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Jansen BA, Bargon CA, Dinger TL, van den Goor M, Postma EL, Young-Afat DA, Verkooijen HM, Doeksen A. Breast cancer patients' needs and perspectives on a one-on-one peer support program: quantitative and qualitative analyses. Support Care Cancer 2023; 31:656. [PMID: 37882849 PMCID: PMC10602952 DOI: 10.1007/s00520-023-08009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/21/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE Although peer support programs as a health resource have become increasingly popular, only limited studies evaluated the added value of one-on-one peer support for breast cancer patients. This study aims to bridge the knowledge gap by focusing on two related research topics. First, we evaluated emotional well-being and (unmet) needs regarding supportive care. Second, we evaluated patients' perspectives on their experiences after having one-on-one peer support. METHODS A quantitative analysis was conducted to provide insight in patients' symptoms of anxiety and depression (HADS), quality of life (EORTC-QLQ-C30), and supportive care needs (CaSUN-questionnaire). Furthermore, approximately 1 year after the implementation of a one-on-one peer support program, focus groups were conducted to evaluate patients' perspectives regarding one-on-one peer support. RESULTS Two hundred twenty-five of 537 patients diagnosed with breast cancer between 2019 and 2020 completed the questionnaires. Quantitative analysis showed increased symptoms of anxiety and depression among breast cancer patients and lower scores on all EORTC-QLQ-C30 domains compared to the Dutch normative population. Of all patients, 27.6% (95%CI = 0.22-0.34) reported to have unmet needs regarding emotional support and 23.1% (95%CI = 0.18-0.29) reported an unmet need to talk to someone who has experienced breast cancer. For the qualitative analysis, 19 breast cancer patients who were taking part in the one-on-one peer support program participated in three focus groups. Benefits, limitations, and wishes regarding the one-on-one peer support program were discussed. CONCLUSION Breast cancer patients showed increased anxiety and depression and lower quality of life, physical, role, emotional, cognitive, and social functioning compared to the Dutch normative population. Almost one-third of breast cancer patients reported unmet needs regarding emotional support and a desire to talk to other breast cancer patients. These (unmet) needs can successfully be met by providing a low-threshold one-on-one peer support program.
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Affiliation(s)
- Britt Am Jansen
- Division of Imaging and Oncology, University Medical Centre (UMC) Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Department of Surgery, St. Antonius Hospital, Soestwetering 1, 3543 AZ, Utrecht, The Netherlands.
- Department of Plastic, Reconstructive and Hand Surgery, St. Antonius Hospital, Soestwetering 1, 3543 AZ, Utrecht, The Netherlands.
| | - Claudia A Bargon
- Division of Imaging and Oncology, University Medical Centre (UMC) Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Department of Surgery, St. Antonius Hospital, Soestwetering 1, 3543 AZ, Utrecht, The Netherlands
| | - Tessa L Dinger
- Department of Surgery, St. Antonius Hospital, Soestwetering 1, 3543 AZ, Utrecht, The Netherlands
| | - Myra van den Goor
- Q3 Performance, Company for Professional Physician Development, Den Bosch, The Netherlands
| | - Emily L Postma
- Department of Surgery, St. Antonius Hospital, Soestwetering 1, 3543 AZ, Utrecht, The Netherlands
| | - Danny A Young-Afat
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Helena M Verkooijen
- Division of Imaging and Oncology, University Medical Centre (UMC) Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Utrecht University (UU), Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Annemiek Doeksen
- Department of Surgery, St. Antonius Hospital, Soestwetering 1, 3543 AZ, Utrecht, The Netherlands.
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Jäkel K, Richter D, Leuteritz K, Sender A, Hinz A. Sexuality, fertility, family planning, family life, and partnership in young breast cancer patients: a longitudinal study. Front Psychol 2023; 14:1127359. [PMID: 37251020 PMCID: PMC10213958 DOI: 10.3389/fpsyg.2023.1127359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Objectives Adolescent and young adult (AYA) breast cancer patients are often faced with sexuality-related problems. Since healthcare providers are often unfamiliar with problems specific to AYA cancer this topic is too little integrated into routine oncological care. The objective of this study was to analyze sexuality, fertility, family planning, family life, and partnership regarding satisfaction and supportive care needs in AYA breast cancer patients. Methods A total of 139 AYA breast cancer patients were examined twice, 1 year apart. The patients were asked to complete several questionnaires and to answer multiple questions about satisfaction with sexuality, fertility, family planning, family life, and corresponding supportive care needs in these domains. Results While the patients were largely satisfied with their family life and partnerships, they were less satisfied with their sexuality and family planning. Only small mean score changes were observed in these variables over the course of a year. Being a parent already and having the possibility of further completing family planning were strongly associated with higher satisfaction and lower supportive care needs in these domains. Satisfaction was generally negatively associated with supportive care needs. Older age was predictive of lower satisfaction with sexuality at follow-up. Conclusion AYA cancer patients deserve special consultations concerning the impact of cancer and treatment on their sexuality and fertility, and it is especially important that women who have yet to complete their family planning be actively offered information and support concerning sexuality and fertility protection before beginning treatment.
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Vassilev I, Lin SX, Calman L, Turner J, Frankland J, Wright D, Foster C. The role of social networks in the self-management support for young women recently diagnosed with breast cancer. PLoS One 2023; 18:e0282183. [PMID: 37053231 PMCID: PMC10101384 DOI: 10.1371/journal.pone.0282183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/09/2023] [Indexed: 04/14/2023] Open
Abstract
It is widely acknowledged that social network support plays an important role in the quality of life and illness management of breast cancer survivors. However, the factors and processes that enable and sustain such support are less well understood. This paper reports baseline findings from a prospective UK national cohort of 1,202 women with breast cancer (aged <50 years at diagnosis), recruited before starting treatment, conducted in 2016-2019. Descriptive, univariate and multivariate regression analyses explored associations between the individual, and network member characteristics, and the type of support provided. Social network members provided a substantial level of illness-related, practical and emotional support. Highest contribution was provided by friends, followed by close family members. The social network members of women who did not have a partner provided a higher level of support than those in networks with a partner. Women without higher education were more reliant on close family members than those with higher education, and this was more so for women without a partner. Women with higher education without a partner were more reliant on friends and were overall best supported. Women without higher education who did not have a partner were overall least well supported. They had much smaller networks, were highly reliant on close family members, and on high level contributions from all network members. There is a need to develop network-based interventions to support people with a cancer diagnosis, prioritising support for the groups identified as most at risk. Interventions that support engagement with existing network members during treatment, and those that help extend such networks after treatment, are likely to be of benefit. A network perspective can help to develop tailored support and interventions by recognising the interactions between network and individual level processes.
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Affiliation(s)
- Ivaylo Vassilev
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Sharon Xiaowen Lin
- ARC Wessex, University of Southampton, Southampton, United Kingdom
- Management School, Xian Polytechnic University, Xian, China
| | - Lynn Calman
- Centre for Psychosocial Research in Cancer: CentRIC+, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Josh Turner
- Centre for Psychosocial Research in Cancer: CentRIC+, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Jane Frankland
- Centre for Psychosocial Research in Cancer: CentRIC+, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - David Wright
- Centre for Psychosocial Research in Cancer: CentRIC+, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Claire Foster
- Centre for Psychosocial Research in Cancer: CentRIC+, School of Health Sciences, University of Southampton, Southampton, United Kingdom
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Ziegler E, Nickel S, Trojan A, Klein J, Kofahl C. Self-help friendliness in cancer care: A cross-sectional study among self-help group leaders in Germany. Health Expect 2022; 25:3005-3016. [PMID: 36129136 DOI: 10.1111/hex.13608] [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: 03/07/2022] [Revised: 08/23/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Peer support is increasingly recognized as crucial for improving health and psychosocial outcomes in oncological care. The integration of cancer self-help groups (SHGs) into cancer care facilities has gained importance in recent years. Yet, there is a lack of knowledge of the extent and quality of cooperation between cancer care facilities and SHGs and their integration into routine care. The concept of self-help friendliness (SHF) provides a feasible instrument for the measurement of cooperation and integration. METHODS A cross-sectional study across Germany investigates the experiences of 266 leaders of cancer SHGs concerning their cooperation with cancer care facilities based on the criteria for SHF. The participatory study was developed and conducted with representatives of the House of Cancer Self-Help and the federal associations of cancer self-help. RESULTS According to the SHG leaders, about 80% of their members primarily find their way to an SHG via other patients and only less than 50% more or less frequently via hospitals or rehabilitation clinics. The quality of cooperation with cancer centres, hospitals and rehabilitation clinics, however, is rated as good to very good by more than 70% of the respondents. Nine out of 10 quality criteria for SHF are fully or at least partially implemented, the values vary between 53% and 87%. Overall, 58% of the SHG leaders feel well to be very well integrated into care facilities. CONCLUSIONS The results show a positive assessment of the involvement of SHGs in oncological care, but differences between inpatient and outpatient care and low referrals to SHGs are prominent. The concept of SHF is a feasible solution for a systematic and measurable involvement of SHGs. PATIENT OR PUBLIC CONTRIBUTION The perspectives and insight of patient representatives obtained through qualitative interviews were directly incorporated into this study. Representatives of cancer self-help organizations were involved in the development of the questionnaire, reviewed it for content and comprehensibility, and further helped to recruit participants.
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Affiliation(s)
- Elâ Ziegler
- Centre for Psychosocial Medicine, Institute of Medical Sociology, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Nickel
- Centre for Psychosocial Medicine, Institute of Medical Sociology, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alf Trojan
- Centre for Psychosocial Medicine, Institute of Medical Sociology, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Klein
- Centre for Psychosocial Medicine, Institute of Medical Sociology, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher Kofahl
- Centre for Psychosocial Medicine, Institute of Medical Sociology, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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O'Shea ME, Sheehan Gilroy B, Greaney AM, MacDonald A. Moving through adulthood: The lived experience of Irish adults with PKU. Front Psychol 2022; 13:983154. [PMID: 36176784 PMCID: PMC9513515 DOI: 10.3389/fpsyg.2022.983154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThis paper represents a portion of the findings from one of the first research studies eliciting the lived experience of adults with an early diagnosis of Phenylketonuria (PKU) living in Ireland. Ireland has one of the highest prevalence rates of PKU in Europe, however, little is known about the experience of Irish adults with PKU. Furthermore, Ireland is one of the first countries in the world to introduce neonatal screening followed by the introduction of long-term dietary therapy over 50 years ago. This study presents the first comprehensive assessment of the lived experience of Irish adults with PKU on long term dietary therapy.MethodsNarrative data was collected from eleven self-selected participants, using semi-structured interviews. The interviews were divided into five sections focused on eliciting a holistic understanding of the lived experience of adults with PKU living in Ireland. Thematic analysis was guided by Colaizzi's Framework (1978) in conjunction with NVivo qualitative data analysis software.FindingsFindings from the original research encompassed a broad understanding of the lived experience of adults with PKU living in Ireland, including factors influencing dietary therapy and managing PHE blood levels. The themes being discussed within this article are those which appear to be least represented within current literature: living with PKU, including reproductive health, the importance of self-management and establishing routine, support networks in adulthood and concerns regarding aging with PKU.ConclusionIt was evident from the findings that a diagnosis of PKU can influence how adults with PKU may experience aging and their own mortality. These findings offer new insight into the vulnerability attached to the experience of aging with PKU and may be beneficial to advocacy groups and for future development of policy and practice.
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Affiliation(s)
- Mary-Ellen O'Shea
- School of Health and Social Sciences, Munster Technological University, Kerry, Ireland
- *Correspondence: Mary-Ellen O'Shea
| | | | - Anna-Marie Greaney
- School of Health and Social Sciences, Munster Technological University, Kerry, Ireland
| | - Anita MacDonald
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
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Bovbjerg K, Graves K, Waltz M, Farrell D, Yanez B, Chicaiza A, Omar R, Thompson R, Kop M, Van Denburg AN, Lorch D, Rowley SD, Rini C. Expanding access to cancer peer support: development of a website to deliver written peer support that meets patients' individual emotional and informational needs while reducing potential harms. PROCEDIA COMPUTER SCIENCE 2022; 206:195-205. [PMID: 36567868 PMCID: PMC9788802 DOI: 10.1016/j.procs.2022.09.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Cancer patients often want information from "peers" with the same diagnosis or treatment. To increase access to this valuable resource, we developed a website to deliver written peer support to cancer patients undergoing stem cell transplant. Because little evidence describes how to optimize benefits or reduce potential harms of written peer support, we gathered multiple forms of stakeholder feedback to inform the website's ethical approach, personalization, design, function, and content: a Community Advisory Board; a longitudinal study of patients' written peer support needs and motivations; focus groups; semi-structured interviews; and usability testing. Findings provide a rich foundation for website development.
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Affiliation(s)
- Katrin Bovbjerg
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA
| | - Kristi Graves
- Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, 2115 Wisconsin Ave N, Ste. 300, Washington, DC 20007 USA
| | - Margaret Waltz
- University of North Carolina School of Medicine, Department of Social Medicine, 333 S Columbia St, Chapel Hill, NC 27516 USA
| | - David Farrell
- People Designs, Inc., 1304 Broad Street, Durham, NC 27705 USA
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, 675 N St Clair St. Floor 21, Suite 100, Chicago, IL 60611 USA
| | - Anthony Chicaiza
- Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, 2115 Wisconsin Ave N, Ste. 300, Washington, DC 20007 USA
| | - Rahma Omar
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA
| | - Rebecca Thompson
- John Theurer Cancer Center at Hackensack University Medical Center, 92 2nd Street, Hackensack, NJ 07601 USA
| | - Mariska Kop
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA,John Theurer Cancer Center at Hackensack University Medical Center, 92 2nd Street, Hackensack, NJ 07601 USA
| | - Alyssa N. Van Denburg
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA
| | - Danielle Lorch
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA
| | - Scott D. Rowley
- Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, 2115 Wisconsin Ave N, Ste. 300, Washington, DC 20007 USA,John Theurer Cancer Center at Hackensack University Medical Center, 92 2nd Street, Hackensack, NJ 07601 USA
| | - Christine Rini
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, 675 N St Clair St. Floor 21, Suite 100, Chicago, IL 60611 USA,Corresponding author
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Hu Y, Xu J, Wang X, Shi Y, Chen M, Im EO. Socio-Ecological Environmental Characteristics of Young Chinese Breast Cancer Survivors. Oncol Nurs Forum 2021; 48:481-490. [PMID: 34411083 DOI: 10.1188/21.onf.481-490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the environmental characteristics of young breast cancer survivors (YBCSs) in China. PARTICIPANTS & SETTING 17 participants aged 18-45 years were recruited from hospitals and through participant referral in Shanghai, China. METHODOLOGIC APPROACH Semistructured interviews were conducted to explore the environmental characteristics of YBCSs. Content analysis was performed to analyze the data. FINDINGS The following four domains emerged from the analysis. IMPLICATIONS FOR NURSING The study provides insights into the specific issues of YBCSs at different environmental levels. Nurses should collaborate with the healthcare team, family members, and other stakeholders in addressing these issues to support YBCSs. Culturally tailored support should be developed to release the burden of socially desired roles and other cultural issues for Chinese YBCSs.
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Affiliation(s)
- Yun Hu
- Shanghai Jiao Tong University
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Walshe C, Roberts D, Calman L, Appleton L, Croft R, Perez Algorta G, Skevington S, Lloyd-Williams M, Grande G. Peer Mentors for People with Advanced Cancer: Lessons Learnt from Recruiting and Training Peer Mentors for a Feasibility Randomized Controlled Trial. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:710-718. [PMID: 31994006 PMCID: PMC8328854 DOI: 10.1007/s13187-020-01692-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Peer mentors may offer distinctive forms of support to people with advanced cancer. Whilst peer mentor programmes are known, little is understood about recruiting and training peer mentors to support those with advanced cancer. The purpose of this study is to determine the feasibility of recruiting and training peer mentors for a novel peer mentor intervention to promote well-being in people with advanced cancer. Feasibility study testing proactive introduction to a trained peer mentor for 12 weeks in the context of a randomized controlled two-arm trial and nested qualitative process evaluation was used. Peer mentors have/had cancer, recruited via an open call. Two-day training included a new bespoke module on coping with cancer. Descriptive recruitment and training data were captured, supplemented by qualitative interviews, analysed thematically. Forty-eight people expressed interest, mostly female (69%), with breast cancer (32%), and recruited via social media (49%). Twelve people completed training, with attrition often due to availability or mentors' own health; many had advanced cancer themselves. They wanted to 'give something back', but also formed supportive bonds with fellow mentors. It is feasible to recruit and train people with lived experience of cancer to be peer mentors, but those with particular characteristics may predominate. Broad social media based recruitment may have merit in widening the pool of potential peer mentors.
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Affiliation(s)
- Catherine Walshe
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Bailrigg, Lancaster, UK.
| | - Diane Roberts
- Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, Southampton University, Southampton, UK
| | - Lynda Appleton
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | | | | | - Suzanne Skevington
- Manchester Centre for Health Psychology, School of Psychological Sciences, Manchester University, Manchester, UK
| | | | - Gunn Grande
- Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK
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Perspectives of oncology nurses on peer support for patients with cancer. Eur J Oncol Nurs 2021; 51:101925. [PMID: 33647543 DOI: 10.1016/j.ejon.2021.101925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To understand the perspectives of oncology nurses on peer support for patients with cancer and the role of oncology nurses in its provision. METHOD Thematic semi-structured interviews of 10 oncology nurses working in a single university hospital were conducted. The data were analysed using content analysis. RESULTS Oncology nurses thought that peer support promotes the psychosocial wellbeing of patients with cancer by increasing their social contact and strengthening their emotional resources. In their daily work, oncology nurses engaged in several activities that promote the interactions between patients with cancer and informal forms of peer support. However, directing patients with cancer to formal peer support services outside specialised health care was not an established practice. Oncology nurses expressed several concerns about the availability of support and the coping ability of peer supporters and expressed scepticism about the reliability of information shared in peer support groups. CONCLUSIONS The awareness of oncology nurses regarding formal peer support services appears rather limited. This knowledge gap should be reduced, such as through closer collaboration between hospitals and third sector cancer organisations, which does not appear effective at present based on the results. In addition, patients with cancer should be systematically informed about peer support.
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Bargon CA, Batenburg MCT, van Stam LE, Mink van der Molen DR, van Dam IE, van der Leij F, Baas IO, Ernst MF, Maarse W, Vermulst N, Schoenmaeckers EJP, van Dalen T, Bijlsma RM, Young-Afat DA, Doeksen A, Verkooijen HM. Impact of the COVID-19 Pandemic on Patient-Reported Outcomes of Breast Cancer Patients and Survivors. JNCI Cancer Spectr 2020; 5:pkaa104. [PMID: 33437925 PMCID: PMC7665619 DOI: 10.1093/jncics/pkaa104] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/10/2020] [Accepted: 10/14/2020] [Indexed: 12/20/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic (officially declared on the March 11, 2020), and the resulting measures, are impacting daily life and medical management of breast cancer patients and survivors. We evaluated to what extent these changes have affected quality of life, physical, and psychosocial well-being of patients previously or currently being treated for breast cancer. Methods This study was conducted within a prospective, multicenter cohort of breast cancer patients and survivors (Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaLuAtion). Shortly after the implementation of COVID-19 measures, an extra survey was sent to 1595 participants, including the validated European Organization for Research and Treatment of Cancer (EORTC) core (C30) and breast cancer-specific (BR23) Quality of Life Questionnaire (EORTC QLQ-C30/BR23) and Hospital Anxiety and Depression Scale (HADS) questionnaire. Patient-reported outcomes (PROs) were compared with the most recent PROs collected within UMBRELLA pre-COVID-19. The impact of COVID-19 on PROs was assessed using mixed model analysis, adjusting for potential confounders. Results 1051 patients and survivors (65.9%) completed the survey; 31.1% (n = 327) reported a higher threshold to contact their general practitioner amid the COVID-19 pandemic. A statistically significant deterioration in emotional functioning was observed (mean = 82.6 [SD = 18.7] to 77.9 [SD = 17.3]; P < .001), and 505 (48.0%, 95% confidence interval [CI] = 45.0% to 51.1%) patients and survivors reported moderate to severe loneliness. Small improvements were observed in quality of life and physical, social, and role functioning. In the subgroup of 51 patients under active treatment, social functioning strongly deteriorated (77.3 [95% CI = 69.4 to 85.2] to 61.3 [95% CI = 52.6 to 70.1]; P = .002). Conclusion During the COVID-19 pandemic, breast cancer patients and survivors were less likely to contact physicians and experienced a deterioration in their emotional functioning. Patients undergoing active treatment reported a substantial drop in social functioning. One in 2 reported loneliness that was moderate or severe. Online interventions supporting mental health and social interaction are needed during times of social distancing and lockdowns.
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Affiliation(s)
- Claudia A Bargon
- Division of Imaging and Oncology, University Medical Centre Utrecht, Heidelberglaan, Utrecht, the Netherlands
- Department of Surgery, St Antonius Hospital, Soestwetering, Utrecht, the Netherlands
| | - Marilot C T Batenburg
- Department of Radiation Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, the Netherlands
| | - Lilianne E van Stam
- Division of Imaging and Oncology, University Medical Centre Utrecht, Heidelberglaan, Utrecht, the Netherlands
| | | | - Iris E van Dam
- Department of Radiation Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, the Netherlands
| | - Femke van der Leij
- Department of Radiation Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, the Netherlands
| | - Inge O Baas
- Department of Medical Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, the Netherlands
| | - Miranda F Ernst
- Department of Surgery, Alexander Monro Clinics, Bilthoven, the Netherlands
| | - Wiesje Maarse
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Nieke Vermulst
- Department of Surgery, Rivierenland Hospital, Tiel, the Netherlands
| | | | - Thijs van Dalen
- Department of Surgery, Diakonessenhuis Utrecht, Utrecht, the Netherlands
| | - Rhodé M Bijlsma
- Department of Medical Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, the Netherlands
| | - Danny A Young-Afat
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centre, Location VUmc, the Netherlands
| | - Annemiek Doeksen
- Department of Surgery, St Antonius Hospital, Soestwetering, Utrecht, the Netherlands
| | - Helena M Verkooijen
- Division of Imaging and Oncology, University Medical Centre Utrecht, Heidelberglaan, Utrecht, the Netherlands
- Utrecht University, Heidelberglaan, Utrecht, the Netherlands
- Correspondence to: Helena M. Verkooijen, MD, PhD, Imaging Division, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands (e-mail: )
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Schmidt F, Ribi K, Haslbeck J, Urech C, Holm K, Eicher M. Adapting a peer-led self-management program for breast cancer survivors in Switzerland using a co-creative approach. PATIENT EDUCATION AND COUNSELING 2020; 103:1780-1789. [PMID: 32345575 DOI: 10.1016/j.pec.2020.03.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 03/08/2020] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The peer-led Cancer Thriving and Surviving Program (CTS) has demonstrated improved health outcomes for cancer survivors. We describe a co-creative process for adapting the CTS for breast cancer survivors in Switzerland and integrating the program into the clinical pathway of Swiss breast centers. METHODS A co-creative approach was employed. Breast cancer survivors and health care professionals (total n = 81) participated in three workshops, an online rating, and a consensus conference. An iterative cycle (evidence, ideas, refining, rating, and synthesis) guided the adaptation process. RESULTS Survivors involvement in the adaptation process allowed to tailor the self-management program to the psychosocial needs identified as the highest priority. New contents "Being a woman", "Breast cancer and my (working) life" and "My exercise" were added to the CTS. Program duration was expanded from 6 to 7 weeks. Transition to follow-up care was considered as the optimal time point for program integration into the clinical pathway. CONCLUSION The co-creative process may serve as a model in adapting supportive interventions for cancer. A subsequent pilot testing examined the feasibility and preliminary efficacy. PRACTICE IMPLICATIONS Combining expertise of health care professionals and patients to co-create a peer-led breast cancer self-management program may enhance acceptability and adoption.
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Affiliation(s)
- Franziska Schmidt
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and University Hospital Lausanne, Lausanne, Switzerland
| | - Karin Ribi
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and University Hospital Lausanne, Lausanne, Switzerland; International Breast Cancer Study Group (IBCSG), Bern, Switzerland
| | - Joerg Haslbeck
- Swiss Cancer League, Division Follow-up Care, Bern, Switzerland; Nursing Science, University of Basel, Basel, Switzerland
| | - Corinne Urech
- Women's Hospital, University Hospital Basel, Basel, Switzerland
| | - Karin Holm
- Patient Advocates for Cancer Research and Treatment (Association PACRT), Geneva, Switzerland
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and University Hospital Lausanne, Lausanne, Switzerland.
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Peer support interventions for breast cancer patients: a systematic review. Breast Cancer Res Treat 2019; 174:325-341. [PMID: 30600413 DOI: 10.1007/s10549-018-5033-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 10/27/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Due to the clear efficacy of peer support as a means of improving emotional well-being and healthy behaviors in a highly cost-effective manner, this program is widely used. Controversy remains, however, with regard to its efficacy in breast cancer patients. Given the heterogeneity of peer support interventions, this review aimed to categorize, assess, and synthesize the existing evidence from randomized controlled trials (RCTs) to clarify the effects of different types of peer support on breast cancer patients. METHODS We searched Pubmed, EMBase, CENTRAL, CINAHL, PsychINFO, Chinese National Knowledge Infrastructure (CNKI) and Wanfang Data for English and Chinese language RCTs. The Cochrane Collaboration 'risk of bias' tool for systematic reviews was used to assess the methodological quality of each RCT. RESULTS Of the 1494 studies screened, 15 studies met eligibility criteria for inclusion, comprising 1695 breast cancer patients. Overall, there were more positive effects than invalid or negative effects across peer interventions, with notable exceptions: unmoderated and unstructured group peer support interventions as well as Internet-based models without peer training had no effect or adverse effects on proximal and distal outcomes. However, adding other peer roles to the peer support structure or using one-on-one models could significantly improve the patients' negative emotions. Peer education showed promising effects on stress management, quality of life, and healthy behaviors. CONCLUSIONS This systematic review found that different types of peer support have different effects on outcomes for breast cancer patients. Web-based group peer support without peer training must be avoided or used with caution in the future. Peer education is recommended for breast cancer patient support models, given its excellent results and cost-effectiveness.
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