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Goerling U, Hinz A, Koch-Gromus U, Hufeld JM, Esser P, Mehnert-Theuerkauf A. Prevalence and severity of anxiety in cancer patients: results from a multi-center cohort study in Germany. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04600-w. [PMID: 36757620 PMCID: PMC10356888 DOI: 10.1007/s00432-023-04600-w] [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: 12/09/2022] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Anxiety is an accompanying symptom in cancer patients that can have a negative impact on patients. The aim of the present analyses is to determine the prevalence of anxiety, taking into account sociodemographic and medical variables, and to determine the odds ratio for the occurrence of anxiety in cancer patients compared to general population. METHODS In this secondary analyses, we included 4,020 adult cancer patients during and after treatment from a multi-center epidemiological study from 5 regions in Germany in different treatment settings and a comparison group consisting of 10,000 people from the general population in Germany. Anxiety was measured with the Generalized Anxiety Disorder (GAD-7) questionnaire. In multivariate analyses adjusted for age and sex, we calculated the odds of being anxious. RESULTS The prevalence of anxiety was observed to be 13.8% (GAD-7 ≥ 10). The level of anxiety was significant higher for patients in rehabilitation, compared to patients during inpatient and outpatient treatment (p = .013). Comparison with the general population yielded a 2.7-fold increased risk for anxiety among cancer patients (95% CI 2.4-3.1; p < .001). Patients with bladder cancer (OR, 5.3; 95% CI 3.0-9.4) and testicular cancer (OR, 5.0; 95% CI 2.1-12.1) showed the highest risk of having high levels of anxiety. CONCLUSION The results highlight the importance of identifying anxiety in cancer patients.
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Affiliation(s)
- Ute Goerling
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Charitéplatz 1, 10117, Berlin, Germany.
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Marie Hufeld
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Abstract
PURPOSE OF REVIEW Chronic cough is common in severe diseases, such as COPD, interstitial lung disease, lung cancer and heart failure, and has a negative effect on quality of life. In spite of this, patients with cough sometimes feel their cough is neglected by healthcare workers. This review aims to briefly describe cough mechanisms, highlight the burden chronic cough can be for the individual, and the clinical impact of chronic cough. RECENT FINDINGS Chronic cough is likely caused by different mechanisms in different diseases, which may have therapeutic implications. Chronic cough, in general, has a significant negative effect on quality of life, both with and without a severe comorbid disease. It can lead to social isolation, recurrent depressive episodes, lower work ability, and even conditions such as urinary incontinence. Cough may also be predictive of more frequent exacerbations among patients with COPD, and more rapid lung function decline in idiopathic pulmonary fibrosis. Cough is sometimes reported by patients to be underappreciated by healthcare. SUMMARY Chronic cough has a significant negative impact on quality of life, irrespective of diagnosis. Some differences are seen between patients with and without severe disease. Healthcare workers need to pay specific attention to cough, especially patients with severe disease.
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Caterino U, Amore D, Petagna MC, Casazza D, Marchese R. Emergency rigid bronchoscopy in two lower social class patients with mirror like complete pulmonary malignant atelectasis. Monaldi Arch Chest Dis 2021; 91. [PMID: 33666071 DOI: 10.4081/monaldi.2021.1564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/10/2020] [Indexed: 11/22/2022] Open
Abstract
Several factors as cultural factors and social class other than biological and genetic factor can affect symptom perception in patients with malignant airway obstruction. Poor perception of dyspnoea can result in the delayed seeking of medical care so increase access to intensive care due to impeding respiratory failure. In patients issued from malignant airway obstruction, therapeutic bronchoscopy procedure can not affect the endotracheal extubation although immediate airway patency can be obtained. We reported the outcome of two patients from lower social classes admitted in intensive care and underwent emergency rigid bronchoscopy for malignant complete pulmonary atelectasis.
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Affiliation(s)
| | - Dario Amore
- Department of Thoracic Surgery, V Monaldi Hospital, Naples.
| | | | - Dino Casazza
- Department of Thoracic Surgery, V Monaldi Hospital, Naples.
| | - Roberto Marchese
- Interventional Pulmonology Unit, La Maddalena Cancer Center, Palermo.
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Ruegg TA, Morse JM, Yechieli RL. Nurse-Delivered Telephone Intervention to Reduce Oral Mucositis and Prevent Dehydration. Oncol Nurs Forum 2021; 48:242-256. [PMID: 33600392 DOI: 10.1188/21.onf.242-256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM STATEMENT This study evaluates the feasibility of a nurse-delivered telephone intervention to reduce oral mucositis severity and prevent dehydration in patients with lung or head and neck cancer undergoing chemotherapy and radiation therapy. DESIGN This study used a two-phase, qualitatively driven, mixed-methods descriptive design. DATA SOURCES 11 participants were recruited from an academic cancer center in southern Florida. Participants received symptom management education followed by twice-weekly tailored nurse coaching telephone calls. ANALYSIS Questionnaires measuring symptom severity, health-related quality of life, perceived self-efficacy, and symptom self-management were administered at four data points. Data on unscheduled medical visits were collected. Guided interviews were conducted four weeks post-treatment and analyzed qualitatively using content analysis. FINDINGS Participants found the intervention to be acceptable. Oral mucositis symptom severity was minimized, and dehydration was avoided. The intervention enabled symptom self-management and improved perceived self-efficacy. IMPLICATIONS FOR PRACTICE Emotional support provided by the nurse was crucial, exemplifying improvement over an automated system.
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Affiliation(s)
- Tracy A Ruegg
- University of Miami Sylvester Comprehensive Cancer Center
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Borrayo EA, Scott KL, Drennen A, Bendriss TM, Kilbourn KM, Valverde P. Treatment challenges and support needs of underserved Hispanic patients diagnosed with lung cancer and head-and-neck cancer. J Psychosoc Oncol 2020; 38:449-462. [PMID: 31920170 DOI: 10.1080/07347332.2019.1705453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose: We explored the treatment challenges and support needs that Hispanic underserved lung cancer and head-and-neck cancer patients face while undergoing cancer treatment.Design: Qualitative design - ethnography.Sample: Using a sample of 29 participants, we conducted semi-structured interviews with nine lung cancer and head-and-neck cancer survivors and seven health care providers and focus group interviews with six caregivers and seven patient navigators.Method: Relevant themes were extracted with Ethnographic content analysis.Findings: Participants reported treatment challenges and support needs in four areas: medical, financial, socio-cultural, and mental health. Health care providers and navigators primarily identified medical and financial challenges that impact treatment adherence, while patients and caregivers expressed the need for support for mental health problems (i.e., depression, anxiety).Implications for psychosocial providers: Understanding the experiences of underserved Hispanic cancer survivors can aid in creating psychosocial interventions that successfully target treatment-related challenges and provide them with the support they need.
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Affiliation(s)
- Evelinn A Borrayo
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katie L Scott
- Department of Neurology, Spectrum Health Medical Group, Grand Rapids, MI, USA
| | - Ava Drennen
- Health Psychology Associates, P.C., Greeley, CO, USA
| | - Tiare M Bendriss
- Psychiatry, Fremont Medical Center, Kaiser Permanente, Fremont, CA, USA
| | - Kristin M Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Patricia Valverde
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Harle A, Molassiotis A, Buffin O, Burnham J, Smith J, Yorke J, Blackhall FH. A cross sectional study to determine the prevalence of cough and its impact in patients with lung cancer: a patient unmet need. BMC Cancer 2020; 20:9. [PMID: 31906892 PMCID: PMC6943945 DOI: 10.1186/s12885-019-6451-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 12/11/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is absence of literature related to cough prevalence and its characteristics in lung cancer patients, with information deriving only from broader symptoms occurrence studies. The aims of this study were to provide a snapshot of the prevalence of all-cause-cough in lung cancer patients and to characterise cough in terms of its impact and severity. METHODS A cross-sectional study recruiting consecutive lung cancer patients over a pre-defined period of time and using cough-specific validated tools in a tertiary referral centre in the UK, including a cough severity VAS and the Manchester Cough in Lung Cancer scale (MCLCS). RESULTS Data was collected from 202 patients. All-cause cough prevalence was 57% (through VAS) both in the screened (N = 223) and research (N = 202) population or 67% (through the MCLCS), and cough severity was moderate at a mean of 32 mm (in a 100 mm VAS). Age, sex, smoking status, lung cancer histology, stage and comorbidities were not associated with cough prevalence. The only variable associated with lower cough reports was being 'on anticancer treatment'; fewer patients on treatment reported a cough (40%) compared to those off treatment (54%) (p = 0.04). The impact of cough (as measured by MCLCS) was also significant (mean score = 22). About 18% of patients felt moderate/severe distress from their cough and about 15% often or always reported disturbed sleep due to coughing. Half the patients felt their cough warranted treatment. CONCLUSIONS Cough is a common symptom in lung cancer with considerable impact on patients' lives. Cough presence and severity should regularly be assessed in clinical practice. There is an urgent need to focus on developing more potent antitussive treatments and improve the management of this complex and distressing symptom.
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Affiliation(s)
- Amélie Harle
- Dorset Cancer Centre, Poole NHS Foundation Trust, Longfleet Road, Poole, BH15 2LB UK
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Oliver Buffin
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Royal Gwent Hospital, Wales Deanery, Newport, Gwent, Wales, UK
| | - Jack Burnham
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Department of General Medicine, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Jaclyn Smith
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Janelle Yorke
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - Fiona H. Blackhall
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
- Division of Cancer Sciences, University of Manchester, Manchester, UK
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Sio TT, Atherton PJ, Pederson LD, Zhen WK, Mutter RW, Garces YI, Ma DJ, Leenstra JL, Rwigema JCM, Dakhil S, Bearden JD, van der Veen SJ, Ganti AK, Schild SE, Miller RC. Daily Lisinopril vs Placebo for Prevention of Chemoradiation-Induced Pulmonary Distress in Patients With Lung Cancer (Alliance MC1221): A Pilot Double-Blind Randomized Trial. Int J Radiat Oncol Biol Phys 2018; 103:686-696. [PMID: 30395904 DOI: 10.1016/j.ijrobp.2018.10.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/20/2018] [Accepted: 10/24/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Chemoradiation (CRT) is an integral treatment modality for patients with locally advanced lung cancer. It has been hypothesized that current use of an angiotensin-converting enzyme inhibitor during CRT may be protective for treatment-related lung damage and pneumonitis. METHODS AND MATERIALS We conducted a pilot, double-blind, placebo-controlled, randomized trial. Study-eligible patients receiving curative thoracic radiation therapy (RT) were randomly assigned to 20 mg of lisinopril or placebo once daily during and up to 3 months after RT. All patients received concurrent chemotherapy. The primary endpoint was adverse event profiling. Multiple patient-reported outcome (PRO) surveys, including the Lung Cancer Symptom Scale, Function Assessment of Cancer Therapy-Lung, and the European Organisation for Research and Treatment of Cancer Lung Cancer Questionnaire, were applied with a symptom experience questionnaire. Exploratory comparative statistics were used to detect differences between arms with χ2 and Kruskal-Wallis testing. RESULTS Five institutions enrolled 23 patients. However, accrual was less than expected. Eleven and 12 patients were in the placebo and lisinopril arms, respectively (mean age, 63.5 years; male, 62%). Baseline characteristics were balanced. Eighteen patients (86%) were former or current smokers. The primary endpoint was met; neither arm had grade 3 or higher hypotension, acute kidney injury, allergic reaction (medication-induced cough), or anaphylaxis (medication-related angioedema). Few PRO measures suggested that compared with the placebo arm, patients receiving lisinopril had less cough, less shortness of breath, fewer symptoms from lung cancer, less dyspnea with both walking and climbing stairs, and better overall quality of life (for all, P < .05). CONCLUSIONS Although underpowered because of low accrual, our results suggest that there was a clinical signal for safety-and possibly beneficial by limited PRO measures-in concurrently administering lisinopril during thoracic CRT to mitigate or prevent RT-induced pulmonary distress. Our results showed that a definitive, larger-scale, randomized phase 3 trial is needed in the future.
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Affiliation(s)
- Terence T Sio
- Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, Arizona.
| | - Pamela J Atherton
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Levi D Pederson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - W Ken Zhen
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Robert W Mutter
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Yolanda I Garces
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Daniel J Ma
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - James L Leenstra
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - Shaker Dakhil
- Department of Radiation Oncology, Cancer Center of Kansas, Wichita, Kansas
| | - James D Bearden
- Department of Radiation Oncology, Spartanburg Medical Center, Spartanburg, South Carolina
| | - Sonja J van der Veen
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Apar K Ganti
- Division of Oncology-Hematology, Department of Internal Medicine, VA Nebraska Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, Nebraska
| | - Steven E Schild
- Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Robert C Miller
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida
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Harle ASM, Blackhall FH, Molassiotis A, Yorke J, Dockry R, Holt KJ, Yuill D, Baker K, Smith JA. Cough in Patients With Lung Cancer: A Longitudinal Observational Study of Characterization and Clinical Associations. Chest 2018; 155:103-113. [PMID: 30321508 DOI: 10.1016/j.chest.2018.10.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 09/21/2018] [Accepted: 10/02/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Cough is common in patients with lung cancer, and current antitussive treatments are suboptimal. There are little published data describing cough in patients with lung cancer or work assessing clinical associations. The aim of this study is to fill that gap. METHODS This was a longitudinal prospective observational single-cohort study over 60 days. Patients were assessed through self-reported validated scales and, in a subsample, ambulatory cough monitoring at study entry (day 0), day 30, and day 60. RESULTS At study entry, 177 patients were included and 153 provided data at day 60. The median duration of cough was 52 weeks (interquartile range, 8.5-260). Cough was described as severe enough to warrant treatment in 62% of the patients. Depending on the scale used, performance status was associated with both cough severity and cough impact (P < .001) at study entry, whereas higher cough severity at study entry was associated with female sex (P = .02), asthma (P = .035), and reflux disease (P < .001). Cough impact at study entry was additionally associated with experiencing nausea (P = .018). Cancer characteristics (ie, cancer stage, histology) were not associated with cough severity nor cough impact; neither was smoking or COPD. CONCLUSIONS This is the first study to describe characteristics of cough in patients with lung cancer and to identify clinical associations that may be relevant for its treatment. Our data suggest that cough is a frequent and distressing symptom and an unmet clinical need. Its association with gastrointestinal symptoms in this study may improve our understanding of pathophysiology and therapeutic options for cough occurring in patients with lung cancer.
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Affiliation(s)
- Amélie S M Harle
- Dorset Cancer Centre, Poole NHS Foundation Trust, Poole, England; Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, England.
| | - Fiona H Blackhall
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, England; Division of Cancer Sciences, University of Manchester, Manchester, England
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Janelle Yorke
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, England; Department of Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, England
| | - Rachel Dockry
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, England
| | - Kimberley J Holt
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, England
| | - Danielle Yuill
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, England
| | - Katie Baker
- Clinical and Experimental Pharmacology Group, Cancer Research UK Manchester Institute, University of Manchester, Manchester, England
| | - Jaclyn A Smith
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, England; Manchester University NHS Foundation Trust, Manchester, England
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Stowe E, Wagland R. A qualitative exploration of distress associated with episodic breathlessness in advanced lung cancer. Eur J Oncol Nurs 2018; 34:76-81. [PMID: 29784142 DOI: 10.1016/j.ejon.2018.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 03/22/2018] [Accepted: 03/26/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE Breathlessness is a distressing symptom, particularly common in those with advanced lung cancer. Previous research has identified the symptom occurrence of episodic breathlessness, identifying average frequency, duration and severity of episodes, but has not explored the distress specifically associated with these episodes. This study explored the distress associated with episodic breathlessness for adults with advanced cancer and the relative impact of three elements; frequency, duration or severity. METHODS Semi-structured interviews were conducted with four participants with advanced lung cancer. Analysis adopted an interpretative phenomenological approach. RESULTS A complex relationship existed between distress caused by episodic breathlessness and its frequency, duration and severity for study participants. Episodic breathlessness had a significant impact on participant's perceptions of self and previous experience effected how distressed they were by their breathlessness. The emotional work created by the symptom was considerable for individuals. CONCLUSION The study highlights the importance of recognizing symptoms as a combination of different experiences that may each cause different levels of distress. Initial evidence is provided that the emotional work involved for patients to self-manage each separate element of breathlessness should be considered in its treatment.
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Affiliation(s)
- Emily Stowe
- St Clare Hospice, Hastingwood Road, Hastingwood, Essex, CM17 9JX, United Kingdom.
| | - Richard Wagland
- Faculty of Health Sciences, Building 67, Highfield, University of Southampton, SO17 1BJ, United Kingdom.
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Sohail MM, Yasin MG, Ahmad S. A phenomenological account of social sources, coping effects and relational role of social support in nursing among chronic patients with hepatitis. J Res Nurs 2017; 23:23-39. [PMID: 34394404 DOI: 10.1177/1744987117736362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Social support plays an important role in the nursing of patients at a terminal stage. A literature review explored the influential link of social support in coping with chronic disease, but patients with chronic liver disease have not been studied in this context. The current study examined the lived experiences of social sources of social support, patients' expectations and the role of social support. Furthermore, it explored the importance of support for patients, coping effect and whose support matters for nursing of terminal chronic liver disease patients. A total of 21 terminally ill patients with chronic liver disease were selected through an appropriate screening process. Subsequently, in-depth detailed interviews were conducted to gather experiences of the hepatitis patients. Researchers fulfilled all the ethical considerations during the process of data collection. Social support exerts multiple beneficial effects that help in coping with chronic diseases of terminally ill patients. It was found that patients with hepatitis expected emotional, instrumental and informational support from social relations. Social support was a source of emotional gratification and a buffer in psychological distress, and helped in enabling a peaceful death for patients with chronic diseases. Among all social sources of support, spousal and child support were the most important for patients.
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Affiliation(s)
- M M Sohail
- PhD student, Department of Sociology, University of Sargodha, Pakistan
| | - M G Yasin
- Professor, Department of Sociology, University of Sargodha, Pakistan
| | - S Ahmad
- Lecturer, Department of Sociology, University of Gujrat, Pakistan
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11
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Jung JY, Lee JM, Kim MS, Shim YM, Zo JI, Yun YH. Comparison of fatigue, depression, and anxiety as factors affecting posttreatment health-related quality of life in lung cancer survivors. Psychooncology 2017; 27:465-470. [DOI: 10.1002/pon.4513] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Ju Youn Jung
- Department of Biomedical Science; Seoul National University College of Medicine and Hospital; Seoul South Korea
| | - Jong Mog Lee
- Center for Lung Cancer; National Cancer Center; Goyang South Korea
| | - Moon Soo Kim
- Center for Lung Cancer; National Cancer Center; Goyang South Korea
| | - Young Mog Shim
- Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center; Samsung Medical Center; Seoul South Korea
| | - Jae Ill Zo
- Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center; Samsung Medical Center; Seoul South Korea
| | - Young Ho Yun
- Department of Biomedical Science; Seoul National University College of Medicine and Hospital; Seoul South Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul South Korea
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12
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Taylor MF, Pooley JA. Sarcoma survivors’ perspectives on their body image and functional quality of life post-resection/limb salvage surgery. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12667] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 01/09/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Myra F. Taylor
- School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
| | - Julie A. Pooley
- School of Psychology; Edith Cowan University; Joondalup WA Australia
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13
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Soleimani MA, Lehto RH, Negarandeh R, Bahrami N, Nia HS. Relationships between Death Anxiety and Quality of Life in Iranian Patients with Cancer. Asia Pac J Oncol Nurs 2016; 3:183-191. [PMID: 27981157 PMCID: PMC5123493 DOI: 10.4103/2347-5625.182935] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: The purpose of the study was to examine relationships between death anxiety and quality of life (QOL) parameters of patients with cancer in the Iranian sociocultural context. Methods: A descriptive, correlational methodology was used. The sample included 330 patients. Demographics, health information, religious behaviors, death anxiety, and QOL data were collected. Results: Overall death anxiety levels were moderate with satisfactory overall QOL. Death anxiety was predictive of lowered QOL. Female patients had lower QOL and higher death anxiety compared to men Conclusions: Findings support that higher death anxiety negatively impacts QOL in an Iranian sample with cancer. Alleviation of existential concerns in vulnerable patients may palliate mental health distress associated with facing cancer and its challenging treatments.
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Affiliation(s)
- Mohammad A Soleimani
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Rebecca H Lehto
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Bahrami
- School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Mazandaran, Iran
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To carry on as before: A meta-synthesis of qualitative studies in lung cancer. Lung Cancer 2016; 99:88-93. [PMID: 27565920 DOI: 10.1016/j.lungcan.2016.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 11/22/2022]
Abstract
As a complement to quantitative studies, qualitative studies give us a better understanding of how persons affected by lung cancer live their everyday lives and how they deal with the obvious strain of having lung cancer. Because qualitative studies are based on only a few participants in specific contexts, the purpose of the present study is to synthesize knowledge from these qualitative studies to get a more general picture of the everyday lives of patients with lung cancer. A search on PubMed, CINAHL, Medline and PsychInfo yielded 383 hits. After exclusion we found 16 studies that focused on how these patients lived, reflected, and dealt with their new life situation. These studies comprised 393 interviews with 283 patients with primary lung cancer, and the findings from these studies were synthesized into a core process with subcategories. The overarching process was that the patients were eager "to carry on as before". They wanted to resume their former everyday life, and their views on their relationships with their bodies and side effects of treatments, their families, the health care staff, and with dying and death were very much related to how these could assist the core process. The synthesis presented here suggests that health care in consultations with patients with lung cancer should defer to the importance of the patient's core idea that life carries on despite the fact that it will probably soon come to an end.
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Peddireddy V. Psychological interventions to improve the quality of life in Indian lung cancer patients: A neglected area. J Health Psychol 2016; 24:100-112. [PMID: 27287601 DOI: 10.1177/1359105316650930] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The incidence of lung cancer is very high and evidence suggests that patients experience imbalanced emotional capabilities due to less survival rate compared to other cancers. Direct and indirect psychological interventions are mandatory to improve the outcome of lung cancer treatment. Although such interventions are being practiced in developed nations, the effects of psychological interventions on the treatment outcome in the Indian context are lacking. Since there is a definite correlation between treatment outcome and psychological issues, it is high time that clinicians in developing countries including India adopt practices to enhance the quality of life of lung cancer patients.
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Abstract
INTRODUCTION To evaluate the perception of lung cancer in the general population to identify obstacles in patient-doctor communications. METHODS A prospective nationwide survey was conducted using a questionnaire and lexical approaches given to 2200 healthy subjects selected within a representative polling database. RESULTS Of the 1469 subjects eligible for full analysis, most were well informed regarding the epidemiological changes to lung cancer and the main risk factors. The overall survival of patients with lung cancer (32%) was overestimated, and the survival of patients with early stages of lung cancer was underestimated (52%). Lung cancer was identified as a severe disease (82%) with a worse prognosis than other cancers. Most of the population was aware of the main treatments available, except for targeted therapy. Using lexical analyses, we observed that a major proportion considered lung cancer to be a tobacco-induced, life-threatening disease that involved major treatment, and a minor proportion considered it to be an environmentally induced disease. Compared with breast cancer, lung cancer was characterized by a greater feeling of guilt and was more frequently associated with lifestyle. CONCLUSIONS We have identified knowledge gaps in the perception of lung cancer and have highlighted a need for a public information campaign on lung-cancer screening to promote the good survival rate from early-stage disease and the progress achieved with new therapeutic strategies.
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Bayly JL, Lloyd-Williams M. Identifying functional impairment and rehabilitation needs in patients newly diagnosed with inoperable lung cancer: a structured literature review. Support Care Cancer 2016; 24:2359-2379. [DOI: 10.1007/s00520-015-3066-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 12/21/2015] [Indexed: 01/01/2023]
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Shi Y, Gu F, Hou LL, Hu YQ. Self-reported depression among patients with non-small cell lung cancer. Thorac Cancer 2015; 6:334-7. [PMID: 26273380 PMCID: PMC4448394 DOI: 10.1111/1759-7714.12179] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 09/09/2014] [Indexed: 11/30/2022] Open
Abstract
Background Lung cancer is a disease with a poor prognosis and psychological impact. Lung cancer causes both physical and psychological burdens on patients, and financial burdens on families and society. The aim of this study was to examine the relationship between depression and influencing factors in non-small-cell lung cancer (NSCLC) patients. Methods A quantitative study was applied. Data was obtained from the Shanghai Pulmonary Hospital in China. One hundred and four patients with NSCLC were surveyed. Self-rating depression scale (SDS), social support rating scale (SSRS), and visual analog scale (VAS) were used. Results Among the 104 patients, 48 (46.1%) were diagnosed with depression. Gender (P = 0.000), disease duration (P = 0.006), self-care ability (P = 0.004), and pain (P = 0.003) were statistically significant predictors of self-reported depression in non-small-cell lung cancer patients. Conclusions Self-reported depression is highly prevalent in NSCLC patients. In addition, gender, disease duration, self-care ability, pain and social support may increase self-reported depression.
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Affiliation(s)
- Yan Shi
- Department of Nursing, Tenth People's Hospital of Tongji University Shanghai, China
| | - Fen Gu
- Department of Nursing, Shanghai Pulmonary Hospital of Tongji University Shanghai, China
| | - Li-Li Hou
- Department of Nursing, Shanghai Pulmonary Hospital of Tongji University Shanghai, China
| | - Yin-Qing Hu
- Department of Nursing, Shanghai Pulmonary Hospital of Tongji University Shanghai, China
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Hopkins KG, Hoffman LA, Dabbs ADV, Ferson PF, King L, Dudjak LA, Zullo TG, Rosenzweig MQ. Postthoracotomy Pain Syndrome Following Surgery for Lung Cancer: Symptoms and Impact on Quality of Life. J Adv Pract Oncol 2015; 6:121-32. [PMID: 26649245 PMCID: PMC4601892 DOI: 10.6004/jadpro.2015.6.2.4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Postthoracotomy pain syndrome (PTPS) is a common complication following thoracic surgery. Most studies examining the influence of PTPS on patient-reported symptoms include few patients managed using a minimally invasive approach. Associated sensory changes, potentially neuropathic in origin, are not well described. We therefore examined the symptoms and quality of life (QOL) of patients with and without PTPS who underwent a standard thoracotomy (n = 43) or minimally invasive surgery (n = 54). Patients in this prospective, cross-sectional study completed questionnaires to assess pain (McGill Pain Questionnaire), neuropathic symptoms (Neuropathic Symptom Questionnaire), symptom distress (Symptom Distress Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and QOL (Functional Assessment Cancer Therapy–Lung). Excepting younger age (p = .009), no demographic or surgical characteristic differentiated patients with and without PTPS. Patients with PTPS described discomfort as pain only (15.1%), neuropathic symptoms only (30.2%) or pain and neuropathic symptoms (54.7%). Scores differed between patients with and without PTPS for symptom distress (p < .001), anxiety and depression (p < .001), and QOL (p = .009), with higher distress associated with PTPS. Despite new surgical techniques, PTPS remains common and results in considerable distress. A focused assessment is needed to identify all experiencing this condition, with referral to pain management specialists if symptoms persist.
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Affiliation(s)
- Kathleen G Hopkins
- Carlow University College of Health and Wellness, Department of Nursing, Pittsburgh, Pennsylvania
| | - Leslie A Hoffman
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
| | | | - Peter F Ferson
- University of Pittsburgh School of Medicine, Department of Cardiothoracic Surgery, Pittsburgh, Pennsylvania
| | - Linda King
- University of Pittsburgh School of Medicine, Department of General Internal Medicine, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania
| | - Linda A Dudjak
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
| | - Thomas G Zullo
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
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Blum T, Schönfeld N. The lung cancer patient, the pneumologist and palliative care: a developing alliance. Eur Respir J 2014; 45:211-26. [DOI: 10.1183/09031936.00072514] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Considerable evidence is now available on the value of palliative care for lung cancer patients in all stages and at all times during the course of the disease. However, pneumologists and their institutions seem to be widely in arrears with the implementation of palliative care concepts and the development of integrated structures.This review focuses on the available evidence and experience of various frequently unmet needs of lung cancer patients, especially psychological, social, spiritual and cultural ones. A PubMed search for evidence on these aspects of palliative care as well as on barriers to the implementation, on outcome parameters and effectiveness, and on structure and process quality was performed with a special focus on lung cancer patients.As a consequence, this review particularly draws pneumologists’ attention to improving their skills in communication with the patients, their relatives and among themselves, and to establish team structures with more far-reaching competences and continuity than existing multilateral cooperations and conferences can provide. Ideally, any process of structural and procedural improvement should be accompanied by scientific evaluation and measures for quality optimisation.
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Dean GE, Redeker NS, Wang YJ, Rogers AE, Dickerson SS, Steinbrenner LM, Gooneratne NS. Sleep, mood, and quality of life in patients receiving treatment for lung cancer. Oncol Nurs Forum 2014; 40:441-51. [PMID: 23989018 DOI: 10.1188/13.onf.441-451] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE/OBJECTIVES To distinguish relationships among subjective and objective characteristics of sleep, mood, and quality of life (QOL) in patients receiving treatment for lung cancer. DESIGN Descriptive, correlational study. SETTING Two ambulatory oncology clinics. SAMPLE 35 patients with lung cancer. METHODS The following instruments were used to measure the variables of interest: Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, Functional Assessment of Cancer Treatment-Lung (FACT-L), a sleep diary, and a motionlogger actigraph. MAIN RESEARCH VARIABLES Sleep, mood, and QOL. FINDINGS Significant differences were found between sleep diary and actigraph measures of sleep efficiency (p = 0.002), sleep latency (p = 0.014), sleep duration (p < 0.001), and wake after sleep onset (p < 0.001). Poor sleepers (PSQI score greater than 5) were significantly different from good sleepers (PSQI score of 5 or lower) on sleep diary measures of sleep efficiency and sleep latency and the FACT-L lung cancer symptom subscale, but not on mood or actigraphy sleep measures. CONCLUSIONS Although patients with lung cancer may report an overall acceptable sleep quality when assessed by a single question, those same patients may still have markedly increased sleep latencies or reduced total sleep time. The findings indicate the complexity of sleep disturbances in patients with lung cancer. Lung cancer symptoms had a stronger association with sleep than mood. Research using prospective methods will help to elucidate their clinical significance. IMPLICATIONS FOR NURSING Patients receiving treatment for lung cancer are at an increased risk for sleep disturbances and would benefit from routine sleep assessment and management. In addition, assessment and management of common symptoms may improve sleep and, ultimately, QOL. KNOWLEDGE TRANSLATION A high frequency of sleep disturbances in patients receiving treatment for lung cancer was evident, and poor sleepers had lower QOL. Sleep disturbances may be more related to lung cancer symptoms than anxiety or depression. Improving lung cancer symptoms such as dyspnea may improve sleep.
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Affiliation(s)
- Grace E Dean
- School of Nursing, University at Buffalo, State Univerity of New York
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Johnston B, Buchanan D, Papadopoulou C, Sandeman G, Lord H. Integrating palliative care in lung cancer: an early feasibility study. Int J Palliat Nurs 2014; 19:433-7. [PMID: 24071834 DOI: 10.12968/ijpn.2013.19.9.433] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM The aim of this preliminary study was to evaluate the feasibility of conducting an effectiveness trial of early access to palliative care services for people with lung cancer through use of an integrated outpatient model. METHODS Newly diagnosed patients with lung cancer receiving palliative-intent treatment or best supportive care treatment were recruited over a 5-month period from one out-patient clinic in Scotland. Patients were offered a clinical review appointment with a palliative medicine consultant at two time points: baseline and 12 weeks later. Prior to each appointment patients completed three outcome measures addressing symptom severity, wellbeing, and health-care needs. One-to-one interviews were also conducted to explore patients' experiences of being involved in the study. RESULTS Three patients participated in the study. The main reasons for low recruitment were patients' deteriorating condition and unwillingness to undertake extra hospital visits. However, qualitative data indicated that the participants found this extra layer of supportive care useful in identifying and managing their needs, as well as enabling future planning. CONCLUSION Further testing is needed to ascertain the feasibility of conducting a trial of integrating early access to palliative care services into routine practice for people with lung cancer.
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Affiliation(s)
- Bridget Johnston
- Reader in Palliative Care, University of Dundee, School of Nursing and Midwifery, Dundee, Scotland, and Honorary Nurse Consultant (Palliative Care) NHS Tayside
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23
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Pozo CLP, Morgan MAA, Gray JE. Survivorship Issues for Patients with Lung Cancer. Cancer Control 2014; 21:40-50. [DOI: 10.1177/107327481402100106] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Christie L. Pratt Pozo
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- LATTE Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Mary Ann A. Morgan
- Cancer Survivorship Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Jhanelle E. Gray
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
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Lowery AE, Krebs P, Coups EJ, Feinstein MB, Burkhalter JE, Park BJ, Ostroff JS. Impact of symptom burden in post-surgical non-small cell lung cancer survivors. Support Care Cancer 2013; 22:173-80. [PMID: 24018910 DOI: 10.1007/s00520-013-1968-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 08/27/2013] [Indexed: 12/20/2022]
Abstract
PURPOSE Pain, fatigue, dyspnea, and distress are commonly reported cancer-related symptoms, but few studies have examined the effects of multiple concurrent symptoms in longer-term cancer survivors. We examined the impact of varying degrees of symptom burden on health-related quality of life (HRQOL) and performance status in surgically treated non-small cell lung cancer (NSCLC) survivors. METHODS A sample of 183 NSCLC survivors 1-6 years post-surgical treatment completed questionnaires assessing five specific symptoms (pain, fatigue, dyspnea, depression, and anxiety), HRQOL, and performance status. The number of concurrent clinically significant symptoms was calculated as an indicator of symptom burden. RESULTS Most survivors (79.8 %) had some degree of symptom burden, with 30.6 % reporting one clinically significant symptom, 27.9 % reporting two symptoms, and 21.3 % reporting three or more symptoms. Physical HRQOL significantly decreased as the degree of symptom burden increased, but mental HRQOL was only significantly decreased in those with three or more symptoms. Receiver-operating characteristic (ROC) curves showed that having multiple concurrent symptoms (two or more) was most likely associated with limitations in functioning (area under a ROC curve = 0.75, sensitivity = 0.81, specificity = 0.54). CONCLUSIONS Two or more clinically significant symptoms are identified as the "tipping point" for showing adverse effects on HRQOL and functioning. This highlights the need for incorporating multiple-symptom assessment into routine clinical practice. Comprehensive symptom management remains an important target of intervention for improved post-treatment HRQOL and functioning among lung cancer survivors.
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Affiliation(s)
- Amy E Lowery
- School of Medicine, University of Pittsburgh, 5115 Centre Ave, Suite 140, Pittsburgh, PA, USA,
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Maguire R, Papadopoulou C, Kotronoulas G, Simpson MF, McPhelim J, Irvine L. A systematic review of supportive care needs of people living with lung cancer. Eur J Oncol Nurs 2013; 17:449-64. [PMID: 23246484 DOI: 10.1016/j.ejon.2012.10.013] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 10/23/2012] [Accepted: 10/30/2012] [Indexed: 11/18/2022]
Affiliation(s)
- Roma Maguire
- School of Nursing & Midwifery, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, UK.
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Patient-Reported Outcome Measures for the Identification of Supportive Care Needs in People With Lung Cancer. Cancer Nurs 2013; 36:E1-17. [DOI: 10.1097/ncc.0b013e31826f3c8f] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Paredes TF, Canavarro MC, Simões MR. Social support and adjustment in patients with sarcoma: the moderator effect of the disease phase. J Psychosoc Oncol 2012; 30:402-25. [PMID: 22747105 DOI: 10.1080/07347332.2012.684852] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study examined the association between different types of perceived social support and adjustment of patients with sarcoma, and if these relationships would differ depending on the outcome measure and phase of disease. Forty-nine patients in the diagnostic phase, 43 in the treatment phase, and 59 in the follow-up phase were recruited. Participants completed the Medical Outcomes Study Social Support Survey Questionnaire, the Hospital Anxiety and Depression Scale, and World Health Organization Quality of Life Assessment. Positive social interaction, emotional/informational, affectionate, and tangible supports were significantly associated with depression scores, but not with anxiety. Except for affectionate support, all the associations with overall quality of life were significant. A moderating effect of the phase of the disease was also found in the association between tangible support and anxiety, and between affectionate support, depression, and overall quality of life. In clinical practice it is important to implement phase-specific psychosocial interventions and to take into consideration other factors beyond perceived social support while handling patients with sarcoma.
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Affiliation(s)
- Tiago F Paredes
- Institute of Cognitive Psychology, Vocational and Social Development, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
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Ellis J, Lloyd Williams M, Wagland R, Bailey C, Molassiotis A. Coping with and factors impacting upon the experience of lung cancer in patients and primary carers. Eur J Cancer Care (Engl) 2012; 22:97-106. [PMID: 22978743 DOI: 10.1111/ecc.12003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is a paucity of research exploring patients' and their informal carers' experience of coping with and factors impacting on the lung cancer experience. This study aims to explore how patients and their informal carers cope with a diagnosis of lung cancer and describe the key factors that mediate distress in this population in order that they may be better supported in the future. This was a qualitative study employing semi-structured interviews and framework analysis to elicit the experience of 37 patients with lung cancer and 23 primary carers regarding their coping with and factors influencing patient/carer distress. The findings illustrate that participants used both emotional- and problem-focused coping strategies, including accepting the reality of lung cancer, adopting a positive attitude/fighting spirit, denial, avoidance and distraction and information seeking. Maintaining normality was also important. Key factors that mediate the lung cancer experience were also identified including hope, social network, prior experience of cancer and other chronic illnesses, the competing coping strategies of patients and their primary carers, the unpredictable nature of patients' behaviour, changing symptomatology, the perceived attitudes of health professionals and the impact of perceived delays in diagnosis. This study provides important insights into how patients with lung cancer and their primary carers might be better supported.
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Affiliation(s)
- J Ellis
- Academic Palliative and Supportive Care Studies Group, Division of Health Service Research, University of Liverpool, Liverpool, UK.
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Leydon GM, Guerin M, Eyles C, Jacques L, Darlison L. ‘What matters to me’: an international online survey of people treating, affected by and living with lung cancer. Future Oncol 2012; 8:883-96. [DOI: 10.2217/fon.12.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Lung cancer is a common malignancy that occurs worldwide and generally has a poor prognosis. Its diagnosis presents significant physical and emotional challenges for patients and their family, friends and caregivers (FFCs). This study aimed to gain insights into patients’ and FFCs’ perspectives regarding lung cancer and its treatment, as well as physicians’ perceptions of patients’ thoughts about their illness. Patients & methods: An international online survey was conducted, assessing 113 patients diagnosed with non-small-cell lung cancer, 70 corresponding FFCs and 188 treating physicians. Data were collected using an interactive internet-based tool, in order to establish respondents’ priorities. Results: Interesting differences between patients’, FFCs’ and physicians’ perspectives on lung cancer were revealed. For all respondents, the primary feeling about lung cancer was described as “sadness”. Patients were more likely to express a determination to be positive, whereas fear was a common response for FFCs and was a perspective also reported by physicians. Physicians’ views on how they had communicated disease information were more positive than those of the patients, with many patients detecting physician hesitancy to communicate negative news. Conclusion: This study provides important insights into the self-reported thoughts and feelings of patients with lung cancer, their personal networks of FFCs and the physicians who care for them.
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Affiliation(s)
- Geraldine M Leydon
- Primary Medical Care Group, Primary Care & Population Science Unit, University of Southampton School of Medicine, Aldermoor Health Centre, Southampton, SO16 5ST, UK
| | - Maria Guerin
- Aintree Chest Centre, University Hospital Aintree, Liverpool, UK
| | - Caroline Eyles
- Complementary & Integrated Medicine Research Unit, Primary Care & Population Sciences, University of Southampton School of Medicine, Southampton, UK
| | | | - Liz Darlison
- Mesothelioma UK, University Hospitals of Leicester, Leicester, UK
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Abstract
This article aims to provide a brief review of the literature with regard to the impact of lung cancer on patients and their informal carers. Compared to other types of cancer, the distress associated with lung cancer has been found to be the most intense. Rather than focusing on symptoms in isolation recent emphasis regarding the symptom experience has been on symptoms clusters, as understanding these clusters may improve the management of ongoing and unrelieved symptoms. However, the disparities in methodology are significant barriers to producing comparable results, although recent efforts have been made to address these. Whilst research into symptoms has enormous potential for the management of symptom clusters, it needs to move away from the essentially reductionist stance which currently dominates and broaden its scope to one that acknowledges the complexity of the experience of symptom clusters from the perspective of the patient and their informal carer. Poor management of symptoms complicates patient care and potentially contributes to the heavy burden which often falls on family caregivers, especially as the disease progresses. The majority of studies focus on the experiences of primary care providers, most often the partner/spouse. Such studies have shown that spouses of patients with lung cancer exhibit significant distress and lower levels of quality of life than the general population. Research also indicates that significant others go through a transition process due to changes brought about by the diagnosis of lung cancer and struggle to endure and overcome difficulties and distress. Significant others were seen to suffer during this process of transition and experienced altered relationships. Clinicians working with patients suffering from lung cancer and their carers should intervene to enhance their quality of life from diagnosis, during the disease trajectory and during bereavement. Interventions need to be developed to support both patients and carers.
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Affiliation(s)
- Jackie Ellis
- Department of Health Service Research, Academic, Palliative and Supportive Care Studies Group (APSCSG), Institute of Psychology, Health and Society, Liverpool, UK.
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Bausewein C, Le Grice C, Simon S, Higginson I. The use of two common palliative outcome measures in clinical care and research: a systematic review of POS and STAS. Palliat Med 2011; 25:304-13. [PMID: 21464119 DOI: 10.1177/0269216310395984] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The Palliative Care Outcome Scale (POS) and the Support Team Assessment Schedule (STAS) are outcome measures assessing quality of care in palliative care patients. This review aims to appraise their use in clinical care and research. Five electronic databases were searched (February 2010) for original papers describing the validation or use of POS and/or STAS. Of the 83 papers included, 43 studies were on POS, 39 on STAS and one study using both. Eight STAS studies validated the original version, four an adaptation; 20 studies applied the STAS in another culture and 19 in other languages. POS papers reported included: 14 adapted POS versions, 12 translations of the POS and 15 studies of use in different cultures. Both measures have been used in cancer, HIV/AIDS and in mixed groups. POS has also been applied in neurological, kidney, pulmonary and heart disease. Both tools were used in different areas such as the evaluation of care or interventions, description of symptom prevalence and implementation of outcome measures in clinical practice. Overall, they seem to be well accepted tools for outcome measurement in palliative care, both in clinical care and research.
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Affiliation(s)
- C Bausewein
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, London, UK.
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Kaptein AA, Yamaoka K, Snoei L, Kobayashi K, Uchida Y, van der Kloot WA, Tabei T, Kleijn WC, Koster M, Wijnands G, Kaajan H, Tran T, Inoue K, van Klink R, van Dooren-Coppens E, Dik H, Hayashi F, Willems L, Annema-Schmidt D, Annema J, van der Maat B, van Kralingen K, Meirink C, Ogoshi K, Aaronson N, Nortier H, Rabe K. Illness perceptions and quality of life in Japanese and Dutch patients with non-small-cell lung cancer. Lung Cancer 2011; 72:384-90. [DOI: 10.1016/j.lungcan.2010.09.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 08/31/2010] [Accepted: 09/14/2010] [Indexed: 11/25/2022]
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Abstract
Quality of life (QOL) is a key clinical outcome in patients with lung cancer because of the debilitating nature of the disease and its treatments. In recent years, advances have been made in the assessment of QOL via patient-reported outcomes. A brief history of the evolution of QOL measures in oncology clinical trials and practice is given with specific reference to early-stage lung cancer. The role that QOL can play as a prognostic factor, especially among lung cancer patients, is delineated. The most commonly seen symptoms among lung cancer patients are listed. This review is intended to provide the clinical researcher with a summary of the alternative measures that are both valid and reasonable to consider when assessing QOL in early-stage lung cancer patients. Suggestions for QOL assessment in both a research setting and clinical environment are considered. A review of the most popular QOL assessments in general application to lung cancer and disease-specific measures is provided. An algorithm for selecting appropriate QOL assessments for lung cancer clinical research is provided. The primary conclusion from this work is that scientifically sound investigations into the QOL of early-stage lung cancer patients are feasible and encouraged so that the care of these patients can be optimized.
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Affiliation(s)
- Jeff A Sloan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
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Family physician involvement in cancer care and lung cancer patient emotional distress and quality of life. Support Care Cancer 2010; 19:1719-27. [PMID: 20882393 DOI: 10.1007/s00520-010-1010-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 09/14/2010] [Indexed: 12/25/2022]
Abstract
PURPOSE This study aims to describe emotional distress and quality of life (QoL) of patients at different phases of their lung cancer and the association with their family physician (FP) involvement. METHODS A prospective study on patients with lung cancer was conducted in three regions of Quebec, Canada. Patients completed, at baseline, several validated questionnaires regarding their psychosocial characteristics and their perceived level of FP involvement. Emotional distress [profile of mood states (POMS)] and QoL [European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30)] were reassessed every 3-6 months, whether patients had metastasis or not, up to 18 months. Results were regrouped according to cancer phase. Mixed models with repeated measurements were performed to identify variation in distress and QoL. RESULTS In this cohort of 395 patients, distress was low at diagnosis (0.79 ± 0.7 on a 0-4 scale), raising to 1.36 ± 0.8 at the advance phase (p < 0.0001). Patient's global QoL scores significantly decreased from the diagnosis to the advance phase (from 66 to 45 on a 0-100 scale; p < 0.0001). At all phases of cancer, FP involvement was significantly associated with patients' distress (p = 0.0004) and their global perception of QoL (p = 0.0080). These associations remained statistically significant even after controlling for age, gender, and presence of metastases. CONCLUSIONS This study provides new knowledge on patients' emotional distress and QoL with cancer evolution and, particularly, their association with FP involvement. Other studies should be conducted to further explore FP role in cancer supportive care.
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