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Joaquim A, Vieira C, Ribeiro L, Barros A, Leão I, Alvim C, Pinheiro S, Nogueira M, Morais C. Head and neck cancer patient journey's health literacy: a multidisciplinary team perspective. VOICE study. Support Care Cancer 2024; 32:133. [PMID: 38280025 PMCID: PMC10821956 DOI: 10.1007/s00520-023-08256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/12/2023] [Indexed: 01/29/2024]
Abstract
PURPOSE Health literacy is a current Public Health priority in Portugal. The participation of well-informed patients in their care and shared decision making are essential, especially in chronic aggressive and debilitating pathologies such as recurrent or metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC). AIMS This study aimed to characterize R/M HNSCC patients' and caregivers' information needs identified by healthcare professionals (HCPs). METHODS Two online Focus Groups, one with only medical doctors and the other with other HCPs involved in the treatment of R/M HNSCC patients, were conducted, using a modified Metaplan, Lean or adapted PDCA methodology. The discussions were audio recorded in full and content analysis was performed using ATLAS.ti qualitative data analysis software. RESULTS Topics addressed were diagnosis, treatment, quality of life, and global evaluation. In general, all experts agreed that only essential information should be cautiously given, according to patients' and caregivers' wishes. It was consensual that patients are given the necessary information to adhere to treatment. Two main barriers were identified: one barrier was associated with verbal communication due to the lack of health literacy of these patients, and the other barrier regarded healthcare access. It was also considered important to remind patients of the daily and social activities that they could and should maintain, as well as providing sufficient social resources and problem-solving training to caregivers. CONCLUSIONS This qualitative study highlights the complexity of R/M HNSCC patients' care. Immediate availability of psychologists and psychiatrists should be implemented in all centers that treat HNSCC patients. The differences found between the physicians' Focus Group and other HCPs' Focus Group in some of the addressed topics emphasize the importance of a multidisciplinary and holistic approach, in a biomedical model integrated with a biopsychosocial model.
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Affiliation(s)
- Ana Joaquim
- Centro Hospitalar Vila Nova de Gaia E Espinho, Vila Nova de Gaia, Portugal
| | | | - Leonor Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Anabela Barros
- Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Inês Leão
- Centro Hospitalar Vila Nova de Gaia E Espinho, Vila Nova de Gaia, Portugal
| | - Cecília Alvim
- Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Sara Pinheiro
- Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Mafalda Nogueira
- MSD Portugal, R. da Qt. da Fonte 19, 2770-192, Paço de Arcos, Portugal
| | - Catarina Morais
- MSD Portugal, R. da Qt. da Fonte 19, 2770-192, Paço de Arcos, Portugal.
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Zheng M, Zhong W, Chen X, Wang N, Liu Y, Zhang Q, Cheng Y, Li W, Yu Q, Zhao X, Yuan L, Shen Z, Hao Y, Du Y, Zou K, Zhu C, Long L, Li J. Factors influencing parents' willingness to vaccinate their preschool children against COVID-19: Results from the mixed-method study in China. Hum Vaccin Immunother 2022; 18:2090776. [PMID: 35763311 DOI: 10.1080/21645515.2022.2090776] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
During the COVID-19 pandemic, little is known about parental hesitancy to receive the COVID-19 vaccine for preschool children who are the potential vaccinated population in the future. The purpose of this mixed-method study was to explore the factors influencing Chinese parents' decision to vaccinate their children aged 3-6 years old against COVID-19. In July 2021, we conducted semi-structured interviews (n = 19) and a cross-sectional survey (n = 2605) with parents of kindergarten children in an urban-rural combination pilot area in China. According to the qualitative study, most parents were hesitant to vaccinate their children with the COVID-19 vaccine. In the quantitative study, we found that three-fifths of 2605 participants were unwilling to vaccinate their children against COVID-19. Furthermore, the main predictors of parents' intention to vaccinate their children were fathers, lower level of education, and positive attitudes toward vaccination. Based on our findings, targeted health education techniques may be able to boost childhood COVID-19 immunization rates.
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Affiliation(s)
- Mengmou Zheng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wanzhen Zhong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiyue Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Nan Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yadan Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qian Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yaoyilian Cheng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wen Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qiong Yu
- Health Center of Hongguang Street Pidu District Chengdu, Chengdu, China
| | - Xunying Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lu Yuan
- Health Center of Hongguang Street Pidu District Chengdu, Chengdu, China
| | - Ziqiong Shen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yu Hao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yu Du
- Health Center of Hongguang Street Pidu District Chengdu, Chengdu, China
| | - Kun Zou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chenyan Zhu
- Health Center of Hongguang Street Pidu District Chengdu, Chengdu, China
| | - Lu Long
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiayuan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Getting back on track: a group psychoeducational intervention for patients and families living with head and neck cancer. Support Care Cancer 2022; 30:3259-3268. [PMID: 34984551 DOI: 10.1007/s00520-021-06771-z] [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: 06/29/2021] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Head and neck cancer survivors are increasing in prevalence, and 60-70% still experience at least one unmet emotional and/or physical need after treatment has ended. The purpose of this study was to determine the efficacy of a brief post-treatment psychoeducational intervention on perceived preparedness for coping with recovery using post-session evaluations. METHODS Between August 2013 and May 2018, a two-session, multidisciplinary "getting back on track" class was delivered to head and neck cancer patients approximately 2 months following radiation treatment at Princess Margaret Cancer Centre in Toronto, Canada. Three hundred and fifty attendees completed evaluations. Statistical analyses of the 310 patients surveyed measured change in level of preparedness to cope with recovery using the b-prepared scale. Qualitative analyses provided insight into potential benefits for future patients. RESULTS Almost two-thirds (58%) of patients reported an increase in level of preparedness in post-intervention surveys. Comparing self-reported level of preparedness among patients from before to after the class showed an increase in feeling prepared from 50 to 58%, and of those feeling very prepared, from 6 to 34%. The proportion of patients who reported feeling unprepared (11%) or neutral (33%) before the class decreased post-intervention, with 0% feeling unprepared and 7% feeling neutral. There were statistically significant differences in the ideal timing of the class, but overall attendees agreed that the class is an essential part of their recovery. CONCLUSION Results confirm the efficacy of this brief psychoeducational intervention to improve preparedness in head and neck cancer survivors following radiation treatment.
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George M, Smith A, Ranmuthugula G, Sabesan S. Barriers to Accessing, Commencing and Completing Cancer Treatment Among Geriatric Patients in Rural Australia: A Qualitative Perspective. Int J Gen Med 2022; 15:1583-1594. [PMID: 35210830 PMCID: PMC8859537 DOI: 10.2147/ijgm.s338128] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/29/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore patients’, caregivers’, and health professionals’ perspectives on barriers and challenges to accessing, commencing and completing cancer therapy, with a focus on geriatric patients and the impacts of comorbidities and rurality. Patients and Methods A qualitative sub-study using focus group discussions was conducted in a regional cancer center and one of its outreach clinics in rural New South Wales, Australia. Five discussions with three distinct cohorts were undertaken, including: 1) geriatric cancer patients (two discussions); 2) caregivers (two discussions); and 3) health professionals (one discussion). Each focus group comprised eight to ten participants. A question guide was used to elicit participants’ experiences of receiving/providing cancer care and support during cancer treatment in a rural setting. Iterative thematic analysis was undertaken, with transcripts coded using NVivo software. Results Participants identified travel to larger regional centers and/or metropolitan areas and related arrangements as primary challenges to accessing diagnostic tests, surgeries, some treatments, and follow-up tests. Financial stress, and a lack of knowledge regarding available support services and mechanisms, was also a key issue for most patients and caregivers. Differences in availability of specific testing equipment, such as PET-CT, further complicated patients’ and caregivers’ experience of seeking diagnosis and management of cancer. While all interview cohorts identified positive rapport between clinicians and patients as a key characteristic of their experience of cancer management in rural and regional areas, difficulty in retaining clinical staff and related staffing levels at some health services were understood to negatively impact patients’ and caregivers’ experiences. Conclusion Overall, the study highlights the effects of geographical, social, and informational isolation on patients’ and caregivers’ experience of cancer diagnosis and management, and suggests several implications for further research and practice improvement.
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Affiliation(s)
- Mathew George
- Department of Medical Oncology, North West Cancer Centre, Tamworth, NSW, Australia
- School of Rural Medicine, University of New England, Armidale, NSW, Australia
- Correspondence: Mathew George Tel +61 2 6767 7760Fax +61 2 6766 9173 Email
| | - Alexandra Smith
- Department of Medical Oncology, North West Cancer Centre, Tamworth, NSW, Australia
| | - Geetha Ranmuthugula
- School of Rural Medicine, University of New England, Armidale, NSW, Australia
| | - Sabe Sabesan
- Townsville Cancer Centre, Townsville University Hospital, Townsville, QLD, Australia
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Toralla O, Lopez Jornet P, Pons-Fuster E. The Effect of an Informative Video upon Anxiety and Stress in Patients Requiring an Oral Biopsy: A Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020783. [PMID: 35055603 PMCID: PMC8775441 DOI: 10.3390/ijerph19020783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The use of multimedia tools improves patient understanding of surgical procedures, reduces anxiety and increases satisfaction. The present study evaluates the impact of an audiovisual intervention (video) upon anxiety and stress in patients requiring an oral biopsy. MATERIAL AND METHODS A prospective randomized clinical trial was carried out in patients requiring an oral biopsy. The control group (n = 60) received verbal standard information while the experimental group (n = 60) received information in the form of a video. The following data were recorded: gender, age, educational level and hemodynamic parameters (blood pressure, heart rate and blood oxygen saturation). The following questionnaires were used to assess anxiety and stress before and after the biopsy procedure: Corah's Modified Dental Anxiety Scale (MDAS), the State-Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS). RESULTS The final study sample consisted of 120 patients, of which 65.8% were women and 34.2% men, with a mean age of 40.5 ± 15.3 years. At the end of the study, the experimental group presented a significantly lower MDAS score than the control group (p = 0.041). The STAI score also showed a significant decrease with respect to the control group at the end of the study (p = 0.012). There were no statistically significant changes in the hemodynamic parameters in either group. CONCLUSIONS The video constituted a useful and easy tool for reducing anxiety among patients requiring an oral biopsy.
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Affiliation(s)
- Oscar Toralla
- Departamento Odontologia, Universidad San Carlos de Guatemala, Guatemala 01018, Guatemala;
| | - Pia Lopez Jornet
- Faculty of Medicine and Odontology, University of Murcia, 30008 Murcia, Spain;
- Correspondence:
| | - Eduardo Pons-Fuster
- Faculty of Medicine and Odontology, University of Murcia, 30008 Murcia, Spain;
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Missaoui AM, Hamza F, Maaloul M, Charfi H, Ghrissi W, Abid M, Guermazi F. Health-related quality of life in long-term differentiated thyroid cancer survivors: A cross-sectional Tunisian-based study. Front Endocrinol (Lausanne) 2022; 13:999331. [PMID: 36093070 PMCID: PMC9449324 DOI: 10.3389/fendo.2022.999331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND AIM The incidence of differentiated thyroid cancer (DTC) has risen dramatically worldwide. Despite an excellent prognosis, the growing DTC survivors' community often features poor health-related quality of life (HRQoL), which challenges long-term DTC care, particularly in developing Southern Mediterranean and African countries. We aimed to assess the HRQoL and to investigate its determinants in disease-free Tunisian DTC survivors. METHODS We conducted a three-month cross-sectional study that included 266 patients diagnosed with DTC. We assessed the HRQoL in eligible participants using the short form-36 health survey, in comparison with 76 healthy controls. RESULTS The 86 eligible DTC survivors were predominantly female (89.5%) with an average age of 44.3 ± 12.5 years. Physical-functioning (PF), role-physical (RP), and pain domains were substantially altered compared to the reference population. Age was negatively associated with PF, RP, role-emotional (RE), and social functioning (SF). Tumor size and lymph node metastases affected general health and PF, respectively. The cancer-free survival duration was positively correlated with mental health (MH). Poor neck scar healing and persistent post-operative hypoparathyroidism significantly deteriorate MH. Pain perception was positively correlated with the radioactive iodine cumulative dose. Subclinical hyperthyroidism significantly reduced PF and RP scores. TSH suppression was negatively and strongly correlated with MH and SF scores. CONCLUSION HRQoL is substantially reduced in DTC survivors compared to the normative Tunisian population. These results could be extrapolated to similar individuals in other South Mediterranean and African countries. The development of coordinated multidisciplinary aftercare interventions in this region is warranted to preserve HRQoL in DTC survivors.
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Affiliation(s)
- Abdel Mouhaymen Missaoui
- Department of Endocrinology and Diabetology, Hedi Chaker Univsersity Hospital, Sfax, Tunisia
- *Correspondence: Abdel Mouhaymen Missaoui,
| | - Fatma Hamza
- Department of Nuclear Medicine, Habib Bouguiba University Hospital, Sfax, Tunisia
| | - Mohamed Maaloul
- Department of Nuclear Medicine, Habib Bouguiba University Hospital, Sfax, Tunisia
| | - Hana Charfi
- Department of Endocrinology and Diabetology, Hedi Chaker Univsersity Hospital, Sfax, Tunisia
| | - Wiem Ghrissi
- Department of Endocrinology and Diabetology, Hedi Chaker Univsersity Hospital, Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology and Diabetology, Hedi Chaker Univsersity Hospital, Sfax, Tunisia
| | - Fadhel Guermazi
- Department of Nuclear Medicine, Habib Bouguiba University Hospital, Sfax, Tunisia
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Karampela M, Porat T, Mylonopoulou V, Isomursu M. Rehabilitation Needs of Head and Neck Cancer Patients and Stakeholders: Case Study. Front Oncol 2021; 11:670790. [PMID: 34631516 PMCID: PMC8499693 DOI: 10.3389/fonc.2021.670790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background The incidents of Head and Neck Cancer (HNC) are rising worldwide, suggesting that this type of cancer is becoming more common. The foreseen growth of incidents signifies that future rehabilitation services will have to meet the needs of a wider population. Objective The aim of this paper is to explore the needs of patients, caregivers and healthcare professionals during HNC rehabilitation. Methods This paper reports the empirical findings from a case study that was conducted in a cancer rehabilitation center in Copenhagen to elicit the needs of HNC cancer patients, informal caregivers and healthcare professionals. Results Four areas of needs during the rehabilitation process were identified: service delivery, emotional, social and physical needs. Service delivery needs and emotional needs have been identified as the most prevalent. Conclusions Stakeholders' needs during the rehabilitation process were found to be interrelated. All stakeholders faced service delivery challenges in the form of provision and distribution of information, including responsibilities allocation between municipalities, hospitals and rehabilitation services. Emotional and social needs have been reported by HNC patients and informal caregivers, underlining the importance of inclusion of all actors in the design of future healthcare interventions. Connected Health (CH) solutions could be valuable in provision and distribution of information.
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Affiliation(s)
- Maria Karampela
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
| | - Talya Porat
- Faculty of Engineering, Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| | - Vasiliki Mylonopoulou
- Department Of Applied Information Technology, Division of Human Computer Interaction, University of Gothenburg, Gothenburg, Sweden
| | - Minna Isomursu
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
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Bagnasco A, Rosa F, Dasso N, Aleo G, Catania G, Zanini M, Rocco G, Turci C, Ghirotto L, Hayter M, Sasso L. Caring for patients at home after acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study of family caregivers' experiences. J Clin Nurs 2021; 30:2246-2257. [PMID: 33350526 DOI: 10.1111/jocn.15613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 12/18/2022]
Abstract
AIMS AND OBJECTIVES To understand the experiences and support needs of informal caregivers of patients with chronic obstructive pulmonary diseases chronic obstructive pulmonary disease who return home following an acute exacerbation. BACKGROUND The presence of an informal caregiver is important to provide practical and emotional support after an episode of acute exacerbation of chronic obstructive pulmonary disease. However, caregiving in such circumstances can be challenging and stressful. DESIGN Phenomenology. METHODS This is a phenomenological study based on semi-structured interviews with sixteen primary caregivers of chronic obstructive pulmonary disease patients. Interview data were analysed using Colaizzi's descriptive analysis framework, to identify significant themes and sub-themes. Data were collected between April-December 2017 in a Teaching Hospital in Italy. The study was designed and reported following the COREQ guidelines and checklist. RESULTS Analysis elicited five themes embracing various aspects of the caregivers' lived experiences: (a) a home disrupted, (b) living with constant vigilance and anxiety, (c) feeling the need to escape (d) self-justifications for caregiving role/duty, and (e) feeling abandoned by professionals. CONCLUSIONS Our results show that carers experience a range of difficulties when caring for their relative at home with chronic obstructive pulmonary disease. Some of these are linked to the physical disruption of their home but many are linked to feelings of inability to cope and the psycho-social impact of the caring role. The study also shows how participants felt unsupported by professionals. Focused support for carers is required to enable them to meet these challenges. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should be trained to provide technical and psychological support to caregivers especially during the phases of disease that may involve episodes of exacerbation. Home care and continuity of care can work if there is excellent communication and collaboration between healthcare professionals and caregivers. Developing appropriate support for family caregivers is essential to address the problems they can face.
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Affiliation(s)
| | - Francesca Rosa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Nicoletta Dasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gennaro Rocco
- National Social Security Council (ENPAPI, Roma, Italy
| | - Carlo Turci
- Ordine Professioni Infermieristiche di Roma, Roma, Italy
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL - IRCCS di Reggio Emilia, Emilia, Italy
| | - Mark Hayter
- School of Health & Social Work, University of Hull, Hull, UK
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Crowder SL, Najam N, Sarma KP, Fiese BH, Arthur AE. Quality of life, coping strategies, and supportive care needs in head and neck cancer survivors: a qualitative study. Support Care Cancer 2021; 29:4349-4356. [PMID: 33415365 DOI: 10.1007/s00520-020-05981-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/29/2020] [Indexed: 01/24/2023]
Abstract
PURPOSE The purpose of this qualitative study was to better understand the lived experience of head and neck cancer (HNC) survivors between 6 months to 9 years post-radiation. Quality of life, coping strategies, concerns for the future, and preferences for supportive care were explored. METHODS Semi-structured interviews were conducted in 31 HNC survivors from a Midwestern hospital. Interviews were recorded, transcribed verbatim and analyzed using qualitative thematic analysis. RESULTS Survivors described restrictions on daily living, social eating, and financial concerns. Despite these restrictions, survivors reported an overall high mentality and enjoyment of life. Coping considerations included adapting to a new normal and increased involvement in cancer support and faith groups. Preferences for supportive care included receiving more information about and being more involved in the treatment care plan, referrals to therapy and support groups, and more comprehensive follow-up in survivorship. CONCLUSIONS While long-term HNC survivors adapt to daily living restrictions, a high proportion continue to have unmet needs. This data can guide the development of HNC survivorship interventions to inform optimal clinical guidelines based on patients' perceived needs. This qualitative study uncovered distinct perceived needs of HNC survivors which can inform future service development. Incorporating referrals to supportive care services including speech language pathologist, physical therapists, and dietitians into the standard of care before, during, and after treatment would assist survivors in adapting to life after treatment and managing long-term health consequences of their disease.
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Affiliation(s)
- Sylvia L Crowder
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 386 Bevier Hall 905 S Goodwin Ave, Urbana, IL, 61801, USA.,Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4117 E Fowler Ave., Tampa, FL, 33617, USA
| | - Natasha Najam
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 386 Bevier Hall 905 S Goodwin Ave, Urbana, IL, 61801, USA
| | - Kalika P Sarma
- Carle Cancer Center, Carle Foundation Hospital, 602 W University Ave., Urbana, IL, 61801, USA
| | - Barbara H Fiese
- Family Resiliency Center and Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 1016B Doris Kelley Christopher Hall. 904 West Nevada Street., Urbana, IL, 61801, USA
| | - Anna E Arthur
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 386 Bevier Hall 905 S Goodwin Ave, Urbana, IL, 61801, USA.
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Head and Neck Cancer Survivors' Experiences with Chronic Nutrition Impact Symptom Burden after Radiation: A Qualitative Study. J Acad Nutr Diet 2020; 120:1643-1653. [PMID: 32646742 DOI: 10.1016/j.jand.2020.04.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/29/2020] [Accepted: 04/15/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Head and neck cancer (HNC) survivors may face an array of nutrition impact symptoms (NIS), including dysphagia, xerostomia, taste alterations, and difficulty chewing, which occur as a result of tumor location and treatment with radiation. Few qualitative studies have assessed the chronic impact of NIS on everyday life. OBJECTIVE The aim of this study was to obtain a comprehensive understanding of the lived experience of chronic NIS burden on HNC survivors. DESIGN AND PARTICIPANTS Semi-structured, face-to-face interviews were conducted with 31 HNC survivors to address the research aims and objectives. An interview guide was utilized to consider themes that had been generated through the review of literature and through the researchers' clinical experience within the field. There were probes within the interview for participants to raise unanticipated issues and flexibility to follow such leads. Interviews were conducted between March 2018 and May 2019. ANALYSIS A single researcher conducted the interviews to maintain consistency in data collection. Interviews lasted approximately 1 hour and were audio-recorded. All interview transcripts were professionally transcribed verbatim and checked for accuracy to ensure a complete account of participants' responses. Two researchers applied qualitative thematic content analysis to identify major themes. RESULTS The following 4 major thematic categories emerged from the interview data: symptom presence, dietary preferences, eating adjustments, and addressing symptoms. The most common symptoms were dysphagia, xerostomia, taste alterations, and bothered chewing. As a result of dietary preferences, survivors avoided citrus fruits, dry foods, raw vegetables, sweets, and meats. Survivors preferred soft and moist foods, spices or seasonings, and sauces or gravies. Eating adjustments were described as increased time to consume meals, cutting food into smaller pieces, consuming less food, and consuming more fluid. As a result of food preference changes and eating adjustments, survivors reported dietary pattern changes from pre to post treatment. All survivors experienced 1 or more chronic NIS, yet nearly 40% were unaware before treatment that NIS had the potential to persist chronically. CONCLUSIONS The results of this study provide unique qualitative insight into the lived experience of chronic NIS burden on HNC survivors. By recognizing the daily challenges, health care team members can better support HNC survivors in the transition from active treatment to follow-up care.
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Capodanno I, Rocchi M, Prandi R, Pedroni C, Tamagnini E, Alfieri P, Merli F, Ghirotto L. Caregivers of Patients with Hematological Malignancies within Home Care: A Phenomenological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114036. [PMID: 32517057 PMCID: PMC7312962 DOI: 10.3390/ijerph17114036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 11/16/2022]
Abstract
The role of caregivers in homecare settings is relevant to the patient’s wellbeing and quality of life. This phenomenon is well described in the literature for the oncological setting but not specifically for that of hematological malignancies. The aim of this study was to explore the experience of primary caregivers of patients with hematological malignancies within home care. We conducted a phenomenological study based on interviews with 17 primary caregivers of hematological patients. Analysis of the contents led to the identification of five main themes. Perhaps, the innovative aspects of this study can be summarized in three points: This service was demonstrated to fulfil the ethical aspects of providing the patient with a dignified accompaniment to the end of life. Secondly, the efficiency of the service and the benefit are directly dependent on the caregivers’ wellbeing, so knowledge of the dynamics and emotions involved can lead to the development and implementation of programs for hematological malignancies. Lastly, a collaborative caregivers–professionals relationship can improve a sense of accomplishment for all parties involved, lessening the family’s frustration related to not having done their best. Home care brings significant benefits for both the patient and the caregivers and fulfils the ethical obligation of providing the patient dignified end-of-life care.
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Affiliation(s)
- Isabella Capodanno
- Department of Hematology, Azienda USL–IRCCS di Reggio Emilia, Viale Risorgimento, 80-42123 Reggio Emilia, Italy; (I.C.); (P.A.); (F.M.)
| | - Mirta Rocchi
- Hospice “Casa Madonna dell’Uliveto” Via Oliveto, 34-42020 Albinea, Reggio Emilia, Italy;
| | - Rossella Prandi
- Servizio Infermieristico Domiciliare, Azienda USL di Modena, piazzale dei Donatori di Sangue, 3-41012 Carpi, Italy;
| | - Cristina Pedroni
- Direzione delle Professioni Sanitarie Azienda USL-IRCCS di Reggio Emilia Viale Amendola, 2-42122 Reggio Emilia, Italy;
| | - Enrica Tamagnini
- Department of Primary Care, Azienda USL-IRCCS di Reggio Emilia Viale Amendola, 2-42122 Reggio Emilia, Italy;
| | - Pierluigi Alfieri
- Department of Hematology, Azienda USL–IRCCS di Reggio Emilia, Viale Risorgimento, 80-42123 Reggio Emilia, Italy; (I.C.); (P.A.); (F.M.)
| | - Francesco Merli
- Department of Hematology, Azienda USL–IRCCS di Reggio Emilia, Viale Risorgimento, 80-42123 Reggio Emilia, Italy; (I.C.); (P.A.); (F.M.)
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia Viale Umberto I, 50-42123 Reggio Emilia, Italy
- Correspondence: ; Tel.: +39-0522-2956-17
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Sandmael JA, Sand K, Bye A, Solheim TS, Oldervoll L, Helvik AS. Nutritional experiences in head and neck cancer patients. Eur J Cancer Care (Engl) 2019; 28:e13168. [PMID: 31571296 DOI: 10.1111/ecc.13168] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 04/23/2019] [Accepted: 09/04/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Extensive research has documented the negative nutritional impact of head neck cancer (HNC) treatment, but few studies have addressed the patients' experiences. The purpose of this study was to describe how patients with HNC experience the nutritional situation and perceive nutritional support from diagnosis to the post-treatment phase. METHODS Patients with HNC were recruited from a randomised pilot study. Individual interviews were conducted after radiotherapy with 10 participants aged 49 - 70 years and analysed by qualitative content analysis. RESULTS Undergoing surgery was experienced as a poor nutritional starting point for the upcoming radiotherapy. During radiotherapy, increasing side effects made the participants customise their meals to improve food intake. About halfway through radiotherapy, virtually no food intake was experienced and hospital admissions and initiations of tube-feeding occurred in this period. Oral nutritional supplements were recommended for all, but eventually became unbearable to ingest. When radiotherapy was finally completed, the participants felt discouraged about the persistent side effects preventing them from resume eating. The participants missed tailored information about development of side effects and involvement of a dietitian when reflecting on the treatment-period. CONCLUSION The comprehensive nutritional problems experienced by patients with HNC require early nutritional assessments and improved individually tailored nutritional support.
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Affiliation(s)
- Jon Arne Sandmael
- LHL-Clinics, The Norwegian Heart and Lung Association, Røros, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari Sand
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asta Bye
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMET-Oslo Metropolitan University, Oslo, Norway.,European Palliative Care Research Centre, Department of Oncology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tora Skeidsvoll Solheim
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Line Oldervoll
- LHL-Clinics, The Norwegian Heart and Lung Association, Røros, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne-Sofie Helvik
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Ear-Nose-Throat, Eye and Maxillofacial Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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A commentary on: Pirola et al. (2019) "Validation of the Brazilian version of the Shame and Stigma Scale (SSS-Br) for patients with head and neck cancers". Palliat Support Care 2019; 18:250-251. [PMID: 31554522 DOI: 10.1017/s1478951519000725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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van Uden-Kraan CF, Jansen F, Lissenberg-Witte BI, Eerenstein SEJ, Leemans CR, Verdonck-de Leeuw IM. Health-related and cancer-related Internet use by patients treated with total laryngectomy. Support Care Cancer 2019; 28:131-140. [PMID: 30993449 PMCID: PMC6892363 DOI: 10.1007/s00520-019-04757-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/18/2019] [Indexed: 01/28/2023]
Abstract
Objectives To investigate among patients treated with a total laryngectomy (TL) (1) Internet-use and Internet use to search for information on health and cancer (content); (2) which patients are most likely to use the Internet in general, for health-related and cancer-related purposes; (3) which other types of eHealth (community, communication, care) are used; and (4) preferences towards future use. Methods Patient members of the Dutch TL patient society were asked to complete a questionnaire on Internet use, health-related and cancer-related Internet use, types of eHealth, preferences towards future use, socio-demographics, clinical factors, and quality of life (QOL). Factors associated with Internet use and health-related and cancer-related Internet use were investigated using stepwise logistic regression analysis. Results In total, 279 TL patients participated, of whom 68% used the Internet. Of these, 63% used the Internet to search for information on health and 49% on cancer. Younger and higher educated TL patients and those with better QOL used the Internet more often. Patients with worse QOL searched more often for health-related information. Younger patients and those with shorter time since TL searched more often for cancer-related information. The current use of eHealth for communication, community, and care purposes among Internet users was limited (range, 2 to 15%). Many were interested in using these types of eHealth in the future (range, 21 to 72%). Conclusion The majority used the Internet, especially to search for information on health and cancer, but only few for communication, community, or care purposes. Many were interested in future use.
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Affiliation(s)
- Cornelia F van Uden-Kraan
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Femke Jansen
- Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Simone E J Eerenstein
- Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - C René Leemans
- Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
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