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Abioye O, Kiel L, Kaufman R, Florez N. Cancer health disparities in minority communities: peer support networks can bridge the gap. Cancer Causes Control 2024:10.1007/s10552-024-01903-2. [PMID: 39117791 DOI: 10.1007/s10552-024-01903-2] [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: 03/20/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE Peer support networks have been suggested to have significant utility in the care of patients with cancer, especially among racial minorities. This article proposes an approach to integrate peer support networks into the care of racial minorities with cancer. METHODS Methods to integrate peer support groups across racial minorities with cancer include utilizing language and religion in strategic recruitment of peer supporters, recruiting minority peer supporters in online oncology peer support groups, and emphasizing relationship & trust building for participant retention. RESULTS Language concordance among peer support groups may enhance patient understandability, emotional expression, and create a sense of community and safety. Religious integration may also promote support group accessibility, particularly among Blacks, who tend to depend on their religious communities for cancer care guidance to a greater extent. In addition to providing knowledge, online opportunities may also decrease cancer-related stress, depression, and trauma. Trust between individuals and their sociocultural environment and healthcare system, as well as between the community and the healthcare system, is necessary, particularly for racial minorities who may harbor a historical mistrust of the healthcare system. CONCLUSIONS To close the racial cancer care gap, a multi-pronged approach is crucial. This includes establishing tailored peer support networks within minority communities that account for language, religion, and cultural factors to build trust and meet psycho-social needs. However, peer support is just one tool. Other critical tools such as holding healthcare institutions accountable for providing equitable care to racial minorities is equally vital in reducing disparities and improving survival outcomes.
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Affiliation(s)
| | - Lauren Kiel
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Narjust Florez
- Dana-Farber Cancer Institute, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Cancer Care Equity Program, Dana-Farber Cancer Institute Member of the Faculty, Harvard Medical School, 150 Brookline Ave, Dana 1230P, Boston, MA, 02215, USA.
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Shah KP, Khan SS, Baldridge AS, Grady KL, Cella D, Goyal P, Allen LA, Smith JD, Lagu TC, Ahmad FS. Health Status in Heart Failure and Cancer: Analysis of the Medicare Health Outcomes Survey 2016-2020. JACC. HEART FAILURE 2024; 12:1166-1178. [PMID: 37930290 DOI: 10.1016/j.jchf.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND People with heart failure (HF) and cancer experience impaired physical and mental health status. However, health-related quality of life (HRQOL) has not been directly compared between these conditions in a contemporary population of older people. OBJECTIVES The authors sought to compare HRQOL in people with HF vs those with lung, colorectal, breast, and prostate cancers. METHODS The authors performed a pooled analysis of Medicare Health Outcomes Survey data from 2016 to 2020 in participants ≥65 years of age with a self-reported history of HF or active treatment for lung, colon, breast, or prostate cancer. They used the Veterans RAND-12 physical component score (PCS) and mental component score (MCS), which range from 0-100 with a mean score of 50 (based on the U.S. general population) and an SD of 10. The authors used pairwise Student's t-tests to evaluate for differences in PCS and MCS between groups. RESULTS Among participants with HF (n = 71,025; 54% female, 16% Black), mean PCS was 29.5 and mean MCS 47.9. Mean PCS was lower in people with HF compared with lung (31.2; n = 4,165), colorectal (35.6; n = 4,270), breast (37.7; n = 14,542), and prostate (39.6; n = 17,670) cancer (all P < 0.001). Participants with HF had a significantly lower mean MCS than those with lung (31.2), colon (50.0), breast (52.0), and prostate (53.0) cancer (all P < 0.001). CONCLUSIONS People with HF experience worse HRQOL than those with cancer actively receiving treatment. The pervasiveness of low HRQOL in HF underscores the need to implement evidence-based interventions that target physical and mental health status and scale multidisciplinary clinics.
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Affiliation(s)
- Kriti P Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sadiya S Khan
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Abigail S Baldridge
- Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, Illinois, USA
| | - Kathleen L Grady
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Center for Patient-Centered Outcomes, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Parag Goyal
- Program for the Care and the Study of the Aging Heart, Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Larry A Allen
- Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Justin D Smith
- Division of Health System Innovation and Research, Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Tara C Lagu
- Division of Hospital Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Center for Health Services and Outcomes Research, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Faraz S Ahmad
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Center for Health Information Partnerships, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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Evans M, Cuddeback GS, Golin C, Muessig K, Bellamy C, Costa M, O'Connell M, Fisher EB. Diverse elements comprising studies of peer support complicate evidence synthesis. J Ment Health 2024:1-15. [PMID: 38556804 DOI: 10.1080/09638237.2024.2332798] [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: 02/24/2023] [Accepted: 01/20/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Innovative approaches to care, such as peer support, are needed to address the substantial and frequently unmet needs of people with serious mental illnesses such as schizophrenia. Although peer support services continue to expand in mental healthcare, findings of effectiveness from systematic reviews are mixed. However, the studies evaluated in these reviews consisted of diverse elements which the review methods neglected to consider. AIMS This review aims to demonstrate the substantial diversity in intervention components and measured outcomes among studies of peer support and lay the groundwork for more focused reviews of individual intervention components. METHODS As part of a realist review of the literature, here we synthesize evidence in a way that examines the substantial diversity in intervention components and measured outcomes comprising studies of peer support. RESULTS Seven categories of outcomes were represented, including recovery, symptoms and functioning, and care utilization. Importantly, seven distinct intervention components were represented in 26 studies: "being there," assistance in self-management, linkage to clinical care and community resources, social and emotional support, ongoing support, explicit utilization of shared lived experience or peer support values, and systems advocacy. Reflecting diversity in approaches, no study reported all intervention components, and no component was found among all studies. IMPLICATIONS Peer support services constitute a category of intervention approaches far too varied to evaluate as a single entity. Results suggest intervention components deserving more focused research, including assistance in self-management, "being there," and explicit utilization of shared lived experience or peer support values. PRISMA/PROSPERO As this article reports results from a realist review of the literature, we did not follow the PRISMA guidance which is suitable for systematic reviews. We did follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines.This review was not registered on PROSPERO as it is not a systematic review.
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Affiliation(s)
- Megan Evans
- Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Gary S Cuddeback
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
| | - Carol Golin
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kathryn Muessig
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Chyrell Bellamy
- Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Mark Costa
- Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Maria O'Connell
- Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Edwin B Fisher
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Walsh CA, Currin-McCulloch J, Faris NR, Nguyen TST, Al Achkar M. "Living with Loss": A qualitative exploration of existential fears among people with advanced lung cancer in online lung cancer support groups. Palliat Support Care 2024:1-6. [PMID: 38420708 DOI: 10.1017/s147895152400004x] [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: 03/02/2024]
Abstract
OBJECTIVES With targeted therapies, people are surviving longer with advanced lung cancer and engaging in online lung cancer support communities. While these groups provide a sense of community, witnessing the death of peers can lead to emotional distress. This qualitative study aims to (1) explore the experience of witnessing death in online cancer support groups; (2) identify factors that contribute to the emotional struggles of witnessing the death of peers; and (3) identify strategies/options for dealing with losses in the cancer community. METHODS We conducted a cross-sectional analysis of qualitative interviews exploring existential concerns with participants (n = 25) from oncogene-specific online lung cancer support groups. The principal investigator conducted study interviews between August 2018 and March 2019 where participants were asked about their cancer experiences and existential concerns. We used thematic analysis and NVIVO 11 software to examine and store the de-identified interview data. RESULTS Participants indicated that they had often witnessed their peers die and felt the pain of the loss. Factors that played a part in their struggle with witnessing others' death included the closeness of the relationship with the person, the age of the person who died, seeing oneself in the experience of the other dying, disparities in care, and losing touch in the final stages. Participants used varied coping strategies such as celebrating the life of the individual who died, engaging in advocacy efforts, not focusing on the loss, participating in therapy, and bringing self-preserving thoughts. SIGNIFICANCE OF RESULTS Our study highlights the importance of addressing existential fears in online lung cancer support groups and incorporating conversations about death in spaces that deal with cancer.
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Affiliation(s)
- Casey A Walsh
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | | | - Nicholas R Faris
- Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA
| | - Thu Suong Thi Nguyen
- School of Education, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Morhaf Al Achkar
- Department of Family Medicine, University of Washington, Seattle, WA, USA
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Keramatikerman M, Varaei S, Vaezi M, Sayadi L. Peer support-based online education, burden of care and quality of life among family caregivers of patients with leukaemia: non-randomised clinical trial. BMJ Support Palliat Care 2024:spcare-2023-004610. [PMID: 38272654 DOI: 10.1136/spcare-2023-004610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVE The responsibility of caring for patients with leukaemia places a heavy burden on family caregivers (FCs) and negatively impacts their quality of life (QoL). This study aimed to investigate the effects of peer support (PS)-based online education programme on the burden of care (BoC) and QoL of FCs of patients with leukaemia. METHODS This before-after study involved a total of 80 eligible FCs of patients with leukaemia (40 individuals per group). The participants received the necessary information from a researcher and peers through online sessions and WhatsApp group. To collect data, the Zarit Burden Interview and the Caregiver Quality of Life Index-Cancer (CQOLC) had been been completed once before the intervention and once 1 month after the intervention. RESULTS There was no significant difference between the two groups regarding baseline variables except the mean BoC that was significantly higher in the intervention group (IG) (p<0.001). However, after controlling for the effects of confounding variables, the mean BoC score of participants in IG was significantly lower than that of the control group (p<0.001). Additionally, there was no significant difference between the two groups in terms of CQOLC before (p=0.178) and after (p=0.538) the intervention. CONCLUSION The PS-based online education programme had a positive impact on reducing the care burden of FCs of patients with leukaemia. This programme can effectively reduce costs, particularly during emergencies and crises such as pandemics, as it eliminates the need for FCs and peers to physically visit hospitals. REGISTRATION The study was registered at the Iranian Registry of Clinical Trials on 18 July 2021 (IRCT registration number: IRCT20210507051209N1).
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Affiliation(s)
| | - Shokoh Varaei
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Vaezi
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Research Institute for Oncology, Hematology and Cell Therapy Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Sayadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Honoré Grauslund AM, Ammentorp J, Timmermann C. Moving towards holistic rehabilitation - A qualitative study exploring how people diagnosed with cancer and cancer survivors experience a dance-like intervention. Scand J Caring Sci 2023; 37:970-979. [PMID: 37280771 DOI: 10.1111/scs.13171] [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: 10/22/2021] [Revised: 03/13/2023] [Accepted: 03/18/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Rehabilitation that supports the individual on the journey back to their usual selves after cancer treatment becomes increasingly important. Studies have shown that a focus on the connection between body and mind might be beneficial. Consequently, Whole Person Care and initiatives that fall in line with this holistic approach to health care, such as a dance-like intervention needs further examination. The aim of this study was to explore the qualitative aspects of 5Rhythms® as experienced by people diagnosed with cancer. METHOD A total of 29 (17 in 2017) participants were recruited through purposeful sampling. Participants underwent one 5Rhythms® session per week for 2 months. This qualitative study with a phenomenological approach used diaries and individual interviews as its methods for data collection. Data were analysed using Giorgi's phenomenological framework and Maurice Merleau-Ponty's theoretical perspectives on phenomenological approaches to the body, perception and consciousness were applied. RESULTS Three main themes ('(now) I sense my entire body', 'Something liberating is happening inside my body' and 'We travel together') and five connecting sub-themes were identified through the analysis process. CONCLUSION Participating in 5Rhythms® contributed to reconnecting body and soul during or after battling cancer. It evoked thoughts and feelings of existential matter. Results suggest that participating in 5Rhythms® can assist in personal growth. The benefit of being among peers while on the path to recovery was also illuminated. In regard to rehabilitation, this study underlines the importance of being aware of the connection between body and mind.
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Affiliation(s)
- Anne-Mette Honoré Grauslund
- Department of Regional Health Research, Center for Patient Communication, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle Hospital, University of Southern Denmark, Vejle, Denmark
| | - Jette Ammentorp
- Department of Regional Health Research, Center for Patient Communication, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle Hospital, University of Southern Denmark, Vejle, Denmark
| | - Connie Timmermann
- Department of Regional Health Research, Center for Patient Communication, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle Hospital, University of Southern Denmark, Vejle, Denmark
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Aagesen M, la Cour K, Hauken MA, Pilegaard MS. The 'Young Adult Taking Action' programme for young adult cancer survivors: A study protocol for a feasibility study. Scand J Occup Ther 2023; 30:1472-1488. [PMID: 37557906 DOI: 10.1080/11038128.2023.2244563] [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: 11/14/2022] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Young adult cancer survivors (YACS) aged 18-39 report age-specific multifactorial challenges with self-care, leisure, work and education requiring multicomponent rehabilitation intervention. Therefore, the 'Young Adult Taking Action' (YATAC) programme was developed. AIMS/OBJECTIVES To present a protocol for a feasibility study evaluating the acceptability of the YATAC programme and exploring implementation, mechanisms of impact and outcomes. MATERIAL AND METHODS A mixed-method feasibility study with a convergent research design will be conducted. The programme is an age-specific, multicomponent, goal-oriented, and peer-based rehabilitation programme delivered by an interdisciplinary staff consisting of nine components: 1) Goal setting, 2) Everyday life, 3) Physical activity, 4) Psychological issues, 5) Work and study, 6) Sexuality and relationship, 7) Rights and finance, 8) Peer-to-peer support and 9) Individual consultation. Quantitative and qualitative data about acceptability, implementation, mechanisms of impact and outcomes will be collected. RESULTS The results will provide essential knowledge about the programme's acceptability, implementation, mechanisms of impact and outcomes. CONCLUSION AND SIGNIFICANCE The study will inform adjustment of the programme and will provide knowledge of whether and how to deliver age-specific rehabilitation to YACS.
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Affiliation(s)
- Maria Aagesen
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karen la Cour
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - May Aasebø Hauken
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Marc Sampedro Pilegaard
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
- DEFACTUM, Central Region Denmark, Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Regional Hospital Gødstrup, Herning, Denmark
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Salm S, Houwaart S, Cecon-Stabel N, Dresen A, Pfaff H, Scholten N, Krieger T. Integrating one-to-one peer support into psycho-oncological care in Germany: multi-perspective, mixed-methods evaluation of the isPO onco-guide service. J Cancer Res Clin Oncol 2023; 149:10399-10422. [PMID: 37273104 PMCID: PMC10240138 DOI: 10.1007/s00432-023-04951-4] [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: 04/27/2023] [Accepted: 05/27/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE One-to-one peer supporters called isPO onco-guides (isPO OGs) are an integral part of the new German psycho-oncological form of care 'integrated, cross-sectoral Psycho-Oncology' (isPO), additionally to professional care. The isPO OGs are cancer survivors with experiential knowledge, offering information on local support services and answering questions 'all around cancer' to newly diagnosed cancer patients. We aimed to evaluate the isPO OG service from three perspectives: patients, isPO OGs, and professional service providers. METHODS A mixed-methods approach was pursued. We conducted interviews and focus groups with the three person groups, and applied qualitative content analysis on the reported resources, processes and outcomes regarding the isPO OG service. Relations with patients' utilisation and isPO OGs' work satisfaction were identified with regression and correlation analyses of questionnaire and isPO care data. We compared isPO care networks (CN) with X2-tests or ANOVA. Qualitative and quantitative results were integrated during interpretation phase. RESULTS Qualitatively, the three person groups agreed on the benefits of the isPO OG service. The implementation's maturity differed between the CN concerning established processes and resource availability. Attitudes of professional service providers appeared to be crucial for patients' utilisation of the isPO OG service. Quantitative results emphasised the differences between the CN. CONCLUSION Beyond differences in the CN, the isPO OG service has two psychosocial benefits: providing relevant, reliable, and understandable information; and offering the encouraging example that surviving and living with cancer is possible. TRIAL REGISTRATION The study was registered in the German Clinical Trials Register (No. DRKS00015326) on 30.10.2018.
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Affiliation(s)
- Sandra Salm
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany.
- Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany.
| | - Stefanie Houwaart
- House of the Cancer Patient Support Associations of Germany (HKSH-BV), Bonn, Germany
| | - Natalia Cecon-Stabel
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany
- Unit of Health Services Research in Childhood and Adolescence, Clinic of General Pediatrics, Neonatology and Pediatric Cardiology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Antje Dresen
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Holger Pfaff
- Faculty of Medicine and University Hospital Cologne, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Quality Development and Evaluation in Rehabilitation, University of Cologne, Cologne, Germany
- Center for Health Services Research, University of Cologne, Cologne, Germany
| | - Nadine Scholten
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Theresia Krieger
- Faculty of Medicine, Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Eupener Str. 129, 50933, Cologne, Germany
- Faculty of Medicine, Department of Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, University Hospital Cologne, Cologne, Germany
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Thomson MD, Van Houtven CH, Xu R, Siminoff LA. The many "costs" of transportation: Examining what cancer caregivers experience as transportation obstacles. Cancer Med 2023; 12:17356-17364. [PMID: 37485648 PMCID: PMC10501274 DOI: 10.1002/cam4.6351] [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: 04/12/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Transportation has been identified as a specific source of burden for cancer caregivers. This study examined cancer caregivers' subjective experiences and objectives costs associated with transportation over a 6-month period of providing end-of-life care to a family member or friend. METHODS This was a multi-site longitudinal, prospective cohort study that followed 223 caregiver-patient dyads. Data were collected using biweekly, semi-structured interviews for up to 6 months and collection of all caregiving related receipts. Interviews were coded and analyzed using a comparative, iterative analysis and actual out of pockets costs were described using descriptive statistics. RESULTS Over the 6-month study period most caregivers (n = 143; 74%) discussed transportation at one or more timepoints. Average biweekly transportations costs to caregivers were $43.6. Caregivers described (n = 56; 39%) multiple direct and indirect costs of transportation, and 58% (n = 84) discussed the need for transportations services or assistance at the institutional level. CONCLUSIONS Caregivers described the multifaceted costs of transportation they experienced which are in line with previous work. Alongside descriptions of direct costs, caregivers described key opportunity costs, such as personal and work time forgone to transporting patients. Caregivers also made suggestions for institutional and/or civic based solutions to facilitate reliable modes of transportation, rather than individual-level intervention.
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Affiliation(s)
- Maria D. Thomson
- Department of Health Behavior and PolicyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Courtney Harold Van Houtven
- Department of Population Health SciencesDuke UniversityDurhamNorth CarolinaUSA
- Durham ADAPT, Durham Veterans Affairs Medical CenterDurhamNorth CarolinaUSA
| | - Rebecca Xu
- Virginia Commonwealth University School of MedicineRichmondVirginiaUSA
| | - Laura A. Siminoff
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvaniaUSA
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Driessen HPA, Busschbach JJV, van der Rijt CCD, Elfrink EJ, Raijmakers NJH, van Roij J, Rietjens J, Kranenburg LW. Unmet care needs of patients with advanced cancer and their relatives: multicentre observational study. BMJ Support Palliat Care 2023:spcare-2023-004242. [PMID: 37491145 DOI: 10.1136/spcare-2023-004242] [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: 02/28/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES The care needs of patients with advanced cancer and their relatives change throughout the disease trajectory. This study focused on the care-related problems and needs of patients with advanced cancer and their relatives. This was done from the perspective of centres for information and support. METHODS This cross-sectional study used data from the eQuiPe study: an observational cohort study in which 40 Dutch hospitals participated. All adult patients with a diagnosis of a metastasised tumour and their relatives were eligible. Measures included information on the patients' and relatives' care problems and needs, assessed by the short version of the Problems and Needs in Palliative Care questionnaire. Socioeconomic demographics were also collected. RESULTS 1103 patients with advanced cancer and 831 relatives were included. Both patients (M=60.3, SD=29.0) and relatives (M=59.2, SD=26.6) experienced most problems in the domain of 'psychological issues'. Both patients (M=14.0, SD=24.2) and relatives (M=17.7, SD=25.7) most frequently reported unmet needs within this domain. The most often reported unmet need by patients was 'worrying about the future of my loved ones' (22.0%); for relatives this was 'fear for physical suffering of the patient' (32.8%). There was no clear relationship between socioeconomic demographics and the experienced unmet needs. CONCLUSIONS The most often mentioned unmet needs consisted of fears and worries, followed by a broad range of topics within multiple domains. Centres for information and support may play a role in reducing the unmet needs of (potential) visitors as these centres provide support on a broad range of topics.
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Affiliation(s)
- Helen P A Driessen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Erna J Elfrink
- Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Janneke van Roij
- The Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Judith Rietjens
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Design, Organization, and Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Leonieke W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
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Kiemen A, Czornik M, Weis J. How effective is peer-to-peer support in cancer patients and survivors? A systematic review. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04753-8. [PMID: 37120782 PMCID: PMC10374798 DOI: 10.1007/s00432-023-04753-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/08/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE Core components of peer-to-peer (PTP) support for cancer survivors include informational, emotional, and psychosocial aspects. Previous literature on peer support in cancer includes both professionally and peer-led support. Our objective was to summarize studies on the effects of non-professionally led PTP support in cancer. METHODS We performed a systematic research on studies in PTP support of adult cancer survivors with an interventional design, comparing outcomes of PTP support against any control. We included all studies with a precise definition of a PTP support, published from January 2000 up to March 2023 in peer-reviewed journals in English or German. RESULTS Out of N = 609 identified publications, we were are able to include n = 18 randomized-controlled trials (RCTs) fulfilling our inclusion criteria. Main settings were dyadic support via telephone, face-to-face (FTF), and web-based online support. Most common outcomes were distress, depressive symptoms, anxiety, and quality of life (QoL). Overall, we found only small effects of PTP support on depression/anxiety, coping, or sexual functioning. Beneficial effects associated with the PTP intervention were apparent in particular in BRCA, in FTF settings, and in assessments of cancer-specific QoL outcomes. CONCLUSION This review shows that there are a few RCT investigating the effect of PTP support with short-term effects. Overall, there is a need for more RCTs with high methodological standards to evaluate the effectiveness of PTP support.
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Affiliation(s)
- A Kiemen
- Comprehensive-Cancer Centre Freiburg (CCCF), Medical Faculty of the Albert-Ludwigs University, Endowed Professorship for Self-Help Research University Clinic, Hugstetterstr. 49, 79106, Freiburg, Germany.
| | - M Czornik
- Comprehensive-Cancer Centre Freiburg (CCCF), Medical Faculty of the Albert-Ludwigs University, Endowed Professorship for Self-Help Research University Clinic, Hugstetterstr. 49, 79106, Freiburg, Germany
| | - J Weis
- Comprehensive-Cancer Centre Freiburg (CCCF), Medical Faculty of the Albert-Ludwigs University, Endowed Professorship for Self-Help Research University Clinic, Hugstetterstr. 49, 79106, Freiburg, Germany
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12
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Pomey MP, Paquette J, Iliescu-Nelea M, Vialaron C, Mourad R, Bouchard K, Normandin L, Côté MA, Desforges M, Pomey-Carpentier P, Fortin I, Ganache I, Régis C, Rosberger Z, Charpentier D, Bélanger L, Dorval M, Ghadiri DP, Lavoie-Tremblay M, Boivin A, Pelletier JF, Fernandez N, Danino AM, de Guise M. Accompanying patients in clinical oncology teams: Reported activities and perceived effects. Health Expect 2023; 26:847-857. [PMID: 36704843 PMCID: PMC10010089 DOI: 10.1111/hex.13710] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Since 2018, four establishments in Quebec, Canada, have decided to implement the PAROLE-Onco programme, which introduced accompanying patients (APs) in healthcare teams to improve the experience of cancer patients. APs are patient advisors who have had a cancer treatment experience and who conduct consultations to complement the service offered by providing emotional, informational and educational support to patients undergoing treatments (e.g., radiotherapy, chemotherapy, surgery), mostly for breast cancer. We aimed to explore the evolution of APs' perspectives regarding their activities within the clinical oncology teams as well as the perceived effects of their intervention with patients, the clinical team and themselves. METHODS A qualitative study based on semistructured interviews and focus groups was conducted with APs at the beginning of their intervention (T1) and 2 years afterwards (T2). The themes discussed were APs' activities and the perceived effects of their interventions on themselves, on the patients and on the clinical team. RESULTS In total, 20 APs were interviewed. In T2, APs' activities shifted from listening and sharing experiences to empowering patients by helping them become partners in their care and felt generally more integrated into the clinical team. APs help patients feel understood and supported, alleviate stress and become partners in the care they receive. They also alleviate the clinical team's workload by offering a complementary service through emotional support, which, according to them, helps patients feel calmer and more prepared for their appointments with healthcare professionals. They communicate additional information about their patients' health journey, which makes the appointment more efficient for healthcare professionals. When APs accompany patients, they feel as if they can make a difference in patients' lives. Their activities are perceived by some as an opportunity to give back but also as a way of giving meaning to their own experience, in turn serving as a learning experience. CONCLUSION By mobilizing their experiential knowledge, APs provide emotional, informational, cognitive and navigational support, which allows patients to be more empowered in their care and which complements professionals' scientific knowledge, thereby helping to refine their sensitivity to the patients' experiences. PATIENT OR PUBLIC CONTRIBUTION Two patient-researchers have contributed to the study design, the conduct of the study, the data analysis and interpretation, as well as in the preparation and writing of this manuscript.
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Affiliation(s)
- Marie-Pascale Pomey
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre d'excellence sur le partenariat avec les patients et le public, Montréal, Quebec, CA.,Department of Health Policy, Management and Evaluation, School of Public Health, University of Montréal, Montréal, Quebec, Canada
| | - Jesseca Paquette
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Monica Iliescu-Nelea
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Cécile Vialaron
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Rim Mourad
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Karine Bouchard
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Louise Normandin
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Marie-Andrée Côté
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Mado Desforges
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | | | - Israël Fortin
- Centre Intégré Universitaire de santé et services sociaux de l'Est-de-l'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, Montréal, Québec, Canada
| | - Isabelle Ganache
- Institut national d'excellence en santé et services sociaux (INESSS), Montréal, Québec, Canada
| | - Catherine Régis
- Université de Montréal-Faculté de Droit, Montréal, Québec, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, Lady Davis Institute for Medical Research, Jewish General Hospital & McGill University, Montréal, Québec, Canada
| | | | - Lynda Bélanger
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Michel Dorval
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada.,Université Laval-Faculté de pharmacie, Québec, Québec, Canada.,Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de recherche du CISSS Chaudière Appalaches, Lévis, Québec, Canada
| | | | - Mélanie Lavoie-Tremblay
- Faculté des sciences infirmières, Université de Montréal, Montréal, Québec, Canada.,Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Antoine Boivin
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre d'excellence sur le partenariat avec les patients et le public, Montréal, Quebec, CA.,Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Jean-François Pelletier
- Centre intégré de santé et de services sociaux de la Montérégie-Ouest, St-Hubert, Québec, Canada.,Yale Program for Recovery & Community Health, New Haven, Connecticut, USA
| | - Nicolas Fernandez
- Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Alain M Danino
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre Hospitalier Universitaire de Montréal (CHUM), Montréal, Québec, Canada
| | - Michèle de Guise
- Institut national d'excellence en santé et services sociaux (INESSS), Montréal, Québec, Canada
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13
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Que WQ, Zhao JY, Tang J, Su XQ, Li JM, Gu CH, Guo YJ. Peer Supporters' Experience of Supporting Cancer Patients: A Meta-synthesis. Cancer Nurs 2023; Publish Ahead of Print:00002820-990000000-00112. [PMID: 36867009 DOI: 10.1097/ncc.0000000000001214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND With the widespread use of peer support in the cancer field, more and more cancer survivors are becoming supporters. However, they may bear a huge psychological burden in the peer support project. There has been little effort to analyze supporters' experiences from a meta-perspective. OBJECTIVE The aims of this study were to review the literature on the experience of patients serving as peer supporters, integrate qualitative data to explore the experiences of supporters participating in peer support programs, and provide suggestions for future researchers. INTERVENTIONS/METHODS China Knowledge Network, Wanfang Database, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, CINAHL, and PsycINFO were searched. Titles, abstracts, and full texts were screened. Included articles (n = 10) underwent data extraction, the Joanna Briggs Institute Critical Appraisal Tool for qualitative researches (2016) quality evaluation, and thematic synthesis. RESULTS The literature ultimately included 10 studies from which 29 themes were distilled and grouped into 2 main categories: benefits and challenges of peer support for supporters. CONCLUSIONS Peer supporters will not only gain social support, growth, and recovery but also experience various challenges when providing peer support. Both supporters' and patients' experiences of participating in peer support programs deserve the attention of researchers. Researchers need to be rigorous in controlling the implementation of peer support programs to help supporters gain and overcome challenges. IMPLICATIONS FOR PRACTICE Future researchers can use study findings to better develop peer support programs. More peer support projects are needed to explore a standardized peer support training guide.
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Affiliation(s)
- Wen-Qian Que
- Author Affiliation: School of Nursing, Medical School of Nantong University, Jiangsu, China
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14
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Mullard JCR, Kawalek J, Parkin A, Rayner C, Mir G, Sivan M, Greenhalgh T. Towards evidence-based and inclusive models of peer support for long covid: A hermeneutic systematic review. Soc Sci Med 2023; 320:115669. [PMID: 36708608 PMCID: PMC9840228 DOI: 10.1016/j.socscimed.2023.115669] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/14/2022] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Since the first wave of COVID-19 in March 2020 the number of people living with post-COVID syndrome has risen rapidly at global pace, however, questions still remain as to whether there is a hidden cohort of sufferers not accessing mainstream clinics. This group are likely to be constituted by already marginalised people at the sharp end of existing health inequalities and not accessing formal clinics. The challenge of supporting such patients includes the question of how best to organise and facilitate different forms of support. As such, we aim to examine whether peer support is a potential option for hidden or hardly reached populations of long COVID sufferers with a specific focus on the UK, though not exclusively. Through a systematic hermeneutic literature review of peer support in other conditions (57 papers), we evaluate the global potential of peer support for the ongoing needs of people living with long COVID. Through our analysis, we highlight three key peer support perspectives in healthcare reflecting particular theoretical perspectives, goals, and understandings of what is 'good health', we call these: biomedical (disease control/management), relational (intersubjective mutual support) and socio-political (advocacy, campaigning & social context). Additionally, we identify three broad models for delivering peer support: service-led, community-based and social media. Attention to power relations, social and cultural capital, and a co-design approach are key when developing peer support services for disadvantaged and underserved groups. Models from other long-term conditions suggest that peer support for long COVID can and should go beyond biomedical goals and harness the power of relational support and collective advocacy. This may be particularly important when seeking to reduce health inequalities and improve access for a potentially hidden cohort of sufferers.
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Affiliation(s)
- Jordan C R Mullard
- Durham University and University of Leeds, UK; University of Johannesburg, South Africa.
| | | | | | - Clare Rayner
- University of Leeds LOCOMOTION Patient Advisory Group (Co-Lead), UK.
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15
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Storman D, Jemioło P, Swierz MJ, Sawiec Z, Antonowicz E, Prokop-Dorner A, Gotfryd-Burzyńska M, Bala MM. Meeting the Unmet Needs of Individuals With Mental Disorders: Scoping Review on Peer-to-Peer Web-Based Interactions. JMIR Ment Health 2022; 9:e36056. [PMID: 36469366 PMCID: PMC9788841 DOI: 10.2196/36056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/24/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND An increasing number of online support groups are providing advice and information on topics related to mental health. OBJECTIVE This study aimed to investigate the needs that internet users meet through peer-to-peer interactions. METHODS A search of 4 databases was performed until August 15, 2022. Qualitative or mixed methods (ie, qualitative and quantitative) studies investigating interactions among internet users with mental disorders were included. The φ coefficient was used and machine learning techniques were applied to investigate the associations between the type of mental disorders and web-based interactions linked to seeking help or support. RESULTS Of the 13,098 identified records, 44 studies (analyzed in 54 study-disorder pairs) that assessed 82,091 users and 293,103 posts were included. The most frequent interactions were noted for people with eating disorders (14/54, 26%), depression (12/54, 22%), and psychoactive substance use disorders (9/54, 17%). We grouped interactions between users into 42 codes, with the empathy or compassion code being the most common (41/54, 76%). The most frequently coexisting codes were request for information and network (35 times; φ=0.5; P<.001). The algorithms that provided the best accuracy in classifying disorders by interactions were decision trees (44/54, 81%) and logistic regression (40/54, 74%). The included studies were of moderate quality. CONCLUSIONS People with mental disorders mostly use the internet to seek support, find answers to their questions, and chat. The results of this analysis should be interpreted as a proof of concept. More data on web-based interactions among these people might help apply machine learning methods to develop a tool that might facilitate screening or even support mental health assessment.
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Affiliation(s)
- Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Paweł Jemioło
- AGH University of Science and Technology, Krakow, Poland
| | - Mateusz Jan Swierz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Zuzanna Sawiec
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Ewa Antonowicz
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Prokop-Dorner
- Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | | | - Malgorzata M Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
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16
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Aagesen M, Pilegaard MS, Hauken MA, Wæhrens EEE, la Cour K. Users' perspective on rehabilitation interventions for young adult cancer survivors: A group concept mapping study. Eur J Cancer Care (Engl) 2022; 31:e13734. [PMID: 36218020 PMCID: PMC9786878 DOI: 10.1111/ecc.13734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We aim to identify and prioritise rehabilitation interventions to strengthen participation in everyday life for young adult cancer survivors (YACS) between 18 and 39 years, involving the perspectives of YACS and relevant stakeholders. METHODS A group concept mapping study was conducted in Denmark from 2019 to 2020. Online, participants generated and sorted ideas followed by rating their importance. Multidimensional scaling followed by hierarchical cluster analyses were applied to generate a cluster rating map of the prioritised interventions, which participants validated at a face-to-face meeting. Finally, a concluding conceptual model of prioritised rehabilitation intervention for YACS was developed. RESULTS The study involved 25 YACS, three family members and 31 professionals working with YACS. The conceptual model included 149 ideas classified into eight intervention components created by the participants: (1) Treatment and possibilities within the social and healthcare system, (2) Rights and Finance, (3) Education and Work, (4) Psychological problems, (5) Body and Everyday Life, (6) Peer-to-peer, (7) Sexuality and Relationships and (8) Family and Friends. All components were rated equally important, whereby 17 ideas across the eight components were rated very important. CONCLUSION This study indicates that rehabilitation of YACS should be composed of eight equally important intervention components requiring an interdisciplinary approach.
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Affiliation(s)
- Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Marc Sampedro Pilegaard
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,OPEN, Open Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - May Aasebø Hauken
- Centre for Crisis Psychology, Faculty of PsychologyUniversity of BergenBergenNorway
| | - Eva Elisabet Ejlersen Wæhrens
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,The Parker Institute, Copenhagen University Hospitals Bispebjerg–FrederiksbergFrederiksbergDenmark
| | - Karen la Cour
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
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17
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Dyregrov K, Titlestad KB, Selseng LB. Why Informal Support Fails for Siblings Bereaved by a Drug-Related Death: A Qualitative and Interactional Perspective. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221129372. [PMID: 36154325 DOI: 10.1177/00302228221129372] [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: 11/16/2022]
Abstract
Drug-related deaths constitute a significant challenge that strongly impacts the lives of the bereaved and the risks of mental and social problems are well-documented. This paper is the first one to explore how bereaved siblings experience informal support after drug-related deaths. Reflexive thematic analysis is used to analyze ten semi-structured interviews with bereaved siblings. Three main themes were identified: (1) valued support elaborates on the range of desired support and content of the support received; (2) barriers to support were connected to complex family relations, different grief reactions, and stigma, shame, and devaluation; (3) ways to promote support focus on openness and mutual closeness. The discussion revolves around the 'strong' sibling role, complex family relations, stigma, protective silence, and disenfranchised grief. Interactional aspects involved in social support and the importance of addressing this in clinical practice, to utilize the vital support potential for the bereaved experiencing drug-related death, are discussed.
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Affiliation(s)
- Kari Dyregrov
- Western Norway University of Applied Sciences, Bergen, Norway
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18
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Jablotschkin M, Binkowski L, Markovits Hoopii R, Weis J. Benefits and challenges of cancer peer support groups: A systematic review of qualitative studies. Eur J Cancer Care (Engl) 2022; 31:e13700. [DOI: 10.1111/ecc.13700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 07/27/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Martina Jablotschkin
- Institute for Continuing Scientific Education Catholic University of Applied Sciences Freiburg Germany
| | - Lena Binkowski
- Comprehensive Cancer Center, Department of Self‐Help Research University of Freiburg Medical Center Freiburg Germany
| | | | - Joachim Weis
- Comprehensive Cancer Center, Department of Self‐Help Research University of Freiburg Medical Center Freiburg Germany
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19
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Zwaiman A, da Luz LT, Perrier L, Hacker Teper M, Strauss R, Harth T, Haas B, Nathens AB, Gotlib Conn L. The involvement of trauma survivors in hospital-based injury prevention, violence intervention and peer support programs: A scoping review. Injury 2022; 53:2704-2716. [PMID: 35773023 DOI: 10.1016/j.injury.2022.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/26/2022] [Accepted: 06/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite decades-long involvement of trauma survivors in hospital-based program delivery, their roles and impact on trauma care have not been previously described. We aimed to characterize the literature on trauma survivor involvement in hospital-based injury prevention, violence intervention and peer support programs to map what is currently known and identify future research opportunities. METHODS A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. Articles were identified through electronic databases and gray literature. Included articles described hospital-based injury prevention programs, violence intervention programs and peer support programs that involved trauma survivors leveraging their injury experiences to counsel others. Studies were screened and data were abstracted in duplicate. Data were synthesized generally and by program type. RESULTS Thirty-six published articles and four program reports were included. Peer support programs were described in 21 articles, mainly involving trauma survivors as mentors or peer supporters. Peer support programs' most commonly reported outcome was participant satisfaction (n = 6), followed by participant self-efficacy (n = 5), depression (n = 4), and community integration (n = 3). Eleven injury prevention studies were included, all involving trauma survivors as speakers in youth targeted programs. Injury prevention studies commonly reported outcomes of participants' risk behaviors and awareness (n = 9). Violence intervention programs were included in four articles involving trauma survivors as intervention counsellors. Recidivism rate was the most commonly reported outcome (n = 3). Variability exists across and within program types when reporting on involved trauma survivors' gender, age, selection and training, duration of involvement and number of survivors involved. Outcomes related to trauma survivors' own experiences and the impacts to them of program involvement were under-studied. CONCLUSIONS Significant opportunity exists to fill current knowledge gaps in trauma survivors' involvement in trauma program delivery. There is a need to describe more fully who involved trauma survivors are to inform the development of effective future interventions.
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Affiliation(s)
- Ashley Zwaiman
- University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1 Canada
| | - Luis T da Luz
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Laure Perrier
- University Health Network, 190 Elizabeth St, Toronto, ON M5G 2C4, Canada
| | | | - Rachel Strauss
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Tamara Harth
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Barbara Haas
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada
| | - Avery B Nathens
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada
| | - Lesley Gotlib Conn
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada.
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20
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Zhang S, Li J, Hu X. Peer support interventions on quality of life, depression, anxiety, and self-efficacy among patients with cancer: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2022; 105:3213-3224. [PMID: 35858869 DOI: 10.1016/j.pec.2022.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Peer support is a common form of social support that is provided by individuals with the same disease, which is cost-effective and has enhanced health outcomes for patients. This study aimed to determine the effectiveness of peer support interventions on quality of life (QOL), depression, anxiety, and self-efficacy among patients with cancer. METHODS A systematic search of seven databases were conducted from inception to January 2021. Studies were screened and assessed by two independent reviewers. Data synthesis was conducted using RevMan 5.3 software, and the standardized mean difference was used to calculate pooled effect sizes. RESULTS Seventeen studies were included in current review. The meta-analysis indicated significant beneficial effects of peer support on QOL (SMD = 0.48, 95% CI 0.21-0.75; p < 0.001), depression (SMD = -0.23, 95% CI -0.39 to -0.07; p = 0.005), anxiety (SMD = -0.24, 95% CI -0.45 to 0.03; p = 0.03), and self-efficacy (SMD = 0.22, 95% CI 0.03-0.42; p = 0.03) relative to controls. The subgroup analysis for QOL revealed that peer support delivered in the mixed mode contributed more than peer support delivered in the single mode (e.g., face-to-face or telephone). CONCLUSION Peer support has significant effects on improving QOL and self-efficacy as well as alleviating depression and anxiety among patients with cancer. Additional randomized controlled trials with rigorous design and larger sample sizes are warranted in the future. PRACTICE IMPLICATIONS Peer support programs might benefit patients with cancer and could be used as a complementary approach to traditional healthcare services during cancer rehabilitation.
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Affiliation(s)
- Shufang Zhang
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China.
| | - Juejin Li
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China.
| | - Xiaolin Hu
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China.
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21
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Luu KL, Witkamp FE, Nieboer D, Bakker EM, Kranenburg LW, van der Rijt CCD, Lorig K, van der Heide A, Rietjens JAC. Effectiveness of the "Living with Cancer" peer self-management support program for persons with advanced cancer and their relatives: study protocol of a non-randomized stepped wedge study. Palliat Care 2022; 21:107. [PMID: 35692043 PMCID: PMC9188837 DOI: 10.1186/s12904-022-00994-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Persons with advanced cancer and their relatives experience physical, emotional, and psychosocial consequences of the illness. Most of the time, they must deal with these themselves. While peer self-management support programs may be helpful, there is little evidence on their value for this population. We present the research protocol of our SMART study that will evaluate the effectiveness of the “Living with Cancer” peer self-management support program, aimed at improving self-management behaviors, self-efficacy, and health-related quality of life of persons with advanced cancer and their relatives. Methods We will conduct a non-randomized stepped wedge study in the Netherlands. We will include 130 persons with advanced cancer and 32 relatives. Participants can choose to either start the program within 4 weeks after inclusion or after eight to 10 weeks. The “Living with Cancer” is a peer self-management support program, based on the Chronic Disease Self-Management Program. It consists of six 1,5 hours video-conferencing group meetings with eight to 12 participants, preceded by two or three preparatory audio clips with supportive text per session. The program has the following core components: the learning of self-management skills (action-planning, problem-solving, effective communication, and decision-making), discussing relevant themes (e.g. dealing with pain and fatigue, living with uncertainty, and future planning), and sharing experiences, knowledge, and best practices. The primary outcome for both persons with advanced cancer and relatives is self-management behavior assessed by the subscale “constructive attitudes and approaches” of the Health Education Impact Questionnaire. Secondary outcomes are other self-management behaviors, self-efficacy, health-related quality of life, symptoms, depression and anxiety, and loneliness. Participants complete an online questionnaire at baseline, and after eight and 16 weeks. After each session, they complete a logbook about their experiences. Group meetings will be video recorded. Discussion SMART aims to evaluate an innovative program building on an evidence-based self-management program. New features are its use for persons with advanced cancer, the inclusion of relatives, and the video-conferencing format for this population. The use of both quantitative and qualitative analyses will provide valuable insight into the effectiveness and value of this program. Trial registration This study was registered in the Dutch Trial Register on October 2021, identifier NL9806. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00994-5.
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Affiliation(s)
- K L Luu
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - F E Witkamp
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Center of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - D Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - E M Bakker
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - L W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - C C D van der Rijt
- Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - K Lorig
- Stanford School of Medicine, CA, Stanford, USA
| | - A van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J A C Rietjens
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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22
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Brodar KE, Carlisle V, Tang PY, Fisher EB. Identification and Characterization of Peer Support for Cancer Prevention and Care: A Practice Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:645-654. [PMID: 32892278 PMCID: PMC7474572 DOI: 10.1007/s13187-020-01861-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Research across the cancer care continuum indicates peer support can improve patient outcomes, yet little is known about how cancer peer support programs are implemented in practice. This study aimed to describe cancer peer support programs in "real world" (i.e., non-research) settings. A web search identified 100 programs in a wide variety of settings and locations; 48 published contact information on their website and were invited to participate in semi-structured interviews. Twenty-nine program leaders participated. From the interviews, we observed eight primary themes, which centered on challenges and responses regarding training and content of peer support services as well as program organization and support. Obstacles include inconsistent funding, reliance on volunteers, and physician concerns about peer supporters' advice to patients, while increasing diversity, reach, and accessibility are future priorities. Peer support should be recognized and funded as a routine part of cancer care in order to expand its reach and address priorities such as increasing the diversity of supporters and those they help.
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Affiliation(s)
- Kaitlyn E Brodar
- Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 336A Rosenau Hall, CB #7400, Chapel Hill, NC, 27599-7400, USA
- Department of Psychology, University of Miami, 5665 Ponce de Leon Drive, Coral Gables, FL, 33146-0751, USA
| | - Veronica Carlisle
- Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 336A Rosenau Hall, CB #7400, Chapel Hill, NC, 27599-7400, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Patrick Yao Tang
- Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 336A Rosenau Hall, CB #7400, Chapel Hill, NC, 27599-7400, USA
| | - Edwin B Fisher
- Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 336A Rosenau Hall, CB #7400, Chapel Hill, NC, 27599-7400, USA.
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23
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Amonoo HL, Harnedy LE, Staton SC, Longley RM, Daskalakis E, El-Jawahri A, Huffman JC. Peer support in patients with hematologic malignancies: a systematic review. Bone Marrow Transplant 2022; 57:1240-1249. [PMID: 35597891 DOI: 10.1038/s41409-022-01709-3] [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: 02/25/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Peer support has been utilized and associated with clinical outcomes (e.g., improved mood) in patients with solid malignancies. However, to date, there is minimal literature examining peer support among patients with hematologic malignancies and/or patients who have undergone hematopoietic stem cell transplantation (HSCT). METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we completed a systematic review using five databases to assess the relationship between peer support and clinical outcomes (e.g., distress, physical symptoms) among patients with hematologic malignancies or HSCT recipients. RESULTS The eight included studies examined peer support in a total of 574 patients. Four intervention studies highlighted the potential benefits of peer support, such as improved physical symptoms. Two studies, one interventional and one cross-sectional, highlighted the need for more empirically based peer support interventions in the HSCT population. CONCLUSION Among patients with hematologic malignancies and/or HSCT recipients, there is a dearth of literature examining the association between peer support and outcomes, although few studies have described a positive association between peer support and better health outcomes. More randomized controlled studies are needed to better understand the role of peer support and peer support interventions on outcomes in these vulnerable populations.
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Affiliation(s)
- Hermioni L Amonoo
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. .,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Lauren E Harnedy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sophie C Staton
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Areej El-Jawahri
- Harvard Medical School, Boston, MA, USA.,Mass General Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Jeff C Huffman
- Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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24
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Husted Nielsen I, Piil K, Tolver A, Grønbæk K, Kjeldsen L, Jarden M. Family caregiver ambassador support for caregivers of patients with newly diagnosed hematological cancer: a feasibility study. Support Care Cancer 2022; 30:6923-6935. [PMID: 35543814 PMCID: PMC9091143 DOI: 10.1007/s00520-022-07089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/21/2022] [Indexed: 10/30/2022]
Abstract
PURPOSE This study investigated the feasibility of a one-on-one peer support intervention in family caregivers of newly diagnosed patients with a hematological cancer during initial treatment. METHODS The study was a one-arm feasibility study including family caregivers of newly diagnosed patients with hematological cancer (n = 26) and caregiver ambassadors who were family caregivers of previously treated patients as peer supporters (n = 17). The one-on-one peer support intervention consisted of three components: a caregiver ambassador preparatory course; 12 weeks of one-on-one peer support, and caregiver ambassador network meetings. RESULTS Family caregivers reported high satisfaction with the delivery and flexibility of one-on-one peer support and improved in most psychosocial outcomes over time. Telephone and text messages were the most used form of contact between the peers. Caregiver ambassadors reported high satisfaction with the preparatory course and used the available support from the network meetings. No adverse events were reported. CONCLUSION One-on-one peer support provided by a caregiver ambassador is feasible and safe in family caregivers of newly diagnosed hematological cancer patients during their initial treatment. Utilizing volunteer caregiver ambassadors has the potential to be a new support model in family caregivers of hematological cancer patients across diagnostic groups within a clinical setting. CLINICAL TRIAL REGISTRATION NUMBER NCT04039100, July 29, 2019.
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Affiliation(s)
- Iben Husted Nielsen
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Anders Tolver
- Department of Mathematical Sciences, Data Science Laboratory, University of Copenhagen, Universitetsparken 5, 2200, Copenhagen, Denmark
| | - Kirsten Grønbæk
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Biotech Research & Innovation Centre (BRIC), University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Lars Kjeldsen
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Mary Jarden
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
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25
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Wendel C, Sun V, Tallman N, Simons C, Yonsetto P, Passero F, Donahue D, Fry D, Iverson R, Pitcher P, Friedlaender J, MacDougall L, Henson J, McCorkle RC, Ercolano E, Cidav Z, Holcomb MJ, Weinstein RS, Hornbrook MC, Grant M, Krouse RS. Stakeholder engagement and participation in the design, delivery, and dissemination of the ostomy self-management telehealth (OSMT) program. Support Care Cancer 2022; 30:6187-6193. [PMID: 35438337 DOI: 10.1007/s00520-022-06878-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/28/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Stakeholder engagement is increasingly integrated into clinical research processes. We conducted a mixed methods analysis to describe stakeholders' (peer ostomates, ostomy nurses, telehealth engineers) perceptions of their engagement and participation in a multisite, randomized trial of a telehealth-delivered curriculum for cancer survivors with ostomies. METHODS Stakeholder notes were analyzed using narrative analysis. We constructed a 15-item survey that assessed the following areas: adherence to stakeholder engagement principles, engagement/influence throughout the study process, impact on perceived well-being, and satisfaction. Stakeholders were invited to complete the survey anonymously. Quantitative survey data were tabulated through summary statistics. RESULTS Across intervention sessions, an average of 7.7 ± 1.4 stakeholders attended and 2.6 ± 1.4 submitted a note per session. The survey response rate was 73% (11/15). Stakeholders reported high agreement that the study adhered to engagement principles (91% reciprocal relationships, 100% co-learning, partnership, and transparency/honesty/trust). They felt highly engaged (18% moderate, 73% great deal) and that they had influence on study initiation (27% moderate, 55% great deal), intervention delivery (9% moderate, 82% great deal), fidelity assessment (18% moderate, 73% great deal), analysis and interpretation (55% moderate, 27% great deal), and dissemination (45% moderate, 45% great deal). They reported high overall satisfaction with roles (91% great deal), believed the program was helpful for participants (91%), and that serving on study team benefited their own well-being (100%). CONCLUSIONS Our strategy of stakeholder inclusion led to high engagement, input, satisfaction, and belief in success of program, which could be mirrored in other trials.
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Affiliation(s)
- Christopher Wendel
- Department of Medicine, Arizona Center On Aging, University of Arizona, 1501 N. Campbell, PO Box 245027, Tucson, AZ, 85724-5027, USA.
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA.,Department of Surgery, City of Hope, Duarte, CA, USA
| | - Nancy Tallman
- Unaffiliated (Wound, Ostomy, and Continence Nurse), Tucson, AZ, USA
| | - Christie Simons
- Unaffiliated (Wound, Ostomy, and Continence Nurse), Tucson, AZ, USA
| | - Peter Yonsetto
- Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA
| | - Frank Passero
- Unaffiliated (Patient Partner), Philadelphia, PA, USA
| | | | - Dan Fry
- Unaffiliated (Patient Partner), Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Zuleyha Cidav
- Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael J Holcomb
- Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA
| | | | - Mark C Hornbrook
- Center for Health Research, Kaiser Permanente, Portland, OR, USA
| | - Marcia Grant
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Robert S Krouse
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
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26
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Velure GK, Müller B, Hauken MA. Symptom burden and health-related quality of life six months after hyperbaric oxygen therapy in cancer survivors with pelvic radiation injuries. Support Care Cancer 2022; 30:5703-5711. [PMID: 35320424 PMCID: PMC9135809 DOI: 10.1007/s00520-022-06994-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/16/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Late radiation tissue injuries (LRTIs) after treatment for pelvic cancer may impair health related quality of life (HRQoL). Hyperbaric oxygen therapy is an adjuvant therapy for LRTIs, but limited studied. The aim of this study was to explore the development and association between symptoms of LRTI and HRQoL following hyperbaric oxygen treatment. METHODS A pretest-posttest design was used to evaluate the changes in pelvic LRTIs and HRQoL from baseline (T1), immediately after treatment (T2) and at six-month follow-up (T3). EPIC and EORTC-QLQ-C30 were used to assess LRTIs and HRQoL. Changes were analysed with t-tests, and associations with Pearson's correlation and multiple regression analyses. RESULTS Ninety-five participants (mean age 65 years, 52.6% men) were included. Scores for urinary and bowel symptoms, overall HRQoL, all function scales and the symptoms scales sleep, diarrhoea, pain and fatigue were significantly improved six months after treatment (P-range = 0.00-0.04). Changes were present already at T2 and maintained or further improved to T3. Only a weak significant correlation between changes in symptoms and overall HRQoL was found (Pearson r-range 0.20-0.27). CONCLUSION The results indicate improvement of pelvic LRTIs and HRQoL following hyperbaric oxygen therapy, corresponding to minimal or moderate important changes. Cancer survivors with pelvic LRTIs and impaired HRQoL may benefit from undergoing hyperbaric oxygen therapy. Especially the reduced symptom-severity and improved social- and role function can influence daily living positively. TRIAL REGISTRATION ClinicalTrials.gov: NCT03570229. Released 2. May 2018.
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Affiliation(s)
- Grete K Velure
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Møllendalsbakken 9, N - 5009, Bergen, Norway. .,Hyperbaric Medicine Unit, Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
| | - Bernd Müller
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Møllendalsbakken 9, N - 5009, Bergen, Norway.,Hyperbaric Medicine Unit, Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - May Aa Hauken
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Møllendalsbakken 9, N - 5009, Bergen, Norway
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27
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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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28
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Yoshikawa E, Fujisawa D, Hisamura K, Murakami Y, Okuyama T, Yoshiuchi K. The potential role of peer support interventions in treating depressive symptoms in cancer patients. J NIPPON MED SCH 2021; 89:16-23. [PMID: 34840208 DOI: 10.1272/jnms.jnms.2022_89-117] [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] [Indexed: 11/19/2022]
Abstract
Depressive symptoms are prevalent in cancer patients and are one of the most distressing symptoms in this population. Although mental health professionals such as psychiatrists and psychologists are now engaged in cancer care, the management of depressive symptoms in cancer patients needs further improvement. Peer support interventions (PSIs) in cancer care have attracted substantial attention and have several advantages over support by medical professionals, potentially improving depressive symptoms in cancer patients. However, there may be some potential risks. Several strategies using PSIs have been developed to improve depressive symptoms and have been evaluated in randomized controlled trials. The strategies include education on stress management skills, promoting emotional support, counseling on specific topics that are difficult to discuss with others, helping patients navigate the use of resources, and promoting health-related behaviors to decrease depressive symptoms. In this paper, we present recent findings on PSIs in cancer, focusing on randomized controlled trials.
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Affiliation(s)
| | | | - Kazuho Hisamura
- Department of Medical Oncology, School of Medicine, Kanazawa Medical University
| | | | - Toru Okuyama
- Department of Psychiatry, Nagoya City University West Medical Center
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo
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29
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Giri VN, Shimada A, Leader AE. Predictors of Population Awareness of Cancer Genetic Tests: Implications for Enhancing Equity in Engaging in Cancer Prevention and Precision Medicine. JCO Precis Oncol 2021; 5:PO.21.00231. [PMID: 34778693 PMCID: PMC8585288 DOI: 10.1200/po.21.00231] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 12/17/2022] Open
Abstract
Racial and ethnic disparities in genetic awareness (GA) can diminish the impact of personalized cancer treatment and risk assessment. We assessed factors predictive of GA in a diverse population-based sample to inform awareness strategies and reduce disparities in genetic testing. METHODS A cross-sectional study was conducted from July 2019 to August 2019, with the survey e-mailed to 7,575 adult residents in southeastern Pennsylvania and New Jersey. Constructs from National Cancer Institute Health Information and National Trends Survey assessed cancer attitudes or beliefs, health literacy, and numeracy. Characteristics were summarized with mean ± standard deviation for numeric variables and frequency counts and percentages for categorical variables. Comparison of factors by race or ethnicity (non-Hispanic White and non-Hispanic Black) and sex was conducted by t-tests, chi-square, or Fisher's exact tests. Multivariate logistic regression models were conducted to identify factors independently predictive of GA. RESULTS Of 1,557 respondents, data from 940 respondents (the mean age was 45 ± 16.2 years, 35.5% males, and 23% non-Hispanic Blacks) were analyzed. Factors associated with higher GA included female gender (P < .001), non-Hispanic White (P < .001), college education (P < .001), middle-higher income (P < .001), stronger belief in genetic basis of cancer (P < .001), lower cancer fatalism (P = .004), motivation for cancer information (P < .001), and higher numeracy (P = .002). On multivariate analysis, college education (odds ratio [OR] 1.79; 95% CI, 1.22 to 2.63), higher motivation for cancer information (OR 1.56; 95% CI, 1.17 to 2.09), stronger belief in genetics of cancer (OR 2.21; 95% CI, 1.48 to 3.30), and higher medical literacy (OR 2.21; 95% CI, 1.34 to 3.65) predicted greater GA. CONCLUSION This population-based study conducted in the precision medicine era identified novel modifiable factors, importantly perceptions of cancer genetics and medical literacy, as predictive of GA, which informs strategies to promote equitable engagement in genetically based cancer care.
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Affiliation(s)
- Veda N. Giri
- Departments of Medical Oncology, Cancer Biology, and Urology, Cancer Risk Assessment and Clinical Cancer Genetics, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Ayako Shimada
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Amy E. Leader
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
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30
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Evans M, Barker H, Peddireddy S, Zhang A, Luu S, Qian Y, Tang PY, Fisher EB. Peer-delivered services and peer support reaching people with schizophrenia: A scoping review. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1975441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Megan Evans
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hannah Barker
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Snigdha Peddireddy
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Angela Zhang
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Samantha Luu
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yiqing Qian
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Patrick Y. Tang
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Edwin B. Fisher
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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31
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Grunberg PH, Da Costa D, Dennis CL, O'Connell S, Lahuec A, Zelkowitz P. 'How did you cope with such concerns?': insights from a monitored online infertility peer support forum. HUM FERTIL 2021:1-15. [PMID: 34347545 DOI: 10.1080/14647273.2021.1959952] [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] [Indexed: 01/06/2023]
Abstract
The Research Question posed was 'What coping strategies do fertility patients and trained peer supporters discuss in an online infertility peer support forum?' A thematic analysis was used to examine 244 online posts from a sample of 39 users (37 women and two men) for themes in coping with fertility-related stressors. Data were collected from Connect, a monitored online discussion forum with trained peer supporters. Connect users ranged from 27 to 44 years of age (mean = 34.38) and 33 (84.6%) were nulliparous at the time of the study. A variety of cognitive-reappraisal and practical management coping strategies was discussed across four themes: (i) balancing interpersonal relationships; (ii) partner support; (iii) uncertainty and lack of control; and (iv) positivity and negativity. Experiences of uncertainty and lack of control related to time and schedule, outcomes and waiting for physical symptoms, and the clinic. Connect users commonly discussed the helpfulness of coping strategies. Connect users actively requested experiential information about ways of coping from other patients and peer supporters, highlighting the importance of lived experience to those currently in treatment. Findings support conceptualizations of infertility coping as a process that is unique to the infertility treatment context and that may change throughout a patient's treatment. Trained peer supporters may benefit fertility patients by normalizing, reappraising, and providing practical strategies to ameliorate difficult infertility-related challenges.
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Affiliation(s)
- Paul H Grunberg
- Department of Psychology, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Deborah Da Costa
- Department of Medicine, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Siobhan O'Connell
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Alix Lahuec
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Phyllis Zelkowitz
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
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Jones JM, Saeed H, Katz MS, Lustberg MB, Forster VJ, Nekhlyudov L. Readdressing the Needs of Cancer Survivors During COVID-19: A Path Forward. J Natl Cancer Inst 2021; 113:955-961. [PMID: 33367655 PMCID: PMC7799033 DOI: 10.1093/jnci/djaa200] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 12/17/2022] Open
Abstract
The growing number of cancer survivors and the high prevalence of cancer-related physical and psychosocial effects pose important and pressing challenges to health systems. The coronavirus disease 2019 (COVID-19) pandemic has led to further stressors on cancer survivors and health care systems. As the pandemic continues to have substantial impact on the world, it is critical to focus attention on the health care needs of cancer survivors. In this commentary, we propose an adoption of essential steps that should be part of a continuous adaptive approach to promote effective cancer survivorship care during ongoing COVID-19 waves and beyond.
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Affiliation(s)
- Jennifer M Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Hina Saeed
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Matthew S Katz
- Department of Radiation Medicine, Lowell General Hospital, Lowell, MA, USA
| | - Maryam B Lustberg
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State Comprehensive Cancer Center, Columbus, OH, USA
| | - Victoria J Forster
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Brain cancer patient and support persons' experiences of psychosocial care: a mapping of research outputs. Support Care Cancer 2021; 29:5559-5569. [PMID: 33710411 DOI: 10.1007/s00520-021-06071-6] [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: 01/10/2021] [Accepted: 02/09/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND People with brain cancer and their support persons (SPs) are critical sources of information on the components of care that contribute to psychosocial outcomes. AIMS To determine the proportion of studies that examined (1) at least one of 14 nominated components of psychosocial cancer care and (2) more than one component of care. METHODS Medline, The Cochrane Library, PsycINFO and Embase were electronically searched for publications from January 1999 to December 2019. Publications that met the inclusion criteria were coded according to the number and type of psychosocial care components assessed from 14 listed components, and whether patient and/or SPs' views about care were elicited. RESULTS Of the 113 included publications, 61 publications included patient-reported data only (54%), 27 included both patient and SP-reported data (24%) and 25 included SP-reported data only (22%). Most assessed a single component of care (77% of patient-reported and 71% of SP-reported). No publications assessed all 14 components. The "Psychosocial" component was the most frequently assessed component of care for patient-reported (n = 80/88, 91%) and SP-reported publications (n = 46/52, 88%). CONCLUSIONS Publications reporting on psychosocial care in brain cancer present a relatively narrow view of patient and support person experiences. The inclusion of both patient and support person perspectives and the assessment of multiple components of care are required in future research to optimize psychosocial outcomes in brain cancer.
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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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Beckerman-Hsu JP, Gago C, Aftosmes-Tobio A, Jurkowski JM, Lansburg K, Leonard J, Torrico M, Haneuse S, Subramanian SV, Kenney EL, Davison KK. Acceptability and appropriateness of a novel parent-staff co-leadership model for childhood obesity prevention in Head Start: a qualitative interview study. BMC Public Health 2021; 21:201. [PMID: 33482774 PMCID: PMC7825243 DOI: 10.1186/s12889-021-10159-3] [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: 09/16/2020] [Accepted: 01/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background Peer leadership can be an effective strategy for implementing health programs, benefiting both program participants and peer leaders. To realize such benefits, the peer leader role must be appropriate for the community context. Also, peer leaders must find their role acceptable (i.e., satisfactory) to ensure their successful recruitment and retention. To date, parent peer leaders have seldom been part of early childhood obesity prevention efforts. Moreover, parents at Head Start preschools have rarely been engaged as peer leaders. The aim of this study is to evaluate the appropriateness and acceptability of an innovative model for engaging parents as peer leaders for this novel content area (early childhood obesity prevention) and setting (Head Start). Methods Parents Connect for Healthy Living (PConnect) is a 10-session parent program being implemented in Head Start preschools as part of the Communities for Healthy Living early childhood obesity prevention trial. PConnect is co-led by a parent peer facilitator who is paired with a Head Start staff facilitator. In the spring of 2019, 10 PConnect facilitators participated in a semi-structured interview about their experience. Interview transcripts were analyzed by two coders using an inductive-deductive hybrid analysis. Themes were identified and member-checked with two interviewees. Results Themes identified applied equally to parent and staff facilitators. Acceptability was high because PConnect facilitators were able to learn and teach, establish meaningful relationships, and positively impact the parents participating in their groups, although facilitators did express frustration when low attendance limited their reach. Appropriateness was also high, as PConnect provided adequate structure and support without being overly rigid, and facilitators were able to overcome most challenges they encountered. Conclusions The PConnect co-facilitation model was highly acceptable and appropriate for both the parent facilitators (peer leaders) and the staff facilitators. Including parents as peer leaders aligns to Head Start’s emphasis on parent engagement, making it a strong candidate for sustained implementation in Head Start. The insights gained about the drivers of peer leadership appropriateness and acceptability in this particular context may be used to inform the design and implementation of peer-led health programs elsewhere. Trial registration clinicaltrials.gov, NCT03334669 (7–11-17). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10159-3.
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Affiliation(s)
- Jacob P Beckerman-Hsu
- Boston College School of Social Work, McGuinn Hall 106K, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA.
| | - Cristina Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
| | - Alyssa Aftosmes-Tobio
- Boston College School of Social Work, McGuinn Hall 106K, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - Janine M Jurkowski
- Department of Health Policy, Management, & Behavior, University at Albany School of Public Health, 1 University Pl, Rensselaer, NY, 121440, USA
| | - Kindra Lansburg
- Action for Boston Community Development, 178 Tremont Street, Boston, MA, 02111, USA
| | - Jessie Leonard
- Community Action Agency of Somerville, 66 Union Square, Somerville, MA, 02143, USA
| | - Merieka Torrico
- Action for Boston Community Development, 178 Tremont Street, Boston, MA, 02111, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.,Harvard Center for Population & Development Studies, 9 Bow Street, Cambridge, MA, 02138, USA
| | - Erica L Kenney
- Department of Nutrition and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
| | - Kirsten K Davison
- Boston College School of Social Work, McGuinn Hall 106K, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
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Moadel-Robblee A, Camacho F, Milner GE, Kertzner A, Schlecht NF. Peer navigation-delivered loving kindness meditation: A pilot project. Complement Ther Med 2021; 57:102661. [PMID: 33418067 DOI: 10.1016/j.ctim.2021.102661] [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: 06/27/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022] Open
Abstract
Peer navigators (PNs), including trained cancer survivor volunteers, can be an important resource to the cancer care team in reducing barriers to screening, treatment, and psychosocial care among underserved communities through their roles in outreach, education, advocacy, and peer support. As cancer centers face growing patient demand and evidence for integrating complementary therapies into conventional care, opportunities to envision new roles for PN arise. Based on psychosocial assessments conducted at an academic cancer center serving the low-income population of Bronx, NY, we found strong interest in both providing (44 %) and receiving (76 %) peer support, as well as in (76 %) mind-body practices (e.g., meditation). In research, these mind-body modalities and peer support have both been found to improve many aspects of physical and emotional outcomes in cancer patients, but none has looked at PNs as a potential resource for delivering such mind-body interventions. Towards this end, we conducted two pilot studies to train PN from an onsite peer navigation program called the BOLD Buddy Program, to deliver a well-defined, easy to learn, and culturally-aligned mind-body practice, i.e., Loving Kindness (LK) Meditation, to each other and to patients. Incorporating comparison to professional meditation instructors, our pilot work demonstrated that peer-lead LKM was associated with benefits to emotional well-being, relaxation, satisfaction, and perceived usability and that PNs were equally well-received in delivering LK as their professional counterparts. Evaluating 8 domains of feasibility using standardized measures, we were able to demonstrate that peer-lead LK was: in demand, acceptable, implementable, practical, adaptable, adoptable, expandable, and promising in efficacy.
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Affiliation(s)
- Alyson Moadel-Robblee
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, United States; Albert Einstein Cancer Center, Montefiore Health System, Bronx, NY 10467, United States.
| | - Fernando Camacho
- Albert Einstein Cancer Center, Montefiore Health System, Bronx, NY 10467, United States
| | - Gabrielle E Milner
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, United States
| | - Alexander Kertzner
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, United States
| | - Nicolas F Schlecht
- Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention & Control, Elm & Carlton Streets, Buffalo, NY, 14263, United States
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Pomey MP, de Guise M, Desforges M, Bouchard K, Vialaron C, Normandin L, Iliescu-Nelea M, Fortin I, Ganache I, Régis C, Rosberger Z, Charpentier D, Bélanger L, Dorval M, Ghadiri DP, Lavoie-Tremblay M, Boivin A, Pelletier JF, Fernandez N, Danino AM. The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLE-onco): a longitudinal multiple case study protocol. BMC Health Serv Res 2021; 21:10. [PMID: 33397386 PMCID: PMC7780212 DOI: 10.1186/s12913-020-06009-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/09/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. METHODS/DESIGN We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients' experience of emotional support throughout their care trajectory. DISCUSSION This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.
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Affiliation(s)
- M P Pomey
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.
- Centre d'Excellence pour le Partenariat avec les Patients et le Public, 900, rue Saint-Denis, Porte S03.900, Montréal, Québec, H2X 0A9, Canada.
- École de santé publique de l'université de Montréal-Département de gestion, évaluation et politique de santé, 7101 Av du Parc, Montréal, Québec, H3N 1X9, Canada.
- Université de Montréal - Faculté de Médecine, 2900 boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada.
- Institut national d'excellence en santé et services sociaux (INESSS), 2021, avenue Union, 12e étage, bureau 1200, Montréal, Québec, H3A 2S9, Canada.
| | - M de Guise
- Institut national d'excellence en santé et services sociaux (INESSS), 2021, avenue Union, 12e étage, bureau 1200, Montréal, Québec, H3A 2S9, Canada
| | - M Desforges
- Centre Intégré Universitaire de santé et services sociaux de l'Est-de-l'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, 5415, boulevard de l'Assomption, Montréal, Québec, H1T 2M4, Canada
| | - K Bouchard
- CHU de Québec-Université Laval, 10, Rue de l'Espinay, Québec, Québec, G1L 3L5, Canada
| | - C Vialaron
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - L Normandin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - M Iliescu-Nelea
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - I Fortin
- Centre Intégré Universitaire de santé et services sociaux de l'Est-de-l'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, 5415, boulevard de l'Assomption, Montréal, Québec, H1T 2M4, Canada
| | - I Ganache
- Institut national d'excellence en santé et services sociaux (INESSS), 2021, avenue Union, 12e étage, bureau 1200, Montréal, Québec, H3A 2S9, Canada
| | - C Régis
- Université de Montréal - Faculté de Droit, 3101 chemin de la Tour, Montréal, Québec, H3T 1J7, Canada
| | - Z Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital & McGill University, Gerald Bronfman Department of Oncology, 5100 de Maisonneuve Blvd West, Montréal, Québec, H4A 3T2, Canada
| | - D Charpentier
- Centre Hospitalier Universitaire de Montréal (CHUM), 1000 rue Saint-Denis, Montréal, Québec, H2X 0C1, Canada
| | - L Bélanger
- CHU de Québec-Université Laval, 10, Rue de l'Espinay, Québec, Québec, G1L 3L5, Canada
| | - M Dorval
- CHU de Québec-Université Laval, 10, Rue de l'Espinay, Québec, Québec, G1L 3L5, Canada
- Université Laval - Faculté de pharmacie, 050, avenue de la Médecine, Québec, Québec, G1V 0A6, Canada
- Centre de recherche du CHU de Québec-Université Laval, 1050 chemin Sainte-Foy, Québec, Québec, G1S4L8, Canada
- Centre de recherche du CISSS Chaudière Appalaches, 143 rue Wolfe, Lévis, Québec, G6V 3Z1, Canada
| | - D P Ghadiri
- HEC Montréal, Department of management, 3000, chemin de la Côte-Sainte-Catherine, Montréal, Québec, H3T 2A7, Canada
| | - M Lavoie-Tremblay
- McGill University, Ingram School of Nursing (IsoN), 680 Sherbrooke Street West, Montreal, Québec, H3A 2M7, Canada
- Centre Universitaire de Santé McGill (CUSM), 1650, avenue Cedar, Montréal, Québec, H3G 1A4, Canada
| | - A Boivin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
- Centre d'Excellence pour le Partenariat avec les Patients et le Public, 900, rue Saint-Denis, Porte S03.900, Montréal, Québec, H2X 0A9, Canada
- Université de Montréal - Faculté de Médecine, 2900 boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada
| | - J F Pelletier
- Université de Montréal - Faculté de Médecine, 2900 boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada
- Centre de Recherche de l'Institut universitaire en santé mentale de Montréal, 7331 Rue Hochelaga, Montréal, Québec, H1N 3V2, Canada
| | - N Fernandez
- Université de Montréal - Faculté de Médecine, 2900 boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada
| | - A M Danino
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
- Centre Hospitalier Universitaire de Montréal (CHUM), 1000 rue Saint-Denis, Montréal, Québec, H2X 0C1, Canada
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Thomas TH, Donovan HS, Rosenzweig MQ, Bender CM, Schenker Y. A Conceptual Framework of Self-advocacy in Women With Cancer. ANS Adv Nurs Sci 2021; 44:E1-E13. [PMID: 33181568 PMCID: PMC7894983 DOI: 10.1097/ans.0000000000000342] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Researchers define self-advocacy as the ability of an individual with cancer to overcome challenges in getting their preferences, needs, and values met. While imperative in all health care settings, self-advocacy is especially important in cancer care. The goal of this article is to present a conceptual framework for self-advocacy in cancer. We review foundational studies in self-advocacy, define the elements of the conceptual framework, discuss underlying assumptions of the framework, and suggest future directions in this research area. This framework provides an empirical and conceptual basis for studies designed to understand and improve self-advocacy among women with cancer.
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Affiliation(s)
- Teresa H Thomas
- School of Nursing, University of Pittsburgh, Pennsylvania (Drs Thomas, Donovan, Rosenzweig, and Bender); and Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, Pennsylvania (Dr Schenker)
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Ellis KR, Black KZ, Baker S, Cothern C, Davis K, Doost K, Goestch C, Griesemer I, Guerrab F, Lightfoot AF, Padilla N, Samuel CA, Schaal JC, Yongue C, Eng E. Racial Differences in the Influence of Health Care System Factors on Informal Support for Cancer Care Among Black and White Breast and Lung Cancer Survivors. FAMILY & COMMUNITY HEALTH 2020; 43:200-212. [PMID: 32427667 PMCID: PMC7265975 DOI: 10.1097/fch.0000000000000264] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This retrospective, secondary qualitative analysis investigates whether health system factors influence social support among Black and white breast and lung cancer survivors and racial differences in support. These data come from race- and cancer-stratified focus groups (n = 6) and interviews (n = 2) to inform a randomized controlled trial utilizing antiracism and community-based participatory research approaches. Findings indicate social support was helpful for overcoming treatment-related challenges, including symptom management and patient-provider communication; racial differences in support needs and provision were noted. Resources within individual support networks reflect broader sociostructural factors. Reliance on family/friends to fill gaps in cancer care may exacerbate racial disparities.
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Affiliation(s)
| | - Kristin Z. Black
- College of Health and Human Performance, East Carolina University
| | | | - Carol Cothern
- Greensboro Health Disparities Collaborative, Greensboro, North Carolina
| | - Kia Davis
- School of Medicine, Washington University
| | - Kay Doost
- Greensboro Health Disparities Collaborative, Greensboro, North Carolina
| | - Christina Goestch
- Greensboro Health Disparities Collaborative, Greensboro, North Carolina
| | - Ida Griesemer
- Department of Health Behavior, University of North Carolina
| | - Fatima Guerrab
- Department of Health Behavior, University of North Carolina
| | - Alexandra F. Lightfoot
- Department of Health Behavior, University of North Carolina
- Center for Health Promotion and Disease Prevention, University of North Carolina
| | - Neda Padilla
- Department of Health Policy and Management, University of North Carolina
| | - Cleo A. Samuel
- Department of Health Policy and Management, University of North Carolina
| | | | - Christina Yongue
- Department of Public Health Education, University of North Carolina at Greensboro
| | - Eugenia Eng
- Department of Health Behavior, University of North Carolina
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Walshe C, Roberts D, Calman L, Appleton L, Croft R, Skevington S, Lloyd-Williams M, Grande G, Perez Algorta G. Peer support to maintain psychological wellbeing in people with advanced cancer: findings from a feasibility study for a randomised controlled trial. BMC Palliat Care 2020; 19:129. [PMID: 32807157 PMCID: PMC7433175 DOI: 10.1186/s12904-020-00631-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 08/07/2020] [Indexed: 12/12/2022] Open
Abstract
Background Advanced cancer affects people’s lives, often causing stress, anxiety and depression. Peer mentor interventions are used to address psychosocial concerns, but their outcomes and effect are not known. Our objective was to determine the feasibility of delivering and investigating a novel peer mentor intervention to promote and maintain psychological wellbeing in people with advanced cancer. Methods A mixed methods design incorporating a two-armed controlled trial (random allocation ratio 1:1) of a proactive peer mentor intervention plus usual care, vs. usual care alone, and a qualitative process evaluation. Peer mentors were recruited, trained, and matched with people with advanced cancer. Quantitative data assessed quality of life, coping styles, depression, social support and use of healthcare and other supports. Qualitative interviews probed experiences of the study and intervention. Results Peer mentor training and numbers (n = 12) met feasibility targets. Patient participants (n = 12, from 181 eligible who received an information pack) were not recruited to feasibility targets. Those who entered the study demonstrated that intervention delivery and data collection were feasible. Outcome data must be treated with extreme caution due to small numbers, but indicate that the intervention may have a positive effect on quality of life. Conclusions Peer mentor interventions are worthy of further study and researchers can learn from these feasibility data in planning participant recruitment and data collection strategies. Pragmatic trials, where the effectiveness of an intervention is tested in real-world routine practice, may be most appropriate. Peer mentor interventions may have merit in enabling survivors with advanced cancer cope with their disease. Trial Registration The trial was prospectively registered 13.6.2016: ISRCTN10276684.
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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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Henckel C, Revette A, Huntington SF, Tulsky JA, Abel GA, Odejide OO. Perspectives Regarding Hospice Services and Transfusion Access: Focus Groups With Blood Cancer Patients and Bereaved Caregivers. J Pain Symptom Manage 2020; 59:1195-1203.e4. [PMID: 31926969 PMCID: PMC7239741 DOI: 10.1016/j.jpainsymman.2019.12.373] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 01/31/2023]
Abstract
CONTEXT Patients with blood cancers have low rates of timely hospice use. Barriers to hospice use for this population are not well understood. Lack of transfusion access in most hospice settings is posited as a potential reason for low and late enrollment rates. OBJECTIVES We explored the perspectives of patients with blood cancers and their bereaved caregivers regarding the value of hospice services and transfusions. METHODS Between June 2018 and January 2019, we conducted three focus groups with blood cancer patients with an estimated life expectancy of six months or less and two focus groups with bereaved caregivers of patients with blood cancers. We asked participants their perspectives regarding quality of life (QOL) and about the potential association of traditional hospice services and transfusions with QOL. A hematologic oncologist, sociologist, and qualitatively trained research assistant conducted thematic analysis of the data. RESULTS Twenty-seven individuals (18 patients and nine bereaved caregivers) participated in the five focus groups. Participants identified various QOL domains that were important to them but focused largely on a desire for energy to maintain physical/functional well-being. Participants considered transfusions a high-priority service for their QOL. They also felt that standard hospice services were important for QOL. Bereaved caregivers reported overall positive experiences with hospice. CONCLUSION Our analysis suggests that although patients with blood cancers value hospice services, they also consider transfusions vital to their QOL. Innovative care delivery models that combine the elements of standard hospice services with other patient-valued services like transfusions are most likely to optimize end-of-life care for patients with blood cancers.
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Affiliation(s)
| | - Anna Revette
- Dana-Farber/Harvard Cancer Center Survey and Data Management Core, Boston, Massachusetts, USA
| | | | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Division of Palliative Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - Gregory A Abel
- Harvard Medical School, Boston, Massachusetts, USA; Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Oreofe O Odejide
- Harvard Medical School, Boston, Massachusetts, USA; Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
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Yoshioka K, Manne-Goehler J, Maguire JH, Reich MR. Access to Chagas disease treatment in the United States after the regulatory approval of benznidazole. PLoS Negl Trop Dis 2020; 14:e0008398. [PMID: 32569280 PMCID: PMC7347212 DOI: 10.1371/journal.pntd.0008398] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 07/09/2020] [Accepted: 05/18/2020] [Indexed: 01/06/2023] Open
Abstract
Approximately 300,000 persons in the United States (US) are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease, but less than 1% are estimated to have received antiparasitic treatment. Benznidazole was approved by the US Food and Drug Administration (FDA) for treatment of T. cruzi infection in 2017 and commercialized in May 2018. This paper analyzes factors that affect access to benznidazole following commercialization and suggests directions for future actions to expand access. We applied an access framework to identify barriers, facilitators, and key actors that influence the ability of people with Chagas disease to receive appropriate treatment with benznidazole. Data were collected from the published literature, key informants, and commercial databases. We found that the mean number of persons who obtained benznidazole increased from just under 5 when distributed by the CDC to 13 per month after the commercial launch (from May 2018 to February 2019). Nine key barriers to access were identified: lack of multi-sector coordination, failure of health care providers to use a specific order form, lack of an emergency delivery system, high medical costs for uninsured patients, narrow indications for use of benznidazole, lack of treatment guidelines, limited number of qualified treaters, difficulties for patients to make medical appointments, and inadequate evaluation by providers to determine eligibility for treatment. Our analysis shows that access to benznidazole is still limited after FDA approval. We suggest six areas for strategic action for the pharmaceutical company that markets benznidazole and its allied private foundation to expand access to benznidazole in the US. In addition, we recommend expanding the existing researcher-clinician network by including government agencies, companies and others. This paper's approach could be applied to access programs for benznidazole in other countries or for other health products that target neglected populations throughout the world.
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Affiliation(s)
- Kota Yoshioka
- Doctor of Public Health Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Jennifer Manne-Goehler
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - James H. Maguire
- Division of Infectious Disease, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Michael R. Reich
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Grunberg PH, Dennis CL, Da Costa D, Gagné K, Idelson R, Zelkowitz P. Development and evaluation of an online infertility peer supporter training program. PATIENT EDUCATION AND COUNSELING 2020; 103:1005-1012. [PMID: 31761526 DOI: 10.1016/j.pec.2019.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/09/2019] [Accepted: 11/16/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To outline the development and evaluation of an online infertility peer supporter training program. METHODS Men and women with diverse infertility backgrounds were recruited and trained to provide online peer support to people undergoing fertility treatment. Training required volunteers to (1) read a peer support training manual, (2) watch a webinar, and (3) complete practice questions, each of which was evidence-based and reviewed by key stakeholders. RESULTS Seventeen women and one man were trained and provided online peer support. Program satisfaction was high and training materials were rated as helpful. Peer supporters felt comfortable providing support and having their discussions monitored. They liked helping others and the convenience of a mobile application. CONCLUSION Online recruitment and training of infertility peer supporters is feasible. The current program was acceptable and offers steps for improving future online peer support interventions. PRACTICE IMPLICATIONS Current evidence supports the acceptability and feasibility of this training and supervision program, and provides service providers with information guiding its development and implementation.
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Affiliation(s)
- Paul H Grunberg
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, H3A 1G1, Canada; Department of Psychiatry, Jewish General Hospital, Montreal, 4333 Cote Ste. Catherine Road, H3T 1E4, Canada
| | - Cindy-Lee Dennis
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, 155 College St. Suite 130, Toronto, M5T 1P8, Canada
| | - Deborah Da Costa
- McGill University, Department of Medicine, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 Boulevard de Maisonneuve O, Montreal, QC H4A 3S5, Canada
| | - Karolanne Gagné
- Department of Psychiatry, Jewish General Hospital, Montreal, 4333 Cote Ste. Catherine Road, H3T 1E4, Canada
| | - Rachel Idelson
- Department of Psychiatry, Jewish General Hospital, Montreal, 4333 Cote Ste. Catherine Road, H3T 1E4, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, Jewish General Hospital, Montreal, 4333 Cote Ste. Catherine Road, H3T 1E4, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine Road, Montreal, H3T1E2, Canada.
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Effect of a brief physical activity-based presentation by a former patient for men treated with radical prostatectomy for prostate cancer: a mixed methods pilot study. Support Care Cancer 2020; 29:145-154. [PMID: 32323003 PMCID: PMC7686188 DOI: 10.1007/s00520-020-05455-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/01/2020] [Indexed: 11/17/2022]
Abstract
Purpose Existing research indicates that physical activity (PA) is beneficial to men with prostate cancer (PCa). We examined the potential of a single-contact peer-support-based behavioural intervention to promote PA engagement in men treated for PCa. Methods A mixed methods design was employed, comprising a two-arm pragmatic trial and semi-structured interviews. The intervention was a 10-min PA-based presentation by a former patient, delivered in group seminars that are provided for patients as standard care. Seminars were alternately allocated to (a) cancer exercise specialist talk + patient speaker talk or (b) cancer exercise specialist talk only. Self-reported PA, exercise motivation, quality of life, fatigue and clinical and demographic characteristics were obtained from n = 148 (intervention: n = 69; control: n = 79) patients immediately prior to the seminar, and at follow-up ≈ 100 days later. Data were analysed using ANCOVA models and χ2 tests. Fourteen semi-structured interviews with intervention participants, which explored how the intervention was experienced, were analysed using a grounded theory-style approach. Results The intervention had no significant effect on quantitatively self-reported PA (p = 0.4). However, the intervention was statistically and clinically beneficial for fatigue (p = 0.04) and quality of life (p = 0.01). Qualitative analysis showed that the intervention was beneficial to psychological wellbeing and some participants had increased intention to engage in PA as a result of the intervention. Conclusions A brief one-off PA-based presentation for men with PCa, delivered by a former patient alongside cancer exercise specialist advice, may result in clinically significant benefits to quality of life and may influence PA intention in certain individuals. Electronic supplementary material The online version of this article (10.1007/s00520-020-05455-4) contains supplementary material, which is available to authorized users.
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Dawson C, Roe J, Starmer H, Brady G, Nund R, Coffey M, Govender R, Patterson JM, Nankivell P, Topping A, Sharma N, Parmar S, Elkington C, Merrit M, Stanbury D, Pracy P. Patient advocacy in head and neck cancer: Realities, challenges and the role of the multi‐disciplinary team. Clin Otolaryngol 2020; 45:437-444. [DOI: 10.1111/coa.13508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/12/2020] [Indexed: 12/17/2022]
Affiliation(s)
| | - Justin Roe
- Department of Speech & Language Therapy The Royal Marsden NHS Foundation Trust London UK
- Department of Surgery and Cancer Imperial College Healthcare NHS Trust London UK
- National Centre for Airway ReconstructionImperial College Healthcare Trust London UK
| | - Heather Starmer
- Department of Otolaryngology and Head and Neck Cancer Speech and Swallowing Rehabilitation Stanford Cancer Center CA USA
| | - Grainne Brady
- Department of Speech and Language Therapy The Royal Marsden NHS Foundation Trust London UK
| | - Rebecca Nund
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Qld. Australia
| | | | - Roganie Govender
- University College London Hospital NHS Foundation Trust London UK
| | | | | | | | - Neil Sharma
- Queen Elizabeth Hospital Birmingham Birmingham UK
| | - Sat Parmar
- Queen Elizabeth Hospital Birmingham Birmingham UK
| | | | | | | | - Paul Pracy
- Queen Elizabeth Hospital Birmingham Birmingham UK
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Galica J, Giroux J, Francis JA, Maheu C. Coping with fear of cancer recurrence among ovarian cancer survivors living in small urban and rural settings: A qualitative descriptive study. Eur J Oncol Nurs 2019; 44:101705. [PMID: 32006720 DOI: 10.1016/j.ejon.2019.101705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/15/2019] [Accepted: 11/26/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is a paramount concern among ovarian cancer survivors. Evidence shows that cancer survivors living in regional or rural areas have higher psychological morbidity; however, no known studies have explored how ovarian cancer survivors living in small urban and rural areas cope with FCR. METHODS In this qualitative descriptive study, a semi-structured questioning process was developed in accordance with Carver et al.'s conceptualization of coping. Focus groups or 1:1 telephone interviews were used to collect data from a convenience sample of ovarian cancer survivors. Participants completed a demographic form and the Fear of Cancer Recurrence Inventory, and clinical information was extracted from hospital charts. RESULTS The average age of participants (n = 15) was 62.8 years (Range 51-76 years) and the average time since diagnosis was 2.7 years (Range 1-19 years). Most women had elevated levels of FCR. Five themes for coping were expressed by all women: 1) health care provider support; 2) knowing, trusting, and prioritizing self; 3) finding what works; 4) uniqueness and belonging; and 5) redirecting thoughts and actions. One additional theme was expressed by most women (n = 11): 6) preparing for the future. CONCLUSION Fear of cancer recurrence was a concern for most ovarian cancer survivors who used a variety of ways to cope. Results can be used to guide nurses' discussions with post-treatment ovarian cancer survivors or be used to inform refinement and development of resources to assist ovarian cancer survivors living in small urban and rural settings to cope with FCR.
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Affiliation(s)
- Jacqueline Galica
- School of Nursing, Queen's University, 92 Barrie Street, Kingston, Ontario, K7L 3N6, Canada; Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, 10 Stuart Street, Kingston, Ontario, K7L 3N6, Canada.
| | - Janet Giroux
- School of Nursing, Queen's University, 92 Barrie Street, Kingston, Ontario, K7L 3N6, Canada; Kingston Health Sciences Centres, Department of Obstetrics and Gynecology, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada
| | - Julie-Ann Francis
- Lakeridge Health Oshawa, Division of Gynecologic Oncology, 1 Hospital Court, Oshawa, Ontario, L1G 2B9, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, 680 Sherbrooke West #1800, Montréal, Québec, H3A 2M7, Canada
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Magasi S, Banas J, Horowitz B, Reis JP, The K, Wilson T, Victoson D. WeCanConnect: Development of a Community-Informed mHealth Tool for People with Disabilities and Cancer. Prog Community Health Partnersh 2019; 13:49-59. [PMID: 31378735 DOI: 10.1353/cpr.2019.0038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cancer care for people with disabilities (PWD) is rife with uncertainty and obstacles. Not only do PWD have to contend with cancer and treatment-related sequelae, but also its impact on disabling conditions and functional capacity, as well as a health care system lacking accessibility and disability competence. Peer support can address important needs for emotional and informational support. mHealth tools for smart phones, tablets, or laptops hold promise to deliver such support in an accessible and scalable manner. This concept is unexplored for use among PWD with cancer. OBJECTIVES To describe a community-based participatory study that 1) identifies consumer-reported support needs and priorities among PWD and cancer and 2) integrates consumer perspectives into the design of an mHealth cancer support tool to address these needs and priorities. METHODS Part 1 is a thematic analysis of semistructured, qualitative interviews with a purposive sample of experts in health and cancer care for PWD (n = 7) and a convenience sample of cancer survivors with preexisting disabilities (n = 9). In part 2, results were integrated to develop an mHealth peer support tool to addresses identified needs. RESULTS Themes included 1) barriers across the cancer care continuum, 2) strengths within the disability community, and 3) recommendations for mHealth and peer support. Based on the qualitative findings, we designed a mHealth tool for peer support and information sharing among PWD with cancer. CONCLUSION Consumer-informed mHealth tools hold great potential to leverage strengths in the disability community to address emotional and informational needs created by a lack of disability competence across the cancer care continuum.
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