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Ogunsanya ME, Kaninjing E, Ellis TN, Bamidele OO, Morton DJ, McIntosh AG, Dickey SL, Kendzor DE, Dwyer K, Young ME, Odedina FT. Quality of life assessment among ethnically diverse Black prostate cancer survivors: a constructivist grounded theory approach. J Cancer Surviv 2024:10.1007/s11764-024-01619-x. [PMID: 38805150 DOI: 10.1007/s11764-024-01619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the USA, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. METHODS In-depth interviews were conducted with 34 participants: native-born BM (NBBM) (n = 17), African-born BM (ABBM) (n = 11), and Caribbean-born BM (CBBM) (n = 6) CaP survivors recruited through QR code-embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the USA. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. RESULTS Participants were thirty-four men aged 49-84 years (mean ± SD, 66 ± 8). Most were married (77%), likely to be diagnosed at stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. CONCLUSION The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices. IMPLICATIONS FOR CANCER SURVIVORS Black CAP survivors experience significant burdens and challenges that impact their overall quality of life. Understanding the factors that impact the complex survivorship journey can inform design and implementation of interventions to address the multiple challenges and thus improve quality of life.
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Affiliation(s)
- Motolani E Ogunsanya
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA.
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
| | - Ernest Kaninjing
- School of Health and Human Performance, Georgia College & State University, Milledgeville, GA, USA
| | - Tanara N Ellis
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA
| | - Olufikayo O Bamidele
- Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX, UK
| | - Daniel J Morton
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Andrew G McIntosh
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Sabrina L Dickey
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Kathleen Dwyer
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Mary Ellen Young
- Prevention, Symptom Control and Survivorship, and Care Delivery Transformation (CPSD) Program, Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Jacksonville, FL, USA
| | - Folakemi T Odedina
- Prevention, Symptom Control and Survivorship, and Care Delivery Transformation (CPSD) Program, Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Jacksonville, FL, USA
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Ogunsanya M, Kaninjing E, Ellis T, Bamidele O, Morton D, McIntosh A, Dickey S, Kendzor D, Dwyer K, Young ME, Odedina F. Quality of Life Assessment Among Ethnically Diverse Black Prostate Cancer Survivors: A Constructivist Grounded Theory Approach. RESEARCH SQUARE 2024:rs.3.rs-3941497. [PMID: 38464107 PMCID: PMC10925397 DOI: 10.21203/rs.3.rs-3941497/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Purpose Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the US, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. Methods In-depth interviews were conducted with 34 participants: Native-born BM (NBBM) (n=17), African-born BM (ABBM) (n=11), and Caribbean-born BM (CBBM) (n=6) CaP survivors recruited through QR-code embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the US. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. Results Participants were thirty-four men aged 49-84 years (mean±SD, 66±8). Most were married (77%), likely to be diagnosed at Stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. Conclusion The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices.
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Hellinga J, Stenekes MW, Werker PMN, Janse M, Fleer J, van Etten B. Quality of Life, Sexual Functioning, and Physical Functioning Following Perineal Reconstruction with the Lotus Petal Flap. Ann Surg Oncol 2020; 27:5279-5285. [PMID: 32617757 PMCID: PMC7669788 DOI: 10.1245/s10434-020-08771-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Lotus petal flaps (LPF) may be used for the reconstruction of extralevator abdominoperineal defects that cannot be closed primarily. Limited data are available on how perineal reconstruction with the LPF impacts on patients' quality of life (QoL), sexual functioning, and physical functioning. METHODS A cross-sectional study was performed following perineal reconstruction with the LPF. The QoL of patients having undergone LPF reconstruction was compared with a control group in which perineal defects were closed without flaps. Sexual and physical functioning (presence of perineal herniation and range of motion [ROM] of the hip joints) could only be evaluated in the LPF group. Psychometrically sound questionnaires were used. Physical functioning was evaluated subjectively with binary questions and objectively by physical examination. RESULTS Of the 23 patients asked to participate, 15 (65%) completed the questionnaires and 11 (47%) underwent physical examination. In the control group, 16 patients were included. There were no significant differences in QoL between the LPF and control groups. Within the LPF group, 33% of patients were sexually active postoperatively compared with 87% preoperatively. No perineal herniation was found. The ROM of the hip joints was bilaterally smaller compared with the generally accepted values. CONCLUSIONS Conclusions should be made with care given the small sample size. Despite a supposedly larger resection area in the LPF group, QoL was comparable in both groups. Nonetheless, reconstruction seemed to affect sexual function and physical function, not hampering overall satisfaction.
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Affiliation(s)
- Joke Hellinga
- Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Martin W Stenekes
- Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Paul M N Werker
- Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Moniek Janse
- Department of Health Sciences, Section Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joke Fleer
- Department of Health Sciences, Section Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Boudewijn van Etten
- Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Ten Ham RMT, Broering JM, Cooperberg MR, Carroll P, Wilson LS. Understanding the Major Factors Affecting Response Shift Effects on Health-Related Quality of Life: What the Then-Test Measures in a Longitudinal Prostate Cancer Registry. Clin Genitourin Cancer 2019; 18:e21-e27. [PMID: 31796344 DOI: 10.1016/j.clgc.2019.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Localized prostate cancer (PCa) treatments provide high survival rates, with patients often surviving a decade or longer after treatment. Therefore, treatment options are progressively based on quality of life. The objective of this research was to investigate magnitude of response shift (RS) in health-related quality of life (HRQOL) responses in men with clinically localized PCa using a generic questionnaire and a disease-specific questionnaire in an observational longitudinal patient registry study. PATIENTS AND METHODS A cohort study was conducted using the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) database. Patients were annually surveyed using the Medical Outcomes Study Questionnaire Short Form 36 (SF-36) and the UCLA Prostate Cancer Index (PCI) HRQOL measures. A total of 3161 active patients were eligible for a one-off supplemental study asking retrospective HRQOL scores (then-test). We calculated RS, observed change, and RS adjusted change. Statistical difference was determined by t test. RESULTS Patients consistently reported higher recalled pretreatment HRQOL compared to baseline scores for SF-36 and PCI, confirming the existence of a RS (P < .05). On average, PCI demonstrated larger RS by a factor of 2 than SF-36. More specific, RS was greater especially in SF-36 physical domains compared to mental health items. PCI measured PCa-specific physical adverse effects only. Patients whose cancer had recurred reported slightly lower SF-36 RS than those whose cancer had not recurred. CONCLUSION RS occurrence was measured in both the disease-specific questionnaire and the generic HRQOL questionnaire, demonstrating continued low health and symptom scores after RS adjustment. Therefore, health professionals should adjust for this phenomenon when assessing patient's HRQOL treatment responses, and clinicians should address their continued sexual and urinary functional loss.
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Affiliation(s)
- Renske M T Ten Ham
- Health Policy and Economics, Department of Clinical Pharmacy, University of California, San Francisco, CA
| | - Jeanette M Broering
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Matthew R Cooperberg
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA; Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Peter Carroll
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Leslie S Wilson
- Health Policy and Economics, Department of Clinical Pharmacy, University of California, San Francisco, CA; Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA.
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Ilie G, Bradfield J, Moodie L, Lawen T, Ilie A, Lawen Z, Blackman C, Gainer R, Rutledge RDH. The Role of Response-Shift in Studies Assessing Quality of Life Outcomes Among Cancer Patients: A Systematic Review. Front Oncol 2019; 9:783. [PMID: 31482068 PMCID: PMC6710367 DOI: 10.3389/fonc.2019.00783] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/02/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: Response-shift has been cited as an important measurement consideration when assessing patient reported quality of life (QoL) outcomes over time among patients with severe chronic conditions. Here we report the results of a systematic review of response shift in studies assessing QoL among cancer patients. Methods: A systematic review using MEDLINE, EMBASE, and PsychINFO along with a manual search of the cited references of the articles selected, was conducted. A quality review was performed using STROBE criteria and reported according to PRISMA guidelines. Results: A systematic review of 1,487 records published between 1,887 and December 2018 revealed 104 potentially eligible studies, and 35 studies met inclusion criteria for content and quality. The most common cancer patient populations investigated in these studies were breast (18 studies), lung (14 studies), prostate (eight studies), and colorectal (eight studies). Response shift was identified among 34 of the 35 studies reviewed. Effect sizes were reported in 17 studies assessing QoL outcomes among cancer patients; 12 of which had negligible to small effect sizes, four reported medium effect sizes which were related to physical, global QoL, pain, and social (role) functioning and one reported a large effect size (fatigue). The most prevalent method for assessing response shift was the then-test, which is prone to recall bias, followed by the pre-test and post-test method. Given the heterogeneity among the characteristics of the samples and designs reviewed, as well as the overall small to negligible effect sizes for the effects reported, conclusions stating that changes due to internal cognitive shifts in perceived QoL should account for changes observed in cancer patients' QoL outcomes should be interpreted with caution. Conclusion: Further work is needed in this area of research. Future studies should control for patient characteristics, time elapsed between diagnosis and baseline assessment and evaluate their contribution to the presence of response shift. Time between assessments should include short and longer periods between assessments and evaluate whether the presence of response shift holds over time. Possible avenues for inquiry for future investigation are discussed.
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Affiliation(s)
- Gabriela Ilie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Urology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Jillian Bradfield
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Louise Moodie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Tarek Lawen
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Urology, Halifax Infirmary-QEII-Nova Scotia Health Authority, Halifax Regional Municipality, NS, Canada
| | - Alzena Ilie
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Zeina Lawen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Chloe Blackman
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Ryan Gainer
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Robert D H Rutledge
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Nova Scotia Cancer Centre, Queen Elizabeth II Health Sciences Centre, Halifax Regional Municipality, NS, Canada
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Does the Time Trade-Off Method Reflect Health-Related Quality of Life? A Mixed-Methods Analysis of Preference Measures 10 Years After Aneurysmal Subarachnoid Hemorrhage. World Neurosurg 2019; 126:11-20. [DOI: 10.1016/j.wneu.2019.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 11/20/2022]
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Schmidt H, Nordhausen T, Boese S, Vordermark D, Wheelwright S, Wienke A, Johnson CD. Factors Influencing Global Health Related Quality of Life in Elderly Cancer Patients: Results of a Secondary Data Analysis. Geriatrics (Basel) 2018; 3:E5. [PMID: 31011053 PMCID: PMC6371108 DOI: 10.3390/geriatrics3010005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 12/03/2022] Open
Abstract
Cancer treatment for elderly patients is often complicated by poor physical condition, impaired functioning and comorbidities. Patient reported health related quality of life (HRQOL) can contribute to decisions about treatment goals and supportive therapy. Knowledge about factors influencing HRQOL is therefore needed for the development of supportive measures and care pathways. An exploratory secondary data analysis on 518 assessments of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire (EORTC QLQ-C30) and the elderly module (EORTC QLQ-ELD14) was performed to identify factors predictive for global HRQOL. Preliminary simple and multivariable regression analyses were conducted resulting in a final model comprising sociodemographic and disease specific variables and scales of the QLQ-C30 and QLQ-ELD14. Age, sex and disease related variables explained only part of the variance of global HRQOL (adjusted R2 = 0.203). In the final model (adjusted R2 = 0.504) fatigue, social function, burden of illness and joint stiffness showed possible influence on global HRQOL. Fatigue, social function and burden of illness seem to have the largest impact on global HRQOL of elderly cancer patients. Further prospective studies should examine these domains. Actionable symptoms should be given special attention to initiate targeted supportive measures aiming to maximize HRQOL of older cancer patients.
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Affiliation(s)
- Heike Schmidt
- Institute of Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany.
| | - Thomas Nordhausen
- Institute of Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany.
| | - Stephanie Boese
- Institute of Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany.
| | - Dirk Vordermark
- Department of Radiation Oncology, University Hospital Halle (Saale), Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40 06120 Halle (Saale), Germany.
| | - Sally Wheelwright
- Health Sciences, University of Southampton, SO17 1BJ Southampton, UK.
| | - Andreas Wienke
- Institute for Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany.
| | - Colin D Johnson
- Cancer Sciences, University of Southampton, SO17 1BJ Southampton, UK.
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Fosså SD, Dahl AA. Global Quality of Life After Curative Treatment for Prostate Cancer: What Matters? A Study Among Members of the Norwegian Prostate Cancer Patient Association. Clin Genitourin Cancer 2015; 13:518-24. [PMID: 26303590 DOI: 10.1016/j.clgc.2015.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/17/2015] [Accepted: 07/18/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The purpose of this study was to identify factors that are associated with quality of life (QoL) in relapse-free patients after radical prostatectomy or high-dose radiotherapy with or without hormone treatment. PATIENTS AND METHODS A cross-sectional postal survey among members of the Norwegian Prostate Cancer Patient Association was used. We analyzed associations between QoL and general health, "typical" adverse effects (sexual, urinary, and bowel assessed using the Expanded Prostate Cancer Composite items) and psychosocial variables (work ability, family life, social life and/or leisure activities) in univariate and multivariate regression analyses. Statistical significance was defined as P < .01. RESULTS Among 612 responders (approximately 50% compliance; median age, 70 years), in univariate analyses QoL was significantly associated with functional aspects and the level of bother within the sexual, urinary, and bowel domains and with general health and psychosocial aspects of daily life. In the multivariate analysis only general health and social life and/or leisure activities remained associated with QoL, with work ability being a third factor in patients younger than 65 years old. Posttreatment worsening of partnership was reported by 12% of the patients. CONCLUSION Prostate cancer patients who are to undergo curative treatment should be informed about the risk of reduced function within the sexual, urinary, and bowel domains, but also about these dysfunctions' relation to bother and QoL, considered together with the patients' general health and their preferences as to their social life activities.
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Affiliation(s)
- Sophie D Fosså
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital Oslo, Oslo, Norway.
| | - Alv A Dahl
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital Oslo, Oslo, Norway
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An evaluation of support of patients with prostate cancer during and beyond radiotherapy treatment. A local perspective on future provision. JOURNAL OF RADIOTHERAPY IN PRACTICE 2015. [DOI: 10.1017/s1460396915000308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractPurposeThis study was designed to evaluate whether radiographer-led on-treatment review clinics are meeting the wider needs of prostate patients receiving radiotherapy.MethodsSemi-structured interviews were used to elicit patient and staff perspectives. Interviews are used extensively in qualitative research to produce a breadth and depth of insight into participants’ experiences and opinions. Seven patients and two radiographers participated in individual audio-taped interviews. Thematic analysis of the data identified some key themes and their perceived importance within the review service for both patients and staff.ResultsSemi-structured interviews were used to elicit patient and staff views. Several themes emerged from patient and radiographer perspectives. Radiographers and patients both expressed overall satisfaction with the service. Strengths included staff communication, relaxed environment, individualised support, regular information spread throughout the review pathway and consistency in managing acute side effects. Weaknesses included information and communication gaps at the beginning and end of treatment, information inconsistency between staff groups, gaps in specialist knowledge and a possible gap in skills where staff could train as supplementary prescribers.ConclusionInterviews produced an in-depth view of patient and staff experiences. Staff and patients identified both strengths and areas for improvement within the local service. Study findings support review radiographers in sourcing additional specialist training and a closer collaboration with other staff groups, which will further develop the service. As a next step, triangulation of research methods with questionnaires could be used to evaluate whether this small sample of patients is characteristic of prostate patients in general.
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Pérez-Campdepadrós M, Castellano-Tejedor C, Sábado-Álvarez C, Gros-Subías L, Capdevila L, Blasco-Blasco T. Type of tumour, gender and time since diagnosis affect differently health-related quality of life in adolescent survivors. Eur J Cancer Care (Engl) 2014; 24:635-41. [DOI: 10.1111/ecc.12215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2014] [Indexed: 11/29/2022]
Affiliation(s)
- M. Pérez-Campdepadrós
- Department of Pediatric Oncology and Hematology; Hospital Universitari Vall d'Hebron; Barcelona Spain
- Department of Basic Psychology; Universitat Autònoma de Barcelona; Bellaterra Spain
| | - C. Castellano-Tejedor
- Department of Basic Psychology; Universitat Autònoma de Barcelona; Bellaterra Spain
- Departament of Psychiatry; Hospital Universitari Vall d'Hebron-Fundació Institut de Recerca; Barcelona Spain
| | - C. Sábado-Álvarez
- Department of Pediatric Oncology and Hematology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - L. Gros-Subías
- Department of Pediatric Oncology and Hematology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - L. Capdevila
- Department of Basic Psychology; Universitat Autònoma de Barcelona; Bellaterra Spain
| | - T. Blasco-Blasco
- Department of Basic Psychology; Universitat Autònoma de Barcelona; Bellaterra Spain
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Serdà i Ferrer BC, Valle AD, Marcos-Gragera R. Prostate Cancer and Quality of Life: Analysis of Response Shift Using Triangulation Between Methods. J Gerontol Nurs 2014; 40:32-41. [DOI: 10.3928/00989134-20140211-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 12/05/2013] [Indexed: 11/20/2022]
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Jacoby A, Ring A, Whitehead M, Marson A, Baker GA. Exploring loss and replacement of loss for understanding the impacts of epilepsy onset: a qualitative investigation. Epilepsy Behav 2014; 33:59-68. [PMID: 24632355 DOI: 10.1016/j.yebeh.2014.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 11/27/2022]
Abstract
Previous research identifies loss as a key concept for our understanding of the impact of chronic illness. In this in-depth qualitative study, we explored the utility of the concept of loss and loss replacement as a means of gaining a fuller understanding of the implications of a diagnosis of epilepsy for overall quality of life (QOL). Potential participants were identified from the database of a large UK-based randomized controlled trial of antiepileptic drug treatment for new-onset epilepsy and selected using purposive sampling methods. In-depth interviews were conducted with 67 people; interview material was analyzed thematically. Our findings confirm 'loss' as a key concept in understanding epilepsy impact. Participants cited profound physical and social losses, and the links between these and psychological loss were clearly articulated. Informants described two main processes via which the linked losses they experienced occurred: personal withdrawal processes and externally enforced processes. Seizure control was integral to restoring psychological well-being and a sense of normality but was only one of a number of influences moderating the degree of loss experienced following seizure onset. Our work emphasizes that people with epilepsy (PWE) require active support for their continued engagement or reengagement in roles and activities identified as central to their psychological well-being and overall QOL. Achieving this requires a multiagency approach to drive forward key strategies for reduction of the negative impacts of epilepsy and to engender a sense of normality in the context of a condition often experienced as placing the individual outside the socially determined parameters of the 'normal'.
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Affiliation(s)
- Ann Jacoby
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK.
| | - Adele Ring
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK
| | - Margaret Whitehead
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK
| | - Anthony Marson
- Department of Molecular & Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Gus A Baker
- Department of Molecular & Clinical Pharmacology, University of Liverpool, Liverpool, UK
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Pettersson A, Turesson I, Persson C, Johansson B. Assessing patients' perceived bother from the gastrointestinal side effects of radiotherapy for localized prostate cancer: initial questionnaire development and validation. Acta Oncol 2014; 53:368-77. [PMID: 23957649 DOI: 10.3109/0284186x.2013.819994] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The present study reports on the development and first steps of validation of the Gastrointestinal Side Effects Questionnaire (GISEQ), a measure of patient-reported gastrointestinal symptoms following local radiotherapy to the prostate. The questionnaire design provides a novel approach of assessment of side effects of prostate radiotherapy, by enabling measurement of patient-perceived change in symptoms. MATERIAL AND METHODS The eight-item GISEQ was administered to 130 prostate cancer patients referred to radiotherapy. Patients completed the GISEQ at four, eight and 15 weeks after start of radiotherapy. The psychometric properties including validity, reliability, responsiveness and feasibility were evaluated. The EORTC QLQ-C30 and QLQ-PR25 were chosen as comparative measures. RESULTS Expert opinion supported content validity. For concurrent validity, correlation between the GISEQ and matching items in the EORTC questionnaires was moderate but significant (r > 0.41, p < 0.001). The responsiveness was adequate, indicated by changes in GISEQ scores over time corresponding to the effects of radiation. Internal consistency was satisfactory (overall Cronbach's α> 0.70). Sensitivity and specificity for items diarrhea, constipation and blood in stools ranged from 50% to 100% and from 68% to 100%, respectively. All items had a floor effect above 15%. The response rates ranged from 85% to 92% and missing items was < 0.8%, indicating good feasibility. CONCLUSIONS The GISEQ showed satisfactory internal consistency and adequate content validity, concurrent validity and responsiveness. It is brief, easy to use and can be quickly evaluated, making it useful not only for research but possibly also for clinical settings. Modification of response scale and extension of items are potential improvements. Further work is needed to strengthen the psychometric qualities of the GISEQ and to evaluate its clinical use and potential effects of response shift and recall bias.
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Affiliation(s)
- Anna Pettersson
- Department of Radiology, Oncology and Radiation Science, Uppsala University , Uppsala , Sweden
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Bhattasali O, Chen LN, Woo J, Park JW, Kim JS, Moures R, Yung T, Lei S, Collins BT, Kowalczyk K, Suy S, Dritschilo A, Lynch JH, Collins SP. Patient-reported outcomes following stereotactic body radiation therapy for clinically localized prostate cancer. Radiat Oncol 2014; 9:52. [PMID: 24512837 PMCID: PMC3931491 DOI: 10.1186/1748-717x-9-52] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 02/06/2014] [Indexed: 02/07/2023] Open
Abstract
Background Stereotactic body radiation therapy (SBRT) delivers high doses of radiation to the prostate while minimizing radiation to adjacent normal tissues. Large fraction sizes may increase the risk of functional decrements. Treatment-related bother may be more important to a patient than treatment-related dysfunction. This study reports on patient-reported outcomes following SBRT for clinically localized prostate cancer. Methods Between August 2007 and July 2011, 228 consecutive hormone-naïve patients with clinically localized prostate cancer were treated with 35–36.25 Gy SBRT delivered using the CyberKnife Radiosurgical System (Accuray) in 5 fractions. Quality of life was assessed using the American Urological Association Symptom Score (AUA) and the Expanded Prostate Cancer Index Composite (EPIC)-26. Urinary symptom flare was defined as an AUA score 15 or more with an increase of 5 or more points above baseline 6 months after treatment. Results 228 patients (88 low-, 126 intermediate- and 14 high-risk) at a median age of 69 (44–90) years received SBRT with a minimum follow-up of 24 months. EPIC urinary and bowel summary scores declined transiently at 1 month and experienced a second, more protracted decline between 9 months and 18 months before returning to near baseline 2 years post-SBRT. 14.5% of patients experienced late urinary symptom flare following treatment. Patients who experienced urinary symptom flare had poorer bowel quality of life following SBRT. EPIC scores for urinary bother declined transiently, first at 1 month and again at 12 months, before approaching pre-treatment scores by 2 years. Bowel bother showed a similar pattern, but the second decline was smaller and lasted 9 months to 18 months. EPIC sexual summary and bother scores progressively declined over the 2 years following SBRT without recovery. Conclusions In the first 2 years, the impact of SBRT on urination and defecation was minimal. Transient late increases in urinary and bowel dysfunction and bother were observed. However, urinary and bowel function and bother recovered to near baseline by 2 years post-SBRT. Sexual dysfunction and bother steadily increased following treatment without recovery. SBRT for clinically localized prostate cancer was well tolerated with treatment-related dysfunction and bother comparable to conventionally fractionated radiation therapy or brachytherapy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sean P Collins
- Department of Radiation Medicine, Georgetown University Hospital, 3800 Reservoir Road, N,W,, Washington, D,C 20007, USA.
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Jacoby A, Baker GA, Crossley J, Schachter S. Tools for assessing quality of life in epilepsy patients. Expert Rev Neurother 2013; 13:1355-69. [PMID: 24215282 DOI: 10.1586/14737175.2013.850032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this review, we attempt to bring the reader up to date with recent developments in the area of assessment of quality of life (QOL) of patients with epilepsy, in both the research and clinical contexts. We present evidence from recent publications on the major and most commonly used QOL instruments for both adults and children with epilepsy, including both strengths and limitations. We discuss both generic measures and ones that have been developed specifically for use in the epilepsy population. We draw attention to some of the broader issues that render the QOL assessment endeavor a somewhat complex one - in particular, that epilepsy is not a single condition, with a common clinical trajectory; and that QOL measures as currently configured almost universally focus on its negative impacts, largely neglecting the possibility of those affected being able to retain reasonable social adjustment and life satisfaction. Finally, we suggest that further work needs to focus on plugging the current evidence gaps in relation to psychometric and cross-cultural applicability issues; and on the value of QOL instruments in the clinical care setting. We conclude by highlighting a number of issues from the QOL literature that will, in our view, be the focus of increasing research interest in the next few years.
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Affiliation(s)
- Ann Jacoby
- Department of Public Health & Policy, University of Liverpool, Liverpool, L69 3GB, UK
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16
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Kyrdalen AE, Dahl AA, Hernes E, Småstuen MC, Fosså SD. A national study of adverse effects and global quality of life among candidates for curative treatment for prostate cancer. BJU Int 2012; 111:221-32. [PMID: 22672151 DOI: 10.1111/j.1464-410x.2012.11198.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To provide population-based estimates of typical adverse effects (AEs), e.g. urinary, bowel and sexual dysfunction, in patients with non-metastatic recurrence-free prostate cancer (PCa) by curative treatment method, including no treatment. To describe associations between typical AEs and global quality of life (QoL) and to study patients' use of medication for erectile dysfunction (EDmed) and the relationship between such use and global QoL. PATIENTS AND METHODS In October 2006 a national population-based sample of PCa survivors diagnosed in 2004 was invited to a postal survey focusing on treatment-related AEs and global QoL, 12-32 months after treatment start. All had completed their initial treatment. In the present study, 771 compliers were categorized into four groups of localized or locally advanced PCa related to the treatment they completed: (i) no treatment; (ii) radical prostatectomy (RP); (iii) radiotherapy (RAD) without hormones; and (iv) RAD with hormone therapy of 3-24 months duration. Measurement of AEs was restricted to function, using selected items from the 50-item Expanded Prostate Cancer Index Composite and the Brief Sexual Function Inventory among others, whereas global QoL was measured with the 12-item short-form health survey. National prescription data enabled assessment of adjuvant hormone application and EDmed use. RESULTS Men who had undergone RP reported more urinary incontinence (24%) than the other treatment groups, but had the lowest level of moderate/severe urinary irritative-obstructive symptoms. Men from the 'no treatment' group had the highest level of moderate/severe irritative-obstructive urinary symptoms. Men who had undergone RAD reported higher levels of irritative intestinal symptoms and faecal leakage compared with the RP group and the no treatment group. In all treatment groups, poor sexual drive and poor erectile function were common AEs, with men treated with RP reporting the highest prevalence of poor erectile function (89%). Presence of irritative-obstructive urinary symptoms and poor sexual drive were independently associated with low global QoL in multivariate analyses. Fifty percent of the study group had used EDmed after treatment start, but only 47% of them were still using EDmed at the time of the survey. Use of EDmed was not significantly associated with global QoL. CONCLUSIONS PCa survivors after curative treatment, but also patients without any anticancer therapy, report high levels of urinary and sexual AEs. Irritative-obstructive urinary symptoms and poor sexual drive were significantly associated with low global QoL, whereas erectile function and use of EDmed were not.
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Visser MRM, Oort FJ, van Lanschot JJB, van der Velden J, Kloek JJ, Gouma DJ, Schwartz CE, Sprangers MAG. The role of recalibration response shift in explaining bodily pain in cancer patients undergoing invasive surgery: an empirical investigation of the Sprangers and Schwartz model. Psychooncology 2012; 22:515-22. [DOI: 10.1002/pon.2114] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 09/26/2011] [Accepted: 11/22/2011] [Indexed: 11/05/2022]
Affiliation(s)
- Mechteld R. M. Visser
- Department of Medical Psychology; Academic Medical Center; Amsterdam; The Netherlands
| | - Frans J. Oort
- Department of Medical Psychology; Academic Medical Center; Amsterdam; The Netherlands
| | | | - Jacobus van der Velden
- Department of Obstetrics and Gynaecology; Academic Medical Center; Amsterdam; The Netherlands
| | | | - Dirk J. Gouma
- Department of Surgery; Academic Medical Center; Amsterdam; The Netherlands
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van Haaren MAC, Lawrence M, Goossens PH, van den Bossche B, Wermer MJH, Kaptein AA. Pirandello's analogy: a source for a better understanding of the social impact of stroke. Eur Neurol 2012; 67:92-7. [PMID: 22236661 DOI: 10.1159/000334846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 11/04/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Suffering a stroke has major implications for the patient. To understand human suffering, one should understand society. Pirandello described society as a higher entity than the individual, thereby justifying human adaptability to society. We explore a qualitative finding that suggests that social trends may influence how stroke patients prioritize aspects of their rehabilitation. METHODS We compare a contemporary patient's experience of stroke recovery with that of a fictional character from the works of Luigi Pirandello. Both patients had two main residual symptoms: hemiparesis and aphasia. RESULTS The rehabilitation priorities of the two patients differed, and appeared to reflect the contemporaneous demands of society. Mobility was prioritized in 1910; communication was prioritized in 2010. However, essential aspects of 'being a stroke patient' remained unchanged; both patients retained a sense of self and both coped emotionally by being hopeful. CONCLUSIONS We conclude that stroke patients respond to society's contemporaneous demands and expectations. Currently, society demands participation in a large social environment and this is reflected in stroke patients' priorities. This analogy could enable medical professionals to better understand the social impact of stroke, and consequently offer appropriate interventions to improve rehabilitation outcomes for individual patients.
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Affiliation(s)
- M A C van Haaren
- Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands.
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Chambers SK, Meng X, Youl P, Aitken J, Dunn J, Baade P. A five-year prospective study of quality of life after colorectal cancer. Qual Life Res 2011; 21:1551-64. [PMID: 22200938 DOI: 10.1007/s11136-011-0067-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2011] [Indexed: 11/28/2022]
Abstract
PURPOSE Long-term (≥5 years) quality of life after colorectal cancer is not well described. The present study assessed quality of life (QOL) and psychological distress in colorectal cancer survivors more than 5 years to describe changes over time and antecedents of long-term outcomes. METHOD A prospective survey of a population-based sample of 763 colorectal cancer patients assessed socio-demographic variables, health behaviors, optimism, threat appraisal, and perceived social support at 5 months post-diagnosis as predictors of QOL and psychological distress 5 years post-diagnosis. RESULTS QOL improved over time (P < 0.01 for each measure); however, measures of psychological distress remained stable (P > 0.07 for each measure). Risk factors for poorer QOL and/or greater psychological distress included: later stage disease, having a permanent stoma, rectal cancer, fatigue, smoking, being single, low social support, low optimism, and a more negative cancer threat appraisal. Being women, having a pet, having a private health insurance, and receiving both surgery and adjuvant treatment were protective. CONCLUSION Consistent with response shift theory, the antecedents of QOL after colorectal cancer are multifactorial and include predisposing socio-demographic, medical, and psychological variables. Psychosocial interventions that target both social support and threat appraisal may be effective for this patient group. Additional stepped-up support may be needed for people from a poorer social environment who have multiple risk factors for poorer adjustment. Health system effects require further investigation.
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Affiliation(s)
- Suzanne K Chambers
- Griffith Health Institute, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
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