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Shin A, Banubakode S, Taveras Alam S, Gonzalez AO. Evaluating the Readability of Online Blood Cancer Education Materials Across Different Readability Measures. Cureus 2024; 16:e58488. [PMID: 38765438 PMCID: PMC11101262 DOI: 10.7759/cureus.58488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction The National Institutes of Health and the American Medical Association recommend patient education materials (EMs) be at or below the sixth-grade reading level. The American Cancer Society, Leukemia & Lymphoma Society, and National Comprehensive Cancer Network have accurate blood cancer EMs. Methods One hundred one (101) blood cancer EMs from the above organizations were assessed using the following: Flesch Reading Ease Formula (FREF), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook Index (SMOG), and the Coleman-Liau Index (CLI). Results Only 3.96% of patient EMs scored at or below the seventh-grade reading level in all modalities. Healthcare professional education materials (HPEMs) averaged around the college to graduate level. For leukemia and lymphoma patient EMs, there were significant differences for FKGL vs. SMOG, FKGL vs. GFI, FKGL vs. CLI, SMOG vs. CLI, and GFI vs. CLI. For HPEMs, there were significant differences for FKGL vs. GFI and GFI vs. CLI. Conclusion The majority of patient EMs were above the seventh-grade reading level. A lack of easily readable patient EMs could lead to a poor understanding of disease and, thus, adverse health outcomes. Overall, patient EMs should not replace physician counseling. Physicians must close the gaps in patients' understanding throughout their cancer treatment.
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Affiliation(s)
- Ashley Shin
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Surbhi Banubakode
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Sara Taveras Alam
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Anneliese O Gonzalez
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
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Bozovic Spasojevic I, Ferrari A, De Munter J, Gamble A, Konsoulova-Kirova A, Rizvi K, Schneider C, Balsat M, Castleton A, Gofti-Laroche L, Kienesberger A, Timmermann B, Vormoor J, Saloustros E, Stark DP. Have we made progress in taking care of adolescents and young adults with cancer? Results of a European multi-professional survey. TUMORI JOURNAL 2023; 109:546-554. [PMID: 37486101 DOI: 10.1177/03008916231183477] [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] [Indexed: 07/25/2023]
Abstract
BACKGROUND It is well documented that traditional health care models do not meet the specific needs of Adolescents and Young Adults (AYA) cancer patients. METHODS We explore a map of the development of age-specific AYA cancer care across Europe, from the perspective of healthcare professionals with an interest in AYA care, in order to understand the specific challenges and map progress over time. An on-line survey was developed by international professional cancer organisations. RESULTS We had 377 respondents from 60 countries. The majority of respondents were physicians 298 (79%), a minority of survey respondents (39, 10.4%) work exclusively with AYA patients, most respondents declared substantial and routine clinical service collaborations to provide care and treatment to AYA with cancer. Policy for the multidisciplinary management of AYA cancer patients commonly appears in Europe now, and was reported by 234 (78.52%) respondents. Specific professional training for AYA cancer care is not uniformly available. CONCLUSION There is considerable opportunity for many organisations to work together in raising the profile of AYA cancer related issues, in providing education and in encouraging research and collaboration.
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Affiliation(s)
- Ivana Bozovic Spasojevic
- Medical Oncology Department, Institute for Oncology and Radiology of Serbia, Belgrade, Republic of Serbia
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Johan De Munter
- University Hospital Ghent Cancer Center, Ghent, Belgium
- European Oncology Nursing Society
| | - Ashley Gamble
- Children's Cancer and Leukaemia Group, Leicester, UK
| | | | | | | | - Marie Balsat
- Department of Hematology, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - Leila Gofti-Laroche
- Department of Public Health-University of Grenoble Alps, AYA Unit-Centre Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
| | | | - Beate Timmermann
- University Medicine Essen, Clinic for Particle Therapy, West German Proton Therapy Center Essen, Essen, Germany
| | - Josef Vormoor
- Princess Máxima Center for Pediatric Oncology and University Medical Center Utrecht, Netherlands
| | | | - Daniel P Stark
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK
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3
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Tremolada M, Taverna L, Vietina F, Incardona RM, Pierobon M, Bonichini S, Biffi A, Bisogno G. Adolescents and young adults with oncohematological disease: use of social networks, impact of SARS-COV-2, and psychosocial well-being. Front Psychiatry 2023; 14:1239131. [PMID: 38025461 PMCID: PMC10646548 DOI: 10.3389/fpsyt.2023.1239131] [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: 06/17/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Adolescents and young adults (AYA) with oncohematological diseases could have important psychosocial difficulties that could be worsened by the effects of the COVID19 pandemic. At this developmental stage, it is also important to assess the use of social networks (SNs). This study aims to investigate the type of social network use and the consequences of the COVID19 period. These patients are compared with matched healthy peers. Methods After the informant consent signature, the adolescents completed a series of self-report questionnaires on the use of SNs, on communication preferences, on social anxiety and on Covid19 impact through the online platform of LimeSurvey. Most of the adolescents belonged to the 18-20 age group (42.5%), were female (62%) and mainly off therapy (72%). Results Adolescents spent more than 2 h/day on Instagram and 1 h and half on Whatsapp, while Tik Tok use was on average 1 h/day, especially used by younger patients (r = -0.33, p = 0.023). Males used Twitch (t45 = -2.06, p = 0.05) and Youtube (t45 = -2.18, p = 0.03) for longer than females. AYA in therapy used more Tik Tok (U = 137.50; p = 0.03), Ask/Tellonym (U = 172.50; p = 0.05) and Twitch (U = 144; p = 0.017) than those off therapy. Healthy AYA showed lower levels of exposure (Z = -4.17; p = 0.00001) and impact (Z = -5.12; p = 0.00001) to Covid19, while the level of social anxiety is comparable and is in the normal range in both groups. Discussion Some clinical considerations and suggestions could be given based on these empirical results to health professionals in the care of AYA cancer patients.
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Affiliation(s)
- Marta Tremolada
- Department of Developmental Psychology and Socialization, School of Psychology, University of Padua, Padua, Italy
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Livia Taverna
- Faculty of Education, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Francesco Vietina
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Roberta Maria Incardona
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Marta Pierobon
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Sabrina Bonichini
- Department of Developmental Psychology and Socialization, School of Psychology, University of Padua, Padua, Italy
| | - Alessandra Biffi
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Gianni Bisogno
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
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4
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Cheung CK, Norlander MG, Vest AN, Thomas BN, Zebrack BJ. A Thin Line Between Helpful and Harmful Internet Usage: Embodied Research on Internet Experiences Among Adolescent and Young Adult Cancer Patients. J Adolesc Young Adult Oncol 2022; 11:478-485. [PMID: 34882036 PMCID: PMC11071103 DOI: 10.1089/jayao.2021.0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The purpose of this study was to expand upon findings from a prior Delphi study of adolescent and young adults' (AYAs') preferences for cancer resources. Utilizing an embodied approach, this study intended to elucidate a deeper and nuanced understanding of the expressed benefits and risks of engaging in cancer-related online interactions. Methods: Using Gale et al.'s framework method for qualitative, multidisciplinary health research and Thanem and Knights's embodied research methods for the social sciences, an investigative team of embodied researchers (AYA cancer patients turned researchers) conducted semistructured in-depth interviews with AYA cancer patients (n = 10) diagnosed between ages 15 and 39 years. To generate themes, researchers identified commonalities and differences within the qualitative data, and indexed codes according to the agreed analytic framework. Furthermore, by fully engaging with personal reflexivity, bracketing, and analytic memos across data collection and analysis, the investigative team elucidated benefits and risks of embodied research. Results: Findings impart evidence on AYAs' needs for internet-based content at the time of cancer diagnosis, use of the internet to fulfill cancer-related needs, perception of gaps in online cancer resources, and advice to other AYA cancer patients accessing internet-based information and support. Content analysis of interview data on participants' descriptions of personal engagement with the internet revealed beneficial themes of empowerment and harmful themes of fear-inducing consequences. Conclusions: In our rapidly evolving context of postpandemic internet reliance, developers of online cancer content should prioritize and respond to the nuanced vulnerabilities of AYAs. Future research must include socioeconomically disadvantaged participants to better understand practical challenges and promote health equity.
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Affiliation(s)
| | | | - Adriana N. Vest
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Bria N. Thomas
- Loyola University Maryland, Department of Biology and Department of Psychology, Baltimore, Maryland, USA
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Watanabe T, Yada S, Aramaki E, Yajima H, Kizaki H, Hori S. Extracting Multiple Worries from Breast Cancer Patient Blogs Using Multi-Label Classification with a Natural Language-Processing Model BERT (Bidirectional Encoder Representations from Transformers): Infodemiology Study of Blogs (Preprint). JMIR Cancer 2022; 8:e37840. [PMID: 35657664 PMCID: PMC9206207 DOI: 10.2196/37840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/10/2022] [Accepted: 05/23/2022] [Indexed: 12/26/2022] Open
Abstract
Background Patients with breast cancer have a variety of worries and need multifaceted information support. Their accumulated posts on social media contain rich descriptions of their daily worries concerning issues such as treatment, family, and finances. It is important to identify these issues to help patients with breast cancer to resolve their worries and obtain reliable information. Objective This study aimed to extract and classify multiple worries from text generated by patients with breast cancer using Bidirectional Encoder Representations From Transformers (BERT), a context-aware natural language processing model. Methods A total of 2272 blog posts by patients with breast cancer in Japan were collected. Five worry labels, “treatment,” “physical,” “psychological,” “work/financial,” and “family/friends,” were defined and assigned to each post. Multiple labels were allowed. To assess the label criteria, 50 blog posts were randomly selected and annotated by two researchers with medical knowledge. After the interannotator agreement had been assessed by means of Cohen kappa, one researcher annotated all the blogs. A multilabel classifier that simultaneously predicts five worries in a text was developed using BERT. This classifier was fine-tuned by using the posts as input and adding a classification layer to the pretrained BERT. The performance was evaluated for precision using the average of 5-fold cross-validation results. Results Among the blog posts, 477 included “treatment,” 1138 included “physical,” 673 included “psychological,” 312 included “work/financial,” and 283 included “family/friends.” The interannotator agreement values were 0.67 for “treatment,” 0.76 for “physical,” 0.56 for “psychological,” 0.73 for “work/financial,” and 0.73 for “family/friends,” indicating a high degree of agreement. Among all blog posts, 544 contained no label, 892 contained one label, and 836 contained multiple labels. It was found that the worries varied from user to user, and the worries posted by the same user changed over time. The model performed well, though prediction performance differed for each label. The values of precision were 0.59 for “treatment,” 0.82 for “physical,” 0.64 for “psychological,” 0.67 for “work/financial,” and 0.58 for “family/friends.” The higher the interannotator agreement and the greater the number of posts, the higher the precision tended to be. Conclusions This study showed that the BERT model can extract multiple worries from text generated from patients with breast cancer. This is the first application of a multilabel classifier using the BERT model to extract multiple worries from patient-generated text. The results will be helpful to identify breast cancer patients’ worries and give them timely social support.
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Affiliation(s)
- Tomomi Watanabe
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Shuntaro Yada
- Nara Institute of Science and Technology, Nara, Japan
| | - Eiji Aramaki
- Nara Institute of Science and Technology, Nara, Japan
| | | | - Hayato Kizaki
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Satoko Hori
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
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6
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Bender JL, Puri N, Salih S, D’Agostino NM, Tsimicalis A, Howard AF, Garland SN, Chalifour K, Drake EK, Marrato A, McKean NL, Gupta AA. Peer Support Needs and Preferences for Digital Peer Navigation among Adolescent and Young Adults with Cancer: A Canadian Cross-Sectional Survey. Curr Oncol 2022; 29:1163-1175. [PMID: 35200598 PMCID: PMC8870696 DOI: 10.3390/curroncol29020099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
Abstract
Adolescents and young adults (AYA) with cancer desire peer support and require support programs that address their unique needs. This study investigated the need for, and barriers to, peer support and preferences for digital peer navigation among AYA. A cross-sectional survey was administered to AYA, diagnosed with cancer between the ages of 15–39, at a cancer center and through social media. Descriptive summary statistics were calculated. Participants (n = 436) were on average 31.2 years (SD = 6.3), 3.3 years since-diagnosis (SD = 3.8), and 65% (n = 218) were women. Over three-quaters (n = 291, 76.6%) desired peer support from cancer peers, but 41.4% (n = 157) had not accessed peer support. Main access barriers were: Inconvenience of in-person support groups (n = 284, 76.1%), finding AYA with whom they could relate (n = 268, 72.4%), and finding AYA-specific support programs (n = 261, 70.4%). Eighty-two percent (n = 310) desired support from a peer navigator through a digital app, and 63% (n = 231) were interested in being a peer navigator. Participants indicated a greater need for emotional (n = 329, 90.1%) and informational support (n = 326, 89.1%) than companionship (n = 284, 78.0%) or practical support (n = 269, 73.6%) from a peer navigator. Foremost peer matching characteristics were cancer-type (n = 329, 88.4%), specific concerns (n = 317, 86.1%), and age-at-diagnosis (n = 316, 86.1%). A digital peer navigation program was desired by over 80% of a large Canadian sample of AYA and could potentially overcome the barriers AYA experience in accessing peer support. The design of a peer navigation program for AYA should consider the matching characteristics and multidimensional support needs of AYA.
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Affiliation(s)
- Jacqueline L. Bender
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (N.M.D.); (A.A.G.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M7, Canada
- Correspondence: ; Tel.: +1-416-581-8606
| | - Natasha Puri
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
| | - Sarah Salih
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
| | - Norma M. D’Agostino
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (N.M.D.); (A.A.G.)
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC H3A 2M7, Canada;
| | - A. Fuchsia Howard
- School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada;
| | - Sheila N. Garland
- Department of Psychology, Memorial University, St. John’s, NL A1C 3X9, Canada;
| | | | - Emily K. Drake
- Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Anthony Marrato
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
| | - Nikki L. McKean
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada; (N.P.); (S.S.); (A.M.); (N.L.M.)
| | - Abha A. Gupta
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (N.M.D.); (A.A.G.)
- Adolescent and Young Adult Cancer Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada
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7
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Ishiki H, Hirayama T, Horiguchi S, Iida I, Kurimoto T, Asanabe M, Nakajima M, Sugisawa A, Mori A, Kojima Y, Udagawa R, Tsuchiya H, Oki M, Shimizu M, Yanai Y, Touma S, Nozawa K, Kojima R, Inamura N, Maehara A, Suzuki T, Satomi E. A Support System for Adolescent and Young Adult Patients with Cancer at a Comprehensive Cancer Center. JMA J 2022; 5:44-54. [PMID: 35224259 PMCID: PMC8827278 DOI: 10.31662/jmaj.2021-0106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/05/2021] [Indexed: 01/08/2023] Open
Abstract
Cancer patients in adolescents and young adults (AYA) generation aged 15-39 years have various psychosocial needs during their treatment course such as school enrollment, finding employment, marriage, and fertility. It is difficult for medical professionals to gain experience related to providing medical care and consultation support to these kinds of AYA generation cancer patients. There is a need to provide information and establish both support and medical care systems that are able to meet the diverse needs unique to this generation. This review will explain how to launch an AYA support team (AST). We have worked and established the AST since 2016, which is medical care teams that provide support according to the life stage of each individual patient and build a multidisciplinary AYA generation patient support system. The team-building process consisted of two main projects: building and enlarging multidisciplinary team and establishing screening process of psychosocial needs of AYA generation patients. Multidisciplinary healthcare professionals got involved in the AST with already-existing patient support functions in our center: the patient support center, which is an outpatient department and the palliative care team, which is an inpatient interdepartmental team. The AST systematically finds patients in need of assistance and offers them support as a multidisciplinary team. The AST also established a procedure that systematically gathers information about the needs of patients by using a screening tool. In addition, the AST provides the following specialized services: reproductive medicine, supporting cancer patients with children, employment support, and peer support. The AST has been established and sophisticatedly worked. It can flexibly provide various psychosocial support services. This review will explain how to launch an AST.
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Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Saki Horiguchi
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Ikumi Iida
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Tamae Kurimoto
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Mihoko Asanabe
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Miho Nakajima
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akiko Sugisawa
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Ayako Mori
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoko Udagawa
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Hayato Tsuchiya
- Nutrition Management Office, National Cancer Center Hospital, Tokyo, Japan
| | - Mami Oki
- Department of Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Mariko Shimizu
- Center for Physician Referral and Medical Social Service, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Yanai
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shoko Touma
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Keiko Nozawa
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Rebekah Kojima
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Naoko Inamura
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Asami Maehara
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Center for Physician Referral and Medical Social Service, National Cancer Center Hospital, Tokyo, Japan
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8
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Lehmann V, Laan ETM, den Oudsten BL. Sexual health-related care needs among young adult cancer patients and survivors: a systematic literature review. J Cancer Surviv 2021; 16:913-924. [PMID: 34669141 PMCID: PMC9300501 DOI: 10.1007/s11764-021-01084-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/02/2021] [Indexed: 01/05/2023]
Abstract
Purpose Young adult cancer patients and survivors have age-specific care needs, but care needs related to sexual health are poorly understood. A systematic literature review was conducted to examine sexual health-related care needs among patients/survivors diagnosed with cancer during young adulthood (age: 18–39 years). The prevalence and types needs were assessed along with associated patient factors. Methods Four major databases were screened to identify relevant studies, which were also assessed for risk of bias; all following PRISMA guidelines. Results Identified studies (N = 35) often assessed sexual health-related care needs by whether participants experienced a generic need for support from providers. The prevalence of such needs ranged between 8 and 61.7% and was higher in female survivors and those with more health impairments. The type of diagnosis could also play a role in these varying prevalence rates, but was not systematically tested in included studies. Types of sexual health-related care needs were clustered into practical/emotional support needs (e.g., coping with physical side effects), information needs (e.g., more details), and communication needs (e.g., providers should initiate conversations, validate concerns, be empathetic/open). Needs should be addressed in-person and/or online. Conclusions The extent of needs related to sexual health varies among young adult patients and survivors, but types of needs center around improving provision of support and information by providers. Implications for Cancer Survivors Sexual health should routinely be addressed alongside other potential effects of cancer treatment to allow for constructive conversations between patients and providers. Referrals to (online) resources or specialists should be tailored to individual preferences. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01084-w.
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Affiliation(s)
- Vicky Lehmann
- Department of Medical Psychology, Amsterdam University Medical Center, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - Ellen T M Laan
- Department of Sexology and Psychosomatic Gynecology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Brenda L den Oudsten
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders, Tilburg University, Tilburg, Netherlands
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9
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Yan AP, Howden K, Glidden C, Romanescu RG, Scott I, Deleemans JM, Chalifour K, Eaton G, Gupta AA, Bolton JM, Garland SN, Mahar AL, Oberoi S. COVID-19-Related Information Sources, Behavioral Changes, and Adherence to Social Distancing Among Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2021; 11:352-359. [PMID: 34597190 DOI: 10.1089/jayao.2021.0126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: This study aimed to assess the sources of COVID-19 information used, behavioral changes in response to the pandemic, and factors associated with adherence to social distancing guidelines among adolescents and young adults (AYAs) with cancer during the COVID-19 pandemic. Methods: We conducted a self-administered online survey of AYAs with cancer (aged 18-39 years) diagnosed between ages 15 and 39 and living in Canada during January and February 2021. Data were summarized using descriptive statistics. Multiple logistic regression was used to identify the factors associated with adherence to the social distancing guidelines. Results: In total, 805 AYAs were included. Participants were most likely to obtain COVID-19-related information from social media (60.5%), news reports (51.6%), and medical professionals (46.5%). The preferred modes of receiving information were websites of cancer organizations (47.9%), social media (44.8%), and medical professionals (40.2%). The common behavioral changes in response to the COVID-19 pandemic included wearing a protective mask (60.2%), avoiding crowded and public places (56.9%), and abiding by social distancing rules (49.4%). On multivariable analysis, participants were more likely to adhere to social distancing rules if they were women, unemployed or collecting disability/unemployment benefits, or had a personal income of <$40,000 in year 2020 (p < 0.05). Conclusion: Social media and websites of cancer organizations are the preferred modes of COVID-19 information. Since many AYAs are nonadherent to preventative health measures, cancer organizations should help develop and disseminate digital resources that provide tailored information to AYAs with cancer during this pandemic.
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Affiliation(s)
- Adam P Yan
- Division of Pediatric Hematology-Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Kaitlyn Howden
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Camille Glidden
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Razvan G Romanescu
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Canada
| | - Ian Scott
- Department of Psychosocial Oncology, CancerCare Manitoba, Winnipeg, Canada
| | - Julie M Deleemans
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Karine Chalifour
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, St. John's, Canada
| | - Geoff Eaton
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, St. John's, Canada
| | - Abha A Gupta
- Division of Pediatric Hematology-Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Canada.,Adolescent and Young Adult Program, Princess Margaret Cancer Care Research Institute, Toronto, Ontario, Canada
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada
| | - Sheila N Garland
- Department of Psychology, Memorial University, St. John's, Canada
| | - Alyson L Mahar
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.,Department of Pediatric Hematology-Oncology, CancerCare Manitoba, Winnipeg, Canada
| | - Sapna Oberoi
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Department of Pediatric Hematology-Oncology, CancerCare Manitoba, Winnipeg, Canada.,CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Canada
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10
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Perspectives of adolescent and young adult cancer survivors: review of community-based discussion boards. J Cancer Surviv 2021; 16:1079-1089. [PMID: 34471949 DOI: 10.1007/s11764-021-01098-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Given the overall increase in the number of adolescent and young adult (AYA) cancer survivors, there has been a growing interest in identifying and implementing effective care for this patient population. To date, there are remaining gaps in research, partly due to challenges in reaching AYA survivors. Our study aimed to assess AYA cancer survivors' concerns using postings from the American Cancer Society Cancer Survivors Network, an online, publicly available forum. METHODS Using qualitative methods, posts from AYA survivors and/or their family/friends in the "Young Cancer Survivors" discussion board from January 2010 to October 2020 were systematically assessed using a previously published cancer survivorship care framework. RESULTS We identified 158 individuals (145 AYA and 13 family or friends), aged 15 to 39 years old, who contributed to 181 posts with concerns regarding cancer survivorship. A majority of posts pertained to surveillance and management of psychosocial effects. Less than half related to concerns about the surveillance and management of physical effects and a few regarding surveillance for recurrence and new cancers. Psychological challenges, including coping and depression, as well as interpersonal topics, including community support and non-family relationships, were the most prevalent psychosocial concerns. Some issues across multiple domains were mentioned. Concerns pertaining to contextual healthcare delivery domains, such as communication, care coordination, and care experience, were less common. CONCLUSIONS Our study found that AYA cancer survivors and their family/friends expressed concerns in several survivorship care domains. Physical and psychosocial issues were most prevalent. IMPLICATIONS FOR CANCER SURVIVORS Interventions tailored towards identifying and addressing the continued unmet needs of AYA cancer survivors are needed. Use of social media may provide opportunities to access this patient population for both clinical and research interventions.
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11
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Darabos K, Barakat LP, Schapira M, Hill-Kayser C, Schwartz LA. Association of Demographic and Cancer-Specific Factors on Health Behavior Recommendations Specific to Cancer Prevention and Control Among Adolescent and Young Adult Survivors of Childhood Cancer. J Adolesc Young Adult Oncol 2020; 10:619-628. [PMID: 33211609 DOI: 10.1089/jayao.2020.0130] [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: 10/22/2022] Open
Abstract
Purpose: Adolescent and young adult survivors of childhood cancer (AYA) are at risk for long-term health problems that are exacerbated by not meeting health behavior recommendations (e.g., exercise). To identify AYA at risk for not meeting health behavior recommendations, we explored demographic (e.g., age) and cancer-specific (e.g., intensity of treatment) factors associated with not meeting specific health behavior recommendations that have implications for cancer prevention and control. Methods: Regression (linear/binary) was used to examine demographic and cancer-specific associates regarding fruit/vegetable intake, binge drinking, sleep duration, sunscreen use, tobacco use, and physical activity among 307 AYA (Mage = 20.33, range = 15-34) across three combined studies, treated at a pediatric cancer center. Health behavior measures were adapted from The Health Behaviors Survey and the Youth Risk Behavior Surveillance System questionnaire. Results: AYA in general did not meet health behavior recommendations. Compared with AYA with public insurance, AYA with private insurance (β = -0.19, p < 0.01) were more likely to meet multiple health behavior recommendations. AYA at greatest risk for not meeting specific health behaviors were more likely to be diagnosed in middle childhood (11.35years) compared with early childhood (8.38years), be closer to diagnosis (8.77years vs. 11.76years) and closer to treatment completion (6.97years vs. 9.91years), and have a solid tumor (32.7%) compared with a brain tumor (10.6%). Conclusion: Not meeting health behavior recommendations is common among AYA survivors of childhood cancer. Early education in the context of survivorship care is critical to provide teachable moments to AYA; such interventions might impact future long-term health and reduce risk for secondary cancers.
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Affiliation(s)
- Katie Darabos
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lamia P Barakat
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Marilyn Schapira
- Department of Medicine, and Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christine Hill-Kayser
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Radiation Oncology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lisa A Schwartz
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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