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Acquaye-Mallory A, Vera E, Choi A, Wall K, Gilbert MR, Armstrong TS. Identifying associations between sample characteristics, symptoms, and self-efficacy differences in adult patients with rare tumors of the central nervous system who participated in a novel web-based natural history study. Cancer Med 2024; 13:e70017. [PMID: 39101481 DOI: 10.1002/cam4.70017] [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: 04/12/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
OBJECTIVE High self-efficacy is associated with improved self-care and reduced symptoms in cancer patients but has not been fully interrogated in adults with central nervous system (CNS) cancers. We aimed to identify the relationship between self-efficacy levels in managing emotions (SEMEM) and social interactions (SEMSI) by examining sample characteristics and symptom burden. METHODS Sample characteristics and patient-reported outcome (PRO) measures addressing self-efficacy (PROMIS SEMEM & SEMSI) and symptom burden (MDASI BT or SP) were collected in a novel web-based study of 158 adult patients diagnosed with rare CNS tumors. RESULTS The sample was predominantly female (73%), diagnosed with an ependymoma (66%), and had a median age of 45 (19-75). Low SEMEM was associated with a longer duration of symptoms before surgery (r = -0.26) and female gender (92%) among brain tumor (BT) participants and in spinal cord tumors (SCT), those with lower education (r = 0.29). Reporting low SEMSI was associated with being married (42%), lower education (r = 0.22), and a prolonged time with symptoms before surgery (r = 0.29) in those with BTs, with no associations identified in SCT. More severe mood-related interference (including mood, enjoyment of life, and relationship with others) was associated with lower SEMEM among both locations (r = -0.61 brain, r = -0.28 spine) and SEMSI in BT participants (r = -0.54). CONCLUSIONS Low self-efficacy was linked to a prolonged time between symptom onset and initial surgery, education, gender, and marital status and was associated with higher mood-related interference. Understanding characteristics associated with low self-efficacy underscores a need for future studies to tailor interventions that enhance self-efficacy.
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Affiliation(s)
- Alvina Acquaye-Mallory
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Elizabeth Vera
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Anna Choi
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kathleen Wall
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Feng TL, Stoessl AJ, Harrison RA. Integrated Care in Neurology: The Current Landscape and Future Directions. Can J Neurol Sci 2024:1-9. [PMID: 38679923 DOI: 10.1017/cjn.2024.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
The rising burden of neurological disorders poses significant challenges to healthcare systems worldwide. There has been an increasing momentum to apply integrated approaches to the management of several chronic illnesses in order to address systemic healthcare challenges and improve the quality of care for patients. The aim of this paper is to provide a narrative review of the current landscape of integrated care in neurology. We identified a growing body of research from countries around the world applying a variety of integrated care models to the treatment of common neurological conditions. Based on our findings, we discuss opportunities for further study in this area. Finally, we discuss the future of integrated care in Canada, including unique geographic, historical, and economic considerations, and the role that integrated care may play in addressing challenges we face in our current healthcare system.
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Affiliation(s)
- Tanya L Feng
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
| | - A Jon Stoessl
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
- Pacific Parkinson's Research Centre, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Rebecca A Harrison
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
- British Columbia Cancer Agency, Vancouver, BC, Canada
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Piil K, Boele F. Paving the way to evidence-based clinical practice: Establishing effective caregiver and family support interventions. Neurooncol Pract 2023; 10:504-505. [PMID: 38009121 PMCID: PMC10666806 DOI: 10.1093/nop/npad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023] Open
Affiliation(s)
- Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Florien Boele
- Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, United Kingdom
- Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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Van Dyk K, Wall L, Heimberg BF, Choi J, Raymond C, Wang C, Lai A, Cloughesy TF, Ellingson BM, Nghiemphu P. Daily functioning in glioma survivors: associations with cognitive function, psychological factors and quality of life. CNS Oncol 2022; 11:CNS84. [PMID: 35583041 PMCID: PMC9134930 DOI: 10.2217/cns-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/07/2022] [Indexed: 11/21/2022] Open
Abstract
Aim: Understanding and supporting quality of life (QoL) and daily functioning in glioma patients is a clinical imperative. In this study, we examined the relationship between cognition, psychological factors, measures of health-related QoL and functioning in glioma survivors. Materials & methods: We examined neuropsychological, self-reported cognition, mood and QoL correlates of work and non-work-related daily functioning in 23 glioma survivors, and carried out linear models of the best predictors. Results & conclusion: A total of 13/23 participants were working at the time of enrollment. The best model for worse work-related functioning (R2 = .83) included worse self-reported cognitive function, depression, loneliness and brain tumor symptoms. The best model for worse non-work-related functioning (R2 = .61) included worse self-reported cognitive functioning, anxiety, sleep disturbance and physical functioning. Neuropsychological variables were not among the most highly correlated with function. Worse cognitive, particularly self-reported and psychosocial outcomes may compromise optimal functioning in glioma survivors.
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Affiliation(s)
- Kathleen Van Dyk
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Lucy Wall
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Brandon F Heimberg
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Justin Choi
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision & Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Chencai Wang
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision & Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Albert Lai
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA 90024, USA
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Timothy F Cloughesy
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA 90024, USA
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Benjamin M Ellingson
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA 90024, USA
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision & Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Phioanh Nghiemphu
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA 90024, USA
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
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