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Torreggiani M, Maselli D, Costi S, Guberti M. Models of Care in Providing Comprehensive Healthcare on Cancer Survivors: A Scoping Review with a TIDieR Checklist Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:122. [PMID: 38397613 PMCID: PMC10888265 DOI: 10.3390/ijerph21020122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The study's aim is to identify the models of care used to provide survivorship care plans (SCPs) to cancer survivors in healthcare services, describing what kind of professionals are involved, in which settings and timings, and their feasibility. METHODS The Joanna Briggs Institute methodology for scoping reviews is followed. Studies that considered the SCPs applying different models of care, in any healthcare setting on any adult cancer survivors who completed oncological treatments, have been included. Pubmed, Embase, Cochrane Library, Scopus, and Cinahal were searched from 2013 to 2023 with these keywords: "Survivorship Care Plan", "Oncology", and "Program". The study selection process was reported with the PRISMA-ScR. A total of 325 records were identified, 42 were screened, and, ultimately, 23 articles were included. RESULTS The models of care include: SCP standardization in hospitals; self-support oriented; consultation-based; primary or specialist direct referral; shared care; a multimodal approach. Multidisciplinary teams were involved in the SCP models of care. The settings were private clinics or cancer centers. One-hour SCP interventions were most frequently delivered through in-person visits, by telephone, or online. CONCLUSIONS Implementing SCPs is feasible in healthcare contexts, but with challenges, like time and resource management. Patient-centered programs promoting coordinated care are promising models of care.
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Affiliation(s)
- Martina Torreggiani
- Health Professions Department, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Deborah Maselli
- International Doctorate School in Clinical and Experimental Medicine, Università degli Studi di Modena e Reggio Emilia, 41125 Reggio Emilia, Italy;
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Monica Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy;
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Kantilal K, Hardeman W, Whiteside H, Karapanagioutou E, Small M, Bhattacharya D. Facilitating healthcare practitioners to deliver self-management support in adult cancer survivors: A realist review. Res Social Adm Pharm 2022; 18:3870-3883. [DOI: 10.1016/j.sapharm.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
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Syrjala KL, Walsh CA, Yi JC, Leisenring WM, Rajotte EJ, Voutsinas J, Ganz PA, Jacobs LA, Palmer SC, Partridge A, Baker KS. Cancer survivorship care for young adults: a risk-stratified, multicenter randomized controlled trial to improve symptoms. J Cancer Surviv 2021; 16:1149-1164. [PMID: 34590205 DOI: 10.1007/s11764-021-01105-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Young adult (YA) cancer survivors have high rates of adverse health and psychosocial outcomes. This risk-stratified, multicenter, randomized controlled trial (RCT) compared a self-management survivorship intervention to usual care in YA survivors with symptoms of cancer-related distress, insomnia, fatigue, pain, and/or depression. METHODS Eligibility included age 18-39 at diagnosis with an invasive malignancy in the previous 1-5 years. Baseline assessment determined "high need" participants, with 2-5 elevated targeted symptoms. We randomized high need participants to intervention or usual care and offered intervention participants a survivorship clinic visit, which included mutually decided action plans for symptoms. Follow-up calls at 1 and 3 months after the clinic visit reviewed action plan progress. Outcomes compared rates of improved symptoms for intervention vs usual care at 6 months and 12 months. RESULTS N = 344 completed baseline assessment, with n = 147 (43%) categorized as high need and randomized. Of n = 73 randomized to the intervention, n = 42 (58%) did not attend their survivorship clinic visit. In intent-to-treat analyses, aggregate symptom scores did not differ between arms, though distress improved for 46% in the intervention arm at 6 months compared to 18% in usual care (p = 0.03) among those with elevated distress at baseline. CONCLUSIONS Distress improved for YAs who received self-management survivorship care. However, the study demonstrates a need for alternative strategies for providing YA survivorship care. TRIAL REGISTRATION NCT02192333 IMPLICATIONS FOR CANCER SURVIVORS: While YA survivors demonstrate some improved distress when provided survivorship care, to make care accessible and effective, they require options such as remote delivery of care.
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Affiliation(s)
- Karen L Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, D5-22098109, USA. .,University of Washington School of Medicine, Seattle, WA, USA.
| | - Casey A Walsh
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, D5-22098109, USA.,Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Jean C Yi
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, D5-22098109, USA
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, D5-22098109, USA.,University of Washington School of Medicine, Seattle, WA, USA
| | - Emily Jo Rajotte
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, D5-22098109, USA
| | - Jenna Voutsinas
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, D5-22098109, USA
| | - Patricia A Ganz
- UCLA Jonsson Comprehensive Cancer Center and UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Linda A Jacobs
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Steven C Palmer
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | | | - K Scott Baker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, D5-22098109, USA.,University of Washington School of Medicine, Seattle, WA, USA
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Vistad I, Skorstad M, Demmelmaier I, Småstuen MC, Lindemann K, Wisløff T, van de Poll-Franse LV, Berntsen S. Lifestyle and Empowerment Techniques in Survivorship of Gynaecologic Oncology (LETSGO study): a study protocol for a multicentre longitudinal interventional study using mobile health technology and biobanking. BMJ Open 2021; 11:e050930. [PMID: 34253678 PMCID: PMC8276283 DOI: 10.1136/bmjopen-2021-050930] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION The number of gynaecological cancer survivors is increasing and there is a need for a more sustainable model of follow-up care. Today's follow-up model is time-consuming and patients have reported unmet needs regarding information about their cancer and strategies for managing the consequences of treatment. The main aim of this study is to assess health-related empowerment-in terms of patient education, psychosocial support, and promotion of physical activity-in a new follow-up model by comparing it to standard follow-up in a quasi-randomised study involving intervention hospitals and control hospitals. METHODS AND ANALYSIS At the intervention hospitals, patients will be stratified by risk of recurrence and late effects to either 1 or 3 years' follow-up. Nurses will replace doctors in half of the follow-up visits and focus in particular on patient education, self-management and physical activity. They will provide patients with information and guide them in goal setting and action planning. These measures will be reinforced by a smartphone application for monitoring symptoms and promoting physical activity. At the control hospitals, patients will be included in the standard follow-up programme. All patients will be asked to complete questionnaires at baseline and after 3, 6, 12, 24 and 36 months. Blood samples will be collected for biobanking at 3, 12 and 36 months. The primary outcome is health-related empowerment. Secondary outcomes include health-related quality of life, adherence to physical activity recommendations, time to recurrence, healthcare costs and changes in biomarkers. Changes in these outcomes will be analysed using generalised linear mixed models for repeated measures. Type of hospital (intervention or control), time (measurement point), and possible confounders will be included as fixed factors. ETHICS AND DISSEMINATION The study is approved by the Regional Committee for Medical Research Ethics (2019/11093). Dissemination of findings will occur at the local, national and international levels. TRIAL REGISTRATION NUMBER NCT04122235.
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Affiliation(s)
- Ingvild Vistad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
- Clinical Department 2, University of Bergen, Bergen, Hordaland, Norway
| | - Mette Skorstad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Lifestyle and Rehabilitation in Long-term Illness, Uppsala Universitet, Uppsala, Sweden
| | | | - Kristina Lindemann
- Department of Gynaecologic Oncology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torbjørn Wisløff
- Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Lonneke V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
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Peixoto NMDSM, Peixoto TADSM, Pinto CAS, Santos CSVDB. Nursing intervention focusing on health promotion behaviors in adult cancer patients: a scoping review. Rev Esc Enferm USP 2021; 55:e03673. [PMID: 33886904 DOI: 10.1590/s1980-220x2019039403673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 05/29/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This review aims to map and provide an overview of literature concerning nursing strategies and intervention programs that promote healthy behaviors in cancer patients. METHOD A scoping review was conducted using the methodological framework developed by Joanna Briggs Institute and preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. Twelve databases were searched (2012-2019). Retrieved data included descriptive analyses exploring studies' methodological characteristics and results. RESULTS From 1589 studies, 12 were included. Most studies included patients on survivorship period (n=10) and selected intervention strategies focusing patient's knowledge and awareness (n=8). Educational sessions were supported by behavioral change reinforcements and motivational incentives. Only two of the considered studies analysed intervention cost effectiveness, but none disclosed intervention-related costs. CONCLUSION Nursing interventions are effective in promoting health behaviors when include health education and encouragement towards change. Survivorship is the perfect time for health promotion. Nurses can be considered health promoters, by encouraging health education and enhance survivor's motivation.
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Preussler JM, Denzen EM, Majhail NS, Baker KS, McCann M, Burns LJ, Yi J, Syrjala KL. Engaging hematopoietic cell transplantation patients and caregivers in the design of print and mobile application individualized survivorship care plan tools. Support Care Cancer 2020; 28:2805-2816. [PMID: 31729567 PMCID: PMC7189809 DOI: 10.1007/s00520-019-05114-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/01/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE INSPIRE (INteractive Survivorship Program with Information and REsources) is an online health program that includes a mobile app, website, health action plan, and individualized survivorship care plans for adult hematopoietic cell transplant (HCT) survivors. The INSPIRE program integrates two previously effective randomized control trials that tested an internet-based program and patient-centered survivorship care plans for HCT survivors. METHODS Three focus groups were conducted with a total of 22 participants (20 patients, 2 caregivers/patient advocates) to explore patient and caregiver preferences and to optimize the patient-centered emphasis of INSPIRE. Adult (age > 18 years at the time of study entry) HCT recipients had to be at least 1-year post-HCT to participate; caregivers/patient advocates were also eligible. Participants had to be able to communicate in English, could have any diagnosis, transplant type, or donor source, and could have had multiple transplants. RESULTS All patient participants received an allogeneic HCT; average time since HCT was 8 years (range 2-22 years). The majority of participants were female (77.3%). Overall, the tools were well received by participants in this study, particularly the personalized features of all the tools. Major themes included interest in having the ability to tailor features to individual needs, and an interest in tracking information over time. DISCUSSION Engaging patients and caregivers is invaluable to optimize tools designed to improve HCT survivorship care. Print, online, and mobile-based tools, tailored to individual patients' treatment history and requisite follow-up care, can provide otherwise unavailable expertise and guidelines for care.
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Affiliation(s)
- Jaime M Preussler
- National Marrow Donor Program/Be The Match, Minneapolis, MN, USA.
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, 55401, USA.
| | - Ellen M Denzen
- National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, 55401, USA
| | - Navneet S Majhail
- Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - K Scott Baker
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Meggan McCann
- National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Linda J Burns
- National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, 55401, USA
| | - Jean Yi
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Hill RE, Wakefield CE, Cohn RJ, Fardell JE, Brierley ME, Kothe E, Jacobsen PB, Hetherington K, Mercieca‐Bebber R. Survivorship Care Plans in Cancer: A Meta-Analysis and Systematic Review of Care Plan Outcomes. Oncologist 2020; 25:e351-e372. [PMID: 32043786 PMCID: PMC7011634 DOI: 10.1634/theoncologist.2019-0184] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/06/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The Institute of Medicine recommends that survivorship care plans (SCPs) be included in cancer survivorship care. Our meta-analysis compares patient-reported outcomes between SCP and no SCP (control) conditions for cancer survivors. Our systematic review examines the feasibility of implementing SCPs from survivors' and health care professionals' perspectives and the impact of SCPs on health care professionals' knowledge and survivorship care provision. METHODS We searched seven online databases (inception to April 22, 2018) for articles assessing SCP feasibility and health care professional outcomes. Randomized controlled trials comparing patient-reported outcomes for SCP recipients versus controls were eligible for the meta-analysis. We performed random-effects meta-analyses using pooled standardized mean differences for each patient-reported outcome. RESULTS Eight articles were eligible for the meta-analysis (n = 1,286 survivors) and 50 for the systematic review (n = 18,949 survivors; n = 3,739 health care professionals). There were no significant differences between SCP recipients and controls at 6 months postintervention on self-reported cancer and survivorship knowledge, physical functioning, satisfaction with information provision, or self-efficacy or at 12 months on anxiety, cancer-specific distress, depression, or satisfaction with follow-up care. SCPs appear to be acceptable and potentially improve survivors' adherence to medical recommendations and health care professionals' knowledge of survivorship care and late effects. CONCLUSION SCPs appear feasible but do not improve survivors' patient-reported outcomes. Research should ascertain whether this is due to SCP ineffectiveness, implementation issues, or inappropriate research design of comparative effectiveness studies. IMPLICATIONS FOR PRACTICE Several organizations recommend that cancer survivors receive a survivorship care plan (SCP) after their cancer treatment; however, the impact of SCPs on cancer survivors and health care professionals is unclear. This systematic review suggests that although SCPs appear to be feasible and may improve health care professionals' knowledge of late effects and survivorship care, there is no evidence that SCPs affect cancer survivors' patient-reported outcomes. In order to justify the ongoing implementation of SCPs, additional research should evaluate SCP implementation and the research design of comparative effectiveness studies. Discussion may also be needed regarding the possibility that SCPs are fundamentally ineffective.
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Affiliation(s)
- Rebecca E. Hill
- School of Women's and Children's Health, University of New South Wales (UNSW) SydneyRandwickAustralia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's HospitalRandwickAustralia
| | - Claire E. Wakefield
- School of Women's and Children's Health, University of New South Wales (UNSW) SydneyRandwickAustralia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's HospitalRandwickAustralia
| | - Richard J. Cohn
- School of Women's and Children's Health, University of New South Wales (UNSW) SydneyRandwickAustralia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's HospitalRandwickAustralia
| | - Joanna E. Fardell
- School of Women's and Children's Health, University of New South Wales (UNSW) SydneyRandwickAustralia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's HospitalRandwickAustralia
| | - Mary‐Ellen E. Brierley
- School of Women's and Children's Health, University of New South Wales (UNSW) SydneyRandwickAustralia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's HospitalRandwickAustralia
| | - Emily Kothe
- School of Psychology, Deakin UniversityGeelongAustralia
| | | | - Kate Hetherington
- School of Women's and Children's Health, University of New South Wales (UNSW) SydneyRandwickAustralia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's HospitalRandwickAustralia
| | - Rebecca Mercieca‐Bebber
- School of Women's and Children's Health, University of New South Wales (UNSW) SydneyRandwickAustralia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's HospitalRandwickAustralia
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of SydneyCamperdownAustralia
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Supported self-management for cancer survivors to address long-term biopsychosocial consequences of cancer and treatment to optimize living well. Curr Opin Support Palliat Care 2018; 12:92-99. [DOI: 10.1097/spc.0000000000000329] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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O'Caoimh R, Cornally N, O'Sullivan R, Hally R, Weathers E, Lavan AH, Kearns T, Coffey A, McGlade C, Molloy DW. Advance care planning within survivorship care plans for older cancer survivors: A systematic review. Maturitas 2017; 105:52-57. [PMID: 28687135 DOI: 10.1016/j.maturitas.2017.06.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 06/17/2017] [Accepted: 06/22/2017] [Indexed: 12/24/2022]
Abstract
Advances in the medical treatment of cancer have increased the number of survivors, particularly among older adults, who now represent the majority of these. Survivorship care plans (SCPs) are documents that cancer patients receive summarising their care, usually at the end of treatment but preferably from initial diagnosis. These may increase patient satisfaction and represent an opportunity to initiate preventative strategies and address future care needs. Advance care planning (ACP), incorporating advance healthcare decision-making, including formal written directives, increases satisfaction and end-of-life care. This paper systematically reviews evaluations of ACP within SCPs among older (≥65 years) cancer survivors. No studies meeting the inclusion criteria were identified by search strategies conducted in PubMed/MEDLINE and the Cochrane databases. One paper examined cancer survivors' mainly positive views of ACP. Another discussed the use of a SCP supported by a 'distress inventory' that included an advance care directive (living will) as an issue, though no formal evaluation was reported. Although ACP is important for older adults, no study was found that evaluated its role within survivorship care planning. Despite the risk of recurrence and the potential for morbidity and mortality, especially among older cancer survivors, ACP is not yet a feature of SCPs.
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Affiliation(s)
- Rónán O'Caoimh
- Health Research Board, Clinical Research Facility Galway, National University of Ireland, Galway, Geata an Eolais, University Road, Galway, Ireland; Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland; COLLAGE (COLLaboration on AGEing), University College Cork, Cork City and Louth Age Friendly County Initiative, Co Louth, Ireland.
| | - Nicola Cornally
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland; School of Nursing and Midwifery, University College Cork, College Road, Cork City, Ireland
| | - Ronan O'Sullivan
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland
| | - Ruth Hally
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland
| | - Elizabeth Weathers
- Health Research Board, Clinical Research Facility Galway, National University of Ireland, Galway, Geata an Eolais, University Road, Galway, Ireland; School of Nursing and Midwifery, University College Cork, College Road, Cork City, Ireland
| | - Amanda H Lavan
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland
| | - Tara Kearns
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland
| | - Alice Coffey
- School of Nursing and Midwifery, University College Cork, College Road, Cork City, Ireland
| | - Ciara McGlade
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland
| | - D William Molloy
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland; COLLAGE (COLLaboration on AGEing), University College Cork, Cork City and Louth Age Friendly County Initiative, Co Louth, Ireland
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Reb A, Ruel N, Fakih M, Lai L, Salgia R, Ferrell B, Sampath S, Kim JY, Raz DJ, Sun V. Empowering survivors after colorectal and lung cancer treatment: Pilot study of a Self-Management Survivorship Care Planning intervention. Eur J Oncol Nurs 2017; 29:125-134. [PMID: 28720259 DOI: 10.1016/j.ejon.2017.06.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE This study evaluates the feasibility and acceptability of a Self-Management Survivorship Care Planning (SM-SCP) intervention in colorectal and lung cancer survivors. METHODS This is a single-group, pre- and post-mixed methods study of an advance practice nurse-driven survivorship care intervention that integrates a survivorship care plan with self-management skills coaching. Colorectal and lung cancer survivors with stage I-III disease were enrolled at 3-6 months after completing treatments, and the intervention was administered in one in-person or telephone session. Survivor outcome measures included depression, anxiety, self-efficacy, QOL, and satisfaction. Paired t-tests were used for exploratory evaluations of pre-to post-intervention score changes. Content analysis was conducted to analyze the qualitative data to describe survivors' experience with the intervention. RESULTS Thirty participants (15 colorectal, 15 lung) enrolled and completed the study (73% retention). It took an average of 40 min to complete the TS/CP and 34.2 min to deliver the intervention. Exploratory analysis revealed significant differences from baseline to post-intervention in depression, anxiety, self-efficacy, physical functioning, role limitations-physical, pain, general health, health transition, physical health summary, and total QOL. Three qualitative themes emerged: 1) Feeling empowered about having a plan; 2) Struggling with psychosocial concerns; and 3) Suggestions for intervention content and delivery. CONCLUSIONS The SM-SCP intervention was feasible and acceptable for colorectal and lung cancer survivors after treatment completion. Survivorship care interventions have potential to fulfill the unmet needs of colorectal and lung cancer survivors. Their effectiveness might be greater by integrating conceptually-based models of care, such as self-management skills building.
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Affiliation(s)
- Anne Reb
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Nora Ruel
- Biostatistics Core, Department of Information Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Marwan Fakih
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Lily Lai
- Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Ravi Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Sagus Sampath
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States.
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Evaluation of effectiveness of survivorship programmes: how to measure success? Lancet Oncol 2017; 18:e51-e59. [DOI: 10.1016/s1470-2045(16)30563-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/26/2016] [Accepted: 09/01/2016] [Indexed: 11/23/2022]
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Ose D, Winkler EC, Berger S, Baudendistel I, Kamradt M, Eckrich F, Szecsenyi J. Complexity of care and strategies of self-management in patients with colorectal cancer. Patient Prefer Adherence 2017; 11:731-742. [PMID: 28435231 PMCID: PMC5391842 DOI: 10.2147/ppa.s127612] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Given the inherent complexity of cancer care, in which personal, social, and clinical aspects accumulate and interact over time, self-management support need to become more comprehensive. This study has the following two aims: 1) to analyze and describe the complexity of individual patient situations and 2) to analyze and describe already established self-management strategies of patients to handle this complexity. METHODS A qualitative study was conducted. Ten focus groups were performed collecting perspectives of the following three user groups: patients with colorectal cancer (n=12) and representatives from support groups (n=2), physicians (n=17), and other health care professionals (HCPs; n=16). Data were analyzed using qualitative content analysis. RESULTS The results showed that cancer patients are struggling with the complexity of their individual situations characterized by the 1) "complexity of disease", 2) "complexity of care", and 3) "complexity of treatment-related data". To deal with these multifaceted situations, patients have established several individual strategies. These strategies are "proactive demanding" (eg, to get support and guidance or a meaningful dialog with the doctor), "proactive behavior" (eg, preparation of visits), and "proactive data management" (eg, in terms of merging treatment-related data and to disseminate these to their health care providers). CONCLUSION Patients with colorectal cancer have to handle a high complexity of individual situations within treatment and care of their disease. Private and social challenges have a culminating effect. This complexity increases as patients experience a longer duration of treatment and follow-up as patients have to handle a significantly higher amount of data over time. Self-management support should focus more on the individual complexity in a patient's life. This includes assisting patients with strategies that have already been established by themselves (like preparation of visits).
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Affiliation(s)
- Dominik Ose
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
- Department of Population Health, Health System Innovation and Research, University of Utah, Salt Lake City, UT, USA
- Correspondence: Dominik Ose, University of Utah, Department of Population Health Sciences, Health System Innovation and Research, Williams Building, 295 Chipeta Way, Salt Lake City, UT 84108, USA, Tel +1 801 587 2263, Fax +1 801 581 3623, Email
| | - Eva C Winkler
- Program for Ethics and Patient-oriented Care in Oncology, National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Sarah Berger
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Ines Baudendistel
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Martina Kamradt
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Felicitas Eckrich
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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Murphy J, Mollica M. All Hands on Deck: Nurses and Cancer Care Delivery in Women's Health. Front Oncol 2016; 6:174. [PMID: 27500124 PMCID: PMC4956645 DOI: 10.3389/fonc.2016.00174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 07/07/2016] [Indexed: 12/04/2022] Open
Affiliation(s)
- Jeanne Murphy
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
| | - Michelle Mollica
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
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