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Kelmendi N, Nilsson M, Taloyan M, Sundberg K, Langius-Eklöf A, Craftman ÅG. Preferences for Tailored Support - Patients' and Health Care Professionals' Experiences Regarding Symptoms and Self-Management Strategies During the First Year After Curatively Intended Prostate Cancer Treatment. Patient Prefer Adherence 2024; 18:275-288. [PMID: 38333642 PMCID: PMC10850763 DOI: 10.2147/ppa.s440689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/06/2024] [Indexed: 02/10/2024] Open
Abstract
Purpose There is an increase in the number of men undergoing screening for prostate cancer, and advancements in treatments, which implies current knowledge about symptoms and self-management. This study aims to explore experiences of symptom distress, and self-management strategies during the first year after curatively intended treatment for prostate cancer, as identified by patients and health care professionals. Methods A qualitative design was used, including data triangulation from individual interviews with patients (n =17) and one focus group interview with healthcare professionals (n =5). Thematic analysis was used. Results The two main themes were identified: living with the consequences of treatment and navigating a new situation. Living with the consequences of treatment illustrated how losing control of bodily functions such as bladder, bowel, and sexual functions interfered with daily life. A stigma around the disease was described, and a life living in an unfamiliar body challenged ideas of masculinity. The first months after treatment ended was a distressing period related to the abruption in frequent contact with healthcare providers, and concerns about the future. The second theme, navigating a new situation, illustrates that self-management strategies varied, due to individual factors as did the need for tailored information and support provided from healthcare professionals and family, which was highly valued. Information and support were described as complex topics and healthcare professionals emphasized the need for appropriate education for staff to provide proper support to men after ended treatment. Conclusion Lingering symptoms and concerns were evident during the first year after treatment. Self-management strategies varied, and timely and tailored information and support during the first year were considered highly valued, important, and preferred by patients. Our results indicate that support should be offered immediately after curatively intended treatment.
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Affiliation(s)
- Nazmije Kelmendi
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
| | - Marie Nilsson
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Marina Taloyan
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Kay Sundberg
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Åsa G Craftman
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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Shahsavar Y, Choudhury A. Examining influential factors in newly diagnosed cancer patients and survivors: Emphasizing distress, self-care ability, peer support, health perception, daily life activity, and the role of time since diagnosis. PLoS One 2023; 18:e0291064. [PMID: 37656716 PMCID: PMC10473484 DOI: 10.1371/journal.pone.0291064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
This study investigates the complex interrelationships between peer support, mental distress, self-care abilities, health perceptions, and daily life activities among cancer patients and survivors while considering the evolving nature of these experiences over time. A cross-sectional survey design is employed, utilizing de-identified data from the National Cancer Institute's 2022 nationally representative dataset, which comprises responses from 1234 participants, including 134 newly diagnosed patients undergoing cancer treatment. Partial least squares structural equation modeling is employed for data analysis. The results reveal that peer support significantly reduces mental distress and positively influences the perception of self-care abilities and health perceptions among cancer patients and survivors. Additionally, the study finds that mental distress negatively affects daily life activities and self-care abilities. This means that when cancer patients and survivors experience high levels of mental distress, they may struggle with everyday tasks and find it challenging to care for themselves effectively. The research also shows that mental distress tends to decrease as time passes since diagnosis and health perceptions improve, highlighting the resilience of cancer patients and survivors over time. Furthermore, the study uncovers significant moderating effects of age, education, and income on the relationships between daily life activity difficulties, perception of self-care ability, and perception of health. In conclusion, this research provides a comprehensive understanding of the intricate associations between the variables of interest among cancer patients and survivors. The findings underscore the importance of peer support and targeted interventions for promoting well-being, resilience, and quality of life in this population, offering valuable insights for healthcare providers, researchers, and policymakers. Identifying moderating effects further emphasizes the need to consider individual differences when designing and implementing support systems and interventions tailored to the unique needs of cancer patients and survivors.
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Affiliation(s)
- Yeganeh Shahsavar
- Industrial and Management Systems Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia, United States of America
| | - Avishek Choudhury
- Industrial and Management Systems Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia, United States of America
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Kim WS, Langer S, Todd M, Larkey L, Jo S, Bangerter LR, Khera N. Feasibility of a Digital Storytelling Intervention for Hematopoietic Cell Transplant Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1275-1285. [PMID: 33389660 DOI: 10.1007/s13187-020-01948-2] [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] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
Patients undergoing hematopoietic cell transplantation (HCT) are at risk for psychological and social impairment given the rigors and multiple sequelae of treatment. The purpose of this pilot study was to test the feasibility of a digital storytelling (DS) intervention for HCT patients, and to examine limited efficacy of the intervention relative to control arm on psychological distress and perceived social support. Adult HCT patients (n = 40, M age = 59.2 years) were enrolled immediately post-HCT and randomly assigned to either DS intervention or information control (IC). DS participants viewed four 3-min personal, emotionally rich digital stories, and IC condition participants viewed four videos containing information about post-HCT care. Feasibility regarding recruitment, enrollment efforts, and change scores from pre- to post-intervention (Δs) on depression, anxiety, and perceived social support were tracked. Fifty-four (51.4%) of 105 eligible patients consented. Forty (74%) patients completed the intervention. All but one completed the post-intervention assessments demonstrating that HCT patients can be recruited and retained for this intervention. On average, perceived social support increased for the DS group (Δ = 0.06) but decreased for the IC group (Δ = - 0.05). Anxiety and depression improved over time in both conditions. Viewing digital stories with content evoking emotional contexts similar to one's own health challenges may improve perceptions of social support among HCT patients. How DS can improve perceived social support for both short-term and longer-term sustained effects in a longitudinal study is an area ripe for additional investigation.
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Affiliation(s)
- Wonsun Sunny Kim
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA.
| | - Shelby Langer
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA
| | - Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA
| | - Soojung Jo
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA
| | | | - Nandita Khera
- College of Medicine, Mayo Clinic of Arizona, Phoenix, AZ, USA
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Faithfull S, Cockle-Hearne J, Lemanska A, Otter S, Skene SS. Randomised controlled trial to investigate the effectiveness of the symptom management after radiotherapy (SMaRT) group intervention to ameliorate lower urinary tract symptoms in men treated for prostate cancer. Support Care Cancer 2021; 30:3165-3176. [PMID: 34932140 PMCID: PMC8857109 DOI: 10.1007/s00520-021-06749-x] [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] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/07/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate the effectiveness of the symptom management after radiotherapy (SMaRT) group intervention to improve urinary symptoms in men with prostate cancer. METHODS The randomised controlled trial (RCT) recruited men from one radiotherapy centre in the UK after curative radiotherapy or brachytherapy and with moderate to severe urinary symptoms defined as scores ≥ 8 on the International Prostate Symptom Score (IPSS) questionnaire. Sixty-three men were randomised either; to SMaRT, a 10-week symptom-management intervention including group support, education, pelvic floor muscle exercises, or a care-as-usual group. The primary outcome was the IPSS at 6 months from baseline assessment. Secondary outcomes were IPSS at 3 months, and International Continence Society Male Short Form (ICS), European Organisation for Research and Treatment of Cancer Quality of Life prostate scale (EORTC QLQ-PR25), EORTC QLQ-30 and Self-Efficacy for Symptom Control Inventory (SESCI) at 3 and 6 months from baseline. Analysis of covariance (ANCOVA) was used to analyse the effect of the intervention. RESULTS SMaRT group intervention did not improve urinary symptoms as measured by IPSS at 6-months. The adjusted difference was - 2.5 [95%CI - 5.0 to 0.0], p = 0.054. Significant differences were detected at 3 months in ICS voiding symptoms (- 1.1 [- 2.0 to - 0.2], p = 0.017), ICS urinary incontinence (- 1.0 [- 1.8 to - 0.1], p = 0.029) and SESCI managing symptoms domain (13.5 [2.5 to 24.4], p = 0.017). No differences were observed at 6 months. CONCLUSIONS SMaRT group intervention provided short-term benefit in urinary voiding and continence and helped men manage symptoms but was not effective long term.
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Affiliation(s)
- Sara Faithfull
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK.
| | - Jane Cockle-Hearne
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - Agnieszka Lemanska
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - Sophie Otter
- Royal Surrey County Hospital, Egerton Road, Guildford, GU2 7XX, Surrey, UK
| | - Simon S Skene
- Surrey Clinical Trials Unit, University of Surrey, Egerton Road, Guildford, GU2 7XP, UK
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Kelly C, Pericleous M, Ahmed A, Vandrevala T, Hendy J, Shafi S, Skene SS, Verma S, Edge C, Nicholls M, Gore C, de Lusignan S, Ala A. Improving uptake of hepatitis B and hepatitis C testing in South Asian migrants in community and faith settings using educational interventions-A prospective descriptive study. Int J Infect Dis 2020; 100:264-272. [PMID: 32861830 DOI: 10.1016/j.ijid.2020.08.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/19/2020] [Accepted: 08/22/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic viral hepatitis (CVH) is a leading contributor to the UK liver disease epidemic, with global migration from high prevalence areas (e.g., South Asia). Despite international guidance for testing high-risk groups in line with elimination targets, there is no consensus on how to achieve this. The objectives of this study were to assess the following: (1) the feasibility of recruiting South Asian migrants to view an educational film on CVH, (2) the effectiveness of the film in promoting testing and increasing knowledge of CVH, and (3) the methodological issues relevant to scale-up to a randomized controlled trial. METHODS South Asian migrants were recruited to view the film (intervention) in community venues (primary care, religious, community), with dried blood spot CVH testing offered immediately afterwards. Pre/post-film questionnaires assessed the effectiveness of the intervention. RESULTS Two hundred and nineteen first-generation migrants ≥18 years of age (53% female) were recruited to view the film at the following sites: religious, n = 112 (51%), community n = 98 (45%), and primary care, n = 9 (4%). One hundred and eighty-four (84%) underwent CVH testing; hepatitis B core antibody or hepatitis C antibody positivity demonstrated exposure in 8.5%. Pre-intervention (n = 173, 79%) and post-intervention (n = 154, 70%) questionnaires were completed. CONCLUSIONS This study demonstrated the feasibility of recruiting first-generation migrants to view a community-based educational film promoting CVH testing in this higher risk group, confirming the value of developing interventions to facilitate the global World Health Organization plan for targeted case finding and elimination, and a future randomized controlled trial. We highlight the importance of culturally relevant interventions including faith and culturally sensitive settings, which appear to minimize logistical issues and effectively engage minority groups, allowing ease of access to individuals 'at risk'.
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Affiliation(s)
- Claire Kelly
- Department of Gastroenterology and Hepatology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK; Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Marinos Pericleous
- Department of Gastroenterology and Hepatology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK; Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Ayesha Ahmed
- Brunel Business School, Brunel University, London, UK
| | | | - Jane Hendy
- Brunel Business School, Brunel University, London, UK
| | - Shuja Shafi
- Research and Documentation Committee, The Muslim Council of Britain, London, UK
| | - Simon S Skene
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Sumita Verma
- Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School and Department of Gastroenterology and Hepatology, Brighton and Sussex University Hospital, Brighton, UK
| | - Chantal Edge
- Institute of Epidemiology and Health Care, UCL, London, UK
| | | | | | - Simon de Lusignan
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; Royal College of General Practitioners Research and Surveillance Centre, London, UK
| | - Aftab Ala
- Department of Gastroenterology and Hepatology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK; Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
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Cockle-Hearne J, Barnett D, Hicks J, Simpson M, White I, Faithfull S. A Web-Based Intervention to Reduce Distress After Prostate Cancer Treatment: Development and Feasibility of the Getting Down to Coping Program in Two Different Clinical Settings. JMIR Cancer 2018; 4:e8. [PMID: 29712628 PMCID: PMC5952123 DOI: 10.2196/cancer.8918] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 02/12/2018] [Accepted: 02/20/2018] [Indexed: 12/25/2022] Open
Abstract
Background Distress after prostate cancer treatment is a substantial burden for up to one-third of men diagnosed. Physical and emotional symptoms and health service use can intensify, yet men are reticent to accept support. To provide accessible support that can be cost effectively integrated into care pathways, we developed a unique, Web-based, self-guided, cognitive-behavior program incorporating filmed and interactive peer support. Objective To assess feasibility of the intervention among men experiencing distress after prostate cancer treatment. Demand, acceptability, change in distress and self-efficacy, and challenges for implementation in clinical practice were measured. Methods A pre-post, within-participant comparison, mixed-methods research design was followed. Phase I and II were conducted in primary care psychological service and secondary care cancer service, respectively. Men received clinician-generated postal invitations: phase I, 432 men diagnosed <5 years; phase II, 606 men diagnosed <3.5 years. Consent was Web-based. Men with mild and moderate distress were enrolled. Web-based assessment included demographic, disease, treatment characteristics; distress (General Health Questionnaire-28); depression (Patient Health Questionnaire-9); anxiety (General Anxiety Disorder Scale-7); self-efficacy (Self-Efficacy for Symptom Control Inventory); satisfaction (author-generated, Likert-type questionnaire). Uptake and adherence were assessed with reference to the persuasive systems design model. Telephone interviews explored participant experience (phase II, n=10); interviews with health care professionals (n=3) explored implementation issues. Results A total of 135 men consented (phase I, 61/432, 14.1%; phase II, 74/606, 12.2%); from 96 eligible men screened for distress, 32% (30/96) entered the intervention (phase I, n=10; phase II, n=20). Twenty-four completed the Web-based program and assessments (phase I, n=8; phase II, n=16). Adherence for phase I and II was module completion rate 63% (mean 2.5, SD 1.9) versus 92% (mean 3.7, SD 1.0); rate of completing cognitive behavior therapy exercises 77% (mean 16.1, SD 6.2) versus 88% (mean 18.6, SD 3.9). Chat room activity occurred among 63% (5/8) and 75% (12/16) of men, respectively. In phase I, 75% (6/8) of men viewed all the films; in phase II, the total number of unique views weekly was 16, 11, 11, and 10, respectively. The phase II mood diary was completed by 100% (16/16) of men. Satisfaction was high for the program and films. Limited efficacy testing indicated improvement in distress baseline to post intervention: phase I, P=.03, r=−.55; phase II, P=.001, r=−.59. Self-efficacy improved for coping P=.02, r=−.41. Service assessment confirmed ease of assimilation into clinical practice and clarified health care practitioner roles. Conclusions The Web-based program is acceptable and innovative in clinical practice. It was endorsed by patients and has potential to positively impact the experience of men with distress after prostate cancer treatment. It can potentially be delivered in a stepped model of psychological support in primary or secondary care. Feasibility evidence is compelling, supporting further evaluative research to determine clinical and cost effectiveness.
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Affiliation(s)
- Jane Cockle-Hearne
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Deborah Barnett
- Time to Talk, Brighton General Hospital, Sussex Community NHS Foundation Trust, Brighton, United Kingdom
| | - James Hicks
- St. Richard's Hospital, Western Sussex Hospitals NHS Trust, Chichester, United Kingdom
| | - Mhairi Simpson
- Access Division - Cancer, NHS Lanarkshire, Monklands Hospital, Airdrie, United Kingdom
| | - Isabel White
- Applied Health Research Group, Department of Psychological Support and Pastoral Care, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Sara Faithfull
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Datta A, Aditya C, Mukhopadhyay A. RETRACTED ARTICLE: The Impact of Breast Cancer on Women's Everyday Life in Eastern India. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:816. [PMID: 27237721 DOI: 10.1007/s13187-016-1045-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Arunima Datta
- Department of Psychology, Netaji Subhas Bose National Cancer Research Institute, 16A Park Lane, 700016, Kolkata, India.
| | - Chandana Aditya
- Department of Psychology, Bijoykrishna Girls' College, Howrah, India
| | - Ashis Mukhopadhyay
- Department of Oncology, Netaji Subhas Bose National Cancer Research Institute, Kolkata, India
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