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Adriaans DJM, Rosendaal M, Nieuwenhuijzen GAP, Heesakkers FBM, Notenboom L, Teijink JAW, Laarhoven HWMV, Dierick-van Daele ATM. Expectations and needs of patients with esophageal cancer during curative treatment regarding self-management, self-management support and eHealth: a qualitative study. Eur J Oncol Nurs 2024; 71:102638. [PMID: 38943774 DOI: 10.1016/j.ejon.2024.102638] [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: 11/09/2023] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE Self-management is an essential component of the curative treatment trajectory of esophageal cancer patients. The aims of this study were to explore expectations and needs of esophageal cancer patients during curative treatment regarding self-management, relevant aspects of self-management in which they need additional support, and to explore their willingness to use eHealth. METHODS Semi-structured interviews were conducted with esophageal cancer patients, who had been treated with neoadjuvant chemo(radio)therapy followed by surgery, maximally 1 year after surgery. Based on the general model of self-management, the following themes were discussed: experience-based knowledge, contribution to care, living with the condition, and organization of care and support. A stepwise systematic text condensation guided the data analysis. RESULTS All four domains of the general model of self-management were identified. All participants described a remarkable difference between the pre-operative pathway, when it felt like they were taken by the hand, and the postoperative pathway, when it felt like they were thrown into the deep end. They adjusted to their new life situation by learning new experiences, while dealing with their diminished confidence in their bodies. Patients expressed the need for support from different sources, and were open to the idea of using eHealth in addition to usual care. (digital) Self-management support should be easily accessible, person-centered, confidential, and include personal contact. CONCLUSION Differences were found among esophageal cancer patients regarding self-management, self-management support and eHealth for self-management purposes, indicating there is no one approach that will meet the needs of all patients at all times.
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Affiliation(s)
- Daniëlle J M Adriaans
- Fontys University of Applied Sciences, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands; Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, 6200, MD, Maastricht, the Netherlands.
| | - Mariëlle Rosendaal
- Fontys School of HRM and Psychology, Fontys University of Applied Science, P.O. Box 347, 5600, AH, Eindhoven, the Netherlands
| | - Grard A P Nieuwenhuijzen
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands
| | - Fanny B M Heesakkers
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands
| | - Loes Notenboom
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Joep A W Teijink
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, 6200, MD, Maastricht, the Netherlands
| | - Hanneke W M van Laarhoven
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Angelique T M Dierick-van Daele
- Fontys University of Applied Sciences, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands; Department of Education and Research, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; Fontys School of People and Health Studies, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands
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Mullan LJ, Blackburn NE, Lorimer J, Semple CJ. Evaluating the effects of lymphoedema management strategies on functional status and health-related quality of life following treatment for head and neck cancer: Protocol for a systematic review. PLoS One 2024; 19:e0297757. [PMID: 38306345 PMCID: PMC10836692 DOI: 10.1371/journal.pone.0297757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/11/2024] [Indexed: 02/04/2024] Open
Abstract
INTRODUCTION/BACKGROUND Patients living with and after head and neck cancer often experience treatment-related consequences. Head and neck lymphoedema can be described as a common chronic side effect of head and neck cancer and recognised as a contributing factor to impairment of functional status, symptom burden and health-related quality of life. The effects of head and neck lymphoedema can limit patients' involvement in daily activities and alter their appearance, increasing symptom burden and negatively affecting health-related quality of life. OBJECTIVE The protocol outlines the rationale and aims for the systematic review. The main aim of the systematic review is to identify and systematically synthesise the literature on the effectiveness of head and neck lymphoedema management strategies, on both function status and health-related quality of life for head and neck cancer patients. METHODS AND ANALYSIS This protocol will be conducted according to the PRISMA-P guidelines. Electronic databases will be systematically searched using MEDLINE via Ovid and PubMed, CINAHL, Cochrane Central Register of Controlled Trials and Scopus. Inclusion criteria will involve intervention studies for head and neck lymphoedema management, English language, and adult human participants following head and neck cancer. The software Covidence will be used to export, manage, and screen results. Risk of bias and quality will be assessed in included studies using the Cochrane Handbook of Systematic Reviews of Intervention risk of bias and GRADE tools. A meta-analysis will be performed if there are sufficient homogenous studies. Alternatively, a narrative synthesis will be completed on study findings. ETHICS AND DISSEMINATION No ethical approval is required as the study does not involve patient and public involvement. The findings of the review will be disseminated in conferences and submitted for approval to be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022378417. (S1 Appendix).
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Affiliation(s)
- Lauren J. Mullan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, United Kingdom
| | - Nicole E. Blackburn
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, United Kingdom
| | - Jill Lorimer
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Cherith J. Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, United Kingdom
- Cancer Services, South Eastern Health and Social Care Trust, Belfast, United Kingdom
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Jung JY, Yun YH. Self-Management Strategy Clustering, Quality of Life, and Health Status in Cancer Patients Considering Cancer Stages. Int J Behav Med 2023; 30:769-776. [PMID: 36169885 DOI: 10.1007/s12529-022-10128-z] [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] [Accepted: 08/26/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND In the cancer-care continuum, self-management can help cancer patients regardless of their treatment plan or cancer stage. However, research examining self-management strategy clusters considering cancer stages is lacking. Thus, we examined self-management strategy clusters considering cancer stages and the effects of self-management strategy clusters on quality of life (QoL) and overall health status. METHOD A total of 256 patients who completed both baseline and second surveys for a 6-month period ultimately participated in this prospective cohort study. To identify the interrelationship between self-management strategies measured by the Smart management strategies for health assessment tool (SAT), we conducted cluster analysis using a principal component analysis in varimax rotation and the k-mean clustering method. We also performed multivariate-adjusted analyses in QoL and overall health status comparisons by dividing the cancer stage into early (I, II) and advanced (III, IV). RESULTS All patients experienced two domains of self-management strategies concurrently. However, self-management strategy clusters differed by cancer stage, and the effect of self-management strategy clusters on quality of life and overall health status also differed. Self-management strategy clusters effectively improved the quality of life and overall health status of the entire cohort of patients, even in patients with advanced-stage cancer. CONCLUSION This study revealed that the pattern of using self-management strategies might differ by cancer stage. The strategy cluster positively affected QoL and overall health status in cancer patients. Identifying the self-management clusters of cancer patients with different cancer stages may have clinical implications for supporting their health management.
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Affiliation(s)
- Ju Youn Jung
- Department of Biomedical Science, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Young Ho Yun
- Department of Family Medicine, Seoul National University College of Medicine and Hospital, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, South Korea.
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Song J, Li R, Hu X, Ding G, Chen M, Jin C. Current status of and future perspectives on care for cancer survivors in China. Glob Health Med 2023; 5:208-215. [PMID: 37655186 PMCID: PMC10461331 DOI: 10.35772/ghm.2023.01014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 09/02/2023]
Abstract
Cancer is currently a major public health issue faced by countries around the world. With the progress of medical science and technology, the survival rate of cancer patients has increased significantly and the survival time has been effectively prolonged. How to provide quality and efficient care for the increasingly large group of cancer survivors with limited medical resources will be a key concern in the field of global public health in the future. Compared to developed countries, China's theoretical research and practical experience in care for cancer survivors are relatively limited and cannot meet the multi-faceted and diverse care needs of cancer patients. Based on the existing models of care worldwide, the current work reviews care for cancer survivors in China, it proposes considerations and suggestions for the creation of models of cancer care with Chinese characteristics in terms of optimizing top-level system design, enhancing institutional mechanisms, accelerating human resource development, and enhancing self-management and social support for patients.
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Affiliation(s)
- Jie Song
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Ruijia Li
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Xiaojing Hu
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Gang Ding
- Oncology Department, Shanghai International Medical Center, Shanghai, China
| | - Minxing Chen
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Chunlin Jin
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
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Mullan LJ, Blackburn NE, Gracey J, Dunwoody L, Lorimer J, Semple CJ. Evaluating the effects of lymphoedema management strategies on functional status and health-related quality of life following treatment for head and neck cancer: a systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01453-7. [PMID: 37648875 DOI: 10.1007/s11764-023-01453-7] [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: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Patients living with head and neck lymphoedema (HNL) after completion of head and neck cancer (HNC) often can experience long-term functional challenges and overall poorer health-related quality of life (HRQOL). This systematic review aims to explore components of effective HNL interventions through identification and synthesising literature on existing HNL management interventions. METHODS Five electronic databases (MEDLINE via Ovid and PubMed, CINAHL, CENTRAL, and Scopus) were systematically searched using Medical Subject Headings and free text, as well as citation tracking and Google Scholar for grey literature. RESULTS A total of 1910 studies were screened, with 12 studies meeting the inclusion criteria. Findings indicated vast heterogeneity within HNL interventions. Patients' adherence to intervention strategies was reported as low and partially adhered to, particularly at home. This impacted on function domains and overall HRQOL during the post-treatment HNC phase, as well as further increasing the demands placed on healthcare professionals. CONCLUSIONS Synthesis of the research findings highlighted a need to provide and educate patients with individualised HNL self-management intervention strategies. Promoting adherence was reported as being essential, with self-efficacy and behaviour change techniques being emphasised as a critical element to enhance motivation and therefore effective intervention delivery. Further work is important to address barriers to adherence and promote both motivation and behaviour change, to develop individualised self-management interventions for this cancer population. IMPLICATIONS FOR CANCER SURVIVORS The findings from this systematic review will provide guidance in the development and delivery of individualised self-management HNL interventions for patients who have completed HNC treatment.
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Affiliation(s)
- Lauren J Mullan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK.
| | - Nicole E Blackburn
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Jackie Gracey
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Lynn Dunwoody
- School of Psychology, Faculty of Life and Health Sciences, Ulster University, Londonderry, UK
| | - Jill Lorimer
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Cherith J Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK
- Cancer Services, South Eastern Health and Social Care Trust, Belfast, UK
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6
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Mali SB. Surveillance of head neck cancer: Case for personalized and standardized surveillance. Oral Oncol 2023; 139:106354. [PMID: 36878144 DOI: 10.1016/j.oraloncology.2023.106354] [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: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
Although surgery, radiotherapy, chemotherapy, or combined treatment often elicits an initial satisfactory response, relapses are frequently observed within two years. Current surveillance methods, including clinical exams and imaging evaluations, have not unambiguously demonstrated a survival benefit, most probably due to a lack of sensitivity in detecting very early recurrence. Current guidelines advise post-treatment surveillance of head and neck cancer (HNC) patients should involve scheduled appointments with a variety of practitioners. The benefits of prolonged routine follow-up on survival have not been proven. Increasing numbers of HNC survivors raise the burden to provide efficient and effective care.
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Affiliation(s)
- Shrikant B Mali
- Mahatma Gandhi Vidya Mandir's Dental College and Hospital Nashik, India.
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Greenway K, Frisone C, Placidi A, Kumar S, Guest W, Winter SC, Shah K, Henshall C. Using immersive technology and architectural design to assist head and neck cancer patients' recovery from treatment: A focus group and technology acceptance study. Eur J Oncol Nurs 2023; 62:102261. [PMID: 36716531 DOI: 10.1016/j.ejon.2022.102261] [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: 08/30/2022] [Revised: 11/09/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Head and neck cancer patients can face debilitating treatment related side-effects, resulting in requirement for support and negatively impacting on care outcomes. This study aimed to develop a digital recovery support package and assess its acceptability with head and neck cancer patients to support their information needs and assist with their self-management. It provided additional support through development of a WebXR platform 'recovery' package, which allowed patients to live a 'virtual reality' experience, entering and moving inside a 'virtual room', accessing targeted resources and specific learning materials related to their cancer. METHOD A qualitative intervention development study consisting of three phases. This study followed the COREQ checklist for qualitative research. Phase 1- Focus groups with seven head and neck cancer patients and six healthcare professionals. Phase 2- Development of 'recovery' package based on the focus group data which informed the content and design of the WebXR recovery platform. Phase 3- Technology acceptance study. Once developed, the platform's acceptability of the experience lived inside the virtual room was assessed via qualitative interviews with six different patient participants. RESULTS Most participants felt comfortable using the virtual reality platform, finding it a realistic and useful support for identifying resources and signposting to relevant materials. Participants agreed the WebXR platform was a feasible tool for the head and neck cancer setting and helped reduce anxiety. CONCLUSIONS Head and neck cancer patients welcome specific targeted, information and advice to support their ability to self-manage their rehabilitation and thus focus their nursing care. The platform was implemented during the Covid-19 pandemic, demonstrating its versatility and accessibility in providing complementary support to head and neck cancer patients, to empower them to adjust to their 'new' normal as part of their ongoing cancer journeys.
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Affiliation(s)
- Kathleen Greenway
- Oxford Institute of Nursing Midwifery and Allied Health, Faculty of Health and Life Sciences, Oxford School of Nursing and Midwifery, Oxford Brookes University, Jack Straws Lane, Marston, Oxford, OX3 OFL, UK.
| | - Caterina Frisone
- Faculty of Technology, Design and Environment, School of Architecture, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, UK.
| | - Andrea Placidi
- Faculty of Technology, Design and Environment, School of Architecture, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, UK.
| | - Sanjay Kumar
- Faculty of Health and Life Sciences, Department of Psychology, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, UK.
| | - Will Guest
- Faculty of Technology, Design and Environment, School of Computing and Communication Technologies, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, UK.
| | - Stuart C Winter
- University of Oxford, Consultant Head and Neck Surgeon, Oxford Cancer Centre, Churchill Hospital, Oxford, OX3 7LE, UK.
| | - Ketan Shah
- Oxford Cancer Centre, Churchill Hospital, Oxford, OX3 7LE, UK.
| | - Catherine Henshall
- Oxford Institute of Nursing Midwifery and Allied Health, Faculty of Health and Life Sciences, Oxford School of Nursing and Midwifery, Oxford Brookes University, Jack Straws Lane, Marston, Oxford, OX3 OFL, UK.
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Cavalieri S, Vener C, LeBlanc M, Lopez-Perez L, Fico G, Resteghini C, Monzani D, Marton G, Pravettoni G, Moreira-Soares M, Filippidou DE, Almeida A, Bilbao A, Mehanna H, Singer S, Thomas S, Lacerenza L, Manfuso A, Copelli C, Mercalli F, Frigessi A, Martinelli E, Licitra L. A multicenter randomized trial for quality of life evaluation by non-invasive intelligent tools during post-curative treatment follow-up for head and neck cancer: Clinical study protocol. Front Oncol 2023; 13:1048593. [PMID: 36798825 PMCID: PMC9927199 DOI: 10.3389/fonc.2023.1048593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/10/2023] [Indexed: 02/02/2023] Open
Abstract
Patients surviving head and neck cancer (HNC) suffer from high physical, psychological, and socioeconomic burdens. Achieving cancer-free survival with an optimal quality of life (QoL) is the primary goal for HNC patient management. So, maintaining lifelong surveillance is critical. An ambitious goal would be to carry this out through the advanced analysis of environmental, emotional, and behavioral data unobtrusively collected from mobile devices. The aim of this clinical trial is to reduce, with non-invasive tools (i.e., patients' mobile devices), the proportion of HNC survivors (i.e., having completed their curative treatment from 3 months to 10 years) experiencing a clinically relevant reduction in QoL during follow-up. The Big Data for Quality of Life (BD4QoL) study is an international, multicenter, randomized (2:1), open-label trial. The primary endpoint is a clinically relevant global health-related EORTC QLQ-C30 QoL deterioration (decrease ≥10 points) at any point during 24 months post-treatment follow-up. The target sample size is 420 patients. Patients will be randomized to be followed up using the BD4QoL platform or per standard clinical practice. The BD4QoL platform includes a set of services to allow patients monitoring and empowerment through two main tools: a mobile application installed on participants' smartphones, that includes a chatbot for e-coaching, and the Point of Care dashboard, to let the investigators manage patients data. In both arms, participants will be asked to complete QoL questionnaires at study entry and once every 6 months, and will undergo post-treatment follow up as per clinical practice. Patients randomized to the intervention arm (n=280) will receive access to the BD4QoL platform, those in the control arm (n=140) will not. Eligibility criteria include completing curative treatments for non-metastatic HNC and the use of an Android-based smartphone. Patients undergoing active treatments or with synchronous cancers are excluded. Clinical Trial Registration: ClinicalTrials.gov, identifier (NCT05315570).
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Affiliation(s)
- Stefano Cavalieri
- Head and Neck Medical Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,*Correspondence: Stefano Cavalieri,
| | - Claudia Vener
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Marissa LeBlanc
- Oslo Center for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway,Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Laura Lopez-Perez
- Universidad Politécnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Madrid, Spain
| | - Giuseppe Fico
- Universidad Politécnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Madrid, Spain
| | - Carlo Resteghini
- Head and Neck Medical Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy
| | - Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy,Department of Psychology, Educational Science and Human Movement (SPPEFF), University of Palermo, Palermo, Italy
| | - Giulia Marton
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | | | - Aitor Almeida
- Information Technology Programme Management Office, DOTSOFT, Thessaloniki, Greece
| | - Aritz Bilbao
- DeustoTech, Faculty of Engineering, Universidad de Deusto, Bilbao, Spain
| | - Hisham Mehanna
- Institute of head and neck studies and Education, University of Birmingham, Birmingham, United Kingdom
| | - Susanne Singer
- Division of Epidemiology and Health Care Research, JGU - Johannes Gutenberg University, Mainz, Germany
| | - Steve Thomas
- Division of Oral and Maxillofacial Surgery - Bristol Dental Hospital, University of Bristol - Bristol Medical School, Bristol, United Kingdom
| | - Luca Lacerenza
- Maxillo-Facial Surgery, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Alfonso Manfuso
- Maxillo-Facial Surgery, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Chiara Copelli
- Maxillo-Facial Surgery, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | | | - Arnoldo Frigessi
- Oslo Center for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway,Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Elena Martinelli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Lorenc A, Greaves C, Duda J, Brett J, Matheson L, Fulton‐Lieuw T, Secher D, Rhodes P, Ozakinci G, Nankivell P, Mehanna H, Jepson M. Exploring the views of patients' and their family about patient-initiated follow-up in head and neck cancer: A mixed methods study. Eur J Cancer Care (Engl) 2022; 31:e13641. [PMID: 35789510 PMCID: PMC9787693 DOI: 10.1111/ecc.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/21/2022] [Accepted: 06/06/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objective of this work was to explore head and neck cancer (HNC) patients' and their family members' views on acceptability and feasibility of patient-initiated follow-up (PIFU), including concerns and anticipated benefits. METHODS Patients were recruited from UK HNC clinics, support groups and advocacy groups. They completed a survey (n = 144) and/or qualitative interview (n = 30), three with a family member. Qualitative data were analysed thematically, quantitative data using descriptive statistics. RESULTS Preference for follow-up care in HNC was complex and individual. Many patients thought PIFU could beneficially reallocate health care resources and encourage self-management. Patients' main concerns with PIFU were losing the reassurance of regular clinic appointments and addressing mental well-being needs within PIFU, possibly using peer support. Patients were concerned about their ability to detect recurrence due to lack of expertise and information. They emphasised the importance of a reliable, direct and easy urgent appointment service and of feeling supported and heard by clinicians. Patients believed family and friends need support. CONCLUSION PIFU may be feasible and acceptable for certain HNC patients, providing it addresses support for mental well-being, provides quick, reliable and direct clinician access and information on "red flag" symptoms, and ensures patients and their caregivers feel supported.
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Affiliation(s)
- Ava Lorenc
- QuinteT Research Group, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Colin Greaves
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Joan Duda
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Jo Brett
- Supportive Cancer Care Research Group, Faculty of Health and Life SciencesOxford Brookes UniversityOxfordUK
| | - Lauren Matheson
- Supportive Cancer Care Research Group, Faculty of Health and Life SciencesOxford Brookes UniversityOxfordUK
| | - Tessa Fulton‐Lieuw
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | | | | | - Gozde Ozakinci
- Division of Psychology, Faculty of Natural SciencesUniversity of StirlingStirlingUK
| | - Paul Nankivell
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK,University Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Hisham Mehanna
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK,University Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Marcus Jepson
- QuinteT Research Group, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
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Knowledge, Attitudes and Behaviors toward Healthy Eating among Chinese Cancer Patients Treated with Chemotherapy: A Systematic Review. Asia Pac J Oncol Nurs 2022; 10:100163. [DOI: 10.1016/j.apjon.2022.100163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/30/2022] [Indexed: 11/08/2022] Open
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11
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Watson L, Hamilton D, Patterson JM. Patient experience of the acute post-surgical period following total laryngectomy during the COVID-19 era. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:737-748. [PMID: 35403774 PMCID: PMC9111097 DOI: 10.1111/1460-6984.12709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Total laryngectomy (TL) results in permanent functional changes requiring rapid development of complex new skills. A significant portion of this learning happens in the acute post-surgical stage. There is increasing interest in enhanced recovery after surgery (ERAS) protocols in TL; however, implementation has been difficult. COVID-19 has placed significant pressures on acute services, requiring rapid service changes for TL patients. AIMS To understand the acute patient experience of having a TL both before and during COVID-19. METHODS & PROCEDURES Semi-structured interviews using a pre-designed topic guide were conducted with 10 people who had undergone a TL within the last 2 years. Participants were recruited by their speech and language therapists using purposive sampling. Braun and Clarke's iterative approach to data collection and thematic analysis was used to generate key themes from the data. OUTCOMES & RESULTS Thematic analysis identified four main themes: (1) pre-operative information-giving: 'it was just words'; (2) decision-making influences: 'I just wanted them to get it all out and get it over with'; (3) coping with adjustment to the new normal: 'this is part of me now'; and (4) the importance of relationship-building: 'when you've had something like this, you need some care and understanding'. CONCLUSIONS & IMPLICATIONS The need for an individualized approach to TL intervention which incorporates medical and psycho-social approaches from pre-treatment to acute discharge is vital. ERAS models should be reviewed to shift beyond the medical model alone. Rapid service changes due to COVID-19 did not contribute any major changes to the acute patient-reported experience. WHAT THIS PAPER ADDS What is already known on the subject We know that ERAS protocols have the potential to improve patient outcomes following TL. However, the research does not consider anything other than the early oral feeding debate and it has therefore been difficult to implement ERAS protocols in current service models. COVID19 required head and neck cancer services to make quick changes to surgical pathways, with the potential that some ERAS protocols had been adopted inadvertently. In order to understand the impact of this, we need to understand the patient experience following TL both before and during COVID19. What this paper adds to existing knowledge This paper used qualitative interviews to understand the acute patient experience following TL both during and before COVID19. Findings from these interviews highlighted that people were on the most part, well prepared for the functional changes they would experience after surgery. However, people felt there were gaps in service delivery at the pre-treatment and early discharge home period. Overall, the gaps identified were from a more psycho-social need suggesting that future ERAS models of care should consider both medical and psycho-social principles to enhance patient experience and outcome. What are the potential or actual clinical implications of this work? Pre-treatment services provided to people who have a TL could be reviewed to help maximize long-term adjustment to life. Areas which could be reviewed include the method and mode of information delivery. Further work needs to be done in partnership with community services to improve the immediate discharge home experience.
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Affiliation(s)
- Laura‐Jayne Watson
- Speech & Language TherapySouth Tyneside & Sunderland NHS Foundation TrustSunderland Royal HospitalSunderlandUK
| | - David Hamilton
- OtolaryngologyHead and Neck SurgeryFreeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Joanne M. Patterson
- School of Health Sciences, Institute of Population Health/Liverpool Head and Neck CentreUniversity of LiverpoolLiverpoolUK
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12
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Lorenc A, Wells M, Fulton-Lieuw T, Nankivell P, Mehanna H, Jepson M. Clinicians' Views of Patient-initiated Follow-up in Head and Neck Cancer: a Qualitative Study to Inform the PETNECK2 Trial. Clin Oncol (R Coll Radiol) 2022; 34:230-240. [PMID: 34862101 PMCID: PMC8950325 DOI: 10.1016/j.clon.2021.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/13/2021] [Accepted: 11/12/2021] [Indexed: 12/23/2022]
Abstract
AIMS Current follow-up for head and neck cancer (HNC) is ineffective, expensive and fails to address patients' needs. The PETNECK2 trial will compare a new model of patient-initiated follow-up (PIFU) with routine scheduled follow-up. This article reports UK clinicians' views about HNC follow-up and PIFU, to inform the trial design. MATERIALS AND METHODS Online focus groups with surgeons (ear, nose and throat/maxillofacial), oncologists, clinical nurse specialists and allied health professionals. Clinicians were recruited from professional bodies, mailing lists and personal contacts. Focus groups explored views on current follow-up and acceptability of the proposed PIFU intervention and randomised controlled trial design (presented by the study co-chief investigator), preferences, margins of equipoise, potential organisational barriers and thoughts about the content and format of PIFU. Data were interpreted using inductive thematic analysis. RESULTS Eight focus groups with 34 clinicians were conducted. Clinicians highlighted already known limitations with HNC follow-up - lack of flexibility to address the wide-ranging needs of HNC patients, expense and lack of evidence - and agreed that follow-up needs to change. They were enthusiastic about the PETNECK2 trial to develop and evaluate PIFU but had concerns that PIFU may not suit disengaged patients and may aggravate patient anxiety/fear of recurrence and delay detection of recurrence. Anticipated issues with implementation included ensuring a reliable route back to clinic and workload burden on nurses and allied health professionals. CONCLUSIONS Clinicians supported the evaluation of PIFU but voiced concerns about barriers to help-seeking. An emphasis on patient engagement, psychosocial issues, symptom reporting and reliable, quick routes back to clinic will be important. Certain patient groups may be less suited to PIFU, which will be evaluated in the trial. Early, meaningful, ongoing engagement with clinical teams and managers around the trial rationale and recruitment process will be important to discourage selective recruitment and address risk-averse behaviour and potential workload burden.
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Affiliation(s)
- A Lorenc
- QuinteT Research Group, Bristol Medical School, University of Bristol, Bristol, UK.
| | - M Wells
- Nursing Directorate, Imperial College Healthcare, NHS Trust / Department of Surgery and Oncology, Imperial College, London, London, UK
| | - T Fulton-Lieuw
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - P Nankivell
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; University Hospitals, Birmingham NHS Foundation Trust, Birmingham, UK
| | - H Mehanna
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; University Hospitals, Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Jepson
- QuinteT Research Group, Bristol Medical School, University of Bristol, Bristol, UK
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Noel CW, Du Y(J, Baran E, Forner D, Husain Z, Higgins KM, Karam I, Chan KKW, Hallet J, Wright F, Coburn NG, Eskander A, Gotlib Conn L. Enhancing Outpatient Symptom Management in Patients With Head and Neck Cancer: A Qualitative Analysis. JAMA Otolaryngol Head Neck Surg 2022; 148:333-341. [PMID: 35238872 PMCID: PMC8895314 DOI: 10.1001/jamaoto.2021.4555] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
IMPORTANCE Patients with head and neck cancer manage a variety of symptoms at home on an outpatient basis. Clinician review alone often leaves patient symptoms undetected and untreated. Standardized symptom assessment using patient-reported outcomes (PROs) has been shown in randomized clinical trials to improve symptom detection and overall survival, although translation into real-world settings remains a challenge. OBJECTIVE To better understand how patients with head and neck cancer cope with cancer-related symptoms and to examine their perspectives on standardized symptom assessment. DESIGN, PARTICIPANTS, AND SETTING This was a qualitative analysis using semistructured interviews of patients with head and neck cancer and their caregivers from November 2, 2020, to April 16, 2021, at a regional tertiary center in Canada. Purposive sampling was used to recruit a varied group of participants (cancer subsite, treatment received, sociodemographic factors). Drawing on the Supportive Care Framework, a thematic approach was used to analyze the data. Data analysis was performed from November 2, 2020, to August 2, 2021. MAIN OUTCOMES AND MEASURES Patient perception of ambulatory symptom management and standardized symptom assessment. RESULTS Among 20 participants (median [range] age, 59.5 [33-74] years; 9 [45%] female; 13 [65%] White individuals), 4 themes were identified: (1) timely physical symptom management, (2) information as a tool for symptom management, (3) barriers to psychosocial support, and (4) external factors magnifying symptom burden. Participants' perceptions of standardized symptom assessment varied. Some individuals described the symptom monitoring process as facilitating self-reflection and symptom detection. Others felt disempowered by the process, particularly when symptom scores were inconsistently reviewed or acted on. CONCLUSIONS AND RELEVANCE This qualitative analysis provides a novel description of head and neck cancer symptom management from the patient perspective. The 4 identified themes and accompanying recommendations serve as guides for enhanced symptom monitoring.
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Affiliation(s)
- Christopher W. Noel
- Department of Otolaryngology−Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada
| | - Yue (Jennifer) Du
- Department of Otolaryngology−Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elif Baran
- Department of Otolaryngology−Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David Forner
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Division of Otolaryngology−Head and Neck Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Zain Husain
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kevin M. Higgins
- Department of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Irene Karam
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kelvin K. W. Chan
- Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Hallet
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada,Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Frances Wright
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Department of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Natalie G. Coburn
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada,Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,Ontario Health Cancer Care, Toronto, Ontario, Canada
| | - Antoine Eskander
- Department of Otolaryngology−Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada,Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Lesley Gotlib Conn
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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14
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Bilodeau K, Henriksen C, Lee V, Vachon MF, Charpentier D, Folch N, Pepin J, Pomey MP, Piché L, Fernandez N. The Experiential Learning Pathway of Cancer Survivors as They Recover Their Lives Post-Treatment: A Qualitative Study. Glob Qual Nurs Res 2022; 9:23333936221083026. [PMID: 35572366 PMCID: PMC9099223 DOI: 10.1177/23333936221083026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/23/2022] Open
Abstract
For many cancer survivors, post-treatment challenges are predominantly related to their personal and social lives. These challenges are part of an experiential learning process linked to a survivor's identity, their desire to preserve independence, their social roles, and responsibilities along with a return to their normal lives. We used interpretive description to describe the experiential learning process of cancer survivors as they recover post-treatment. Data from five group discussions with 27 participants were combined with data from 9 in-depth individual interviews that examined post-treatment challenges. Through an iterative qualitative analysis, we uncovered 3 experiential learning pathways. Narrative vignettes are used to portray and highlight learning involved in accepting loss, asking for help, and rebuilding authentic social networks. Experiential learning shares recognizable features among individuals identified as milestones. These lead to a greater understanding of how cancer survivors acquire a new sense of self and recover their lives post-treatment.
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Affiliation(s)
| | | | - Virginia Lee
- McGill University Health Centre, Montreal, QC, Canada
| | | | | | - Nathalie Folch
- University of Montreal Hospital
Centre, Montreal, QC, Canada
| | | | | | - Lynda Piché
- University of Montreal Hospital
Centre, Montreal, QC, Canada
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McLaren O, Perkins C, Zhu Y, Smith M, Williams R. Patient perspectives on surveillance after head and neck cancer treatment: A systematic review. Clin Otolaryngol 2021; 46:1345-1353. [PMID: 34363645 DOI: 10.1111/coa.13846] [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: 02/04/2021] [Revised: 06/30/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Current guidelines advise post-treatment surveillance of head and neck cancer (HNC) patients should involve scheduled appointments with a variety of practitioners. Increasing numbers of HNC survivors raise the burden to provide efficient and effective care. With resource limitation, there is growing importance to identify how surveillance can be justified and optimised for survivors. This systematic review presents current evidence on patient perspectives of post-treatment HNC surveillance, aiming to inform future work putting patient priorities at the forefront of surveillance planning. DESIGN MEDLINE, Embase, the Cochrane Library, NIHR Dissemination Centre, The Kings Fund Library, Clinical Evidence, NHS Evidence and NICE Clinical Evidence were searched to identify publications regarding patient perspectives of HNC post-treatment surveillance. Studies not reporting on both surveillance and patient perspectives were excluded. RESULTS Three thousand five hundred fifty-eight citations were screened and 49 full-text articles reviewed. Sixteen studies were included in the final review. Three authors reviewed all articles prior to final analysis to ensure all met inclusion criteria. Most evidence was low quality. Study models returned included cross-sectional surveys, structured interviews and one systematic review. Overall, positive perceptions of HNC surveillance were mostly related to increased reassurance. Negative perceptions predominantly focused on anxiety and fear of recurrence, but a lack of psychological support and inadequate access to certain aspects of care were also reported. CONCLUSIONS This systematic review demonstrates that patients' perceptions of surveillance after HNC are mostly positive, feeling it provides reassurance. However, several studies report unmet needs, particularly regarding managing anxiety.
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Affiliation(s)
| | | | - Yinan Zhu
- University Hospital Plymouth NHS Trust, Plymouth, UK
| | - Mary Smith
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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16
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Breast cancer-related lymphedema patient and healthcare professional experiences in lymphedema self-management: a qualitative study. Support Care Cancer 2021; 29:8027-8044. [PMID: 34226959 DOI: 10.1007/s00520-021-06390-8] [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: 03/23/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Breast cancer-related lymphedema (BCRL) self-management plays an important role in the lymphedema therapy. However, clinical knowledge of BCRL self-management remains minimal. This study aims to explore the experience surrounding lymphedema self-management from the perspectives of BCRL patients and healthcare professionals. METHODS Semi-structured interviews were implemented with BCRL patients and healthcare professionals. Audio-recordings of interviews were transcribed verbatim and thematic analysis was undertaken to analyze the interview data. RESULTS Thirteen BCRL patients (aged 34-65 years) and nine healthcare professionals (2 physicians, 4 nurses, and 3 lymphedema therapists) were interviewed. Five themes emerged from interviews with participants: knowledge-attitude-practice surrounding lymphedema self-management, emotional reactions towards lymphedema self-management, factors influencing lymphedema self-management, support needs for lymphedema self-management, healthcare professional support of BCRL self-management. CONCLUSIONS This study showed knowledge-attitude-practice, feelings, influencing factors, roles, dilemmas, and support needs regarding BCRL self-management. Greater effort is required for healthcare professionals to strengthen the lymphedema self-management. Providing more educational program and holistic support, and strengthening the facilitators and controlling the barriers might benefit promoting lymphedema self-management. Likewise, healthcare professionals need adequate training to be able to meet patients' self-management support needs.
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Saeidzadeh S, Gilbertson-White S, Cherwin CH, Reisinger HS, Kendell N, Pagedar NA, Seaman AT. Post-treatment head and neck cancer survivors' approaches to self-management: A qualitative study. Eur J Oncol Nurs 2021; 52:101944. [PMID: 33774374 DOI: 10.1016/j.ejon.2021.101944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 02/08/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Post-treatment head and neck cancer (HNC) survivors contend with distinct, long-term challenges related to cancer treatments that impact their day-to-day lives. Alongside follow-up cancer care, they also must be responsible for the daily management of often intrusive physical and psychological symptoms, as well as maintaining their health and a lifestyle to promote their well-being. The purpose of this study was to identify HNC survivors' approaches toward engagement in self-management activities. METHODS Post-treatment HNC survivors (N=22) participated in the study through purposeful sampling. Participants were eligible if they 1) had a history of upper aerodigestive tract cancer; 2) completed their most recent primary treatment (i.e. chemotherapy, radiation, and surgery) more than eighteen months prior and had no evidence of HNC, and 3) could speak in English. A semi-structured interview was used. Data was analyzed using content analysis. RESULTS We identified three approaches that survivors took towards self-management activities: taking charge, living with it, and engaging as needed. Our results showed that taking charge is when survivors take an active role in evaluating their health and taking action subsequently; as needed represents engaging in self-management as necessary; and living with it reflects adapting to the symptoms and side effects without managing them. CONCLUSIONS We propose self-management approaches as a novel mechanism to understand the relationship between survivors' characteristics and health preferences and their self-management. It is important for clinicians to highlight the variation in individuals 'self-management approaches as they work to identify tailored patient-centered strategies that compliment specific patient needs.
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Affiliation(s)
| | | | | | - Heather Schacht Reisinger
- Institute for Clinical and Translational Research, Iowa City, IA, USA; Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Nitin A Pagedar
- Department of Otolaryngology, College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Aaron T Seaman
- Institute for Clinical and Translational Research, Iowa City, IA, USA; Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, IA, USA
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18
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Dornan M, Semple C, Moorhead A, McCaughan E. A qualitative systematic review of the social eating and drinking experiences of patients following treatment for head and neck cancer. Support Care Cancer 2021; 29:4899-4909. [PMID: 33646367 PMCID: PMC8295127 DOI: 10.1007/s00520-021-06062-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/07/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE Patients living with and beyond head and neck cancer (HNC) often have long-term, functional challenges as a result of treatment. A key functional challenge relates to eating and drinking; often associated with physical, emotional, and social difficulties. Eating and drinking with family members and friends can become a struggle, increasing the risk of social isolation and loneliness. This systematic review aims to identify and synthesise the literature on the experiences of social eating and drinking for patients following treatment for HNC. METHODS Six electronic databases (Pubmed, Web of Science, CINAHL, EMBASE, PsychINFO, and Scopus) were systematically searched using subject headings and free-text word searches in February 2020. Citation chaining and Google Scholar were used to identify grey literature. PRISMA procedures were followed. RESULTS Of 6910 records identified, 24 studies met the inclusion criteria. Synthesis of the research findings results in two major themes: (1) the experience of loss associated with social eating and drinking, and (2) adjusting and support to promote social eating and drinking. CONCLUSION Losses associated with social eating affect a patient's psychological and emotional well-being and impact on close relationships. To promote positive participation in social eating, patients were more likely to seek and receive support from someone within their close social network, rather than a healthcare professional. Family and friends are an essential source of support and are integral in facilitating engagement with social eating following treatment for HNC. Future interventions should promote family orientated resources, incorporating self-management strategies.
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Affiliation(s)
- Mark Dornan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK.
| | - Cherith Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
- Cancer Services and Ulster Hospital, South Eastern Health and Social Care Trust, Belfast, UK
| | - Anne Moorhead
- School of Communication and Media, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Eilís McCaughan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Coleraine, UK
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