1
|
Bognár SA, Teutsch B, Bunduc S, Veres DS, Szabó B, Fogarasi B, Zahariev OJ, Vörhendi N, Almog O, Hadani Y, Gergő D, Mihály E, Erőss B, Bunduc S, Márta K, Hegyi P. Psychological intervention improves quality of life in patients with early-stage cancer: a systematic review and meta-analysis of randomized clinical trials. Sci Rep 2024; 14:13233. [PMID: 38853187 PMCID: PMC11162999 DOI: 10.1038/s41598-024-63431-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/29/2024] [Indexed: 06/11/2024] Open
Abstract
The effectiveness of psychological interventions (PI) for malignant diseases is controversial. We aimed to investigate the effect of PI on survival and quality of life (QoL) in patients with cancer. We performed a systematic search of MEDLINE, Cochrane, and Embase databases to identify randomized controlled trials comparing PI to standard care (PROSPERO registration number CRD42021282327). Outcomes were overall survival (OS), recurrence-free survival (RFS), and different domains of QoL. Subgroup analysis was performed based on the provider-, type-, environment-, duration of intervention; cancer stage, and type. Pooled hazard ratios (HR) and standardized mean difference (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. The OS and RFS did not differ significantly between the two groups (OS:HR = 0.97; CI 0.87-1.08; RFS:HR = 0.99; CI 0.84-1.16). However, there was significant improvement in the intervention group in all the analyzed domains of QoL; in the global (SMD = 0.65; CI 0.35-0.94), emotional (SMD = 0.64; CI 0.33-0.95), social (SMD = 0.32; CI 0.13-0.51) and physical (SMD = 0.33; CI 0.05-0.60) domains. The effect of PI on QoL was generally positive immediately, 12 and 24 weeks after intervention, but the effect decreased over time and was no longer found significant at 48 weeks. The results were better in the breast cancer group and early stages of cancer. PIs do not prolong survival, but they significantly improve the QoL of cancer patients. PI should be added as standard of care 3-4 times a year, at least for patients with early-stage cancer.
Collapse
Affiliation(s)
- Sára Anna Bognár
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Dániel Sándor Veres
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, 1085, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Beatrix Fogarasi
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
| | - Olga Júlia Zahariev
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Nóra Vörhendi
- Institute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, Hungary
- Department of Internal Medicine, Siófok City Hospital and Outpatient Clinic, 8601, Siófok, Hungary
| | - Omer Almog
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Yael Hadani
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Dorottya Gergő
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Department of Pharmacognosy, Semmelweis University, Üllői út 26, 1085, Budapest, Hungary
| | - Emese Mihály
- Department of Internal Medicine and Hematology, Medical School, Semmelweis University, 1088, Budapest, Hungary
| | - Bálint Erőss
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Center for Digestive Diseases and Liver Transplant, Fundeni Clinical Institute, 022328, Bucharest, Romania
| | - Katalin Márta
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation University of Szeged, 6725, Szeged, Hungary
| | - Péter Hegyi
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary.
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary.
- Institute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, Hungary.
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation University of Szeged, 6725, Szeged, Hungary.
| |
Collapse
|
2
|
González-Fernández L, Romero-Morales C, Martínez-Pascual B, Río-González A, Cerezo-Téllez E, López-Martín I. Breast cancer survivors suffering from lymphedema: What really do affect to corporeality/body image? A qualitative study. Breast Cancer Res 2024; 26:47. [PMID: 38486203 PMCID: PMC10941543 DOI: 10.1186/s13058-024-01806-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
Breast cancer-related lymphedema is currently one of the most serious complications that most affect the quality of life of women undergoing breast cancer. The aim of this study was to explore in-depth the experience of women who suffer from lymphoedema after breast cancer and how does this condition affect corporeality, with no judgements. For this purpose, a qualitative methodology was followed. In-depth interviews, interviewer's field notes and participants' letters were used for data collection. The participants were twenty Spanish women with lymphoedema after overcome a breast cancer in the past. Healthcare specialists with experience in the topic were also included. Results showed 2 main categories: "From cancer to lymphedema, another disease another disease" and "Potential for transition and transformation towards a new way of life". As a conclusion, the difficulty in accessing adequate treatment, the need for greater awareness of lymphedema and the importance of the emotional and psychological dimension of this chronic disease. Highlighting the attitudes that these women develop for self-care and the concept of new corporeality. After breast cancer, women with lymphedema experience a drastic change that affects all areas of their lives. The adaptation process, and the search for resources and aid, play a fundamental role in overcoming this process.
Collapse
Affiliation(s)
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | | | - Angela Río-González
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Asociación Española de Linfedema y Lipedema, AEL, Madrid, Spain
| | - Ester Cerezo-Téllez
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Inmaculada López-Martín
- Escuela de Enfermería Fundación Jiménez Díaz, Instituto de Investigación Sanitaria - Hospital Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| |
Collapse
|
3
|
El-Khoury F, Mino JC, Deschamps N, Lopez C, Menvielle G, Dargent-Molina P. Effectiveness of a community-based multicomponent lifestyle intervention (the ADA programme) to improve the quality of life of French breast cancer survivors: protocol for a pragmatic cluster randomised trial and embedded qualitative study. BMJ Open 2024; 14:e081447. [PMID: 38485475 PMCID: PMC10941123 DOI: 10.1136/bmjopen-2023-081447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/27/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Breast cancer survivors (BCSs) are often faced with multiple mental and physical sequelae and are at increased risk of emotional distress, degraded health-related quality of life (HRQoL), chronic pain and fatigue.Physical activity is strongly associated with improved HRQoL and survival rates; however, adherence rates to recommendations for a healthy lifestyle are seldom satisfactory among BCSs. Also, few studies have examined the effectiveness of multicomponent and personalised interventions that integrate physical activity and motivational techniques to improve the HRQoL of BCS. METHOD AND ANALYSIS "Activité physique adaptée Doublée d'un Accompagnement d'après cancer" (ADA) is an integrated programme of physical activity enriched with a dietary and supportive care approach targeting BCS in the early post-treatment phase. The effectiveness of the ADA intervention will be evaluated using a cluster randomised controlled trial design with two arms (ADA programme vs usual care; 1:1 ratio).The ADA intervention aims to recruit 160 participants and will be implemented by Siel Bleu, a non-profit association specialised in health prevention via adapted physical activity. Measurements will be performed at baseline, 3, 6 and 12 months after the start of the intervention. The primary outcome will be participants' HRQoL, at 12 months measured by the Functional Assessment of Chronic Illness Therapy-Fatigue global score. Secondary outcome will include participants' physical, social, emotional and functional well-being. The effect of the intervention on physical activity level, motivation for physical activity, relation to food and self-efficacy will also be evaluated. ETHICS AND DISSEMINATION The study was approved by the 'CPP Paris XI' Institutional Review Board on 5 May 2022 (Ref no.: 21.04512.000048-22004). The study's findings will be shared through various channels, including academic publications, simplified reports for wider audiences and active engagement with medical and institutional organisations as well as patients' associations. TRIAL REGISTRATION NUMBER NCT05658341.
Collapse
Affiliation(s)
- Fabienne El-Khoury
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, Île-de-France, France
| | | | | | - Chloé Lopez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, Île-de-France, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, Île-de-France, France
- INSERM, Gustave Roussy Institute, University Paris Saclay, Unit Molecular Predictors and New Targets in Oncology, Villejuif, Île-de-France, France
| | - Patricia Dargent-Molina
- Université Paris Cité et Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, Île-de-France, France
| |
Collapse
|
4
|
Kawasaki Y, Hirai K, Nii M, Kizawa Y, Uchinuno A. Actual situation of decision-making support from medical staff when cancer patients make treatment choices. Future Oncol 2023; 19:2263-2272. [PMID: 37905530 DOI: 10.2217/fon-2023-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Background: We investigated factors involved in decision-making support provided by physicians, nurses, pharmacists and medical and psychiatric social workers involved in cancer care. Materials & methods: A questionnaire survey on decision-making support was conducted. The level of clinician support was classified as 'supporting patients' 'decision-making process regarding cancer treatment', 'no support for patients' 'decision-making process regarding cancer treatment' or 'team-based support for patients' 'decision-making process regarding cancer treatment'. Results: Physicians estimated that 83.7% of patients made a cancer treatment decision within 1 week, but 45.4% of patients had difficulty making a decision. Conclusion: Medical personnel should support patients who have difficulty making decisions, establish a screening method to identify those needing support and develop a system providing decision-making support through interprofessional work.
Collapse
Affiliation(s)
- Yuko Kawasaki
- College of Nursing Art & Science, University of Hyogo, Hyogo, Japan
| | - Kei Hirai
- Osaka University Graduate School of Human Sciences, Suita, Japan
| | - Manabu Nii
- Department of Electronics & Computer Science, University of Hyogo, Himeji, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative & Supportive Care, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Atsuko Uchinuno
- Faculty of Nursing, Tsuruga Nursing University, Tsuruga, Japan
| |
Collapse
|
5
|
A Scoping Review and a Taxonomy to Assess the Impact of Mobile Apps on Cancer Care Management. Cancers (Basel) 2023; 15:cancers15061775. [PMID: 36980661 PMCID: PMC10046563 DOI: 10.3390/cancers15061775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/01/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Mobile Health (mHealth) has a great potential to enhance the self-management of cancer patients and survivors. Our study aimed to perform a scoping review to evaluate the impact and trends of mobile application-based interventions on adherence and their effects on health outcomes among the cancer population. In addition, we aimed to develop a taxonomy of mobile-app-based interventions to assist app developers and healthcare researchers in creating future mHealth cancer care solutions. Relevant articles were screened from the online databases PubMed, EMBASE, and Scopus, spanning the time period from 1 January 2016 to 31 December 2022. Of the 4135 articles initially identified, 55 were finally selected for the review. In the selected studies, breast cancer was the focus of 20 studies (36%), while mixed cancers were the subject of 23 studies (42%). The studies revealed that the usage rate of mHealth was over 80% in 41 of the 55 studies, with factors such as guided supervision, personalized suggestions, theoretical intervention foundations, and wearable technology enhancing adherence and efficacy. However, cancer progression, technical challenges, and unfamiliarity with devices were common factors that led to dropouts. We also proposed a taxonomy based on diverse theoretical foundations of mHealth interventions, delivery methods, psycho-educational programs, and social platforms. We suggest that future research should investigate, improve, and verify this taxonomy classification to enhance the design and efficacy of mHealth interventions.
Collapse
|
6
|
Nascimben M, Lippi L, de Sire A, Invernizzi M, Rimondini L. Algorithm-Based Risk Identification in Patients with Breast Cancer-Related Lymphedema: A Cross-Sectional Study. Cancers (Basel) 2023; 15:cancers15020336. [PMID: 36672283 PMCID: PMC9856619 DOI: 10.3390/cancers15020336] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
Background: Breast cancer-related lymphedema (BCRL) could be one consequence of breast cancer (BC). Although several risk factors have been identified, a predictive algorithm still needs to be made available to determine the patient's risk from an ensemble of clinical variables. Therefore, this study aimed to characterize the risk of BCRL by investigating the characteristics of autogenerated clusters of patients. Methods: The dataset under analysis was a multi-centric data collection of twenty-three clinical features from patients undergoing axillary dissection for BC and presenting BCRL or not. The patients' variables were initially analyzed separately in two low-dimensional embeddings. Afterward, the two models were merged in a bi-dimensional prognostic map, with patients categorized into three clusters using a Gaussian mixture model. Results: The prognostic map represented the medical records of 294 women (mean age: 59.823±12.879 years) grouped into three clusters with a different proportion of subjects affected by BCRL (probability that a patient with BCRL belonged to Cluster A: 5.71%; Cluster B: 71.42%; Cluster C: 22.86%). The investigation evaluated intra- and inter-cluster factors and identified a subset of clinical variables meaningful in determining cluster membership and significantly associated with BCRL biological hazard. Conclusions: The results of this study provide potential insight for precise risk assessment of patients affected by BCRL, with implications in prevention strategies, for instance, focusing the resources on identifying patients at higher risk.
Collapse
Affiliation(s)
- Mauro Nascimben
- Center for Translational Research on Autoimmune and Allergic Diseases-CAAD, Department of Health Sciences, Università del Piemonte Orientale “A. Avogadro”, 28100 Novara, Italy
- Enginsoft SpA, 35129 Padua, Italy
- Correspondence:
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, Università del Piemonte Orientale “A. Avogadro”, 28100 Novara, Italy
- Infrastruttura Ricerca Formazione Innovazione (IRFI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, Università del Piemonte Orientale “A. Avogadro”, 28100 Novara, Italy
- Infrastruttura Ricerca Formazione Innovazione (IRFI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Lia Rimondini
- Center for Translational Research on Autoimmune and Allergic Diseases-CAAD, Department of Health Sciences, Università del Piemonte Orientale “A. Avogadro”, 28100 Novara, Italy
| |
Collapse
|
7
|
Siira H, Kääriäinen M, Jämsä U. Experiences of implementation of the group-based adaptation training intervention for patients with chronic somatic illnesses or disabilities among multi-professional teams in specialized healthcare. Ann Med 2023; 55:2253725. [PMID: 37695695 PMCID: PMC10496520 DOI: 10.1080/07853890.2023.2253725] [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: 04/22/2023] [Revised: 08/12/2023] [Accepted: 08/26/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To describe the experiences of multi-professional teams of implementation of group-based adaptation training intervention for patients with chronic somatic illnesses or disabilities in specialized healthcare. MATERIALS AND METHODS Multi-professional teams (n = 7) implementing adaptation training courses for chronically ill patients in specialised healthcare were interviewed between 09/2020 and 12/2021. The themes for thematic group interviews were based on the standard protocol implementation of adaptation training in specialised healthcare, including planning, implementation and evaluation of the adaptation training courses. The interviews were audio-recorded and transcribed. The data were analysed using inductive content analysis. RESULTS The experiences of multi-professional teams involved using pedagogical methods, providing guidance and counselling to support the rehabilitation process, ensuring opportunities for peer support, and supporting the course participants' involvement and activities in everyday life. CONCLUSIONS Healthcare professionals should use pedagogical methods in reflective guidance and counselling to promote client-oriented approach in supporting adaptation. Their competence in pedagogy needs to be build and maintained by continuous education. Multi-professional teams need to ensure sufficient and versatile conditions for peer support and involvement of family members by creating open and trusting atmosphere, unhurried encounters, discussions, different and varying ways of working. Adaptation training can strengthen the self-efficacy of participants and help them shift their attention from illness and disability to thoughts of the future. Adaptation training can support active and meaningful daily life in a changed life situation.
Collapse
Affiliation(s)
- Heidi Siira
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Medical Rehabilitation, Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
| | - Ulla Jämsä
- Department of Medical Rehabilitation, Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
8
|
Effects of Ultrasound-Guided Injection Combined with a Targeted Therapeutic Exercise in Breast Cancer Women with Subacromial Pain Syndrome: A Randomized Clinical Study. J Pers Med 2022; 12:jpm12111833. [PMID: 36579554 PMCID: PMC9697338 DOI: 10.3390/jpm12111833] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/01/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
In this randomized controlled study, we aimed to assess the effects of US-guided injections of the subacromial bursa followed by a personalized rehabilitation program for breast cancer (BC) survivors. We assessed patients with subacromial pain syndrome without tendon lesions and with a history of post-surgical non-metastatic BC. Thirty-seven patients were enrolled and randomly assigned 1:1 to receive US-guided corticosteroid injections combined with a personalized rehabilitation program (Group A; n: 19) or US-guided corticosteroid injections alone (Group B; n: 18). The primary outcome was pain relief, assessed using a numerical pain rating scale (NPRS). The secondary outcomes were muscle strength, shoulder function, and quality of life. No major or minor late effects were reported after the multidisciplinary intervention. Statistically significant within-group differences were found in terms of NPRS (p ≤ 0.05) in both groups. No significant between-group differences were reported after one week. However, the between-group analysis showed significant differences (p ≤ 0.05) after three months of follow-up in terms of pain intensity, muscle strength, shoulder function, and quality of life. Our findings suggested positive effects of a multidisciplinary approach including US-guided corticosteroid injections combined with a personalized rehabilitation program in improving pain intensity and quality of life of BC survivors with subacromial pain syndrome.
Collapse
|
9
|
Invernizzi M, Lippi L, Folli A, Turco A, Zattoni L, Maconi A, de Sire A, Fusco N. Integrating molecular biomarkers in breast cancer rehabilitation. What is the current evidence? A systematic review of randomized controlled trials. Front Mol Biosci 2022; 9:930361. [PMID: 36158576 PMCID: PMC9493088 DOI: 10.3389/fmolb.2022.930361] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/13/2022] [Indexed: 01/18/2023] Open
Abstract
Background: Quality of life issues is a crucial burden in breast cancer (BC) survivors with relevant implications in terms of survivorship and health-care costs. The increasing long-term survival of these patients provides new challenges, with translational research now focusing on innovative and tailored approaches to improve their complex management. In this scenario, several emerging biomarkers have the potential to improve the clinical rehabilitative management of patients with BC. However, to date, guidelines supporting biomarker implementation in this area are still lacking. Therefore, the aim of this systematic review was to summarize the currently available biomarkers that might be potentially integrated into rehabilitation practice to promote a precision medicine approach to BC survivorship issues. Methods: On 9th March 2022, PubMed, Scopus, Web of Science, Cochrane, and PEDro were systematically searched for randomized controlled trials (RCTs) assessing rehabilitation interventions in BC patients. Molecular biomarker modifications induced by physical exercise have been assessed through the review of the study protocols and published results. The Jadad scale was used to assess the quality of the studies included. Results: Out of 2,224 records, 22 studies were included in the present systematic review. Exercise therapy showed significant results in 15 RCTs, in terms of metabolic biomarkers, including glycemic and insulin profile, and lipid profile (p ≤ 0.05). Similarly, 12 studies underlined significant effects in inflammation and immune response biomarkers, including TNF-α, IL-6, IL-10, C-reactive protein, leptin, and adiponectin (p ≤ 0.05). On the other hand, cardiac biomarkers were assessed in three studies without reporting significant differences after exercise therapy (p = NS). The quality assessment identified 19 RCTs as high-quality studies and three RCTs of low quality. Conclusion: Our findings reveal significant biochemical perturbations in key molecules induced by physical exercise in patients with BC, suggesting room for the implementation of actionable biomarkers. Future research might clarify the role of biomarkers on treatment effectiveness monitoring, to optimize rehabilitative strategies tailored to patient’s needs.
Collapse
Affiliation(s)
- Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
- *Correspondence: Marco Invernizzi,
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Arianna Folli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
| | - Alessio Turco
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
| | - Lorenzo Zattoni
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Antonio Maconi
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - Nicola Fusco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| |
Collapse
|
10
|
Stehle L, Hoosain M, van Niekerk L. A systematic review of work-related interventions for breast cancer survivors: Potential contribution of occupational therapists. Work 2022; 72:59-73. [DOI: 10.3233/wor-210053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: A high number of breast cancer survivors need to resume work. Therefore, interventions aimed at effective work-related transitions are important. OBJECTIVE: A systematic review to determine what occupational therapy interventions are effective in work-related transitions of breast cancer survivors. METHODS: Multiple databases were searched for studies on work-related interventions within the scope of occupational therapy. Studies were included if 70% or more study participants were working age (> 18 years) breast cancer survivors, and work-related transition outcome measures were used. RESULTS: The search yielded 2 872 articles, of which 12 met the inclusion criteria. When classified according to the International Classification of Function Framework, quantitative sources focussed on Body Structures and Functions component and Multicomponents (consists of the Body Structures and Functions Component and the Activities Component) showed positive effects on improving the work-related transitions of BC survivors, however, the effects were statistically insignificant and the strength of evidence was moderate. Participants in a qualitative source reported that after they underwent a physical exercise programme their work performance improved. A Multicomponents intervention study showed statistically significant improvements on self-reported work-related outcomes of BC survivors. Low evidence was found for implementing a vocational rehabilitation case management programme targeting the Activities component, which showed positive effects in reducing the sick leave days of BC survivors, but the effects were statistically insignificant. No evidence was found for programmes focussed on restoring the Participation component. CONCLUSION: The evidence included in this systematic review were insufficient to recommend occupational therapy interventions that are effective (showing statistically significant improvements) for work-related transitions of BC cancer survivors.
Collapse
Affiliation(s)
- Luna Stehle
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Munira Hoosain
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lana van Niekerk
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
11
|
Getting back on track: a group psychoeducational intervention for patients and families living with head and neck cancer. Support Care Cancer 2022; 30:3259-3268. [PMID: 34984551 DOI: 10.1007/s00520-021-06771-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Head and neck cancer survivors are increasing in prevalence, and 60-70% still experience at least one unmet emotional and/or physical need after treatment has ended. The purpose of this study was to determine the efficacy of a brief post-treatment psychoeducational intervention on perceived preparedness for coping with recovery using post-session evaluations. METHODS Between August 2013 and May 2018, a two-session, multidisciplinary "getting back on track" class was delivered to head and neck cancer patients approximately 2 months following radiation treatment at Princess Margaret Cancer Centre in Toronto, Canada. Three hundred and fifty attendees completed evaluations. Statistical analyses of the 310 patients surveyed measured change in level of preparedness to cope with recovery using the b-prepared scale. Qualitative analyses provided insight into potential benefits for future patients. RESULTS Almost two-thirds (58%) of patients reported an increase in level of preparedness in post-intervention surveys. Comparing self-reported level of preparedness among patients from before to after the class showed an increase in feeling prepared from 50 to 58%, and of those feeling very prepared, from 6 to 34%. The proportion of patients who reported feeling unprepared (11%) or neutral (33%) before the class decreased post-intervention, with 0% feeling unprepared and 7% feeling neutral. There were statistically significant differences in the ideal timing of the class, but overall attendees agreed that the class is an essential part of their recovery. CONCLUSION Results confirm the efficacy of this brief psychoeducational intervention to improve preparedness in head and neck cancer survivors following radiation treatment.
Collapse
|
12
|
Valentini J, Fröhlich D, Stolz R, Mahler C, Martus P, Klafke N, Horneber M, Frasch J, Kramer K, Bertz H, Grün B, Tomaschko-Ubeländer K, Joos S. Interprofessional evidence-based counselling programme for complementary and integrative healthcare in patients with cancer: study protocol for the controlled implementation study CCC-Integrativ. BMJ Open 2022; 12:e055076. [PMID: 35149568 PMCID: PMC8845169 DOI: 10.1136/bmjopen-2021-055076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION According to international literature, patients with cancer wish to have information on complementary and integrative healthcare (CIH). Medical guidelines recommend actively approaching patients with cancer discussing potential benefits and risks of individual CIH methods. While some CIH methods, for example, acupuncture and yoga, have been proven effective in high-quality studies, other CIH methods lack studies or bear the risk of interactions with chemotherapeutics, for example, herbal drugs. Therefore, an evidence-based interprofessional counselling programme on CIH will be implemented at four Comprehensive Cancer Centres in the federal state of Baden-Wuerttemberg, Germany. METHODS AND ANALYSIS A complex intervention consisting of elements on patient, provider and system levels will be developed and evaluated within a multilayer evaluation design with confirmatory evaluation on patient level. Patients with a cancer diagnosis within the last 6 months will receive three individual counselling sessions on CIH within 3 months (=intervention on patient level). The counselling will be provided by an interprofessional team of medical and nursing staff. For this purpose, an intensive online training programme, a CIH knowledge database and an interprofessional team-building process were developed and implemented (=intervention on provider level). Moreover, training events on the basics of CIH are offered in the outpatient setting (=intervention on system level). Primary outcome of the evaluation at the patient level is patient activation measured (PAM) with the PAM-13 after 3 months. Secondary outcomes, for example, quality of life, self-efficacy and clinical parameters, will be assessed at baseline, after 3 months and at 6 months follow-up. The intervention group (n=1000) will be compared with a control group (n=500, treatment as usual, no CIH counselling. The outcomes and follow-up times in the control group are the same as in the intervention group. Moreover, the use of health services will be analysed in both groups using routine data. A qualitative-quantitative process evaluation as well as a health economic evaluation will identify relevant barriers and enabling factors for later roll-out. ETHICS AND DISSEMINATION The study has been approved by the appropriate Institutional Ethical Committee of the University of Tuebingen, No. 658/2019BO1. The results of these studies will be disseminated to academic audiences and in the community. TRIAL REGISTRATION NUMBER DRKS00021779; Pre-results.
Collapse
Affiliation(s)
- Jan Valentini
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Daniela Fröhlich
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Regina Stolz
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Cornelia Mahler
- Institute for Health Sciences, Department of Nursing Science, University Hospital Tübingen, Tübingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biostatistics, University Hospital Tübingen, Tübingen, Germany
| | - Nadja Klafke
- Department of General Practice and Health Services Reseach, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus Horneber
- Department of Internal Medicine, Division of Pneumology, Paracelsus Medical University, Klinikum Nurnberg, Nurnberg, Germany
| | - Jona Frasch
- aQua Institute for Applied Quality Improvement and Research in Health Care, Goettingen, Germany
| | - Klaus Kramer
- Department of Integrative Medicine, Faculty of Medicine, University Hospital Ulm, Ulm, Germany
| | - Hartmut Bertz
- Department of Medicine I, Faculty of Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Barbara Grün
- Department of Medical Oncology, National Centre for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| |
Collapse
|
13
|
Sanchez Antelo V, Szwarc L, Paolino M, Saimovici D, Massaccesi S, Viswanath K, Arrossi S. A Counseling Mobile App to Reduce the Psychosocial Impact of Human Papillomavirus Testing: Formative Research Using a User-Centered Design Approach in a Low-Middle-Income Setting in Argentina. JMIR Form Res 2022; 6:e32610. [PMID: 35023843 PMCID: PMC8796044 DOI: 10.2196/32610] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/01/2021] [Accepted: 11/17/2021] [Indexed: 01/16/2023] Open
Abstract
Background Human papillomavirus (HPV) testing detects sexually transmitted infections with oncogenic types of HPV. For many HPV-positive women, this result has negative connotations. It produces anxiety, fear of cancer or death, and disease denial. Face-to-face counseling could present many difficulties in its implementation, but a counseling mobile app could be practical and may help HPV-positive women reduce the psychosocial impact of the result, improve their knowledge of HPV and cervical cancer, and increase adherence to follow-up. Objective This study aims to understand HPV-tested women’s perceptions about an app as a tool to receive information and support to reduce the emotional impact of HPV-positive results. We investigated their preferences regarding app design, content, and framing. Methods We conducted formative research based on a user-centered design approach. We carried out 29 individual online interviews with HPV-positive women aged 30 years and over and 4 focus groups (FGs) with women through a virtual platform (n=19). We shared a draft of the app's potential screens with a provisional label of the possible content, options menus, draft illustrations, and wording. This allowed us to give women understandable triggers to debate the concepts involved on each screen. The draft content and labels were developed drawing from the health belief model (HBM) and integrative behavioral model (IBM) variables and findings of mobile health literature. We used an FG guide to generate data for the information architecture (ie, how to organize contents into features). We carried out thematic analysis using constructs from the HBM and IBM to identify content preferences and turn them into app features. We used the RQDA package of R software for data processing. Results We found that participants required more information regarding the procedures they had received, what HPV-positive means, what the causes of HPV are, and its consequences on their sexuality. The women mentioned fear of the disease and stated they had concerns and misconceptions, such as believing that an HPV-positive result is a synonym for cancer. They accepted the app as a tool to obtain information and to reduce fears related to HPV-positive results. They would use a mobile app under doctor or health authority recommendation. The women did not agree with the draft organization of screens and contents. They believed the app should first offer information about HPV and then provide customized content according to the users’ needs. The app should provide information via videos with experts and testimonies of other HPV-positive women, and they suggested a medical appointment reminder feature. The app should also offer information through illustrations, or infographics, but not pictures or solely text. Conclusions Providing information that meets women’s needs and counseling could be a method to reduce fears. A mobile app seems to be an acceptable and suitable tool to help HPV-positive women.
Collapse
Affiliation(s)
- Victoria Sanchez Antelo
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucila Szwarc
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Melisa Paolino
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Diana Saimovici
- Centro de Estudios de Estado y Sociedad, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Massaccesi
- Secretaria de Salud de Ituzaingó, Instituto Provincial del Cáncer, Ministerio de Salud de la Provincia de Buenos Aires, Ituzaingo, Argentina
| | - Kasisomayajula Viswanath
- McGraw-Patterson Center for Population Sciences, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Silvina Arrossi
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Yamaki C, Takayama T, Hayakawa M, Wakao F. Users' evaluation of Japan's cancer information services: process, outcomes, satisfaction and independence. BMJ Open Qual 2021; 10:bmjoq-2021-001635. [PMID: 34949579 PMCID: PMC8705375 DOI: 10.1136/bmjoq-2021-001635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/01/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Cancer information service (CIS) programmes are becoming increasingly important because patients need to obtain appropriate information and take an active role in their treatment decisions. Programme evaluation is required to determine the level of satisfaction and quality of experiences of users. The purpose of this study is (1) to identify users' evaluation of CIS programmes by both satisfaction and outcomes that reflect the quality of experience and impact of using the CIS, (2) to examine the related factors of these evaluation outcomes and (3) to analyse the differences of those relations between patients and families. METHOD The self-reported questionnaire was answered by 447 patients and 216 families of patients who used Cancer Information Support Centres (CISCs) at 16 designated cancer hospitals from January 2016 to April 2016. We developed 12 evaluation items, including satisfaction, experience and the impact of using CISC. RESULTS Respondents evaluated the CISC highly, especially in terms of overall satisfaction, followed by the counselling process. Immediate access to CISC was the strongest factor affecting outcomes. Patients who wanted to consult about 'disease or symptoms' or 'had no specific problem' tended to provide high scores for some outcomes, but those who wanted to consult about a 'financial problem' or 'discharge or care at home' provided negative scores. These trends were also observed in families but to a more limited extent. CONCLUSION Users' evaluation of CISCs was sufficiently high in terms of overall satisfaction, showing reasonable scores in outcome levels. Immediate access was the strongest factor affecting outcomes and topics of consultation more directly affected evaluation by patients than by families. The distribution of the scores of the measures and related factors was reasonable. The 12-item measurement tool employed in this study seems to be useful for quality monitoring of the CIS.
Collapse
Affiliation(s)
- Chikako Yamaki
- Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| | - Tomoko Takayama
- Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| | - Masayo Hayakawa
- Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| | - Fumihiko Wakao
- Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| |
Collapse
|
16
|
Ośmiałowska E, Misiąg W, Chabowski M, Jankowska-Polańska B. Coping Strategies, Pain, and Quality of Life in Patients with Breast Cancer. J Clin Med 2021; 10:jcm10194469. [PMID: 34640484 PMCID: PMC8509228 DOI: 10.3390/jcm10194469] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/19/2021] [Accepted: 09/23/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction: Each year, around 16,500 women in Poland are diagnosed with breast cancer, the second most common cause of death in women. In Poland, nearly 70,000 women live with breast cancer diagnosed within the last 5 years. Quality of life (QoL) research is particularly important in cancer patients, as it provides knowledge on their psychological and physical health, as well as the environment in which the patients function, all of which is essential to implementing multidisciplinary care involving the best use of the appropriate methods. Carrying the burden of cancer is a major challenge for patients. The strategy that patients use to cope with breast cancer significantly affects their quality of life. The purpose of the study is to assess the impact of coping strategies on the QoL in breast cancer patients. Material and Methods: The prospective study included a group of 202 women who had undergone surgical treatment for breast cancer at the Lower Silesian Cancer Center and who reported for follow-up appointments at the Oncology Clinic and the Surgical Oncology Clinic. For the study, we used the: EORTC QLQ-C30 cancer questionnaire, EORTC QLQ-BR23 module, Mental Adjustment to Cancer (Mini-MAC) scale, visual analog scale (VAS) for pain intensity, as well as the patients’ medical records, hospital records, and our own survey form. Results: The mean patient age was 53 years. Most patients had been diagnosed with cancer between one and two years before. In the women studied, there was a negative association between QoL and the choice of a destructive strategy for coping with cancer, and a positive one between QoL and a constructive coping strategy. Severe pain caused by the disease and its treatment significantly decreased the patients’ QoL in multiple domains. Conclusions: Patients choosing constructive strategies obtained higher QoL scores, while greater reliance on destructive coping strategies was associated with significantly worse QoL. In all functioning domains, higher levels of pain were associated with poorer QoL and more severe symptoms associated with the disease and its treatment.
Collapse
Affiliation(s)
- Edyta Ośmiałowska
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Weronika Misiąg
- Student Research Group No 180, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Mariusz Chabowski
- Department of Clinical Nursing, Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
- Department of Surgery, 4th Military Teaching Hospital, 50-981 Wroclaw, Poland
| | - Beata Jankowska-Polańska
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
| |
Collapse
|
17
|
Martínez-Jaimez P, Armora Verdú M, Forero CG, Álvarez Salazar S, Fuster Linares P, Monforte-Royo C, Masia J. Breast cancer-related lymphoedema: Risk factors and prediction model. J Adv Nurs 2021; 78:765-775. [PMID: 34363640 DOI: 10.1111/jan.15005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/08/2021] [Accepted: 07/24/2021] [Indexed: 12/30/2022]
Abstract
AIMS To identify the risk factors for lymphoedema following axillary lymph node dissection (ALND) in a European sample and to propose a lymphoedema prediction model for this population. DESIGN Predictive retrospective cohort study comparing women who developed lymphoedema in 2 years of undergoing ALND with those who did not developed lymphoedema. METHODS We reviewed the clinical records of 504 women who, between January 2008 and May 2018, underwent surgery for breast cancer that involved ALND. Logistic regression was used to identify significant risk factors for lymphoedema. The prediction accuracy of the model was assessed by calculating the area under the receiver operating characteristic curve. RESULTS Of the 504 women whose records were analysed, 156 developed lymphoedema. Significant predictors identified in the regression model were level of lymph node dissection, lymph node status, post-operative complications, body mass index (BMI) and number of lymph nodes extracted. The prediction model showed good sensitivity (80%) in the study population. CONCLUSIONS The factor contributing most to the risk of lymphoedema was the level of lymph node dissection, and the only patient-related factor in the prediction model was BMI. The model offers good predictive capacity in this population and it is a simple tool that breast care units could use to assess the risk of lymphoedema following ALND. Nurses with specialist knowledge of lymphoedema have a key role to play in ensuring that women receive holistic and individualized care. IMPACT What problem did the study address? Secondary lymphoedema is one of the main complications in the treatment of breast cancer. What were the main findings? The prediction model included five factors associated with the risk of lymphoedema following ALND. The strongest predictor was the level of lymph node dissection, and the only patient-related factor was BMI. Where and on whom will the research have an impact? The prediction model offers breast care units a tool for assessing the risk of lymphoedema in women undergoing surgery involving ALND. The results highlight the importance of weight reduction as a preventive measure and support a more conservative surgical approach.
Collapse
Affiliation(s)
- Patricia Martínez-Jaimez
- Breast Reconstruction and Lymphoedema Surgery Unit, Clínica Planas, Barcelona, Spain.,Nursing Department. Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Miriam Armora Verdú
- Nursing Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain
| | - Carlos G Forero
- Department of Medicine. Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Samantha Álvarez Salazar
- Department of Medicine. Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Pilar Fuster Linares
- Nursing Department. Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Monforte-Royo
- Nursing Department. Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jaume Masia
- Breast Reconstruction and Lymphoedema Surgery Unit, Clínica Planas, Barcelona, Spain.,Nursing Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain.,Department of Plastic Surgery, Hospital del Mar, Barcelona, Spain
| |
Collapse
|
18
|
Adaptation of Quality of Life Measure for Limb Lymphedema-Arm in Turkish Women With Breast Cancer-Related Lymphedema. Cancer Nurs 2021; 44:45-52. [PMID: 31469672 DOI: 10.1097/ncc.0000000000000741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Quality-of-life measures are needed for clinicians and researchers to identify quality of women's life with breast cancer-related lymphedema (BCRL). OBJECTIVE To adapt Quality of Life Measure for Limb Lymphedema-Arm into Turkish (TR) and to test its validity and reliability. METHODS This is a methodological and cross-sectional study and was conducted in the lymphedema outpatient clinic of a university hospital. The study included 109 women with BCRL. After linguistic validity of the scale was achieved, confirmatory factor analyses and known group validity were used to test its construct validity. Reliability of the scale was tested with Cronbach's α, item-total correlations, and Spearman-Brown coefficient. RESULTS After linguistic validity was achieved, opinions requested from 5 experts specializing in lymphedema showed that item and content validity indexes of the scale were 1. Fit indexes of confirmatory factor analysis were as follows: χ/df = 1.86, root mean square error of approximation = 0.089, standardized root mean square residual = 0.09, and comparative fit index = 0.81. Known group validity analysis showed a significant difference in the mean scores for the subscales of Quality of Life Measure for Limb Lymphedema-Arm-TR, symptom, function, and body image/appearance in terms of lymphedema stages (P < .05). The internal reliability coefficients for the subscales ranged from 0.78 and 0.86. The item-total correlation coefficients ranged between 0.36 and 0.73. CONCLUSION Quality of Life Measure for Limb Lymphedema-Arm-TR was found to be valid and reliable in the TR population. It could be used in research to evaluate the quality of life in patients with BCRL. IMPLICATIONS FOR PRACTICE The scale can be used to evaluate effectiveness of nursing interventions directed toward patients developing breast cancer-related lymphedema in clinical settings and studies.
Collapse
|
19
|
Validation of the Persian version of the satisfaction with life scale (SWLS) in Iranian women with breast Cancer. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01662-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
20
|
Mokhatri-Hesari P, Montazeri A. Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018. Health Qual Life Outcomes 2020; 18:338. [PMID: 33046106 PMCID: PMC7552560 DOI: 10.1186/s12955-020-01591-x] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Breast cancer still is a topic. This overview of the literature aimed to update the current knowledge on quality of life in breast cancer patients. METHODS A review of literature in MEDLINE, Cochrane Database of Systematic Reviews and Google Scholar were carried out to identify review papers on health-related quality of life in breast cancer during the 2008 to 2018. All publications were screened using the PRISMA guideline. The methodological quality of reviews was assessed using the AMSTAR. The findings were summarized and tabulated accordingly. RESULTS Within over a decade, a total of 974 review papers were identified which according to the study selection criteria finally we have evaluated 82 reviews. Of these about 85% had a reasonable methodological quality. The findings were mainly summarized on several headings including instruments used to measure quality of life, treatment, supportive care, psychological distress, and symptoms. Questionnaires had a good performance to quantify quality of life in breast cancer patients. Most reviews were focused on the impact of treatment including endocrine therapy as well as integrating complementary and alternative medicine into the current practice. According to the reviews, yoga was the most recommended exercise to improve quality of life in breast cancer patients. CONCLUSION Overall, the findings from this overview indicated that quality of life in breast cancer patients enhanced during the last decade. Several simple but effective interventions such as physical activity and psychosocial interventions proved to be effective in improving quality of life in this population. However, management of symptoms such as pain, and lymphedema, issues related to worry, sexual function especially for young patients, and the future outlooks all are among topics that deserve further consideration. Also, this overview indicated that methodological issues in measuring quality of life in breast cancer patients improved greatly, but still there is a long way to go to understand what really matter to patients.
Collapse
Affiliation(s)
- Parisa Mokhatri-Hesari
- Integrative Oncology Research Group, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.,Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. .,Faculty of Humanity Sciences, University of Science and Culture, ACECR, Tehran, Iran.
| |
Collapse
|
21
|
Jankowska-Polańska B, Świątoniowska-Lonc N, Ośmiałowska E, Gałka A, Chabowski M. The Association Between Illness Acceptance and Quality of Life in Women with Breast Cancer. Cancer Manag Res 2020; 12:8451-8464. [PMID: 32982439 PMCID: PMC7500846 DOI: 10.2147/cmar.s261624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/30/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Breast cancer is the most common cause of cancer death in women. Aim The aim of the study was to investigate the association between illness acceptance and quality of life (QoL) in patients with breast cancer. Patients and Methods The study included 150 patients who had undergone surgery for breast cancer. The following standardized questionnaires were used: the Acceptance of Illness Scale (AIS), the EORT QLQ-C30 (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), and the EORT QL-BR 23 (Quality of Life Questionnaire for Breast Cancer) for QoL evaluation. Socio-clinical data were obtained from the patients' medical records. Results In the study group, the overall QoL score was 62.67±17.11 in the BCT group, 63±14.3 in the MTX group, and the highest: 65.5±20.2 in the reconstruction group. Comparative analysis showed that patients in the BCT group reported significantly more fatigue (p=0.007) and appetite loss (p=0.032) than those in the MTX+R group. Patients in the MTX group were significantly less satisfied with their body image (p=0.001) and experienced more financial troubles (p=0.013) than the remaining patients. Patients in the MTX+R group reported significantly better sexual function and more sexual enjoyment than the remaining patients (p<0.001). All patients scored high for illness acceptance, though patients in the MTX group had lower scores (28.17±7.2) than the others: 31.84±6.51 in the BCT group and 32.78±7.97 in the MTX+R group. The comparative analysis of QoL according to the level of AIS showed the significantly better QoL and less intense symptoms within all the domains except for the insomnia and hair loss domains in the group of high AIS in comparison with medium and lack of AIS. Acceptance of illness significantly correlated with 4 domains of the QLQ-C30 (p<0.05). The correlation between illness acceptance and overall QoL was positive (r=0.243; p=0.003) - the higher the acceptance, the better the QoL. Correlations with pain, diarrhoea, and financial difficulties were negative. Illness acceptance was positively correlated with QoL in 3 domains of the EORTC-BR23: body image (p<0.001), sexual function (p=0.015), and sexual enjoyment (p=0.047), and negatively with the "treatment side effects" (p=0.011). Conclusion The level of illness acceptance varies depending on the treatment method, and is the lowest in the group of women having undergone a mastectomy, and the highest in patients after a mastectomy with immediate breast reconstruction. Acceptance of illness improves the QoL of women treated for breast cancer, regardless of the specific treatment method.
Collapse
Affiliation(s)
- Beata Jankowska-Polańska
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Natalia Świątoniowska-Lonc
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Edyta Ośmiałowska
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Aneta Gałka
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Mariusz Chabowski
- Division of Oncology and Palliative Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland.,Department of Surgery, 4th Military Teaching Hospital, Wroclaw 50-981, Poland
| |
Collapse
|
22
|
Paolucci T, Bernetti A, Bai AV, Segatori L, Monti M, Maggi G, Ippolitoni G, Tinelli L, Santilli V, Paoloni M, Agostini F, Mangone M. The sequelae of mastectomy and quadrantectomy with respect to the reaching movement in breast cancer survivors: evidence for an integrated rehabilitation protocol during oncological care. Support Care Cancer 2020; 29:899-908. [DOI: 10.1007/s00520-020-05567-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/05/2020] [Indexed: 01/05/2023]
|
23
|
Barbieri E, Frusone F, Bottini A, Sagona A, Gatzemeier W, Canavese G, Anghelone CAP, De Luca A, Marrazzo E, Amabile MI, Tinterri C. Evolution and time trends of nipple-sparing mastectomy: a single-center experience. Updates Surg 2020; 72:893-899. [PMID: 32449032 DOI: 10.1007/s13304-020-00796-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 05/09/2020] [Indexed: 01/27/2023]
Abstract
Nipple Sparing Mastectomy (NSM) requires the entire breast tissue to be removed, maintaining the nipple-areola complex, and represents nowadays the gold standard of the demolitive breast surgery. Although it represents the evolution of conservative breast surgery, NSM presents some limitations in the selection of women candidates for treatment, and still there are no real guidelines regarding its indications, but simply objective data to address the choice. How the breast surgery approach to demolitive and conservative surgery has changed over time? We evaluated throughout the years (from 2009 up to 2018) the time trend of NSM at our institution and analysed the main differences between patients undergone NSM and other mastectomies and/or breast conserving surgery in terms of cancer size, multicentricity and biological profile. We found 781 NSMs, 1261 other mastectomies and 5621 breast conservative surgeries. Among NSMs, 39.6% were reconstructed with tissue expander and 58.1% with definitive prosthesis. From 2009 to 2018 we found a general increase of NSM rate (from 21.3% of all mastectomies in 2009 to 67.3% in 2018) and a decrease of total mastectomies (from 78.7% of all mastectomies in 2009 to 32.7% in 2018). In line with the literature data, our data confirm that in the recent years NSM represents the gold standard for radical breast surgery. Undisputed in prophylaxis, NSM is continuously acquiring more support in being used as first line treatment for locally advanced disease.
Collapse
Affiliation(s)
- Erika Barbieri
- Breast Surgery Department, Humanitas Research Hospital and Cancer Center, Rozzano, Milan, Italy
| | - Federico Frusone
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
| | - Alberto Bottini
- Breast Surgery Department, Humanitas Research Hospital and Cancer Center, Rozzano, Milan, Italy
| | - Andrea Sagona
- Breast Surgery Department, Humanitas Research Hospital and Cancer Center, Rozzano, Milan, Italy
| | - Wolfgang Gatzemeier
- Breast Surgery Department, Humanitas Research Hospital and Cancer Center, Rozzano, Milan, Italy
| | - Giuseppe Canavese
- Breast Surgery Department, Humanitas Research Hospital and Cancer Center, Rozzano, Milan, Italy
| | | | - Alessandro De Luca
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Emilia Marrazzo
- Breast Surgery Department, Humanitas Research Hospital and Cancer Center, Rozzano, Milan, Italy
| | - Maria Ida Amabile
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Corrado Tinterri
- Breast Surgery Department, Humanitas Research Hospital and Cancer Center, Rozzano, Milan, Italy
| |
Collapse
|
24
|
Olsson Möller U, Olsson IM, Sjövall K, Beck I, Rydén L, Malmström M. Barriers and facilitators for individualized rehabilitation during breast cancer treatment - a focus group study exploring health care professionals' experiences. BMC Health Serv Res 2020; 20:252. [PMID: 32216786 PMCID: PMC7098158 DOI: 10.1186/s12913-020-05107-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/12/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Breast cancer (BC) and related treatment are associated with the risk of developing a wide range of persistent disabling impairments. Despite extensive research in the field and an enhanced focus on BC rehabilitation, up to 34-43% of these patients are at risk of developing chronic distress. In addition, it is known that these patients repeatedly report unmet needs, which are strongly associated with reduced quality of life. However, despite knowledge that patients' needs for support during BC rehabilitation varies greatly, individualized rehabilitation is often lacking. Therefore, this study aimed to explore health care professionals' (HCPs) experiences of current rehabilitation practice and describe current barriers and facilitators for individualized rehabilitation for patients following BC treatment. METHODS A total of 19 HCPs were included, representing various professions in BC care/rehabilitation within surgical, oncological and specialized cancer rehabilitation units at a university hospital in Sweden. Five semi structured focus group interviews were conducted and inductively analysed using conventional qualitative content analysis. RESULTS Three categories were captured: (1) varying attitudes towards rehabilitation; (2) incongruence in how to identify and meet rehabilitation needs and (3) suboptimal collaboration during cancer treatment. The results showed a lack of consensus in how to optimize individualized rehabilitation. It also illuminated facilitators for individualized rehabilitation in terms of extensive competence related to long-term experience of working with patients with BC care/rehabilitation. Further, the analysis exposed barriers such as a great complexity in promoting individualized rehabilitation in a medically and treatment-driven health care system, which lacked structure and knowledge, and overarching collaboration for rehabilitation. CONCLUSION This study suggests that the cancer trajectory is medically and treatment-driven and that rehabilitation plays a marginal role in today's BC trajectory. It also reveals that structures for systematic screening for needs, evidence-based guidelines for individualized rehabilitation interventions and structures for referring patients for advanced rehabilitation are lacking. To enable optimal and individualized recovery for BC patients', rehabilitation needs to be an integrated part of the cancer trajectory and run in parallel with diagnostics and treatment.
Collapse
Affiliation(s)
- Ulrika Olsson Möller
- Department of Nursing and Integrated Health Sciences, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Ing-Marie Olsson
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden.,Skåne University Hospital, Lund, Sweden
| | - Katarina Sjövall
- Department of Clinical Sciences in Lund, Oncology and Pathology, Lund University, Lund, Sweden
| | - Ingela Beck
- Department of Nursing and Integrated Health Sciences, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.,Department of Clinical Sciences in Lund, Oncology and Pathology, Lund University, Lund, Sweden.,The Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden
| | - Lisa Rydén
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund, Sweden
| | - Marlene Malmström
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden. .,Skåne University Hospital, Lund, Sweden. .,The Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.
| |
Collapse
|
25
|
Klernäs P, Johnsson A, Boyages J, Brorson H, Munnoch A, Johansson K. Quality of Life Improvements in Patients with Lymphedema After Surgical or Nonsurgical Interventions with 1-Year Follow-Up. Lymphat Res Biol 2019; 18:340-350. [PMID: 31808720 DOI: 10.1089/lrb.2018.0065] [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] [Indexed: 11/12/2022] Open
Abstract
Background: Lymphedema may impact patients' health-related quality of life (HRQoL). The purpose of this study was to evaluate HRQoL after two different treatments to the 12-month follow-up point. Methods and Results: Study participants were patients with moderate lymphedema in the upper or lower limb who attended a Swedish rehabilitation program (RP) undergoing conservative treatment, or those with severe, chronic lymphedema dominated by excess adipose tissue, who underwent liposuction (LS) combined with controlled compression therapy (CCT) in Australia, Scotland, or Sweden. The patients completed the Lymphedema Quality of Life Inventory (LyQLI) before intervention and after 1, 3, 6, and 12 months. Mean values and standard deviations were calculated for total limb volume and excess limb volume. Mean values were also calculated for the three LyQLI domains (physical, psychosocial, and practical). To detect and analyze differences in LyQLI responses in the three domains, the Wilcoxon signed rank test was performed. In the RP, 18 eligible patients completed the LyQLI. The results show improvements in HRQoL in physical (p = 0.003) and psychosocial domains (p = 0.002) at 1 month after the RP, with results remaining steady for 12 months for the physical domain (p = 0.024). Fifty-seven eligible LS patients completed the LyQLI. The results show improvements in HRQoL in all three domains (p < 0.001), with results remaining steady up to the 12-month follow-up (p < 0.001). The total volume in affected limb and the excess volume decreased significantly in both patient groups 1 month after intervention (p < 0.001). Conclusions: Treatment with a conservative RP in moderate lymphedema or with LS combined with CCT in severe lymphedema improves HRQoL.
Collapse
Affiliation(s)
- Pia Klernäs
- Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.,Bräcke Diakoni, Rehabcenter Sfären, Solna, Sweden
| | - Aina Johnsson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.,Neurobiology, Care Science and Society, Division of Family Medicine, Karolinska Institutet, Huddinge, Sweden
| | - John Boyages
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Håkan Brorson
- Lymphedema Center, Department of Plastic and Reconstructive Surgery, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Alex Munnoch
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.,Department of Plastic Surgery, Ninewells Hospital, Dundee, Scotland
| | - Karin Johansson
- Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden
| |
Collapse
|
26
|
Rupp J, Hadamitzky C, Henkenberens C, Christiansen H, Steinmann D, Bruns F. Frequency and risk factors for arm lymphedema after multimodal breast-conserving treatment of nodal positive breast Cancer - a long-term observation. Radiat Oncol 2019; 14:39. [PMID: 30845971 PMCID: PMC6407279 DOI: 10.1186/s13014-019-1243-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/25/2019] [Indexed: 01/11/2023] Open
Abstract
Background Arm-lymphedema is a major complication after breast cancer. Recent studies demonstrate the validity of predicting Breast Cancer Related Lymphedema (BCRL) by self-reports. We aimed to investigate the rate of BCRL and its risk factors in the long-term using self-reported symptoms. Methods Data was collected from 385 patients who underwent multimodal therapy for nodal positive breast cancer, including breast conserving surgery, axillary dissection, and local or locoregional radiotherapy. Two validated questionnaires were used for the survey of BCRL (i.e. LBCQ-D and SDBC-D). These were analysed collectively with retrospective data of our medical records. Results 23.5% (n = 43) suffered a permanent BCRL (stage II-III) after a median follow-up time of 10.1 years (4.9–15.9 years); further 11.5% (n = 23) reported at least one episode of reversible BCRL (Stage 0-I) during the follow-up time. 87.1% of the patients with lymphedema developed this condition in the first two years. Adjuvant chemotherapy was a significant risk factor for the appearance of BCRL (p = 0.001; 95%-CI 7.7–10.2). Conclusions Breast cancer survivors face a high risk of BCRL, particularly if axillary dissection was carried out. Almost 90% of BCRL occurred during the first two years after radiotherapy. Self-report of symptoms seems to be a suitable instrument of early detection of BCRL.
Collapse
Affiliation(s)
- Julia Rupp
- Department of Radiation Oncology, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany.,Department of Gynecology and Obstetrics, DIAKOVERE Hospital Henriettenstift, Hannover, Germany
| | - Catarina Hadamitzky
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.,Practice for Lympho-Vascular Diseases, Bahnhofstraße 12, Hannover, Germany
| | - Christoph Henkenberens
- Department of Radiation Oncology, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Hans Christiansen
- Department of Radiation Oncology, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Diana Steinmann
- Department of Radiation Oncology, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Frank Bruns
- Department of Radiation Oncology, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| |
Collapse
|
27
|
Itani L, Calugi S, Kreidieh D, El Kassas G, El Masri D, Tannir H, Dalle Grave R, Harfoush A, El Ghoch M. Validation of an Arabic Version of the Obesity-Related Wellbeing (ORWELL 97) Questionnaire in Adults with Obesity. Curr Diabetes Rev 2019; 15:127-132. [PMID: 29332589 DOI: 10.2174/1573399814666180111111934] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/22/2017] [Accepted: 01/03/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND No specific questionnaire that evaluates Health-Related Quality Of Life (HRQOL) in individuals with obesity is available in the Arabic language. The aim of this study was therefore to propose and examine the validity and reliability of an Arabic language version of the ORWELL 97, a validated obesity-related HRQOL questionnaire. METHODS The ORWELL 97 questionnaire was translated from English to Arabic language and administered to 318 Arabic-speaking participants (106 from clinical and 212 from community samples), and underwent internal consistency, test-retest reliability, construct and discriminative validity analysis. RESULTS Internal consistency and the test-retest reliability were excellent for ORWELL 97 global scores in the clinical sample. Participants with obesity displayed significantly higher ORWELL 97 scores than participants from the community sample, confirming the good discriminant validity of the questionnaire. Confirmatory factor analysis in the clinical sample revealed a good fit for a modified two-factor structure. CONCLUSION Overall, the Arabic version of the ORWELL 97 can be considered validated in Arabic adult patients with obesity, paving the way to further assessment of its responsiveness in measuring changes in health-related quality of life associated with obesity treatment.
Collapse
Affiliation(s)
- Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda (VR), Italy
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Germine El Kassas
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda (VR), Italy
| | - Aya Harfoush
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda (VR), Italy
| |
Collapse
|
28
|
Myrhaug HT, Mbalilaki JA, Lie NEK, Hansen T, Nordvik JE. The effects of multidisciplinary psychosocial interventions on adult cancer patients: a systematic review and meta-analysis. Disabil Rehabil 2018; 42:1062-1070. [DOI: 10.1080/09638288.2018.1515265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Julia Aneth Mbalilaki
- Regional Knowledge Translation Center, Southern-Eastern Norway Regional Health Authority, Sunnaas Rehabilitation Hospital, Oslo, Norway
| | | | - Tone Hansen
- The Norwegian Leukemia Association, Oslo, Norway
| | - Jan Egil Nordvik
- Regional Knowledge Translation Center, Southern-Eastern Norway Regional Health Authority, Sunnaas Rehabilitation Hospital, Oslo, Norway
| |
Collapse
|
29
|
Zoorob RJ, Salemi JL, Mejia de Grubb MC, Modak S, Levine RS. A nationwide study of breast cancer, depression, and multimorbidity among hospitalized women and men in the United States. Breast Cancer Res Treat 2018; 174:237-248. [PMID: 30465155 DOI: 10.1007/s10549-018-5059-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/16/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Breast cancer is the most common and second most deadly cancer for women in the US. Comorbidities like depression exacerbate the burden. This national study provides data on depression and comorbidity for both women and men with breast cancer. METHODS We conducted a serial cross-sectional analysis of the 2002-2014 National Inpatient Sample, the largest all-payer inpatient discharge database in the United States. We identified patients with primary site breast cancer, and captured information on their concomitant depression and other major chronic comorbidities. Logistic regression was used to generate adjusted odds ratios representing associations between patient and hospital characteristics and depression. Joinpoint regression was used to estimate temporal trends in depression rates. RESULTS Depression prevalence was higher for women than men, with little difference between cancer subtypes. Comorbidity burden was nearly twice as high for men. From 2002 to 2014, the average number of comorbidities doubled. Depression rates were highest for patients with four or more chronic comorbidities and those with unplanned hospitalizations. Significant yearly increases of 6-10% in depression were also observed. CONCLUSIONS Breast cancer patient depression rates were higher than the general inpatient population with a strong gradient effect between increasing numbers of comorbidities and the odds of depression. Comorbidities, including mental health-related, negatively impact breast cancer prognosis, increasing cancer-specific mortality as well as mortality for other conditions. Unplanned hospitalization episodes in a patient with breast cancer can be noted as an opportunity for mental health screening and intervention.
Collapse
Affiliation(s)
- Roger J Zoorob
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Dr., Suite 600, MS: BCM700, Houston, TX, 77098, USA.
| | - Jason L Salemi
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Dr., Suite 600, MS: BCM700, Houston, TX, 77098, USA
| | - Maria C Mejia de Grubb
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Dr., Suite 600, MS: BCM700, Houston, TX, 77098, USA
| | - Sanjukta Modak
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Dr., Suite 600, MS: BCM700, Houston, TX, 77098, USA
| | - Robert S Levine
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Dr., Suite 600, MS: BCM700, Houston, TX, 77098, USA
| |
Collapse
|
30
|
Sibeoni J, Picard C, Orri M, Labey M, Bousquet G, Verneuil L, Revah-Levy A. Patients' quality of life during active cancer treatment: a qualitative study. BMC Cancer 2018; 18:951. [PMID: 30286733 PMCID: PMC6172766 DOI: 10.1186/s12885-018-4868-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 09/26/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Patients' quality of life has become a major objective of care in oncology. At the same time, it has become the object of increasing interest by researchers, working with both quantitative and qualitative methods. Progress in oncology has enabled more patients to survive longer, so that cancer is increasingly often a chronic disease that requires long-term treatment that can have negative effects on patients' quality of daily life. Nonetheless, no qualitative study has explored what patients report affects their quality of daily life during the treatment period. This study is intended to fill this gap. METHODS We conducted a multicenter qualitative study based on 30 semi-structured interviews. Participants, purposively selected until data saturation, had diverse types of cancer and had started treatment at least 6 months before interview. Data were examined by thematic analysis. RESULTS Our analysis found two themes: (1) what negatively affected for patient's quality of daily life during the treatment period, a question to which patients responded by talking only about the side effects of treatment; and (2) what positively affected their quality of daily life during the treatment period with three sub-themes: (i) The interest in having -investing in - a support object that can be defined as an object, a relationship or an activity particularly invested by the patients which makes them feel good and makes the cancer and its treatment bearable, (ii)The subjective perception of the efficacy of the antitumor treatment and (iii) the positive effects of relationships, with friends and family, and also with their physician. CONCLUSIONS Patients must be involved in their care if they are to be able to bear their course of treatment and find ways to endure the difficult experience of cancer care. The support object represents an important therapeutic lever that can be used by their oncologists. They should be interested in their support objects, in order to support the patients in this investment and to help them to maintain it throughout the health care pathway. Furthermore, showing interest in this topic, important to the patient, could improve the physician-patient relation without using up very much of the physician's time.
Collapse
Affiliation(s)
- Jordan Sibeoni
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, 69 rue du LTC Prud'hon, 95107, Argenteuil, France. .,ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.
| | - Camille Picard
- Department of Dermatology, Caen University Hospital, F-14033, Caen, France.,Université de Caen Normandie, Medical School, F-14000, Caen, France
| | - Massimiliano Orri
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.,McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Canada
| | - Mathilde Labey
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.,EPSM Lille métropole, pôle de psychiatrie adulte 59g21, Lille, France
| | - Guilhem Bousquet
- Université Paris 13 - Léonard de Vinci, Villetaneuse, France.,AP-HP-Hôpital Avicenne, Service d'Oncologie médicale-Bobigny, Bobigny, France
| | - Laurence Verneuil
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France
| | - Anne Revah-Levy
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, 69 rue du LTC Prud'hon, 95107, Argenteuil, France.,ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France
| |
Collapse
|
31
|
Park JH, Chun M, Jung YS, Bae SH, Jung YM. Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer. J Korean Acad Nurs 2018; 48:669-678. [DOI: 10.4040/jkan.2018.48.6.669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Jin-Hee Park
- College of Nursing · Research Institute of Nursing Science, Ajou University, Suwon, Korea
| | - Mison Chun
- Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Korea
| | - Yong Sik Jung
- Department of Surgery, School of Medicine, Ajou University, Suwon, Korea
| | - Sun Hyoung Bae
- College of Nursing · Research Institute of Nursing Science, Ajou University, Suwon, Korea
| | - Young-Mi Jung
- Department of Nursing, College of Health Sciences, Cheongju University, Cheongju, Korea
| |
Collapse
|