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Siao CL, Chang WC, Chen CH, Lee YH, Lai YH. Symptoms, distress, finances, social support, resource utilization, and unmet care needs of patients with gynecological cancer. Eur J Oncol Nurs 2024; 72:102686. [PMID: 39317144 DOI: 10.1016/j.ejon.2024.102686] [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: 05/27/2024] [Revised: 08/09/2024] [Accepted: 08/17/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE This study explored the unmet care needs of gynecological cancer patients, including overall and subdomain needs (i.e., physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and information needs), and related factors. METHODS In this cross-sectional study, gynecological cancer patients treated at a medical center in northern Taiwan were recruited. Data on demographics, symptoms, distress, finances, social support, resource utilization, and care needs were collected. Spearman's correlation and the Mann-Whitney U test were used for analysis. RESULTS This study of 118 cancer patients found that 73% had unmet psychological and emotional needs, followed by 54% with unmet health system and information needs. The most common physical symptoms were insomnia, fatigue, and pain, with 51.7% experiencing moderate or high levels of distress. Overall, the patients received considerable social support, both instrumental and emotional, primarily through medical information booklets (39.0%), cancer information websites (28.8%), and rehabilitative resources (20.3%). Factors associated with unmet care needs included younger age, non-ovarian cancer, symptoms (pain, fatigue, appetite loss, insomnia, dyspnea, nausea, and vomiting), distress, finances, social support, and the use of cancer information websites. CONCLUSION Psychological and emotional unmet needs is prevalent among patients with gynecological cancer; psychological support is crucial. Younger patients and those with non-ovarian cancer had more unmet care needs. These needs are linked to severe symptoms, distress, financial difficulties, limited social support, and low use of cancer information websites. Enhancing support for this population through targeted interventions is necessary.
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Affiliation(s)
- Chia-Li Siao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Wen-Chun Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chi-Hau Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Yun-Hsiang Lee
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
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Sun CX, Ni XY, Gui SJ, Wu F, Pan RJ, Gui M, Lei XH, Wang MY, Li XS, Zeng GQ. Effects of an explain-simulate-practice-communicate-support intervention on quality of life for patients with chronic heart failure: A randomized control trial. Heliyon 2024; 10:e25313. [PMID: 38333861 PMCID: PMC10850896 DOI: 10.1016/j.heliyon.2024.e25313] [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: 12/14/2022] [Revised: 12/18/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Background Patients with New York Heart Association (NYHA) grade III chronic heart failure (CHF) present with low capacity for daily activities, severe self-perceived burden, and poor quality of life. Effective nursing interventions may reduce patients' self-perceived burden and improve their quality of life. Objectives To explore the effects of an explain-simulate-practice-communicate-support intervention on the self-perceived burden, cardiac function, and activities of daily living (ADL) ability in patients with New York Heart Association grade III chronic heart failure. Methods Of the 100 patients with New York Heart Association grade III chronic heart failure who were electronically randomized and equally divided into control and intervention groups, data from 88 patients who completed our study were analyzed. The primary outcome was quality of life; secondary outcomes were self-perceived burden, 6-min walking test distances, serum N-terminal pro-brain natriuretic peptide levels, New York Heart Association cardiac function classification, and ability to perform activities of daily living. Results After 12 weeks' intervention, the intervention group had significantly lower self-perceived burden, Minnesota Living with Heart Failure Questionnaire scores, N-terminal pro-brain natriuretic peptide levels, and New York Heart Association grades compared with the control group, while 6-min walking test distances, left ventricular ejection fraction, and modified Barthel Index scale scores were significantly higher than those in the control group (P > 0.05). Conclusions The explain-simulate-practice-communicate-support intervention improved patients' quality of life through reducing the level of self-perceived burden, and improving cardiac function and activities of daily living ability. This intervention was found to be effective for patients with New York Heart Association grade III chronic heart failure.
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Affiliation(s)
- Cai-Xia Sun
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Joint Training Base for Nursing Postgraduates By University of South China and TD Care, Intelligent Nursing Research Center of Hunan Province, Hengyang, Hunan, 421001, China
| | - Xiao-Yan Ni
- The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Si-Jie Gui
- The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Fei Wu
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Joint Training Base for Nursing Postgraduates By University of South China and TD Care, Intelligent Nursing Research Center of Hunan Province, Hengyang, Hunan, 421001, China
| | - Rong-Jia Pan
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Min Gui
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Xiu-Hong Lei
- The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Man-Yi Wang
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Xiao-Shan Li
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Gu-Qing Zeng
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Joint Training Base for Nursing Postgraduates By University of South China and TD Care, Intelligent Nursing Research Center of Hunan Province, Hengyang, Hunan, 421001, China
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Psychological Distress and Its Association with Unmet Needs and Symptom Burden in Outpatient Cancer Patients: A Cross-Sectional Study. Semin Oncol Nurs 2021; 37:151214. [PMID: 34483014 DOI: 10.1016/j.soncn.2021.151214] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the relationships of sociodemographic and clinical characteristics, symptom burden, and supportive care needs of patients with a prevalence of psychological distress in outpatients with cancer. DATA SOURCES The study was carried out with 298 outpatient cancer patients at an oncology center in Turkey, and a descriptive correlational design was used. The data were collected through Hospital Anxiety-Depression Scale (HADS), Nightingale Symptom Assessment Scale (N-SAS), and Supportive Care Needs Scale Short Form (SCNS-SF34). Descriptive statistics and hierarchical regression analyses were performed. CONCLUSION The study determined that the anxiety and depression scores of a significant portion of cancer patients receiving outpatient treatment were clinically significant. It was observed that the physical and psychological symptom burden of the patients and the increase in unmet care needs related to psychological, physical, and activities of daily life contributed to the development of anxiety and depression. Of the sociodemographic and disease-related characteristics of the patients, female sex was found to be an important factor for both anxiety and depression, and advanced age was found to be an important factor for depression. These results indicate that cancer patients receiving outpatient treatment need intensive supportive psychosocial care. IMPLICATIONS FOR NURSING PRACTICE It is recommended that patients' psychological distress levels and supportive care needs be included in the care process as a routine component of care, as in symptom assessment, and to develop a more sensitive and supportive care environment in meeting psychosocial care needs and accessing support.
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Clinton-McHarg T, Paul C, Sanson-Fisher R, Turon H, Butler M, Lindeman R. Are the Physical Environments of Treatment Centres Meeting Recommendations for Patient-Centred Care? Perceptions of Haematological Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094892. [PMID: 34064433 PMCID: PMC8125011 DOI: 10.3390/ijerph18094892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/26/2021] [Accepted: 04/30/2021] [Indexed: 11/16/2022]
Abstract
The physical environment of a treatment centre may impact the well-being of patients and their perceptions of care. Outpatients with haematological cancer may be in contact with the treatment centre over long periods and could be particularly affected. This study aimed to identify haematological cancer patients' perceptions of supportive design elements in the hospital they attended and associations with self-reported mood or well-being. Outpatients from three large metropolitan hospitals in Australia were mailed a self-report questionnaire and responded to statements about the treatment centre concerning their sense of control over the physical surroundings; access to social support; and access to positive distractions. Participants also reported whether they felt the overall environment affected their mood or wellbeing. Of the outpatients who returned the questionnaire (n = 165), almost one-quarter (24%) agreed that the physical environment of the hospital affected their mood or well-being. Patients who disagreed that the hospital was a comfortable temperature or agreed that waiting rooms were crowded had significantly higher odds of reporting that the treatment environment affected their mood or wellbeing. Implementing systems to reduce overcrowding in waiting rooms and increasing patient control over personal temperature in clinics may be the most effective strategies to improve patient wellbeing.
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Affiliation(s)
- Tara Clinton-McHarg
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (C.P.); (R.S.-F.); (H.T.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Psychology, The University of Newcastle, Callaghan, NSW 2308, Australia
- Correspondence:
| | - Christine Paul
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (C.P.); (R.S.-F.); (H.T.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Rob Sanson-Fisher
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (C.P.); (R.S.-F.); (H.T.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Heidi Turon
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (C.P.); (R.S.-F.); (H.T.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Michelle Butler
- Hunter New England Population Health, Wallsend, NSW 2287, Australia;
| | - Robert Lindeman
- Department of Haematology, Prince of Wales Hospital, Randwick, NSW 2031, Australia;
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Kamışlı S, Gökler B. Adjustment to life with metastatic cancer through psychodrama group therapy: A qualitative study in Turkey. Perspect Psychiatr Care 2021; 57:488-498. [PMID: 33118158 DOI: 10.1111/ppc.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This study describes the experiences of patients with metastatic cancer participating in psychodrama group therapy. DESIGN AND METHODS This study was carried out at the cancer hospital of the university, Turkey. The sample consisted of patients with metastatic cancer who participated in 16 weekly psychodrama sessions of 3 h each. The study was analyzed using the NVivo 11 software, the sessions which summarize and code the interviews. FINDINGS Five main themes were identified: Anxiety of death, coping strategies, psychological resilience, relieving suffering, and the meaning of life. PRACTICE IMPLICATIONS Psychodrama can be used in patients diagnosed with metastatic and other types of cancer to cope with their psychosocial difficulties. Psychiatric nurses can play a leading role in this area.
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Affiliation(s)
- Songül Kamışlı
- Department of Gerontology, Faculty of Health Sciences, Cankırı Karatekin University, Çankırı, Turkey
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Rai P, Shen C, Kolodney J, Kelly KM, Scott VG, Sambamoorthi U. Prevalence and risk factors for multimorbidity in older US patients with late-stage melanoma. J Geriatr Oncol 2020; 12:388-393. [PMID: 32988783 DOI: 10.1016/j.jgo.2020.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/06/2020] [Accepted: 09/16/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Presence of multimorbidity can affect prognosis, treatment, and outcomes of individuals with cancer. However, the prevalence and factors associated with multimorbidity among older late-stage melanoma is not well studied. We estimated the prevalence of any type of pre-existing multimorbidity (autoimmune disorder (AD), physical health conditions (PHC), and mental health conditions (MHC)) among older adults with late-stage melanoma in the United States. We further examined the association of patient-level factors to multimorbidity in late-stage melanoma. METHODS We derived data on older fee-for-service Medicare beneficiaries (age ≥ 66 years) diagnosed with late-stage melanoma between 2011 and 2015 (N = 4,519) from the linked Surveillance, Epidemiology, and End Results cancer registry and Medicare claims. We defined multimorbidity as the prevalence of two or more chronic conditions prior to the diagnosis of melanoma. We used unadjusted and adjusted logistic regressions to examine the association of patient-level factors to multimorbidity. RESULTS An overwhelming majority (85%) of older patients with late-stage melanoma had multimorbidity. Pre-existing PHC multimorbidity (84%) was the most prevalent, followed by AD (12%), and MHC (6%). Age and region were associated with any and PHC multimorbidity. Sex, marital status, and region were factors associated with pre-existing AD while sex, marital status, and dual eligibility were associated with MHC multimorbidity. CONCLUSIONS Pre-existing multimorbidity was highly prevalent among older individuals with late-stage melanoma; prevalence rates and factors associated with multimorbidity varied by type of chronic conditions. This highlights the need for developing systematic approaches to optimizing care of older patients with late-stage melanoma and multimorbidity.
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Affiliation(s)
- Pragya Rai
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, United States.
| | - Chan Shen
- Department of Surgery Chief, Division of Outcomes, Research and Quality Cancer Institute, Cancer Control Penn State Cancer Institute, Hershey, PA, United States
| | - Joanna Kolodney
- Department of Medicine, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Kimberly M Kelly
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, United States
| | - Virginia G Scott
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, United States
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, United States
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