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Deis N, Unsöld L, Siegle A, Krisam J, Thomas M, Villalobos M. HELP - Heidelberg decision aid for lung cancer patients: a randomized controlled clinical trial. Trials 2023; 24:356. [PMID: 37231417 DOI: 10.1186/s13063-023-07365-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM), which increases the patient's well-being, adherence, and success of treatment, is becoming increasingly important in medicine and especially in oncology. To empower patients to participate more actively in consultations with their physicians decision aids have been developed. In non-curative settings, such as the treatment of advanced lung cancer, decisions differ substantially from the curative setting, as uncertain gains in terms of survival outcomes and quality of life have to be weighed against the severe side effects of treatment regimens. There is still a lack of tools developed and implemented for such specific settings in cancer therapy that support shared decision-making. The aim of our study is to evaluate the effectiveness of the HELP decision aid. METHODS The HELP-study is designed as a randomized, controlled, open monocenter trial with two parallel groups. The intervention consists of the use of the HELP decision aid brochure, accompanied by a decision coaching session. The primary endpoint is clarity of personal attitude as operationalized by the Decisional Conflict Scale (DCS) after the decision coaching. Randomization will be performed as stratified block randomization according to the characteristic of preferred decision-making at baseline with a 1:1 allocation. The participants in the control group get usual care, i.e., the doctor-patient conversation takes place without preliminary coaching and deliberation about their preferences and goals. DISCUSSION Developing decision aids (DA) for (lung) cancer patients with limited prognosis should empower patients to address these aspects and include information about "Best Supportive Care" as a treatment option. Using and implementing the decision aid HELP can not only give patients the possibility to include their personal wishes and values in the decision-making process, but also raise the awareness of shared decision-making itself among these patients and their physicians. TRIAL REGISTRATION German Clinical Trial Register DRKS00028023. Registered on 8 February 2022.
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Affiliation(s)
- Nicole Deis
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Laura Unsöld
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Anja Siegle
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Johannes Krisam
- Institute of Medical Biometry, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Michael Thomas
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Matthias Villalobos
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Röntgenstraße 1, D-69126, Heidelberg, Germany.
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Wu X, Xie J, Lin X, Hua L, Ding P, Liu S, Shi S. Translation and validation of chinese version of MDASI immunotherapy for early-phase trials module: a cross-sectional study. BMC Nurs 2023; 22:176. [PMID: 37217922 DOI: 10.1186/s12912-023-01217-9] [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: 10/28/2022] [Accepted: 02/21/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND During immunotherapy treatment and survival, identifying symptoms requires a standardized and validated assessment tool. The aim of this study was to translate, validate and use the Chinese version of the Immunotherapy of the M.D. Anderson Symptom Inventory for Early-Phase Trials module (MDASI-Immunotherapy EPT) to assess the symptom burden of cancer patients receiving immunotherapy in China. METHODS The MDASI-Immunotherapy EPT was translated into Chinese using Brislin's translation model and the back-translation method. In total, 312 Chinese-speaking colorectal cancer patients receiving immunotherapy were enrolled in the trial from August 2021 to July 2022 after receiving definitive diagnoses in our cancer center. The reliability and validity of the translated version was evaluated. RESULTS Cronbach's α values were 0.964 and 0.935 for the symptom severity and interference scales, respectively. Significant correlations were found between the MDASI-Immunotherapy EPT-C and FACT-G scores (-0.617-0.732, P < 0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by ECOG PS (all P < 0.01). The overall mean subscale scores for the core and interference subscales were 1.92 ± 1.75 and 1.46 ± 1.87, respectively. Fatigue, numbness/tingling, and disturbed sleep had the highest scores for the most serious symptoms. CONCLUSION The MDASI-Immunotherapy EPT-C showed adequate reliability and validity for measuring symptoms among Chinese-speaking colorectal cancer patients receiving immunotherapy. The tool could be used in clinical practice and clinical trials to gather patients' health and quality of life data and manage their symptoms in a timely manner in the future.
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Affiliation(s)
- Xiaodan Wu
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Jingyue Xie
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Xiumei Lin
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China
| | - Limei Hua
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China
| | - Peirong Ding
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China.
| | - Shuyue Liu
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China.
| | - Simei Shi
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China.
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Campbell JK, Erickson JM. Interactive Health Literacy and Symptom Self-management in Patients With Lung Cancer: A Critical Realist Analysis. Cancer Nurs 2023:00002820-990000000-00142. [PMID: 37158678 DOI: 10.1097/ncc.0000000000001245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Patients with lung cancer experience multiple symptoms requiring self-management. Little is known about how self-management is influenced by interactive health literacy, defined as communicating with healthcare providers to obtain and process information. OBJECTIVE This study explored how interactive health literacy relates to symptom self-management among patients with lung cancer. A second aim explored how interactive health literacy might be integrated into the Individual and Family Self-management Theory. METHODS This study used a cross-sectional mixed-methods design. Quantitative data included demographics, the All Aspects of Health Literacy Scale, and the Memorial Symptom Assessment-Short Form. Qualitative data were collected using semistructured interviews. Data analysis followed a critical realist model. RESULTS Twelve adults who recently received treatment for lung cancer reported an average of 14 symptoms that caused moderate distress. Average interactive health literacy of the sample was in the moderate range. Participants' experiences of self-management differed based on their interactive health literacy. A generative mechanism proposes that those with higher interactive health literacy who accessed online information used this information as a basis for engaging with providers regarding potential symptom self-management strategies. CONCLUSIONS Interactive health literacy skills may play a role in patients' ability and confidence in symptom self-management through interactions with oncology providers. Further research should clarify the relationship between interactive health literacy, self-efficacy, and collaboration with oncology providers. IMPLICATIONS FOR PRACTICE The patient-provider relationship is a key factor influencing how patients obtain and process symptom self-management information. Oncology providers should implement patient-centered strategies to engage patients in symptom self-management.
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Affiliation(s)
- Julie K Campbell
- Authors Affiliations: School of Nursing, Lee University, Cleveland, Tennessee (Dr Campbell); and College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI (Dr Erickson)
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Kroenke K, Lam V, Ruddy KJ, Pachman DR, Herrin J, Rahman PA, Griffin JM, Cheville AL. Prevalence, Severity, and Co-Occurrence of SPPADE Symptoms in 31,866 Patients With Cancer. J Pain Symptom Manage 2023; 65:367-377. [PMID: 36738867 PMCID: PMC10106386 DOI: 10.1016/j.jpainsymman.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To examine the prevalence, severity, and co-occurrence of SPPADE symptoms as well as their association with cancer type and patient characteristics. BACKGROUND The SPPADE symptoms (sleep disturbance, pain, physical function impairment, anxiety, depression, and low energy /fatigue) are prevalent, co-occurring, and undertreated in oncology and other clinical populations. METHODS Baseline SPPADE symptom data were analyzed from the E2C2 study, a stepped wedge pragmatic, population-level, cluster randomized clinical trial designed to evaluate a guideline-informed symptom management model targeting the six SPPADE symptoms. Symptom prevalence and severity were measured with a 0-10 numeric rating (NRS) scale for each of the six symptoms. Prevalence of severe (NRS ≥ 7) and potential clinically relevant (NRS ≥ 5) symptoms as well as co-occurrence of clinical symptoms were determined. Distribution-based methods were used to estimate the minimally important difference (MID). Associations of cancer type and patient characteristics with a SPPADE composite score were analyzed. RESULTS A total of 31,886 patients were assessed for SPPADE symptoms prior to, during, or soon after an outpatient medical oncology encounter. The proportion of patients with a potential clinically relevant symptom ranged from 17.5% for depression to 33.4% for fatigue. Co-occurrence of symptoms was high, with the proportion of patients with three or more additional clinically relevant symptoms ranging from 45.2% for fatigue to 68.6% for depression. The summed SPPADE composite score demonstrated good internal reliability (Cronbach's alpha of 0.86), with preliminary MID estimates of 4.1-4.3. Symptom burden differed across several types of cancer but was generally similar across most sociodemographic characteristics. CONCLUSION The high prevalence and co-occurrence of SPPADE symptoms in patients with all types of cancer warrants clinical approaches that optimize detection and management.
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Affiliation(s)
- Kurt Kroenke
- Indiana University School of Medicine (K.K.), Indianapolis, Indiana, USA; Regenstrief Institute, Inc. (K.K.), Indianapolis, Indiana, USA.
| | - Veronica Lam
- Department of Physical Medicine and Rehabilitation (V.L., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA
| | - Kathryn J Ruddy
- Division of Medical Oncology (K.J.R.), Mayo Clinic, Rochester, Minnesota, USA
| | - Deirdre R Pachman
- Division of Community Internal Medicine, Geriatrics, and Palliative Care (D.R.P.), Mayo Clinic, Rochester, Minnesota, USA
| | - Jeph Herrin
- Yale University School of Medicine (J.H.), New Haven, Connecticut, USA
| | - Parvez A Rahman
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (P.A.R., J.M.G., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA
| | - Joan M Griffin
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (P.A.R., J.M.G., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA; Division of Health Care Delivery Research (J.M.G.), Mayo Clinic, Rochester, Minnesota, USA
| | - Andrea L Cheville
- Department of Physical Medicine and Rehabilitation (V.L., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (P.A.R., J.M.G., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA
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Chen RW, Wang Q, Hu T, Xie YX, Chang HY, Cheng J. Validation and Application of the Chinese Version of the M. D. Anderson Symptom Inventory in Breast Cancer Patients. Curr Med Sci 2022; 42:426-433. [PMID: 35314928 DOI: 10.1007/s11596-022-2544-1] [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: 11/03/2021] [Accepted: 12/09/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To validate and use the Chinese Version of the M. D. Anderson Symptom Inventory (MDASI-C) to assess the symptom burden of breast cancer patients in China. METHODS A total of 342 breast cancer patients in China participated in this study. Their symptoms were investigated with the MDASI-C from November 2020 to February 2021, and the reliability and validity of this tool were evaluated, respectively. Cluster analysis and correlation analysis were also performed. RESULTS The Cronbach's alpha coefficient values of the symptom and interference items were 0.827 and 0.880, respectively. Construct validity revealed a four-factor structure. The Kaiser-Meyer-Olkin value was 0.760. The Karnofsky Performance Status, treatment phase, and cancer stage of the patients were grouped, and the differences of scores within the groups were significant. In addition, the employment status, education level, and age of the patients were significantly correlated with the symptoms. The correlation analysis of the education level of the patients showed that most of the symptoms and interference items were reduced as the education level was increased. The top three symptoms were disturbed sleep (3.10±2.52), difficulty remembering (2.54±2.30), and fatigue (2.24±2.13). The clinical and biochemical indicators such as body mass index and neutral granulocyte lymphocyte ratio had effects on many symptoms. As the patients' BMI increased, the patients' pain, disturbed sleep, and difficulty remembering were aggravated, and numbness was alleviated. CONCLUSION The MDASI-C is a reliable and effective assessment tool to evaluate patients with breast cancer in China. The symptoms are related to many clinical and biochemical indicators.
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Affiliation(s)
- Ren-Wang Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Qiong Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ting Hu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yu-Xiu Xie
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hai-Yan Chang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jing Cheng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Kwekkeboom KL, Wieben A, Stevens J, Tostrud L, Montgomery K. Guideline-Recommended Symptom Management Strategies That Cross Over Two or More Cancer Symptoms. Oncol Nurs Forum 2021; 47:498-511. [PMID: 32830800 DOI: 10.1188/20.onf.498-511] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Patients with cancer experience multiple symptoms, but current practice is driven by guidelines that address single symptoms. Identifying symptom management strategies recommended across two or more symptoms could relieve multiple symptoms and reduce patient burden. LITERATURE SEARCH The Oncology Nursing Society, National Comprehensive Cancer Network, and American Society of Clinical Oncology websites were searched to identify management guidelines for 15 symptoms. DATA EVALUATION The authors extracted symptom management strategies and recommendations. Recommendations were synthesized by symptom across the guidelines, and recommended strategies were compared across symptoms. SYNTHESIS Among 32 guidelines reviewed, a total of 88 symptom management strategies (41 pharmacologic, 47 nonpharmacologic) were recommended across two or more symptoms. IMPLICATIONS FOR PRACTICE Findings support the potential for coordinated selection of symptom management strategies that cross over multiple symptoms in a patient. Investigators should test these symptom management strategies in the context of co-occurring symptoms and develop guidelines that address multiple symptoms.
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Electronic Patient-Reported Outcome Measures Evaluating Cancer Symptoms: A Systematic Review. Semin Oncol Nurs 2021; 37:151145. [PMID: 33773879 DOI: 10.1016/j.soncn.2021.151145] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 11/30/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This systematic review aims to evaluate the psychometric properties and the methodologic quality of studies describing smartphone-, tablet- or computer-based questionnaires for Patient-Reported Outcome Measures (PROM) evaluating symptoms in oncology and hematology patients. DATA SOURCES A literature search was conducted in PubMed, Scopus, Cochrane, Cinahl, Cuiden, Lilacs, and PsycINFO. Criteria for inclusion were (i) primary studies evaluating scales for symptoms assessment, (ii) developed in adult population (>18 years) with an oncology or hematology malignancy diagnosis, (iii) validations tested via phone or computer, and (iv) describing at least one psychometric property. The exclusion criteria were (i) tools diagnosing any type of cancer and (ii) case series, surveys, and audits. The outcome variables were internal consistency, test-retest reliability, measurement error, content validity, structural validity, hypothesis testing, cross-cultural validity, and responsiveness. For the evaluation of the quality of methodology, the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used. CONCLUSION The present study gathered five tools in 12 articles to evaluate cancer symptoms through smartphone, tablet, or computer format. Although four were generic, one was specific for breast cancer. Although none of the tools had been fully validated, some of the items of the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) were successfully tested for content, reliability, construct validity, and responsiveness. IMPLICATIONS FOR NURSING PRACTICE Our results can guide professionals choosing symptoms assessment instruments when performing telepractice, and they raise awareness of using with precaution scales not intended for remote use.
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Mah K, Swami N, O'Connor B, Hannon B, Rodin G, Zimmermann C. Early palliative intervention: effects on patient care satisfaction in advanced cancer. BMJ Support Palliat Care 2021; 12:218-225. [PMID: 33419858 DOI: 10.1136/bmjspcare-2020-002710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE In a cluster-randomised controlled trial of early palliative care (EPC) in advanced cancer, EPC was robustly associated with increased patient satisfaction with care. The present study evaluated mediational mechanisms underlying this EPC effect, including improved physical and psychological symptoms and quality of life, as well as relationships with healthcare providers and preparation for end of life. METHOD Participants with advanced cancer (n=461) completed measures at baseline and then monthly to 4 months. Mediational analyses, using a robust bootstrapping approach, focused on 3-month and 4-month follow-up data. RESULTS At 3 months, EPC decreased psychological symptoms, which resulted in greater satisfaction either directly (βindirect effect=0.05) or through greater quality of life (βindirect effect=0.02). At 4 months, EPC increased satisfaction through improved quality of life (βindirect effect=0.08). Physical symptom management showed no significant mediational effects at either time point. Better relationships with healthcare providers consistently mediated the EPC effect on patient satisfaction at 3 and 4 months, directly (βindirect effect=0.13-0.16) and through reduced psychological symptoms and/or improved quality of life (βindirect effect=0.00-0.02). At 4 months, improved preparation for end-of-life mediated EPC effects on satisfaction by enhancing quality of life (βindirect effect=0.01) or by reducing psychological symptoms and thereby increasing quality of life (βindirect effect=0.02). CONCLUSION EPC increases satisfaction with care in advanced cancer by attending effectively to patients' emotional distress and quality of life, enhancing collaborative relationships with healthcare providers, and addressing concerns about preparation for end-of-life. TRIAL REGISTRATION NUMBER NCT01248624.
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Affiliation(s)
- Kenneth Mah
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Nadia Swami
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Brenda O'Connor
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Breffni Hannon
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Princess Margaret Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada .,Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Siegelmann-Danieli N, Michaelis O, Katzir I, Wolner M, Zwang Gonen A. Acupuncture Treatment in Cancer Patients in a Community Setting: Feasibility and Positive Impact on Quality of Life. J Altern Complement Med 2020; 26:758-759. [PMID: 32589446 DOI: 10.1089/acm.2020.0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
| | | | - Itzhak Katzir
- Health Division, Maccabi Healthcare Services, Tel-Aviv, Israel
| | - Miriana Wolner
- Oncology clinic, Maccabi Healthcare Services, Haifa, Israel
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Brunelli C, Borreani C, Caraceni A, Roli A, Bellazzi M, Lombi L, Zito E, Pellegrini C, Spada P, Kaasa S, Foschi AM, Apolone G. PATIENT VOICES, a project for the integration of the systematic assessment of patient reported outcomes and experiences within a comprehensive cancer center: a protocol for a mixed method feasibility study. Health Qual Life Outcomes 2020; 18:252. [PMID: 32723341 PMCID: PMC7388528 DOI: 10.1186/s12955-020-01501-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 07/20/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Listening to "patient voices" in terms of symptoms, emotional status and experiences with care, is crucial for patient empowerment in clinical practice. Despite convincing evidence that routine patient reported outcomes and experience measurements (PRMs) with rapid feed-back to oncologists can improve symptom control, patient well-being and cost effectiveness, PRMs are not commonly used in cancer care, due to barriers at various level. Part of these barriers may be overcome through electronic PRMs collection (ePRMs) integrated with the electronic medical record (EMR). The PATIENT VOICES initiative is aimed at achieving a stepwise integration of ePRMs assessment into routine cancer care. The feasibility project presented here is aimed at assessing the knowledge, use and attitudes toward PRMs in a comprehensive cancer centre; developing and assessing feasibility of a flexible system for ePRM assessment; identifying barriers to and developing strategies for implementation and integration of ePRMs clinical practice. METHODS The project has been organized into four phases: a) pre-development; b) software development and piloting; c) feasibility assessment; d) post-development. A convergent mixed method design, based on concurrent quantitative and qualitative data collection will be applied. A web-survey on health care providers (HCPs), qualitative studies on patients and HCPs (semi-structured interviews and focus groups) as well as longitudinal and cross-sectional quantitative studies will be carried out. The quantitative studies will enroll 600 patients: 200 attending out-patient clinics (physical symptom assessement), 200 attending inpatient wards (psychological distress assessment) and 200 patients followed by multidisciplinary teams (patient experience with care assessment). The Edmonton symptom assessment scale, the Distress Thermometer, and a tool adapted from existing patient reported experience with cancer care questionnaires, will be used in quantitative studies. A multi-disciplinary stakeholder team including researchers, clinicians, health informatics professionals, health system administrators and patients will be involved in the development of potentially effective implementation strategies in the post development phase. DISCUSSION The documentation of potential advantages and implementation barriers achieved within this feasibility project, will serve as a starting point for future and more focused interventions aimed at achieving effective ePRMs routine assessment in cancer care. TRIAL REGISTRATION ClinicalTrials.gov ( NCT03968718 ) May 30th, 2019.
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Affiliation(s)
- Cinzia Brunelli
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Claudia Borreani
- Clinical psychology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Augusto Caraceni
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Anna Roli
- Quality, education and data protection Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marco Bellazzi
- Information and communication technology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Linda Lombi
- Department of Sociology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Emanuela Zito
- Information and communication technology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy.
| | - Chiara Pellegrini
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Pierangelo Spada
- Nursing, technical and rehabilitation services Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stein Kaasa
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anna Maria Foschi
- Patient representative, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Finney Rutten LJ, Ruddy KJ, Chlan LL, Griffin JM, Herrin J, Leppin AL, Pachman DR, Ridgeway JL, Rahman PA, Storlie CB, Wilson PM, Cheville AL. Pragmatic cluster randomized trial to evaluate effectiveness and implementation of enhanced EHR-facilitated cancer symptom control (E2C2). Trials 2020; 21:480. [PMID: 32503661 PMCID: PMC7275300 DOI: 10.1186/s13063-020-04335-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/21/2020] [Indexed: 01/01/2023] Open
Abstract
Background The prevalence of inadequate symptom control among cancer patients is quite high despite the availability of definitive care guidelines and accurate and efficient assessment tools. Methods We will conduct a hybrid type 2 stepped wedge pragmatic cluster randomized clinical trial to evaluate a guideline-informed enhanced, electronic health record (EHR)-facilitated cancer symptom control (E2C2) care model. Teams of clinicians at five hospitals that care for patients with various cancers will be randomly assigned in steps to the E2C2 intervention. The E2C2 intervention will have two levels of care: level 1 will offer low-touch, automated self-management support for patients reporting moderate sleep disturbance, pain, anxiety, depression, and energy deficit symptoms or limitations in physical function (or both). Level 2 will offer nurse-managed collaborative care for patients reporting more intense (severe) symptoms or functional limitations (or both). By surveying and interviewing clinical staff, we will also evaluate whether the use of a multifaceted, evidence-based implementation strategy to support adoption and use of the E2C2 technologies improves patient and clinical outcomes. Finally, we will conduct a mixed methods evaluation to identify disparities in the adoption and implementation of the E2C2 intervention among elderly and rural-dwelling patients with cancer. Discussion The E2C2 intervention offers a pragmatic, scalable approach to delivering guideline-based symptom and function management for cancer patients. Since discrete EHR-imbedded algorithms drive defining aspects of the intervention, the approach can be efficiently disseminated and updated by specifying and modifying these centralized EHR algorithms. Trial registration ClinicalTrials.gov, NCT03892967. Registered on 25 March 2019.
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Affiliation(s)
- Lila J Finney Rutten
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. .,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
| | - Kathryn J Ruddy
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Linda L Chlan
- Department of Nursing, Mayo Clinic, Rochester, MN, USA
| | - Joan M Griffin
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Jeph Herrin
- Yale University School of Medicine, New Haven, CT, USA
| | - Aaron L Leppin
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.,Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | - Jennifer L Ridgeway
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Parvez A Rahman
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Curtis B Storlie
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Patrick M Wilson
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Andrea L Cheville
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Division of Community Palliative Medicine, Mayo Clinic, Rochester, MN, USA
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Mah K, Swami N, Le LW, Chow R, Hannon BL, Rodin G, Zimmermann C. Validation of the 7-item Functional Assessment of Cancer Therapy-General (FACT-G7) as a short measure of quality of life in patients with advanced cancer. Cancer 2020; 126:3750-3757. [PMID: 32459377 DOI: 10.1002/cncr.32981] [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: 11/19/2019] [Revised: 01/17/2020] [Accepted: 03/28/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Assessing quality of life is essential for individuals with advanced cancer, but lengthy assessments can be burdensome. The authors investigated the psychometric characteristics of the FACT-G7, a 7-item quality-of-life measure derived from the Functional Assessment of Cancer Therapy-General (FACT-G) scale, in advanced cancer. METHODS Data were obtained from outpatients with advanced cancer who were enrolled in a randomized controlled trial of early palliative care. At baseline, 228 intervention participants and 233 control participants (N = 461) completed the FACT-G and measures of symptom severity, quality of life near the end of life, problematic medical communication, and satisfaction with care. Follow-up measures were administered monthly for 4 months. RESULTS The FACT-G7 showed good internal consistency (Cronbach α = .72-.80), and its single-factor structure was supported. It correlated strongly with the FACT-G total, physical, and functional indices and with symptom severity (absolute r = 0.73-0.92); more moderately with the FACT-G emotional index and with symptom impact and preparation for the end of life (r = .40-.71); and least with the FACT-G social/family index and with relationship with health care provider, life completion, problematic medical communication, and care satisfaction measures (absolute r = .26-.44). Eastern Cooperative Oncology Group performance status groups differed on FACT-G7 scores, as expected (all P < .001). Improvements in FACT-G7 scores in the intervention group compared with the control group at 3-month (P = .049) and 4-month (P = .034) follow-up supported responsiveness to change and somewhat greater sensitivity than the FACT-G scores. CONCLUSIONS The FACT-G7 is a valid, brief measure particularly of the physical and functional facets of quality of life. It may enable rapid quality-of-life assessments in patients with advanced cancer.
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Affiliation(s)
- Kenneth Mah
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Nadia Swami
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Lisa W Le
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Ronald Chow
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Breffni L Hannon
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
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13
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Murtagh FE, Ramsenthaler C, Firth A, Groeneveld EI, Lovell N, Simon ST, Denzel J, Guo P, Bernhardt F, Schildmann E, van Oorschot B, Hodiamont F, Streitwieser S, Higginson IJ, Bausewein C. A brief, patient- and proxy-reported outcome measure in advanced illness: Validity, reliability and responsiveness of the Integrated Palliative care Outcome Scale (IPOS). Palliat Med 2019; 33:1045-1057. [PMID: 31185804 PMCID: PMC6691591 DOI: 10.1177/0269216319854264] [Citation(s) in RCA: 183] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few measures capture the complex symptoms and concerns of those receiving palliative care. AIM To validate the Integrated Palliative care Outcome Scale, a measure underpinned by extensive psychometric development, by evaluating its validity, reliability and responsiveness to change. DESIGN Concurrent, cross-cultural validation study of the Integrated Palliative care Outcome Scale - both (1) patient self-report and (2) staff proxy-report versions. We tested construct validity (factor analysis, known-group comparisons, and correlational analysis), reliability (internal consistency, agreement, and test-retest reliability), and responsiveness (through longitudinal evaluation of change). SETTING/PARTICIPANTS In all, 376 adults receiving palliative care, and 161 clinicians, from a range of settings in the United Kingdom and Germany. RESULTS We confirm a three-factor structure (Physical Symptoms, Emotional Symptoms and Communication/Practical Issues). Integrated Palliative care Outcome Scale shows strong ability to distinguish between clinically relevant groups; total Integrated Palliative care Outcome Scale and Integrated Palliative care Outcome Scale subscale scores were higher - reflecting more problems - in those patients with 'unstable' or 'deteriorating' versus 'stable' Phase of Illness (F = 15.1, p < 0.001). Good convergent and discriminant validity to hypothesised items and subscales of the Edmonton Symptom Assessment System and Functional Assessment of Cancer Therapy-General is demonstrated. The Integrated Palliative care Outcome Scale shows good internal consistency (α = 0.77) and acceptable to good test-retest reliability (60% of items kw > 0.60). Longitudinal validity in form of responsiveness to change is good. CONCLUSION The Integrated Palliative care Outcome Scale is a valid and reliable outcome measure, both in patient self-report and staff proxy-report versions. It can assess and monitor symptoms and concerns in advanced illness, determine the impact of healthcare interventions, and demonstrate quality of care. This represents a major step forward internationally for palliative care outcome measurement.
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Affiliation(s)
- Fliss Em Murtagh
- 1 Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.,2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Christina Ramsenthaler
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.,3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Alice Firth
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Esther I Groeneveld
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Natasha Lovell
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Steffen T Simon
- 4 Center for Palliative Medicine, University of Cologne, Cologne, Germany
| | - Johannes Denzel
- 3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Ping Guo
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Florian Bernhardt
- 3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Eva Schildmann
- 3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Birgitt van Oorschot
- 5 Interdisciplinary Centre for Palliative Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Farina Hodiamont
- 3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sabine Streitwieser
- 3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Irene J Higginson
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Claudia Bausewein
- 3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
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14
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Using a Patient-Centered Approach to Identify Symptom Clusters Among Adolescents With Cancer. Cancer Nurs 2019; 42:198-207. [DOI: 10.1097/ncc.0000000000000587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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15
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Pedrosa TM, Martins TCDF, Souza ALLP, Silva DGF, Moura SF, Muzi CD, Guimarães RM. Avaliação clínica dos sintomas de pacientes com câncer de cabeça e pescoço. AVANCES EN ENFERMERÍA 2019. [DOI: 10.15446/av.enferm.v37n2.73149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objetivo: avaliar os sintomas mais frequentes apresentados pelos pacientes com câncer de cabeça e pescoço e fatores associados.Metodologia: trata-se de um estudo transversal realizado com 77 pacientes do serviço de cirurgia de cabeça e pescoço do Instituto Nacional de Câncer (Brasil). Foi utilizado o Memorial Symptom Assessment Scale (MSAS), adaptado ao Brasil. Foi avaliada a prevalência dos sintomas, bem como sua associação com variáveis demográficas e clínicas por meio dos testes de qui- quadrado e de ANOVA.Resultados: os sintomas mais prevalentes foram boca seca (62,5 %), tristeza (60 %), preocupações (53,75 %), nervosismo (48,75 %) e tosse (46,25 %). Quanto à faixa etária, identificou-se diferença nos sintomas físicos de baixa frequência (PHYS-L), com maior queixa entre os jovens (p < 0,01). Na escala global (TMSAS) houve queixa maior dos pacientes ambulatoriais comparados aos internados (p = 0,05). Houve, ainda, queixa maior de sintomas de baixa frequência entre pacientes sem metástase (p = 0,05).Conclusão: considerando-se a ocorrência de múltiplos sintomas no paciente oncológico, é necessário ter métodos que sejam capazes de avaliar, de forma mais ampla, os sintomas. Dessa forma, o enfermeiro terá melhor compreensão da complexidade dos grupos de sintomas, permitindo aperfeiçoar as intervenções clínicas no processo de enfermagem.
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16
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Chen RW, Yang SL, Xu ZY, Peng M, Chen MN, Wang QS, Chang J, Hu JL. Validation and Application of the Chinese Version of the M. D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI-C). J Pain Symptom Manage 2019; 57:820-827. [PMID: 30684634 DOI: 10.1016/j.jpainsymman.2019.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To validate and use the Chinese Version of the M. D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI-C) to assess the symptom burden of Chinese-speaking patients with gastrointestinal cancer. METHODS In total, 527 patients with postoperative or advanced digestive tract tumors were enrolled in the trial, who had definitive diagnoses and different treatments in our cancer center. MDASI-GI-C was administered to these patients between February and December 2017. The item-scale correlations and internal consistency were evaluated. Construct validity was established by factor analysis. Hierarchical cluster analysis was performed. RESULTS Cronbach's alpha of the symptom severity and interference subscales was 0.842 and 0.859, respectively. Construct validity revealed a four-factor structure. Known-group validity was established by comparing the MDASI-GI-C scores between patients having different Karnofsky Performance Status scores (≤70 or >70), which were observed to have significant differences. The overall mean subscale scores for the core and interference subscales were 1.63 ± 2.02 and 2.17 ± 2.34, respectively. Fatigue, disturbed sleep, and lack of appetite had the highest scores for most serious symptoms. No significant differences in age, working status, and educational level were found. CONCLUSIONS MDASI-GI-C is a reliable and valid tool for assessing cancer-related symptoms in Chinese-speaking patients with digestive tract tumors, facilitates the understanding of the common symptoms of patients with digestive tract tumors, and enables timely management of these symptoms. Cognitive debriefing demonstrated that the patients found MDASI-GI-C to be an easy-to-use and understandable instrument.
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Affiliation(s)
- Ren-Wang Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng-Li Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhong-Yu Xu
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China
| | - Miao Peng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng-Ni Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiu-Shuang Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Chang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Li Hu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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17
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Hagan TL, Gilbertson-White S, Cohen SM, Temel JS, Greer JA, Donovan HS. Symptom Burden and Self-Advocacy: Exploring the Relationship Among Female Cancer Survivors. Clin J Oncol Nurs 2019; 22:E23-E30. [PMID: 29350706 DOI: 10.1188/18.cjon.e23-e30] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although patient self-advocacy is a critical component of patient-centered care, the association between symptom burden and self-
advocacy has received little attention.
. OBJECTIVES This analysis evaluates the degree to which self-advocacy is associated with symptom burden among women with a history of cancer.
. METHODS Participants completed online or paper questionnaires. Descriptive statistics and ordinary least squares regression models were used to analyze the association between the three dimensions of self-advocacy and two dimensions of symptom burden. FINDINGS Participants reported moderate levels of symptom burden. Fatigue, disturbed sleep, and memory problems were most common. Informed decision making was positively associated with symptom burden and participants' burden across the three most severe symptoms. Effective communication was negatively associated with total symptom burden and the degree to which symptoms interfered with daily life.
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19
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Haryani H, Hsu YY, Warsini S, Wang ST. Measuring the Symptom Experience of Patients With Cancer in Indonesia: Cross-Cultural Adaptation and Validation of the Memorial Symptom Assessment Scale-Indonesian Version. J Pain Symptom Manage 2018; 56:920-927. [PMID: 30176284 DOI: 10.1016/j.jpainsymman.2018.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/21/2018] [Accepted: 08/21/2018] [Indexed: 11/25/2022]
Abstract
CONTEXT Little is known about cancer-related symptoms in terms of prevalence, severity, and distress among patients with cancer in Indonesia because of a lack of a valid and reliable scale. OBJECTIVES To translate and validate the Memorial Symptom Assessment Scale (MSAS) among cancer patients in Indonesia. METHODS Two procedures consisting of forward-backward translation and validation were conducted. The validation process including pretesting involved 34 cancer patients, and the psychometric testing of the Indonesian version of MSAS (MSAS-I) involved 207 cancer patients. Internal consistency, test-retest reliability, construct, and concurrent validity of the MSAS-I were established. RESULTS Cronbach's alpha coefficients for the total scale and subscales of the MSAS-I ranged from 0.75 to 0.87. The interclass correlations for test-retest reliability ranged from 0.80 to 0.89. A two-factor structure in the MSAS-I was produced by exploratory factor analysis, and the two factors accounted for 28.34% of the cumulative variance. In addition, the concurrent validity was demonstrated by the significant associations between the subscales of the MSAS-I and their corresponding subscales in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, with r = -0.25 to -0.65 (all P < 0.001). CONCLUSION The MSAS-I presents a valid and reliable scale for assessing symptom frequency, severity, and distress among patients with cancer in Indonesia. IMPLICATION FOR NURSING The MSAS-I can assess physical and psychological symptoms during cancer treatment. In addition, the MSAS-I may facilitate in measuring the effectiveness of symptom management strategies.
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Affiliation(s)
- Haryani Haryani
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Yu-Yun Hsu
- Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan.
| | - Sri Warsini
- Department of Mental Health Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Shan-Tair Wang
- Department of Gerontology, College of Medicine, National Cheng Kung University, Taiwan
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20
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Williams LA, Whisenant MS, Mendoza TR, Haq S, Keating KN, Cuffel B, Cleeland CS. Modification of existing patient-reported outcome measures: qualitative development of the MD Anderson Symptom Inventory for malignant pleural mesothelioma (MDASI-MPM). Qual Life Res 2018; 27:3229-3241. [PMID: 30187393 DOI: 10.1007/s11136-018-1982-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2018] [Indexed: 11/12/2022]
Abstract
PURPOSE Malignant pleural mesothelioma (MPM) is an aggressive cancer of the lung pleura. The MD Anderson Symptom Inventory (MDASI) is a patient-reported outcome (PRO) measure of symptom burden, the combined impact of disease-related and treatment-related symptoms on functioning. Validated PRO measures may require modification for use in specific study populations. We sought to modify the MDASI for patients with MPM and create a fit-for-purpose symptom-burden measure for use in a clinical trial, according to US Food and Drug Administration guidance on PRO utilization to support labeling claims. METHODS A literature review for MPM symptoms was conducted. Patients with MPM were qualitatively interviewed about experiences of disease and treatment. Descriptive analysis identified symptoms and interference with functioning to define MPM-related symptom burden. An expert panel rated the relevance of identified symptoms to patients with MPM. Patients who received the investigational drug in a previous Phase I study were interviewed for drug-specific symptoms. RESULTS Literature review and interviews of 20 patients identified 31 MPM-related symptoms. A conceptual model of MPM-related symptom burden was developed. After expert-panel relevance review, five MPM-specific items and the 13 core MDASI symptoms met criteria for inclusion in a provisional MDASI-MPM for psychometric testing. Interviews with six patients identified six drug-specific symptoms; three were mentioned by multiple patients. Of these three, one was not in the core MDASI. CONCLUSIONS The MDASI-MPM has established content validity and, with the addition of one symptom item, is ready for psychometric testing as fit-for-purpose for a clinical trial of an investigational agent.
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Affiliation(s)
- Loretta A Williams
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA.
| | - Meagan S Whisenant
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
| | - Tito R Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
| | - Shireen Haq
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
| | - Karen N Keating
- Bayer HealthCare Pharmaceuticals, 100 Bayer Boulevard, Whippany, NJ, 07981, USA
| | - Brian Cuffel
- Bayer HealthCare Pharmaceuticals, 100 Bayer Boulevard, Whippany, NJ, 07981, USA
| | - Charles S Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
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Anxiety and depression associated with tyrosine kinase inhibitor discontinuation in patients with chronic myeloid leukemia. Int J Clin Oncol 2018; 23:974-979. [DOI: 10.1007/s10147-018-1275-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
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22
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McFarland DC, Shaffer KM, Tiersten A, Holland J. Prevalence of physical problems detected by the distress thermometer and problem list in patients with breast cancer. Psychooncology 2018; 27:1394-1403. [PMID: 29315955 DOI: 10.1002/pon.4631] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Patients with breast cancer have high rates of physical symptoms that negatively impact their quality of life. The relationship between women's perceptions of these physical symptoms and patient demographic and breast cancer characteristics is less well known. This study describes physical symptoms of patients with breast cancer and their relationship with patient characteristics. METHODS Patients (n = 125) with breast cancer (stage 0-IV) completed questionnaires in a dedicated academic medical center breast cancer clinic. Patients reported demographics (age, race/ethnicity, marital status, and employment status) and disease characteristics (surgery type, receipt of chemotherapy, or antihormonal therapy). Patients reported whether they were bothered by any of the 22 physical problem list (PPL) variables from the distress thermometer and problem list. RESULTS The median number of physical problems endorsed by patients was 3.0 (M = 3.43, SD = 3.42). Approximately one-fourth endorsed no physical symptoms while three-fourths reported at least 1 problem, and three-fifths endorsed 2 or more problems. Fatigue (40.0%), sleep (34.7%), skin dry/itchy (22.9%), pain (19.5%), and feeling swollen (19.5%) were most commonly reported. Age, race/ethnicity, marital status, employment status, and receipt of chemotherapy were associated with certain physical problems. Problems with breathing, eating, memory/concentration, nausea, and total number of endorsed PPL variables were associated with distress. CONCLUSION The breast cancer population demonstrates heavy physical symptom burden with multiple physical problems that are related to overall functioning. Special attention should be given to the physical symptom burden of younger, nonwhite, unmarried, and unemployed patients. Future research should investigate the PPL of the distress thermometer and problem list with other measures of symptom burden.
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Affiliation(s)
- Daniel C McFarland
- Division of Network Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, West Harisson, NY, USA
| | - Kelly M Shaffer
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amy Tiersten
- Department of Medicine, Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Jimmie Holland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Do Correlates of Pain-Related Stoicism and Cautiousness Differ in Younger and Older People With Advanced Cancer? THE JOURNAL OF PAIN 2017; 19:301-316. [PMID: 29155166 DOI: 10.1016/j.jpain.2017.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/31/2017] [Accepted: 11/06/2017] [Indexed: 11/20/2022]
Abstract
Age differences are not evident in pain-related stoicism and cautiousness in people with cancer pain. Little is known about the factors associated with these pain-related attitudes or age-related patterns in these associations. The present cross-sectional study investigated the biopsychosocial correlates of the attitudes in younger and older patients with advanced cancer. Pain-related stoicism (fortitude, concealment, superiority) and cautiousness (self-doubt, reluctance) were assessed using the Pain Attitudes Questionnaire-Revised (PAQ-R). Participants, 155 younger (younger than 60 years old) and 114 older (60 years old or older) patients with advanced cancer completed the PAQ-R and measures of sociodemographic and medical characteristics, pain intensity, cognitive-affective pain-related responses, physical functioning, psychological distress and well-being, and psychosocial functioning. Backwards regression analyses identified correlates for each PAQ-R factor separately for younger and older patients. Activity engagement was a frequent correlate, but its relationship with concealment was the only association common to both age groups. Younger and older patients exhibited different avoidance-related constructs suggesting relational challenges in the former group (avoidant attachment) and intrapersonal fear in the latter (cognitive avoidance). Medical correlates also showed age differences: younger patients showed symptom-focused correlates, whereas older patients showed aging-related correlates. Findings support a biopsychosocial framework of cancer-pain adaptation incorporating a lifespan-developmental perspective. PERSPECTIVE To our knowledge, this article is the first to identify biopsychosocial correlates of stoic and cautious attitudes toward cancer pain in younger and older patients with advanced cancer. Findings highlight possible age-related motivations for greater pain-related stoicism or cautiousness and can potentially inform interventions addressing challenges in cancer-pain adaptation in advanced cancer.
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The effect of weekly specialist palliative care teleconsultations in patients with advanced cancer -a randomized clinical trial. BMC Med 2017; 15:119. [PMID: 28625164 PMCID: PMC5474887 DOI: 10.1186/s12916-017-0866-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Teleconsultation seems to be a promising intervention for providing palliative care to home-dwelling patients; however, its effect on clinically relevant outcome measures remains largely unexplored. Therefore, the purpose of this study was to determine whether weekly teleconsultations from a hospital-based specialist palliative care consultation team (SPCT) improved patient-experienced symptom burden compared to "care as usual". Secondary objectives were to determine the effects of these teleconsultations on unmet palliative care needs, continuity of care, hospital admissions, satisfaction with teleconsultations, and the burden experienced by informal caregivers. METHODS Seventy-four home-dwelling patients diagnosed with advanced cancer were recruited from outpatient clinics of a tertiary university hospital and from regional home care organizations between May 2011 and January 2015. Participants were randomized to receive weekly, prescheduled teleconsultations with an SPCT-member (intervention group), or to receive "care as usual" (control group), for a period of 12 weeks. The primary outcome of this study was: patient-experienced symptom burden indicated by the following: (1) Total Distress Score (defined as the sum of all nine subscales of the Edmonton Symptom Assessment System) and (2) the Hospital Anxiety and Depression Scale. Mixed models were used to test for differences between the two groups. RESULTS The Total Distress Score became significantly higher in the intervention group than in the control group, reaching significance at week 12 (adjusted difference at week 12: 6.90 points, 95% CI, 0.17 to 13.63; P = 0.04). The adjusted anxiety scores were higher in the intervention group than in the control group (estimate effect: 1.40; 95% CI, 0.14 to 2.55; P = 0.03). No difference was found between the groups in adjusted depression scores (estimate effect: 0.30; 95% CI, -1.39 to 1.99; P = 0.73) or in secondary outcome measures. CONCLUSIONS Adding weekly teleconsultations to usual palliative care leads to worse reported symptom scores among home-dwelling patients with advanced cancer. Possible explanations for these findings include excess attention on symptoms and (potential) suffering, the supply-driven care model for teleconsultations used in this trial, and the already high level of specialist palliative care provided to the control group in this study. TRIAL REGISTRATION "The Netherlands National Trial Register", NTR2817 , prospectively registered: March 21, 2011.
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Caruso R, Nanni MG, Riba M, Sabato S, Mitchell AJ, Croce E, Grassi L. Depressive spectrum disorders in cancer: prevalence, risk factors and screening for depression: a critical review. Acta Oncol 2017; 56:146-155. [PMID: 28140731 DOI: 10.1080/0284186x.2016.1266090] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although depression and mood-related disorders are common in persons with cancer, these conditions remain frequently overlooked in clinical practice. Negative consequences of depressive disorder spectrum have been reported (e.g. suicidal ideation, increase physical complications and somatic symptoms, negative influence on prognosis), indicating the need for routine screening, assessment and management. METHODS A search of the major databases (Medline, Embase, PsycLIT, PsycINFO, and the Cochrane Library) was conducted on the reviews and meta-analyses available in order to summarize relevant data concerning depressive disorders spectrum in terms of prevalence, risk factors, and screening and assessment among patients with cancer across the trajectory of the disease. RESULTS The data show a prevalence of depression and depressive disorders between 5% and 60% according to the different diagnostic criteria, the tools used in the studies (e.g. semi-structured psychiatric interview and psychometric questionnaires), as well as the stage and type of cancer. Furthermore, despite the significant health care resources devoted to cancer care and the importance of addressing depressive symptoms, assessment and management of depressive spectrum disorders in cancer patients remains suboptimal. CONCLUSIONS Routine screening and adequate assessment of depressive spectrum disorders is necessary in patients with cancer in order to effectively manage the multifaceted and complex consequences on cancer care.
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Affiliation(s)
- R. Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy
| | - M. G. Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy
| | - M. Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA and University of Michigan Comprehensive Cancer Center, Ann, Arbor, MI, USA
- Psycho-oncology Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | - S. Sabato
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - A. J. Mitchell
- Department of Psycho-oncology, University of Leicester and Leicestershire Partnership Trust, Leicester, UK
| | - E. Croce
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - L. Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy
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Cooley ME, Siefert ML. Assessment of Multiple Co-Occurring Cancer Symptoms in the Clinical Setting. Semin Oncol Nurs 2016; 32:361-372. [PMID: 27776830 DOI: 10.1016/j.soncn.2016.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To discuss multiple co-occurring cancer symptoms, review symptom assessment instruments, identify innovative methods to integrate symptom assessment and management in the clinical setting, and examine barriers and facilitators for implementation of symptom assessment and use of clinical practice guidelines. DATA SOURCES Peer-reviewed articles, guidelines, systematic reviews, and web-based resources. CONCLUSION Despite the availability of brief, reliable, and valid instruments, symptom assessment has not been integrated as a routine aspect of clinical care. New technologies and changes in health policy provide an optimal environment to integrate electronic symptom assessment and management into cancer care. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses play a key role in early identification and management of distressing symptoms.
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Zimmerman L, Pozehl B, Vuckovic K, Barnason S, Schulz P, Seo Y, Ryan CJ, Zerwic JJ, DeVon HA. Selecting symptom instruments for cardiovascular populations. Heart Lung 2016; 45:475-496. [PMID: 27686695 DOI: 10.1016/j.hrtlng.2016.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 08/24/2016] [Accepted: 08/31/2016] [Indexed: 01/11/2023]
Abstract
The purpose of this review is to provide a guide for researchers and clinicians in selecting an instrument to measure four commonly occurring symptoms (dyspnea, chest pain, palpitations, and fatigue) in cardiac populations (acute coronary syndrome, heart failure, arrhythmia/atrial fibrillation, and angina, or patients undergoing cardiac interventions). An integrative review of the literature was conducted. A total of 102 studies summarizing information on 36 different instruments are reported in this integrative review. The majority of the instruments measured multiple symptoms and were used for one population. A majority of the symptom measures were disease-specific and were multi-dimensional. This review summarizes the psychometrics and defining characteristics of instruments to measure the four commonly occurring symptoms in cardiac populations. Simple, psychometrically strong instruments do exist and should be considered for use; however, there is less evidence of responsiveness to change over time for the majority of instruments.
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Affiliation(s)
- Lani Zimmerman
- University of Nebraska, College of Nursing, Lincoln, NE, 68588, USA.
| | - Bunny Pozehl
- University of Nebraska, College of Nursing, Lincoln, NE, 68588, USA
| | - Karen Vuckovic
- University of Illinois at Chicago, College of Nursing, Chicago, IL, 60612, USA
| | - Susan Barnason
- University of Nebraska, College of Nursing, Lincoln, NE, 68588, USA
| | - Paula Schulz
- University of Nebraska, College of Nursing, Lincoln, NE, 68588, USA
| | - Yaewon Seo
- University of Nebraska, College of Nursing, Lincoln, NE, 68588, USA
| | - Catherine J Ryan
- University of Illinois at Chicago, College of Nursing, Chicago, IL, 60612, USA
| | - Julie J Zerwic
- University of Illinois at Chicago, College of Nursing, Chicago, IL, 60612, USA
| | - Holli A DeVon
- University of Illinois at Chicago, College of Nursing, Chicago, IL, 60612, USA
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Revorêdo LDS, Dantas MMC, Maia RS, Torres GDV, Maia EMC. Validação de conteúdo de um instrumento para identificação de violência contra criança. ACTA PAUL ENFERM 2016. [DOI: 10.1590/1982-0194201600029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Elaborar e validar o conteúdo de um instrumento para identificação de violência contra criança. Métodos Estudo metodológico composto por duas etapas: a primeira foi a elaboração do instrumento, a partir de revisão da literatura; a segunda, de validação de conteúdo, mediante a avaliação do instrumento por 25 especialistas. Para análise, adotaram-se coeficiente Kappa ≥0,61 e índice de validade de conteúdo ≥0,75. Resultados Na primeira rodada, dos 62 itens, observou-se necessidade de reformulação do conteúdo de 23. Após as alterações sugeridas pelos especialistas, na segunda rodada, o instrumentou passou a possuir 50 itens. Destes, apenas um apresentou Kappa >0,61 (Kappa = 0,50). A insuficiência de concordância entre os especialistas ocasionou na exclusão dele, em uma terceira rodada. Conclusão O instrumento apresentou índice de validade de conteúdo satisfatório e pode ser utilizado para identificar os sinais de suspeita de violência e auxiliar os profissionais de saúde na assistência à criança.
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No Negative Impact of Palliative Sedation on Relatives' Experience of the Dying Phase and Their Wellbeing after the Patient's Death: An Observational Study. PLoS One 2016; 11:e0149250. [PMID: 26871717 PMCID: PMC4752210 DOI: 10.1371/journal.pone.0149250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 01/28/2016] [Indexed: 11/19/2022] Open
Abstract
Background Palliative sedation is the widely-used intervention of administering sedating agents to induce a state of unconsciousness to take away a dying patient’s perception of otherwise irrelievable symptoms. However, it remains questionable whether this ethically complex intervention is beneficial for patients and whether the associated lack of communication in the last phase of life has a negative impact on relatives’ wellbeing. Methods An observational questionnaire study was conducted among relatives of a consecutive sample of patients who died a non-sudden death in the Erasmus MC Cancer Institute or in the hospice ‘Laurens Cadenza’ (both in Rotterdam) between 2010 and 2013. Results Relatives filled in questionnaires regarding 151 patients who had been sedated and 90 patients who had not been sedated. The median time since all patients had passed away was 21 (IQR 14–32) months. No significant differences were found in relatives´ assessments of the quality of end-of-life care, patients´ quality of life in the last week before death and their quality of dying, between patients who did and did not receive sedation, or in relatives’ satisfaction with their own life, their general health and their mental wellbeing after the patient’s death. Conclusions The use of sedation in these patients appears to have no negative effect on bereaved relatives’ evaluation of the patient’s dying phase, or on their own wellbeing after the patient’s death.
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Holla JFM, van de Poll-Franse LV, Huijgens PC, Mols F, Dekker J. Utilization of supportive care by survivors of colorectal cancer: results from the PROFILES registry. Support Care Cancer 2016; 24:2883-92. [PMID: 26842528 DOI: 10.1007/s00520-016-3109-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 01/26/2016] [Indexed: 01/05/2023]
Abstract
PURPOSE In an equitable healthcare system, healthcare utilization should be predominantly explained by patient-perceived need and clinical need factors. This study aims to analyze whether predisposing, enabling, and need factors are associated with the utilization of supportive care (i.e., dietary care, oncological nursing care, physical therapy, psychological care, or participation in a rehabilitation program consisting of an exercise component and a psycho-educational component) among survivors of colorectal cancer in the Netherlands. METHODS Cross-sectional data of 3957 survivors of colorectal cancer (1-11 years after diagnosis) were used. Clinical data from the Eindhoven Cancer Registry were linked to questionnaire data from the PROFILES registry. Regression analyses were used to examine which predisposing, enabling, and need factors were associated with self-reported utilization of supportive care. RESULTS Utilization of supportive care was primarily associated with younger age, patient-perceived need (i.e., lower physical health, anxious mood, depressive mood, and fatigue), and clinical need (i.e., tumor stage, radiotherapy, chemotherapy, comorbidity, having a stoma and lower BMI) factors. CONCLUSIONS In the Netherlands, utilization of supportive care by survivors of colorectal cancer is primarily associated with younger age, patient-perceived need, and clinical need factors. Apart from the association with younger age, the utilization of supportive care services seems to be quite equitable. Further research is needed to determine whether there is indeed inequity in the provision of supportive care to older survivors, or whether older survivors are less in need of supportive care.
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Affiliation(s)
- Jasmijn F M Holla
- Amsterdam Rehabilitation Research Center
- Reade, Dr. Jan van Breemenstraat 2, PO Box 58271, 1040 HG, Amsterdam, The Netherlands.
| | - Lonneke V van de Poll-Franse
- CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Peter C Huijgens
- Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands.,Department of Hematology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Floortje Mols
- CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Joost Dekker
- Amsterdam Rehabilitation Research Center
- Reade, Dr. Jan van Breemenstraat 2, PO Box 58271, 1040 HG, Amsterdam, The Netherlands.,Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
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Neiman TJ, Kovach CR. Research Needs and Challenges Regarding Palliation for Individuals in Long-Term Care Settings. Res Gerontol Nurs 2016; 9:2-5. [DOI: 10.3928/19404921-20151211-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Tammy J. Neiman
- Jonas Nurse Leadership Scholar, 2014–2016, University of Wisconsin–Milwaukee, Milwaukee, Wisconsin
| | - Christine R. Kovach
- Jewish Home and Care Center Research Professor in Aging, University of Wisconsin–Milwaukee, Milwaukee, Wisconsin
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