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Stevens JM, Montgomery K, Miller M, Saeidzadeh S, Kwekkeboom KL. Common patient-reported sources of cancer-related distress in adults with cancer: A systematic review. Cancer Med 2024; 13:e7450. [PMID: 38989923 PMCID: PMC11238242 DOI: 10.1002/cam4.7450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/14/2024] [Accepted: 06/24/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Cancer-related distress (CRD) is widely experienced by people with cancer and is associated with poor outcomes. CRD screening is a recommended practice; however, CRD remains under-treated due to limited resources targeting unique sources (problems) contributing to CRD. Understanding which sources of CRD are most commonly reported will allow allocation of resources including equipping healthcare providers for intervention. METHODS We conducted a systematic review to describe the frequency of patient-reported sources of CRD and to identify relationships with CRD severity, demographics, and clinical characteristics. We included empirical studies that screened adults with cancer using the NCCN or similar problem list. Most and least common sources of CRD were identified using weighted proportions computed across studies. Relationships between sources of CRD and CRD severity, demographics, and clinical characteristics were summarized narratively. RESULTS Forty-eight studies were included. The most frequent sources of CRD were worry (55%), fatigue (54%), fears (45%), sadness (44%), pain (41%), and sleep disturbance (40%). Having enough food (0%), substance abuse (3%), childbearing ability (5%), fevers (5%), and spiritual concerns (5%) were infrequently reported. Sources of CRD were related to CRD severity, sex, age, race, marital status, income, education, rurality, treatment type, cancer grade, performance status, and timing of screening. CONCLUSIONS Sources of CRD were most frequently emotional and physical, and resources should be targeted to these sources. Relationships between sources of CRD and demographic and clinical variables may suggest profiles of patient subgroups that share similar sources of CRD. Further investigation is necessary to direct intervention development and testing.
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Affiliation(s)
- Jennifer M Stevens
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Megan Miller
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Rowe A, Crawford-Williams F, Goodwin BC, Myers L, Stiller A, Dunn J, Aitken JF, March S. Survivorship care plans and information for rural cancer survivors. J Cancer Surviv 2023; 17:441-448. [PMID: 35334076 PMCID: PMC10036447 DOI: 10.1007/s11764-022-01204-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of the study was to investigate the amount and type of survivorship care information received by cancer survivors living in rural Australia and whether this varies according to demographic factors or cancer type. METHODS Self-reported receipt of a survivorship care plan (SCP) and information on various aspects of survivorship care (e.g., managing side effects, healthy lifestyles, psychosocial advice and monitoring for recurrence) were collected from 215 cancer survivors who had returned home to a rural area in Queensland Australia after receiving cancer treatment in a major city within the previous 5 years (72% in the previous 12 months). Logistic regression was used to assess for differences across demographic factors and cancer type. RESULTS Only 35% of participants reported receiving a SCP and proportions of those reporting the receipt of specific information varied from 74% for information on short-term side effects to less than 30% for information on finances, chemoprevention and monitoring for signs of recurrence. No significant differences were found in the receipt of survivorship care information across demographic factors or cancer type. CONCLUSIONS Findings suggest that cancer survivors living in rural areas are not consistently provided with adequate survivorship care information, particularly that pertaining to long-term health and recovery. IMPLICATIONS FOR CANCER SURVIVORS Without improved systems for delivering survivorship care information to patients returning home to rural communities after treatment, these cancer survivors risk missing out on necessary information and advice to maintain their health, wellbeing and long-term recovery.
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Affiliation(s)
- Arlen Rowe
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
| | - Fiona Crawford-Williams
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Cancer Council Queensland, Fortitude Valley, QLD, Australia
| | - Belinda C Goodwin
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia.
- Cancer Council Queensland, Fortitude Valley, QLD, Australia.
| | - Larry Myers
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
- Cancer Council Queensland, Fortitude Valley, QLD, Australia
| | - Anna Stiller
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
- Cancer Council Queensland, Fortitude Valley, QLD, Australia
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jeff Dunn
- Cancer Council Queensland, Fortitude Valley, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD, Australia
- Prostate Cancer Foundation of Australia, St Leonards, Sydney, NSW, Australia
| | - Joanne F Aitken
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
- Cancer Council Queensland, Fortitude Valley, QLD, Australia
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
- School of Public Health, The University of Queensland, Springfield, QLD, 4300, Australia
| | - Sonja March
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
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Solikhah S, Perwitasari DA, Rejeki DSS. Cross-cultural adaptation and psychometric properties of the Indonesian version for quality of life among breast cancer patients. Front Public Health 2023; 11:1069422. [PMID: 36926172 PMCID: PMC10011654 DOI: 10.3389/fpubh.2023.1069422] [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: 10/13/2022] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Background Breast cancer is one of the most important health problems worldwide. Quality of life (QoL) is an important indicator to evaluate symptoms in cancer patients, including those with breast cancer. Culturally suitable, valid, reliable, and appropriate instruments to measure the QoL of breast cancer patients are needed, which is still rare in Indonesia. This study aimed to translate the EORTC QLQ-BR45 instrument into Indonesian and evaluate its psychometrics. Methods A cross-sectional study was performed on 635 patients conveniently selected from the oncology department in referral hospital. The first phase of this study involved translation of the existing EORTC QLQ-BR45 into Indonesian, and in the second phase, we evaluated its psychometric properties. Construct validity was evaluated using confirmatory factor analysis (CFA). Criterion validity was examined according to the association between disease stage and Karnofsky Performance Scale (KPS). Results A total of 635 (99.00%) completed the EORTC QLQ-BR45 successfully. The instrument indicated good readability and high content validity. All Cronbach's alpha coefficients were satisfactory (overall value, 0.87). For construct validity, patients with KPS ≥80% did better than those with KPS ≤70% as did two multi-item scales in functional scales (body image and breast satisfaction) and five multi-item scales in symptom scales (systemic therapy side effects, endocrine therapy, and arm, breast, and endocrine sexual symptoms). Body image score of late-stage patients was significantly higher. CFA indicated that the nine-factor structure of the Indonesian EORTC QLQ-BR45 was a good fit for the data. Conclusion The Indonesian EORTC QLQ-BR45 questionnaire is reliable and valid with good psychometric properties, thus can be used for breast cancer patients in Indonesia.
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Affiliation(s)
- Solikhah Solikhah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | | | - Dwi Sarwani Sri Rejeki
- Department of Public Health, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
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Seib C, Anderson D, McGuire A, Porter-Steele J, McDonald N, Balaam S, Sapkota D, McCarthy AL. Improving health-related quality of life in women with breast, blood, and gynaecological Cancer with an eHealth-enabled 12-week lifestyle intervention: the women's wellness after Cancer program randomised controlled trial. BMC Cancer 2022; 22:747. [PMID: 35804322 PMCID: PMC9264489 DOI: 10.1186/s12885-022-09797-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/16/2022] [Indexed: 01/04/2023] Open
Abstract
Background The residual effects of cancer and its treatment can profoundly affect women’s quality of life. This paper presents results from a multisite randomized controlled trial that evaluated the clinical benefits of an e-health enabled health promotion intervention (the Women’s Wellness after Cancer Program or WWACP) on the health-related quality of life of women recovering from cancer treatment. Methods Overall, 351 women previously treated for breast, blood or gynaecological cancers were randomly allocated to the intervention (WWACP) or usual care arms. The WWACP comprised a structured 12-week program that included online coaching and an interactive iBook that targeted physical activity, healthy diet, stress and menopause management, sexual wellbeing, smoking cessation, alcohol intake and sleep hygiene. Data were collected via a self-completed electronic survey at baseline (t0), 12 weeks (post-intervention, t1) and 24 weeks (to assess sustained behaviour change, t2). The primary outcome, health-related quality of life (HRQoL), was measured using the Short Form Health Survey (SF-36). Results Following the 12-week lifestyle program, intervention group participants reported statistically significant improvements in general health, bodily pain, vitality, and global physical and mental health scores. Improvements were also noted in the control group across several HRQoL domains, though the magnitude of change was less. Conclusions The WWACP was associated with improved HRQoL in women previously treated for blood, breast, and gynaecological cancers. Given how the synergy of different lifestyle factors influence health behaviour, interventions accounting for the reciprocity of multiple health behaviours like the WWACP, have real potential for immediate and sustainable change. Trial registration The protocol for this randomised controlled trial was submitted to the Australian and New Zealand Clinical Trials Registry on 15/07/2014 and approved on 28/07/2014 (ACTRN12614000800628). Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09797-6.
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Affiliation(s)
- Charrlotte Seib
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Queensland, Australia.
| | - Debra Anderson
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
| | - Amanda McGuire
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Queensland, Australia
| | - Janine Porter-Steele
- The Wesley Hospital Choices Cancer Support Program, Wesley Hospital, Brisbane, Queensland, Australia
| | - Nicole McDonald
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Sarah Balaam
- School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland, Australia
| | - Diksha Sapkota
- Griffith Criminology Institute, Griffith University, Queensland, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, and Mater Research Institute, Queensland, Australia
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DeGuzman PB, Vogel DL, Bernacchi V, Scudder MA, Jameson MJ. Self-reliance, Social Norms, and Self-stigma as Barriers to Psychosocial Help-Seeking Among Rural Cancer Survivors With Cancer-Related Distress: Qualitative Interview Study. JMIR Form Res 2022; 6:e33262. [PMID: 35588367 PMCID: PMC9164097 DOI: 10.2196/33262] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/04/2022] [Accepted: 03/28/2022] [Indexed: 01/19/2023] Open
Abstract
Background Even when technology allows rural cancer survivors to connect with supportive care providers from a distance, uptake of psychosocial referrals is low. Fewer than one-third of participants in a telemedicine intervention for identifying rural survivors with high distress and connecting them with care accepted psychosocial referral. Objective The purpose of this research was to examine the reasons for which rural cancer survivors did not accept a psychosocial referral. Methods We utilized a qualitative design to address the research purpose. We interviewed participants who had been offered psychosocial referral. Semistructured interviews were conducted 6 weeks later (n=14), and structured interviews were conducted 9 months later (n=6). Data were analyzed descriptively using an inductive approach. Results Ultimately, none of the rural cancer survivors (0/14, 0%) engaged with a psychosocial care provider, including those who had originally accepted referrals (0/4, 0%) for further psychosocial care. When explaining their decisions, survivors minimized their distress, emphasizing their self-reliance and the need to handle distress on their own. They expressed a preference for dealing with distress via informal support networks, which was often limited to close family members. No survivors endorsed public stigma as a barrier to accepting psychosocial help, but several suggested that self-stigma associated with not being able to handle their own distress was a reason for not seeking care. Conclusions Rural cancer survivors’ willingness to accept a psychosocial referral may be mediated by the rural cultural norm of self-reliance and by self-stigma. Interventions to address referral uptake may benefit from further illumination of these relationships as well as a strength-based approach that emphasizes positive aspects of the rural community and individual self-affirmation.
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Affiliation(s)
| | - David L Vogel
- Department of Pyschology, Iowa State University, Ames, IA, United States
| | - Veronica Bernacchi
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Margaret A Scudder
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Mark J Jameson
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
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