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Baltussen JC, Cárdenas-Reyes P, Chavarri-Guerra Y, Ramirez-Fontes A, Morales-Alfaro A, Portielje JEA, Ramos-Lopez WA, Rosado-Canto V, Soto-Perez-de-Celis E. Time toxicity among older patients with cancer treated with palliative systemic therapy. Support Care Cancer 2024; 32:621. [PMID: 39212749 DOI: 10.1007/s00520-024-08844-1] [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: 05/15/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE The time toxicity of anticancer therapy, defined as days spent with healthcare contact during treatment, represents a critical but understudied outcome. This study aims to quantify time toxicity among older patients with cancer receiving palliative systemic treatment. METHODS All patients aged ≥ 65 years with metastatic cancer receiving cytotoxic chemotherapy, immunotherapy, or targeted therapy at a single center in Mexico were selected from a prospective patient navigation cohort. Patients completed a baseline assessment, including the G8 screening and quality of life measures. Physical healthcare contact days within the first 6 months were extracted from medical records and divided by days alive during the same period. Beta regression models were used to identify predictors of time toxicity. RESULTS We identified 158 older patients (median age 71 years); 86% received cytotoxic chemotherapy. Seventy-three percent had an impaired G8 score and were considered vulnerable/frail. Six-month overall survival was 74%. Within the first 6 months, patients spent a mean of 21% (95% confidence interval (CI) 19-23%) of days with healthcare contact. Concurrent radiotherapy (odds ratio (OR) 1.55; 95%CI 1.21-1.97), cytotoxic chemotherapy versus targeted therapy (OR 1.64; 95%CI 1.13-2.37), and an impaired G8 (OR 1.27; 95%CI 1.01-1.60) were associated with increased time toxicity. CONCLUSION Older adults with metastatic cancer spend 1 in 5 days with healthcare contact during treatment, with a higher burden of time toxicity for patients receiving radiotherapy or cytotoxic chemotherapy and those with potential frailty. These findings underscore the importance of informing patients about their expected healthcare contact days within the context of a limited life expectancy.
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Affiliation(s)
- Joosje C Baltussen
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico
| | - Paula Cárdenas-Reyes
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico
| | - Yanin Chavarri-Guerra
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Andrea Ramirez-Fontes
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico
| | - Andrea Morales-Alfaro
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico
| | | | - Wendy A Ramos-Lopez
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Valentina Rosado-Canto
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico.
- Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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Moussa Y, Jimenez Y, Wang W, Nahar N, Ahern V, Stuart K. The Development and Evaluation of an Educational Video for Breast Cancer Patients Requiring Adjuvant Radiation Therapy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:279-287. [PMID: 38388826 PMCID: PMC11102385 DOI: 10.1007/s13187-024-02408-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
Patient education and informed consent are required prior to adjuvant radiation therapy (RT) for early breast cancer (EBC), and include the role, rationale, potential toxicities and practicalities of the treatment process. Current education of patients about RT is verbal, in the form of a consultation by a radiation oncologist, often supplemented with print or online materials. This approach is limited by its doctor-dependency and non-standardised nature. Video education is being recognised increasingly as an opportunity to remediate this and appeal to patients' preference for visual learning. The purpose of this study was to design and produce a video as an educational adjunct for EBC patients' viewing prior to adjuvant RT, and to evaluate its acceptability through content analysis of three online focus group discussions, among ten participants with EBC requiring RT. After qualitative content analysis of the focus group transcripts, data were summarised into three main categories: (1) understanding of RT, (2) ease of engagement with the video and (3) anxiety and preparedness for RT. The 18-min video was positively received by all participants, and discussion feedback was used to inform improvements to the video. This focus group study demonstrated that the video was well understood, informative and acceptable to EBC patients in preparing them for RT. The effectiveness of the video in improving knowledge and alleviating distress in preparation for therapy will be further evaluated in an ethics-approved biphasic quasi-experimental study.
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Affiliation(s)
- Yvonne Moussa
- Sydney Medical School, C24-Westmead Hospital, The University of Sydney, Sydney, NSW, Australia
| | - Yobelli Jimenez
- Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Wei Wang
- Sydney Medical School, C24-Westmead Hospital, The University of Sydney, Sydney, NSW, Australia
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia
- Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, 166-174 Hawkesbury Rd, Westmead, NSW, 2145, Australia
| | - Najmun Nahar
- Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, 166-174 Hawkesbury Rd, Westmead, NSW, 2145, Australia
- Department of Radiation Oncology, Blacktown Cancer and Haematology Centre, Blacktown Hospital, Blacktown, NSW, Australia
| | - Verity Ahern
- Sydney Medical School, C24-Westmead Hospital, The University of Sydney, Sydney, NSW, Australia
- Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, 166-174 Hawkesbury Rd, Westmead, NSW, 2145, Australia
| | - Kirsty Stuart
- Sydney Medical School, C24-Westmead Hospital, The University of Sydney, Sydney, NSW, Australia.
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia.
- Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, 166-174 Hawkesbury Rd, Westmead, NSW, 2145, Australia.
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Nayak SG, George A, Sharan K, Nayak BS, Ravishankar N. Effectiveness of Comprehensive Intervention Programme on Quality of life, fatigue, self-efficacy, and psychosocial distress among head and neck cancer patients receiving radiotherapy. Support Care Cancer 2024; 32:216. [PMID: 38448712 PMCID: PMC10917822 DOI: 10.1007/s00520-024-08381-x] [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: 09/28/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE The study aimed at evaluating the Effectiveness of Comprehensive Intervention Programme (CIP) on Quality of life (QOL), fatigue, self-efficacy, and psychosocial distress among Head and Neck Cancer (HNC) patients receiving radiotherapy treatment. METHODS Single-centre non-RCT time series study was conducted among 134 HNC patients (67 observed, followed by 67 subjected to CIP). FACT- H&N, FACT-F, Cancer Behavior Inventory and psychosocial distress scales were used to assess QOL, fatigue, self-efficacy, and psychosocial distress respectively. CIP was provided to the intervention arm twice a week during the course of radiation therapy along with the standard care; the control arm received only standard care. Data were collected before commencing radiotherapy, and post-test assessments were carried out at the end of radiotherapy treatment, and at 3 and 6 months after completion of radiotherapy. RESULTS Repeated measures ANOVA revealed a statistically significant improvement with CIP in QOL (F (1.917) = 454.103, p = 0.001), fatigue (F (2.106) = 183.775, p = 0.001), self-efficacy (F (2.429) = 190.861, p = 0.001), and psychosocial distress (F (2.288) = 290.105, p = 0.001) in the intervention arm. CONCLUSION The CIP implemented to address multitude of issues in HNC patients receiving radiotherapy, proved to be effective in reducing the impact of treatment on QOL, fatigue, self-efficacy and psychosocial distress in HNC patients receiving radiotherapy.
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Affiliation(s)
- Shalini Ganesh Nayak
- Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anice George
- Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Krishna Sharan
- Radiotherapy & Oncology, KS Hegde Medical Academy, Nitte (Deemed to Be University), Mangalore, Karnataka, India
| | - Baby S Nayak
- Department of Child Health Nursing Manipal College of Nursing Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - N Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
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Juan HY, Khachemoune A. A review of Merkel cell carcinoma. JAAPA 2023; 36:11-16. [PMID: 37820270 DOI: 10.1097/01.jaa.0000979460.69305.b7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
ABSTRACT Merkel cell carcinoma (MCC) is a rare and aggressive type of metastatic, nonmelanoma skin cancer derived from Merkel cells in the epidermis. MCC can be induced by sun exposure or via Merkel cell polyomavirus (MCV) gene expression. MCV is found in most patients with MCC and is associated with a lower recurrence rate of MCC. MCC has a wide range of clinical presentations that make diagnosis challenging. Histologic examination is performed using unique markers to differentiate it from other diagnoses. This article reviews the pathogenesis, clinical presentation, histopathology, differential diagnosis, and treatment of MCC.
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Affiliation(s)
- Hui Yu Juan
- At the time this article was written, Hui Yu Juan was a student in the Virginia Commonwealth University School of Medicine in Richmond, Va. Amor Khachemoune practices at the Brooklyn (N.Y.) VA Medical Center and SUNY Downstate's Department of Dermatology, also in Brooklyn, N.Y. The authors have disclosed no potential conflicts of interest, financial or otherwise
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Sousa-Leite M, Costa R, Figueiredo B, Gameiro S. Discussing the possibility of fertility treatment being unsuccessful as part of routine care offered at clinics: patients' experiences, willingness, and preferences. Hum Reprod 2023:7169439. [PMID: 37196325 DOI: 10.1093/humrep/dead096] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/28/2023] [Indexed: 05/19/2023] Open
Abstract
STUDY QUESTION Are patients willing to discuss the possibility of treatment being unsuccessful as part of routine care offered at clinics, and what are the factors associated with this willingness? SUMMARY ANSWER Nine in every 10 patients are willing to discuss this possibility as part of routine care, with willingness being associated with higher perceived benefits, lower barriers, and stronger positive attitudes towards it. WHAT IS KNOWN ALREADY Fifty-eight percent of patients who complete up to three cycles of IVF/ICSI in the UK do not achieve a live birth. Offering psychosocial care for unsuccessful fertility treatment (PCUFT), defined as assistance and guidance on the implications of treatment being unsuccessful, could reduce the psychosocial distress patients experience when it happens, and promote positive adjustment to this loss. Research shows 56% of patients are willing to plan for an unsuccessful cycle, but little is known about their willingness and preferences towards discussing the possibility of definitive unsuccessful treatment. STUDY DESIGN, SIZE, DURATION The study was of cross-sectional design, comprising a theoretically driven and patient-centred bilingual (English, Portuguese) mixed-methods online survey. The survey was disseminated via social media (April 2021-January 2022). Eligibility criteria included being aged 18 or older, waiting to or undergoing an IVF/ICSI cycle, or having completed a cycle within the previous 6 months without achieving a pregnancy. Out of 651 people accessing the survey, 451 (69.3%) consented to participate. From these, 100 did not complete 50% of the survey questions, nine did not report on the primary outcome variable (willingness), and 342 completed the survey (completion rate 75.8%, 338 women). PARTICIPANTS/MATERIALS, SETTING, METHODS The survey was informed by the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB). Quantitative questions covered sociodemographic characteristics and treatment history. Quantitative and qualitative questions gathered data on past experiences, willingness, and preferences (with whom, what, how and when) to receive PCUFT, as well as theory-informed factors hypothesized to be associated with patients' willingness to receive it. Descriptive and inferential statistics were used on quantitative data about PCUFT experiences, willingness, and preferences, and thematic analysis was applied to textual data. Two logistic regressions were used to investigate the factors associated with patients' willingness. MAIN RESULTS AND THE ROLE OF CHANCE Participants were, on average, 36 years old and most resided in Portugal (59.9%) and the UK (38.0%). The majority (97.1%) were in a relationship for around 10 years, and 86.3% were childless. Participants were undergoing treatment for, on average, 2 years [SD = 2.11, range: 0-12 years], with most (71.8%) having completed at least one IVF/ICSI cycle in the past, almost all (93.5%) without success. Around one-third (34.9%) reported having received PCUFT. Thematic analysis showed participants received it mainly from their consultant. The main topic discussed was patients' low prognosis, with the emphasis being put on achieving a positive outcome. Almost all participants (93.3%) would like to receive PCUFT. Reported preferences indicated that 78.6% wanted to receive it from a psychologist/psychiatrist/counsellor, mostly in case of a bad prognosis (79.4%), emotional distress (73.5%), or difficulties in accepting the possibility of treatment being unsuccessful (71.2%). The preferred time to receive PCUFT was before initiating the first cycle (73.3%), while the preferred format was in an individual (mean = 6.37, SD = 1.17; in 1-7 scale) or couple (mean = 6.34, SD = 1.24; in 1-7 scale) session. Thematic analysis showed participants would like PCUFT to provide an overview of treatment and all possible outcomes tailored to each patient's circumstances and to encompass psychosocial support, mainly focused on coping strategies to process loss and sustain hope towards the future. Willingness to receive PCUFT was associated with higher perceived benefit of building psychosocial resources and coping strategies (odds ratios (ORs) 3.40, 95% CI 1.23-9.38), lower perceived barrier of triggering negative emotions (OR 0.49, 95% CI 0.24-0.98), and stronger positive attitudes about PCUFT being beneficial and useful (OR 3.32, 95% CI 2.12-5.20). LIMITATIONS, REASONS FOR CAUTION Self-selected sample, mainly composed of female patients who had not yet achieved their parenthood goals. The small number of participants unwilling to receive PCUFT reduced statistical power. The primary outcome variable was intentions, and research shows a moderate association between intentions and actual behaviour. WIDER IMPLICATIONS OF THE FINDINGS Fertility clinics should provide patients with early opportunities to discuss the possibility of their treatment being unsuccessful as part of routine care. PCUFT should focus on minimizing suffering associated with grief and loss by reassuring patients they can cope with any treatment outcome, promoting coping resources, and signposting to additional support. STUDY FUNDING/COMPETING INTEREST(S) M.S.-L. holds a doctoral fellowship from the Portuguese Foundation for Science and Technology, I.P. [Fundação para a Ciência e a Tecnologia] (FCT; SFRH/BD/144429/2019). R.C. holds a post-doctoral fellowship supported by the European Social Fund (ESF) and FCT (SFRH/BPD/117597/2016). The EPIUnit, ITR and CIPsi (PSI/01662) are also financed by FCT through the Portuguese State Budget, in the scope of the projects UIDB/04750/2020, LA/P/0064/2020 and UIDB/PSI/01662/2020, respectively. Dr Gameiro reports consultancy fees from TMRW Life Sciences and Ferring Pharmaceuticals A/S, speaker fees from Access Fertility, SONA-Pharm LLC, Meridiano Congress International and Gedeon Richter, grants from Merck Serono Ltd, an affiliate of Merck KgaA, Darmstadt, Germany. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Sousa-Leite
- School of Psychology, Cardiff University, Cardiff, UK
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - R Costa
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - B Figueiredo
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - S Gameiro
- School of Psychology, Cardiff University, Cardiff, UK
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Grilo AM, Almeida B, Rodrigues C, Isabel Gomes A, Caetano M. Using virtual reality to prepare patients for radiotherapy: A systematic review of interventional studies with educational sessions. Tech Innov Patient Support Radiat Oncol 2023; 25:100203. [PMID: 36873800 PMCID: PMC9982317 DOI: 10.1016/j.tipsro.2023.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/06/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose To understand the impact of radiotherapy educational sessions with virtual reality on oncologic adult patients' psychological and cognitive outcomes related to the treatment experience. Methods This review was performed according to the Preferred Reporting Items for Systematic Reviews guidelines. A systematic electronic search in three databases, MEDLINE, Scopus, and Web of Science, was conducted in December 2021 to find interventional studies with adult patients undergoing external radiotherapy who received an educational session with virtual reality before or during the treatment. The studies that provided qualitative or quantitative information about the impact of educational sessions on patients' psychological and cognitive dimensions related to RT experience were retained for analysis. Results Of the 25 records found, eight articles about seven studies were analysed that involved 376 patients with different oncological pathologies. Most studies evaluated knowledge and treatment-related anxiety, mainly through self-reported questionnaires. The analysis showed a significant improvement in patients' knowledge and comprehension of radiotherapy treatment. Anxiety levels also decreased with virtual reality educational sessions and throughout the treatment in almost all the studies, although with less homogeneous results. Conclusion Virtual reality methods in standard educational sessions can enhance cancer patients' preparation for radiation therapy by increasing their understanding of treatment and reducing anxiety.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC − Health & Technology Research Center, ESTeSL − Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
- CICPSI − Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Corresponding author.
| | - Bárbara Almeida
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Carolina Rodrigues
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Ana Isabel Gomes
- CICPSI − Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Marco Caetano
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
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Zucca A, Mansfield E, Sanson-Fisher R, Wyse R, Johnston SA, Fakes K, Robinson S, Smith S. Perceived Provision of Perioperative Information and Care by Patients Who Have Undergone Surgery for Colorectal Cancer: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15249. [PMID: 36429966 PMCID: PMC9690373 DOI: 10.3390/ijerph192215249] [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] [Received: 10/17/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Active patient participation in preparation and recovery from colorectal cancer surgery can be facilitated by timely information and care and may improve patient wellbeing and reduce hospitalizations; Methods: We aimed to identify gaps in perioperative information and care by asking colorectal cancer surgical patients to retrospectively report on their perceptions of care via a cross-sectional survey; Results: Overall, 179 (64% consent rate) patients completed one of two 64-item surveys exploring their views of 'optimal care' or their experiences of 'actual care'. In total, 41 (64%) aspects of care were endorsed as optimal. Of these, almost three-quarters (73%) were received by most patients (80% or more). Gaps in care were identified from discrepancies in the endorsement of optimal versus actual survey items. Of the 41 items identified as representing 'optimal care', 11 items were received by fewer than 80% of patients, including the provision of information about the impact of surgical wait-times on cancer cure (69%); pre-habilitation behaviors to improve health (75%); the type of questions to ask the health care team (74%); impact of pain medications on bowel movements (73%); how to obtain medical supplies for self-care at home (67%); dietary or exercise advice after discharge (25-31%); and emotional advice after discharge (44%). CONCLUSIONS These gaps represent patient-centered priorities and targets for supportive interventions.
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Affiliation(s)
- Alison Zucca
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Elise Mansfield
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Rob Sanson-Fisher
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Rebecca Wyse
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Sally-Anne Johnston
- Department of Colorectal Surgery, Division of Surgery, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
| | - Kristy Fakes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Sancha Robinson
- Department of Anaesthesia, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Department of Anaesthesia, Calvary Mater Newcastle Hospital, Newcastle, NSW 2298, Australia
| | - Stephen Smith
- Department of Colorectal Surgery, Division of Surgery, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Department of Surgery, Calvary Mater Newcastle Hospital, Newcastle, NSW 2298, Australia
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Sousa-Leite M, Fernandes M, Reis S, Costa R, Figueiredo B, Gameiro S. Feasibility and acceptability of psychosocial care for unsuccessful fertility treatment. Health Expect 2022; 25:2902-2913. [PMID: 36128606 DOI: 10.1111/hex.13598] [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: 04/26/2022] [Revised: 08/09/2022] [Accepted: 08/22/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Many people undergo fertility treatment to have biological children, but around four in ten patients complete all treatment cycles without having the children they desire. This triggers intense grief from which patients report taking on average 2 years to recover. Fertility guidelines and regulators stress the need to support patients through this process, but there is a scarcity of evaluated interventions to this end and evidence about when and how to offer care is lacking. This study explored patients' and healthcare professionals' (HCPs) experiences of and views about provision of psychosocial care (to patients facing unsuccessful fertility treatment, i.e., care provided by a mental health professional to address the emotional, cognitive, behavioural, relational and social needs that patients have at this stage of treatment). METHODS Five qualitative online focus groups were conducted with Portuguese participants: three with patients waiting to initiate or undergoing their last cycle of in vitro fertilization/intracytoplasmic sperm injection or having completed it within the last 2 months without achieving a pregnancy and two with HCPs working at fertility clinics. Focus groups were recorded and transcribed verbatim, and data were analysed with Framework Analysis. RESULTS Thirteen patients and nine HCPs participated. Analysis resulted in 1293 codes, systematically organized into 13 categories, 4 themes and 1 metatheme. The latter showed high consensus about the need for psychosocial care for unsuccessful treatment, but perceived challenges in its implementation. Themes reflected (1) consensual demand for psychosocial care at all stages of treatment but particularly at the end, (2) high perceived acceptability of integrating preventive care initiated during treatment with early psychosocial care only for those patients who experience unsuccessful treatment, (3) perceived challenges of implementing psychosocial care for unsuccessful treatment at clinics and (4) suggestions to promote its acceptability and feasibility. CONCLUSION Patients and HCPs perceive that clinics should improve care provision across the whole treatment pathway and in particular for unsuccessful fertility treatment. Suggestions were made to inform future research focusing on the development and evaluation of psychosocial interventions to this end. PATIENT OR PUBLIC CONTRIBUTION Patients and HCPs participated in the focus groups. Two HCPs also revised the manuscript.
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Affiliation(s)
- Mariana Sousa-Leite
- Cardiff Fertility Studies Group, School of Psychology, Cardiff University, Cardiff, UK.,Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Mónica Fernandes
- Psychiatry and Mental Health Service, University Hospital Centre of Porto (CHUP)/Northern Maternal and Child Centre (CMIN), Porto, Portugal
| | - Salomé Reis
- Department of Psychology, University Hospital Centre of São João (CHUSJ), Porto, Portugal
| | - Raquel Costa
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Bárbara Figueiredo
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Sofia Gameiro
- Cardiff Fertility Studies Group, School of Psychology, Cardiff University, Cardiff, UK
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Effects of Self-Care Education Intervention Program (SCEIP) on Activation Level, Psychological Distress, and Treatment-Related Information. Healthcare (Basel) 2022; 10:healthcare10081572. [PMID: 36011229 PMCID: PMC9408020 DOI: 10.3390/healthcare10081572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Self-care education can direct patients to manage their side effects during treatment, reduce psychological distress, and improve self-care information. In this study, the effectiveness of the Self-Care Education Intervention Program (SCEIP) on patient activation levels, psychological distress, and treatment-related concerns in women with breast cancer was assessed by adopting a longitudinal quasi-experimental pre-test and post-test design. The data for 246 women with breast cancer undergoing adjuvant chemotherapy were collected. Pre- and post-interventional assessments were conducted at baseline (T1) and the second (T2), fourth (T3), and sixth (T4) cycles using the 13-item Patient Activation Measure, 14-item Hospital Anxiety and Depression Scale, and 25-item Cancer Treatment Survey. It was found that the SCEIP significantly improved the activation level (p ≤ 0.001), psychological distress (anxiety level (p ≤ 0.001), the depression level (p ≤ 0.001)), and treatment-related concerns (sensory/psychological concerns (p = 0.05); procedural concerns (p ≤ 0.001)). Therefore, the SCEIP could potentially improve patients’ activation level, psychological distress, and treatment-related concerns regarding symptom management during chemotherapy, specifically for Malaysian women with breast cancer.
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Turon H, Hobden B, Fakes K, Clapham M, Proietto A, Sanson-Fisher R. Preparation for Cancer Treatment: A Cross-Sectional Study Examining Patient Self-Reported Experiences and Correlates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10167. [PMID: 36011803 PMCID: PMC9407820 DOI: 10.3390/ijerph191610167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Given the significant physical and psychosocial side-effects cancer treatment has on individuals, it is important to ensure patients receive adequate preparation prior to treatment. The purpose of this study was to explore, among Australian oncology patients, (i) the self-reported treatment preparation information they received; and (ii) the patient characteristics associated with the treatment preparation information received. Patients in the early stages of cancer treatment were invited to complete a survey exploring their receipt of information about treatment preparation. Items assessed patients' self-report of whether they had received information about the treatment process. A total of 165 participants completed the survey. Patients most frequently reported receiving information about how they might feel physically (94%) and what side effects to watch for (93%). One in five patients reported not receiving information about how to cope with any stress or worry related to treatment. Females reported receiving significantly fewer items of care compared to males (p = 0.0083). This study suggests that while self-reported preparation for cancer treatment is generally high, components of preparation related to psychosocial concerns could be improved. Survey data could be used as a feedback tool for centres to monitor delivery of care.
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Affiliation(s)
- Heidi Turon
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Kristy Fakes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Matthew Clapham
- Clinical Research Design and Statistics, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Anthony Proietto
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
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11
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Smith-Lickess SK, Stefanic N, Shaw J, Shepherd H, Naehrig D, Turner RM, Cabrera-Aguas M, Meiser B, Halkett GK, Jackson M, Saade G, Bucci J, Milross C, Dhillon HM. What is the effect of a low literacy talking book on patient knowledge, anxiety and communication before radiation therapy starts? A pilot study. J Med Radiat Sci 2022; 69:463-472. [PMID: 35839313 DOI: 10.1002/jmrs.606] [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: 09/03/2021] [Accepted: 06/29/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Radiation therapy is a common cancer treatment, requiring timely information to help patients prepare for treatment. We pilot tested a low literacy, psycho-educational talking book (written booklet, with accompanying audio recording) to examine (i) the effect of the tool on knowledge, anxiety and communication; (ii) acceptability, and (iii) how it was used in appointments. METHODS A pre-post design was employed. Patients scheduled to receive radiation therapy for any cancer were recruited from two hospitals in Sydney, Australia. Participants were sent the talking book before treatment planning and completed baseline and follow-up surveys, before and after the intervention. RESULTS Forty participants were recruited, and 39 completed all study assessments. Overall, knowledge increased after receiving the talking book by 3.8 points from 13.9 to 17.7/20 (95% confidence interval (CI) 2.7, 4.8, P < 0.001). Anxiety and concerns were significantly lower after receiving the talking book (P = 0.015 and P = 0.004, respectively). Nearly half of participants (s = 17, 48%) reported using the book during appointments. Most reported finding it easier to communicate (n = 31, 89%) and to ask more questions (n = 21, 62%). CONCLUSION The talking book shows promise in improving knowledge, reducing anxiety and enhancing communication. Strategies to support the implementation of the talking book are required. Further studies to translate the book into different languages are also planned.
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Affiliation(s)
- Sian K Smith-Lickess
- Psychosocial Research Group, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia.,Department of Psychology, University of Bath, Bath, UK
| | - Natalie Stefanic
- Psychosocial Research Group, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Heather Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Diana Naehrig
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Chris O'Brien Lifehouse, Radiation Oncology and Medical Services, Sydney, NSW, Australia
| | - Robin M Turner
- Dunedin School of Medicine, Otago University, Wellington, New Zealand
| | - Maria Cabrera-Aguas
- Psychosocial Research Group, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia.,The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, NSW, Australia
| | - Bettina Meiser
- Psychosocial Research Group, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia
| | - Georgia Kb Halkett
- Faculty of Health Sciences, Curtin School of Nursing, Curtin University, Perth, WA, Australia
| | - Michael Jackson
- UNSW Sydney, Prince of Wales Clinical School, Randwick, Sydney, NSW, Australia.,Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
| | - George Saade
- Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Joseph Bucci
- St George Hospital Cancer Care, Radiation Oncology Unit, Sydney, NSW, Australia
| | - Christopher Milross
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Chris O'Brien Lifehouse, Radiation Oncology and Medical Services, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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12
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Li G, Zhang Q, Han Z, Zhu Y, Shen H, Liu Z, Zhou Z, Ding W, Han S, He J, Yin Z, Zhou J, Ou R, Luo M, Liu S. IL-7 and CCR2b Co-Expression-Mediated Enhanced CAR-T Survival and Infiltration in Solid Tumors. Front Oncol 2021; 11:734593. [PMID: 34778046 PMCID: PMC8579717 DOI: 10.3389/fonc.2021.734593] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/06/2021] [Indexed: 01/06/2023] Open
Abstract
Chimeric antigen receptor T (CAR-T) cells are not effective in solid tumor treatment due to reduced invasion and expansion, and short survival time. This study aimed to explore whether interleukin (IL)-7 and CCR2b expression could improve GD2-CAR-T cell survival and infiltration in neuroblastoma and melanoma treatment. IL-7 and CCR2b were inserted into the classical second-generation CAR structure to construct 7×2b CAR. The 7×2b CAR-T cell phenotypes were evaluated by flow cytometry and the chemokine levels by ELISA. The 7×2b CAR-T cell migration and anti-tumor abilities were detected by Transwell assay and animal experiments in vivo. We report that compared with that of CAR-T cells, 7×2b CAR-T cell IL-7 secretion and CCR2b expression did not affect the T cell surface expression of CAR or CAR-T specificity and efficacy against tumor cells. The 7×2b CAR-T cells could induce IFN-γ secretion in GD2-positive tumor cells, killing them as well as conventional CAR-T cells. Moreover, IL-7 and CCR2b co-expression enhanced the 7×2b CAR-T cell survival and migration. Similar to conventional CAR-T, 7×2b CAR-T cells could also inhibit tumor growth and increase IFN-γ, Gzms-B, and IL-2 expression. Finally, unlike in mice injected with CAR-T cells, CD3 expression was the most abundant in the spleen and tumor tissues in mice injected with 7×2b CAR-T cells. Our study demonstrates that IL-7 and CCR2b co-expression in GD2-CAR-T cells exhibit stronger anti-tumor activity than classical second-generation CAR-T cells, shedding light on the potential novel GD2-positive neuroblastoma and melanoma treatment approach.
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Affiliation(s)
- Guangchao Li
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China.,Department of Research and Development, Guangzhou Bio-gene Technology Co., Ltd, Guangzhou, China
| | - Qing Zhang
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zeping Han
- Department of Laboratory, Central Hospital of Panyu District, Guangzhou, China
| | - Yangmin Zhu
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Huijuan Shen
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhi Liu
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhao Zhou
- Department of Research and Development, Guangzhou Bio-gene Technology Co., Ltd, Guangzhou, China
| | - Wen Ding
- Department of Research and Development, Guangzhou Bio-gene Technology Co., Ltd, Guangzhou, China
| | - Siqi Han
- Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Southern Medical University, Nanjing, China
| | - Jinhua He
- Department of Laboratory, Central Hospital of Panyu District, Guangzhou, China
| | - Zhao Yin
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jie Zhou
- Department of Hematology, People's Hospital of Deyang City, Deyang, China
| | - Ruiming Ou
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Min Luo
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China.,Department of Research and Development, Guangzhou Bio-gene Technology Co., Ltd, Guangzhou, China
| | - Shuang Liu
- Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China
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13
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Wu D, Wei C, Li Y, Yang X, Zhou S. Pyroptosis, a New Breakthrough in Cancer Treatment. Front Oncol 2021; 11:698811. [PMID: 34381721 PMCID: PMC8350724 DOI: 10.3389/fonc.2021.698811] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/02/2021] [Indexed: 12/11/2022] Open
Abstract
The way of cell death can be roughly divided into two categories: cell necrosis and PCD(programmed cell death). Pyroptosis is a kind of PCD, its occurrence depends on the gasdermin protein family and it will produce inflammatory response. With constant research in recent years, more and more evidences show that pyroptosis is closely related to the occurrence and development of tumors. The treatment of tumors is a big problem worldwide. We focus on whether we can discover new potential tumor markers and new therapeutic targets from the mechanism. If we can understand the mechanism of pyroptosis and clear the relationship between pyroptosis and the development of tumors, this may provide a new reference for clinical cancer treatment.
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Affiliation(s)
- Dengqiang Wu
- National Center for International Research of Bio-targeting Theranostics, Guangxi Key Laboratory of Bio-targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-targeting Theranostics, Guangxi Medical University, Nanning, China
| | - Changhong Wei
- National Center for International Research of Bio-targeting Theranostics, Guangxi Key Laboratory of Bio-targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-targeting Theranostics, Guangxi Medical University, Nanning, China
| | - Yujie Li
- Department of Biochemistry and Molecular Biology, School of Pre-Clinical Science, Guangxi Medical University, Nanning, China
| | - Xuejia Yang
- National Center for International Research of Bio-targeting Theranostics, Guangxi Key Laboratory of Bio-targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-targeting Theranostics, Guangxi Medical University, Nanning, China
| | - Sufang Zhou
- National Center for International Research of Bio-targeting Theranostics, Guangxi Key Laboratory of Bio-targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-targeting Theranostics, Guangxi Medical University, Nanning, China.,Department of Biochemistry and Molecular Biology, School of Pre-Clinical Science, Guangxi Medical University, Nanning, China
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14
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Grynne A, Browall M, Fristedt S, Ahlberg K, Smith F. Integrating perspectives of patients, healthcare professionals, system developers and academics in the co-design of a digital information tool. PLoS One 2021; 16:e0253448. [PMID: 34270564 PMCID: PMC8284604 DOI: 10.1371/journal.pone.0253448] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 06/06/2021] [Indexed: 11/29/2022] Open
Abstract
Background Patients diagnosed with cancer who are due to commence radiotherapy, often, despite the provision of a considerable amount of information, report a range of unmet information needs about the treatment process. Factors such as inadequate provision of information, or the stressful situation of having to deal with information about unfamiliar things, may influence the patient’s ability to comprehend the information. There is a need to further advance the format in which such information is presented. The composition of information should be tailored according to the patient’s individual needs and style of learning. Method and findings The PD methodology is frequently used when a technology designed artefact is the desired result of the process. This research is descriptive of its kind and provides a transparent description of the co-design process used to develop an innovative digital information tool employing PD methodology where several stakeholders participated as co-designers. Involving different stakeholders in the process in line with recommended PD activities enabled us to develop a digital information tool that has the potential to be relevant and user-friendly for the ultimate consumer. Conclusions Facilitating collaboration, structured PD activities can help researchers, healthcare professionals and patients to co-design patient information that meets the end users’ needs. Furthermore, it can enhance the rigor of the process, ensure the relevance of the information, and finally have a potential to employ a positive effect on the reach of the related digital information tool.
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Affiliation(s)
- Annika Grynne
- Department of Nursing, School of Health and Welfare, IMPROVE, Jönköping University, Jönköping, Sweden
- * E-mail:
| | - Maria Browall
- Department of Nursing, School of Health and Welfare, IMPROVE, Jönköping University, Jönköping, Sweden
- Affiliated to Department of Oncology, Inst of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sofi Fristedt
- The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Karin Ahlberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Gothenburg, Sweden
| | - Frida Smith
- Regional Cancer Centre West, Gothenburg, Sweden
- Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
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15
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Berg MN, Ngune I, Schofield P, Grech L, Juraskova I, Strasser M, Butt Z, Halkett GKB. Effectiveness of online communication skills training for cancer and palliative care health professionals: A systematic review. Psychooncology 2021; 30:1405-1419. [PMID: 33909328 DOI: 10.1002/pon.5702] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To determine the reported effect of online communication skills training (CST) on health professional (HP) communication skills and patient care outcomes in cancer and palliative care. METHODS Primary research published in English between January 2003 and April 2019 was identified in bibliographic databases including Medline, Embase and Proquest (Prospero: CRD42018088681). An integrated mixed-method approach included studies describing a CST intervention and its effect, for cancer or palliative care HPs, delivered online or blended with an online component. Included studies' outcomes were categorised then findings were stratified by an evaluation framework and synthesised in an effect direction plot. Risk of bias was assessed using Joanna Briggs Institute's tools. RESULTS Nineteen included studies (five randomised controlled trials, 11 pre-post, two post-test and one qualitative study) evaluated a CST intervention (median duration = 3.75 h; range 0.66-96 h) involving 1116 HPs, 422 students and 732 patients. Most interventions taught communication skills for specific scenarios and approximately half were delivered solely online and did not involve role plays. Online CST improved HPs' self-assessed communication skills (three studies, 215 participants), confidence (four studies, 533 participants), and objective knowledge (five studies, 753 participants). While few studies evaluated patient outcomes, CST may benefit observed communication skills in care settings (two studies, 595 participants). CONCLUSIONS Online CST benefits oncology HPs' subjectively-reported communication skills and confidence, and objective knowledge. Translation to patient outcomes requires further investigation. The quality of research varied and few studies had a control group. We recommend improvements to study design, evaluation and implementation.
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Affiliation(s)
- Melissa N Berg
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.,School of Nursing and Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Irene Ngune
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.,School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Penelope Schofield
- Behavioural Science Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Psychology, and Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Lisa Grech
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.,School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Ilona Juraskova
- The University of Sydney, Centre for Medical Psychology and Evidence-based Decision-making, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Strasser
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Zoe Butt
- The University of Sydney, Centre for Medical Psychology and Evidence-based Decision-making, Sydney, New South Wales, Australia
| | - Georgia K B Halkett
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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16
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Turon H, Hill D, Watson R, Hobden B, Millar J, Sanson-Fisher R. A patient-centred approach to determine optimal supportive care across the cancer trajectory: a cross-sectional study. Eur J Cancer Care (Engl) 2021; 30:e13455. [PMID: 33881182 DOI: 10.1111/ecc.13455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/04/2021] [Accepted: 04/05/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Supportive care is recognised as an integral component of cancer care. To comprehensively improve supportive care and to inform policy, it is essential to examine consumer's views of health services. This study aimed to develop and test a patient-centred approach by measuring consumer perspectives on the importance of aspects of supportive care to determine what patients consider highest quality or 'optimal' care. METHODS A cross-sectional survey was conducted in oncology outpatient clinics. Eligible patients were invited to complete the optimal care survey on an iPad. The survey consisted of 69 items assessing 14 care domains across five phases of the care trajectory. RESULTS A total of 359 participants completed the survey. Items in the 'preparation for treatment' and 'follow-up and end-of-life care' phases were endorsed as very important/essential to optimal care by most participants (79-97% and 80-100%, respectively). Items in the 'preparation for first appointment' (48-84%), 'first appointment' (51-97%) and 'receiving treatment' (32-93%) phases showed greater variation in endorsement. CONCLUSION This study provides a patient-centred tool for quantifying optimal supportive care for people with cancer across the treatment trajectory. This tool could be used by healthcare providers to evaluate existing care quality, develop policies and guide clinical service improvements.
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Affiliation(s)
- Heidi Turon
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - David Hill
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Cancer Council Victoria, Melbourne, VIC, Australia.,School of Population & Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Rochelle Watson
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Jeremy Millar
- Cancer Council Victoria, Melbourne, VIC, Australia.,Alfred Health Radiation Oncology Services, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
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17
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Fristedt S, Smith F, Grynne A, Browall M. Digi-Do: a digital information tool to support patients with breast cancer before, during, and after start of radiotherapy treatment: an RCT study protocol. BMC Med Inform Decis Mak 2021; 21:76. [PMID: 33632215 PMCID: PMC7908724 DOI: 10.1186/s12911-021-01448-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/18/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Radiation Therapy (RT) is a common treatment after breast cancer surgery and a complex process using high energy X-rays to eradicate cancer cells, important in reducing the risk of local recurrence. The high-tech environment and unfamiliar nature of RT can affect the patient's experience of the treatment. Misconceptions or lack of knowledge about RT processes can increase levels of anxiety and enhance feelings of being unprepared at the beginning of treatment. Moreover, the waiting time is often quite long. The primary aim of this study will be to evaluate whether a digital information tool with VR-technology and preparatory information can decrease distress as well as enhance the self-efficacy and health literacy of patients affected by breast cancer before, during, and after RT. A secondary aim will be to explore whether the digital information tool increase patient flow while maintaining or increasing the quality of care. METHOD The study is a prospective and longitudinal RCT study with an Action Research participatory design approach including mixed-methods data collection, i.e., standardised instruments, qualitative interviews (face-to-face and telephone) with a phenomenological hermeneutical approach, diaries, observations, and time measurements, and scheduled to take place from autumn 2020 to spring 2022. The intervention group (n = 80), will receive standard care and information (oral and written) and the digital information tool; and the control group (n = 80), will receive standard care and information (oral and written). Study recruitment and randomisation will be completed at two centres in the west of Sweden. DISCUSSION Research in this area is scarce and, to our knowledge, only few previous studies examine VR as a tool for increasing preparedness for patients with breast cancer about to undergo RT that also includes follow-ups six months after completed treatment. The participatory approach and design will safeguard the possibilities to capture the patient perspective throughout the development process, and the RCT design supports high research quality. Digitalisation brings new possibilities to provide safe, person-centred information that also displays a realistic picture of RT treatment and its contexts. The planned study will generate generalisable knowledge of relevance in similar health care contexts. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04394325. Registered May 19, 2020. Prospectively registered.
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Affiliation(s)
- Sofi Fristedt
- Jönköping Academy For Improvement of Health and Welfare and IMPROVE, School of Health and Welfare, Jönköping University, Jönköping, Sweden. .,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Frida Smith
- Regional Cancer Centre West, Gothenburg, Sweden.,Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
| | - Annika Grynne
- Department of Nursing and IMPROVE, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Maria Browall
- Department of Nursing and IMPROVE, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Affiliated with the Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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18
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Yang Y, Sun X, Zhao Y, Ge W, Ding Z, Liu J, Wang L, Xu X, Zhang J. Anti-tumor activity and immunogenicity of a succinoglycan riclin. Carbohydr Polym 2020; 255:117370. [PMID: 33436203 DOI: 10.1016/j.carbpol.2020.117370] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 12/14/2022]
Abstract
Natural polysaccharides have attracted considerable interests due to diverse biological activities. Succinoglycan is an extracellular polysaccharide produced by most Agrobacterium strains. Here, we confirmed riclin was a typical succinoglycan by NMR and methylation analysis, and investigated the antitumor effects of riclin in sarcoma 180 tumor-bearing mice. The results showed that riclin inhibited the tumor growth significantly as well as cyclophosphamide (CTX). While CTX caused serious damage to spleen structure, riclin increased the spleen index and promoted lymphocytes proliferation in peripheral blood, spleen and lymph nodes. Riclin decreased splenocytes apoptosis as evidenced by alterations of B-cell lymphoma-2 family proteins and Cleaved Caspase-3 protein. Moreover, 1H nuclear magnetic resonance (NMR)-based metabolomics analysis revealed that riclin partially altered the metabolic profiles of splenocytes. In conclusion, riclin is a succinoglycan that performed strong immunogenicity and suppressed sarcoma growth in mice. Succinoglycan riclin could be a potential antitumor agent for functional food and pharmaceutical purpose.
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Affiliation(s)
- Yunxia Yang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
| | - Xiaqing Sun
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
| | - Yang Zhao
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
| | - Wenhao Ge
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
| | - Zhao Ding
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
| | - Junhao Liu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
| | - Lei Wang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
| | - Xi Xu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
| | - Jianfa Zhang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China.
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19
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Samoil D, Abdelmutti N, Gallagher LO, Jivraj N, Quartey NK, Tinker L, Giuliani M, Trang A, Ferguson SE, Papadakos J. Evaluating the effect of a group pre-treatment chemotherapy psycho-education session for chemotherapy-naive gynecologic cancer patients and their caregivers. Gynecol Oncol 2020; 160:234-243. [PMID: 33077261 DOI: 10.1016/j.ygyno.2020.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The objective was to evaluate the effects of a pre-chemotherapy education class on chemotherapy-naïve patients diagnosed with gynecologic cancer and their informal caregivers. METHODS A prospective cohort study was conducted at a cancer centre in Toronto, Canada. All women diagnosed with gynecologic cancer, who were scheduled to receive chemotherapy treatment, and their caregivers were invited to attend the GyneChemo class, newly introduced as the centre's standard of care. Consenting attendees were asked to complete pre-and post-class survey measures assessing anxiety, self-efficacy, information needs, preparedness to begin chemotherapy treatment, and satisfaction with the class. RESULTS Between September 2014 to September 2016, 642 individuals attended the GyneChemo class. 75 patients and 64 caregivers completed both pre- and post-class measures. Over 80% of participants agreed that the class was beneficial, specific to their needs, and administered in an appropriate setting. Significant increases in patient and caregiver self-efficacy (p < 0.001) and preparedness to begin chemotherapy treatment (p < 0.001) were found following class completion. Significant differences in patient's anxiety scores were found, with patients who reported an annual household income of <$25,000 experiencing increased anxiety (MD = +5.33) and patients reporting an income of $25,000-$75,000 reporting decreased anxiety (MD = -4.75) following class completion (p = 0.034). No significant difference in the average pre-post caregiver anxiety score (p = 0.207) was found. CONCLUSION This educational model provides patients and informal caregivers with information specific to their chemotherapy regimen and disease site. Integrating pre-treatment education into cancer care has the potential to improve the survivorship experience by increasing self-efficacy, treatment preparedness, and psychological well-being.
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Affiliation(s)
- Diana Samoil
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Nazek Abdelmutti
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Lisa Ould Gallagher
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Nazlin Jivraj
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Naa Kwarley Quartey
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Lisa Tinker
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Meredith Giuliani
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Aileen Trang
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Sarah E Ferguson
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada
| | - Janet Papadakos
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2M9, Canada; Ontario Health, Cancer Care Ontario, 620 University Ave, Toronto, Ontario M5G 2L7, Canada; University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada.
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20
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Arden JD, Rutka E, Ye H, Robertson JM. A Personalized Patient Teaching Session at the Time of Radiation Simulation May Improve Patient Satisfaction Scores. Adv Radiat Oncol 2020; 6:100570. [PMID: 33553809 PMCID: PMC7848435 DOI: 10.1016/j.adro.2020.09.010] [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: 06/15/2020] [Revised: 09/03/2020] [Accepted: 09/15/2020] [Indexed: 10/30/2022] Open
Abstract
Purpose Radiation therapy simulation is an excellent time for patient education. We implemented a comprehensive personalized patient experience-focused (PX) teaching session at the time of simulation and assessed its effect using patient satisfaction scores. Methods and Materials From February 2016 to June 2018, a single PX-trained radiation therapy therapist met patients at simulation to address and resolve all treatment-related questions. Results from a Centers for Medicare & Medicaid Services approved voluntary patient satisfaction tool were used to assess the effect of this intervention, using tools the patients received during the on-treatment period. Scores from patients contacted by the PX therapist were compared with those of noncontacted patients. Results For the survey, 1369 patients were contacted (median contact duration, 23 minutes; range, 0-117). Of 732 surveys submitted during this time, 98 were from on-treatment patients (69 contacted, 29 not contacted). The majority of contacted patients and survey responders were women (64% and 62%, respectively), patients with breast cancer (38%, 41%), and patients who had received curative therapy (82%, 69%). Scores from contacted patients were significantly higher for 10 of the 17 questions (registration helpfulness, P = .03; registration wait time, P = .048; facility way finding, P = .03; facility cleanliness, P = .01; treatment staff skill, P = .03; treatment staff concern for questions, P = .003; response to concerns, P = .01; staff worked together, P = .01; overall rating of care, P = .01; and likelihood of recommending care, P = .04) and 4 of the 5 domains (registration, P = .04; facility, P = .03; personal issues, P = .02; overall assessment, P = .002). Conclusions Contact by a PX therapist was associated with higher patient satisfaction scores, including areas specifically addressed by the PX teaching session (concerns for questions, response to concerns) as well as other areas (cleanliness, registration wait time).
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Affiliation(s)
- Jessica D Arden
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan
| | - Elizabeth Rutka
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan
| | - Hong Ye
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan
| | - John M Robertson
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan
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21
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Bacher H, Schweyen R, Kuhnt T, Leplow B, Hey J. Use of a Patient Information Leaflet on Oro-Dental Care During Radiotherapy. Patient Prefer Adherence 2020; 14:1751-1759. [PMID: 33061317 PMCID: PMC7532906 DOI: 10.2147/ppa.s262471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/21/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE A patient information leaflet (PIL) on oral and dental care during radiotherapy was tested whether and at which time during therapy it would be helpful to increase the knowledge about the therapy and the resulting side effects and the management of these. Additionally, the participants' subjective perception of being well informed about the topic was examined. PARTICIPANTS AND METHODS Surveys were conducted in August 2018-April 2019, at the University Hospitals Halle and Leipzig (Germany). The study population consisted of patients who were treated with radiotherapy in the head and neck region. Half of them received access to the PIL. The survey was conducted with three different versions of a printout questionnaire, which covered the relevant topics at three different times of therapy. The time the participants were surveyed depended on the time of their first therapy appointment. The items of the questionnaires tested their concrete knowledge and assessed the subjective perception of the level of information received. RESULTS Of the 81 participants who received the PIL, 93.8% read it and 92.1% of them considered it helpful. The sample comprised 181 participants aged 32 to 85 years (M = 62.9), of which 135 were males, 42 were females, and 4 were unspecified. Evaluation showed a difference of 4.7%; 18.5%; and 13.6% in correct answers between subjects with and without access to the PIL before, during, and after the therapy, respectively. The assessment of the participants' personal information level was independent of their access to the PIL (chi-squared test, p = 0.89). CONCLUSION Having access to the PIL increased participants' ability to answer the questionnaires correctly. Access to the PIL had no influence on the subjective feeling of being well informed.
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Affiliation(s)
- Helene Bacher
- Department of Dental Prosthetics, University Hospital Halle/Saale, Halle (Saale), Germany
| | - Ramona Schweyen
- Department of Dental Prosthetics, University Hospital Halle/Saale, Halle (Saale), Germany
| | - Thomas Kuhnt
- Clinic for Radiotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Bernd Leplow
- Institute of Psychology, Institute for Therapy and Health Research (IFT-Nord), Martin Luther University Halle-Wittenberg, Halle/Saale, Germany
| | - Jeremias Hey
- Department of Dental Prosthetics, University Hospital Halle/Saale, Halle (Saale), Germany
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22
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DePasquale N, Cabacungan A, Ephraim PL, Lewis-Boyér L, Diamantidis CJ, Powe NR, Boulware LE. "I Wish Someone Had Told Me That Could Happen": A Thematic Analysis of Patients' Unexpected Experiences With End-Stage Kidney Disease Treatment. J Patient Exp 2020; 7:577-586. [PMID: 33062881 PMCID: PMC7534108 DOI: 10.1177/2374373519872088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Preparedness regarding prognosis and treatment options enables patients to cope with uncertainties, make value-based treatment decisions, and set treatment goals. Yet, little is known about the expectedness of end-stage kidney disease (ESKD) patients' treatment experiences beyond their desire for better treatment education. OBJECTIVE To describe unexpected adverse treatment experiences among ESKD patients. METHOD The authors conducted 7 focus groups with 55 dialysis patients and living-donor kidney transplantation recipients receiving medical care in Baltimore, Maryland. Data were analyzed thematically. Themes present in different treatment groups were highlighted to provide insight into common experiences. RESULTS The authors identified 5 themes: (1) psychological reactions, (2) constrained freedom of choice, (3) treatment delivery and logistics, (4) morbidity, and (5) finances. CONCLUSION Patients were unprepared for nonclinical, logistical, and clinical aspects of ESKD treatment. The need for providers' use of tailored preparatory techniques and the development of pretreatment interventions to help patients know what to expect from and feel psychologically prepared for treatment, particularly with respect to nonclinical implications, is critical. These efforts have great potential to improve patients' treatment experiences.
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Affiliation(s)
- Nicole DePasquale
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Ashley Cabacungan
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Patti L Ephraim
- Department of Epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - LaPricia Lewis-Boyér
- General Internal Medicine & Physical Medicine and Rehabilitation, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Clarissa J Diamantidis
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Neil R Powe
- School of Medicine, University of California at San Francisco, CA, USA
| | - L Ebony Boulware
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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23
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Wang TF, Huang RC, Yang SC, Chou C, Chen LC. Evaluating the Effects of a Mobile Health App on Reducing Patient Care Needs and Improving Quality of Life After Oral Cancer Surgery: Quasiexperimental Study. JMIR Mhealth Uhealth 2020; 8:e18132. [PMID: 32716303 PMCID: PMC7418017 DOI: 10.2196/18132] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Intervention with a mobile Health (mHealth) app can improve the efficacy of early detection of oral cancer and the outcomes for patients taking oral anticancer medications. The quality of life of oral cancer patients is significantly reduced within three months after surgery; also, their needs for nursing care and health information increase, mainly due to side effects and associated psychological problems. OBJECTIVE This study aimed to evaluate changes in the care needs and quality of life of patients with oral cancer after receiving the intervention of a newly developed mHealth app. METHODS After surgery, oral cancer patients were divided into an experimental group (n=50) who received the mHealth app intervention and a control group (n=50) who received routine health care and instruction. After 3 months of intervention, survey questionnaires were used to assess the patients' quality of life, nursing care needs, and acceptance of the mHealth app. RESULTS The physiological care needs were significantly decreased in the experimental group compared with the control group (P<.05). Although the differences were not statistically significant, the psychological needs, communication needs, and care support needs all improved after the mHealth app intervention. The overall improvement in quality of life was higher in the experimental group than in the control group (-7.24 vs -4.36). In terms of intention to use, perceived usefulness, and perceived ease of use, the acceptability scores of the mHealth app were significantly increased after 3 months of intervention (P<.05). CONCLUSIONS Compared with routine health care and instruction, for patients after surgery, the education/information intervention using the mHealth app significantly reduced their nursing care needs, improved their quality of life, and increased their acceptance of using an mHealth app on a mobile device. These findings can provide a theoretical basis for future health care app design and improvement. This study suggests that an mHealth app should be incorporated into the routine care of oral cancer patients to provide medical information quickly and improve their self-management abilities, thereby reducing the patients' need for physiological care and improving their quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT04049968; https://www.clinicaltrials.gov/ct2/show/NCT04049968.
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Affiliation(s)
- Tze-Fang Wang
- School of Nursing, National Yang-Ming University, Taipei City, Taiwan
| | - Rou-Chen Huang
- School of Nursing, National Yang-Ming University, Taipei City, Taiwan
| | - Su-Chen Yang
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chyuan Chou
- Excellent Dental Center, Taipei City, Taiwan
| | - Lee-Chen Chen
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
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24
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Turon H, Wall L, Fakes K, Brown SD, Sanson-Fisher R. Cancer patient preferences for the provision of information regarding emotional concerns in relation to medical procedures: A discrete choice experiment. PATIENT EDUCATION AND COUNSELING 2020; 103:1439-1443. [PMID: 32098742 DOI: 10.1016/j.pec.2020.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/05/2020] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the preferences of people with cancer regarding the timing and format of information provision about emotional concerns that may occur when undergoing medical procedures. METHODS Eligible cancer survivors were mailed a survey containing discrete choice scenarios examining their timing and format preferences for information about potential emotional concerns associated with an upcoming hypothetical medical procedure. RESULTS Of 356 eligible patients, 271 (76 %) completed the survey. Both face-to-face discussion and written materials were preferred as the mode of information delivery over access to a website. In order of descending preference, participants preferred to receive the information 1 week, 3 days and the day of the procedure. There were no differences in preferences for timing or format between subgroups based on age, gender, education and cancer type. CONCLUSION This study has demonstrated that cancer patients prefer receiving information about emotional concerns that might be experienced as part of a medical procedure in either written or via face-to-face format, and one week before the procedure. PRACTICE IMPLICATIONS In order to provide patient-centred care, clinicians and the healthcare system more broadly should consider patient preferences for information delivery about upcoming medical procedures. INFORMATION: preparation for medical procedures; discrete choice; oncology; patient preference; emotional response.
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Affiliation(s)
- Heidi Turon
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Newcastle, Australia.
| | - Laura Wall
- School of Psychology, University of Newcastle, Callaghan, Australia; Newcastle Business School, University of Newcastle, Newcastle, Australia.
| | - Kristy Fakes
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Newcastle, Australia.
| | - Scott D Brown
- School of Psychology, University of Newcastle, Callaghan, Australia.
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Newcastle, Australia.
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25
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Bange EM, Doucette A, Gabriel PE, Porterfield F, Harrigan JJ, Wang R, Wojcieszynski AP, Boursi B, Mooney BI, Reiss KA, Mamtani R. Opportunity Costs of Receiving Palliative Chemotherapy for Metastatic Pancreatic Ductal Adenocarcinoma. JCO Oncol Pract 2020; 16:e678-e687. [PMID: 32130074 DOI: 10.1200/jop.19.00328] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE The median overall survival (OS) for metastatic pancreatic ductal adenocarcinoma (mPDAC) is < 1 year. Factors that contribute to quality of life during treatment are critical to quantify. One factor-time spent obtaining clinical services-is understudied. We quantified total outpatient time among patients with mPDAC receiving palliative systemic chemotherapy. METHODS We conducted a retrospective analysis using four patient-level time measures calculated from the medical record of patients with mPDAC receiving 5-fluorouracil infusion, leucovorin, oxaliplatin, and irinotecan; gemcitabine/nab-paclitaxel; or gemcitabine within the University of Pennsylvania Health System between January 1, 2011 and January 15, 2019. These included the total number of health care encounter days (any day with at least one visit) and total visit time. Total visit time represented the time spent receiving care (care time) plus time spent commuting and waiting for care (noncare time). We performed descriptive statistics on these outpatient time metrics and compared the number of encounter days to OS. RESULTS A total of 362 patients were identified (median age, 65 years; 52% male; 78% white; 62% received gemcitabine plus nab-paclitaxel). Median OS was 230.5 days (7.6 months), with 79% of patients deceased at the end of follow-up. On average, patients had 22 health care encounter days, accounting for 10% of their total days survived. Median visit time was 4.6 hours, of which 2.5 hours was spent commuting or waiting for care. CONCLUSION On average, patients receiving palliative chemotherapy for mPDAC spend 10% of survival time on outpatient health care. More than half of this time is spent commuting and waiting for care. These findings provide an important snapshot of the patient experience during ambulatory care, and efforts to enhance efficiency of care delivery may be warranted.
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Affiliation(s)
- Erin M Bange
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Abigail Doucette
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Peter E Gabriel
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | | | - James J Harrigan
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Robin Wang
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | | | - Ben Boursi
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA.,Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel, Tel-Aviv University, Tel-Aviv, Israel
| | - Bethany I Mooney
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Kim A Reiss
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Ronac Mamtani
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
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26
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Olausson K, Sharp L, Fransson P, Nyholm T, Zackrisson B, Östlund U. What matters to you? - Free-text comments in a questionnaire from patients undergoing radiotherapy. Tech Innov Patient Support Radiat Oncol 2020; 13:11-16. [PMID: 32128457 PMCID: PMC7042152 DOI: 10.1016/j.tipsro.2019.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/13/2019] [Accepted: 11/22/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Most cancer patients undergo external radiotherapy (RT) at some stage during their treatment trajectory and RT is often associated with unfamiliar procedures in a highly technical environment. The purpose of this study was to explore how patients experience RT and the related processes, as described in free-text comments in a large Swedish survey with questionnaires including items on psychosocial climate and treatment environment. METHODS The data consisted of free-text comments from one open-ended question: "Is there anything else you want us to know" and were analysed using qualitative content analysis. RESULTS Of 825 returned questionnaires, 261 contained free-text comments from patients (32%). The hand-written, free-text comments reflected the patients' experience of the RT process and were abstracted into the four major categories with sub-categories: experiencing the high-tech RT environment, understanding the RT procedures and side effects, dealing with daily life during RT, and the nurses' role and performance. The categories reflect the patients' experiences and emphasize how important it is to evaluate what really matters to the patients when changing procedures, practices, and how to minimize disturbances in the patients' daily lives. CONCLUSION The main conclusions from this study are that the involvement of patients in choosing daily appointment times, providing good information during the RT process to make the patients feel safe, experience and attitude of the staff and respect for the patient's autonomy are highly ranked values for patients. An implementation of person-centred care may help relieve many of these problems.
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Affiliation(s)
| | - Lena Sharp
- Karolinska Institute, Department of Learning, Informatics, Management and Ethics, Stockholm, Sweden
- Regional Cancer Centre, Stockholm-Gotland, Sweden
| | - Per Fransson
- Umeå University, Department of Nursing, Umeå, Sweden
| | - Tufve Nyholm
- Umeå University, Department of Radiation Sciences, Umeå, Sweden
| | | | - Ulrika Östlund
- Centre for Research & Development, Uppsala University/Region Gävleborg, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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27
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Keast R, Sundaresan P, Burns M, Butow PN, Dhillon HM. Exploring head and neck cancer patients' experiences with radiation therapy immobilisation masks: A qualitative study. Eur J Cancer Care (Engl) 2019; 29:e13215. [PMID: 31883285 DOI: 10.1111/ecc.13215] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/08/2019] [Accepted: 12/11/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Head and neck cancer (HNC) patients commonly undergo radiation therapy requiring immobilisation by a mask. Some find the mask distressing, and this can disrupt treatment sessions. This study aimed to explore the patient experience of immobilisation masks in the Australian and New Zealand (ANZ) context, to guide possible intervention. METHODS Semi-structured interviews were conducted with HNC patients who had completed radiation therapy, recruited via hospitals and social media. Interviews continued until data saturation; then, three further interviews were conducted for member-checking purposes. Qualitative methodology with thematic analysis was used to identify themes in the data. RESULTS Twenty HNC survivors participated in interviews, and seven themes were identified: information received by participants, potential predictors of mask anxiety, participant reactions to the mask, trajectories of mask anxiety, supportive behaviour and communication of health professionals, coping with the mask, and thoughts and feelings about the mask. CONCLUSIONS Participant experiences of the immobilisation mask were diverse. The findings fit with Lazarus and Folkman's (Stress, appraisal, and coping. New York, NY: Springer Pub. Co) transactional model of stress and coping, as participants appeared to make cognitive appraisals of the mask and their coping abilities throughout treatment, resulting in varied levels of mask-related distress. Complex intervention is recommended to reduce mask anxiety in HNC patients across ANZ.
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Affiliation(s)
- Rachael Keast
- Faculty of Science, School of Psychology, Centre for Medical Psychology & Evidence-Based Decision-making, University of Sydney, Sydney, NSW, Australia
| | - Puma Sundaresan
- Radiation Oncology Network, Western Sydney Local Health District, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Melissa Burns
- Radiation Oncology Network, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Phyllis N Butow
- Faculty of Science, School of Psychology, Centre for Medical Psychology & Evidence-Based Decision-making, University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Faculty of Science, School of Psychology, Centre for Medical Psychology & Evidence-Based Decision-making, University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, NSW, Australia
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28
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Stevenson W, Bryant J, Watson R, Sanson-Fisher R, Oldmeadow C, Henskens F, Brown C, Ramanathan S, Tiley C, Enjeti A, Guest J, Tzelepis F, Paul C, D'Este C. A multi-center randomized controlled trial to reduce unmet needs, depression, and anxiety among hematological cancer patients and their support persons. J Psychosoc Oncol 2019; 38:272-292. [PMID: 31833452 DOI: 10.1080/07347332.2019.1692991] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: Individuals diagnosed with a high-grade hematological malignancy are at high risk for psychosocial distress. This study aimed to examine the effectiveness of a web-based information tool and nurse delivered telephone support in reducing: (i) unmet information needs; (ii) depression; and (iii) anxiety, among hematological cancer patients and their support persons (SPs).Methods: Patients with a new diagnosis of acute myeloid leukemia, acute lymphoblastic leukemia, Burkitt lymphoma, or lymphoblastic lymphoma and their SPs were enrolled in a prospective multi-site randomized trial. Participants received either access to an online information tool and telephone support from a hematology nurse, or usual care. Outcome data were collected 2, 4, 8, and 12 weeks post-recruitment. The primary endpoint was unmet information needs.Results: Data from 60 patients and 15 SPs were included in the analysis. There were no statistically significant differences in unmet information needs, depression or anxiety between intervention and control groups for patients. Patients in both groups demonstrated a decrease in information needs over the intervention period. Post hoc analyses revealed that patients who did not achieve remission with the first cycle of treatment experienced increased anxiety from 4 weeks until the end of the study (p = 0.008).Conclusions: A web-based information tool and nurse delivered telephone support did not reduce unmet information needs, depression or anxiety among hematological cancer patients, however this finding is inconclusive given the low power of the study.Implications for Psychosocial Providers or Policy: Patients who do not achieve remission are at high risk of anxiety, and may benefit from targeted psychological intervention.
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Affiliation(s)
- William Stevenson
- Department of Haematology, Royal North Shore Hospital, Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, Australia
| | - Jamie Bryant
- Faculty of Health and Medicine, Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Rochelle Watson
- Faculty of Health and Medicine, Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Rob Sanson-Fisher
- Faculty of Health and Medicine, Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,Clinical Research Design, IT and Statistical Support Unit, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Frans Henskens
- Faculty of Health and Medicine, Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Christina Brown
- Department of Haematology, Royal Prince Alfred Hospital, University of Sydney, Camperdown, New South Wales, Australia
| | - Sundra Ramanathan
- Department of Haematology, St George Hospital, Kogarah, New South Wales, Australia
| | - Campbell Tiley
- Department of Haematology, Gosford Hospital, Gosford, New South Wales, Australia
| | - Anoop Enjeti
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,Haematology Unit, Calvary Mater Newcastle, Waratah, New South Wales, Australia.,NSW Health Pathology North-Hunter, New Lambton Heights, New South Wales, Australia.,National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Johanna Guest
- Department of Haematology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Flora Tzelepis
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
| | - Christine Paul
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.,School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
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Babapour Mofrad R, Visser LNC, Fruijtier AD, Scheltens P, Smets E(EMA, van der Flier WM, Teunissen CE. Cerebrospinal fluid collection: An informative animation video for patients and caregivers. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2019; 11:435-438. [PMID: 31211216 PMCID: PMC6562320 DOI: 10.1016/j.dadm.2019.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Daily clinical practice has shown that patients are often hesitant to undergo a lumbar puncture (LP) because of unfamiliarity with the awaiting procedure and/or unrealistic ideas concerning post-LP complications. In light of increased number of LPs in diagnostic and research settings, our institute has developed an educational video for patients and caregivers in which we inform them about and prepare them for the LP procedure. This video was based on the latest literature and was developed with the help of communication experts, medical doctors, and two separate patient panels.
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Affiliation(s)
- R. Babapour Mofrad
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam UMC, Amsterdam, the Netherlands
| | - Leonie Nicoline Cornelia Visser
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam Public Health, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Agnetha Diantha Fruijtier
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam Public Health, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Wiesje Maria van der Flier
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam UMC, Amsterdam, the Netherlands
| | - Charlotte Elisabeth Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
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Fakes KL, Hall AE, Carey ML, Boyes AW, Symonds M, Evans TJ, Sanson-Fisher RW. Development and Validation of the MiPrep Survey: An Instrument Assessing Patients' Perceived Preparation for Medical Interventions Including Medical Imaging, Radiotherapy, and Surgery. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:704-711. [PMID: 31198188 DOI: 10.1016/j.jval.2019.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 12/12/2018] [Accepted: 01/13/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Adequately preparing patients for medical interventions is an important component of quality healthcare. Nevertheless, few instruments for assessing patients' preparation exist. OBJECTIVES To develop a psychometrically rigorous instrument to assess patients' perceptions of the quality of preparation. METHODS An instrument to measure patients' preparation for medical interventions (MiPrep) was developed and tested with patients undergoing medical imaging, radiotherapy, or surgery. Patients were recruited and asked to complete 2 surveys. Survey A assessed patient and intervention characteristics. Survey B (postintervention) contained MiPrep to assess validity (face, content, and construct) and reliability (internal consistency and test-retest). RESULTS A total of 869 (85%) patients consented to participate and 551 (63%) returned the postintervention survey. Face and content validity were demonstrated. Exploratory factor analysis identified 2 survey modules: receipt and adequacy of information (2 domains) and overall appraisal of patient-centered care (1 domain). Reliability was evidenced by adequate internal consistency (Cronbach α 0.81-0.89) and item-total correlations higher than 0.20. Nevertheless, individual item test-retest reliability requires further confirmation. The final instrument contained 27 items. CONCLUSIONS The MiPrep instrument has evidence of being a valid and reliable instrument of preparation for medical interventions. Healthcare providers can use the instrument as a quality assurance tool to identify areas for improvement and areas of excellence in patients' preparation. Future studies should verify these findings in other populations and examine the divergent and predictive validity of the instrument.
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Affiliation(s)
- Kristy L Fakes
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
| | - Alix E Hall
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Clinical Research Design, Information Technology and Statistical Support, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Mariko L Carey
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Allison W Boyes
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Michael Symonds
- Hunter New England Imaging, John Hunter Hospital/Royal Newcastle Centre, New Lambton Heights, New South Wales, Australia
| | - Tiffany-Jane Evans
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Clinical Research Design, Information Technology and Statistical Support, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Rob W Sanson-Fisher
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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De Feudis RL, Graziano G, Lanciano T, Garofoli M, Lisi A, Marzano N. An art therapy group intervention for cancer patients to counter distress before chemotherapy. Arts Health 2019; 13:35-48. [PMID: 31044654 DOI: 10.1080/17533015.2019.1608566] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: The aim of this study was to investigate the feasibility and effectiveness of a single group session based on art therapy (AT) for adult cancer patients to reduce anxiety and distress before anticancer treatment. Methods: A non-randomized pre-post study design was adopted. Sixty-two patients took part in one of twenty-seven "one-off" sessions held over a four-month period. Sixty-six patients, who simply received routine medical treatment, served as the control group (CG). Results: The intervention was appropriate to patients' needs and feasible in the context of their routine medical care. In contrast to the CG, the intervention group(IG) participants demonstrated a decrease in symptoms of anxiety, drowsiness and tiredness. Conclusions: The intervention proved suitable to the medical routine of patients' care. The clinical implications of the AT protocol and future research aimed at testing it vs. a different type of psychosocial intervention in a randomized controlled study are discussed.
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Affiliation(s)
- Rossana L De Feudis
- Departmental Unit of Medical Oncology, 'San Paolo' Hospital, ASL BA , Bari, Italy
| | - Giusi Graziano
- Scientific Direction, 'Giovanni Paolo II' Cancer Institute IRCSS , Bari, Italy
| | - Tiziana Lanciano
- Department of Education, Psychology, Communication, 'Aldo Moro' University of Bari , Bari, Italy
| | - Manuela Garofoli
- Departmental Unit of Medical Oncology, 'San Paolo' Hospital, ASL BA , Bari, Italy
| | - Andrea Lisi
- Psychological Services, 'Giovanni Paolo II' Cancer Institute IRCSS , Bari, Italy
| | - Nicola Marzano
- Departmental Unit of Medical Oncology, 'San Paolo' Hospital, ASL BA , Bari, Italy
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Sanson-Fisher R, Fakes K, Waller A, Mackenzie L, Bryant J, Herrmann A. Assessing patients' experiences of cancer care across the treatment pathway: a mapping review of recent psychosocial cancer care publications. Support Care Cancer 2019; 27:1997-2006. [PMID: 30891626 DOI: 10.1007/s00520-019-04740-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/07/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE Patients are a critical source of information about the quality of the components of cancer care that contributes to optimal psychosocial outcomes. Recently published research was examined to determine the: (1) proportion of studies that examined at least one of 14 components of cancer care, (2) the proportion of studies that included multiple components of care, and (3) the phase of the cancer care pathway in which data collection occurred (i.e. pre-, during and post-treatment). METHODS MEDLINE was searched to retrieve all data-based publications indexed for two international psychosocial cancer care journals (Supportive Care in Cancer and Psycho-Oncology) over a 2-year period. A total of 333 publications yielded 214 eligible publications that were assessed against the 14 components of care for which measurement by healthcare providers at multiple phases during cancer care is recommended. Publications were coded based on the: (1) specific component/s of care focused upon in the research, (2) number of components examined and (3) timing of data collection. RESULTS The most frequently assessed component of care was physical and psychosocial screening (n = 198, 93%). Most studies (n = 187, 87%) examined a single component of care. No studies assessed all 14 components. Only seven studies (2.1%) examined components of care across multiple phases of the care pathway. CONCLUSIONS Recently published studies have examined limited segments of patients' experiences of cancer care. To improve psychosocial outcomes among people living with and beyond cancer, there should be a greater focus on patients' experiences across multiple components and the whole care pathway.
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Affiliation(s)
- Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia. .,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Kristy Fakes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Amy Waller
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Lisa Mackenzie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Anne Herrmann
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Behboudifar A, Heshmati Nabavi F, Anvari K, Shakeri MT. Effect of pretreatment education on anxiety in patients undergoing radiation therapy for the first time: A randomized clinical trial. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1483612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Atefeh Behboudifar
- Medical-Surgical Department, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Heshmati Nabavi
- Evidence Based Care Research Centre, Department of Nursing Management, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kazem Anvari
- Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Watson R, Bryant J, Sanson-Fisher R, Turon H, Hyde L, Herrmann A. Do haematological cancer patients get the information they need about their cancer and its treatment? Results of a cross-sectional survey. Support Care Cancer 2018; 27:1509-1517. [DOI: 10.1007/s00520-018-4525-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 10/19/2018] [Indexed: 01/06/2023]
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Smith SK, Cabrera-Aguas M, Shaw J, Shepherd H, Naehrig D, Meiser B, Jackson M, Saade G, Bucci J, Halkett GKB, Turner RM, Milross C, Dhillon HM. A low literacy targeted talking book about radiation therapy for cancer: development and acceptability. Support Care Cancer 2018; 27:2057-2067. [PMID: 30225574 DOI: 10.1007/s00520-018-4446-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/26/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To develop a low literacy talking book (written book with accompanying audio-recording) about radiation therapy and explore its acceptability with patients and caregivers. METHOD The talking book was developed iteratively using low literacy design principles and a multidisciplinary committee comprising consumers and experts in radiation oncology, nursing, behavioural sciences, and linguistics. It contained illustrations, photos, and information on: treatment planning, daily treatment, side effects, psychosocial health, and a glossary of medical terms. Semi-structured interviews were conducted with patients who self-reported low functional health literacy and caregivers to explore their views on the resource. Thematic analysis using a framework approach informed the analysis. RESULTS Participants were very satisfied with the content, illustrations, and language in the resource. Most were unfamiliar with the term 'talking book', but liked the option of different media (text and audio). The resource was seen as facilitating communication with the cancer care team by prompting question-asking and equipping patients and their families with knowledge to communicate confidently. CONCLUSIONS The low literacy talking book was well accepted by patients and their caregivers. The next step is to examine the effect of the resource on patients' knowledge, anxiety, concerns, and communication with the cancer care team.
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Affiliation(s)
- Sian K Smith
- Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Lowy Cancer Research Centre C25 Level 4, Cnr High Street and Botany Street, Kensington, NSW, 2033, Australia.
| | - Maria Cabrera-Aguas
- Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Lowy Cancer Research Centre C25 Level 4, Cnr High Street and Botany Street, Kensington, NSW, 2033, Australia
- Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Heather Shepherd
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Diana Naehrig
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Chris O'Brien Lifehouse, Integrative Oncology & Supportive Care, Sydney, NSW, Australia
| | - Bettina Meiser
- Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Lowy Cancer Research Centre C25 Level 4, Cnr High Street and Botany Street, Kensington, NSW, 2033, Australia
| | - Michael Jackson
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
| | - George Saade
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Joseph Bucci
- St George Hospital Cancer Care, Radiation Oncology Unit, Sydney, NSW, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, School of Nursing School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
| | - Robin M Turner
- Biostatistics Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Christopher Milross
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Chris O'Brien Lifehouse, Radiation Oncology and Medical Services, Sydney, NSW, Australia
| | - Haryana M Dhillon
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Halkett G, O'Connor M, Jefford M, Aranda S, Merchant S, Spry N, Kane R, Shaw T, Youens D, Moorin R, Schofield P. RT Prepare: a radiation therapist-delivered intervention reduces psychological distress in women with breast cancer referred for radiotherapy. Br J Cancer 2018; 118:1549-1558. [PMID: 29855611 PMCID: PMC6008448 DOI: 10.1038/s41416-018-0112-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/11/2018] [Accepted: 04/17/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The aims of this study were to determine whether a radiation therapist-led patient education intervention (RT Prepare) reduced breasts cancer patients' psychological distress (primary endpoint); anxiety, depression and concerns about radiotherapy, and increased knowledge of radiotherapy and preparedness (secondary endpoints). Patient health system usage and costs were also assessed. METHODS A multiple-baseline study across three sites. The RT Prepare intervention comprised two consultations with a radiation therapist: prior to treatment planning and on the first day of treatment. Radiation therapists focused on providing sensory and procedural information and addressing patients' pre-treatment anxiety. Usual care data were collected prior to intervention commencement. Data collection occurred: after meeting their radiation oncologist, prior to treatment planning, first day of treatment and after treatment completion. Multilevel mixed effects regression models were used. RESULTS In total, 218 usual care and 190 intervention patients participated. Compared with usual care, intervention participants reported lower psychological distress at treatment commencement (p = 0.01); lower concerns about radiotherapy (p < 0.01); higher patient knowledge (p < 0.001); higher preparedness for procedural concerns (p < 0.001) and higher preparedness for sensory-psychological concerns at treatment planning (p < 0.001). Mean within-trial costs per patient were estimated at $AU159 (US$120); mean ongoing costs at $AU35 (US$26). CONCLUSION The RT Prepare intervention was effective in reducing breast cancer patients' psychological distress and preparing patients for treatment. This intervention provides an opportunity for radiation therapists to extend their role into providing patients with information and support prior to treatment to reduce psychological distress.
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Affiliation(s)
- Georgia Halkett
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
| | - Moira O'Connor
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Michael Jefford
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Sanchia Aranda
- Cancer Council Australia, Sydney, NSW, Australia
- School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Susan Merchant
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Nigel Spry
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Radiation Oncology, Genesis Cancer Care, Perth, WA, Australia
| | - Robert Kane
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Thérèse Shaw
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - David Youens
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Rachael Moorin
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Centre for Health Services Research, School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Penelope Schofield
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
- Department of Psychology, Swinburne University of Technology, Hawthorn, VIC, Australia
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Nguyen LT, Yates P, Annoussamy LC, Truong TQ. The effectiveness of non-pharmacological interventions in the management of symptom clusters in adult cancer patients: a systematic review protocol. ACTA ACUST UNITED AC 2018; 14:49-59. [PMID: 27532309 DOI: 10.11124/jbisrir-2016-2476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
REVIEW QUESTION/OBJECTIVE To what extent are non-pharmacological interventions effective in reducing symptom clusters in terms of presence, frequency and severity, compared with standard care?More specifically, the objectives are to: CENTER CONDUCTING THE REVIEW:: The Hanoi Medical University Nursing Research Center for Evidence Based Health Care: a Collaborating Centre of the Joanna Briggs Institute; and Centre for Evidence-based Healthy Aging: an Affiliate Centre of the Joanna Briggs Institute, School of Nursing, Queensland University of Technology, Australia.
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Affiliation(s)
- Ly Thuy Nguyen
- 1Hanoi Medical University, Hanoi, Vietnam 2School of Nursing, Queensland University of Technology, Australia 3L'Hôpital Francais de Hanoi, Hanoi, Vietnam
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Jimenez YA, Cumming S, Wang W, Stuart K, Thwaites DI, Lewis SJ. Patient education using virtual reality increases knowledge and positive experience for breast cancer patients undergoing radiation therapy. Support Care Cancer 2018. [PMID: 29536200 DOI: 10.1007/s00520-018-4114-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Improved access to technology in the radiation therapy (RT) workforce education has resulted in opportunities for innovative patient education methods. This study investigated the impact of a newly developed education tool using the Virtual Environment for Radiotherapy Training (VERT) system on patients' RT knowledge and anxiety. METHOD Breast cancer patients were recruited into a control group (CG) (n = 18) who underwent the standard pre-RT education package at a targeted cancer therapy centre, followed by a VERT group (VG) (n = 19). VG patients attended a VERT-based education session detailing RT immobilisation, planning and treatment. All patients completed questionnaires at four time points throughout their treatment, with survey sub-sections on RT knowledge, experience and anxiety. RESULTS For both groups, anxiety levels were highest at time point 1(T1 after initial radiation oncologist consultation) (CG, 41.2; VG, 43.1), with a gradual decrease observed thereafter at time points before simulation, at the beginning of treatment and at the end of treatment (p > 0.05). The VG's RT knowledge scores were statistically significantly higher than those of the CG scores at all time points following VERT education (p < 0.05). CONCLUSION This study reports the high value of VERT breast cancer-targeted education programs in improving RT knowledge and perhaps decreasing patient anxiety. Continued efforts are required to improve patients' accessibility to VERT in Australia, and to better understand the effect of VERT's unique educational features on patients' emotional and physical needs throughout their RT.
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Affiliation(s)
- Yobelli A Jimenez
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia.
| | - Steven Cumming
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Wei Wang
- The Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - Kirsty Stuart
- The Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - David I Thwaites
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia
| | - Sarah J Lewis
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
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Forshaw K, Hall AE, Boyes AW, Carey ML, Martin J. Patients' Experiences of Preparation for Radiation Therapy: A Qualitative Study. Oncol Nurs Forum 2017; 44:E1-E9. [PMID: 27991606 DOI: 10.1188/17.onf.e1-e9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore patients' experiences of and preferences for preparation for radiation therapy.
. RESEARCH APPROACH Qualitative study.
. PARTICIPANTS 26 individuals who recently received radiation therapy for cancer.
. SETTING One Australian radiation oncology clinic located within a tertiary referral hospital in New South Wales.
. METHODOLOGIC APPROACH Semistructured interviews were conducted and analyzed based on a qualitative descriptive approach and content analysis of the transcribed interviews.
. FINDINGS Four main themes related to preparation techniques were identified. CONCLUSIONS The information gained in this study indicates what strategies may best prepare patients for radiation therapy.
. INTERPRETATION Providing patients with information that creates a realistic expectation of what radiation therapy involves both before and after treatment seems particularly important in helping them feel prepared.
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Patients' experience of decision-making and receiving information during radiation therapy: A qualitative study. Eur J Oncol Nurs 2017; 30:97-106. [DOI: 10.1016/j.ejon.2017.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/09/2017] [Accepted: 08/19/2017] [Indexed: 02/03/2023]
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Halkett G, O'Connor M, Aranda S, Jefford M, Merchant S, York D, Miller L, Schofield P. Communication skills training for radiation therapists: preparing patients for radiation therapy. J Med Radiat Sci 2016; 63:232-241. [PMID: 27741388 PMCID: PMC5167288 DOI: 10.1002/jmrs.171] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/11/2016] [Accepted: 02/22/2016] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Patients sometimes present for radiation therapy with high levels of anxiety. Communication skills training may assist radiation therapists to conduct more effective consultations with patients prior to treatment planning and treatment commencement. The overall aim of our research is to examine the effectiveness of a preparatory programme 'RT Prepare' delivered by radiation therapists to reduce patient psychological distress. The purpose of this manuscript was to describe the communication skills workshops developed for radiation therapists and evaluate participants' feedback. METHODS Radiation therapists were invited to participate in two communication skills workshops run on the same day: (1) Consultation skills in radiation therapy and (2) Eliciting and responding to patients' emotional cues. Evaluation forms were completed. Radiation therapists' consultations with patients were then audio-recorded and evaluated prior to providing a follow-up workshop with participants. RESULTS Nine full day workshops were held. Sixty radiation therapists participated. Positive feedback was received for both workshops with 88% or more participants agreeing or strongly agreeing with all the statements about the different components of the two workshops. Radiation therapists highlighted participating in role play with an actor, discussing issues; receiving feedback; acquiring new skills and knowledge; watching others role play and practicing with checklist were their favourite aspects of the initial workshop. The follow-up workshops provided radiation therapists with feedback on how they identified and addressed patients' psychological concerns; time spent with patients during consultations and the importance of finding private space for consultations. CONCLUSION Communication skills training consisting of preparing patients for radiation therapy and eliciting and responding to emotional cues with follow-up workshops has the potential to improve radiation therapists' interactions with patients undergoing radiation therapy. Further research is warranted, similar to the RT Prepare study, to determine whether patient anxiety can be reduced as a result of improving communication and information provision.
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Affiliation(s)
- Georgia Halkett
- School of Nursing, Midwifery and ParamedicineFaculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Moira O'Connor
- School of Psychology and Speech PathologyFaculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Sanchia Aranda
- Department of Cancer Experiences ResearchPeter MacCallum Cancer CentreEast MelbourneVictoriaAustralia
- School of Health SciencesUniversity of MelbourneMelbourneVictoriaAustralia
- Cancer Council AustraliaSydneyNew South WalesAustralia
| | - Michael Jefford
- Department of Cancer Experiences ResearchPeter MacCallum Cancer CentreEast MelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneVictoriaAustralia
- Division of Cancer MedicinePeter MacCallum Cancer CentreEast MelbourneVictoriaAustralia
| | - Susan Merchant
- School of Nursing, Midwifery and ParamedicineFaculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
- Radiation Oncology DepartmentRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Debra York
- School of Nursing, Midwifery and ParamedicineFaculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Lisa Miller
- Department of PsychiatrySir Charles Gairdner HospitalPerthWestern AustraliaAustralia
- WA Cancer and Palliative Care NetworkDepartment of Health WAPerthWestern AustraliaAustralia
- School of Psychiatry & Clinical NeurosciencesUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Penelope Schofield
- Department of Cancer Experiences ResearchPeter MacCallum Cancer CentreEast MelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneVictoriaAustralia
- Department of PsychologySwinburne University of TechnologyHawthornVictoriaAustralia
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42
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Forshaw KL, Carey ML, Hall AE, Boyes AW, Sanson-Fisher R. Preparing patients for medical interventions: A systematic review of the psychometric qualities of published instruments. PATIENT EDUCATION AND COUNSELING 2016; 99:960-973. [PMID: 26774681 DOI: 10.1016/j.pec.2015.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/02/2015] [Accepted: 12/11/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Preparing patients for medical interventions improves patient outcomes and is an ethical and legal imperative. This review examines the characteristics and psychometric properties of published instruments which assess patients' preparation for medical interventions. METHODS Medline, CINAHL, EMBASE and PsycINFO electronic databases were searched from the date of their inception to November 2015. Data-based publications describing the development or validation of a self-report instrument designed to assess the quality of adult patients' perceived preparation for a medical intervention were included. RESULTS Nine publications described the development or validation of seven instruments which met inclusion criteria. The psychometric qualities of the instruments varied. None met all of the accepted criteria for psychometric rigour. Although the Satisfaction with Cancer Information Profile met the highest number (n=5) of the defined psychometric properties, the study sample size was less than 100. Overall, content validity of the included instruments was the most frequently assessed criteria. CONCLUSION Few instruments have been specifically developed to assess patients' self-reported preparation for medical interventions. Of the available instruments, none demonstrated adequate rigour across essential psychometric properties. PRACTICE IMPLICATIONS The need to develop instruments examining patient preparation for medical interventions is apparent given the limitations of the instruments reviewed.
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Affiliation(s)
- Kristy L Forshaw
- Priority Research Centre for Health Behaviour, Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Callaghan, Australia.
| | - Mariko L Carey
- Priority Research Centre for Health Behaviour, Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Callaghan, Australia.
| | - Alix E Hall
- Priority Research Centre for Health Behaviour, Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Callaghan, Australia.
| | - Allison W Boyes
- Priority Research Centre for Health Behaviour, Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Callaghan, Australia.
| | - Rob Sanson-Fisher
- Priority Research Centre for Health Behaviour, Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Callaghan, Australia.
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Vanbockstael J, Coquan E, Gouerant S, Allouache D, Faveyrial A, Noal S, Delcambre C, Galais MP, Héron JF, Lefebvre AC, Sevin E, Hrab I, Polycarpe F, André M, Kaluzinski L, Gervais R, Gunzer K, Vié B, Saucier G, Lemenand N, Grellard JM, Clarisse B, Dugué AE, Joly F. How to improve the prevention of chemotherapy-induced nausea and vomiting? The French NAVI study. Support Care Cancer 2015; 24:1131-8. [PMID: 26268784 DOI: 10.1007/s00520-015-2882-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/29/2015] [Indexed: 01/30/2023]
Abstract
PURPOSE Chemotherapy-induced nausea and vomiting (CINV) still remain frequent. The procedure for announcing the diagnosis (PAD) was an emblematic measure of the first French Plan Cancer aiming at providing patients with time to listen, information after cancer diagnosis, and discussion on treatments and their side effects. We aimed at assessing the risk factors of CINV, focusing on patients' satisfaction with the PAD. METHODS This prospective multicentre study assessed the frequency and intensity of CINV among chemonaïve patients during the first cycle of treatment. CINV was defined by ≥1 emetic episode or reported nausea intensity ≥3 on a 0-10 scale. Multivariate analysis was used to identify factors related to global CINV onset including satisfaction with the PAD (satisfaction score ≥the median on a 0-10 scale). RESULTS Data from 291 patients (women, 85.2%; mean age, 57 years) were analyzed. Most patients (69.4%) received highly emetogenic chemotherapy regimens and 77.7% received antiemetic drugs consistent with international guidelines. Acute, delayed and overall CINV were experienced by 40.4, 34.8 and 52.4% of patients, respectively. Sixty-seven per cent of patients were satisfied with the PAD. No relation was noted between PAD satisfaction and CINV onset. The nausea and vomiting dimension of the QLQ-C30 questionnaire before chemotherapy (OR 3.62), motion sickness history (OR 2.73), highly emetogenic CT (OR 2.73), anxiety (OR 1.99) and younger age (OR 1.96) were independent predictive factors. CONCLUSIONS Although patients were mostly satisfied with the PAD, half of them experienced CINV. A state of anxiety could be identified during the PAD to be managed.
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Affiliation(s)
| | - Elodie Coquan
- Centre François Baclesse, Department of Oncology, Caen, France.
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France.
| | - Sophie Gouerant
- Rouen University Hospital, Department of Oncology, Rouen, France
- Centre Henri Becquerel, Department of Oncology, Rouen, France
| | | | | | - Sabine Noal
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | | | | | | | - Emmanuel Sevin
- Centre François Baclesse, Department of Oncology, Caen, France
| | - Ioana Hrab
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | - Michel André
- Hôpital Monod, Department of Oncology, Flers, France
| | - Laure Kaluzinski
- Centre Hospitalier Public du Cotentin, Department of Oncology, Cherbourg-Octeville, France
| | - Radj Gervais
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | - Brigitte Vié
- Clinique Armoricaine, Department of Oncology, Saint-Brieuc, France
| | | | - Noëmie Lemenand
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Jean-Michel Grellard
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Bénédicte Clarisse
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Audrey Emmanuelle Dugué
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Florence Joly
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
- Université de Caen Basse-Normandie, UMR-S1077, Caen, France
- INSERM, U1086, Caen, France
- CHU de Caen, Department of Oncology, Caen, France
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Baliousis M, Rennoldson M, Snowden JA. Psychological interventions for distress in adults undergoing haematopoietic stem cell transplantation: a systematic review with meta-analysis. Psychooncology 2015; 25:400-11. [PMID: 26249330 DOI: 10.1002/pon.3925] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/13/2015] [Accepted: 07/07/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate the characteristics, methodology, quality, and efficacy of psychological interventions for distress in adult patients undergoing haematopoietic stem cell transplantation (HSCT). METHODS A systematic review of relevant studies was conducted using six databases with supplementary hand searching. Included studies employed an experimental or quasi-experimental design, interventions included at least one psychological component, and outcomes involved psychological distress in affective terms. Data were abstracted, and study quality was assessed using Cochrane Foundation criteria amended to include confounder and common factors control. Data were examined and synthesised using a narrative approach and meta-analysis. RESULTS Eleven articles for nine interventions met the inclusion criteria out of 11,741 abstracts. The studies varied in quality, general, intervention, and methodological characteristics while findings were mixed. Interventions tended to show better efficacy when incorporating a major psychological component involving cognitive behavioural or emotional processing methods with substantial interventionist input. However, this was also associated with methodological limitations and threats to internal validity such as poor confounder and common factors control. A meta-analysis yielded a small but significant pooled effect size estimate in favour of interventions with inconsequential heterogeneity. Risk of bias remained a concern. CONCLUSIONS Psychological interventions may provide some benefit in alleviating distress in HSCT but conclusions remain tentative in light of methodological limitations and risk of bias. Further research is needed to evidence the individual contribution of intervention components and mechanism of change together with improving intervention efficiency and methodological quality.
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Affiliation(s)
- Michael Baliousis
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Michael Rennoldson
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - John A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Halkett G, O'Connor M. What is the best way to support patients undergoing radiation therapy? J Med Radiat Sci 2015; 62:3-5. [PMID: 26229661 PMCID: PMC4364800 DOI: 10.1002/jmrs.100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 01/21/2015] [Indexed: 11/24/2022] Open
Affiliation(s)
- Georgia Halkett
- Faculty of Health Sciences, School of Nursing and Midwifery, Curtin University Perth, Western Australia, Australia
| | - Moira O'Connor
- Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University Perth, Western Australia, Australia
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Halkett G, O'Connor M, Aranda S, Jefford M, Spry N, Shaw T, Moorin R, Schofield P. Protocol for the RT Prepare Trial: a multiple-baseline study of radiation therapists delivering education and support to women with breast cancer who are referred for radiotherapy. BMJ Open 2014; 4:e006116. [PMID: 25138815 PMCID: PMC4139661 DOI: 10.1136/bmjopen-2014-006116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 07/17/2014] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION There is limited evidence to guide the preparation of patients for radiotherapy. This paper describes the protocol for an evaluation of a radiation therapist led education intervention delivered to patients with breast cancer in order to reduce psychological distress. METHODS A multiple-baseline study is being used. Usual care data is being collected prior to the start of the intervention at each of three sites. The intervention is delivered by radiation therapists consulting with patients prior to their treatment planning and on the first day of treatment. The intervention focuses on providing sensory and procedural information to patients and reducing pretreatment anxiety. Recruitment is occurring in three states in Australia. Eligible participants are patients who have been referred for radiotherapy to treat breast cancer. 200 patients will be recruited during a usual care phase and, thereafter, 200 patients in the intervention phase. Measures will be collected on four occasions-after meeting with their radiation oncologist, prior to treatment planning, on the first day of treatment and after treatment completion. The primary hypothesis is that patients who receive the radiotherapy preparatory intervention will report a significantly greater decrease in psychological distress from baseline to prior to radiotherapy treatment planning in comparison with the usual care group. Secondary outcome measures include concerns about radiotherapy, patient knowledge of radiotherapy, patient preparedness and quality of life. Patient health system usage and costs will also be measured. Multilevel mixed effects regression models will be applied to test for intervention effects. ETHICS Ethics approval has been gained from Curtin University and the three recruiting sites. DISSEMINATION Results will be reported in international peer reviewed journals. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trials Registration: ACTRN12611001000998.
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Affiliation(s)
- Georgia Halkett
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Moira O'Connor
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Sanchia Aranda
- Cancer Services and Information, Cancer Institute NSW, Sydney, New South Wales, Australia
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology and Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michael Jefford
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology and Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nigel Spry
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- Department of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Therese Shaw
- School of Exercise and Health Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Rachael Moorin
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Penelope Schofield
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology and Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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