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts;,Division of Pediatric Hematology/Oncology, Boston Children’s Hospital;,Department of Pediatrics, Boston Children’s Hospital;,Harvard Medical School, Harvard University
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11
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Roberts BW, Puri NK, Trzeciak CJ, Mazzarelli AJ, Trzeciak S. Socioeconomic, racial and ethnic differences in patient experience of clinician empathy: Results of a systematic review and meta-analysis. PLoS One 2021; 16:e0247259. [PMID: 33657153 PMCID: PMC7928470 DOI: 10.1371/journal.pone.0247259] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 02/03/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction Empathy is essential for high quality health care. Health care disparities may reflect a systemic lack of empathy for disadvantaged people; however, few data exist on disparities in patient experience of empathy during face-to-face health care encounters with individual clinicians. We systematically analyzed the literature to test if socioeconomic status (SES) and race/ethnicity disparities exist in patient-reported experience of clinician empathy. Methods Using a published protocol, we searched Ovid MEDLINE, PubMed, CINAHL, EMBASE, CENTRAL and PsychINFO for studies using the Consultation and Relational Empathy (CARE) Measure, which to date is the most commonly used and well-validated methodology for measuring clinician empathy from the patient perspective. We included studies containing CARE Measure data stratified by SES and/or race/ethnicity. We contacted authors to request stratified data, when necessary. We performed quantitative meta-analyses using random effects models to test for empathy differences by SES and race/ethnicity. Results Eighteen studies (n = 9,708 patients) were included. We found that, compared to patients whose SES was not low, low SES patients experienced lower empathy from clinicians (mean difference = -0.87 [95% confidence interval -1.72 to -0.02]). Compared to white patients, empathy scores were numerically lower for patients of multiple race/ethnicity groups (Black/African American, Asian, Native American, and all non-whites combined) but none of these differences reached statistical significance. Conclusion These data suggest an empathy gap may exist for patients with low SES. More research is needed to further test for SES and race/ethnicity disparities in clinician empathy and help promote health care equity. Trial registration Registration (PROSPERO): CRD42019142809.
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Affiliation(s)
- Brian W. Roberts
- Cooper University Health Care, Camden, New Jersey, United States of America
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
- Center for Humanism, Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
| | - Nitin K. Puri
- Cooper University Health Care, Camden, New Jersey, United States of America
- Department of Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
| | | | - Anthony J. Mazzarelli
- Cooper University Health Care, Camden, New Jersey, United States of America
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
- Center for Humanism, Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
| | - Stephen Trzeciak
- Cooper University Health Care, Camden, New Jersey, United States of America
- Center for Humanism, Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
- Department of Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
- * E-mail:
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