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Lambrineas LJ, Brock HG, Ong HI, Tisseverasinghe S, Carrington E, Heriot A, Burgess A, Proud D, Mohan H. Challenges in evaluating pelvic floor physiotherapy based strategies in low anterior resection syndrome: a systematic review and qualitative analysis. Colorectal Dis 2024; 26:258-271. [PMID: 38173138 DOI: 10.1111/codi.16839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/08/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024]
Abstract
AIM Physiotherapy is an established treatment strategy for low anterior resection syndrome (LARS). However, data on its efficacy are limited. This is in part due to the inherent challenges in study design in this context. This systematic review aims to analyse the methodology of studies using pelvic floor physiotherapy for treatment of LARS to elucidate the challenges and limitations faced, which may inform the design of future prospective trials. METHODOLOGY A systematic review of the literature was undertaken through MEDLINE, Embase and Cochrane Library, yielding 345 unique records for screening. Five studies were identified for review. Content thematic analysis of study limitations was carried out using the Braun and Clarke method. Line-by-line coding was used to organize implicit and explicit challenges and limitations under broad organizing categories. RESULTS Key challenges fell into five overarching categories: patient-related issues, cancer-related issues, adequate symptomatic control, intervention-related issues and measurement of outcomes. Adherence, attrition and randomization contributed to potential bias within these studies, with imbalance in the baseline patient characteristics, particularly gender and baseline pelvic floor function scores. Outcome measurements consisted of patient-reported measures and quality of life measures, where significant improvements in bowel function according to patient-reported outcome measures were not reflected in the quality of life scores. CONCLUSION Upcoming trial design in the area of pelvic floor physiotherapy for faecal incontinence related to rectal cancer surgery can be cognisant of and design around the challenges identified in this systematic review, including the reduction of bias, exclusion of the placebo effect and the potential cultural differences in attitude towards a sensitive intervention.
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Affiliation(s)
- Lauren J Lambrineas
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Henry G Brock
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | - Hwa Ian Ong
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | | | | | - Alexander Heriot
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Adele Burgess
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - David Proud
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Helen Mohan
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
- Peter MacCallum Cancer Centre, Melbourne, Australia
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Proctor CJ, Reiman AJ, Best LA. Cancer, now what? A cross-sectional study examining physical symptoms, subjective well-being, and psychological flexibility. Health Psychol Behav Med 2023; 11:2266220. [PMID: 37849745 PMCID: PMC10578084 DOI: 10.1080/21642850.2023.2266220] [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: 04/25/2022] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
Background: The impact of cancer extends beyond treatment and evaluating the adverse psychological effects in survivors is important. We examined: (1) the relationship between diagnosis, relapse, and subjective well-being using a short and a holistic measure of well-being, including comparisons between our sample and established norms; (2) if reported physical symptoms were related to components of subjective well-being; and (3) if increased psychological flexibility predicted overall subjective well-being. Methods: In total, 316 survivors completed online questionnaires to assess cancer, physical health (Edmonton Symptom Assessment Scale-R; ESAS-R), subjective well-being (Comprehensive Inventory of Thriving; CIT; Satisfaction with Life Scale; SWLS) and psychological flexibility (Comprehensive Assessment of Acceptance and Commitment Therapy). Results: Relative to ESAS-R cut-points (Oldenmenger et al., 2013), participants reported only moderate levels of tiredness and slightly elevated drowsiness, depression, and anxiety; participants reported more problems with psychological health. SWLS scores were lower than published norms (M = 18.23, SD = 8.23) and a relapse was associated with the lowest SWLS scores (M = 16.95, SD = 7.72). There were differences in thriving between participants and age-matched norms (Su et al., 2014). Participants reported lower community involvement, respect, engagement with activities, skill mastery, sense of accomplishment, self-worth, self-efficacy, autonomy, purpose, optimism, subjective well-being, and positive emotions coupled with higher loneliness and negative emotions. In regression analysis, two components of psychological flexibility, Openness to Experience, t = 2.50, p < 0.13, β = -0.18, and Valued Action, t = 7.08, p < 0.001, β = -0.47, predicted 28.8% of the variability in total CIT scores, beyond the effects of demographic and disease characteristics and reported physical symptoms. Conclusion: Cancer is an isolating experience, with the adverse psychological effects that impact subjective well-being continuing after the cessation of physical symptoms. Specific components of psychological flexibility may explain some variability in thriving beyond disease characteristics and may inform psychological intervention after diagnosis.
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Affiliation(s)
- Cecile J. Proctor
- Department of Psychology, University of New Brunswick, Saint John, Canada
| | - Anthony J. Reiman
- Department of Biological Sciences, University of New Brunswick, Saint John, Canada
- Horizon Health Network, Saint John, Canada
| | - Lisa A. Best
- Department of Psychology, University of New Brunswick, Saint John, Canada
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Vear NK, Goodman W, Rose GL, McCarthy AL. Impact of exercise and/or dietary interventions, and their behaviour change techniques, on quality of life in middle-aged and older women following treatment for cancer: A systematic review. Maturitas 2023; 175:107783. [PMID: 37327577 DOI: 10.1016/j.maturitas.2023.05.007] [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: 04/23/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023]
Abstract
Many middle-aged or older women are treated for cancer and their quality of life can be significantly impaired following treatment. Exercise and dietary interventions could address this. The aim of this review was to determine whether exercise and/or dietary interventions which are scaffolded by behaviour change theories and techniques are associated with improved quality of life in middle-aged and older women following cancer treatment. Secondary outcomes included self-efficacy, distress, waist circumference, and food variety. A search of CINAHL (EBSCOhost), Embase, MEDLINE (EBSCOhost), PsycINFO, PubMed and Scopus databases up to 17th November 2022 was conducted. A narrative summary was provided. Twenty articles discussing 18 independent randomised controlled trials/interventions were included, with a total of 1754 participants. No studies reported the outcomes of distress or food variety. Exercise and/or dietary interventions had mixed effects on quality of life, self-efficacy and waist circumference (positive effect: n = 4/14; n = 3/5; n = 4/7, respectively). Two-thirds of the interventions (exercise-only, n = 2; exercise and diet, n = 2) that demonstrated an improvement in quality-of-life scores were based upon Social Cognitive Theory. All studies that reported improvements in waist circumference employed combined exercise and dietary interventions, with individualised aspects for the dietary components. Exercise and/or dietary interventions could potentially enhance quality of life and self-efficacy, and reduce waist circumference, in middle-aged and older women treated for cancer. Although findings are currently mixed, avenues for the development of interventions include ensuring there is a theoretical underpinning and incorporating more behaviour change techniques in exercise and/or dietary interventions in this population.
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Affiliation(s)
- Natalie K Vear
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia.
| | - William Goodman
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia; Leeds Institute of Health Science, University of Leeds, Clarendon Way, Leeds LS2 9JT, United Kingdom.
| | - Grace L Rose
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia; School of Health, Level 4, T Building, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia.
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia; Mater Research Institute, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia.
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Way KM, Bourne JE, Armstrong MEG. "I'm Hooked on e-cycling, I Can Finally Be Active Again": Perceptions of e-cycling as a Physical Activity Intervention during Breast Cancer Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5197. [PMID: 36982111 PMCID: PMC10049330 DOI: 10.3390/ijerph20065197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Electrically-assisted bicycles (e-bikes) are a means through which to increase individual physical activity (PA) and overcome some commonly reported barriers to engaging in conventional cycling. Fatigue is a common side effect to breast cancer treatment, and the rate of PA engagement drops significantly following a breast cancer diagnosis. The aim of this qualitative study was to examine perceptions of e-cycling as a means of increasing PA in this population. Twenty-four participants (mean age = 57.88 (standard deviation 10.8), 100% female) who have had a breast cancer diagnosis, completed two semi-structured interviews via Zoom. One interview was conducted prior to an e-bike taster session and a second, after the session. Taster sessions were conducted by certified cycling instructors in the community. Interviews were conducted between December 2021 and May 2022. Data were transcribed verbatim and analyzed thematically using NVivo 12 software. An inductive and deductive approach to analysis was adopted. Five themes were generated: (1) Perceived role of e-bikes during treatment, (2) The relationship between e-bikes and fatigue, (3) Cancer-specific considerations, (4) Is e-cycling 'enough'?, and (5) Optimizing the intervention. Negative perceptions of e-bikes noted before the taster session were altered following riding an e-bike. The multiple levels of assistance made cycling manageable and less impacted by fatigue, thereby enabling individuals to re-establish previous cycling habits. E-cycling may be a suitable option to increase PA behavior amongst individuals being treated for breast cancer, with the potential to overcome many of the barriers of conventional cycling. Enabling this population to trial an e-bike elicits positive physical and psychological responses that may help to promote future engagement.
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Baek SY, Lee SB, Lee Y, Chung S, Choi CM, Lee HJ, Jo MW, Yun SC, Lee JW. Effects of Mobile Healthcare Applications on the Lifestyle of Patients With Breast Cancer: A Protocol for a Randomized Clinical Trial. J Breast Cancer 2022; 25:425-435. [PMID: 36314766 PMCID: PMC9629966 DOI: 10.4048/jbc.2022.25.e42] [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: 04/22/2022] [Revised: 08/25/2022] [Accepted: 10/10/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Physical activity (PA) in patients with breast cancer is associated with improved quality of life (QoL); however, many breast cancer survivors do not meet the recommended PA level. This study aims to evaluate the effect of digital health interventions using mobile apps to promote PA and QoL in patients with postoperative breast cancer. This study will also identify effective digital intervention methods and perform an economic analysis. The main hypothesis is that the use of mobile healthcare apps will improve health-related quality of life (HRQOL), promote PA, and reduce healthcare costs. METHODS The Promotion of a better lifestyle (PA) with Precise and Practicable digital healthcare in postoperative CANCER patients through a Multi-Disciplinary Network (P4CancerMDnet) study is examined by a prospective 4-group randomized controlled trial with a concurrent cost-utility evaluation. Patients are randomly assigned to 3 different mobile app intervention groups or control groups in a 1:1:1:1 ratio. The intervention group is encouraged to use the assigned mobile app. The targeted outcomes are HRQOL, metabolic health markers, and quality-adjusted life-years. The outcomes will be measured at the 6- and 12-month follow-ups. DISCUSSION This study will contribute towards a better lifestyle and HRQOL through digital healthcare for postoperative breast cancer patients. These findings are expected to provide evidence of the effectiveness of mobile apps for breast cancer survivors. TRIAL REGISTRATION Clinical Research Information Service Identifier: KCT0005447.
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Affiliation(s)
- Soo Yeon Baek
- Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sae Byul Lee
- Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yura Lee
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang-Min Choi
- Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hui Jeong Lee
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Cheol Yun
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jong Won Lee
- Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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The psychosocial responses of patients in cancer clinical trials: are they a barrier to participation? JOURNAL OF RADIOTHERAPY IN PRACTICE 2022. [DOI: 10.1017/s1460396922000139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Introduction:
This paper aims to discuss the psychosocial concomitants with involvement in oncology clinical trials, focusing on barriers that can impact upon participation. It will conclude with some recommendations for strategies to address potential psychosocial barriers with the aim of increasing trial participation rates.
Materials and methods:
A literature search was carried out using CINAHL, PubMed and EMCare databases with the following keywords for filtering: psychological distress, clinical trials, participation and oncology. The final selection of papers that met the inclusion criteria for this review was manually subjected to Critical Appraisal Skills Programme tool for relevance.
Results:
Thirteen papers were included in the review. The dominant theme within the literature is psychosocial obstacles to oncology clinical trial participation. Five key barriers were identified: anxiety and fear; ethnicity and social background; tensions between scientific objectives and personal motivations to participation; tensions between personal benefits versus altruism; carer perspectives.
Conclusions:
The key barriers discussed led to the identification of a set of strategies to help mediate conflicting tensions and motivations of trial enrolment with a view to increasing participation rates. Further prospective research garnering primary data investigating both the psychological and psychosocial factors influencing cancer clinical trial participation for patients needs to be undertaken.
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Psychosocial protective interventions associated with a better quality of life and psychological wellbeing for African American/Black female breast cancer survivors: an integrative review. Support Care Cancer 2022; 30:1093-1114. [PMID: 34417643 PMCID: PMC8787847 DOI: 10.1007/s00520-021-06425-0] [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: 03/16/2021] [Accepted: 07/08/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE This integrative review provides an overview of current psychosocial interventions and qualitative studies exploring African American Breast Cancer Survivors (AABCS)' psychosocial wellbeing. METHODS We conducted a search of five databases: PubMed, Academic Search Ultimate, CINAHL, PsycINFO, and Web of Science. Peer-reviewed articles written in English and published from 2011 to May 26, 2021 were included. We critically appraised intervention studies and qualitative studies using established frameworks. RESULTS Of the 633 unique studies identified, seven interventions and twenty-one qualitative studies were included. Analysis of the interventions revealed the importance of alleviating structural barriers and facilitating peer support for AABCS. Analysis of the qualitative studies revealed seven themes: (1) spirituality/religion, (2) social support, (3) cultural perceptions of BC, (4) lack of representation, (5) negative impacts of treatment, (6) healthcare system experience, and (7) barriers to psychosocial care. CONCLUSIONS This review highlights the dearth of psychosocial interventions created specifically for AABCS. The qualitative literature in this review elucidates the unique psychosocial challenges that AABCS experience, providing rich data to inform the creation of future culturally competent interventions in this population. IMPLICATIONS FOR CANCER SURVIVORS This review found spirituality and social support to be protective factors for AABCS' psychosocial wellbeing. Further research using rigorous methodologies is needed to further evaluate how to most effectively alleviate structural barriers that AABCS face in obtaining long-term support.
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Wells KJ, Drizin JH, Ustjanauskas AE, Vázquez-Otero C, Pan-Weisz TM, Ung D, Carrizosa C, Laronga C, Roetzheim RG, Johnson K, Norton M, Aguilar RC, Quinn GP. The psychosocial needs of underserved breast cancer survivors and perspectives of their clinicians and support providers. Support Care Cancer 2022; 30:105-116. [PMID: 34231040 PMCID: PMC8639634 DOI: 10.1007/s00520-021-06286-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/09/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Breast cancer survivors (BrCS) experience many psychosocial difficulties following treatment, leading to an increased risk of psychological distress compared to the general population. This is especially true for underserved BrCS whose unmet supportive care needs can result in worse physical and mental health outcomes. This qualitative study compared healthcare and support providers' perceptions of BrCS' needs to survivors' perceptions of their own needs. METHODS Semi-structured in-depth interviews were conducted with 25 underserved BrCS and 20 cancer survivorship stakeholders identified using purposeful sampling. Using the constant comparison method and content analysis, data were analyzed via an iterative process of coding and discussion. Data were summarized according to three intermediate and proximal themes mentioned by both stakeholders and survivors: (1) psychosocial needs of cancer survivors, (2) support, and (3) benefit finding/positive feelings about cancer. Demographic data were analyzed by calculating descriptive statistics. RESULTS There was consistency in providers' and survivors' perceptions of post-treatment mood changes, financial burden, familial stress, and physical changes. Providers and survivors differed in perceptions of BrCS' preferred sources of care and support, effects of cancer treatment on body image, the effects of fear of cancer recurrence on follow-up care, and benefit finding. CONCLUSIONS This study provides valuable insight into areas in which healthcare and support providers' perceptions may differ from underserved BrCS' lived experiences. Results from this study can be used to develop interventions and inform healthcare and support providers on how to provide high-quality care to underserved BrCS.
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Affiliation(s)
- Kristen J. Wells
- San Diego State University, San Diego, CA, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Julia H. Drizin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Amy E. Ustjanauskas
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego, San Diego, CA, USA
| | - Coralia Vázquez-Otero
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Dana-Farber Cancer Institute, Boston, MA, USA
| | - Tonya M. Pan-Weisz
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego, San Diego, CA, USA
| | | | | | | | | | | | | | | | - Gwendolyn P. Quinn
- Departments of OB-GYN, Population Health, Grossman School of Medicine, New York University, NY, NY
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Lindert J, Sancassiani F, Massa E, Nardi AE. An Overview of the International Literature on Health-Related Quality of Life, Mental Health and Psychosocial Issues in People with Cancer. Clin Pract Epidemiol Ment Health 2021; 17:253-256. [PMID: 35444711 PMCID: PMC8985473 DOI: 10.2174/1745017902117010253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Cancer is one of the most important leading causes of death worldwide. Early detection, screening and diagnosis have been demonstrated to significantly improve patients' survival rates and increase awareness of the benefit of prompt therapies and healthy lifestyles. In this context, Health-related Quality of Life (HRQoL) and several psychosocial difficulties are of relevance as prognostic factors for the trajectory of the diseases of people living with cancer. Methods This Special Issue aims to present a set of systematic reviews and research studies focusing on several psychosocial aspects in people suffering from hematologic and solid cancer. Results Three systematic reviews regard HRQoL, the quality of patient-physician communication, depression and other stress-related difficulties, respectively. One review pointed out the difficulties in diagnosing depression in the elderly with solid cancer; another one regards the risk of cancer in severe mental illnesses, such as schizophrenia, bipolar disorders, and severe depressive disorders. One additional review regards HRQoL in people with cancer in the present era of COVID-19 pandemic. Furthermore, some research studies pointed out the usefulness of a validated instrument to assess satisfaction with care in the oncology field, as well as of the self-reinforcing feedback loop to improve fatigue, insomnia and depression in people with cancer. Other two research studies evaluate, respectively, the attributable burden in worsening HRQoL in people suffering both from cancer and depression and the Type D personality as a risk factor for stress-related difficulties in women with breast cancer. Conclusion This Special Issue is a contribution to enhance future research mainly about such interventions useful to assess and improve HRQoL and overall well-being in people with cancer.
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Affiliation(s)
- Jutta Lindert
- University of Applied Sciences Emden/Leer, Emden, Germany; WRSC, Brandeis University, Waltham, United States
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy,Address correspondence to this author at Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Tel: 0039 3493119215; E-mail:
| | - Elena Massa
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Aviles Gonzalez CI, Angermeyer M, Deiana L, Loi C, Murgia E, Holzinger A, Cossu G, Massa E, Romano F, Scartozzi M, Carta MG. The Quality of Life of People with Solid Cancer is Less Worse than Other Diseases with better Prognosis, Except in the Presence of Depression. Clin Pract Epidemiol Ment Health 2021; 17:315-323. [PMID: 35444707 PMCID: PMC8985466 DOI: 10.2174/1745017902117010315] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 01/17/2023]
Abstract
Background: Suffering from Solid Cancer (SC) may adversely impact the Health-related Quality of Life (H-QoL). The aims of this study are to measure the H-QoL in a sample of people suffering from SC and to clarify the role of the co-occurrence of depressive episodes. Results were compared with a healthy control group and with groups of other disorders. Methods: In 151 patients with SC (mean±sd age 63.1±11.5; female 54.3%), H-QoL was assessed by SF-12, depressive episodes were identified by PHQ-9. The attributable burden of SC in impairing H-QoL was calculated as the difference between SF-12 score of a community sex and age ¼ matched healthy control group and that of the study sample. The attributable burden of SC was compared with other chronic diseases using specific diagnostic groups drawn from case-control studies that used the same database for selecting control samples. Results: H-QoL in people with SC was significantly worse than in the healthy control group (p<0.0001). The attributable burden in worsening the H-QoL due to SC was similar to those of severe chronic diseases, but lower than Multiple Sclerosis (p<0.0001) or Fibromyalgia (p<0.00001). Having a depressive episode was a strong determinant of decreasing H-QoL, regardless of the severity of cancer. Conclusion: The findings confirm a strong impact of SC but showed that H-QoL in SC was higher than in chronic diseases with better “quoad vitam” outcome. Since depression was a strong determinant, its prevention, early detection and therapy are the main objectives that must be reached in cancer patients.
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Streck JM, Luberto CM, Muzikansky A, Skurla S, Ponzani CJ, Perez GK, Hall DL, Gonzalez A, Mahaffey B, Rigotti NA, Ostroff JS, Park ER. Examining the effects of stress and psychological distress on smoking abstinence in cancer patients. Prev Med Rep 2021; 23:101402. [PMID: 34094817 PMCID: PMC8163988 DOI: 10.1016/j.pmedr.2021.101402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Cancer patients who smoke report more stress and psychological distress than patients who do not smoke. It is unclear how these emotional symptoms may modify smoking behavior in cancer patients. We examined the influence of a smoking cessation intervention for cancer patients on stress and distress, and the effects of these symptoms on smoking abstinence. METHODS Mixed-methods secondary analysis of data from the Smokefree Support Study, a two-site randomized controlled trial examining the efficacy of Intensive (IT; n = 153) vs. Standard Treatment (ST; n = 150) for smoking cessation in newly diagnosed cancer patients. Stress coping, perceived stress, distress, and anxiety were self-reported at baseline, 3, and 6 months. Abstinence was biochemically-confirmed at 6 months. A subset of patients (n = 72) completed qualitative exit-interviews. RESULTS Patients were on average, 58 years old, 56% female, and smoked a median of 10 cigarettes/day. There were no significant treatment group × time interactions or main effects of treatment group on stress or distress measures (p's > 0.05), however there were significant main effects of time suggesting symptom improvements on each measure in both study groups (p's < 0.05). In adjusted logistic regression models, lower levels anxiety at 3 months predicted confirmed smoking abstinence at 6 months (p = .03). Qualitatively, at 6 months, patients reported their stress and smoking were connected and that the cessation counseling was helpful. CONCLUSIONS Cancer patients enrolled in a smoking cessation trial report decreases in stress, distress and anxiety over time, and anxiety symptoms may impact smoking cessation success at follow-up resulting in an important intervention target.
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Affiliation(s)
- Joanna M. Streck
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Christina M. Luberto
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Alona Muzikansky
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Center for Biostatistics, Memorial Sloan Kettering Cancer Center, United States
| | - Sarah Skurla
- VA Center for Clinical Management Research, Memorial Sloan Kettering Cancer Center, United States
| | - Colin J. Ponzani
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Giselle K. Perez
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Daniel L. Hall
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Adam Gonzalez
- Stony Brook University, School of Medicine, Memorial Sloan Kettering Cancer Center, United States
| | - Brittain Mahaffey
- Stony Brook University, School of Medicine, Memorial Sloan Kettering Cancer Center, United States
| | - Nancy A. Rigotti
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
- Department of Medicine, Memorial Sloan Kettering Cancer Center, United States
| | - Jamie S. Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, United States
| | - Elyse R. Park
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
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12
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Hu K, Sjölander A, Lu D, Walker AK, Sloan EK, Fall K, Valdimarsdóttir U, Hall P, Smedby KE, Fang F. Aspirin and other non-steroidal anti-inflammatory drugs and depression, anxiety, and stress-related disorders following a cancer diagnosis: a nationwide register-based cohort study. BMC Med 2020; 18:238. [PMID: 32900363 PMCID: PMC7487710 DOI: 10.1186/s12916-020-01709-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cancer patients have a highly increased risk of psychiatric disorders following diagnosis, compared with cancer-free individuals. Inflammation is involved in the development of both cancer and psychiatric disorders. The role of non-steroidal anti-inflammatory drugs (NSAIDs) in the subsequent risk of psychiatric disorders after cancer diagnosis is however unknown. METHODS We performed a cohort study of all patients diagnosed with a first primary malignancy between July 2006 and December 2013 in Sweden. Cox proportional hazards models were used to assess the association of NSAID use during the year before cancer diagnosis with the risk of depression, anxiety, and stress-related disorders during the first year after cancer diagnosis. RESULTS Among 316,904 patients identified, 5613 patients received a diagnosis of depression, anxiety, or stress-related disorders during the year after cancer diagnosis. Compared with no use of NSAIDs, the use of aspirin alone was associated with a lower rate of depression, anxiety, and stress-related disorders (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.81 to 0.97), whereas the use of non-aspirin NSAIDs alone was associated with a higher rate (HR, 1.24; 95% CI, 1.15 to 1.32), after adjustment for sociodemographic factors, comorbidity, indications for NSAID use, and cancer characteristics. The association of aspirin with reduced rate of depression, anxiety, and stress-related disorders was strongest for current use (HR, 0.84; 95% CI, 0.75 to 0.93), low-dose use (HR, 0.88; 95% CI, 0.80 to 0.98), long-term use (HR, 0.84; 95% CI, 0.76 to 0.94), and among patients with cardiovascular disease (HR, 0.81; 95% CI, 0.68 to 0.95) or breast cancer (HR, 0.74; 95% CI, 0.56 to 0.98). CONCLUSION Pre-diagnostic use of aspirin was associated with a decreased risk of depression, anxiety, and stress-related disorders during the first year following cancer diagnosis.
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Affiliation(s)
- Kejia Hu
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Donghao Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Adam K Walker
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, 3052, Australia.,Laboratory of ImmunoPsychiatry, Neuroscience Research Australia, Randwick, New South Wales, 2031, Australia.,School of Psychiatry, University of New South Wales, Sydney, 2052, Australia
| | - Erica K Sloan
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, 3052, Australia
| | - Katja Fall
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.,Clinical Epidemiology and Biostatistics School of Medical Sciences, Örebro Universitet, Örebro, Sweden
| | - Unnur Valdimarsdóttir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Centre of Public Health Sciences Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Karin E Smedby
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.
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13
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Sirri L, Tossani E, Potena L, Masetti M, Grandi S. Manifestations of health anxiety in patients with heart transplant. Heart Lung 2020; 49:364-369. [DOI: 10.1016/j.hrtlng.2019.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 02/09/2023]
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14
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Ingley KM, Klein R, Theobalds N, Burtenshaw S, Abdul Razak AR, Chen B, Xu W, Gladdy R, Li M, Gupta AA. High prevalence of persistent emotional distress in desmoid tumor. Psychooncology 2019; 29:311-320. [DOI: 10.1002/pon.5250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/12/2019] [Accepted: 09/29/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Katrina M. Ingley
- Department of Medical Oncology and Hematology Princess Margaret Cancer Center Toronto Ontario Canada
- Division of Medical Oncology and Hematology Sinai Health System Toronto Canada
| | - Roberta Klein
- Department of Supportive Care Princess Margaret Cancer Centre Toronto Ontario Canada
| | - Nicole Theobalds
- Department of Medical Oncology and Hematology Princess Margaret Cancer Center Toronto Ontario Canada
- Division of Medical Oncology and Hematology Sinai Health System Toronto Canada
| | - Sally Burtenshaw
- Division of General Surgery Sinai Health System Toronto Canada
- Department of Surgery University of Toronto Toronto Ontario Canada
| | - Albiruni R. Abdul Razak
- Department of Medical Oncology and Hematology Princess Margaret Cancer Center Toronto Ontario Canada
- Division of Medical Oncology and Hematology Sinai Health System Toronto Canada
| | - Bo Chen
- Department of Biostatistics Princess Margaret Cancer Centre Toronto Ontario Canada
| | - Wei Xu
- Department of Biostatistics Princess Margaret Cancer Centre Toronto Ontario Canada
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
| | - Rebecca Gladdy
- Division of General Surgery Sinai Health System Toronto Canada
- Department of Surgery University of Toronto Toronto Ontario Canada
- Department of Surgical Oncology Princess Margaret Cancer Centre Toronto Ontario Canada
| | - Madeline Li
- Department of Supportive Care Princess Margaret Cancer Centre Toronto Ontario Canada
| | - Abha A. Gupta
- Department of Medical Oncology and Hematology Princess Margaret Cancer Center Toronto Ontario Canada
- Division of Medical Oncology and Hematology Sinai Health System Toronto Canada
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15
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Harms CA, Cohen L, Pooley JA, Chambers SK, Galvão DA, Newton RU. Quality of life and psychological distress in cancer survivors: The role of psycho‐social resources for resilience. Psychooncology 2018; 28:271-277. [DOI: 10.1002/pon.4934] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/04/2018] [Accepted: 10/24/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Craig A. Harms
- School of Arts and Humanities, Psychology and CriminologyEdith Cowan University Joondalup Australia
| | - Lynne Cohen
- Faculty of Education and ArtsEdith Cowan University Joondalup Australia
| | - Julie Ann Pooley
- School of Arts and Humanities, Psychology and CriminologyEdith Cowan University Joondalup Australia
| | - Suzanne K. Chambers
- Exercise Medicine Research InstituteEdith Cowan University Joondalup Australia
- Menzies Health Institute QueenslandGriffith University Southport QLD Australia
- Cancer Council QueenslandCancer Research Centre Brisbane QLD Australia
| | - Daniel A. Galvão
- Exercise Medicine Research InstituteEdith Cowan University Joondalup Australia
| | - Robert U. Newton
- Exercise Medicine Research InstituteEdith Cowan University Joondalup Australia
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16
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Buonaccorso L, Martucci G, Miccinesi G, Maruelli A, Ripamonti C. Construction of new personal meanings by cancer patients: a qualitative analysis in an Italian patient population. Support Care Cancer 2018; 27:1911-1918. [DOI: 10.1007/s00520-018-4444-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/26/2018] [Indexed: 10/28/2022]
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β2ARs stimulation in osteoblasts promotes breast cancer cell adhesion to bone marrow endothelial cells in an IL-1β and selectin-dependent manner. J Bone Oncol 2018; 13:1-10. [PMID: 30245970 PMCID: PMC6146568 DOI: 10.1016/j.jbo.2018.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022] Open
Abstract
Progression and recurrence of breast cancer, as well as reduced survival of patients with breast cancer, are associated with chronic stress, a condition known to impact the hypothalamic-pituitary axis and the autonomic nervous system. Preclinical and clinical evidence support the involvement of the sympathetic nervous system in the control of bone remodeling and in pathologies of the skeleton, including bone metastasis. In experimental mouse models of skeletal metastasis, administration of the βAR agonist isoproterenol (ISO), used as a surrogate of norepinephrine, the main neurotransmitter of sympathetic neurons, was shown to favor bone colonization of metastatic breast cancer cells via an increase bone marrow vascularity. However, successful extravasation of cancer cells into a distant organ is known to be favored by an activated endothelium, itself stimulated by inflammatory signals. Based on the known association between high sympathetic outflow, the expression of inflammatory cytokines and bone metastasis, we thus asked whether βAR stimulation in osteoblasts may alter the vascular endothelium to favor cancer cell engraftment within the skeleton. To address this question, we used conditioned medium (CM) from PBS or ISO-treated bone marrow stromal cells (BMSCs) in adhesion assays with bone marrow endothelial cells (BMECs) or the endothelial cell line C166. We found that ISO treatment in differentiated BMSCs led to a robust induction of the pro-inflammatory cytokines interleukin-1 beta (IL-1β) and interleukin-6 (IL-6). The CM from ISO-treated BMSCs increased the expression of E- and P-selectin in BMECs and the adhesion of human MDA-MB-231 breast cancer cells to these cells in short-term static and dynamic adhesion assays, and a blocking antibody against IL-1β, but not IL-6, reduced this effect. Direct IL-1β treatment of BMECs had a similar effect, whereas the impact of IL-6 treatment on the expression of adhesion molecules by BMECs and on the adhesion of cancer cells to BMECs was negligible. Collectively, these in vitro results suggest that in the context of the multicellular and dynamic bone marrow environment, sympathetic activation and subsequent βAR stimulation in osteoblasts may profoundly remodel the density but also the activation status of bone marrow vessels to favor the skeletal engraftment of circulating breast cancer cells. β2AR activation in osteoblasts increases the expression of pro-inflammatory cytokines IL-1β and IL-6. IL-1β promotes the adhesion of breast cancer cells to endothelium via an endothelial increase in E- and P-selectin expression. IL-1β blockade and selectin inhibition inhibits breast cancer cell adhesion to endothelial cells.
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18
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Gálvez-Hernández CL, Ortega Mondragón A, Villarreal-Garza C, Ramos del Río B. Mujeres Jóvenes con Cáncer de Mama: Necesidades de Apoyo en Atención y Resiliencia. PSICOONCOLOGIA 2018. [DOI: 10.5209/psic.61436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Antecedentes: las mujeres menores de 40 años con cáncer de mama (CaMa) presentan características bio-psico-sociales únicas que ameritan ser atendidas y estudiadas. Objetivo: evaluara) la percepción de necesidades de apoyo en la atención (NAT) insatisfechas y nivel de resiliencia,b) la diferencia de NAT entre pacientes en tratamiento y sobrevivientes y c) la relación entre NAT y resiliencia, y su asociación con variables clínicas y sociodemográficas, respectivamente. Método: se estudiaron transversalmente a 150 mujeres jóvenes con CaMa en tratamiento y sobrevivientes, con una encuesta de NAT y una de resiliencia mexicanas. Resultados: la mediana de edad de las participantes fue de 36 años. Las necesidades menos satisfechas fueron las de sistema de salud e información. El grupo de tratamiento presentó más NAT comparado con las sobrevivientes (p=0,005). Se encontró que cuanto más NAT insatisfechas (globales, psicológicas, cuidado y apoyo, e información), menores valores en los dominios de resiliencia (p<0,005) en ambos grupos y por separado. Conclusiones: las condiciones externas (infraestructura, servicios de salud proporcionados y apoyo en seguridad social), habilidades propias (auto-confianza, estructura y organización) y/o recursos de apoyo externo (social y familiar) pudieron contribuir a que las pacientes percibieran pocas NAT insatisfechas. Los resultados resaltan la relevancia clínica de implementar intervenciones basadas en resiliencia.
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Gonzales MJ, Gross DM, Cooke E. Psychosocial Aspects of Hematologic Disorders. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00090-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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20
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Trudel-Fitzgerald C, Tworoger SS, Poole EM, Zhang X, Giovannucci EL, Meyerhardt JA, Kubzansky LD. Psychological symptoms and subsequent healthy lifestyle after a colorectal cancer diagnosis. Health Psychol 2017; 37:207-217. [PMID: 29154605 DOI: 10.1037/hea0000571] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Although medical professionals recommend lifestyle changes following a colorectal cancer (CRC) diagnosis to improve outcomes, such changes are not consistently implemented. This study examines whether higher distress is associated with lower likelihood of engaging in favorable behaviors after CRC diagnosis. METHOD Women from the Nurses' Health Study prospective cohort who completed anxiety (n = 145) and depression (n = 227) symptom scales within 4 years after receiving a CRC diagnosis were included. Measures of lifestyle (diet, physical activity, alcohol, smoking, body mass index [BMI]) were queried prediagnosis, when psychological symptoms were assessed (1988 and 1992, respectively), and then every 4 years thereafter until 2010. Women were categorized according to initial psychological symptoms levels and followed through 2010 or until last follow-up completed. RESULTS Higher versus lower anxiety symptoms were significantly related to unhealthier lifestyle scores throughout follow-up (β = -0.25, CI [-0.44, -0.05]); however, the rate of change over time was similar across groups (pinteraction effect = 0.41). Stratified analyses hinted that higher anxiety and depression symptoms were related to increased odds of reporting a future unhealthy lifestyle within 10-years postdiagnosis. Beyond 10 years, anxiety became statistically unrelated with future lifestyle, and higher depressive symptoms were associated with lower odds of subsequently having an unhealthy lifestyle, albeit nonstatistically significant (OR = 0.35, 95% CI [0.10, 1.24], p = 0.10). CONCLUSIONS Among women with CRC, higher anxiety and depression symptoms were associated with subsequent unhealthier lifestyle in the 10 years following diagnosis. With replication, such findings may suggest that treating psychological symptoms early in the cancer trajectory may not solely reduce psychological distress but also promote healthier lifestyle. (PsycINFO Database Record
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Affiliation(s)
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital
| | | | | | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
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Consent to Donate Surgical Biospecimens for Research: Perceptions of People With Colorectal Cancer. Cancer Nurs 2017; 39:221-7. [PMID: 26050142 DOI: 10.1097/ncc.0000000000000274] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Biospecimens for cancer research are commonly sought from people who undergo surgery for a new diagnosis of cancer, and the demand for these biospecimens is increasing. OBJECTIVE The objective of this study was to explore the perceptions of people with colorectal cancer regarding the impact of an opt-in model of consent for biospecimen donation. METHODS The qualitative method of Grounded Theory was used, and data were gathered through digitally recorded semistructured interviews with 18 participants. Data were analyzed using the constant comparative method to the descriptive level. RESULTS Four major categories were identified describing the response to the consent process used for donating tissue for research purposes. These were as follows: consent is "no big deal" compared with the diagnosis of cancer; helping others; trusting the surgeon; and information related to donation of biospecimens. CONCLUSIONS Results from this study indicate that the achievement of ideal informed and voluntary consent is difficult when patients are confronted with the trauma of newly diagnosed illness. Innovative approaches are implicated to obtain consent while protecting the autonomy and dignity of patients. IMPLICATIONS FOR PRACTICE The results from this study can contribute to further development of processes for the donation of biospecimens for research purposes that respect the needs and views of patients.
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Post KE, Flanagan J. Web based survivorship interventions for women with breast cancer: An integrative review. Eur J Oncol Nurs 2016; 25:90-99. [PMID: 27865259 DOI: 10.1016/j.ejon.2016.10.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/23/2016] [Accepted: 10/19/2016] [Indexed: 01/23/2023]
Abstract
PURPOSE Breast cancer survivors' experience a range of negative sequelae post-treatment including depression, anxiety, physical side effects from treatment, sexuality concerns and decreased quality of life. Survivorship care is recommended by the IOM to meet the post treatment needs of survivors but implementation is variable and barriers to delivery such as time and resource restraints have been identified. Web-based interventions may be a way to overcome some barriers to providing quality survivorship care that is efficacious, cost efficient and convenient. The purpose of this integrative review is to summarize and synthesize the current research on web-based interventions for breast cancer survivorship care and evaluate the data to determine potential implications for practice. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide this integrative review. Key search terms included breast cancer, survivor, intervention, web, internet and technology. Articles evaluating web-based survivorship interventions (n = 405) for early stage breast cancer patients who completed active therapy were included. RESULTS Fifteen studies met inclusion criteria: six randomized controlled trials, six survey based studies, one qualitative study, one retrospective chart review and one mixed methods study. Studies evaluating cognitive behavioral therapy provided the strongest data. Other studies evaluated exercise and lifestyle interventions, symptom management programs and pilot/exploratory work. Findings suggest that web-based survivorship interventions are feasible and acceptable to breast cancer survivors. CONCLUSIONS Web-based survivorship interventions have the potential to meet the needs of breast cancer survivors while possibly overcoming some of the documented barriers to survivorship care implementation.
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Affiliation(s)
- Kathryn E Post
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; Massachusetts General Hospital, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
| | - Jane Flanagan
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; Massachusetts General Hospital, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
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Laffan AJ, Daniels J, Osborn M. Profiling the Psychological Training and Support Needs of Oncology Staff, and Evaluating the Effectiveness of a Level 2 Psychological Support Training Program Workshop. J Psychosoc Oncol 2015; 33:686-702. [PMID: 26317638 DOI: 10.1080/07347332.2015.1082170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The importance of training non-psychology healthcare professionals to offer psychological support to people with cancer is becoming increasingly recognized. This small-scale pilot project sought to identify the training and support needs of oncology staff and to evaluate the effectiveness of a Level 2 Psychological Support Training Program workshop. Semi-structured interviews with five members of multidisciplinary oncology staff identified that training needs were primarily around communication skills, recognizing and dealing with emotions, offering support and empathy, and self-care. Pre and post-training questionnaires developed with these themes in mind revealed that the Level 2 Training Program workshops run in this network of hospitals are effective in increasing participants' levels of perceived knowledge and confidence across each of these domains. Recommendations are made for further enhancing this effectiveness.
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Affiliation(s)
| | - Jo Daniels
- a Department of Psychology , University of Bath , Bath , UK
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Kadakia KC, Hui D, Chisholm GB, Frisbee-Hume SE, Williams JL, Bruera E. Cancer patients' perceptions regarding the value of the physical examination: a survey study. Cancer 2014; 120:2215-21. [PMID: 24899511 DOI: 10.1002/cncr.28680] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 12/30/2013] [Accepted: 01/07/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Despite its clinical utility, progressive reliance on technology can lead to devaluing the physical examination in patients with advanced cancer. The primary objective of this study was to determine whether these patients have a positive or negative perception of the physical examination. A secondary objective was to determine whether these perceptions are related to interpersonal/relational values (symbolic) or diagnostic/objective values (pragmatic). METHODS One hundred fifty patients with cancer who were receiving concurrent oncology and palliative care were administered a 26-item survey regarding their overall perception of the physical examination. The primary outcome-patient responses to "In the last 3 months, I believe my experience while being examined has been overall: very negative (a score of -5) to very positive (a score of +5),"-was analyzed using the Sign test. Other items were predefined as either symbolic or pragmatic statements, and patient responses from strongly disagree (a score of 1) to strongly agree (a score of 5) were further analyzed. Multivariable logistic regression was used to test for associations between baseline characteristics and the primary outcome. RESULTS Most patients (83%) indicated that the overall experience of being examined was highly positive (median score, 4; interquartile range [IQR], 2-5; P ≤ .0001). Patients valued both the pragmatic aspects (median score, 5; IQR, 4-5) and symbolic aspects (median score, 4; IQR, 4-5) of the physical examination. Increasing age was independently associated with a more positive perception of the physical examination (odds ratio, 1.07 per year; 95% confidence interval, 1.02-1.12 per year; P = .01). CONCLUSIONS Patients with advanced cancer indicate that the physical examination is a highly positive aspect of their care. These benefits are perceived as having both symbolic and pragmatic value. The physical examination should remain a cornerstone of clinical encounters.
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Affiliation(s)
- Kunal C Kadakia
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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